A multistate model and its standalone tool to predict hospital and ICU occupancy by patients with COVID-19

Objective: This study aims to build a multistate model and describe a predictive tool for estimating the daily number of intensive care unit (ICU) and hospital beds occupied by patients with coronavirus 2019 disease (COVID-19). Material and methods: The estimation is based on the simulation of patient trajectories using a multistate model where the transition probabilities between states are estimated via competing risks and cure models. The input to the tool includes the dates of COVID-19 diagnosis, admission to hospital, admission to ICU, discharge from ICU and discharge from hospital or death of positive cases from a selected initial date to the current moment. Our tool is validated using 98,496 cases positive for severe acute respiratory coronavirus 2 extracted from the Aragón Healthcare Records Database from July 1, 2020 to February 28, 2021. Results: The tool demonstrates good performance for the 7- and 14-days forecasts using the actual positive cases, and shows good accuracy among three scenarios corresponding to different stages of the pandemic: 1) up-scenario, 2) peak-scenario and 3) down-scenario. Long term predictions (two months) also show good accuracy, while those using Holt-Winters positive case estimates revealed acceptable accuracy to day 14 onwards, with relative errors of 8.8%. Discussion: In the era of the COVID-19 pandemic, hospitals must evolve in a dynamic way. Our prediction tool is designed to predict hospital occupancy to improve healthcare resource management without information about clinical history of patients. Conclusions: Our easy-to-use and freely accessible tool (https://github.com/peterman65) shows good performance and accuracy for forecasting the daily number of hospital and ICU beds required for patients with COVID-19

Processing reflectivity and Doppler velocity from EarthCARE's cloud-profiling radar: the C-FMR, C-CD and C-APC products

The Earth Clouds, Aerosols and Radiation (EarthCARE) satellite mission is a joint effort by the European Space Agency (ESA) and the Japanese Aerospace Exploration Agency (JAXA). The EarthCARE mission features the first spaceborne 94 GHz cloud-profiling radar (CPR) with Doppler capability. The raw CPR observations and auxiliary information are used as input to three Level-2 (L2) algorithms: (1) C-APC: Antenna Pointing Characterization; (2) C-FMR: CPR feature mask and reflectivity; (3) C-CD: Corrected CPR Doppler Measurements. These algorithms apply quality control and corrections to the CPR primary measurements and derive important geophysical variables, such as hydrometeor locations, and best estimates of particle sedimentation fall velocities. The C-APC algorithm uses natural targets to introduce any corrections needed to the CPR raw Doppler velocities due to the CPR antenna pointing. The C-FMR product provides the feature mask based on only-reflectivity CPR measurements and quality-controlled radar-reflectivity profiles corrected for gaseous attenuation at 94 GHz. In addition, C-FMR provides best estimates of the path-integrated attenuation (PIA) and flags identifying the presence of multiple scattering in the CPR observations. Finally, the C-CD product provides the quality-controlled, bias-corrected mean Doppler velocity estimates (Doppler measurements corrected for antenna mispointing, non-uniform beam filling and velocity folding). In addition, the best estimate of the particle sedimentation velocity is estimated using a novel technique.</p

The Campo de Dalias GNSS Network Unveils the Interaction between Roll-Back and Indentation Tectonics in the Gibraltar Arc

The Gibraltar Arc includes the Betic and Rif Cordilleras surrounding the Alboran Sea; it is formed at the northwest–southeast Eurasia–Nubia convergent plate boundary in the westernmost Mediterranean. Since 2006, the Campo de Dalias GNSS network has monitored active tectonic deformation of the most seismically active area on the north coast of the Alboran Sea. Our results show that the residual deformation rates with respect to Eurasia range from 1.7 to 3.0 mm/year; roughly homogenous west-southwestward displacements of the northern sites occur, while the southern sites evidence irregular displacements towards the west and northwest. This deformation pattern supports simultaneous east-northeast–west-southwest extension, accommodated by normal and oblique faults, and north-northwest–south-southeast shortening that develops east-northeast–west-southwest folds. Moreover, the GNSS results point to dextral creep of the main northwest–southeast Balanegra Fault. These GNNS results thus reveal, for the first time, present-day interaction of the roll-back tectonics of the Rif–Gibraltar–Betic slab in the western part of the Gibraltar Arc with the indentation tectonics affecting the eastern and southern areas, providing new insights for improving tectonic models of arcuate orogens.Junta de Andalucia; European Regional Development Fund; grant numbers: AGORA P18-RT-3275, PAPEL B-RNM-301-UGR18. Programa Operativo FEDER-Andalucia 2014–2020 Project ref. 1263446; University of Jaén; CEACTEMA; grant number: POAIUJA 21/22. Junta de Andalucía (Andalusian Board); grant numbers: RNM-148, RNM-282, RNM-370. V.T.S. was supported by the FPU PhD grant (16/04038)

Small Bowel Enteroscopy - A Joint Clinical Guideline by the Spanish and Portuguese Small-Bowel Study Groups

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly.info:eu-repo/semantics/publishedVersio

Geodetic fault slip rates on active faults in the Baza sub-Basin (SE Spain): Insights for seismic hazard assessment

One of the most significant parameters for seismic hazard assessment analyses is the fault slip rate. The combination of both geological (long-term) and geodetic (short-term) data offers a more complete characterization of the seismic potential of active faults. Moreover, geodetic data are also a helpful tool for the analysis of geodynamic processes. In this work, we present the results of a local GPS network from the Baza sub-Basin (SE Spain). This network, which includes six sites, was established in 2008 and has been observed for seven years. For the first time, we obtain short-term slip rates for the two active faults in this area. For the normal Baza Fault, we estimate slip rates ranging between 0.3 ± 0.3 mm/yr and 1.3 ± 0.4 mm/yr. For the strike-slip Galera Fault, we quantify the slip rate as 0.5 ± 0.3 mm/yr. Our GPS study shows a discrepancy for the Baza Fault between the short-term slip rates and previously reported long-term rates. This discrepancy indicates that the fault could be presently in a period with a displacement rate higher than the mean of the magnitude 6 seismic cycle. Moreover, the velocity vectors that we obtained also show the regional tectonic significance of the Baza Fault, as this structure accommodates one-third of the regional extension of the Central Betic Cordillera. Our GPS-related slip rates form the basis for future seismic hazard analysis in this area. Our results have further implications, as they indicate that the Baza and Galera Faults are kinematically coherent and they divide the Baza sub-Basin into two tectonic blocks. This points to a likely physical link between the Baza and Galera Faults; hence, a potential complex rupture involving both faults should be considered in future seismic hazard assessment studies.We acknowledge the comments of Editor Prof. Irina M. Artemieva and two anonymous reviewers, which significantly improved the quality of this paper. This research was funded by the Spanish Ministry of Science, Innovation and University (Research Projects: RTI2018-100737-BI00 and CGL2016-80687-R), the University of Alicante (Research Project: VIGROB053), the University of Jaén (PAIUJA 2019-2020 and Programa Operativo FEDER Andalucía 2014-2020 - call made by UJA 2018), the University of Granada (B-RNM-301-UGR18) and the Junta de Andalucía regional government (RNM148, RNM282, and RNM370 and P18-RT-3275 research groups). We thank all observers who collected the data of survey-mode GPS measurements

Small bowel enteroscopy - A joint clinical guideline from the spanish and portuguese small bowel study groups

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.Estas recomendações baseadas na evidência detalham o uso da enteroscopia assistida por dispositivo no manejo clínico das doenças do intestino delgado. Um conjunto de Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e Português de intestino delgado para rever a evidência disponível sobre as principais indicações desta técnica, o seu papel nos algoritmos de manejo de cada indicação e sobre o seu rendimento diagnóstico e terapêutico. Foi gerado um conjunto de recomendações pelos autores

4kscore test, prostate cancer prevention trial-risk calculator y european research screening prostate-risk calculator en la predicción del cáncer de próstata de alto grado; estudio preliminar

Introducción: Frente al sobrediagnóstico y al sobretratamiento en cáncer de próstata (CaP) se establecen estrategias terapéuticas como la vigilancia activa o la terapia focal, o métodos para precisar el diagnóstico del CaP de alto grado (CaP-AG), Gleason = 7, como la resonancia magnética multiparamétrica o nuevos marcadores como el 4Kscore Test (4KsT).: Es nuestro propósito testar mediante un estudio piloto la capacidad del 4KsT como identificador de CaP-AG (suma de Gleason = 7) en biopsia de próstata (Bx) y compararlo con otros modelos pronósticos multivariantes disponibles, como el Prostate Cancer Prevention Trial-Risk Calculator 2.0 (PCPTRC 2.0) y el European Research Screening Prostate Cancer-Risk Calculator 4 (ERSPC-RC 4). Material y métodos: Cincuenta y un pacientes sometidos a BxP según práctica clínica habitual, con un mínimo de 10 cilindros. Diagnóstico de CaP-AG consensuado por 4 uropatólogos. Comparación de las predicciones ofrecidas por los diferentes modelos mediante prueba U Mann-Whitney, áreas bajo la curva ROC (AUC) (test de DeLong), funciones de densidad de probabilidad, diagramas de caja y curvas de utilidad clínica (CUC). Resultados: Un 43% presentaron CaP y un 23,5% CaP-AG. Las medianas de probabilidad de 4KsT, PCPTRC 2.0 y ERSPC-RC 4 fueron significativamente diferentes entre los pacientes con CaP-AG y no CaP-AG (p = 0,022), siendo más diferenciadas en el caso de 4KsT (mediana en CaP-AG: 51,5% [percentil 25-75: 25-80,5%], frente a 16% [P 25-75: 8-26,5%] en no CaP-AG [p = 0,002]). Todos los modelos mostraron AUC por encima de 0,7 sin diferencias significativas entre ninguno de ellos y 4KsT (p = 0,20). Las funciones de densidad de probabilidad y diagramas de caja muestran una buena capacidad discriminativa, especialmente en los modelos de ERSPC-RC 4 y 4KsT. Las CUC muestran como un punto de corte del 9% de 4KsT identifica a todos los CaP-AG y permite un ahorro del 22% de biopsias, similar a lo que ocurre con los modelos de ERSPC-RC 4 y un punto de corte del 3%. Conclusiones: Los modelos predictivos evaluados ofrecen una buena capacidad de discriminación del CaP-AG en Bx. 4KsT es un buen modelo clasificatorio en su conjunto, seguido de ERSPC-RC 4 y PCPTRC 2.0. Las CUC permiten sugerir puntos de corte de decisión clínica: 9% para 4KsT y 3% en ERSPC-RC 4. Este estudio preliminar debe ser interpretado con cautela por su limitado tamaño muestral. Introduction: To prevent the overdiagnosis and overtreatment of prostate cancer (PC), therapeutic strategies have been established such as active surveillance and focal therapy, as well as methods for clarifying the diagnosis of high-grade prostate cancer (HGPC) (defined as a Gleason score =7), such as multiparametric magnetic resonance imaging and new markers such as the 4Kscore test (4. KsT).By means of a pilot study, we aim to test the ability of the 4. KsT to identify HGPC in prostate biopsies (Bx) and compare the test with other multivariate prognostic models such as the Prostate Cancer Prevention Trial Risk Calculator 2.0 (PCPTRC 2.0) and the European Research Screening Prostate Cancer Risk Calculator 4 (ERSPC-RC 4). Material and methods: Fifty-one patients underwent a prostate Bx according to standard clinical practice, with a minimum of 10 cores. The diagnosis of HGPC was agreed upon by 4 uropathologists. We compared the predictions from the various models by using the Mann-Whitney U test, area under the ROC curve (AUC) (DeLong test), probability density function (PDF), box plots and clinical utility curves. Results: Forty-three percent of the patients had PC, and 23.5% had HGPC. The medians of probability for the 4. KsT, PCPTRC 2.0 and ERSPC-RC 4 were significantly different between the patients with HGPC and those without HGPC (p=.022) and were more differentiated in the case of 4. KsT (51.5% for HGPC 25-75 percentile: 25-80.5%] vs. 16% P 25-75: 8-26.5%] for non-HGPC; p = 002). All models presented AUCs above 0.7, with no significant differences between any of them and 4. KsT (p=.20). The PDF and box plots showed good discriminative ability, especially in the ERSPC-RC 4 and 4. KsT models. The utility curves showed how a cutoff of 9% for 4. KsT identified all cases of HGPC and provided a 22% savings in biopsies, which is similar to what occurs with the ERSPC-RC 4 models and a cutoff of 3%. Conclusions: The assessed predictive models offer good discriminative ability for HGPCs in Bx. The 4. KsT is a good classification model as a whole, followed by ERSPC-RC 4 and PCPTRC 2.0. The clinical utility curves help suggest cutoff points for clinical decisions: 9% for 4. KsT and 3% for ERSPC-RC 4. This preliminary study should be interpreted with caution due to its limited sample size

Automated Turbidimetry of Serum Lipoprotein(a)

We describe a simple iminunoturbidimetric method for quantifying lipoprotein(a) in serum based on latex-enhanced particle agglutination technology. Carboxylated latex particles (diameter 240 nm) covalently coated with F(ab')2 fragments of anti-lipoprotein(a) antibodies are incubated with the sample for 5 min at 37°C, and the resulting agglutination is quantified by measuring the change of turbidity produced at 700 nm. The assay is rapid, precise and fully automated on the Hitachi 911 analyser. The assay range is about 0.03—0.9 g/l. Average analytical recovery was 97.8%. Precision (CV) ranged from 1.9 to 3.1% at different lipoprotein(a) values. There was no interference from bilirubin, Intfalipid®, haemoglobin, plasminogen or apolipoprotein B. Comparisons with a latex nephelometric assay carried out on the Behring nephelometer analyser, and with three commercially available methods, a radioimmunoassay and two ELISA assays, gave good correlations (r > 0.95), although a large among-method variation in lipoprotein(a) values was found. We conclude that the proposed latex turbidimetric immunoassay method is suitable for routine use in clinical laboratories.Peer Reviewe