UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) action plan

Eight million Ukrainians have taken refuge in the European Union. Many have asthma and/or allergic rhinitis and/or urticaria, and around 100,000 may have a severe disease. Cultural and language barriers are a major obstacle to appropriate management. Two widely available mHealth apps, MASK-air® (Mobile Airways Sentinel NetworK) for the management of rhinitis and asthma and CRUSE® (Chronic Urticaria Self Evaluation) for patients with chronic spontaneous urticaria, were updated to include Ukrainian versions that make the documented information available to treating physicians in their own language. The Ukrainian patients fill in the questionnaires and daily symptom-medication scores for asthma, rhinitis (MASK-air) or urticaria (CRUSE) in Ukrainian. Then, following the GDPR, patients grant their physician access to the app by scanning a QR code displayed on the physician's computer enabling the physician to read the app contents in his/her own language. This service is available freely. It takes less than a minute to show patient data to the physician in the physician's web browser. UCRAID—developed by ARIA (Allergic Rhinitis and its Impact on Asthma) and UCARE (Urticaria Centers of Reference and Excellence)—is under the auspices of the Ukraine Ministry of Health as well as European (European Academy of Allergy and Clinical immunology, EAACI, European Respiratory Society, ERS, European Society of Dermatologic Research, ESDR) and national societies

Patient-centered digital biomarkers for allergic respiratory diseases and asthma: The ARIA-EAACI approach – ARIA-EAACI Task Force Report

Biomarkers for the diagnosis, treatment and follow-up of patients with rhinitis and/or asthma are urgently needed. Although some biologic biomarkers exist in specialist care for asthma, they cannot be largely used in primary care. There are no validated biomarkers in rhinitis or allergen immunotherapy (AIT) that can be used in clinical practice. The digital transformation of health and health care (including mHealth) places the patient at the center of the health system and is likely to optimize the practice of allergy. Allergic Rhinitis and its Impact on Asthma (ARIA) and EAACI (European Academy of Allergy and Clinical Immunology) developed a Task Force aimed at proposing patient-reported outcome measures (PROMs) as digital biomarkers that can be easily used for different purposes in rhinitis and asthma. It first defined control digital biomarkers that should make a bridge between clinical practice, randomized controlled trials, observational real-life studies and allergen challenges. Using the MASK-air app as a model, a daily electronic combined symptom-medication score for allergic diseases (CSMS) or for asthma (e-DASTHMA), combined with a monthly control questionnaire, was embedded in a strategy similar to the diabetes approach for disease control. To mimic real-life, it secondly proposed quality-of-life digital biomarkers including daily EQ-5D visual analogue scales and the bi-weekly RhinAsthma Patient Perspective (RAAP). The potential implications for the management of allergic respiratory diseases were proposed

Digitally-enabled, patient-centred care in rhinitis and asthma multimorbidity: The ARIA-MASK-air® approach

MASK-air®, a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air® is a Good Practice of DG Santé on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air® results should lead to change management in rhinitis and asthma

Digitally‐Enabled, Patient‐Centred Care in Rhinitis and Asthma Multimorbidity: The ARIA‐MASK‐air ® Approach

MASK-air® , a validated mHealth app (Medical Device regulation Class IIa) has enabled large observational implementation studies in over 58,000 people with allergic rhinitis and/or asthma. It can help to address unmet patient needs in rhinitis and asthma care. MASK-air® is a Good Practice of DG Santé on digitally-enabled, patient-centred care. It is also a candidate Good Practice of OECD (Organisation for Economic Co-operation and Development). MASK-air® data has enabled novel phenotype discovery and characterisation, as well as novel insights into the management of allergic rhinitis. MASK-air® data show that most rhinitis patients (i) are not adherent and do not follow guidelines, (ii) use as-needed treatment, (iii) do not take medication when they are well, (iv) increase their treatment based on symptoms and (v) do not use the recommended treatment. The data also show that control (symptoms, work productivity, educational performance) is not always improved by medications. A combined symptom-medication score (ARIA-EAACI-CSMS) has been validated for clinical practice and trials. The implications of the novel MASK-air® results should lead to change management in rhinitis and asthma.info:eu-repo/semantics/publishedVersio

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

Stability of plant material after cryopreservation

W pracach poświęconych krioprezerwacji często pomija się weryfikację stabilności przechowywanych prób. Aby jednak było możliwe wprowadzenie tkanek do ciekłego azotu, konieczne jest ich wcześniejsze przygotowanie związane z zastosowaniem kultur in vitro, krioprotektantów oraz odwadniania. Te etapy procedury kriozabezpieczania mogą przyczynić się do wystąpienia zmienności. Może się ona objawiać na poziomie sekwencji DNA, ploidalności, aktywności metabolicznej i/lub fenotypu. Możliwe są także zmiany o charakterze epigenetycznym. Rzadko jednak się zdarza, aby zmiany te pojawiały się na wszystkich poziomach. Zwykle wykrywane są one na poziomie genetycznym (sekwencji DNA) lub epigenetycznym (metylacji cytozyny), rzadziej natomiast rzutują na fenotyp uzyskanych roślin. Zasadniczo nie obserwuje się zmian ploidalności czy zawartości jądrowego DNA. Zdarza się także, że obserwowana zmienność z czasem mija. Zwykle w celu weryfikacji stabilności materiału po krioprezerwacji wykorzystuje się markery molekularne. Tylko wyjątkowo w badaniach użyto dwa markery lub więcej. Obraz stabilności roślin po krioprezerwacji pozostaje więc wciąż nie w pełni poznany.Every year the number of the plant cultivars available is increasing. The new highly-efficient but scarce cultivars are replacing the previous, more numerous, ones. The old cultivars, however, constitute a very important source of genes for breeding. In order to prevent genetic erosion, it is essential to develop efficient long-term storage methods for countless cultivars and plant species. Today cryopreservation is believed to be the most effective technique; the plant material is stored in liquid nitrogen at –196°C. Cryopreservation has been developing rapidly since the 1940s. Over time several cryopreservation techniques have been developed. Long-standing studies have facilitated the optimization of cryopreservation protocols of numerous usable, ornamental, medicinal and threatened plant species in terms of high survival and recovery rates recorded after thawing. The genetic liquid-nitrogen-derived plants stability verification is, however, often neglected. A properly optimized procedure should not trigger any (negative) biological material alternations. It is generally assumed that storage in liquid nitrogen itself does not cause any changes in plant properties; Earth radiation not included. However, to make the intravital tissues storage at such low temperature possible, first a proper protection is required, which is associated with the application of in vitro cultures, chemical cryoprotectants and dehydration. Those steps may contribute to the occurrence of variation. Alternations affect the DNA sequence, chromosome number, ultrastructural, metabolic activity and/or phenotype levels. Epigenetic changes are also possible and sometimes they are even more frequent than the genetic ones. Such changes, however, are not observed at all levels at the same time. Usually they are detectable in the DNA sequence or at the cytosine methylation level. Phenotype alternations are less frequently described. In general cryopreservation affects neither the ploidy level nor the amount of nuclear DNA. It is sometimes observed that the variation intensity changes in time and occurs at specific developmental stages of the plant. Usually, in order to verify the stability of the plant material recovered after cryopreservation, molecular markers (RAPD, ISSR, AFLP etc.) are applied. It is uncommon to use more than one or two (usually molecular and cytogenetic) stability marker types. In the past phenotype markers were more popular, however today they are infrequently used. Still, even though they are time-consuming, phenotype markers provide valuable information, which is especially important with ornamental plants and chimeras, in particular. In general there is no complete information on plant stability after cryopreservation. A complex issue analysis is still required. The aim of this paper is to gather information on plant material stability after cryostorage

Indukcja embriogenezy somatycznej u Astrophytum asterias (Zucc.) Lem. w aspekcie wpływu warunków świetlnych oraz stężenia auksyny 2,4-D

Astrophytum asterias (Zucc.) Lem. is a cactus which is among those most desired by producers and collectors all across the world and, at the same time, a species threatened with extinction in the natural environment. Micropropagation techniques can be helpful both in terms of its ex situ protection and its popularisation on the market, thus satisfying the needs of cacti breeders and collectors. Somatic embryogenesis is the most effective method of multiplication and it involves the formation of somatic embryos from vegetative cells. The medium, light conditions and type of explant demonstrate the key effect on its efficiency. Auxin 2,4-D (2,4-Dichlorophenoxyacetic acid) is most frequently applied to embryogenesis induction. In the present study we determined the effect of its concentration and light conditions on the efficiency of Astrophytum asterias somatic embryogenesis. Seeds were placed on the modified MS medium with a reduced content of macronutrients and sucrose ½MS (pH 5.7 – before autoclaving). All the in vitro cultures were incubated in the growth room (24 ± 2°C, 16 h light/8 h dark photoperiod, the intensity of quantum irradiation: 24.3 μmol·m⁻²·s⁻¹). After 14 days 70% of the seeds were produced of seedlings. To regenerate somatic embryos, halves of green seedlings were placed on the modified MS medium with auxin 2,4-D added at different concentrations: 5; 7 and 10 mg·dm⁻³, the MS0 medium without growth regulators was our control. To verify the effect of light conditions, half of explants were incubated in the light, and half in the dark. After 10 weeks of culture, the regenerated embryos were isolated, counted and measured. They were produced on all the media types, in both light conditions. The present research confirmed a positive effect of 2,4-D and light on the number of explants forming embryoid structures and on the number of regenerating embryos. The most number of embryos per 1 explant (1.8) were obtained on the MS7 medium (7 mg·dm⁻³ 2,4-D) in the light conditions.Astrophytum asterias (Zucc.) Lem. jest jednym z najbardziej pożądanych przez producentów i kolekcjonerów kaktusów na świecie, a jednocześnie gatunkiem zagrożonym wyginięciem w środowisku naturalnym. Techniki mikrorozmnażania mogą być pomocne zarówno w jego ochronie ex situ, jak i przyczynić się do jego rozpowszechnienia na rynku, zaspokajając potrzeby hodowców i kolekcjonerów kaktusów. Embriogeneza somatyczna jest najefektywniejszą spośród metod mikrorozmnażania i polega na tworzeniu zarodków somatycznych z komórek wegetatywnych. Pożywka, warunki świetlne oraz rodzaj eksplantatu, mają kluczowy wpływ na jej wydajność. W indukcji embriogenezy najczęściej stosowaną jest auksyna 2,4-D (kwas 2,4-dichlorofenoksyoctowy). W badaniach określono wpływ jej stężenia i warunków świetlnych na wydajność embriogenezy somatycznej. Nasiona wykładano na zmodyfikowaną pożywkę MS o zredukowanej zawartości makroelementów oraz sacharozy ½MS (pH 5,7 – przed autoklawowaniem). Wszystkie kultury in vitro inkubowano w pokoju wzrostowym (24 ± 2°C, 16 h dzień/ 8 h noc fotoperiod, natężenie napromienienia kwantowego: 24,3 μmol·m⁻²·s⁻¹). Po 14 dniach z 70% nasion uzyskano siewki. W celu regeneracji zarodków somatycznych, połówki zielonych siewek wyłożono na zmodyfikowaną pożywkę MS z dodatkiem auksyny 2,4-D w stężeniu: 5; 7 i 10 mg·dm⁻³, kontrolę stanowiła pożywka MS0 bez regulatorów wzrostu. W celu zweryfikowania wpływu warunków świetlnych, połowa eksplantatów była inkubowana na świetle, a reszta w ciemności. Po 10 tygodniach trwania kultury wyizolowano, zliczono i zmierzono zregenerowane zarodki. Uzyskano je na wszystkich pożywkach w obu warunkach świetlnych. Badania własne potwierdziły pozytywny wpływ 2,4-D i światła na liczbę eksplantatów tworzących struktury embrioidalne oraz na liczbę regenerujących zarodków. Najwięcej zarodków na jedenym eksplantacie (1,8) otrzymano na pożywce MS7 w warunkach światła

Optymalizacja procedury krioprezerwacji chryzantemy wielkokwiatowej (Chrysanthemum × grandiflorum (Ramat.) Kitam.) metodą kapsułkowania-dehydratacji

To optimize the protocol, the shoot tips of Chrysanthemum × grandiflorum (Ramat.) Kitam. radiomutants have been cryopreserved using the encapsulationdehydration technique, following different approaches. In the experiment the influence of abscisic acid – ABA (0; 10; 20 and 30 μM), sucrose concentration (0.09; 0.25 and 0.5 M) and temperature (5ºC or 22ºC) during preculture were tested. Furthermore two dehydration methods, gradual and one-step, were considered. Since the best results were reported with 10 μM ABA + 0.09 M sucrose at room temperature and gradual dehydration, only this combination was selected for the next desiccation-adjustment step. From the time of air desiccation under laminar air-flow applied (0; 1; 2; 3; 4 and 5 hours), 3 hours provided the best results. Due to the growth inhibition on the hormone-free medium, the addition of plant growth regulators during that phase was also tested, confirming the need to apply cytokinins into the medium.W celu optymalizacji procedury pąki wierzchotkowe radiomutantów chryzantemy wielkokwiatowej pochodzące z różnych warunków kultury in vitro poddane zostały krioprezerwacji techniką kapsułkowania-dehydratacji. W trakcie doświadczenia zbadano wpływ kwasu abscysynowego – ABA (0; 10; 20 i 30 μM), stężenia sacharozy (0,09; 0,25 i 0,5 M) oraz temperatury (5ºC lub 22ºC) w trakcie prekultury. Uwzględnione zostały dwie metody dehydratacji (stopniowa i jednoetapowa). Ponieważ najlepsze wyniki uzyskano na pożywce zawierającej 10 μM ABA + 0,09 M sacharozy w temperaturze pokojowej i po zastosowaniu stopniowej dehydratacji, tylko tę kombinację wykorzystano w kolejnym etapie – optymalizacji czasu desykacji. Spośród zastosowanych okresów suszenia (0, 1, 2, 3, 4 i 5 godzin), suszenie przez 3 godziny zapewniło najlepsze wyniki. W związku z zahamowaniem wzrostu roślin na pożywce pozbawionej regulatorów wzrostu określono wpływ auksyn i cytokinin na ten proces, potwierdzając konieczność stosowania tych ostatnich