Powering West Midlands Growth: A Regional Approach to Clean Energy Innovation

The West Midlands is uniquely positioned to lead the UK in taking advantage of the economic opportunities arising from the global transition to a clean energy system. The region’s strengths include: strong and coherent political leadership committed to sustainability; the diversity of economic needs and scale of demand required to build competitive markets to support radical innovation; a world-class concentration of both academic and commercial expertise in the low-carbon energy sector; a massive programme of public and private investment in infrastructure planned for the next decade, and above all, the determination to secure long-term economic benefit from clean energy innovation. This report makes the case for the creation of a small number of Energy Innovation Zones (EIZs) across the region, acting as pathfinders for an approach that might subsequently be adopted across the country as a whole. EIZs enable barriers – such as powerful institutional silos separating transport, digital, planning and energy – to be overcome within designated geographies. They create a risk-managed and commercial-scale context for the development of new local clean energy markets. They also provide a practical mechanism to help attract investment and muster local political support. At a national level, they can help ensure innovation is built into the government’s strategic sector deals and other large scale public investment projects

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

COVID-19 vaccination, risk-compensatory behaviours, and contacts in the UK

The physiological effects of vaccination against SARS-CoV-2 (COVID-19) are well documented, yet the behavioural effects not well known. Risk compensation suggests that gains in personal safety, as a result of vaccination, are offset by increases in risky behaviour, such as socialising, commuting and working outside the home. This is potentially important because transmission of SARS-CoV-2 is driven by contacts, which could be amplified by vaccine-related risk compensation. Here, we show that behaviours were overall unrelated to personal vaccination, but—adjusting for variation in mitigation policies—were responsive to the level of vaccination in the wider population: individuals in the UK were risk compensating when rates of vaccination were rising. This effect was observed across four nations of the UK, each of which varied policies autonomously

Embryos and ancestors

xii+197hlm.;21c

Voltaire's British visitors

In Voltaire's British visitors, Sir Gavin de Beer and André-Michel Rousseau have collected accounts of one hundred and fifty visits by British travellers to Voltaire in Switzerland, where he spent the last years of his life on the shores of Lake Geneva. One hundred and twenty-three of these visitors have been identified, and they range from men as young as fifteen on a Grand Tour to Thomas Pitt, brother of William, and Edward Gibbon. As the Seven Years' War made Switzerland, rather than France, part of the normal route for Englishmen making their way to Italy, Geneva became a destination for more and more British travellers, and many of these, whether they held letters of recommendation from people known to Voltaire, or had merely read his work, wanted to see the famous Frenchman, their motives ranging, as Rousseau puts it in his introduction, from 'very superficial curiosity to downright admiration'. The accounts run from a bare mention of a visit, consisting of a few lines, to fascinating accounts of lively conversations with Voltaire about politics, religion and English literature and descriptions of his home at Ferney with its chapel and little playhouse. John Morgan in 1764, visiting with a Mr Samuel Powel, writes of his surprise when Voltaire saw a little dog in the room, turned to Mr Powel and 'as I thought, a little abruptly ask'd him, what think you of that little dog; has he any Soul or not, & what do the People in England now think of the Soul.' James Boswell, who stayed for three days in 1764, calls Voltaire's home an 'enchanted castle' and records conversation ranging from impassioned Biblical debate to Voltaire's comment on Scotland's painters when Boswell told him of the failure of an Academy of painting there: 'No; to paint well it is necessary to have warm feet. It's hard to paint when your feet are cold.' Together, these one hundred and fifty vignettes offer a fascinating and unusual glimpse into Voltaire's life from 1754 to 1778 through immediate and personal accounts of his conversation, hospitality and domestic life

Correspondence with (Sir) Gavin R. de Beer, (British Museum, Natural History)

March 1935 - June 1962. 38 letters and notes