Long Term Trends in Resource Exergy Consumption and Useful Work Supplies in the UK, 1900-2000

Our aim is to explain historical economic growth in the UK economy by introducing an empirical measure for useful work derived from natural resource energy inputs into an augmented production function. To do this, we estimate the long-term (1900-2000) trends in resource exergy supply and conversion to useful work in the United Kingdom. The exergy resources considered included domestic consumption of coal, crude oil and petroleum products, natural gas, nuclear and renewable resources (including biomass). All flows of exergy were allocated to an end use such as providing heat, light, transport, human and animal work and electrical power. For each end-use we estimated a time dependent efficiency of conversion from exergy to useful work. The 3-factor production function (of capital, labour and useful work) is able to reproduce the historic trajectory of economic growth without recourse to any exogenous assumptions of technological progress or total factor productivity. The results indicate that useful work derived from natural resource exergy is an important factor of production.exergy, energy, efficiency, economic growth, United Kingdom

Design of indicators for measuring product performance in the circular economy

This paper explores measurement of product performance with respect to circular economy (CE) principles. Potential indicators are assessed with special attention given to questions such as: the variables that should be measured; how these variables should be assessed; and in which format they should be presented. The resulting considerations are used to develop a prototype whose design is informed through feedback from CE experts. The prototype uses a points-based questionnaire which converges into a simple final result with minimum and maximum limits. The selected approach is critically appraised, and its utility for decision-making discussed. The prototype is tested against a product in the chemical processing industry. The strengths include: ease of use; simplicity; speed; and an effective metaphor for the diffusion of CE principles. The limitations include: the opaque and potentially misleading nature of a single metric; superficial engagement with decision-making; and the reliance on context-specific assumptions. Future developments could include refining the approach to encourage deeper reflection, and generalisation of the approach to different industry sectors or sustainability frameworks

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388. Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16, p<0·0001). Interpretation: Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice