Long-term results from MOPPEBVCAD chemotherapy with optional limited radiotherapy in advanced Hodgkin's disease

The purpose was to verify the 5-year results of the MOPPEBVCAD chemotherapy regimen with limited radiotherapy in relation to the promising preliminary data. Mechlorethamine, vincristine, procarbazine, prednisone, epidoxorubicin, bleomycin, vinblastine, lomustine, melphalan, and vindesine were delivered according to a schedule derived through hybridization, intensification, and shortening of the corresponding alternating CAD/MOPP/ABV regimen. Radiotherapy was restricted to sites of bulky involvement or to areas that responded incompletely to chemotherapy. This multicenter, controlled, nonrandomized trial involved 145 eligible patients. Radiotherapy was administered to 47 patients, 46 of whom were in complete remission after chemotherapy. Remissions were complete in 137 patients (94%), partial in 4 (3%), and null in the remaining 4. Tumor-specific, overall, relapse-free, and failure-free survival at 5 years were 0.89, 0.86, 0.82, and 0.78, respectively. Hematologic toxicity was considerable, whereas nonhematologic side effects were fully acceptable. Most of the unfavorable prognostic factors lost their clinical weight. Only age and lymphocyte depletion histologic type were statistically correlated with major follow up endpoints; performance status and bone marrow involvement were subordinate to age. Seven patients developed a second cancer (including 3 myelodysplasias). MOPPEBVCAD with selected radiotherapy is a highly effective regimen in advanced Hodgkin\ub4s disease. Early and late toxicity are no more severe than what would be expected with other alternating or hybrid regimens. A comparison with ABVD, which is currently considered the standard regimen for advanced Hodgkin\ub4s disease, is needed

Inside and outside the boardroom: Collaborative practices in the performing arts sector

Collaboration is crucial in the arts sector, where forms of collaborative governance (CG) – the inclusion of private partners in the decision-making process – have been implemented in order to overcome scarcity of resources and to engage with stakeholders. The governance of performing arts organizations today must be based on constant collaboration between public and private entities in order to generate greater value. The purpose of this study is to identify the drivers of CG in performing arts organizations by means of a case study of I Teatri Foundation of Reggio-Emilia, one of the first theatres in Italy to include private partners in governance. The methodology is based on both documentary analysis and interviews. The findings show that CG should be applied at micro and meso levels (inside and outside the boardroom), as both levels contribute to the creation of value for the audience

Inside and outside the boardroom: Collaborative practices in the performing arts sector

Collaboration is crucial in the arts sector, where forms of collaborative governance (CG) – the inclusion of private partners in the decision-making process – have been implemented in order to overcome scarcity of resources and to engage with stakeholders. The governance of performing arts organizations today must be based on constant collaboration between public and private entities in order to generate greater value. The purpose of this study is to identify the drivers of CG in performing arts organizations by means of a case study of I Teatri Foundation of Reggio-Emilia, one of the first theatres in Italy to include private partners in governance. The methodology is based on both documentary analysis and interviews. The findings show that CG should be applied at micro and meso levels (inside and outside the boardroom), as both levels contribute to the creation of value for the audience

Improved microwave imaging procedure for non-destructive evaluations of two-dimensional structures

Improved microwave imaging procedure for nondestructive evaluations of two dimensional structures Author(s): Caorsi, S (Caorsi, S); Massa, A (Massa, A); Pastorino, M (Pastorino, M); Donelli, M (Donelli, M) Source: IEEE TRANSACTIONS ON ANTENNAS AND PROPAGATION Volume: 52 Issue: 6 Pages: 1386-1397 DOI: 10.1109/TAP.2004.830254 Published: JUN 2004 Times Cited: 31 (from Web of Science) Cited References: 23 [ view related records ] Citation Map Abstract: An improved microwave procedure for detecting defects in dielectric structures is proposed. The procedure is based on the integral equations of the inverse scattering problem. A hybrid genetic algorithm (GA) is applied in order to minimize the obtained nonlinear functional. Since in nondestructive evaluations the unperturbed object is completely known, it is possible off-line to numerically compute the. Green's function for the configuration without defects. Consequently, a very significant computation saving is obtained, since the "chromosome" of the GA codes only the parameters describing the unknown defect. Accession Number: WOS:000221857300001 Document Type: Article Language: English Author Keywords: genetic algorithms (GAs); Green's function; microwave imaging; nondestructive evaluation (NDE) KeyWords Plus: GENETIC ALGORITHM; ELECTROMAGNETICS; RECONSTRUCTION Reprint Address: Caorsi, S (reprint author), Univ Pavia, Dept Elect, Via Palestro 3, I-27100 Pavia, Italy Addresses: 1. Univ Pavia, Dept Elect, I-27100 Pavia, Italy E-mail Address: [email protected] Publisher: IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC, 445 HOES LANE, PISCATAWAY, NJ 08855 USA Web of Science Category: Engineering, Electrical & Electronic; Telecommunications Subject Category: Engineering; Telecommunications IDS Number: 826VJ ISSN: 0018-926

Balancing artistic and financial performance: is collaborative governance the answer?

Purpose: Opera houses have been traditionally publicly financed in many western countries. However, today many opera houses are facing serious financial troubles, due to the recent financial crisis. There is thus a widespread public debate on measures to ensure agency efficiency for performing arts organizations. Focusing on the reform implemented recently in Italy, which submitted opera houses that had severe financial difficulties to a recovery plan and encouraged forms of collaborative governance (CG), the purpose of this paper is to investigate the impact of CG on the performance of the arts sector. Design/methodology/approach: Multiple case studies are used, on longitudinal data from multiple sources over a period of up to five years, in order to triangulate the narrative of financial and artistic performance and ensure trustworthiness. The study thus spans the period before the Bray Law came into force (2013) and covers the entire period in which recovery plans were implemented. Findings: The analysis explores how opera houses are building sustainability for themselves and the community in terms of financial and artistic performance through CG. Various forms of CG adopted yielded positive results. Furthermore, more robust forms of CG generated better performance, especially from a financial point of view. Originality/value: This paper adds to the limited knowledge of CG in the non-profit sector by bridging the fields of agency performance and CG. It discusses how the introduction of forms of CG can build up long-term sustainability, solving the dilemma of how to achieve financial equilibrium without compromising artistic quality, focusing on the case of opera houses, which are notably affected by Baumol’s cost disease

Disruptive crisis management: lessons from managing a hospital during the COVID-19 pandemic

Purpose: Healthcare organizations worldwide were badly hit by the “surprise” of the pandemic. Hospitals in particular are trying hard to manage problems it caused, searching for solutions to protect the health of citizens and reorienting operations. The implementation of resilience solutions in the coping phase and the ability to react promptly and redefine activities is essential. Integrating crisis management and resiliency literature, this paper discusses how health organizations were able to cope with adversity during the crisis. Design/methodology/approach: The research is conducted through a case study of a large Italian hospital, the Gemelli Polyclinic Foundation, which was one of the leading hospitals in the Italian response to the pandemic. Findings: The case reports actions taken in order to continue functioning and to maintain core activities despite severe adversity. The overall response of the Gemelli was the result of the three types of response: behavioral (effective leadership), cognitive (rapid resource reallocation) and the contextual reinforcement (multiagency network response). The authors highlight how an integrative framework of crisis management and resiliency could be applied to healthcare organizations in the coping phase of the pandemic. The experience of the Gemelli can thus be useful for other hospitals and organizations facing external crises and for overall improvement of crisis management and resilience. Responding to crisis brings the opportunity to make innovations introduced during emergencies structural, and embed them moving forward. Research limitations/implications: The paper focuses only on the coping phase of the response to the pandemic, whereas building long-term resilience requires understanding how organizations accumulate knowledge from crises and adapt to the “new normal.” Originality/value: The paper responds to the call for empirical studies to advance knowledge of an integrative framework of crisis management and resiliency theories with reference to complex organizations such as healthcare

Big data analysis for decision-making processes: challenges and opportunities for the management of health-care organizations.

Purpose This study aims to provide a picture of the current state of art in the use of big data for decision-making processes for the management of health-care organizations. Design/methodology/approach A systematic literature review was carried out. The research uses two analyses: descriptive analysis, describing the evolution of citations; keywords; and the ten most influential papers, and bibliometric analysis, for content evaluation, for which a cluster analysis was performed. Findings A total of 48 articles were selected for bibliographic coupling out of an initial sample of more than 5,000 papers. Of the 48 articles, 29 are linked on the basis of their bibliography. Clustering the 29 articles on the basis of actual content, four research areas emerged: quality of care, quality of service, crisis management and data management. Originality/value Health-care organizations believe strongly that big data can become the most effective tool for correctly influencing the decision-making processes. Thus, more and more organizations continue to invest in big data analytics, and the literature on this topic has expanded rapidly. This study seeks to provide a comprehensive picture of the different streams of literature existing, together with gaps in research and future perspectives. The literature is mature enough for an analysis to be made and provide managers with useful insights on opportunities, criticisms and perspectives on the use of big data for health-care organizations. However, to date, there is no comprehensive literature review on the big data analysis in health care. Furthermore, as big data is a “sexy catchphrase,” more clarity on its usage may be needed. It represents an important tool to be investigated and its great potential is often yet to be discovered. This study thus sheds light on emerging issues and suggests further research that may be neede

Single-Step IGHV Next-Generation Sequencing Detects Clonality and Somatic Hypermutation in Lymphoid Malignancies: A Phase III Diagnostic Accuracy Study

Background: Multiplex PCR based on consensus primers followed by capillary electrophoresis and Sanger sequencing are considered as the gold standard method for the evaluation of clonality and somatic hypermutation in lymphoid malignancies. As an alternative, the next-generation sequencing (NGS) of immune receptor genes has recently been proposed as a solution, due to being highly effective and sensitive. Here, we designed a phase III diagnostic accuracy study intended to compare the current gold standard methods versus the first commercially available NGS approaches for testing immunoglobulin heavy chain gene rearrangements. Methods: We assessed IGH rearrangements in 68 samples by means of both the NGS approach (LymphoTrack® IGH assay, and LymphoTrack® IGH somatic hypermutation assay, run on Illumina MiSeq) and capillary electrophoresis/Sanger sequencing to assess clonality and somatic hypermutations (SHM). Results: In comparison to the routine capillary-based analysis, the NGS clonality assay had an overall diagnostic accuracy of 96% (63/66 cases). Other studied criteria included sensitivity (95%), specificity (100%), positive predictive value (100%) and negative predictive value (75%). In discrepant cases, the NGS results were confirmed by a different set of primers that provided coverage of the IGH leader sequence. Furthermore, there was excellent agreement of the SHM determination with both the LymphoTrack® FR1 and leader assays when compared to the Sanger sequencing analysis (84%), with NGS able to assess the SHM rate even in cases where the conventional approach failed. Conclusion: Overall, conventional Sanger sequencing and next-generation-sequencing-based clonality and somatic hypermutation analyses gave comparable results. For future use in a routine diagnostic workflow, NGS-based approaches should be evaluated prospectively and an analysis of cost-effectiveness should be performed

Effects On Palatal Surface Area In Mixed Dentition Patients Treated With Leaf Expander And Rapid Palatal Expander, Compared To Untreated Subjects: A Randomised Clinical Trial

Aim: To evaluate palatal surface effects induced by LE and RPE, alongside spontaneous changes in an untreated group, and to compare differences in canine and molar inclination among the three groups. Materials and Methods: This randomised clinical trial aimed to compare digital models pre- and post-treatment over 12 months in patients receiving tooth-borne Leaf Expander® (LE) and tooth-borne Hyrax-type maxillary expander (RPE) treatments, alongside untreated patients. Analysis included 24 LE patients (13 males, 11 females, mean age 8.5±1.5), 22 RPE patients (10 males, 12 females, mean age 7.9±1.6), and 17 untreated subjects (7 males, 10 females, mean age 8.1±1.2). Inclusion criteria comprised indications for maxillary expansion treatment, mixed dentition, CVMS ≤ 3, erupted first molars, and good oral hygiene. Digital models were obtained using an intraoral scanner pre- and post-treatment. Palatal surface, segmented into anterior, median, and posterior zones, and canine/molar inclination were measured at T0-T1 using VAM software as the primary and secondary endpoint. Statistical analyses involved paired-sample T-tests for intra-group comparisons and ANOVA tests with Bonferroni correction for inter-group comparisons. Results: Total surface increment for LE was 155.4 mm2 (±49.92mm2); for RPE, it was 187.7 mm2 (±58.06 mm2); and for the control group, it was 55.35 mm2 (±18.69mm2), significant in all three groups. Statistically significant differences were observed in the anterior, median, and posterior zones, as well as in the total surface increment, between the LE and control groups, and between the RPE and control groups. No significant difference was found between the LE and RPE groups in surface increments. The RPE group exhibited a significant increase in vestibular inclination for molars and canines post-therapy. Conclusions: No significant difference in palatal surface increment was found between the two experimental groups (LE and RPE); both demonstrated a significant increase in palatal surface. The greatest increment occurred in the median palate zone for both experimental groups. The increment in the untreated control group was not significant. Furthermore, the RPE group showed a greater inclination of permanent molars compared to those treated with LE, indicating that expansion with lighter and continuous forces may lead to fewer dental side effects.Aim To evaluate palatal surface effects induced by LE and RPE, alongside spontaneous changes in an untreated group, and to compare differences in canine and molar inclination among the three groups. Materials and Methods This randomised clinical trial aimed to compare digital models pre- and post-treatment over 12 months in patients receiving tooth-borne Leaf Expander® (LE) and tooth-borne Hyrax-type maxillary expander (RPE) treatments, alongside untreated patients. Analysis included 24 LE patients (13 males, 11 females, mean age 8.5±1.5), 22 RPE patients (10 males, 12 females, mean age 7.9±1.6), and 17 untreated subjects (7 males, 10 females, mean age 8.1±1.2). Inclusion criteria comprised indications for maxillary expansion treatment, mixed dentition, CVMS ≤ 3, erupted first molars, and good oral hygiene. Digital models were obtained using an intraoral scanner pre- and post-treatment. Palatal surface, segmented into anterior, median, and posterior zones, and canine/molar inclination were measured at T0-T1 using VAM software as the primary and secondary endpoint. Statistical analyses involved paired-sample T-tests for intra-group comparisons and ANOVA tests with Bonferroni correction for inter-group comparisons. Results Total surface increment for LE was 155.4 mm2 (±49.92 mm2); for RPE, it was 187.7 mm2 (±58.06 mm2); and for the control group, it was 55.35 mm2 (±18.69mm2), significant in all three groups. Statistically significant differences were observed in the anterior, median, and posterior zones, as well as in the total surface increment, between the LE and control groups, and between the RPE and control groups. No significant difference was found between the LE and RPE groups in surface increments. The RPE group exhibited a significant increase in vestibular inclination for molars and canines post-therapy. Conclusions No significant difference in palatal surface increment was found between the two experimental groups (LE and RPE); both demonstrated a significant increase in palatal surface. The greatest increment occurred in the median palate zone for both experimental groups. The increment in the untreated control group was not significant. Furthermore, the RPE group showed a greater inclination of permanent molars compared to those treated with LE, indicating that expansion with lighter and continuous forces may lead to fewer dental side effects