COVID-19 epidemic strongly affected cancer research in Italy: a survey of the Italian Cancer Society (SIC)

Background: Italy was among the first countries hit by the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The application of strict lockdown measures disproportionately affected both cancer patient care as well as basic and translational cancer research. Materials and methods: The Italian Cancer Society (SIC) conducted a survey on the effect of lockdown on laboratories involved in cancer research in Italy. The survey was completed by 570 researchers at different stages of their career, working in cancer centers, research institutes and universities from 19 Italian regions. Results: During the lockdown period, the impact of the COVID-19 pandemic emergency on face-to-face research activities was high, with a complete (47.7%) or partial (36.1%) shutdown of the laboratories. In the post-lockdown period, research activities were resumed in most of the respondents’ institutions (80.4%), though with some restrictions (77.2%). COVID-19 testing was offered to research personnel only in ~50% of research institutions. Overall, the response to the pandemic was fragmented as in many cases institutions adopted different strategies often aimed at limiting possible infections without a clearly defined contingency plan. Nevertheless, research was able to provide the first answers and possible ways out of the pandemic, also with the contribution of many cancer researchers that sacrificed their research programs to help overcome the pandemic by offering their knowledge and technologies. Conclusions: Given the current persistence of an emergency situation in many European countries, a more adequate organization of research centers will be urgent and necessary to ensure the continuity of laboratory activities in a safe environment

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Diagnostic accuracy of a rapid fecal test to confirm H pylori eradication after therapy: prospective comparison with a laboratory stool test.

AIM: To investigate the clinical performances of rapid stool test (ImmunoCard STAT HpSA, Meridian Diagnostic Inc.) in the evaluation of eradication therapy of H pylori and to compare it with a well-known and validated laboratory stool test (Amplified IDEA Hp StAR, Dako). METHODS: Stool samples of 122 patients were evaluated after eradication therapy of H pylori. H pylori status was assessed by 13C-urea breath test (UBT). Stool specimens were tested using either the rapid immunoassay kit or the laboratory immunoassay kit. RESULTS: Forty-three patients were infected and 79 non-infected. Sensitivity and specificity of ImmunoCard STAT and Hp StAR were 58.14% and 76.4%, and 97.47% and 98.73%, respectively (P > 0.05). Overall agreement between the two tests was 92.6% (113 of 122 cases). CONCLUSION: ImmunoCard STAT seems to have rather low performances, and it cannot be regarded as a reliable tool in the post-treatment setting. Also Hp StAR cannot be recommended to confirm H pylori eradication after treatment

Integrated safety and architecture modeling for automotive embedded systems

EAST-ADL is an architecture description language (ADL) for model-based development of automotive embedded systems. The formalization of domain-specific engineering information and methodology brings a potential for a wide range of benefits for information management, system design and integration, tool interaction, documentation and communication. This paper describes the EAST-ADL language support for safety requirements, faults/failures, hazards and safety constraints in the context of ISO/DIS 26262 reference safety lifecycle. Based on the language support, the safety related information can be derived and managed seamlessly along with its target nominal system architecture model with multiple abstraction levels and view extensions. Through model transformation and tool integration, automated safety analysis is allowed. © 2011 Springer-Verlag

EAST-ADL: An architecture description language for automotive software-intensive systems

International audienceEAST-ADL is an Architecture Description Language (ADL) initially defined in several European-funded research projects and subsequently refined and aligned with the more recent AUTOSAR automotive standard. It provides a comprehensive approach for defining automotive electronic systems through an information model that captures engineering information in a standardized form. Aspects covered include vehicle features, requirements, analysis functions, software and hardware components, and communication. The representation of the system's implementation is not defined in EAST-ADL itself but by AUTOSAR. However, traceability is supported from EAST-ADL's lower abstraction levels to the implementation level elements in AUTOSAR. In this chapter, the authors describe EAST-ADL in detail, show how it relates to AUTOSAR as well as other significant automotive standards, and present current research work on using EAST-ADL in the context of fully-electric vehicles, the functional safety standard ISO 26262, and for multi-objective optimization

Automatic allocation of safety integrity levels

In this paper, we describe a concept for the automatic allocationof general Safety Integrity Levels (SILs) to subsystems andcomponents of complex hierarchical networked architectures thatdeliver sets of safety critical functions. The concept is generic andcan be adapted to facilitate the safety engineering approachdefined in several standards that employ the concept of integrityor assurance levels including ISO 26262, the emergingautomotive safety standard. SIL allocation is facilitated by HiPHOPS,an automated safety analysis tool, and can be performed inthe context of development using EAST-ADL2, an automotivearchitecture description language. The process rationalizescomplex risk allocation and leads to optimal/economic allocationof SILs