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Even if the economy nowadays is still locked into a linear model of production, tighter environmental standards, resource scarcity and changing consumer expectations are forcing organizations to find alternatives to lighten their impacts. The concept of Circular Economy (CE) is to an increasing extent treated as a solution to this series of challenges. That said, the multitude of approaches and definitions around CE and Life Cycle Extension Strategies (LCES) makes it difficult to provide (Small and Medium Enterprise) SMEs with a consistent understanding of the topic. This paper aims at bridging this gap by providing a systematic literature review of the most prominent papers related to the CE and lifetime extension, with a particular focus on the equipment and machinery sector. A taxonomy was used to define and cluster a subset of selected papers to build a homogeneous approach for understanding the multiple strategies used in the industry, and the standards in maintenance and remanufacturing strategies. As a final research step, we also propose a Strategy Characterization Framework (SCF) to build the ground for the selection of the best strategy to be applied for production equipment life cycle extension on several industrial use cases.

The reuse and recycling of critical raw materials is limited, as waste electrical and electronic recycling focuses on base and precious metals, and device component reuse is in its infancy. To help to address this issue this paper provides the conceptual design of a Digital Product Passport based circular supply management system. To enable the recovery of critical raw materials at component and material levels for reuse and recycling. The works include an assessment of existing critical raw materials information management and an information needs identification survey, with 10 manufacturers, producer responsibility organisations, collectors and recyclers. The needs were used to generate 14 key product information management processes and exchanges that when implemented form a Digital Product Passport based circular supply management system. Information managed via a physical-digital linkage through individual product tags includes product registrations, materials declarations, life cycle status updates, the sorting of products at collection points based on critical raw material contents, and flagging of products for critical raw materials component extraction. A dataspace-based IT systems architecture is proposed for the implementation of the supply management system taking into account global and European information standards. Finally, key challenges to implement such an IT architecture are discussed.

BACKGROUNDMycoplasma genitalium was previously less common among men who have sex with men (MSM) compared with men with only female partners (MSW) in men with nongonococcal urethritis (NGU) in Sydney, Australia. We aimed to determine the prevalence of M. genitalium and of macrolide-resistant M. genitalium in men with NGU and to compare differences between prevalence and resistance rates between MSM and MSW. METHODSWe enrolled 588 men with NGU in a prospective study at two urban sexual health services. The ResistancePlus MG assay (SpeeDx, Australia) was used to detect both M. genitalium, and macrolide resistance-associated mutations in first-void urine samples. Demographic, behavioral and clinical data were analyzed to investigate associations with M. genitalium infection or the presence of macrolide resistance. RESULTSMycoplasma genitalium prevalence was 12.8% (75 of 588) overall and among MSM (12.8% [39 of 306]) and MSW (12.8% [36 of 282]; risk ratio [RR], 1.00; 95% confidence interval [CI], 0.65–1.52). Overall, 70.7% (53 of 75) of M. genitalium strains were macrolide-resistant, with significantly more resistance among MSM (89.7%, 35 of 39) than MSW (50%, 18 of 36) (RR, 1.80; 95% CI, 1.27–2.54; P = 0.001). On multivariate analysis, the presence of M. genitalium macrolide resistance mutations was independently associated with having male sexual partners compared with having only female partners (RR, 1.55; 95% CI, 1.02–2.38; P = 0.042). CONCLUSIONSPrevalence of M. genitalium among men with NGU is now similar for MSW and MSM and has increased locally from 5.2% to 12.8% within the last 10 years. Men who have sex with men are significantly more likely than MSW to harbor macrolide-resistant M. genitalium infections. This has treatment implications.

Mycoplasma genitalium was previously less common among men who have sex with men (MSM) compared with men with only female partners (MSW) in men with nongonococcal urethritis (NGU) in Sydney, Australia. We aimed to determine the prevalence of M. genitalium and of macrolide-resistant M. genitalium in men with NGU and to compare differences between prevalence and resistance rates between MSM and MSW. We enrolled 588 men with NGU in a prospective study at two urban sexual health services. The ResistancePlus MG assay (SpeeDx, Australia) was used to detect both M. genitalium, and macrolide resistance-associated mutations in first-void urine samples. Demographic, behavioral and clinical data were analyzed to investigate associations with M. genitalium infection or the presence of macrolide resistance. Mycoplasma genitalium prevalence was 12.8% (75 of 588) overall and among MSM (12.8% [39 of 306]) and MSW (12.8% [36 of 282]; risk ratio [RR], 1.00; 95% confidence interval [CI], 0.65-1.52). Overall, 70.7% (53 of 75) of M. genitalium strains were macrolide-resistant, with significantly more resistance among MSM (89.7%, 35 of 39) than MSW (50%, 18 of 36) (RR, 1.80; 95% CI, 1.27-2.54; P = 0.001). On multivariate analysis, the presence of M. genitalium macrolide resistance mutations was independently associated with having male sexual partners compared with having only female partners (RR, 1.55; 95% CI, 1.02-2.38; P = 0.042). Prevalence of M. genitalium among men with NGU is now similar for MSW and MSM and has increased locally from 5.2% to 12.8% within the last 10 years. Men who have sex with men are significantly more likely than MSW to harbor macrolide-resistant M. genitalium infections. This has treatment implications.

Nowadays, Circular Economy (CE) is shifting from a nice-to-have marketing operation to a business development strategy that is central to the restoring and preservation of our natural ecosystem. However, despite motivated promotion efforts, the concrete application of this model at the micro-level is still in its infancy due to several challenges that companies face. One of these challenges is the uncertainty that businesses have in the estimation of the actual impact that adopting CE strategies can have on their activities from an environmental and economic perspective. This work aims to define a conceptual framework to be applied to the Life Cycle Extension Strategies (LCES) of products, which is meant to understand whether the application of a strategy is beneficial from an environmental and economic point of view. In order to address the identified need, a list of indicators to be exploited in the LCES performance analysis has been designed and divided into the two categories of environmental and economic indicators. On the top of this, a calculation methodology that is based on life cycle perspective approaches is applied, which exploits a gap-based approach and thus, compares the effects generated by the linear strategy and those created by the LCES analysis. The evaluation approach is meant to highlight the possible advantages and disadvantages offered by the CE model for product lifecycles. The conceptual framework is tested through an industrial case study and further analysis leading to the improvement of the calculation methodology is discussed.

The Italian Society of Colorectal Surgery (SICCR) promoted the project reported here, which consists of a Position Statement of Italian colorectal surgeons to address the surgical aspects of ulcerative colitis management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of ulcerative colitis. The committee was able to identify some points of major disagreement and suggested strategies to improve the quality of available data and acceptance of guidelines.

The affiliation of the author Silvio Danese has been incorrectly published in the original publication.The affiliation of the author Silvio Danese has been incorrectly published in the original publication.

Mentor relationships are crucial to retention, success, and wellbeing of women and underrepresented minority scientists in academia. A network of diverse mentors may support achieving long-term career goals, advancement, and retention of both mentors and mentees, thus enhancing diversity, equity, and inclusion initiatives.

During the development of heart failure (HF), the capacity for cardiomyocyte (CM) fatty acid oxidation (FAO) and ATP production is progressively diminished, contributing to pathologic cardiac hypertrophy and contractile dysfunction. Receptor-interacting protein 140 (RIP140, encoded by Nrip1) has been shown to function as a transcriptional corepressor of oxidative metabolism. We found that mice with striated muscle deficiency of RIP140 (strNrip1-/-) exhibited increased expression of a broad array of genes involved in mitochondrial energy metabolism and contractile function in heart and skeletal muscle. strNrip1-/- mice were resistant to the development of pressure overload-induced cardiac hypertrophy, and CM-specific RIP140-deficient (csNrip1-/-) mice were protected against the development of HF caused by pressure overload combined with myocardial infarction. Genomic enhancers activated by RIP140 deficiency in CMs were enriched in binding motifs for transcriptional regulators of mitochondrial function (estrogen-related receptor) and cardiac contractile proteins (myocyte enhancer factor 2). Consistent with a role in the control of cardiac fatty acid oxidation, loss of RIP140 in heart resulted in augmented triacylglyceride turnover and fatty acid utilization. We conclude that RIP140 functions as a suppressor of a transcriptional regulatory network that controls cardiac fuel metabolism and contractile function, representing a potential therapeutic target for the treatment of HF.

Approximately 50% of patients with metastatic HER2-positive (HER2+) breast cancer develop brain metastases (BCBMs). We report that the tumor suppressor p16 INK4A is deficient in the majority of HER2+ BCBMs. p16 INK4A -deficiency as measured by protein immunohistochemistry predicted response to combined tucatinib and abemaciclib in orthotopic patient-derived xenografts (PDXs) of HER2 + BCBMs. Our findings establish the rationale for a biomarker-driven clinical trial of combined CDK4/6- and HER2-targeted agents for patients with HER2 + BCBM. HER2+ breast cancer often develop brain metastases (BCBMs) that are difficult to treat. Here, the authors show that p16 INK4A loss in BCBMs from HER2+ breast tumors results in resistance to the HER2 inhibitor Tucatinib, and that CDK4/6 inhibition can restore sensitivity to this drug.