A multicenter, multinational analysis of mitomycin C in refractory metastatic colorectal cancer

Background: A considerable number of metastatic colorectal cancer (mCRC) patients who progress on standard treatment with 5-fluorouracil (5FU), oxaliplatin, irinotecan and monoclonal antibodies, still have adequate performance status and desire further treatment. Mitomycin C (MMC) has been widely used in this context, and despite good tolerability, there are doubts regarding its true benefit. Methods: In order to assess the activity of MMC in the refractory mCRC setting, we retrospectively evaluated 109 heavily pre-treated patients who received MMC as single agent or in combination for mCRC at three different institutions in two countries. Results: Median patient's age was 54 years old, 57% were male and 94% had performance status ECOG 0 or 1. MMC was used in second line in 11%, third line in 38% and fourth line or beyond in 51% of patients. 58% received MMC combinations, mainly with capecitabine. Grade 3 or 4 toxicity was observed in 5% of patients and 6% required dose reductions. Median time to treatment failure (TTF) was 1.7 months with MMC and 3.6 months on the regimen prior to MMC, with a ratio between these TTF below 1 in 82% of patients. Median survival was only 4.5 months (95% confidence interval (CI) of 3.48-5.56). Conclusions: This retrospective data represent the largest reported series of unselected refractory mCRC patients treated with MMC. The median survival of 4.5 months is similar to the survival expected for best supportive care. This lack of activity strongly suggests that MMC should not be routinely used in refractory mCRC. (C) 2012 Elsevier Ltd. All rights reserved.

IINTERNATIONAL STRATEGY FOR AN EMERGING MULTINATIONAL IN BRAZIL: THE CASE OF JBS

The focus of this study is on questioning whether the traditional theories of internationalization are adequate to explain the international expansion of multinationals from emerging countries. Looking forward on this issue, we investigate the internationalization strategies adopted by JBS, a Brazilian multinational of the beef industry. The results show that the company adopted two of the five generic strategies specific to the context of emerging countries suggested by Ramamurti and Singh (2009): global consolidator and vertical integrator. Moreover, when analyzing the internationalization of the company under study, the speed of the process is highlighted when compared to traditional multinationals. It is concluded that the main mode of entry that allowed the international expansion was the acquisition and that this strategy has advantages to the company, such as access to strategic resources and rapid growth, possibly overcoming the liability of foreignness, the opportunity to compete globally and the diversification of segments that generate synergies to the company's activities.

A comparison of non-HDL and LDL cholesterol goal attainment in a large, multinational patient population: The Lipid Treatment Assessment Project 2

Objective: This study evaluated the success in attaining non-HDL-cholesterol (non-HDL-C) goals in the multinational L-TAP 2 study. Methods: 9955 patients >= 20 years of age with dyslipidemia on stable lipid-lowering therapy were enrolled from nine countries. Results: Success rates for non-HDL-C goals were 86% in low, 70% in moderate, and 52% in high-risk patients (63% overall). In patients with triglycerides of >200 mg/dL success rates for non-HDL-C goals were 35% vs. 69% in those with <= 200 mg/dL (p < 0.0001). Among patients attaining their LDL-C goal, 18% did not attain their non-HDL-C goal. In those with coronary disease and at least two risk factors, only 34% and 30% attained respectively their non-HDL-C and LDL-C goals. Rates of failure in attaining both LDL-C and non-HDL-C goals were highest in Latin America. Conclusions: Non-HDL-C goal attainment lagged behind LDL-C goal attainment; this gap was greatest in higher-risk patients. (c) 2012 Elsevier Ireland Ltd. All rights reserved.

Analisi e sviluppo di strumenti performance-aware per la migrazione cloud enterprise

Questa tesi affronta il tema dell'analisi della migrazione verso un ambiente cloud enterprise, con considerazioni sui costi e le performance rispetto agli ambienti di origine

Introduzione di un sistema di accesso wireless distribuito a gestione centralizzata in ambiente di tipo Enterprise o Campus

Nata dal progetto di migrazione, in un ambiente consolidato, di una infrastruttura Wireless distribuita su territorio all'interno di una MAN (Metropolitan Area Network), si cerca di illustrare quali sono i passi fondamentali da seguire e con cosa ci si deve misurare per progettare una soluzione funzionale ed elaborare una strategia avendo a che fare con architetture complesse, dove la messa in esercizio di un servizio offerto ad un numero elevato di utenti prevede uno studio ben preciso delle attività da svolgere. Un'attenta analisi, ci consentirà di seguire e riadattare le scelte implementative in funzione delle esigenze infrastrutturali, illustrandone le difficoltà, gli imprevisti e le modifiche intraprese passo passo. Gli argomenti trattati tendono a far comprendere con quali problematiche si ha a che fare nella fase implementativa passando dalla fase di analisi a quella decisionale, quella di migrazione architetturale e di installazione, oltre che alla scelta delle componenti e delle tecnologie specifiche che, prima di essere portate a regime, devono essere sottoposte agli opportuni test per la comprensione/risoluzione di problematiche complesse; come le operazioni necessarie per operare con una efficace metodologia.

Progetto e strumenti di federazione di endpoint sparql per Enterprise Architecture

La Federazione è un concetto molto utilizzato ed implementato in vari ambiti dell’informatica. In particolare sta avendo grande interesse nel Semantic Web, e risulta essere significativo e importante il suo utilizzo in una disciplina in grande evoluzione come l’Enterprise Architecture. L’obiettivo di questa tesi è stato implementare il concetto di Federazione di Endpoint SPARQL, dove l’elemento centrale è stata la condivisione del modello dei dati tra i vari membri, il quale rappresenta il patto della federazione. Successivamente sono stati messi in luce i benefici che questo tipo di soluzione apporta alla disciplina dell’Enterprise Architecture, in particolar modo nell’ambito dell’analisi dei dati. In relazione a quest’ultimo aspetto, il Semantic Web offre un linguaggio flessibile e facilmente evolvibile per rappresentare l’azienda e i suoi dati, oltre che ad un protocollo standard per la loro interrogazione, ovvero lo SPARQL. La federazione, invece, apporta dei miglioramenti rendendo le fonti dato omogenee dal punto di vista del modello, utilizza un unico protocollo per l’accesso ad essi (SPARQL), ed elimina le criticità in relazione alla normalizzazione dei dati nei processi di analisi. Questi due aspetti risultano abilitanti proprio per l’Enterprise Architecture. Infine sono state definite due possibili evoluzioni, in particolare un costrutto che permetta l’implementazione e la gestione della federazione a livello di linguaggio SPARQL, ed una ontologia standard e condivisibile tramite la quale gestire la federazione in modo trasparente.

Recovery and Analysis of Transaction Scope from Scattered Information in Java Enterprise Applications

Java Enterprise Applications (JEAs) are large systems that integrate multiple technologies and programming languages. Transactions in JEAs simplify the development of code that deals with failure recovery and multi-user coordination by guaranteeing atomicity of sets of operations. The heterogeneous nature of JEAs, however, can obfuscate conceptual errors in the application code, and in particular can hide incorrect declarations of transaction scope. In this paper we present a technique to expose and analyze the application transaction scope in JEAs by merging and analyzing information from multiple sources. We also present several novel visualizations that aid in the analysis of transaction scope by highlighting anomalies in the specification of transactions and violations of architectural constraints. We have validated our approach on two versions of a large commercial case study.

Diagnostic reproducibility of tumour budding in colorectal cancer: a multicentre, multinational study using virtual microscopy

Puppa G, Senore C, Sheahan K, Vieth M, Lugli A, Zlobec I, Pecori S, Wang L M, Langner C, Mitomi H, Nakamura T, Watanabe M, Ueno H, Chasle J, Conley S A, Herlin P, Lauwers G Y & Risio M (2012) Histopathology Diagnostic reproducibility of tumour budding in colorectal cancer: a multicentre, multinational study using virtual microscopy Aims:  Despite the established prognostic relevance of tumour budding in colorectal cancer, the reproducibility of the methods reported for its assessment has not yet been determined, limiting its use and reporting in routine pathology practice. Methods and results:  A morphometric system within telepathology was devised to evaluate the reproducibility of the various methods published for the assessment of tumour budding in colorectal cancer. Five methods were selected to evaluate the diagnostic reproducibility among 10 investigators, using haematoxylin and eosin (H&E) and AE1-3 cytokeratin-immunostained, whole-slide digital scans from 50 pT1-pT4 colorectal cancers. The overall interobserver agreement was fair for all methods, and increased to moderate for pT1 cancers. The intraobserver agreement was also fair for all methods and moderate for pT1 cancers. Agreement was dependent on the participants' experience with tumour budding reporting and performance time. Cytokeratin immunohistochemistry detected a higher percentage of tumour budding-positive cases with all methods compared to H&E-stained slides, but did not influence agreement levels. Conclusions:  An overall fair level of diagnostic agreement for tumour budding in colorectal cancer was demonstrated, which was significantly higher in early cancer and among experienced gastrointestinal pathologists. Cytokeratin immunostaining facilitated detection of budding cancer cells, but did not result in improved interobserver agreement.

Service Descriptions and Linked Data for Integrating WSNs into Enterprise IT

This paper presents our ongoing work on enterprise IT integration of sensor networks based on the idea of service descriptions and applying linked data principles to them. We argue that using linked service descriptions facilitates a better integration of sensor nodes into enterprise IT systems and allows SOA principles to be used within the enterprise IT and within the sensor network itself.