Transforming innovation for decarbonisation? Insights from combining complex systems and social practice perspectives

Technological innovations seem to be among the great promises for achieving the urgent modernisation of economies towards carbon-neutrality. Ranging from fusion energy, bio-based fuels, carbon capture and storage to PV panels and so-called smart energy systems, plenty of technologies promise to reduce use or greenhouse gas emissions of carbon based energy sources. This techno-centric view disregards to a great extent that technological change affects and is affected by societal practices and norms. The present paper argues that contemporary methodological approaches informed by complex systems and social practices theories provide urgently needed insights into innovation for decarbonisation. It specifically addresses the following questions: Why are current conceptualisations of innovation narrowly framed and with what consequences? How would a framing of innovation grounded on complex systems and social practice theories improve the understanding of opportunities and challenges at stake with innovation for decarbonisation? How could this framing help uncover and deploy an important and still often neglected social innovation potential? In a nutshell, the authors advocate for research and policy agendas that are firmly grounded in social practices and take complex and dynamic interactions of energy supply and demand as departing point to seriously reflect about the transitions that are put before us

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

A novel neuroferritinopathy mouse model (FTL 498InsTC) shows progressive brain iron dysregulation, morphological signs of early neurodegeneration and motor coordination deficits

Neuroferritinopathy is a rare genetic disease with a dominant autosomal transmission caused by mutations of the ferritin light chain gene (FTL). It belongs to Neurodegeneration with Brain Iron Accumulation, a group of disorders where iron dysregulation is tightly associated with neurodegeneration. We studied the 498-499InsTC mutation which causes the substitution of the last 9 amino acids and an elongation of extra 16 amino acids at the C-terminus of L-ferritin peptide. An analysis with cyclic voltammetry on the purified protein showed that this structural modification severely reduces the ability of the protein to store iron. In order to analyze the impact of the mutation in vivo, we generated mouse models for the some pathogenic human FTL gene in FVB and C57BL/6J strains.Transgenic mice in the FVB background showed high accumulation of the mutated ferritin in brain where it correlated with increased iron deposition with age, as scored by magnetic resonance imaging. Notably, the accumulation of iron-ferritin bodies was accompanied by signs of oxidative damage. In the C57BL/6 background, both the expression of the mutant ferritin and the iron levels were lower than in the FVB strain. Nevertheless, also these mice showed oxidative alterations in the brain. Furthermore, post-natal hippocampal neurons obtained from these mice experienced a marked increased cell death in response to chronic iron overload and/or acute oxidative stress, in comparison to wild-type neurons. Ultrastructural analyses revealed an accumulation of lipofuscin granules associated with iron deposits, particularly enriched in the cerebellum and striatum of our transgenic mice. Finally, experimental subjects were tested throughout development and aging at 2-, 8- and 18-months for behavioral phenotype. Rotarod test revealed a progressive impaired motor coordination building up with age, FTL mutant old mice showing a shorter latency to fall from the apparatus, according to higher accumulation of iron aggregates in the striatum. Our data show that our 498-499InsTC mouse models recapitulate early pathological and clinical traits of the human neuroferritinopathy, thus providing a valuable model for the study of the disease. Finally, we propose a mechanistic model of lipofuscine formation that can account for the etiopathogenesis of human neuroferritinopathy

Lung cancer risk among bricklayers in a pooled analysis of case-control studies.

OBJECTIVES: Bricklayers may be exposed to several lung carcinogens, including crystalline silica and asbestos. Previous studies reported an excess of lung cancer among these workers. We examined lung cancer risk among bricklayers within SYNERGY, a large international pooled analysis of case-control studies on lung cancer and the joint effects of occupational carcinogens (http://SYNERGY.iarc.fr).\n\nMETHOD: The pooled dataset included 15 608 cases and 18 531 controls from 22 centres in Europe, Canada, Hong Kong, and New Zealand. For men ever employed as bricklayers we estimated odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for study centre, age, lifetime cigarette smoking history, and employment in occupations with exposures to known or suspected lung carcinogens.\n\nRESULTS: We found 1322 cases and 1004 controls who had ever worked as bricklayers (OR: 1.35; 95% CI: 1.22-1.49). There was a clear positive trend with length of employment (P <0.0001). The relative risk was higher for squamous (OR: 1.44, 95% CI: 1.28-1.63, 578 cases) and small cell carcinomas (OR: 1.60, 95% CI: 1.36-1.87, 248 cases), than for adenocarcinoma (OR: 1.14, 95% CI: 0.98-1.32, 289 cases) (P-value for homogeneity: 0.0007). ORs were still elevated after additional adjustment for education and in analyses using blue collar workers as referents.\n\nCONCLUSIONS: This study provided additional evidence of increased lung cancer risk in bricklayers. Although non-causal explanations cannot be completely ruled out, the association is plausible in view of the potential for exposure to several carcinogens, notably crystalline silica and to a lesser extent asbestos

Giant cervical polyp: A case report and review of a rare entity

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