HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers

The presence of anti-human leucocyte antigen (HLA) antibodies in the potential solid organ transplant recipient’s blood is one of the main barriers to access to a transplantation. The HLA sensitization is associated with longer waitlist time, antibody mediated rejection and transplant lost leading to increased recipient’s morbidity and mortality. However, solid organ transplantation across the HLA immunological barriers have been reported in recipients who were highly sensitized to HLA using desensitization protocols. These desensitization regimens are focused on the reduction of circulating HLA antibodies. Despite those strategies improve rates of transplantation, it remains several limitations including persistent high rejection rate and worse long-term outcomes when compare with non-sensitized recipient population. Currently, interest is growing in the development of new desensitization approaches which, beyond targeting antibodies, would be based on the modulation of alloimmune pathways. Plasma cells appears as an interesting target given their critical role in antibody production. In the last decade, CD38-targeting immunotherapies, such as daratumumab, have been recognized as a key component in the treatment of myeloma by inducing an important plasma cell depletion. This review focuses on an emerging concept based on targeting CD38 to desensitize in the field of transplantation.

Forward Osmosis as Concentration Process: Review of Opportunities and Challenges

In the past few years, osmotic membrane systems, such as forward osmosis (FO), have gained popularity as “soft” concentration processes. FO has unique properties by combining high rejection rate and low fouling propensity and can be operated without significant pressure or temperature gradient, and therefore can be considered as a potential candidate for a broad range of concentration applications where current technologies still suffer from critical limitations. This review extensively compiles and critically assesses recent considerations of FO as a concentration process for applications, including food and beverages, organics value added compounds, water reuse and nutrients recovery, treatment of waste streams and brine management. Specific requirements for the concentration process regarding the evaluation of concentration factor, modules and design and process operation, draw selection and fouling aspects are also described. Encouraging potential is demonstrated to concentrate streams more than 20-fold with high rejection rate of most compounds and preservation of added value products. For applications dealing with highly concentrated or complex streams, FO still features lower propensity to fouling compared to other membranes technologies along with good versatility and robustness. However, further assessments on lab and pilot scales are expected to better define the achievable concentration factor, rejection and effective concentration of valuable compounds and to clearly demonstrate process limitations (such as fouling or clogging) when reaching high concentration rate. Another important consideration is the draw solution selection and its recovery that should be in line with application needs (i.e., food compatible draw for food and beverage applications, high osmotic pressure for brine management, etc.) and be economically competitive.

Ultrahigh water permeation with high multivalent metal ions rejection rate through graphene oxide membranes

Graphene oxide (GO) membranes show exceptional molecular permeation properties and have gained tremendous attention in the area of wastewater treatment. However, they still suffer from some limitations, such as low water permeance when the ion rejection rate is at a satisfactory level and unstable performance. Here, we develop a sort of GO membrane that exhibits ultrahigh water permeance up to 75.2 L m−2 h−1 bar−1 while still maintaining a high rejection rate of 99.9% for multivalent metal ions. Importantly, of all state-of-the-art nanofiltration membranes, this is the most permeable membrane with a satisfactory level of rejection rate for multivalent ions. Furthermore, the GO membrane has outstanding stability over long-time operation. Our work provides a simple way to fabricate GO membranes with outstanding water purification performance.

Evaluation of a Novel Ear Pulse Oximeter: Towards Automated Oxygen Titration in Eyeglass Frames

Current oxygen delivery modes lack monitoring and can be cumbersome for patients with chronic respiratory diseases. Integrating a pulse oximeter and nasal oxygen cannulas into eyeglasses would reduce the burden of current solutions. An ear pulse oximeter (OxyFrame) was evaluated on 16 healthy volunteers and 20 hypoxemic patients with chronic respiratory diseases undergoing a prespecified protocol simulating daily activities. Correlation, error, and accuracy root mean square error (ARMS) were calculated to compare SpO2 measured by OxyFrame, a standard pulse oximeter (MASIMO), and arterial blood gas analysis (aBGA). SpO2 measured by OxyFrame and MASIMO correlated strongly in volunteers, with low error and high accuracy (r = 0.85, error = 0.2 ± 2.9%, ARMS = 2.88%). Performances were similar in patients (r = 0.87, error 0 ± 2.5%, ARMS = 2.49% compared with MASIMO; and r = 0.93, error = 0.4 ± 1.9%, ARMS = 1.94% compared with aBGA). However, the percentage of rejected measurements was high (volunteers 77.2%, patients 46.9%). The OxyFrame cavum conchae pulse oximeter was successfully evaluated, and demonstrated accurate SpO2 measurements, compliant with ISO 80601-2-61:2017. Several reasons for the high rejection rate were identified, and potential solutions were proposed, which might be valuable for optimization of the sensor hardware.

Improved Performance of Polysulfone Ultrafiltration Membrane Using TCPP by Post-Modification Method

Ultrafiltration (UF) membranes have found great application in sewage purification and desalination due to their high permeation flux and high rejection rate for contaminants under low-pressure conditions, but the flux and antifouling ability of UF membranes needs to be improved. Tetrakis (4-carboxyphenyl) porphyrin (TCPP) has good hydrophilicity, and it is protonated under strongly acidic conditions and then forms strong hydrogen bonds with N, O and S, so that the TCPP would be well anchored in the membrane. In this work, NaHCO3 was used to dissolve TCPP and TMC (trimesoyl chloride) was used to produce a strong acid. Then, TCPP was modified in a membrane with a different rejection rate by a method similar to interfacial polymerization. Performance tests of TCPP/polysulfone (PSf) membranes show that for the membrane with a high BSA (bovine serum albumin) rejection, when the ratio of NaHCO3 to TCPP is 16:1 (wt.%), the pure water flux of membrane Z1 16:1 is increased by 34% (from 455 to 614 Lm−2h−1bar−1) while the membrane retention was maintained above 95%. As for the membrane with a low BSA rejection, when the ratio of NaHCO3 to TCPP was 32:1, the rejection of membrane B2 32:1 was found to increase from 81% to 96%. Although the flux of membrane B2 32:1 decreased, it remained at 638 Lm−2h−1bar−1, which is comparable to the reported polymer ultrafiltration membrane. The above dual results are thought to be attributed to the synergistic effect of protonated TCPP and NaHCO3, where the former increases membrane flux and the latter increases the membrane rejection rate. This work provides a way for the application of porphyrin and porphyrin framework materials in membrane separation.

Guatemala's Giammattei will face immediate challenges

Significance The victory of Giammattei, of the opposition Vamos grouping, marks a win for conservative forces in Guatemala and a high rejection rate for Torres. However, a high abstention rate and a weak position in the legislature will undermine Giammattei from the start, signalling a weak presidency dependent on legislative alliances. Giammattei will take office in January 2020, with the intervening months likely to see the appointment of his cabinet and clarification of his immediate policy agenda. Impacts Giammattei’s election means the mandate of the International Commission Against Impunity in Guatemala is set to end in September. The outgoing president is likely to leave Guatemala as soon as his term ends, given ongoing corruption investigations. Bilateral relations with the United States will depend on the outcome of the controversial “safe third country” migration deal.