944 resultados para Project 2001-003-C : Value Alignment Process for Project Delivery
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VVALOSADE is a research project of professor Anita Lukka's VALORE research team in the Lappeenranta University of Technology. The VALOSADE includes the ELO technology program of Tekes. SMILE is one of four subprojects of the VALOSADE. The SMILE study focuses on the case of the company network that is composed of small and micro-sized mechanical maintenance service providers and forest industry as large-scale customers. The basic principle of the SMILE study is the communication and ebusiness in supply and demand networks. The aim of the study is to develop ebusiness strategy, ebusiness model and e-processes among the SME local service providers, and onthe other hand, between the local service provider network and the forest industry customers in a maintenance and operations service business. A literature review, interviews and benchmarking are used as research methods in this qualitative case study. The first SMILE report, 'Ebusiness between Global Company and Its Local SME Supplier Network', concentrated on creating background for the SMILE study by studying general trends of ebusiness in supply chains and networks of different industries. This second phase of the study concentrates on case network background, such as business relationships, information systems and business objectives; core processes in maintenance and operations service network; development needs in communication among the network participants; and ICT solutions to respond needs in changing environment. In the theory part of the report, different ebusiness models and frameworks are introduced. Those models and frameworks are compared to empirical case data. From that analysis of the empirical data, therecommendations for the development of the network information system are derived. In process industry such as the forest industry, it is crucial to achieve a high level of operational efficiency and reliability, which sets up great requirements for maintenance and operations. Therefore, partnerships or strategic alliances are needed between the network participants. In partnerships and alliances, deep communication is important, and therefore the information systems in the network also are critical. Communication, coordination and collaboration will increase in the case network in the future, because network resources must be optimised to improve competitive capability of the forest industry customers and theefficiency of their service providers. At present, ebusiness systems are not usual in this maintenance network. A network information system among the forest industry customers and their local service providers actually is the only genuinenetwork information system in this total network. However, the utilisation of that system has been quite insignificant. The current system does not add value enough either to the customers or to the local service providers. At present, thenetwork information system is the infomediary that share static information forthe network partners. The network information system should be the transaction intermediary, which integrates internal processes of the network companies; the network information system, which provides common standardised processes for thelocal service providers; and the infomediary, which share static and dynamic information on right time, on right partner, on right costs, on right format and on right quality. This study provides recommendations how to develop this system in the future to add value to the network companies. Ebusiness scenarios, vision, objectives, strategies, application architecture, ebusiness model, core processes and development strategy must be considered when the network information system will be developed in the next development step. The core processes in the case network are demand/capacity management, customer/supplier relationship management, service delivery management, knowledge management and cash flow management. Most benefits from ebusiness solutions come from the electrifying of operational level processes, such as service delivery management and cash flow management.
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The objective of the thesis is to structure and model the factors that contribute to and can be used in evaluating project success. The purpose of this thesis is to enhance the understanding of three research topics. The goal setting process, success evaluation and decision-making process are studied in the context of a project, business unitand its business environment. To achieve the objective three research questionsare posed. These are 1) how to set measurable project goals, 2) how to evaluateproject success and 3) how to affect project success with managerial decisions.The main theoretical contribution comes from deriving a synthesis of these research topics which have mostly been discussed apart from each other in prior research. The research strategy of the study has features from at least the constructive, nomothetical, and decision-oriented research approaches. This strategy guides the theoretical and empirical part of the study. Relevant concepts and a framework are composed on the basis of the prior research contributions within the problem area. A literature review is used to derive constructs of factors withinthe framework. They are related to project goal setting, success evaluation, and decision making. On the basis of this, the case study method is applied to complement the framework. The empirical data includes one product development program, three construction projects, as well as one organization development, hardware/software, and marketing project in their contexts. In two of the case studiesthe analytic hierarchy process is used to formulate a hierarchical model that returns a numerical evaluation of the degree of project success. It has its origin in the solution idea which in turn has its foundation in the notion of projectsuccess. The achieved results are condensed in the form of a process model thatintegrates project goal setting, success evaluation and decision making. The process of project goal setting is analysed as a part of an open system that includes a project, the business unit and its competitive environment. Four main constructs of factors are suggested. First, the project characteristics and requirements are clarified. The second and the third construct comprise the components of client/market segment attractiveness and sources of competitive advantage. Together they determine the competitive position of a business unit. Fourth, the relevant goals and the situation of a business unit are clarified to stress their contribution to the project goals. Empirical evidence is gained on the exploitation of increased knowledge and on the reaction to changes in the business environment during a project to ensure project success. The relevance of a successful project to a company or a business unit tends to increase the higher the reference level of project goals is set. However, normal performance or sometimes performance below this normal level is intentionally accepted. Success measures make project success quantifiable. There are result-oriented, process-oriented and resource-oriented success measures. The study also links result measurements to enablers that portray the key processes. The success measures can be classified into success domains determining the areas on which success is assessed. Empiricalevidence is gained on six success domains: strategy, project implementation, product, stakeholder relationships, learning situation and company functions. However, some project goals, like safety, can be assessed using success measures that belong to two success domains. For example a safety index is used for assessing occupational safety during a project, which is related to project implementation. Product safety requirements, in turn, are connected to the product characteristics and thus to the product-related success domain. Strategic success measures can be used to weave the project phases together. Empirical evidence on their static nature is gained. In order-oriented projects the project phases are oftencontractually divided into different suppliers or contractors. A project from the supplier's perspective can represent only a part of the ¿whole project¿ viewed from the client's perspective. Therefore static success measures are mostly used within the contractually agreed project scope and duration. Proof is also acquired on the dynamic use of operational success measures. They help to focus on the key issues during each project phase. Furthermore, it is shown that the original success domains and success measures, their weights and target values can change dynamically. New success measures can replace the old ones to correspond better with the emphasis of the particular project phase. This adjustment concentrates on the key decision milestones. As a conclusion, the study suggests a combination of static and dynamic success measures. Their linkage to an incentive system can make the project management proactive, enable fast feedback and enhancethe motivation of the personnel. It is argued that the sequence of effective decisions is closely linked to the dynamic control of project success. According to the used definition, effective decisions aim at adequate decision quality and decision implementation. The findings support that project managers construct and use a chain of key decision milestones to evaluate and affect success during aproject. These milestones can be seen as a part of the business processes. Different managers prioritise the key decision milestones to a varying degree. Divergent managerial perspectives, power, responsibilities and involvement during a project offer some explanation for this. Finally, the study introduces the use ofHard Gate and Soft Gate decision milestones. The managers may use the former milestones to provide decision support on result measurements and ad hoc critical conditions. In the latter milestones they may make intermediate success evaluation also on the basis of other types of success measures, like process and resource measures.
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In crop rotations that include alfalfa (Medicago sativa L.), agronomic and environmental concerns mean that it is important to determine the N fertilizer contribution of this legume for subsequent crops in order to help to increase the sustainability of cropping systems. To determine the N fertilizer replacement value (FRV) of a 2-yr alfalfa crop on subsequent crops of corn (Zea mays L.) followed by wheat (Triticum aestivum L.) under irrigated Mediterranean conditions, two 4-yr rotations (alfalfa-corn-wheat and corn-corn-corn-wheat) were conducted from 2001 to 2004 in a Typic Xerofluvent soil. Corn yields were compared after two years of alfalfa and a third year of corn under monoculture and wheat yields were also compared after both rotations. Corn production after alfalfa outyielded monoculture corn at all four rates of N fertilizer application analyzed (0, 100, 200 and 300 kg N/ha). The FRV of 2-yr alfalfa for corn was about 160 kg N/ha. Wheat grown after the alfalfa-corn rotation outyielded that grown after corn under monoculture at both the rates of N studied (0 and 100 kg N/ha). The FRV of alfalfa for wheat following alfalfa-corn was about 76 kg N/ha. Soil NO3 -N content after alfalfa was greater than with the corn monoculture at all rates of N fertilizer application and this higher value persisted during the second crop after alfalfa. This was probably one of the reasons for the better yields associated with the alfalfa rotation. These results make a valuable contribution to irrigated agriculture under mediterranean conditions, show reasons for interest in rotating alfalfa with corn, and explain how it is possible to make savings when applying N fertilizer.
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La repoblación forestal es una de las alternativas técnicas más importantes en la restauración ecológica. La selección correcta de las especies es una de las decisiones más importantes del proyecto, por las implicaciones significativas que a largo plazo tiene en los costes de gestión y en el valor de la comunidad final. Se analizan los factores y las etapas del proceso de selección así como los conceptos teóricos que han servido de base a los modelos de restauración forestal. En este artículo presentamos algunas de las contribuciones que el Profesor Ruiz de la Torre ha realizado en relación al conocimiento de las características ecológicas y selvícolas de las principales especies arbóreas españolas, así como de los mecanismos de sucesión de la vegetación.
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El presente estudio se enmarca en el proyecto europeo SIBERIA. Trata de explorar el uso de imágenes radar de satélite (ERS y JERS) para la actualización de la cartografía de vegetación de zonas boreales. Se dispone de 8 imágenes de amplitud y coherencia tomadas en 1998, así como de un inventario de vegetación georreferenciado de dos pequeñas zonas. Se proponen tres tipos de clasificaciones supervisadas por el método de máxima verosimilitud. La primera con las imágenes de satélite, la segunda añadiendo algunas imágenes texturales, y la tercera utilizando sólo las imágenes de los componentes principales más significativos. Se siguen los criterios establecidos en el proyecto SIBERIA para la obtención de áreas de entrenamiento. Se propone una doble validación, por una parte vía matrices de confusión a partir de áreas de verdad-terreno obtenidas por el mismo método que las áreas de entrenamiento, y por otra parte contrastando y correlacionando las clasificaciones con los parámetros de inventario disponibles para dos pequeñas áreas de verdad-terreno. Los resultados indican una sensible mejora en la clasificación con la incorporación de imágenes texturales (la precisión aumenta de un 66% a un 75%), y señalan el parámetro biomasa como el mejor correlacionado con las clasificaciones derivadas (coeficiente de correlación r de hasta 0,49). Diferentes fuentes de error permiten augurar un margen de mejora para posteriores estudios.
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Tenint en compte el temps i la energia que els mestres i professors dediquen a la correcció de redaccions i produccions escrites i el poc efecte que aquestes semblen tenir en altres produccions dels aprenents, es va dissenyar la recerca que es presenta en aquest article. Els resultats de l'estudi semblen suggerir que les correccions no faciliten l'aprenentatge. Com presentem aquesta activitat de retroalimentació a l'alumnat i la posició que li donem dins d'un enfocament basat en el procés de l'escriptura seran clau per fer que les correccions siguin facilitadores de l'aprenentatge de la producció escrita.
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Tämä työ on osa tutkimusprojektia, jonka tarkoituksena on kehittää uudentyyppinen kaasutustekniikkaan perustuva kiinteistöjen lämmitysjärjestelmä. Työ on tehty osaksi kirjallisuustutkimuksena käyttämällä hyödyksi alalla tehtyjä tutkimuksia ja kirjallisuutta. Kirjallisuustutkimuksen tavoitteena oli luoda yhtenäinen tietopaketti lämmitysjärjestelmän kehityksen tueksi. Työn kokeellisen osion tavoitteena oli tutkia lämmitysjärjestelmän kaasuttimen prototyypin toimintaa ja selvittää sen käyttöön liittyviä ongelmia. Kirjallisuusosiossa käsitellään kaasutuksen vaiheita: alkulämpeneminen ja kuivuminen, syttyminen, pyrolyysi sekä jäännöshiilen palaminen ja kaasutus. Varsinkin pyrolyysiprosessin tunteminen on merkittävää, kun halutaan parantaa biomassan poltto- ja kaasutusprosessien suunnittelua. Lisäksi kirjallisuusosiossa käsitellään kaasutuksessa syntyvän tuotekaasun ominaisuuksia: koostumus, lämpöarvo, tiheys ja palamisominaisuudet. Tuotekaasun ominaisuudet vaihtelevat suuresti kaasutusprosessista ja -olosuhteista sekä polttoaineesta riippuen. Tuotekaasun kohdalta käsitellään myös sen käyttökohteita. Perinteisesti kaasutuksen tuotekaasua käytetään lämmöntuotantoon, mutta tulevaisuuden haasteena on tuotekaasun käyttö kaasuturbiineissa sähköntuotantoon. Tuotekaasun käyttöä laajemmin rajoittaa sen sisältämät epäpuhtaudet. Tämän vuoksi kirjallisuusosiossa käsitellään myös tuotekaasun puhdistusmenetelmiä ja sen poltossa syntyvien päästöjen vähentämiskeinoja. Kokeellisessa osiossa suoritettiin puupellettien kaasutuskokeita TTKK:n Energia- ja prosessitekniikan laitoksen raskaaseen laboratorioon rakennetulla kaasutusreaktorilla. Kaasutuskokeiden avulla löydettiin kaasutusreaktorin toiminnan ongelmakohdat ja pystyttiin aloittamaan lämmitysjärjestelmän jatkokehitys.
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Työn tutkimusongelma oli selventää, tutkia ja analysoida dynaamisen hinnoittelun tekijät ja mahdollisuudet tuotevarianttien hinnoittelussa. Tutkimusongelman selvittämiseksi työlle asetettiin 8 tavoitetta - Saada selville miksi tuotevarianttien hinnoittelu on ongelmallista - Esittää kuinka tuotevarianttien hinnat teoreettisesti tulisi asettaa - Tunnistaa tuotevarianttien hinnoittelun ulottuvuudet ja selvittää dynaamisen hinnoittelun edut staattiseen hinnoitteluun verrattuna - Esitellä analyysikehikko hinnoittelun tilan analysointiin - Tunnistaa dynaamisen hinnoittelun tuotevarianteille suomat mahdollisuudet - Etsiä soveltuvat hinnoittelumenetelmät tuotevarianttien dynaamiseen hinnoitteluun - Analysoida tuotevariantteja myyvän yrityksen hinnoittelu - Tunnistaa ja arvioida dynaamisen hinnoittelun edut yritykselle Diplomityössä käytettiin useita tutkimusmenetelmiä. Perustieto haettiin kirjallisuustutkimuksella ja sitä täydennettiin haastatteluilla. Tutkimusprosessi alkoi tutkimuksella tuotevarianttien hinnoittelusta ja kirjallisuuden perusteella luotiin näkökulma ja yleiset kehityssuunnat tarkempaa tutkimusta varten. Kaksi tärkeintä tuotevariaatioiden hinnoitteludimensiota tunnistettiin ja niiden analysointia varten luotiin nelikenttämalli. Kirjallisuustutkimuksen ja tarkemman kohdeyrityksen tarkastelun perusteella dynaaminen tuotelinjahinnoittelu on tuotevarianttien dynaamisen hinnoittelun tavoitetila. Nelikenttämallia käytettiin kohdeyrityksen hinnoittelun tilan arviointiin ja dynaamisen hinnoittelun suurimmat hyödyt löydettiin. Tutkimuksen päätulokset ovat - Hinnoittelun dynaamisuutta tulee tuotevarianteilla tutkia hinnoittelun älykkyyden ja kehittyneisyyden kanssa - Tuotevariaatioiden hinnoittelun tavoitetila on dynaaminen tuotelinjahinnoittelu - Hinnoittelun kehittäminen staattisesta dynaamiseen tuo huomattavia etuja - Tärkein etu on parempi hintojen hallinta ja mahdollisuus johtaa hintoja tehokkaasti. Tämän vuoksi hinnoitteluanalyysissa havaittiin selvästi lisääntyneitä voittoja - Hinnoittelun älykkyyden nostaminen hyödyttää yritystä ja saa aikaan lisäyksen voitoissa
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Tutkimuksen tavoitteena oli selvittää sisäisen kommunikoinnin tilannetta case-yrityksissä. Yritykset kuuluvat kahteen case-arvoverkostoon, jotka toimivat informaatio- ja kommunikaatioteknologian alalla. Sisäinen kommunikointi valittiin tutkimusalueeksi, koska se muodostaa perustan ulkoiselle, yritysten väliselle kommunikoinnille. Tutkimuksen painopiste oli web-pohjaisessa kommunikoinnissa ja webin ominaisuuksissa arvoverkoston näkökulmasta. Tutkimusprosessissa käytettiin sekä kvalitatiivisia että kvantitatiivisia menetelmiä. Tutkimuksen kvantitatiivinen osa toteutettiin web-kyselynä, jonka tulokset osoittivat, että case-yritysten sisäinen kommunikointi perustuu pääasiassa perinteisten kommunikointivälineiden käyttöön. Toisin sanoen, webin hyödyntäminen on vähäistä, mihin vaikuttavat monet eri tekijät. Webissä on kuitenkin useita ominaisuuksia, jotka parantavat kommunikointia arvoverkostossa ja siksi nämä web-pohjaiset välineet tulisi huomioida, kun suunnitellaan yleistä kommunikointijärjestelmää. Tutkimuksen teoreettisessa osassa määriteltiin vuorovaikutteisuus-ominaisuuteen perustuva kommunikointivälineiden luokittelu. Tämän lisäksi määriteltiin myös arvoverkoston käsite. Empiirinen osa koostui web-kyselyn toteutuksen ja tulosten raportoinnista, jonka jälkeen yhteenvetokappale koosti merkittävimmät havainnot sekä mahdolliset jatkotutkimusaiheet.
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Tutkielman tavoitteena oli tutkia, millaista arvoa digitaalinen painatusmenetelmä tuo yrityksen arvoverkostoon. Teoriaosassa tavoite oli rakentaa digitaalipainatuksen arvoverkostoa tutkien kirjallisuutta liittyen arvoketju- ja arvoverkostoajatteluun. Myös aiemmat tutkimukset ja kirjallisuus liittyen digitaalipainatukseen rakensivat osaltaan teoreettisen viitekehyksen muodostumista. Aiemmat tutkimukset digitaalisen painomenetelmän mahdollisuuksista ovat hyvin tekniikkapainotteisia, siksi tämä tutkimus liittyy enemmän kaupallisiin mahdollisuuksiin. Empiirinen osio tutkimuksesta tehtiin kvalitatiivisena case -tutkimuksena, johon sisältyi yksi alayksikkö. Eli tutkittiin yhtä casea, jossa oli kaksi osapuolta. Tutkielma liittyy kiinteästi Stora Enson ja Valion väliseen digipainatus-projektiin, joka käynnistettiin helmikuussa 2001. Tutkielman teemahaastatteluihin valittiin henkilöt tästä projektiryhmästä. Projektiryhmän mielipiteitä ja havaintoja hyödyntäen pyrittiin löytämään tukea ja eroavaisuuksia teoriaosan muodostamaan viitekehykseen ja informaatioon. Empiirinen osuus tuki teoriaosassa esittämiä väittämiä hyvin, mutta myös muutamia uusia havaintoja esiintyi. Tutkimusongelmaan löydettiin monia vastauksia: digitaalipainatus luo arvoa yrityksen jakeluketjuun vähentämällä varastoja ja nopeuttamalla toimituksia. Jäätelöpakkausten markkinointi on aivan uuden haasteen edessä, koska mahdollisuudet kasvavat digitaalipainatuksen myötä huomattavasti. Kartongin valmistajalle arvo tulee parempien tuotteiden kautta, joista saa myös paremman tuoton. Digitaalipainatuksen arvoverkostossa tulee tapahtumaan muutoksia jatkossa, eri osapuolten roolit saattavat muuttua radikaalisti. Kuka hoitaa painatusta ja miten?
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Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.
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Background: Ethical conflicts are arising as a result of the growing complexity of clinical care, coupled with technological advances. Most studies that have developed instruments for measuring ethical conflict base their measures on the variables"frequency" and"degree of conflict". In our view, however, these variables are insufficient for explaining the root of ethical conflicts. Consequently, the present study formulates a conceptual model that also includes the variable"exposure to conflict", as well as considering six"types of ethical conflict". An instrument was then designed to measure the ethical conflicts experienced by nurses who work with critical care patients. The paper describes the development process and validation of this instrument, the Ethical Conflict in Nursing Questionnaire Critical Care Version (ECNQ-CCV). Methods: The sample comprised 205 nursing professionals from the critical care units of two hospitals in Barcelona (Spain). The ECNQ-CCV presents 19 nursing scenarios with the potential to produce ethical conflict in the critical care setting. Exposure to ethical conflict was assessed by means of the Index of Exposure to Ethical Conflict (IEEC), a specific index developed to provide a reference value for each respondent by combining the intensity and frequency of occurrence of each scenario featured in the ECNQ-CCV. Following content validity, construct validity was assessed by means of Exploratory Factor Analysis (EFA), while Cronbach"s alpha was used to evaluate the instrument"s reliability. All analyses were performed using the statistical software PASW v19. Results: Cronbach"s alpha for the ECNQ-CCV as a whole was 0.882, which is higher than the values reported for certain other related instruments. The EFA suggested a unidimensional structure, with one component accounting for 33.41% of the explained variance. Conclusions: The ECNQ-CCV is shown to a valid and reliable instrument for use in critical care units. Its structure is such that the four variables on which our model of ethical conflict is based may be studied separately or in combination. The critical care nurses in this sample present moderate levels of exposure to ethical conflict. This study represents the first evaluation of the ECNQ-CCV.
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AIMS: c-Met is an emerging biomarker in pancreatic ductal adenocarcinoma (PDAC); there is no consensus regarding the immunostaining scoring method for this marker. We aimed to assess the prognostic value of c-Met overexpression in resected PDAC, and to elaborate a robust and reproducible scoring method for c-Met immunostaining in this setting. METHODS AND RESULTS: c-Met immunostaining was graded according to the validated MetMab score, a classic visual scale combining surface and intensity (SI score), or a simplified score (high c-Met: ≥20% of tumour cells with strong membranous staining), in stage I-II PDAC. A computer-assisted classification method (Aperio software) was developed. Clinicopathological parameters were correlated with disease-free survival (DFS) and overall survival(OS). One hundred and forty-nine patients were analysed retrospectively in a two-step process. Thirty-seven samples (whole slides) were analysed as a pre-run test. Reproducibility values were optimal with the simplified score (kappa = 0.773); high c-Met expression (7/37) was associated with shorter DFS [hazard ratio (HR) 3.456, P = 0.0036] and OS (HR 4.257, P = 0.0004). c-Met expression was concordant on whole slides and tissue microarrays in 87.9% of samples, and quantifiable with a specific computer-assisted algorithm. In the whole cohort (n = 131), patients with c-Met(high) tumours (36/131) had significantly shorter DFS (9.3 versus 20.0 months, HR 2.165, P = 0.0005) and OS (18.2 versus 35.0 months, HR 1.832, P = 0.0098) in univariate and multivariate analysis. CONCLUSIONS: Simplified c-Met expression is an independent prognostic marker in stage I-II PDAC that may help to identify patients with a high risk of tumour relapse and poor survival.
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PURPOSE: Pretreatment measurements of systemic inflammatory response, including the Glasgow prognostic score (GPS), the neutrophil-to-lymphocyte ratio (NLR), the monocyte-to-lymphocyte ratio (MLR), the platelet-to-lymphocyte ratio (PLR) and the prognostic nutritional index (PNI) have been recognized as prognostic factors in clear cell renal cell carcinoma (CCRCC), but there is at present no study that compared these markers. METHODS: We evaluated the pretreatment GPS, NLR, MLR, PLR and PNI in 430 patients, who underwent surgery for clinically localized CCRCC (pT1-3N0M0). Associations with disease-free survival were assessed with Cox models. Discrimination was measured with the C-index, and a decision curve analysis was used to evaluate the clinical net benefit. RESULTS: On multivariable analyses, all measures of systemic inflammatory response were significant prognostic factors. The increase in discrimination compared with the stage, size, grade and necrosis (SSIGN) score alone was 5.8 % for the GPS, 1.1-1.4 % for the NLR, 2.9-3.4 % for the MLR, 2.0-3.3 % for the PLR and 1.4-3.0 % for the PNI. On the simultaneous multivariable analysis of all candidate measures, the final multivariable model contained the SSIGN score (HR 1.40, P < 0.001), the GPS (HR 2.32, P < 0.001) and the MLR (HR 5.78, P = 0.003) as significant variables. Adding both the GPS and the MLR increased the discrimination of the SSIGN score by 6.2 % and improved the clinical net benefit. CONCLUSIONS: In patients with clinically localized CCRCC, the GPS and the MLR appear to be the most relevant prognostic measures of systemic inflammatory response. They may be used as an adjunct for patient counseling, tailoring management and clinical trial design.
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Spermiogenesis and the ultrastructural characters of the spermatozoon of Echinobothrium euterpes are described by means of transmission electron microscopy, including cytochemical analysis for glycogen. Materials were obtained from a common guitarfish Rhinobatos rhinobatos caught in the Gulf of Gabès (Tunisia). Spermiogenesis in E. euterpes is characterized by the orthogonal development of two unequal flagella followed by the flagellar rotation and the proximodistal fusion of these flagella with the median cytoplasmic process. The most interesting pattern characterizing the diphyllidean cestodes is the presence of a triangular body constituted by fines and dense granules without visible striation and assimilated at the striated rootlets. This pattern, only related in the Diphyllidea cestodes may be a synapomorphy of this order. Spermiogenesis is also characterized by the presence of a very short flagellum (around 1 μm long), observed in all the stages of spermiogenesis. This type of flagellum has never been commented in the diphyllidean cestodes and should be considered as an evolved character in this group. In the latest stage of spermiogenesis, this short axoneme probably degenerates. Thus, the mature spermatozoon of E. euterpes possesses only one axoneme of 9 + '1' trepaxonematan pattern. It also exhibits a single helical electron-dense crested body, a spiraled nucleus, few parallel cortical microtubules, and α-glycogen granules. Similitudes and differences between spermatozoa of diphyllideans are discussed.