Emerging serverless computing technologies, such as function as a service (FaaS), enable developers to virtualize the internal logic of an application, simplifying the management of cloud-native ...services and allowing cost savings through billing and scaling at the level of individual functions. Serverless computing is therefore rapidly shifting the attention of software vendors to the challenge of developing cloud applications deployable on FaaS platforms. In this vision paper, we present the research agenda of the RADON project (
http://radon-h2020.eu
), which aims to develop a model-driven DevOps framework for creating and managing applications based on serverless computing. RADON applications will consist of fine-grained and independent microservices that can efficiently and optimally exploit FaaS and container technologies. Our methodology strives to tackle complexity in designing such applications, including the solution of optimal decomposition, the reuse of serverless functions as well as the abstraction and actuation of event processing chains, while avoiding cloud vendor lock-in through models.
Radiation-induced hypopituitarism is an important late complication of cranial radiotherapy in children and adults. The purpose of this cross-sectional study was to evaluate the effects of ...radiotherapy on pituitary function in adult nasopharyngeal carcinoma patients.
Pituitary function was evaluated in 30 patients after cranial radiotherapy for nasopharyngeal carcinoma. Somatotroph and corticotroph axes were assessed by insulin tolerance test while gonadotroph and thyroid axes were evaluated by basal pituitary and end organ hormone levels at 10-133 months after radiotherapy.
At least one hormonal disorder was observed in 28 (93%) patients after radiotherapy. 26 (87%) patients had one or more anterior pituitary hormone deficiencies. The rates of pituitary hormone deficiencies were 77% for growth hormone, followed by adrenocorticotropic hormone (73%), thyroid-stimulating hormone (27%) and gonadotropins (7%). Hyperprolactinemia was present in 13 (43%) patients.
Radiation-induced hypopituitarism is more common than expected in patients with nasopharyngeal carcinoma.
In this study, we aimed to evaluate the effect of tumor size and tumor sidedness on prognosis in patients with stage 2 colon cancer.
Data of 501 patients diagnosed with stage 2 colon cancer were ...evaluated retrospectively. It was evaluated whether the patients' age, gender, tumor differentiation, tumor node metastasis (TNM) stage, overall survival rate, and disease-free survival rate had any correlation with horizontal tumor diameter and tumor sidedness. In the ROC analysis performed to determine the cut-off value for the tumor diameter, which we think will predict survival, no significant results were obtained with maximum sensitivity and specificity. Therefore, the median value of the tumor diameter, which is 5 cm, was accepted as the cut-off value. Kaplan-Meier method and Cox regression analysis were used for survival analysis and determination of prognostic factors.
When the patients were evaluated in terms of tumor localization, 189 (37.7%) patients had right colon tumors and 312 (62.3%) patients had left colon tumors. There was no statistically significant difference in terms of disease-free survival and overall survival according to tumor localization. When the patients were analyzed by dividing them into two groups according to the horizontal tumor size (<5 cm and ≥5 cm), no statistically significant difference was found between the groups in terms of disease-free survival (DFS) and overall survival (OS) p=0.085, p=0.699, respectively.
Our results suggest that the management of patients with stage 2 colon cancer requires a better understanding of tumor biology rather than features such as tumor size and localization.
Introduction High and equitable coverage of systematic cardiovascular disease (CVD) prevention programmes, such as the NHS Health Check programme in England, is essential if they are to effectively ...reduce the population CVD burden. Methods We conducted a cross-sectional study using data from 151 English primary care trusts (PCTs) on NHS Health Check coverage during 2011-12. We examined the associations between programme coverage and primary care and population factors, including patient demographics, primary care workforce and cardiovascular health need. Results Median coverage of NHS Health Checks was 8.2%, with wide PCT-level variation (range = 0-29.8%). Coverage was significantly higher in PCTs in the most deprived areas compared with the least deprived (P = 0.035), adjusting for covariates. Significant negative associations between coverage and a higher proportion of PCT population aged 40-74 years—the eligible Health Check age group, a larger total population size and higher practice staffing levels were found in the unadjusted analyses. Conclusions NHS Health Check coverage during 2011 -12 was lower than the government projection of 18% coverage. Coverage must be increased through concerted multi-disciplinary strategies, for the programme to improve cardiovascular health in England. Considerable variation in participation between PCTs warrants attention, with enhanced support for poor performers.
Purpose
There is clinical need to predict risk of febrile neutropenia before a specific cycle of chemotherapy in cancer patients.
Methods
Data on 3882 chemotherapy cycles in 1089 consecutive patients ...with lung, breast, and colon cancer from four teaching hospitals were used to construct a predictive model for febrile neutropenia. A final nomogram derived from the multivariate predictive model was prospectively confirmed in a second cohort of 960 consecutive cases and 1444 cycles.
Results
The following factors were used to construct the nomogram: previous history of febrile neutropenia, pre-cycle lymphocyte count, type of cancer, cycle of current chemotherapy, and patient age. The predictive model had a concordance index of 0.95 (95 % confidence interval (CI) = 0.91–0.99) in the derivation cohort and 0.85 (95 % CI = 0.80–0.91) in the external validation cohort. A threshold of 15 % for the risk of febrile neutropenia in the derivation cohort was associated with a sensitivity of 0.76 and specificity of 0.98. These figures were 1.00 and 0.49 in the validation cohort if a risk threshold of 50 % was chosen.
Conclusions
This nomogram is helpful in the prediction of febrile neutropenia after chemotherapy in patients with lung, breast, and colon cancer. Usage of this nomogram may help decrease the morbidity and mortality associated with febrile neutropenia and deserves further validation.
Purpose
In this study, we aimed to describe the real-life practice outcomes of pertuzumab–trastuzumab–taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) ...patients.
Methods
This study was conducted by Turkish Oncology Group and included 317 patients’ data from 36 centers.
Results
Median age was 51 (22–82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (
n
: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m;
p
= 0.002) and OS (26.7 m vs. 40.3 m;
p
= 0.009). Patients older than 65 years of age (
n
: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m;
p
= 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5–40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure.
Conclusions
Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab–trastuzumab–taxane therapy to date.
Reasearch Highlights • Despite a number of limitations to our study findings, we were careful in interpreting the findings and presented them in a balanced manner. • We argue that secular trends in ...risk factors may not have large impact on the changes in risk in our study. • We suggest that regression to the mean does not account for the observed changes in risk. • We argue that our title was not suggestive that the program was effective, but explores the impact of the program.
Background Identification of biomarkers that can be used for the prognostic evaluation of NSCLC patients is important. The aim of this study was to evaluate the potential prognostic value of XRCC1 , ...ERCC1 , ERCC2 , and TP53 SNPs in completely resected NSCLC patients. Methods One hundred and thirty patients, who had been surgically treated for NSCLC between 2000 and 2012, were included in this study. Analysis of SNPs from peripheral blood cells was performed by PCR. XRCC1 Arg399Gln, ERCC1 Asn118Asn, ERCC2 Lys751Gln, and TP53 Arg72Pro polymorphisms were evaluated in conjunction with clinical and pathological parameters and survival. Kaplan–Meier method and Cox regression analysis were used. Findings In the univariate analysis for disease-free survival (DFS), postoperative stage (hazard ratio HR 0.50, 95% confidence interval CI 0.26–0.96; p = 0.03), ERCC2 genotype (HR 2.47, 95% CI 1.28–4.78; p = 0.007), and PET-CT staging (HR 0.27, 95%CI 0.14–0.52; p < 0.001) were significant parameters. Adjuvant chemotherapy, age, and the other SNPs were not significant. In the multivariate analysis, post-operative stage (HR 0.40, 95% CI 0.20–0.81; p = 0.01), ERCC2 genotype (HR 2.66, 95% CI 1.35–5.27; p = 0.005), PET-CT staging (HR 0.24, 95% CI 0.12–0.47; p < 0.001) retained their significance. Median DFS was 56.5 months (95% CI 24.6–88.4) for the ERCC2 mutant (TT) and heterozygote (GT) genotypes, and 28.3 months (95% CI 20.8–35.8) for the ERCC2 normal (GG) genotype (p = 0.005). Interpretation In addition to stage and PET-CT staging, ERCC2 genotype independently predicted DFS in resected NSCLC patients. Future prospective studies are needed for the further evaluation of potential prognostic SNPs in resected NSCLC.
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