The Pin Factory Blog

This week, I was sent an email from Drinker’s Alliance, reminding me of the upcoming Budget which Mr. Darling will release on 22 April. In the past, Drinker’s Alliance encouraged people to write to their MPs in favour of scrapping an increased alcohol tax, sign petitions, spread the word, and more. This time, however, they included direct links to both a pre-drafted email to the office of Alistair Darling, (which you can modify if you wish) as well as the phone number to the office (with a form to report back the office’s retort).

As I am opposed to this rise in taxes, I sent an email (highly modified from the form), and the next day received a generated response from the ‘enquiry unit’. I was told the alcohol duty increases “were not designed to tackle problem drinking" and instead were “an important revenue stream" for the government. Finally they finished off their response with “the police, local authorities, and others have the powers to stop [those abusing the right to drink] and are encouraged to use them." What exactly they mean by ‘powers’ for ‘others’ I am quite unsure of, and am inclined to ask for further clarification. The justification for their increase the alcohol duty is tenuous, rude, and most of all – unfair. The government should be looking for ways to decrease wasteful spending and stop punishing the citizens of Britain for the government’s mistakes. [Click 'Read More' to view the email exchange]

As someone from Michigan, I’m upset by the plight of the 'Big Three' car manufacturers. However, it is not Congress that has dismayed me by not bailing them out, but rather the extraordinarily selfish refusal of the UAW (United Auto Workers) to accept pay cuts. GM currently pays workers over $70/hr (wages, plus pensions, and health care for workers, retirees, and spouses), while Toyota’s labour costs only $48/hr. The UAW have refused to guarantee to take a pay cut before their current contract ends in 2011, seemingly oblivious to the fact that the companies may well not exist by then.
 
I'm in full agreement with those who voted against the bill: the UAW needs to make sacrifices for the sake of its workers and the survival of the industry. It is unfortunate that the local press has blamed the Senate for the failure to reach a deal, while the unions get away with strangling the life out once world-beating businesses. Sadly, chapter 11 bankruptcy is probably the Big Three's only way out.

And with an estimated 3 million jobs tied to the Big Three and their failure, it’s only a matter of time before Michigan finds itself in serious trouble as well. While the Bureau of Labor Statistics reports national unemployment at 6.7 percent, Michigan sits at 9.3 percent, with nearly half a million residents unemployed. The US as a whole is coming to realize that it is in a recession; Michigan, however, has (arguably) been in one for eight years. Unlike the rest of the US, the state was unable to recover after the downturn of 2000, thanks to its uncompetitive industrial base.
 
Regardless of whether a bailout yet goes ahead, the cost of Detroit to the taxpayer is expected to be high.  According to the Detroit News, “If two of the Big Three declare bankruptcy and are forced to liquidate, federal and state taxpayers would lose $66 billion in the first two years alone".

In the long run, I understand that automakers would be best off filing for bankruptcy protection, allowing for massive restructuring and rebuilding of the auto industry.  In the short term, however, it’s a frightening time for Michigan.

It’s that wonderful time of year, again - Election Day! And, as a good citizen, I registered for my absentee ballot.  When it arrived, I showed it to several colleagues (English, French, Canadian, etc), and they all agreed on one point – the ballot was big, puzzling, and overwhelming.

On one ballot, I can vote for everything from US President to township clerk, from US Senator to County Drain Commission, from Education Boards and University Trustees to judges, sheriffs and county surveyors. And then to top it off, there are a couple of ballot initiatives to vote 'yes' or 'no' on. To illustrate, I’ve included all the options citizens are expected to vote for at the bottom of this blog (just click 'read more' to see them).

I guess there are a couple of points to make. Firstly, it's probably a good thing that US voters get a democratic say over so many different areas of government. The contrast with the UK – where so much political power is wielded by unelected and unaccountable bureaucrats in Brussels, Whitehall, and beyond – is stark.

But on the other hand, the average voter can surely not have a clue about the candidates for the majority of these positions. While the democratic process is clearly being exercised, it just confuses most people. And finding out more, frankly, would probably not be a rational use of their time. So they make up their mind based on propaganda, mudslinging, and (frequently biased) media reporting.

Perhaps separating issues onto different ballots would to help reduce the confusion on election day, and hopefully diminish the amount of recounts to come.

It’s been 1-2 days: you’ve a temperature of 38.5/39^oC, a cough (not dry), sore throat, and paracetamol is all that keeps your temperature normal (37^oC). What do you do?

Your options: visit the GP (though you may not get in on short notice), visit an NHS walk-in centre, or call NHS direct and talk to a nurse. Say you’re lucky enough get into your GP, who prescribes you antibiotics. Problem solved! Or is it…?

Now, let’s say you didn’t get antibiotics, but were instead told you had a virus — go home, rest and come back if it gets much worse.

Which would you choose?

These days, antibiotics are being over-prescribed in the UK. Taking antibiotics for a virus will not cure the infection. In fact, £270 million, put forth by Health Secretary Alan Johnson earlier this year, will be spent to advertise this simple fact.

So who is to blame: GPs for being uninformed, or patients for being too demanding and pushy?

Last year, 38 million prescriptions for antibiotics on the NHS cost taxpayers £175 million. New guidance has been issued to GPs to try and reduce this level, to help prevent building immunity. MRSA, for example, is antibiotic resistant, as are other superbugs plaguing hospital wards. But — more interestingly, this call is coming from the NHS drugs rationing body, the National Institute for Health and Clinical Excellence (‘NICE’).

Notice — the body in charge of drugs for NHS is asking for fewer drugs to be prescribed. Yes, this will have some effect against superbugs, but nearly TWICE as much money is being spent telling people they don’t need the prescriptions than is spent filling them. Perhaps, financial motives taking precedent over health? It’s a little hard to believe taking penicillin a few more times than necessary will make you susceptible to MRSA.

According to the General Medical Council GPs have a responsibility to patients to, “provide effective treatments based on the best available evidence; take steps to alleviate pain and distress whether or not a cure may be possible." GPs should be upholding this and letting the rest cure the virus.
 

On Tuesday, the Rector of a top UK university announced a new entrance test may be used to distinguish between applicants with high marks. Sir Richard Sykes, of Imperial College London, informed the Independent Schools Council’s annual conference that while applicants have four or five A-levels, "grade inflation" had "destroyed" the intended role A-levels have in measuring undergraduate acceptance. Surprisingly, 40% of those applicants receive private schooling, from a mere 7% of UK schools.

“We are doing this not because we don't believe in A-level but we cannot use A-levels any more as a discriminatory factor." –Sir Richard Sykes

A-levels have received much criticism over the past few years, and rightly so. From the Qualifications and Curriculum Authority (QCA)’s website, the Q&A section answers ‘How are A level grades set?’ with this:

“With great care. Criteria are set across particular grade boundaries and it is important that these criteria are met each year. Up until the mid-80s there were fixed percentages of students awarded grades with little variation from year to year… Whereas the system used since that time, called ‘criteria referencing’ is a much fairer system and it measures standards of achievement rather than fixed percentages."

In the US, specialised postgraduate schools require an entry test based upon percentages. For example, the LSAT, and MCAT results state this percentage to distinguish the pupil’s rank in relation to their competition. Though undergraduate course quality will vary, individuals applying are expected to undertake a set coursework (pre-med, etc) and the tests. Furthermore, a report has been recently released by Reform demonstrating a significant decline in the standard of maths testing, with the steepest change since 1990.

Frankly, it’s about time a UK university started requiring entrance tests. Universities should not be forced to lower their expectations, nor bear any unnecessary risk for students whom are incapable of completing the coursework. The UK education system needs radical reform, including an open access scheme, much like the one proposed here. Until the government stops interfering and allows a rigorous school exaxmination system to develop independently, it will become increasingly common for applicants to be tested.

The past two days have certainly been heated ones in Parliament.  MP’s have been voting on amendments proposed to the Human Fertilisation and Embryology Bill. On Monday, I attended an event held by the Progress Education Trust entitled Half-truths? The Science, Politics and Morality of Hybrid Embryos.

Three panellists debated the topic: John Burn, Clinical Geneticist at Newcastle Hospitals NHS Foundation Trust and Professor at Newcastle University, (in support of the embryos); Josephine Quintavalle, Co-founder of Comment on Reproductive Ethics, (against); and Brenda Almond, Emiritus Professor of Moral and Social Philosophy at the University of Hull, (explaining the ethics of the bill).

Several examples why “closing some roads" would harm science in the future were provided from the audience:

• IVF was highly debated in the past and is now a common technique for many people.
• Organ transplantation initially provoked much public scrutiny, but today many people benefit from this practice.
• Not enough adult stem cells could be obtained to replace the amount of tissue harmed by a heart attack affecting 25% of the left ventricle.
• Far more animal DNA would exist in a human with a heart valve replacement supplied from a cow or pig than these cells would have if grown into a heart valve.
• Only the mitochondria (energy providers for the cells) in the cell contain any animal DNA.
• This issue was about a small clump of cells in a dish that will be prevented from becoming a full organism at day 14.

Ms. Almond described old definitions and proposed these ‘embryos’ be called “pseudo embryos", as they are not true embryos. Ultimately, this debate was less about the embryos and more about the government telling scientists what they may or may not do.  Luckily MP’s recognised the need not to close the book on this topic. My favourite quote from the evening was from Prof. Burn comparing stem cells with replacing tires on his car: “ I don’t want retreads (adult stem cells), I want new ones (embryonic stem cells)!"

If you picked up the Daily Mail this week and came across this article you may have been quite cynical. Glass, in bones, that heals? They must be joking! Well, no, it is true.  Scientists at three English universities (Imperial College London, University of Kent, and Warwick) are working together to develop just that – a glass to heal bones. 
 
Now, before you go thinking they’re crushing up windows and putting them in people, glass can be (simply) defined as: a brittle, transparent solid made from silica without a crystalline molecular structure.  Back in the 1969, Larry Hench developed BioGlass (pictured left), after being challenged by a US colonel to help Vietnam War vets with devastating injuries.  BioGlass was the first man-made material to bond with living tissues, and has many uses today, including dental, middle ear implants, and orthopaedic applications.
 
In patients where grafts are necessary, often there is little spare bone to graft from one place to another. Animal grafts or bone from donor banks introduce immune responses, and require lots of medication to prevent rejection. This research aims to eliminate that need altogether.
 
Today, scientists are working on improving this glass, making it more bioactive and like the shape of trabecular bone.  Researchers at Imperial College were the first to take BioGlass and make it into a 3-D porous structure. The improved shape allows cells to grow and form tissue, while providing strength and support like native bone. 
 
When implanted, these bioactive glasses gradually release necessary ions, such as calcium and phosphorus, stimulating the bone to mend itself.  They are also biodegradable, and slowly break down as the bone re-grows, preventing a loss of strength while repairing. These glasses are now being combined with other materials on the nanoscale, widening their potential applications in the body. These implants have the potential to greatly improve patients’ quality of life and change the future of medicine.

The future of medicine lies in the hands of researchers, doctors, and most importantly – private funders.

Imperial College London's Institute of Biomedical Engineering (IBE) was founded in 2004, the first of its kind in the UK. Recently profiled in the Financial Times, it serves as a model for other institutions. Gone is the day that University researchers fear commercial involvement in their work, for as the FT put it:

IBE staff have been enterprising not only in spinning out companies – seven so far – but also in raising money to build and run a postgraduate research institute at the heart of Imperial's South Kensington campus. A particularly innovative feature of IBE's £28m fundraising was the £10m invested by the Esmée Fairbairn Foundation, a charity that focuses on culture, education and the environment.

Although this foundation is a charity, the investment was purely commercial. In return, any future spin-outs or licensed agreements have a portion returning to the Foundation. Rather than relying on government funding to raise money for big capital projects, some universities also have similar deals with financial institutions.

Successful biomedical engineering programs require excellent medical schools and engineering programmes – and also private funding. This is exactly what the Johns Hopkins University has, and being the top BME programme in the US with nine spin-out companies, one can see why.

The Whitaker Foundation, established in 1976, supported the enhancement or establishment of educational programmes in biomedical engineering, especially encouraging the formation of departments. Over 30 years it has given $805 million in funding to institutions like Johns Hopkins. It is private donations such as these have made the US a world leader in this field.

Oxford University has recently launched its own IBE with a similar structure of private funding. As an alumnus of Johns Hopkins BME and a current Imperial IBE student, I’ve benefited from this structure. Other universities should follow suit and create similar opportunities, allowing a higher standard of education for more students.

Yet again, the state is trying to assume control over our bodies. Last week it was Gordon Brown’s 'presumed consent' for organ donation, this week it is 'specific consent' over tissue being used for stem cell research.

The Human Fertilisation and Embryology Authority's bill would require specific consent from those whose tissue would be used for stem cell research, regardless of the date of tissue donation. That may sound reasonable, but as a letter to The Times from twenty-nine top stem cell researchers (including three Nobel laureates) put it:

…many existing cell and tissue samples and cell lines were donated, for any research purpose, by patients (now untraceable) with particular diseases, before this sort of research was even imagined. These cells have been well characterised over many years, or have unique properties and may therefore be the best samples to use for the derivation of embryonic stem cells. Such stem cell lines would be of great value in understanding how diseases develop, as well in the search for therapies.

Clearly people donating tissue or their entire bodies are interesting in progressing science and healthcare for the sake of others, but HFEA's proposed legislation will require a new bank of tissue will need to be created, costing hundreds of thousands of pounds, and more importantly – time. The bill also blocks any donations from children, regardless of consent, which means that some scientists whose research has already been approved will not be able to proceed.

Baroness Royall has told the House of Lords that ministers will reconsider the bill, but that they could not accept the amendments put forth by Lord Patel of Dunkeld, the chairman of the UK Stem Cell Network Steering Committee:

We believe the use of their genetic material to create cloned embryos or human admixed [interspecies] embryos is exceptional and requires exceptional consent.

One week consent is presumed, the next it is specifically needed. It seems as though the government can’t make up their minds about anything.