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2022 ◽  
Vol 41 ◽  
pp. 103341
Author(s):  
Benoît Clavel ◽  
Sébastien Lepetz ◽  
Lorelei Chauvey ◽  
Stéphanie Schiavinato ◽  
Laure Tonasso-Calvière ◽  
...  

2022 ◽  
Vol 196 ◽  
pp. 103331
Author(s):  
Gonzalo Rizzo ◽  
Sebastian R. Mazzilli ◽  
Oswaldo Ernst ◽  
Walter E. Baethgen ◽  
Andres G. Berger

Author(s):  
O. Chernilevskaya

The article presents an example of strategic planning of school development in order to improve educational results. The author provides arguments and justifications for the choice of specific strategic approaches from understanding the categories of "school performance", "development factors", "management team", "social capital", "innovative activity" to researching the potential of the school, specific management decisions, demonstrating the structure and content developed development models. The material of the article reflects in detail the strategy of planning the educational process in a particular school in terms of development. The model of the innovative project "Educational Navigator" is described. A model of intraschool education quality assessment is presented. The article provides examples of the results of the study.


2021 ◽  
Vol 14 (1) ◽  
pp. 41
Author(s):  
P. M. Govindakrishnan ◽  
A. N. Ganeshamurthy ◽  
N. K. Krishna Kumar ◽  
F. Beggi ◽  
S. Bhaskar ◽  
...  

Soil health information is still not widely used in decision making in agriculture. One of the reasons is the lack of a simple and effective method for selection of soil health indicators that have direct relevance to management decisions. A framework for soil health indicators selection and developing location-specific management practices that improve soil health are presented. The framework involves selection of a minimum data set of soil health indicators based on ‘DUS(Soil)’ criteria. In this framework ‘D’ represents Distinctness (indicators representing distinct functional soil processes), ‘U’ represents Utility (amenability for amelioration of the status of the indicator or altering its impact through management practices) and ‘S’ represents Simplicity (amenability for measurement in the field/small laboratories using simple protocols). This study also outlines a method for developing management guidelines for farmers based on the status of the selected soil health indicators. This involved classifying the status of each of the indicators into three classes. Thereafter, taking cognizance of the agroecological context, suitable field management schedules were developed for each class of the indicators, based on literature and local expert knowledge. The use of this framework was demonstrated by developing management guidelines for a coarse textured soil with optimum pH, low soil carbon, poor in water stable aggregates (highly slaking), optimum porosity and poor in soil macro fauna in Mandla district, Madhya Pradesh, India. The study showed that the framework is flexible, generic as well as simple and is useful to develop site-specific management guidelines logically, to overcome the soil quality constraints.


Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6166
Author(s):  
Alessandro Mussa ◽  
Diana Carli ◽  
Simona Cardaropoli ◽  
Giovanni Battista Ferrero ◽  
Nicoletta Resta

Congenital disorders of lateralized or segmental overgrowth (LO) are heterogeneous conditions with increased tissue growth in a body region. LO can affect every region, be localized or extensive, involve one or several embryonic tissues, showing variable severity, from mild forms with minor body asymmetry to severe ones with progressive tissue growth and related relevant complications. Recently, next-generation sequencing approaches have increased the knowledge on the molecular defects in LO, allowing classifying them based on the deranged cellular signaling pathway. LO is caused by either genetic or epigenetic somatic anomalies affecting cell proliferation. Most LOs are classifiable in the Beckwith–Wiedemann spectrum (BWSp), PI3KCA/AKT-related overgrowth spectrum (PROS/AROS), mosaic RASopathies, PTEN Hamartoma Tumor Syndrome, mosaic activating variants in angiogenesis pathways, and isolated LO (ILO). These disorders overlap over common phenotypes, making their appraisal and distinction challenging. The latter is crucial, as specific management strategies are key: some LO is associated with increased cancer risk making imperative tumor screening since childhood. Interestingly, some LO shares molecular mechanisms with cancer: recent advances in tumor biological pathway druggability and growth downregulation offer new avenues for the treatment of the most severe and complicated LO.


2021 ◽  
Vol 4 (96) ◽  
pp. 81-92
Author(s):  
Bohdan Lohvinenko ◽  

The relevance of the study of the processes of coordination of decisions at enterprises by means of mathematical modeling of the corresponding processes has been substantiated in the paper. The concept of horizontal coordination of decisions at enterprises has been defined. The modeling of the process of horizontal coordination of decisions at an enterprise with the presence of a coordination center at a higher level than the one where the coordination takes place is considered. At the same time, two options for managing the process of coordinating decisions at enterprises with different goals of the coordination center are given. The first case assumes the achievement of the goal of managing a focal point, interested in obtaining reliable information from agents at the level of decision coordination with an employment of a non-manipulated direct mechanism. The second case assumes that the coordination center has a specific management goal in the process of horizontal coordination of decisions at the enterprise. Reflexive control in this case provides for the manipulation of obtaining the result of agreement, which will be as close as possible to a certain fixed value – the control goal of the coordination center. The use of the models of reflexive management of the process of horizontal coordination of decisions at the enterprise, which are given in the article, depends on the existing management goal of the coordination center. The use of appropriate models of horizontal coordination at management levels will help to increase the efficiency of collective decision-making processes at enterprises, which will improve the efficiency of their functioning. A promising direction of research has been defined – modeling the processes of coordinating decisions at different levels of management.


Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1926-1926
Author(s):  
Viktoria Blumenberg ◽  
Lisa Siegmund ◽  
Lisa Frölich ◽  
Kai Rejeski ◽  
Friederike Hildebrandt ◽  
...  

Abstract The Bispecific T-cell engager (BiTE) Blinatumomab and CD19-specific Chimeric Antigen Receptor (CAR) T-cell products are approved for the treatment of relapsed and refractory B-cell neoplasms. However, these T-cell based immunotherapies can be accompanied by immune-related toxicities differing from adverse events of classical cytotoxic agents. Toxicity management can pose a challenge for health care professionals. Additionally, logistics of CAR T-cell patient management, particularly with regard to timelines of apheresis, bridging therapies, and CAR T-cell transfusion, require coordinated efforts between referring physicians and treatment centers. To support the optimal management of these patients, we developed an interactive smartphone application ("myTcell") which educates physicians in the pre-treatment logistics of CARs and BiTEs and provides recommendations on management and treatment of immune-related toxicities. We initiated a multi-step content development process with an extensive literature research of toxicity guidelines consented by the ASTCT, SITC, NCCN and EBMT as well as of officially released drug information. Findings were integrated in an information platform to provide diagnostic and therapeutic recommendations as well as algorithms for interactive toxicity grading tools. We could successfully implement an app ("myTcell") guiding health workers in a disease- and product-specific step by step process through the clinical workflow of CAR and BiTE therapy (Fig.1). This includes recommendations for eligibility, patient screening, safety assessment and stopping rules prior to leukapheresis and CAR T-cell transfusion. Upon entering relevant clinical data for grading of CRS, ICANS and HLH, interactive tools display toxicity grade and grade-specific management (Fig. 2). Further, "myTcell" assists with the diagnosis and treatment of pancytopenia and infections. The app includes an overview of important publications with direct links to respective abstracts to support evidence-based decision-making. A prototype was validated at five Geman treatment centers through a questionnaire which measured the advantage of the app compared to common clinical practice. 38 physicians with a median working experience of 8 years validated the app protoype in a real-world setting of CAR T-cells or BiTE application for the treatment of Diffuse Large-B-Cell Lymphoma (89.5%) and B-Cell Precursor Acute Lymphoblastic Leukemia (39.5%) at five German treatment centers (University Hospitals of LMU Munich, Cologne, Göttingen, Erlangen, Tübingen). 78.9% of the users most valued the content of toxicity management. In addition, 63.2% reported to dominantly use the interactive tools and calculators to assess severity of toxicities and to instantly receive grade-specific management recommendations. As expected, the tools were most frequently used for the two most commonly occurring side effects CRS (68.4%) and ICANS (65.8%). In addition, most of the users agreed, that the interactive tools improved toxicity management (94.7%) and saved time during their clinical practice (81.6%). Based on these results, "myTcell" has been certified as a medicinal product class I and has been released in the app stores and for desktop application (www.mytcell.de) on July 15, 2021. "myTcell" is a smartphone app supporting the use of T-cell based immunotherapy platforms. The app supports assessment and treatment of novel CAR T and BITE mediated immunotoxicities. Health care professionals validated feasibility and in particular appreciated fast and easy assessment of toxicity grading and management. Thus, "myTcell" is a tool that has the potential to improve guideline adherence and accelerate broader and safer application of CARs and BiTEs based immunotherapy. Figure 1 Figure 1. Disclosures Blumenberg: Novartis: Consultancy, Research Funding; BMS/Celgene: Research Funding; Janssen: Research Funding; Kite/Gilead: Consultancy, Research Funding. Schmidt: Bayer Healthcare: Research Funding; Novartis: Consultancy, Honoraria, Other: Travel, Accommodations, Expenses; Kite/Gilead: Consultancy, Honoraria, Other: Travel, Accommodations, Expenses, Research Funding; Janssen: Other: Travel, Accommodations, Expenses; Takeda: Consultancy, Other: Travel, Accommodations, Expenses; BMS: Consultancy, Other: Travel, Accommodations, Expenses. von Bergwelt: Astellas: Honoraria, Research Funding, Speakers Bureau; Mologen: Honoraria, Research Funding, Speakers Bureau; Miltenyi: Honoraria, Research Funding, Speakers Bureau; MSD Sharpe & Dohme: Honoraria, Research Funding, Speakers Bureau; Kite/Gilead: Honoraria, Research Funding, Speakers Bureau; BMS: Honoraria, Research Funding, Speakers Bureau; Novartis: Honoraria, Research Funding, Speakers Bureau; Roche: Honoraria, Research Funding, Speakers Bureau. Buecklein: BMS/Celgene: Consultancy, Research Funding; Miltenyi: Research Funding; Kite/Gilead: Consultancy, Honoraria, Other: Congress and travel support, Research Funding; Amgen: Consultancy, Honoraria; Novartis: Consultancy, Other: congress and travel support, Research Funding, Speakers Bureau; Pfizer: Consultancy, Honoraria, Speakers Bureau. Subklewe: Janssen: Consultancy; Gilead: Consultancy, Research Funding, Speakers Bureau; Roche: Research Funding; Takeda: Speakers Bureau; Klinikum der Universität München: Current Employment; BMS/Celgene: Consultancy, Research Funding, Speakers Bureau; Amgen: Consultancy, Research Funding, Speakers Bureau; Miltenyi: Research Funding; Seattle Genetics: Consultancy, Research Funding; Pfizer: Consultancy, Speakers Bureau; Novartis: Consultancy, Research Funding, Speakers Bureau; MorphoSys: Research Funding.


2021 ◽  
pp. 449-470
Author(s):  
Nicholas Eaddy ◽  
Alexandra Cardinal

This chapter describes the blood products which are commonly required as part of anaesthetic practice, including red cells, plasma, cryoprecipitate, platelet concentrate, and concentrated coagulation factor preparations. The essential components of patient blood management, aiming to reduce the requirement for transfusion, are described. The principles and practice of massive blood transfusion are described. The specific management of Jehovah’s Witnesses, and other patients who decline blood transfusion, is discussed. The chapter finishes with a discussion of the common intravenous fluid preparations which are used in practice, and how to use them appropriately.


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