Kidney transplantation after rescue allocation—meticulous selection yields the chance for excellent outcome

Background The small number of organ donors forces transplant centres to consider potentially suboptimal kidneys for transplantation. Eurotransplant established an algorithm for rescue allocation (RA) of kidneys repeatedly declined or not allocated within 5 h after procurement. Data on the outcomes and benefits of RA are scarce to date. Methods We conducted a retrospective 8-year analysis of transplant outcomes of RA offers based on our in-house criteria catalogue for acceptance and decline of organs and potential recipients. Results RA donors and recipients were both older compared with standard allocation (SA). RA donors more frequently had a history of hypertension, diabetes or fulfilled expanded criteria donor key parameters. RA recipients had poorer human leucocyte antigen (HLA) matches and longer cold ischaemia times (CITs). However, waiting time was shorter and delayed graft function, primary non-function and biopsy-proven rejections were comparable to SA. Five-year graft and patient survival after RA were similar to SA. In multivariate models accounting for confounding factors, graft survival and mortality after RA and SA were comparable as well. Conclusions Facing relevant comorbidities and rapid deterioration with the risk of being removed from the waiting list, kidney transplantation after RA was identified to allow for earlier transplantation with excellent outcome. Data from this survey propose not to reject categorically organs from multimorbid donors with older age and a history of hypertension or diabetes to aim for the best possible HLA matching and to carefully calculate overall expected CIT.

Evaluation of a Standardized Instrument for Post Hoc Analysis of Trauma-Team-Activation-Criteria in 75,613 Injured Patients An Analysis of the TraumaRegister DGU®

IntroductionIn order to improve the quality of criteria for trauma-team-activation it is necessary to identify patients who benefited from the treatment by a trauma team. Therefore, we evaluated a post hoc criteria catalogue for trauma-team-activation which was developed in a consensus process by an expert group and published recently. The objective was to examine whether the catalogue can identify patients that died after admission to hospital and therefore can benefit of a specialized trauma team mostly.Materials and MethodThe catalogue was applied to the data of 75,613 patients from the TraumaRegister DGU® between the 01/2007 and 12/2016 with a maximum Abbreviated Injury Score (AIS) severity ≥ 2. The endpoint was hospital mortality, which was defined as death before discharge from acute care.ResultsThe TraumaRegister DGU® dataset contains 18 of the 20 proposed criteria within the catalogue which identified 99.6% of the patients who were admitted to the trauma room following an accident and who died during their hospital stay. Moreover, our analysis showed that at least one criterion was fulfilled in 59,785 cases (79.1%). The average ISS in this group was 21.2 points (SD 9.9). None of the examined criteria applied to 15,828 cases (average ISS 8.6; SD 5). The number of consensus-based criteria correlated with the severity of injury and mortality. Of all deceased patients (8,451), only 31 (0.37%) could not be identified on the basis of the 18 examined criteria. Where only one criterion was fulfilled, mortality was 1.7%; with 2 or more criteria, mortality was at least 4.6%.DiscussionThe consensus-based criteria identified nearly all patients who died as a result of their injuries. If only one criterion was fulfilled, mortality was relatively low. However, it increased to almost 5% if two criteria were fulfilled. Further studies are necessary to analyse and examine the relative weighting of the various criteria.

Quality criteria catalogue for citizen science projects on Österreich forscht – Questionnaire for project managers

In the course of one year the working group for quality criteria of the Citizen Science Network Austria developed a catalogue of criteria for citizen science projectson the platform Österreich forscht. From this catalogue questions were generated, which should help the project leaders of projects in Austria to fulfil the criteria. By answering the questions, important topics are addressed during the implementation of a project and can thus also be considered by the project management. On the other hand, the answers help potential project participants to make an informed decision about participation on the basis of the information presented.Project leaders receive this catalogue of questions and send the answers back to Österreich forscht. The platform coordinators read the answers, consult with the Working Group for Quality Criteria if necessary and contact the project leaders in case of ambiguities for clarification and possible assistance. The aim of this processis not to exclude individual projects, but to jointly ensure the quality of the citizen science characteristics of the projects and eventually even increase them. An open dialogue and exchange and a respectful interaction between all participants is the prerequisite for this.

A Multi-Criteria Cataloging of the Immovable Items of Industrial Heritage of Andalusia

Any research in any field needs an initial background, and in the same way, any decision should be supported by previous knowledge and study of the problem and its context. In the case of the industrial heritage, both the study of the typology and the decision making about the actions of conservation and reutilization of its assets must be based on a deep knowledge of the set of elements that the typology includes. All of that refers to the corresponding territory being analyzed, since the intensity and productive tradition will be different between each territory, region, or country. In that context, this paper represents the continuation of the main research line of the authors, and exposes their efforts to develop a useful tool for the study, management, and cultural promotion of the assets related to industrial heritage in Spain through the development of a multi-criteria catalogue of assets. Thus, based on the initial catalogue developed by some of the authors, this paper significantly increases the number of assets considered. In addition, it includes new classification criteria, reviews the observed trends, and establishes the future lines of work and suitable strategies for these kinds of initiatives.

Geriatric Fracture Centre (German Trauma Society): guidelines and certification to improve geriatric trauma care

Because of demographic changes and the increasing proportion of orthogeriatric patients, the German Trauma Society (DGU) established a certification process for geriatric fracture centres (AltersTraumaZentrum DGU®). This article is a detailed illustration of the certification process and the related Registry. The main goal of the certification is to support orthogeriatric comanagement and to improve the quality of care for geriatric patients. The requirements of the Criteria Catalogue force participating centres to continuously survey and improve their standards and structures. As a result, the requirements should lead to a high quality of care. To prove that the certification leads to higher quality of care, the DGU started a Geriatric Fracture Registry (AltersTraumaRegister DGU®) in 2016, which is obligatory for all certified centres. Studies on comanaged care and the improvement of quality by certified geriatric fracture centres are planned. Further health-care research will also be possible with the collected data.

Reporting Experiments in Homeopathic Basic Research—Description of the Checklist Development

The objective of this study was to develop a criteria catalogue serving as a guideline for authors to improve quality of reporting experiments in basic research in homeopathy. A Delphi Process was initiated including three rounds of adjusting and phrasing plus two consensus conferences. European researchers who published experimental work within the last 5 years were involved. A checklist for authors provide a catalogue with 23 criteria. The “Introduction” should focus on underlying hypotheses, the homeopathic principle investigated and state if experiments are exploratory or confirmatory. “Materials and methods” should comprise information on object of investigation, experimental setup, parameters, intervention and statistical methods. A more detailed description on the homeopathic substances, for example, manufacture, dilution method, starting point of dilution is required. A further result of the Delphi process is to raise scientists' awareness of reporting blinding, allocation, replication, quality control and system performance controls. The part “Results” should provide the exact number of treated units per setting which were included in each analysis and state missing samples and drop outs. Results presented in tables and figures are as important as appropriate measures of effect size, uncertainty and probability. “Discussion” in a report should depict more than a general interpretation of results in the context of current evidence but also limitations and an appraisal of aptitude for the chosen experimental model. Authors of homeopathic basic research publications are encouraged to apply our checklist when preparing their manuscripts. Feedback is encouraged on applicability, strength and limitations of the list to enable future revisions.