Blood cultures with one venipuncture instead of two: a prospective clinical comparative single-center study including patients in the ICU, haematology, and infectious diseases departments.

OBJECTIVES: Blood culture is a key method for diagnosing bloodstream infections. In this prospective study, we aimed to investigate whether blood cultures collected with the one-puncture method results in fewer contaminants, i.e. microorganisms from the skin or the environment, and the same detection of relevant pathogens compared to the two-puncture method. Further, we aimed to investigate if the time to blood culture positivity could be useful in evaluating contaminants. METHODS: Patients planned for blood cultures were asked to participate in the study. From each recruited patient, six blood culture bottles were drawn, bottles 1-4 from the first venipuncture and bottles 5-6 from the second venipuncture. Within each patient, bottles 1-4 were compared to bottles 1, 2, 5, and 6 for contaminants and relevant pathogens. A sub-analysis was conducted on patients admitted to the ICU and those in the haematology department. We also assessed time-to-positivity for coagulase-negative staphylococci. RESULTS: In the final analysis, 337 episodes from 312 patients were included. Relevant pathogens were identified in 62/337 (18.4%) episodes in both methods. Contaminants were detected in 12 (3.6%) and 19 episodes (5.6%) using the one-puncture and two-puncture method (p = .039), respectively. Corresponding results were observed in the sub-analysis. Notably, relevant coagulase-negative staphylococci demonstrated a shorter time-to-positivity compared to contaminant coagulase-negative staphylococci. CONCLUSION: Blood cultures obtained using the one-puncture method resulted in significantly fewer contaminants and detected relevant pathogens equally to the two-puncture method. Time-to-positivity may be a useful additive indicator for predicting coagulase-negative staphylococci contamination in blood cultures.

Deliberating a Sustainable Welfare-Work Nexus.

Very few countries have managed to decouple economic growth from resource use and greenhouse gas emissions in absolute terms and at rates to meet the climate targets of the Paris Agreement. To achieve this, technological solutions would need to be combined with sufficiency-oriented policies in a postgrowth context. This paper develops policy ideas for a sustainable welfare-work nexus via citizen engagement and examines the level of democratic support for such ideas. Theoretically, it employs "sustainable welfare" to understand welfare and wellbeing within planetary and social limits. The paper first sketches the welfare-work nexus as developed in the postwar circumstances in Western Europe, highlighting that this model was at no point in time ecologically generalizable to the rest of the world, and then briefly reviews the existing debate on sustainable welfare. The empirical analyses start with qualitative data from 11 deliberative forums on sustainable needs satisfaction, with emphasis on policies targeted at respecting the upper and lower boundaries of a "safe and just operating space" for economic and social development. The qualitative data are then triangulated with quantitative data from a representative survey, which was constructed based on the policy suggestions from the forums, hence allowing for an exploration of their popularity in the Swedish population as a whole. We find a considerable gap between the far-reaching policy measures that forum participants consider necessary and the measures that the general public in Sweden are prepared to support, especially when it comes to policies targeting maximum levels of needs satisfaction.

A global overview of biodiversity offsetting governance.

We analyze the development of biodiversity offsetting governance through a research-weaving approach. Here, we combine information from a systematized review of the literature and a qualitative analysis of the institutional developments in different world regions. Through this triangulation, we synthesize and map the different developmental streams of biodiversity offsetting governance around the globe over the last four decades. We find that there is a global mainstreaming of core principles such as avoidance, no-net-loss, and a mitigation hierarchy, as well as pooling and trading of offsets for unavoidable residual damages. Furthermore, we can observe an ongoing diversification of institutional designs and actors involved. Together this constitutes an emerging regime complex of biodiversity offsetting governance that comes with both a set of shared norms and a growing institutional complexity. While this may imply institutional innovation through diversification and policy experimentation, it also raises questions regarding the effectiveness of offsetting practices.

Elucidation of Changes in Cellulose Ultrastructure and Accessibility in Hardwood Fractionation Processes with Carbohydrate Binding Modules.

We have recently presented a sequential treatment method, in which steam explosion (STEX) was followed by hydrotropic extraction (HEX), to selectively fractionate cellulose, hemicellulose, and lignin in hardwood into separate process streams. However, above a treatment severity threshold, the structural alterations in the cellulose-enriched fraction appeared to restrict the enzymatic hydrolyzability and delignification efficiency. To better understand the ultrastructural changes in the cellulose, hardwood chips were treated by single (STEX or HEX) and combined treatments (STEX and HEX), and the cellulose accessibility quantified with carbohydrate-binding modules (CBMs) that bind preferentially to crystalline (CBM2a) and paracrystalline cellulose (CBM17). Fluorescent-tagged versions of the CBMs were used to map the spatial distribution of cellulose substructures with confocal laser scanning microscopy. With increasing severities, STEX increased the apparent crystallinity (CBM2a/CBM17-ratio) and overall accessibility (CBM2aH6 + CBM17) of the cellulose, whereas HEX demonstrated the opposite trend. The respective effects could also be discerned in the combined treatments where increasing severities further resulted in higher hemicellulose dissolution and, although initially beneficial, in stagnating accessibility and hydrolyzability. This study suggests that balancing the severities in the two treatments is required to maximize the fractionation and simultaneously achieve a reactive and accessible cellulose that is readily hydrolyzable.

Sequential fractionation of the lignocellulosic components in hardwood based on steam explosion and hydrotropic extraction.

BACKGROUND: The forest biorefinery plays an important part in the evolving circular bioeconomy due to its capacity to produce a portfolio of bio-based and sustainable fuels, chemicals, and materials. To tap into its true potential, more efficient and environmentally benign methods are needed to fractionate woody biomass into its main components (cellulose, hemicellulose, and lignin) without reducing their potential for valorization. This work presents a sequential fractionation method for hardwood based on steam pretreatment (STEX) and hydrotropic extraction (HEX) with sodium xylene sulfonate. By prehydrolyzing the hemicellulose (STEX) and subsequently extract the lignin from the cellulose fraction (HEX), the major wood components can be recovered in separate process streams and be further valorized. RESULTS: Using autocatalyzed STEX and HEX, hemicellulose (> 70%) and lignin (~ 50%) were successfully fractionated and recovered in separate liquid streams and cellulose preserved (99%) and enriched (~ twofold) in the retained solids. Investigation of pretreatment conditions during HEX showed only incremental effects of temperature (150-190 °C) and hold-up time (2-8 h) variations on the fractionation efficiency. The hydrolyzability of the cellulose-rich solids was analyzed and showed higher cellulose conversion when treated with the combined process (47%) than with HEX alone (29%), but was inferior to STEX alone (75%). Protein adsorption and surface structure analysis suggested decreased accessibility due to the collapse of the fibrillose cellulose structure and an increasingly hydrophobic lignin as potential reasons. CONCLUSION: This work shows the potential of sequential STEX and HEX to fractionate and isolate cellulose, hemicellulose, and a sulfur-free lignin in separate product streams, in an efficient, sustainable, and scalable process.

Correspondence to the supplementary opinions on alternative cooling technologies in hot climate.

At present, air conditioning (AC) is the most effective means for the cooling of indoor space. However, its increased global use is problematic for various reasons. This is a correspondence to the supplementary opinion provided by Dr. Bin Yang, Dr. Stefano Schiavon, and Dr. Faming Wang to our paper titled "Challenges of using air conditioning in an increasingly hot climate." The paper explored the challenges linked to increased AC use and discusses more sustainable alternatives. The supplementary opinion provides a great technical complement to our paper. However, there is a need for a more holistic view both when it comes to combining various solutions and involving various levels in society.

Challenges of using air conditioning in an increasingly hot climate.

At present, air conditioning (AC) is the most effective means for the cooling of indoor space. However, its increased global use is problematic for various reasons. This paper explores the challenges linked to increased AC use and discusses more sustainable alternatives. A literature review was conducted applying a transdisciplinary approach. It was further complemented by examples from cities in hot climates. To analyse the findings, an analytical framework was developed which considers four societal levels-individual, community, city, and national. The main challenges identified from the literature review are as follows: environmental, organisational, socio-economical, biophysical and behavioural. The paper also identifies several measures that could be taken to reduce the fast growth of AC use. However, due to the complex nature of the problem, there is no single solution to provide sustainable cooling. Alternative solutions were categorised in three broad categories: climate-sensitive urban planning and building design, alternative cooling technologies, and climate-sensitive attitudes and behaviour. The main findings concern the problems arising from leaving the responsibility to come up with cooling solutions entirely to the individual, and how different societal levels can work towards more sustainable cooling options. It is concluded that there is a need for a more holistic view both when it comes to combining various solutions as well as involving various levels in society.

Mutagenesis as a tool in plant genetics, functional genomics, and breeding.

Plant mutagenesis is rapidly coming of age in the aftermath of recent developments in high-resolution molecular and biochemical techniques. By combining the high variation of mutagenised populations with novel screening methods, traits that are almost impossible to identify by conventional breeding are now being developed and characterised at the molecular level. This paper provides a comprehensive overview of the various techniques and workflows available to researchers today in the field of molecular breeding, and how these tools complement the ones already used in traditional breeding. Both genetic (Targeting Induced Local Lesions in Genomes; TILLING) and phenotypic screens are evaluated. Finally, different ways of bridging the gap between genotype and phenotype are discussed.

Local stakeholders' acceptance of model-generated data used as a communication tool in water management: The Rönneå Study.

The objective of this study was to increase the knowledge of local stakeholders' acceptance of model-generated data when used as a communication tool in water quality management. The Rönneå catchment in the southwest of Sweden was chosen as the study area. The results indicate the model-generated data served as a uniting factor. Simultaneously, the stakeholders were concerned with presented data, the main problems being sources of pollution, which were not accounted for, lack of trustworthiness when measuring pollution, and the uncertainty of the impact of natural variation and delayed effects. Four clusters of factors were identified as influencing stakeholders' acceptance of the model-generated data: confidence in its practical applications, confidence in the people involved in or providing material for the dialog (such as experts, decision-makers, and media), the social characteristics of the participants (such as age and profession), and the way of communicating the data (such as tone of communication, group composition, duration, and geographical scope of the dialog). The perception of the fairness of the practical application of given model-generated data was also an important factor for acceptance.