Although the importance of reusing products has been stated frequently, both in legislation and by academics, the scientific literature does not provide comprehensive and systematic methods of ...assessing the reuse of a generic product from an environmental point of view. Moreover, the definitions of reuse provided in the literature and legislation are not always consistent. This article introduces an original classification of different types of reuse, including some suggested definitions. It then focuses on remanufacturing, a type of reuse in which a used product (or its components) is returned to at least its original performance level. The article describes the development of a method for assessing, from a life-cycle perspective, the potential environmental benefits of remanufacturing energy-related products. The method includes several novel aspects: it helps to analyse possible trade-offs between potential environmental impacts and energy efficiency; it allows the independent modelling of some parameters that influence product reuse; and it can be applied even at the early stages of the design process, when some specifications may not yet have been defined. The environmental impacts of a product's life-cycle stages are used as input parameters for the assessment. The method is then applied to an enterprise server, a case-study product for which remanufacturing is a current market practice. A sensitivity analysis is included to check how uncertainties could affect the overall results. The results of the case study show that remanufactured servers, even those that are less energy efficient, can have lower environmental impacts than new ones. For example, reusing some components (e.g. hard disk drives and memory cards) is environmentally beneficial even if the remanufactured server consumes up to 7% more energy than a newly manufactured server. The case study also demonstrates how the method proposed could be used in the context of product policy discussions.
•The article introduces an original classification of different types of reuse.•It presents a method for the environmental assessment of remanufactured products.•The method uses a life cycle approach to compare new and remanufactured products.•The method is applied to the case-study of enterprise servers.•A remanufactured server can have lower life cycle impacts than newly manufactured one.
Policies related to the Circular Economy are currently being implemented intensively within the European Union. A central role is attributed to the Ecodesign Directive: since the publication of the ...Circular Economy Action Plan in December 2015, reinforced by the 2020 Circular Economy Action Plan, material efficiency requirements are being systematically investigated in the preparatory work preceding each Ecodesign Regulation. A systematic and updated review about the coverage of Circular Economy aspects (such as product durability, repairability, recyclability and spare parts availability) within Ecodesign Regulations is, to date, missing in literature. Within this framework, this paper firstly analyses the scope and the expected impacts of Ecodesign requirements on material efficiency aspects already in application at the European Union level. Secondly, it identifies a number or research priorities, in order to provide policymakers with tools such as standardised metrics on Circular Economy aspects, methods for the evaluation of environmental externalities at product level and models for the quantification of environmental and economic impacts stemming from Circular Economy requirements. Finally, the paper devises some regulatory approaches and areas for policy intervention in order to enable further and more ambitious Circular Economy objectives within the framework of the Ecodesign Directive.
Polverini elaborates on the chosen policy approach, at European Union (EU) level, to tackle the environmental impact of ventilation units. At EU level, buildings consume approximately 40% of primary ...energy, and are responsible for 36% of CO2 emissions. It has been estimated that, by improving the energy efficiency of buildings, the total EU energy consumption could be reduced by 5% to 6% and CO2 emissions could be lowered by about 5%; to this extent, legislative measures are in place to address, among others, the issue of the reduction of the energy consumption of buildings. At EU policy level, the Ecodesign Directive requires product manufacturers to improve the environmental performance of their products, typically by meeting minimum energy efficiency requirements, as well as other environmental requirements such as water consumption, emission levels or minimum durability of certain components. By removing the poorest-performing products from the market, the chosen policy approach will increase the manufacture and installation of more energy efficient products and systems.
•The paper is about the techno-economic assessment of circular economy requirements for products.•The research is related to the Methodology for Ecodesign of Energy-related Products.•It is suggested ...to systematically include externalities, lifetime and material consumption.•These improvements enhance the uptake of circular economy requirements in the Ecodesign policy.•Some practical applications of the theoretical discussions are presented.
At European Union level, the 2015 Circular Economy Action Plan establishes challenging yet achievable policy objectives. In this context, it is expected that a key role could be played by the Ecodesign Directive, among the most renowned legislative initiatives addressing the environmental impact of products. This policy has the potential to implement the circular economy principles into actual requirements at product level. To this extent, improvements are needed to the supporting analytical tool, the Methodology for Ecodesign of Energy-related Products. This paper focuses on the techno-economic aspects of this methodology, devising improvements such as the systematic inclusion of a) externalities (by proposing to account them as environmental fees to be added in the consumer life cycle costing), b) lifetime (by proposing to switch from the life cycle cost to the 'equivalent annual cost') and c) material consumption aspects (by proposing to determine the life cycle cost as a function of energy and material). These methodological improvements are expected to contribute enhancing the uptake of circular economy requirements in the Ecodesign policy, notably on product durability, on product reparability and capability to be refurbished, on spare parts availability, on product recyclability and on the reuse of secondary raw materials and/or components.
The introduction of direct-acting antiviral agents (DAAs) into clinical practice has rev- olutionized the therapeutic approach to patients with chronic hepatitis C virus (HCV) infection. According to ...the most recent guidelines, the first line of treatment for HCV infection involves the use of one of three pan-genotypic DAA combinations, sofosbuvir/velpatasvir (SOF/VEL), glecapre- vir/pibrentasvir (GLE/PIB), and sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX). These drugs have been shown to be effective and safe in numerous clinical trials and real-world studies, but special populations have been neglected. Among the special populations to be treated are elderly patients, whose numbers are increasing in clinical practice. The management of these patients can be challenging, in particular due to multiple comorbidities, polypharmacotherapy, and potential drug-drug interactions. This narrative review aims to summarize the current scientific evidence on the efficacy and safety of DAAs in the elderly population, both in clinical trials and in real-life settings. Although there is still a paucity of real-world data and no clinical trials have yet been conducted in the population aged >= 75 years old, some considerations about the efficacy and safety of DAAs in the elderly can be made based on the results of these studies. The pan-genotypic associations of DAAs appear to be as efficacious and safe in the elderly population as in the general population; this is both in terms of similar sustained virologic response (SVR) rates and similar frequencies of adverse events (AEs). However, further studies specifically involving this patient population would be necessary to confirm this evidence.
Background: Artificial intelligence (AI)-based chatbots have shown promise in providing counseling to patients with metabolic dysfunction-associated steatotic liver disease (MASLD). While ChatGPT3.5 ...has demonstrated the ability to comprehensively answer MASLD-related questions in English, its accuracy remains suboptimal. Whether language influences these results is unclear. This study aims to assess ChatGPT’s performance as a counseling tool for Italian MASLD patients. Methods: Thirteen Italian experts rated the accuracy, completeness and comprehensibility of ChatGPT3.5 in answering 15 MASLD-related questions in Italian using a six-point accuracy, three-point completeness and three-point comprehensibility Likert’s scale. Results: Mean scores for accuracy, completeness and comprehensibility were 4.57 ± 0.42, 2.14 ± 0.31 and 2.91 ± 0.07, respectively. The physical activity domain achieved the highest mean scores for accuracy and completeness, whereas the specialist referral domain achieved the lowest. Overall, Fleiss’s coefficient of concordance for accuracy, completeness and comprehensibility across all 15 questions was 0.016, 0.075 and −0.010, respectively. Age and academic role of the evaluators did not influence the scores. The results were not significantly different from our previous study focusing on English. Conclusion: Language does not appear to affect ChatGPT’s ability to provide comprehensible and complete counseling to MASLD patients, but accuracy remains suboptimal in certain domains.
Aims: Lumen-apposing metal stents (LAMSs) in ultrasonography-guided gallbladder drainage (EUS-GBD) have become increasingly important for high-risk surgical patients. Our study aims to evaluate the ...technical and clinical success, safety, and feasibility of endoscopic ultrasonography-guided gallbladder drainage using a new dedicated LAMS. Methods: This is a retrospective multicenter study that included all consecutive patients not suitable for surgery who were referred to a tertiary center for EUS-GBD using a new dedicated electrocautery LAMS for acute cholecystitis at eight different centers. Results: Our study included 54 patients with a mean age of 76.48 years (standard deviation: 12.6 years). Out of the 54 endoscopic gallbladder drainages performed, 24 (44.4%) were cholecysto-gastrostomy, and 30 (55.4%) were cholecysto-duodenostomy. The technical success of LAMS placement was 100%, and clinical success was achieved in 23 out of 30 patients (76.67%). Adverse events were observed in two patients (5.6%). Patients were discharged after a median of 5 days post-stenting. Conclusions: EUS-GBD represents a valuable option for high-surgical-risk patients with acute cholecystitis. This new dedicated LAMS has demonstrated a high rate of technical and clinical success, along with a high level of safety.
Abstract Policies related to the circular economy are currently being implemented intensively within the European Union, with a central role attributed to the Ecodesign Directive. Within this ...framework, this paper devises a general methodology to be applied for the formulation of recyclability indexes for products, with particular regard to the specific case of PV modules. Recyclability indexes can be intended as an aggregated manner to assess and present information about the product aspects related to recyclability, with the view to convey this multi‐layered information to various audiences. The key elements, as well as the related design features, for the definition of such type of index have been identified. An assessment on the environmental benefits stemming from the availability of a recyclability index is also presented. Finally, the policy approaches for the application of a recyclability index in regulatory terms are discussed, by means, in particular, of requirements in the legal framework of the EU Ecodesign Directive.
This work assesses the opportunities for technological development and innovation that may be imposed or created by environmental policy. Working within the legislative framework of European Union ...(EU) sustainable product policies, a study of the feasibility of four specific policy instruments (Ecodesign Directive, Energy Labelling, Green Public Procurement and the EU Ecolabel) to photovoltaic products (modules, inverters and systems) led to the identification of key performance metrics and design features. Starting from an analysis of the environmental hotspots of photovoltaic products throughout the whole life cycle (from raw material extraction to their end of life and disposal), a number of areas of attention for innovation are identified and a policy approach is proposed to tackle these aspects in regulatory terms by means, in particular, of requirements within the legal framework of the Ecodesign Directive.
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