Costs and effects of on-demand treatment of hereditary angioedema in Italy : a prospective cohort study of 167 patients

Objectives To explore treatment behaviours in a cohort of Italian patients with hereditary angioedema due to complement C1-inhibitor deficiency (C1-INH-HAE), and to estimate how effects and costs of treating attacks in routine practice differed across available on-demand treatments. Design Cost analyses and survival analyses using attack-level data collected prospectively for 1 year. Setting National reference centre for C1-INH-HAE. Participants 167 patients with proved diagnosis of C1-INH-HAE, who reported data on angioedema attacks, including severity, localisation and duration, treatment received, and use of other healthcare services. Interventions Attacks were treated with either icatibant, plasma-derived C1-INH (pdC1-INH) or just supportive care. Main outcome measures Treatment efficacy in reducing attack duration and the direct costs of acute attacks. Results Overall, 133 of 167 patients (79.6%) reported 1508 attacks during the study period, with mean incidence of 11 attacks per patient per year. Only 78.9% of attacks were treated in contrast to current guidelines. Both icatibant and pdC1-INH significantly reduced attack duration compared with no treatment (median times from onset 7, 10 and 47 hours, respectively), but remission rates with icatibant were 31% faster compared with pdC1-INH (HR 1.31, 95% CI 1.14 to 1.51). However, observed treatment behaviours suggest patterns of suboptimal dosing for pdC1-INH. The average cost per attack was \u20ac1183 (SD \u20ac789) resulting in \u20ac1.58 million healthcare costs during the observation period (\u20ac11 912 per patient per year). Icatibant was 54% more expensive than pdC1-INH, whereas age, sex and prophylactic treatment were not associated to higher or lower costs. Conclusions Both icatibant and pdC1-INH significantly reduced attack duration compared with no treatment, however, icatibant was more effective but also more expensive. Treatment behaviours and suboptimal dosing of pdC1-INH may account for the differences, but further research is needed to define their role

Durability assessment of external thermal insulation composite systems in urban and maritime environments

Funding Information: The authors acknowledge the Portuguese Foundation for Science and Technology (FCT) for funding the research project PTDC/ECI-EGC/30681/2017 (WGB_Shield – Shielding building facades for cities revitalization. Triple resistance to water, graffiti and biocolonization of external thermal insulation systems), the research units CERIS ( UIDB/04625/2020 ), CERENA ( UIDB/04028/2020 ) and iBB ( UIDP/04565/2020 ), the Associate Laboratory Institute for Health and Bioeconomy – i4HB ( LA/P/0140/2020 ), and the Ph.D. scholarship 2020.05180.BD (J. L. Parracha). The authors also acknowledge CIN, Saint-Gobain and Secil for the material supply and the Portuguese Institute for Sea and Atmosphere (IPMA) for the meteorological data. Funding Information: The authors acknowledge the Portuguese Foundation for Science and Technology (FCT) for funding the research project PTDC/ECI-EGC/30681/2017 (WGB_Shield – Shielding building facades for cities revitalization. Triple resistance to water, graffiti and biocolonization of external thermal insulation systems), the research units CERIS (UIDB/04625/2020), CERENA (UIDB/04028/2020) and iBB (UIDP/04565/2020), the Associate Laboratory Institute for Health and Bioeconomy – i4HB (LA/P/0140/2020), and the Ph.D. scholarship 2020.05180.BD (J. L. Parracha). The authors also acknowledge CIN, Saint-Gobain and Secil for the material supply and the Portuguese Institute for Sea and Atmosphere (IPMA) for the meteorological data. Publisher Copyright: © 2022 Elsevier B.V.External Thermal Insulation Composite Systems (ETICS) are multilayer solutions which provide an enhanced thermal performance to the building envelope. However, significant anomalies can be detected on ETICS facades, in some cases shortly after the application of these systems. This study intends to evaluate and compare the durability of six commercially available ETICS after two years of outdoor exposure at both urban and maritime conditions in Portugal. The systems were characterized by means of non-destructive testing (i.e., visual and microscopic assessment, water transport properties, thermal conductivity, surface roughness), thus allowing to evaluate the performance loss throughout natural aging. The bio-susceptibility and aesthetic properties (color and gloss) were also investigated. Results showed that the performance and durability of the complete system is significantly affected by the rendering system formulation. The lime-based specimens obtained the highest rate of mold development after one year of aging in a maritime environment, becoming considerably darker and with lower surface gloss. Fungal analysis of this darkish stained area indicated the presence of mold species of the genera Alternaria, Didymella, Cladosporium and Epicoccum, and yeasts of the genera Vishniacozyma and Cystobasidium. An increase of both capillary water absorption and water vapor permeability was also registered for the aged lime-based specimens. Acrylic-based systems obtained lower capillary water absorption after aging and greater dirt deposition on their surfaces, especially in urban conditions. These systems had also higher color variation and surface gloss decrease and slightly higher mold growth, when compared with those aged in a maritime environment. Finally, no mold growth was detected on the silicate-based specimens after two years of aging. However, these specimens obtained higher capillary water absorption and lower vapor permeability after aging, possibly leading to moisture accumulation within the system. Results contribute towards the development of ETICS with enhanced performance and durability.publishersversionpublishe

Parity transitions in the superconducting ground state of hybrid InSb-Al Coulomb islands

The number of electrons in small metallic or semiconducting islands is quantized. When tunnelling is enabled via opaque barriers this number can change by an integer. In superconductors the addition is in units of two electron charges (2e), reflecting that the Cooper pair condensate must have an even parity. This ground state (GS) is foundational for all superconducting qubit devices. Here, we study a hybrid superconducting-semiconducting island and find three typical GS evolutions in a parallel magnetic field: a robust 2e-periodic even-parity GS, a transition to a 2e-periodic odd-parity GS,and a transition from a 2e- to a 1e-periodic GS. The 2e-periodic odd-parity GS persistent in gate-voltage occurs when a spin-resolved subgap state crosses zero energy. For our 1e-periodic GSs we explicitly show the origin being a single zero-energy state gapped from the continuum, i.e. compatible with an Andreev bound states stabilized at zero energy or the presence of Majorana zero modes

Farinhas integrais de banana verde prata e nanica: potencial de aplicação na alimentação humana.

bitstream/item/215181/1/farinha-de-banana-verde.pd

Extrusion Cooking using Fruits Peels, Whole Cereals and Grains.

Mini review

Federico Cesi's Mycological Codex and its copies

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Mapping research activity on mental health disorders in Europe: Study protocol for the Mapping_NCD project

© 2016 The Author(s). Background: Mental health disorders (MHDs) constitute a large and growing disease burden in Europe, although they typically receive less attention and research funding than other non-communicable diseases (NCDs). This study protocol describes a methodology for the mapping of MHD research in Europe as part of Mapping_NCD, a 2-year project funded by the European Commission which seeks to map European research funding and impact for five NCDs in order to identify potential gaps, overlaps, synergies and opportunities, and to develop evidence-based policies for future research. Methods: The project aims to develop a multi-focal view of the MHD research landscape across the 28 European Union Member States, plus Iceland, Norway and Switzerland, through a survey of European funding entities, analysis of research initiatives undertaken in the public, voluntary/not-for-profit and commercial sectors, and expert interviews to contextualize the gathered data. The impact of MHD research will be explored using bibliometric analyses of scientific publications, clinical guidelines and newspaper stories reporting on research initiatives. Finally, these research inputs and outputs will be considered in light of various metrics that have been proposed to inform priorities for the allocation of research funds, including burden of disease, treatment gaps and cost of illness. Discussion: Given the growing burden of MHDs, a clear and broad view of the current state of MHD research is needed to ensure that limited resources are directed to evidence-based priority areas. MHDs pose a particular challenge in mapping the research landscape due to their complex nature, high co-morbidity and varying diagnostic criteria. Undertaking such an effort across 31 countries is further challenged by differences in data collection, healthcare systems, reimbursement rates and clinical practices, as well as cultural and socioeconomic diversity. Using multiple methods to explore the spectrum of MHD research funding activity across Europe, this project aims to develop a broad, high-level perspective to inform priority setting for future research