Decarbonisation of Kidney Care in the United Arab Emirates: A Roadmap to an Environmentally Sustainable Care.

Chronic kidney disease (CKD) remains a major public health burden and a leading cause of mortality worldwide and in the United Arab Emirates (UAE). Alongside its clinical and humanistic burden, CKD care is associated with a significant carbon footprint. In this narrative review, we present an overview of the carbon footprint of current CKD treatments and the results of an analysis estimating the carbon footprint of CKD treatments in the UAE.

Supervised Disulfiram Should Be Considered First-line Treatment for Alcohol Use Disorder.

Despite the prevalence of alcohol use disorder (AUD) in the United States, the armamentarium of FDA-approved medications available for AUD treatment is remarkably small. Disulfiram, 1 of only 3 approved medications, is consistently designated as a second-line option in national treatment guidelines, citing inconsistent evidence, lack of patient preference, and safety concerns. These concerns, however, stem from a misguided interpretation of the evidence that exclusively relies upon double-blind randomized controlled trials (RCT).

Projecting the clinical burden of chronic kidney disease at the patient level (): a microsimulation modelling study.

Background: Chronic kidney disease (CKD) is a global concern that presents significant challenges for disease management. Several factors drive CKD prevalence, including primary risk factors, such as type 2 diabetes and hypertension, and an ageing population. is an international initiative that aims to raise awareness of the substantial burden incurred by CKD.

Shared Medical Appointment: A Novel Model for Incorporating Group Visits Into Residency Training for Substance Use Disorders.

Background: Shared medical appointments (SMAs) are a novel modality for treating patients with similar conditions, together, by a team of interdisciplinary providers. SMAs benefit patients with substance use disorder (SUD), but no research has focused on the feasibility of implementation of SMAs in a teaching clinic.

Methods: Primary care residents rotated in a half-day ambulatory addiction clinic for 4 weeks where a third-year resident co-facilitated 4 SMAs.

Gender, age and nationality differences in chronic kidney disease prevalence in the emirate of Abu Dhabi, UAE.

Aim: We aimed to better understand the prevalence of chronic kidney disease in Abu Dhabi, UAE, where a very diverse ethnic population lives, each with their own risk profile.

Methods: Data were analysed on all patients who were tested for serum creatinine in December 2019 for 4 years within our healthcare network. We analysed data for kidney disease by age, gender and nationality to study differences in prevalence and risk.

Preparing Physicians to Treat Addiction: Inclusion of Dedicated Addiction Training During Internal Medicine Residency.

Background: Physicians in internal medicine lack comfort and skills required to diagnose and treat substance use disorder (SUD). Formal training in substance use treatment within primary care training has traditionally been inconsistent and sparse. The purpose of this study is to assess the impact of a longitudinal experiential addiction curriculum on the attitudes and experiences of graduates from a primary care/internal medicine residency program that included formal addiction didactics, rotations in an outpatient addiction clinic embedded within the resident primary care clinic, and exposure to addiction medicine faculty across treatment settings.

A novel model for predicting hospitalization risk among hemodialysis patients based on blood test variables.

Hemodialysis patients are at high risk of hospitalization. Predicting such risk in dialysis patients may be critical to maintaining quality of life and reducing costs to the healthcare system. In this paper, we present and fractional polynomial stepwise logistic regression model to specify how routinely collected blood test variables could be linked to a significant increase in hospitalization risk.

Triglyceride-Tethered Membrane Lipase Sensor.

Sensors that can quickly measure the lipase activity from biological samples are useful in enzyme production and medical diagnostics. However, current lipase sensors have limitations such as requiring fluorescent labels, pH control of buffer vehicles, or lengthy assay preparation. We introduce a sparsely tethered triglyceride substrate anchored off of a gold electrode for the impedance sensing of real-time lipase activity.

Chief resident behaviors that lead to effective morning reports, a multisite qualitative study.

Background: Morning report is a fundamental component of internal medicine training and often represents the most significant teaching responsibility of Chief Residents. We sought to define Chief Resident behaviors essential to leading a successful morning report.

Methods: In 2016, we conducted a multi-site qualitative study using key informant interviews of morning report stakeholders.

Quantifying the advantages and acceptability of linking dialysis machines to an electronic medical record.

Aim: To establish and quantify the time saved by redirecting nursing workload from recording and entering haemodynamic data during chronic dialysis sessions by linking dialysis machines directly to the electronic medical record.

Methods: We developed a bespoke interface from the HL7 feed from the dialysis machines (largely Fresenius 5008) to our EMR system (Cerner). We quantified the time nurses spent with the patient, computer, dialysis machine and sorting our patient related issues by observation using independent observers in a time and motion study.

Metformin reduces insulin resistance and attenuates progressive renal injury in prepubertal obese Dahl salt-sensitive rats.

Prepubertal obesity is currently an epidemic and is considered as a major risk factor for renal injury. Previous studies have demonstrated that insulin resistance contributes to renal injury in obesity, independent of diabetes. However, studies examining the relationship between insulin resistance and renal injury in obese children are lacking.

Native Function of the Bacterial Ion Channel SthK in a Sparsely Tethered Lipid Bilayer Membrane Architecture.

The plasma membrane protects the interiors of cells from their surroundings and also plays a critical role in communication, sensing, and nutrient import. As a result, the cell membrane and its constituents are among the most important drug targets. Studying the cell membrane and the processes it facilitates is therefore crucial, but it is a highly complex environment that is difficult to access experimentally.

Sterol Structural Features' Impact on the Spontaneous Membrane Insertion of CLIC1 into Artificial Lipid Membranes.

: A membrane protein interaction with lipids shows distinct specificity in terms of the sterol structure. The structure of the sterol's polar headgroup, steroidal rings, and aliphatic side chains have all been shown to influence protein membrane interactions, including the initial binding and subsequent oligomerization to form functional channels. Previous studies have provided some insights into the regulatory role that cholesterol plays in the spontaneous membrane insertion of the chloride intracellular ion channel protein, CLIC1.

Spatz: the time-of-flight neutron reflectometer with vertical sample geometry at the OPAL research reactor.

The Spatz neutron beam instrument is the second time-of-flight neutron reflectometer to be installed at the OPAL research reactor. The instrument was formerly the V18 BioRef reflectometer at the BER-II reactor in Berlin and was transferred to Australia in 2016. Subsequently the instrument was re-installed in the neutron guide hall of the OPAL reactor at the end position of the CG2B cold-neutron guide and recommissioned.

Examining inequality in the time cost of waiting.

Time spent waiting for services represents unproductive time lost while fulfilling needs. We use time diary data from the nationally representative American Time Use Survey to estimate the difference between high- and low-income people in time spent waiting for basic services. Relative to high-income people, low-income people are one percentage point more likely to wait on an average day, are three percentage points more likely to wait when using services, spend an additional minute waiting for services on a typical day and spend 12 more minutes waiting when waiting occurs.

Obstacles to Early Diagnosis and Treatment of Pruritus in Patients with Chronic Kidney Disease: Current Perspectives.

Chronic kidney disease-associated pruritus (CKD-aP) is a common condition amongst patients with advanced chronic kidney disease (CKD). Several studies have confirmed that more than four out of ten early-stage CKD patients suffer from this condition, while its prevalence among CKD patients on dialysis reaches up to seven out of ten. It is noted to be associated with other disabling symptoms and serious outcomes.

Serum Calciprotein Monomers and Chronic Kidney Disease Progression.

Introduction: Elevated levels of fibroblast growth factor-23 (FGF23) in chronic kidney disease (CKD) are associated with progression of CKD. FGF23 inhibits proximal tubular phosphate reabsorption, raising phosphate concentrations in the tubular fluid of functioning nephrons, predisposing to spontaneous precipitation of calcium phosphate crystals and resultant tubular injury. Calciprotein monomers (CPM) form spontaneously in biological fluids when clusters of calcium phosphate ions are bound by the liver-derived glycoprotein fetuin-A.

Effect of the phosphate binder sucroferric oxyhydroxide in dialysis patients on endogenous calciprotein particles, inflammation, and vascular cells.

Background: Calciprotein particles (CPPs), colloidal mineral-protein nanoparticles, have emerged as potential mediators of phosphate toxicity in dialysis patients, with putative links to vascular calcification, endothelial dysfunction and inflammation. We hypothesized that phosphate binder therapy with sucroferric oxyhydroxide (SO) would reduce endogenous CPP levels and attenuate pro-calcific and pro-inflammatory effects of patient serum towards human vascular cells in vitro.

Methods: This secondary analysis of a randomised controlled crossover study compared the effect of 2-week phosphate binder washout with high-dose (2000 mg/day) and low-dose (250 mg/day) SO therapy in 28 haemodialysis patients on serum CPP levels, inflammatory cytokine/chemokine arrays and human aortic smooth muscle cell (HASMC) and coronary artery endothelial cell (HCAEC) bioassays.

Effectiveness of BBIBP-CorV vaccine against severe outcomes of COVID-19 in Abu Dhabi, United Arab Emirates.

The effectiveness of the inactivated BBIBP-CorV vaccine against severe COVID-19 outcomes (hospitalization, critical care admission and death due to COVID-19) and its long-term effectiveness have not been well characterized among the general population. We conducted a retrospective cohort study using electronic health records of 3,147,869 adults, of which 1,099,886 vaccinated individuals were matched, in a 1:1 ratio to 1,099,886 unvaccinated persons. A Cox-proportional hazard model with time varying coefficients was used to assess the vaccine effectiveness adjusting for age, sex, comorbidity, ethnicity, and the calendar month of entry into the study.

Coronavirus Disease 2019 Infection and ABO Blood Groups in a Hemodialysis Cohort in the United Arab Emirates.

Some epidemiological data have implicated blood groups in susceptibility to coronavirus disease 2019 (COVID-19) infection. We were interested to see if there was any apparent effect of different ABO blood groups on susceptibility to COVID-19 infection in unvaccinated hemodialysis (HD) patients, as they had a high rate of mortality from this infection. Blood group O has been suggested to be protective against COVID-19 infection; however, since the ABO frequency is affected by ethnicity, we looked at infection frequency and blood group and corrected the expected frequency for the ethnicity of our cohort.

Effect of lanthanum carbonate on serum calciprotein particles in patients with stage 3-4 CKD-results from a placebo-controlled randomized trial.

Background: Calciprotein particles (CPP) are colloidal aggregates of calcium phosphate and the mineral-binding protein fetuin-A, and are potential mediators of cardiovascular disease in chronic kidney disease (CKD). Emerging evidence suggests non-calcium-containing phosphate binders may reduce serum CPP in patients with kidney failure who require dialysis; however, it is unclear whether similar interventions are effective in patients with earlier stages of CKD.

Methods: The IMpact of Phosphate Reduction On Vascular End-points in CKD (IMPROVE-CKD) was a multi-centre, placebo-controlled, randomized trial of lanthanum carbonate on cardiovascular markers in 278 participants with stage 3b/4 CKD.