Use Of Access Research Articles

ProtVar: mapping and contextualizing human missense variation.

Genomic variation can impact normal biological function in complex ways and so understanding variant effects requires a broad range of data to be coherently assimilated. Whilst the volume of human variant data and relevant annotations has increased, the corresponding increase in the breadth of participating fields, standards and versioning mean that moving between genomic, coding, protein and structure positions is increasingly complex. In turn this makes investigating variants in diverse formats and assimilating annotations from different resources challenging. ProtVar addresses these issues to facilitate the contextualization and interpretation of human missense variation with unparalleled flexibility and ease of accessibility for use by the broadest range of researchers. By precalculating all possible variants in the human proteome it offers near instantaneous mapping between all relevant data types. It also combines data and analyses from a plethora of resources to bring together genomic, protein sequence and function annotations as well as structural insights and predictions to better understand the likely effect of missense variation in humans. It is offered as an intuitive web server https://www.ebi.ac.uk/protvar where data can be explored and downloaded, and can be accessed programmatically via an API.

Climate services for agriculture: Steering towards inclusive innovation in Australian climate services design and delivery

CONTEXTClimate services are integral to climate change adaptation in agriculture. Inclusive innovation prioritises inclusion of marginalised actors, grassroots knowledge and accessibility of use. Yet many innovation processes are multi-stakeholder, complex and may not prioritise inclusion from the outset. In these circumstances, researchers and designers may seek to influence existing projects towards greater inclusivity. OBJECTIVESThis paper explores efforts to increase the inclusivity of existing innovation processes, focusing on the design of My Climate View, an online Australian climate services platform for agriculture. Findings relate to contemporary issues in inclusive innovation literature, including: (1) Who should be included in innovation processes (within given resourcing)?; (2) How requirements for inclusion or exclusion can emerge through the design and use of a technology; and (3) The influence of program level structures upon inclusivity and design. METHODSOur approach is informed by Responsible Innovation and Inclusive Innovation theory and enacted through user-centred design. Findings are synthesised from analysis of 60 semi-structured interviews with farmers, advisors and extension officers. We additionally draw on observations as researchers in the multi-actor My Climate View development team, where extensive engagement separate to research activities has included agricultural and Indigenous stakeholders. RESULTS AND CONCLUSIONEngaging with a broad sample of potential target users enabled diverse and sometimes unexpected use cases. Customisation of interface parameters allowed the incorporation of tacit knowledge and positively affected the inclusivity of My Climate View, extending the value of the platform to growers of niche commodities outside of the original scope. Inclusivity in innovation can be impacted by diverse factors, including design team decisions, structural factors, budget and external factors. Requirements for inclusion and exclusion can emerge and evolve throughout a design process, supporting Responsible Innovation's framing of inclusivity alongside principles of reflexivity and responsiveness. SIGNIFICANCEThe findings enrich the evidence base for climate services and broader agricultural technology development processes by providing insights for those seeking greater impact by practicing inclusivity in innovation. We provide four implications for increasing inclusivity in the design of climate services: (1) Maximising customisation and avoiding prescriptive interpretation enables greater flexibility of use; (2) Sampling broadly within target users to uncover unanticipated values and opportunities for inclusion and exclusion; (3) It is important to embed efforts towards inclusion alongside processes of reflexivity; and (4) Responsible and inclusive approaches to climate services design are valuable even if brought in once development has commenced.

Record-keeping and political advocacy in late colonial Uganda: the case of Abataka Abasoga, Busoga, 1940 to 1950

ABSTRACT This paper analyses the nexus between record-keeping and political advocacy in the late colonial Busoga which formed one of eastern ethno-geographical regions of the Uganda Protectorate. It illustrates the vexed position of the Abataka Abasoga attempting to build and use archival knowledge while the colonial government moved against the indigenous use of archival records as a tool of anti-colonial defiance. By weaving together archival materials with secondary sources, the paper reveals the precarious position of Ugandan archival records as denoted by the subsequent regimes’ involvement in the management of documentary materials. Ultimately, the example shows how the ruling regimes’ interests have been central in determining the nature of information made available for future preservation and its accessibility for use by both the political elite and reading publics.

ОЦІНКА ЯКОСТІ ПРОЦЕСУ КОНТРОЛЮ НА ПІДПРИЄМСТВІ

The article considers the importance of assessing the quality of the control process at an enterprise. Based on the analysis of literature sources and the authors' own research, the article focuses on control as a key management function that combines the formation of information about the status and functioning of the object of management, analysis of activities and effectiveness of strategies. It is noted that the issues of assessing the effectiveness of the control exercised remain urgent, especially in the context of existing resource constraints and the impossibility of conducting high-quality external comparative control in the context of war and martial law. The main purpose of the article is to develop a simple and accessible toolkit for control assessment which takes into account modern challenges. It is emphasized that control assessment promotes transparency and accountability at all levels of management, and stimulates a culture of continuous improvement and innovation. The authors provide a generalized algorithm of key steps that can help assess the level of control. Internal control is assessed by analyzing its effectiveness, which includes policies, procedures, and instructions that safeguard assets, ensure the accuracy of financial reporting, and facilitate compliance with legal and operational requirements, but in the current environment, it is not always feasible and possible to implement these actions. Therefore, the authors propose to assess the quality of control by interviewing employees, which allows identifying potential risks, identifying opportunities for improvement and stimulating a culture of continuous improvement. The use of this tool has a number of advantages, including simplicity and accessibility of use. The authors propose their own questionnaire, which allows for a multi-level analysis of the quality of control assessment through the prism of the attitude of the employees of the relevant enterprise. The carried out approbation allows to assert the primary effectiveness of the questionnaire. It is emphasized that this questionnaire cannot serve as the only source of assessment and requires the use of other methods and tools. In further research, the authors plan to improve the questionnaire and develop more specialized questionnaires aimed primarily at determining the quality of control over the subject-object composition.

Evaluation of cost-effective system designs for long axial field-of-view PET scanners

Objective. Current commercial positron emission tomography (PET) scanners have excellent performance and diagnostic image quality primarily due to improvements in scanner sensitivity and time-of-flight (TOF) resolution. Recent years have seen the development of total-body PET scanners with longer axial field-of-view (AFOV) that increase sensitivity for single organ imaging, and also image more of the patient in a single bed position thereby enabling multi-organ dynamic imaging. While studies have shown significant capabilities of these systems, cost will be a major factor in their widespread adoption in the clinic. Here we evaluate alternative designs that achieve many advantages of long AFOV PET while utilizing cost-effective detector hardware. Approach. We utilize Monte Carlo simulations and clinically relevant lesion detectability metric to study the impact of scintillator type lutetium oxyorthosilicate or bismuth germanate (LSO or BGO), scintillator thickness (10–20 mm), and TOF resolution on resultant image quality in a 72 cm long scanner. Detector TOF resolution was varied based on current scanner performance, as well as expected future performance from detector designs that currently hold most promise for scaling into a scanner. Main results. Results indicate that BGO is competitive with LSO (both 20 mm thick) if we assume that it uses TOF (e.g. Cerenkov timing with 450 ps fwhm and Lorentzian distribution) and the LSO scanner has TOF resolution similar to the latest PMT-based scanners (∼500–650 ps). Alternatively, a system using 10 mm thick LSO with 150 ps TOF resolution can also provide similar performance. Both these alternative systems can provide cost savings (25%–33%) relative to a scanner using 20 mm LSO with ∼50% of effective sensitivity, but still 500%–700% higher than a conventional AFOV scanner. Significance. Our results have relevance to the development of long AFOV PET, where reduced cost of these alternative designs can provide wider accessibility for use in situations requiring imaging of multiple organs simultaneously.

POSSIBILITIES OF USING THE PRINCIPLES OF UNIVERSAL DESIGN IN INSTITUTIONS OF HIGHER AND VOCATIONAL PRE-HIGHER EDUCATION

The article defines the relevance of introducing universal design into the educational process of institutions of higher and vocational pre-higher education. The analysis of Ukrainian educational and normative sources, as well as domestic and foreign scientific research devoted to its study, is suggested. The article analyzes the history and essence of the concept of "universal design", systematizes the possibilities of its implementation, namely: in social space, design, things, products, creation of environment and places accessible to the widest range of people, design of information, communication and policy that allows them to be used by individuals with different needs in most diverse situations and does not provide for the creation of separate or special opportunities for such use, the organization of information technologies or services that are equally accessible or understandable to all and meet the requirements of shared use. The study summarizes the definition of the concept of "universal design in education" and systematizes the components of the educational process in institutions of higher and vocational pre-higher education, the accessibility of which can be increased by its means. Among such components are: didactic foundations of learning (approaches and principles); educational documentation (educational programs, curricul and sillabi); architecture of educational components (structure and features of educational process planning); teaching aids, in particular electronic ones; teaching and assessment methods; forms of educational interaction; design of the educational environment. 7 principles of universal design are presented: equality and accessibility of use; flexibility of use; simplicity and intuitiveness of use; accessibility of information; error tolerance; little physical effort; availability of the necessary size, place, space. Directions for their implementation in higher and vocational pre-higher education are proposed in order to increase their accessibility for students with special educational needs.

Item Understanding of Common Quality of Life Measures for use with Autistic Adults.

Quality of life (QOL) and life satisfaction are important research priorities for autistic adults. As such, we saw a need to evaluate individual items of commonly used subjective QOL scales to understand how they are interpreted and perceived by autistic adults. This study used cognitive interviews and repeated sampling to evaluate the accessibility, test-retest reliability and internal consistency of several common QOL measures in a sample of young autistic adults (n = 20; aged 19-32). Cognitive interviews suggested that the Satisfaction with Life Scale was well understood and demonstrated excellent internal consistency and test-retest reliability. While the WHOQoL-BREF and WHOQoL Disability Modules had adequate reliability, cognitive interviews suggested that additional instructions and examples would further enhance their accessibility for use with autistic adults.

Exploring regional aspects of 3D facial variation within European individuals

Facial ancestry can be described as variation that exists in facial features that are shared amongst members of a population due to environmental and genetic effects. Even within Europe, faces vary among subregions and may lead to confounding in genetic association studies if unaccounted for. Genetic studies use genetic principal components (PCs) to describe facial ancestry to circumvent this issue. Yet the phenotypic effect of these genetic PCs on the face has yet to be described, and phenotype-based alternatives compared. In anthropological studies, consensus faces are utilized as they depict a phenotypic, not genetic, ancestry effect. In this study, we explored the effects of regional differences on facial ancestry in 744 Europeans using genetic and anthropological approaches. Both showed similar ancestry effects between subgroups, localized mainly to the forehead, nose, and chin. Consensus faces explained the variation seen in only the first three genetic PCs, differing more in magnitude than shape change. Here we show only minor differences between the two methods and discuss a combined approach as a possible alternative for facial scan correction that is less cohort dependent, more replicable, non-linear, and can be made open access for use across research groups, enhancing future studies in this field.

Research on TTT Curve of Alloy structural Steel based on Machine Learning

Austenite isothermal transformation curve (IT) of steel, also known as time-temperature-transformation curve (TTT) is an very important basic data for the heat treatment process design of steel. Traditionally, obtaining TTT information on metal mainly depends on experiments, so there are problems such as data dispersion, large errors, and inconvenient access in use. Using artificial intelligence and machine learning technology, the TTT curve of steel can be predicted with limited experimental data. Taking the authoritative data collected as training samples, the TTT curve of alloy structural steel was predicted based on a variety of machine learning algorithms.. Alloying element category, austenitizing temperature, phase transformation time are taken as input characteristics, and 10 kinds of transformation characteristics are taken as output targets. Correlation coefficient (R), and error analysis (RMSE, MAE) are used to evaluate and finalize the model, and the best algorithm is selected to form a combined-machine-learning algorithm (CML), and predict the TTT curve. Take the application of CML multi-model prediction method in 40Cr, 38CrMoAl, 35SiMn, and 20Mn2, and the predicted results reflect that the CML model has high prediction ability and good generalization.

Attitudes Toward Providing Open Access for Use of Biospecimens and Health Records: A Cross-Sectional Study from Jordan.

Biospecimen repositories and big data generated from clinical research are critically important in advancing patient-centered healthcare. However, ethical considerations arising from reusing clinical samples and health records for subsequent research pose a hurdle for big-data health research. This study aims to assess the public's opinions in Jordan toward providing blanket consent for using biospecimens and health records in research. A cross-sectional study utilizing a self-reported questionnaire was carried out in different cities in Jordan, targeting adult participants. Outcome variables included awareness of clinical research, participation in clinical research, and opinions toward providing open access to clinical samples and records for research purposes. Descriptive analysis was utilized for reporting the outcome as frequency (percentages) out of the total responses. Univariate and multivariate logistic regression were used to investigate the association between independent variables and the outcome of interest. A total of 1033 eligible participants completed the questionnaire. Although the majority (90%) were aware of clinical research, only 24% have ever participated in this type of research. About half (51%) agreed on providing blanket consent for the use of clinical samples, while a lower percentage (43%) agreed on providing open access to their health records. Privacy concerns and lack of trust in the researcher were cited as major barriers to providing blanket consent. Participation in clinical research and having health insurance were predictors for providing open access to clinical samples and records. The lack of public trust in Jordan toward data privacy is evident from this study. Therefore, a governance framework is needed to raise and maintain the public's trust in big-data research that warrants the future reuse of clinical samples and records. As such, the current study provides valuable insights that will inform the design of effective consent protocols required in data-intensive health research.

DATA MINING PREPARATION: PROCESS, TECHNIQUES AND MAJOR ISSUES IN DATA ANALYSIS

Data preparation is an iterative-agile process for exploring, combining, cleaning and transforming raw data into curated datasets for self-service data integration, data science, data discovery, and BI/analytics. To perform data preparation, data preparation tools are used by analysts, citizen data scientists and data scientists for self- service. The tools are also used by citizen integrators and data engineers for data enablement to reduce the time and complexity of interactively accessing, cataloging, harmonizing, transforming and modeling data for analytics in an agile manner with metadata and lineage support. These tools can provide data access for use in mostly analytical tasks that include storage, logical and physical data modeling, and data manipulation for data visualization, data integration and analytics. Some tools support machine-learning algorithms that can recommend or even automate actions to augment and accelerate data preparation. Keywords: Data Mining, Data preparation, Data Analysis, Big Data Analytics

Vascular accesses for hemodialysis in Ceará-Brazil

Backgroung: the ideal access for hemodialysis is represented by arteriovenous fistulas both as initial access and in use and are determinants of health care parameters for chronic renal patients. Objective: to evaluate vascular access for hemodialysis. Methods: this is a cross-sectional study, with a sample of 2513 individuals on hemodialysis in Ceará. Data were collected on age, sex, time of treatment, underlying disease, initial access and access in use. The data were divided into two groups, the interior of the state and the Metropolitan Region of Fortaleza, in the State of Ceará, and compared using the Student’s Test (p<0.05). Results: the most common age group was between 19 and 64 years (73%). Men prevailed in both regions, 713 (63%) in the countryside and 792 (57%) in the metropolitan area. The most common cause of Chronic Kidney Disease was Hypertension 306 (27%), followed by Disease of undetermined cause 295 (26%) in the countryside; in the metropolitan region, Diabetes Mellitus 356 (26%) was the main cause, followed by Hypertension and Disease of undetermined cause, each with 344 (25%), p=0.001. In the countryside, 9% started treatment for fistula while in the metropolitan area 12%, p=0.011. 79% of patients in the countryside used fistulas and 81% in the metropolitan area, p=0.156. Conclusion: arteriovenous fistulas are more frequent as initial accesses in the metropolitan region than in the interior, but there is an equivalence of fistulas in use in both regions. Catheter is the main initial access route. The evaluation of vascular accesses in Ceará showed that hemodialysis services are able to maintain good parameters of care for patients with chronic kidney disease.

Source material for breeding winter bread wheat for grain quality in the north of the Middle Volga Region

Background. Development of cultivars with high stable yields and high grain quality is the main trend in wheat breeding. The aim of this study was to characterize a set of winter bread wheat accessions from the VIR collection and the working collection of Kazan Scientific Center in terms of their yield, protein content in grain (P, %), and swelling of flour in acetic acid (S, ml), and select the best accessions for the combination of these characters for use in a crossbreeding program.Materials and methods. Twenty-three winter bread wheat accessions were studied for the abovementioned characters in the north of the Middle Volga Region using conventional techniques. The study lasted three years (2016–2019).Results and conclusion. The yield of the accessions varied across the years of studies; however, none of them surpassed the reference cv. ‘Kazanskaya 560’. The values of protein content in grain were medium or high. The following accessions had high and stable levels of protein content in grain (15.1–16.1%): ‘TAW 42971/80’ (k-58363, Germany); ‘Lutescens 471 N8’ (Kazakhstan); ‘Rita’ (k-58057), ‘Scotty’ (k-59322) and ‘Nelson’ (all from the U.S.); ‘Moskovskaya 39’ (k-65160, Russia); ‘Bilotserkivchanka’ (k-64330) and ‘Barkan’ (k-64495) (both from Ukraine). Flour swelling power in acetic acid did not fall below 50 ml, attesting to the formation of high-quality grain. This was also confirmed by the protein quality index determined by the S : P ratio, which ranged from 3.6 to 4.7. Sources with high-quality protein were selected from the tested accessions for use in breeding: ‘CDC Clair’ (k-64168, Canada), ‘Lutescens 471 Н8’ (Kazakhstan), ‘Moskovskaya 39’ (Russia), ‘Barkan’ (Ukraine), and ‘Favorytka’ (k-64337, Ukraine).

The Practiced Pattern of Vascular Access used in Hemodialysis

Background: The incidence of end-stage renal disease (ESRD) is increasing considerably worldwide; moreover, most of the patients start their therapy by hemodialysis (HD). Arteriovenous fistula (AVF) is the best type of vascular access for use in such therapy, due to its decreased rate of complications, followed by arteriovenous graft (AVG) and finally, central venous catheters, which are associated with, increased mortality and morbidity. In this study, we aim to find out the proportion of the current to initial vascular access used, the timing of creating permanent access, and any complications experienced. Patients and Methods: A cross-sectional study was conducted on two hundred eighteen patients currently on regular hemodialysis program. Their records were reviewed and the data was analyzed for vascular accesses type used at the start of hemodialysis and at the current time, the timing of the creation of permanent access, and the complications occurred. Data collected were statistically analyzed using IBM-SPSS statistics software Inc. Chicago, IL, USA. Results: Out-of-the 218 patients on hemodialysis, 193 patients (88.5%) started hemodialysis via Central venous catheters (CVC), 23 patients (10.5%) had an arterio-venous fistula (AVF), and only two patients (0.9%) used tunneled CVC, while no one has AV-graft. Currently, 82.1% of patients have AVF, 7.8% have chronic CVC, 5.9% have acute CVC and only 4.1% have AV-Graft, Many complications are noted in all types of access with different percentages of occurrence. Conclusion: We concluded that although a high percentage of patients have AVF, still pre-emptive AVF counts very low percentage, serious complications are still happening and we recommend the establishment of joined pre-dialysis clinic with surgeons and psychologists in each dialysis center.

Preservation and Organization of Electronic Resources for Effective Service Delivery in Federal College of Education Libraries in Northern Nigeria

The study investigated the preservation and organization of electronic resources for effective service delivery in Federal College of Education Libraries in Northern Nigeria. The objective is to examine the electronic resources preservation strategies, ICT facilities used for resources preservation,organization of electronic resources and types of electronic resources organized. The research adopted qualitative research methodology. The population of the study is the 12 college librarians and was sampled. Interview was used for data collections, data collected were analyzed using thematic analysis. The findings revealed that, the strategies applied for preservation of resources were migration and normalization. The libraries used external hard drive, drop box/cloud and institutional repository for preserving electronic resources. Majority of the libraries organize their resources. In conclusion, proper management of e-resources is a prerequisite to easy access and use of the resources to enhance research, teaching and learning. The study recommended the use of preservation strategies that can prolong the life span of the resources; organize the resources for easy retrieval; provides access to the resources remotely and lastly, the management of the colleges and their libraries should ensure that all the challenges are minimized in order to provide access for use of the resources.

Quality Evaluation of Wild Germplasm of Chinese Prickly Ash (Zanthoxylum bungeanum Maxim) from Qinling Mountains at Different Elevations Based on HPLC-Fingerprint.

Wild Chinese prickly ash resources provide a valuable genetic resource for Zanthoxylum bungeanum Maxim improvement and breeding. The Qinling Mountains was an abundant source for wild Chinese prickly ash. In this study, the phenolic and flavonoid compounds of wild germplasm resources from different altitudes and six cultivated varieties were analyzed by high performance liquid chromatography (HPLC). The chromatograms of them were essentially consistent, although their chemical composition contents were greatly different. The thirty samples were divided into three categories through the hierarchical clustering analysis. Catechin, hyperoside and quercitrin were considered to be key compounds for the quality evaluation, and by contrast, the wild samples with an altitude of 2300±50 m (Group IV) had the highest content of key compounds, and presented stronger antioxidant activity and antibacterial ability, indicating that these wild samples could be identified as the excellent breeding resources. This is the first time to evaluate the quality of wild Chinese prickly ash at different altitudes in Qinling Mountains. These excellent wild germplasm resources provided substantial potential accessions for use directly in Chinese prickly ash breeding programs.

English

Knowledge of existing genetic variability is essential for initiating a successful breeding program. A set of 628 finger millet accessions comprising accessions from the core collection, farmer preferred and improved varieties released in Kenya, Tanzania and Uganda were profiled for nutrient content. Accessions showed very high variability for the different nutrient contents. Local cultivars and varieties released in the ESA region had significantly lower levels of the main essential nutrients (Ca, Fe, Zn) found in finger millet. Country of origin was highly significant for all the nutrients, with accessions from eastern and southern Africa having significantly lower nutrient contents. Grain color was associated with nutrient content with darker grains having higher compared to white colored. All nutrients were positively correlated (P<0.001) to each other. Grain yield was not significantly correlated to any nutrient content. The substantial variability for the grain nutrients observed in the finger millet core collection and local germplasm indicates the possibility for the selection of nutrient-rich accessions for use in the breeding programs. Key words: Finger millet, micro and macro nutrients, diversity, grain color, glume cover, malnutrition.

Genetic variability and genome‐wide marker association studies for starch traits contributing to low glycaemic index in pearl millet

AbstractPearl millet grains are naturally rich in high quality starch, dietary fibre, polyphenols and important micronutrients. Grains from a random subset of the global diversity panel (PMiGAP) comprising 166 pearl millet accessions were assessed for total starch (TS), rapidly digestible Starch (RDS), slowly digestible starch (SDS) and resistant starch (RS) content based on available glucose percentage after digestion at various time points. Highly significant genetic variations for SDS, RS and other starch traits were evident amongst the PMiGAP accessions leading to the identification of best accessions for use in the future pearl millet‐breeding programmes. To identify potential candidate genes associated with these starch traits, genome‐wide association studies (GWAS) were performed using 78K single‐nucleotide polymorphisms (SNPs) well distributed across the seven chromosomes of pearl millet. A total of 902 SNPs showed a strong association with various starch traits at ‐log p‐value range from 4.0–9.08. A total of 364 probable candidate genes were identified in the flanking regions of the significantly associated SNPs and high LD (linkage disequilibrium) region, which explains a correlation between nearby variants. Out of these, 19 probable candidate genes exhibited functional relationships with the starch biosynthesis pathway. Three starch synthase genes (Pgl_GLEAN_10026059 and Pgl_GLEAN_10027180) were found to be key probable candidate genes for SDS owing to their prior demonstrated involvement in amylose biosynthesis. Pgl_GLEAN_10018323, encoding β‐amylase and Pgl_GLEAN_10009197, encoding α‐amylase enzyme were identified as probable candidate genes for RDS content. The genetic variability being reported for SDS and RS in the germplasm panel, and the SNP markers associated with such variability, raises the possibility of developing pearl millet varieties with low glycaemic index using conventional and molecular breeding approaches.

ANXIETY OF HEMODIALYSIS PATIENT WITH ACCESS ARTERIOVENOUS FISTULA (AV-SHUNT): A QUALITATIVE STUDY

Background: Cannulation is an intervention that inserts a needle through the skin into a blood vessel. Av-shunt is the most recommended access for use in the hemodialysis therapy process. Psychosocial problems, especially feelings of anxiety and fear can be felt by patients due to AV-shunt. Anxiety is a scientific attitude experienced by each individual as a form of response in dealing with problems or threats Vascular access complications may threaten lives and reduce treatment satisfaction and life quality. 
 Objectives: This study aimed to describe hemodialysis patient anxiety with arteriovenous fistula (AV-shunt) access.
 Methods: A descriptive qualitative study using the in-depth interview method with phenomenology approach. The study was carried out with four informants undergoing hemodialysis in RSUD dr. Haryoto Lumajang. Samples were taken using purposive sampling. Participant statements were recorded using a voice recorded, transcribed, coded, interpreted, and categorized to create a theme.
 Results: The study results produced three themes: (1) Emotional feeling perceived associated with AV-shunt experience: Anxiety, fear, and helplessness, (2) Physical and physical activity changes: Dark skin, dry skin, limp body, and fatigue, and (3) Patient knowledge regarding av-shunt, i.e., AV-shunt access and based on information sources.
 Conclusion: Patients with arteriovenous fistula (AV-shunt) access had anxieties caused by cannulation initial pain, fear, and sense of uselessness.

Vascular Access, Complications and Survival in Incident Hemodialysis Patients

The arteriovenous fistula (AVF) has long been considered the optimal vascular access. However, the evolving characteristics of the ageing dialysis population limit the creation of an AVF in all patients. Thus, more patients start hemodialysis (HD) with a central venous catheter (CVC) rather than an AVF, and the supremacy of the AVF has recently been questioned. The aim of this study was to analyze the incidence and rate of access complications in 100 patients between 2010 and 2015. A total of 63 patients started HD with an AVF, while 37 began HD with a CVC. We found no differences in patient survival according to the vascular access in use at the beginning of dialysis, but patients were more likely to die while undergoing dialysis by means of a CVC than an AVF. Patients started on dialysis with a CVC had more cardiovascular disease, while patients who began dialysis with an AVF presented more hypertension. Fistulas presented a longer survival time despite more hospital admissions, but CVCs bore a higher risk of infections. Our results suggest that starting dialysis with a CVC does not confer a greater risk of death.