Anaplastic large cell lymphoma Hodgkin's-like: a randomized trial of ABVD versus MACOP-B with and without radiation therapy

During the last few years, morphological, immunohistochemical, and genetic findings have placed anaplastic large cell lymphoma (ALCL) as a distinct clinicopathologic entity, and several reports have focused on the existence of different subtypes of the tumor. Particular attention has been paid to the ALCL-Hodgkin's-like (HL) subtype, which seems to be on the border between Hodgkin's disease (HD) and high-grade non-Hodgkin's lymphoma (HG-NHL). From September 1994 to July 1997, during the course of an Italian multicentric trial, 40 ALCL-HLs were randomized to receive as front-line chemotherapy MACOP-B (methotrexate with leucovorin, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin-a third-generation HG-NHL regimen) or ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine-a scheme specific for HD). All patients with bulky disease in the mediastinum at diagnosis underwent local radiotherapy after the chemotherapeutic program. Complete response (CR) was achieved in 17 of the 19 (90%) patients who were treated with MACOP-B, and in 19 of the 21 (91%) patients who were administered ABVD. The probability of relapse-free survival, projected at 32 months, was 94% for the MACOP-B subset and 91% for the ABVD subset. The majority of patients with mediastinal bulky disease obtained CR (evaluated with 67Ga single photon emission computed tomography [SPECT]) after their radiotherapy. The present study suggests that ALCL-HL, in line with its borderline status, responds in an equivalent way to third-generation chemotherapy for HG-NHL and to conventional HD treatment in terms of both CR and relapse-free survival rates. However, as to the latter, a longer follow-up period may be needed before stating the absolute equivalence of the two regimens used.     

Urinary stress incontinence. Comparison of the Raz technique and the Bologna technique. Analysis of a series of 188 patients

OBJECTIVE: Our purpose was to evaluate and compare the perioperative morbidity and the long-term results of the Raz colposuspension and the Bologna operation for the treatment of stress urinary incontinence in women. STUDY DESIGN: Data of 188 women who underwent either a Bologna operation (group 1) or a Raz colposuspension (group 2) for the treatment of stress urinary incontinence between January 1, 1987 and December 1, 1995 were analysed retrospectively regarding history, preoperative evaluation, associated surgical procedures, complications and cure and failure rate. POPULATION AND METHODS: 80 patients were treated with the Bologna operation and 108 with the Raz colposuspension. Patients with prior anti-incontinence surgery, and patients with a preoperative diagnosis of urge incontinence were excluded from the study. Success was defined both subjectively (complete absence of complaint of stress urinary incontinence) and objectively (no evidence of loss of urine on cough provocation during physical examination). Survival curves were generated in each group for time to event data: "time to recurrent stress incontinence" and compared by the logrank test. A multivariate analysis using a Cox proportional hazards regression model was performed to indentify possible outcome predictors. RESULTS: The success rate of group 1 was significantly higher than that of group 2 (p = 0.00001). The median of success was 51 months in group 1 and 21 months in group 2 (p = 0.00001). The incidence of intraoperative complications in each group (inadvertent cystostomy, hemorrhage) did not differ. The multivariate analyses using the Cox regression model showed that the most highly correlated variable with the surgical cure rate was the type of surgical anti-incontinence procedure adopted: Bologna or Raz (p = 0.00001) CONCLUSION: In our hands, the Bologna operation has a higher cure rate than the Raz colposuspension. For us, when treating patients with stress urinary incontinence by the vaginal route, the Bologna operation is indicated when sufficient anterior vaginal tissue is available to create vaginal bands.     

The Cartwright Report ten years on: the obligations and rights of health consumers and providers

It is ten years since the Cartwright report was published, three years since the code of health and disability services consumers' rights was promulgated and two years since the code came into force which makes it due for review next year. This paper reviews the issues identified by Cartwright and the effect that her investigation into the "Unfortunate Experiment" has had on the provision of health services. Issues of clinical freedom, peer supervision and informed consent are discussed in relation to the Health and Disability Commissioner Act, the Privacy Act and concepts of partnership in health care. Some comments on the present state of the relationships between consumers and providers in the health system are included.     

Properties of whole saliva and dental plaque in relation to 40-month consumption of chewing gums containing xylitol, sorbitol of sucrose

The concern with nursing research in the future work of nurse graduates. Expectations from the viewpoint of the nurse researcher. Keeping in mind the concerns which occupy nurse researchers now and in the future, expectations are raised of the graduates of degree programmes in nursing science which are now also being established in the Federal Republic of Germany. This takes into account the structurally determined areas of self determined action in new fields of professional practice. Nurse graduates will be seen as "change agents" in their future areas of work and will have three essential aspects of involvement with nursing research: 1. they themselves will conduct research 2. they will receive, put into practice and transmit results of nursing research 3. they will initiate and commission nursing research projects. According to the broad topics of nursing research, requirements for nurses to act as professionals in their new working fields are formulated referring to the given structural conditions in Germany.     

Event-triggered sliding mode control for a class of nonlinear systems

ABSTRACT

Event-triggering strategy is one of the real-time control implementation techniques which aims at achieving minimum resource utilisation while ensuring the satisfactory performance of the closed-loop system. In this paper, we address the problem of robust stabilisation for a class of nonlinear systems subject to external disturbances using sliding mode control (SMC) by event-triggering scheme. An event-triggering scheme is developed for SMC to ensure the sliding trajectory remains confined in the vicinity of sliding manifold. The event-triggered SMC brings the sliding mode in the system and thus the steady-state trajectories of the system also remain bounded within a predesigned region in the presence of disturbances. The design of event parameters is also given considering the practical constraints on control execution. We show that the next triggering instant is larger than its immediate past triggering instant by a given positive constant. The analysis is also presented with taking delay into account in the control updates. An upper bound for delay is calculated to ensure stability of the system. It is shown that with delay steady-state bound of the system is increased than that of the case without delay. However, the system trajectories remain bounded in the case of delay, so stability is ensured. The performance of this event-triggered SMC is demonstrated through a numerical simulation.     

Circular polarized dual‐band antenna for WLAN/Wi‐MAX application

A novel square ring printed antenna has been suggested for dual‐band circular polarization (CP). The geometry contains a square patch and a square ring structure for dual‐band operation. Circular polarization is achieved using triangular cut at the boundary and right angle bend with inner perturbation. The suggested antenna is excited from the lower layer through electromagnetic (EM) coupling technique. The antenna shows good impedance bandwidths of 90 MHz (2.43‐2.52 GHz) and 800 MHz (5.7‐6.5 GHz, respectively. The antenna shows 3 dB axial ratio bandwidth of 20 MHz at lower band and 120 MHz at upper band with improved gain > 6 dBi. The simulated and measured results are well agreed with each other. The antenna is promising wideband operation at the upper band. This antenna was implemented on fiberglass reinforcement laminated Arlon substrate with dielectric constant (?_r = 2.55), and the overall physical dimension of 30 × 30 × 3.048 mm³. The designed antenna can be extensibly applicable in WLAN/Wi‐MAX communication. The presented antenna is designed using hyperlynx IE3D and the simulated results are presented.     

Experimental realization of quantum cheque using a five-qubit quantum computer

Quantum cheques could be a forgery-free way to make transaction in a quantum networked banking system with perfect security against any no-signalling adversary. Here, we demonstrate the implementation of quantum cheque, proposed by Moulick and Panigrahi (Quantum Inf Process 15:2475–2486, 2016), using the five-qubit IBM quantum computer. Appropriate single qubit, CNOT and Fredkin gates are used in an optimized configuration. The accuracy of implementation is checked and verified through quantum state tomography by comparing results from the theoretical and experimental density matrices.     

Query based model learning and stable tracking of a robot arm using radial basis function network

In the context of a robot manipulator, a generalized neural emulator over the complete workspace is very difficult to obtain because of dimensionally insufficient training data. A query based learning algorithm is proposed in this paper that can generate new examples where control inputs are independent of states of the system. This algorithm is centered around the concept of network inversion using an extended Kalman filtering based algorithm. This is a novel idea since robot manipulator is an open loop unstable system and generation of control input independent of state is a research issue for neural model identification. Two trajectory independent stable control schemes have been designed using the neural emulator. One of the control schemes uses forward-inverse-modeling approach to update the controller parameters adaptively following Lyapunov function synthesis technique. The proposed scheme is trajectory independent unlike the back-propagation scheme. The second type of controller predicts the minimum variance estimate of control action using recall process (network inversion) and the control law is derived following a Lyapunov function synthesis approach so that the closed loop system consisting of controller and neural emulator remains stable. The simulation experiments show that the model validation approach is efficient and the proposed control schemes guarantee stable accurate tracking.     

Studies of dielectric and electrical properties of a new type of complex tungsten bronze electroceramics

A polycrystalline ceramic with a new type of complex tungsten-bronze type structure, having a general formula K₂Ba₂Nd₂Ti₄Nb₄W₂O₃₀ has been prepared using a high temperature solid-state reaction route after optimizing the calcinations conditions on the basis of thermal analysis results. The material has been characterized by different experimental techniques. The formation of the compound has been confirmed using X-ray diffraction analysis. Dielectric properties (ε_r and tanδ) of the compound as a function of temperature at different frequencies have been carried out. Temperature dependence of dielectric constant indicates the presence of ferroelectric phase transition well above the room temperature. Complex impedance spectroscopic analysis has been carried out as a function of frequency at different temperatures to establish some correlation between the microstructure and electrical properties of the material. The nature of frequency dependence of ac conductivity obeys the Jonscher’s power law. The dc conductivity calculated from the ac conductivity spectrum shows the negative temperature coefficient of resistance behavior like a semiconductor.     

Efficient financial time series prediction with evolutionary virtual data position exploration

Prediction of stock index remains a challenging task of the financial time series prediction process. Random fluctuations in the stock index make it difficult to predict. Usually the time series prediction is based on the observations of past trend over a period of time. In general, the curve the time series data follows has a linear part and a non-linear part. Prediction of the linear part with past history is not a difficult task, but the prediction of non linear segments is difficult. Though different non-linear prediction models are in use, but their prediction accuracy does not improve beyond a certain level. It is observed that close enough data positions are more informative where as far away data positions mislead prediction of such non linear segments. Apart from the existing data positions, exploration of few more close enough data positions enhance the prediction accuracy of the non-linear segments significantly. In this study, an evolutionary virtual data position (EVDP) exploration method for financial time series is proposed. It uses multilayer perceptron and genetic algorithm to build this model. Performance of the proposed model is compared with three deterministic methods such as linear, Lagrange and Taylor interpolation as well as two stochastic methods such as Uniform and Gaussian method. Ten different stock indices from across the globe are used for this experiment and it is observed that in majority of the cases performance of the proposed EVDP exploration method is better. Some stylized facts exhibited by the financial time series are also documented.