581 research outputs found
The role of mitochondria in modifying the cellular ionic environment. Calcium-induced respiratory activities in mitochondria isolated from various tumour cells
Nothing Ventured — Nothing Gained? Empirical Evidence on Venture Capital Financing in Switzerland
The future of social is personal: the potential of the personal data store
This chapter argues that technical architectures that facilitate the longitudinal, decentralised and individual-centric personal collection and curation of data will be an important, but partial, response to the pressing problem of the autonomy of the data subject, and the asymmetry of power between the subject and large scale service providers/data consumers. Towards framing the scope and role of such Personal Data Stores (PDSes), the legalistic notion of personal data is examined, and it is argued that a more inclusive, intuitive notion expresses more accurately what individuals require in order to preserve their autonomy in a data-driven world of large aggregators. Six challenges towards realising the PDS vision are set out: the requirement to store data for long periods; the difficulties of managing data for individuals; the need to reconsider the regulatory basis for third-party access to data; the need to comply with international data handling standards; the need to integrate privacy-enhancing technologies; and the need to future-proof data gathering against the evolution of social norms. The open experimental PDS platform INDX is introduced and described, as a means of beginning to address at least some of these six challenges
Early relapse after high‐dose melphalan autologous stem cell transplant predicts inferior survival and is associated with high disease burden and genetically high‐risk disease in multiple myeloma
Predicting patient outcome in multiple myeloma remains challenging despite the availability of standard prognostic biomarkers. We investigated outcome for patients relapsing early from intensive therapy on NCRI Myeloma XI. Relapse within 12 months of autologous stem cell transplant was associated with markedly worse median progression‐free survival 2 (PFS2) of 18 months and overall survival (OS) of 26 months, compared to median PFS2 of 85 months and OS of 91 months for later relapsing patients despite equal access to and use of subsequent therapies, highlighting the urgent need for improved outcome prediction and early intervention strategies for myeloma patients
The role of behavioural competences in predicting entrepreneurial funding resource orchestration
This study examines how a psychometric testing tool can be used to explain, predict and measure behavioural competences and how entrepreneurs fund the firm. Reference is made to studies of personality traits (McClelland, 1961; Sandberg & Hoffer, 1987; Brockhaus, 1980; Baum & Locke, 2004; Ciaveralla, 2004; Rauch & Frese, 2007). More recent studies have called for research into behaviour and competences (Zhao, 2010; Bird at al, 2012; Mueller, 2012) and specifically in the finance context of orchestration of resources (Wright and Sigliani 2013). The authors take a pragmatic realism perspective using a mixed method study to explore the “reality” of the entrepreneur (Watson, 2013). Cluster analysis is used to identify the relationship between behavioural competences and funding outcomes. Applying Big 5 Theory of Personality and the Great 8 Competences indicates how behaviour impacts outcomes as entrepreneurs seek to access finance. The identification of three distinct groups in this longitudinal study means belonging to one of these groups predicts likely behaviour when searching for finance. A strong behavioural characteristic which emerged, validated through interviews and psychometric testing, was an orientation towards engagement and working with other organisations. In a funding context, this manifested itself in using networks, seeking advice and sharing equity. These co-operative, collaborative characteristics are different to the classic image of the entrepreneur as a risk-taker or extrovert. The study identifies entrepreneurs who are both successful and unsuccessful in finance applications and compares behavioural competency profiles, thus overcoming the limitations of many studies (Rauch 2007) that are biased towards successful enterprises
The evaluation criteria used by venture capitalists:evidence from a UK fund
GRAHAM BOOCOCK AND MARGARET WOODS are Lecturers in Banking and Finance, and Financial Management, respectively, at Loughborough University Business School, England. The paper examines how venture fund managers select their investee companies, by exploring the evaluation criteria and the decision-making process adopted at one United Kingdom regional venture fund (henceforth referred to as the Fund). The analysis confirms that relatively consistent evaluation criteria are applied across the industry and corroborates previous models which suggest that the venture capitalist's decision-making consists of several stages. With the benefit of access to the Fund's internal records, however, this paper adds to the current literature by differentiating the evaluation criteria used at each successive stage of the decision-making process. The paper presents a model of the Fund's activities which demonstrates that the relative importance attached to the evaluation criteria changes as applications are systematically processed. Proposals have to satsfy different criteria at each stage of the decision-making process before they receive funding. In the vast majority of cases, applications are rejected by the fund managers. In addition, the length of time taken by the fund managers in appraising propositions can lead to withdrawal of applications at an advanced stage
Towards a ‘Long View’: Historical Perspectives on the Scaling and Replication of Social Ventures
Social ventures are now widely regarded as playing an essential role in addressing persistent and pervasive societal challenges. This insight has prompted an active search for readily-scaleable and replicable business models. However, relatively little consideration has been given to the longer-term growth and performance of these hybrid organizational forms. This paper examines how historically-informed research might enhance our understanding of growth processes. It considers the conceptualization of organizational growth in social ventures and the relevance of prevailing constructs. The explanatory potential of ‘long view’ approaches examined by applying three constructs, opportunity recognition, entrepreneurial adjustment, and institutional structure, in a comparative historical analysis of two British social ventures
Upfront autologous haematopoietic stem-cell transplantation versus carfilzomib–cyclophosphamide–dexamethasone consolidation with carfilzomib maintenance in patients with newly diagnosed multiple myeloma in England and Wales (CARDAMON): a randomised, phase 2, non-inferiority trial
Background: Standard-of-care treatment for patients with newly diagnosed multiple myeloma is bortezomib-based induction followed by high-dose melphalan and autologous haematopoietic stem-cell transplantation (HSCT) and lenalidomide maintenance. We aimed to evaluate whether an immunomodulatory-free carfilzomib-based induction, consolidation, and maintenance protocol without autologous HSCT was non-inferior to the same induction regimen followed by autologous HSCT and maintenance. Methods: CARDAMON is a randomised, open-label, phase 2 trial in 19 hospitals in England and Wales, UK. Newly diagnosed, transplantation-eligible patients with multiple myeloma aged 18 years or older with an Eastern Cooperative Oncology Group (ECOG) performance status of 0–2 received four 28-day cycles of carfilzomib (56 mg/m2 intravenously on days 1, 2, 8, 9, 15, and 16), cyclophosphamide (500 mg orally on days 1, 8, and 15), and dexamethasone (40 mg orally on days 1, 8, 15, and 22; KCd), followed by peripheral blood stem cell mobilisation. Patients with at least a partial response were randomly assigned (1:1) to either high-dose melphalan and autologous HSCT or four cycles of KCd. All randomised patients received 18 cycles of carfilzomib maintenance (56 mg/m2 intravenously on days 1, 8, and 15). The primary outcomes were the proportion of patients with at least a very good partial response after induction and difference in progression-free survival rate at 2 years from randomisation (non-inferiority margin 10%), both assessed by intention to treat. Safety was assessed in all patients who started treatment. The trial is registered with ClinicalTrials.gov (NCT02315716); recruitment is complete and all patients are in follow-up. Findings: Between June 16, 2015, and July 8, 2019, 281 patients were enrolled, with 218 proceeding to randomisation (109 assigned to the KCd consolidation group [99 of whom completed consolidation] and 109 to the HSCT group [104 of whom underwent transplantation]). A further seven patients withdrew before initiation of carfilzomib maintenance (two in the KCd consolidation group vs five in the HSCT group). Median age was 59 years (IQR 52 to 64); 166 (59%) of 281 patients were male and 115 (41%) were female. 152 (71%) of 214 patients with known ethnicity were White, 37 (17%) were Black, 18 (8%) were Asian, 5 (2%) identified as Mixed, and 2 (1%) identified as other. Median follow-up from randomisation was 40·2 months (IQR 32·7 to 51·8). After induction, 162 (57·7%; 95% CI 51·6 to 63·5) of 281 patients had at least a very good partial response. The 2-year progression-free survival was 75% (95% CI 65 to 82) in the HSCT group versus 68% (95% CI 58 to 76) in the KCd group (difference –7·2%, 70% CI –11·1 to –2·8), exceeding the non-inferiority margin. The most common grade 3–4 events during KCd induction and consolidation were lymphocytopenia (72 [26%] of 278 patients who started induction; 15 [14%] of 109 patients who started consolidation) and infection (50 [18%] of 278 for induction; 15 [14%] of 109 for consolidation), and during carfilzomib maintenance were hypertension (20 [21%] of 97 patients in the KCd consolidation group vs 23 [23%] of 99 patients in the HSCT group) and infection (16 [16%] of 97 patients vs 25 [25%] of 99). Treatment-related serious adverse events at any point during the trial were reported in 109 (39%) of 278 patients who started induction, with infections (80 [29%]) being the most common. Treatment-emergent deaths were reported in five (2%) of 278 patients during induction (three from infection, one from cardiac event, and one from renal failure) and one of 99 patients during maintenance after autologous HSCT (oesophageal carcinoma). Interpretation: KCd did not meet the criteria for non-inferiority compared with autologous HSCT, but the marginal difference in progression-free survival suggests that further studies are warranted to explore deferred autologous HSCT in some subgroups, such as individuals who are MRD negative after induction. Funding: Cancer Research UK and Amgen
Thrombotic microangiopathy in untreated myeloma patients receiving carfilzomib, cyclophosphamide and dexamethasone on the CARDAMON study
Proteasome inhibitors have been associated with thrombotic microangiopathy (TMA) — a group of disorders characterised by occlusive microvascular thrombosis causing microangiopathic haemolytic anaemia, thrombocytopenia and end‐organ damage. To date, carfilzomib‐associated TMA has predominantly been described in relapsed/refractory myeloma patients. We report eight patients with newly diagnosed myeloma who experienced TMA events while receiving carfilzomib on the phase II CARDAMON trial. The first three occurred during maintenance single‐agent carfilzomib, two occurred at induction with carfilzomib given with cyclophosphamide and dexamethasone (KCd) and three occurred during KCd consolidation. At TMA presentation 6/8 were hypertensive; 7/8 had acute kidney injury and in three, renal impairment persisted after resolution of TMA in other respects. The mechanism of carfilzomib‐associated TMA remains unclear, though patients with known hypertension seem particularly susceptible. Given the first three cases occurred during maintenance after a longer than five‐week treatment break, a protocol amendment was instituted with: aggressive hypertension management, carfilzomib step‐up dosing (20 mg/m2 on day 1) at start of maintenance before dose escalation to 56 mg/m2 maximum, and adding 10 mg dexamethasone as premedication to maintenance carfilzomib infusions. No further TMA events occurred during maintenance following this amendment and the TMA incidence reduced from 4·2 to 1·6 per 1 000 patient cycles
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