Objectives: To assess whether high doses of Low Molecular Weight Heparin (LMWH) (i.e. Enoxaparin 70 IU/kg twice daily) compared to standard prophylactic dose (i.e., Enoxaparin 4000 IU once day), in hospitalized patients with COVID19 not requiring Invasive Mechanical Ventilation [IMV], are: a) more effective in preventing clinical worsening, defined as the occurrence of at least one of the following events, whichever comes first: 1. Death 2. Acute Myocardial Infarction [AMI] 3. Objectively confirmed, symptomatic arterial or venous thromboembolism [TE] 4. Need of either: a. Continuous Positive Airway Pressure (Cpap) or Non-Invasive Ventilation (NIV) or b. IMV in patients who at randomisation were receiving standard oxygen therapy

COVID-19 infection causes respiratory pathology with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The current guidelines recommend the use of thromboprophylaxis in patients with COVID-19, however, the optimal heparin dosage treatment is not well-established. We conducted a multicentre, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. The strategies used for thromboprophylaxis and its role on patient outcome were, also, described. 1091 patients hospitalized were included in the START-COVID-19 Register. During hospital stay, 769 (70.7%) patients were treated with antithrombotic drugs: low molecular weight heparin (the great majority enoxaparin), fondaparinux, or unfractioned heparin. These patients were more frequently affected by comorbidities, such as hypertension, atrial fibrillation, previous thromboembolism, neurological disease, and cancer with respect to patients who did not receive thromboprophylaxis. During hospital stay, 1.2% patients had a major bleeding event. All patients were treated with antithrombotic drugs; 5.4%, had venous thromboembolism [30.5% deep vein thrombosis (DVT), 66.1% pulmonary embolism (PE), and 3.4% patients had DVT + PE]. In our cohort the mortality rate was 18.3%. Heparin use was independently associated with survival in patients aged ≥ 59 years at multivariable analysis. We confirmed the high mortality rate of COVID-19 in hospitalized patients in ordinary wards. Treatment with antithrombotic drugs is significantly associated with a reduction of mortality rates especially in patients older than 59 years.

Wheelchair Mounted Robotic Arms (WMRA) can be used by people with severe motor skill impairment, such as SMA (Spinal Muscular Atrophy), Cerebral Palsy etc⋯, in order to achieve daily life tasks. Many of those systems have been presented in literature and are available on the market but they are really expensive and bulky. Instead we propose a simple robotic arm with 4 Degrees of Freedom (DOF), controlled by a cheap embedded platform in order to keep the size and the cost as low as possible. This paper presents the design and evaluation of a simple visual servoing control loop for the robotic arm based on a camera mounted on the arm end effector. A lot of attention has been given to the design process of an effective and more accessible human machine interface, in order to make the arm simply usable by the user. Tests and evaluations were performed on a simplified version of the final system prove the effectiveness of the proposed solution. However further optimization have to be achieved in order to make the whole system really usable in a real-word scenario

D-dimer assay is used to stratify patients with unprovoked venous thromboembolism (VTE) for the risk of recurrence. However, this approach was never evaluated since direct oral anticoagulants are available. With this multicenter, prospective cohort study we aimed at assessing the value of an algorithm incorporating serial D-dimer testing and administration of reduced dose apixaban (2.5 mg twice daily) only to patients with positive test. 732 outpatients aged 18 to 74 years, anticoagulated for at least 12 months after a first unprovoked VTE were included. Patients underwent D-dimer testing with commercial assays and pre-established cutoffs. If the baseline D-dimer, during anticoagulation, was negative, anticoagulation was stopped and testing repeated after 15, 30, and 60 days. Patients with serially negative results (286; 39.1%) were left without anticoagulation. At first positive result, the remaining 446 patients (60.9%) were given apixaban for 18 months. All patients underwent follow-up planned for 18 months. The study was interrupted after a planned interim analysis for the high rate of primary outcomes (7.3%; 95% CI, 4.5 to 11.2), including symptomatic proximal DVT or PE recurrence, death for VTE, major bleeding, occurring in patients off anticoagulation, versus that in those receiving apixaban (1.1%; 95% CI, 0.4 to 2.6; adjusted HR, 8.2; 95% CI, 3.2 to 25.3). In conclusion, in patients anticoagulated for at least one year after a first unprovoked VTE, the decision whether to further extend anticoagulation should not be based on D-dimer testing. The results confirmed the high efficacy and safety of reduced dose apixaban against recurrences. ClinTrials.gov: NCT03678506.

Modern networks have critical security needs and a suitable level of protection and performance is usually achieved with the use of dedicated hardware cryptographic cores. Although the Advanced Encryption Standard (AES) is considered the best approach when symmetric cryptography is required, one of its main weaknesses lies in its measurable power consumption. Side-Channel Attacks (SCAs) use this emitted power to analyse and revert the mathematical steps and extract the encryption key. Nowadays they exist several dedicated equipments and workstations for SCA weaknesses analysis and the evaluation of the related countermeasures, but they can present significant drawbacks as an high cost for the instrumentation or, in case of cheaper instrumentation, the need to underclock the physical circuit implementing the AES cipher, in order to adapt the circuit clock frequency accordingly to the power sampling rate of ADCs or oscilloscopes bandwidth. In this work we proposed a methodology for Correlation and Differential Power Analysis against hardware implementations of an AES core, relying only on a simulative approach. Our solution extracts simulated power traces from a gate-level netlist and then elaborates them using mathematical-statistical procedures. The main advantage of our solution is that it allows to emulate a real attack scenario based on emitted power analysis, without requiring any additional physical circuit or dedicated equipment for power samples acquisition, neither modifying the working conditions of the target application context (such as the circuit clock frequency). Thus our approach can be used to validate and benchmark any SCA countermeasure during an early step of the design, thereby shortening and helping the designers to find the best solution during a preliminary phase and potentially without additional costs.