Spatial analysis of toxic emissions in LCA: A sub-continental nested USEtox model with freshwater archetypes

This paper develops continent-specific factors for the USEtox model and analyses the accuracy of different model architectures, spatial scales and archetypes in evaluating toxic impacts, with a focus on freshwater pathways. Inter-continental variation is analysed by comparing chemical fate and intake fractions between sub-continental zones of two life cycle impact assessment models: (1) the nested USEtox model parameterized with sub-continental zones and (2) the spatially differentiated IMPACTWorld model with 17 interconnected sub-continental regions. Substance residence time in water varies by up to two orders of magnitude among the 17 zones assessed with IMPACTWorld and USEtox, and intake fraction varies by up to three orders of magnitude. Despite this variation, the nested USEtox model succeeds in mimicking the results of the spatially differentiated model, with the exception of very persistent volatile pollutants that can be transported to polar regions. Intra- continental variation is analysed by comparing fate and intake fractions modelled with the a-spatial (one box) IMPACT Europe continental model vs. the spatially differentiated version of the same model. Results show that the one box model might overestimate chemical fate and characterisation factors for freshwater eco-toxicity of persistent pollutants by up to three orders of magnitude for point source emissions. Subdividing Europe into three archetypes, based on freshwater residence time (how long it takes water to reach the sea), improves the prediction of fate and intake fractions for point source emissions, bringing them within a factor five compared to the spatial model. We demonstrated that a sub-continental nested model such as USEtox, with continent-specific parameterization complemented with freshwater archetypes, can thus represent inter- and intra-continental spatial variations, whilst minimizing model complexity. (C) 2014 Elsevier Ltd. All rights reserved

Review of methods addressing freshwater use in life cycle inventory and impact assessment

Purpose: In recent years, several methods have been developed which propose different freshwater use inventory schemes and impact assessment characterization models considering various cause-effect chain relationships. This work reviewed a multitude of methods and indicators for freshwater use potentially applicable in life cycle assessment (LCA). This review is used as a basis to identify the key elements to build a scientific consensus for operational characterization methods for LCA. Methods: This evaluation builds on the criteria and procedure developed within the International Reference Life Cycle Data System Handbook and has been adapted for the purpose of this project. It therefore includes (1) description of relevant cause-effect chains, (2) definition of criteria to evaluate the existing methods, (3) development of sub-criteria specific to freshwater use, and (4) description and review of existing methods addressing freshwater in LCA. Results and discussion: No single method is available which comprehensively describes all potential impacts derived from freshwater use. However, this review highlights several key findings to design a characterization method encompassing all the impact pathways of the assessment of freshwater use and consumption in life cycle assessment framework as the following: (1) in most of databases and methods, consistent freshwater balances are not reported either because output is not considered or because polluted freshwater is recalculated based on a critical dilution approach; (2) at the midpoint level, most methods are related to water scarcity index and correspond to the methodological choice of an indicator simplified in terms of the number of parameters (scarcity) and freshwater uses (freshwater consumption or freshwater withdrawal) considered. More comprehensive scarcity indices distinguish different freshwater types and functionalities. (3) At the endpoint level, several methods already exist which report results in units compatible with traditional human health and ecosystem quality damage and cover various cause-effect chains, e.g., the decrease of terrestrial biodiversity due to freshwater consumption. (4) Midpoint and endpoint indicators have various levels of spatial differentiation, i.e., generic factors with no differentiation at all, or country, watershed, and grid cell differentiation. Conclusions: Existing databases should be (1) completed with input and output freshwater flow differentiated according to water types based on its origin (surface water, groundwater, and precipitation water stored as soil moisture), (2) regionalized, and (3) if possible, characterized with a set of quality parameters. The assessment of impacts related to freshwater use is possible by assembling methods in a comprehensive methodology to characterize each use adequatel

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

An instrumental value-based framework for assessing the damages of abiotic resources use in life cycle assessment

Introduction and literature review : Abiotic resources are extensively used in industrialized societies to deliver multiple services that contribute to human well-being. Their increased extraction and use can potentially reduce their accessibility, increase competition among users, and ultimately lead to a deficit of those services. Life cycle assessment is a relevant tool to assess the potential damages of dissipating natural resources. Building on the general consensus recommending evaluating the damages on the instrumental value of resources to humans in order to assess the consequences of resources dissipation, this research work proposes a novel conceptual framework to assess the potential loss of services provided by abiotic resources, which when facing unmet demand can lead to a deficit to human users and have consequences on human well-being. Results : A framework is proposed to describe the mechanisms that link human intervention on the resources in the accessible stock to competition among users. Users facing the deficit of resource services are assumed to have to pay to recover the services, using backup technologies. The mechanisms that are proposed to be characterized are dissipation and degradation. Data needed to later operationalize the framework for abiotic resources are identified. It also proposes a framework at the life cycle inventory level to harmonize life cycle inventories with the current impact assessment framework to fully characterize impacts on resource services. It regards ensuring mass balances of elements between inputs and outputs of life cycle inventory datasets as well as including the functionality of resource flows. Discussion and conclusions : The framework provides recommendations for the development of operational life cycle impact assessment (LCIA) methods for resource services deficit assessment. It establishes the impact pathway to damage on the area of protection “Resource Services”, data needed to feed the model and recommendations to improve the current state of life cycle inventories to be harmonized with the LCIA framework