Cell entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) depends on binding of the viral spike (S) proteins to angiotensin-converting enzyme 2 and on S protein priming by TMPRSS2. ...Inhibition of TMPRSS2 may work to block or decrease the severity of SARS-CoV-2 infections. Intriguingly, TMPRSS2 is an androgen-regulated gene that is up-regulated in prostate cancer where it supports tumor progression and is involved in a frequent genetic translocation with the ERG gene. First- or second-generation androgen-deprivation therapies (ADTs) decrease the levels of TMPRSS2. Here we put forward the hypothesis that ADTs may protect patients affected by prostate cancer from SARS-CoV-2 infections.
We extracted data regarding 9280 patients (4532 males) with laboratory-confirmed SARS-CoV-2 infection from 68 hospitals in Veneto, one of the Italian regions that was most affected by the coronavirus disease 2019 (COVID-19) pandemic. The parameters used for each COVID-19-positive patient were sex, hospitalization, admission to intensive care unit, death, tumor diagnosis, prostate cancer diagnosis, and ADT.
There were evaluable 9280 SARS-CoV-2-positive patients in Veneto on 1 April 2020. Overall, males developed more severe complications, were more frequently hospitalized, and had a worse clinical outcome than females. Considering only the Veneto male population (2.4 million men), 0.2% and 0.3% of non-cancer and cancer patients, respectively, tested positive for SARS-CoV-2. Comparing the total number of SARS-CoV-2-positive cases, prostate cancer patients receiving ADT had a significantly lower risk of SARS-CoV-2 infection compared with patients who did not receive ADT (OR 4.05; 95% CI 1.55–10.59). A greater difference was found comparing prostate cancer patients receiving ADT with patients with any other type of cancer (OR 4.86; 95% CI 1.88–12.56).
Our data suggest that cancer patients have an increased risk of SARS-CoV-2 infections compared with non-cancer patients. However, prostate cancer patients receiving ADT appear to be partially protected from SARS-CoV-2 infections.
•SARS-CoV-2-infected men have a worse clinical outcome than women.•Cancer patients have an increased risk of SARS-CoV-2 infection.•Prostate cancer patients receiving androgen-deprivation therapies appear to be partially protected from the infection.
In this article we provide a comprehensive review of the existing literature on techniques and protocols for in-network aggregation in wireless sensor networks. We first define suitable criteria to ...classify existing solutions, and then describe them by separately addressing the different layers of the protocol stack while highlighting the role of a cross-layer design approach, which is likely to be needed for optimal performance. Throughout the article we identify and discuss open issues, and propose directions for future research in the area
AIMSWe assessed the cumulative incidence of recurrent stroke, major bleeding and all-cause mortality associated with restarting antithrombotic treatment, in patients experiencing an ...anticoagulation-related event (stroke or major bleeding), occurred during anticoagulation therapy for AF.METHODS AND RESULTSWe performed a retrospective population-based analysis on linked claims data of patients resident in the Veneto Region, treated with DOACs for AF and discharged (2013-2020) from the hospital for stroke, intracranial haemorrhage (ICH), and major bleeding. To adjust for competing risk of death and reduce confounding, we started the follow up after a 120-days blanking period, counting events in patients resuming oral anticoagulation versus those that did not. Risks of all-cause mortality, ischemic stroke (IS)intracranial haemorrhage (ICH), and other major bleeding events (MB) were estimated with multivariable Cox proportional hazard models and propensity score to adjust for differences in baseline characteristics. Overall, 1029 patients (mean age 77 years) were included in the final cohort: 23% experienced an IS, 18% an ICH, and 59% MB. Of these, 77% resumed anticoagulation. The cumulative incidence of events was significantly lower in patients resuming therapy. In the multivariable analysis considering age, sex and propensity score as covariates, resumption of anticoagulation significantly reduced the risk of a cumulative event (HR 0.45, 95%CI 0.35-0.57, p < 0.01). Stratifying for the index event, among patients with IS (92% resumed therapy), we observed a risk reduction of 81%; in patients with ICH (64% resumed therapy), we observed a risk reduction of 64% and for patients with MB (76% resuming therapy), we observed a risk reduction of 49%.CONCLUSIONSIn patients with AF who experienced an anticoagulation-related event, resuming oral anticoagulation was associated with better outcomes for all-cause mortality and subsequent events as compared with patients who did not resume treatment.
Interest in underwater acoustic networks has grown rapidly with the desire to monitor the large portion of the world covered by oceans. Fundamental differences between underwater acoustic propagation ...and terrestrial radio propagation may call for new criteria for the design of networking protocols. In this paper, we focus on some of these fundamental differences, including attenuation and noise, propagation delays, and the dependence of usable bandwidth and transmit power on distance (which has not been extensively considered before in protocol design studies). Furthermore, the relationship between the energy consumptions of acoustic modems in various modes (i.e., transmit, receive, and idle) is different than that of their terrestrial radio counterparts, which also impacts the design of energy-efficient protocols. The main contribution of this work is an in-depth analysis of the impacts of these unique relationships. We present insights that are useful in guiding both protocol design and network deployment. We design a class of energy-efficient routing protocols for underwater sensor networks based on the insights gained in our analysis. These protocols are tested in a number of relevant network scenarios, and shown to significantly outperform other commonly used routing strategies and to provide near optimal total path energy consumption. Finally, we implement in ns2 a detailed model of the underwater acoustic channel, and study the performance of routing choices when used with a simple MAC protocol and a realistic PHY model, with special regard to such issues as interference and medium access.
Cognitive radio methodologies have the potential to dramatically increase the throughput of wireless systems. Herein, control strategies which enable the superposition in time and frequency of ...primary and secondary user transmissions are explored in contrast to more traditional sensing approaches which only allow the secondary user to transmit when the primary user is idle. In this paper, the optimal transmission policy for the secondary user when the primary user adopts a retransmission-based error control scheme is investigated. The policy aims to maximize the secondary users' throughput, with a constraint on the throughput loss and failure probability of the primary user. Due to the constraint, the optimal policy is randomized, and determines how often the secondary user transmits according to the retransmission state of the packet being served by the primary user. The resulting optimal strategy of the secondary user is proven to have a unique structure. In particular, the optimal throughput is achieved by the secondary user by concentrating its transmission, and thus its interference to the primary user, in the first transmissions of a primary user packet. The rather simple framework considered in this paper highlights two fundamental aspects of cognitive networks that have not been covered so far: 1) the networking mechanisms implemented by the primary users (error control by means of retransmissions in the considered model) react to secondary users' activity; 2) if networking mechanisms are considered, then their state must be taken into account when optimizing secondary users' strategy, i.e., a strategy based on a binary active/idle perception of the primary users' state is suboptimal.
We performed a systematic review of phase I trials specifically designed for lymphoma patients. PubMed and Cochrane Library databases were searched using (lymphoma*) AND (phase 1) and publication ...date 2015–2020 to identify phase I dose-finding trials including a majority of lymphoma patients. Eighty-two trials (n = 3289 lymphoma patients) were included: 46 (55%) enrolled only lymphoma patients, 34 (41%) included also other hematologic malignancies, 2 (2%) solid tumors. Forty-six trials (56%) evaluated a combination (in 25 addition of experimental drug to standard therapy). Seven trials (9%) enrolled untreated patients. Among trials reporting activity in lymphoma patients, 74% (n = 57) reported an overall response rate ≥ 30%. All trials reported grade ≥ 3 adverse events; however, rates were not comparable across trials. Thirty-one treatment-related deaths in lymphoma patients were reported (overall treatment-related grade 5 adverse events rate 0.94%). Phase I trials designed for lymphoma patients were generally safe and the majority reported overall response rate ≥ 30%.
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•Phase I trials represent the first clinical evaluation of a new drug or combination.•Several phase I trials have been designed specifically for lymphoma patients.•We identified 82 trials (2015–2020) including a majority of lymphoma patients.•These trials were overall safe, the majority reported an overall response rate≥ 30%.•A greater degree of standardization in reporting safety results should be encouraged.
We propose an indexed natural deduction system for the modal logic
, ideally following Wansing's previous work in the context of tableaux sequents. The system, given both in the classical and ...intuitionistic versions (called
and
respectively), is designed to match as much as possible the structure and properties of the standard system of natural deduction for first-order logic, exploiting the formal analogy between modalities and quantifiers. We study a (syntactical) normalization theorem for both
and
and its main consequences, the sub-formula principle and the consistency theorem. In particular, we propose an intuitionistic encoding of classical
(via a suitable extension of the Gödel translation for first-order classical logic). Moreover, via the BHK interpretation of intuitionistic proofs, we propose a suitable Curry-Howard isomorphism for
. By translation into the natural deduction system given by Galmiche and Salhi in (2010b). Label-free proof systems for intuitionistic modal logic is5. In E. M. Clarke & A. Voronkov (Eds.), Logic for programming, artificial intelligence, and reasoning (pp. 255-271). Springer Berlin Heidelberg., we prove the equivalence of
w.r.t. an Hilbert-style axiomatization of
. However, when considering the sheer provability of labelled formulas, our system is comparable to the one presented by Simpson in (1993). The proof theory and semantics of intuitionistic modal logic PhD thesis, University of Edinburgh, UK.. Nevertheless, it remains uncertain whether it is feasible to establish a translation between the corresponding derivations.
Abstract Introduction The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this ...study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. Methods All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included. The adjusted odd ratios for risk factors for in-hospital mortality, 30-day readmission, and LOS were calculated using multilevel multivariable logistic regression. Results Among the 353 941 patients, rates of in-hospital mortality and 30-day readmission were 2.5% and 6%, respectively, and the median LOS was 13 days. High comorbidity, emergent/urgent admission, male gender, creation of a stoma, and an open approach increased the risks of all the outcomes at multivariable analysis. Age, hospital volume, hospital geographic location, and discharge to home/non-home produced different effects depending on the outcome considered. The most frequent causes of readmission were infection (19%) and bowel obstruction (14.6%). Conclusions We assessed national averages for mortality, LOS and readmission and related trends over a 10-year time. Laparoscopic surgery was the only one that could be modified by improving surgical education. Higher hospital volume was associated with a LOS reduction, but our findings only partially support a policy of centralization for colorectal cancer procedures. Surgical site infection was identified as the most preventable cause of readmission.
We consider a scenario in which wireless users want to connect to the Internet using one of several available network access opportunities, possibly using different radio technologies. We propose a ...distributed cognitive network access scheme with the aim of providing the best quality of service with respect to both radio link and core network performance and user application requirements. Knowledge of the service quality experienced by active connections is shared, and prospective users use Fuzzy Logic techniques to process cross-layer communication quality metrics and to estimate the expected transport-layer performance. These estimates are compared to the Quality of Service requirements of the application using Fuzzy Decision Making techniques to choose the most suitable access opportunity. This scheme naturally fits into the recently proposed Cognitive Network paradigm in that it defines a cognition process leveraging on end-to-end and cross-layer performance evaluation techniques as well as information sharing among users; moreover, it offers a significant amount of flexibility and extensibility, thanks to its modularity and its independence from the particular technology and application being used. The proposed scheme is shown to outperform state-of-the-art solutions in several multi-technology and multi-application scenarios, while at the same time achieving similar performance to application-specific omniscient schemes that we introduce in this paper as a benchmark.
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