Corrigendum to "Environmental sustainability of European production and consumption assessed against planetary boundaries"

• Planetary Boundaries help quantify the environmental sustainability of consumption. • We developed LCIA-based planetary boundaries for evaluating the EU consumption. • EU consumption occupies a high share of the safe operating space globally available. • Planetary boundaries are fundamental to support policy making towards sustainability. • LCA-based planetary boundaries show intrinsic uncertainties.

Environmental sustainability of European production and consumption assessed against planetary boundaries

The planetary boundaries (PBs) represent a well-known concept, which helps identify whether production and consumption systems are environmentally sustainable in absolute terms, namely compared to the Earth's ecological limits and carrying capacity. In this study, the impacts of production and consumption of the European Union in 2010 were assessed by means of life cycle assessment (LCA)-based indicators and compared with the PBs. Five different perspectives were adopted for assessing the impacts: a production perspective (EU Domestic Footprint) and four distinct consumption perspectives, resulting from alternative modelling approaches including both top-down (input-output LCA) and bottom-up (process-based LCA). Life cycle impact assessment (LCIA) results were assessed against LCIA-based PBs, which adapted the PBs framework to the LCIA indicators and metrics of the Environmental Footprint method (EF). Global environmental impacts transgressed several LCIA-based PBs. When assessing the overall environmental impacts of EU consumption compared to the global LCIA-based PBs, impacts of EU consumption related to climate change, particulate matter, land use and mineral resources were close or already transgressed the global boundaries. The EU, with less than 10% of the world population, was close to transgress the global ecological limits. Moreover, when downscaling the global PBs and comparing the impacts per capita for an average EU citizen and a global one, the LCIA-PBs were significantly transgressed in many impact categories. The results are affected by uncertainty mainly due to: (a) the intrinsic uncertainties of the different LCA modelling approaches and indicators; (b) the uncertainties in estimating LCIA-based PBs, due to the difficulties in identifying limits for the Earth's processes and referring them to LCIA metrics. The results may anyway be used to define benchmarks and policy targets to ensure that consumption and production in Europe remains within safe ecological boundaries, as well as to understand the magnitude of the effort needed to reduce the impacts.

Assessing the decoupling of economic growth from environmental impacts in the European Union: A consumption-based approach

Pursuing a responsible and sustainable development, the United Nations urged to decouple economic growth from environmental impacts. Several European Union (EU) policies have been implemented towards such goal. Although multiple authors have evaluated the decoupling of the economic growth from the resource use or environmental concerns, the environmental assessment mostly focused on pressures rather than impacts, and used single indicators assumed to be a proxy of the overall effects on the environment. Furthermore, no studies were found using a process-based life cycle approach to quantify the environmental impacts of consumption. To solve such research gap, this paper assesses the decoupling in the EU focusing on potential environmental impacts, complementing a production-based approach with two options for accounting for the impacts of consumption. The aim of this paper is to evaluate the decoupling of the economic growth (in terms of Gross Domestic Product) from the environmental impacts due to EU-28 consumption, assessed by means of life cycle assessment (LCA). The decoupling is then assessed in impact terms rather than limited to pressures by using the Environmental Footprint (EF2017) indicators, which allows assessing 16 different impacts. The Consumption Footprint indicator quantified the environmental impacts of EU apparent consumption, including the territorial impacts (Domestic Footprint) and the embodied impacts in both imports and exports (Trade Footprint). The inventory of pressures for the trade component is compiled either with a bottom-up approach (process-based LCA of representative traded goods) or a top-down approach (input-output-based LCA). Methodological aspects influencing the decoupling assessment and the resulting outputs are presented and discussed. According to the results, the environmental impacts of EU-28 consumption showed decoupling during the last decades (2005-2014), between relative to absolute decoupling depending on the inventory modeling approach taken. Some countries showed higher decoupling levels than others displaying a heterogeneous map of EU-28 decoupling, which was led by acidification, particulate matter, land use and eutrophication impacts. Notwithstanding current limitations, the assessment of decoupling using consumption-based environmental indicators is very promising for supporting policy-making towards addressing the actual impacts driven by the EU production and consumption system.

An atypical presentation of diffuse midline pontine glioma in a middle age patient: Case report

INTRODUCTION

Diffuse midline glioma is a newly WHO defined entity (grade IV) (Louis et al., 2016) which includes diffuse intrinsic pontine glioma (DIPG) reported in pediatric population and, occasionally, in young adults. Here, we present a detailed description of an atypical case of diffuse midline glioma in a 53 years old woman.

CASE REPORT

A caucasian woman aged 53 from Ukraine, was referred to another neurological department complaining of 3 months history of progressive postural instability and gait impairment with frequent falling. Magnetic resonance demonstrated two brainstem lesions, hyperintense in FLAIR with "patchy" peripheral enhancement, leptomeningeal and cranial nerves enhancement. CSF was normal. Due to positive antinuclear antibodies test (ANA 1:360), intravenous steroid treatment was administered and reported to initially improve the patient condition. However, the following weeks the lady worsened. Imaging features were unchanged. Because quantiferon test resulted positive, MRI-Spectroscopy showed an inflammatory pattern and MRI perfusion study and brain FDG-PET, were normal, tubercolar granulomatous hypothesis was initially favored. Antitubercular therapy with isoniazid, pyrazinamide, ethambutol and rifampicin was started without any clinical improvement. Hence, the biopsy was proposed. The procedure revealed a diffuse midline pontine glioma. Considering the advanced stage of the disease, radiotherapy was not indicated. Patient died after eight months from the onset of neurological disturbances.

CONCLUSION

Our case shows that diffuse midline glioma is a CNS tumor not limited to young population but occurring also in middle aged patients with an insidious pattern. We therefore recommend to perform biopsy at very early stages in patients with atypical brainstem lesions.

Building national emission inventories of toxic pollutants in Europe

The reduction of chemical pollution is a priority in many regional, national, and international policies, including in EU countries. To effectively do so, quantified overviews of pollutant emissions at national levels and with some granularity in their sources, are required. However, current monitoring efforts are often scattered and a quantitative and comprehensive inventory of toxic emissions in Europe is lacking. Toxic pollutants stem from a large variety of emission sources from industry, agriculture, households, etc. and the difficulty to cover all of them is manifest in public databases and official reports, where data gaps across countries and years exist for several substances. Here, we propose a methodology to tackle this problem and build comprehensive and harmonized national inventories of toxic pollutants. Using public databases, official reports, scientific literature and developing extrapolation techniques specific to each emission source, we derived harmonized annual inventories of toxic pollutants in all EU Member States over the years 2000-2014. They present an unprecedented coverage of 805, 572, and 468 substances emitted to air, water and soil, respectively. Although the resulting dataset shows a relatively good agreement with previous inventories of narrower scopes, uncertainties can be identified for specific emission sources and in the development of extrapolation techniques, thus calling for further research in these areas. Such efforts should also explore adaptation of the methodology to derive comprehensive inventories for countries outside EU, where data is scarcer. Nonetheless, the developed national inventories can provide a starting point for territorial chemical footprints of toxic pollutants and could be coupled with environmental impact assessment for gauging the damages to ecosystems and human health from toxic pollutants emitted in Europe. This can ultimately support policy-makers in their pollutants prioritisation and benchmarking across substances and countries towards improved toxic emission reduction policies.

Assessing the environmental impacts of EU consumption at macro-scale

Sustainable Consumption and Production is one of the leading principle towards reducing environmental impacts globally. This study aims at combining Environmentally-Extended Input-Output Analysis (using EXIOBASE 3) with up-to-date impact assessment models to quantify the environmental impacts induced by final consumption in the EU Member States in 2011. The environmental extensions are characterized in 14 environmental impact categories out of the 16 used in the Environmental Footprint life cycle impact assessment method. A contribution analysis of key products and services as well as emissions and resources, which drive the environmental impacts of EU consumption, is conducted. Environmental impacts are mainly induced along the supply-chain of products and services. Several expenditures relative to services represent large shares both in the total final consumption and in the 14 impacts under study, despite a relatively low impact intensity. Food products, in particular meat and dairy products, are identified as key contributors regarding acidification, eutrophication, land use, and water use, and to a lower extent climate change. Finally, several manufactured products, raw materials and basic products respectively importantly contribute to impacts on human toxicity, freshwater ecotoxicity and resource uses. The total volume of final consumption expenditures per EU Member State appears a key explanatory variable to most of the impacts embodied in their consumption, yet to a lower extent regarding water use and fossils resource use. Finally, the current limitations in using EXIOBASE 3 for environmental impact assessment are discussed, with specific attention to EXIOBASE environmental extensions and to the case study on EU consumption. Since the classification of emissions and resources for impact assessment requires a number of assumptions that may influence the results, a sensitivity analysis is performed to exemplify some of the key issues relative to the characterization of impacts based on EXIOBASE environmental extensions.

Soil quality index: Exploring options for a comprehensive assessment of land use impacts in LCA

Impacts associated with land use are increasingly recognized as important aspects to consider when conducting Life Cycle Assessment (LCA). Across the existing models accounting for land use activities in life cycle impact assessment, a balance is yet to be found between complexity and comprehensiveness on one hand, and applicability on the other hand. This work builds on the LANd use indicator value CAlculation (LANCA^®) model, assessing the impacts of land use activities on five soil properties, and aims at developing an aggregated index to improve its applicability. First a statistical analysis is conducted, leading to the shortlisting of the four most significant soil quality indicators. Then two options for aggregating the selected indicators are presented: the soil quality index (SQI), based on linear aggregation, and the normalisation-based soil quality index (NSQI), where the aggregation process involves normalisation integrated into the characterisation step. Country-specific and global average characterisation factors (CFs) are calculated for 57 land use types considering both land occupation and land transformation interventions with the two suggested approaches. The two indices present similar ranking of land use types but the relative contribution of the separate indicators to the aggregated index varies according to the approach adopted. The differences between the aggregation approaches suggested are discussed, together with the limitations related to both the LANCA^® model and the aggregation approaches. This work represents a first step towards the widespread application of a comprehensive and robust land use model at midpoint level in LCA. Finally, a number of recommendations for the future development of the LANCA^® model and of the related soil quality models are provided.

Improving substance information in USEtox® , part 1: Discussion on data and approaches for estimating freshwater ecotoxicity effect factors

The scientific consensus model USEtox^® is recommended by the European Commission as the reference model to characterize life cycle chemical emissions in terms of their potential human toxicity and freshwater aquatic ecotoxicity impacts in the context of the International Reference Life Cycle Data System Handbook and the Environmental Footprint pilot phase looking at products (PEF) and organizations (OEF). Consequently, this model has been systematically used within the PEF/OEF pilot phase by 25 European Union industry sectors, which manufacture a wide variety of consumer products. This testing phase has raised some questions regarding the derivation of and the data used for the chemical-specific freshwater ecotoxicity effect factor in USEtox. For calculating the potential freshwater aquatic ecotoxicity impacts, USEtox bases the effect factor on the chronic hazard concentration (HC50) value for a chemical calculated as the arithmetic mean of all logarithmized geometric means of species-specific chronic median lethal (or effect) concentrations (L[E]C50). We investigated the dependency of the USEtox effect factor on the selection of ecotoxicological data source and toxicological endpoints, and we found that both influence the ecotoxicity ranking of chemicals and may hence influence the conclusions of a PEF/OEF study. We furthermore compared the average measure (HC50) with other types of ecotoxicity effect indicators, such as the lowest species EC50 or no-observable-effect concentration, frequently used in regulatory risk assessment, and demonstrated how they may also influence the ecotoxicity ranking of chemicals. We acknowledge that these indicators represent different aspects of a chemical's ecotoxicity potential and discuss their pros and cons for a comparative chemical assessment as performed in life cycle assessment and in particular within the PEF/OEF context. Environ Toxicol Chem 2017;36:3450-3462. © 2017 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of SETAC.

Improving substance information in USEtox® , part 2: Data for estimating fate and ecosystem exposure factors

The scientific consensus model USEtox^® has been developed since 2003 under the auspices of the United Nations Environment Programme-Society of Environmental Toxicology and Chemistry Life Cycle Initiative as a harmonized approach for characterizing human and freshwater toxicity in life cycle assessment and other comparative assessment frameworks. Using physicochemical substance properties, USEtox quantifies potential human toxicity and freshwater ecotoxicity impacts by combining environmental fate, exposure, and toxicity effects information, considering multimedia fate and multipathway exposure processes. The main source to obtain substance properties for USEtox 1.01 and 2.0 is the Estimation Program Interface (EPI Suite™) from the US Environmental Protection Agency. However, since the development of the original USEtox substance databases, new chemical regulations have been enforced in Europe, such as the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) and the Plant Protection Products regulations. These regulations require that a chemical risk assessment for humans and the environment is performed before a chemical is placed on the European market. Consequently, additional physicochemical property data and new toxicological endpoints are now available for thousands of chemical substances. The aim of the present study was to explore the extent to which the new available data can be used as input for USEtox-especially for application in environmental footprint studies-and to discuss how this would influence the quantification of fate and exposure factors. Initial results show that the choice of data source and the parameters selected can greatly influence fate and exposure factors, leading to potentially different rankings and relative contributions of substances to overall human toxicity and ecotoxicity impacts. Moreover, it is crucial to discuss the relevance of the exposure factor for freshwater ecotoxicity impacts, particularly for persistent highly adsorbing and bioaccumulating substances. Environ Toxicol Chem 2017;36:3463-3470. © 2017 The Authors. Environmental Toxicology and Chemistry Published by Wiley Periodicals, Inc. on behalf of SETAC.

Lost stones during laparoscopic cholecystectomy

BACKGROUND

Gallbladder perforation, with loss of calculi in the abdomen is frequent during laparoscopic cholecystectomy. Recent publications report complications in port sites or in the abdominal cavity. A study of 3686 laparsocopic cholecystectomies performed by 6 surgeons was undertaken. In 627 patients, perforation of the gallbladder occurred and in 254 stones were spilled into the abdominal cavity. In 214 they were retrieved and in 40 left in the abdomen. Twelve patients developed complications. Percutaneous drainage was successful in 2 with serous collections. Two patients with abdominal abscesses were reoperated, stones retrieved and the abdomen drained. One patient developed an intestinal obstruction due to a stone in the ileum. One patient who had a cholecystectomy in another hospital developed a paraumbilical tumor. At reoperation a stone was retrieved. In another six patients, stones were found in port sites. Stones lost into the abdomen should be removed because of their potential morbidity, especially if they are large or if infection is present in the gallbladder at the time of initial surgery. There is no indication for routine conversion to open surgery when stone spillage occurs, although patients should be informed to avoid legal consequence, and to hasten early diagnosis of later complications.

Progressive hepatic arterial flow increase after end-to-side portacaval shunt in normal and cirrhotic rats

Hepatic blood flow (HBF; ml/min/g of liver) has been measured in Wistar rats with a Xenon 133 washout method. The hepatic arterial blood flow (HABF) which amounts to 23 +/- 3% of the total HBF increases immediately after occlusion of the portal vein to ensure 36 +/- 4% of the control HBF, but continues to increase progressively for the next 4 h to furnish 69 +/- 5% of the control HBF. This represents a 183 +/- 16% increase of the control HABF. Thereafter, the liver starts to atrophy, whereas the total liver blood flow remains constant. Thus, the HBF increases and 30 days later does not differ significantly from the control value. Similar experiments were performed in rats in which cirrhosis was induced by CCl4. The HBF is decreased and the contribution of the hepatic artery raised. After portacaval shunting, the increase of the HABF, although less pronounced, is also progressive and takes 4 h to reach its maximum.

5'-Nucleotidase activity in liver homogenates of rats treated with CCl4, colchicine, cycloheximide, emetine, ethanol, ethionine and 5-fluorotryptophan

5'-Nucleotidase activity an enzyme marker of the plasma membranes, increases in female rat liver homogenates following ethionine administration, while homogenates from males show no changes. Treatment with CCl4, colchicine, cycloheximide, emetine, ethanol and 5-fluorotryptophan does not significantly modify the 5'-nucleotidase activity of liver homogenates of either female or male rats.