37 research outputs found
NAHT Aspire Pilot Evaluation (Executive Summary)
The NAHT Aspire Partner Schools programme is based on a multi-strand approach to school improvement. It utilises a five strand design focusing on, leadership, assessment for learning, learning environment, pedagogy and curriculum, and student and family support. This is delivered within clusters groups, underpinned by distributed leadership and supported by external advisers. The model is aligned with current international research on school improvement and effectiveness. It aims to support schools to progress from a Requires Improvement Ofsted assessment to a Good grading within three years. This evaluation reports on the implementation and the impact of NAHT Aspire at just over the two-year point in the programme (six of the nine term cycles of activity). Participants believe that it has improved their school, has empowered teaching staff and built leadership capacity. In addition, it is cost effective and has provided value for money when compared with the costs of forced academisation.National Association of Head Teachers (NAHT
On acceptance conditions for membrane systems: characterisations of L and NL
In this paper we investigate the affect of various acceptance conditions on
recogniser membrane systems without dissolution. We demonstrate that two
particular acceptance conditions (one easier to program, the other easier to
prove correctness) both characterise the same complexity class, NL. We also
find that by restricting the acceptance conditions we obtain a characterisation
of L. We obtain these results by investigating the connectivity properties of
dependency graphs that model membrane system computations
Whole-Sample Mapping of Cancerous and Benign Tissue Properties
Structural and mechanical differences between cancerous and healthy tissue
give rise to variations in macroscopic properties such as visual appearance and
elastic modulus that show promise as signatures for early cancer detection.
Atomic force microscopy (AFM) has been used to measure significant differences
in stiffness between cancerous and healthy cells owing to its high force
sensitivity and spatial resolution, however due to absorption and scattering of
light, it is often challenging to accurately locate where AFM measurements have
been made on a bulk tissue sample. In this paper we describe an image
registration method that localizes AFM elastic stiffness measurements with
high-resolution images of haematoxylin and eosin (H\&E)-stained tissue to
within 1.5 microns. Color RGB images are segmented into three structure types
(lumen, cells and stroma) by a neural network classifier trained on
ground-truth pixel data obtained through k-means clustering in HSV color space.
Using the localized stiffness maps and corresponding structural information, a
whole-sample stiffness map is generated with a region matching and
interpolation algorithm that associates similar structures with measured
stiffness values. We present results showing significant differences in
stiffness between healthy and cancerous liver tissue and discuss potential
applications of this technique.Comment: Accepted at MICCAI201
Renal toxicity in patients with multiple myeloma receiving zoledronic acid vs. ibandronate: A retrospective medical records review
Aims : This retrospective study investigated the rates of renal
impairment in patients with multiple myeloma treated with zoledronic
acid and ibandronate. Materials and Methods : We retrospectively
reviewed medical records in a German oncology clinic, from May 2001 to
December 2005. Creatinine measurements were analyzed from baseline
(before zoledronic acid or ibandronate treatment) to last evaluation
for each patient. A total of 84 patients were included. Results :
Zoledronic acid increased the risk of renal impairment by approximately
3-fold compared with ibandronate (renal impairment rates: zoledronic
acid 37.7% vs. ibandronate 10.5%, relative risk [RR]=3.6, P=0.0029
serum creatinine [SCr]; 62.3% vs. 23.7%, RR=2.6, P=0.0001 glomerular
filtration rate [GFR]). Ibandronate-treated patients switched from
zoledronic acid had a significantly higher risk of renal impairment
than patients receiving ibandronate monotherapy (zoledronic acid over
ibandronate 39.1% vs. ibandronate monotherapy 6.7%, RR= 5.9, P=0.028
[SCr]; 65.2% vs 26.7%, RR=2.4, P=0.022 [GFR]). Multivariate analysis
found significantly higher hazard ratios for zoledronic acid over
ibandronate (SCr: Cox = 4.38, P=0.01; Andersen-Gill=8.22, P < 0.01;
GFR: Cox = 4.31, P < 0.01; Andersen-Gill = 3.71, P < 0.01).
Conclusions : Overall, this retrospective study suggests that multiple
myeloma patients are more likely to experience renal impairment with
zoledronic acid than with ibandronate. The risk of renal impairment
increased if patients had received prior therapy with zoledronic acid
Progranulin Gene Variability and Plasma Levels in Bipolar Disorder and Schizophrenia
Basing on the assumption that frontotemporal lobar degeneration (FTLD), schizophrenia and bipolar disorder (BPD) might share common aetiological mechanisms, we analyzed genetic variation in the FTLD risk gene progranulin (GRN) in a German population of patients with schizophrenia (n = 271) or BPD (n = 237) as compared with 574 age-, gender- and ethnicity-matched controls. Furthermore, we measured plasma progranulin levels in 26 German BPD patients as well as in 61 Italian BPD patients and 29 matched controls
Is desire for social relationships mediated by the serotonergic system in the prefrontal cortex? An [ 18
The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease
Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial
Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study
Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research