Oral versus intravenous empirical antimicrobial therapy for fever in patients with granulocytopenia who are receiving cancer chemotherapy. International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer.

BACKGROUND: Intravenously administered antimicrobial agents have been the standard choice for the empirical management of fever in patients with cancer and granulocytopenia. If orally administered empirical therapy is as effective as intravenous therapy, it would offer advantages such as improved quality of life and lower cost. METHODS: In a prospective, open-label, multicenter trial, we randomly assigned febrile patients with cancer who had granulocytopenia that was expected to resolve within 10 days to receive empirical therapy with either oral ciprofloxacin (750 mg twice daily) plus amoxicillin-clavulanate (625 mg three times daily) or standard daily doses of intravenous ceftriaxone plus amikacin. All patients were hospitalized until their fever resolved. The primary objective of the study was to determine whether there was equivalence between the regimens, defined as an absolute difference in the rates of success of 10 percent or less. RESULTS: Equivalence was demonstrated at the second interim analysis, and the trial was terminated after the enrollment of 353 patients. In the analysis of the 312 patients who were treated according to the protocol and who could be evaluated, treatment was successful in 86 percent of the patients in the oral-therapy group (95 percent confidence interval, 80 to 91 percent) and 84 percent of those in the intravenous-therapy group (95 percent confidence interval, 78 to 90 percent; P=0.02). The results were similar in the intention-to-treat analysis (80 percent and 77 percent, respectively; P=0.03), as were the duration of fever, the time to a change in the regimen, the reasons for such a change, the duration of therapy, and survival. The types of adverse events differed slightly between the groups but were similar in frequency. CONCLUSIONS: In low-risk patients with cancer who have fever and granulocytopenia, oral therapy with ciprofloxacin plus amoxicillin-clavulanate is as effective as intravenous therapy.

From evolution to co-evolution – An empirical study of the role of innovation, policy and public research in industrial dynamics

In the past decades since Schumpeter’s influential writings economists have pursued research to examine the role of innovation in certain industries on firm as well as on industry level. Researchers describe innovations as the main trigger of industry dynamics, while policy makers argue that research and education are directly linked to economic growth and welfare. Thus, research and education are an important objective of public policy. Firms and public research are regarded as the main actors which are relevant for the creation of new knowledge. This knowledge is finally brought to the market through innovations. What is more, policy makers support innovations. Both actors, i.e. policy makers and researchers, agree that innovation plays a central role but researchers still neglect the role that public policy plays in the field of industrial dynamics. Therefore, the main objective of this work is to learn more about the interdependencies of innovation, policy and public research in industrial dynamics. The overarching research question of this dissertation asks whether it is possible to analyze patterns of industry evolution – from evolution to co-evolution – based on empirical studies of the role of innovation, policy and public research in industrial dynamics. This work starts with a hypothesis-based investigation of traditional approaches of industrial dynamics. Namely, the testing of a basic assumption of the core models of industrial dynamics and the analysis of the evolutionary patterns – though with an industry which is driven by public policy as example. Subsequently it moves to a more explorative approach, investigating co-evolutionary processes. The underlying questions of the research include the following: Do large firms have an advantage because of their size which is attributable to cost spreading? Do firms that plan to grow have more innovations? What role does public policy play for the evolutionary patterns of an industry? Are the same evolutionary patterns observable as those described in the ILC theories? And is it possible to observe regional co-evolutionary processes of science, innovation and industry evolution? Based on two different empirical contexts – namely the laser and the photovoltaic industry – this dissertation tries to answer these questions and combines an evolutionary approach with a co-evolutionary approach. The first chapter starts with an introduction of the topic and the fields this dissertation is based on. The second chapter provides a new test of the Cohen and Klepper (1996) model of cost spreading, which explains the relationship between innovation, firm size and R&D, at the example of the photovoltaic industry in Germany. First, it is analyzed whether the cost spreading mechanism serves as an explanation for size advantages in this industry. This is related to the assumption that the incentives to invest in R&D increase with the ex-ante output. Furthermore, it is investigated whether firms that plan to grow will have more innovative activities. The results indicate that cost spreading serves as an explanation for size advantages in this industry and, furthermore, growth plans lead to higher amount of innovative activities. What is more, the role public policy plays for industry evolution is not finally analyzed in the field of industrial dynamics. In the case of Germany, the introduction of demand inducing policy instruments stimulated market and industry growth. While this policy immediately accelerated market volume, the effect on industry evolution is more ambiguous. Thus, chapter three analyzes this relationship by considering a model of industry evolution, where demand-inducing policies will be discussed as a possible trigger of development. The findings suggest that these instruments can take the same effect as a technical advance to foster the growth of an industry and its shakeout. The fourth chapter explores the regional co-evolution of firm population size, private-sector patenting and public research in the empirical context of German laser research and manufacturing over more than 40 years from the emergence of the industry to the mid-2000s. The qualitative as well as quantitative evidence is suggestive of a co-evolutionary process of mutual interdependence rather than a unidirectional effect of public research on private-sector activities. Chapter five concludes with a summary, the contribution of this work as well as the implications and an outlook of further possible research.

Lean Transition of Emerging Industrial Capability

This volume of the final report documents the technical work performed from December 1998 through December 2002 under Cooperative Agreement F33615-97-2-5153 executed between the U.S. Air Force, Air Force Research Laboratory, Materials and Manufacturing Directorate, Manufacturing Technology Division (AFRL/MLM) and the McDonnell Douglas Corporation, a wholly-owned subsidiary of The Boeing Company. The work was accomplished by The Boeing Company, Phantom Works, Huntington Beach, St. Louis, and Seattle; Ford Motor Company; Integral Inc.; Sloan School of Management in the Massachusetts Institute of Technology; Pratt & Whitney; and Central State University in Xenia, Ohio and in association with Raytheon Corporation. The LeanTEC program manager for AFRL is John Crabill of AFRL / MLMP and The Boeing Company program manager is Ed Shroyer of Boeing Phantom Works in Huntington Beach, CA. Financial performance under this contract is documented in the Financial Volume of the final report.

A utilização de estratégias organizacionais no processo de internacionalização no setor de cooperativismo no estado do Paraná: estudo de caso da cooperativa industrial C&M do estado do Paraná.

A presente pesquisa possui um enfoque no processo de internacionalização das empresas brasileiras, um fenômeno que vem ocorrendo de forma lenta e gradual ao longo dos últimos 25 anos, com grande ênfase nos anos 1990, quando o Brasil abriu sua economia ao capital externo, proporcionando maiores investimentos em novos produtos, novas tecnologias, e a adoção por parte das nossas organizações de novas formas e práticas de gestão empresarial, as quais já faziam parte há um bom tempo das organizações multinacionais pelo mundo afora, que sempre utilizaram essas melhores formas de gestão empresarial em seu estado da arte. Este atraso do Brasil em relação ao mundo desenvolvido, em que o País se fechou como uma verdadeira "ostra", refletiu-se em prejuízos imensuráveis ao desenvolvimento social, político e econômico, resultando em atrasos tecnológicos e educacionais e na consequente falta de pessoal qualificado em face de um mundo globalizado, no qual se mostram imprescindíveis as inovações tecnológicas e a capacitação humana. Nesse contexto, o processo de internacionalização de empresas, especificamente o segmento do cooperativismo de agronegócio no estado do Paraná, ganha um impulso significativo, quando as cooperativas, a partir da década de 1980, buscam sua inserção internacional no mundo globalizado através de um aumento gradativo em suas exportações, inicialmente somente com produtos in natura e, posteriormente, com a introdução de novas tecnologias, equipamentos, pesquisas, modernas formas de gestão e educação continuada de pessoal, possibilitando às cooperativas, e de forma geral ao setor cooperativista paranaense, um grande salto financeiro e um aumento expressivo na composição do PIB do Paraná, representando nos dias atuais aproximadamente 40% do total das exportações do estado. Dessa forma, este trabalho procura contribuir com a academia e com as organizações cooperativistas do estado do Paraná no sentido de buscar as razões para esse importante e irreversível processo de internacionalização, que trouxe, e ainda traz, vantagens financeiras, tecnológicas e dinamismo à economia local com os seus diversos atores, e que transforma essas organizações paranaenses e brasileiras em grandes players globais nos negócios internacionais.

Changes in the intermediate water mass formation rates in the global ocean for the Last Glacial Maximum, mid-Holocene and pre-industrial climates

The paleoclimate version of the National Center for Atmospheric Research Community Climate System Model version 3 (NCAR-CCSM3) is used to analyze changes in the water formation rates in the Atlantic, Pacific, and Indian Oceans for the Last Glacial Maximum (LGM), mid-Holocene (MH) and pre-industrial (PI) control climate. During the MH, CCSM3 exhibits a north-south asymmetric response of intermediate water subduction changes in the Atlantic Ocean, with a reduction of 2 Sv in the North Atlantic and an increase of 2 Sv in the South Atlantic relative to PI. During the LGM, there is increased formation of intermediate water and a more stagnant deep ocean in the North Pacific. The production of North Atlantic Deep Water (NADW) is significantly weakened. The NADW is replaced in large extent by enhanced Antarctic Intermediate Water (AAIW), Glacial North Atlantic Intermediate Water (GNAIW), and also by an intensified of Antarctic Bottom Water (AABW), with the latter being a response to the enhanced salinity and ice formation around Antarctica. Most of the LGM intermediate/mode water is formed at 27.4 < sigma(theta) < 29.0 kg/m(3), while for the MH and PI most of the subduction transport occurs at 26.5 < sigma(theta) < 27.4 kg/m(3). The simulated LGM Southern Hemisphere winds are more intense by 0.2-0.4 dyne/cm(2). Consequently, increased Ekman transport drives the production of intermediate water (low salinity) at a larger rate and at higher densities when compared to the other climatic periods.

The use of participant-observation protocol in an industrial engineering research

Based on literature, this article aims to present the "participant-observation" research protocol, and its practical application in the industrial engineering field, more specifically within the area of design development, and in the case shown by this article, of interiors' design. The main target is to identify the concept of the method, i.e., from its characteristics to structure a general sense about the subject, so that the protocol can be used in different areas of knowledge, especially those ones which are committed with the scientific research involving the expertise from researchers, and subjective feelings and opinions of the users of an engineering product, and how this knowledge can be benefic for product design, contributing since the earliest stage of design.

Addition of bevacizumab to chemotherapy in acute myeloid leukemia at older age: a randomized phase 2 trial of the Dutch-Belgian Cooperative Trial Group for Hemato-Oncology (HOVON) and the Swiss Group for Clinical Cancer Research (SAKK)

An urgent need for new treatment modalities is emerging in elderly patients with acute myeloid leukemia (AML). We hypothesized that targeting VEGF might furnish an effective treatment modality in this population. Elderly patients with AML were randomly assigned in this phase 2 study (n = 171) to receive standard chemotherapy (3 + 7) with or without bevacizumab at a dose of 10 mg/kg intravenously at days 1 and 15. In the second cycle, patients received cytarabine 1000 mg/m(2) twice daily on days 1-6 with or without bevacizumab. The complete remission rates in the 2 arms were not different (65%). Event-free survival at 12 months was 33% for the standard arm versus 30% for the bevacizumab arm; at 24 months, it was 22% and 16%, respectively (P = .42). The frequencies of severe adverse events (SAEs) were higher in the bevacizumab arm (n = 63) compared with the control arm (n = 28; P = .043), but the percentages of death or life-threatening SAEs were lower in the bevacizumab arm (60% vs 75% of SAEs). The results of the present study show that the addition of bevacizumab to standard chemotherapy does not improve the therapeutic outcome of older AML patients. This trial is registered as number NTR904 in The Nederlands Trial Register (www.trialregister.nl).

Gemcitabine plus capecitabine compared with gemcitabine alone in advanced pancreatic cancer: a randomized, multicenter, phase III trial of the Swiss Group for Clinical Cancer Research and the Central European Cooperative Oncology Group

This phase III trial compared the efficacy and safety of gemcitabine (Gem) plus capecitabine (GemCap) versus single-agent Gem in advanced/metastatic pancreatic cancer.

Regional Cooperation of Small & Medium Firms in Japanese Industrial Clusters

This study examines the effects of intra-regional cooperation among firms and institutions on the growth of firms, using the unique data set of questionnaire survey collected in the three major industrial clusters in Japan. In contrast to the existing studies on regional innovations or agglomeration economies, this study explicitly focuses on the detailed contents of cooperative activities with two specific viewpoints: 1) the contents of regional cooperation in each of the three production stages of R&D, commercialization, and marketing, and 2) the detailed types of alliance partners. Our results demonstrate three points: 1) positive correlations are observed between the intensity of regional cooperation and the firm growth rate and R&D expenditure, 2) horizontal cooperation such as alliances with universities and cross-industry exchange organizations has positive significant effects on the growth rate of firms, which is in contrast with the previous studies that stressed only the role of vertically integrated inter-firm linkages in Japan, and 3) contents and partners of regional cooperation are different among the three clusters based on different dominant industries.