Preferred Solution Research Articles

EXPRESS: Normal Saline Versus Balanced Intravenous Fluids in Acute Ischemic Stroke: A Retrospective Study.

Background While some studies have suggested better outcomes for critically ill patients with balanced solutions over normal saline, the best type of intravenous fluid to use for stroke patients remains unknown.Objective To determine if balanced solutions or normal saline are associated with risk of hemorrhagic transformation or 90-day disability in patients with acute ischemic stroke treated with intravenous thrombolysis.Methods This was a retrospective review of the 2015-2019 Get with the Guidelines® data at a single academic medical center. Exposure was type of intravenous fluid and outcomes were modified Rankin scale (mRS) ≤2 at 90 days and hemorrhagic transformation. Multivariate analysis controlled for age, demographics, medical history, time to tPA, and admission stroke scale.Results We included 302 patients who received thrombolysis, of which 166 patients had mRS data at 90 days. In univariate analysis, exposure to any balanced solution was associated with increased 90-day disability (OR 4.3, 95% CI 3.8-4.9) and hemorrhagic transformation (OR 2.0, 95% CI 1.3-2.2). In multivariate analysis, exposure to a balanced solution at any time was associated with increased 90-day disability (OR 6.3, 95% CI 2.4-17.0, p<0.01), but not hemorrhagic transformation.Conclusion This observational trial demonstrated that exposure to balanced solutions is associated with increased risk of disability at 90 days and possibly hemorrhagic transformation in patients with acute ischemic stroke treated with intravenous thrombolysis. This data would suggest that normal saline is a preferred solution in these patients, though larger future trials are needed.

Analysing Turbulence Patterns in Nature‐Like Fishways: An Experimental Approach

ABSTRACTNature‐like fishways are an important measure for restoring fish passage, mitigating the impacts of barriers, and providing valuable habitat benefits in a more natural and effective way than traditional technical fishways. Their ecological advantages make them a preferred solution in many river restoration projects. The turbulence at the fishway's pool is a key challenge in the design of fishways. This study evaluated the hydraulic performance of the nature‐like fishway section of the Zongyang Fishway Project in China. This utilized a trapezoidal cross‐section with a 1:242 bottom slope, 1:2 side slopes, and an operating water depth of 1–3 m. The bottom and sides were paved with 0.2–0.5 m diameter pebbles to create suitable habitat for bottom‐dwelling fish. The target design velocity was 0.7–0.9 m s−1. A physical model was constructed to assess the hydraulic characteristics of the nature‐like fishway, including flow velocities within the slots and turbulence levels in the pools. The results showed that the slot velocities were within the target range, the head loss was parallel to the bottom elevation, and the flow field near the bottom mimicked technical fishway conditions, whereas the surface flow resembled open channel flow. Turbulence intensity remained below 60% of the design velocity. These findings provide valuable insights into the hydraulic performance and suitability of this nature‐like fishway design for facilitating fish passage of the target freshwater species along with directly aiding to SDGs 6 and 14.

Media Coverage of Antimicrobial Resistances in Germany and Switzerland: An Interpretation through the Multiple Streams Framework

This article analyzes the newspaper coverage of antimicrobial resistance (AMR) between 1999 and 2021 in Germany and Switzerland through the lens of the Multiple Streams Framework (MSF). The MSF serves as an organizing framework to trace the development of AMR media coverage by focusing on key elements of the policy process: problems, solutions, problem brokers and policy entrepreneurs. The analysis produces three main findings: First, the overall newspaper coverage of AMR is increasing from 1999 to 2021, albeit non-linearly but related to specific events. Second, the general growth in AMR and the use of antibiotics with animals are the most frequently mentioned problems. Different types of solutions are prominent in the media, but only some actors manage to connect their preferred solution to a given problem, while other solutions appear independently of specific problems. Third, scientific and state actors from the national level are most prominent in AMR media coverage, and potentially act as entrepreneurs. Overall, the analysis highlights the diversity of problems, solutions, and actors, and thus of multiple perspectives and dynamics, on AMR as an issue of emerging attention.

A tale of two (Florida) cities: perceptions of flooding risk and adaptation in Tampa’s Hyde Park and Saint Augustine

AbstractSea level rise is not a problem for the future alone. It is already affecting many small to medium cities on the East Coast of the USA. These cities are adapting to their problems without sufficient help from the federal or state government. To escape the perils of short-term reactionary ad hoc measures to deal with such problems, there is a need to utilize longer-term visions and frameworks. One such approach, Adaptation Pathway Planning, requires the involvement of locally affected people. This study looks at the perceptions and preferred adaptation solutions of the residents of St. Augustine and the Hyde Park neighborhood in Tampa, FL, two cities that are already experiencing the worsening flooding effects caused by rising seas. The results show that those living in areas at higher risk, and which are already experiencing frequent tidal flooding, had a greater knowledge of this risk and a higher desire for increased action from multiple levels of government. Also, such people were more aware of what their municipalities were already doing to adapt. Finally, when faced with two different scenarios of the possible rise in sea levels by 2050, those presented with the higher scenarios were more likely to choose a wider range of adaptation countermeasures. All this indicates the need to carefully consider the awareness of residents regarding the effects of sea level rise and how long-term adaptation should be discussed with them.

IT Team Project Management Transformation Plan for TIC Company’s IT Division

Nowadays, organizations are increasingly reliant on information technology to maintain efficient and effective internal systems, stay competitive, and meet the evolving needs of their customers. However, organizations facing challenges often include delays in project delivery, difficulties in managing workflows, and issues with accurately tracking progress and performance. The Information Technology Division of one of the testing, inspection, and certification companies in Indonesia is responsible for application development but frequently encounters operational issues such as development delays, unaddressed requests, difficulties in tracking project timelines and completions, and unclear job description alignments. This study examines Waterfall, Kanban, and Scrum Agile methodologies through case studies and Design Science Research Methodology to address these issues. Scrum Agile, with its principles and practices, is selected as the preferred solution for resolving these recurring problems. The research proposes transitioning project management to Scrum Agile methods and demonstrates how these methods effectively address several existing challenges. This approach results in the development of a new system that implements Scrum Agile for project management within the department. This research can enhance the efficiency and effectiveness of application development and improve project visibility and control for the organization. Additionally, it provides learning through comparative analysis to identify appropriate new methods and systems based on the case study.

Epsilon-Greedy Thompson Sampling to Bayesian Optimization

Abstract Bayesian optimization (BO) has become a powerful tool for solving simulation-based engineering optimization problems thanks to its ability to integrate physical and mathematical understandings, consider uncertainty, and address the exploitation–exploration dilemma. Thompson sampling (TS) is a preferred solution for BO to handle the exploitation–exploration trade-off. While it prioritizes exploration by generating and minimizing random sample paths from probabilistic models—a fundamental ingredient of BO—TS weakly manages exploitation by gathering information about the true objective function after it obtains new observations. In this work, we improve the exploitation of TS by incorporating the e-greedy policy, a well-established selection strategy in reinforcement learning. We first delineate two extremes of TS, namely the generic TS and the sample-average TS. The former promotes exploration, while the latter favors exploitation. We then adopt the e-greedy policy to randomly switch between these two extremes. Small and large values of e govern exploitation and exploration, respectively. By minimizing two benchmark functions and solving an inverse problem of a steel cantilever beam, we empirically show that e-greedy TS equipped with an appropriate e is more robust than its two extremes, matching or outperforming the better of the generic TS and the sample-average TS.

Generalized transport costs in intermodal shipping: the context of the Northeast Passage

Intermodality is regarded as one way of achieving more sustainable transport solutions. To make intermodal transport the preferred solution among shippers, it must be attractive according to the concept of generalized transport costs. An extended model for generalized transport costs is developed which includes elements important for comparing maritime transport solutions in the Artic. This framework forms the basis for a principal discussion on the conditions that make one transport solution preferable to another within the context of maritime logistics. This model is then applied to the context of the Northeast Passage to discuss the necessary requirements for making an intermodal transport solution attractive relative to the current main route from Northeast Asia to Northwest Europe through the Suez Canal. Even though intermodality could be preferable in principle, current solutions cannot compete with either Arctic routes using unimodal solutions with high ice-class vessels or with the Suez route. Due to uncertainty and limited empirical evidence, a sensitivity analysis is conducted, focusing on the variables with the greatest impact on the result. Policymakers and stakeholders can consider the findings to improve transport competitiveness via the Northeast Passage.

Let decision-makers direct the search for robust solutions: An interactive framework for multiobjective robust optimization under deep uncertainty

The robust decision-making framework (RDM) has been extended to consider multiple objective functions and scenarios. However, the practical applications of these extensions are mostly limited to academic case studies. The main reasons are: (i) substantial cognitive load in tracking all the trade-offs across scenarios and the interplay between uncertainties and trade-offs, (ii) lack of decision-makers’ involvement in solution generation and confidence. To address these problems, this study proposes a novel interactive framework involving decision-makers in searching for the most preferred robust solutions utilizing interactive multiobjective optimization methods. The proposed interactive framework provides a learning phase for decision-makers to discover the problem characteristics, the feasibility of their preferences, and how uncertainty may affect the outcomes of a decision. This involvement and learning allow them to control and direct the multiobjective search during the solution generation process, boosting their confidence and assurance in implementing the identified robust solutions in practice.

Performance Evaluation of Real-Time Kinematic Global Navigation Satellite System with Survey-Grade Receivers and Short Observation Times in Forested Areas

The Real-Time Kinematic (RTK) method is currently the most widely used method for positioning using Global Navigation Satellite Systems (GNSSs) due to its accuracy, efficiency and ease of use. In forestry, position is a critical factor for numerous applications, with GNSS currently being the preferred solution for obtaining such data. However, the decreased performance of GNSS observations in challenging environments, such as under the forest canopy, must be considered. This paper analyzes the performance of a survey-grade GNSS receiver under coniferous/deciduous tree cover. Unlike most previous research concerning this topic, the focus here is on employing a methodology that is as close as possible to real working conditions in the field of forestry. To achieve this, short observation times of 30 s were used, with corrections received directly in the field from a Continuously Operating Reference Station (CORS) of the national RTK network in Romania. In total, 84 test points were determined, randomly distributed under the canopy, with reference data collected by topographical surveys using total station equipment. In terms of the overall horizontal accuracy, an RMSE of 2.03 m and MAE of 1.63 m are found. Meanwhile, the overall vertical accuracy is lower, as expected, with an RMSE of 4.85 m and MAE of 4.01 m. The variation in GNSS performance under the different forest compositions was found to be statistically significant, while GNSS-specific factors such as DOP values only influenced the precision and not the accuracy of observations. We established that this methodology offers sufficient accuracy, which is application-dependent, even if the majority of GNSS solutions were code-based, rather than carrier-phase-based, due to strong interference from the vegetation.

Why middle-sized matters: Quantum realism, minds and the Problem of Macro-Objects

Abstract The Problem of Macro-Objects concerns how three-dimensional, middle-sized objects, such as scientists and their measuring devices, can exist in a quantum world. This paper discusses the problem for wave function realism and the primitive ontology approach to quantum mechanics, focussing on Alyssa Ney’s recent two-stage solution, in which macro-objects are functionally reduced to micro-objects and micro-objects are parts of a whole in which they are grounded (the wave function field). It raises metaphysical difficulties with this proposal which a hylomorphic account of wholes may be able to address, noting possible implications for one’s philosophy of mind depending on one’s preferred solution to the Measurement Problem.

Decarbonizing Transportation: A critical examination of strategy effectiveness within sustainable energy capacity constraints

In this study, a consequential life cycle assessment to evaluate CO2 emission reduction strategies in transportation is applied. The study focusses on fossil-fuel-driven vehicles, battery electric vehicles, and e-fuel-driven vehicles across various energy scenarios without constrictions to a specific region or period. A key discovery is the critical role of sustainable electricity availability in determining the effectiveness of these strategies. The study highlights the significance of strategically sequencing the electrification of energy subsectors, particularly under a constrained carbon budget. The findings indicate that, given the constraints on sustainable electricity supply in the short to medium term, battery electric vehicles do not achieve the expected reduction in CO2 emissions, potentially rendering optimized fossil-fuel-driven vehicles with over 30% average efficiency a more effective interim solution. However, a tipping point exists where battery electric vehicles become a preferable solution in terms of CO2 emissions, dependent on the share of sustainable electricity in the energy mix. By quantitatively analyzing the CO2 reduction efficiency per unit of added sustainable electricity for different strategies, this study establishes a basis for informed, nuanced policy decisions.

High-temperature resistant SnSe/MSN film for thermal runaway prevention in lithium-ion batteries

Recent years have witnessed an accelerated development of electric vehicles (EVs) driven by the pressing need to curb carbon emissions. Lithium-ion batteries (LIBs) stand out as preferred energy storage solutions owing to their high energy density and extended cycle life. Nonetheless, the persistent threat of thermal runaway (TR) remains a critical safety concern. This study endeavors to tackle this issue by introducing a novel composite insulating film tailored to function as a thermal barrier within LIBs. Comprising exfoliated SnSe (tin selenide) and mesoporous silica bonded via Zn ion gelation, the composite showcases a low thermal conductivity of 0.131 W/mK alongside a robust tensile strength of 52.7 MPa. These attributes stem from the distinctive amalgamation of materials and the robust interfacial interactions facilitated by Zn ion gelation, thus enhancing thermal stability and mechanical resilience. The devised DGEBA/SnSe-MSN composite exhibits notable flame retardant properties and superior thermal management capabilities, positioning it as a promising candidate to bolster the safety and dependability of LIBs. This research introduces a promising approach for crafting high-performance insulating films applicable across diverse industries, particularly in the realm of lithium-ion battery technology, leveraging SnSe as an insulating material—a departure from its prior application as a thermoelectric material.

Multi-objective predictive maintenance scheduling models integrating remaining useful life prediction and maintenance decisions

This paper presents two novel data-driven multi-objective predictive maintenance scheduling models that integrate remaining useful life (RUL) prediction into maintenance planning. First, we propose a deep learning ensemble model that includes a convolutional neural network and bidirectional long short-term memory network with a temporal self-attentional mechanism and Bayesian optimization method to predict system RUL effectively. Then, two novel multi-objective mixed-integer linear programming (MILP) models are developed based on the system-predicted RUL to deal with the system predictive maintenance problem, which aims to minimize the total maintenance completion time and maintenance-related costs simultaneously. To solve this problem, we design an iteration ϵ-constraint method to achieve Pareto solutions. Meanwhile, a fuzzy logic method is proposed to recommend a preferred Pareto solution for decision-makers. Finally, the aircraft engine C-MAPSS dataset from NASA validates that the effectiveness of the proposed data-driven multi-objective predictive maintenance scheduling models are effective. For the predictive maintenance of 20 aircraft engines, both the maintenance completion time and maintenance cost are reduced by more than 40%.

International governance of advancing artificial intelligence

AbstractNew technologies with military applications may demand new modes of governance. In this article, we develop a taxonomy of technology governance forms, outline their strengths, and red-team their weaknesses. In particular, we consider the challenges and opportunities posed by advancing artificial intelligence, which is likely to have substantial dual-use properties. We conclude that subnational governance, though prevalent and mitigating some risks, is insufficient when the individual rewards from societally harmful actions outweigh normative sanctions, as is likely to be the case with AI. Nationally enforced standards are promising ways to govern AI deployment, but they are less viable in the “race-to-the-bottom” environments that are becoming common. When it comes to powerful technologies with military implications, there is only one multilateral option with a strong historical precedent: a non-proliferation plus norms-of-use regime, which we call NPT+. We believe that a non-proliferation regime may, therefore, be the necessary foundation for AI governance. However, AI may exhibit characteristics that would make a non-proliferation regime less effective than it has proven for nuclear weapons. As an alternative, verification-backed restrictions on AI development and use would address more risks, but they face challenges in the case of advanced AI, and we show how these challenges may not have technical solutions. Perhaps more importantly, we show that there is no clear example of major powers restricting the development of a powerful military technology when that technology lacks a ready substitute. We, therefore, turn to a final alternative, International Monopoly, which was the preferred solution of many scholars and policymakers in the early nuclear era. It should be considered again for governing AI: a monopoly would require less-invasive monitoring, though at the possible cost of eroding national sovereignty. Ultimately, we conclude that it is too soon to tell whether a non-proliferation regime, a verification-based regime, or an International Monopoly is most feasible for governing AI. Nonetheless, a variety of policies would yield a high return across all three scenarios, and we conclude by identifying some of these steps that could be taken today.

Implementation of a magnet hospital model: attracting and retaining healthcare staff in a Swedish hospital

PurposeStaff shortages in the healthcare sector increase the competition for qualified staff. A magnet hospital is intended to attract, and retain healthcare professionals. This article aims to investigate the challenges related to implementation of a magnet hospital model, and given these challenges, to analyse the interplay between different organisational levels in a Swedish hospital.Design/methodology/approachThe data collection followed the implementation of a magnet hospital model and consisted of 14 meeting observations, 31 interviews and 13 document analyses.FindingsThe model implementation was driven by a top-down approach, with accompanying bottom-up activities, involving healthcare professionals, to ensure adaption to the hospital’s conditions at different organisational levels. The findings revealed that the model was more appealing to top management, seeking a standardised solution to attract and retain nurses. Clinic managers preferred tailor-made solutions for managing their employee resourcing challenges. Difficulties in translating and contextualising the model to the hospital’s conditions created challenges at every organisational level. Some were contained within a level while others spread to the organisational level below and turned into something else.Originality/valueApart from unique empirical material depicting the implementation of a magnet hospital model as an effort to attract and retain healthcare professionals, the value of this study lies in the attention given to the challenges that arise when responsibility for implementing a management model is shifted from top management to change agents tasked with facilitating and executing the organisational change.

Globally and locally optimized Pannini projection for high FoV rendering of 360° images

To render a spherical (360° or omnidirectional) image on planar displays, a 2D image - called as viewport - must be obtained by projecting a sphere region on a plane, according to the user's viewing direction and a predefined field of view (FoV). However, any sphere to plan projection introduces geometric distortions, such as object stretching and/or bending of straight lines, which intensity increases with the considered FoV. In this paper, a fully automatic content-aware projection is proposed, aiming to reduce the geometric distortions when high FoVs are used. This new projection is based on the Pannini projection, whose parameters are firstly globally optimized according to the image content, followed by a local conformality improvement of relevant viewport objects. A crowdsourcing subjective test showed that the proposed projection is the most preferred solution among the considered state-of-the-art sphere to plan projections, producing viewports with a more pleasant visual quality.

Good practice with fluid management in operative hysteroscopy.

Hysteroscopic surgery requires a balance of continuous controlled irrigation and aspiration to distend the endometrial cavity to a degree that provides the clear and stable visual environment necessary for diagnostic and therapeutic procedures. Whereas the preferred distending solution should be isotonic and isonatremic, radiofrequency (RF) electrosurgery with monopolar instrumentation can only be performed with non-ionic (hyponatremic) solutions. Absorption of as little as 500 mL and certainly more than 1000 mL of non-ionic solutions can result in fluid overload and/or dilutional hyponatremia with potentially serious adverse effects under certain conditions and patient characteristics. Both hysteroscopic RF electrosurgery with bipolar instrumentation and electro-mechanical morcellation and aspiration systems use isotonic and isonatremic solutions. Depending on the clinical context, absorption of more than 1500 mL of isonatremic solutions can also result in serious adverse effects. Automated fluid management systems are preferred and recommended, and surgeons should aim to maintain the maximum allowable intravasation of distending media below 1000 and 1500 mL for non-ionic and ionic fluids, respectively.

Carbon dots-doped melamine–formaldehyde microsphere as a dual functional material for sensing and adsorption of oxytetracycline

The abuse of oxytetracycline (OTC) leaves serious environmental residues and triggers accumulation in organisms, constituting a threat to human health. Constructing an effective platform based on dual-functional materials for monitoring and removing OTC residues is a preferable solution. Herein, we proposed a novel composite material by doping carbon dots (CDs) into melamine–formaldehyde microsphere (MFM) through a one-pot method and named CDs@MFM, which inherited the fluorescence property of CDs and porous structure of MFM simultaneously. CDs@MFM demonstrated dual functions for the detection and removal of OTC concurrently within a few minutes, with its performance compared in detail with bare CDs and MFM as controls. By virtue of the pre-enrichment effect attributed to its porous structure, CDs@MFM exhibited a lower detection limit for OTC than bare CDs (0.027 mg/L vs 0.067 mg/L) and a higher adsorption capacity than MFM (73.01 mg/g vs 68.76 mg/g) resulting from more affiliated functional groups available for OTC provided by the CDs. Overall, CDs@MFM has proven to be an efficient and convenient candidate capable of monitoring and removing OTC synchronously, and this work offers an avenue for the design of dual-functional materials in the field of environmental science.

Amplitude analysis of the radiative decay Bs0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {\ extrm{B}}_{\ extrm{s}}^0 $$\\end{document}→ K+K−γ

A search for radiative decay of Bs0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {B}_s^0 $$\\end{document} mesons to orbitally excited K+K− states is performed using proton proton collisions recorded by the LHCb experiment, corresponding to an integrated luminosity of 9 fb−1. The dikaon spectrum in the mass range mKK < 2400 MeV/c2 is dominated by the ϕ(1020) resonance that accounts for almost 70% of the decay rate. Considering the possible contributions of f2(1270), f2′\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {f}_2^{\\prime } $$\\end{document}(1525) and f2(2010) meson states, the overall tensor contribution to the amplitude is measured to beFf2=16.8±0.5stat.±0.7syst.%,\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {\\mathcal{F}}_{\\left\\{{f}_2\\right\\}}=16.8\\pm 0.5\\left(\ extrm{stat}.\\right)\\pm 0.7\\left(\ extrm{syst}.\\right)\\%, $$\\end{document}mostly dominated by the f2′\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {f}_2^{\\prime } $$\\end{document}(1525) state. Several statistically equivalent solutions are obtained for the detailed resonant structure depending on whether the smaller amplitudes interfere destructively or constructively with the dominant amplitude. The preferred solution that corresponds to the lowest values of the fit fractions along with constructive interference leads to the relative branching ratio measurementBBs0→f2′γBBs0→ϕγ=19.4−0.8+0.9stat.−0.5+1.4syst.±0.5B%,\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\frac{\\mathcal{B}\\left({B}_s^0\ o {f}_2^{\\prime}\\gamma \\right)}{\\mathcal{B}\\left({B}_s^0\ o \\phi \\gamma \\right)}={19.4}_{-0.8}^{+0.9}{\\left(\ extrm{stat}.\\right)}_{-0.5}^{+1.4}\\left(\ extrm{syst}.\\right)\\pm 0.5\\left(\\mathcal{B}\\right)\\%, $$\\end{document}where the last uncertainty is due to the ratio of measured branching fractions to the K+K− final state. This result represents the first observation of the radiative Bs0→f2′1525γ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {B}_s^0\ o {f}_2^{\\prime }(1525)\\gamma $$\\end{document} decay, which is the second radiative transition observed in the Bs0\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ {B}_s^0 $$\\end{document} sector.

Kidney After Lung Transplants or Combined Kidney-Lung Transplantation: A Single-Center Retrospective Cohort Study.

BACKGROUND End-stage renal disease is a major issue in the management of patients undergoing lung transplantation. Combined kidney-lung transplantation (CKLT) and kidney after lung transplantation (KALT) are the 2 preferred solutions to manage this situation. To evaluate these strategies, we describe kidney and lung graft outcomes and patient survival in patients managed with CKLT and KALT. MATERIAL AND METHODS We conducted a retrospective single-center cohort study. Patients who underwent a CKLT or a KALT were included in this study. Retrospective extraction of data from medical records was performed. RESULTS Seventeen patients underwent CKLT and 9 underwent KALT. Most of the patients had cystic fibrosis and presented renal failure related to anti-calcineurin toxicity. The 30-day and 1-year survival of CKLT recipients were both 75.6%. No patients with KALT died during the follow-up. Kidney graft prognosis was almost exclusively influenced by patient survival in relation to postoperative lung transplant complications. The rate of severe surgical complications was close to 60% for CKLT compared with 30% for KALT. The kidney graft function (estimated kidney graft function) did not differ according to the transplantation strategy. CONCLUSIONS KALT is a safe option, with postoperative morbidity and renal graft function identical to those of kidney transplantation in non-lung-transplanted patients. The results of CKLT depend mainly on the morbidity associated with lung transplantation but remain an attractive option for patients with respiratory failure associated with end-stage renal disease. The choice of transplant strategy must also take into account the most ethical and efficient allocation of kidney grafts.