Evolution of a Project Based Organization, a Case study

Little research has been conducted on how project-based organizations navigate internal and external pressures to develop and improve project competences over time. Using a cases study approach, this paper examines the development and implementation of project based organization over a period of 30 years. Overall, the evolution of project management competencies in the organization broadly followed the prevailing approaches in improving organizational management practices uncovered in review of literature. The organization’s capability to adopt and implement project management frameworks improved over time as senior managers became more masterful at matching improvement actions into the organizational context. This research also presents how a systematic approach of project management maturity models for identifying and implementing project management practices and processes can increase the effectiveness and comprehensiveness of overall management practices. The study concludes with a series of recommendations in further improving project management practices and processes in project-based organizations

Choosing project risk management techniques. A theoretical framework

The pressure for increasing quality while reducing time and costs places particular emphasis on managing risk in projects. To this end, several models and techniques have been developed in literature and applied in practice, so that there is a strong need for clarifying when and how each of them should be used. At the same time, knowledge about risk management is becoming of paramount importance to effectively deal with the complexity of projects. However, communication and knowledge creation are not easy tasks, especially when dealing with uncertainty, because decision-making is often fragmented and a comprehensive perspective on the goals, opportunities, and threats of a project is missing. With the purpose of providing guidelines for the selection of risk techniques taking into account the most relevant aspects characterising the managerial and operational scenario of a project, a theoretical framework to classify these techniques is proposed. Based on a literature review of the criteria to categorise risk techniques, three dimensions are defined: the phase of the risk management process, the phase of the project life cycle, and the corporate maturity towards risk. The taxonomy is then applied to a wide selection of risk techniques according to their documented applications. This work helps to integrate the risk management and the knowledge management processes. Future research efforts will be directed towards refining the framework and testing it in multiple industrie

Treatment of Older Patients with Mantle-Cell Lymphoma

BACKGROUND: The long-term prognosis for older patients with mantle-cell lymphoma is poor. Chemoimmunotherapy results in low rates of complete remission, and most patients have a relapse. We investigated whether a fludarabine-containing induction regimen improved the complete-remission rate and whether maintenance therapy with rituximab prolonged remission. METHODS: We randomly assigned patients 60 years of age or older with mantle-cell lymphoma, stage II to IV, who were not eligible for high-dose therapy to six cycles of rituximab, fludarabine, and cyclophosphamide (R-FC) every 28 days or to eight cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) every 21 days. Patients who had a response underwent a second randomization to maintenance therapy with rituximab or interferon alfa, each given until progression. RESULTS: Of the 560 patients enrolled, 532 were included in the intention-to-treat analysis for response, and 485 in the primary analysis for response. The median age was 70 years. Although complete-remission rates were similar with R-FC and R-CHOP (40% and 34%, respectively; P=0.10), progressive disease was more frequent with R-FC (14%, vs. 5% with R-CHOP). Overall survival was significantly shorter with R-FC than with R-CHOP (4-year survival rate, 47% vs. 62%; P=0.005), and more patients in the R-FC group died during the first remission (10% vs. 4%). Hematologic toxic effects occurred more frequently in the R-FC group than in the R-CHOP group, but the frequency of grade 3 or 4 infections was balanced (17% and 14%, respectively). In 274 of the 316 patients who were randomly assigned to maintenance therapy, rituximab reduced the risk of progression or death by 45% (in remission after 4 years, 58%, vs. 29% with interferon alfa; hazard ratio for progression or death, 0.55; 95% confidence interval, 0.36 to 0.87; P=0.01). Among patients who had a response to R-CHOP, maintenance therapy with rituximab significantly improved overall survival (4-year survival rate, 87%, vs. 63% with interferon alfa; P=0.005). CONCLUSIONS: R-CHOP induction followed by maintenance therapy with rituximab is effective for older patients with mantle-cell lymphom

Measurements of π±\pi^\pm, K±^\pm, p and pˉ\bar{\textrm{p}} spectra in proton-proton interactions at 20, 31, 40, 80 and 158 GeV/c with the NA61/SHINE spectrometer at the CERN SPS

Measurements of inclusive spectra and mean multiplicities of $\pi^\pm$, K$^\pm$, p and $\bar{\textrm{p}}$ produced in inelastic p+p interactions at incident projectile momenta of 20, 31, 40, 80 and 158 GeV/c ($\sqrt{s} =$ 6.3, 7.7, 8.8, 12.3 and 17.3 GeV, respectively) were performed at the CERN Super Proton Synchrotron using the large acceptance NA61/SHINE hadron spectrometer. Spectra are presented as function of rapidity and transverse momentum and are compared to predictions of current models. The measurements serve as the baseline in the NA61/SHINE study of the properties of the onset of deconfinement and search for the critical point of strongly interacting matter

Flow cytometric enumeration of CD34+ hematopoietic stem and progenitor cells in leukapheresis product and bone marrow for clinical transplantation: a comparison of three methods.

Flow cytometric enumeration of CD34+ hematopoietic stem and progenitor cells (HSCs) is widely used for evaluation of graft adequacy of peripheral blood and bone marrow stem cell grafts. In the present study, we review and compare the major counting techniques of stem and progenitor cells. The methods are: the Milan/Mullhouse protocol, two-platform ISHAGE (International Society of Hematotherapy and Graft Engineering) and single-platform ISHAGE analysis system. According to the Milan/Mulhouse protocol, HSCs are identified by CD34 antibody staining and easy gating strategy. The ISHAGE guidelines for detection of CD34+ cells are based on a four-parameter flow cytometry method (CD34PE/CD45PerCP staining, side and forward angle light scatter) thus employing multiparameter gating strategy. With two-platform ISHAGE protocol, an absolute CD34+ count is generated by incorporating the leukocyte count from an automated hematology analyser. The single-platform ISHAGE method to determine the absolute CD34+ count directly from a flow cytometer includes the use of Trucount tubes (Becton Dickinson) with a known number of fluorescent beads. CD34+ cells were quantified in mobilized peripheral blood, collected by leukapheresis, and bone marrow from 42 samples from patients with hematological malignancies. The differences against the means display low disagreement between the Milan/Mulhouse and ISHAGE protocols, with discrepancies of up to 2.5% (two-platform ISHAGE)--2.6% (single-platform ISHAGE) in enumeration of CD34+ cells in leukapheresis product and 4.8% (two-platform ISHAGE)--4.9% (single-platform ISHAGE) in bone marrow. Our results show high correlation among all three methods. Since the three protocols are compatible, choosing the most convenient in terms of costs, simplicity and compliance with clinical results appears to be a logical consequence

Prospective subgroup analyses of the randomized MCL‐002 (SPRINT) study: lenalidomide \u3ci\u3eversus\u3c/i\u3e investigator\u27s choice in relapsed or refractory mantle cell lymphoma

In the mantle cell lymphoma (MCL)-002 study, lenalidomide demonstrated significantly improved median progression-free survival (PFS) compared with investigator\u27s choice (IC) in patients with relapsed/refractory MCL. Here we present the long-term follow-up data and results of preplanned subgroup exploratory analyses from MCL-002 to evaluate the potential impact of demographic factors, baseline clinical characteristics and prior therapies on PFS. In MCL-002, patients with relapsed/refractory MCL were randomized 2:1 to receive lenalidomide (25 mg/day orally on days 1–21; 28-day cycles) or single-agent IC therapy (rituximab, gemcitabine, fludarabine, chlorambucil or cytarabine). The intent-to-treat population comprised 254 patients (lenalidomide, n = 170; IC, n = 84). Subgroup analyses of PFS favoured lenalidomide over IC across most characteristics, including risk factors, such as high MCL International Prognostic Index score, age ≥65 years, high lactate dehydrogenase (LDH), stage III/IV disease, high tumour burden, and refractoriness to last prior therapy. By multivariate Cox regression analysis, factors associated with significantly longer PFS (other than lenalidomide treatment) included normal LDH levels (P \u3c 0·001), nonbulky disease (P = 0·045), \u3c3 prior antilymphoma treatments (P = 0·005), and ≥6 months since last prior treatment (P = 0·032). Overall, lenalidomide improved PFS versus single-agent IC therapy in patients with relapsed/refractory MCL, irrespective of many demographic factors, disease characteristics and prior treatment history

43 Izolowany szpiczak kości tkanek miękkich

Izolowany szpiczak kości (ISK) lub tkanek miękkich (ISTM) stanowi ok. 7% chorób układu krwiotwórczego.MateriałGrupę stanowi 17 chorych z rozpoznaniem izolowanego szpiczaka kości (ISK) i 10 chorych z izolowanym szpiczakiem tkanek miękkich (ISTM) leczonych w Centrum Onkologii w Warszawie w latach 1990–1998. W grupie ISK było 9 kobiet i 8 mężczyzn w wieku 37–72 (średnia wieku 54 lata) z lokalizacją zmian: kręgi piersiowe (8 chorych), lędźwiowe (2 chorych), szyjne (1 chory), kości biodrowo - kulszowej (3 chorych), kość ramienna (1 chory), żuchwa (1 chory), natomiast w grupie ISTM: 4 kobiety i 6 mężczyzn w wieku 35–81 lat (średnio 61 lat) z lokalizacją zmian: zatoka szczękowa i sitowie (3 chorych) jama nosowa (3 chorych), podniebienie miękkie (2 chorych), krtań (1 chora).MetodaW grupie ISK u 10 chorych wykonano laminektonię z powodu kompresji rdzenia z uzupełniającym napromienianiem w dawce 30–44 Gy/T. Dawka całkowita napromieniania w całej grupie wynosiła 30–50 Gy/T. W grupie EMP 6 chorych leczono wyłącznie napromienianiem, 1 chorego operacyjnie, pozostałych metodą skojarzoną: napromienianie i chemioterapia. Dawka całkowita leczenia napromienianiem wynosiła 30–60 Gy/T.WynikiW grupie ISK żyje 13 chorych, w tym 2 chorych z uogólnioną postaciąq choroby, 4 chorych zmarło z powodu postępu procesu nowotworowego przejście w szpiczaka mnogiego). Czas wolny od choroby wynosi 12–71 miesięcy (średnio 49 miesięcy). W grupie ISTM żyje 8 chorych, w tym 6 z całkowitąq remisją. Czas przeżycia wolnego od choroby wynosi 29–104 miesiące (średnio 54 miesiące).WnioskiDotychczasowe obserwacje potwierdzają doniesienia literaturowe: chorzy z postaciąq ISK narażeni są częściej na uogólnienie procesu chorobowego. Okres wolny od choroby w grupie z ISTM jest dłuższy niż chorych z ISK

41 Pierwotne chłoniaki noso-i orogardła

Najczęstszym umiejscowieniem chłoniaków pozawęzłowych jest okolica głowy i szyi: pierścień Waldeyera: nosogardło, podstawa języka i migdałki.MateriałW latach 1995–1998 W Klinice Nowotworów Układu Chłonnego Centrum Onkologii – Instytutu leczono 30 chorych na pierwotne chłoniaki pierścienia Waldeyera w tym 22 chorych ze zmianami w lokalizacji orogardła i 8 chorych nosogardła. Stopień zaawansowania klinicznego: IEA-14 chorych i II EA –16 chorych. Grupę stanowiło 11 kobiet i 19 mężczyzn w wieku 34–77 lat (średnio 62,3 lata). Rozpoznanie histopatologiczne: u 12 chorych chłoniak o średnim stopniu złośliwości z komórek B, u 8 chorych o wysokim stopniu złośliwości z komórek B oraz u 10 chorych chłoniak o mniejszym stopniu złośliwości. U żadnego chorego nie występowały objawy ogólne.Metoda26 chorych leczono metodą skojarzoną: chemioterapia (schematy z adriamycyną) z następowym leczeniem napromienianiem. Radioterapia w warunkach promieniowania gamma kobaltu 60 lub fotonami X o energii 9 MV technikąq dwóch pól twarzowo – szyjnych naprzeciwległych i pole szyjne dolne; w przypadkach guzów nosogardłar również pole przednie z objęciem sitowia. Dawka całkowita z pól bocznych w granicach 40–50 Gy/T oraz pole szyjne dolne 40–50 Gy. Oceniono powikłania wczesne leczenia napromienianiem według skali EORTC/RTOG.WynikiŻyje 23 chorych (w tym 2 chorych leczonych z powodu progresji procesu nowotworowego). 21 chorych żyje w całkowitej remisji w okresie wolnym od choroby od 12 do 48 miesięcy. Średni czas wolny od choroby 33,4 miesiące

The Effects of Migration and Remittances in Rural Moldova

Remittances in Moldova reach 36% of GDP, hence they constitute an essential part of the Moldovan economy. The most visible characteristic of remittances is their unequal distribution. The analysis applying the standard Lorenz Curve proves that 75% receiving households gets only 25% of total amount being sent to the country. The way remittances are distributed does not seem to be random. Higher amounts go in general to younger and more educated households. Remittances strongly influence the economic potential of households, especially if they are high enough. They often constitute the main source of households' income, but they not discourage the members of receiving households from economic activity. It indicates that migration and working abroad is the manifest of economic activity, on the other hand it suggest that lack of employment opportunities in the country is an important reason for migration. Those who obtain remittances tend to have higher share of investments in their total household spending. Significant share of remittances for all groups is spent on education - the basic investment increasing the future competitiveness. In rural areas remittances are much more often used to improve the quality of farms than to start running other businesses. It seems that lack of infrastructure and good governance is the main reason for which educated and young emigrants sending significant amounts of money do not decide to invest them in entrepreneurial activities. Eradicating these impediments for local development should be become a highest priority