Methodological Aspects of Applying Life Cycle Assessment to Industrial Symbioses

In view of recent studies of the historical development and current status of industrial symbiosis (IS), life cycle assessment (LCA) is proposed as a general framework for quantifying the environmental performance of by‐product exchange. Recent guidelines for LCA (International Reference Life Cycle Data System [ILCD] guidelines) are applied to answer the main research questions in the IS literature reviewed. A typology of five main research questions is proposed: (1) analysis, (2) improvement, and (3) expansion of existing systems; (4) design of new eco‐industrial parks, and (5) restructuring of circular economies. The LCA guidelines were found useful in framing the question and choosing an appropriate reference case for comparison. The selection of a correct reference case reduces the risk of overestimating the benefits of by‐product exchange. In the analysis of existing systems, environmentally extended input‐output analysis (EEIOA) can be used to streamline the analysis and provide an industry average baseline for comparison. However, when large‐scale changes are applied to the system, more sophisticated tools are necessary for assessment of the consequences, from market analysis to general equilibrium modeling and future scenario work. Such a rigorous application of systems analysis was not found in the current IS literature, but would benefit the field substantially, especially when the environmental impact of large‐scale economic changes is analyzed.     

Cardiovascular disease in patients with rheumatoid arthritis: results from the QUEST-RA study

Introduction

We analyzed the prevalence of cardiovascular (CV) disease in patients with rheumatoid arthritis (RA) and its association with traditional CV risk factors, clinical features of RA, and the use of disease-modifying antirheumatic drugs (DMARDs) in a multinational cross-sectional cohort of nonselected consecutive outpatients with RA (The Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis Program, or QUEST-RA) who were receiving regular clinical care.

Methods

The study involved a clinical assessment by a rheumatologist and a self-report questionnaire by patients. The clinical assessment included a review of clinical features of RA and exposure to DMARDs over the course of RA. Comorbidities were recorded; CV morbidity included myocardial infarction, angina, coronary disease, coronary bypass surgery, and stroke. Traditional risk factors recorded were hypertension, hyperlipidemia, diabetes mellitus, smoking, physical inactivity, and body mass index. Unadjusted and adjusted hazard ratios (HRs) (95% confidence interval [CI]) for CV morbidity were calculated using Cox proportional hazard regression models.

Results

Between January 2005 and October 2006, the QUEST-RA project included 4,363 patients from 48 sites in 15 countries; 78% were female, more than 90% were Caucasian, and the mean age was 57 years. The prevalence for lifetime CV events in the entire sample was 3.2% for myocardial infarction, 1.9% for stroke, and 9.3% for any CV event. The prevalence for CV risk factors was 32% for hypertension, 14% for hyperlipidemia, 8% for diabetes, 43% for ever-smoking, 73% for physical inactivity, and 18% for obesity. Traditional risk factors except obesity and physical inactivity were significantly associated with CV morbidity. There was an association between any CV event and age and male gender and between extra-articular disease and myocardial infarction. Prolonged exposure to methotrexate (HR 0.85; 95% CI 0.81 to 0.89), leflunomide (HR 0.59; 95% CI 0.43 to 0.79), sulfasalazine (HR 0.92; 95% CI 0.87 to 0.98), glucocorticoids (HR 0.95; 95% CI 0.92 to 0.98), and biologic agents (HR 0.42; 95% CI 0.21 to 0.81; P < 0.05) was associated with a reduction of the risk of CV morbidity; analyses were adjusted for traditional risk factors and countries.

Conclusion

In conclusion, prolonged use of treatments such as methotrexate, sulfasalazine, leflunomide, glucocorticoids, and tumor necrosis factor-alpha blockers appears to be associated with a reduced risk of CV disease. In addition to traditional risk factors, extra-articular disease was associated with the occurrence of myocardial infarction in patients with RA.     

Gender‐dependent progression of systemic metabolic states in early childhood

Little is known about the human intra‐individual metabolic profile changes over an extended period of time. Here, we introduce a novel concept suggesting that children even at a very young age can be categorized in terms of metabolic state as they advance in development. The hidden Markov models were used as a method for discovering the underlying progression in the metabolic state. We applied the methodology to study metabolic trajectories in children between birth and 4 years of age, based on a series of samples selected from a large birth cohort study. We found multiple previously unknown age‐ and gender‐related metabolome changes of potential medical significance. Specifically, we found that the major developmental state differences between girls and boys are attributed to sphingolipids. In addition, we demonstrated the feasibility of state‐based alignment of personal metabolic trajectories. We show that children have different development rates at the level of metabolome and thus the state‐based approach may be advantageous when applying metabolome profiling in search of markers for subtle (patho)physiological changes.     

Differences in Muscle and Adipose Tissue Gene Expression and Cardio-Metabolic Risk Factors in the Members of Physical Activity Discordant Twin Pairs

High physical activity/aerobic fitness predicts low morbidity and mortality. Our aim was to identify the most up-regulated gene sets related to long-term physical activity vs. inactivity in skeletal muscle and adipose tissues and to obtain further information about their link with cardio-metabolic risk factors. We studied ten same-sex twin pairs (age range 50–74 years) who had been discordant for leisure-time physical activity for 30 years. The examinations included biopsies from m. vastus lateralis and abdominal subcutaneous adipose tissue. RNA was analyzed with the genome-wide Illumina Human WG-6 v3.0 Expression BeadChip. For pathway analysis we used Gene Set Enrichment Analysis utilizing active vs. inactive co-twin gene expression ratios. Our findings showed that among the physically active members of twin pairs, as compared to their inactive co-twins, gene expression in the muscle tissue samples was chronically up-regulated for the central pathways related to energy metabolism, including oxidative phosphorylation, lipid metabolism and supportive metabolic pathways. Up-regulation of these pathways was associated in particular with aerobic fitness and high HDL cholesterol levels. In fat tissue we found physical activity-associated increases in the expression of polyunsaturated fatty acid metabolism and branched-chain amino acid degradation gene sets both of which associated with decreased ‘high-risk’ ectopic body fat and plasma glucose levels. Consistent with other findings, plasma lipidomics analysis showed up-regulation of the triacylglycerols containing the polyunsaturated fatty acids. Our findings identified skeletal muscle and fat tissue pathways which are associated with the long-term physical activity and reduced cardio-metabolic disease risk, including increased aerobic fitness. In particular, improved skeletal muscle oxidative energy and lipid metabolism as well as changes in adipocyte function and redistribution of body fat are associated with reduced cardio-metabolic risk.     

Remission makes its way to rheumatology

Remission was a rare event, even in the most advanced rheumatology clinics, until recent times. However, in the early 1990s, it was chosen as the treatment goal and the primary outcome measure for the Finnish Rheumatoid Arthritis Combination Therapy (FIN-RACo) trial, which can be considered the beginning of remission's way to rheumatology. In addition to remission in patients with rheumatoid arthritis, remission in patients with psoriatic arthritis is now being studied, although remission criteria for psoriatic arthritis have yet to be defined. Better treatment results with more active treatment strategies and availability of biologic agents motivate rheumatologists to monitor their patients as part of usual rheumatology care.     

Comparison of Lipid and Fatty Acid Composition of the Liver,Subcutaneous and Intra‐abdominal Adipose Tissue,and Serum

Ceramides may mediate saturated fat–induced insulin resistance, but there are no data comparing ceramide concentrations between human tissues. We therefore performed lipidomic analysis of human subcutaneous (SCfat) and intra‐abdominal (IAfat) adipose tissue, the liver, and serum in eight subjects. The liver contained (nmol/mg tissue) significantly more ceramides (1.5–3‐fold), sphingomyelins (7–8‐fold), phosphatidylethanolamines (10–11‐fold), lysophosphatidylcholines (7–12‐fold), less ether‐linked phosphatidylcholines (2–2.5‐fold) but similar amounts of diacylglycerols as compared to SCfat and IAfat. The amounts of ceramides and their synthetic precursors, such as palmitic (16:0) free fatty acids and sphingomyelins, differed considerably between the tissues. The liver contained proportionally more palmitic, stearic (18:0), and long polyunsaturated fatty acids than adipose tissues. Stearoyl‐CoA desaturase 1 (SCD1) activity reflected by serum, estimated from the 16:1/16:0‐ratio, was closely related to that in the liver (r = 0.86, P = 0.024) but not adipose tissues. This was also true for estimated elongase (18:1/16:1, r = 0.89, P = 0.01), and Δ5 (20:4/20:3, r = 0.89, P = 0.012) and Δ6 (18:3[n‐6]/18:2, r = 1.0, P < 0.001) desaturase activities. We conclude that the human liver contains higher concentrations of ceramides and saturated free fatty acids than either SCfat or IAfat.     

Differential phenolic profiles in six African savanna woody species in relation to antiherbivore defense

Low molecular weight phenolics are suggested to have a role in mediating diet selection in mammalian herbivores. However, very little is known about low molecular weight phenolic profiles of African savanna woody species. We determined low molecular weight phenolic profiles of six woody species with different life history, morphological and functional traits. We investigated interspecific phytochemical variation between species and found that: (1) related Acacia species were chemically dissimilar; (2) similarity percentage analysis revealed that Acacia grandicornuta was most dissimilar from other species and that the evergreen and unpalatable Euclea divinorum had a qualitatively similar chemical profile to the deciduous and palatable Acacia exuvialis and Combretum apiculatum; (3) C. apiculatum had the highest chemical diversity; (4) relative to spineless plants, spinescent plants contained significantly less HPLC phenolics and condensed tannins; and (5) the major quantitative difference between the evergreen and unpalatable E. divinorum and other species was its high myricitrin concentration.     

Analyzing the Environmental Benefits of Industrial Symbiosis

Studies of industrial symbiosis (IS) focus on the physical flows of materials and energy in local industrial systems. In an ideal IS, waste material and energy are shared or exchanged among the actors of the system, thereby reducing the consumption of virgin material and energy inputs, and likewise the generation of waste and emissions. In this study, the environmental impacts of an industrial ecosystem centered around a pulp and paper mill and operating as an IS are analyzed using life cycle assessment (LCA). The system is compared with two hypothetical reference systems in which the actors would operate in isolation. Moreover, the system is analyzed further in order to identify possibilities for additional links between the actors. The results show that of the total life cycle impacts of the system, upstream processes made the greatest overall contribution to the results. Comparison with stand‐alone production shows that in the case studied, the industrial symbiosis results in modest improvements, 5% to 20% in most impact categories, in the overall environmental impacts of the system. Most of the benefits occur upstream through heat and electricity production for the local town. All in all it is recommended that when the environmental impacts of industrial symbiosis are assessed, the impacts occurring upstream should also be studied, not only the impacts within the ecosystem.     

Declining needs for total joint replacements for rheumatoid arthritis

This millennium brings new views to rheumatology. Total joint replacement surgery is needed less often as active treatment strategies combined with availability of new medications has led to more effective rheumatoid arthritis control. This was beautifully shown in a recent issue of Arthritis Research & Therapy by a Swedish study that uses data from national registers and compares incidence rates for total hip and knee arthroplasties before and after the establishment of biologic agents use for rheumatoid arthritis