COVID-19 has caused a worldwide illness and New York has become the epicenter of COVID-19 in the ... more COVID-19 has caused a worldwide illness and New York has become the epicenter of COVID-19 in the United States. During the last year, The Bronx, one of the five boroughs of New York City, had the highest prevalence per capita in New York making it the epicenter of the pandemic. During the first wave of the pandemic, almost every labratory received tremendous amount of tests, and here we examined demographic and laboratory data, as well as trajectories of laboratory results, in order to determine the relation between these laboratory parameters, in particular tests of coagulation, to illness severity and mortality. Methods: This is a retrospective study of all positive COVID cases who were admitted between 2/22/2020-4/20/2020 at Montefiore Health System (MHS), a large tertiary care center in the Bronx. Together the ambulatory and hospital networks care for 2.8 million visits a year. All adults with positive COVID tests performed by MHS and who were admitted between 2/22/2020-4/20/202...
Systemic inflammation and coagulopathy are characteristic hallmarks of COVID19. “COVID coagulopat... more Systemic inflammation and coagulopathy are characteristic hallmarks of COVID19. “COVID coagulopathy” manifests mainly as a prothrombotic state affecting both large and small blood vessels, and presenting as arterial, venous, and microangiopathic thrombotic events with von Willebrand factor (VWF) and soluble thrombomodulin increased in hospitalized patients. The causes of coagulopathy are poorly understood. Aim: To investigate the relationship between von Willebrand factor (VWF) biomarkers, intravascular hemolysis, coagulation, and organ damage in COVID19 patients and to study their association with disease severity and mortality. Methods: 181 hospitalized adult COVID19 patients were randomly selected with a balanced distribution of survivors and non-survivors during the period of March 26th 2020 to May 5th 2020. The medical records and laboratory values were reviewed. Statistical analysis was performed using R studio V.3.6.2. Results: Patients who died (n=90) had significantly lower...
Summary: Patients treated with Fms-like tyrosine kinase 3 (FLT3) inhibitor–based acute myeloid le... more Summary: Patients treated with Fms-like tyrosine kinase 3 (FLT3) inhibitor–based acute myeloid leukemia therapies nearly always develop resistance. In this issue, Alotaibi and colleagues describe the patterns of mutations that emerge upon relapse after FLT3 inhibitor therapy after initial response, as well as in treatment-refractory disease in a single-institution study; the findings offer insights for sequential therapies targeting the dominant clone at the time of relapse. See related article by Alotaibi et al., p. 125.
As COVID-19 adversely affects patients with cancer, prophylactic strategies are critically needed... more As COVID-19 adversely affects patients with cancer, prophylactic strategies are critically needed. Using a validated antibody assay against SARS-CoV-2 spike protein, we determined a high seroconversion rate (94%) in 200 patients with cancer in New York City that had received full dosing with one of the FDA-approved COVID-19 vaccines. Comparing to solid tumors (98%), a significantly lower rate of seroconversion was observed in patients with hematological malignancies (85%), particularly recipients following highly immunosuppressive therapies such as anti-CD20 therapies (70%) and stem cell transplantation (73%). Patients receiving immune checkpoint inhibitor therapy (97%) or hormonal therapies (100%) demonstrated high seroconversion post-vaccination. Patients with prior COVID-19 infection demonstrated higher anti-spike IgG titers post-vaccination. Relatively lower IgG titers were observed following vaccination with the adenoviral than mRNA-based vaccines. These data demonstrate generally high immunogenicity of COVID-19 vaccination in oncology patients and identify immunosuppressed cohorts that need novel vaccination or passive immunization strategies.
Background Mortality in coronavirus disease of 2019 (COVID-19) is associated with increases in pr... more Background Mortality in coronavirus disease of 2019 (COVID-19) is associated with increases in prothrombotic parameters, particularly D-dimer levels. Anticoagulation has been proposed as therapy to decrease mortality, often adjusted for illness severity. Objective We wanted to investigate whether anticoagulation improves survival in COVID-19 and if this improvement in survival is associated with disease severity. Methods This is a cohort study simulating an intention-to-treat clinical trial, by analyzing the effect on mortality of anticoagulation therapy chosen in the first 48 hours of hospitalization. We analyzed 3,625 COVID-19+ inpatients, controlling for age, gender, glomerular filtration rate, oxygen saturation, ventilation requirement, intensive care unit admission, and time period, all determined during the first 48 hours. Results Adjusted logistic regression analyses demonstrated a significant decrease in mortality with prophylactic use of apixaban (odds ratio [OR] 0.46, p = ...
Lung involvement has been reported in HTLV-1 carriers and in patients with ATLL. Whether there ar... more Lung involvement has been reported in HTLV-1 carriers and in patients with ATLL. Whether there are differences in the pattern of lung involvement between ATLL and HTLV carriers in North American patients is unknown. We aimed to compare CT pulmonary findings among patients with HTLV-1 infection with and without ATLL. Among 140 patients with HTLV-1 diagnosis, 97 had CT chest available. Of these, 72 (74.2%) had ATLL and 25 (25.8%) did not have ATLL. CT chest abnormalities were present in 90 (92.8%) participants (94.4% in ATLL; 88% in non-ATLL). Higher rates of lymphadenopathy (69.4% versus 24%, p < .01) and lower rates of bronchiectasis (25% versus 48%, p ¼ .04) were seen in ATLL compared to non-ATLL. Our study supports that staging of lung involvement in ATLL should consider HTLV-associated pulmonary findings as not all CT chest abnormalities necessarily represent malignant infiltration.
Photonic crystals have been an object of interest because of their properties to inhibit certain ... more Photonic crystals have been an object of interest because of their properties to inhibit certain wavelengths and allow the transmission of others. Using these properties, we designed a photonic structure known as photodyne formed by two porous silicon one-dimensional photonic crystals with an air defect between them. When the photodyne is illuminated with appropriate light, it allows us to generate electromagnetic forces within the structure that can be maximized if the light becomes localized inside the defect region. These electromagnetic forces allow the microcavity to oscillate mechanically. In the experiment, a chopper was driven by a signal generator to modulate the laser light that was used. The driven frequency and the signal modulation waveform (rectangular, sinusoidal or triangular) were changed with the idea to find optimal conditions for the structure to oscillate. The microcavity displacement amplitude, velocity amplitude and Fourier spectrum of the latter and its frequ...
Background: Photonic crystals are artificial structures that have periodic dielectric components ... more Background: Photonic crystals are artificial structures that have periodic dielectric components with different refractive indices. Under certain conditions, they abnormally refract the light, a phenomenon called negative refraction. Here we experimentally characterize negative refraction in a one dimensional photonic crystal structure; near the low frequency edge of the fourth photonic bandgap. We compare the experimental results with current theory and a theory based on the group velocity developed here. We also analytically derived the negative refraction correctness condition that gives the angular region where negative refraction occurs. Methodology/Principal Findings: By using standard photonic techniques we experimentally determined the relationship between incidence and negative refraction angles and found the negative refraction range by applying the correctness condition. In order to compare both theories with experimental results an output refraction correction was utilized. The correction uses Snell's law and an effective refractive index based on two effective dielectric constants. We found good agreement between experiment and both theories in the negative refraction zone. Conclusions/Significance: Since both theories and the experimental observations agreed well in the negative refraction region, we can use both negative refraction theories plus the output correction to predict negative refraction angles. This can be very useful from a practical point of view for space filtering applications such as a photonic demultiplexer or for sensing applications.
The paper addresses the multi-agent path planning (MPP) of mobile agents with multiple goals taki... more The paper addresses the multi-agent path planning (MPP) of mobile agents with multiple goals taking into consideration the kinematic constraints of each agent. The "Swing and Dock" (SaD) robotic system being discussed uses discrete locomotion, where agents swing around fixed pins and dock with their mounting legs to realize displacement from one point to another. The system was developed as a subsystem for mobile robotic fixture (SwarmItFix). Previous work dealt with MPP for SaD agents using the concept of extended temporal graph with Integer Linear Programming (ILP) based formulations. The approach discretized time into unit steps, whereas in reality, the agents are constrained by velocity limits. Hence, a real-time schedule is required to accurately plan the agent movement in a working scenario. We utilize the concept of simple temporal network and extend our ILP formulations to model the velocity kinematic constraints. The mathematical formulations are implemented and tested using a GUROBI solver. Computational results display the effectiveness of the approach.
COVID-19 has caused a worldwide illness and New York has become the epicenter of COVID-19 in the ... more COVID-19 has caused a worldwide illness and New York has become the epicenter of COVID-19 in the United States. During the last year, The Bronx, one of the five boroughs of New York City, had the highest prevalence per capita in New York making it the epicenter of the pandemic. During the first wave of the pandemic, almost every labratory received tremendous amount of tests, and here we examined demographic and laboratory data, as well as trajectories of laboratory results, in order to determine the relation between these laboratory parameters, in particular tests of coagulation, to illness severity and mortality. Methods: This is a retrospective study of all positive COVID cases who were admitted between 2/22/2020-4/20/2020 at Montefiore Health System (MHS), a large tertiary care center in the Bronx. Together the ambulatory and hospital networks care for 2.8 million visits a year. All adults with positive COVID tests performed by MHS and who were admitted between 2/22/2020-4/20/202...
Systemic inflammation and coagulopathy are characteristic hallmarks of COVID19. “COVID coagulopat... more Systemic inflammation and coagulopathy are characteristic hallmarks of COVID19. “COVID coagulopathy” manifests mainly as a prothrombotic state affecting both large and small blood vessels, and presenting as arterial, venous, and microangiopathic thrombotic events with von Willebrand factor (VWF) and soluble thrombomodulin increased in hospitalized patients. The causes of coagulopathy are poorly understood. Aim: To investigate the relationship between von Willebrand factor (VWF) biomarkers, intravascular hemolysis, coagulation, and organ damage in COVID19 patients and to study their association with disease severity and mortality. Methods: 181 hospitalized adult COVID19 patients were randomly selected with a balanced distribution of survivors and non-survivors during the period of March 26th 2020 to May 5th 2020. The medical records and laboratory values were reviewed. Statistical analysis was performed using R studio V.3.6.2. Results: Patients who died (n=90) had significantly lower...
Summary: Patients treated with Fms-like tyrosine kinase 3 (FLT3) inhibitor–based acute myeloid le... more Summary: Patients treated with Fms-like tyrosine kinase 3 (FLT3) inhibitor–based acute myeloid leukemia therapies nearly always develop resistance. In this issue, Alotaibi and colleagues describe the patterns of mutations that emerge upon relapse after FLT3 inhibitor therapy after initial response, as well as in treatment-refractory disease in a single-institution study; the findings offer insights for sequential therapies targeting the dominant clone at the time of relapse. See related article by Alotaibi et al., p. 125.
As COVID-19 adversely affects patients with cancer, prophylactic strategies are critically needed... more As COVID-19 adversely affects patients with cancer, prophylactic strategies are critically needed. Using a validated antibody assay against SARS-CoV-2 spike protein, we determined a high seroconversion rate (94%) in 200 patients with cancer in New York City that had received full dosing with one of the FDA-approved COVID-19 vaccines. Comparing to solid tumors (98%), a significantly lower rate of seroconversion was observed in patients with hematological malignancies (85%), particularly recipients following highly immunosuppressive therapies such as anti-CD20 therapies (70%) and stem cell transplantation (73%). Patients receiving immune checkpoint inhibitor therapy (97%) or hormonal therapies (100%) demonstrated high seroconversion post-vaccination. Patients with prior COVID-19 infection demonstrated higher anti-spike IgG titers post-vaccination. Relatively lower IgG titers were observed following vaccination with the adenoviral than mRNA-based vaccines. These data demonstrate generally high immunogenicity of COVID-19 vaccination in oncology patients and identify immunosuppressed cohorts that need novel vaccination or passive immunization strategies.
Background Mortality in coronavirus disease of 2019 (COVID-19) is associated with increases in pr... more Background Mortality in coronavirus disease of 2019 (COVID-19) is associated with increases in prothrombotic parameters, particularly D-dimer levels. Anticoagulation has been proposed as therapy to decrease mortality, often adjusted for illness severity. Objective We wanted to investigate whether anticoagulation improves survival in COVID-19 and if this improvement in survival is associated with disease severity. Methods This is a cohort study simulating an intention-to-treat clinical trial, by analyzing the effect on mortality of anticoagulation therapy chosen in the first 48 hours of hospitalization. We analyzed 3,625 COVID-19+ inpatients, controlling for age, gender, glomerular filtration rate, oxygen saturation, ventilation requirement, intensive care unit admission, and time period, all determined during the first 48 hours. Results Adjusted logistic regression analyses demonstrated a significant decrease in mortality with prophylactic use of apixaban (odds ratio [OR] 0.46, p = ...
Lung involvement has been reported in HTLV-1 carriers and in patients with ATLL. Whether there ar... more Lung involvement has been reported in HTLV-1 carriers and in patients with ATLL. Whether there are differences in the pattern of lung involvement between ATLL and HTLV carriers in North American patients is unknown. We aimed to compare CT pulmonary findings among patients with HTLV-1 infection with and without ATLL. Among 140 patients with HTLV-1 diagnosis, 97 had CT chest available. Of these, 72 (74.2%) had ATLL and 25 (25.8%) did not have ATLL. CT chest abnormalities were present in 90 (92.8%) participants (94.4% in ATLL; 88% in non-ATLL). Higher rates of lymphadenopathy (69.4% versus 24%, p < .01) and lower rates of bronchiectasis (25% versus 48%, p ¼ .04) were seen in ATLL compared to non-ATLL. Our study supports that staging of lung involvement in ATLL should consider HTLV-associated pulmonary findings as not all CT chest abnormalities necessarily represent malignant infiltration.
Photonic crystals have been an object of interest because of their properties to inhibit certain ... more Photonic crystals have been an object of interest because of their properties to inhibit certain wavelengths and allow the transmission of others. Using these properties, we designed a photonic structure known as photodyne formed by two porous silicon one-dimensional photonic crystals with an air defect between them. When the photodyne is illuminated with appropriate light, it allows us to generate electromagnetic forces within the structure that can be maximized if the light becomes localized inside the defect region. These electromagnetic forces allow the microcavity to oscillate mechanically. In the experiment, a chopper was driven by a signal generator to modulate the laser light that was used. The driven frequency and the signal modulation waveform (rectangular, sinusoidal or triangular) were changed with the idea to find optimal conditions for the structure to oscillate. The microcavity displacement amplitude, velocity amplitude and Fourier spectrum of the latter and its frequ...
Background: Photonic crystals are artificial structures that have periodic dielectric components ... more Background: Photonic crystals are artificial structures that have periodic dielectric components with different refractive indices. Under certain conditions, they abnormally refract the light, a phenomenon called negative refraction. Here we experimentally characterize negative refraction in a one dimensional photonic crystal structure; near the low frequency edge of the fourth photonic bandgap. We compare the experimental results with current theory and a theory based on the group velocity developed here. We also analytically derived the negative refraction correctness condition that gives the angular region where negative refraction occurs. Methodology/Principal Findings: By using standard photonic techniques we experimentally determined the relationship between incidence and negative refraction angles and found the negative refraction range by applying the correctness condition. In order to compare both theories with experimental results an output refraction correction was utilized. The correction uses Snell's law and an effective refractive index based on two effective dielectric constants. We found good agreement between experiment and both theories in the negative refraction zone. Conclusions/Significance: Since both theories and the experimental observations agreed well in the negative refraction region, we can use both negative refraction theories plus the output correction to predict negative refraction angles. This can be very useful from a practical point of view for space filtering applications such as a photonic demultiplexer or for sensing applications.
The paper addresses the multi-agent path planning (MPP) of mobile agents with multiple goals taki... more The paper addresses the multi-agent path planning (MPP) of mobile agents with multiple goals taking into consideration the kinematic constraints of each agent. The "Swing and Dock" (SaD) robotic system being discussed uses discrete locomotion, where agents swing around fixed pins and dock with their mounting legs to realize displacement from one point to another. The system was developed as a subsystem for mobile robotic fixture (SwarmItFix). Previous work dealt with MPP for SaD agents using the concept of extended temporal graph with Integer Linear Programming (ILP) based formulations. The approach discretized time into unit steps, whereas in reality, the agents are constrained by velocity limits. Hence, a real-time schedule is required to accurately plan the agent movement in a working scenario. We utilize the concept of simple temporal network and extend our ILP formulations to model the velocity kinematic constraints. The mathematical formulations are implemented and tested using a GUROBI solver. Computational results display the effectiveness of the approach.
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Papers by Jesus Lugo