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OBJECTIVE: Cranial computed tomography (CT) scan is the most widely used tool to rule out intracranial lesions after pediatric traumatic brain injury (TBI). However, in pediatric population, the radiation exposure can lead to an increased risk of hematological and brain neoplasm. Defined in 2019 National Institute for Health and Care Excellence (NICE) guidelines as "troponins for the brain", serum biomarkers measurements, particularly S100B, have progressively emerged as a supplementary tool in the management of TBI thanks to their capacity to predict intracranial post-traumatic lesions. METHODS: This systematic review was conducted following the PRISMA protocol (preferred reporting items for systematic reviews and meta-analyses). No chronological limits of study publications were included. Studies reporting data from children with TBI undergoing serum S100B measurement and computed tomography (CT) scans were included. RESULTS: Of 380 articles screened, 10 studies met the inclusion criteria. Patients admitted with mild-TBI in the Emergency Department (ED) were 1325 (80.25%). The overall pooled sensitivity and specificity were 98% (95% CI, 92-99%) and 45% (95% CI, 29-63%), respectively. The meta-analysis revealed a high negative predictive value (NVP) (99%; 95% CI, 94-100%) and a low positive predictive value (PPV) (41%; 95% CI, 16-79%). Area under the curve (AUC) was 76% (95% CI, 65-85%). The overall pooled negative predictive value (NPV) was 99% (95% CI, 99-100%). CONCLUSIONS: The measurement of serum S100B in the diagnostic workflow of mTBI could help informed decision-making in the ED setting, potentially safely reducing the use of CT scan in the pediatric population. The high sensitivity and excellent negative predictive values look promising and seem to be close to the values found in adults. Despite this, it must be pointed out the high heterogeneity (> 90%) found among studies. In order for S100B to be regularly introduced in the pediatric workflow for TBI, it is important to conduct further studies to obtain cut-off levels based on pediatric reference intervals.
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The ongoing invasion of Russia of Ukraine and energy crises have sparked concern about economic and geopolitical stability all over the world. In Europe, the war has destabilized and endangered the energy cooperation and transition between European countries within and outside of the EU. This emergency has shown once more the importance of energy resilience policies to offset the vulnerability of energy systems and energy insecurity at the national and regional levels. Consilience has been reached on the necessity of enhancing EU energy security as an adaptation strategy. This work contributes to the existing scholarship on renewable energy transition and citizens' perception, focusing on European Union member states. Key characteristics of the renewable energy transition in the EU prior to the energy crisis and the war in Ukraine are examined. To this end, we analyze selected economic, environmental, social, policy and political variables on energy sorting from the Eurobarometer studying European citizens' perceptions. The exercise makes use of spatially-clustered regression to explore spatial heterogeneity and to elicit determinant information on specific regional groups. We learn that southern Europeans attribute less importance to energy infrastructure to facilitate the renewable energy transition and repute the EU solidity not a requirement for energy security access. Conversely, northern European citizens tend not to associate the responsibility of the EU in guiding competitiveness and policy toward green energy sources transformation. Robustness tests confirm our hypothesis. Regardless of regional differences, the EU energy and ecological transition will thrive with industrial and political cohesion. This process will pass through increased trust in institutions and dedicated energy policy action which will smooth the risks and disruptions coming from current and future shocks.
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Política Pública , Energía Renovable , Humanos , Ucrania , Europa (Continente) , Federación de Rusia , Análisis EspacialRESUMEN
Back in December 2019, the novel coronavirus disease 2019 (Covid-19) started rapidly spreading worldwide, especially in Italy that was among the most affected countries. The geographical distribution of air pollution and Covid-19 mortality in Italy suggested atmospheric pollution as a worsening factor of severe Covid-19 health outcomes. The present nationwide ecological study focused on all 107 Italian territorial areas, aiming to assess the potential association between Particulate Matter concentration, less than 2.5 µm in diameter (exposure), and Covid-19 mortality rate (outcome) throughout 2020, by looking at 28 potential confounders. A potential positive association between exposure and outcome was observed when performing a multivariate regression analysis with a Negative Binomial model, suggesting that an increase of 1 µg/m3 in the exposure is associated with an increase of 9.0% (95% CI: 6.5%-11.6%) in the average Covid-19 mortality rate, conditional on all 28 potential confounders. A sensitivity analysis, based on the E-value, shows that a hypothetical unmeasured confounder would have to be associated with both PM2.5 concentration and Covid-19 mortality rate by a rate ratio of at least 1.40-fold each to explain away the exposure-outcome association, conditional on all 28 covariates included in the main analysis model. Moreover, the Observed Covariate E-value (OCE) was reported to provide a contextualization of the E-value on the observed covariates included in the study. The OCE sensitivity analysis shows that a set of unknown confounders similar in size and magnitude to the set of the considered climatic factors could potentially explain away the estimated exposure-outcome association. Consequently, the role of climatic factors in the Covid-19 pandemic is worth of further investigation.
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Contaminantes Atmosféricos , Contaminación del Aire , COVID-19 , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/análisis , Contaminación del Aire/estadística & datos numéricos , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Humanos , Italia/epidemiología , Pandemias , Material Particulado/análisis , Material Particulado/toxicidad , SARS-CoV-2RESUMEN
This work introduces a revised version of the Food Sustainability Index, proposed by the Economist Intelligence Unit and the Barilla Center for Food and Nutrition in 2016. Our Adjusted Food Sustainability Index features two important advantages: 1) it employs the Mazziotta-Pareto method to compute weights, hence granting an objective aggregation criterion and 2) it does not take policy variables into account, thus focusing on the status quo. The policy variables are aggregated into the Policy Index, measuring the quality of the food sustainability policies. We compute the two indices for 25 countries worldwide, then we use the Data Envelopment Analysis to evaluate policy efficiency. Our results show that country-level variation in policy efficiency is wide and policies affect food sustainability significantly, especially when they target nutritional challenges.
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Abastecimiento de Alimentos , Política Nutricional , Agricultura , Alimentos , Evaluación NutricionalRESUMEN
Artisanal processes are crucial for examining major economic development, industrial, and historical forces. Among the different industries, fashion is regarded as one of the most polluting business activities. The indication of origin "Made in Italy" has found extensive scholarly economic appetite; however, the leather sector in its socioeconomic and environmental components has been scarcely investigated. The paper at hand analyzes selected leather poles in Campania, Italy - namely, the tanning, shoes, and gloves industries. Besides, the industrial processes and sustainability implications required are examined to render these productions. The tannery districts are characterized by a strong artisanal component in the productive processes and follow diverse geographical agglomeration rationales. Field visits and in-depth interviews were conducted in the local districts of Solofra (tanning), Grumo Nevano-Aversa (shoemaking), and Rione Sanità pole (glove-making). The local activities and specific operational industrial processes are mapped, highlighting the technical industrial phases needed to produce the three leather outputs. Besides, the sustainability repercussions of these industries are analyzed. The study finds that most of the activities heavily rely on traditional techniques and would benefit in socioeconomic and environmental terms from modernization, management, ICT upgrades, as well as process revisions and spatial agglomeration organization. Selected sectoral sustainable development, CSR, ESG, labeling, ethics, and environmental strategy recommendations are presented - especially concerning tanning wastewater treatment. These measures result in a compulsion to face the massive multidimensional crises occurring in the three sectors and business activities.
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Seasonal hunger is the most common food insecurity experience for millions of small dryland farmers. This study tests the relationships between food insecurity, farm forests, and biomass poverty using a longitudinal dataset from the Amhara region of Ethiopia. These data form part of the Ethiopia Socioeconomic Survey, which collected panel data over three survey rounds from 530 households between 2011 and 2016. This dataset represents a collection of unique socioeconomic, wellbeing, and micro-land use measures, including farm forests. Hierarchical mixed effect regression models assessed the relationship between food insecurity and farm forests as well as the conditional effects of biomass poverty among the poorest farmers and women-headed households. Over a six-year study period, farmers reported increased stress from smaller land holdings, higher prices, and climate-related shocks. A clear trend towards spontaneous dispersed afforestation is observed by both researchers and satellite remote sensing. Model results indicate, dedicating approximately 10% of farm area to forest reduces months of food insecurity by half. The greatest reductions in food insecurity from farm forests are reported by ultra-poor and crop residue-burning households, suggesting that biomass poverty may be a major constraint to resilient food security on these farms. This research provides novel quantitative evidence of induced intensification and food security impacts of farm management preserving and building stores of biomass value as green assets. The results reported here have important implications for nature-based solutions as a major strategy to achieve sustainable development in some contexts.
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Hambre , Pobreza , Humanos , Femenino , Granjas , Etiopía , Estaciones del Año , Biomasa , Abastecimiento de AlimentosRESUMEN
The growing interest in advancing microfluidic devices for manipulating fluids within micrometer-scale channels has prompted a shift in manufacturing practices, moving from single-component production to medium-size batches. This transition arises due to the impracticality of lab-scale manufacturing methods in accommodating the increased demand. This experimental study focuses on the design of master benchmarks 1-5, taking into consideration critical parameters such as rib width, height, and the relative width-to-height ratio. Notably, benchmarks 4 and 5 featured ribs that were strategically connected to the inlet, outlet, and reaction chamber of the master, enhancing their utility for subsequent replica production. Vat photopolymerization was employed for the fabrication of benchmarks 1-5, while replicas of benchmarks 4 and 5 were generated through polydimethylsiloxane casting. Dimensional investigations of the ribs and channels in both the master benchmarks and replicas were conducted using an optical technique validated through readability analysis based on the Michelson global contrast index. The primary goal was to evaluate the potential applicability of vat photopolymerization technology for efficiently producing microfluidic devices through a streamlined production process. Results indicate that the combination of vat photopolymerization followed by replication is well suited for achieving a minimum rib size of 25 µm in width and an aspect ratio of 1:12 for the master benchmark.
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Introduction: There are no clear indications for the best choice of anti-seizure medications to control brain tumor related epilepsy. In vitro studies have shown an antitumoral effect of Levetiracetam and Lacosamide on glioblastoma IDH-wild type. Research question: This study investigates whether the use of levetiracetam and/or lacosamide impacts survival rates. The secondary aim was to evaluate the efficacy of both ASMs in controlling seizures. Materials and methods: In this observational retrospective single-cohort study, patients underwent chemoradiation protocol after GBM surgery. They were grouped as follows: (1) use of levetiracetam, (2) use of lacosamide, (3) simultaneous use of levetiracetam and lacosamide, (4) no ASM usage. Survival curves were plotted using the Kaplan-Meier method coupled with a log-rank test for difference assesments. To evaluate the pharmacological efficacy of post-operative seizure control, a negative binomial regression was conducted. Results: The study included 272 patients, 174 of which underwent adjuvant chemoradiation treatment. Patients without ASM therapy had a non-significant longer median OS (compared to the other groups (log-rank = 0.37). The IRR of seizure relapse was 2.57 (p = 0.007) times higher in lacosamide users, and MGMT promoter methylation demonstrated a protective effect against postoperative seizure onset (p = 0.05), regardless of the aforementioned confounding factors. Discussion and conclusions: In patients diagnosed with GBM IDH-WT undergoing chemoradiation therapy, the use of levetiracetam or lacosamide for controlling BTRE does not seem to modify survival. Lacosamide users exhibited a higher IRR of postoperative seizures compared to levetiracetam users, and MGMT promoter methylation appears to be a protective factor.
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The COVID-19 pandemic has placed the world's population in a state of unprecedented public health and global health vulnerability. Risks to public and global health have escalated due to COVID-19 contamination. This has raised the statistics of inequity and environmental concerns. A possible outlook entails reducing the pandemic consequences by prioritizing development, biodiversity, and adaptability, offering buffer solutions. It contains vital methods for studying, comprehending, and unraveling events-examining early responses to COVID-19, sustainability, and development, relating them with overall Coronaviruses reaction. This study maps out environmental, socioeconomic, and medical/technological issues using as statistical techniques multiple correspondence analysis and validated cluster analysis. The findings encourage rapid, long-term development policy involvement to address the pandemic. The resulting crises have highlighted the necessity for the revival of health justice policies anchored in distinctive public health ethical patterns in response to them. As a general rule, resilience and preparedness will be targeted at developing and vulnerable nations and are prone to include access to vaccines, public health care, and health investment. Our findings show the relevance of innovating on sustainable development routes and yardsticks. Sustainable global health requires crucial measures in prevention, preparation, and response. Long-term policy recommendations are needed to address pandemics and their interrelated crises and foster sustained growth and socioecological protection.
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COVID-19 , Humanos , COVID-19/epidemiología , Pandemias/prevención & control , SARS-CoV-2 , Salud PúblicaRESUMEN
Stakeholders and communities' involvement is vital for shaping novel intergenerational resource governance frameworks. This is crucial for modelling upcoming energy transitions towards cleaner and more sustainable production systems. New models envisage energy mixes in which renewable resources are prominent and offer sustainable development advantages. Examining electricity production figures is, hence, necessary to understand trends and formulate policies and actions. This paper aims at drafting the state-of-the-art of electricity production in the Nordic-Baltic Sea area, moving an exploratory regional appraisal. Aggregated and disaggregated data on electricity production sources are explored and compared for all the eleven selected countries-at domestic, sub-regional, and regional levels. The region shows great national diversity, which implies diversified energy policies. Thus, the role of local initiatives-such as power grid implementation-in local communities empowerment is revealed. From this outcome, possible strategies are prescribed locally to assist the regional sustainable energy appraisal and furnish indications for the European energy and ecological transition.
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Electricidad , Energía Renovable , HumanosRESUMEN
The attachment or entrapment of microbial cells and enzymes are promising solutions for various industrial applications. When the traps are beads, they are dispersed in a fluidized bed in a vessel where a pump guarantees fresh liquid inflow and waste outflow without washing out the cells. Scientific papers report numerous types of cell entrapment, but most of their applications remain at the laboratory level. In the present research, rigid polymer beads were manufactured by two different additive manufacturing (AM) techniques in order to verify the economy, reusability, and stability of the traps, with a view toward a straightforward industrial application. The proposed solutions allowed for overcoming some of the drawbacks of traditional manufacturing solutions, such as the limited mechanical stability of gel traps, and they guaranteed the possibility of producing parts of constant quality with purposely designed exchange surfaces, which are unfeasible when using conventional processes. AM proved to be a viable manufacturing solution for beads with complex shapes of two different size ranges. A deep insight into the production and characteristics of beads manufactured by AM is provided. The paper provides biotechnologists with a manufacturing perspective, and the results can be directly applied to transit from the laboratory to the industrial scale.
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Commons governance theory is central to identifying and managing conflicts arising from natural and cultural resources traps. Scholars - using game theory and economic analysis of law - have proposed alternative models, consisting of a set of mitigated scenarios, multiple players, and new equilibria in commons governance. Likewise, novel legal innovations of the commons have also been designed. Reinterpreting the commons in light of political economy, ecology, and pluralistic approaches, a critical review of existing scholarship, economic analysis of law, and case study investigations are performed. Examining an array of views - including governance of water in Ecuador, Bolivia, and Italy - a research and policy agenda is put forward to offer original interpretations and novel holistic perspectives. Germane environmental policy implications deriving from SDGs, resilient governance, and polycentric perspectives are thus extrapolated. Finally, pluralistic frameworks drafted by mitigation and adaptation are measured by improved sustainable development performance in commons, resource, and water governance.
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Conservación de los Recursos Naturales , Desarrollo Sostenible , Ecología , Política Ambiental , AguaRESUMEN
This research paper aims to address the problem of financial inclusion and resilience in the current sustainable development framework. The development agenda designs access to finance a human right and a prior strategy to achieve Sustainable Development Goals (SDGs). Microfinance can play a decisive role in smoothing the risk of adverse events It acts as resilience policy, tackling vulnerability and poverty, empowering people and vulnerable categories and improving and enlarging their capabilities. This work explores the existing connections between the development agenda and microfinance as a strategy to foster financial access. To this end, summative content analysis is performed on the United Nations General Assembly Resolution A/RES/69/315 - fulfilling a research gap. This inquiry handles 6 selected SDGs, ascribable to 3 dimensions, detecting 5 sub-dimensions and 16 domains. Analysing Millennium Development Goals and Sustainable Development Goals, the study also finds increased importance attributed to the topic, key issues and policy strengths and limitations. Importantly, the analysis shows that the environmental dimension is still neglected in the analysed corpus, not appearing in any of the examined SDGs. The findings suggest investing in these channels, drafting governance patterns and modelling resilience and development policy to vehiculate improved ecological and institutional results and concerns.
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Ambio is a leading journal in environmental science and policy, sustainable development, and human-environment interactions. The paper at hand aims to run a bibliometric analysis to inspect the main publications features of Ambio in Science Citation Index Expanded SCI-EXPANDED. For this scope, a bibliometric survey has been carried out to investigate the journal's historic characteristics in the Web of Science (WoS) categories of environmental sciences and environmental engineering for Ambio from 1980 to 2019. These are the categories for which the journal has been indexed throughout the indexed time frame. The paper proposes technical and methodological innovations, including improvements in the methods and original characteristics analyzed. Documents published in Ambio were searched out from SCI-EXPANDED. Six publication indicators were applied to evaluate the publication performance of countries, institutes, and authors. Three citation indicators were used to compare publications. As a parameter, the journal impact factor contributor was applied to compare the most frequently cited publications. The journal impact factor contributing publications were also discussed. Results show that Sweden ranked top in six publication indicators and that the top three productive institutes were located in Sweden. A low percentage of productive authors emerged as a journal impact factor contributor. Similarly, a low relationship between the IF contributing publications and the highly cited publications was also found. Less than half of the top 100 highly cited publications in Ambio did not lie within the high impact in most the recent year of 2019. Three members of the advisory board in Ambio were the main productive authors. T.V. Callaghan contributed to most of the publications while papers published by J. Rockstrom as first and corresponding author contributed the most to the journal impact factor. An article authored by Steffen et al. (2007) scored the highest total citations in 2019.
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Bibliometría , Ciencia Ambiental , Humanos , Factor de Impacto de la Revista , Publicaciones , SueciaRESUMEN
Petroleum-reliant developing and transition economies account for 15-20% of global greenhouse gas emissions. This group of countries have a disproportionately high share of oil and natural gas in their energy mix and a relatively high carbon footprint over their petroleum value chains. The present data set is an extensive compilation of the essential indicators related to economy, energy, environmental pollution, and institutional quality of 37 oil and gas producing developing and transition economies in the time interval spanning between 1989 and 2019. The data set can serve as a basis for the macroeconomic analysis of energy, environment, social and institutional issues in this group of countries and draft further industry explorations as well as sustainable development policy analyses and recommendations. Furthermore, based on the mentioned data series, we propose three novel indexes - i.e. Energy Sector Development Indexes I, II, and III. Those indexes are developed in the context of fossil fuel abundant settings. Despite focusing on the fossil fuel abundant settings, the Energy Sector Development Indexes could be expanded for petroleum and coal scarce countries as well.
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Metal additive manufacturing is now taking the lead over traditional manufacturing techniques in applications such as aerospace and biomedicine, which are characterized by low production volumes and high levels of customization. While fulfilling these requirements is the strength of metal additive manufacturing, respecting the tight tolerances typical of the mentioned applications is a harder task to accomplish. Powder bed fusion (PBF) is a class of additive manufacturing in which layers of metal powder are fused on top of each other by a high-energy beam (laser or electron beam) according to a computer-aided design (CAD) model. The quality of raw powders for PBF affects the mechanical properties of additively manufactured parts strongly, and therefore it is crucial to avoid the presence of any source of contamination, particularly cross-contamination. In this study, the identification and quantification of cross-contamination in powders of Ti-6Al-4V and maraging steel was performed using scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) techniques. Experimental results showed an overall good reliability of the developed method, opening the way for applications in machine learning environments.
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Laser Powder Bed Fusion (LPBF) technology was used to produce samples based on the Ti-6Al-4V alloy for biomedical applications. Solid-state phase transformations induced by thermal treatments were studied by neutron diffraction (ND), X-ray diffraction (XRD), scanning transmission electron microscopy (STEM) and energy-dispersive spectroscopy (EDS). Although, ND analysis is rather uncommon in such studies, this technique allowed evidencing the presence of retained ß in α' martensite of the as-produced (#AP) sample. The retained ß was not detectable by XRD analysis, nor by STEM observations. Martensite contains a high number of defects, mainly dislocations, that anneal during the thermal treatment. Element diffusion and partitioning are the main mechanisms in the α â ß transformation that causes lattice expansion during heating and determines the final shape and size of phases. The retained ß phase plays a key role in the α' â ß transformation kinetics.
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The development of novel Ti-based amorphous or ß-phase nanostructured metallic materials could have significant benefits for implant applications, due to potentially improved corrosion properties, and mechanical characteristics (lower Young's modulus, better wear performance, improved fracture toughness) in comparison to the standardized α+ß titanium alloys. Moreover, the devitrification phenomenon, occurring during heating, could contribute to lower input power during additive manufacturing technologies. Ti-based alloy ribbons were obtained by melt-spinning, considering the ultra-fast cooling rates this method can provide. The titanium alloys contain Zr, Nb, and Si (Ti60Zr10Si15Nb15, Ti64Zr10Si15Nb11, Ti56Zr10Si15Nb19) in various proportions. These elements were chosen due to their reported biological safety, as in the case of Zr and Nb, and the metallic glass-forming ability and biocompatibility of Si. The morphology and chemical composition were analyzed by scanning electron microscopy and energy-dispersive X-ray spectroscopy, while the structural features (crystallinity, phase attribution after devitrification (after heat treatment)) were assessed by X-ray diffraction. Some of the mechanical properties (hardness, Young's modulus) were assessed by instrumented indentation. The thermal stability and crystallization temperatures were measured by differential thermal analysis. High-intensity exothermal peaks were observed during heating of melt-spun ribbons. The corrosion behavior was assessed by electrocorrosion tests. The results show the potential of these alloys to be implemented as materials for biomedical applications.
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BACKGROUND: The clinical application of prosthetic components obtained by different manufacturing processes lacks technological foundation: the dimensional tolerance of individual parts and their assembly accuracy are not known. The rotational misfit (RM) of the hexagonal connection is critical in single-tooth implant restorations, but no standard control procedures are available for its evaluation. PURPOSE: The research aimed at proposing a new protocol for the dimensional assessment of implant-abutment connections, based on noncontact measurement and statistical data processing. The procedure was applied to machined- and cast-on abutments, as well of the matching implants. MATERIALS AND METHODS: Three groups of five abutments each were studied: machined titanium abutments, pre-machined calcinable abutments before casting procedures and the same specimens after casting. A group of five corresponding implants was considered as well. Twice the apothem was measured on each hexagon through an optical measuring microscope. The data were processed to obtain the international tolerance (IT) grade. The RM was then calculated using the apothems of the external and the internal hexagon. RESULTS: All the components were classified between IT8 and IT9, and the maximum RM was around 3-4° for all the assemblies, inferior to the critical limits for the screw joint stability. CONCLUSION: An original measuring protocol was developed, independent of parts assembly and based on ITs. An objective dimensional characterization of prosthetic components and assemblies has been achieved, which is the basis for their reliability in clinical applications.