Hythe Hospital

As a retired GP and grandfather of a 3-year-old asthma sufferer I am troubled and not a little alarmed by the current standard of asthma care being offered today, as described in the article …

A seriesof non-ionic poly(glycerol monomethacrylate)–poly(2-hydroxypropylmethacrylate) (PGMA–PHPMA) diblock copolymer vesicles has beenprepared by reversible addition–fragmentation chain transfer(RAFT) aqueous dispersion polymerization of HPMA at 70 °C atlow pH using a carboxylic acid-based chain transfer agent. The degreeof polymerization (DP) of the PGMA block was fixed at 43, and theDP of the PHPMA block was systematically varied from 175 to 250 inorder to target vesicle phase space. Based on our recent work describingthe analogous PGMA–PHPMA diblock copolymer worms [LovettJ. R.; Angew. Chem.2015, 54, 1279−128325418214], such diblock copolymer vesicles were expectedto undergo an order–order morphological transition via ionizationof the carboxylic acid end-group on switching the solution pH. Indeed,irreversible vesicle-to-sphere and vesicle-to-worm transitions wereobserved for PHPMA DPs of 175 and 200, respectively, as judged byturbidimetry, transmission electron microscopy (TEM), and dynamiclight scattering (DLS) studies. However, such morphological transitionsare surprisingly slow, with relatively long time scales (hours) beingrequired at 20 °C. Moreover, no order–order morphologicaltransitions were observed for vesicles comprising longer membrane-formingblocks (e.g., PGMA43–PHPMA225–250) on raising the pH from pH 3.5 to pH 6.0. However, in such casesthe application of a dual stimulus comprising the same pH switch immediatelyfollowed by cooling from 20 to 5 °C, induces an irreversiblevesicle-to-sphere transition. Finally, TEM and DLS studies conductedin the presence of 100 mM KCl demonstrated that the pH-responsivebehavior arising from end-group ionization could be suppressed inthe presence of added electrolyte. This is because charge screeningsuppresses the subtle change in the packing parameter required todrive the morphological transition.

Abstract Polvinen observes “We must find an alternative to thinking of engagement as primarily a response to systems of knowledge and belief.” My essay takes this imperative as a starting point for proposing an alternative to the knowledge/belief analysis: the Trichotomy of Knowledge. I argue that the knowledge/belief analyses made by A.D. Woozley and A.J. Ayer lack the inclusiveness demanded by a theory of knowledge and that it is this very delimitation which has led to the analytical hindrance which Polvinen is experiencing. The Woozley/Ayer premises impose an exclusive disjunction upon a region (knowledge) whose undefinable entity transcends the object of their investigation. The Trichotomy of Knowledge, as a multimodal system, has greater complexity than the knowledge/belief model; this complexity is justified, however, by the need to complement the deficiencies in the scope of the latter. In my system, art and music and fiction are accorded equal epistemological status with logic, mathematics and science.

Twenty products, containing a radiolabelled form of each active in typical cosmetic formulations, were made and applied to female human epidermal membranes mounted in Franz diffusion cells for 48h under 'in use' conditions. The products consisted of combinations of five formulations (a hydro-alcoholic gel, an oil in water emulsion, a water in oil emulsion, a microemulsion and an oil) with four model drug actives (testosterone, hydrocortisone, 5-fluorouracil and ketoconazole). Steady-state flux appeared to be reached by 8h and maintained for all products, other than for the microemulsions, consistent with the actives being present in the residual formulation on the skin at saturation. The recovery for each active at the end of the 48-h study (from a series of stratum corneum tape strips, the remaining skin, cumulative amount penetrating into the receptor solution, product washed from the skin and on the donor chamber cap) ranged from 86.5% to 100.6%. The rank order of the fluxes for the actives from the hydro-alcoholic gel is consistent with the known active molecular size and polarity determinants for maximum epidermal flux. Actives with similar steady-state (maximum) fluxes from a range of formulations had retention in the stratum corneum and similar transport rate constants through the stratum corneum. The microemulsion formulation significantly enhanced both the stratum corneum steady-state flux and transport rate constant for 5-fluorouracil, hydrocortisone and testosterone. The penetration flux of each active could be related to its size and polarity and appeared maximal when the actives in the different cosmetic formulations applied to the skin under 'in use' conditions were likely to remain in the residual product on the skin as a saturated solution after solvent evaporation. Enhanced penetration fluxes can be achieved by formulation selection and an appropriate choice/mix of emollients/adjuvants. The principles described here provide a framework for understanding the delivery of cosmetic ingredients from various formulations.

The report 'Views sought on HCA rights' (News January 31) made me feel very angry and undervalued.

We compared techniques to assess diet at 17 Hen Harrier (Circus cyaneus) nests. Diet was measured directly from observations and compared to estimates from pellets, prey remains and a combination of pellets and remains. For data pooled across nests, pellets over-represented mammalian prey and under-represented avian prey. Prey remains over-represented large prey and under-represented small prey. Combining pellet and remains data did not eliminate these biases. Pellets gave higher diversity values than direct observations and detected more small prey species. For data analyzed on a nest by nest basis, estimates from pellets were significantly related to estimates from direct observations for three prey types by frequency and all types by biomass. These linear relationships were used to predict frequencies and biomass of prey types in the observed diet at five new nests. Our findings suggest that pellets are useful for estimates of prey diversity and as an index of the frequency of certain prey types in the diet, but direct observations are necessary to help quantify the biases inherent in diet estimates.

Presentation de 9 cas de paralysie faciale, dont 8 dues a la maladie de Lyme (Borrelia burgdorferi) et 1 a la paralysie de Bell. La maladie de Lyme se distingue precocement par l'erytheme chronique migrant

MEDIBLNoRrHL 1445 within the hepatic duct for the relief of obstruction by extrinsic carcinoma (cf.Cattell, 1943 ; Grey Turner, 1955; McGoon and Clagett