Estimating the magnitude of trastuzumab effects within patient subgroups in the HERA trial.

BACKGROUND: Trastuzumab (Herceptin(R)) improves disease-free survival (DFS) and overall survival for patients with human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. We aimed to assess the magnitude of its clinical benefit for subpopulations defined by nodal and steroid hormone receptor status using data from the Herceptin Adjuvant (HERA) study. PATIENTS AND METHODS: HERA is an international multicenter randomized trial comparing 1 or 2 years of trastuzumab treatment with observation after standard chemotherapy in women with HER2-positive breast cancer. In total, 1703 women randomized to 1-year trastuzumab and 1698 women randomized to observation were included in these analyses. Median follow-up was 23.5 months. The primary endpoint was DFS. RESULTS: The overall hazard ratio (HR) for trastuzumab versus observation was 0.64 [95% confidence interval (CI) 0.54-0.76; P < 0.0001], ranging from 0.46 to 0.82 for subgroups. Estimated improvement in 3-year DFS in subgroups ranged from +11.3% to +0.6%. Patients with the best prognosis (those with node-negative disease and tumors 1.1-2.0 cm) had benefit similar to the overall cohort (HR 0.53, 95% CI 0.26-1.07; 3-year DFS improvement +4.6%, 95% CI -4.0% to 13.2%). CONCLUSIONS: Adjuvant trastuzumab therapy reduces the risk of relapse similarly across subgroups defined by nodal status and steroid hormone receptor status, even those at relatively low risk for relapse.

Balitskiǐ-Fadin-Kuraev-Lipatov equation versus data from DESY HERA

The BFKL equation and the kT-factorization theorem are used to obtain predictions for F2 in the small Bjo/rken-x region over a wide range of Q2. The dependence on the parameters, especially on those concerning the infrared region, is discussed. After a background fit to recent experimental data obtained at DESY HERA and at Fermilab (E665 experiment) we find that the predicted, almost Q2 independent BFKL slope λ≳0.5 appears to be too steep at lower Q2 values. Thus there seems to be a chance that future HERA data can distinguish between pure BFKL and conventional field theoretic renormalization group approaches. © 1995 The American Physical Society.

Color evaporation description of inelastic photoproduction of J/psi at DESY HERA

The H1 Collaboration recently reported a new analysis of data on the inelastic photoproduction of J/psi mesons at DESY's HERA ep collider. We show that these new experimental results are well described by the color evaporation model for quarkonium production. Moreover, these new data require the introduction of resolved photon contributions in order to accommodate the results in the kinematic region where the fractional energy carried by the J/psi is small, demonstrating that colored perturbative c (c) over bar states contribute to the production of a color singlet.

Bounds on contact interactions from LEP1 data and high-Q2 HERA events

A contact four-fermion interaction between light quarks and electrons has been evoked as a possible explanation for the excess of events observed by HERA at high-Q2. We explore the 1-loop effects of such interaction in Γ(Z0 → e+e-) measured at LEP and impose strong bounds on the lower limit of the effective scale. Our results are able to discard some of the contact interactions as possible explanation for the HERA events. © 1997 Elsevier Science B.V.

Inelastic photoproduction at HERA: A second charmonium crisis?

Measurements of the inelastic photoproduction of charmonium at HERA have ignited a new charmonium crisis. The Color Singlet approach to computing onium production cross sections fits the data for large charmonium energy fraction z, where color octet models fail. This approach is however in qualitative disagreement with a wealth of information that exist on charmonium production by other initial states. We here suggest that the source of the discrepancy between color octet models (whether implemented in the soft color or NRQCD formalism) and data is due to the neglect of non-perturbative effects. Implementing these in a scheme originally developed for Drell-Yan phenomenology, we illustrate how agreement with the data is achieved. © 1999 Elsevier Science B.V. All rights reserved.

Modellazione di processo in impianti di depurazione urbana finalizzata allo sviluppo di linee guida progettuali. Simulazioni e confronti su dati HERA full - scale.

Gli impianti di depurazione rappresentano, nei contesti urbani, elementi di imprescindibile importanza nell’ambito di una corretta gestione e tutela della risorsa idrica e dell’ambiente. Il crescente grado di antropizzazione delle aree urbanizzate e parallelamente le sempre minori disponibilità in termini di spazi utilizzabili a fini depurativi comportano sempre di più la necessità di ottimizzare i processi di dimensionamento degli impianti. Inoltre, l’obiettivo di aumentare l’efficienza del ciclo depurativo andando a minimizzare i costi correlati alla gestione degli stessi indirizza verso una omogeneizzazione nei criteri di dimensionamento adottati. In questo senso, la normativa tecnica di settore risulta carente, andandosi a concentrare prevalentemente sul rispetto di fissati standard ambientali senza però fornire indicazioni precise sui criteri di progettazione da adottare per perseguire tali standard. La letteratura scientifica pur indicando range di possibili valori di riferimento da adottare, nel dimensionamento degli impianti, lascia un ampio margine di discrezionalità al progettista. La presente tesi si pone pertanto, a partire da tali valori di letteratura, di andare a definire da un lato le caratteristiche quali-quantitative del refluo in ingresso e dall’altro i valori di riferimento da adottare in sede di progettazione per perseguire gli obiettivi precedentemente indicati. La prima parte, di valenza generale, oltre alla caratterizzazione dell’influente descrive nel dettaglio le diverse fasi del processo e il loro dimensionamento che in tutte le sezioni, ad eccezione del biologico, viene effettuato attraverso equazioni semplificate mettendo a confronto e analizzando i parametri progettuali proposti da letteratura. Per quanto riguarda il comparto biologico la maggior complessità del fenomeno da descrivere rende difficile la valutazione delle grandezze che caratterizzano il funzionamento mediante l’utilizzo di equazioni semplificate. Per questo si è deciso di modellare questo comparto, unito a quello della sedimentazione, attraverso un software (WEST) che permette non solo di simulare il processo ma anche, attraverso le analisi di scenario, di determinare quelli che sono i valori progettuali puntuali che consentono di ottenere da un lato una minimizzazione dei costi dell’impianto, sia costruttivi che gestionali, e dall’altro la massimizzazione delle rese depurative. Nello specifico si è fatto riferimento ad impianto fanghi attivi a schema semplificato con potenzialità fissata pari a 10000 AE. Il confronto con i dati di esercizio di alcuni impianti di analoga tipologia ha evidenziato che una buona capacità dello strumento di modellazione utilizzato di descrivere i processi. E’ possibile quindi concludere che tali strumenti, affiancati ad una lettura critica dei risultati ottenuti possono essere ottimi strumenti di supporto sia in fase di progettazione che in prospettiva di gestione dell’impianto al fine di ottimizzare i processi e quindi i costi.

Dematerializzazione e risparmio energetico in Hera spa: Analisi LCA e titoli di efficienza energetica.

Il seguente lavoro di tesi è stato svolto in Hera S.p.A. Il caso di studio riguarda il passaggio dalla bolletta cartacea alla bolletta elettronica. In particolare, sono stati messi a confronto i due modelli di bollettazione attraverso l'analisi LCA. In seguito sono stati calcolati i risparmi energetici conseguiti, misurati in tep, attraverso i quali è stato possibile creare una proposta di scheda tecnica per la quantificazione dei risparmi di energia primaria.

Longer-term assessment of trastuzumab-related cardiac adverse events in the Herceptin Adjuvant (HERA) trial

We investigated the incidence of cardiac adverse events in patients with early breast cancer in the Herceptin Adjuvant (HERA) trial who were treated with 1 year of trastuzumab after completion of (neo)adjuvant chemotherapy.

2 years versus 1 year of adjuvant trastuzumab for HER2-positive breast cancer (HERA): an open-label, randomised controlled trial

BACKGROUND Trastuzumab has established efficacy against breast cancer with overexpression or amplification of the HER2 oncogene. The standard of care is 1 year of adjuvant trastuzumab, but the optimum duration of treatment is unknown. We compared 2 years of treatment with trastuzumab with 1 year of treatment, and updated the comparison of 1 year of trastuzumab versus observation at a median follow-up of 8 years, for patients enrolled in the HERceptin Adjuvant (HERA) trial. METHODS The HERA trial is an international, multicentre, randomised, open-label, phase 3 trial comparing treatment with trastuzumab for 1 and 2 years with observation after standard neoadjuvant chemotherapy, adjuvant chemotherapy, or both in 5102 patients with HER2-positive early breast cancer. The primary endpoint was disease-free survival. The comparison of 2 years versus 1 year of trastuzumab treatment involved a landmark analysis of 3105 patients who were disease-free 12 months after randomisation to one of the trastuzumab groups, and was planned after observing at least 725 disease-free survival events. The updated intention-to-treat comparison of 1 year trastuzumab treatment versus observation alone in 3399 patients at a median follow-up of 8 years (range 0-10) is also reported. This study is registered with ClinicalTrials.gov, number NCT00045032. FINDINGS We recorded 367 events of disease-free survival in 1552 patients in the 1 year group and 367 events in 1553 patients in the 2 year group (hazard ratio [HR] 0·99, 95% CI 0·85-1·14, p=0·86). Grade 3-4 adverse events and decreases in left ventricular ejection fraction during treatment were reported more frequently in the 2 year treatment group than in the 1 year group (342 [20·4%] vs 275 [16·3%] grade 3-4 adverse events, and 120 [7·2%] vs 69 [4·1%] decreases in left ventricular ejection fraction, respectively). HRs for a comparison of 1 year of trastuzumab treatment versus observation were 0·76 (95% CI 0·67-0·86, p<0·0001) for disease-free survival and 0·76 (0·65-0·88, p=0·0005) for overall survival, despite crossover of 884 (52%) patients from the observation group to trastuzumab therapy. INTERPRETATION 2 years of adjuvant trastuzumab is not more effective than is 1 year of treatment for patients with HER2-positive early breast cancer. 1 year of treatment provides a significant disease-free and overall survival benefit compared with observation and remains the standard of care. FUNDING F Hoffmann-La Roche (Roche).

Developing Hera-FFX for WCAG 2.0

WCAG 2.0 was published in December 2008. It has many differences to WCAG 1.0 as to rationale, structure and content. Two years later there are still few tools supporting WCAG 2.0, and none of them fully mirrors the WCAG 2.0 approach organized around principles, guidelines, success criteria, situations and techniques. This paper describes the on-going development of an update to the Hera-FFX Firefox extension to support WCAG 2.0. The description is focused on the challenges that we have found and our resulting decisions.