Intensive care of the cancer patient: recent achievements and remaining challenges

A few decades have passed since intensive care unit (ICU) beds have been available for critically ill patients with cancer. Although the initial reports showed dismal prognosis, recent data suggest that an increased number of patients with solid and hematological malignancies benefit from intensive care support, with dramatically decreased mortality rates. Advances in the management of the underlying malignancies and support of organ dysfunctions have led to survival gains in patients with life-threatening complications from the malignancy itself, as well as infectious and toxic adverse effects related to the oncological treatments. In this review, we will appraise the prognostic factors and discuss the overall perspective related to the management of critically ill patients with cancer. The prognostic significance of certain factors has changed over time. For example, neutropenia or autologous bone marrow transplantation (BMT) have less adverse prognostic implications than two decades ago. Similarly, because hematologists and oncologists select patients for ICU admission based on the characteristics of the malignancy, the underlying malignancy rarely influences short-term survival after ICU admission. Since the recent data do not clearly support the benefit of ICU support to unselected critically ill allogeneic BMT recipients, more outcome research is needed in this subgroup. Because of the overall increased survival that has been reported in critically ill patients with cancer, we outline an easy-to-use and evidence-based ICU admission triage criteria that may help avoid depriving life support to patients with cancer who can benefit. Lastly, we propose a research agenda to address unanswered questions

Academic patenting: the importance of industry support

This paper provides evidence that university-industry collaboration is important for turning commercial opportunities into patents. The results suggest that researchers who receive a large share of research grants from industry have a higher propensity to file a patent. Small dissemination grants generally exert a positive effect, whether they come from industry or not. It also finds that these interactions do not increase the number of industry owned patents alone but benefit universities’ commercialisation efforts in general

Recovery after critical illness: putting the puzzle together-a consensus of 29.

In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new insights into ICU acquired weakness, to emphasize the importance of value-based healthcare, and to delineate the elements of family-centered care. This consensus of 29 also provides a perspective and a research agenda about post-ICU recovery

Quality of transition to end-of-life care for cancer patients in the intensive care unit

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.BACKGROUND: There have been few studies that have evaluated the quality of end-of-life care (EOLC) for cancer patients in the ICU. The aim of this study was to explore the quality of transition to EOLC for cancer patients in ICU. METHODS: The study was undertaken on medical patients admitted to a specialist cancer hospital ICU over 6 months. Quantitative and qualitative methods were used to explore quality of transition to EOLC using documentary evidence. Clinical parameters on ICU admission were reviewed to determine if they could be used to identify patients who were likely to transition to EOLC during their ICU stay. RESULTS: Of 85 patients, 44.7% transitioned to EOLC during their ICU stay. Qualitative and quantitative analysis of the patients' records demonstrated that there was collaborative decision-making between teams, patients and families during transition to EOLC. However, 51.4 and 40.5% of patients were too unwell to discuss transition to EOLC and DNACPR respectively. In the EOLC cohort, 76.3% died in ICU, but preferred place of death known in only 10%. Age, APACHE II score, and organ support, but not cancer diagnosis, were identified as associated with transition to EOLC (p = 0.017, p < 0.0001 and p = 0.001). CONCLUSIONS: Advanced EOLC planning in patients with progressive disease prior to acute deterioration is warranted to enable patients' wishes to be fulfilled and ceiling of treatments agreed. Better documentation and development of validated tools to measure the quality EOLC transition on the ICU are needed.Peer reviewe

Context Factors and the Performance of Mobile Individuals in Research Teams

This article studies how workforce composition is related to a firm’s success in introducing radical innovations. Pre-vious studies have argued that teams composed of individuals with diverse backgrounds are able to perform moreinformation processing and make deeper use of the information, which is important to accomplish complex tasks.We suggest that this argument can be extended to the level of the aggregate workforce of high-technology firms. Inparticular, we argue that ethnic and higher education diversity within the workforce is associated with superior per-formance in radical innovation. Using a sample of 3,888 Swedish firms, this article demonstrates that having greaterworkforce diversity in terms of both ethnic background and educational disciplinary background is positively corre-lated to the share of a firm’s turnover generated by radical innovation. Having more external collaborations does,however, seem to reduce the importance of educational background diversity. The impact of ethnic diversity is notaffected by external collaboration. These findings hold after using alternative measures of dependent and indepen-dent variables, alternative sample sizes, and alternative estimation techniques. The research findings presented inthis article would seem to have immediate and important practical implications. They would suggest that companiesmay pursue recruitment policies inspired by greater ethnic and disciplinary diversity as a way to boost the innova-tiveness of the organ ization. From a managerial perspective, it may be conc luded tha t workforce disciplinary diver-sity could be potentially replaced by more external links, while ethnic diversity could not

The decline of science in corporate R&D

Research summary: In this article, we document a shift away from science by large corporations between 1980 and 2006. We find that publications by company scientists have declined over time in a range of industries. We also find that the value attributable to scientific research has dropped, whereas the value attributable to technical knowledge (as measured by patents) has remained stable. These trends are unlikely to be driven principally by changes in publication practices. Furthermore, science continues to be useful as an input into innovation. Our evidence points to a reduction of the private benefits of internal research. Large firms still value the golden eggs of science (as reflected in patents), but seem to be increasingly unwilling to invest in the golden goose itself (the internal scientific capabilities). Managerial summary: There is a widespread belief among commentators that large American corporations are withdrawing from research. Large corporations may still collaborate with universities and acquire promising science-based start-ups, but their labs increasingly focus on developing existing knowledge and commercializing it, rather than creating new knowledge. In this article, we combine firm-level financial information with a large and comprehensive data set on firm publications, patents and acquisitions to quantify the withdrawal from science by large American corporations between 1980 and 2006. This withdrawal is associated with a decline in the private value of research activities, even though scientific knowledge itself remains important for corporate invention. We discuss the managerial and policy implications of our findings

The Double-Edged Sword of Industry Collaboration: Evidence from Engineering Academics in the UK

This paper studies the impact of university‐industry collaboration on academic research output. We analyze the channels through which the degree of industry collaboration may be affecting research output. We exploit a unique longitudinal dataset on all the researchers in all the engineering departments of 40 major universities in the UK for the last 20 years. We use an innovative measure of collaboration based on the fraction of public research grants that include industry partners. Our empirical findings corroborate that the relationship between collaboration degree and publication rates is curvilinear, and shed some light on the selection mechanisms at work. Our results are robust to several econometric methods, measures of research output, and subsamples of academics