Opening the Door to Breakthroughs that Address Strategic Organizational Needs: Applying Technology Roadmapping Tools and Techniques at an Electric Utility

Over the course of a decade, the Bonneville Power Administration\u27s Technology Innovation Office has developed a roadmapping approach that captures business challenges and opportunities critical to the agency, links these with barriers to success, and connects these with technical solutions and research questions. Senior leaders from across the agency establish strategic goals and objectives, and international technical subject matter experts are convened to articulate technology-associated paths to achieve these. Each roadmap captures insights from diverse experts in highly collaborative environments and focuses them on critically important topics. These roadmaps are an important element in the Bonneville Power Administration\u27s strategic approach to technology research and development

Ciclosporin compared to prednisolone therapy for patients with pyoderma gangrenosum: cost-effectiveness analysis of the STOP GAP trial

Background Pyoderma gangrenosum (PG) is a painful, ulcerating skin disease with poor evidence for management. Prednisolone and ciclosporin are the most commonly used treatments, although not previously compared within a randomised controlled trial (RCT) Objectives To compare the cost-effectiveness of ciclosporin and prednisolone-initiated treatment for patients with PG. Methods Quality-of-life (EuroQoL EQ-5D-3L) and resource data were collected as part of the STOP-GAP trial: a multicentre, parallel-group, observer-blind RCT. Within-trial analysis used bivariate regression of costs and QALYs, with multiple imputation of missing data, informing a probabilistic assessment of incremental treatment cost-effectiveness from a health service perspective. Results In the base case analysis, when compared with prednisolone, ciclosporin was cost-effective due to a reduction in costs (net cost: -£1160; 95%CI: (-2991 to 672) and improvement in quality of life (net QALYs: 0.055; 95%CI: 0.018 to 0.093). However, this finding appears driven by a minority of patients with large lesions (≥20cm2) (net cost: -£5310; 95%CI: -9729 to -891; net QALYs: 0.077; 95%CI: 0.004 to 0.151). The incremental cost-effectiveness of ciclosporin for the majority of patients with smaller lesions was £23,374/QALY although the estimate is imprecise: the probability of being cost-effective at a willingness to pay of £20,000/QALY was 43%. Conclusions Consistent with the clinical findings of the STOP-GAP trial, patients with small lesions should receive treatment guided by the side effect profiles of the drugs and patient preference - neither strategy is clearly a preferred use of NHS resources. However, ciclosporin-initiated treatment may be more cost-effective for patients with large lesions

Clinical outcomes and response to treatment of patients receiving topical treatments for pyoderma gangrenosum: a prospective cohort study

Background: pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment. Objective: to estimate the effectiveness of topical therapies in the treatment of PG. Methods: prospective cohort study of UK secondary care patients with a clinical diagnosis of PG suitable for topical treatment (recruited July 2009 to June 2012). Participants received topical therapy following normal clinical practice (mainly Class I-III topical corticosteroids, tacrolimus 0.03% or 0.1%). Primary outcome: speed of healing at 6 weeks. Secondary outcomes: proportion healed by 6 months; time to healing; global assessment; inflammation; pain; quality-of-life; treatment failure and recurrence. Results: Sixty-six patients (22 to 85 years) were enrolled. Clobetasol propionate 0.05% was the most commonly prescribed therapy. Overall, 28/66 (43.8%) of ulcers healed by 6 months. Median time-to-healing was 145 days (95% CI: 96 days, ∞). Initial ulcer size was a significant predictor of time-to-healing (hazard ratio 0.94 (0.88;80 1.00); p = 0.043). Four patients (15%) had a recurrence. Limitations: No randomised comparator Conclusion: Topical therapy is potentially an effective first-line treatment for PG that avoids possible side effects associated with systemic therapy. It remains unclear whether more severe disease will respond adequately to topical therapy alone

Regeneration von Podozyten in einem Podozytenschädigungsmodell der Ratte

In unserer tierexperimentellen Studie mit transgenen Ratten, wollten wir herausfinden, ob nach Schädigung der Rattennieren mit Diphtherietoxin eine Regeneration von Podozyten stattfindet und wenn ja, ob knochenmarkstämmige Stammzellen dabei eine Rolle spielen bzw. ob diese dabei als Quelle für die Podozytenregeneration dienen. Dafür wurden die Versuchsratten zunächst einer Knochenmarkstransplantation unterzogen und anschliessend mit Diphtherietoxin in unterschiedlicher Dosis geschädigt. Mithilfe immunhistologischer sowie Immun-Fluoreszenz-Färbungen konnten knochenmarkstämmige Zellen identifiziert werden. Zugleich setzten wir podozytenspezifische Marker (sowie Marker für andere spezifische Zellen in der Immunfluoreszenz-Histologie) ein, sodass eine doppelte Positivität den extrarenalen Ursprung des Podozyten bzw. der spezifisch markierten Zelle nachwies. In keinem unserer Versuchstiere konnten doppeltmarkierte und somit knochenmarkstämmige Podozyten nachgewiesen werden, wobei eine Regeneration anderen Ursprungs nicht sicher ausgeschlossen werden konnte, denn die Zahl der Podozyten-spezifisch markierten Zellen nahm nach der initial gesetzten Schädigung im Laufe der Zeit wieder zu. Außerdem konnte gezeigt werden, dass im Rahmen der renalen Reparatur- und „Remodeling“-Vorgänge tatsächlich Stammzellen aus dem Knochenmark in das Glomerulum eingewandert sind und schließlich zu Mesangialzellen, zu Zellen des Immunsystems sowie zu Zellen, die an der Fibrose beteiligt sind, ausdifferenziert sind. In Anbetracht der neusten Entwicklungen der Stammzellforschung sowie der Möglichkeit mit gentechnischen Mitteln induzierte pluripotente Stammzellen herzustellen, besteht durchaus Hoffnung eine Regeneration von Podozyten zu ermöglichen und damit die Nierenfunktion bei zahlreichen Erkrankungen erhalten zu können

Exploring the Functions and Applications of Organizational Foresight Programs

As far as we know, nobody can predict the future. And yet, the quality of our personal and professional existence is reliant, at least in part, on our ability to perceive and plan for the future on a regular basis. In some way or another, everyone must at some point draw on their must draw on their ability to perceive and plan for the future—whether it is an hour, day, month, year, or decades ahead. Of course, not only does this impact everyone on a personal level, it also impacts us on an organizational level as well. Informally, organizations are likely to have acquired or developed some form of foresight acumen within their own existing pool of talent. Some corporations, however, have established more formal foresight programs in order to aid them in their strategy development and to inform their decision-making. This paper is more concerned with the latter, exploring two key questions: What are the formal functions typically attributed to corporate foresight programs? What evidence, if any, is there regarding whether or not any of these functions enhance the innovative capacity of the organizations within which they have been employed

Past Phantoms and Pollutions: Evolution of the Ghost Story From Ancient Greece to Modern America

This work explores the tradition of ghost stories in Ancient Greece and Rome and compares them to modern ghost stories. It argues that modern ghost stories are closest to Roman ones in their descriptions of ghosts and narrative structure. It begins by introducing the concept of ghost stories and how they are defined. The first chapter covers the stories\u27 descriptions of ghosts. It discusses the similarities and differences between their appearances, behaviors, and conditions. It shows that the modern conception of ghosts are more similar to the Roman conceptions of ghosts than Greek conceptions. The second chapter focuses on the narrative structure of ghost stories, comparing standard ghost story written works to folklore stories, both ancient and modern. It shows that the manner in which modern ghost stories are told are closer in structure to the Roman ones than to the Greek ones. The third chapter shows the reason behind the great difference between Ancient Greek and Roman ghost stories, namely that the concept of miasma in Ancient Greece replaced the fear of ghosts. This is shown by the fact that there are similarities between the way ghosts are described and the way miasma is described. The paper concludes by showing how ghost stories have evolved over time

Indonesian Business Cases: From Innovation To Financial Excellence

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