Clinical and testing protocols for the analysis of epidermal growth factor receptor mutations in East Asian patients with non-small cell lung cancer:a combined clinical-molecular pathological approach

Several randomized phase III studies in advanced stage non-small cell lung cancer (NSCLC) confirmed the superior response rate and progression-free survival of using epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor as first-line therapy compared with chemotherapy in patients with activating EGFR mutations. Despite the need for EGFR mutation tests to guide first-line therapy in East Asian NSCLC, there are no current standard clinical and testing protocols.

Dual-colour HER2/chromosome 17 chromogenic in situ hybridisation assay enables accurate assessment of HER2 genomic status in gastric cancer and has potential utility in HER2 testing of biopsy samples

Determination of HER2 protein expression by immunohistochemistry (IHC) and genomic status by fluorescent in situ hybridisation (FISH) are important in identifying a subset of high HER2-expressing gastric cancers that might respond to trastuzumab. Although FISH is considered the standard for determination of HER2 genomic status, brightfield ISH is being increasingly recognised as a viable alternative. Also, the impact of HER2 protein expression/genomic heterogeneity on the accuracy of HER2 testing has not been well studied in the context of gastric biopsy samples.

Design and testing of transonic linear cascade tunnel with optimized slotted walls

In linear cascade wind tunnel tests, a high level of pitchwise periodicity is desirable to reproduce the azimuthal periodicity in the stage of an axial compressor or turbine. Transonic tests in a cascade wind tunnel with open jet boundaries have been shown to suffer from spurious waves, reflected at the jet boundary, that compromise the flow periodicity in pitch. This problem can be tackled by placing at this boundary a slotted tailboard with a specific wall void ratio s and pitch angle a. The optimal value of the s-a pair depends on the test section geometry and on the tunnel running conditions. An inviscid two-dimensional numerical method has been developed to predict transonic linear cascade flows, with and without a tailboard, and quantify the nonperiodicity in the discharge. This method includes a new computational boundary condition to model the effects of the tailboard slots on the cascade interior flow. This method has been applied to a six-blade turbine nozzle cascade, transonically tested at the University of Leicester. The numerical results identified a specific slotted tailboard geometry, able to minimize the spurious reflected waves and regain some pitchwise flow periodicity. The wind tunnel open jet test section was redesigned accordingly. Pressure measurements at the cascade outlet and synchronous spark schlieren visualization of the test section, with and without the optimized slotted tailboard, have confirmed the gain in pitchwise periodicity predicted by the numerical model. Copyright © 2006 by ASME.

Testing the efficacy of the glacial buzzsaw: insights from the Sredinny Mountains, Kamchatka

Peak altitudes, hypsometry, geology, and former equilibrium-line altitudes (ELAs) are analyzed across the Sredinny Mountains (Kamchatka). Overall, evidence is found to suggest that the glacial buzzsaw has operated to shape the topography of this mountain range, but the strength of this signature is not spatially uniform. In the southern sector of the mountains, we see evidence that an efficient glacial buzzsaw has acted to impose constraints upon topography, limiting peak altitudes, and concentrating land-surface area (hypsometric maxima) close to palaeo-ELAs. By contrast, in the northern sector of the mountains, a number of peaks rise high above the surrounding topography, and land-surface area is concentrated well below palaeo-ELAs. This deviation from a classic ‘buzzsaw signature’, in the northern sector of the mountains, is considered to reflect volcanic construction during the Quaternary, resulting in a series of high altitude peaks, combined with the action of dynamic glaciers, acting to skew basin topography toward low altitudes, well below palaeo-ELAs. These glaciers are considered to have been particularly dynamic because of their off-shore termination, their proximity to moisture-bearing air masses from the North Pacific, and because accumulation was supplemented by snow and ice avalanching from local high altitude peaks. Overall, the data suggest that the buzzsaw remains a valid mechanism to generally explain landscape evolution in mountain regions, but its signature is significantly weakened in mountain basins that experience both volcanic construction and climatic conditions favouring dynamic glaciation.

Impact of Testing Procedure on Permeability of Compacted Soils

The commonly used British Standard constant head triaxial permeability (BS) test, for permeability testing of fine grained soils, is known to have a relatively long test duration. Consequently, a reduction in the required time for permeability test provides potential cost savings, to the construction industry (specifically, for use during Construction Quality Control (CQA) of landfill mineral liners). The purpose of this article is to investigate and evaluate alternative short duration testing methods for the measurement of the permeability of fine grained soils.

As part of the investigation the feasibility of an existing method of short duration permeability test, known as the Accelerated Permeability (AP) test was assessed and compared with permeability measured using British Standard method (BS) and Ramp Accelerated Permeability (RAP). Four different fine grained materials, of a variety of physical properties were compacted at various moisture contents to produced analogous samples for testing using three the three different methodologies. Fabric analysis was carried out on specimens derived from post-test samples using Mercury Intrusion Porosimetry (MIP) and Scanning Electron Microscope (SEM) to assess the effects of testing methodology on soil structure. Results showed that AP testing in general under predicts permeability values derived from the BS test due to large changes in structure of the soil caused by AP test methodology, which is also validated using MIP and SEM observations. RAP testing, in general provides an improvement to the AP test but still under-predicts permeability values. The potential savings in test duration are shown to be relatively minimal for both the AP and RAP tests.

Advancing impact prediction and hypothesis testing in invasion ecology using a comparative functional response approach

Invasion ecology urgently requires predictive methodologies that can forecast the ecological impacts of existing, emerging and potential invasive species. We argue that many ecologically damaging invaders are characterised by their more efficient use of resources. Consequently, comparison of the classical ‘functional response’ (relationship between resource use and availability) between invasive and trophically analogous native species may allow prediction of invader ecological impact. We review the utility of species trait comparisons and the history and context of the use of functional responses in invasion ecology, then present our framework for the use of comparative functional responses. We show that functional response analyses, by describing the resource use of species over a range of resource availabilities, avoids many pitfalls of ‘snapshot’ assessments of resource use. Our framework demonstrates how comparisons of invader and native functional responses, within and between Type II and III functional responses, allow testing of the likely population-level outcomes of invasions for affected species. Furthermore, we describe how recent studies support the predictive capacity of this method; for example, the invasive ‘bloody red shrimp’ Hemimysis anomala shows higher Type II functional responses than native mysids and this corroborates, and could have predicted, actual invader impacts in the field. The comparative functional response method can also be used to examine differences in the impact of two or more invaders, two or more populations of the same invader, and the abiotic (e.g. temperature) and biotic (e.g. parasitism) context-dependencies of invader impacts. Our framework may also address the previous lack of rigour in testing major hypotheses in invasion ecology, such as the ‘enemy release’ and ‘biotic resistance’ hypotheses, as our approach explicitly considers demographic consequences for impacted resources, such as native and invasive prey species. We also identify potential challenges in the application of comparative functional responses in invasion ecology. These include incorporation of numerical responses, multiple predator effects and trait-mediated indirect interactions, replacement versus non-replacement study designs and the inclusion of functional responses in risk assessment frameworks. In future, the generation of sufficient case studies for a meta-analysis could test the overall hypothesis that comparative functional responses can indeed predict invasive species impacts.

Testing genuine multipartite nonlocality in phase spacea

We demonstrate genuine three-mode nonlocality based on phase-space formalism. A Svetlichny-type Bell inequality is formulated in terms of the s-parametrized quasiprobability function. We test such a tool using exemplary forms of three-mode entangled states, identifying the ideal measurement settings required for each state. We thus verify the presence of genuine three-mode nonlocality that cannot be reproduced by local or nonlocal hidden variable models between any two out of three modes. In our results, GHZ- and W-type nonlocality can be fully discriminated. We also study the behavior of genuine tripartite nonlocality under the effects of detection inefficiency and dissipation induced by local thermal environments. Our formalism can be useful to test the sharing of genuine multipartite quantum correlations among the elements of some interesting physical settings, including arrays of trapped ions and intracavity ultracold atoms. DOI: 10.1103/PhysRevA.87.022123

Testing a model for developing, implementing and evaluating a strategy to improve the quality of nursing and midwifery care in an acute hospital trust.

Abstract:
Background: Health care organisations
worldwide are faced with the need to develop
and implement strategic organisational plans
to meet the challenges of modern health care.
There is a need for models for developing, implementing and evaluating strategic plans that engage practitioners, and make a measurable difference to the patients that they serve. These presentations describe the development, implementation and evaluation of such a model by a team of senior nurses and practice developers, to underpin a strategy for nursing and midwifery in an acute hospital trust. Developing a Strategy The PARIHS (Promoting Action on Research Implementation in Health Services) conceptual framework (Kitson et al, 1998) proposes that successful implementation of change in practice is a function of the interplay of three core elements: the level of evidence supporting the proposed change; the context or environment in which the change takes place, and the way in which change is facilitated. We chose to draw on this framework to develop our strategy and implementation plan (O’Halloran, Martin and Connolly, 2005). At the centre of the plan are ward managers. These professionals provide leadership for the majority of staff in the trust and so were seen to be a key group in the implementation process.

Physician recommendation for invasive prenatal testing: the case of the 'precious baby'

Do clinicians manage pregnancies conceived by assisted reproductive technologies (ART) differently from spontaneous pregnancies?

Clinicians decisions about prenatal testing during pregnancy depend, at least partially, on the method of conception.

Research thus far has shown that patients decisions regarding prenatal screening are different in ART pregnancies compared with spontaneous ones, such that ART pregnancies may be considered more valuable or precious than pregnancies conceived without treatment.

In this cross-sectional study, preformed during the year 2011, 163 obstetricians and gynecologists in Israel completed an anonymous online questionnaire.

Clinicians were randomly assigned to read one of two versions of a vignette describing the case of a pregnant woman. The two versions differed only with regard to the method of conception (ART; n 78 versus spontaneous; n 85). Clinicians were asked to provide their recommendations regarding amniocentesis.

The response rate among all clinicians invited to complete the questionnaire was 16.7. Of the 85 clinicians presented with the spontaneous pregnancy scenario, 37 (43.5) recommended amniocentesis. In contrast, of the 78 clinicians presented with the ART pregnancy scenario, only 15 (19.2) recommended the test. Clinicians were 3.2 (95 confidence interval [CI]: 1.66.6) times more likely to recommend amniocentesis for a spontaneous pregnancy than for an ART pregnancy.

The study is limited by a low response rate, the relatively small sample and the hypothetical nature of the decision, as clinician recommendations may have differed in an actual clinical setting.

Our findings show that fertility history and use of ART may affect clinicians recommendations regarding amniocentesis following receipt of screening test results. This raises the question of how subjective factors influence clinicians decisions regarding other aspects of pregnancy management.

There was no funding source to this study. The authors declare no conflicts of interest.