Design and characterisation of an additive manufacturing benchmarking artefact following a design-for-metrology approach

We present the design and characterisation of a high-speed sintering additive manufacturing benchmarking artefact following a design-for-metrology approach. In an important improvement over conventional approaches, the specifications and operating principles of the instruments that would be used to measure the manufactured artefact were taken into account during its design process. With the design-for-metrology methodology, we aim to improve and facilitate measurements on parts produced using additive manufacturing. The benchmarking artefact has a number of geometrical features, including sphericity, cylindricity, coaxiality and minimum feature size, all of which are measured using contact, optical and X-ray computed tomography coordinate measuring systems. The results highlight the differences between the measuring methods, and the need to establish a specification standards and guidance for the dimensional assessment of additive manufacturing parts

Dissecting the role of TP53 alterations in del(11q) chronic lymphocytic leukemia

© 2021 The Authors.[Background]: Several genetic alterations have been identified as driver events in chronic lymphocytic leukemia (CLL) pathogenesis and oncogenic evolution. Concurrent driver alterations usually coexist within the same tumoral clone, but how the cooperation of multiple genomic abnormalities contributes to disease progression remains poorly understood. Specifically, the biological and clinical consequences of concurrent high-risk alterations such as del(11q)/ATM-mutations and del(17p)/TP53-mutations have not been established.[Methods]: We integrated next-generation sequencing (NGS) and clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 techniques to characterize the in vitro and in vivo effects of concurrent monoallelic or biallelic ATM and/or TP53 alterations in CLL prognosis, clonal evolution, and therapy response.[Results]: Targeted sequencing analysis of the co-occurrence of high-risk alterations in 271 CLLs revealed that biallelic inactivation of both ATM and TP53 was mutually exclusive, whereas monoallelic del(11q) and TP53 alterations significantly co-occurred in a subset of CLL patients with a highly adverse clinical outcome. We determined the biological effects of combined del(11q), ATM and/or TP53 mutations in CRISPR/Cas9-edited CLL cell lines. Our results showed that the combination of monoallelic del(11q) and TP53 mutations in CLL cells led to a clonal advantage in vitro and in in vivo clonal competition experiments, whereas CLL cells harboring biallelic ATM and TP53 loss failed to compete in in vivo xenotransplants. Furthermore, we demonstrated that CLL cell lines harboring del(11q) and TP53 mutations show only partial responses to B cell receptor signaling inhibitors, but may potentially benefit from ATR inhibition.[Conclusions]: Our work highlights that combined monoallelic del(11q) and TP53 alterations coordinately contribute to clonal advantage and shorter overall survival in CLL.Spanish Fondo de Investigaciones Sanitarias, Grant/Award Numbers: PI15/01471, PI18/01500); Fundación Memoria Don Samuel Solórzano Barruso, Grant/Award Number: RD12/0036/006

TRAF3 alterations are frequent in del-3′IGH chronic lymphocytic leukemia patients and define a specific subgroup with adverse clinical features

Interstitial 14q32 deletions involving IGH gene are infrequent events in chronic lymphocytic leukemia (CLL), affecting less than 5% of patients. To date, little is known about their clinical impact and molecular underpinnings, and its mutational landscape is currently unknown. In this work, a total of 871 CLLs were tested for the IGH break-apart probe, and 54 (6.2%) had a 300 kb deletion of 3′IGH (del-3′IGH CLLs), which contributed to a shorter time to first treatment (TFT). The mutational analysis by next-generation sequencing of 317 untreated CLLs (54 del-3′IGH and 263 as the control group) showed high mutational frequencies of NOTCH1 (30%), ATM (20%), genes involved in the RAS signaling pathway (BRAF, KRAS, NRAS, and MAP2K1) (15%), and TRAF3 (13%) within del-3′IGH CLLs. Notably, the incidence of TRAF3 mutations was significantly higher in del-3′IGH CLLs than in the control group (p < .001). Copy number analysis also revealed that TRAF3 loss was highly enriched in CLLs with 14q deletion (p < .001), indicating a complete biallelic inactivation of this gene through deletion and mutation. Interestingly, the presence of mutations in the aforementioned genes negatively refined the prognosis of del-3′IGH CLLs in terms of overall survival (NOTCH1, ATM, and RAS signaling pathway genes) and TFT (TRAF3). Furthermore, TRAF3 biallelic inactivation constituted an independent risk factor for TFT in the entire CLL cohort. Altogether, our work demonstrates the distinct genetic landscape of del-3′IGH CLL with multiple molecular pathways affected, characterized by a TRAF3 biallelic inactivation that contributes to a marked poor outcome in this subgroup of patients.Funding information: Universidad de Salamanca; Fundación Española de Hematología y Hemoterapia (FEHH); Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Grant/Award Number: CB16/12/00233; Red Temática de Investigación Cooperativa en Cáncer (RTICC); “Fundación Memoria Don Samuel Solórzano Barruso”: FS/33–2020, Grant/Award Number: RD12/0036/0069; “Gerencia Regional de Salud, SACYL”:, Grant/Award Numbers: GRS2385/A/21, GRS2140/A/20; Consejería de Educación, Junta de Castilla y León, Grant/Award Number: SA118P20; European Regional Development Fund and Instituto de Salud Carlos III, Grant/Award Numbers: CD19/00222, FI19/00191; Spanish Fondo de Investigaciones Sanitarias, Grant/Award Numbers: PI21/00983, PI18/0150

La secuenciación masiva dirigida revela que los pacientes con leucemia linfática crónica y reordenamiento de igh presentan mutaciones en los genes POT1, EGR2, BRAF, IGLL5 Y MGA

Abstract [CO-081] Introducción: La traslocación de la región 14q32, que contiene el gen de la cadena pesada de las inmunoglobulinas (IGH), aparece en el 4-9% de pacientes de leucemia linfática crónica(LLC). Aunque algunos estudios le atribuyen a este subgrupo un pronóstico desfavorable, sus características clínicas y biológicas no se conocen en profundidad. La secuenciación masiva (NGS) ha mejorado notablemente el conocimiento de la heterogeneidad genética y clínica de la LLC, por lo que nos planteamos el análisis del perfil mutacional de estos pacientes para definir mejor su pronóstico. Métodos: Se analizaron 231 pacientes de LLC, de los cuales 42 presentaban traslocación de 14q32. En todos los casos se disponía de datos clínicos y FISH. Se diseñó un panel personalizado de 54 genes, seleccionados por su frecuencia e implicación en la patogenia de la enfermedad. La secuenciación se realizó en la plataforma NextSeq(Illumina). El panel cubre el 97% de las regiones (>100X) con una profundidad de 606 lecturas/base, permitiendo la detección de variantes presentes en >3% de las células..

Rate and duration of hospitalisation for acute pulmonary embolism in the real-world clinical practice of different countries : Analysis from the RIETE registry

publishersversionPeer reviewe

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

SMOS Level-2 Soil Moisture Product Evaluation in Rain-Fed Croplands of the Pampean Region of Argentina

A field campaign was carried out to evaluate the Soil Moisture (SM) MIR-SMUDP2 product (v5.51) generated from the data of the Microwave Imaging Radiometer using Aperture Synthesis (MIRAS) aboard the Soil Moisture and Ocean Salinity (SMOS) mission. The study area was the Pampean Region of Argentina, which was selected because it is a vast area of flatlands containing quite homogeneous rain-fed croplands, which are considered SMOS nominal land uses and hardly affected by radio-frequency interference contamination. Transects of ground handheld SM measurements were performed using ThetaProbe ML2x probes within four Icosahedral Snyder Equal Area Earth (ISEA) grid nodes, where permanent SM stations are located. The campaign results showed a negative bias of-0.02 m3m-3 between concurrent SMOS data and ground SM measurements, which means a slight SMOS underestimation, and a standard deviation of ±0.06 m3m-3. Additionally, a good correlation was obtained between the handheld SM measurements taken during the campaign and the permanent SM station data within a node, which pointed out that the station data could be used as reference data to evaluate the SMOS product over a longer temporal period. SMOS-retrieved data were also compared with station mean SM values from 2012 to 2014. A general SMOS underestimation of ± -0.05m3m-3 was observed, with a standard deviation of ± 0.04m3m-3, which yields an uncertainty of ± 0.07m3m-3 for the SMOS product. Although the random error meets the SMOS mission's goal of ± 0.04m3m-3, the product overall uncertainty is higher than that due to the significant dry bias, which is also found in other regions of the world.Fil: Niclos, Raquel. Universidad de Valencia; EspañaFil: Rivas, Raúl Eduardo. Universidad Nacional del Centro de la Provincia de Buenos Aires. Rectorado. Instituto de Hidrología de Llanuras - Sede Tandil. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Hidrología de Llanuras - Sede Tandil; ArgentinaFil: Garcia Santos, Vicente. Universidad de Valencia; EspañaFil: Doña, Carolina. Universidad de Valencia; EspañaFil: Valor, Enric. Universidad de Valencia; EspañaFil: Holzman, Mauro Ezequiel. Universidad Nacional del Centro de la Provincia de Buenos Aires. Rectorado. Instituto de Hidrología de Llanuras - Sede Tandil. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Hidrología de Llanuras - Sede Tandil; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Bayala, Martin Ignacio. Universidad Nacional del Centro de la Provincia de Buenos Aires. Rectorado. Instituto de Hidrología de Llanuras - Sede Tandil. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Hidrología de Llanuras - Sede Tandil; ArgentinaFil: Carmona, Facundo. Universidad Nacional del Centro de la Provincia de Buenos Aires. Rectorado. Instituto de Hidrología de Llanuras - Sede Tandil. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Hidrología de Llanuras - Sede Tandil; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ocampo, Dora Ester. Universidad Nacional del Centro de la Provincia de Buenos Aires. Rectorado. Instituto de Hidrología de Llanuras - Sede Tandil. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas. Instituto de Hidrología de Llanuras - Sede Tandil; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Soldano, Alvaro. Comision Nacional de Actividades Espaciales; ArgentinaFil: Thibeault, Marc. Comision Nacional de Actividades Espaciales; ArgentinaFil: Caselles, Vicente. Universidad de Valencia; EspañaFil: Sanchez, Juan M.. Universidad de Castilla-La Mancha; Españ