Fasting before living-kidney donation:effect on donor well-being and postoperative recovery: study protocol of a multicenter randomized controlled trial

BACKGROUND: One of the main effectors on the quality of life of living-kidney donors is postoperative fatigue. Caloric restriction (CR) and short-term fasting (STF) are associated with improved fitness and increased resistance to acute stress. CR/STF increases the expression of cytoprotective genes, increases immunomodulation via increased anti-inflammatory cytokine production, and decreases the expression of pro-inflammatory markers. As such, nutritional preconditioning by CR or STF represents a non-invasive and cost-effective method that could mitigate the effects of acute surgery-induced stress and postoperative fatigue. To investigate whether preoperative STF contributes to a reduction in fatigue after living-kidney donation, a randomized clinical trial is indicated. METHODS: We aim to determine whether 2.5 days of fasting reduces postoperative fatigue score in subjects undergoing living-kidney donation. In this randomized study, the intervention group will follow a preoperative fasting regime for 2.5 days with a low-dose laxative, while the control group will receive standard care. The main study endpoint is postoperative fatigue, 4 weeks after living-kidney donation. Secondary endpoints include the effect of preoperative fasting on postoperative hospital admission time, the feasibility of STF, and the postoperative recovery of donor and recipient kidney function. This study will provide us with knowledge of the feasibility of STF and confirm its effect on postoperative recovery. DISCUSSION: Our study will provide clinically relevant information on the merits of caloric restriction for living-kidney donors and recipients. We expect to reduce the postoperative fatigue in living-kidney donors and improve the postoperative recovery of living-kidney recipients. It will provide evidence on the clinical merits and potential caveats of preoperative dietary interventions. TRIAL REGISTRATION: Netherlands Trial Register NL9262. EudraCT 2020-005445-16. MEC Erasmus MC MEC-2020-0778. CCMO NL74623.078.21 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-021-05950-x

Citizenship, Justice and the Right to the Smart City

This paper provides an introduction to the smart city and engages with its idea and ideals from a critical social science perspective. After setting out in brief the emergence of smart cities and current key debates, we note a number of practical, political and normative questions relating to citizenship, justice, and the public good that warrant examination. The remainder of the paper provides an initial framing for engaging with these questions. The first section details the dominant neoliberal conception and enactment of smart cities and how this works to promote the interests of capital and state power and reshape governmentality. We then detail some of the ethical issues associated with smart city technologies and initiatives. Having set out some of the more troubling aspects of how social relations are produced within smart cities, we then examine how citizens and citizenship have been conceived and operationalised in the smart city to date. We then follow this with a discussion of social justice and the smart city. In the final section, we explore the notion of the ‘right to the smart city’ and how this might be used to recast the smart city in emancipatory and empowering ways

Measuring the burden of herpes zoster and post herpetic neuralgia within primary care in rural Crete, Greece

<p>Abstract</p> <p>Background</p> <p>Research has indicated that general practitioners (GPs) have good clinical judgment in regards to diagnosing and managing herpes zoster (HZ) within clinical practice in a country with limited resources for primary care and general practice. The objective of the current study was to assess the burden of HZ and post herpetic neuralgia (PHN) within rural general practices in Crete, Greece.</p> <p>Methods</p> <p>The current study took place within a rural setting in Crete, Greece during the period of November 2007 to November 2009 within the catchment area in which the Cretan Rural Practice-based Research Network is operating. In total 19 GP's from 14 health care units in rural Crete were invited to participate, covering a total turnover patient population of approximately 25, 000 subjects. For the purpose of this study an electronic record database was constructed and used as the main tool for monitoring HZ and PHN incidence. Stress related data was also collected with the use of the Short Anxiety Screening Test (SAST).</p> <p>Results</p> <p>The crude incidence rate of HZ was 1.4/1000 patients/year throughout the entire network of health centers and satellite practices, while among satellite practices alone it was calculated at 1.3/1000 patients/year. Additionally, the standardised incidence density within satellite practices was calculated at 1.6/1000 patients/year. In regards to the stress associated with HZ and PHN, the latter were found to have lower levels of anxiety, as assessed through the SAST score (17.4 ± 3.9 vs. 21.1 ± 5.7; <it>p </it>= 0.029).</p> <p>Conclusions</p> <p>The implementation of an electronic surveillance system was feasible so as to measure the burden of HZ and PHN within the rural general practice setting in Crete.</p

How Smart Cities Transform Operations Models: A New Research Agenda for Operations Management in the Digital Economy

The notion of smart cities is growing in prominence in the digital economy. The integration of urban infrastructures with information and communication technologies (ICT) enables the development of new operations models. Digitised infrastructures offer opportunities for public and private organisations to design and deliver more customer-centric products or services, particularly for those that require geographical proximity with consumers in the O2O (online to offline) context. A framework is developed and used to analyse three case examples. These cases illustrate the emergence of new operations models and, demonstrate how smart cities are re-defining the characteristics of operations models around their scalability, analytical output and, connectivity. We also explore the feasibility, vulnerability and acceptability of each new operation. This paper contributes to our understanding of how smart cities can potentially transform operational models, and sets out a research agenda for operations management in smart cities in the digital economy

A framework for cloud-based context-aware information services for citizens in smart cities

© 2014 Khan et al.; licensee Springer. Background: In the context of smart cities, public participation and citizen science are key ingredients for informed and intelligent planning decisions and policy-making. However, citizens face a practical challenge in formulating coherent information sets from the large volumes of data available to them. These large data volumes materialise due to the increased utilisation of information and communication technologies in urban settings and local authorities’ reliance on such technologies to govern urban settlements efficiently. To encourage effective public participation in urban governance of smart cities, the public needs to be facilitated with the right contextual information about the characteristics and processes of their urban surroundings in order to contribute to the aspects of urban governance that affect them such as socio-economic activities, quality of life, citizens well-being etc. The cities on the other hand face challenges in terms of crowd sourcing with quality data collection and standardisation, services inter-operability, provisioning of computational and data storage infrastructure. Focus: In this paper, we highlight the issues that give rise to these multi-faceted challenges for citizens and public administrations of smart cities, identify the artefacts and stakeholders involved at both ends of the spectrum (data/service producers and consumers) and propose a conceptual framework to address these challenges. Based upon this conceptual framework, we present a Cloud-based architecture for context-aware citizen services for smart cities and discuss the components of the architecture through a common smart city scenario. A proof of concept implementation of the proposed architecture is also presented and evaluated. The results show the effectiveness of the cloud-based infrastructure for the development of a contextual service for citizens

Is small really beautiful? A review of the concept of niches in innovation

This article reviews the concept of innovation niches through three categories: strategic niche management (SNM), specialised markets and niches formed as a technology declines. In the literature, innovation niches generate interest from both innovation and marketing perspectives. This review focuses predominately on the former from which the niche types have been adopted and analysed. Mostly, contributions since 1980 have been included, representing the period of academic interest in innovative small firms, while both temporal and locational filters were applied to the study. It is noted that SNM has been proposed as a means to protect potentially useful innovations from full market competition, while specialist niches supply technologies to few customers in more stable environments. Incumbent technologies at the stage of decline may also retreat to niches where they can still remain competitive. Finally, it is suggested that further research on innovation niches would extend our understanding of technology dynamics

Binding the Smart City Human-Digital System with Communicative Processes

This chapter will explore the dynamics of power underpinning ethical issues within smart cities via a new paradigm derived from Systems Theory. The smart city is an expression of technology as a socio-technical system. The vision of the smart city contains a deep fusion of many different technical systems into a single integrated “ambient intelligence”. ETICA Project, 2010, p. 102). Citizens of the smart city will not experience a succession of different technologies, but a single intelligent and responsive environment through which they move. Analysis of such an environment requires a framework which transcends traditional ontologically-based models in order to accommodate this deep fusion. This chapter will outline a framework based on Latour’s Actor-Network Theory and Luhmann’s treatment of society as an autopoetic system. We shall use this framework to map the influence of relevant factors on ethical issues, irrespective of their composition or type. For example, under this treatment, both human praxis and technical design can be viewed as comparable tools of domination. This chapter will provide a framework for the analysis of relations between any elements of the smart city, ranging from top-level urban management processes down to individual device operations. While we will illustrate the use of this schema through examination of ethical issues arising from power dynamics within the smart city, it is intended that this example will demonstrate the wider utility of the model in general

Privacy enhancing technologies (PETs) for connected vehicles in smart cities

This is an accepted manuscript of an article published by Wiley in Transactions on Emerging Telecommunications Technologies, available online: https://doi.org/10.1002/ett.4173 The accepted version of the publication may differ from the final published version.Many Experts believe that the Internet of Things (IoT) is a new revolution in technology that has brought many benefits for our organizations, businesses, and industries. However, information security and privacy protection are important challenges particularly for smart vehicles in smart cities that have attracted the attention of experts in this domain. Privacy Enhancing Technologies (PETs) endeavor to mitigate the risk of privacy invasions, but the literature lacks a thorough review of the approaches and techniques that support individuals' privacy in the connection between smart vehicles and smart cities. This gap has stimulated us to conduct this research with the main goal of reviewing recent privacy-enhancing technologies, approaches, taxonomy, challenges, and solutions on the application of PETs for smart vehicles in smart cities. The significant aspect of this study originates from the inclusion of data-oriented and process-oriented privacy protection. This research also identifies limitations of existing PETs, complementary technologies, and potential research directions.Published onlin