Transformative innovation and translocal diffusion

This paper develops a conceptual understanding of transformative innovations as shared activities, ideas and objects across locally rooted sustainability initiatives that explore and develop alternatives to incumbent and (perceived) unsustainable regimes that they seek to challenge, alter or replace. We synthesize empirical work from two European research projects (TRANSIT and ARTS), in which initiatives and networks were empirically studied, to develop a broader conceptual understanding of the emergence of transformative innovation. The development of initiatives can occur through growing, replicating, partnering, instrumentalising and embedding. This is supported through translocal networks that connect initiatives by sharing ideas, objects and activities across local contexts. This translocal characteristic of transformative innovations harnesses an enormous potential for sustainability transitions, but requires further understanding a

Effect of intravenous clarithromycin in patients with sepsis, respiratory and multiple organ dysfunction syndrome: a randomized clinical trial.

Clarithromycin may act as immune-regulating treatment in sepsis and acute respiratory dysfunction syndrome. However, clinical evidence remains inconclusive. We aimed to evaluate whether clarithromycin improves 28-day mortality among patients with sepsis, respiratory and multiple organ dysfunction syndrome. We conducted a multicenter, randomized, clinical trial in patients with sepsis. Participants with ratio of partial oxygen pressure to fraction of inspired oxygen less than 200 and more than 3 SOFA points from systems other than the respiratory function were enrolled between December 2017 and September 2019. Patients were randomized to receive 1 gr of clarithromycin or placebo intravenously once daily for 4 consecutive days. The primary endpoint was 28-day all-cause mortality. Secondary outcomes were 90-day mortality; sepsis response (defined as at least 25% decrease in SOFA score by day 7); sepsis recurrence; and differences in peripheral blood cell populations and leukocyte transcriptomics. Fifty-five patients were allocated to each arm. By day 28, 27 (49.1%) patients in the clarithromycin and 25 (45.5%) in the placebo group died (risk difference 3.6% [95% confidence interval (CI) - 15.7 to 22.7]; P = 0.703, adjusted OR 1.03 [95%CI 0.35-3.06]; P = 0.959). There were no statistical differences in 90-day mortality and sepsis response. Clarithromycin was associated with lower incidence of sepsis recurrence (OR 0.21 [95%CI 0.06-0.68]; P = 0.012); significant increase in monocyte HLA-DR expression; expansion of non-classical monocytes; and upregulation of genes involved in cholesterol homeostasis. Serious and non-serious adverse events were equally distributed. Clarithromycin did not reduce mortality among patients with sepsis with respiratory and multiple organ dysfunction. Clarithromycin was associated with lower sepsis recurrence, possibly through a mechanism of immune restoration. Clinical trial registration clinicaltrials.gov identifier NCT03345992 registered 17 November 2017; EudraCT 2017-001056-55

The relational shift in urban ecology: from place and structures to multiple modes of coproduction for positive urban futures

This perspective emerged from ongoing dialogue among ecologists initiated by a virtual workshop in 2021. A transdisciplinary group of researchers and practitioners conclude that urban ecology as a science can better contribute to positive futures by focusing on relationships, rather than prioritizing urban structures. Insights from other relational disciplines, such as political ecology, governance, urban design, and conservation also contribute. Relationality is especially powerful given the need to rapidly adapt to the changing social and biophysical drivers of global urban systems. These unprecedented dynamics are better understood through a relational lens than traditional structural questions. We use three kinds of coproduction—of the social-ecological world, of science, and of actionable knowledge—to identify key processes of coproduction within urban places. Connectivity is crucial to relational urban ecology. Eight themes emerge from the joint explorations of the paper and point toward social action for improving life and environment in urban futures

Advancing urban transitions and transformations research

Urban transitions and transformations research fosters a dialogue between sustainability transitions theory an inter- and transdisciplinary research on urban change. As a field, urban transitions and transformations research encompasses plural analytical and conceptual perspectives. In doing so, this field opens up sustainability transitions research to new communities of practice in urban environments, including mayors, transnational municipal networks, and international organizations

One transition, many transitions? A corpus-based study of societal sustainability transition discourses in four civil society’s proposals

When the civil society makes ‘transition’ its label, it cannot be assumed that different civil society actors share compatible varieties of localist or radical transformationists discourses. This study has comparatively analyzed the discourses in four civil society sustainability transition proposals using a corpus-based methodology. We found that the proposals are similar as they identify the economy as an object and an entry point for transition, frame the economy as embedded in the socio–ecological system, ascribe agency to grassroots movements for transitions from the bottom–up. We also found crucial differences among the discourses regarding the role of the State, the degree of reform or radical innovation, the degree of imaginative character of the sustainability vision, the degree of opposition to capitalism. We suggest that insights on how the civil society employs notions of transition with respect to the themes of politics, emotions and place can help advance theorizations and practices of societal sustainability transitions led by the civil society

Sustainable Urban Systems: Co-design and Framing for Transformation

Rapid urbanisation generates risks and opportunities for sustainable development. Urban policy and decision makers are challenged by the complexity of cities as social–ecological–technical systems. Consequently there is an increasing need for collaborative knowledge development that supports a whole-of-system view, and transformational change at multiple scales. Such holistic urban approaches are rare in practice. A co-design process involving researchers, practitioners and other stakeholders, has progressed such an approach in the Australian context, aiming to also contribute to international knowledge development and sharing. This process has generated three outputs: (1) a shared framework to support more systematic knowledge development and use, (2) identification of barriers that create a gap between stated urban goals and actual practice, and (3) identification of strategic focal areas to address this gap. Developing integrated strategies at broader urban scales is seen as the most pressing need. The knowledge framework adopts a systems perspective that incorporates the many urban trade-offs and synergies revealed by a systems view. Broader implications are drawn for policy and decision makers, for researchers and for a shared forward agenda

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Transformative capacity and local action for urban sustainability.

There is a consensus about the strategic importance of cities and urban areas for achieving a global transformation towards sustainability. While there is mounting interest in the types of qualities that increase the capacity of urban systems to attain deep transformations, empirical evidence about the extent to which existing institutional and material systems exhibit transformative capacity is lacking. This paper thereby seeks to determine the extent to which sustainability initiatives led by local governments and their partners reflect the various components that the literature claims can influence the emergence of transformative capacity as a systemic property of urban settings. Using an evaluative framework consisting of ten components of transformative capacity and associated indicators, the specific objective is to identify patterns in these initiatives regarding the presence of individual components of transformative capacity and their interrelations with other components. The analysis of 400 sustainability initiatives reveals thin evidence of transformative capacity. When detected, evidence of transformative capacity tended to emerge in relation to wider processes of institutional- and social-learning and initiatives that linked outcomes to a city-wide vision of planning and development. However, instances of such initiatives were rare. This widespread lack of evidence for transformative capacity raises concerns that this set of attributes normalised in the literature is in fact rarely found in sustainability action on the ground