Building back better: policies for a strong and sustainable recovery

There's an opportunity to build a new social contract, tackle inequality, foster innovation and adopt a long-term industrial strategy, write Sam Unsworth and Anna Valer

Increasing support for clean innovation: a win-win-win strategy?

Political support for government spending to deal with the economic aftermath of the COVID pandemic has grown. It is now greater than during the 2008 financial crisis, and ‘build back better’ pledges have multiplied. Ralf Martin, Sam Unsworth, Anna Valero, and Dennis Verhoeven have developed a new methodology that estimates the national return of government support for different technology areas and argue that a sustainable growth strategy can achieve net zero, improve productivity and contribute to levelling up, a win-win-win

Overcoming ecological feedbacks in seagrass restoration

Overcoming ecological feedbacks is a major limiting factor reducing the success of many seagrass restoration projects. Negative feedbacks occur when biotic or abiotic conditions of a site are changed sufficiently after the loss of seagrass to prevent its recovery, even after the original stressors are remediated. While negative feedbacks in seagrass restoration are common, there remain limited studies of ways to reduce them and kick-start the necessary positive feedbacks to promote recovery. We used field and laboratory experiments to investigate key ecological feedbacks in seagrass (Zostera marina) restoration by testing the role of hessian bags and seed burial in reducing seed predation and promoting plant development. We used a double-hurdle model approach to predict “seagrass emergence success” and “seagrass growth success” across planted field plots. We found that planting seeds in hessian bags and burying them in the sediment improved the likelihood of seeds developing into mature plants. We recorded an average 13-fold increase in shoot density for seeds planted in buried bags relative to raked furrows. This could be the combined result of reduced predation as well as bags mimicking emergent traits of mature seagrass to withstand physical impacts. We supplement these findings with laboratory evidence that hessian bags provide protection from predation by green shore crabs. Overall, we found a low and variable success rate for seed-based restoration and indicate other feedbacks in the system beyond those we controlled. However, we show that small methodological changes can help overcome some key feedbacks and improve restoration success

An LSE action plan for a strong and sustainable recovery

What does ‘building back better’ actually mean? Nicholas Stern, Sam Unsworth, Anna Valero, Dimitri Zenghelis, James Rydge and Nick Robins (LSE) set out the actions the government needs to take to deliver a sustainable recovery

Developmental reprogramming of reproductive and metabolic dysfunction in sheep: native steroids vs. environmental steroid receptor modulators

The inappropriate programming of developing organ systems by exposure to excess native or environmental steroids, particularly the contamination of our environment and our food sources with synthetic endocrine disrupting chemicals that can interact with steroid receptors, is a major concern. Studies with native steroids have found that in utero exposure of sheep to excess testosterone, an oestrogen precursor, results in low birth weight offspring and leads to an array of adult reproductive/metabolic deficits manifested as cycle defects, functional hyperandrogenism, neuroendocrine/ovarian defects, insulin resistance and hypertension. Furthermore, the severity of reproductive dysfunction is amplified by excess postnatal weight gain. The constellation of adult reproductive and metabolic dysfunction in prenatal testosterone-treated sheep is similar to features seen in women with polycystic ovary syndrome. Prenatal dihydrotestosterone treatment failed to result in similar phenotype suggesting that many effects of prenatal testosterone excess are likely facilitated via aromatization to oestradiol. Similarly, exposure to environmental steroid imposters such as bisphenol A (BPA) and methoxychlor (MXC) from days 30 to 90 of gestation had long-term but differential effects. Exposure of sheep to BPA, which resulted in maternal levels of 30–50 ng/mL BPA, culminated in low birth weight offspring. These female offspring were hypergonadotropic during early postnatal life and characterized by severely dampened preovulatory LH surges. Prenatal MXC-treated females had normal birth weight and manifested delayed but normal amplitude LH surges. Importantly, the effects of BPA were evident at levels, which approximated twice the highest levels found in human maternal circulation of industrialized nations. These findings provide evidence in support of developmental origin of adult reproductive and metabolic diseases and highlight the risk posed by exposure to environmental endocrine disrupting chemicals.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78725/1/j.1365-2605.2009.01024.x.pd

Factors affecting the microwave coking of coals and the implications on microwave cavity design

The work carried out in this paper assessed how processing conditions and feedstock affect the quality of the coke produced during microwave coke making. The aim was to gather information that would support the development of an optimised microwave coke making oven. Experiments were carried out in a non-optimised 2450 MHz cylindrical cavity. The effect of treatment time (15–120 min), power input (750 W–4.5 kW) and overall power input (1700–27,200 kWh/t) on a range of coals (semi-bituminous–anthracite) was investigated. Intrinsic reactivity, random reflectance, strength index and dielectric properties of the produced cokes were compared with those of two commercial cokes to assess the degree of coking produced in the microwave system. Overall energy input and coal rank were found to be the major factors determining the degree of coking following microwave treatment. The dependency on coal rank was attributed to the larger amount of volatiles that had to be removed from the lower ranked coals, and the increasing dielectric loss of the organic component of the coal with rank due to increased structural ordering. Longer treatment times at lower powers or shorter treatment times at higher powers are expected to produce the same degree of coking. It was concluded that microwave coke making represents a potential step-change in the coking industry by reducing treatment times by an order of magnitude, introducing flexibility and potentially decreasing the sensitivity to quality requirement in the feedstock. The main challenges to development are the energy requirements (which will need to be significantly reduced in an optimised process) and penetration depth (which will require an innovative reactor design to maximise the advantage of using microwaves). Understanding and quantifying the rapidly changing dielectric properties of the coal and coke materials is vital in addressing both of these challenges

Neural Correlates of Ongoing Conscious Experience: Both Task-Unrelatedness and Stimulus-Independence Are Related to Default Network Activity

The default mode network (DMN) is a set of brain regions that consistently shows higher activity at rest compared to tasks requiring sustained focused attention toward externally presented stimuli. The cognitive processes that the DMN possibly underlies remain a matter of debate. It has alternately been proposed that DMN activity reflects unfocused attention toward external stimuli or the occurrence of internally generated thoughts. The present study aimed at clarifying this issue by investigating the neural correlates of the various kinds of conscious experiences that can occur during task performance. Four classes of conscious experiences (i.e., being fully focused on the task, distractions by irrelevant sensations/perceptions, interfering thoughts related to the appraisal of the task, and mind-wandering) that varied along two dimensions (“task-relatedness” and “stimulus-dependency”) were sampled using thought-probes while the participants performed a go/no-go task. Analyses performed on the intervals preceding each probe according to the reported subjective experience revealed that both dimensions are relevant to explain activity in several regions of the DMN, namely the medial prefrontal cortex, posterior cingulate cortex/precuneus, and posterior inferior parietal lobe. Notably, an additive effect of the two dimensions was demonstrated for midline DMN regions. On the other hand, lateral temporal regions (also part of the DMN) were specifically related to stimulus-independent reports. These results suggest that midline DMN regions underlie cognitive processes that are active during both internal thoughts and external unfocused attention. They also strengthen the view that the DMN can be fractionated into different subcomponents and reveal the necessity to consider both the stimulus-dependent and the task-related dimensions of conscious experiences when studying the possible functional roles of the DMN

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome