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The wine industry has faced two significant environmental problems in recent years: productivity is challenged by environmental trends such as global warming, and buyers are becoming more environmentally conscious. From an environmental standpoint, the food industry is one of the most impacting sectors and wine results as one of the most studied agri-food products in the scientific literature. In general, comprehensive studies that consider an application of set of indicators to evaluate the overall sustainability of wine sector are lacking in literature. This paper aims to carry out a sustainable assessment using different indicators for fifteen Italian red wines: Water Footprint (WF), Carbon Footprint (CF), Vineyard Indicator (VI), and Territory Indicator (TI). VI is an indicator of the vineyard's agronomic management's sustainability at plot level with values ranging from 0 (fully sustainable) to 1 (fully not sustainable), while TI covers the socio-economical aspects of sustainability. Considering system boundaries from cradle to grave, at 90% confidence interval, CF results ranged between 0.97 kg CO 2 eq./functional unit and 1.97 kg CO 2 eq./functional unit, with an average estimated at 1.47 kg CO 2 eq./functional unit, while the WF of a 0.75 L bottle of wine from cradle to gate is 666.7 L/functional unit on average, out of which 86.75% is green, 1.92% is blue and 11.34% is grey water. Concerning the VI, at 90% confidence interval VI results were between 0.117 and 0.498 with an average estimated at 0.307. The results of the correlation analyses confirmed that each indicator is not statistically correlated with each other. Concerning the sub-indicators, a positive correlation has been found between the total CF and the sum of blue and grey WF. The application of a multi-criteria analysis for sustainability performances evaluation of the wine sector presented in this study can be used by wine companies' experts to better assess sustainability performances., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background and Aims: Linked-color imaging (LCI), a new image-enhancing technology emphasizing contrast in mucosal color, has been demonstrated to substantially reduce polyp miss rate as compared with standard white-light imaging (WLI) in tandem colonoscopy studies. Whether LCI increases adenoma detection rate (ADR) remains unclear., Methods: Consecutive subjects undergoing screening colonoscopy after fecal immunochemical test (FIT) positivity were 1:1 randomized to undergo colonoscopy with LCI or WLI, both in high-definition systems. Insertion and withdrawal phases of each colonoscopy were carried out using the same assigned light. Experienced endoscopists from 7 Italian centers participated in the study. Randomization was stratified by gender, age, and screening round. The primary outcome measure was represented by ADR., Results: Of 704 eligible subjects, 649 were included (48.9% men, mean age ± standard deviation, 60.8 ± 7.3 years) and randomized to LCI (n = 326) or WLI (n = 323) colonoscopy. The ADR was higher in the LCI group (51.8%) than in the WLI group (43.7%) (relative risk, 1.19; 95% confidence interval, 1.01-1.40). The proportions of patients with advanced adenomas and sessile serrated lesions were, respectively, 21.2% and 8.6% in the LCI arm and 18.9% and 5.9% in the WLI arm (not significant for both comparisons). At multivariate analysis, LCI was independently associated with ADR, along with male gender, increasing age, and adequate (Boston Bowel Preparation Scale score ≥6) bowel preparation. At per-polyp analysis, the mean ± standard deviation number of adenomas per colonoscopy was comparable in the LCI and WLI arms, whereas the corresponding figures for proximal adenomas was significantly higher in the LCI group (.72 ± 1.2 vs .55 ± 1.07, P = .05) CONCLUSIONS: In FIT-positive patients undergoing screening colonoscopy, the routine use of LCI significantly increased the ADR. (Clinical trial registration number: NCT03690297.)., (Copyright © 2020 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Background: Budesonide-MMX has an established role in the management of relapsing mild-to-moderate ulcerative colitis. Data regarding effectiveness and tolerability in real-life clinical practice are limited., Aim: The aim of this study was to assess the use of budesonide-MMX in ulcerative colitis, as well as short-term effectiveness and tolerability in real-life practice., Methods: We conducted a retrospective study of adult patients with mild-to-moderate ulcerative colitis treated with budesonide-MMX at four tertiary inflammatory bowel disease centres in Italy from June 2016 to February 2018. Demographic and clinical features of patients, the use of budesonide-MMX, disease course and concomitant therapy were recorded. The primary outcome assessed was clinical remission at 2 months., Results: A total of 82 patients with active mild-to-moderate ulcerative colitis were included in the study with a mean age of 45.9 years and a median partial Mayo Score of 4 (interquartile range 3-5). A total of 41 patients were male. Overall, 36 had extensive colitis, 38 left-sided colitis and eight proctitis. Treatments at the time of inclusion included 10 patients receiving biologic therapy, seven azathioprine and 54 mesalazine or salazopyrin. The main reasons for the addition of budesonide-MMX were clinical relapse (47.5%) or inadequate response to current therapy (39.0%). In total, 50% of patients achieved clinical remission, whereas 9.8% had clinical improvement. No response was noted in 40.2% of subjects. Using multivariate binary logistic regression, a moderate degree of activity was the main independent predictor of non-response. Eight significant adverse effects were reported in six patients with three discontinuing treatment., Conclusion: In real-life clinical practice, budesonide-MMX is commonly used in combination with other therapies, both for acute disease flares and for partial response to therapy., (© Author(s) 2019.)

Background: Rising antibiotic resistance requires the evaluation of new and effective therapies., Aims: To test the efficacy and safety of the new bismuth-containing quadruple therapy in patients infected with Helicobacter pylori., Material and Methods: Consecutive H. pylori-positive dyspeptic patients were enrolled, either naïve or with previous failure treatment. Patients were treated with Pylera ® (three-in-one capsules containing bismuth subcitrate potassium 140 mg, metronidazole 125 mg, and tetracycline 125 mg) three capsules q.i.d. plus omeprazole 20 mg or esomeprazole 40 mg b.i.d. for 10 days. Eradication was confirmed using an urea breath test (at least 30 days after the end of treatment). Efficacy was assessed by UBT and safety by means of treatment-emergent adverse events., Results: One hundred and thirty-one patients were included in the study: 42% of patients were naïve, and 58%, with previous failure treatment. H. pylori eradication was achieved in 124 patients (94.7%, 95% confidence intervals (CIs) 89.3-97.8) in ITT population. In the PP population, the percentage was 97.6% (95%, CIs 93.3-99.2). No difference in eradication rate was found either between naïve and previously treated patients (92.7% vs 96.0%, P=.383), or smoking and nonsmoking ones, or in patients taking omeprazole or esomeprazole. Treatment-emergent adverse events occurred in 35 patients (26.7%, 95% CIs 19.9-34.9). They were mild in all cases except in four, who discontinued the study due to diarrhea (three patients) and diffuse urticarial rush (one patient)., Conclusions: Pylera ® achieved a remarkable eradication rate in clinical practice, irrespective if it was used as first treatment or as a rescue therapy. Treatment-emergent adverse events were uncommon generally mild., (© 2017 John Wiley & Sons Ltd.)

Background & Aims: Infliximab (IFX) is an anti-tumor necrosis factor alpha agent used in inflammatory bowel diseases (IBD) therapy. Usually, it is administered over a 2-hour intravenous infusion. However, shortening the infusion duration to 1 hour has proved to be feasible and safe. In the present study we evaluated whether shortening the IFX infusion could affect the patients' quality of life (QoL) compared to the standard protocol., Methods: Subjects affected by IBD receiving IFX were prospectively recruited. The main criterion to shorten the infusion was the absence of IFX-related adverse reactions during the previous three 2-h infusions. For each patient, demographic, clinical and anthropometric data were collected. A questionnaire investigating their overall/job/social/sexual QoL was administered. Ordinal regression was performed with odds ratios (OR) for significant independent variables., Results: Eighty-one patients were included (46 with ulcerative colitis - UC, 35 with Crohn's disease - CD). Sixteen received the 2-h infusion due to previous adverse reactions, and the remaining 65 underwent the 1-h schedule. Shortening the infusion to 1 hour determined a better QoL (OR=0.626). However, the QoL was negatively influenced by age (OR=1.023), female sex (OR=2.04) and severe disease activity (OR=7.242). One-hour IFX infusion induced a better outcome on work (OR=0.588) and social (OR=0.643) QoL. Long-standing disease was correlated with a slightly better sexual QoL (OR=0.93). Conversely, older age (OR=1.046), severe clinical score (OR=15.579), use of other immunomodulators (OR=3.693) and perianal CD (OR=3.265) were related to an unsatisfactory sexual life. The total number of infusions (OR=0.891), proctitis (OR=0.062) or pancolitis (OR=0.1) minimized the perception of infusion-related side effects., Conclusion: The 1-h short infusion improves overall, social and job QoL, so that, when indicated, it should be recommended.

Background and Aim: The authors aimed to evaluate the frequency with which pregnant Sicilian women with a high risk of recurring neural tube defects (NTD) attending the Ultrasonography and Prenatal Diagnosis Clinic in the Department of Diagnosis and Treatment at Ospedale S. Bambino in Catania were aware of the preventive effect of folic acid supplements during the periconceptional period and whether they therefore took folic acid supplements before the next pregnancy., Methods: All pregnant women undergoing ultrasonography between January 1997 and December 1998 were interviewed. It was noted whether any earlier offspring had suffered from NTD or whether relatives (sisters, brothers, parents) had also suffered from the same experience. They were also asked whether they knew about the preventive effect of periconceptional folic acid supplements on the development of NTD, whether their pregnancy was planned and whether they had taken periconceptional folic acid supplements and, if so, at what dose., Results: Eighteen couples were identified as being at risk for recurring NTD, in 3 cases owing to an earlier pregnancy resulting in NTD (2 cases of spina bifida and 1 case of anencephaly) with a negative family history for NTD; a further 15 couples showed a positive family history for NTD. None of the women were aware of the preventive effect of acid folic supplements during the periconceptional period on the development of NTD. Out of 11 programmed pregnancies, none of the pregnant women took folic acid during the periconceptional phase., Conclusions: Pregnant Sicilian women at risk for recurring NTD interviewed by the authors were not aware of the possible prevention of NTD using folic acid supplements during the periconceptional phase.

The control during the planning of a factory is a sort of prevention. For instance, we suggested industrial hygiene standards for a new chemical plant, which have been into account. According to our suggestions they set up a closed factory process, a dust and fumes filtering plant and the water recycle. After some controls outside the factory, lead and dust concentrations were below the maximum allowed levels (30 and 5 mg/Nmc).