Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

Using GPGPU techniques to accelerate modelling of ultrasonic systems

[EN] The development of acoustic field simulation in real time for non destructive ultrasonic evaluation applications would be an useful tool for both the planning and evaluation of inspections in-situ. However, they are algorithms which require high computing power, not due to their complexity but because of the large number of points to be analysed, which limits their use to laboratory workstations for high performance. The parallelization resources currently available in computer systems, such as multicore processors and GPGPU techniques, are a very interesting chance for the development of such applications. This work analyses the parallelization model of both alternatives in order to develop a portable ultrasonic field simulation system for real-time. The changes for both algorithms are described, in order to adapt it to GPGPU philosophy and a estimation of the computational cost of both implementations is given.[ES] El desarrollo de sistemas de simulación de campo acústico en tiempo real para aplicaciones de Evaluación no Destructiva ultrasónica constituiría una herramienta muy útil tanto para la planificación de las inspecciones como para la interpretación de los resultados de evaluaciones in-situ. Sin embargo, son algoritmos que requieren una alta capacidad de cómputo, no tanto por su complejidad sino por el gran número de puntos a analizar, lo que limita su uso al laboratorio sobre estaciones de trabajo de altas prestaciones. Los recursos de paralelización que actualmente ofrecen los sistemas informáticos, como son los procesadores multicore o las técnicas GPGPU, constituyen una oportunidad muy interesante para el desarrollo de este tipo de aplicaciones. Este trabajo analiza el modelo de paralelización de ambas alternativas con objeto de desarrollar un sistema portable de simulación de campo ultrasónico para tiempo real. Se describen por tanto los cambios en el algoritmo de cálculo de campo acústico para adaptarlo a una estrategia GPGPU y se valora el coste computacional de ambas implementaciones.Este trabajo está apoyado por el Ministerio de Economía y Competitividad a través del proyecto DPI2010-19376 y la beca BES-2008-008675.Romero Laorden, D.; Martínez Graullera, O.; Martín Argueda, C.; Pérez, M.; Ullate, L. (2012). Técnicas GPGPU para acelerar el modelado de sistemas ultrasónicos. Revista Iberoamericana de Automática e Informática industrial. 9(3):282-289. https://doi.org/10.1016/j.riai.2012.05.002OJS28228993Cea, 2003. Civa: Simulation software for non destructive testing.Choi, J.-H. L. S.-W., 2000. A parametric study of ultrasonic beam profiles for a linear phased array transducer. IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control 47, 644-650.E. Lindholm, J. Nickolls, S., Montrym, J., 2008. Nvidia tesla: A unified graphics and computing architecture. IEEE Micro 28 (2), 39-55.J. Nickolls, I. Buck, M.G., Skadron, K., 2008. Scalable parallel programming with cuda. Queue 6 (2), 40-53.Jensen, J., 1991. A model for the propagation and scattering of ultrasound in tissue. J. Acoust. Soc. Am. N. 89 (1), 182-190.Kino, G.S., 1987. Acoustic Waves, devices, imaging and analog signal processing. Prentice-Hall.Nvidia, 2012a. Gtx680 kepler white paper. Nvidia, Enero 2012b. Guía de Programación de CUDA 4.1.Pinar Crombie, e., 1997. Calculating the pulsed response of linear arrays accuracy versus computational effciency. IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control 44, 997-1009.Piwakowsky, B., Sbai, K., 1999. A new approach to calculate the field radiated from arbitrary structuredtransducer arrays. IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control 46 (2), 422-439.Romero-Laorden, David, e., Mar. 2011. Field modelling acceleration on ultrasonic systems using graphic hardware. Computer Physics Communications 182 (3), 590-599. DOI: 10.1016/j.cpc.2010.10.032.Smith, S.W., 1998. Digital Signal Processing. Analog Devices.Steinberg, B.D., 1976. Principles of Aperture and Array System Design.Wiley- Interscience

Primary Melanoma of the CNS in Children Is Driven by Congenital Expression of Oncogenic NRAS in Melanocytes

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Early Post-treatment Prostate-specific Antigen at 4 Weeks and Abiraterone and Enzalutamide Treatment for Advanced Prostate Cancer: An International Collaborative Analysis

Background: Declines in prostate-specific antigen (PSA) levels at 12 wk are used to evaluate treatment response in metastatic castration-resistant prostate cancer (mCRPC). PSA fall by ≥30% at 4 wk (PSA4w30) has been reported to be associated with better outcome in a single-centre cohort study. Objective: To evaluate clinical relevance of early PSA decline in mCRPC patients treated with next-generation hormonal treatments (NGHTs) such as abiraterone and enzalutamide. Design, setting, and participants: This was a retrospective multicentre analysis. Eligible patients received NGHT for mCRPC between 6 January 2006 and 31 December 2017 in 13 cancer centres worldwide, and had PSA levels assessed at baseline and at 4 and/or 12 wk after treatment. PSA response was defined as a ≥30% decline (progression as a ≥25% increase) from baseline. Outcome measurements and statistical analysis: Association with overall survival (OS) was analysed using landmark multivariable Cox regression adjusting for previous chemotherapy, including cancer centre as a shared frailty term. Results and limitations: We identified 1358 mCRPC patients treated with first-line NGHT (1133 had PSA available at 4 wk, and 948 at both 4 and 12 wk). Overall, 583 (52%) had a PSA4w30; it was associated with longer OS (median: 23; 95% confidence interval [CI]: 21–25) compared with no change (median: 17; 95% CI: 15–18) and progression (median: 13; 95% CI: 10–15). A PSA12w30 was associated with lower mortality (median OS 22 vs 14; hazard ratio = 0.57; 95% CI = 0.48–0.67; p < 0.001). PSA4w30 strongly correlated with PSA12w30 (ρ = 0.91; 95% CI = 0.90–0.92; p < 0.001). In total, 432/494 (87%) with a PSA4w30 achieved a PSA12w30. Overall, 11/152 (7%) patients progressing at 4 wk had a PSA12w30 (1% of the overall population). Conclusions: PSA changes in the first 4 wk of NGHT therapies are strongly associated with clinical outcome from mCRPC and can help guide early treatment switch decisions. Patient summary: Prostate-specific antigen changes at 4 wk after abiraterone/enzalutamide treatment are important to determine patients’ outcome and should be taken into consideration in clinical practice.SCOPUS: ar.jinfo:eu-repo/semantics/publishe