No abstract

Neuroendocrine neoplasms (NENs) are rare tumours that arise mainly in the gastrointestinal or pulmonary system. Most NENs are well-differentiated and may obtain prolonged survival besides the presence of metastatic disease; however, a subset (poorly differentiated NENs) may display a truly aggressive behaviour exhibiting a poor prognosis. The recently developed classification systems along with advances in functional imaging have helped stratify patients to the administration of appropriate therapeutic options. Surgery is the mainstay of treatment of NENs, but in recent decades there has been a considerable evolution of medical treatments that are used for locally advanced or metastatic disease not amenable to surgical resection. Long acting somatostatin analogues are the main therapeutic modality for patients with functioning and well-differentiated low grade NENs exhibiting symptomatic control and mainly stabilisation of tumour growth. Other systemic treatments include chemotherapy, molecular targeted agents, interferon-α, peptide receptor radionuclide therapy (PRRT), and immunotherapy. In addition, new agents such as telotristat may be used for the control of symptoms of carcinoid syndrome. The choice and/or sequence of therapeutic agents should be individualized according to tumour origin and differentiation, disease burden, presence of clinical symptoms and patients’ performance status in the context of a multidisciplinary approach. Recent advances in the molecular pathogenesis of NENs set the field for a more personalised treatment approach.

The router buffer sizing problem has been identified recently as an important problem in networking research. Contrary to static proposals and rules of thumb recent efforts have been attempting to develop simple practical algorithms for dynamic queue size management, where the problem is defined on a heuristic optimization basis and the objective is to track a volatile optimum point by continuously tuning at runtime the buffer queue size, thereby adapting to the current traffic conditions. On the basis of a robust extremum control solution to the problem, proposed recently, in this paper we evaluate the QoS improvements that can be obtained with a dynamic router buffer sizing strategy compared to static proposals. The analysis is based on a plethora of data collected from several representative Ns-2 simulation experiments. Simple SLAs are adopted to reflect the QoS requirements of different applications in generic Internet traffic scenarios.