Clinical staging versus laparotomy and combined modality with MOPP versus ABVD in early-stage hodgkin's disease: the H6 twin randomized trials from the european organization for research and treatment of cancer lymphoma cooperative group

info:eu-repo/semantics/published

Development and standardization of solid phase assays for the detection of anti-neutrophil cytoplasmic antibodies (ANCA). A report on the second phase of an international cooperative study on the standardization of ANCA assays

Anti-neutrophil cytoplasmic antibodies (ANCA) are diagnostic markers for systemic vasculitis. They are classically I detected by an indirect immunofluorescence test using normal donor neutrophils as substrate. This assay lacks antigenic specificity and is not quantitative. The 'EC/BCR Project for ANCA Assay Standardization' is an international collaboration study with the aim to develop and standardize solid phase assays for ANCA detection. In this part of the study the isolation and characterization of proteinase-3 and myeloperoxidase, the two main target molecules for ANCA, and the development and standardization of ELISAs with these antigens are described. Six laboratories successfully isolated purified proteinase-3 preparations that could be used. Three of these preparations, together with one myeloperoxidase preparation, were subsequently used for ANCA testing by ELISA. The ELISA technique was standardized in two rounds of testing in the 14 participating laboratories. The coefficient of variation of these new assays decreased from values of approx. 50% in the first round to approx. 20% in the second round. We conclude that purified proteinase-3 and myeloperoxidase can be used in standardized ELISAs for ANCA detection. Whether such procedures offer advantages over the IIF test will be determined in a prospective clinical study.

A strategy to advance the evidence base in palliative medicine: formation of a palliative care research cooperative group.

BACKGROUND: Palliative medicine has made rapid progress in establishing its scientific and clinical legitimacy, yet the evidence base to support clinical practice remains deficient in both the quantity and quality of published studies. Historically, the conduct of research in palliative care populations has been impeded by multiple barriers including health care system fragmentation, small number and size of potential sites for recruitment, vulnerability of the population, perceptions of inappropriateness, ethical concerns, and gate-keeping. METHODS: A group of experienced investigators with backgrounds in palliative care research convened to consider developing a research cooperative group as a mechanism for generating high-quality evidence on prioritized, clinically relevant topics in palliative care. RESULTS: The resulting Palliative Care Research Cooperative (PCRC) agreed on a set of core principles: active, interdisciplinary membership; commitment to shared research purposes; heterogeneity of participating sites; development of research capacity in participating sites; standardization of methodologies, such as consenting and data collection/management; agile response to research requests from government, industry, and investigators; focus on translation; education and training of future palliative care researchers; actionable results that can inform clinical practice and policy. Consensus was achieved on a first collaborative study, a randomized clinical trial of statin discontinuation versus continuation in patients with a prognosis of less than 6 months who are taking statins for primary or secondary prevention. This article describes the formation of the PCRC, highlighting processes and decisions taken to optimize the cooperative group's success.

Intrinsic measure of diversity gains in generalised distributed antenna systems with cooperative users

The diversity gains achievable in the generalised distributed antenna system with cooperative users (GDAS-CU) are considered. A GDAS-CU is comprised of M largely separated access points (APs) at one side of the link, and N geographically closed user terminals (UTs) at the other side. The UTs are collaborating together to enhance the system performance, where an idealised message sharing among the UTs is assumed. First, geometry-based network models are proposed to describe the topology of a GDAS-CU. The mean cross-correlation coefficients of signals received from non-collocated APs and UTs are calculated based on the network topology and the correlation models derived from the empirical data. The analysis is also extendable to more general scenarios where the APs are placed in a clustered form due to the constraints of street layout or building structure. Subsequently, a generalised signal attenuation model derived from several stochastic ray-tracing-based pathloss models is applied to describe the power-decaying pattern in urban built-up areas, where the GDAS-CU may be deployed. Armed with the cross-correlation and pathloss model preliminaries, an intrinsic measure of cooperative diversity obtainable from a GDAS-CU is then derived, which is the number of independent fading channels that can be averaged over to detect symbols. The proposed analytical framework would provide critical insight into the degree of possible performance improvement when combining multiple copies of the received signal in such systems.

Cooperative communications in ultra-wideband wireless body area networks: Channel modeling and system diversity analysis

In this paper, we explore the application of cooperative communications in ultra-wideband (UWB) wireless body area networks (BANs), where a group of on-body devices may collaborate together to communicate with other groups of on-body equipment. Firstly, time-domain UWB channel measurements are presented to characterize the body-centric multipath channel and to facilitate the diversity analysis in a cooperative BAN (CoBAN). We focus on the system deployment scenario when the human subject is in the sitting posture. Important channel parameters such as the pathloss, power variation, power delay profile (PDP), and effective received power (ERP) crosscorrelation are investigated and statistically analyzed. Provided with the model preliminaries, a detailed analysis on the diversity level in a CoBAN is provided. Specifically, an intuitive measure is proposed to quantify the diversity gains in a single-hop cooperative network, which is defined as the number of independent multipaths that can be averaged over to detect symbols. As this measure provides the largest number of redundant copies of transmitted information through the body-centric channel, it can be used as a benchmark to access the performance bound of various diversity-based cooperative schemes in futuristic body sensor systems.

Stakeholder engagement in sustainable housing refurbishment in the UK

The UK government is committed to effectively implement a viable sustainable agenda in the social housing sector. To this end housing associations and local authorities are being encouraged to improve the environmental performance of their new and existing homes. Whilst much attention has been focused on new housing (e.g. the Code for Sustainable Homes) little effort has been focussed on improving the 3.9 (approx) million homes maintained and managed by the public sector (in England), which, given the low rate of new build and demolition (<1% in England), will represent approximately 70% of the public housing stock in 2050. Thus, if UK is to achieve sustainable public housing the major effort will have to focus on the existing stock. However, interpreting the sustainability agenda for an existing housing portfolio is not a straight foreword activity. In addition to finding a ‘technical’ solution, landlords also haveto address the socio-economic issues that balance quality of expectations of tenants with the economic realities of funding social housing refurbishment. This paper will report the findings of a qualitative study (participatory approach) that examined the processes by which a large public landlord sought to develop a long-term sustainable housing strategy. Through a series of individual meetings and group workshops the research team identified: committed leadership; attitudes towards technology; social awareness; and collective understanding of the sustainability agenda as key issues that the organisation needed to address in developing a robust and defendable refurbishment strategy. The paper concludes that the challenges faced by the landlord in improving the sustainability of their existing stock are not primarily technical, but socio-economic. Further, while the economic challenges: initial capital cost; lack of funding; and pay-back periods can be overcome, if the political will exists, by fiscal measures; the social challenges: health & wellbeing; poverty; security; space needs; behaviour change; education; and trust; are much more complex in nature and will require a coordinated approach from all the stakeholders involved in the wider community if they are to be effectively addressed. The key challenge to public housing landlords is to develop mechanisms that can identify and interpret the complex nature of the social sustainability agenda in a way that reflects local aspirations (although the authors believe the factors will exist in all social housing communities, their relative importance is likely to vary between communities) whilst addressing Government agendas.

Can evidence-based healthy housing interventions be put into practice in the UK's private housing sector?

The UK’s public health agenda has encouraged enhanced housing and health interventions. The private housing sector (privately rented and owner occupied) is the favoured and majority UK tenure, but is it seen as a primarily health promoting environment, or a commercial asset? There has been a growing interest in integrating health and housing policy in recent years. However, housing and public health fall under separate government departments and funding regimes. Partnership working has sought to overcome silo working and encourage evidence-based practice, yet is particularly challenging for interventions in the private housing sector, with an increased emphasis on ‘personal responsibility’ for conditions. Strategic public health frameworks are in place, but barriers remain and there is pressure for organisations to revert to core activities. An accessible, continually updated evidence base specific to private sector housing is recommended, to help estimate health gain arising from interventions to prioritise activities and address inequalities.

Routine maintenance and sustainability of existing social housing

Improving the sustainability of the housing stock is a major challenge facing the UK social housing sector. UK social housing accounts for approximately 18% of total UK housing and generates maintenance costs in the region of 1.25 billion pounds per annum. The extent to which routine maintenance can be used as a vehicle to improve the overall sustainability (social, environmental and economic) of existing social housing is one focus of a 5 year EPSRC funded research programme. This paper reports the findings of a questionnaire survey examining current social housing maintenance practices and attitudes towards sustainability. The research found that, whilst the stock condition survey is the favoured format for determining maintenance need and economics the basis for priority setting; neither systematically addresses wider sustainability issues; and, whilst cost is a major barrier to more sustainable solutions being adopted, landlords are able and have the desire to improve their practices.

Routine maintenance and sustainability of existing social housing

Presently the UK social housing stock accounts for approximately 18% of the total UK housing with maintenance costs in the region of £1.25 billion per annum. In terms of its impact on the environment, housing is generally responsible for approximately 27% of the UK’s CO2 emissions. The extent to which routine maintenance (planned preventative and responsive) can be used as a vehicle to improve the overall sustainability (social, environmental and economic) of existing social housing is one focus of a 5 year EPSRC funded research programme. This paper reports on the findings of a series of in-depth interviews with social housing providers examining current social housing maintenance practices and attitudes towards sustainability. This paper will report the initial findings of interviews and outline a new performance based multi-criteria maintenance model from which an AHP hierarchy will be presented, integrating the principles of sustainability into maintenance strategies