96 research outputs found
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
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Leflunomide treatment for patients hospitalised with COVID-19: DEFEAT-COVID randomised controlled trial
Objective
To evaluate the clinical efficacy and safety of leflunomide (L) added to the standard-of-care (SOC) treatment in COVID-19 patients hospitalised with moderate/critical clinical symptoms.
Design
Prospective, open-label, multicentre, stratified, randomised clinical trial.
Setting
Five hospitals in UK and India, from September 2020 to May 2021.
Participants
Adults with PCR confirmed COVID-19 infection with moderate/critical symptoms within 15 days of onset.
Intervention
Leflunomide 100 mg/day (3 days) followed by 10â20 mg/day (7 days) added to standard care.
Primary outcomes
The time to clinical improvement (TTCI) defined as two-point reduction on a clinical status scale or live discharge prior to 28 days; safety profile measured by the incidence of adverse events (AEs) within 28 days.
Results
Eligible patients (n=214; age 56.3±14.9 years; 33% female) were randomised to SOC+L (n=104) and SOC group (n=110), stratified according to their clinical risk profile. TTCI was 7 vs 8 days in SOC+L vs SOC group (HR 1.317; 95% CI 0.980 to 1.768; p=0.070). Incidence of serious AEs was similar between the groups and none was attributed to leflunomide. In sensitivity analyses, excluding 10 patients not fulfilling the inclusion criteria and 3 who withdrew consent before leflunomide treatment, TTCI was 7 vs 8 days (HR 1.416, 95% CI 1.041 to 1.935; p=0.028), indicating a trend in favour of the intervention group. All-cause mortality rate was similar between groups, 9/104 vs 10/110. Duration of oxygen dependence was shorter in the SOC+L group being a median 6 days (IQR 4â8) compared with 7 days (IQR 5â10) in SOC group (p=0.047).
Conclusion
Leflunomide, added to the SOC treatment for COVID-19, was safe and well tolerated but had no major impact on clinical outcomes. It may shorten the time of oxygen dependence by 1 day and thereby improve TTCI/hospital discharge in moderately affected COVID-19 patients
Avaliação do efeito do bagaço de cana-de-açĂșcar in natura obtido por dois mĂ©todos sobre o desempenho e o comportamento ingestivo de bovinos de corte
CaracterĂsticas da Carcaça e Qualidade da Carne de Tourinhos Alimentados com Dietas de Alta Energia
Circadian variation of fatigue in both patients with paralytic poliomyelitis and post-polio syndrome
Clinical applications of immunoglobulin in neuromuscular diseases: focus on inflammatory myopathies
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