Life cycle inventory data for the Italian agri-food sector: background, sources and methodological aspects

AbstractPurposeFor the development of any life cycle assessment study, the practitioner frequently integrates primary data collected on-field, with background data taken from various life cycle inventory databases which are part of most commercial LCA software packages. However, such data is often not generally applicable to all product systems since, especially concerning the agri-food sector, available datasets may not be fully representative of the site specificity of the food product under examination. In this context, the present work investigates the background, sources and methodological aspects that characterise the most known commercial databases containing agri-food data, with a focus on four agri-food supply chains (olive oil, wine, wheat products and citrus fruit), which represent an important asset for the Italian food sector.MethodsSpecifically, the paper entails a review of currently available LCI databases and their datasets with a twofold scope: firstly, to understand how agri-food data is modelled in these databases for a coherent and consistent representation of regional scenarios and to verify whether they are also suitable for the Italian context and, secondly, to identify and analyse useful and relevant methodological approaches implemented in the existing LCI databases when regional data are modelled.ResultsBased on the aforementioned review, it is possible to highlight some problems which may arise when developing an LCI pertaining to the four Italian agri-food supply chains, namely:1. The need for specific inventory datasets to tackle the specificities of agri-food product systems.2. The lack of datasets, within the existing DBs, related to the Italian context and to the abovementioned supply chains. In fact, at present, in the currently available LCI DBs, there are very few (or in some cases none) datasets related to Italian wine, olive oil, wheat-based products and citrus fruit. The few available datasets often contain some data related to the Italian context but also approximate data with that of product systems representing other countries.Furthermore, the present study allowed to identify and discuss the main aspects to be used as starting elements for modelling regional data to be included in a future Italian LCI database of the abovementioned four supply chains.ConclusionsThe results of the present study represent a starting point for the collection of data and its organisation, in order to develop an Italian LCI agri-food database with datasets which are representative of the regional specificities of four agri-food supply chains which play an important role in the Italian economy

Life cycle inventory data for the Italian agri-food sector: background, sources and methodological aspects

Purpose: For the development of any life cycle assessment study, the practitioner frequently integrates primary data collected on-field, with background data taken from various life cycle inventory databases which are part of most commercial LCA software packages. However, such data is often not generally applicable to all product systems since, especially concerning the agri-food sector, available datasets may not be fully representative of the site specificity of the food product under examination. In this context, the present work investigates the background, sources and methodological aspects that characterise the most known commercial databases containing agri-food data, with a focus on four agri-food supply chains (olive oil, wine, wheat products and citrus fruit), which represent an important asset for the Italian food sector. Methods: Specifically, the paper entails a review of currently available LCI databases and their datasets with a twofold scope: firstly, to understand how agri-food data is modelled in these databases for a coherent and consistent representation of regional scenarios and to verify whether they are also suitable for the Italian context and, secondly, to identify and analyse useful and relevant methodological approaches implemented in the existing LCI databases when regional data are modelled. Results: Based on the aforementioned review, it is possible to highlight some problems which may arise when developing an LCI pertaining to the four Italian agri-food supply chains, namely: 1. The need for specific inventory datasets to tackle the specificities of agri-food product systems. 2. The lack of datasets, within the existing DBs, related to the Italian context and to the abovementioned supply chains. In fact, at present, in the currently available LCI DBs, there are very few (or in some cases none) datasets related to Italian wine, olive oil, wheat-based products and citrus fruit. The few available datasets often contain some data related to the Italian context but also approximate data with that of product systems representing other countries. Furthermore, the present study allowed to identify and discuss the main aspects to be used as starting elements for modelling regional data to be included in a future Italian LCI database of the abovementioned four supply chains. Conclusions: The results of the present study represent a starting point for the collection of data and its organisation, in order to develop an Italian LCI agri-food database with datasets which are representative of the regional specificities of four agri-food supply chains which play an important role in the Italian economy

Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews

Clinical or care pathways are developed by a multidisciplinary team of healthcare practitioners, based on clinical evidence, and standardized processes. The evaluation of their framework/content quality is unclear. The aim of this study was to describe which tools and domains are able to critically evaluate the quality of clinical/care pathways. An overview of systematic reviews was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, using Medline, Embase, Science Citation Index, PsychInfo, CINAHL, and Cochrane Library, from 2015 to 2020, and with snowballing methods. The quality of the reviews was assessed with Assessment the Methodology of Systematic Review (AMSTAR-2) and categorized with The Leuven Clinical Pathway Compass for the definition of the five domains: processes, service, clinical, team, and financial. We found nine reviews. Three achieved a high level of quality with AMSTAR-2. The areas classified according to The Leuven Clinical Pathway Compass were: 9.7% team multidisciplinary involvement, 13.2% clinical (morbidity/mortality), 44.3% process (continuity-clinical integration, transitional), 5.6% financial (length of stay), and 27.0% service (patient-/family-centered care). Overall, none of the 300 instruments retrieved could be considered a gold standard mainly because they did not cover all the critical pathway domains outlined by Leuven and Health Technology Assessment. This overview shows important insights for the definition of a multiprinciple framework of core domains for assessing the quality of pathways. The core domains should consider general critical aspects common to all pathways, but it is necessary to define specific domains for specific diseases, fast pathways, and adapting the tool to the cultural and organizational characteristics of the health system of each country

Surfactant lung delivery with LISA and InSurE in adult rabbits with respiratory distress

Background In preterm infants, InSurE (Intubation–Surfactant–Extubation) and LISA (less invasive surfactant administration) techniques allow for exogenous surfactant administration while reducing lung injury associated with mechanical ventilation. We compared the acute pulmonary response and lung deposition of surfactant by LISA and InSurE in surfactant-depleted adult rabbits. Methods Twenty-six spontaneously breathing surfactant-depleted adult rabbits (6–7 weeks old) with moderate RDS and managed with nasal continuous positive airway pressure were randomized to 3 groups: (1) 200 mg/kg of surfactant by InSurE; (2) 200 mg/kg of surfactant by LISA; (3) no surfactant treatment (Control). Gas exchange and lung mechanics were monitored for 180 min. After that, surfactant lung deposition and distribution were evaluated monitoring disaturated-phosphatidylcholine (DSPC) and surfactant protein C (SP-C), respectively. Results No signs of recovery were found in the untreated animals. After InSurE, oxygenation improved more rapidly compared to LISA. However, at 180’ LISA and InSurE showed comparable outcomes in terms of gas exchange, ventilation parameters, and lung mechanics. Neither DSPC in the alveolar pool nor SP-C signal distributions in a frontal lung section were significantly different between InSurE and LISA groups. Conclusions In an acute setting, LISA demonstrated efficacy and surfactant lung delivery similar to that of InSurE in surfactant-depleted adult rabbits. Impact Although LISA technique is gaining popularity, there are still several questions to address. This is the first study comparing LISA and InSurE in terms of gas exchange, ventilation parameters, and lung mechanics as well as surfactant deposition and distribution. In our animal study, three hours post-treatment, LISA method seems to be as effective as InSurE and showed similar surfactant lung delivery. Our findings provide some clarifications on a fair comparison between LISA and InSurE techniques, particularly in terms of surfactant delivery. They should reassure some of the concerns raised by the clinical community on LISA adoption in neonatal units

Surfactant lung delivery with LISA and InSurE in adult rabbits with respiratory distress

Background: In preterm infants, InSurE (Intubation\u2013Surfactant\u2013Extubation) and LISA (less invasive surfactant administration) techniques allow for exogenous surfactant administration while reducing lung injury associated with mechanical ventilation. We compared the acute pulmonary response and lung deposition of surfactant by LISA and InSurE in surfactant-depleted adult rabbits. Methods: Twenty-six spontaneously breathing surfactant-depleted adult rabbits (6\u20137 weeks old) with moderate RDS and managed with nasal continuous positive airway pressure were randomized to 3 groups: (1) 200 mg/kg of surfactant by InSurE; (2) 200 mg/kg of surfactant by LISA; (3) no surfactant treatment (Control). Gas exchange and lung mechanics were monitored for 180 min. After that, surfactant lung deposition and distribution were evaluated monitoring disaturated-phosphatidylcholine (DSPC) and surfactant protein C (SP-C), respectively. Results: No signs of recovery were found in the untreated animals. After InSurE, oxygenation improved more rapidly compared to LISA. However, at 180\u2019 LISA and InSurE showed comparable outcomes in terms of gas exchange, ventilation parameters, and lung mechanics. Neither DSPC in the alveolar pool nor SP-C signal distributions in a frontal lung section were significantly different between InSurE and LISA groups. Conclusions: In an acute setting, LISA demonstrated efficacy and surfactant lung delivery similar to that of InSurE in surfactant-depleted adult rabbits. Impact: Although LISA technique is gaining popularity, there are still several questions to address. This is the first study comparing LISA and InSurE in terms of gas exchange, ventilation parameters, and lung mechanics as well as surfactant deposition and distribution.In our animal study, three hours post-treatment, LISA method seems to be as effective as InSurE and showed similar surfactant lung delivery.Our findings provide some clarifications on a fair comparison between LISA and InSurE techniques, particularly in terms of surfactant delivery. They should reassure some of the concerns raised by the clinical community on LISA adoption in neonatal units

Partial Deconfinement in Color Superconductivity

We analyze the fate of the unbroken SU(2) color gauge interactions for 2 light flavors color superconductivity at non zero temperature. Using a simple model we compute the deconfining/confining critical temperature and show that is smaller than the critical temperature for the onset of the superconductive state itself. The breaking of Lorentz invariance, induced already at zero temperature by the quark chemical potential, is shown to heavily affect the value of the critical temperature and all of the relevant features related to the deconfining transition. Modifying the Polyakov loop model to describe the SU(2) immersed in the diquark medium we argue that the deconfinement transition is second order. Having constructed part of the equation of state for the 2 color superconducting phase at low temperatures our results are relevant for the physics of compact objects featuring a two flavor color superconductive state.Comment: 9 pp, 4 eps-figs, version to appear in PR

Resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with major trauma and uncontrolled haemorrhagic shock: a systematic review with meta-analysis

Background Multiple studies regarding the use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in patients with non-compressible torso injuries and uncontrolled haemorrhagic shock were recently published. To date, the clinical evidence of the efficacy of REBOA is still debated. We aimed to conduct a systematic review assessing the clinical efficacy and safety of REBOA in patients with major trauma and uncontrolled haemorrhagic shock. Methods We systematically searched MEDLINE (PubMed), EMBASE and CENTRAL up to June 2020. All randomized controlled trials and observational studies that investigated the use of REBOA compared to resuscitative thoracotomy (RT) with/without REBOA or no-REBOA were eligible. We followed the PRISMA and MOOSE guidelines. Two authors independently extracted data and appraised the risk of bias of included studies. Effect sizes were pooled in a meta-analysis using random-effects models. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Primary outcomes were mortality, volume of infused blood components, health-related quality of life, time to haemorrhage control and any adverse effects. Secondary outcomes were improvement in haemodynamic status and failure/success of REBOA technique. Results We included 11 studies (5866 participants) ranging from fair to good quality. REBOA was associated with lower mortality when compared to RT (aOR 0.38; 95% CI 0.20–0.74), whereas no difference was observed when REBOA was compared to no-REBOA (aOR 1.40; 95% CI 0.79–2.46). No significant difference in health-related quality of life between REBOA and RT (p = 0.766). The most commonly reported complications were amputation, haematoma and pseudoaneurysm. Sparse data and heterogeneity of reporting for all other outcomes prevented any estimate. Conclusions Our findings on overall mortality suggest a positive effect of REBOA among non-compressible torso injuries when compared to RT but no differences compared to no-REBOA. Variability in indications and patient characteristics prevents any conclusion deserving further investigation. REBOA should be promoted in specific training programs in an experimental setting in order to test its effectiveness and a randomized trial should be planned

Recurrent Modification of a Conserved Cis-Regulatory Element Underlies Fruit Fly Pigmentation Diversity

The development of morphological traits occurs through the collective action of networks of genes connected at the level of gene expression. As any node in a network may be a target of evolutionary change, the recurrent targeting of the same node would indicate that the path of evolution is biased for the relevant trait and network. Although examples of parallel evolution have implicated recurrent modification of the same gene and cis-regulatory element (CRE), little is known about the mutational and molecular paths of parallel CRE evolution. In Drosophila melanogaster fruit flies, the Bric-à-brac (Bab) transcription factors control the development of a suite of sexually dimorphic traits on the posterior abdomen. Female-specific Bab expression is regulated by the dimorphic element, a CRE that possesses direct inputs from body plan (ABD-B) and sex-determination (DSX) transcription factors. Here, we find that the recurrent evolutionary modification of this CRE underlies both intraspecific and interspecific variation in female pigmentation in the melanogaster species group. By reconstructing the sequence and regulatory activity of the ancestral Drosophila melanogaster dimorphic element, we demonstrate that a handful of mutations were sufficient to create independent CRE alleles with differing activities. Moreover, intraspecific and interspecific dimorphic element evolution proceeded with little to no alterations to the known body plan and sex-determination regulatory linkages. Collectively, our findings represent an example where the paths of evolution appear biased to a specific CRE, and drastic changes in function were accompanied by deep conservation of key regulatory linkages. © 2013 Rogers et al

The ACTIVE (Acute Cholecystitis Trial Invasive Versus Endoscopic) study: Multicenter randomized, double-blind, controlled trial of laparoscopic (LC) versus open (LTC) surgery for acute cholecystitis (AC) in adults

<p>Abstract</p> <p>Background</p> <p>In some randomized trials successful laparoscopic cholecystectomy for cholecystitis is associated with an earlier recovery and shorter hospital stay when compared with open cholecystectomy. Other studies did not confirm these results and showed that the potential advantages of laparoscopic cholecystectomy for cholecystitis can be offset by a high conversion rate to open surgery. Moreover in these studies a similar postoperative programme to optimize recovery comparing laparoscopic and open approaches was not standardized. These studies also do not report all eligible patients and are not double blinded.</p> <p>Design</p> <p>The present study project is a prospective, randomized investigation. The study will be performed in the Department of General, Emergency and Transplant Surgery St Orsola-Malpighi University Hospital (Bologna, Italy), a large teaching institutions, with the participation of all surgeons who accept to be involved in (and together with other selected centers). The patients will be divided in two groups: in the first group the patient will be submitted to laparoscopic cholecystectomy within 72 hours after the diagnosis while in the second group will be submitted to laparotomic cholecystectomy within 72 hours after the diagnosis.</p> <p>Trial Registration</p> <p>TRIAL REGISTRATION NUMBER ISRCTN27929536 – The ACTIVE (Acute Cholecystitis Trial Invasive Versus Endoscopic) study. A multicentre randomised, double-blind, controlled trial of laparoscopic versus open surgery for acute cholecystitis in adults.</p