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Contains fulltext : 290814.pdf (Publisher’s version ) (Open Access) Owing to the vulnerability of patients with chronic kidney disease to infectious diseases, the coronavirus disease 2019 (COVID-19) pandemic has been particularly devastating for the nephrology community. Unfortunately, the possibility of future COVID-19 waves or outbreaks of other infectious diseases with pandemic potential cannot be ruled out. The nephrology community made tremendous efforts to contain the consequences of the COVID-19 pandemic. Despite this, the COVID-19 pandemic has highlighted several shortcomings in our response to the pandemic and has taught us important lessons that can be utilized to improve our preparedness for any future health crises of a similar nature. In this article we draw lessons from the European Renal Association COVID-19 Database (ERACODA) project, a pan-European collaboration initiated in March 2020 to understand the prognosis of COVID-19 in patients on kidney function replacement therapy. We discuss the challenges faced in generating timely and robust evidence for informed management of patients with kidney disease and give recommendations for our preparedness for the next pandemic in Europe. Limited collaboration, the absence of common data architecture and the sub-optimal quality of available data posed challenges in our response to COVID-19. Aligning different research initiatives, strengthening electronic health records, and involving experts in study design and data analysis will be important in our response to the next pandemic. The European Renal Association may take a leading role in aligning research initiatives via its engagement with other scientific societies, national registries, administrators and researchers.

Purpose of this article is to demonstrate the "Operation Rainbow Canada" cleft lip revision technique. This is a surgical technique used by Operation Rainbow Canada on volunteer surgical missions in developing nations. We show how to convert previous Millard or straight line cleft lip repairs to a Fisher anatomic subunit repair, placing a favourable scar along the philtrum. We show a case series of results and explain how this technique gives satisfying aesthetic results for patients seeking unilateral cleft lip revision.This technique combines the principles of the anatomic subunit repair for primary cleft lip repair as described by Fisher and the correction of the cleft nose deformity as described by McComb. We apply these 2 techniques to unilateral cleft lip revision at the same operation.Patients for revision unilateral lip and nose deformities were treated with this technique over the course of several international surgical missions. There were over 90 cases of revisions performed by our group on previous repaired cleft lips. These procedures were done in India, China, and Cambodia.Previously repaired cleft lips can be improved by our revision procedure. We show how incorporating 2 triangular flaps to lengthen the cleft side of the repaired lip can be done in a revision setting. During lip revision, McCombs sutures can be placed to improve the aesthetic of the nose and correct the nasal alar dome.Le présent article vise à enseigner la technique de correction de la fente labiale d’Operation Rainbow Canada. L’organisme utilise cette technique lors des missions chirurgicales de volontaires dans les pays en développement. Les chercheurs démontrent comment convertir la technique de Millard et la technique en ligne droite en une réparation sous-unitaire anatomique de Fisher, pour former une cicatrice favorable le long du sillon sous-nasal. Ils présentent les observations d’une série de cas et expliquent que cette technique donne des résultats esthétiques pour les patients qui veulent faire corriger une fente palatine unilatérale.La présente technique combine les principes des sous-unités anatomiques pour réparer les fentes palatines primaires décrites par Fisher et la correction de la fente palatine décrite par McComb. Les chercheurs appliquent ces deux techniques à la correction d’une fente labiale unilatérale lors de la même opération.La technique a été utilisée auprès de patients qui devaient faire corriger une fente labiale et palatine unilatérale dans le cadre de plusieurs missions chirurgicales internationales. Le groupe a effectué plus de 90 corrections de fentes palatines déjà réparées en Inde, en Chine et au Cambodge.Les fentes labiales déjà réparées peuvent être améliorées grâce à une intervention de correction. Les auteurs démontrent comment intégrer deux lambeaux triangulaires pour allonger le côté réparé de la lèvre. Pendant cette correction de la lèvre, on peut utiliser des sutures de McCombs pour améliorer l’esthétique du nez et corriger les dômes des cartilages alaires nasaux.

The western is a cultural phenomenon of the U.S., but the genealogy of its ideology—aristocratic honor, courage, and justice—extends back to ages of conquest and stories of heroes like Beowulf, Achilles, and Odysseus. Audiences in the infancy of the western craved an idealism taken from the white knight of medieval kingdoms, a hero known as the cowboy, whom they believed, built the country. Deirdre McCloskey argues that the modern world, not just the U.S., was built on a recasted set of ideals, a bourgeois ethic that is cause of our material improvement over last 300 years. The American ideology that attracts audiences to the western is thus at odds with the ideology in McCloskey’s economic history. Altogether independently, David Milch exploits this mismatch of ideas in the HBO series Deadwood (2004-2006). He creates a world that likewise challenges the ideology that the U.S. was built on aristocratic conquest. The transition from an aristocratic to a bourgeois ethical system plays out in the first 14 episodes of Deadwood, culminating in a classic showdown that the hero in a western must win. The questions are, who is the hero, who is the villain, and how did the hero win?