The Building Blocks of Battery Technology: Using Modified Tower Block Game Sets to Explain and Aid the Understanding of Rechargeable Li-Ion Batteries.

While Li-ion batteries are abundant in everyday life from smart phones to electric vehicles, there are a lack of educational resources that can explain their operation, particularly their rechargeable nature. It is also important that any such resource can be understood by a wide range of age groups and backgrounds. To this end, we describe how modified tower block games sets, such as Jenga, can be used to explain the operation of Li-ion batteries. The sets can also be utilized to explain more advanced topics such as battery degradation and challenges with charging these batteries at high rates. In order to make the resource more inclusive, we also illustrate modifications to prepare tactile tower block sets, so that the activity is also suitable for blind and partially sighted students. Feedback from a range of groups supports the conclusion that the tower block sets are a useful tool to explain Li-ion battery concepts.

Cost-effectiveness of onabotulinumtoxinA for the treatment of wrist and hand disability due to upper-limb post-stroke spasticity in Scotland.

BACKGROUND AND PURPOSE: The objective was to evaluate the cost-effectiveness of treating upper-limb post-stroke spasticity (ULPSS) with usual care (UC) plus onabotulinumtoxinA versus UC alone in Scotland. METHODS: We developed a model to simulate costs and quality-adjusted life years (QALYs) gained from treating ULPSS. Efficacy data and health utilities were taken from clinical trials. Unit costs were taken from published Scottish sources. We compared UC plus onabotulinumtoxinA and UC alone in three scenarios: (i) a scenario from the National Health Service perspective, which included differences in onabotulinumtoxinA use, specialist visits and day-hospital visits; (ii) a scenario that only included differences in onabotulinumtoxinA use and specialist visits; and (iii) a scenario from a societal perspective that included differences in onabotulinumtoxinA use, specialist visits and caregiver burden. RESULTS: In the first scenario, the model predicted that UC plus onabotulinumtoxinA produced 0.107 QALYs at an additional cost of £1099 compared with UC alone over 5 years, resulting in an incremental cost-effectiveness ratio (ICER) of £10,271/QALY. In the second scenario, the ICER increased to £27,134/QALY. In the third scenario (societal perspective), UC plus onabotulinumtoxinA produced lower total cost and higher QALYs, and therefore was superior to UC alone. CONCLUSIONS: Based on a model, UC plus onabotulinumtoxinA improved disability, which translated into greater QALYs but also increased direct medical costs compared with UC alone; however, the resulting ICER can be considered cost-effective. Moreover, UC plus onabotulinumtoxinA can be cost-saving if reduction in caregiver burden was included. OnabotulinumtoxinA offers value for money in the management of ULPSS in Scotland.

The ethical responsibility of the hospital to the environment.

The ethical responsibility of the hospital to the environment is a relatively new concept. It is complex and ever changing as the whole field of medicine continues to evolve. The recent dilemmas of medical waste washing up on beaches and waste-laden barges not finding an accepting port should convince us that this issue is becoming more serious. Responsible change in this area calls for creative and imaginative leadership. It is a terrible contradiction when an institution committed to the health and wholeness of those whom it serves is not also committed to the health and wholeness of the environment.

A short N-proximal region of prochymosin inhibits the secretion of hybrid proteins from Escherichia coli.

A gene encoding bovine prochymosin (PC) was fused to the coding sequence (phoA) for the Escherichia coli alkaline phosphatase (AP) signal peptide and expressed in E. coli under the control of the phoA promoter. Upon induction, an AP-PC fusion protein was produced which was neither processed nor exported into the periplasm. We investigated this lack of secretion by constructing a series of gene fusions in which different regions of the PC gene were inserted between the coding regions of the AP leader and mature protein. Analysis of the cellular location of the proteins encoded by these fusions revealed that a region of PC (between amino acids 6 and 29) prevented processing and secretion of an AP-PC fusion when inserted near to the AP signal peptide. In contrast, when this 'blocking sequence' was inserted elsewhere in AP the hybrid proteins were efficiently processed and translocation was initiated.

Endocrine therapy for advanced carcinoma of the breast: effect of tumor heterogeneity and site of biopsy on the predictive value of progesterone receptor estimations.

This study was carried out to assess the influence of site of biopsy and tumor heterogeneity upon the value of progesterone receptor (PR) measurements for prediction of response of patients with advanced carcinoma of the breast to tamoxifen or ovarian ablation. One hundred eighty-one assessable patients were studied. Sixty-nine % of responders and 31% of nonresponders were PR positive. The times to progression and survival were not significantly different for responders whether they were receptor positive or receptor negative. PR was measured on operable primary tumors (97), inoperable primary tumors (59), and secondary deposits (69). The proportion of responders who had PR-positive biopsies from these sites was 59%, 88%, and 61%, respectively, and the proportion of PR-positive nonresponders was 30%, 27%, and 42%, respectively. Ten to 12 separate PR measurements were made on seven tumors, and in four of them, there were PR-positive and PR-negative areas which could account for false positive and false negative results. We conclude that the optimum prediction of response was seen when the biopsy was performed on inoperable primary tumors. Errors in prediction of response at this site were, in part, explained by within-tumor heterogeneity of PR; the greater errors in prediction when measurements were made on operable primary tumors or on secondary deposits are presumed to be related to the additional effects of change in receptor status with time and between-tumor-site heterogeneity, respectively.

Endocrine therapy for advanced carcinoma of the breast: relationship between the effect of tamoxifen upon concentrations of progesterone receptor and subsequent response to treatment.

In some cell lines and tumors of mammary origin, tamoxifen causes an increase of progesterone receptor (PR) as a result of its partial estrogen agonist activity. In this study we have assessed the effect of tamoxifen on PR in patients with advanced carcinoma of the breast in order to test if those with a rise in PR are more likely to respond to endocrine therapy. PR was measured before and a median of 13 days after treatment with tamoxifen in a group of 52 patients with either locally advanced (n = 28) or recurrent (n = 24) carcinoma of the breast. Controls were a group of patients with operable disease who had two biopsies with no intervening tamoxifen (n = 51) or with intervening tamoxifen (n = 58). In the test group PR was higher in the second biopsy than the first in 21 patients, and 19 of these responded to continued endocrine therapy (90%). In the remaining 31 patients PR was either lower in the second biopsy (n = 19) or was negative in both biopsies (n = 12), and 11 of the total of 31 patients (35%) responded to continued endocrine therapy. The prediction of response and time to progression was better when both biopsies were taken into account than either the first or the second alone. The prediction of survival was similar for the group selected by an increase in the second biopsy and the group with PR present in the second biopsy. The controls without tamoxifen showed a marked variation in the level of PR in the first and second biopsies, suggesting heterogeneity of PR across the tumors studied. However, the PR level was significantly higher in the second biopsy in the controls given tamoxifen and in the test group compared with those with no intervening treatment (p = 0.031). This study indicates that some effect of tamoxifen upon PR can be demonstrated in human mammary tumors in vivo and that, by taking a second biopsy for PR estimation during treatment with tamoxifen, a more precise indication of subsequent response is obtained. The value of a single estimation of PR before treatment on secondary deposits is limited, and if one biopsy only is performed, it is of greater predictive value if taken after a few days treatment with tamoxifen.

Clinical biochemistry and pathology of mature beef cattle following ante-mortem intravenous administration of a commercial papain preparation.

Ten healthy beef cattle in a commercial abbatoir were treated intravenously before slaughter with a commercial papain-based tenderising injection (Pro Ten). Animals were observed for behavioural and clinical abnormalities following treatment. Serum enzyme activities were measured pre-treatment and post-treatment immediately pre-slaughter < 6 min later to detect liver and muscle damage. Carcases were examined grossly post mortem. Histological examination of liver, kidney and muscle followed. Nine contemporary, age-matched controls were similarly examined. It was concluded that ProTen treatment did not cause any detectable hepatocellular or renal damage and there was no significant difference in the parameters examined between treated and untreated cattle. A decision to ban the use of ProTen in cattle could not therefore be based on the premise that it interfered with the animal's welfare in the period following injection under the conditions pertaining in this experiment.

Alpha 1-adrenergic blockade raises epinephrine-arrhythmia threshold in halothane-anesthetized dogs in a dose-dependent fashion.

The authors determined whether increasing alpha 1-adrenergic blockade resulted in progressively less arrhythmic activity in the canine halothane-epinephrine arrhythmia model. Dogs (n = 7) were anesthetized with halothane (1.5%) in oxygen. Stepwise increases in steady-state plasma levels of either of two alpha 1-adrenoceptor antagonists (droperidol, doxazosin) were produced by applying Wagnerian principles to the known pharmacokinetic parameters of these drugs. At each steady state plasma level of these antagonists, the extent of the alpha 1-adrenergic blockade produced was assessed by defining a phenylephrine (PE) dose pressor response curve. The degree of alpha 1-blockade produced was quantitated as the dose of PE that caused a 25-mmHg increase in mean arterial pressure (ED25) as derived by polynomial regression analysis. By analysis of variance (ANOVA) the ED25 increased significantly for each targeted steady state plasma level of either droperidol (P less than 0.001) or doxazosin (P less than 0.001). For an assessment of the antiarrhythmic activity of these alpha 1-antagonists, the arrhythmogenic dose of epinephrine (ADE) was determined at each of the states of alpha 1-adrenergic blockade previously defined. By ANOVA there was a significant increase in the ADE over the range of alpha blockade produced for either droperidol (P less than 0.001) or doxazosin (P less than 0.001). A close correlation (r2) existed between the ED25 and the ADE for the target steady state levels that were achieved for either droperidol (0.99) or doxazosin (0.74).(ABSTRACT TRUNCATED AT 250 WORDS)

Steroid receptors in human meningioma.

It is well recognised that there is an increased frequency of meningioma in women compared with men and that rapid progression of the disease may occur during pregnancy. Recent studies have demonstrated steroid receptors in human meningioma. In this study we have looked for the presence of nuclear and cytoplasmic estrogen receptor (ER) and cytoplasmic progesterone receptor (PR) in 22 cases of meningioma. Radioreceptor assays using a six-point dextran-coated charcoal procedure failed to demonstrate specific ER, but 17 of 22 meningiomas did have specific PR (range 11-314 fmol/mg cytosol protein). Flat-bed isoelectric focusing in agarose gel was used to confirm the results in a few of these cases. We were not able to correlate the presence of receptor with age or sex of patient, or the site of tumour with receptor content. Of the five PR-negative tumors, one was a poor specimen when the histology was examined and two belonged to the angioblastic group (haemangiopericytic variety), a particularly aggressive tumour with a tendency to be more necrotic. The presence of PR in many of these tumours suggests a possible role for hormone therapy where total resection is not possible.