Regional environments and sector developments: the biotech sector in Oxfordshire

This paper explores the interdependence between national policy, the local characteristics of the UK’s biotechnology sectoral system of innovation and the growth of Oxfordshire’s biotech sector. It considers on the one hand the county’s research capacity and on the other its innovation performance. The latter is captured by a series of indicators from a recently completed study of the sector, recording the sector’s evolution both in the number of firms and their employment size, their status (independent, merged/acquired), product group and contribution to local employment and wealth creation. It considers the implications of the relative weaknesses in the system of innovation in this sector which relate to an underperformance of its firms in relation to the strength of the science base

Contributory factors in surgical incidents as delineated by a confidential reporting system

Background Confidential reporting systems play a key role in capturing information about adverse surgical events. However, the value of these systems is limited if the reports that are generated are not subjected to systematic analysis. The aim of this study was to provide the first systematic analysis of data from a novel surgical confidential reporting system to delineate contributory factors in surgical incidents and document lessons that can be learned. Methods One-hundred and forty-five patient safety incidents submitted to the UK Confidential Reporting System for Surgery over a 10-year period were analysed using an adapted version of the empirically-grounded Yorkshire Contributory Factors Framework. Results The most common factors identified as contributing to reported surgical incidents were cognitive limitations (30.09%), communication failures (16.11%) and a lack of adherence to established policies and procedures (8.81%). The analysis also revealed that adverse events were only rarely related to an isolated, single factor (20.71%) – with the majority of cases involving multiple contributory factors (79.29% of all cases had more than one contributory factor). Examination of active failures – those closest in time and space to the adverse event – pointed to frequent coupling with latent, systems-related contributory factors. Conclusions Specific patterns of errors often underlie surgical adverse events and may therefore be amenable to targeted intervention, including particular forms of training. The findings in this paper confirm the view that surgical errors tend to be multi-factorial in nature, which also necessitates a multi-disciplinary and system-wide approach to bringing about improvements

Innovation capacity in the healthcare sector and historical anchors: examples from the UK, Switzerland and the US

Innovation is an integral part of economic development in developed economies. In the post 2008 period, a key policy agenda is that of sustainable development, which calls for innovation in all aspects of value-chains. In this paper, we focus on innovation from the biotech—pharma perspective to see whether or not this will lead to a sustainable future for the regions where there are clusters of firms in this sector. We examine data from a recently completed European Union study of innovation in the Healthcare sector from the UK and Switzerland, countries with an historical base in pharma, to understand how innovation pathways vary at the regional level in the broader life sciences, which incorporate biotech and more. Innovation in the healthcare sector in two regions, Oxfordshire in the UK and Zurich in Switzerland are compared. We contextualize our discussion by drawing on studies that focus on the sector in the US, specifically Boston. The analytical framework comprises three elements: innovation systems and national and regional economic development theories are the first two, followed by approaches which consider organizational or institutional activity. This framework is used to help explain and understand the complexity of how innovation is organized at the sub-national level. The overall context is that it is increasing becoming a condition for government financing of research that it has more immediate application in industry or have the possibility of commercialisation (e.g., translational research)

Dust heating sources in galaxies: the case of M33 (HERM33ES)

Dust emission is one of the main windows to the physics of galaxies and to star formation as the radiation from young, hot stars is absorbed by the dust and reemitted at longer wavelengths. The recently launched Herschel satellite now provides a view of dust emission in the far-infrared at an unequaled resolution and quality up to 500 \mu m. In the context of the Herschel HERM33ES open time key project, we are studying the moderately inclined Scd local group galaxy M33 which is located only 840 kpc away. In this article, using Spitzer and Herschel data ranging from 3.6 \mu m to 500 \mu m, along with HI, H\alpha\ maps, and GALEX ultraviolet data we have studied the emission of the dust at the high spatial resolution of 150 pc. Combining Spitzer and Herschel bands, we have provided new, inclination corrected, resolved estimators of the total infrared brightness and of the star formation rate from any combination of these bands. The study of the colors of the warm and cold dust populations shows that the temperature of the former is, at high brightness, dictated by young massive stars but, at lower brightness, heating is taken over by the evolved populations. Conversely, the temperature of the cold dust is tightly driven by the evolved stellar populations.Comment: 29 pages, 12 figures, accepted for publication in A

Introduced plants as novel Anthropocene habitats for insects

Major environmental changes in the history of life on Earth have given rise to novel habitats, which gradually accumulate species. Human‐induced change is no exception, yet the rules governing species accumulation in anthropogenic habitats are not fully developed. Here we propose that nonnative plants introduced to Great Britain may function as analogues of novel anthropogenic habitats for insects and mites, analysing a combination of local‐scale experimental plot data and geographic‐scale data contained within the Great Britain Database of Insects and their Food Plants. We find that novel plant habitats accumulate the greatest diversity of insect taxa when they are widespread and show some resemblance to plant habitats which have been present historically (based on the relatedness between native and nonnative plant species), with insect generalists colonizing from a wider range of sources. Despite reduced per‐plant diversity, nonnative plants can support distinctive insect communities, sometimes including insect taxa that are otherwise rare or absent. Thus, novel plant habitats may contribute to, and potentially maintain, broader‐scale (assemblage) diversity in regions that contain mixtures of long‐standing and novel plant habitats

Proof of the Hyperplane Zeros Conjecture of Lagarias and Wang

We prove that a real analytic subset of a torus group that is contained in its image under an expanding endomorphism is a finite union of translates of closed subgroups. This confirms the hyperplane zeros conjecture of Lagarias and Wang for real analytic varieties. Our proof uses real analytic geometry, topological dynamics and Fourier analysis.Comment: 25 page

Examining the Connections within the Startup Ecosystem: A Case Study of St. Louis

This paper documents the resurgence of entrepreneurial activity in St. Louis by reporting on the collaboration and local learning within the startup community. This activity is happening both between entrepreneurs and between organizations that provide support, such as mentoring and funding, to entrepreneurs. As these connections deepen, the strength of the entrepreneurial ecosystem grows. Another finding from the research is that activity-based events, where entrepreneurs have the chance to use and practice the skills needed to grow their businesses, are most useful. St. Louis provides a multitude of these activities, such as Startup Weekend, 1 Million Cups, Code Until Dawn, StartLouis, and GlobalHack. Some of these are St. Louis specific, but others have nationwide or global operations, providing important implications for other cities

Glyceryl trinitrate to reduce the need for manual removal of retained placenta following vaginal delivery:the GOT-IT RCT

Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 70. See the NIHR Journals Library website for further project information.Peer reviewedPublisher PD

A pragmatic group sequential placebo controlled randomised trial to determine the effectiveness of Glyceryl trinitrate for retained placenta (GOT-IT): a study protocol

A retained placenta is diagnosed when the placenta is not delivered following delivery of the baby. It is a major cause of postpartum haemorrhage and treated by the operative procedure of manual removal of placenta (MROP).The aim of this pragmatic, randomised, placebo-controlled, double-blind UK-wide trial, with an internal pilot and nested qualitative research to adjust strategies to refine delivery of the main trial, is to determine whether sublingual glyceryl trinitrate (GTN) is (or is not) clinically and cost-effective for (medical) management of retained placenta. The primary clinical outcome is need for MROP, defined as the placenta remaining undelivered 15 min poststudy treatment and/or being required within 15 min of treatment due to safety concerns. The primary safety outcome is measured blood loss between administration of treatment and transfer to the postnatal ward or other clinical area. The primary patient-sided outcome is satisfaction with treatment and a side effect profile. The primary economic outcome is net incremental costs (or cost savings) to the National Health Service of using GTN versus standard practice. Secondary outcomes are being measured over a range of clinical and economic domains. The primary outcomes will be analysed using linear models appropriate to the distribution of each outcome. Health service costs will be compared with multiple trial outcomes in a cost-consequence analysis of GTN versus standard practice.Ethical approval has been obtained from the North-East Newcastle and North Tyneside 2 Research Ethics Committee (13/NE/0339). Dissemination plans for the trial include the Health Technology Assessment Monograph, presentation at international scientific meetings and publication in high-impact, peer-reviewed journals.ISCRTN88609453; Pre-results

A pilot randomised controlled trial of personalised care for depressed patients with symptomatic coronary heart disease in South London general practices: the UPBEAT-UK RCT protocol and recruitment.

ABSTRACT: Background: Community studies reveal people with coronary heart disease (CHD) are twice as likely to be depressed as the general population and that this co-morbidity negatively affects the course and outcome of both conditions. There is evidence for the efficacy of collaborative care and case management for depression treatment, and whilst NICE guidelines recommend these approaches only where depression has not responded to psychological, pharmacological, or combined treatments, these care approaches may be particularly relevant to the needs of people with CHD and depression in the earlier stages of stepped care in primary care settings. Methods: This pilot randomised controlled trial will evaluate whether a simple intervention involving a personalised care plan, elements of case management and regular telephone review is a feasible and acceptable intervention that leads to better mental and physical health outcomes for these patients. The comparator group will be usual general practitioner (GP) care. 81 participants have been recruited from CHD registers of 15 South London general practices. Eligible participants have probable major depression identified by a score of ≥8 on the Hospital Anxiety and Depression Scale depression subscale (HADS-D) together with symptomatic CHD identified using the Modified Rose Angina Questionnaire. Consenting participants are randomly allocated to usual care or the personalised care intervention which involves a comprehensive assessment of each participant’s physical and mental health needs which are documented in a care plan, followed by regular telephone reviews by the case manager over a 6-month period. At each review, the intervention participant’s mood, function and identified problems are reviewed and the case manager uses evidence based behaviour change techniques to facilitate achievement of goals specified by the patient with the aim of increasing the patient’s self efficacy to solve their problems. Depressive symptoms measured by HADS score will be collected at baseline and 1, 6- and 12 months post randomisation. Other outcomes include CHD symptoms, quality of life, wellbeing and health service utilisation. Discussion: This practical and patient-focused intervention is potentially an effective and accessible approach to the health and social care needs of people with depression and CHD in primary care. Trial registration: ISRCTN21615909