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Why good projects fail anyway.

Big projects fail at an astonishing rate--more than half the time, by some estimates. It's not hard to understand why. Complicated long-term projects are customarily developed by a series of teams working along parallel tracks. If managers fail to anticipate everything that might fall through the cracks, those tracks will not converge successfully at the end to reach the goal. Take a companywide CRM project. Traditionally, one team might analyze customers, another select the software, a third develop training programs, and so forth. When the project's finally complete, though, it may turn out that the salespeople won't enter in the requisite data because they don't understand why they need to. This very problem has, in fact, derailed many CRM programs at major organizations. There is a way to uncover unanticipated problems while the project is still in development. The key is to inject into the overall plan a series of miniprojects, or "rapid-results initiatives," which each have as their goal a miniature version of the overall goal. In the CRM project, a single team might be charged with increasing the revenues of one sales group in one region by 25% within four months. To reach that goal, team members would have to draw on the work of all the parallel teams. But in just four months, they would discover the salespeople's resistance and probably other unforeseen issues, such as, perhaps, the need to divvy up commissions for joint-selling efforts. The World Bank has used rapid-results initiatives to great effect to keep a sweeping 16-year project on track and deliver visible results years ahead of schedule. In taking an in-depth look at this project, and others, the authors show why this approach is so effective and how the initiatives are managed in conjunction with more traditional project activities.

Efficiency, Organizational↗

A therapeutic index that predicts the individual effects of prednisone in patients with cirrhosis.

Our aim was to construct an index that accurately predicts the degree of benefit or harm that prednisone therapy holds for patients with liver cirrhosis. The admission and survival data of 488 patients with cirrhosis who participated in a controlled clinical trial of prednisone in a dosage of 10-15 mg daily (251 patients) versus placebo (237 patients) and who were observed for up to 12 yr were analyzed using Cox's multiple regression model. Four variables each provided significant therapeutic information: antinuclear factor (p = 0.02) and large piecemeal necroses (p = 0.02) were associated with a beneficial effect, whereas ascites (p = 0.0004) and large regenerative nodules (p = 0.0007) were associated with a harmful effect of prednisone. From these four variables a therapeutic index was constructed. For a given patient the therapeutic index is a measure of how big the effect will be if prednisone is given. The gain in survival time obtained by administering prednisone according to the therapeutic index was estimated to be 349 yr, mainly confined to 217 patients with a significant positive (121) or negative (96) therapeutic index. The therapeutic index may prove useful for the optimal administration of prednisone treatment in new patients with cirrhosis.

Antibodies, Antinuclear↗

Chromatographic determination of plant saponins.

The methods used for saponin determination in plant materials are presented. It is emphasised that the biological and spectrophotomeric methods still being used for saponin determination provide, to some extent, valuable results on saponin concentrations in plant material. However, since they are sensitive to the structural variation of individual saponins they should be standardized with saponin mixtures isolated from the plant species in which the concentration is measured. However, one plant species may contain some saponins which can be determined with a biological test and others which cannot. That is why biological and colorimetric determinations do not provide accurate data and have to be recognized as approximate. Thin-layer chromatography on normal and reversed-phases (TLC, HPTLC, 2D-TLC) provides excellent qualitative information and in combination with on-line coupling of a computer with dual-wavelength flying-spot scanner and two-dimensional analytical software can be used for routine determination of saponins in plant material. The densitometry of saponins has been very sensitive, however, to plate quality, spraying technique and the heating time and therefore appropriate saponin standards have to be run in parallel with the sample. Gas-liquid chromatography has limited application for determination since saponins are quite big molecules and are not volatile compounds. Thus, there are only few applications of GC for determination of intact saponins. The method has been used for determination of TMS, acetyl or methyl derivatives of an aglycones released during saponin hydrolysis. However, structurally different saponins show different rates of hydrolysis and precise optimisation of hydrolysis conditions is essential. Besides, during hydrolysis a number of artefacts can be formed which can influence the final results. High performance liquid chromatography on reversed-phase columns remains the best technique for saponin determination and is the most-widely used method for this group of compounds. However, the lack of chromophores allowing detection in UV, limits the choice of gradient and detection method. The pre-column derivatisation with benzoyl chloride, coumarin or 4-bromophenacyl bromide has been used successfully in some cases allowing UV detection of separation. Standardisation and identification of the peaks in HPLC chromatograms has been based on comparison of the retention times with those observed for authentic standards. But new hyphenated techniques, combining HPLC with mass spectrometry and nuclear magnetic resonance are developing rapidly and allow on-line identification of separated saponins. Capillary electrophoresis has been applied for saponin determination only in a limited number of cases and this method is still being developed.

Chromatography, Gas↗

Using buzz marketing to promote ideas, services, and products.

OBJECTIVE: To (1) discuss buzz marketing, contrast it with traditional forms of promotional communications, and provide guidelines for use and (2) describe a successful buzz-marketing program used by Sentara Healthcare to decrease overuse and inappropriate use of antibiotic medications. DATA SOURCES: An English-language-only literature search of ABI Inform, Lexus-Nexus, InfoTrac, and university library databases from 1980 to the present using the keywords buzz, word of mouth, opinion leader, and thought leader. Articles and books were cross referenced for other works of interest. STUDY SELECTION: Performed by the author for their contribution to an exploratory analysis of this topic. DATA EXTRACTION: Performed by the author. DATA SYNTHESIS: Buzz marketing is an indirect communications method that has been used successfully in the promotion of a wide variety of products, services, and ideas. By identifying and cultivating nonmedia opinion leaders, the technique generates word-of-mouth communications between these early adopters of products and services and the early and late majority of people who tend to follow their lead. Opinion leaders can be categorized as ordinary or extraordinary, technical or social, and specialist or generalist, depending on the nature of their communications, expertise, and range of knowledge. Buzz marketing is most useful for ideas that are memorable, produce small changes in behavior that have big effects over time, and have the potential to reach a "tipping point" in terms of momentum among a target population. Pharmacists can use buzz marketing for promoting innovative services such as pharmaceutical care. A case study is presented on the use of buzz marketing by a health system for decreasing antibiotic resistance through lessening of public demand for antibiotics and support of physicians in prescribing the agents appropriately. CONCLUSION: Buzz marketing is a potent force in the promotion of pharmaceuticals and can be used by pharmacists. It works best when patients perceive the benefits of innovations. Providing samples and demonstrations of the innovation will foster positive perceptions. Innovations also spread better when they are compatible with the needs, desires, and preferences of individuals and can be adapted to the unique situation of the adopter.

Advertising↗

Body build classification for ordinary schoolgirls (aged 7-18 years) and volleyball girls (aged 13-16 years).

The article describes two Estonian anthropometric cross-sectional studies of 1549 ordinary schoolgirls (aged 7-18) and 46 girls, who regularly practised volleyball (aged 13-16). Data are presented on 22 basic anthropometric measurements and 6 body composition characteristics (body mass index, mean skinfold, body density, relative mass of fat by Siri, absolute mass and relative mass of subcutaneous adipose tissue). All anthropometric variables were classified into five height-weight SD classes. Schoolgirls were divided into six age groups (7-8, 9-10, 11-12, 13-14, 15-16, 17-18). Volleyballers were observed as one group as their age in SD classes did not differ significantly. The classification consisted of five categories: three height-weight concordant categories: I--small (small height, small weight), II--medium (medium height, medium weight), III large--(big height, big weight) and two height/weight discordant categories: IV--so-called pyknomorphs, V--so-called leptomorphs. To assess the differences between classes the Scheffé-test was used (alpha = 0.05). It proved likewise possible to comparatively systematize length, breadth and depth measurements, circumferences and body composition characteristics in all six age groups (7-18 years) of ordinary schoolgirls and in 13-16-year-old volleyballers as in their case the average age did not differ significantly between the classes.

Adolescent↗

How "Caucasoids" got such big crania and why they shrank. From Morton to Rushton.

In the 19th century measurements of cranial capacity by Morton and others supported a "Caucasoid>Mongoloid>Negroid" hierarchy of intelligence. This continued through most of the 20th century but was challenged by a nonhierarchical view originating with Boas. Beginning in the 1980s Rushton correlated cranial and IQ measurements and presented a hierarchy with "Mongoloids" at the top. Each of these periods relates to its social context: the 19th-century hierarchy paralleled the height of European world domination; the nonhierarchy of the 20th century reflected world wars, worldwide depression, and the breakup of empires; the "Mongoloid>Caucasoid>Negroid" hierarchy followed the economic success of several Asian nations. Morton's cranial ranking was the result of his sampling error and his acceptance of the hierarchical thinking of his time. But how is it possible for Rushton to support the M>C>N ordering while using the data of several anthropologists who have rejected racial hierarchies on empirical grounds? The answer to this question involves a critique of Rushton's use of the race concept, his aggregation of diverse populations into three traditional races, his claim to explain differences in "cultural achievements" on the basis of variation in brain size, and a number of other problems. The study concludes by noting that the major consequence of these hierarchies is the apparent justification for the exploitation of those at the bottom.

Anthropology↗

Restoration of genetic diversity in the dry forest tree Swietenia macrophylla (Meliaceae) after pasture abandonment in Costa Rica.

We studied the levels of genetic diversity of Swietenia macrophylla (big leaf mahogany) in five successional plots in the Santa Rosa National Park, Guanacaste, Costa Rica. We selected sites with different lengths of time since the last major disturbance (typically fire): 6, 9, 15 and 20 years. In addition, we also included a patch of mature forest that had experienced selective logging and other human activity in the past 100 years. Genetic diversity was assessed using five polymorphic DNA microsatellite loci. We found a total of 21 alleles in the five loci examined, in which the number of alleles present varied among the five sites studied. Allelic diversity varied between sites ranging from 20 to 14 alleles, and our data revealed that earlier successional sites have more alleles than older sites. There was significant heterogeneity in allele frequencies between sites; however, genetic differentiation between populations was low (FST = 0.063) indicating that most of the variation was found within sites and extensive gene flow between sites. In addition, our analysis also showed that genetic diversity of adult trees does not solely determine the diversity of seedlings and saplings found around them, also supporting the existence of extensive gene flow. The impact of these findings for the design of conservation strategies for tropical dry forests trees is discussed.

Cluster Analysis↗

Discrimination of two-wavefront echoes by the big brown bat, Eptesicus fuscus: behavioral experiments and receiver simulations.

1. Echolocating bats (Eptesicus fuscus) were trained to discriminate between simulated targets consisting of one or two echo-wavefronts with internal time delays of up to 100 microseconds. Spectral and temporal properties and total signal energy of the targets were evaluated and predictions for performances of bats derived from receiver models were compared with measured performances. 2. Eptesicus fuscus was able to discriminate a one-wavefront target from two-wavefront targets with distinct internal time delays (12 microseconds, 32-40 microseconds and 52-100 microseconds). Performance was not affected by changes in total signal energy. Bats also successfully discriminated between two-wavefront targets with different internal time delays. 3. Performance predicted from differences in total energy between targets did not match the measured performance, indicating that bats did not rely on total echo energy. This finding is also supported by the behavioral data. Performance predicted from spectral and temporal receiver models both matched the measured performance and, therefore, neither one of these models can be favored over the other. 4. The behavioral data suggest that Eptesicus fuscus did not transform echo information into estimates of target range separation and, therefore, did not perceive the two wavefronts of each simulated two-wavefront echo as two separate targets.

Acoustic Stimulation↗

Eater: a big bite into phagocytosis.

The phagocytosis of invading microorganisms by specialized blood cells is a crucial element of innate immunity in both mammals and insects. In this issue of Cell, Kocks et al. (2005) demonstrate that Eater, a scavenger receptor, plays an important role in the recognition and phagocytosis of bacteria in the fruit fly Drosophila.

Amino Acid Motifs↗

Variations in the molecular forms of prolactin during the menstrual cycle, pregnancy and lactation.

Size heterogeneity of immunoreactive prolactin (PRL) was studied in serum samples obtained from eight normoprolactinemic women during the menstrual cycle and five additional patients at pregnancy and lactation. Gel filtration of sera from women with normal ovarian function tested at day 10-12th of their menstrual cycle showed two predominant PRL forms, approximately 22K and 26K mol wt. In addition two polymeric variants, 50K ("big" PRL) and 100K ("big-big" PRL) were found in less proportion, accounting for approximately 34% of the total PRL immunoreactivity detected in the sera. It was also noted a low mol wt form eluting around the region of 16K mol wt. In pregnant women the major PRL form was the 22K and its proportion showed a gradual increase as progression of gestation. The polymeric PRL forms were found in substantially less amount as gestation progressed. After parturition, in nursing mothers the 22K form remained prominent and in greater concentrations than the 26K monomeric variant. Large and low mol wt PRL forms were constantly detected in sera from women during the lactation period. From these data we confirmed that PRL circulates at various molecular forms and the relative proportion of these molecular variants exhibit changes according to the physiological state. In our study the predominant form was the 22K PRL (nonglycosylated) and it was of interest to discover the presence of a low mol wt PRL which elutes in the 16K area. The significance of this latter finding is not clear at the present.

Adult↗

Comparison of the inhibitory activity of seven anti-T8 antibodies on specific cellular cytotoxicity.

To evaluate the functional significance of the T-cell membrane structure recognized by OKT8 or Leu2a, seven different monoclonal antibodies, reacting with different epitopes of this 76 KD big membrane structure, were evaluated for their ability to alter specific cell mediated lympholysis after a mixed leukocyte reaction. The stimulated effector cells were first incubated with a monoclonal antibody, washed and then tested for their cytotoxicity. Those antibodies, which react with a highly trypsin-sensitive region of the T8 glycoprotein, were the most effective inhibitors of the cytotoxicity (T811, FK18). Those antibodies, which react with a relative trypsin-resistant region (OKT8, Leu2a, WT82, WT85) or with a trypsin-sensitive epitope (WT81), which is in a close neighborhood to WT82 or WT85, appear to be able to block the cytotoxicity only in certain effector/target cell combinations. The data suggest that different regions of the T8 glycoprotein are involved in the specific cytotoxic reactions, and that the involvement of certain epitopes may depend on the effector/target cell combination.

Antibodies, Monoclonal↗

UGT1A7 and UGT1A9 polymorphisms predict response and toxicity in colorectal cancer patients treated with capecitabine/irinotecan.

PURPOSE: Capecitabine and irinotecan are commonly used in the treatment of metastatic colorectal cancer (CRC). We hypothesized that germline polymorphisms within genes related to drug target (thymidylate synthase) or metabolizing enzymes (UDP-glucuronosyltransferase, UGT) would impact response and toxicity to the combination of capecitabine plus irinotecan (CPT-11). EXPERIMENTAL DESIGN: Sixty-seven patients with measurable CRC were treated with irinotecan i.v. (100 or 125 mg/m(2)) on days 1 and 8 and capecitabine orally (900 or 1,000 mg/m(2), twice daily) on days 2 through 15 of each 3-week cycle. Genomic DNA was extracted from peripheral blood and genotyped using Pyrosequencing, GeneScan, and direct sequencing (Big Dye terminator) technologies. RESULTS: The overall objective response rate was 45% with 21 patients (31%) exhibiting grade 3 or 4 diarrhea and 3 patients (4.5%) demonstrating grade 3 or 4 neutropenia in the first two cycles. Low enzyme activity UGT1A7 genotypes, UGT1A7*2/*2 (six patients) and UGT1A7*3/*3 (seven patients), were significantly associated with antitumor response (p = 0.013) and lack of severe gastrointestinal toxicity (p = 0.003). In addition, the UGT1A9 -118 (dT)(9/9) genotype was significantly associated with reduced toxicity (p = 0.002) and increased response (p = 0.047). There were no statistically significant associations between UGT1A1, UGT1A6, or thymidylate synthase genotypes and toxicity or tumor response. CONCLUSIONS: These data strongly suggest that UGT1A7 and/or UGT1A9 genotypes may be predictors of response and toxicity in CRC patients treated with capecitabine plus irinotecan. Specifically, patients with genotypes conferring low UGT1A7 activity and/or the UGT1A9 (dT)(9/9) genotype may be particularly likely to exhibit greater antitumor response with little toxicity.

Adult↗

Endothelin increases cyclic GMP levels in LLC-PK1 porcine kidney epithelial cells via formation of an endothelium-derived relaxing factor-like substance.

The effect of endothelin (ET) on cyclic GMP levels in cultured porcine kidney epithelial cells, LLC-PK1, was investigated. ET-1 or ET-3, but not big ET-1 or ET C-terminal hexapeptide 16-21, elevated cyclic GMP levels in a concentration-dependent manner with an EC50 value of about 5 x 10(-10) M. This effect of ET-1 was enhanced with superoxide dismutase, diminished with oxyhemoglobin, inhibited with methylene blue, totally dependent on extracellular calcium and unaffected by indomethacin. L-Arginine derivatives, NG-methyl-L-arginine and NG-nitro-L-arginine also inhibited cyclic GMP responses to 10(-8) M ET-1 with IC50 values of 1.2 x 10(-6) M and 7.6 x 10(-8) M, respectively, and the inhibition was prevented with L-arginine. These data strongly suggest that ET-1 stimulates formation of an endothelium-derived relaxing factor-like substance from L-arginine or a related endogenous material(s) in a Ca(++)-dependent fashion, which in turn activates soluble guanylate cyclase to elevate cellular cyclic GMP levels. The concentrations required for these effects were 10 times lower than those required for atrial natriuretic factor. Thus, the effects of ET on cyclic GMP accumulation may be related to the natriuretic effects of ET in vivo.

Animals↗

D-Val22 containing human big endothelin-1 analog, [D-Val22]Big ET-1[16-38], inhibits the endothelin converting enzyme.

Endothelin converting enzyme (ECE) is essential for generation of the biological effects of endothelin-1 (ET-1) from a precursor, big endothelin-1 (Big ET-1). We synthesized four analogs of human Big ET-1[16-38], substituted with single D-amino acids at P1, P2, P1' and P2' positions. ECE activity was determined using an ET-1 specific radioimmunoassay system. None of the D-amino acid containing Big ET-1 analogs were apparently cleaved by ECE, however, one of the synthetic peptides, [D-Val22]Big ET-1[16-38], strongly inhibited the ECE activity. Furthermore, when this D-Val22 containing peptide was preadministered to rat striatum, it was found to inhibit the dopamine release induced by Big ET-1. This result suggests that the D-Val22 containing peptide inhibits the ECE activity in vivo. The D-Val22 containing inhibitor offers hope of developing more potent and highly specific ECE inhibitors of therapeutic significance.

Amino Acid Sequence↗

Comparison of endothelin binding and calcium mobilization in C6-BU-1 rat glioma and N18TG2 mouse neuroblastoma cells.

We have previously reported that endothelin (RT) receptor activation increases intracellular calcium concentrations ([Ca2+]i) in NG108-15 cells, a hybrid of rat glioma C6-BU-1 and mouse neuroblastoma N18TG2 cells. This study was designed to further explore the origin of the ET receptor and [Ca2+]i mobilization in the parent cell lines hybridized to form the NG108-15 cells. [125I]ET-1 bound to a single class of high affinity sites in C6-BU-1 cells with a KD value of 108pM and Bmax of 12,400 sites/cell. ET-1, ET-2, ET-3 and big ET inhibited [125I]ET-1 binding to C6-BU-1 cells with KD values of 0.074, 0.167, 261 and 187 nM, respectively. All ETs produced a rapid increase in [Ca2+]i in C6-Bu-1 cells. EC50 values for ET-1, ET-2, ET-3 and big ET were 0.71, 1.14, 120 and 243 nM respectively. There was a significant correlation between the KD values obtained from competition binding experiments and the EC50 values from [Ca2+]i response curves in C6-BU-1 cells (r = 0.996, p less than 0.004). Ten nM ET-1 produced about 85% of the maximal [Ca2+]i increase in C6-BU-1 cells which was reduced by 96% in the absence of extracellular calcium. Furthermore, diltiazem (10 microM) and nifedipine (1 microM) failed to block ET-induced [Ca2+]i mobilization. None of the ETs elevated [Ca2+]i or displayed any specific [125I]ET-1 binding in N18TG2 cells. These data suggest that ET binds to a specific ET receptor in C6-BU-1 cells, and elevates [Ca2+]i through dihydropyridine-insensitive, receptor-mediated calcium influx. Further, the ability of ETs to elevate [Ca2+]i in NG108-15 hybrid cells is due to the ET receptor inherent to the C6-BU-1 glioma parent line.

Animals↗

Cryorenin in the newborn human and lamb.

Renin and big renin (cryorenin) were measured in the plasma of 78 babies at birth, and studied in six newborn lambs 2-3 weeks of age in response to angiotensin II (0.25 microgram/kg per min) infusion. There were (mean +/- S.E.M.) 15.9 +/- 2.0 ng/ml per h of renin and 11.1 +/- 2.3 of cryorenin, measured as plasma renin activity (PRA) in newborn cord blood. Cryorenin and renin decreased in parallel in the newborn lamb from 19 +/- 2.3 ng/ml per h and 28.6 +/- 2.7 to 6.5 +/- 1.8 (P less than 0.001) and 15.9 +/- 1.8 (P less than 0.01), respectively after 30 min of the angiotensin II infusion. Mean aortic blood pressure increased 30 mm Hg. These data suggest that cryorenin levels are high in the newborn lamb and human, and that both cryorenin and renin are under angiotensin II control in the newborn lamb.

Angiotensin II↗

Clearance and acid-stimulating action of human big and little gastrins in duodenal ulcer subjects.

Acid-stimulating action and clearance of pure natural human big gastriin (HG-34-I) and little gastrin (HG-17-I) were assessed in four male subjects with inactive duodenal ulcer (DU) disease. Disappearance half-times for HG-17-I after intravenous infusion (5.2 min) or rapid intravenous injection (6.4 min) were six to eight times shorter than those for HG-34-I (41.5 and 37.8 min, respectively). Studies of clearance of synthetic human little gastrin (HG-17-I) were performed in three of these same four DU subjects, eight additional male DU subjects, and eleven normal male subjects. The disappearance halftime of synthetic HG-17-I averaged 6.2 min in both the DU subjects and the normal subjects. These data suggest that clearance of exogenous gastrin is not altered in patients with DU. Acid secretion in response to rapid intravenous injection of HG-34-I reached a higher peak and lasted longer than in response to an equimolar dose of HG-17-I; the total response to HG-34-I was about three times that to HG-17-I. During constant intravenous infusion, acid responses to equimolar exogenous doses of the two peptides were similar but the increment in molar concentration of circulating gastrin was six to eight times greater with HG-34-I than with HG-17-I. Chromatography of serum obtained during infusions of HG-34-I revealed no evidence of conversion to HG-17-I, nor was there any increase in circulating G-34 activity during infusions of HG-17-I. The increment in serum gastrin concentration required to produce half-maximal stimulation of gastric acid secretion (D50) was estimated in each subject for each gastrin from curves relating acid secretion to change in serum gastrin concentration produced by infusion of these peptides. After instilling peptone solution into the stomach, acid secretion was measured by intragastric titration, and increases in circulating G-17 and G-34 were determined by chromatography and radioimmunoassay of serum. Increases in circulating G-17 and G-34 in response to the peptone meal, taken together, were equivalent to 1.5 times the D50 determined from infusions of G-34 and G-17. Acid secretion during the same time period averaged 55% of maximal rates. Although G-34 comprised approximately three-fourths of the total molar concentration of circulating gastrin after stimulation, it was estimated to contribute less than half of the acid-stimulating activity.

Dose-Response Relationship, Drug↗

The whole is more than the sum of its parts: Modeling community-level effects of UVR in marine ecosystems.

The effect of UVB radiation (UVBR, 290-320 nm) on the dynamics of the lower levels of the marine plankton community was modeled. The model was built using differential equations and shows a good fit to experimental data collected in mesocosms (defined as large enclosures of 1500 L filled with natural marine waters). Some unexpected results appear to be possible by indirect effects in prey (bacteria, phytoplankton and heterotrophic flagellates). In particular, apparent competition appears between small phytoplankton and bacteria. This effect is caused by a shared predator (ciliates). Another remarkable effect is an increase in bacteria and flagellates populations due to enhanced UVBR. This effect is similar to that observed under mesocosm experimental conditions and is related to the decrease of predation due to the direct damage to predators (ciliates) by UVBR. The effect of UVBR changing interaction coefficients may be dramatic on the community structure, producing big changes in equilibrium populations, as demonstrated by sensitivity analysis of the model. In order to generalize these results to field conditions it will be necessary to increase model complexity and include extra organic mater sources, mixing and sinking effects and predation by large zooplankton. This work shows that UVBR may produce community global responses that are consequence of both direct and indirect effects among populations.

Ecosystem↗