Skin cancer excision is more efficient and cost effective in a specialist secondary care service

Aim: To compare the relative efficiencies of skin excisions in primary and secondary care. Methods: We compared the benign: malignant ratio for specimens referred by General Practice, General Surgery and the Skin Cancer Service to the regional pathology laboratory over one month. We used cost minimization analysis to compare the relative efficiencies of the services. Results: 620 excisions were received: 139 from General Practice, 118 from General Surgery and 363 from the Skin Cancer Service. The number (%) of malignant lesions was 13 (9.4%) from General Practice, 18 (15.2%) from General Surgery and 137 (37.7%) from the Skin Cancer Service. Excision was cheaper in General Practice at €84.58 as compared to €97.49 in the hospital day surgical unit. However, the cost per malignant lesion excised was €1779.80 in general practice versus €381.78 in the Skin Cancer Service. Conclusion: Our results indicate that moving skin cancer treatment to General Practice may result in an excess of benign excisions and therefore be both less efficient and less cost effective

Mediation, translation and local ecologies: understanding the impact of policy levers on FE colleges

This article reports the views of managers and tutors on the role of policy ‘levers’ on teaching, learning, and inclusion in colleges of Further Education (FE) in our research project, ‘The impact of policy on learning and inclusion in the Learning and Skills Sector (LSS)’.i Using data from five research visits conducted over two years in eight FE learning sites, we explore the processes by which colleges ‘mediate’ and ‘translate’ national policy levers and how this affects their ability to respond to local need. The paper tentatively develops three related concepts/metaphors to explain the complexity of the policy/college interface – ‘the process of mediation’, ‘acts of translation’ and ‘local ecologies’. We found that policy levers interacted with a complex set of national, local and institutional factors as colleges responded to pressures from the external environment and turned these into internal plans, systems and practices. We conclude by suggesting that national policy-makers, who design national policy levers, may not be fully aware of these complexities and we make the case for the benefits of greater local control over policy levers, where these interactions are better understood

Genetic and pharmacologic blockade of central melanocortin signaling attenuates cardiac cachexia in rodent models of heart failure

The central melanocortin system plays a key role in the regulation of food intake and energy homeostasis. We investigated whether genetic or pharmacologic blockade of central melanocortin signaling attenuates cardiac cachexia in mice and rats with heart failure. Permanent ligation of the left coronary artery (myocardial infarction (MI)) or sham operation was performed in wild-type (WT) or melanocortin-4 receptor (MC4R) knockout mice. Eight weeks after surgery, WT-Sham mice had significant increases in lean body mass (LBM; P<0·05) and fat mass (P<0·05), whereas WT-MI did not gain significant amounts of LBM or fat mass. Resting basal metabolic rate (BMR) was significantly lower in WT-Sham mice compared to WT-MI mice (P<0·001). In contrast, both MC4-Sham and MC4-MI mice gained significant amounts of LBM (P<0·05) and fat mass (P<0·05) over the study period. There was no significant difference in the BMR between MC4-Sham and MC4-MI mice. In the second experiment, rats received aortic bands or sham operations, and after recovery received i.c.v. injections of either artificial cerebrospinal fluid (aCSF) or the melanocortin antagonist agouti-related protein (AGRP) for 2 weeks. Banded rats receiving AGRP gained significant amount of LBM (P<0·05) and fat mass (P<0·05) over the treatment period, whereas banded rats receiving aCSF did not gain significant amounts of LBM or fat mass. These results demonstrated that genetic and pharmacologic blockade of melanocortin signaling attenuated the metabolic manifestations of cardiac cachexia in murine and rat models of heart failure

A Web-based Adaptive and Intelligent Tutor by Expert Systems

Todays, Intelligent and web-based E-learning is one of regarded topics. So researchers are trying to optimize and expand its application in the field of education. The aim of this paper is developing of E-learning software which is customizable, dynamic, intelligent and adaptive with Pedagogy view for learners in intelligent schools. This system is an integration of adaptive web-based E-learning with expert systems as well. Learning process in this system is as follows. First intelligent tutor determines learning style and characteristics of learner by a questionnaire and then makes his model. After that the expert system simulator plans a pre-test and then calculates his score. If the learner gets the required score, the concept will be trained. Finally the learner will be evaluated by a post-test. The proposed system can improves the education efficiency highly as well as de-creases the costs and problems of an expert tutor. As a result, every time and eve-rywhere (ETEW) learning would be provided via web in this system. Moreover the learners can enjoy a cheap remote learning even at home in a virtual simulated physical class. So they can learn thousands courses very simple and fast.Comment: 10 pages, 3 figures, The Second International Conference on Advances in Computing and Information Technology (ACITY 2012). arXiv admin note: substantial text overlap with arXiv:1304.404

Effect of lithographically-induced strain relaxation on the magnetic domain configuration in microfabricated epitaxially grown Fe81Ga19

We investigate the role of lithographically-induced strain relaxation in a micron-scaled device fabricated from epitaxial thin films of the magnetostrictive alloy Fe81Ga19. The strain relaxation due to lithographic patterning induces a magnetic anisotropy that competes with the magnetocrystalline and shape induced anisotropy to play a crucial role in stabilising a flux-closing domain pattern. We use magnetic imaging, micromagnetic calculations and linear elastic modelling to investigate a region close to the edges of an etched structure. This highly-strained edge region has a significant influence on the magnetic domain configuration due to an induced magnetic anisotropy resulting from the inverse magnetostriction effect. We investigate the competition between the strain-induced and shape-induced anisotropy energies, and the resultant stable domain configurations, as the width of the bar is reduced to the nanoscale range. Understanding this behaviour will be important when designing hybrid magneto-electric spintronic devices based on highly magnetostrictive materials

Compression of Antiproton Clouds for Antihydrogen Trapping

Control of the radial profile of trapped antiproton clouds is critical to trapping antihydrogen. We report the first detailed measurements of the radial manipulation of antiproton clouds, including areal density compressions by factors as large as ten, by manipulating spatially overlapped electron plasmas. We show detailed measurements of the near-axis antiproton radial profile and its relation to that of the electron plasma