The UK Renal Registry Advanced CKD Study: frequency of incorrect reporting of date of start of RRT

Background: A preliminary review of the UK Renal Registry (UKRR) pre-RRT study data revealed results suggesting that, for some patients, the date of start of renal replacement therapy (RRT), as reported to the UKRR, was incorrect and often significantly later than the true date of start. A more detailed study then aimed to validate a set of criteria to identify patients with an incorrect start date. Methods: Pre-RRT laboratory data were electronically extracted from 8,810 incident RRT patients from 9 UK renal centres. Any patient with a low urea (<15 mmol/L) at the start of RRT or with a substantial improvement in kidney function (either a fall in urea >10 mmol/L or rise in eGFR >2 ml/min/1.73 m) within the two months prior to RRT were considered to potentially have an incorrect date of start. In 4
selected centres, the electronic patient records of all patients flagged were reviewed to validate these criteria.
Results: Of 8,810 patients, 1,616 (18.3%) were flagged by the identification criteria as having a potentially incorrect date of start of RRT, although a single centre accounted for 41% of the total flagged cohort. Of these flagged patients, 61.7% had been assigned an incorrect date of start of haemodialysis (HD), 5.7% had evidence of acute RRT being given before the reported date of start of HD
and 9.2% had evidence of starting peritoneal dialysis exchanges prior to the reported date of start. Of
those flagged, 10.7% had a correct date of start of RRT.
Conclusions: Accurate reporting of RRT episodes is vital for the analysis of time dependent studies such as survival or time to transplantation. A proportion of patients starting RRT were assigned an incorrect start date. In order to improve the accuracy of this reporting the UK Renal Registry
must work with renal centres and clinical staff on improving data input for the start of RRT.

Optimisation of time/temperature treatment, for heat treated soft wheat flour

Chlorination of wheat flour in the EU countries has been replaced in recent years, to some extent, by heat treated flour which is used to produce high ratio cakes. Heat treated flour allows high ratio recipes to be developed which generate products with longer shelf life, finer texture, moist crumb and sweeter taste. The mechanism by which heat treatment improves the flour is not fully understood, but it is known that during the heat treatment process, protein denaturation and partial gelatinisation of the starch granules occurs, as well as an increase in batter viscosity. Therefore, it is important to optimize the flour heat treatment process, in order to enhance baking quality. Laboratory preparation of heat treated base wheat flour (culinary, soft, low protein) was carried out in a fluidised bed drier using a range of temperatures and times. The gluten was extracted from the final product and its quality was tested, to obtain objective and comparative information on the extent of protein denaturation. The results indicated that heat treatment of flour decreases gluten extensibility and partial gelatinisation of the starch granules occurred. After heat treatment the gluten appeared to retain moisture. The optimum time/temperature for the heat treatment of base flour was 120-130°C for 30 min with moisture content of ˜12.5%.© 2012 Elsevier Ltd. All rights reserved.

A comparison of the application of STOPP/START to patients' drug lists with and without clinical information

Background A European screening tool (STOPP/START) has been formulated to identify the prescribing of potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). Pharmacists working in community pharmacies could use STOPP/START as a guide to conducting medication use reviews; however, community pharmacists do not routinely have access to patients' clinical records. Objective To compare the PIM and PPO detection rates from application of the STOPP/START criteria to patients' medication details alone with the detection rates from application of STOPP/START to information on patients' medications combined with clinical information. Setting Community Pharmacy. Method Three pharmacists applied STOPP/START to 250 patient medication lists, containing information regarding dose, frequency and duration of treatment. The PIMs and PPOs identified by each pharmacist were compared with those identified by consensus agreement of two other pharmacists, who applied STOPP/START criteria using patients' full clinical records. Main outcome measure The main outcome measures were: (1) PIM and PPO detection rates among pharmacists with access to patients' clinical information compared to PIM and PPO detection rates among pharmacists using patients' medication information only, and (2) the levels of agreement (calculated using Cohen's kappa statistic (k)) for the three most commonly identified PIMs and PPOs. Results Pharmacists with access to patients' clinical records identified significantly fewer PIMs than pharmacists without (p = 0.002). The three most commonly identified PIMs were benzodiazepines, proton pump inhibitors and duplicate drug classes, with kappa (k) statistic agreement ranges of 0.87-0.97, 0.60-0.68 and 0.39-0.85 respectively. PPOs were identified more often (p 

The (Soft) Power of Commitment:The EU and Conflict Resolution in Northern Ireland

This paper examines the potential of international actors to contribute to conflict resolution by analysing the evolving role of the European Union (EU) in embedding Northern Ireland's peace process. Scrutiny of the EU's approach to conflict resolution in Northern Ireland offers useful insights into the scope and potential of soft power for facilitating behavioural change from governmental to grass-roots levels. This paper traces the development of the EU's approach to conflict resolution in Northern Ireland from one concentrated on encouraging state-level agreement, to nurturing peace through multilevel funding, through now to consolidating the peace by facilitating regional-level empowerment. The core argument is that, in sum, the most critical element of the EU's contribution to peace in Northern Ireland has been, quite simply, that of enduring commitment.

On the relativistic iron line and soft excess in the Seyfert 1 galaxy Markarian 335

We report a 133-ks XMM-Newton observation of the Seyfert 1 galaxy Markarian 335. The 0.4-12 keV spectrum contains an underlying power-law continuum, a soft excess below 2 keV, and a double-peaked iron emission feature in the 6-7 keV range. We investigate the possibility that the double-peaked emission might represent the characteristic signature of the accretion disc. Detailed investigations show that a moderately broad accretion disc line is most likely present, but that the peaks may be due to narrower components from more distant material. The peaks at 6.4 and 7 keV can be identified, respectively, with the molecular torus in active galactic nucleus unification schemes, and very highly ionized, optically thin gas filling the torus. The X-ray variability spectra on both long (~100 ks) and short (~1 ks) time-scales do not support the recent suggestion that the soft excess is an artefact of variable, moderately ionized absorption. © 2007 The Authors. Journal compilation © 2007 RAS.

Spatial autocorrelation in the response of soft-bottom marine benthos to gas extraction activities: The case of amphipods in the Ionian Sea

The spatial distributions of marine fauna and of pollution are both highly structured, and thus the resulting high levels of autocorrelation may invalidate conclusions based on classical statistical approaches. Here we analyse the close correlation observed between proxies for the disturbance associated with gas extraction activities and amphipod distribution patterns around four hydrocarbon platforms. We quantified the amount of variation independently accounted for by natural environmental variables, proxies for the disturbance caused by platforms, and spatial autocorrelation. This allowed us to demonstrate how each of these three factors significantly affects the community structure of amphipods. Sophisticated statistical techniques are required when taking into account spatial autocorrelation: nevertheless our data demonstrate that this approach not only enables the formulation of robust statistical inferences but also provides a much deeper understanding of the subtle interactions between human disturbance and natural factors affecting the structure of marine invertebrates communities. (C) 2012 Elsevier Ltd. All rights reserved.

Plasma polymerization of 2-iodothiophene

Continuous wave rf plasma polymerization of 2-iodothiophene has been studied using X-ray photoelectron spectroscopy (XPS), X-ray absorption near-edge spectroscopy (XANES), and Fourier transform infrared spectroscopy (FTIR). The variation in plasma polymer stoichiometry and the extent of monomer fragmentation are found to be critically dependent upon the electrical discharge power.

Evaluation of a substructured soft Real-time Hybrid Test for performing Seismic analysis of complex structural systems

The hybrid test method is a relatively recently developed dynamic testing technique that uses numerical modelling combined with simultaneous physical testing. The concept of substructuring allows the critical or highly nonlinear part of the structure that is difficult to numerically model with accuracy to be physically tested whilst the remainder of the structure, that has a more predictable response, is numerically modelled. In this paper, a substructured soft-real time hybrid test is evaluated as an accurate means of performing seismic tests of complex structures. The structure analysed is a three-storey, two-by-one bay concentrically braced frame (CBF) steel structure subjected to seismic excitation. A ground storey braced frame substructure whose response is critical to the overall response of the structure is tested, whilst the remainder of the structure is numerically modelled. OpenSees is used for numerical modelling and OpenFresco is used for the communication between the test equipment and numerical model. A novel approach using OpenFresco to define the complex numerical substructure of an X-braced frame within a hybrid test is also presented. The results of the hybrid tests are compared to purely numerical models using OpenSees and a simulated test using a combination of OpenSees and OpenFresco. The comparative results indicate that the test method provides an accurate and cost effective procedure for performing
full scale seismic tests of complex structural systems.

A laboratory based model study. Experimental observations of footings supported on soft clay reinforced with granular columns.

The inclusion of granular columns in soft clay deposits leads to improvements in bearing capacity and overall stiffness along with a reduction in consolidation settlement. Many laboratory investigations have focused on aspects of bearing capacity, but published data on settlement performance is limited. This paper reports on some interesting findings obtained from a laboratory model study in respect of these issues. In this investigation, 300 mm diameter by 400 mm long samples of soft kaolin clay were reinforced with single or multiple granular columns of various lengths using the displacement and replacement installation methods. The experimental findings revealed that, for the same area replacement ratio, limited settlement reduction was achieved for single long floating columns and end-bearing column groups. Marginal improvements in settlement performance were also achieved for columns installed by the displacement method. No settlement reduction was achieved for short single floating columns while short floating granular column groups produced increased settlements. These observations were verified using contact pressure measurements between the footing and column/surrounding clay.