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Background: There has been growing interest in exploring combined interventions to achieve a more effective heparin-free treatment approach. Aim: to evaluate combination of interventions compared to standard practice (intermittent flushes) to prevent clotting and consequently reduce premature interruptions of hemodialysis. Methods: This open-label randomized controlled trial recruited chronic hemodialysis patients with contra-indication to systemic heparinization. Participants were randomized into one of five groups to receive different strategies of heparin-free hemodialysis treatment for up to three sessions. Primary endpoint: the successful completion of hemodialysis without clotting. Secondary outcomes: the clotting of the air traps assessed by a semi-quantitative scale, online KT/V, and safety of the interventions. Results: Forty participants were recruited and randomized between May and December 2020. Participants showed similar baseline biochemistry results and coagulation profiles. The highest success rates were observed in group 3 (heparin-coated dialyzers combined with intermittent flushes) (100%) and group 5 (hemodiafiltration with online predilution combined with heparin-coated dialyzers), with 91% vs. the control (intermittent flushes) (64%). Group 2 (heparin-coated dialyzers alone) had the poorest success rate, with 38% of the sessions being prematurely terminated due to clotting. KT/V and clotting scores were similar between groups. No adverse events related to the trial interventions were observed. Conclusions: The proposed combination of interventions may have had additive effects, leading to less frequent clotting and the premature termination of an HD/HDF session. Our study supports the feasibility of conducting a larger randomized controlled trial focusing on the efficacy of combined interventions for heparin-free HD in patients with a high risk of bleeding.

Background: Cladribine is a highly effective immunotherapy that is applied in two short-term courses over 2 years and reduces relapse rate and disease progression in patients with relapsing multiple sclerosis (MS). Despite the short treatment period, cladribine has a long-lasting effect on disease activity even after recovery of lymphocyte counts, suggesting a yet undefined long-term immune modulating effect. Objectives: Our aim was to provide a more profound understanding of the detailed effects of cladribine, also with regard to the patients’ therapy response. Design: We performed an open-labeled, explorative, prospective, single-arm study, in which we examined the detailed lymphocyte subset development of MS patients who received cladribine treatment over 2 years. Methods: We performed in-depth profiling of the effects of cladribine on peripheral blood lymphocytes by flow cytometry, bulk RNA sequencing of sorted CD4 + T cells, CD8 + T cells, and CD19 + B cells as well as single-cell RNA sequencing of peripheral blood mononuclear cells in a total of 23 MS patients before and at different time points up to 24 months after cladribine treatment. Data were correlated with clinical and cranial magnetic resonance imaging (MRI) disease activity. Results: Flow cytometry revealed a predominant and sustained reduction of memory B cells compared to other B cell subsets after cladribine treatment, whereas T cell subsets were slightly reduced in a more uniform pattern. The overall transcriptional profile of total blood B cells exhibited reduced expression of proinflammatory and T cell activating genes, while single-cell transcriptomics revealed that gene expression within each B cell cluster did not change over time. Stable patients displayed stronger reductions of selected memory B cell clusters as compared to patients with clinical or cerebral MRI disease activity. Conclusion: We describe a pronounced and sustained effect of cladribine on the memory B cell compartment, and the resulting change in B cell subset composition causes a significant alteration of B cell transcriptional profiles resulting in reduced proinflammatory and T cell activating capacities. The extent of reduction in selected memory B cell clusters by cladribine may predict treatment response.

Spectroscopic photoemission microscopy is used to detect and quantify a ponderomotive shift in the energy of electrons that are emitted from a surface plasmon polariton focus. The focus is formed on an atomically flat Au(111) surface by an Archimedean spiral and is spatiotemporally separated from the circularly polarized light pulse used to excite the spiral. A spectroscopic analysis of electrons emitted from the focus exhibits a peaked above-threshold electron emission spectrum. From the shift of the peaks as function of laser power the field strength of the surface plasmon polariton was quantitatively determined without free parameters. Estimations of the Keldysh parameter γ = 4.4 and the adiabaticity parameter δ = 4700 indicate that electron emission occurs in a regime of multiplasmon absorption and nonlocalized surface plasmon fields.

This article explores the way local states can challenge the process of housing financialization, by focusing on policy innovation for housing vulnerability. Building upon theoretical discourses that emphasize the influence of financial investors in shaping policy frameworks, we suggest that institutional settings that develop independently of financial logics and prioritize social policies can both incite shifts in financial investors' strategies and change the dynamics in the financialization of housing. This is the case even within rental systems where local states demonstrate limited capacity to intervene in housing markets. Using desk-based research and interviews with expert informants, this study investigates the way new municipalism policies have addressed housing vulnerability in Barcelona. It considers investors' responses to an institutional framework that prioritized social criteria, and interrogates the relation between housing policy and financial innovation. Key findings suggest that housing financialization is a dynamic process, contingent on the way different actors interrelate and mutually redefine power relations in housing affairs. [ABSTRACT FROM AUTHOR]

Background: There has been growing interest in exploring combined interventions to achieve a more effective heparin-free treatment approach. Aim: to evaluate combination of interventions compared to standard practice (intermittent flushes) to prevent clotting and consequently reduce premature interruptions of hemodialysis. Methods: This open-label randomized controlled trial recruited chronic hemodialysis patients with contra-indication to systemic heparinization. Participants were randomized into one of five groups to receive different strategies of heparin-free hemodialysis treatment for up to three sessions. Primary endpoint: the successful completion of hemodialysis without clotting. Secondary outcomes: the clotting of the air traps assessed by a semi-quantitative scale, online KT/V, and safety of the interventions. Results: Forty participants were recruited and randomized between May and December 2020. Participants showed similar baseline biochemistry results and coagulation profiles. The highest success rates were observed in group 3 (heparin-coated dialyzers combined with intermittent flushes) (100%) and group 5 (hemodiafiltration with online predilution combined with heparin-coated dialyzers), with 91% vs. the control (intermittent flushes) (64%). Group 2 (heparin-coated dialyzers alone) had the poorest success rate, with 38% of the sessions being prematurely terminated due to clotting. KT/V and clotting scores were similar between groups. No adverse events related to the trial interventions were observed. Conclusions: The proposed combination of interventions may have had additive effects, leading to less frequent clotting and the premature termination of an HD/HDF session. Our study supports the feasibility of conducting a larger randomized controlled trial focusing on the efficacy of combined interventions for heparin-free HD in patients with a high risk of bleeding. [ABSTRACT FROM AUTHOR]

London's housing crisis is rooted in a neo-liberal urban project to recommodify and financialise housing and land in a global city. But where exactly is the crisis heading? What future is being prepared for London's urban dwellers? How can we learn from other country and city contexts to usefully speculate about London's housing future? In this paper, we bring together recent evidence and insights from the rise of what we call ‘global corporate landlords’ (GCLs) in ‘post-crisis’ urban landscapes in North America and Europe to argue that London's housing crisis—and the policies and processes impelling and intervening in it—could represent a key moment in shaping the city's long-term housing future. We trace the variegated ways in which private equity firms and institutional investors have exploited distressed housing markets and the new profitable opportunities created by states and supra-national bodies in coming to the rescue of capitalism in the USA, Spain, Ireland and Greece in response to the global financial crisis of 2007–2008. We then apply that analysis to emerging developments in the political economy of London's housing system, arguing that despite having a very low presence in the London residential property market and facing major entry barriers, GCLs are starting to position themselves in preparation for potential entry points such as the new privatisation threat to public and social rented housing.

La producción de vivienda de interés social fue por diez años uno de los emblemas de la política ecuatoriana de la Revolución Ciudadana presidida por Rafael Correa. Desde el caso de Ecuador, se analiza cómo los gobiernos progresistas aplicaron políticas en el ámbito de la vivienda social y el desarrollo urbano. Este artículo rastrea qué escalas de aplicación tuvieron estas políticas sociales respecto al neoliberalismo, desde el punto de vista de las violencias y contestaciones que el proceso suscitó. En Quito, las familias se organizaron para obtener las viviendas prometidas tras años de espera. En Guayaquil, la violencia policial desplazó barrios enteros para concretar la renovación urbana mediante un plan ecológico. En Portoviejo, a partir del terremoto de 2016, se reconvirtió el centro y se desplazó la vivienda a la periferia. Desde una metodología mixta histórica, espacial y cualitativa, este análisis muestra las limitaciones de las propuestas de los gobiernos progresistas y la organización popular para evitar desplazamientos hacia las periferias.