Life cycle energy and environmental assessment of the thermal insulation improvement in residential buildings

The refurbishment of the building stock is a key strategy towards the achievement of the climate and energy goals of the European Union. This study aims at evaluating the energy and environmental impacts associated with retrofitting a residential apartment to improve its vertical envelope thermal insulation. Two insulation materials, stone wool and cellulose fibers, are compared. The life cycle assessment methodology is applied assuming 1 m2 of retrofitted vertical envelope as functional unit. Moreover, to estimate the net energy and environmental benefits achievable in the retrofitted scenario compared with the non‐retrofitted one, a second analysis is performed in which the system boundaries are expanded to include the building operational phase, and 1 m2 of walkable floor per year is assumed as reference. The results show that the use of cellulose fibers involve lower impacts in most of the assessed categories compared to stone wool, except for abiotic resource depletion. In detail, the use of cellulose fibers allows to reduce the impact on climate change up to 20% and the consumption of primary energy up to 10%. The evaluation of the net energy and environmental benefits shows the effectiveness of the retrofit energy policies

Life Cycle Environmental Impacts and Health Effects of Protein-Rich Food as Meat Alternatives: A Review

The food sector is responsible for a considerable impact on the environment in most environmental contexts: the food supply chain causes greenhouse gas emissions, water consumption, reduction in cultivable land, and other environmental impacts. Thus, a change in food supply is required to reduce the environmental impacts caused by the food supply chain and to meet the increasing demand for sufficient and qualitative nutrition. Large herds of livestock are inappropriate to achieve these goals due to the relevant impact of meat supply chain on the environment, e.g., the land used to grow feed for animals is eight times more than that for human nutrition. The search for meat alternatives, especially for the intake of critical nutrients such as protein, is a consequent step. In the above context, this paper summarizes the health aspects of protein-rich food alternatives to meat and carries out a literature review on the life-cycle environmental impacts of this alternative food

Monoclonal antibodies in gastrointestinal cancers

none11noIntroduction: Among gastrointestinal cancers, colorectal and gastric neoplasms are the most frequent. The development of new targeted drugs improved the efficacy of systemic therapy in advanced stages of those malignancies. Areas covered: This review highlights the main biological processes implicated in gastrointestinal cancer development and progression, such as angiogenesis and epidermal growth factor receptor (EGFR) signaling pathway. On these bases, anti-EGFR and anti-vascular endothelial growth factor (VEGF) monoclonal antibodies in colorectal and gastric cancer are discussed. Data about further monoclonal antibodies in development are also reported. Expert opinion: The use of monoclonal antibodies in colorectal and gastric cancers showed the best outcomes when combined with chemotherapy, even though single agent anti-EGFR antibodies seem active in particular setting of metastatic colorectal cancer (CRC) patients. It is not well defined whether the addition of anti-VEGF and anti-EGFR to chemotherapy could improve outcome in those patients susceptible to CRC-related metastases resection. Little and conflicting data are available about the role of these drugs in adjuvant setting. Tests are available to select patients with higher probability to get benefit from these treatments. Further biomarkers need to be evaluated to improve this selection and achieve "tailorization" of systemic therapy. © 2013 Informa UK, Ltd.openBronte G.; Cicero G.; Cusenza S.; Galvano A.; Musso E.; Rizzo S.; Sortino G.; Roselli M.; Bazan V.; Fiorentino E.; Russo A.Bronte, G.; Cicero, G.; Cusenza, S.; Galvano, A.; Musso, E.; Rizzo, S.; Sortino, G.; Roselli, M.; Bazan, V.; Fiorentino, E.; Russo, A

Is there any room for PD-1 inhibitors in combination with platinum-based chemotherapy as frontline treatment of extensive-stage small cell lung cancer? A systematic review and meta-analysis with indirect comparisons among subgroups and landmark survival analyses

Background: The addition of PD-L1 inhibitors to platinum-based chemotherapy (CT) has newly received United States Food and Drug Administration (FDA) approval in extensive stage-small cell lung cancer (ES-SCLC). PD-1 agents similarly improved survival rates, even if not yet supported by international regulatory agencies. The current work aims to assess different efficacy and safety profiles among chemoimmunotherapy plus immuno-oncology (CT+IO) approaches according to different immune checkpoint inhibitor (ICI) subtypes. Material & Methods: We included in our meta-analysis six first-line randomised controlled trials (RCTs) comparing the association of single-agent ICI with CT versus CT alone in ES-SCLC. Pooled hazard ratios (HRs) and risk ratios (RRs) for progression-free survival (PFS), overall survival (OS), objective response rates (ORR), 12-month duration of response rate (DORR), disease control rate (DCR), treatment-related adverse events (TRAEs) and discontinuation rates (DRs) were obtained. Moreover, we performed indirect comparisons according to ICI subtypes, also among subgroups and landmark survival analyses. Results: Although no ORR benefit was observed, our results showed how CT+IO significantly improved DORR, resulting in improved PFS and OS with no differences in TRAEs; however, CT+IO led to a significant increase in DR. Interestingly, an Eastern Cooperative Oncology Group performance status (ECOG PS) of 1, the use of cisplatin, and the absence of brain metastases seem to be associated with a survival gain using CT+IO in ES-SCLC. Indirect comparisons suggested a slight advantage in favour of programmed cell death-1 (PD-1) and programmed death ligand 1 (PD-L1) over anti-CTLA-4 agents in terms of efficacy with no additional safety concerns. No further differences were observed between PD-1 and PD-L1 inhibitors among subgroups and landmark survival analyses with benefit trends towards anti-PD-1 in terms of DORR and DR. Conclusion: While confirming a survival advantage of CT+IO in selected patients, these results suggested the association of PD-1 inhibitors with CT as a viable option for novel therapeutic approaches in the frontline management of ES-SCLC. Further trials evaluating anti-CTLA-4 agents should be carefully studied in biomarker-selected patients

Linear and non-linear parameterization of EEG during monitoring of carotid endarterectomy

In this paper, new quantitative linear (HLF ratio: high frequency/low frequency spectral power ratio) and non-linear parameters (ZC: zero crossing and FD: fractal dimension) which can assist the physician in real-time decision whether a shunt is required or not during intra-operative EEG monitoring of carotid endarterectomy are presented. The results obtained with the new parameters are compared with those achieved by other indexes proposed in the literature. The HLF ratio and ZC parameters yielded the best results with a 100% of correct identification of both shunt and no-shunt situations. The ZC can be also easily implemented in the real-time monitoring of EEG