Effect of age on the prognostic value of left ventricular function in patients with acute coronary syndrome : A prospective registry study

© The European Society of Cardiology 2015. Funding The project was funded by the Sir Halley Stewart Trust. MINAP is funded by the Health Quality Improvement Partnership (HQIP).

What do UK doctors in training value in a post? : A discrete choice experiment

© 2016 John Wiley & Sons Ltd. Funding: our thanks go to NHS Education for Scotland for funding this programme of work.

Implicit Feature Selection with the Value Difference Metric

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Public-Private Partnership Design for Inclusive Cocoa Global Value Chains in Ghana

Within 10 years, there could be a severe global shortage in the supply of cocoa, according to industry practitioners and other experts. Due to global population growth and the emergence of a growing global middle class, by 2025 the cocoa crop would need to increase by nearly 50 per cent to keep up with projected demand. A potential shortage of supply is a direct threat to the business model of lead firms – including cocoa grinders and processors, chocolate confectioners, and retail distributors. But these international firms – the ones that will suffer the most if there is a shortage of cocoa supply – are helping create the market failure that is stifling sustainability. Functioning as a two-tiered consolidated oligopoly with a combined market share of approximately 89%, these firms enjoy the largest portion of value capture in the cocoa-chocolate global value chain (GVC). The smallholder cocoa producers, conversely, are trapped in low value-add segments of the GVC. In fact, most smallholder farmers survive on less than $1.00 per day per capita, on average in many cocoa exporting countries. In Ghana - the second largest producer of cocoa in the world - the government has accomplished little to help these smallholders upgrade and make cocoa an attractive sector for the next generation to inherit. The result – both in Ghana and around the world – is a lack of sustainability of the supply of cocoa. Demand is already beginning to outstrip supply. As a result of these underlying circumstances, the United States Agency for International Development (USAID) has posed the following policy question: "Under what conditions could USAID, as a development agency, support and enhance potential public-private partnerships in order to improve the bargaining power (and financial wherewithal) of smallholder organizations and farmers in the context of the global value chain for cocoa in Ghana?"

Annotated record of the detailed examination of Mn deposits from R/V Hakuho Maru Cruise KH-74-4 stations

Using scanning electron microscopy (SEM) the authors have examined the microtexture of Mn nodules. Previous researches using SEM observation on marine Mn nodules have revealed many characteristic features which may relate to their formation. They report the discovery of in situ calcareous nannoplankton fossils in a Mn nodule collected during the RV Hakuho-Maru Cruise KH-74-4, and present a preliminary calculation of the growth rate, using a biostratigraphic method. They also discuss the potential value of Mn nodule biostratigraphy in terms of deep sea palaeoenvironments.

The value of military oath in civil wars in Rome: The example of conflict 49-45 BC

During the civil war between Caesar and Pompey, the military oath which binds the soldier to his army is often openly violated. Yet despite this offense, commanders of armed struggle require recursively the oath to their men. Admittedly, this ritual act seems ineffective given the many desertions and mutinies identified, but military leaders use its symbolic and sacred meaning to legitimize one hand their “anti-republican” actions, on the other armies fighting in a context deemed impius.

Investigation of the chemical origin and evidential value of differences in the SERS spectra of blue gel inks

Highly swellable polymer films doped with Ag nanoparticle aggregates (poly-SERS films) have been used to record very high signal:noise ratio, reproducible surface-enhanced (resonance) Raman (SER(R)S) spectra of in situ dried ink lines and their constituent dyes using both 633 and 785 nm excitation. These allowed the chemical origins of differences in the SERRS spectra of different inks to be determined. Initial investigation of pure samples of the 10 most common blue dyes showed that the dyes which had very similar chemical structures such as Patent Blue V and Patent Blue VF (which differ only by a single OH group) gave SERRS spectra in which the only indications that the dye structure had been changed were small differences in peak positions or relative intensities of the bands. SERRS studies of 13 gel pen inks were consistent with this observation. In some cases inks from different types of pens could be distinguished even though they were dominated by a single dye such as Victoria Blue B (Zebra Surari) or Victoria Blue BO (Pilot Acroball) because their predominant dye did not appear in other inks. Conversely, identical spectra were also recorded from different types of pens (Pilot G7, Zebra Z-grip) because they all had the same dominant Brilliant Blue G dye. Finally, some of the inks contained mixtures of dyes which could be separated by TLC and removed from the plate before being analysed with the same poly-SERS films. For example, the Pentel EnerGel ink pen was found to give TLC spots corresponding to Erioglaucine and Brilliant Blue G. Overall, this study has shown that the spectral differences between different inks which are based on chemically similar, but nonetheless distinct dyes, are extremely small, so very close matches between SERRS spectra are required for confident identification. Poly-SERS substrates can routinely provide the very stringent reproducibility and sensitivity levels required. This, coupled with the awareness of the reasons underlying the observed differences between similarly coloured inks allows a more confident assessment of the evidential value of inks SERS and should underpin adoption of this approach as a routine method for the forensic examination of inks.

CLLU1 expression has prognostic value in chronic lymphocytic leukemia after first-line therapy in younger patients and in those with mutated IGHV genes.

CLLU1, located at chromosome 12q22, encodes a transcript specific to chronic lymphocytic leukemia and has potential prognostic value. We assessed the value of CLLU1 expression in the LRF CLL4 randomized trial. Samples from 515 patients with chronic lymphocytic leukemia were collected immediately before the start of treatment. After RNA extraction and cDNA synthesis, CLLU1 expression was assessed by quantitative polymerase chain reaction. In total, 247 and 268 samples were identified as having low and high CLLU1 expression, respectively. The median follow-up was 88 months. High CLLU1 expression was significantly correlated with unmutated IGHV genes, ZAP-70 and CD38 positivity, and absence of 13q deletion (all r>0.2, P

A compendium of myeloma-associated chromosomal copy number abnormalities and their prognostic value.

To obtain a comprehensive genomic profile of presenting multiple myeloma cases we performed high-resolution single nucleotide polymorphism mapping array analysis in 114 samples alongside 258 samples analyzed by U133 Plus 2.0 expression array (Affymetrix). We examined DNA copy number alterations and loss of heterozygosity (LOH) to define the spectrum of minimally deleted regions in which relevant genes of interest can be found. The most frequent deletions are located at 1p (30%), 6q (33%), 8p (25%), 12p (15%), 13q (59%), 14q (39%), 16q (35%), 17p (7%), 20 (12%), and 22 (18%). In addition, copy number-neutral LOH, or uniparental disomy, was also prevalent on 1q (8%), 16q (9%), and X (20%), and was associated with regions of gain and loss. Based on fluorescence in situ hybridization and expression quartile analysis, genes of prognostic importance were found to be located at 1p (FAF1, CDKN2C), 1q (ANP32E), and 17p (TP53). In addition, we identified common homozygously deleted genes that have functions relevant to myeloma biology. Taken together, these analyses indicate that the crucial pathways in myeloma pathogenesis include the nuclear factor-κB pathway, apoptosis, cell-cycle regulation, Wnt signaling, and histone modifications. This study was registered at http://isrctn.org as ISRCTN68454111.

Shooting for the Moon or Flying Too Near the Sun? Crossing the Value Rubicon in Precision Cancer Care

In his last two State of the Union addresses, President Barack Obama has focused on the need to deliver innovative solutions to improve human health, through the Precision Medicine Initiative in 2015 and the recently announced Cancer Moonshot in 2016. Precision cancer care has delivered clear patient benefit, but even for high-impact medicines such as imatinib mesylate (Glivec) in chronic myeloid leukaemia, the excitement at the success of this practice-changing clinical intervention has been somewhat tempered by the escalating price of this 'poster child' for precision cancer medicine (PCM). Recent studies on the costs of cancer drugs have revealed significant price differentials, which are a major causative factor behind disparities in the access to new generations of immunological and molecularly targeted agents. In this perspective, we will discuss the benefits of PCM to modern cancer control, but also emphasise how increasing costs are rendering the current approaches to integrating the paradigm of PCM unsustainable. Despite the ever increasing pressure on cancer and health care budgets, innovation will and must continue. Value-based frameworks offer one of the most rational approaches for policymakers committed to improving cancer outcomes through a public health approach.

"Bolagsverket är mer modernt än jag tänkte mig" : Hur kan statliga myndigheter arbeta med Employer Branding för att attrahera Generation Y?

Bakgrund: Employer Branding är ett relativt nytt begrepp som har börjat användas som en strategi inom Human Resource Management. Genom att utveckla ett Employer Brand kan or-ganisationer attrahera och behålla talangfull arbetskraft och på så vis säkra sin överlevnad. Det saknas emellertid forskning på hur Employer Branding kan användas i offentlig verksamhet för att attrahera den senaste generationen på arbetsmarknaden; Generation Y. Syfte: Öka förståelse för hur statliga myndigheter kan arbeta med Employer Branding för att attrahera Generation Y. Metod: Studien baseras på kvalitativ metod och har en fenomenologisk samt deduktiv forsk-ningsansats. Undersökningsdesignen var i form av en fallstudie. Nio semistrukturerade inter-vjuer har genomförts med respondenter på Bolagsverket, varav fyra intervjuer med personer som har inflytande över Employer Branding och fem med personer ur Generation Y. Teorier: "Employer Branding Predictive Model" Slutsatser: I studien visar att den statliga arbetsgivaren är attraktiv för Generation Y. Proble-matiken ligger i att det finns brister beträffande hur kommunikationen av arbetsgivarvarumärket ser ut externt. Utan en uttalad målgrupp och ett uttalat Employee Value Proposition blir den externa kommunikationen otydlig vilket minskar arbetsgivarens attraktionskraft hos potentiella arbetstagare. Attraktiviteten uppstår först när individen från Generation Y redan rekryterats in i organisationen.

"Vad som behövs? Det är sällan glasklart!" : En studie kring en organisations tillväxt och växtvärksproblematik

I en organisation belägen på Dalarnas landsbygd framkommer det i en medarbetarundersökning att ett ökande missnöje finns hos de anställda, där flera av problemen kan kopplas till den kraftiga expansion som organisationen just nu genomgår. Även en positiv organisationsförändring som tillväxt kan alltså bidra till problem hos de anställda. Denna studie har avsett att undersöka vilka utmaningar och möjligheter som upplevs hos de anställda i organisationen kopplat till den tillväxtfas de genomgår. Detta genom åtta djupintervjuer där urvalet var såväl chefer, medarbetare som HR-ansvariga. Utifrån respondenternas upplevelse av situationen fann vi fyra stora problemområden; avsaknad av gemensamma rutiner, otydliga roller, bristfällig information och kommunikation samt brist på proaktivt arbete för att säkerställa medarbetarnas kompetens. Vårt empiriska material tyder på att organisationen har ett gap när det kommer till utvecklingen av såväl de mänskliga resurserna, arbetssystem som ledarskapet. Antalet anställda ökar i en högre takt än organisationens infrastrukturella processer, något som kan ses som en organisatorisk växtvärk. Med utgångspunkt från resultatet ger vi förslag på vilka aktiviteter HR-funktionen bör fokusera på. För att bemöta utvecklingsgapet samt förhindra att fler växtvärkssymptom uppstår anser vi att HR bör fokusera på ett proaktivt arbete. En nyckelfaktor som vi genom vår utvecklade modell visar är att ledaren är av stor vikt för hur organisationen och dess medarbetare hanterar en växtvärkssituation. HR bör därför ha en klar bild över vilket stöd verksamhetens ledare behöver för att kunna skapa värde för organisationen, ledarna och medarbetarna. Några generella förslag på HR-aktiviteter går däremot inte att ge eftersom, precis som tidigare forskning visar, verksamheters individuella situation och kontext avgör vilka aktiviteter som är aktuella.

Uppföljning och utvärdering av det balanserade styrkortet : Är balanserat styrkort ett värdeskapande och strategiskt instrument inom den kommunala verksamheten?

The need to steer economic development has always been great and as management model has the balanced scorecard has been popular since the mid- 1990s, mainly in the private sector but also in the municipal sector. The introduction of the balanced scorecard has been primarily to organizations to see more than economic dimensions. The Balanced Scorecard was originally a measurement system, and today it works more as a strategic instrument. In our study is a case study to evaluate a municipality and how they make use of the balanced scorecard as a tool for strategic and value-adding work in municipal activities. In the local business is it important that the organization adapts the balanced scorecard, so it fits on the basis that it is a politically driven organization, with mandates, committees and administrations. In our study, we used a qualitative method with a deductive approach. In the study, we have gathered information through a case study where we interviewed 7 people in leading positions. In our analysis and results section, we came to the conclusion that the municipality does not use the balanced scorecard correctly. We also found that the balanced scorecard as a tool for value creation and strategic planning does not work in a favorable way. In our study, we see difficulties with the implementation of the balanced scorecard. If the municipality has invested in implementing the balanced scorecard at all levels of the business so the municipality would be able to use it on one of the activities more adequately. When the municipality is a politically driven organization, it is important that vision alive and changing based on the conditions that reflect the outside world and the municipality in general. Looking at a vivid vision, goals and business ideas, it's balanced scorecard in line with how a balanced scorecard should look like. The municipality has a strategic plan in terms of staff and employees at large. In the study, we have seen that the strategic plan is not followed up in a good way and for the business favorably, the municipality chooses the easy way out for evaluation. Employee participation to changes and ongoing human resources management feels nonexistent. However, as has been the vision of creating empowered and motivated employees. In our conclusion, we describe how we in our study look at the use of the balanced scorecard in municipal operations. We can also discern that a balanced scorecard as a tool for value creation and strategic work is good if it is used properly. In the study, we have concluded that the municipality we have chosen to study should not use the balanced scorecard when you have not created the tools and platforms required for employees, civil servants and politicians to evaluate, monitor and create a living scorecard change over time. The study reveals major shortcomings in the implementation, evaluation and follow-up possibilities, and the consequence of this is that the balanced scorecard is not - 4 - preferable in municipal operations as a strategic instrument for value creation and long-term planning.

Den goda viljan och framtida lönsamhet : En studie om nedskrivning av goodwill är en ledande indikator på framtida minskad lönsamhet i svenska och finska börsnoterade bolag

Bakgrund: Goodwill är en omdebatterad immateriell tillgångspost. En nedskrivning ska enligt redovisningsstandarden IAS 36 baseras på bolagens framtida ekonomiska utveckling. Därmed kan en nedskrivning vara en indikation på hur bolagets ekonomiska framtid kommer att gestalta sig. Tidigare forskning visar att bolagsledningens subjektiva bedömningar kan leda till att nedskrivningens relevans kan ifrågasättas. Syfte: Enligt IFRS 3 och IAS 36 ska goodwill värderas till det framtida uppskattade värde som tillgången ska generera. Grundtanken med standarderna är att öka tillförlitligheten och relevansen för att bättre återspegla bolagens ekonomi i de finansiella rapporterna. Utifrån grundtanken bör en nedskrivning av goodwill vara en ledande indikator på framtida minskad lönsamhet. Vi avser därmed att undersöka om det finns ett samband mellan nedskrivning av goodwill och minskad framtida lönsamhet i svenska och finska börsnoterade bolag samt om det finns en skillnad mellan länderna när det gäller sambandet. Metod: Uppsatsen är baserad på en kvantitativ metod med en deduktiv ansats där sekundärdata hämtats från databas samt årsredovisningar. Informationen har samlats in för att därefter testas med regressionsanalyser. Slutsats: Studien kan inte styrka att standarden ger en bättre återspegling av bolagens ekonomi i de finansiella rapporterna. Resultatet visar att hanteringen av goodwill kan ske utifrån ett opportunistiskt beteende då nedskrivningen kan vara baserad på en redan realiserad försämring av goodwill istället för att vara baserad på framtida bedömningar. Resultatet antyder att tillsynen inte är harmoniserad inom EU, då det finns en signifikant skillnad mellan Sverige och Finland två år efter nedskrivningen. Studiens resultat kan användas till att ifrågasätta gällande standardens utformning.

Exploring value propositions and service innovation : a service-dominant logic study

This paper presents an eight-firm study, conducted from the service-dominant logic perspective, which makes a contribution regarding knowledge of the anatomy of value propositions and service innovation. The paper suggests that value propositions are configurations of several different practices and resources. The paper finds that ten common practices, organized in three main aggregates, constitute and fulfill value propositions: i.e. provision practices, representational practices, and management and organizational practices. Moreover, the paper suggests that service innovation can be equated with the creation of new value propositions by means of developing existing or creating new practices and/or resources, or by means of integrating practices and resources in new ways. It identifies four types of service innovation (adaptation, resource-based innovation, practice-based innovation, and combinative innovation) and three types of service innovation processes (practice-based, resource-based, and combinative). The key managerial insight provided by the paper is that service innovation must be conducted and value propositions must be evaluated from the perspective of the customers’ value creation, the service that the customer experiences. Successful service innovation is not only contingent on having the right resources, established methods and practices for integrating these resources into attractive value propositions are also needed.