Treatment of Adult Patients with Relapsed/Refractory B-Cell Philadelphia-Negative Acute Lymphoblastic Leukemia

The majority of adult patients affected by B-cell acute lymphoblastic leukemia (B-ALL) will relapse after an initial response, while approximately 20% will display primary resistant disease. Patients suffering from relapsed/refractory B-ALL have a very poor outcome. Allogeneic hematopoietic cell transplantation (HCT) still represents the only curative approach, but is not so frequently feasible, because of patient’s fitness, donor availability, and the ability to achieve a remission prior to HCT. The estimated remission rates with conventional cytotoxic agents are around 30%, but they are short-lived. These disappointing results led to the introduction of new immunologic-based treatments—blinatumomab and inotuzumab. They produced a substantial improvement in terms of response rates, with the ability, in most cases, to induce a minimal residual disease (MRD)-negative status. Similarly, T cells engineered to express a CD19-specific chimeric antigen receptor (CAR-T) have yielded sensational results among patients with relapsed/refractory B-ALL, with unexpectedly high MRD-negative complete remissions rates. However, the first studies looking at long-term outcomes after CAR-T infusions told us that a significant fraction of such responses are not durable, and may benefit from a consolidation approach such as an allogeneic HCT

Work In The 21st Century: A Study In Organizational Adaptation To Alternative Work Arrangements

The concept of alternative work arrangements (AWAs) represents a growing trend within many organizations to shift once-common models of working to newer paradigms. Among many options, this includes models where employees may work from somewhere other than a primary physical office space (remote work), or no longer possess a personal desk at their office (desk sharing). Both remote work and desk sharing often require employees to adapt to a mode of “working” far different than they are accustomed to, yielding a range of conflicting opinions, pros and cons, and unique experiences along the way. The research question becomes: How do employees make sense of their organization’s shift towards alternative work arrangements? This capstone explores the transition from the perspective of a higher-education information technology organization (HEITO) in the midst of its journey in adopting and adapting to AWAs, initially presenting the historical circumstances that led to the organization’s current state. A literature review and secondary research is used to explore AWAs and several sub-topics related to the change, and a recent survey of HEITO’s employees is used to gather quantitative and qualitative data on the organization’s transition. This capstone concludes with an analysis of the research data, and thoughts pertaining to further studies on AWAs

Counter-narratives and Revisionism: A Transformative Journey to Closing the Achievement Gap for Indigenous Learners through Culturally Responsive School Leadership, Equity Transformation, and Nurturing Collective Teacher Efficacy

Professional learning in the areas of Indigenous education, reconciliation, and antiracism is as much a personal journey as a professional one for educators today. At New Beginnings Middle School (NBMS, a pseudonym), Indigenous learners experience a significant academic achievement gap. This Organizational Improvement Plan (OIP) explores how to cultivate teaching practices that create a more inclusive school environment and improve academic achievement for all Indigenous students. It proposes to guide educators through bias mitigation with integrated professional learning to develop culturally responsive pedagogy. Given the compelling correlation between inclusiveness and academic success, NBMS educators must work collectively to build confidence in Indigenous learners, reduce racial barriers, mitigate ignorance, and develop programming that reflects student culture. Implementation of the proposed solution is interpreted through a critical social justice lens, and it relies on transformative leadership and culturally responsive and adaptive practices. A proposed blended change implementation plan encourages teachers to listen and awaken, uncover and mobilize, reimagine and accelerate, and move and institutionalize. Measuring and monitoring the plan includes a 10-month timeline, a teacher’s cultural proficiency receptivity scale, various student agency measurement surveys, and a classroom data dashboard tool. The NBMS administration will set conditions for educators to centre Indigenous students by implementing processes to build student voice and agency as cocreators of their learning. This OIP builds collective teacher efficacy for an envisioned state of continual reflexive pedagogy in teachers specific to Indigenous students, with an end goal to close the achievement gap for these learners at NBMS

La Romanizzazione della Britannia

Questi tesi tratta del processo di romanizzazione della Britannia a cui diede inizio la spedizione di Gaio Giulio Cesare sull'isola (55 - 54 a.C.), dei successivi contatti tra le varie popolazioni britanniche e l'impero sotto Augusto, Tiberio e Caligola per concludersi con la definitiva conquista e provincializzazione dell'isola avvenuta durante il principato di Claudio (41 - 54 d.C.) e quello di Nerone (54 - 68 d.C.). La tesi si divide in tre parti: - una Introduzione in cui viene presentato il territorio, i popoli e l'immagine che si aveva a Roma della Britannia prima della definitiva conquista da parte di Claudio -il primo capitolo che tratta delle due spedizioni di Gaio Giulio Cesare sull'isola (55 - 54 a.C) e dei motivi che spinsero il generale romano, allora impegnato nella conquista della Gallia, a recarsi in Britannia -il secondo capitolo in cui si delineano i rapporti che intercorsero tra l'isola e l'impero romano a partire da Augusto e fino alla (inconcludente) spedizione di Caligola -il terzo capitolo in cui si analizza in modo dettagliato la conquista dell'isola avvenuta a partire dalla spedizione del 43 d.C., voluta dall'imperatore Claudio e guidata da Aulo Plauzio, con un'analisi puntuale dei motivi che spinsero alla conquista e delle strategie messe in campo dai due schieramenti opposti. Il capitolo parla dei 17 anni intercorsi tra lo sbarco sull'isola e la rivolta di Boudicca del 60 d.C., trattando dei vari governatori che si alternarono sull'isola (Aulo Plauzio, Ostorio Scapula, Quinto Veranio, Svetonio Paolino) e delle azioni che questi intrapresero per espandere e consolidare il limes provinciale. La tesi si chiude con la rivolta di Boudicca, che segna un netto stacco con la storia precedente e costringerà i Romani a ripensare all'assetto della provincia e ad iniziare una nuova, lunga stabilizzazione, conclusa soltanto durante il governatorato di Agricola

The use of exenatide in managing markers of cardiovascular risk in patients with type 2 diabetes: A systematic review.

This review examines the use of exenatide twice daily in managing changes in markers of cardiovascular risk in patients with type 2 diabetes. Background: Type 2 diabetes is a progressive metabolic disorder, which results from defects in insulin secretion and/or insulin action leading to chronic hyperglycaemia and associated cardiovascular complications. Despite the use of diet, exercise, oral antihyperglycaemic agents and insulin, the progressive nature of the condition means that the levels of the preventive and treatment measures would have to be increased and/or new therapies have to be developed in order to address the long term impact of type 2 diabetes. The advent of exenatide, a glucagon-like peptide-1 receptor agonist provides a useful basis for managing type 2 diabetes and related cardiovascular complications without the side effects of regular diabetes therapies. However, exenatide twice daily is often used in combination with other therapies, although the mechanism of exenatide in managing diabetes and and associated cardiovascular risks and complications remain complex and still evolving. Method: A range of databases including EBSCOhost online research database were used to access articles based on PICO (Population, Interventions, Comparative Interventions, Outcomes) framework and Boolean operators. Results: Eleven randomised controlled studies which met the inclusion criteria were selected for this review. Nine of the eleven studies showed significant decrease in body weight among participants in the exenatide group compared with placebo or control group while the other two studies did not report statistically significant differences in body weight. In adition, all the studies showed statistically significant decrease in glycated haemoglobin (HbA1c) in the exenatide group compared to controls except in one study. In the present review, the seven studies, which looked at the effect of exenatide twice daily on lipid profile, did not find any significant difference between the exenatide group and the control group except for High density lipoprotein-cholesterol in two of the studies. However, statistically significant decrease was observed between exenatide group and controls with respect to blood pressure (systolic and/or diastolic) in these studies. Discussion: It would appear that exenatide is more effective in reducing body weight in patients with type 2 diabetes when used in combination with metformin than when used alone or in combination with thiazolidinedione. The findings of this review would suggest that exenatide twice daily may be useful in managing cardiovascular risks and complications by reducing body weight, HbA1c and blood pressure

De espaldas a la alabanza. (Sonoridad, afecto, memoria en la obra de Igor Barreto).

Este trabajo se propone analizar la obra completa del poeta venezolano Igor Barreto (San Fernando de Apure, 1952), desde sus libros más tempranos como Crónicas llanas (1989) y Tierranegra (1993), hasta los más recientes como Annapurna (2012) y El muro de Maldeshtam (2016), con la finalidad de examinar su proyecto estético a partir de ciertas figuras recurrentes como: la naturaleza, el río, los animales, las antípodas, la memoria, el intervalo, el país, la precariedad. A través de la incorporación de materiales de la cultura que enrarecen la noción de literatura y poesía, Barreto explora estados de interrupción y dificultad de la vida –enfrentamientos, desencuentros, desapariciones, pérdidas, crisis, naufragios– como experiencias en las que el poeta ensaya los límites de su lengua e interviene las formas dominantes de sentir e imaginar para proponer una poética de la vulnerabilidad y el afecto