Early lenalidomide treatment for low and intermediate-1 International Prognostic Scoring System risk myelodysplastic syndromes with del(5q) before transfusion dependence

Lenalidomide is approved for the treatment of transfusion-dependent (TD) del(5q) myelodysplastic syndromes (MDS). However, few data are available in patients with transfusion-independent (TI) del(5q) MDS. In the first, observational, part of this 2-part study, we assessed the impact of transfusion dependence on overall survival (OS) and non-leukemic death in untreated del(5q) MDS patients who were TD (n = 136),TI with hemoglobin (Hb) >= 10 mg/dL (n = 88),or TI with Hb = 10 g/dL],108 months;TI [Hb <10 g/dL],77 months;TD, 44 months). Transfusion dependence also negatively impacted non-leukemic death rates. In the interventional part of the study, baseline Hb levels were found to correlate significantly with physical (R = 0.666, P = 0.035) and fatigue (R = 0.604, P = 0.049) QoL scores. Median physical QoL scores improved significantly after 12 weeks' treatment with lenalidomide (+12.5;P = 0.020). Evaluable TI patients experienced early increases in Hb levels, and all attained an erythroid response. Our findings suggest that TI patients with moderate anemia may benefit from early treatment with lenalidomide

Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review

BACKGROUND: Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies. OBJECTIVE: To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients. METHODS: The systematic review was conducted according to PRISMA guidelines. Studies eligible were identified through PubMed/MEDLINE and Web of Science from inception to March 2021. RESULTS: Eighty-one studies were considered in this systematic review. Seventy-three studies have at least a cognitive inclusion or exclusion criteria, while only seven studies assessed cognitive outcomes. CONCLUSION: Despite the high presence of cognitive instruments used for inclusion/exclusion criteria their heterogeneity did not allow the identification of a guideline for the evaluation of patients in different stroke stages. Therefore, although the heterogeneity and the low percentage of studies that included cognitive outcomes, seemed that the latter were positively influenced by RT in post-stroke rehabilitation. Future larger RCTs are needed to outline which cognitive scales are most suitable and their cut-off, as well as what cognitive outcome measures to use in the various stages of post-stroke rehabilitation

Impact of gastrointestinal side effects on patients’ reported quality of life trajectories after radiotherapy for prostate cancer: Data from the prospective, observational pros-it CNR study

Radiotherapy (RT) represents an important therapeutic option for the treatment of localized prostate cancer. The aim of the current study is to examine trajectories in patients’ reported quality of life (QoL) aspects related to bowel function and bother, considering data from the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study, analyzed with growth mixture models. Data for patients who underwent RT, either associated or not associated with androgen deprivation therapy, were considered. QoL outcomes were assessed over a 2-year period from the diagnosis, using the Italian version of the University of California Los Angeles-Prostate Cancer Index (Italian-UCLA-PCI). Three trajectories were identified for the bowel function; having three or more comorbidities and the use of 3D-CRT technique for RT were associated with the worst trajectory (OR = 3.80, 95% CI 2.04–7.08; OR = 2.17, 95% CI 1.22–3.87, respectively). Two trajectories were identified for the bowel bother scores; diabetes and the non-Image guided RT method were associated with being in the worst bowel bother trajectory group (OR = 1.69, 95% CI 1.06–2.67; OR = 2.57, 95% CI 1.70–3.86, respectively). The findings from this study suggest that the absence of comorbidities and the use of intensity modulated RT techniques with image guidance are related with a better tolerance to RT in terms of bowel side effects

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

Background: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

CoKAAD: a Framework for Collaborative Architectural Design

Architectural Design, as in many other contexts, requires contribution from several experts, each with his/her own knowledge, experience, tools, and a source of possible problems, constraints, and suggestions. A collaborative approach consists in creating an opportunity for each expert to provide a contribution to the design process. In particular, in the early stages of the design process, most decisions with high impact are stated without developing a representation of the project within a standard model with unambiguous language: this would require details and time not available in those phases. Henceforth, there is a little space for provide individual contribution (constraints and/or suggestions) of various experts and compare these in those crucial stages. Such a collaboration would be fostered by adopting: (i) suitable models, with a simple but formal semantics, with the required flexibility for manipulating both data and metadata, and (ii) environments, based on this models, that allow the various experts to “plug-in” their own tools and knowledge, and provide their contribution since the very first stages of the project. Such an framework would provide a powerful environment to teach and learn what is notoriously hard to convoy in books, and even in lectures, that is good design methodologies and practices

The Hard Real-Time Problem on Ethernet

Popular wisdom says Ethernet is non-deterministic. This characteristic leads to consider it unsuitable for Real-Time services, since its fundamental access algorithm, called CSMA/CD, could not provide sufficiently consistent latency for deterministic applications. Simplifying, Ethernet is not able to ensure an access delay within a range known "a priori". At the moment, only three solutions for that problem in the industrial field are able to capture the attention, such as EtherCAT, Ethernet Powerlink and Profinet. This article shows analytically the Ethernet non-deterministic aspect and proposes a new solution that allows using Ethernet in industrial real time environments. Moreover it compares previous solutions with the proposed new one, pointing out pros and cons

Self-configuring BLE deep sleep network for fault tolerant WSN

This paper is focused on Wireless Sensor Network (WSN) leveraging on Bluetooth Low Energy (BLE) connectivity for low energy applications which is fault tolerant versus communication path failures. The topic is important to create a robust sensorized environment to be applied in industrial context or smart infrastructure to enable scheduled monitoring with low power consumption applications. Currently BLE applications are mainly thought for smart home solutions, health care and positioning systems. In those applications the BLE nodes are continuously supplied by external power suppliers. Our goal is to design a self-configuring network with a synchronized deep sleep behavior, aimed to optimize the energy consumption, with an overall active time interval constraint optimized with a data-driven method. The aim is to find a tradeoff between the on time and the ability to collect all the nodes data, pursuing a low power consumption. Our research is based on BLE protocols, interaction between edge systems for data collection and cloud system for data analysis and software agent optimization system. The paper analyses different configurations and describes the possible optimization algorithm to be used for the software agent design, in order to reach a fine-tuned control to improve the fault tolerance and fault diagnosis of the system. Finally experimental results are compared with the estimates obtained via a software simulation tool implemented for this architectural pattern

Ipsilateral supraclavicular lymph nodes metastases from breast cancer as only site of disseminated disease. Chemotherapy alone vs. induction chemotherapy to radical radiation therapy.

To define the role of radiotherapy (RT) in the treatment of ipsilateral supraclavicular lymph-nodes metastases (ISLM) from breast cancer as only site of disseminated disease, we started a prospective non-randomized clinical trial in 1989. Here we report the final results with a median follow-up of 8.75 years.Thirty-seven patients (pts), with ISLM from breast cancer, were consecutively enrolled into two arms. Arm A (18 pts): chemotherapy (CT) for six courses. Arm B (19 pts): CT for three courses followed by RT to the site of ISLM at 'radical' dose of 50-60 Gy.In arm A, a median Time to Progression (TtP) of 7 months with a median Overall Survival (OS) of 28 months was recorded. In comparison, patients in arm B had a longer median TtP with 20 months as well as a better median OS with 41 months, respectively. An actuarial five-year disease-free survival of 5.5\% was obtained in arm A vs. 21\% in arm B. A statistically significant difference in TtP was demonstrated between the two groups (P = 0.01).These data demonstrate that a better event-free survival could be achieved in patients with ISLM submitted to induction CT and radical irradiation. This also translated into a longer survival although this did not achieve statistical significance. We want to stress the importance of local control by RT since it does imply that not all of these patients have micrometastases at the time of relapse in the supraclavicular fossa