ABSTRACT
The European Commission's Green Deal strategic plan aims to achieve EU climate neutrality by 2050. As part of this plan, the Farm-to- Fork (F2F) strategy and the Biodiversity Strategy (BDS) will be accompanied by a new Common Agricultural Policy (CAP post-2020). This paper presents and discusses the results of techno-economic analyses carried out by the European Union's Joint Research Centre (JRC) and the United States Department of Agriculture (USDA). The two analyses are based on fundamentally different economic models, but they converge in stating that the application of F2F and BDS strategies will result in an increase in production costs and consumer prices of agricultural products and a decrease in profitability as well as a reduction in agricultural production, with a consequent loss of domestic market share by European producers to those of other countries. Under these conditions, the lower emissions of pollutants and greenhouse gases will be compensated by an increase in emissions in other areas of the world, to which the agricultural production that Europe will no longer be able to produce will be relocated. In addition, according to the authors, environmental sustainability at the European level will also be called into question if one takes into account that reduced agricultural production will result in a significant reduction in the removal of CO2 from photosynthesis.
ABSTRACT
"Geosafe" is a web-based service enabling insurance agencies to access a climate data-base supporting farm insurance business. Risk indexes are elaborated on the whole national territory according to the local hazard conditions and exposure. The current agrometeorological products are developed for maize, wheat, grape and olive. For each of these crops, phenological models represent the specific weather sensitivity. Meteorological informative layers are then used to define heat stresses, low temperature and drought hazards.
ABSTRACT
Co-production was vital to support public services provision during the first wave of COVID-19 pandemic, and one of the main challenges for service providers is to make co-production sustainable. There are few empirical studies on the sustainability of co-production from a long-term perspective. This study aims to contribute to this topic by exploring the micro-level foundations of co-production persistence through a longitudinal qualitative study in three public service organizations providing developmental services for youth with disabilities. Co-production is analyzed along the service provision process before, during and after the first COVID-19 lockdown, with specific attention on exploring how the conditions for sustainable co-production – mutual commitment, complementarities and institutional arrangements – occur and reinforce one another after an external shock. The findings suggest that the persistence of co-production is a result of a process in which experimentation with new complementarities can enhance previous co-production experiences and generate a context of mutual commitment that facilitates future co-production initiatives and their institutionalization.Points for practitioners: This article suggests how service providers can activate a potential virtuous cycle of co-production by increasing the opportunities that foster and sustain users and families' self-efficacy and reciprocal trust, and the contributions from wider social support networks of the most vulnerable people.
ABSTRACT
Background. Hearing dysfunction, caused by the involvement of the vestibulocochlear nerve or by direct damage on inner ear structures has been described in patients with Sjogren's Syndrome (SS). Previous studies evaluating the prevalence and incidence of hearing dysfunction in SS showed conflicting results, therefore, to date, the exact prevalence has not been extensively evaluated. Objectives. The aim of this study is to evaluate the prevalence of hearing involvement in patients with primary SS (pSS). Materials and methods. Patients with pSS (AECC criteria) with >=18 years of age attending a dedicated Sjogren's syndrome clinic were consecutively enrolled Auditory function was investigated by pure tone audiometry (PTA), It-Matrix test (Speech Reception Threshold in noise leading to 50% correct sentences-SRT) and the Hearing Handicap Inventory (HHI) during a baseline visit and at a follow up visit. A questionnaire of auto-evaluation of hearing loss impact on life was also administered to the patients. Results. Twenty-five patients with pSS (24 females) were enrolled in the study. The median age was 56.2 years (IQR 49-64) The mean disease duration was 3.7 years, 8 were treated with hydroxychloroquine (HCQ) and 1 with methotrexate. At baseline evaluation PTA revealed hearing loss in 17 patients (68%) with severity ranging from mild to severe. Fifteen patients (60%) presented mild hearing loss, 1(4%) moderate e 1 (4%) severe. The It-Matrix score ranged from -9.9 to 0.9 (median - 3.50). Median HHI score was 12.17 (min 0, max 68, SD 177.9). For Covid restrictions, a follow-up evaluation was available for 10 patients only. In these patients, a worsening of PTA and HHI was observed. Interestingly, the it-Matrix scores of patients with a stable disease showed an improvement. Conclusions. These preliminary findings suggest that hearing involvement is common in patients with SS and that it progresses over time. If confirmed on larger cohorts, these data will be useful for physicians in counseling patients about their disease and, in case of suspicious symptoms, an early evaluation by an otolaryngologist may prevent delay in diagnosis and allow an appropriate diagnostic evaluation and therapeutic intervention.
ABSTRACT
Background and aim: The SARS-CoV 2 pandemic has provoked drastic lifestyle changes and distracted the attention of doctors and patients towards “urgent” diseases. Consequently, it could have influenced also the features of the patients referred to a “nonurgent” diagnostic test such as anorectal manometry (ARM). The aim of this study was to evaluate possible differences in the features of patients undergoing ARM before and during the pandemic. Materials and methods: Demographic and clinical information was collected in 388 patients (m 99, f 289;mean age:53 ± 16.4 years) undergoing ARM according to the London Protocol from July to December 2019 (154 pts.), 2020 (101 pts.), 2021 (133 pts.). Information was collected using also dedicated scales: HADS, PACSYM, ODS, SF-12 and Wexner. Results: The indications for ARM were chronic constipation, fecal incontinence, chronic anal pain, evaluation after rehabilitation or before surgery. No difference was detected regarding indications and demographic features in the three different periods apart from the following: - duration of symptoms: in 2019, there was a lower prevalence of long-lasting symptomatology (>10 years) compared to 2020 and 2021 (p = 0.029). - ODS score (constipated patients): mean ODS score was lower in 2020 (11.22 ± 4.37) and in 2021 (10.89 ± 4.64) than in 2019 (14.82 ± 5.09) (p < 0.01). - HADS score mean values were always below the cutoff for diagnosing anxiety or depression. However, the mean score of depression was lower in 2020 (6.64 ± 3.24) and 2021 (5.16 ± 4.62) than in 2019 (7.58 ± 4.84) (p < 0.05). Manometric diagnostic conclusions were not significantly different in the three periods. Conclusions: The features of patients referred to a manometric evaluation were quite similar before and after the pandemic. The pandemic could have partially selected the patients with a long-lasting symptomatology, more prevalent in 2020 and in 2021. The slight differences we detected in the ODS and HADS scores may be related to lifestyle changes imposed by the forced lockdown, which resulted in changes in bowel habits. Our results are different from those reported in the literature regarding a worsening of functional disorders during pandemic. ARM is a niche exam and cannot be considered a mirror of functional disorders because they are very prevalent in the general population, while there are very few patients who undergo ARM. A multicenter study that can validate our conclusions is desirable.
ABSTRACT
Background: COVID-19 shows increased disease burden in patients with diabetic kidney disease (DKD). SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) for host cell entry, so ACE2 levels may influence SARS-CoV-2 susceptibility. We investigated how pre-existing conditions and drug treatments alter receptor expression in kidney cells (Figure 1). Methods: Single cell RNA profiling of 7 healthy living donor kidneys, 44 DKD, 3 BK virus nephropathy (BKVN) and a urine COVID19 patient with acute kidney injury (COV-AKI) revealed ACE2 expression primarily in proximal tubular epithelial cells (PTEC). Results: ACE2 mRNA expression levels were higher in proximal tubule epithelial cells (PTEC) in DKD versus LD, but unaltered by exposures to renin angiotensin aldosterone system inhibitors. Bayesian integrative analysis of public -omics datasets identified molecular network modules induced in ACE2 positive versus negative PTEC in DKD and BKVN (hb.flatironinstitute.org/COVID-kidney), that were linked to viral entry, immune activation, endomembrane reorganization, and RNA processing. Similar programs were seen in COV-AKI ACE2-positive PTEC, and overlapped with programs in SARS-CoV-2 infected cells. Conclusions: A consistent ACE2-coregulated expression program in PTEC may interact with SARS-CoV-2 infection processes. These networks can seed further research into developing therapeutic strategies and assessing risk in patients with COVID-19. (Figure Presented).