493 research outputs found

    Managing conflict in organisational change

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    Organisational change and conflict are two essential topics that engineering managers need to understand and have confidence in acting on, if they are to succeed in todays changing and increasingly competitive environment. This paper examines and dissects the elements of organisational change that almost inevitably result in conflict. Conflicts that impact on organisational change can act as a retardant to progress, creativity, innovation and productivity, and potentially precipitate the demise of an organisation. One of the many difficulties relating to organisational conflict is to define the division between conflict and competition. This paper explores what is known about the various states of conflict and presents an approach to addressing this problem, through identifying and subsequently managing institutional elements influencing organisational change and conflict

    Baseline serum TSH levels predict the absence of thyroid dysfunction in cancer patients treated with immunotherapy

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    Purpose Immunotherapy against immune checkpoints has significantly improved survival both in metastatic and adjuvant setting in several types of cancers. Thyroid dysfunction is the most common endocrine adverse event reported. Patients who are at risk of developing thyroid dysfunction remain to be defined. We aimed to identify predictive factors for the develop- ment of thyroid dysfunction during immunotherapy. Methods This is a retrospective study including a total of 68 patients who were treated with immune checkpoint inhibi- tors (ICIs) for metastatic or unresectable advanced cancers. The majority of patients were treated with anti-PD1 drugs in monotherapy or in combination with anti-CTLA4 inhibitors. Thyroid function and anti-thyroid antibodies, before starting immunotherapy and during treatment, were evaluated. Thyroid ultrasound was also performed in a subgroup of patients at the time of enrolment in the study. Results Eleven out of 68 patients (16.1%) developed immune-related overt thyroid dysfunction. By ROC curve analysis, we found that a serum TSH cut-off of 1.72 mUI/l, at baseline, had a good diagnostic accuracy in identifying patients without overt thyroid dysfunction (NPV = 100%, p = 0.0029). At multivariate analysis, both TSH and positive anti-thyroid antibod- ies (ATAbs) levels, before ICIs treatment, were independently associated with the development of overt thyroid dysfunction during immunotherapy (p = 0.0001 and p = 0.009, respectively). Conclusions Pre-treatment serum TSH and ATAbs levels may help to identify patients at high risk for primary thyroid dysfunction. Our study suggests guidance for an appropriate timely screening and for a tailored management of thyroid dysfunctions in patients treated with ICIs

    Harvested wood products and carbon sink in a young beech high forest

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    Clinical course, therapeutic responses and outcomes in relapsing MOG antibody-associated demyelination.

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    Abstract OBJECTIVE: We characterised the clinical course, treatment and outcomes in 59 patients with relapsing myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination. METHODS: We evaluated clinical phenotypes, annualised relapse rates (ARR) prior and on immunotherapy and Expanded Disability Status Scale (EDSS), in 218 demyelinating episodes from 33 paediatric and 26 adult patients. RESULTS: The most common initial presentation in the cohort was optic neuritis (ON) in 54% (bilateral (BON) 32%, unilateral (UON) 22%), followed by acute disseminated encephalomyelitis (ADEM) (20%), which occurred exclusively in children. ON was the dominant phenotype (UON 35%, BON 19%) of all clinical episodes. 109/226 (48%) MRIs had no brain lesions. Patients were steroid responsive, but 70% of episodes treated with oral prednisone relapsed, particularly at doses <10\u2009mg daily or within 2 months of cessation. Immunotherapy, including maintenance prednisone (P=0.0004), intravenous immunoglobulin, rituximab and mycophenolate, all reduced median ARRs on-treatment. Treatment failure rates were lower in patients on maintenance steroids (5%) compared with non-steroidal maintenance immunotherapy (38%) (P=0.016). 58% of patients experienced residual disability (average follow-up 61 months, visual loss in 24%). Patients with ON were less likely to have sustained disability defined by a final EDSS of 652 (OR 0.15, P=0.032), while those who had any myelitis were more likely to have sustained residual deficits (OR 3.56, P=0.077). CONCLUSION: Relapsing MOG antibody-associated demyelination is strongly associated with ON across all age groups and ADEM in children. Patients are highly responsive to steroids, but vulnerable to relapse on steroid reduction and cessation

    HUWE1 E3 ligase promotes PINK1/PARKINindependent mitophagy by regulating AMBRA1 activation via IKKa

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    The selective removal of undesired or damaged mitochondria by autophagy, known as mitophagy, is crucial for cellular homoeostasis, and prevents tumour diffusion, neurodegeneration and ageing. The pro-autophagic molecule AMBRA1 (autophagy/beclin-1 regulator-1) has been defined as a novel regulator of mitophagy in both PINK1/PARKIN-dependent and -independent systems. Here, we identified the E3 ubiquitin ligase HUWE1 as a key inducing factor in AMBRA1-mediated mitophagy, a process that takes place independently of the main mitophagy receptors. Furthermore, we show that mitophagy function of AMBRA1 is post-translationally controlled, upon HUWE1 activity, by a positive phosphorylation on its serine 1014. This modification is mediated by the IKKα kinase and induces structural changes in AMBRA1, thus promoting its interaction with LC3/GABARAP (mATG8) proteins and its mitophagic activity. Altogether, these results demonstrate that AMBRA1 regulates mitophagy through a novel pathway, in which HUWE1 and IKKα are key factors, shedding new lights on the regulation of mitochondrial quality control and homoeostasis in mammalian cells

    The Barents area changes – How will Finland adapt? (Barentsin alue muuttuu – miten Suomi sopeutuu?)

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    The cumulative impacts of environmental, climatic and societal changes and their consequences will affect the development of the Arctic region in the coming decades. Adaptation to these changes will require measures of all the actors in the region. Finland, part of the Euro-Arctic region, will adapt to these changes in a variety of ways. The Barents area is unique in the Arctic in being a multicultural, relatively densely populated area with well-developed industries and infrastructure. This report examines adaptation to changes and their consequences in the Barents area in terms of governance and Finland’s capacities to adapt. The aim has been to produce comprehensive information from the Finnish perspective for local and national decision-makers about long-term changes in the region, their expected impacts and adaptation options, and to support decision-making that will advance adaptation. The report includes recommendations. This report is based on the contribution of Finnish experts to an Arctic Council and Arctic Monitoring and Assessment Programme (AMAP) project titled ”Adaptation Actions for a Changing Arctic” (AACA). The project has prepared a pilot report by Nordic and Russian experts on the Barents area in English on changes, their impacts and adaptation options. The report will be published in 2017 (AMAP 2017)

    Assessment of Forest Biomass and Carbon Stocks at Stand Level Using Site-Specific Primary Data to Support Forest Management

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    To quantify and map woody biomass (WB) and forest carbon (C) stocks, several models were developed. They differ in terms of scale of application, details related to the input data required and outputs provided. Local Authorities, such as Mountain Communities, can be supported in sustainable forest planning and management by providing specific models in which the reference unit is the same as the one reported in the Forest Management Plans (FMP), i.e. the forest stand. In the Lombardy Region (Northern Italy), a few studies were performed to assess WB and forest C stocks, and they were generally based on data coming from regional\u2014or national\u2014forest inventories and remote sensing, without taking into account data collected in the FMPs. For this study, the first version of the stand-level model \u201cWOody biomass and Carbon ASsessment\u201d (WOCAS) for WB and C stocks calculation was improved into a second version (WOCAS v2) and preliminary results about its first application to 2019 forest stands of Valle Camonica District (Lombardy Region) are presented. Since the model WOCAS uses the growing stock as the main driver for the calculation, it can be applied in any other forest area where the same input data are available

    Multifocal electroretinogram and Optical Coherence tomography spectral-domain in arc welding macular injury: a case report

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    <p>Abstract</p> <p>Background</p> <p>the purpose of this study was to report a binocular photic retinal injury induced by plasma arc welding and the follow-up after treatment with vitamin supplements for a month. In our study, we used different diagnostic tools such as fluorescein angiography (FA), optical coherence tomography (OCT) and multifocal electroretinogram (mfERG).</p> <p>Case presentation</p> <p>in the first visit after five days from arc welding injury in the left eye (LE) the visual acuity was 0.9 and 1.0 in the right eye (RE). FA was normal in both eyes. OCT in the left eye showed normal profile and normal reflectivity and one month later, a hyperreflectivity appeared in the external limiting membrane (ELM). The mfERG signal in the LE was 102.30 nV/deg2 five days after the injury and 112.62 nV/deg2 after one month and in the RE respectively 142.70 nV/deg2 and 159.46 nV/deg2.</p> <p>Conclusions</p> <p>in cases of retinal photo injury it is important for the ophthalmologist to evaluate tests such as OCT and the mfERG in the diagnosis and follow-up of the patient because the recovery of visual acuity cannot exclude the persistence of phototoxic damage charged to the complex inner-outer segment of photoreceptors.</p
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