Andres Muñoz - Academia.edu (original) (raw)

Papers by Andres Muñoz

The Lancet Oncology

The International Initiative on Thrombosis and Cancer is an independent academic working group of... more The International Initiative on Thrombosis and Cancer is an independent academic working group of experts aimed at establishing global consensus for the treatment and prophylaxis of cancer-associated thrombosis. The 2013, 2016, and 2019 International Initiative on Thrombosis and Cancer clinical practice guidelines have been made available through a free, web-based mobile phone application. The 2022 clinical practice guidelines, which are based on a literature review up to Jan 1, 2022, include guidance for patients with cancer and with COVID-19. Key recommendations (grade 1A or 1B) include: (1) low-molecular-weight heparins (LMWHs) for the initial (first 10 days) treatment and maintenance treatment of cancer-associated thrombosis; (2) direct oral anticoagulants for the initial treatment and maintenance treatment of cancer-associated thrombosis in patients who are not at high risk of gastrointestinal or genitourinary bleeding, in the absence of strong drug-drug interactions or of gastrointestinal absorption impairment; (3) LMWHs or direct oral anticoagulants for a minimum of 6 months to treat cancer-associated thrombosis; (4) extended prophylaxis (4 weeks) with LMWHs to prevent postoperative venous thromboembolism after major abdominopelvic surgery in patients not at high risk of bleeding; and (5) primary prophylaxis of venous thromboembolism with LMWHs or direct oral anticoagulants (rivaroxaban or apixaban) in ambulatory patients with locally advanced or metastatic pancreatic cancer who are treated with anticancer therapy and have a low risk of bleeding. Guideline development Development of the 2022 ITAC guidelines followed the same process and methods as with previous iterations, 3-5 and also received support from the Institut National du Cancer. Guideline development is based on GRADE methodology 6 (panel 1; fully detailed in appendix pp 3-23). The panel, which comprised 19 independent international academic experts from various specialties,

Ambient Intelligence and Smart Environments

One paramount aspect to deal with the increase in the amount of plastic are urban planning polici... more One paramount aspect to deal with the increase in the amount of plastic are urban planning policies to efficiently collect plastic waste. However, only developed countries have well-defined policies despite the serious problems this type of waste generally causes. The present paper proposes a novel approach to define urban planning policies able to automatically infer the number of bins required in an urban area based on socio-economic and demographic factors. This is done by analysing open data from several Western cities. The solution has been evaluated in two urban areas of India and the Philippines showing quite consistent results.

Journal of Hepatocellular Carcinoma

Introduction: Besides more common sites such as lung or peritoneum, hepatocellular carcinoma (HCC... more Introduction: Besides more common sites such as lung or peritoneum, hepatocellular carcinoma (HCC) can metastatize to rare sites. We report herein a new metastatic site of HCC: the nail-bed. We also review other recently reported rare site HCC metastases (RSHM). Case Report: A 66-year-old woman with a 12-year history of resected-stage IA HCC who later presented lung, spleen and brain metastases treated with surgery, systemic therapies (sorafenib, sunitinib, capecitabine) and radiotherapy. The patient was referred to us because of a painful and rapidly evolving mass in the nail-bed of the left thumb. Biopsy confirmed nail-bed HCC metastasis, and the finger was amputated. The patient died few weeks later. Conclusion: This case was an opportunity for us to review RSHM. This type of metastasis seems to be an early event, in the context of advanced stage HCC with elevated protein induced by vitamin K absence-II (PIVKA II). The Lee nomogram is useful in detecting patients at high risk of developing RSHM. We would suggest insisting on systemic treatment in these metastatic patients although overall survival after RSHM diagnosis is poor.

eBioMedicine, 2022

Background A major challenge of the SARS-CoV-2 pandemic is to better define "protective threshold... more Background A major challenge of the SARS-CoV-2 pandemic is to better define "protective thresholds" to guide the global response. We aimed to characterize the longitudinal dynamics of the antibody responses in naturally infected individuals in Chile and compared them to humoral responses induced after immunization with CoronaVac-based on an inactivated whole virus-or the BNT162b2-based on mRNA-vaccines. We also contrasted them with the respective effectiveness and efficacy data available for both vaccines. Methods We determined and compared the longitudinal neutralizing (nAb) and anti-nucleocapsid (anti-N) antibody responses of 74 COVID-19 individuals (37 outpatient and 37 hospitalized) during the acute disease and convalescence. We also assessed the antibody boosting of 36 of these individuals who were immunized after convalescence with either the CoronaVac (n = 30) or the BNT162b2 (n = 6) vaccines. Antibody titres were also measured for 50 naÿve individuals immunized with two doses of CoronaVac (n = 35) or BNT162b2 (n = 15) vaccines. The neutralizing level after vaccination was compared to those of convalescent individuals and the predicted efficacy was estimated. Findings SARS-CoV-2 infection induced robust nAb and anti-N antibody responses lasting >9 months, but showing a rapid nAb decay. After convalescence, nAb titres were significantly boosted by vaccination with CoronaVac or BNT162b2. In naÿve individuals, the calculated mean titre induced by two doses of CoronaVac or BNT162b2 was 0¢2 times and 5.2 times, respectively, that of convalescent individuals, which has been proposed as threshold of protection. CoronaVac induced no or only modest anti-N antibody responses. Using two proposed logistic models, the predicted efficacy of BNT162b2 was estimated at 97%, in close agreement with phase 3 efficacy studies, while for CoronaVac it was »50% corresponding to the lowest range of clinical trials and below the real-life data from Chile (from February 2 through May 1, 2021 during the predominant circulation of the Gamma variant), where the estimated vaccine effectiveness to prevent COVID-19 was 62¢8À64¢6%.

Cancer Research, 2021

Background: Improving outcomes of PDAC with checkpoint inhibitors (CPIs) have been ineffective, u... more Background: Improving outcomes of PDAC with checkpoint inhibitors (CPIs) have been ineffective, underscoring the need to co-target alternative pathways. Preclinical data showed that CXCR4-SDF1 axis modulates the tumor microenvironment (TME) in PDAC and that CXCR4 inhibition enhances T cell access to the TME, increasing tumor sensitivity to CPIs. This was confirmed in the COMBAT Cohort 1 (CC1) study showing that the dual combination M+P increases activated CD8+ T cells and decreases myeloid derived suppressor cells (MDSCs) within the TME. Moreover, our pre-clinical studies showed that adding C to M+P resulted in improved efficacy vs C alone. The COMBAT Cohort 2 (CC2) aims to test the safety and efficacy of the triple combination of M+P+C in 2L mPDAC. Methods: Single arm phase 2a study in mPDAC. In cohort 2, patients with stage IV PDAC at diagnose who had progressed to 1L gemcitabine-based C received 5 days M priming, followed by M BIW + P Q3W plus C [Irinotecan liposomal injection/5-...

GeoInformatica, 2022

During the last years, the analysis of spatio-temporal data extracted from Online Social Networks... more During the last years, the analysis of spatio-temporal data extracted from Online Social Networks (OSNs) has become a prominent course of action within the human-mobility mining discipline. Due to the noisy and sparse nature of these data, an important effort has been done on validating these platforms as suitable mobility proxies. However, such a validation has been usually based on the computation of certain features from the raw spatiotemporal trajectories extracted from OSN documents. Hence, there is a scarcity of validation studies that evaluate whether geo-tagged OSN data are able to measure the evolution of the mobility in a region at multiple spatial scales. For that reason, this work proposes a comprehensive comparison of a nation-scale Twitter (TWT) dataset and an official mobility survey from the Spanish National Institute of Statistics. The target time period covers a three-month interval during which Spain was heavily affected by the COVID-19 pandemic. Both feeds have been compared in this context by considering different mobility-related features and spatial scales. The results show that TWT could capture only a limited number features of the latent mobility behaviour of Spain during the study period.

ArXiv, 2020

In this paper, we present a network architecture for video generation that models spatio-temporal... more In this paper, we present a network architecture for video generation that models spatio-temporal consistency without resorting to costly 3D architectures. In particular, we elaborate on the components of noise generation, sequence generation, and frame generation. The architecture facilitates the information exchange between neighboring time points, which improves the temporal consistency of the generated frames both at the structural level and the detailed level. The approach achieves state-of-the-art quantitative performance, as measured by the inception score, on the UCF-101 dataset, which is in line with a qualitative inspection of the generated videos. We also introduce a new quantitative measure that uses downstream tasks for evaluation.

International Journal of Intelligent Systems, 2020

Nowadays, cities are the most relevant type of human settlement and their population has been end... more Nowadays, cities are the most relevant type of human settlement and their population has been endlessly growing for decades. At the same time, we are witnessing an explosion of digital data that capture many different aspects and details of city life. This allows detecting human mobility patterns in urban areas with more detail than ever before. In this context, based on the fusion of mobility data from different and heterogeneous sources, such as public transport, transport‐network connectivity and Online Social Networks, this study puts forward a novel approach to uncover the actual land use of a city. Unlike previous solutions, our work avoids a time‐invariant approach and it considers the temporal factor based on the assumption that urban areas are not used by citizens all the time in the same manner. We have tested our solution in two different cities showing high accuracy rates.

Clinical Cancer Research, 2021

Purpose: Pancreatic ductal adenocarcinoma (PDAC) is largely unresponsive to checkpoint inhibitors... more Purpose: Pancreatic ductal adenocarcinoma (PDAC) is largely unresponsive to checkpoint inhibitors. Blockade of the CXCR4/CXCL12 axis increases intratumoral trafficking of activated T cells while restraining immunosuppressive elements. This study evaluates dual blockade of CXCR4 and PD1 with chemotherapy in PDAC. Patients and Methods: Multicenter, single-arm, phase II study to evaluate the safety and efficacy of motixafortide and pembrolizumab combined with chemotherapy in patients with de novo metastatic PDAC and disease progression on front-line gemcitabine-based therapy (NCT02826486). Subjects received a priming phase of motixafortide daily on days 1–5, followed by repeated cycles of motixafortide twice a week; pembrolizumab every 3 weeks; and nanoliposomal irinotecan, fluorouracil, and leucovorin every 2 weeks (NAPOLI-1 regimen). The primary objective was objective response rate (ORR). Secondary objectives included overall survival (OS), progression-free survival (PFS), disease c...

Melanoma Management, 2020

Aim: Morbidity of open inguinal lymphadenectomy (OIL) is high. We use laparoscopy for pelvic time... more Aim: Morbidity of open inguinal lymphadenectomy (OIL) is high. We use laparoscopy for pelvic time, preservation of the greater saphenous vein and transverse inguinal incisions (laparoscopically assisted ilio-inguinal lymphadenectomy, LIIL) to improve postoperative outcomes. Patients & methods: Retrospective comparison of 14 patients who underwent LIIL and seven patients who underwent OIL. Results: Fourteen LIIL compared with seven OIL showed a statistically significant reduction in morbidity (15.3 vs 75%) and hospital stay (7 vs 15.7 days). Pelvic lymph node involvement (27%) was not detected preoperatively. With a mean follow-up of 36.2 (range: 3–137) months, local recurrence rate was 58.3% in LIIL and 40% in OIL. Overall survival was significantly higher in OIL than in LIIL. Conclusion: Compared with OIL, LIIL reduced postoperative complications and hospital stay.

Nature Medicine, 2020

Programmed cell death 1 (PD-1) inhibitors have limited effect in pancreatic ductal adenocarcinoma... more Programmed cell death 1 (PD-1) inhibitors have limited effect in pancreatic ductal adenocarcinoma (PDAC), underscoring the need to co-target alternative pathways. CXC chemokine receptor 4 (CXCR4) blockade promotes T cell tumor infiltration and is synergistic with anti-PD-1 therapy in PDAC mouse models. We conducted a phase IIa, open-label, two-cohort study to assess the safety, efficacy and immunobiological effects of the CXCR4 antagonist BL-8040 (motixafortide) with pembrolizumab and chemotherapy in metastatic PDAC ( NCT02826486 ). The primary outcome was objective response rate (ORR). Secondary outcomes were overall survival (OS), disease control rate (DCR) and safety. In cohort 1, 37 patients with chemotherapy-resistant disease received BL-8040 and pembrolizumab. The DCR was 34.5% in the evaluable population (modified intention to treat, mITT; N = 29), including nine patients (31%) with stable disease and one patient (3.4%) with partial response. Median OS (mOS) was 3.3 months in the ITT population. Notably, in patients receiving study drugs as second-line therapy, the mOS was 7.5 months. BL-8040 increased CD8 + effector T cell tumor infiltration, decreased myeloid-derived suppressor cells (MDSCs) and further decreased circulating regulatory T cells. In cohort 2, 22 patients received BL-8040 and pembrolizumab with chemotherapy, with an ORR, DCR and median duration of response of 32%, 77% and 7.8 months, respectively. These data suggest that combined CXCR4 and PD-1 blockade may expand the benefit of chemotherapy in PDAC and warrants confirmation in subsequent randomized trials. Results from the phase IIa COMBAT trial combining CXCR4 and PD-1 inhibition in patients with metastatic cancer show encouraging clinical responses in association with enhanced antitumor immune activation.

Annals of Hematology, 2020

The purpose of this report is to provide long-term follow-up of 38 patients diagnosed of post-tra... more The purpose of this report is to provide long-term follow-up of 38 patients diagnosed of post-transplant lymphoproliferative disease (PTLD) included in a phase 2 clinical trial of first line therapy with rituximab and to evaluate the same therapy in a real world cohort of 21 consecutive patients treated once the trial was closed. Eligible patients were ≥ 18 years of age with a biopsyproven CD20 positive B cell PTLD and treatment naive except for reduction of immunosuppression. Treatment consisted in four weekly infusions of rituximab at the standard dose of 375 mg/m 2. Patients in complete remission (CR) were followed without further treatment, and those in partial remission (PR) were treated with another four cycles of weekly rituximab. Median followup in the clinical trial was 13.0 years. Disease-specific survival (DSS) at 10 years was 64.7% [95% confidence interval (CI) 48.2-81.2%]. For those patients who achieved CR (61%), DSS at 5 and 10 years was 94.4% (95% CI 83.8-100%) and 88.1% (95% CI 72.6-100%), respectively, and only 1 patient progressed beyond 5 years. The median follow-up of the real world patients was 6.5 years. DSS at 5 years was 75.2% (95% CI 56.4-94.0%). DSS at 5 years of patients who achieved CR (38%) was 87.5% (95% CI 64.6-100%). In conclusion, PTLD patients in CR after rituximab have an excellent long-term outcome. These results not only apply in the clinical trial setting but are also reproducible in the real world. However, those patients who do not respond represent an unmet clinical need and should be included in prospective clinical trials.

Diálogo andino, 2019

El paisaje y el geopatrimonio se han posicionado como elementos relevantes tanto en las ciencias ... more El paisaje y el geopatrimonio se han posicionado como elementos relevantes tanto en las ciencias de la tierra como en aquellas vinculadas a la conservación de la biodiversidad, el paisaje y la diversidad cultural. Sin embargo, conceptos como valoración, inventario, cuantificación y consolidación de los sitios relevantes, en la perspectiva del geopatrimonio, son aún poco desarrollados, al menos en América Latina y Chile, pues, aunque existen metodologías específicas, estas aún no han sido aplicadas de forma sistemática. En este trabajo se realiza una propuesta para avanzar tanto en la definición de los elementos de geopatrimonio del área de la macrorregión de Atacama como en acciones hacia su consolidación en asociación con figuras ya establecidas como son las áreas protegidas pertenecientes al SNASPE o figuras emergentes relevantes como la de Reservas de la Biosfera. Los resultados expuestos son una lista preliminar de sitios y su relación con áreas preexistentes, así como propuestas de gobernanza en el marco de los desafíos, amenazas e instrumentos de planificación ambiental vigentes. Palabras clave: Gobernanza adaptativa, geosistema, paisaje biogeocultural, Atacama. Landscape and geoheritage has emerged as a very relevant concept both from Earth sciences and related sciences linked to the conservation of biodiversity, landscapes and cultural diversity. However, concepts like valuation, inventory, quantification and consolidation of the relevant sites of geoheritage is still an underdeveloped issue, at least in Latin America and Chile, although there are specific methodologies, these have not yet been systematically applied in Chile. In this work we make a proposal to advance both the definition of the geoheritage of the macro-region of Chilean Atacama, and to concrete actions towards its consolidation in association with already established conservation figures such as the protected areas belonging to the public system (SNASPE) or relevant emerging figures such as the Biosphere Reserves. The results presented are a preliminary list of sites and their possible relationship with pre-existing areas, as well as proposals for governance in the context of current challenges, threats and environmental planning instruments.

Sensors, 2019

Road traffic pollution is one of the key factors affecting urban air quality. There is a consensu... more Road traffic pollution is one of the key factors affecting urban air quality. There is a consensus in the community that the efficient use of public transport is the most effective solution. In that sense, much effort has been made in the data mining discipline to come up with solutions able to anticipate taxi demands in a city. This helps to optimize the trips made by such an important urban means of transport. However, most of the existing solutions in the literature define the taxi demand prediction as a regression problem based on historical taxi records. This causes serious limitations with respect to the required data to operate and the interpretability of the prediction outcome. In this paper, we introduce QUADRIVEN (QUalitative tAxi Demand pRediction based on tIme-Variant onlinE social Network data analysis), a novel approach to deal with the taxi demand prediction problem based on human-generated data widely available on online social networks. The result of the prediction ...

Canadian Journal of Cardiology, 2014

Inorganic Chemistry Communications, 2017

OMe) 3 (4)), with H 2 O 2 , BH 3 •THF or selenium gives the respective cyrhetrenylphosphine oxide... more OMe) 3 (4)), with H 2 O 2 , BH 3 •THF or selenium gives the respective cyrhetrenylphosphine oxides, boranes and selenides. These species were characterized by standard spectroscopic techniques (FT-IR, 1 H and 31 PNMR). Based on the 31 P\ \ 77 Se coupling constant (1 J P-Se) of the phosphineselenides, we established the following order of basicity of the parent cyrhetrenylphosphine 2 N 3 N 4 N 1. We also confirmed the opposite electronic effects of the cyrhetrenyl and ferrocenyl groups attached to a-PR 2 unit. Finally, phosphine selenides 2c and 4c were structurally characterized by X-ray diffraction.

The Journal of the American Academy of Orthopaedic Surgeons, 2015

The modularity and ease of application of modern external fixation has expanded its potential use... more The modularity and ease of application of modern external fixation has expanded its potential use in the management of fractures and other musculoskeletal conditions. In fracture care, it can be used for provisional and definitive fixation. Short-term provisional applications include "damage control" and periarticular fracture fixation. The risk:benefit ratio of added stability needs to be assessed with each fixator. Soft-tissue management is critical during pin insertion to lessen the risk of loosening and infection. Although provisional fixation is safe for early conversion to definitive fixation, several factors affect the timing of definitive surgery, including the initial injury, external fixator stability, infection, and the physiologic state of the patient.