Internet-enabled technologies are becoming more widespread; users are constantly connected to the network in every place and daily activity. Access to transportation-related features—mobile payment ...systems, Global Positioning System connections, real-time public transit timetables or traffic congestion information, and so on—is easy. This access results in new ways to plan mobility. In the innovative mobility systems implemented and developed with these technologies, the new real-time capabilities of dynamic ridesharing, an extended version of traditional ridesharing, can play a key role if the relevant performance is improved. In other words, although ridesharing is not a new idea, recent technological advances should increase its popularity. In this paper, a proposed ridesharing system considers the interactions between drivers or riders and the system manager and the interactions between drivers and riders. The positions and speeds of the shared vehicles and the traffic flows in which such vehicles travel are omitted. To optimize the performance of the ridesharing system, a discrete event, dynamic pickup and delivery model that represents the considered dynamics and an optimal matching problem that optimally allocates an empty seat in a vehicle to a rider are proposed. The dynamic model represents the behavior of the ridesharing system and computes the relevant performance; the optimization problem finds the best match and path in the considered transportation network to minimize the difference between the desired departure and arrival times. In this paper, after the introduction of the ridesharing model, the discussion of the solution to the optimal matching problem, a simulation model is described. A real world case study is then presented and discussed.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
An urban network of signalized intersections can be suitably modeled as a hybrid system, in which the vehicle flow behavior is described by means of a time-driven model and the traffic light dynamics ...are represented by a discrete event model. In this paper, a model of such a network via hybrid Petri nets is used to state and solve the problem of coordinating several traffic lights with the aim of improving the performance of some classes of special vehicles, i.e., public and emergency vehicles. The proposed model has been validated using real traffic data relevant to the city of Torino, Italy. Some relevant experimental results are reported and discussed.
Purpose
Triple-negative breast cancer (TNBC) represents a subtype of breast cancer which lacks the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor ...receptor-2 (HER2): TNBC accounts for approximately 20% of newly diagnosed breast cancers and is associated with younger age at diagnosis, greater recurrence risk and shorter survival time. Therapeutic options are very scarce. Aim of the present analysis is to provide further insights into the clinical activity of metronomic chemotherapy (mCHT), in a real-life setting.
Methods
We used data included in the VICTOR-6 study for the present analysis. VICTOR-6 is an Italian multicentre retrospective cohort study, which collected data of metastatic breast cancer (MBC) patients who have received mCHT between 2011 and 2016. Amongst the 584 patients included in the study, 97 were triple negative. In 40.2% of the TNBC patients, mCHT was the first chemotherapy treatment, whereas 32.9% had received 2 or more lines of treatment for the metastatic disease. 45.4% out of 97 TNBC patients received a vinorelbine (VRL)-based regimen, which resulted in the most used type of mCHT, followed by cyclophosphamide (CTX)-based regimens (30.9%) and capecitabine (CAPE)-based combinations (22.7%).
Results
Overall response rate (ORR) and disease control rate (DCR) were 17.5% and 64.9%, respectively. Median progression free survival (PFS) and overall survival (OS) were 6.0 months (95% CI: 4.9–7.2) and 12.1 months (95% CI: 9.6–16.7). Median PFS was 6.9 months for CAPE-based regimens (95% CI: 5.0–18.4), 6.1 months (95% CI: 4.0–8.9) for CTX-based and 5.3 months (95% CI: 4.1–9.5) for VRL-based ones. Median OS was 18.2 months (95% CI: 9.1-NE) for CAPE-based regimens and 11.8 months for VRL- (95% CI: 9.3–16.7 and CTX-based ones (95%CI: 8.7–52.8). Tumour response, PFS and OS decreased proportionally in later lines.
Conclusion
This analysis represents the largest series of TNBC patients treated with mCHT in a real-life setting and provides further insights into the advantages of using this strategy even in this poor prognosis subpopulation.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
6.
One-Way Carsharing Di Febbraro, Angela; Sacco, Nicola; Saeednia, Mahnam
Transportation research record,
01/2012, Volume:
2319, Issue:
1
Journal Article
Peer reviewed
Carsharing services allow users to benefit from the advantages of a private car without the costs of owning one. One-way systems provide users with a higher level of service than traditional ...carsharing systems in terms of flexibility because users do not need to return to the station of origin. Moreover, the added option to leave the vehicle at any free parking area, which is not necessarily a station, increases the flexibility offered by the one-way system. Introduction of such improvements to the carsharing system, however, leads to a vehicle relocation problem, which should be addressed carefully to avoid concentration of vehicles in certain areas. This paper reports on a study of this issue with the use of discrete event systems (DESs), which allowed an easy representation of the complex dynamics of the carsharing system. A user-based methodology was proposed on the basis of an optimal relocation policy in a rolling horizon framework. This methodology not only offers greater flexibility to users, it also maximizes operator benefits by reducing the number of required staff to relocate vehicles among the stations and determines the minimum number of vehicles needed to satisfy system demand. The DES model was applied to a case study to evaluate the proposed approach. The results showed a significant decrease in the rejection rate from the worst scenario (no relocation) to the best (relocation of all vehicles by their users). The paper concludes with suggestions for additional research and improvements to this study.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Maintaining angiogenesis inhibition and switching the chemotherapy backbone represent the current second-line therapy in patients with RAS-mutant metastatic colorectal cancer (mCRC). Regorafenib, an ...oral multikinase inhibitor, prolonged overall survival (OS) in the chemorefractory setting.
STREAM was an academic, multicenter, single-arm phase II trial, evaluating the activity of regorafenib in RAS-mutant mCRC, in terms of the rate of patients who were progression-free after 6 months from study entry (6mo-PF). Patients were pretreated with fluoropyrimidine, oxaliplatin, and bevacizumab. According to Simon’s two-stage design, ≥18 patients 6mo-PF were needed in the overall population (N = 46). Secondary endpoints were safety, objective response rate (ORR), progression-free survival (PFS), and OS. Early metabolic response by 18F2-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (18F-FDG PET/CT) scan was an exploratory endpoint. EudraCT Number: 2015-001105-13.
The number of patients 6mo-PF was 8/22 at the first stage and 14/46 in the overall population. The ORR was 10.9%, disease control rate was 54.6%, median (m)PFS was 3.6 months 95% confidence interval (CI) 1.9-6.7 months, mOS was 18.9 months (95% CI 10.3-35.3 months), and mPFS2 (from study entry to subsequent-line progression) was 13.3 months (95% CI 8.4-19.7 months). Long benefiter patients (>6mo-PF) significantly more often had a single metastatic site and lung-limited disease. No unexpected toxicity was reported. Grade ≥3 events occurred in 39.1% of patients, with hand–foot syndrome (13%), fatigue, and hyperbilirubinemia (6.5%) occurring mostly. Baseline metabolic assessment was associated with OS in the multivariate analysis, while early metabolic response was not associated with clinical outcomes.
The study did not meet its primary endpoint. However, regorafenib was well tolerated and did not preclude subsequent treatments. Patients with good prognostic features (single metastatic site and lung-limited disease) reported clinical benefit with regorafenib. The exploratory metabolic analysis suggests that baseline 18F-FDG PET/CT might be useful to select patients with a favorable outcome. A chemotherapy-free interval with regorafenib was associated with durable disease control in a selected group of patients with favorable clinical characteristics.
•Early-lines treatment of patients with RAS-mutant mCRC consists of chemotherapy and antiangiogenic agents.•STREAM evaluated regorafenib as second line for RAS-mutant mCRC, in terms of rate of patients progression-free at 6 months.•The primary endpoint of STREAM was not met. Regorafenib had no unexpected toxicity and did not preclude subsequent therapies.•A chemotherapy-free interval with regorafenib was beneficial in patients with good prognostic features.•Baseline 18F-FDG PET/CT might be useful to select patients with favorable outcomes.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Anthracyclines and platinum derivates are active drugs for advanced endometrial carcinoma (AEC), but new schedules with higher efficacy and better tolerability are needed. A phase II study was ...conducted to describe activity and tolerability of carboplatin (C)+pegylated liposomal doxorubicin (PLD) in patients with AEC. Patients with chemonaive AEC, PS < or = 2, aged < 75 years, with at least one measurable lesion were eligible. Treatment was C (area under curve 5)+PLD (40 mg m(-2)) on day 1 every 4 weeks, up to six cycles. Forty-two patients were needed in a single-stage design, with at least 13 objective responses to define the treatment active. Forty-two patients were enrolled. Median age was 64 years (31-74). A total of 64% of patients were recurrent while 36% were advanced. Three complete (7%) and 22 partial responses (52%) were observed, for an overall response rate of 59.5% (95% exact CI: 43.3-74.3). One death potentially related to treatment was recorded (death at home for unknown reasons after 6th cycle). Other relevant toxicities (% of patients) were grade 3/4 neutropaenia 33%/14%, febrile neutropaenia 5%, grade 3/4 thrombocytopaenia 17%/5%, grade 3/4 anaemia 31%/2%. Skin toxicity was mild: grade 1 14%, grade 2 10%, grade 3 5%. Hair loss: complete 5%, partial 12%. The combination of carboplatin and PLD shows good activity and favourable toxicity as first-line chemotherapy of patients with AEC, deserving further studies in this setting.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
•Develops an agent-based modeling framework for planning of intermodal freight transport chains.•Each actor keeps its independent decision-making process.•The dynamics of operations are modeled using ...discrete event systems.•Cooperation improves efficiency significantly in systems operating close to capacity.
The recent development of Intelligent Transportation Systems offers the possibility of cooperative planning of multi-actor systems in a distributed framework, by enabling prompt exchange of information among actors. This paper proposes a modeling framework for cooperation in intermodal freight transport chains as multi-actor systems. In this framework, the problem of optimizing freight transportation is decomposed into a suitable set of sub-problems, each representing the operations of an actor which are connected using a negotiation scheme. A Discrete Event model is developed which optimizes the system on a rolling horizon basis to account for the dynamics of intermodal freight transport operations. This framework allows for an event driven short/medium term planning of intermodal freight transport chains. The proposed methodology is evaluated using a realistic case study, and the results are compared against the First-Come-First-Served strategy, highlighting the significance of cooperation in systems operating close to capacity.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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