1,721,011 research outputs found
Communities of Practice as a Paradigm
No full textIn the last decades radical changes have occurred in advanced societies, essentially due to three factors: the diffusion of information technologies, the acceleration of scientific and technological renewal, and globalization. The advanced society model today is characterized by rapid and forced innovation of products to put on the market and by a process where market and innovation feed each other. Information and knowledge are the resources to improve in order to keep the level of skills required to compete high. There is an increasing demand for professionalization which cannot be acquired a-priori and in a single solution. So, people very often learn from practical experience, by facing new situations that require effective solutions and give them a chance to acquire new knowledge. In pedagogy this phenomenon is defined as informal learning based on tacit knowledge. Therefore, the professional person, does not need static knowledge any more; on the contrary, he/she requires new tools "for learning to learn", in order to increase his/her expertise quickly. In this paper we want to propose the community of practice as a flexible and dynamic methodological tool (paradigm) for defining a professional figure. Our intent is to use the community of practice to create a model of a specific professional figure. Such a model, which traditionally includes the conceptual, logic-functional and physical phases, is not pre-defined, but built by analysing the interactions that occur in the community of practice. Thus, it is modifiable on the basis of the new demands identified in the practice of the profession itself. In order to verify our proposal we assumed the creation of a community of practice among the Didactic Managers of our university, a figure required by the Italian University Reform. The expertise necessary for this profile is not well-defined yet, and only through practice it is possible to clarify tasks and aims. Therefore, it seems an excellent environment in which to experiment our paradigm
Novel immunotherapy strategies for treatment of neuroendocrine neoplasms
No full textNeuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs) are a heterogeneous family of neoplasms. Well-differentiated tumors are often slow growing and characterized by low tumor mutational burden. Poorly differentiated NECs are aggressive, with an increased mutational burden and higher propensity to express PD-L1. While the therapeutic landscape for neuroendocrine neoplasms (NENs) has evolved substantially over the past decade, immunotherapy has been unexplored in NENs until recently. Checkpoint inhibitors such as anti-PD-1 and anti-CTLA-4 agents, bi-specific tumor-targeting antibodies, and chimeric antigen receptor (CAR) T-cell therapy are examples of treatments that have demonstrated efficacy in other cancers and have recently been investigated in NENs. This review examines the immune landscape of NENs in detail, summarizes recent clinical study results, and discusses potential future directions for immunotherapy
Towards Supporting New Professional Skills in Computer-Mediated Interaction
No full textThe technology introduction and diffusion operated a transformation in the job market determining the creation of new professional expertise and the development of technologies to support the collaborative building of knowledge. In this paper we analyse the role of the communities of practice and highlight the importance of the intelligent analysis of computer-mediated interactions for the creation of new professional knowledge
Analysis of the immune landscape of small bowel neuroendocrine tumors
No full textImmune checkpoint inhibitors have shown promising results in different cancers, and correlation between immune infiltration, expression of programmed death-ligand 1 (PD-L1) by tumor cells and response to immunotherapy has been reported. There is limited knowledge regarding the immune microenvironment of small bowel (SB) neuroendocrine tumors (NETs). This work was aimed at characterizing the immune landscape of SB NETs. Expression of PD-L1 and programmed death-1 (PD-1) was evaluated by immunohistochemistry in 102 surgically resected, primary NETs of the duodenum, jejunum and ileum. Extent and characteristics of the tumor-associated immune infiltrate were also assessed and investigated in their prognostic potential. We detected the expression of PD-L1 in ≥1 and ≥50% of tumor cells in 40/102 (39%; 95% CI, 30-49%) and 14/102 (14%; 95% CI, 8-22%) cases respectively. Intratumor host immune response was apparently absent in 35/102 cases (34%; 95% CI, 25-44%), mild to moderate in 46/102 samples (45%, 95% CI, 35-55%), intense in 21/102 tumors (21%, 95% CI, 13-30%). Expression of PD-L1 and extent of immune infiltration were significantly higher in duodenal NETs as compared with jejunal/ileal NETs. A marked peritumoral host response was organized as ectopic lymph node-like structures in 18/102 cases (18%; 95% CI, 11-26%). Neither PD-L1 expression nor the degree of immune infiltration showed any prognostic significance. Overall, the immune landscape of SB NETs is heterogeneous, with adaptive immune resistance mechanisms prevailing in duodenal NETs. Clinical trials of immune checkpoint inhibitors should take into account the immune heterogeneity of SB NETs
Towards Supporting Effective Interaction in a Web Forum
No full textIn this contribution, we argue in favor of the
importance of the role that interaction plays in supporting effective e-learning processes. Interaction among peers, in fact,
either with real or virtual companions, is the fundamental
component of the process of building and sharing new
knowledge. In particular, we intend to argue in favor of a
constructivist approach to e-learning. We support our view by reporting on our experience in the design of a platform for language learning through dramatization. Finally, we present the direction we intend to follow in our future research, towards
the definition of an approach for enhancing effective interaction during collaborative learning and knowledge sharing in online learning environments
Bone Metastases in Neuroendocrine Tumors: Molecular Pathogenesis and Implications in Clinical Practice
No full textSkeletal colonization is often regarded as a rare event in patients with neuroendocrine tumors (NETs) although both national registries and retrospective series report an incidence of bone metastases as high as 20% in subjects with advanced disease. While the biologic mechanisms leading to bone metastatic colonization in NETs have been poorly investigated so far, key steps of osteotropic mechanisms including the epithelial-to-mesenchymal transition, preparation of the pre-metastatic niche, migration of circulating tumor cells towards the bone marrow as well as the resulting alterations of the skeletal metabolism, are likely to operate also during the development of NET bone metastases. The skeleton involvement by NETs has a detrimental impact on both quality of life and patients' prognosis, leading to pain in the majority of symptomatic subjects. While it is currently unclear whether or not the earlier recognition of bone involvement by PET/CT imaging techniques employing 68Ga-DOTA-conjugated peptides might improve outcomes through the exploitation of timely treatments, the management of bone-colonizing NETs is today based only on clinical experience from other osteotropic tumors. Here, we summarize the fundamental molecular mechanisms driving bone colonization and revisit both established and novel treatments for patients with bone metastatic NETs
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