Modelling food policies in Italian urban agendas in the time of Covid-19: Experiences, challenges and opportunities.

Global food systems are broken and in need of profound change. These imbalances and vulnerabilities are particularly strong in cities, where most of the global population lives and that are at the core of the major challenges linked with food production and consumption. The food system transition needs cities as key game-changers towards more sustainable, equitable, healthier and fairer food systems. Against this backdrop, the present article analyses the role of food policies within urban policies, with a focus on Italian cities. In particular, the article discusses data collected from representatives of 100 municipalities across Northern, Central and Southern Italy. Moreover, it addresses the types of policies and initiatives adopted at the local level, the main obstacles encountered, the role of national and international city networks and the impact of Covid-19 on urban food security, with the aim to identify potential models of urban food policies as a structural component of a broader urban agenda. By doing this, the article aims at filling a research gap in current literature, as it is the first large-scale survey on urban food policies in Italy, identifying models of urban food policies that are already being developed within broader urban development agendas.

A High-Throughput Mechanical Activator for Cartilage Engineering Enables Rapid Screening of in vitro Response of Tissue Models to Physiological and Supra-Physiological Loads.

Articular cartilage is crucially influenced by loading during development, health, and disease. However, our knowledge of the mechanical conditions that promote engineered cartilage maturation or tissue repair is still incomplete. Current in vitro models that allow precise control of the local mechanical environment have been dramatically limited by very low throughput, usually just a few specimens per experiment. To overcome this constraint, we have developed a new device for the high throughput compressive loading of tissue constructs: the High Throughput Mechanical Activator for Cartilage Engineering (HiT-MACE), which allows the mechanoactivation of 6 times more samples than current technologies. With HiT-MACE we were able to apply cyclic loads in the physiological (e.g., equivalent to walking and normal daily activity) and supra-physiological range (e.g., injurious impacts or extensive overloading) to up to 24 samples in one single run. In this report, we compared the early response of cartilage to physiological and supra-physiological mechanical loading to the response to IL-1ß exposure, a common but rudimentary in vitro model of cartilage osteoarthritis. Physiological loading rapidly upregulated gene expression of anabolic markers along the TGF-ß1 pathway. Notably, TGF-ß1 or serum was not included in the medium. Supra-physiological loading caused a mild catabolic response while IL-1ß exposure drove a rapid anabolic shift. This aligns well with recent findings suggesting that overloading is a more realistic and biomimetic model of cartilage degeneration. Taken together, these findings showed that the application of HiT-MACE allowed the use of larger number of samples to generate higher volume of data to effectively explore cartilage mechanobiology, which will enable the design of more effective repair and rehabilitation strategies for degenerative cartilage pathologies.

From Patient Reported Outcome Measure (PROM) to Environment Related Outcome Measure (EROM): Towards "Green Breast Surgery".

Climate change is a global issue that has had significant impacts on public health and healthcare policy worldwide. The direct impact of climate change on healthcare has been associated with extreme weather events, resulting in a higher demand for disaster management resources and reduced healthcare access. Moreover, the increase of zoonotic spillover effects has increased the risk of transmission of different diseases, including COVID-19. The healthcare industry alone is responsible for 4.4% of greenhouse gas global emissions. The surgical theatre is a resource-intense healthcare activity and a major carbon emitter, thus surgical processes require rethinking. This article proposes the introduction of environmental-related outcome measures in clinical trials, which will associate highest clinical standards to a reduced impact of care on climate change. Breast cancer care may represent a model disease for the implementation of evidence-based protocols, such as Green Breast Surgery, aiming to optimize the carbon footprint of care without affecting oncological and non-oncological outcomes. Physicians and healthcare workers worldwide should be aware of the importance of addressing environmental issues in healthcare policy, implementing programs to reduce their carbon footprint, and contributing to a more sustainable future.

True Cost Accounting of a healthy and sustainable diet in Italy.

It is widely upheld that global food systems are unsustainable. Sustainable diets are gaining prominence as key components to entangle global food system challenges, as well as to transition towards the pathway of the 2030 Agenda and the Sustainable Development Goals (SDGs). Hence, sustainable and healthy diets are at the core of much research with the aim to bring together nutritional adequacy, cultural acceptability, environmental sustainability, economic affordability, and shape future consumption patterns. This article contributes to advancing knowledge on sustainable diets by proposing a True Cost Accounting method to assess the cost and impact of the adoption of a more sustainable and healthier diet, using Italy as an illustration. The research analyses the complexity of a diet from an environmental, health, and socioeconomic point of view and defines a new assessment framework that can be replicated and adapted to other contexts. Results show that in Italy, the adoption of a sustainable and healthy diet has a 47% lower carbon footprint and 25% lower water footprint than the current diet, while impacting 13% less on the average income and food monthly expenditure. Also, the desirable diet has a 21% lower impact on the sanitary costs related to cardiovascular disease. This study corroborates that the consumption of the desirable diet would provide a total cost saving of 741 EUR per year per capita, if we consider its impact on the environment, health, and socio-economic costs.

Rome, a Policy without Politics: The Participatory Process for a Metropolitan Scale Food Policy.

In light of the challenges that all cities face today, food is offered as a prism through which to read and intervene on various areas that affect the quality of life of the population: circular economy, urban metabolism, social relations, economies, and food quality. In the Roman context, in recent years, numerous initiatives have revitalized the debate on food and brought the discussion to the center of the interest of an ever-increasing number of citizens. However, these experiences appear unrelated and there is a lack of coordination and political coherence. Faced with this evidence, starting from a territorial analysis, this contribution analyzes the process that led a local group of stakeholders to formulate a proposal for a food policy for the city of Rome. The proposal contains a series of possible actions that aim, on the one hand, to recompose the relations between the city and its territory, with a view to re-localization and re-territorialization of agro-food productions and, on the other hand, to reconnect the economic and social relations that the industrialization of food chains has compromised. The network analysis of the bottom-up process, which mainly investigates networking and negotiation skills between various interests, is carried out and related to a careful analysis of the food system in the Roman context. Furthermore, an overview of the state of the art of urban food policies in Italy has been provided to better contextualize the study case. The findings show actors and topics involved in the process, identifying further development towards a more comprehensive participatory process for a systemic food strategy at the metropolitan level.

The Relationship Between Contextual and Dispositional Variables, Well-Being and Hopelessness in School Context.

The literature's interest has been focused on the study of well-being or depression. However, there has been little research that investigates the relationship between well-being and hopelessness (HPL) and the underlying contextual and dispositional variables. Therefore, the aim of the present study was to examine the relationship between some contextual (need-supportive interpersonal behavior and need-thwarting interpersonal behavior) and dispositional variables (dispositional optimism, positive/negative affectivity, explanatory style), academic achievement, general well-being, and school HPL in adolescent students. The results showed that general well-being was positively predicted by need-supportive interpersonal behavior, dispositional optimism, positive affectivity, and adaptive explanatory style (attribution to commitment in the school context), while it was negatively predicted by negative affectivity. Meanwhile, school HPL was positively predicted by need-thwarting interpersonal behavior, negative affectivity, dysfunctional explanatory style (attribution to luck in the school context), while it was negatively predicted by attribution to commitment in the school context and academic achievement. These results provide useful data for the implementation of well-being promotion and school HPL prevention. The implications are discussed as follows.

The impact of COVID-19 in plastic surgery departments: a comparative retrospective study in a COVID-19 and in a non-COVID-19 hospital.

BACKGROUND: COVID-19 is a new human-infecting coronavirus for which the World Health Organization declared a global pandemic. The first Italian cases occurred in February 2020: since then, there has been an exponential increase in new cases, hospitalizations and intensive care assistance demand. This new and sudden scenario led to a forced National Health System reorganization and review of welfare priorities. The aim of this study is to evaluate the effects of this pandemic on ordinary activities in two plastic surgery divisions in Rome, hosted in a COVID-19 and a non-COVID-19 hospital. METHODS: The data of this comparative retrospective study was collected between 9 March and 9 April 2019 and the same period of 2020 from two plastic surgery units, one in a COVID-19 hospital and second in a non-COVID-19 hospital in Rome, Italy. The 2019-2020 data of the two hospitals was compared regarding the number of surgeries, post-operative dressings and first consultations performed. RESULTS: Both units sustained a decrease in workload due to lockdown effects. Statistically significant differences for day surgery procedures (p value = 0.0047) and first consultations (p value < 0.0001) were found between the COVID-19 and non-COVID-19 institutes, with a drastic trend limiting non-urgent access to COVID-19 hospitals. CONCLUSIONS: The long-term effects of healthcare reshuffling in the "COVID-19 era" imply a delay in the diagnosis and treatment of skin cancer and cancellation of many reconstructive procedures. These findings pose a question on the future consequences of a long-term limitation in plastic surgery healthcare.Level of evidence: Level III, risk/prognostic study.

Genome-wide scan for signatures of human population differentiation and their relationship with natural selection, functional pathways and diseases.

Genetic differences both between individuals and populations are studied for their evolutionary relevance and for their potential medical applications. Most of the genetic differentiation among populations are caused by random drift that should affect all loci across the genome in a similar manner. When a locus shows extraordinary high or low levels of population differentiation, this may be interpreted as evidence for natural selection. The most used measure of population differentiation was devised by Wright and is known as fixation index, or F(ST). We performed a genome-wide estimation of F(ST) on about 4 millions of SNPs from HapMap project data. We demonstrated a heterogeneous distribution of F(ST) values between autosomes and heterochromosomes. When we compared the F(ST) values obtained in this study with another evolutionary measure obtained by comparative interspecific approach, we found that genes under positive selection appeared to show low levels of population differentiation. We applied a gene set approach, widely used for microarray data analysis, to detect functional pathways under selection. We found that one pathway related to antigen processing and presentation showed low levels of F(ST), while several pathways related to cell signalling, growth and morphogenesis showed high F(ST) values. Finally, we detected a signature of selection within genes associated with human complex diseases. These results can help to identify which process occurred during human evolution and adaptation to different environments. They also support the hypothesis that common diseases could have a genetic background shaped by human evolution.