PURPOSE: The purpose of this study was to compare the rate of grade 3-4 immune related adverse events (irAEs) in patients with advanced metastatic melanoma treated with the combined anti-CTLA-4 and anti-PD-immune-therapy at the Dana Farber Cancer Institute(DFCI), to that of the published rate of grade 3-4 irAEs among patients treated with the same combination of check-point therapy in the pivotal phase II and phase III trials that led to the FDA approval of the combination regimen. This study also measures the tumor response with the Ipi-Nivo combination therapy and overall-survival of patients in the study cohort at DFCI. METHODS/PROCEDURES: This is a retrospective cohort study conducted at DFCI during 2014 to 2016 among stage III/IV melanoma patients treated outside of the clinical trials with the Ipi-Nivo combination therapy. Chart review of the electronic medical record(EMR) was conducted to abstract the data for this study. irAEs were graded and classified as per the NCI-CTCAE v.4.0 guidelines. The comparison of the rate of grade 3 4 toxicity in the clinical settings at DFCI and the clinical trials was performed using a one sample proportion hypothesis test. For efficacy assessment of tumor response, RECIST1.1 criterion was used to ascertain the best clinical response. RESULTS: During an overall follow-up period of 600 days, 52 patients were treated on expanded access protocol (EAP) and commercial Ipi-Nivo combination therapy at DFCI. The rate of grade 3-4 immune mediated toxicity for this cohort of patients treated outside of clinical trials was 32.6%. The average rate of grade 3-4 irAEs reported in phase II/III clinical trials was approximately 55%. The results from the one-proportion hypothesis test [(P-value: 0.002) (95% C.I: 19.14-46.23)], prove that patients in the “real world” clinical settings have a different safety profile than patients treated in the clinical trials. The rate of grade 3-4 irAEs was found to be lower (19.14% to 46.23%) in the population treated with Ipi/Nivo combination therapy at the DFCI, compared to the check-mate clinical trials (approximately 55%) CONCLUSION: The results from the study indicate a lower rate of grade 3-4 irAEs in patients treated at DFCI, in comparison with the patients treated in the clinical trials for the Ipi-Nivo combination group. The results support the need for preemptive safety signal detection of symptoms of irAEs to improve patient’s safety. However, larger database studies are required for the generalizability of this results to a wider patient population treated outside of DFCI.

Byggindustrin är en komplex bransch där varje byggprojekt är unikt, vilket medför svårigheter i att finna logistiklösningar som är anpassade till byggarbetsplatsen. Beroende på omgivning och plats där bygget skall utföras, storlek på bygget, vilka material som ska användas under byggets olika skeden för konstruktion och hur flödet påverkas av transporter till byggarbetsplatsen. Examensarbetet är utfört i samarbete med Aurum Fastighetsutveckling och forskningsprojektet Fossilfri Bygglogistik, finansierat av Triple F. Aurum Fastighetsutveckling är intresserade av att se hur ett tänkbart transportflöde för byggarbetsplatsen Berg Äng som är planerad mellan 2024–2028 kan se ut under olika faser för byggnadsprojektet. Syftet med denna studie är därför att genomföra en simulering för ett undersöka transportflödet och effekterna för olika logistiklösningar under byggnadsprocessen. Syftet har utformats baserat på tre frågeställningar, vilka har besvarats med hjälp av kvantitativa och kvalitativa metoder. De kvalitativa metoderna består främst av intervjuer och observationer vid insamling av data och för att generera ett resultat har kvantitativ metod i form av simulering använts. Data för beräknandet av antalet förväntade transporter och när dessa ankommer har givits av forskningsprojektet Störningsfri stad vid Linköpings universitet. Totalt har tre kvartal för byggprojektet Berga Äng simulerats. Efter analys av simuleringsresultaten konstaterades att det kommer uppstå logistikutmaningar som måste tas i åtanke vid planeringsfasen. Kvartal Q2 2026 har två potentiella zoner med lägenhetshus på byggarbetsplatsen som eventuellt inte kommer hinna klart inom den utsatta projekttiden. Detta på grund av det höga antalet transporter som förväntas ankomma till zonerna under den planerade tiden för byggnation på dessa. Analysen visar även att eventuella köer och väntetid för lastbilar under byggprocessen kan reduceras vid användning av logistiklösningar, så som en terminal eller check-point. Slutsatsen av denna studie belyser vikten av att ha antalet transporter som förväntas ankomma till byggarbetsplatsen i beaktning under planeringsfasen. För att bidra till en skarpare planering med bättre precision bör mer data för transporthantering samlas in inom byggbranschen, vilket kan bidra till att förutse eventuella perioder under byggnationen där schemaläggning och planering av transporter är extra viktigt. Genom att förutse detta kan även slutsatser kring hur vida användandet av logistiklösningar är nödvändigt eller inte under byggnationen genomföras, och beslut kan tas kring när dessa bör användas. / <p>Examensarbetet är utfört vid Institutionen för teknik och naturvetenskap (ITN) vid Tekniska fakulteten, Linköpings universitet</p>

Submitted by admin tede (tede@pucgoias.edu.br) on 2017-06-29T18:12:20Z No. of bitstreams: 1 LUIZ ANTONIO FIGUEIREDO.pdf: 5501025 bytes, checksum: 98fb8b800c62427de5e93d93791120c3 (MD5) / Made available in DSpace on 2017-06-29T18:12:20Z (GMT). No. of bitstreams: 1 LUIZ ANTONIO FIGUEIREDO.pdf: 5501025 bytes, checksum: 98fb8b800c62427de5e93d93791120c3 (MD5) Previous issue date: 2017-03-09 / Due to the growth of the amount of air transport travelers around the world, it is necessary to deploy an efficient control of the passenger flow in the internal processes of the airport terminals. Like every public place, airport terminals have always been vulnerable to all kinds of crimes. In addition, terminal security concerns not only encompass the fight against acts of terrorism, but also involve problems that may adversely influence the operations of the airport. This work aims to present a model, based on computational simulation of passenger service process from a safety inspection of the airport terminal of Goiânia. It was develop a combined method, based on a quantitative method to deal with measurable elements with a qualitative method to assess the complexity of the problem analyzed. Through the simulation, using Flexsim software it was modelled the inspection system of an airport security, leading to conclusions that the characteristics of passengers directly influence the processing times in the system. In this regard, it was noted the lack of information regarding the procedures that passengers should adopt in relation to their belongings and clothing during the crossing of the airport security system. / Devido ao crescimento da quantidade de viajantes no transporte aéreo em todo o mundo, faz-se necessário implantar um controle eficiente do fluxo de passageiros nos processos internos dos terminais aeroportuários. Como todo local público, os terminais aeroportuários sempre são vulneráveis a todos os tipos de crimes. Além disso, as preocupações da segurança do terminal não englobam somente a luta contra atos de terrorismo, mas também problemas que podem influenciar negativamente as operações do aeroporto. Nesse contexto, este trabalho tem o objetivo de apresentar um modelo, baseado na simulação computacional, do processo de atendimento de passageiros do ponto de inspeção de segurança do terminal aeroportuário de Goiânia. Para atingir seus objetivos foi construído um método combinado, de natureza quantitativa para lidar com elementos mensuráveis do processo de inspeção de segurança, com uma análise qualitativa, destinada a avaliar mais profundamente a complexidade do problema. Através da simulação realizada no software Flexsim, foram obtidos resultados estatísticos de desempenho do sistema de inspeção de segurança do aeroporto, permitindo concluir que as características dos passageiros influenciam diretamente os tempos de processamento no sistema. Nesse sentido, foi constatada a falta de informações a respeito dos procedimentos que os passageiros devem adotar em relação aos seus pertences e vestimentas durante o atravessamento no processo de inspeção.

Submitted by Mariana Dornelles Vargas (marianadv) on 2015-05-19T19:12:55Z No. of bitstreams: 1 BSPonP2P.pdf: 2195234 bytes, checksum: 340cdfee0a4f8e27bd919cc3d5513c45 (MD5) / Made available in DSpace on 2015-05-19T19:12:55Z (GMT). No. of bitstreams: 1 BSPonP2P.pdf: 2195234 bytes, checksum: 340cdfee0a4f8e27bd919cc3d5513c45 (MD5) Previous issue date: 2014-08-29 / Nenhuma / Tecnologias constantemente estão avançando nas áreas de sistemas distribuídos e computação paralela. Isso acontece porque a compra de equipamentos eletrônicos esta acessível, por isso empresas, cada vez mais, estão apostando em soluções baratas para que todos tenham acesso. Consequentemente, existe um problema que é o desperdício na utilização destes equipamentos. Grande parte de seu tempo esses equipamentos ficam ociosos. Nesse contexto, esta dissertação apresenta o modelo BSPonP2P para minimizar o problema, buscando aproveitar esse desperdício para algum fim útil. O BSPonP2P utiliza uma abordagem de Computação em Grade P2P, ela visa utilizar os equipamentos para execução de computação útil. O objetivo e fazer as execuções de maneira concorrente. O BSPonP2P cria um ambiente com abordagens baseadas nos modelos estruturado e não estruturado vindos da arquitetura P2P, o que foi implementado para agilizar o gerenciamento da comunicação e das informações dentro da rede. Outro diferencial do modelo proposto e a utilização do modelo de programação paralela Bulk Synchronous Parallel (BSP), que cria um ambiente para execução de processos, validando as dependências e aprimorando a comunicação entre eles. A partir de avaliações de métricas como memória, computação, comunicação e dados de equipamentos, e criado um índice denominado de PM. Esse índice é avaliado periodicamente para definir migrações conforme a variável de ambiente a , que esta diretamente ligada as barreiras das supersteps. A partir de avaliações obtidas nas distribuições de processos em um ambiente heterogêneo criado, o modelo BSPonP2P se mostrou eficaz porque ele obteve bons resultados, como, por exemplo, na simples execução da aplicação, comparando com a execução do BSPonP2P, houve um aumento menor que 4% no tempo de execução. Além disso, na execução de 26 processos com 2000 Supersteps e a = 16, obteve-se um ganho de 6% a partir de 24 migrações de processos. Sendo assim, como contribuição científica, optou-se pela utilização de redes em Grades P2P com aplicações BSP, usando métricas como memória, computação, comunicação e dados de equipamentos para avaliação do ambiente. Além de, serviços como migração e checkpoint que possibilitaram um bom desempenho do modelo. / Technologies are constantly advancing in the areas of distributed systems and parallel computing. This is because the purchase of electronic equipment is accessible, so companies increasingly are betting on cheap solutions for every one to access. Accordingly, there is a problem that the wasteful use of such equipment. Most of these have access to the execution of computation, however, a large part of their time sit idle. In this context, this dissertation proposal presents BSPonP2P model to minimize the problem trying to enjoy this waste for any useful purpose. In the proposed model, a P2P Desktop Grid that seeks to use equipment to perform useful computing competitor among its users and Desktop Grid network users way approach will be used. The BSPonP2P will create an environment with models based on structured and unstructured P2P architecture approaches coming, that will be implemented to streamline the management and communication of information within the network. Another difference that the proposed model will have is the use of Bulk Synchronous Parallel (BSP) parallel programming model, which creates an environment for process execution dependencies validating and improving the communication between them. From reviews of metrics such as memory, computation, data communications equipment and an index called PM is created. This index is periodically valuated to define migration as the environment variable α, which is directly linked to the supersteps’ barriers. Based on the ratings obtained from the distributions of processes in a heterogeneous environment created, BSPonP2P model is demonstrated effective. This is because the model had good results, for example, the simple execution application compared to running the BSPonP2P there was a smaller increase than 4% in execution time. Moreover, the implementation of 26 cases with 2000 supersteps and alpha = 16 yielded a gain of 6% from 24 migration process. Thus, atom scientific contribution opted for the use of networks in P2P Grids with BSP applications using metrics such as memory, computation, communication and data equipment for environmental assessment.

No description available.