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Implementing policies able to drive energy sector transition is an objective of the European Union. Based on economic literature, we argue that several determinants might be either drivers or barriers to the effectiveness of energy policy interventions: political-institutional, socio-economic and region-specific factors. For understanding their role in the Italian framework, this research aims at assessing to what extent each group of determinants influences the transition towards green energy systems. In doing so, by using several econometric techniques, we are able to offer useful suggestion to the policymaker about potential intervention strategy. Finding shows that institutional and regional-specific drivers play a pivotal role in driving Italian regions energy transition.

Over the past 10 years, the concepts and objectives of circular economy have been increasingly detailed and become strategic issues of international, European, and national policies. However, the transition towards circular production models continues to be affected by several barriers and critical factors that make the transition difficult to achieve. The paper tries to design a relationship between sustainable production and lean production, highlighting the opportunity to invest in reverse‐logistics and how Industry 4.0 system represents a breeding ground for circular economy targets application. The aim of the current study is to examine the relationships among sustainable production, lean production, and Industry 4.0 in order to evidence the need to adopt a lean methodology and Industry 4.0 technologies in a sustainable development perspective for companies. Following a holistic vision, the authors summarize the production principles and formulas, which, although in parallel, lead to similar results and therefore represent the pillars of a competitive and sustainable business. In conclusion, exploring the circular economy principles and production chain model, challenges, opportunities, and future outlooks are formulated.

Temporalis fascia and diced cartilage, in varying combinations, are currently commonly employed for augmentation of the radix in rhinoplasty. Although existing literature is replete with papers and suggested variations, there is some lack of practical detail on how to use such techniques. The authors present a reproducible, multilayered, "pillow" construct of temporalis fascia for selective radix augmentation in primary rhinoplasty, with or without the addition of diced cartilage. Precise measurements for accurate multiple folding, exact tailoring of the construct to recipient size dimensions, and fixation by a "litter" concept with proximal and distal fixation point are key to this technique. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The negative impacts associated to industrial activities have lead policymakers and scholars to elaborate broad interventions for sustainable and circular growth. These strategies entail the participation of a multitude of actors, each of whom is responsible for the achievement of different industrial sustainability and circular economy targets. A successful implementation of these strategies must be based on robust measurement systems, evaluating both policy implementation process and its outcomes. With this purpose, the aim of this paper is to present a novel approach for industrial sector performance, with respect to sustainability and circular economy. In doing so, by exploiting an OECD procedure, we built an Industrial Sustainability Index and four sub-indices evaluating different aspects of industrial sustainability and circular economy interventions: inputs, firm activities, outputs and resource efficiency outcomes. Furthermore, a scenario based on a Disparity Index has been used to evaluate the distance of each statistical observation from an efficient solution. This methodology has been tested on 36 OECD countries. The proposed approach allows policymakers to easily identify both weaknesses and best practices of the whole system and, thus, balance policy interventions according to the punctual needing of sectors, aspects or actors.

Digitalisation of urban metabolism circularity provides policymakers, urban managers, planners and administrators with a useful tool for identifying, controlling and evaluating a wide range of data concerning the flows of social, environmental and economic resources. This approach is based on the crucial role of fixed and mobile digital infrastructures such as real-time monitoring stations, GPS tracking sensors, augmented reality, virtual sharing platforms, social media dashboards, smart grids, and the like in the development and strengthening of the quality and efficiency of the circularity of resources. For these reasons, the integration of digital technologies in mobility, waste, water and wastewater management, energy efficiency, safety, and so on, represents a crucial aspect for cities involved in the circularity of their urban metabolism. Through a systematic literature review and case study approaches, the analysis disclose a wide-range of initiatives adopted by several European circular cities that optimise the circularity of urban metabolic flows, and contributes to the efforts in increasing understanding and awareness of the digitalisation driven by the urban metabolism circularity.

Objective: Coronavirus disease 2019 (COVID-19) is a disease with a high rate of progression to critical illness. However, the stratification of patients at risk of mortality is not well defined. In this study, we aimed to define a mortality risk index to allocate patients to the appropriate intensity of care.Methods: This is a 12 months observational longitudinal study designed to develop and validate a pragmatic mortality risk score to stratify COVID-19 patients aged ≥18 years and admitted to hospital between March 2020 and March 2021. Main outcome was in-hospital mortality.Results: 244 patients were included in the study (mortality rate 29.9%). The Covid-19 Assessment for Survival at Admission (CASA) index included seven variables readily available at admission: respiratory rate, troponin, albumin, CKD-EPI, white blood cell count, D-dimer, Pa02/Fi02. The CASA index showed high discrimination for mortality with an AUC of 0.91 (sensitivity 98.6%; specificity 69%) and a better performance compared to SOFA (AUC = 0.76), age (AUC = 0.76) and 4C mortality (AUC = 0.82). The cut-off identified (11.994) for CASA index showed a negative predictive value of 99.16% and a positive predictive value of 57.58%.Conclusions: A quick and readily available index has been identified to help clinicians stratify COVID-19 patients according to the appropriate intensity of care and minimize hospital admission to patients at high risk of mortality.

By now, the importance of renewable energies is consolidated for the promotion of more and more green systems. Although this issue has become one of the cornerstones of the European Union and of each members States, evaluating the effectiveness of the applied environmental policies still results difficult. The basic aim of the paper is to propose an innovative approach for ex post monitoring of the actions carried out by Italian regions. By using both a multivariate technique and a classic convergence analysis, we set out to test in an original way whether the Italian regions realized in a successful way the environmental policies established by European Union (EU) in the energy sector. The results obtained highlight the existence of several improvements between 2008 and 2015, mainly in Southern regions, historically recognized as the less dynamic ones. Moreover, by using a panel data model we are able to offer useful suggestions about the financial allocation among the several typologies of renewable for reducing pollutants.

In recent years, the renewed interest in environmental issues has gradually required manufacturers to simultaneously pursue a more rational use of resources and a reduction in wastes production. New strategies, technologies and organisational innovations must be therefore conceived to "create more value with less impact" (WBCSD, 2010). An interesting and promising perspective for achieving internal efficiency, market effectiveness and environmental eco-efficiency is that of integrating the environmental variable in the Lean Production (LP) paradigm. Scholars and practitioners have been working for some years in this direction of eco-innovation. The present article aims at obtaining a quali/quantitative overview of Lean and Clean(er) production (LC) research through a bibliometric and network analysis, by using a scientific literature database; in particular, it investigates how Clean(er) Production research and publications are progressively embedded in the field of LP, what are the main topics in this sub-field and common research themes. A comprehensive picture was made by analysing data concerning publications, authors, affiliations, and the countries of origin. Evolutionary profiles, major topics investigated, leading authors and collaborations have been reported. The results also reveal promising spaces for the development of LC production research, in order to achieve economic and environmental benefits.

Digital technologies engaged in urban metabolism for efficiency provide policymakers, urban managers, and planners with useful instruments to collect, monitor, analyze, and evaluate the circularity of environmental, social, and economic resources to improve their effectiveness and quality. At present, the digital technology-based approach is strategic for circular cities engaged in the development of smart and sustainable actions in the fields of mobility, energy, environment, waste, telecommunications, and security. Through the ‘Circular Resource Efficiency Management Framework’ developed by the European Commission, this paper generates insights into the digitalization practices of the circularity of urban metabolism by analyzing the initiatives implemented by the municipalities of Kaunas, Flanders region, Porto, Prato, The Hague, and Oslo, which constitute the Partnership on Circular Economy (PCE) of the Urban Agenda of the European Union. The results of the analysis provide a wide range of practices such as real-time monitoring stations for water and energy consumption, digital cameras for controlling vehicle flows, web platforms for sharing goods and services, and tracking sensors for public transport, which aim to optimize the efficiency of the circularity of urban metabolic flows. This study increases the understanding and awareness of digital technologies in this paradigm shift.

AIM To identify clinical and radiological predictors of long-term motor outcome after childhood-onset arterial ischemic stroke (AIS) in the middle cerebral artery (MCA) territory. METHOD Medical records of 69 children (36 females, 33 males; median age at index AIS 3y 3mo, range: 1mo-16y) who presented to Great Ormond Street Hospital with first AIS in the MCA territory were reviewed retrospectively. Cases were categorized using the Childhood AIS Standardized Classification and Diagnostic Evaluation (CASCADE). Magnetic resonance imaging (MRI) and angiography were evaluated. An Alberta Stroke Program Early Computed Tomography Score (ASPECTS) was calculated on MRI. The Recurrence and Recovery Questionnaire assessed motor outcome and was dichotomized into good/poor. RESULTS Eventual motor outcome was good in 49 children and poor in 20. There were no acute radiological predictors of eventual motor outcome. At follow-up, CASCADE 3A (i.e. moyamoya) and Wallerian degeneration were significantly associated with poor motor outcome. In the multivariate analysis, younger age and CASCADE 3A predicted poor motor outcome. INTERPRETATION In the context of recommendations regarding unproven and potentially high-risk hyperacute therapies for childhood AIS, prediction of outcome could usefully contribute to risk/benefit analysis. Unfortunately, paradigms used in adults, such as ASPECTS, are not useful in children in the acute/early subacute phase of AIS. What this paper adds Adult paradigms, such as the Alberta Stroke Program Early Computed Tomography Score system, are not useful for predicting outcome in children. Younger children tend to have a poorer long-term prognosis than older children. Moyamoya is associated with poor prognosis.

Renewable energy and energy efficiency are recognized among the key factors of transitioning towards a low-consumption and low-carbon society. In order to achieve such transition, the government policies should be aimed at meeting the renewable energy generation and energy efficiency targets of specific localities. Nonetheless, these targets vary between different urban regions, and there is limited knowledge on the correlation between energy transition and urbanization levels. The aim of this paper is to identify that correlation in urban regions. This study places Italian regions under the microscope of an empirical investigation. The study adopts a two-step analysis that provides a useful model for regional analyses. The results of the study consolidates our understanding and highlights that the energy transition process requires greater efforts concerning social participation and provision of incentives for renewable energy production, mainly in the less urbanized areas.

PurposeFirst, the key vulnerability factors from the literature are identified. Second, using the vulnerability factors as indicators, a composite index is developed. Last, from the index values, a set of vulnerability knowledge maps, showing the vulnerability hotspots, are prepared.Design/methodology/approachThis study aims to develop a pandemic vulnerability knowledge visualisation index to support the strategic decision-making efforts of authorities.FindingsTen indicators are identified as vulnerability factors that could significantly impact the virus spread risks. Verifying the identified hotspots against the recorded infected cases and deaths has evidenced the usefulness of the index. Determining and visualising the high-vulnerability locations and communities could help in informed strategic decision-making and responses of the authorities to the pandemic.Originality/valueThe study demonstrates that the developed pandemic vulnerability knowledge visualisation index is particularly appropriate in the context of Australia. Nonetheless, by replicating the methodologic steps of the study, customised versions can be developed for other country contexts.

Strategic management of complex decisional problems in the tourism sector requires the implementation of proper planning procedures for sustainable tourism activities, due to either the number of actors involved, the presence of conflicting goals and the need of resource rationalization. Thus, the aim of the research is to implement a new approach for the selection of projects to be funded by public administration, in order to maximize the efficiency of public resource allocation. Furthermore, the proposed technique enhances the inclusion of the three dimensions of sustainability in tourism policy planning and implementation phases. The Multi-objective Optimization model accounts for environmental, social and economic impacts, to select tourism activities to be realized in order to maximize stakeholder utility. In order to test the model, we selected a case study: a call for tender drafted by an Italian Public administration, whose aim was to support the attractiveness of the urban areas. Findings illustrate that, in comparison with multicriteria techniques, the proposed model allows to achieve a better allocation of public funds, in both quantitative (i.e., amount of resources allocated) and qualitative (selection of projects with positive social and environmental implication) terms.

Aim: To assess the ultrasound features in patients with plantar fasciopathy before and after extracorporeal shock waves therapy (ESWT), using conventional grey-scale imaging and both strain (SE) and shear wave (SWE) elastosonographic evaluation.Material and method: Consecutive patients of both sexes attending our outpatient’s clinic, with diagnosis of unilateral plantar fasciopathy, were enrolled. Patients were treated with 3 sessions of ESWT once a week, and underwent clinical and ultrasound evaluation at baseline and at one and three months after treatment. Roles and Maudsley score (RM), visual analog scale (VAS) and 17-Italian Foot Function Index (FFI), were used to assess pain and functional improvement.Results: Twenty patients (11 female and 9 male) were enrolled in the study. Contralateral asymptomatic healthy plantar fascia was used as a control. At baseline, SWE velocity (SWEv) showed statistically significant difference between affected 3.8 (1.5; 5.1) m/s and healthy side 4.7 (4.07; 7.04) m/s, (p=0.006); no significant difference was found for strain ratio values (p=0.656). SWEv post hoc test results showed a significant difference from baseline 3.8 (1.5-5.1) m/s and three month 5.23 (4.55-6.74) m/s follow up visit (p=0.003). Significant statistical negative correlation was found between the SWEv and VAS (p=0.001) and positive correlation between the SWEv and FFI (p=0.012).Conclusion: SWE was effective in assessing plantar fascia elasticity and its alteration in fasciopathy. Furthermore, on the basis of the correlation with pain and functional scales, this technique appears to be a useful additional technique to conventional ultrasound for monitoring the efficacy of treatment

Background and objectives: Due to COVID-19, various countries introduced lockdowns and limited citizen movements. These restrictions triggered an increased use of digital technologies and platforms by the public. This provides an opportunity for the authorities to capture public perceptions on COVID-19 from social media channels to make informed decisions. The use of social media analytics during pandemics for decision-making, however, is an understudied area of research. Thus, this study aims to generate insights into how social media analytics can assist authorities in pandemic-related policy decisions.Methods: This study involved a social media analysis approach—i.e., systematic geo-Twitter analysis—that contains descriptive, content, sentiment, and spatial analyses. Australian states and territories are selected as the case study context for the empirical investigation. This study collected 96,666 geotagged tweets (originated from Australia between 1 January and 4 May 2020), and analysed 35,969 of them after data cleaning.Results: The findings disclose that: (a) Social media analytics is an efficient approach to capture the attitudes and perceptions of the public during a pandemic; (b) Crowdsourced social media data can guide interventions and decisions of the authorities during a pandemic, and; (c) Effective use of government social media channels can help the public to follow the introduced measures/restrictions.Conclusion: The findings are invaluable for authorities to understand community perceptions and identify communities in needs and demands in a pandemic situation, where authorities are not in a position to conduct direct and lengthily public consultations.

The data-driven approach to sustainable urban development is becoming increasingly popular among the cities across the world. This is due to cities&rsquo, attention in supporting smart and sustainable urbanism practices. In an era of digitalization of urban services and processes, which is upon us, platform urbanism is becoming a fundamental tool to support smart urban governance, and helping in the formation of a new version of cities&mdash, i.e., City 4.0. This new version utilizes urban dashboards and platforms in its operations and management tasks of its complex urban metabolism. These intelligent systems help in maintaining the robustness of our cities, integrating various sensors (e.g., internet-of-things) and big data analysis technologies (e.g., artificial intelligence) with the aim of optimizing urban infrastructures and services (e.g., water, waste, energy), and turning the urban system into a smart one. The study generates insights from the sensor city best practices by placing some of renowned projects, implemented by Huawei, Cisco, Google, Ericsson, Microsoft, and Alibaba, under the microscope. The investigation findings reveal that the sensor city approach: (a) Has the potential to increase the smartness and sustainability level of cities, (b) Manages to engage citizens and companies in the process of planning, monitoring and analyzing urban processes, (c) Raises awareness on the local environmental, social and economic issues, and, (d) Provides a novel city blueprint for urban administrators, managers and planners. Nonetheless, the use of advanced technologies&mdash, e.g., real-time monitoring stations, cloud computing, surveillance cameras&mdash, poses a multitude of challenges related to: (a) Quality of the data used, (b) Level of protection of traditional and cybernetic urban security, (c) Necessary integration between the various urban infrastructure, and, (d) Ability to transform feedback from stakeholders into innovative urban policies.

BackgroundThe mechanisms and pathways to impacts from public health research in the UK have not been widely studied. Through the lens of one funder (NIHR), our aims are to map the diversity of public health research, in terms of funding mechanisms, disciplinary contributions, and public health impacts, identify examples of impacts, and pathways to impact that existing reporting mechanisms may not otherwise have captured, and provide illustrations of how public health researchers perceive the generation of non-academic impact from their work.MethodsA total of 1386 projects were identified as ‘public health research’ by the NIHR and listed in the NIHR Public Health Overview database (2000–2016). From these, a subset of 857 projects were matched as potentially having begun reporting impacts via an external data-gathering platform (Researchfish). Data on the 857 projects were analyzed quantitatively, and nine projects were selected to investigate further through semi-structured interviews with principal investigators. Two workshops took place to validate emerging and final findings and facilitate analysis.ResultsIn addition to the NIHR School for Public Health Research and the NIHR Public Health Research Programme, 89% of projects contained in the NIHR Public Health Overview portfolio as ‘public health research’ are funded via other NIHR research programmes, suggesting significant diversity in disciplines contributing to public health research and outcomes. The pathways to impact observed in our in-depth case studies include contributing to debates on what constitutes appropriate evidence for national policy change, acknowledging local ‘unintended’ impacts, building trusted relationships with stakeholders across health and non-health sectors and actors, collaborating with local authorities, and using non-academic dissemination channels.ConclusionsPublic health as a discipline contributes substantially to impact beyond academia. To support the diversity of these impacts, we need to recognise localized smaller-scale impacts, and the difference in types of evidence required for community and local authority-based impacts. This will also require building capacity and resources to enable impact to take place from public health research. Finally, support is required for engagement with local authorities and working with non-health sectors that contribute to health outcomes.

Sanitaryware products are one of the most diffused ceramic materials. In the present study, an environmental assessment of sanitaryware production was carried out. The Life Cycle Assessment was performed with a cradle-to-gate approach, considering the product life cycle from resource extraction to the factory gate of an Italian company and it aims to evaluate the environmental weight of sanitaryware production, identifying hotspots and comparing different energetic scenarios. The study was performed according to the current international standards and choosing, as the functional unit, 1000 kg of heterogeneous sanitaryware products. The system boundary includes raw materials extraction, transportation of raw materials and all the manufacturing activities within the factory, including electric and thermal energy supply. The results show how the study factory have implemented a mature green-based manufacturing and represents a reference point to estimate how the environmental impact can be improved by energy saving technologies and recycling water. Such technologies were compared to conventional ones and with results of other recent literature research. In addition, a potential improvement, based on cogeneration, was evaluated to consider if the economic improvement goes together with a minor environmental impact. Results show how economic benefit due to the implementation of cogeneration agrees with environmental impact, presenting only an increase in Global Warming Potential and Abiotic Depletion of fossil fuels. This is the inspiration for a further research where Life Cycle Assessment can be coupled to a Life Cycle Cost.

Smart urban metabolism is a hybrid approach—where technological, economic, environmental and social perspectives are simultaneously considered—to develop smart and sustainable cities. This characteristic makes smart urban metabolism a strategic tool for urban policymakers and managers, and planners. Nonetheless, little is known on about the indicators of smart urban metabolism. This study aims to shed light on what the specific indicators of smart urban metabolism are. The paper places international standards and indicators of urban systems under the microscope to determine their focus, and areas of action. The analysis exposes divergences in urban system evaluation approaches by international standardization organizations—particularly with a focus on whether they concentrate on urban smartness or urban metabolism. The results of the analysis demonstrate a challenge in integrating urban metabolism with urban smartness. In this sense, there is no international standard taken into consideration thus far. The study points out to a novel and invaluable approach to improve the understanding and awareness on internationally standardized urban indicators that characterize, and stimulate the knowledge on smart urban metabolism.

In the literature of field innovations, it has always been presented as the most important factor to achieve both the economic growth and the employment growth. Supporting innovations is also one of the aims of the 2030 Agenda for Sustainable Development (Goal 9. Build resilient infrastructure, promote inclusive and sustainable industrialisation and foster innovation). The measurement of the innovation level of world economies has been of interest for several years for both economic theoreticians and practitioners. However, the real innovation level of world economies can be evaluated on the basis of a much more limited set of diagnostic features available in official statistics. That is why the main objective of the work is to assess the level of innovation of the European Union Member States based on the composite index which was proposed by authors using variables indicated in the 2030 Agenda for Sustainable Development strategy. The following specific objectives have been formulated as part of the main objective: (i) comparing the level of innovation of EU Member States based on the results of the ranking constructed by the authors; (ii) simplifying the tools for assessing activities undertaken under the 2030 Agenda strategy; (iii) building a tool that will allow for a long-term assessment of the effectiveness of measures to strengthen innovation within the framework of the sustainable development policy indicated in the 2030 Agenda; (iv) comparison of the results of the conducted research with the Summary Innovation Index (SII) published in the European Innovation Scoreboard (EIS), which in the literature on the subject is one of the most frequently used rankings for assessing the level of innovation in European countries. The comparative analysis carried out here is intended to highlight that the level of innovation of European Union member states can be described equally well on the basis of a limited set of diagnostic features. The taxonomic measure of development based on the Weber median vector was used in the paper to assess the innovation level of the EU Member States. The research was conducted based on the indicators applied by Eurostat to monitor the implementation of Goal 9 of the 2030 Agenda. The applied method and the results obtained can be used in subsequent years to examine the direction of changes observed also from the point of view of the particular EU Member States in the area of the application of innovations for the implementation of sustainable development policy.

Industrial sustainability now appears to be moving up the management agenda in many organizations and thus countries, mainly focused on performance achieved at regional level. In this context, government becomes a significant driver of both environmental policy and technology innovation for firms, which are actually innovating their processes for improving the global sustainability of territories. However, these processes exhibit many difficulties linked to the presence of different guidelines, involved stakeholders and objectives in order to ensure a more sustainable territorial development. In order to evaluate industrial sustainability achieved at regional level, we propose a new approach based on a reappraisal of the classical SWOT analysis. By using multivariate analysis methodologies and a wider battery of indicators, this approach identifies homogeneous groups of regions and describes points of strength and weakness points for each one. The results obtained, as well as evaluating the achievements of regional sustainable industrial policy, provide a guide for the establishment of regional policies, according to European directives.

This paper aims to investigate the impacts of different sources of innovation funding on company performances in the context of an emerging economy. Brazilian software companies are selected as a case for this investigation. Data – related to the types of funding support received and eight types of company performances measured in binary scales – was collected through an online survey from 188 companies located across Brazil. A multivariate probit model was estimated to assess the impacts of different funding schemes on company performances – controlling for other confounding effects. The findings confirmed the critical importance of public innovation funding, and revealed that companies that: (1) Used public funds were more likely to become nationally competitive; (2) Used loans from commercial banks were less likely to become nationally and internationally competitive; (3) Reinvested revenues were more likely to gain market share, and help in increasing the number of employees; (4) Not aware of public funding schemes were less likely to invest on research, development, and innovation. The overall findings suggest the positive impacts of innovation funds on company performance. They can serve as a policy guide to develop targeted performance strategy to determine which funding scheme would be effective to foster what outcomes.

This paper is based on the idea that the success of an environmental policy applied to the industrial sector is driven by cooperation between all parties involved, which represent both public and private actors. An innovative index to measure ecological industrial policy—Industrial Environmental Sustainability Index (IESI)—was designed using the Principal Component Analysis model, implemented through variables identifying both the applied strategy of the involved actors, on a sample of 20 Italian regions. The index allows vertical comparison among the regions in order to evaluate the achievements of national sustainable industrial policy. Its two sub-indexes also enable horizontal comparisons within the regions to encompass the role played by public and private actors. This provides a decision making support tool for policy makers seeking to fulfil their sustainability responsibility effectively, according to the EU directives.

The manufacturing trend nowadays seems to be in contrast with the ecosystem needs, as it is based on the exploitation of limited natural resources. A new paradigm is now driving manufacturing in the direction of sustainability: the green and circular thinking. This latter can now guide SMEs in optimizing its processes and products to be more eco-friendly, and this in turn may lead to significant competitive advantages. The purpose of the study is to analyze the environmental lifecycle performance of a 100% PET fabric used for the outer cover of bed mattresses made by an Italian company, with looms of recent technology (2009–2010). The emissions defined in the community labeling system for textile products and mattresses have been taken into account as well as the mid and final impact categories established by the guidelines for the Product Environmental Footprint developed by European. Results show that the fiber and yarn production processes are the most impacted due to transport from China and the use of Chinese electricity grid mix (rich in coal). Furthermore, the disposal of fabric is another environmental critical point. In order to evaluate the improvements in the environmental sustainability of supply of PET yarns and the disposal phase, a number of scenarios were analysed, while a Monte Carlo simulation was performed to evaluate the sensitivity of the results respect to data uncertainty. A number of recommendations for the textile sector are provided, useful to assure sustainability of production. Critical points to achieve environmental labeling are highlighted and new data about textile, not already available in databases and literature, are provided due to the company's engagement. Finally, hints on the best recycling process of the product are given.

Chlamydia trachomatis is the most frequently-notified sexually transmitted infection in Australia. Effective and timely partner treatment of chlamydia is essential to reduce overall prevalence and the burden of infection. Currently in most of Australia, the only avenue for partner treatment of chlamydia ("standard partner therapy") is a tedious, and often inconvenient, process. The barriers and facilitators of standard partner therapy, and newer models of accelerated partner therapy (APT), need to be identified in the Australian setting. Additionally, the potential role of community pharmacists need to be explored. Semi-structured interview guides for two key stakeholder groups (prescribers and pharmacists) were developed and piloted. Eleven prescribers (general practitioners, sexual health clinicians and nurse practitioners) and twelve pharmacists practicing in the Perth metropolitan region were interviewed. Key reported barriers to standard partner therapy were lack of or delayed chlamydia testing. Key facilitators included ability to test and educate sexual partner. Key barriers for APT included prescribers' legal responsibility and potential for medication-related adverse effects. Healthcare provider consultation and chlamydia testing were seen as potential facilitators of APT. Pharmacists were receptive to the idea of expanding their role in chlamydia treatment, however, barriers to privacy must be overcome in order to be acceptable to prescribers and pharmacists.

Logistics infrastructures play an important role in many fields of economic activity, substantially influencing land use planning. Despite this, scholars and practitioners have dedicated little attention to setting up efficient indicators able to define the effect that infrastructure investments have on industrial activities. Many theoretical and empirical studies have been dedicated to calculating the exact numerical effect of infrastructure investment on social wellbeing, but their explicative capacity has always proved to be scarce since it is difficult work and with high levels of arbitrariness. This work becomes much more difficult when it aims to determine the effects on industrial efficiency. In this paper, we will use an indicator to overcome the problems related to determination of the exact economic impact of infrastructure investment on an economic region or local territory and suggest land use policy models to analyse infrastructure economic impacts. More specifically, we will focus our attention on the factors affecting logistics and economic performance within the economic regions around twenty major European ports. By using the new ACIT (Autoregulation, Compensation, Invariance and Transversality) indicator, we show that positive effects, deriving from port logistics interventions, can occur in those regions that have an ACIT indicator positively associated with other variables, such as propensity to innovation and level of education. This indicator represents a starting point to study how, in the better performing regions, it could be possible to develop logistics services able to stimulate a higher level of transport demand and, at the same time, respect high standards in environmental quality. Finally, we explain how an improvement in logistics performances of a port region may determine an improvement in its socioeconomic and environmental conditions.

Infekcni endokarditida je zavažne onemocněni s vysokou morbiditou. Cardiobacterium hominis patři do skupiny mikroorganismů pod oznacenim HACEK. Popisujeme připad 56leteho muže s infekcni endokarditidou postihujici nativni mitralni chlopeň a vyvolanou bakterii Cardiobacterium hominis. Význam tohoto připadu spociva ve skutecnosti, že infekce vyvolane bakterii Cardiobacterium hominis, i když nejsou přilis caste (přibližně 1-3 % vsech připadů), jsou možnou přicinou infekcni endokarditidy se zavažnými klinickými důsledky.

For many years different scientists have published the results of research related to the usage of UDI (user-driven innovation) concept and its impact on innovation activity of enterprises. None of them, however, concerned the relationship between various determinants for developing the R&amp, D (Research and Development) sphere. It is the reason why the main purpose of the study is to present the empirical evidence in finding the determinants for usage of &ldquo, user-driven innovation&rdquo, concept (UDI). The work focuses on using this concept in R&amp, D departments, which are very often responsible for introducing this kind of innovation in a firm&rsquo, s practice. The use of the UDI concept in R&amp, D in the enterprise will be influenced by various factors which, in the literature, are divided into external, independent of the enterprise, and internal, which can be a result of adopted strategies, action plans and/or operating standards. The implementation of UDI in enterprises gives a number of benefits resulting from interaction with the environment, but also encounters barriers and internal problems that need to be neutralized. It is why, in this paper, the internal factors will be considered. To present the relationship between the selected variables, the correspondence analysis which constitutes one of the methods for multidimensional statistical analysis, was applied. The results presented in the paper allowed to formulate several important conclusions about the potential level of implementation of UDI concept in R&amp, D departments in Poland. Firstly, it should be noted that in Poland, the UDI concept is still seen as new. This is why there are no scientific publications on this topic, as well as a lack of system solutions and strategic documents encouraging entrepreneurs to conduct research and development activity based on contacts with users. That is why authors have made some recommendations regarding the promotion of activities related to the use of UDI in research and development processes. Our research supplements the current knowledge in the field of internal conditions affecting the implementation of the UDI concept in enterprises which are starting to implement this concept.

Built environment represents the man-made surroundings providing setting for human activity and so encompasses places and spaces that were created or modified by people including buildings, parks, and transportation systems. Despite the multiple benefits for living people, built environments of today are created through usage of large amounts of energy and materials, affecting the health of humans and the natural environment in negative manners. This aspect is amplified by built environments enhancing because of urban areas expanding to meet necessities and requirements of an increasing number of citizens. The built environment is responsible for both consumption of resources and energies, the generation of wastes and the emission of greenhouse gases and other pollutants, with the consequent environmental impacts. Buildings contribute hugely to those environmental issues and impacts. Therefore, life cycle evaluations upon the energy and environmental performance of buildings are desirable to find room for improvement. In this context, this chapter highlights the importance and usefulness not only of life cycle assessment but also of guiding and regulating its application in buildings, so to contribute, in turn, to enhancement of the subject literature and knowledge.

Organic Rankine Cycle (ORC) power plants are constantly developing systems and, apart from Stirling engine, are currently the only commercially available technology, which allows electricity generation using low and medium temperature waste thermal energy. A lot of effort has been devoted to improve analysis techniques, with the aim to find the most favorable parameters of ORC as well as the best working fluid for a certain type of energy source and configuration of the system. The aim of the paper is to present a method to determine an optimal pinch point temperature difference interval (OPPTDI) using multi-criteria approach with G(X) as multi-objective function and pinch point temperature difference as a decision variable. The analysis has been carried out for five selected organic fluids: R245fa, R1234yf, R1234ze, R227ea, and R152a. The optimization model has been solved using the linear weighted sum method. The applied technique specifies OPPTDI by assigning different values of weights w1 and w2 to the individual objective functions f1 (economic index) and f2 (environmental index), which are the components of the global function G. The proposed method should be perceived as an initial evaluation of the pinch point temperature difference interval, giving an insight for the designer what is the potentially optimal range of the considered quantity and moreover – the optimal values region of such parameter, if one of the objective functions is evaluated to be more significant than the other.

Since natural resources are finite, new policy instruments to sustain the most efficient processes of waste recycling are required in all countries. To this end, it is critical to explore all technology mechanisms underlying solid waste researchers and practitioners' behaviors. The study focuses on to demonstrate the importance of knowledge diffusion between the source and destination of environmental innovations. This way, policymakers can elaborate opportune strategies to improve the efficiency of innovation activities. By analyzing a sample of 240 large international firms from the USA, Japan, and Europe, this paper discusses the extent to which innovation inputs, research and development, and relative technological spillovers affect environmental innovation-that is measured by the number of waste recycle and land fertilizers patents. The novelty of the study comes from introducing a knowledge production function approach to analyze the role of technological knowledge spillovers on waste recycling and land fertilizers efficiency at the firm level. The technological relatedness between the firms is computed through technological proximity, based on the construction of technological vectors for each firm. The results reveal a significant positive impact of external spillovers on firms' environmental innovation levels. This finding is important particularly in terms of policy implications concerning industrial strategies; as in order to improve environmental innovation, incentives that favor industrial relatedness and establishing integration between firms are crucial.

The effect of environmental innovation on employment is increasingly relevant for sustainable development. However, few studies have examined the role of environmental spillovers based on local innovation at the firm level. We addressed this gap by analysing European, Japanese and American firms, a set of developed economies with different economic structures and subsidies for green innovations. Moreover, we analysed the time frame between 2002 and 2010, which is peculiar for industrial strategies of countries concerning sustainable development, because it included the beginning of the world economic and financial crisis since 2008. The novelty of our work consists in developing a new theoretical framework to discuss the employment effects of innovation at the firm level. Indeed, the proximity between the firms is computed using the original Mahalanobis Environmental Industry Weight matrix (MEIW-matrix), where we used patents distribution for each firm. In particular, we employed econometric methods to handle the heterogeneity and endogenous explanatory variables. The findings show a significant positive impact of environmental spillovers on firms' employment levels. This result sheds some light on the economic effects of policymakers' actions to boost firms' transition toward the use of green technologies.

Purpose The population living in urban areas of the world continues to grow rapidly. It is, thus, a great priority for the planning practice to embed sustainability concept in their urban development endeavors. Currently, development and expansion of urban systems stress the need to control consumption of resources, especially non-renewable ones. There is also a need to reduce related environmental impacts, while stimulating a sustainable pathway for the population and urban growth. Methods Strategic environmental assessment (SEA) is useful for policy design to build an integrated method for supporting the development of a sustainable society. It undertakes territorial assessments and describes urban flows and impacts related to them by using a variety of tools, including material flow accounting (MFA). This study employs MFA, as it fits well within the scope of SEA and supports the growing environmental attention in the urban metabolism approach. Although helpful, MFA has not been systematically applied in the urban development context; for this reason, this paper proposes the integration of SEA and MFA. Results and discussion Integration of SEA and MFA generates a new framework for sustainable development planning. The framework is structured in phases oriented to the continual improvement based on the Deming cycle (i.e., plan, do, check, act), a key management approach mainly used in businesses for improving the effectiveness of an organization. It can also be implemented at the urban system level. In order to maintain normative compliance, each process (urban planning, strategic environmental assessment with urban metabolism approach, participatory processes) is standardized in line with a common and mandatory approach. While the processes are integrated among them, highlighting the reciprocal contact points, the results are combined in a holistic perspective. The framework, hence, transforms the voluntary MFA tool into a mandatory process. Conclusions The proposed SEA-MFA framework has the potential to unify and standardize the processes of categorizing and quantifying data in order to improve the understanding of urban metabolic principles and scale effects. It also supports management and policy development and meets the requirements of different stakeholders. The framework, thus, generated a novel approach for sustainable urban development planning by providing solutions for specific policy problems and ensuring urban ecological balance and sustainable urban futures.

Smart cities are widely seen as localities that actively embrace new technologies to achieve desired urban outcomes. Despite sustainability often claimed to be a desired outcome of smart city initiatives, little evidence exists how sustainability outcomes are incorporated or achieved within the smart city initiatives. This paper aims to address the question of whether cities can become smart without actually being sustainable. The study undertakes a systematic review of the smart and sustainable cities literature. The analysis highlights an expectation in the reviewed academic literature for cities to become sustainable first in order to be considered truly smart. The results point to major challenges of smart cities in delivering sustainable outcomes: (a) Smart city policies are characterised by heavy technocentricity; (b) Smart city practices involve complexities, and; (c) Smart city notions are conceptualised in an ad-hoc manner. The findings provide evidence that the current smart city practice fails to incorporate an overarching sustainability goal that is progressive and genuine. This, then, highlights the need for a post-anthropocentric approach in practice and policymaking for the development of truly smart and sustainable cities. The findings seek to stimulate prospective research and further critical debates on this topic.

Digital technologies integrated into port logistics are becoming increasingly decisive among port cities around the world. This growing importance is due to the need for policymakers, urban managers, port authorities, local administrators, shipping companies, couriers, and so on to develop increasingly digitalized and sustainable logistic processes. Therefore, in a global context characterized by intense datafication and globalization of trade, the data-based approach has become a necessary modus operandi to promote smart and sustainable logistics development. This forward-looking model of port logistics uses technologies such as IoT, sensors, cloud computing platforms, Big Data analytics, Artificial Intelligence (AI), GPS tracking systems, radars, drones, real-time monitoring stations, smart grids, and so on in order to collect, process, monitor and analyse data and information concerning the economic, environmental, social and technological sphere of port cities. In this sense, mobile and fixed platforms help logistics operators to optimize the management of flows (e.g., water, waste, emissions, raw materials, people, monetary investments, etc.) in an efficient and digitized manner. The study proposes a systematic literature review of the most recurring themes concerning smart and sustainable logistics initiatives within port cities in order to develop a multidimensional framework capable of holistically integrating the prevailing enabling factors (Ecosystem, Internal Organization, Data and Security, Policy and Regulation, Finance and Funding, and Digital and Technology), domains (Mobility, Environment, Economy, Telecommunications, Safety and Security, Government, and Community) and goals (Sustainable Development and Digitalization) that characterize smart and sustainable logistical development. To this end, the best practices of several pioneering port cities such as Rotterdam, Hamburg, Singapore, Los Angeles, Amsterdam, etc. implemented in partnerships with technology companies such as Cisco, IBM, Huawei and SAP were also analysed. Therefore, the results of this research show that smart and sustainable logistics initiatives in port cities: (a) have the potential to enhance the efficiency of the economic, environmental, social and technological flows; (b) increase the involvement and awareness of stakeholders such as couriers, shippers, shipping companies, citizens, port authorities, municipalities, security officers, gate and terminal personnel, and so on; and (c) provide a detailed overview of the enabling factors, domains and goals that must be activated by port cities to foster a smart and sustainable logistic transition.

By applying a DEA (Data Envelopment Analysis) framework and Tobit analysis, this paper aims to measure 32 Italian airports’ technical efficiency and investigate how several characteristics impact on their productivity and sustainability. Our findings show that some Italian hubs are technically efficient, although smaller airports that are dominated by low-cost carriers prove to be not least productive. Another conclusion of this paper is that efficiency and environmental impact is independent of an airport’s size, although the size matters in determining an airport’s superior performance. This article highlights how the Italian public shareholder’s system became decisive to increase efficiency in small airports due to the lack of private financing.

Are new technologies in the medicine sector a driver to support the development of a society 5.0? Innovation pushes the artisan to become smart and lean, customer-oriented but within a standardized environment of production, maintaining and ensuring the quality of the product. An artisan is a user and innovator, as an essential part of the industrial chain. In the healthcare sector, the doctor is the industrial artisan, and medicine can be considered as an example of a smart tool, strongly tailored, that embeds the innovation of materials, nano-devices, and smart technology (e.g., sensors and controllers). But how much of society is ready to host smart technology “on board”, becoming “on life”, constantly connected with remote controls that allow us to monitor, gather data, and, in any case, act, with preventive healthcare solutions? After a short overview of the medicine sector, a preliminary, tentative link between technological innovation and the healthcare sector allows us to adopt several outlooks on how to change research, always more transdisciplinary, combining science with social science in order to remain human-centered.

Over the years, the application of Life Cycle Assessment (LCA) to agricultural biogas energy source allowed to depict the environmental impact related to this renewable energy source as well as to highlight mitigation strategies oriented to improvement of Anaerobic Digestion sustainability. A review focused upon the recently published LCAs of agricultural biogas plants was carried out. The review highlighted a huge variability on environmental results due to the ways the feedstock mixtures are produced, managed and supplied; and the regions in which the plants are located. Differences were also related to the ways the energy produced were utilised, whether it was input to the national grid, and/or recycled within the system.

This paper addresses the feasibility of an optical vibrometer that is based on the shift of the optical modes, also known as whispering gallery modes (WGMs), of a magnetorheological optical resonator. The optical resonator that is used in this study is fabricated by mixing polyvinyl chloride plastisol with magnetically polarizable particles. When a permanent magnet that is located nearby the optical resonator is moved, it induces a perturbation of the morphology of the resonator, due to the magnetostrictive effect. This change in the morphology induces a shift in the optical modes of the resonator. The shift of the optical modes can be related to the displacement of the permanent magnet. The proposed sensor concept is based on monitoring the displacement of a tiny magnet that is attached to a moving surface. The optical quality factor of the resonator used in these studies was of the order of 106. The experimental results show a sensitivity of 0.32 pm/&mu, m and a resolution that is less than 300 nm.

Economies 6(1), 1-12 (2018). doi:10.18154/RWTH-2018-222759 special issue: "Special Issue "Selected Papers from the International Conference on Sustainable Development 2017, September 18-20, 2017 New York, USA"", Published by MDPI, Basel

In this paper, we investigate the feasibility of a magnetic field sensor that is based on a magnetorheological micro-optical resonator. The optical resonator has a spherical shape and a diameter of a few hundred micrometers. The resonator is fabricated by using a polymeric matrix made of polyvinyl chloride (PVC) plastisol with embedded magnetically polarizable micro-particles. When the optical resonator is subjected to an external magnetic field, the morphology (radius and refractive index) of the resonator is perturbed by the magnetic forces acting on it, leading to a shift of the optical resonances also known as whispering gallery modes (WGM). In this study, the effect of a static and harmonic magnetic field, as well as the concentration of the magnetic micro-particles on the optical mode shift is investigated. The optical resonances obtained with the PVC plastisol resonator showed a quality factor of ∼106 . The dynamical behavior of the optical resonator is investigated in the range between 0 and 200 Hz. The sensitivity of the optical resonator reaches a maximum value for a ratio between micro-particles and the polymeric matrix of 2:1 in weight. Experimental results indicate a sensitivity of 0.297 pm/mT leading to a resolution of 336 μT.

This report for the Higher Education Funding Council for England (HEFCE) (now Research England), proposes guidance for standardising quantitative indicators of impact within Research Excellence Framework (REF) case studies. We used a blend of text mining and quantitative methods to develop the guidance which is intended to inform the development of the criteria and guidance for the preparation of impact case studies in REF 2021.

Until recently, the sustainable development indicators published by Eurostat were divided into 10 thematic areas. Currently apart of this division, the new indicators system divided into 17 objectives of the Sustainable Development Strategy according The 2030 Agenda for Sustainable Development has been published. The analyses presented in this paper are concentrated on the previous system of division of sustainable development indicators. The indicators in this database are divided into 3 levels reflecting their hierarchy: headline, operational and explanatory level of indicators. The purpose of the paper is a comparative analysis of relationship between the results achieved by individual EU Member States based on hierarchical structure of indicators published by Eurostat. Such a way of analysing sustainable development indicators has not been yet practiced in the literature in this field. The value added of the paper to the current state of knowledge in this field is the opportunity not only to determine, for example, the position occupied by individual Member States within individual areas of sustainable development monitored by Eurostat, but also to analyse interrelationships occurring within particular levels of monitoring of the Sustainable Development Strategy. According to the results of the research, differences in the ranking of EU Member States on the consecutive levels of monitoring the sustainable development strategy for different areas can be observed. In line with the hierarchical method of presenting the sustainable development indicators adopted by Eurostat, state rankings were prepared for each selected indicators aggregation level. For this purpose, a taxonomic measure of development based on Weber median vector was used. The results obtained clearly present the relatively low level of correlation between the results obtained by individual EU Member States on the subsequent levels of monitoring the implementation of EU strategy. This way of hierarchical analysis can be also used in the analysis based on indicators elaborated for The 2030 Agenda for Sustainable Development.

This report documents a survey of 2,465 researchers from 109 countries on the patterns, enablers, obstacles and outcomes of international movement. Over three quarters of respondents had moved to live in another country during their career. Nearly all respondents said research benefits from international movement — helping form collaborations and develop ideas, skills and expertise, but also presenting challenges on a personal level.

Background During the last years, programs to enhance postoperative recovery and decrease morbidity after total knee arthroplasty, have been developed across a variety of surgical procedures and referred to as "Fast-Track Surgery". In this study we aimed to find some answers in the management of osteoarthritic patients subjected to total knee arthroplasty, by using the Fast-Track methodology. To this purpose we evaluated parameters such as early mobilization of patients, better pain management, bleeding, possible complications, reduced hospitalization time, an overall improved recovery and patient satisfaction. Methods 132 patients were selected, of which, 95 treated with "Fast Track" method and 37 treated with traditional method (control group). All the patients were hospitalized and underwent the same rehabilitation program for the first three days after surgery. Results In both groups, the parameters of pain and deformity demonstrated the most rapid improvement, while those of function and movement were normalized as gradual and progressive improvement over the next 2 months. The different functional test used (Barthel, MRC, VAS) showed that the mean values were significantly greater in Fast Track group when compared to the control. Conclusion The results of the study confirm that the application of the Fast Track protocol in orthopaedics after total knee replacement results in rapid post-surgery recovery. Level of evidence IV. Case series, low-quality cohort or case-control studies.

Addressing the long-term sustainability challenge in the policymaking process requires close engagement of private firms—particularly in the green innovation area—along with other actors. Involvement of private firms in the implementation of privatization policies is encouraged by national governments, as it is believed that such engagement will help in producing more sustainable solutions. Transport is a key sustainability issue, where a sound privatization policy could positively affect the transport-related environmental efficiency and sustainability. In this context, the policy transfer process can provide a strong impetus for further growth of transport privatization. Little attention, however, in the literature and practice has been devoted to analyse factors affecting the policy transfer phenomenon in transport privatization policies. This paper, hence, aims to investigate the relationship between policy transfer and transport sustainability via privatization. The paper hypotheses that both economic and institutional determinants increase the effect of policy convergence. As the case study context, the EU is placed under the microscope, and a dyadic dataset on transport policies is analysed. The findings indicate that institutional and economic variables play a highly critical role for policy transfer in achieving transport sustainability in the EU.