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Background: Kidney transplantation (KT) is the treatment of choice for patients with end-stage renal disease (ESRD). General organ donor shortage remains an important limitation on KT, given the increasing number of patients waiting for transplantation. This has led to the adoption of different strategies to increase the pool of donors, such as ABO incompatible (ABOi) living KT. In this single center study, we retrospectively evaluated all donor/recipient pairs proposed for ABOi KT since the beginning of this transplantation program in our hospital in 2014. Methods: Between November 2014 and March 2022, 609 deceased donor and 223 living donor KT were performed in our center. Seventy-one donor/recipient pairs were proposed for ABOi KT and were evaluated for ABO/Rh group, Coombs tests, human leukocyte antigen (HLA) type I (A, B, C) and II (DR) high resolution genotyping and receptor to donor isoagglutinin titers and HLA antibodies. Recipients with immunoglobulins G (IgG) and/or M (IgM) isoagglutinin titers > 1:512 and/or with HLA donor specific alloantibodies (DSAs) were excluded from the ABOi transplantation program. Isoagglutinins removal was performed recurring to therapeutic plasma exchange (TPE) and/or immunoadsorption techniques. Transplanted patients were evaluated for demographic data, diagnosis, relationship with donor, sessions of antibodies removal, pre- and post-KT isoagglutinin titers, graft function, transfusion support, significant complications and overall patient survival. Results: Eighteen patients (14 males and 4 females) were transplanted with an ABOi graft out of 71 ABOi studied pairs. Median baseline IgG and IgM isoagglutinin titers were 1:32 (min 1:2, max 1:256) and 1:8 (min 1:2, max 1:32), respectively. Fifteen patients (83.3%) had pre-KT TPE and/or immunoadsorption sessions for isoagglutinin removal (mean 2.4 ± 1.8 session per patient). Seven patients (36.8%) were submitted to post-KT TPE (mean 1.9 ± 3.2 session per patient). No acute antibody mediated rejection was observed and overall graft survival was 100% on a follow-up period between 3 and 92 months (47.6 ± 25.2 months). All patients were dialysis-free with serum creatinine steady levels (median 1.4 mg/dL) at 47.6 ± 25.2 months of follow up. Conclusion: These results confirm that ABOi KT is a viable treatment for patients with ESRD, thus expanding living donor pool and reducing access time to transplantation.

In a new era for digital health, dry electrodes for biopotential measurement enable the monitoring of essential vital functions outside of specialized healthcare centers. In this paper, a new type of nanostructured titanium-based thin film is proposed, revealing improved biopotential sensing performance and overcoming several of the limitations of conventional gel-based electrodes such as reusability, durability, biocompatibility, and comfort. The thin films were deposited on stainless steel (SS) discs and polyurethane (PU) substrates to be used as dry electrodes, for non-invasive monitoring of body surface biopotentials. Four different Ti–Me (Me = Al, Cu, Ag, or Au) metallic binary systems were prepared by magnetron sputtering. The morphology of the resulting Ti–Me systems was found to be dependent on the chemical composition of the films, specifically on the type and amount of Me. The existence of crystalline intermetallic phases or glassy amorphous structures also revealed a strong influence on the morphological features developed by the different systems. The electrodes were tested in an in-vivo study on 20 volunteers during sports activity, allowing study of the application-specific characteristics of the dry electrodes, based on Ti–Me intermetallic thin films, and evaluation of the impact of the electrode–skin impedance on biopotential sensing. The electrode–skin impedance results support the reusability and the high degree of reliability of the Ti–Me dry electrodes. The Ti–Al films revealed the least performance as biopotential electrodes, while the Ti–Au system provided excellent results very close to the Ag/AgCl reference electrodes.

BackgroundRare pathogenic variants in either the ITGA2B or ITGB3 genes have been linked to autosomal dominant macrothrombocytopenia associated with abnormal platelet production and function, deserving the designation of Glanzmann Thrombasthenia-Like Syndrome (GTLS) or ITGA2B/ITGB3-related thrombocytopenia.ObjectivesTo describe a series of patients with familial macrothrombocytopenia and decreased expression of αIIbβ3 integrin due to defects in the ITGA2B or ITGB3 genes.MethodsWe reviewed the clinical and laboratory records of 10 Portuguese families with GTLS (33 patients and 11 unaffected relatives), including the functional and genetic defects.ResultsPatients had absent to moderate bleeding, macrothrombocytopenia, low αIIbβ3 expression, impaired platelet aggregation/ATP release to physiological agonists and low expression of activation-induced binding sites on αIIbβ3 (PAC-1) and receptor-induced binding sites on its ligand (bound fibrinogen), upon stimulation with TRAP-6 and ADP. Evidence for constitutive αIIbβ3 activation, occurred in 2 out of 9 patients from 8 families studied, but also in 2 out of 12 healthy controls. We identified 7 missense variants: 3 in ITGA2B (5 families), and 4 in ITGB3 (5 families). Three variants (αIIb: p.Arg1026Trp and p.Arg1026Gln and β3: p.Asp749His) were previously reported. The remaining (αIIb: p.Gly1007Val and β3: p.Thr746Pro, p.His748Pro and p.Arg760Cys) are new, expanding the αIIbβ3 defects associated with GTLS. The integration of the clinical and laboratory data allowed the identification of two GTLS subgroups, with distinct disease severity.ConclusionsPreviously reported ITGA2B and ITGB3 variants related to thrombocytopenia were clustered in a confined region of the membrane-proximal cytoplasmic domains, the inner membrane clasp. For the first time, variants are reported at the outer membrane clasp, at the transmembrane domain of αIIb, and at the membrane distal cytoplasmic domains of β3. This is the largest single-center series of inherited macrothrombocytopenia associated with αIIbβ3 variants published to date.

In a new era for digital health, dry electrodes for biopotential measurement enable the monitoring of essential vital functions outside of specialized healthcare centers. In this paper, a new type of nanostructured titanium-based thin film is proposed, revealing improved biopotential sensing performance and overcoming several of the limitations of conventional gel-based electrodes such as reusability, durability, biocompatibility, and comfort. The thin films were deposited on stainless steel (SS) discs and polyurethane (PU) substrates to be used as dry electrodes, for non-invasive monitoring of body surface biopotentials. Four different Ti–Me (Me = Al, Cu, Ag, or Au) metallic binary systems were prepared by magnetron sputtering. The morphology of the resulting Ti–Me systems was found to be dependent on the chemical composition of the films, specifically on the type and amount of Me. The existence of crystalline intermetallic phases or glassy amorphous structures also revealed a strong influence on the morphological features developed by the different systems. The electrodes were tested in an in-vivo study on 20 volunteers during sports activity, allowing study of the application-specific characteristics of the dry electrodes, based on Ti–Me intermetallic thin films, and evaluation of the impact of the electrode–skin impedance on biopotential sensing. The electrode–skin impedance results support the reusability and the high degree of reliability of the Ti–Me dry electrodes. The Ti–Al films revealed the least performance as biopotential electrodes, while the Ti–Au system provided excellent results very close to the Ag/AgCl reference electrodes. [ABSTRACT FROM AUTHOR]

We compute the renormalized energy-momentum tensor of a free scalar field coupled to gravity on an (n + 1)-dimensional Einstein static universe (ESU), {\bb R}\times S^n , with arbitrary low energy effective operators (up to mass dimension n + 1). A generic class of regulators is used, together with the Abel-Plana formula, leading to a manifestly regulator independent result. The general structure of the divergences is analysed to show that all the gravitational couplings (not just the cosmological constant) are renormalized for an arbitrary regulator. Various commonly used methods (damping function, point-splitting, momentum cut-off and zeta function) are shown to, effectively, belong to the given class. The final results depend strongly on the parity of n. A detailed analytical and numerical analysis is performed for the behaviours of the renormalized energy density and a quantity s which determines if the strong energy condition holds for the 'quantum fluid'. We briefly discuss the quantum fluid backreaction problem, via the higher dimensional Friedmann and Raychaudhuri equations, observe that equilibrium radii exist and unveil the possibility of a 'Casimir stabilization of Einstein static universes'. [ABSTRACT FROM AUTHOR]