LCA based circularity indices of systems at different scales: a holistic approach

Many are the definitions of Circular Economy as well as the policies and strategies for its implementation. However, gaps still exist in quantifying the effects of circularity. The existing approaches are usually sector- or product-specific, limited to microscale systems, and/or fail to simultaneously assess the environmental impacts of the studied system. This paper introduces a generally applicable method in which a set of LCA-based indices of circularity are able to detect the effects of circularity/symbiosis strategies on the environmental performance of meso- and macro-systems. These indices quantify the overall system's circularity level by comparing the impacts of a system in which the components interact with each other (with a certain level of circularity) with an equivalent linear system (where no circularity takes place). The method works both on existing and projected systems, being able to track the effects of future circularity policies. This method obviates the limitations and the gaps mentioned above: it applies to meso- and macro-systems, it is not bound to a specific sector, it allows to capture the environmental impacts, and it is sensitive to the temporal dimension. This approach provides a tool to inform managers and policymakers for planning circularity actions and monitor their effectiveness while also capturing the temporal dimension

RE-MIND2: comparative effectiveness of tafasitamab plus lenalidomide versus polatuzumab vedotin/bendamustine/rituximab (pola-BR), CAR-T therapies, and lenalidomide/rituximab (R2) based on real-world data in patients with relapsed/refractory diffuse large B-cell lymphoma

Abstract: RE-MIND2 (NCT04697160) compared patient outcomes from the L-MIND (NCT02399085) trial of tafasitamab+lenalidomide with those of patients treated with other therapies for relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) who are autologous stem cell transplant ineligible. We present outcomes data for three pre-specified treatments not assessed in the primary analysis. Data were retrospectively collected from sites in North America, Europe, and the Asia Pacific region. Patients were aged ≥18 years with histologically confirmed DLBCL and received ≥2 systemic therapies for DLBCL (including ≥1 anti-CD20 therapy). Patients enrolled in the observational and L-MIND cohorts were matched using propensity score-based 1:1 nearest-neighbor matching, balanced for six covariates. Tafasitamab+lenalidomide was compared with polatuzumab vedotin+bendamustine+rituximab (pola-BR), rituximab+lenalidomide (R2), and CD19-chimeric antigen receptor T-cell (CAR-T) therapies. The primary endpoint was overall survival (OS). Secondary endpoints included treatment response and progression-free survival. From 200 sites, 3,454 patients were enrolled in the observational cohort. Strictly matched patient pairs consisted of tafasitamab+lenalidomide versus pola-BR (n = 24 pairs), versus R2 (n = 33 pairs), and versus CAR-T therapies (n = 37 pairs). A significant OS benefit was observed with tafasitamab+lenalidomide versus pola-BR (HR: 0.441; p = 0.034) and R2 (HR: 0.435; p = 0.012). Comparable OS was observed in tafasitamab+lenalidomide and CAR-T cohorts (HR: 0.953, p = 0.892). Tafasitamab+lenalidomide appeared to improve survival outcomes versus pola-BR and R2, and comparable outcomes were observed versus CAR-T. Although based on limited patient numbers, these data may help to contextualize emerging therapies for R/R DLBCL. Clinical trial registration: NCT04697160 (January 6, 2021

Global virtual water trade of avocado

This paper investigates the relationship between international trade of avocado and the related virtual water trade over the period 2000–2016. Using a Physical Trade Analysis, we show that commercial and virtual water trade grew rapidly moving almost hand-in-hand in the years taken into account: in parallel with a remarkable increase of international trade of avocado from 0.4 Mt in 2000 to 1.9 Mt in 2016, the global virtual water trade of avocado increased from 408 Mm3 to 2238 Mm3 over the same period. The analysis emphasizes a large disparity between developed and developing countries, with the former being net importer of water and the latter large net exporter. In particular, large avocado-related water flows move from countries already under chronic water stress such as Mexico, Peru and Chile towards more water-rich regions such as US, Japan, Canada and the European Union. As a consequence, the overexploitation of water underlying the avocado trade flows may end up worsening environmental conditions in many relatively poor countries in which the export of avocado is often regarded as an important source of economic growth

Investigating environment-society-economy relations in time series in Europe using a synthetic input-state-output framework

The design, evaluation and monitor of actions, plans and policies aimed at improving countries’ progress at both national and international level is a hard task to achieve and requires a variety of tools. Part of the complexity of progress assessment is due to the necessity to measure its economic, social, and environmental aspects. The latest international agreements, such as the European Green Deal, highlight the current need of tools capable of measuring progress for groups of countries avoiding the arbitrariness and loss of information commonly due to aggregation of economic, social, and environmental indicators. Besides this, it is necessary to reconsider the sole use of macroeconomic indicators (e.g., GDP) for measuring progress. These indicators should be flanked by complementary ones, able to capture important environmental and social aspects (e.g., equity, life satisfaction, and responsibilities for negative impacts). Here, we apply an Input-State-Output framework to assess the Environment-Society-Economy relations across European countries in time series (2006–2015) by using two different sets of indicators. Our study presents a synthetic framework that enables coexistence of various information and reveals differences in progress evaluation and monitoring, which result from the use of different indicators. This suggests the current need for policy action tailored to the different situations and needs of different European countries. The possibility to adopt multiple perspectives while performing the analysis is a key feature of this tool. By using two alternative sets of indicators, we produced a more complete picture of countries’ progress. The outputs resulting from such versatile tool may be used for sharing good practices among the European countries, acting on progress across the three dimensions of sustainability, and evaluating the effects of policy efforts

Prevalence and clinicopathologic correlates of o6-methylguanine- dna methyltransferase methylation status in patients with triple-negative breast cancer treated preoperatively by alkylating drugs

Background Predictive factors of benefit from specific chemotherapy regimens are not currently available in triple-negative breast cancer (TNBC). MGMT (O6-methylguanine-DNA methyltransferase) controls DNA repair pathways, and its epigenetic silencing is used for predicting the response to the alkylating drug temozolomide in patients with glioma. Materials and Methods The study population was composed of 84 patients with TNBC treated with alkylating agents and evaluated for clinicopathologic parameters (tumor shrinkage and pathologic complete response [pCR]). MGMT methylation status was assessed in formalin-fixed, paraffin-embedded tumor specimens by pyrosequencing. The samples were categorized as methylated (mean methylation value > 5%), indeterminate (4%-5%), and unmethylated ( 643%). Results MGMT methylation status was successfully evaluated in all the cases: 58.3% were methylated; 27.4%, unmethylated; and 14.3%, indeterminate. MGMT methylation was observed in 80%, 62%, and 29% of patients showing a 100%, 99% to 30%, and <30% tumor reduction, respectively, a trend not achieving statistical significance (P =.23). There was no association between MGMT methylation status and pCR. Conclusion The present study provided evidence that pyrosequencing performs well for the evaluation of MGMT methylation even in small bioptic samples, suggesting that it could be reliably used in translational studies of preoperative clinical trials. Although there was an association trend between high methylation levels and clinical response to therapy, no statistically significant association with the pCR was found. Further studies in larger series of patients are warranted for ascertaining the putative clinical role of MGMT in patients with TNBC. \ua9 2014 Elsevier Inc. All rights reserved

Epidermal growth factor receptor-targeted therapy of colorectal cancer with panitumumab

Panitumumab is a fully human monoclonal antibody directed against the epidermal growth factor receptor (EGFR), which when overexpressed may contribute to the development and progression of cancer and is present in several solid tumors, including colorectal cancer (CRC). Panitumumab is registered in USA for the treatment of patients with EGFR expressing CRC after disease progression on or following fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy regimens. The present evidence of effectiveness of Panitumumab for the treatment of metastatic CRC is based on objective tumor respose as well as on progressioh-free survival. This review article summarizes the development of Panitumumab in preclinical and early phase trials in CRC and focuses on the most recent results available from advanced phase clinical trials, with an update on presentations at the 2007 annual meeting of the American Society of Clinical Oncology (ASCO)

Effect of age on hemoglobin levels and quality of life following treatment with epoetin alfa in cancer patients

A subgroup analysis comparing elderly (age > or =70 years; n=95) with younger (age <70 years; n=390) patients was performed on data from a prospective, multicenter, open-label study assessing the effects of once-weekly epoetin alfa 40,000 International Units (IU) for 16-20 weeks on hemoglobin (Hb) levels and quality of life (QoL) in anemic adult patients undergoing chemotherapy for solid tumors. There were significant increases in mean Hb levels at 4, 8, 12, 16-20 weeks in both age groups (p<0.0001), but no significant differences between groups (p=0.7). No significant difference was observed in terms of blood transfusion rates across the study between elderly and younger patients (3.2% vs 6.7%, p=0.2). Although QoL was lower in elderly patients at baseline, the relative percentage increases in QoL scores during treatment were similar for both age groups. Thus, once-weekly epoetin alfa was equally effective in treating chemotherapy-related anemia in elderly and younger adult patients, with similar tolerability

Prognostic relevance of peritumoral vascular invasion in immunohistochemically defined subtypes of node-positive breast cancer

Prognostic factors to better identify subcategories of node-positive breast cancer patients candidate to adjuvant chemotherapy are needed. The prognostic significance of the extent of peritumoral vascular invasion (PVI) in patients with positive axillary nodes is a matter of controversy. No data are available on the role of PVI within immunohistochemically defined subtypes. 3,729 consecutive patients with primary invasive breast cancer and positive axillary nodes were operated and referred for interdisciplinary evaluation from April 1997 to December 2005. Patients were classified as Luminal A, Luminal B(HER2 negative), Luminal B(HER2 positive), Triple Negative and HER-2 positive. The distribution of PVI was as follows: absent 2,010 (54 %), moderate/focal 963 (142 + 821) (26 %), and extensive 756 (20 %). Patients with extensive PVI were more likely to be Luminal B(HER2 negative) (49.3 %), younger (35-50 years), to have larger tumors (>pT2) with higher grade, a higher extent of node involvement (>4 nodes) and higher proliferative index, compared with patients with absence or moderate/focal PVI (p < 0.0001). In the multivariate analysis, extensive PVI (vs. absent) was correlated with a significant higher risk of local recurrence (HR 1.42, 95 %CI, 1.03-1.95, p = 0.0301). The immunohistochemically defined Luminal A-like subtype had a significant better outcome in terms of DFS, OS and reduced incidence of distant metastases when compared with the other subtypes. The occurrence of extensive PVI correlates with an increased risk of local recurrence. Luminal A tumors, classified according to the most recent St. Gallen recommendations, had an excellent outcome irrespective to the occurrence of extensive PVI or lymph node metastases and might be a good candidate to personalized adjuvant treatments. \ua9 2014 Springer Science+Business Media New York

Changes in PgR and Ki-67 in residual tumour and outcome of breast cancer patients treated with neoadjuvant chemotherapy

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Changes in PgR and Ki-67 in residual tumour and outcome of breast cancer patients treated with neoadjuvant chemotherapy

We collected information on 904 consecutive breast cancer patients treated with neoadjuvant chemotherapy at the European Institute of Oncology, Milan, Italy, between 1999 and 2011. The decrease of PgR and Ki-67 expression after preoperative chemotherapy has a prognostic role in breast cancer patients with residual disease