Financial performance drivers and strategic control: The case of cancer treatment centers

Strategic control is defined as the use of qualitative and quantitative tools for the evaluation of strategic organizational performance. Most research in strategic planning has focused on strategy formulation and implementation, but little work has been done on strategic performance evaluation particularly in the area of cancer research. The objective of this study was to identify strategic control approaches and financial performance metrics used by major cancer centers in the country as an initial step in expanding the theory and practice behind strategic organizational performance. Focusing on hospitals which share similar mandate and resource constraints was expected to improve measurement precision. The results indicate that most cancer centers use a wide selection of evaluation tools, but sophisticated analytical approaches were less common. In addition, there was evidence that high-performing centers tend to invest a larger degree of resources in the area of strategic performance analysis than centers showing lower financial results. The conclusions point to the need for incorporating higher degree of analytical power in order to improve the tracking of strategic performance. This study is one of the first to concentrate in the area of strategic control.^

Assessing the improved discriminatory power of a new biomarker in prognostic models

Although the area under the receiver operating characteristic (AUC) is the most popular measure of the performance of prediction models, it has limitations, especially when it is used to evaluate the added discrimination of a new biomarker in the model. Pencina et al. (2008) proposed two indices, the net reclassification improvement (NRI) and integrated discrimination improvement (IDI), to supplement the improvement in the AUC (IAUC). Their NRI and IDI are based on binary outcomes in case-control settings, which do not involve time-to-event outcome. However, many disease outcomes are time-dependent and the onset time can be censored. Measuring discrimination potential of a prognostic marker without considering time to event can lead to biased estimates. In this dissertation, we have extended the NRI and IDI to survival analysis settings and derived the corresponding sample estimators and asymptotic tests. Simulation studies were conducted to compare the performance of the time-dependent NRI and IDI with Pencina’s NRI and IDI. For illustration, we have applied the proposed method to a breast cancer study.^ Key words: Prognostic model, Discrimination, Time-dependent NRI and IDI ^

Effect of patient accrual patterns on power and size of log-rank test for time-to-event outcome in clinical trials

The determination of size as well as power of a test is a vital part of a Clinical Trial Design. This research focuses on the simulation of clinical trial data with time-to-event as the primary outcome. It investigates the impact of different recruitment patterns, and time dependent hazard structures on size and power of the log-rank test. A non-homogeneous Poisson process is used to simulate entry times according to the different accrual patterns. A Weibull distribution is employed to simulate survival times according to the different hazard structures. The current study utilizes simulation methods to evaluate the effect of different recruitment patterns on size and power estimates of the log-rank test. The size of the log-rank test is estimated by simulating survival times with identical hazard rates between the treatment and the control arm of the study resulting in a hazard ratio of one. Powers of the log-rank test at specific values of hazard ratio (≠1) are estimated by simulating survival times with different, but proportional hazard rates for the two arms of the study. Different shapes (constant, decreasing, or increasing) of the hazard function of the Weibull distribution are also considered to assess the effect of hazard structure on the size and power of the log-rank test. ^

Regulation of the heat shock response by thiol-reactive compounds in the yeast Saccharomyces cerevisiae

Cells govern their activities and modulate their interactions with the environment to achieve homeostasis. The heat shock response (HSR) is one of the most well studied fundamental cellular responses to environmental and physiological challenges, resulting in rapid synthesis of heat shock proteins (HSPs), which serve to protect cellular constituents from the deleterious effects of stress. In addition to its role in cytoprotection, the HSR also influences lifespan and is associated with a variety of human diseases including cancer, aging and neurodegenerative disorders. In most eukaryotes, the HSR is primarily mediated by the highly conserved transcription factor HSF1, which recognizes target hsp genes by binding to heat shock elements (HSEs) in their promoters. In recent years, significant efforts have been made to identify small molecules as potential pharmacological activators of HSF1 that could be used for therapeutic benefit in the treatment of human diseases relevant to protein conformation. However, the detailed mechanisms through which these molecules drive HSR activation remain unclear. In this work, I utilized the baker's yeast Saccharomyces cerevisiae as a model system to identify a group of thiol-reactive molecules including oxidants, transition metals and metalloids, and electrophiles, as potent activators of yeast Hsf1. Using an artificial HSE-lacZ reporter and the glucocorticoid receptor system (GR), these diverse thiol-reactive compounds are shown to activate Hsf1 and inhibit Hsp90 chaperone complex activity in a reciprocal, dose-dependent manner. To further understand whether cells sense these reactive compounds through accumulation of unfolded proteins, the proline analog azetidine-2-carboxylic acid (AZC) and protein cross-linker dithiobis(succinimidyl propionate) (DSP) were used to force misfolding of nascent polypeptides and existing cytosolic proteins, respectively. Both unfolding reagents display kinetic HSP induction profiles dissimilar to those generated by thiol-reactive compounds. Moreover, AZC treatment leads to significant cytotoxicity, which is not observed in the presence of the thiol-reactive compounds at the concentrations sufficient to induce Hsf1. Additionally, DSP treatment has little to no effect on Hsp90 functions. Together with the ultracentrifugation analysis of cell lysates that detected no insoluble protein aggregates, my data suggest that at concentrations sufficient to induce Hsf1, thiol-reactive compounds do not induce the HSR via a mechanism based on accumulation of unfolded cytosolic proteins. Another possibility is that thiol-reactive compounds may influence aspects of the protein quality control system such as the ubiquitin-proteasome system (UPS). To address this hypothesis, β-galactosidase reporter fusions were used as model substrates to demonstrate that thiol-reactive compounds do not inhibit ubiquitin activating enzymes (E1) or proteasome activity. Therefore, thiol-reactive compounds do not activate the HSR by inhibiting UPS-dependent protein degradation. I therefore hypothesized that these molecules may directly inactivate protein chaperones, known as repressors of Hsf1. To address this possibility, a thiol-reactive biotin probe was used to demonstrate in vitro that the yeast cytosolic Hsp70 Ssa1, which partners with Hsp90 to repress Hsf1, is specifically modified. Strikingly, mutation of conserved cysteine residues in Ssa1 renders cells insensitive to Hsf1 activation by cadmium and celastrol but not by heat shock. Conversely, substitution with the sulfinic acid and steric bulk mimic aspartic acid led to constitutive activation of Hsf1. Cysteine 303, located in the nucleotide-binding/ATPase domain of Ssa1, was shown to be modified in vivo by a model organic electrophile using Click chemistry technology, verifying that Ssa1 is a direct target for thiol-reactive compounds through adduct formation. Consistently, cadmium pretreatment promoted cells thermotolerance, which is abolished in cells carrying SSA1 cysteine mutant alleles. Taken together, these findings demonstrate that Hsp70 acts as a sensor to induce the cytoprotective heat shock response in response to environmental or endogenously produced thiol-reactive molecules and can discriminate between two distinct environmental stressors.

The effects of omega -3 fatty acid -enriched fish on C -reactive protein levels in postmenopausal women

Coronary heart disease (CHD) is the leading cause of death in women and rates markedly increase among women after 65 years of age. C-reactive protein (CRP) is a new clinical indicator of atherosclerotic-related inflammation with a direct pathogenic role. Studies show lifestyle factors can modulate CRP. Omega-3 fatty acids have anti-inflammatory properties and studies suggest that eating fish high in omega-3 fatty acids may lower CHD risk in women. This study sought to assess the possible role of omega-3 fatty acids in the reduction of CHD-related inflammation by investigating the effect of fish consumption on CRP levels. Methods. Twenty-four healthy postmenopausal women were randomly assigned to a fish group (usual diet plus two servings per week of enriched fish) or control group (usual diet with no fatty fish) for eight weeks. Omega-3 fatty acid-enriched fish developed by the West Virginia University Aquaculture Division was used. Serum CRP, serum interleukin-6 (IL-6), and the fatty acid content of red blood cells (RBC) were measured before and after the study. Women also completed food records. RESULTS: Baseline levels of CRP were low (85% of the fish group had normal levels) and few changes in CRP risk category were observed. Mean IL-6 levels were reduced by 27% and 35% in the fish and control groups, respectively (p for between-group difference = 0.60). Changes in RBC fatty acid composition were not statistically significant. Compared to control women, women in the fish group had greater reductions in mean triglycerides (p = 0.08), total cholesterol (P = 0.04), and LDL cholesterol levels (p = 0.06). Baseline dietary intake of total and monounsaturated fatty acids tended to be positively associated with baseline CRP, while vitamin E intake was inversely related. Saturated fat intake tended to have a positive association with IL-6. Conclusions. Findings regarding the effect of two servings of fish on CRP and IL-6 levels are inconclusive due to low baseline levels of CRP and IL-6. However, results indicate two servings of fatty fish have favorable effects on blood lipids. The relationship of dietary components with CRP and IL-6 is complex and further research is needed to determine the varying roles of diet on the inflammatory process. ^

Extranjeros y poder municipal en la campaña bonaerense : Alcances e influencias en el control del poder municipal en la segunda mitad del siglo XIX

Este trabajo analiza el papel de los inmigrantes en el régimen municipal en la campaña bonaerense. Se indaga la relación entre los extranjeros y un poder local marcado por la dinámica de los avances fronterizos y la construcción de nuevos espacios económicos y sociales. Analizaremos los inicios del régimen en la década de 1850, la posición legal que los extranjeros habrían de ocupar y el papel del Estado provincial controlando esos mecanismos de representación. Se examinan los resultados de las elecciones municipales de 1886 en 16 partidos, con la intención de dimensionar los índices de participación que registraron las colectividades extranjeras

Biopolítica, población y control

Los estudios del poder han volteado hace tiempo a la biopolítica, vista como la intromisión e injerencia del poder y la política sobre la vida. Se da en positivo y en negativo. De ahí la discusión sobre el control social, como una expresión de la biopolítica moderna. La conexión entre biopolítica y población no es menos significativa que la manera cómo el poder administra y regula los nacimientos y la migración así como la calidad de vida de los conglomerados sociales

Extranjeros y poder municipal en la campaña bonaerense : Alcances e influencias en el control del poder municipal en la segunda mitad del siglo XIX

Este trabajo analiza el papel de los inmigrantes en el régimen municipal en la campaña bonaerense. Se indaga la relación entre los extranjeros y un poder local marcado por la dinámica de los avances fronterizos y la construcción de nuevos espacios económicos y sociales. Analizaremos los inicios del régimen en la década de 1850, la posición legal que los extranjeros habrían de ocupar y el papel del Estado provincial controlando esos mecanismos de representación. Se examinan los resultados de las elecciones municipales de 1886 en 16 partidos, con la intención de dimensionar los índices de participación que registraron las colectividades extranjeras

Biopolítica, población y control

Los estudios del poder han volteado hace tiempo a la biopolítica, vista como la intromisión e injerencia del poder y la política sobre la vida. Se da en positivo y en negativo. De ahí la discusión sobre el control social, como una expresión de la biopolítica moderna. La conexión entre biopolítica y población no es menos significativa que la manera cómo el poder administra y regula los nacimientos y la migración así como la calidad de vida de los conglomerados sociales

Extranjeros y poder municipal en la campaña bonaerense : Alcances e influencias en el control del poder municipal en la segunda mitad del siglo XIX

Este trabajo analiza el papel de los inmigrantes en el régimen municipal en la campaña bonaerense. Se indaga la relación entre los extranjeros y un poder local marcado por la dinámica de los avances fronterizos y la construcción de nuevos espacios económicos y sociales. Analizaremos los inicios del régimen en la década de 1850, la posición legal que los extranjeros habrían de ocupar y el papel del Estado provincial controlando esos mecanismos de representación. Se examinan los resultados de las elecciones municipales de 1886 en 16 partidos, con la intención de dimensionar los índices de participación que registraron las colectividades extranjeras

Biopolítica, población y control

Los estudios del poder han volteado hace tiempo a la biopolítica, vista como la intromisión e injerencia del poder y la política sobre la vida. Se da en positivo y en negativo. De ahí la discusión sobre el control social, como una expresión de la biopolítica moderna. La conexión entre biopolítica y población no es menos significativa que la manera cómo el poder administra y regula los nacimientos y la migración así como la calidad de vida de los conglomerados sociales

Calcareous nannofossil datums and control points for the TCMS age model of ODP Site 175-1085

An astronomically calibrated age model for the Pliocene section of Ocean Drilling Program Leg 175 Cape Basin Site 1085 based on magnetic susceptibility data was developed using shipboard biostratigraphic datums. The composite core magnetic susceptibility record was compiled using shipboard correlations between Holes 1085A and 1085B and then tuned to the record of orbital variations in eccentricity to generate an orbitally tuned age model. Magnetic susceptibility apparently records climate variations in the Cape Basin. Strong power spectra values at the 100- and 400-k.y. frequency suggest an orbital control on the beat of Pliocene climate change in the Cape Basin.

Separation of Control and Cash-Flow Rights of State Owned Listed Enterprises: Channels of Expropriation after the Discriminated Share Reform in China

Literature on agency problems arising between controlling and minority owners claim that separation of cash flow and control rights allows controllers to expropriate listed firms, and further that separation emerges when dual class shares or pyramiding corporate structures exist. Dual class share and pyramiding coexisted in listed companies of China until discriminated share reform was implemented in 2005. This paper presents a model of controller to expropriate behavior as well as empirical tests of expropriation via particular accounting items and pyramiding generated expropriation. Results show that expropriation is apparent for state controlled listed companies. While reforms have weakened the power to expropriate, separation remains and still generates expropriation. Size of expropriation is estimated to be 7 to 8 per cent of total asset at mean. If the "one share, one vote" principle were to be realized, asset inflation could be reduced by 13 percent.

Political economy of low sulfurization and air pollution control policy in Japan : SOx emission reduction by fuel conversion

In the early stages of the development of Japan’s environmental policy, sulfur oxide (SOx) emissions, which seriously damage health, was the most important air pollution problem. In the second half of the 1960s and the first half of the 1970s, the measures against SOx emissions progressed quickly, and these emissions were reduced drastically. The most important factor of the reduction was the conversion to a low-sulfur fuel for large-scale fuel users, such as the electric power industry. However, industries started conversion to low-sulfur fuel not due to environmental concerns, but simply to reduce costs. Furthermore, the interaction among the various interests of the electric power industry, oil refineries, the central government, local governments, and citizens over the energy and environmental policies led to the measures against SOx emissions by fuel conversion.

Wake up Radio Architecture for Wireless Sensor Networks Using an Ultra Low Power FPGA

In this paper an implementation of a Wake up Radio(WuR) with addressing capabilities based on an ultra low power FPGA for ultra low energy Wireless Sensor Networks (WSNs) is proposed. The main goal is to evaluate the utilization of very low power configurable devices to take advantage of their speed, flexibility and low power consumption instead of the traditional approaches based on ASICs or microcontrollers, for communication frame decoding and communication data control.