The purpose of this paper is to look at the indicators to which a city can be considered to be a smart city based upon the degree it meets specific indicators within the categories of 'Social Smartness', 'Technological Smartness' and 'Environmental Smartness'. The data collection for this paper was conducted through desk research in academic and nonacademic articles and publications that focus on smart cities and their associated indicators. This study found out common factors based upon the indicators studied. 'Social Smartness' had a focus on the quality of life, civic engagement and wellbeing. 'Technological Smartness' was centric on flexible technology, well utilised and defined applied technology and data. 'Environmental Smartness' was focused on optimisation, waste management and sustainable thinking. This study offers possibilities to advance Lean thinking by looking at indicators to attribute a degree of 'Smartness' to cities which in turn will optimise the development and operation of a Smart City and Smart Districts.
Objective:
The arteriovenous fistula (AVF) is the preferred access type for hemodialysis, owing to its better patency rates and fewer complications. This study aimed to evaluate the outcome of percutaneous transluminal angioplasty in a failing arteriovenous fistula and arteriovenous graft in hemodialysis patients.
Methods:
Clinical data of patients who underwent percutaneous transluminal angioplasty in the vascular department of Aseer Central Hospitals, KSA, from January 2017 to May 2018 and with follow-up of >12 months were analyzed in retrospective cohort study.
Results:
Angioplasties were performed in 55 patients with fistulae, of which 18 patients had venous hypertension on dialysis and the remaining patients had weak or poor flow.
Conclusions:
Percutaneous transluminal angioplasty is an efficacious method for the correction of stenosis of arteriovenous fistulae for patients on hemodialysis, prolonging the patency of the fistula and enabling new interventions.
Highlights:
Risk stratification allows tailoring of treatment protocol using, for selected patients, reduced total chemotherapy exposure, including decreases in alkylator therapy and avoidance of agents with recognized risk of late complications (anthracyclines), elimination of irradiation and reduction of radiotherapy dose. Patients and Methods: Twenty-nine newly diagnosed pediatric rhabdomyosarcoma patients attended the pediatric oncology department between January 2008 and May 2011. Patients were divided into 3 groups according to age, stage, group, pathology and site of the tumor. Treatment protocol tailored according to risk group. Results: Twenty-nine newly diagnosed pediatric rhabdomyosarcoma patients were evaluated. Seven patients had low risk, Intermediate risk included 12 patients, and 10 patients had high risk. After three years median follow up, event free survival was 51.7% for all patients however it was 86%, 67% and 10% for low, intermediate and high risk respectively (P = 0.0002). There was statistical difference for survival among different sites, histology, clinical group and stage as risk factors within each risk group, no statistically survival significance of any of these factors within the same risk group. Conclusion: Risk stratification is the best single predictor factor for pediatric rhabdomyosarcoma and allows tailoring of the treatment protocol. For selected patients, reductions in total chemotherapy exposure, elimination of irradiation in selected low risk patients and reduction of radiotherapy dose according to postoperative margin and nodal status is safe
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