Determination of the axial-vector weak coupling constant with ultracold neutrons

A precise measurement of the neutron decay β asymmetry A₀ has been carried out using polarized ultracold neutrons from the pulsed spallation ultracold neutron source at the Los Alamos Neutron Science Center. Combining data obtained in 2008 and 2009, we report A₀ = -0.119 66±0.000 89{-0.001 40}{+0.001 23}, from which we determine the ratio of the axial-vector to vector weak coupling of the nucleon g{A}/g{V}=-1.275 90{-0.004 45}{+0.004 09}.

What is the ideal pre-hospital analgesic?--a questionnaire study

AIM

To determine clinical opinion of effectiveness of current battlefield analgesia and the realistic options to improve future analgesia in hostile environments.

METHODS

Structured electronic questionnaire distributed to selected individuals in UK and on operations.

POPULATION

122 UK Defence Medical Services and US Medical Corps doctors, nurses and combat medical technicians involved in the early management of severe trauma on deployment.

RESULTS

54 (44%) agreed and 63 (52%) disagreed that intramuscular morphine had the ideal analgesic properties for the military pre-hospital environment. Over half of those with operational experience reported multiple instances of intramuscular morphine providing inadequate analgesia. 86 (70%) desired a more potent analgesic than morphine in the first hour following injury. 101 (83%) identified simplicity and reliability of use by a soldier as of high importance. 99 (81%) identified rapid onset of action of high importance. With regard to an acceptable route of drug self-administration, 88 (72%) supported a nasal spray; 78 (64%) supported a sustained release buccal tablet (adhesive to the gum); 61 (50%) supported a disposable inhaler of volatile gas (although 91% had no experience of the currently available drug in this formulation); and 55 (45%) supported a skin patch.

CONCLUSION

Intramuscular morphine does not meet the needs of the majority of clinical stakeholders. Alternative routes of self-administration are acceptable, but support for available commercial solutions is clouded by incomplete awareness. Anaesthetists and emergency physicians desire a multimodal approach to battlefield analgesia within the evacuation chain.

Gene expression profiling and copy number analysis to identify predictive molecular markers in breast cancer: Successful use of formalin fixed paraffin embedded tissue (FFPE)

574

Background: FFPE is a valuable and widely available resource for translational research which to date has been under-used due to technical limitations. Improvement in technology has enabled genome-wide analysis of FFPE samples. We have assessed gene expression and copy number changes in the same cohort of breast cancers to identify markers or pathways important in prediction of treatment response. Methods: FFPE tissues from patients treated with neoadjuvant adriamycin/cyclophosphamide followed by taxanes in a clinical study were used. Gene expression profiling was assessed using the cDNA mediated annealing selection and ligation assay using the cancer panel which assess 502 genes (DASL assay, Illumina). Data was analysed using BeadStudio software. Copy number changes were assessed using the Molecular inversion probe assay with the 50K SNP panel (Affymetrix, California) and analysed using Nexus software (Biodiscovery). Results: Gene expression profiling was carried out on 44 samples. 12/44 (27%) patients had a pathological complete response (pCR) following chemotherapy. Significant differential expression of genes between pCR and non-pCR cancers were shown. TNFRSF5, CTSD, BCL3, ARNT, BIRC3, TGFBR1, MLLT6, and EVI2A were over-expressed and COL18A1, FGF12, IGFBP1 and NOTCH4 which were down-regulated in cancers that have a pCR (p ≤ 0.01). Copy number changes were assessed in 33 samples and comparison of copy number changes in pCR vs. non-pCR showed gains in regions 6q22, 21q21, 4p14, 4q21, 4p14, and loss at 11q11 (p ≤ 0.01). Three regions containing microRNA coding sequences, mir130a (11q11) mir142 (17q23) and mir21 (17q23) showed significant loss among pCR tumours (p < 0.05). Conclusions: This feasibility study shows that FFPE can be used for gene expression and copy number analysis which is a useful tool for the discovery of predictive markers for treatment response in neoadjuvant treatment trials. The role of TNFRSF5, microRNA 21/130a/142, and 11q11 loss should be further investigated as predictive markers of response to chemotherapy.

[Table: see text]

Anaesthesia for caesarean delivery in a parturient following a recent cerebrovascular event

Ischaemic cerebrovascular events in pregnancy are uncommon. The anaesthetic management of a pregnant patient within six weeks of an ischaemic cerebrovascular event has not previously been reported. Issues raised include consent and minimising further neurological insult. Changes in regional blood flow, cerebral metabolic rate and integrity of the blood brain barrier must be considered although evidence to support regional in preference to general anaesthesia is lacking. We report the case of a woman with known systemic lupus erythematosis and antiphospholipid syndrome who developed idiopathic thrombocytopenic purpura in pregnancy and suffered a thrombotic cerebral vascular accident at 32 weeks of gestation. Ten days later she required urgent caesarean delivery, which was performed under general anaesthesia. There was no deterioration in neurological function following surgery and eight days postoperatively she was transferred to a neuro-rehabilitation centre for further care. The idiopathic thrombocytopenic purpura did not respond to medical therapy following delivery and a second anaesthetic was required for splenectomy four weeks later.

BASH: a tool for managing BeadArray spatial artefacts

SUMMARY

With their many replicates and their random layouts, Illumina BeadArrays provide greater scope fordetecting spatial artefacts than do other microarray technologies. They are also robust to artefact exclusion, yet there is a lack of tools that can perform these tasks for Illumina. We present BASH, a tool for this purpose. BASH adopts the concepts of Harshlight, but implements them in a manner that utilizes the unique characteristics of the Illumina technology. Using bead-level data, spatial artefacts of various kinds can thus be identified and excluded from further analyses.

AVAILABILITY

The beadarray Bioconductor package (version 1.10 onwards), www.bioconductor.org

The operational emergency department attendance register (OPEDAR): a new epidemiological tool

AIM

To determine the number, status and nature of emergency department attendances to deployed field hospitals.

POPULATION

All attendances to the emergency department (ED) of deployed field hospitals in support of Operation TELIC (Iraq) from initial entry war fighting to enduring operations.

METHODS

Analysis of hand written and electronic registers ED attendance registers and validation with four other data sources.

RESULTS

Validation of data held on OpEDAR against 4 other data sources shows that OpEDAR is accurate, but that accuracy can be further improved. 26,746 ED attendances recorded on OP TELIC from 19 March 2003 to 11 November 2006. 21,112 (78.9%) were UK military. Overall, 43.5% were admitted from ED. Attendances peaked during TELIC phases 2 (422.9 per 1,000 troops deployed), but have settled to around 200 per 1,000 troops deployed in the more recent phases. Ophthalmology rates peaked in TELIC 2 to 20.72 per 1,000 and have since reduced to a consistent 10 to 15 per 1,000. This suggests that preventative measures introduced for eye injury are incompletely effective or incompletely utilised.

CONCLUSIONS

OpEDAR is a clinical tool to inform manning, equipment and training requirements for enduring and new operations, focused on the requirements of the emergency department. Multivariate quality control models applied in industry could be applied to OpEDAR to produce a dynamic epidemiological tool that identifies emerging case clusters and facilitates deployed commanders to take preventative action.