Final Results of a Prospective Evaluation of the Predictive Value of Interim Positron Emission Tomography in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP-14 (SAKK 38/07)

PURPOSE Our main objective was to prospectively determine the prognostic value of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) after two cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone given every 14 days (R-CHOP-14) under standardized treatment and PET evaluation criteria. PATIENTS AND METHODS Patients with any stage of diffuse large B-cell lymphoma were treated with six cycles of R-CHOP-14 followed by two cycles of rituximab. PET/CT examinations were performed at baseline, after two cycles (and after four cycles if the patient was PET-positive after two cycles), and at the end of treatment. PET/CT examinations were evaluated locally and by central review. The primary end point was event-free survival at 2 years (2-year EFS). RESULTS Median age of the 138 evaluable patients was 58.5 years with a WHO performance status of 0, 1, or 2 in 56%, 36%, or 8% of the patients, respectively. By local assessment, 83 PET/CT scans (60%) were reported as positive and 55 (40%) as negative after two cycles of R-CHOP-14. Two-year EFS was significantly shorter for PET-positive compared with PET-negative patients (48% v 74%; P = .004). Overall survival at 2 years was not significantly different, with 88% for PET-positive versus 91% for PET-negative patients (P = .46). By using central review and the Deauville criteria, 2-year EFS was 41% versus 76% (P < .001) for patients who had interim PET/CT scans after two cycles of R-CHOP-14 and 24% versus 72% (P < .001) for patients who had PET/CT scans at the end of treatment. CONCLUSION Our results confirmed that an interim PET/CT scan has limited prognostic value in patients with diffuse large B-cell lymphoma homogeneously treated with six cycles of R-CHOP-14 in a large prospective trial. At this point, interim PET/CT scanning is not ready for clinical use to guide treatment decisions in individual patients.

The effect of innovation on hotel market value

The purpose of this article is to analyze the effect of hotel innovations on firm value. Specifically, this study fills a research gap in the previous literature by examining this effect through market value and by distinguishing the potentially different impacts of distinct innovation types: product, process, organization and marketing. This research contributes to consolidating the empirical evidence of hotel innovation and performance by analyzing whether distinct types of innovation lead to different levels of results. The findings show that innovations are perceived to have a positive impact on the future sales of the company: in a four-day period (0,+3), there is an increase in stock exchange returns of 1.53%. In terms of innovation types, process and marketing innovations are found to have a higher positive effect on hotel market value than product and organization innovations; which is explained by potential cost differences among innovations.

The adoption of value-based management in large UK companies:a case for diffusion theory

Purpose – In the 1990s, a growing number of companies adopted value-based management (VBM) techniques in the UK. The purpose of this paper is to explore the motivations for the adoption or non-adoption of VBM for managing a business. Design/methodology/approach – An interview-based study of 37 large UK companies. Insights from diffusion theory and institutional theory are utilised to theorise these motivations. Findings – It was found that the rate of adoption of VBM in the sample companies does follow the classical S-shape. It also suggests that the supply-side of the diffusion process, most notably the role played by consultants, was an influence on many companies. This was not, however, a sufficient condition for companies to adopt the technique. The research also finds evidence of relocation diffusion, as several adopters are influenced by new officers, for example chief executive officers and finance directors, importing VBM techniques that they have used in organizations within which they have previously worked. Research limitations/implications – It is quite a small scale study and further work would be needed to develop the findings. Practical implications – Understanding and theorising the adoption of new management techniques will help understand the management of a business. Originality/value – This research adds further evidence to the value of studying management accounting, and more specifically management accounting change, in practice. It shows the developments in the adoption of a new technique and hence how a technique becomes accepted in practice.

Managing the quality, value and impact of academic libraries: the role of external standards

Purpose – The purpose of this paper is to explore the role and relevance of external standards in demonstrating the value and impact of academic library services to their stakeholders. Design/methodology/approach – Two UK standards, Charter Mark and Customer Service Excellence, are evaluated via an exploratory case study, employing multiple data collection techniques. Methods and results of phases 1-2 of a three phase research project are outlined. Findings – Despite some limitations, standards may assist the manager in demonstrating the value, impact and quality of academic libraries in a recessional environment. Active engagement and partnership with customers is imperative if academic libraries are to be viewed as vital to their parent organisations and thus survive. Originality/value – This paper provides a systematic evaluation of the role of external accreditation standards in measuring academic library service value and impact.

Exploring value through integrated service solutions:the case of e-grocery shopping

Purpose – The purpose of this paper is to demonstrate the need for an improved understanding of consumer value for online grocery purchases and to propose the notion of “integrated service solution” packages as a strategy for growing and successfully sustaining the channel to guide both marketing strategy and policy. Design/methodology/approach – This paper integrates and synthesises research from retailing, consumer behaviour and service quality literatures in order to develop a conceptual framework for understanding the value of e-grocery shopping to aid practitioners to address the critical needs, expectations and concerns of consumers for the development of grocery shopping within the online environment. Findings – This paper offers an alternative approach to allow e-grocery to become a mainstream retail channel in its own right and not to compete with the in-store offerings. The research demonstrates the need for a progressive approach that follows contemporary consumer needs and habits at the household level. The conjecture is that shopping for fast-moving consumer goods follows a learning path that needs to be replicated in the online context. Moreover, it is suggested that consumer resistance to the adoption of the new channel should be addressed not only from a technological perspective but also from the social aspects of online shopping. Originality/value – The research provides a practical framework for both retailers and policy makers on how the “next generation” of online services can be developed using a “bottom up” consumer perspective. This paper also advocates a non-technological bias to e-grocery retailing strategy.

An integrated process for strategic positioning within the value chain

The purpose of this article is to highlight the value of ‘strategic positioning’ as a means of providing competitive edge, and to introduce and describe a novel method of managing this. Strategic positioning is concerned with the choice of business activities a company carries out itself, compared to those provided by suppliers, partners, distributors and even customers. It is therefore directly impacted by, and has direct impact upon, such decisions as outsourcing, off-shoring, partnering, innovation, technology acquisition and customer servicing.

Perceptions of learning and teaching quality in Higher Education:developing a culture of co-creation of value

Perceptions about the quality of learning and teaching in Higher Education has for many years focused upon the application of market based principles. This includes the notion of students as “customers” of the Higher Education Institutions (HEI) service. We argue that the application of the customer analogy is unhelpful however, as students this approach is likely to affect student expectations about the service and their judgements about its quality. The purpose of this paper is to propose a study consisting of a series of interventions to develop a culture of value co-creation at a UK based HEI. By introducing CCV principles, it is hoped to steer students away from seeing themselves as “customers”, and passive recipients of in the learning and teaching process, to one where they take responsibility for their own learning experience, to be explored and acted upon in partnership with their lecturers and other stakeholders.

Understanding high-value manufacturing in Scottish SMEs

Purpose: The purpose of this paper is to investigate the use of high-value manufacturing (HVM) concepts in Scottish SMEs and define how they are being used to gain competitive advantage. Design/methodology/approach: Cross-sectional research carried out using a large-scale survey of 435 SMEs and semi-structured interviews of a subset of 50 SMEs. Findings: Findings indicate that HVM is not a homogeneous state but an umbrella term for a number of operational models adopted by manufacturers that are progressively moving from simple price-based production; companies must, as a foundation, be operationally excellent in all lifecycle phases before extending their capability by offering a more comprehensive service; HVM is not a static state but a journey that differs in nature for each manufacturer depending on the nature of its market and customer. Research limitations/implications: The approach to theory must be more integrated combining aspects of marketing, strategic and operational theory. Research must be carried out using the supply chain, rather than the firm, as the unit of analysis. Practical implications: Manufacturing efficiency has now become an order qualifier and competitive advantage should now be sought through the integration of design, production and service activities from strategic levels down to operational levels across all the functions of a business which link seamlessly to customer and supplier activities. Originality/value: This paper contains insights into Scottish SMEs and their practice of HVM; defines the activity that makes up HVM at an operational as opposed to an economic or strategic level; proposes a model that characterises the stages of HVM that SMEs transition through. © Emerald Group Publishing Limited.

I am the very model of a special purpose vehicle

Purpose – This paper aims to provide a critical comment on complex funding systems. Design/methodology/approach – This is a critical comment written in the form of a poem. The poem is in the style of the English light opera composers Gilbert and Sullivan, and is a variation on their song “I Am the Very Model of a Modern Major General”, from The Pirates of Penzance. Findings - The poem spotlights financial failure. Originality/value - The poem spotlights the crazy names and poor transparency of special purpose vehicles.

Identifying (territorial) tensions in the servitization value chain

Purpose: To understand the tensions that servitization activities create between actors within networks. Design/methodology/approach: Interviews were conducted with manufacturers, intermediaries and customers across a range of industrial sectors. Findings: Tensions relating to two key sets of capabilities are identified: in developing or acquiring (i) operant technical expertise and (ii) operand service infrastructure. The former tension concerns whom knowledge is co-created with and where expertise resides. The latter involves a territorial investment component; firms developing strategies to acquire greater access to, or ownership of, infrastructures closer to customers. Developing and acquiring these capabilities is a strategic decision on the part of managers of servitizing firms, in order to gain recognized power and control in a particular territory. Originality/value: This paper explores how firms’ servitization activities involve value appropriation (from the rest of the network), contrasting with the narrative norm for servitization: that it creates additional value. There is a need to understand the tensions that servitization activities create within networks. Some firms may be able to improve servitization performance through co-operation rather than competition, generating co-opetitive relationships. Others may need to become much more aggressive, if they are to take a greater share of the ‘value’ from the value chain.

The effects of material variations in high value manufacturing industries

It has never been easy for manufacturing companies to understand their confidence level in terms of how accurate and to what degree of flexibility parts can be made. This brings uncertainty in finding the most suitable manufacturing method as well as in controlling their product and process verification systems. The aim of this research is to develop a system for capturing the company’s knowledge and expertise and then reflect it into an MRP (Manufacturing Resource Planning) system. A key activity here is measuring manufacturing and machining capabilities to a reasonable confidence level. For this purpose an in-line control measurement system is introduced to the company. Using SPC (Statistical Process Control) not only helps to predict the trend in manufacturing of parts but also minimises the human error in measurement. Gauge R&R (Repeatability and Reproducibility) study identifies problems in measurement systems. Measurement is like any other process in terms of variability. Reducing this variation via an automated machine probing system helps to avoid defects in future products.Developments in aerospace, nuclear, oil and gas industries demand materials with high performance and high temperature resistance under corrosive and oxidising environments. Superalloys were developed in the latter half of the 20th century as high strength materials for such purposes. For the same characteristics superalloys are considered as difficult-to-cut alloys when it comes to formation and machining. Furthermore due to the sensitivity of superalloy applications, in many cases they should be manufactured with tight tolerances. In addition superalloys, specifically Nickel based, have unique features such as low thermal conductivity due to having a high amount of Nickel in their material composition. This causes a high surface temperature on the work-piece at the machining stage which leads to deformation in the final product.Like every process, the material variations have a significant impact on machining quality. The main cause of variations can originate from chemical composition and mechanical hardness. The non-uniform distribution of metal elements is a major source of variation in metallurgical structures. Different heat treatment standards are designed for processing the material to the desired hardness levels based on application. In order to take corrective actions, a study on the material aspects of superalloys has been conducted. In this study samples from different batches of material have been analysed. This involved material preparation for microscopy analysis, and the effect of chemical compositions on hardness (before and after heat treatment). Some of the results are discussed and presented in this paper.

The value of magnetoencephalography to guide electrode implantation in epilepsy

Purpose: To investigate if magnetoencephalography (MEG) can identify implantation sites for intracranial recordings (IR). Method: Two groups of 12 patients assessed for surgery with IR with and without MEG were compared (MEG and control groups). In the control group, non-invasive presurgical assessment without MEG suggested clear hypotheses for implantation. In the MEG group, non-invasive assessment was inconclusive, and MEG was used to identify implantation sites. Both groups were matched for implantation type. The success of implantation was defined by findings in IR: a) Focal seizure onset; b)Unilateral focal abnormal responses to single pulse electrical stimulation(SPES); and c) Concordance between a) and b). Results: In all MEG patients, at least one virtual MEG electrode generated suitable hypotheses for the location of implantations. The proportion of patients showing focal seizure onset restricted to one hemisphere was similar in control and MEG groups (6/12 vs. 11/12, Fisher’s exact test,p = 0.0686). The proportion of patients showing unilateral responses to SPES was lower in the control than in the MEG group (7/12 vs. 12/12,p = 0.0373). Conclusion: The MEG group showed similar or higher incidence of successful implantations than controls.

The value of tablets as reading aids for individuals with central visual field loss:an evaluation of eccentric reading with static and scrolling text

Purpose: Technological devices such as smartphones and tablets are widely available and increasingly used as visual aids. This study evaluated the use of a novel app for tablets (MD_evReader) developed as a reading aid for individuals with a central field loss resulting from macular degeneration. The MD_evReader app scrolls text as single lines (similar to a news ticker) and is intended to enhance reading performance using the eccentric viewing technique by both reducing the demands on the eye movement system and minimising the deleterious effects of perceptual crowding. Reading performance with scrolling text was compared with reading static sentences, also presented on a tablet computer. Methods: Twenty-six people with low vision (diagnosis of macular degeneration) read static or dynamic text (scrolled from right to left), presented as a single line at high contrast on a tablet device. Reading error rates and comprehension were recorded for both text formats, and the participant’s subjective experience of reading with the app was assessed using a simple questionnaire. Results: The average reading speed for static and dynamic text was not significantly different and equal to or greater than 85 words per minute. The comprehension scores for both text formats were also similar, equal to approximately 95% correct. However, reading error rates were significantly (p=0.02) less for dynamic text than for static text. The participants’ questionnaire ratings of their reading experience with the MD_evReader were highly positive and indicated a preference for reading with this app compared with their usual method. Conclusions: Our data show that reading performance with scrolling text is at least equal to that achieved with static text and in some respects (reading error rate) is better than static text. Bespoke apps informed by an understanding of the underlying sensorimotor processes involved in a cognitive task such as reading have excellent potential as aids for people with visual impairments.

Knowledge and innovation as value drivers in professional services firms: an empirical research in Central and Eastern Europe

The purpose of this study was to investigate empirically the role of knowledge and innovation within Central and Eastern Europe’s changing economy. We applied qualitative research methods, and focused only on professional services firms within the region. The connection between knowledge and innovation as well as knowledge and competitiveness was analyzed by top managers and senior industry experts. Our findings revealed that knowledge might be a real value driver for professional services firms. These companies can significantly contribute to the development of modern economies through the dissemination of their internal best practices in knowledge management. We found three factors that might influence the effectiveness of knowledge management. These three factors are the involvement of international knowledge networks, the investments in human capital, and focus on critical resources. These issues proved to be essential to maximize the potential of knowledge and to leverage this into increased business performance.

A study of learners' perceived value and satisfaction for implied effectiveness of online learning systems

Online learning systems (OLS) have become center stage for corporations and educational institutions as a competitive tool in the knowledge economy. The satisfaction construct has received extensive coverage in information systems literature as an indicator of effectiveness but has been criticized for lack of validity; yet, the value construct has been largely ignored, although it has a long history in psychology, sociology, and behavioral science. The purpose of this dissertation is to investigate the value and satisfaction constructs in the context of OLS, and their perceived by learners relationship for implied effectiveness of OLS. ^ First, a qualitative phase is employed to gather OLS values from learners' focus groups, followed by a pilot phase to refine a proposed instrument, and a main phase to validate the survey. Responses were received from 75 students in four focus groups, 141 in the pilot, and 207 the main survey. Extensive data cleaning and exploratory factor analysis were done to identify factors of learners' perceived value and satisfaction of OLS. Then, Value-Satisfaction grids and the Learners' Value Index of Satisfaction (LeVIS) were developed as benchmarking tools of OLS. Moreover, Multicriteria Decision Analysis (MCDA) techniques were employed to impute value from satisfaction scores in order to reduce survey response time. ^ The results provided four satisfaction and four value factors with high reliability (Cronbach's α). Moreover, value and satisfaction were found to have low linear and nonlinear correlations, indicating that they are two distinct uncorrelated constructs. This is consistent with the literature. Value-Satisfaction grids and the LeVIS index indicated relatively high effectiveness for technology and support characteristics, relatively low effectiveness for professor's characteristics, while course and learner characteristics indicated average effectiveness. ^ The main contributions of this study include identifying, defining, and articulating the relationship between value and satisfaction constructs as assessment of users' implied IS effectiveness, as well as assessing the accuracy of MCDA procedures to predict value scores, thus reducing by half the survey questionnaire size. ^