Renal replacement therapy in Europe: a summary of the 2012 ERA-EDTA Registry Annual Report

BACKGROUND: This article summarizes the 2012 European Renal Association-European Dialysis and Transplant Association Registry Annual Report (available at www.era-edta-reg.org) with a specific focus on older patients (defined as ≥65 years). METHODS: Data provided by 45 national or regional renal registries in 30 countries in Europe and bordering the Mediterranean Sea were used. Individual patient level data were received from 31 renal registries, whereas 14 renal registries contributed data in an aggregated form. The incidence, prevalence and survival probabilities of patients with end-stage renal disease (ESRD) receiving renal replacement therapy (RRT) and renal transplantation rates for 2012 are presented. RESULTS: In 2012, the overall unadjusted incidence rate of patients with ESRD receiving RRT was 109.6 per million population (pmp) (n = 69 035), ranging from 219.9 pmp in Portugal to 24.2 pmp in Montenegro. The proportion of incident patients ≥75 years varied from 15 to 44% between countries. The overall unadjusted prevalence on 31 December 2012 was 716.7 pmp (n = 451 270), ranging from 1670.2 pmp in Portugal to 146.7 pmp in the Ukraine. The proportion of prevalent patients ≥75 years varied from 11 to 32% between countries. The overall renal transplantation rate in 2012 was 28.3 pmp (n = 15 673), with the highest rate seen in the Spanish region of Catalonia. The proportion of patients ≥65 years receiving a transplant ranged from 0 to 35%. Five-year adjusted survival for all RRT patients was 59.7% (95% confidence interval, CI: 59.3-60.0) which fell to 39.3% (95% CI: 38.7-39.9) in patients 65-74 years and 21.3% (95% CI: 20.8-21.9) in patients ≥75 years

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Natural radioactivity of coastal sediments as tracer in dynamic sedimentology

Natural radioactivity of coastal sediments could provide interesting information on sediment dynamics. Natural radioactivity measurements were performed in two areas of the Adriatic Sea littoral of Albanian cost, in the gulfs of Durres and Vlora, where complex studies were carried out in the framework of the maintenance of existing Durres harbour and the design of a new harbour in Vlora. Dynamic mapping of the gamma total radioactivity at the sea bottom sediment was carried out using a 2" × 2" NaI probe. Radiometric data were converted to lithological map, and the sand and silt distribution configuration was interpreted in terms of sediment transport. The obtained results have shown that the natural radioactivity of sediments provides qualitative data about the sediment dynamics. This cost-effective method is recommended to be used as complementary to other tracer techniques for sediment transport in coastal engineering investigations

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data distribution selection in a self-predictin

Informed Data Distribution Selection in a Self-Predicting Storage System

Systems should be self-predicting. They should continuously monitor themselves and provide quantitative answers to What...if questions about hypothetical workload or resource changes. Self-prediction would significantly simplify administrators' decision making, such as acquisition planning and performance tuning, by reducing the detailed workload and internal system knowledge required. This paper describes and evaluates support for self-prediction in a cluster-based storage system and its application to What...if questions about data distribution selection

Informed Data Distribution Selection in a Self-predicting Storage System (CMU-PDL-06-101)

Systems should be self-predicting. They should continuously monitor themselves and provide quantitative answers to What...if questions about hypothetical workload or resource changes. Self-prediction would significantly simplify administrators’ planning challenges, such as performance tuning and acquisition decisions, by reducing the detailed workload and internal system knowledge required. This paper describes and evaluates support for self-prediction in a cluster-based storage system and its application to What...if questions about data distribution selection

Effect of chromium nitride coating on the corrosion and wear resistance of stainless steel

Ion beam-assisted deposition (IBAD) technique has been used to deposit chromium nitride on the stainless steel substrates. Characterization and performance of this coating was carried out by a round-robin test at various laboratories. About 300 samples, prepared at Spire, USA, were distributed to 10 different laboratories. Characterization of coated materials, carried out using Rutherford backscattering (RBS), X-ray diffraction (XRD), glancing X-ray diffraction, Auger electron spectroscopy (AES) and X-ray photoelectron spectroscopy (XPS), confirmed a well-adherent layer of chromium nitride with composition and thickness of Cr0.8N0.2 and 1.2 μm, respectively. The performance of the coating was tested by tribological tests: dynamic micro-indentation, micro-hardness, wear and friction, and corrosion tests. The coating was found to be hard with good wear resistance and had enhanced resistance to corrosion in acid media.© Elsevie