The Glasgow Prognostic Score (GPS) predicts toxicity and efficacy in platinum-based treated patients with metastatic lung cancer

Purpose: Lung cancer is the most common cause of cancer death. A cumulative prognostic score based on C-reactive protein and albumin, termed the Glasgow Prognostic Score (GPS), indicates the presence of systemic inflammatory response. GPS has been proposed as a powerful prognostic tool for patients with various types of malignant tumors, including lung cancer. The aim of this study was to assess the predictive value of baseline GPS in terms of toxicity and response in lung cancer patients treated with platinum-based chemotherapy. Patients and methods: Patients referred to our institution for consideration of first-line platinum-based treatment were eligible. Demographics and disease-related characteristics were recorded. Toxicity was graded according to NCI CTCAE version 3.0 throughout first-line therapy. GPS was calculated before the onset of treatment and was related to the development of toxicity. Response to first-line therapy and survival data were also collected. Results: Totally, 96 lung cancer patients were accrued. GPS was associated with increased mucositis p = 0.004), neurotoxicity (p = 0.038), neutropenia (p =0.02), dose reductions or/ and need for granulocyte colony-stimulating factor (G-CSF) support (p=0.005), toxicity-related termination of treatment (p=0.001) and chemotherapy-related toxic deaths (p=0.013). GPS was associated with overall survival (p=0.016) and progression-free survival (p=0.016) as well as response to treatment (p=0.05). Conclusions: Our data demonstrate that GPS assessment is predictive of the most important aspects of platinum-related toxicity and this may partly explain its associations with poor clinical outcome in patients with metastatic lung cancer. (C) 2012 Elsevier Ireland Ltd. All rights reserved

Beneficial effects of intermediate dosage of anticoagulation treatment on the prognosis of hospitalized COVID-19 patients: The ETHRA study

Background/Aim: To investigate the efficacy (prognosis, coagulation/inflammation biomarkers) and safety (bleeding events) of different anticoagulation dosages in COVID-19 inpatients. Patients and Methods: COVID-19 inpatients (Athens, Greece) were included. The "Enhanced dose THRomboprophylaxis in Admissions (ETHRA)" protocol was applied in certain Departments, suggesting the use of intermediate anticoagulation dosage. The primary endpoint was a composite of intubation/venous thromboembolism/death. Inflammation/coagulation parameters were assessed. Results: Among 127 admissions, 95 fulfilled the inclusion criteria. Twenty-one events (4 deaths, 17 intubations) were observed. Regression analysis demonstrated significant reduction of events with intermediate or therapeutic dosage [HR=0.16 (95%CI=0.05-0.52) p=0.002; HR=0.17 (0.04-0.71) p=0.015, respectively]. D-Dimer values were higher in those who met the composite endpoint. Intermediate dosage treatment was associated with decreased values of ferritin. Three patients (3%) had minor hemorrhagic complications. Conclusion: Anticoagulation treatment (particularly intermediate dosage) appears to have positive impact on COVID-19 inpatients' prognosis by inhibiting both coagulation and inflammatory cascades. © 2021 International Institute of Anticancer Research. All rights reserved

Comparative immunogenicity of BNT162b2 mRNA vaccine with natural SARS-CoV-2 infection

BNT162b2 has proven to be highly effective, but there is a paucity of data regarding immunogenicity factors and comparison between response to vaccination and natural infection. This study included 871 vaccinated healthcare workers (HCW) and 181 patients with natural infection. Immunogenicity was assessed by measuring anti-SARS-CoV-2 against the RBD domain of the spike protein (anti-RBD). Samples were collected 1–2 weeks after vaccination or 15–59 days post-onset of symptoms. Post-vaccine anti-RBD concentrations were associated with age, gender, vaccination side-effects (VSE) and prior infection (Pr-CoV). Anti-RBD median levels (95%CI) were lower by 2466 (651–5583), 6228 (3254–9203) and 7651 (4479–10,823) AU/mL in 35–44, 45–54, 55–70 yrs, respectively, compared with the 18–34 yrs group. In females, the median levels were higher by 2823 (859–4787), 5024 (3122–6926) in individuals with VSE, and 9971 (5158–14,783) AU/mL in HCWs with Pr-CoV. The ratio of anti-RBD in vaccinated individuals versus those with natural infection varied from 1.0 to 19.4. The high immunogenicity of BNT162b2 is verified, although its sustainability has yet to be elucidated. The use of comparative data from natural infection serological panels, expressing the clinical heterogeneity of natural infection, may facilitate early decisions for candidate vaccines to be evaluated in clinical trials. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

A nationwide study about the dispersal patterns of the predominant HIV-1 subtypes A1 and B in Greece: Inference of the molecular transmission clusters

Our aim was to investigate the dispersal patterns and parameters associated with local molecular transmission clusters (MTCs) of subtypes A1 and B in Greece (predominant HIV-1 subtypes). The analysis focused on 1751 (28.4%) and 2575 (41.8%) sequences of subtype A1 and B, respectively. Identification of MTCs was based on phylogenetic analysis. The analyses identified 38 MTCs including 2–1518 subtype A1 sequences and 168 MTCs in the range of 2–218 subtype B sequences. The proportion of sequences within MTCs was 93.8% (1642/1751) and 77.0% (1982/2575) for subtype A1 and B, respectively. Transmissions within MTCs for subtype A1 were associated with risk group (Men having Sex with Men vs. heterosexuals, OR = 5.34, p < 0.001) and Greek origin (Greek vs. non-Greek origin, OR = 6.05, p < 0.001) and for subtype B, they were associated with Greek origin (Greek vs. non-Greek origin, OR = 1.57, p = 0.019), younger age (OR = 0.96, p < 0.001), and more recent sampling (time period: 2011–2015 vs. 1999–2005, OR = 3.83, p < 0.001). Our findings about the patterns of across and within country dispersal as well as the parameters associated with transmission within MTCs provide a framework for the application of the study of molecular clusters for HIV prevention. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

A call to action toward integrated testing and earlier care for viral hepatitis, HIV, STIs and TB

Objectives. The objective of the paper is to present the outcomes of the HepHIV 2019 conference, held in Bucharest under the Romanian EU Presidency and focusing on challenges of timely and integrated testing and care. Methods. The conference programme was put together by the organizing committee. It consisted of invited talks and peer-reviewed abstracts. Results. In all, 65 abstracts from 20 countries were presented during the conference, which had nearly 250 delegates, including high-profile political representation. The conference highlighted the need to shift towards further disease integration because of the epidemiological characteristics of the hepatitis B (HBV), hepatitis C (HCV), HIV, sexually transmitted infection (STIs) and tuberculosis (TB) epidemics in the WHO European region. Integration should be a priority in the response to the epidemics to better reach key populations and to ensure better testing coverage. This relates to both the integration of services in shared care models and the integration of different settings and stakeholders in national strategies. Conclusions. The conference demonstrated the need for greater political support for the policy changes required to implement integration. Testing normalization efforts are key to maximizing the impact of integration efforts. The conference call to action can help to guide developments in testing and linkage-to-care interventions across the European region.The HepHIV 2019 Bucharest Conference was co-funded with the Health Programme of the European Union and the EU Health Project Symposium; Integrated Testing and Synergies was funded by the Health Programme of the European Union. The HepHIV 2019 Bucharest Conference was funded by the HIV in Europe/EuroTEST Initiative that received sponsorship funds for this purpose from Gilead, Merck MSD, ViiV Healthcare, Abbvie, Autotest Santé (AAZ-LMB), Cepheid, InTec, OraSure and SH:24. The funders had no role in the study design, analysis, decision to publish, or preparation of the manuscript

Reinforcement learning-based spectrum management for cognitive radio networks: A literature review and case study

In cognitive radio (CR) networks, the cognition cycle, i.e., the ability of wireless transceivers to learn the optimal configuration meeting environmen- tal and application requirements, is considered as important as the hardware components which enable the dynamic spectrum access (DSA) capabilities. To this purpose, several machine learning (ML) techniques have been applied on CR spectrum and network management issues, including spectrum sensing, spectrum selection, and routing. In this paper, we focus on reinforcement learning (RL), an online ML paradigm where an agent discovers the optimal sequence of actions required to perform a task via trial-end-error interactions with the environment. Our study provides both a survey and a proof of concept of RL applications in CR networking. As a survey, we discuss pros and cons of the RL framework compared to other ML techniques, and we provide an exhaustive review of the RL-CR literature, by considering a twofold perspective, i.e., an applicationdriven taxonomy and a learning methodology-driven taxonomy. As a proof of concept, we investigate the application of RL techniques on joint spectrum sensing and decision problems, by comparing different algorithms and learning strategies and by further analyzing the impact of information sharing techniques in purely cooperative or mixed cooperative/competitive tasks