134 research outputs found
Relationship between cpDNA concentration and RMH prognostic score.
No full text<p>Scatterplot showing the relationship between cpDNA concentration and RMH prognostic score. There was a significant positive linear trend between log<sub>10</sub>(cpDNA) and RMH score (beta = 0.252, p<0.0001).</p
Making an Ancient Egyptian contraceptive: learning from experiment and experience
No full textIt is a great pleasure to dedicate this article to Professor Rosalie David as an educator who has been at the forefront of university adult education. Having single-handedly set up her innovative Certificate in Egyptology at the University of Manchester, she then ran a consistently oversubscribed course for over twenty-five years, enabling successive cohorts of locally-based adult learners to study Egyptology seriously for the first time. I was privileged to be involved as the programme’s external examiner for several years during the 1990s, and witnessed several completers subsequently publish their dissertations; I was particularly delighted to be asked to append the foreword to that by Peter Phillips (2002). It is a testament to her inspirational teaching that several of Rosalie’s students subsequently went on to make a considerable mark on our discipline – I think particularly of the late Bob Partridge in this regard. Others are still actively involved in adult education with the editing of publications such as Ancient Egypt magazine, in the running of their own, now longstanding, Egyptology societies, and as sought after lecturers at conferences both at home and abroad. It is those firm foundations laid by Professor David as an educator and the resultant reputation of the University of Manchester as a provider of Egyptology for adult learners that has enabled the current Egyptology Online distance learning courses, run by Joyce Tyldesley and Glenn Godenho from the Faculty of Life Sciences, to prove equally popular to a now global audience. This is particularly significant when we have in recent years witnessed the sad demise of adult learning provision in the United Kingdom with the amalgamation or, in most cases, the complete closure of several long-established University departments of continuing education.
The aim of this article is to describe and discuss one recent experimental learning session of my own which involved the recreation of an Ancient Egyptian contraceptive. Links to a similar prescription in the Kahun Gynaecological Papyrus mean that it stands as a further acknowledgement to Professor David’s outstanding contribution to both the study of Egyptian medicine, and to her seminal inception of the Kahun Project with its in-depth analysis by experts of the pottery, metals, and textile evidence from the site (David 1986). In my current role as a Lecturer in Education, I finally come full circle from those early days when Rosalie and I worked together on her Certificate to explore what recent educational theory has to tell us about the value of learning from experiment and experience
The First SMH-RMH Ambulance, 1926
No full textThe first Strong Memorial - Rochester Municipal Hospital ambulance is parked inside the courtyard. David Muckle, the driver, is seated behind the wheel; Ernest S. Arena, an orderly, stands beside the vehicle.Ambulances were one of the services shared by Strong Memorial Hospital and the Rochester Municipal Hospital when they opened a shared medical facility in 1925
Supplementary Figure 2B from Survival of 1,181 Patients in a Phase I Clinic: The MD Anderson Clinical Center for Targeted Therapy Experience
No full textPDF file, 90KB, Kaplan - Meier survival curves by dichotomized RMH score (n=1,169 patients for whom RMH score was available). Median survival is 12.3 months (95% CI: 11.2 - 13.8) for RMH score ≤1, and 5.5 months (95% CI: 4.8 - 6.6) for RMH score >1 (Log-rank p-value <0.0001).</p
Approaches and Solutions to Hospital Emergency Department Overcrowding Including Failure Mode and Effect Analysis as a Risk Assessment Technique of Real-time Locating System
No full textEmergency Departments (ED) are highly dynamic environments comprising complex
multi-dimensional patient-care processes. In recent decades, there has been increased
pressure to improve ED services, while taking into account various aspects such as clinical
quality, operational efficiency, and cost performance. Overcrowding has become a major
barrier to receiving a proper and timely emergency care in many acute hospitals throughout
the world. Patients often face long waiting times to be seen and treated. Those who require
admission may even wait longer. The scope of this research is to focus on ED factors that
lead to overcrowding and their management. Technology is being cited as one of the
management tools, specifically the utilization of Radio Frequency Identification (RFID) for
tracking patients as their journey progresses through an ED.
Like any technology, RFID has potential and pitfalls. The author chose to use Failure
Mode and Effect Analysis (FMEA) as a tool to explore the possible failures of RFID
technology as it is utilized in one of the ED in Riyadh Military Hospital (RMH). This
particular ED has been used as a case study to explore those failures and, with the use of
FMEA, propose a set of recommendations to address those failures and improve the design
and implementation of RFID. The experience of RMH-ED was explored through interviews
and a survey in which 100 participants took part. The survey touched upon various aspects of
this experience. This was due to the various roles of the surveyed staff who were involved
with this technology. These roles ranged from front line clinical staff to administrative staff,
management staff and technical support staff. Data analysis showed convincing evidence of
the positive impact RFID had on managing ED overcrowding. However, and as expected,
there are some pitfalls and failures that FMEA helped identifying and suggested potential
solutions to them. RFID is a small link in the chain of other technological innovations and
solutions. It is by no means capable of solving the problems associated with ED
overcrowding by itself. Most of the search carried out by the author identified large variation
in approaches to dealing with the issue of ED overcrowding. Those ranged from applying
more human resources to altering the pathways of managing patients journey through
healthcare system to applying more intermediate layers of management to ease the pressure
of the Emergency departments. Other approaches included some aspects of technology such
as development of early warning systems that have not been widely adopted and remained as
isolated efforts
Pre-clinical quantitative imaging and mouse-specific dosimetry for In-labelled radiotracers
No full textCancer Research UK and Engineering and
Physical Sciences Research Council support to the Cancer Imaging Centre at
The Institute of Cancer Research (ICR) and the Royal Marsden Hospital NHS
Foundation Trust (RMH) in association with Medical Research Council and
Department of Health C1060/A10334, C1060/A16464
Supplementary Figures 1-2 from Liquid Biopsies Using Plasma Exosomal Nucleic Acids and Plasma Cell-Free DNA Compared with Clinical Outcomes of Patients with Advanced Cancers
No full textSupplementary Fig. 1. Isolation of exosomes by spin-column purification; Supplementary Fig. 2. The median survival time of 25 patients with RMH scores of 0 or 1 (dashed blue line; 8.4 months; 95% CI, 6.0-10.8 months) was significantly longer than that of 18 patients with RMH scores of 2 or 3 (red line; 6.0 months; 95% CI, 2.3-9.7 months; P=0.017).</p
Univariate analysis of survival predictors after referral to phase 1 clinic in patients with <i>mutBRAF</i> advanced cancer.
No full text1<p>Royal Marsden Hospital (RMH) <sup>13</sup> prognostic score is determined as follows: 0 points, normal lactate dehydrogenase (LDH), albumin ≥3.5 g/dL, a ≤2 metastatic sites; 1 point- LDH>upper limit of normal, albumin <3.5 g/dL, >2 metastatic sites. Patients with 0–1 points had a good RMH score, and patients with 2–3 points had a poor RMH score.</p>2<p>Includes patients treated with other agents (N = 11) as well as patients who never started on phase 1 trial (N = 13).</p>3<p>One patient of whom the exact date of diagnosis was not documented was excluded only from the univariate analysis comparing the OSref between patients who had a time from diagnosis to metastasis less or more than 2 years.</p>4<p>Patients who never had a restaging at the last follow-up or who never started on a phase 1 trial were excluded in the univariate analysis (N = 22).</p
Validation of prognostic scoring and assessment of clinical benefit for patients with bone sarcomas enrolled in phase I clinical trials
No full textBackgroundWe sought to validate the Royal Marsden Hospital (RMH) and MD Anderson Cancer Center (MDACC) prognostic scoring systems for the selection of bone sarcoma patients for phase I clinical trials and to identify additional risk factors related to survival.Patients and methodsWe retrospectively reviewed the baseline characteristics and outcomes of 92 bone sarcoma patients who were referred to MDACC's Phase I Clinical Trials Program.ResultsNinety-two patients with Ewing sarcoma (N = 47), osteosarcoma (N = 22), chondrosarcoma (N = 16), and other tumors (N = 7) were evaluated; 78 were enrolled in at least 1 of 43 different phase I trials. The median overall survival (OS) was 8.8 months (95% confidence interval [CI] = 6.8-13.7 months). Independent factors that predicted shorter survival were male sex, >2 metastatic sites, >3 previous therapies, hemoglobin level <10.5 g/dL, platelet count >200 x103/L, creatinine level ≥1.3 mg/dL, and lactate dehydrogenase level >ULN. Patients with good RMH scores (0-1) had longer OS than patients with poor RMH scores (2-3) (HR = 5.8, 95% CI = 2.9-11.0; P < 0.0001), as did patients with low MDACC scores (0-1) as compared to patients with higher MDACC scores (2-4) (HR = 3.2, 95% CI = 1.9-5.6; P < 0.0001).ConclusionThe RMH prognostic score can be used to predict the OS of bone cancer patients referred for phase I trials. The MDACC score added no value to the RMH score and therefore does not have a role in assessment of patients with bone tumors. Patients with advanced bone sarcomas should be considered for phase I trials
Consensus guidelines and contouring atlas for pelvic node delineation in prostate and pelvic node intensity modulated radiation therapy
No full textPurpose
The purpose of this study was to establish reproducible guidelines for delineating the clinical target volume (CTV) of the pelvic lymph nodes (LN) by combining the freehand Royal Marsden Hospital (RMH) and Radiation Therapy Oncology Group (RTOG) vascular expansion techniques.
Methods and Materials
Seven patients with prostate cancer underwent standard planning computed tomography scanning. Four different CTVs (RMH, RTOG, modified RTOG, and Prostate and pelvIs Versus prOsTate Alone treatment for Locally advanced prostate cancer [PIVOTAL] trial) were created for each patient, and 6 different bowel expansion margins (BEM) were created to assess bowel avoidance by the CTV. The resulting CTVs were compared visually and by using Jaccard conformity indices. The volume of overlap between bowel and planning target volume (PTV) was measured to aid selection of an appropriate BEM to enable maximal LN yet minimal normal tissue coverage.
Results
In total, 84 nodal contours were evaluated. LN coverage was similar in all groups, with all of the vascular-expansion techniques (RTOG, modified RTOG, and PIVOTAL), resulting in larger CTVs than that of the RMH technique (mean volumes: 287.3 cm3, 326.7 cm3, 310.3 cm3, and 256.7 cm3, respectively). Mean volumes of bowel within the modified RTOG PTV were 19.5 cm3 (with 0 mm BEM), 17.4 cm3 (1-mm BEM), 10.8 cm3 (2-mm BEM), 6.9 cm3 (3-mm BEM), 5.0 cm3 (4-mm BEM), and 1.4 cm3 (5-mm BEM) in comparison with an overlap of 9.2 cm3 seen using the RMH technique. Evaluation of conformity between LN-CTVs from each technique revealed similar volumes and coverage.
Conclusions
Vascular expansion techniques result in larger LN-CTVs than the freehand RMH technique. Because the RMH technique is supported by phase 1 and 2 trial safety data, we proposed modifications to the RTOG technique, including the addition of a 3-mm BEM, which resulted in LN-CTV coverage similar to that of the RMH technique, with reduction in bowel and planning target volume overlap. On the basis of these findings, recommended guidelines including a detailed pelvic LN contouring atlas have been produced and implemented in the PIVOTAL trial.
The PIVOTAL trial was funded by Cancer Research United Kingdom(CRUK) 10/022, C5907/A11880, and C1491/A9895 and supported by National Institute for Health Research (NIHR) Clinical Research Network at participating sites. PIVOTAL was coordinated by CRUK-funded Clinical Trials and Statistics Unit, Institute of Cancer Research. We acknowledge NHS funding to the NIHR Biomedical Research Centre at the Royal Marsden NHS Foundation Trust and Institute of Cancer Research.
Conflict of interest: none
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