Economic and Human Features for Energy and Environmental Indicators: A Tool to Assess Countries’ Progress towards Sustainability

Energy and environmental data represent fundamental information for the analysis of sustainable development. On the other hand, these aspects should be associated with economic and human dimensions in order to obtain a more holistic vision. From this perspective, some indicators are discussed and analyzed in this paper in order to assess the performance of a country. As regards the energetic aspects, the data of total primary energy supply and exergy losses were considered. The environmental aspects were taken into account by considering the greenhouse gas emissions and the particulate matter emissions. These energy and environmental data were put in relation to the GDP (gross domestic product) and HDI (human development index, a multidimensional index proposed by United Nations), respectively. So, two sets of indicators were introduced—the set E for economic properties and the set H for human aspects. A case study was conducted by analyzing a group of countries that meet two criteria: the same macro-geographical area and comparable numbers of citizens. The European area—in particular, its six most populous countries—was chosen. From the results obtained, it is possible to point out that some countries present different rankings depending on whether set E or set H is considered. Another important aspect discussed is the temporal evolution of the indicators (the interval from 1990 to 2017 was considered). Political decision-makers can be supported by the use of the indicators of set H in order to evaluate well-being related to their choices on actions related to the energy and environment. These indicators can be used both to analyze the trends of a country and to compare them with the performance of some other similar countries

Grape VOCs response to postharvest short-term ozone treatments

Ozone has been recently recognized as an efficient sanitizing agent in wine industry because of its powerful oxidizing properties. Furthermore, postharvest treatments of grapes with ozone can stimulate defense responses by synthetizing secondary metabolites against oxidative stress. In this study, the effect of postharvest short-term ozone treatments was assessed for the first time on free and glycosylated volatile organic compounds (VOCs) of winegrapes. Two different ozone concentrations (30 and 60 μL/L) and exposure times (24 and 48 h) were investigated just after treatment (fresh grapes) and after partial dehydration up to 20% weight loss (withered grapes). The study was carried out on Moscato bianco winegrapes (Vitis vinifera L.) due to the importance of terpenes in white aromatic cultivars to produce high quality wines. The results obtained showed that short-term ozone treatment caused a significant decrease in total contents of free VOCs in fresh grapes, mainly due to terpenes. Among them, linalool, geraniol, and nerol are the major aromatic markers of Moscato bianco grapes. Ozone entailed a significant decrease of free linalool contents in fresh grapes, the less stressful ozone treatment showing the smaller linalool degradation. However, the stronger and longer ozone treatment induced the synthesis of this compound probably in response to higher abiotic stress. Instead, significant changes were not observed in geraniol and nerol contents in fresh grapes. This last ozone treatment also reduced the loss of free linalool by water loss in withered grapes even though total VOCs and terpenes remained relatively stable. Furthermore, ozone seems to promote the synthesis of free (+)-4-carene and 4-terpineol in withered grapes under certain treatment conditions. Regarding glycosylated compounds, total VOCs and terpenes were less sensitive to ozone. Our findings highlight that ozone can be used as sanitizing agent in aromatic grape varieties prior to winemaking without affecting sharply the aromatic profile of fresh grapes and even improving it in withered grapes

Comparative Effectiveness of Gemcitabine plus Nab-Paclitaxel and FOLFIRINOX in the First-Line Setting of Metastatic Pancreatic Cancer: A Systematic Review and Meta-Analysis

Gemcitabine and nab-paclitaxel (GEM-NAB) and the combination of 5-fluorouracil, oxaliplatin, and irinotecan (FOLFIRINOX) are valid first-line options for advanced or metastatic pancreatic cancer (mPC). However, no randomized trials comparing the two schemes have been performed. This meta-analysis aims to compare GEM-NAB and FOLFIRINOX in terms of safety and effectiveness, taking into account data from real-life studies on mPC. We systematically searched PubMed, EMBASE and Cochrane library up to November 2018 to identify retrospective or cohort studies on mPC comparing GEM-NAB and FOLFIRINOX. We included 16 retrospective studies, including 3813 patients (2123 treated with GEM-NAB and 1690 treated with FOLFIRINOX). Despite a median weighted overall survival (OS) difference in favor of FOLFIRINOX (mean difference: 1.15, 95% confidence interval CI 0.08\u207b2.22, p = 0.03), in whole population OS was similar (hazard ratio (HR = 0.99, 95% CI 0.84\u207b1.16; p = 0.9). PFS was also not different between the two arms (HR = 0.88, 95% CI 0.71\u207b1.1; p = 0.26). The overall response rate was similar (25 vs. 24% with GEM-NAB and FOLFIRINOX). Among grade 3\u207b4 toxicities, neutropenia, febrile neutropenia, and nausea were lower with GEM-NAB, while neurotoxicity and anemia were lower with FOLFIRINOX. In conclusion, despite a numerically longer median OS with FOLFIRINOX as compared to GEM-NAB, the overall risk of death and progression were similar. Their toxicity was different with less nausea, neutropenia, and febrile neutropenia with GEM-NAB, as compared to less neurotoxicity and anemia with FOLFIRINOX. Therefore, analysis of non-randomized "real world" studies to date has not provided evidence of a major benefit of one regimen over the other

Volatile profile of white wines fermented with sequential inoculation of Starmerella bacillaris and Saccharomyces cerevisiae

Mixed fermentations with Starmerella bacillaris and Saccharomyces cerevisiae affect the chemical composition of wines, by modulating various metabolites of oenological interest. The current study was carried out to elucidate the effect of sequential inoculation of the above mentioned species on the production of white wines, especially on the chemical and aromatic characteristics of Chardonnay, Muscat, Riesling and Sauvignon blanc wines. Titratable acidity and glycerol content exhibited evident differences among the wines after fermentation. For volatile compounds, mixed fermentations led to a reduction of the total esters, including ethyl acetate, which is a compound responsible for wine deterioration. However, Sauvignon blanc wines fermented by mixed cultures contained significantly higher levels of esters and thiols, both associated with positive sensory attributes. These findings suggest that sequential inoculations possess great potential in affecting and modulating the chemical and aromatic profile of white wines, especially those produced from Sauvignon blanc grapes

Ozone Improves the Aromatic Fingerprint of White Grapes

Ozone, a powerful oxidative stressor, has been recently used in wine industry as sanitizing agent to reduce spoilage microflora on grapes. In this study, we evaluated ozone-induced metabolic and molecular responses during postharvest grape dehydration. Ozone increased the contents of total volatile organic compounds (VOCs), which have a great impact on the organoleptic properties of grapes and wines. Among terpenes, responsible for floral and fruity aroma, linalool, geraniol and nerol were the major aromatic markers of Moscato bianco grapes. They were significantly affected by the long-term ozone treatment, increasing their concentration in the last phases of dehydration (>20% weight loss). At molecular level, our results demonstrated that both postharvest dehydration and ozone exposure induce the biosynthesis of monoterpenes via methylerythritol phosphate (MEP) pathway and of aldehydes from lipoxygenase-hydroperoxide lyase (LOX-HPL) pathway. Therefore, transcriptional changes occurred and promoted the over-production of many important volatile compounds for the quality of white grapes

Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study

open14noRectal neuroendocrine tumors (r‐NETs) are rare tumors with overall good prognosis after complete resection. However, there is no consensus on the extension of lymphadenectomy or regarding contraindications to extensive resection. In this study, we aim to identify predictive factors that correlate with nodal metastasis in patients affected by G1–G2 r‐NETs. A retrospective analysis of G1–G2 r‐NETs patients from eight tertiary Italian centers was performed. From January 1990 to January 2020, 210 patients were considered and 199 were included in the analysis. The data for nodal status were available for 159 cases. The nodal involvement rate was 9%. A receiver operating characteristic (ROC) curve analysis was performed to identify the diameter (>11.5 mm) and Ki‐67 (3.5%), respectively, as cutoff values to predict nodal involvement. In a multivariate analysis, diameter > 11.5 mm and vascular infiltration were independently correlated with nodal involvement. A risk scoring system was constructed using these two predictive factors. Tumor size and vascular invasion are predictors of nodal involvement. In addition, tumor size > 11.5 mm is used as a driving parameter of better‐tailored treatment during pre‐operative assessment. Data from prospective studies are needed to validate these results and to guide decision‐making in r‐ NETs patients in clinical practice.openRicci A.D.; Pusceddu S.; Panzuto F.; Gelsomino F.; Massironi S.; De Angelis C.G.; Modica R.; Ricco G.; Torchio M.; Rinzivillo M.; Prinzi N.; Rizzi F.; Lamberti G.; Campana D.Ricci A.D.; Pusceddu S.; Panzuto F.; Gelsomino F.; Massironi S.; De Angelis C.G.; Modica R.; Ricco G.; Torchio M.; Rinzivillo M.; Prinzi N.; Rizzi F.; Lamberti G.; Campana D

Systemic Treatment of Patients With Gastrointestinal Cancers During the COVID-19 Outbreak: COVID-19-adapted Recommendations of the National Cancer Institute of Milan

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak poses a major challenge in the treatment decision-making of patients with cancer, who may be at higher risk of developing a severe and deadly SARS-CoV-2 infection compared with the general population. The health care emergency is forcing the reshaping of the daily assessment between risks and benefits expected from the administration of immune-suppressive and potentially toxic treatments. To guide our clinical decisions at the National Cancer Institute of Milan (Lombardy region, the epicenter of the outbreak in Italy), we formulated Coronavirus-adapted institutional recommendations for the systemic treatment of patients with gastrointestinal cancers. Here, we describe how our daily clinical practice has changed due to the pandemic outbreak, with the aim of providing useful suggestions for physicians that are facing the same challenges worldwide

Systemic Treatment of Patients With Gastrointestinal Cancers During the COVID-19 Outbreak : COVID-19-adapted Recommendations of the National Cancer Institute of Milan

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak poses a major challenge in the treatment decision-making of patients with cancer, who may be at higher risk of developing a severe and deadly SARS-CoV-2 infection compared with the general population. The health care emergency is forcing the reshaping of the daily assessment between risks and benefits expected from the administration of immune-suppressive and potentially toxic treatments. To guide our clinical decisions at the National Cancer Institute of Milan (Lombardy region, the epicenter of the outbreak in Italy), we formulated Coronavirus-adapted institutional recommendations for the systemic treatment of patients with gastrointestinal cancers. Here, we describe how our daily clinical practice has changed due to the pandemic outbreak, with the aim of providing useful suggestions for physicians that are facing the same challenges worldwide