277 research outputs found
The IT-CMF: A Practical Application of Design Science
The IT-Capability Maturity Model [IT-CMF] is a high-level process capability maturity framework for managing the IT function within an organization. The purpose of this paper is to explore and explain the IT-CMF as a “ method meta-model” for IT management, emphasizing the novel approach to addressing the application of design processes and design artifacts by means of a very structured use of engaged scholarship and open innovation techniques to the ongoing challenge of managing organization’s IT capability
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Diffusion of digital innovation in construction: a case study of a UK engineering firm
The UK government is mandating the use of building information modelling (BIM) in large public projects by 2016. As a result, engineering firms are faced with challenges related to embedding new technologies and associated working practices for the digital delivery of major infrastructure projects. Diffusion of innovations theory is used to investigate how digital innovations diffuse across complex firms. A contextualist approach is employed through an in-depth case study of a large, international engineering project-based firm. The analysis of the empirical data, which was collected over a four-year period of close interaction with the firm, reveals parallel paths of diffusion occurring across the firm, where both the innovation and the firm context were continually changing. The diffusion process is traced over three phases: centralization of technology management, standardization of digital working practices, and globalization of digital resources. The findings describe the diffusion of a digital innovation as multiple and partial within a complex social system during times of change and organizational uncertainty, thereby contributing to diffusion of innovations studies in construction by showing a range of activities and dynamics of a non-linear diffusion process
The results of concentration of care: surgical outcomes of neuroblastoma in the Netherlands
Introduction. In the Netherlands pediatric oncological care for solid tumours is concentrated in one centre since November 2014. One of the most frequently diagnosed solid non-brain tumours in children is the neuroblastoma. Results of surgical treatment of neuroblastoma since the start of this centralization are presented and compared to a historic cohort. Methods. The new national cohort of neuroblastoma (n = 111) consists of all consecutive patients treated be-tween January 1st, 2015 and April 1st, 2021. The historic neuroblastoma cohort consists of all operated neuroblastoma patients in the Netherlands between 1998 and 2014 (n = 244). Intra-operative compli-cations and surgical outcome were registered. Post-operative complications were divided in short (30 days). The severity of complications was graded using the Clavien Dindo Classification (CDC) system. Results. Intraoperative outcomes showed significant differences in favour of the new cohort with less blood loss (p < 0.001), fewer vascular complications (p < 0.001) and shorter duration of surgery (p < 0.001). Short term complications were comparable in numbers, but significantly more patients had CDC grade 3/ 4/5 complications in the historic cohort (p = 0.005). Long term complications did not differ. Estimated overall survival showed a better survival in the new cohort (log rank 0.022). Conclusion. Centralization of care for neuroblastoma patients has led to a significant improvement of both intraoperative outcomes and short term complications. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Development and application of statistical models for medical scientific researc
Creating the future together: Toward a framework for research synthesis in entrepreneurship
To develop a body of evidence-based knowledge on entrepreneurship, findings and contributions from the positivist, narrative and design research traditions in this area need to be combined. Therefore, a framework for research synthesis in terms of social mechanisms, contextual conditions and outcome patterns is developed in this paper. Subsequently, a synthesis of the existing body of research findings on entrepreneurial opportunities serves to illustrate how this framework can be applied and provides results that inform entrepreneurial action. Finally, we discuss how this synthetic approach serves to systematically connect the fragmented landscape of entrepreneurship research, and thus gradually build a cumulative and evidence-based body of knowledge on entrepreneurship
Liver Steatosis is Prevalent in Lean People With HIV and Associated With Exposure to Antiretroviral Treatment - A Cross-sectional Study
Background: Steatotic liver disease is suggested to have a higher prevalence and severity in people with HIV (PHIV), including in those with a normal body mass index (BMI). In this study, we used data from the 2000HIV cohort to (1) assess the prevalence of liver steatosis and fibrosis in lean versus overweight/obese PHIV and (2) assess associations in these subgroups between steatosis and fibrosis with traditional risk factors and HIV-specific characteristics. Methods: The 2000HIV study cohort comprises 1895 virally suppressed PHIV that were included between 2019 and 2021 in 4 HIV treatment centers in the Netherlands. The majority (58.5%) underwent vibration-controlled transient elastography for the assessment of liver steatosis and fibrosis. The prevalence of steatosis (controlled attenuation parameter ≥263 dB/m) and fibrosis (liver stiffness measurement ≥7.0 kPa) was estimated. Multiple factors including HIV characteristics and antiretroviral drugs were tested in a logistic regression model for association with steatosis and fibrosis. Analyses were performed separately for lean (Asian descent: BMI < 23 kg/m2, other descent: BMI < 25 kg/m2) and overweight/obese (other BMI) participants. Results: Of 1050 PHIV including 505 lean and 545 overweight/obese PHIV, liver steatosis was observed in 37.7% of the overall study population, 19.7% of lean, and 54% of overweight/obese PHIV, whereas fibrosis was observed in 9.0% of the overall study population, 5.9% of lean, and 12.0% of overweight/obese PHIV. All associations with fibrosis and most associations with steatosis concerned metabolic factors such as type 2 diabetes mellitus (overall population: adjusted odds ratio [aOR] for steatosis: 2.3 [1.21-4.4], P =. 011; aOR for fibrosis: 3.7 [1.82-7.53], P <. 001). Furthermore, in lean PLHIV, liver steatosis was associated with CD4 and CD8 counts at enrollment, dual therapy, and history of treatment with raltegravir (aOR: 3.6 [1.53-8.47], P =. 003), stavudine (aOR: 3.73 [1.69-8.2], P =. 001), and indinavir (aOR: 3.86 [1.59-9.37], P =. 003). These associations were not observed in overweight/obese PHIV. Conclusions: Liver steatosis was highly prevalent, affecting approximately one-fifth of lean PHIV and half of overweight/obese PHIV. Fibrosis was observed in a minority. Both steatosis and fibrosis were associated with traditional metabolic risk factors. In addition, (prior) exposure to specific antiretroviral drugs was associated liver steatosis in lean, but not in overweight/obese PHIV. Implementing increased screening protocols could enhance the identification of steatotic liver disease in lean PHIV.</p
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How are management fashions institutionalized? The role of institutional work
We explore how transitory management fashions become institutionalized. Based on the concepts of institutional entrepreneurship and institutional work, we postulate that fashionable management practices acquire permanence when they are anchored within fieldwide institutions. The building of such institutions requires various types of institutional work, including political work, technical work and cultural work. Based on a review of the empirical literature on various management fashions, we identify the actors engaging in these different types of works, and their skills. Our results suggest that the institutionalization effect is stronger if more types of institutional work are deployed and if the skill sets of the involved actors vary. We also argue that institutional construction in the case of management fashions is likely to take the form of decentralized `partaking' rather than being led by a single dominant institutional entrepreneur. We conclude with implications for the study of management fashions and the role of agency in institutionalization
Clinical implementation and feasibility of long-course fractionated MR-guided chemoradiotherapy for patients with esophageal cancer: An R-IDEAL stage 1b/2a evaluation of technical innovation
Purpose: This R-Ideal stage 1b/2a study describes the workflow and feasibility of long-course fractionated online adaptive MR-guided chemoradiotherapy with reduced CTV-to-PTV margins on the 1.5T MR-Linac for patients with esophageal cancer. Methods: Patients with esophageal cancer scheduled to undergo chemoradiation were treated on a 1.5T MR-Linac. Daily MR-images were acquired for online contour adaptation and replanning. Contours were manually adapted to match the daily anatomy and an isotropic CTV-to-PTV margin of 6 mm was applied. Time was recorded for all individual steps in the workflow. Feasibility and patient tolerability were defined as on-table time of ≤60 min and completion of >95% of the fractions on the MR-Linac, respectively. Positioning verification and post-treatment MRIs were retrospectively analyzed and dosimetric parameters were compared to standard non-adaptive conventional treatment plans. Results: Nine patients with esophageal cancer were treated with chemoradiation; eight patients received 41.4 Gy in 23 fractions and one received 50.4 Gy in 28 fractions. Four patients received all planned fractions on the MR-Linac, whereas for two patients >5% of fractions were rescheduled to a conventional linac for reasons of discomfort. A total of 183 (86%) of 212 scheduled fractions were successfully delivered on the MR-Linac. Three fractions ended prematurely due to technical issues and 26 fractions were rescheduled on a conventional linac due to MR-Linac downtime (n = 10), logistical reasons (n = 3) or discomfort (n = 13). The median time per fraction was 53 min (IQR = 3 min). Daily adapted MR-Linac plans had similar target coverage, whereas dose to the organs-at-risk was significantly reduced compared to conventional treatment (26% and 12% reduction in mean lung and heart dose, respectively). Conclusion: Daily online adaptive fractionated chemoradiotherapy with reduced PTV margins is moderately feasible for esophageal cancer and results in better sparing of heart and lungs. Future studies should focus on further optimization and acceleration of the current workflow
The framing of product ideas in the making: a case study of the development of an energy saving pump
Towards an integrative view of innovation in food sector SMEs
Most literature on innovation focuses on organizational engagement with innovation types in isolation from one another. By establishing the interdependency of innovation types in SMEs in the UK food sector, this study provides evidence to support the case for a more holistic approach in innovation research. Thus the study both contributes to the limited research on innovation in food sector SMEs and supports the integrative view of innovation. Using questionnaire-based data, structured equation modelling was used to propose and test the interrelationships between the level of engagement with product, process, position and paradigm innovation. A significant positive relationship between innovation types was identified
Being careful what we wish for? Challenges and opportunities afforded through engagement with business and management research
Despite the proliferation of work within construction management that draws upon management and organizational theory, two omissions stand out from the body of published work: the absence of any real debate about the values of rigour and relevance in research; and the under-use of dominant perspectives in business and management research (such as institutional theory) to frame construction management and organizational issues. Drawing specifically upon the ideas of institutional logics and institutional work, this paper explores the tensions, ironies and contradictions of the rigour-relevance debate; and the challenges and opportunities facing construction management research (CMR) and its institutions in furthering management and organizational research agendas. In doing so, attention is directed to the complex, contested and changing nature of the knowledge base within the business and management field; as well as key differences between that community of practice and CMR
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