Expert Review and Consensus on the Treat-to-Target Management of Hereditary Angioedema: From Scientific Evidence to Clinical Practice

Background: Hereditary angioedema with C1 inhibitor deficiency (HAE-C1INH) is a rare disease characterized by swelling episodes. It affects quality of life (QOL) and can be fatal when the upper airways are involved. Treatment is individualized, with therapeutic options including on-demand treatment (ODT) and short- and long-term prophylaxis (STP, LTP). However, available guidelines are not always clear about the selection of treatment, the goals of treatment, or how achievement of these goals is assessed. Objective: To review available evidence for the management of HAE-C1INH and build a Spanish expert consensus to steer management towards a treat-to-target approach, while addressing some of the less clear aspects of the Spanish guidelines. Methods: We reviewed the literature on the treat-to-target management of HAE-C1INH, focusing on treatment selection and goals and the tools available to assess whether the goals have been achieved. We discussed the literature based on clinical experience and drew up 45 statements on undefined management aspects. A panel of 53 HAE experts validated the statements through a 2-round Delphi process. Results: The goals for ODT and STP are to minimize the morbidity and mortality of attacks and to prevent attacks caused by known triggers, respectively, while the main goal of LTP is to decrease the rate, severity, and duration of attacks. Furthermore, when prescribing, clinicians should consider the reduction in adverse effects, while increasing patient QOL and satisfaction. Appropriate instruments for assessing achievement of treatment goals are also indicated. Conclusions: We provide recommendations on previously unclear aspects of HAE-C1INH management with ODT, STP, and LTP, focusing on clinical and patient-oriented goals

Genome-wide discovery and development of polymorphic microsatellites from Leishmania panamensis parasites circulating in central Panama

The parasite Leishmania panamensis is the main cause of leishmaniasis in Panama. The disease is largely uncontrolled, with a rising incidence and no appropriate control measures. While microsatellites are considered some of the best genetic markers to study population genetics and molecular epidemiology in these and other parasites, none has been developed for L. panamensisThe parasite Leishmania panamensis is the main cause of leishmaniasis in Panama. The disease is largely uncontrolled, with a rising incidence and no appropriate control measures. While microsatellites are considered some of the best genetic markers to study population genetics and molecular epidemiology in these and other parasites, none has been developed for L. panamensi

Electrical properties of individual tin oxide nanowires contacted to platinum electrodes

A simple and useful experimental alternative to field-effect transistors for measuring electrical properties free electron concentration nd, electrical mobility , and conductivity in individual nanowires has been developed. A combined model involving thermionic emission and tunneling through interface states is proposed to describe the electrical conduction through the platinum-nanowire contacts, fabricated by focused ion beam techniques. Current-voltage I-V plots of single nanowires measured in both two- and four-probe configurations revealed high contact resistances and rectifying characteristics. The observed electrical behavior was modeled using an equivalent circuit constituted by a resistance placed between two back-to-back Schottky barriers, arising from the metal-semiconductor-metal M-S-M junctions. Temperature-dependent I-V measurements revealed effective Schottky barrier heights up to BE= 0.4 eV

Betacoronavirus genomes: How genomic information has been used to deal with past outbreaks and the COVID-19 pandemic

In the 21st century, three highly pathogenic betacoronaviruses have emerged, with an alarming rate of human morbidity and case fatality. Genomic information has been widely used to understand the pathogenesis, animal origin and mode of transmission of betacoronaviruses in the aftermath of the 2002-03 severe acute respiratory syndrome (SARS) and 2012 Middle East respiratory syndrome (MERS) outbreaks. Furthermore, genome sequencing and bioinformatic analysis have had an unprecedented relevance in the battle against the 2019-20 coronavirus disease 2019 (COVID-19) pandemic, the newest and most devastating outbreak caused by a coronavirus in the history of mankind, allowing the follow up of disease spread and transmission dynamics in near real time. Here, we review how genomic information has been used to tackle outbreaks caused by emerging, highly pathogenic, betacoronavirus strains, emphasizing on SARS-CoV, MERS-CoV and SARS-CoV-2.In the 21st century, three highly pathogenic betacoronaviruses have emerged, with an alarming rate of human morbidity and case fatality. Genomic information has been widely used to understand the pathogenesis, animal origin and mode of transmission of betacoronaviruses in the aftermath of the 2002-03 severe acute respiratory syndrome (SARS) and 2012 Middle East respiratory syndrome (MERS) outbreaks. Furthermore, genome sequencing and bioinformatic analysis have had an unprecedented relevance in the battle against the 2019-20 coronavirus disease 2019 (COVID-19) pandemic, the newest and most devastating outbreak caused by a coronavirus in the history of mankind, allowing the follow up of disease spread and transmission dynamics in near real time. Here, we review how genomic information has been used to tackle outbreaks caused by emerging, highly pathogenic, betacoronavirus strains, emphasizing on SARS-CoV, MERS-CoV and SARS-CoV-2

Live synthesis of selective carbon dots as fluorescent probes for cobalt determination in water with an automatic microanalyzer

Altres ajuts: acords transformatius de la UABA new strategy integrating the straight synthesis of carbon dots (CDs) and their direct use for the determination of heavy metals by means of fuorescence quenching is presented. The proposal consists of a modular analyzer, which includes a low temperature co-fred ceramics (LTCC) microreactor for the synthesis of CDs and a cyclic olefn copolymer (COC) microfuidic platform, which automatically performs a reverse fow injection analysis (rFIA) protocol for the determination of heavy metal ions in water by CD fuorescence quenching. As a proof of concept, nitrogen-doped CDs were synthesized from acrylic acid and ethylenediamine (ED) with quantum yields (QYs) of up to 44%, which are selective to cobalt. With the described system, we synthesized homogeneous CDs without the need for further purifcation and with the minimum consumption of reagents, and optimized fuorescence measurements can be performed with freshly obtained luminescent nanomaterials that have not undergone decomposition processes. They have an averagehydrodynamic diameter of 4.2±0.9 nm and maximum excitation and emission wavelengths at 358 nm and 452 nm, respectively. The system allows the automatic dilution and bufering of the synthesized CDs and the sample prior to the determination of cobalt. The concentration of cobalt was determined with good sensitivity and a limit of detection of 7 μg·L−1 with a linear range of 0.02-1 mg·L−1 of Co2+. Spiked tap water and river water samples were analyzed, obtaining recovery from 98 to 104%. This demonstrates the potential of the equipment as an efcient on-site control system for heavy metal monitoring in water

Adaptation of Cu(In, Ga)Se2 photovoltaics for full unbiased photocharge of integrated solar vanadium redox flow batteries

The integration of photovoltaics and vanadium redox flow batteries (VRFBs) is a promising alternative for the direct conversion and storage of solar energy in a single device, considering their inherent higher energy density versus other redox pairs. However, this integration is not seamless unless the photovoltaic system is customized to the voltage needs of the battery, which unlike artificial photosynthesis, continuously increase with the state-of-charge. We have developed an integrated solar VRFB with adapted low-cost Cu(In, Ga)Se2 modules of 3 and 4 series-connected cells (solar efficiency of mini-solar module 8.1%), and considering the voltage requirements (1.3-1.6 V), we have evaluated the influence of the photovoltaic operation region on the final efficiency of the solar VRFB. Full unbiased photocharge under 1 Sun illumination has been achieved resulting in high energy (77%), solar-to-charge (7.5%) and overall round trip energy conversion efficiencies (5.0%) exceeding the values reported in the literature for other solar VRFBs, thus demonstrating the feasibility and intrinsic potential of adapting low-cost commercial photovoltaics to such energy storage systems