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Reason RE Radical Keys [WiN]

Why is it so hard to build and maintain the capacity to innovate? The reason is not simply a failure to execute but a failure to articulate an innovation strategy that aligns innovation efforts with the overall business strategy.

Reason RE Radical Keys [WiN]

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In thinking strategically about the four types of innovation, then, the question is one of balance and mix. Google is certainly experiencing rapid growth through routine innovations in its advertising business, but it is also exploring opportunities for radical and architectural innovations, such as a driverless car, at its Google X facility. Apple is not resting on its iPhone laurels as it explores wearable devices and payment systems. And while incumbent automobile companies still make the vast majority of their revenue and profits from traditional fuel-powered vehicles, most have introduced alternative-energy vehicles (hybrid and all-electric) and have serious R&D efforts in advanced alternatives like hydrogen-fuel-cell motors.

Like food spoils when exposed to oxygen, cells suffer oxidative stress when exposed to more reactive oxygen ions called free radicals than they can handle, which they usually manage partly with certain vitamins and minerals dubbed antioxidants.

Free radicals form in the body as products of normal metabolism but also come from outside sources such as smoking, herbicides, pesticides and fatty foods. Their accumulation contributes to aging, cancer and most neurodegenerative disorders.

These unstable oxygen remnants have unpaired electrons that seek partners by taking electrons from other compounds, initiating a chain reaction of electron stealing that damages proteins and DNA. Cells usually detoxify with antioxidants and other defense mechanisms that break down or neutralize free radicals by offering a spare electron. Thus theories formed that suggested eating more antioxidants would ward off disease.

A second reason is the structural barrier created by the incumbency advantage, said Lawless: Most incumbents run for re-election, and they almost always win. In a field where there are few women to begin with, that incumbency advantage makes it harder for their numbers to increase.

ST. LOUIS -- Cornell University researchers have fabricated a set of "nano-keys" on the same scale as molecules to interact with receptors on cell membranes and trigger larger-scale responses within cells, such as the release of histamines in an allergic response.How cell membranes control cellular function has long been studied but with few results. However, nanotechnology now gives researchers new tools to better understand the role of cell membranes in activating responses within cells.

More and more prostate cancers are also diagnosed in younger men who want treatment that does not compromise their quality of life, take time away from work, or cause worrisome side effects. Laparoscopic radical prostatectomy, robot-assisted laparoscopic radical prostatectomy, and third-generation cryotherapy are promising new treatment options for men diagnosed with prostate cancer.4

Conservative management proved to be an acceptable treatment option for men with low-grade Gleason scores, clinically localized disease, and life expectancies of less than 10 years. Increasing age was described as a risk factor for receiving inadequate treatment for prostate cancer.17 Thus, older men have been shown to receive potentially curative therapy (radical prostatectomy or radiotherapy) less often than younger men.18,19 Radical prostatectomy is preferred treatment in men younger than 70 years, whereas radiation therapy is applied predominantly in patients older than 70 years. Conservative therapy such as watchful waiting or androgen deprivation by luteinizing hormone-releasing hormone analogs is preferentially applied in men older than 80 years. Watchful waiting or hormonal therapy is used to treat 82% of men older than 80 years.

Harlan and colleagues22 investigated the association of sociodemo-graphic and clinical characteristics in 3073 men with clinically localized prostate cancer treated with radical prostatectomy, radiation therapy, hormonal therapy, and watchful waiting. Among other parameters such as pretreatment PSA, clinical stage, or Gleason score, patient age at diagnosis was an important determinant of therapy. Seventy-nine percent of men younger than 60 years at diagnosis were treated by radical prostatectomy. The percentage of men receiving hormonal therapy or watchful waiting increased substantially with age. Fifty-eight percent of the men between 75 and 79 years and 82% of men older than 80 years received hormonal therapy or watchful waiting. Outcomes among men treated by radical prostatectomy and radiation therapy were examined. After adjustment for clinically significant characteristics such as PSA serum levels and comorbidity, age was positively correlated with treatment by radiation therapy. Only 13.9% of men younger than 60 years were treated by radiation therapy compared with 70.5% of men older than 75 years.

Histologic evaluation of radical prostatectomy specimens demonstrated that about 20% to 30% of cancers are small volume, show low Gleason scores, and are consequently clinically harmless.35,36 Many of these cancers pose little threat to life, especially for older men. Has PSA screening resulted in prostate cancer overdiagnosis?

Computer modeling of screen-detected populations at the age of 65 years undergoing radical prostatectomy have shown that surgery may extend life expectancy for 9 to 20 months when averaged out over an entire population.37,38 This benefit is comparable to other treatment strategies, including cardiac revascularization. Nonetheless, overdiagnosis does occur and can be considered a side effect of mass screening programs. A study by Carter and associates39 demonstrated that 65-year-old men with low PSA serum levels are at low risk for developing prostate cancer, and it is unlikely that they will be diagnosed with prostate cancer during the next decade. This study suggests that less intensive PSA screening could maintain the detection of the majority of prostate cancers in men up to the age of 75 years and markedly reduce unnecessary PSA testing for men with low PSA serum levels. This reduction of PSA testing in older men who are at low risk could result in fewer unnecessary prostate biopsies and lead to a more cost-effective management.

Prostate-specific antigen velocity has been found to be a valuable tool to more accurately assess high-risk patients for prostate cancer progression. Berger and coworkers40 investigated the impact of tumor and prostate volumes on prostate-specific antigen velocity (PSAV) to find predictors of biochemical failure after radical prostatectomy. This study showed that the main factor contributing to PSAV in patients with prostate cancer is cancer load and that prostate volume is not significantly associated with PSAV. Men with a PSAV of more than 2 ng/mL/year in the year before diagnosis are at a high risk for relapse. PSAV may be helpful in identifying patients with small tumors and increasing the detection rate of potentially curable prostate cancers.

Dahm and associates45 estimated the long-term probability of death from prostate cancer and other competing diseases. They investigated 484 patients older than 70 years who underwent radical perineal surgery for organ-confined prostate cancer between 1970 and 2000. Men treated with radical prostatectomy had a significantly lower risk of death from prostate cancer compared with patients in the watchful waiting group. It also turned out that patients with life expectancies of 10 years or less whose biopsies showed Gleason score 6 or lower have little biological risk of death from prostate cancer. In the group of patients older than 70 years with Gleason score 7, more patients died of prostate cancer during 10 years of follow-up compared with other causes. The chance of dying from prostate cancer was 40% in patients with Gleason score 8 to 10, but risk of death from other competing causes was even greater. Patients with a given Gleason score and a projected life expectancy of at least 10 years may be at similar risk of dying from prostate cancer as younger patients.

Thompson and colleagues46 investigated otherwise healthy octogenarians diagnosed with prostate cancer who underwent radical prostatectomy. At the last follow-up visit, 10 patients had survived more than a decade after surgery, and 3 patients had died within 10 years of surgery. The remaining 6 patients were alive at less than 10 years of follow-up. Seventy-four percent of patients were continent. No patient had died of prostate cancer, and the 10-year, all-cause survival rate was similar to that observed in healthy patients 60 to 79 years old undergoing radical prostatectomy. These findings indicate that careful selection of patients even older than 80 years can achieve satisfactory oncologic and functional outcomes after surgery. It is important to note, however, that the rate of urinary incontinence after surgery exceeds that of younger counterparts.

GivingTuesday is a global generosity movement unleashing the power of radical generosity. GivingTuesday was created in 2012 as a simple idea: a day that encourages people to do good. Since then, it has grown into a year-round global movement that inspires hundreds of millions of people to give, collaborate, and celebrate generosity.

Before doing a radical prostatectomy, doctors first try to confirm that the prostate cancer has not spread beyond the prostate. They can figure out the statistical risk of spread by looking at tables comparing the results of a biopsy and PSA levels.

Surgeons choose from two approaches to reach and remove the prostate during a radical prostatectomy. One is a traditional approach known as open prostatectomy. The other is minimally invasive. That means it involves several small cuts (incisions) and a few stitches.

The American Cancer Society says a radical perineal prostatectomy can lead to a cure just as well as retropubic surgery if your surgeon does the operation right. Perineal surgery may also cause you less pain and lead to a smoother recovery. 041b061a72

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