COVID-XNet: a custom Deep Learning system to diagnose and locate COVID-19 in chest X-ray images

The COVID-19 pandemic caused by the new coronavirus SARS-CoV-2 has changed the world as we know it. An early diagnosis is crucial in order to prevent new outbreaks and control its rapid spread. Medical imaging techniques, such as X-ray or chest computed tomography, are commonly used for this purpose due to their reliability for COVID-19 diagnosis. Computer-aided diagnosis systems could play an essential role in aiding radiologists in the screening process. In this work, a novel Deep Learning-based system, called COVID-XNet, is presented for COVID-19 diagnosis in chest X-ray images. The proposed system performs a set of preprocessing algorithms to the input images for variability reduction and contrast enhancement, which are then fed to a custom Convolutional Neural Network in order to extract relevant features and perform the classification between COVID-19 and normal cases. The system is trained and validated using a 5-fold cross-validation scheme, achieving an average accuracy of 94.43% and an AUC of 0.988. The output of the system can be visualized using Class Activation Maps, highlighting the main findings for COVID-19 in X-ray images. These promising results indicate that COVID-XNet could be used as a tool to aid radiologists and contribute to the fight against COVID-19.European Regional Development Fund COFNET TEC2016-77785-PAndalusian Regional (Spain) / FEDER Project PAIDI2020Andalusian Regional /FEDER PROMETEO AT17-5410-US

Effects of dose modifications on the safety and efficacy of dacomitinib for EGFR mutation-positive non-small-cell lung cancer

Aim: We evaluated reasons for dacomitinib dose reduction (DR) and examined adverse event (AE) incidence, key efficacy end points (progression-free survival [PFS]/overall survival [OS]), and pharmacokinetics in dose-reducing patients in the ARCHER 1050 trial. Patients & methods: Newly diagnosed patients with EGFR mutation-positive, advanced non-small-cell lung cancer received oral dacomitinib (45 mg once-daily [QD]), with stepwise toxicity-managing DR (30 and 15 mg QD) permitted. Results: Skin toxicities (62.7%) were the most common DR-leading AEs. The AE incidence and severity decreased following DRs. Initial plasma dacomitinib exposure (45 mg QD) was generally lower in patients remaining at 45 mg QD compared with dose-reducing patients. Median PFS and OS were similar in all dacomitinib-treated patients and dose-reducing patients. Conclusion: Tolerability-guided dose modifications enabled patients to continue with dacomitinib and benefit from PFS/OS improvement

Next generation flow for minimally-invasive blood characterization of MGUS and multiple myeloma at diagnosis based on circulating tumor plasma cells (CTPC)

© The Author(s) 2018.Here, we investigated for the first time the frequency and number of circulating tumor plasma cells (CTPC) in peripheral blood (PB) of newly diagnosed patients with localized and systemic plasma cell neoplasms (PCN) using next-generation flow cytometry (NGF) and correlated our findings with the distinct diagnostic and prognostic categories of the disease. Overall, 508 samples from 264 newly diagnosed PCN patients, were studied. CTPC were detected in PB of all active multiple myeloma (MM; 100%), and smoldering MM (SMM) patients (100%), and in more than half (59%) monoclonal gammopathy of undetermined significance (MGUS) cases (p <0.0001); in contrast, CTPC were present in a small fraction of solitary plasmacytoma patients (18%). Higher numbers of CTPC in PB were associated with higher levels of BM infiltration and more adverse prognostic features, together with shorter time to progression from MGUS to MM (p <0.0001) and a shorter survival in MM patients with active disease requiring treatment (p ≤ 0.03). In summary, the presence of CTPC in PB as assessed by NGF at diagnosis, emerges as a hallmark of disseminated PCN, higher numbers of PB CTPC being strongly associated with a malignant disease behavior and a poorer outcome of both MGUS and MM.This work has been supported by the International Myeloma Foundation-Black Swan Research Initiative and the EuroFlow Consortium; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC; Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Madrid, Spain and FONDOS FEDER), numbers: CB16/12/00400, CB16/12/00369, CB16/12/00489 and CB16/12/00233; grant SA079U14 from the Consejería de Educación, Junta de Castilla y León, Valladolid, Spain and; grant DTS15/00119 from Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Madrid, Spain. Acuerdo de colaboración con Fundación de Hemoterapia y Hemodonación de Castilla y León, Valladolid, Spain. This study was also supported by the Qatar National Research Fund (QNRF) Award No. 7-916-3-237, the AACR-Millennium Fellowship in Multiple Myeloma Research (15-40-38-PAIV), ERA-NET TRANSCAN-2 (iMMunocell), by a 2017 Leonardo Grant (BZG10931) for Researchers and Cultural Creators, BBVA Foundation, and the European Research Council (ERC) 2015 Starting Grant (MYELOMANEXT)

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Role of allogeneic hematopoietic cell transplant for relapsed/refractory aggressive B-cell lymphomas in the CART era

Anti-CD19 chimeric antigen receptor T cells (CART) has rapidly been adopted as the standard third-line therapy to treat aggressive B-cell lymphomas (ABCL) after failure of second-line therapy despite the lack of direct comparisons with allogeneic hematopoietic cell transplantation (alloHCT)-based strategies. Using the Grupo Español de Trasplante y Terapia Celular (GETH-TC) registry, we selected patients with the following characteristics: CART or alloHCT performed between 2016 and 2021; ≥18 years old; ABCL diagnosis; ≥2 lines of therapy; and either anti-CD19 CART or alloHCT as therapy at relapse. The analysis included a total of 316 (CART = 215, alloHCT = 101) patients. Median follow-up was 15 and 36 months for the CART and alloHCT cohorts, respectively. In the multivariate analysis, CART was confirmed to be similar to alloHCT for the primary study endpoint (progression-free survival) (hazard ratio [HR] 0.92, CI95%:0.56–1.51, p = 0.75). Furthermore, when the analysis was limited to only patients with chemo-sensitive diseases (complete and partial response) at infusion (CART = 26, alloHCT=93), no differences were reported (progression-free survival at month +18: 65% versus 55%, p = 0.59). However, CART had lower non-relapse mortality (HR 0.34, 95% CI: 0.13–0.85, p = 0.02). Given the lower toxicity and similar survival outcomes, these results suggest the use of CART before alloHCT.We thank CERCA Programme/Generalitat de Catalunya for institutional support.Peer reviewe

Co-limitation towards lower latitudes shapes global forest diversity gradients

The latitudinal diversity gradient (LDG) is one of the most recognized global patterns of species richness exhibited across a wide range of taxa. Numerous hypotheses have been proposed in the past two centuries to explain LDG, but rigorous tests of the drivers of LDGs have been limited by a lack of high-quality global species richness data. Here we produce a high-resolution (0.025° × 0.025°) map of local tree species richness using a global forest inventory database with individual tree information and local biophysical characteristics from ~1.3 million sample plots. We then quantify drivers of local tree species richness patterns across latitudes. Generally, annual mean temperature was a dominant predictor of tree species richness, which is most consistent with the metabolic theory of biodiversity (MTB). However, MTB underestimated LDG in the tropics, where high species richness was also moderated by topographic, soil and anthropogenic factors operating at local scales. Given that local landscape variables operate synergistically with bioclimatic factors in shaping the global LDG pattern, we suggest that MTB be extended to account for co-limitation by subordinate drivers

El cambio climático afecta el número de horas de los rangos térmicos del chile en el norte-centro de México

In Mexico, chili cultivation has a long cultural tradition and is one of the main centers of origin and domestication. An average of 97,306 ha is planted annually in the north of the country. However, the productivity of the chili crop is very erratic due to biotic and abiotic factors that occur during its development. Extreme temperatures and water availability are two of the dominant abiotic stressors. The objective of this work was to know the effect of global warming, on the thermal range of the chili crop. A historical analysis was performed on the variation of the number of hours with temperature inside and outside the thermal range of chili, and a similar analysis in the climatic scenarios 2050 and 2070 in the RCPs 4.5 and 8.5. Both in the historical analysis and in the climatologies we found positive and negative effects of global warming. Global warming will favor chilli cultivation with a surface increase (22.6%) with hourly temperature within development thresholds (15 to 32 °C) and a surface increase (15.8%) within the optimum temperature range (18 to 28 °C). Chili cultivation will be limited by the increase (20.8%) in the surface area with hourly temperature above the upper threshold (32 °C) and an increase (18.5%) in the area with a night time temperature above the upper threshold of night temperature (18 °C) in RCP 4.5 and in climatology 2050. High temperature stress will have an eff ect on the yield decrease due to the negative eff ect on pollination and fruit binding processes. Palabras clave: Capsicum annuum, global warming, hourly temperature, Mexico, RCP.En México el cultivo del chile tiene una larga tradición cultural y es uno de los principales centros de origen y domesticación, anualmente se siembran en promedio 97 306 ha en el Norte Centro del país. Sin embargo, la productividad del cultivo de chile es muy errática debido a factores bióticos y abióticos que se presentan durante su desarrollo. Temperaturas extremas y la disponibilidad de agua son dos de los factores de estrés abiótico dominantes. El objetivo de este trabajo fue conocer el efecto del calentamiento global, sobre el rango térmico del cultivo de chile. Se realizó un análisis histórico sobre la variación del número de horas con temperatura dentro y fuera del rango térmico de chile, y un análisis similar en los escenarios climáticos 2050 y 2070 en los RCP 4.5 y 8.5. Tanto en el análisis histórico como en las climatologías se encontraron efectos positivos y negativos del calentamiento global. El calentamiento global favorecerá al cultivo de chile con un aumento de la superficie (22.6%) con temperatura horaria dentro de los umbrales de desarrollo (15 a 32 °C) y un aumento de la superficie (15.8%) dentro del rango de temperatura óptima (18 a 28 °C). El cultivo de chile se verá limitado por el aumento (20.8%) de la superficie con temperatura horaria mayor al umbral superior (32 °C) y un aumento (18.5%) de la superficie con temperatura nocturna horaria mayor al umbral superior de temperatura nocturna (18 °C) en el RCP 4.5 y en la climatología 2050. El estrés por temperatura alta repercutirá en la disminución del rendimiento debido al efecto negativo en los procesos de polinización y amarre de frutos. Palabras clave: Capsicum annuum , calentamiento global, México, RCP, temperatura horaria

Diseño de un prototipo para un micro - concentrador solar

En éste trabajo aborda el diseño de un concentrador solar usado para micro generación eléctrica, considerando los aspectos teóricos y prácticos necesarios para su construcción. Los Sistemas de Concentración Solar permiten explotar el recurso solar a un menor costo/eficiencia que los paneles fotovoltaicos, además de ocupar un área menor para su funcionamiento. Entre algunas de sus aplicaciones destacan la generación de energía para la operación de motores solares, funcionando bajo el principio de apertura parabólica y concentración de calor en un punto focal. La electricidad se obtiene por generación directa de vapor, usando un fluido a alta presión y presión para impulsar turbinas generadoras, como en una central termoeléctrica a escala. La investigación en tecnologías de generación solar térmica, permite la existencia de prototipos ligeros y resistentes, capaces de funcionar a temperaturas sobre los 400 °C (Fernandez-Garcia et al., 2010). Se consideran dos aspectos que más influencia tienen para la  generación eléctrica solar: concentración de la radiación solar y seguimiento de la trayectoria solar. La metodología utilizada para el diseño y construcción del prototipo es el método propuesto por (Ullman, 2010), en el cual primero se identificarán las necesidades del diseño propuesto, después se desarrollarán especificaciones del prototipo, posteriormente se realizará un modelado matemático con la ayuda de los softwares: Catia V5R18, Dassault Systems, MPLAB IDE v 8.83, Microchip, Proteus Design Suite Labcenter Electronics, Matlab R2010, enseguida se realizará una caracterización del modelo

Diseño de un prototipo para un micro - concentrador solar

En éste trabajo aborda el diseño de un concentrador solar usado para micro generación eléctrica, considerando los aspectos teóricos y prácticos necesarios para su construcción. Los Sistemas de Concentración Solar permiten explotar el recurso solar a un menor costo/eficiencia que los paneles fotovoltaicos, además de ocupar un área menor para su funcionamiento. Entre algunas de sus aplicaciones destacan la generación de energía para la operación de motores solares, funcionando bajo el principio de apertura parabólica y concentración de calor en un punto focal. La electricidad se obtiene por generación directa de vapor, usando un fluido a alta presión y presión para impulsar turbinas generadoras, como en una central termoeléctrica a escala. La investigación en tecnologías de generación solar térmica, permite la existencia de prototipos ligeros y resistentes, capaces de funcionar a temperaturas sobre los 400 °C (Fernandez-Garcia et al., 2010). Se consideran dos aspectos que más influencia tienen para la generación eléctrica solar: concentración de la radiación solar y seguimiento de la trayectoria solar. La metodología utilizada para el diseño y construcción del prototipo es el método propuesto por (Ullman, 2010), en el cual primero se identificarán las necesidades del diseño propuesto, después se desarrollarán especificaciones del prototipo, posteriormente se realizará un modelado matemático con la ayuda de los softwares: Catia V5R18, Dassault Systems, MPLAB IDE v 8.83, Microchip, Proteus Design Suite Labcenter Electronics, Matlab R2010, enseguida se realizará una caracterización del modelo