A hybrid enzyme-nanoparticle system is described for achieving clean reduction of CO 2 to CO using visible light as the energy source. An aqueous dispersion of TiO 2 nanoparticles modified by attachment of carbon monoxide dehydrogenase (CODH) and a Ru photosensitizer produces CO at a rate of 250 μmol CO (g TiO 2 ) -1 h -1 when illuminated with visible light at pH 6 and 20 °C.There is wide interest in converting the greenhouse gas CO 2 into organic molecules by chemical routes 1,2 and a highly desirable goal is to use solar energy to reduce CO 2 to CO, efficiently and cleanly. Carbon monoxide is the feedstock for various synthetic processes, such as the dmetal catalyzed Fischer-Tropsch (production of hydrocarbons), Monsanto and Cativa (both acetic acid) processes. Carbon monoxide also has significant fuel value (Δ c H° = −283.0 kJ mol -1 ), and can readily be converted into methanol (e.g., by the CuO/ZnO/Al 2 O 3 -catalyzed (Fig. S1), CO 2 photo-reduction using natural sunlight (Fig. S2), effect of centrifuging particles and exchanging buffer solution (Fig. S3), effect of pH (Fig. S4), UV-visible study of CODH I adsorption onto TiO 2 nanoparticles (Fig. S5), effect of initial CO concentration (Fig. S6), approximate calculation for CODH I loading on TiO 2 nanoparticles, full list of authors for ref. 12 . This material is available free of charge via the Internet at

A model system for photoreduction of CO 2 to CO using visible light has been extensively studied, using a catalyst for which the CO 2 /CO reaction is electrochemically reversible. The hybrid system comprises metal oxide nanoparticles functionalised with the enzyme carbon monoxide dehydrogenase (CODH), and sensitised to visible light using a ruthenium bipyridyl photosensitiser. An anatase/rutile TiO 2 mixture (Evonik Degussa P25) was selected as the most suitable semiconductor, and CO production rates and stability were examined as a function of each component (photosensitiser, enzyme and TiO 2 ). Tolerance to O 2 and effects of different electron donors were also investigated, together with strategies to control enzyme binding at the surface of TiO 2 in order to enhance overall activity.

Objectives: to evaluate orthogeriatric and nurse-led fracture liaison service (FLS) models of post-hip fracture care in terms of impact on mortality (30 days and 1 year) and second hip fracture (2 years).Setting: Hospital Episode Statistics database linked to Office for National Statistics mortality records for 11 acute hospitals in a region of England.Population: patients aged over 60 years admitted for a primary hip fracture from 2003 to 2013.Methods: each hospital was analysed separately and acted as its own control in a before–after time-series design in which the appointment of an orthogeriatrician or set-up/expansion of an FLS was evaluated. Multivariable Cox regression (mortality) and competing risk survival models (second hip fracture) were used. Fixed effects meta-analysis was used to pool estimates of impact for interventions of the same type.Results: of 33,152 primary hip fracture patients, 1,288 sustained a second hip fracture within 2 years (age and sex standardised proportion of 4.2%). 3,033 primary hip fracture patients died within 30 days and 9,662 died within 1 year (age and sex standardised proportion of 9.5% and 29.8%, respectively). The estimated impact of introducing an orthogeriatrician on 30-day and 1-year mortality was hazard ratio (HR) = 0.73 (95% CI: 0.65–0.82) and HR = 0.81 (CI: 0.75–0.87), respectively. Following an FLS, these associations were as follows: HR = 0.80 (95% CI: 0.71–0.91) and HR = 0.84 (0.77–0.93). There was no significant impact on time to second hip fracture.Conclusions: the introduction and/or expansion of orthogeriatric and FLS models of post-hip fracture care has a beneficial effect on subsequent mortality. No evidence for a reduction in second hip fracture rate was found.

Vitamin D supplementation did not slow the rate of JSN or lead to reduced pain, stiffness or functional loss over a 3-year period. On the basis of these findings we consider that vitamin D supplementation has no role in the management of knee OA.

The development of robust systems for the conversion of solar energy into chemical fuels is an important subject in renewable energy research. Key aspects are efficient and rapid catalysis of both fuel production (reduction of H 2 O or CO 2 ), and water oxidation. Enzymes often have extraordinary and unique capabilities as electrocatalysts, and in this Perspective we consider the role that these molecules can play through their incorporation into model systems for solar fuel production, or as inspiration for synthetic catalysts.

Background Large-scale asymptomatic testing of communities in Liverpool (UK) for SARS-CoV-2 was used as a public health tool for containing COVID-19. The aim of the study is to explore social and spatial inequalities in uptake and case-detection of rapid lateral flow SARS-CoV-2 antigen tests (LFTs) offered to people without symptoms of COVID-19. Methods Linked pseudonymised records for asymptomatic residents in Liverpool who received a LFT for COVID-19 between 6th November 2020 to 31st January 2021 were accessed using the Combined Intelligence for Population Health Action resource. Bayesian Hierarchical Poisson Besag, York, and Mollié models were used to estimate ecological associations for uptake and positivity of testing. Findings 214 525 residents (43%) received a LFT identifying 5192 individuals as positive cases of COVID-19 (1.3% of tests were positive). Uptake was highest in November when there was military assistance. High uptake was observed again in the week preceding Christmas and was sustained into a national lockdown. Overall uptake were lower among males (e.g. 40% uptake over the whole period), Black Asian and other Minority Ethnic groups (e.g. 27% uptake for ‘Mixed’ ethnicity) and in the most deprived areas (e.g. 32% uptake in most deprived areas). These population groups were also more likely to have received positive tests for COVID-19. Models demonstrated that uptake and repeat testing were lower in areas of higher deprivation, areas located further from test sites and areas containing populations less confident in the using Internet technologies. Positive tests were spatially clustered in deprived areas. Interpretation Large-scale voluntary asymptomatic community testing saw social, ethnic, digital and spatial inequalities in uptake. COVID-19 testing and support to isolate need to be more accessible to the vulnerable communities most impacted by the pandemic, including non-digital means of access. Funding Department of Health and Social Care (UK) and Economic and Social Research Council.

The UK government response to COVID-19 has been heavily criticised. We report witnesses’ perceptions of what has shaped UK policies and how these policies have been received by healthcare workers. Such studies are usually affected by hindsight. Here we deploy a novel prospective approach to capture real-time information. We are historians, social scientists and biomedical researchers who study how societies cope with infectious disease. In February 2020 we began regular semi-structured calls with prominent members of policy communities, and health care professionals, to elicit their roles in, and reactions to, the pandemic response. We report witnesses’ perceptions that personal protective equipment (PPE) stocks were too small, early warnings have not led to sufficiently rapid policy decisions, and a lack of transparency is sapping public trust. Significant successes include research mobilisation. The early experiences and reactions of our witnesses suggest important issues for investigation, notably a perception of delay in decision making.

We argue that predictions of a ‘tsunami’ of mental health problems as a consequence of the pandemic of coronavirus disease 2019 (COVID-19) and the lockdown are overstated; feelings of anxiety and sadness are entirely normal reactions to difficult circumstances, not symptoms of poor mental health.  Some people will need specialised mental health support, especially those already leading tough lives; we need immediate reversal of years of underfunding of community mental health services.  However, the disproportionate effects of COVID-19 on the most disadvantaged, especially BAME people placed at risk by their social and economic conditions, were entirely predictable. Mental health is best ensured by urgently rebuilding the social and economic supports stripped away over the last decade. Governments must pump funds into local authorities to rebuild community services, peer support, mutual aid and local community and voluntary sector organisations.  Health care organisations must tackle racism and discrimination to ensure genuine equal access to universal health care.  Government must replace highly conditional benefit systems by something like a universal basic income. All economic and social policies must be subjected to a legally binding mental health audit. This may sound unfeasibly expensive, but the social and economic costs, not to mention the costs in personal and community suffering, though often invisible, are far greater.