Abstract\ud Purpose Social life cycle assessment (S-LCA) method lacks\ud of standard and code of practice. The aim of the study is to\ud classify the wide variety of contributions on S-LCA for tracking\ud the development of different themes and for defining and\ud classifying the main approaches in a systematic and reproducible\ud way.\ud Methods The research addressed to study a collection of 51\ud articles published between January 2006 and November 2014\ud using statistical criteria. We used automatic text analysis\ud (ATA) tools related to lexicon analysis to identify keywords\ud useful in tracing the main topics covered in articles published\ud in different periods. We conducted principal component analysis\ud (PCA) to classify the different approaches in the literature\ud and to outline the orientations of the various research groups.\ud Results and discussion The results from lexicon analysis\ud showed a rapid succession of different topics covered in\ud the analyzed period. This alternation is strongly affected by\ud the introduction of UNEP/Society of Environmental\ud Toxicology and Chemistry (SETAC) S-LCA guidelines\ud and methodological sheets. PCA analysis enabled to synthesize\ud the information related to the numerous\ud approaches. Results did not show a clear division into\ud groups which indicates the absence of a dominant position\ud on the subject in the literature.\ud Conclusions This study attempted to map the state of art in SLCA\ud integrating literature review with multivariate statistical\ud techniques. The analysis showed a highly fragmented field.\ud These results confirm the existence of a variety of approaches\ud that in part have already been identified by literature reviews\ud on S-LCA. Alignment with the results in the literature confirms\ud ATA to be a suitable instrument for the realization of\ud reviews. Moreover, being systematic and reproducible allows\ud ATA to be applied repeatedly, expanding the number of articles\ud and topics analyzed

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Abstract:Companies are increasingly required to deal with sustainability issues through the adoption of Corporate Social Responsibility (CSR) practices. Among the different CSR aspects, workers securities fulfill a necessary issue. SA8000 is an internationally accepted tool that aims to guarantee decent workplace across all industrial sectors. Italian companies represent more than 30% of certified organizations on a global level. Company size is a key factor in the definition of managerial strategies. A survey that involved more than 600 SA8000 certified companies has been conducted. Company dimension has been used as a parameter to interpret survey results. The aspects analyzed mainly consisted of drivers, barriers and benefits in SA8000 certification pathway. The study showed a high level of homogeneity among firms. According to SA8000 requirements, one of the main issues is the implementation of control and awareness mechanisms addressed to suppliers. Survey results highlight that all respondents recognize the importance of suppliers' involvement, considered as one of the most difficult phases in implementing certification. However, there were no significant differences among Micro, Small, Medium and Large companies.

Traceability systems were developed to track back products’ process\ud paths and to monitor the quality level from the sale point up to raw materials\ud production. Thus, these systems could be an efficient tool in supporting\ud sustainable supply chain management. The present research aims to analyse the\ud traceability system applied to the Italian textile sector named Traceability and\ud Fashion (TF) implemented by the Union of Italian Chambers of Commerce\ud along with trade unions, entrepreneurial and professional organisations.\ud Carrying out in-depth interviews of involved stakeholders’ categories, we\ud investigate if the TF system was perceived as an effective inter-organisational\ud control tool, and also an instrument able to ensure customers’ protection.\ud Results showed that TF system is considered accountable; however, there are\ud high barriers to its spread

The last revision of the EMAS (Eco Management and Audit Scheme) Regulation encouraged a cluster approach to increase the participation of the organizations and to involve local stakeholders in the commitment to sustainability. Our research activity intends to partially fill the literature gap in the field by investigating the Italian cluster approach to EMAS, characterized by the creation of a cluster Managing Committee (MC)—which can receive an EMAS Cluster Certificate—in order to improve the implementation of the scheme. We investigated the effectiveness of MCs actions on different stakeholder categories in the nine Italian clusters with EMAS Cluster Certificate. We present the results of a survey conducted through different stakeholder categories in the considered clusters. The main goals of the investigation are to determine the effectiveness of EMAS Certificate for: local stakeholder involvement, network creation, environmental performance improvement and the increase in EMAS single registration. We find that EMAS Cluster Certificate is perceived as effective in improving environmental performance of the area and enhancing cluster image. Despite the recognition of these positive aspects, few organizations showed interest in EMAS registration because of the costs involved and the lack of incentives available from public institutions

Objectives: Hydroxychloroquine has shown to have antiviral activity in vitro against coronaviruses, specifically SARS-CoV-2. It is believed to block virus infection by increasing endosomal pH required for virus cell fusion and glycosylation of viral surface proteins. In addition to its antiviral activity, hydroxychloroquine has an immune-modulating activity that may synergistically enhance its antiviral effect in vivo, making it a potentially promising drug for the prevention and the cure of SARS-CoV-19. However, randomized controlled trials are needed to assess whether it can be used safely to treat COVID-19 patients or to prevent infection. The main objective of the present study is to evaluate the efficacy of hydroxychloroquine for (I) the prevention of COVID-19 or related symptoms in SARS-CoV-2exposed subjects, such as as household members/contacts of COVID-19 patients and (II) the treatment of earlyphase asymptomatic or paucisymptomatic COVID-19 patients. Trial design: This is a controlled, open label, cluster-randomized, superiority trial with parallel group design. Subjects will be randomized either to receive hydroxychloroquine or to observation (2:1).

Cyclophosphamide is frequently used to treat cancer, autoimmune and renal diseases, such as rapidly progressive glomerulonephritis. Its side effects are well-known, including bone marrow depression, infections, alopecia, sterility, bladder malignancy and hemorrhagic cystitis. Moreover, in some cases cyclophosphamide use has been related to the onset of hyponatremia, by development of a syndrome of inappropriate antidiuresis. Indeed, severe hyponatremia has been previously reported in patients treated with high-dose or moderate-dose of intravenous cyclophosphamide, while only few cases have been reported in patients treated with low dose. Here, we discuss a case of a syndrome of inappropriate antidiuresis followed to a single low-dose of intravenous cyclophosphamide in a patient with a histological diagnosis of acute glomerulonephritis, presenting as acute kidney injury. After cyclophosphamide administration (500 mg IV), while renal function gradually improved, the patient developed confusion and headache. Laboratory examinations showed serum sodium concentration dropped to 122 mmol per liter associated with an elevated urinary osmolality of 199 mOsm/kg, while common causes of acute hyponatremia were excluded. He was successfully treated with water restriction and hypertonic saline solution infusion with the resolution of the electrolyte disorder. This case, together with the previous ones already reported, highlights that electrolyte profile should be strictly monitored in patients undergoing cyclophosphamide therapy in order to early recognize the potentially life-threatening complications of acute water retention.

Introduction: Due to its high incidence, evaluating performance of care delivered to breast cancer patients is a crucial issue. The multidisciplinary panel E.Pic.A. (Economic Appropriateness of an Integrated Care Pathway) defined a set of key performance indexes (KPIs) to evaluate economic waste in breast cancer healthcare interventions. Methods: The E.Pic.A. panel identified the principal KPIs that are crucial within the breast cancer care pathway to evaluate the performance of care. KPIs were defined taking into account their reliability, validity, usability and feasibility of measurement through the linkage between multiple routine healthcare data sources. Results: 7 KPIs were identified: 3 on instrumental diagnostics, 2 on surgery and 2 on treatment. The 3 KPIs regarding instrumental diagnostics are aimed at assessing the inappropriateness of diagnostic tests performed before and after the index surgery. The 2 KPIs regarding surgery measure the inappropriateness of possible repeated interventions considering the time elapsed from the index surgery. The 2 KPIs regarding oncologic therapy measure the inappropriateness about the administration time of adjuvant therapy and radiotherapy considering the time elapsed from the index surgery. Conclusion: E.Pic.A methodology could help to evaluate economic waste in healthcare interventions with the objective of redirecting resources to interventions with greater value.