THE CONTRIBUTION OF THE AGRI-FOOD SECTOR TO SUSTAINABLE DEVELOPMENT IN ITALY

O aumento da população mundial, o risco de esgotamento dos recursos naturais necessários para a produção, a intensificação da mudança climática causada pela excessiva pressão antrópica no meio ambiente, exigem mudanças urgentes que atuem na escolha das fontes energéticas, na gestão dos recursos naturais, nas tecnologias de produção, nos estilos de consumo e, mais em geral, nos modelos de desenvolvimento local. Um desenvolvimento sustentável baseado em estratégias bioeconómicas está intimamente associado ao agrobusiness e à sua diversificação, ao desenvolvimento rural e local, aos limites e às oportunidades provenientes dos pilares ambientais e sociais da sustentabilidade. O objetivo deste estudo é o de fornecer um quadro das principais oportunidades através das quais o setor agroalimentar pode contribuir para a sustentabilidade dos modelos de desenvolvimento local em Itália. Após uma breve panorâmica do sistema agroalimentar italiano, o estudo analisa as oportunidades para conciliar o setor agroalimentar e o desenvolvimento sustentável, enfrentando as questões ambientais, o desenvolvimento social, a multifuncionalidade da agricultura.The increase in world population, the risk of depletion of natural resources needed for production, the intensification of climate change caused by excessive anthropogenic pressure on the environment, ask for urgent changes in the choice of energy sources, the management of natural resource, production technologies, consumption patterns and, more generally, local development patterns. A sustainable development based on bio-economic strategies is closely related to agribusiness and its diversification, rural and local development and the limitations and opportunities inherent in the environmental and social pillars of sustainability. The aim of this paper is to provide a picture of the main opportunities through which the Italian agro-food sector may contribute to the sustainability of local development patterns. After a brief overview of the Italian agro-food system, the paper discusses how to reconcile it with sustainable development, and considers aspects such as the environment, social development and multifunctional agriculture

Cardiac Magnetic Resonance as Risk Stratification Tool in Non-Ischemic Dilated Cardiomyopathy Referred for Implantable Cardioverter Defibrillator Therapy—State of Art and Perspectives

Non-ischemic dilated cardiomyopathy (DCM) is a disease characterized by left ventricular dilation and systolic dysfunction. Patients with DCM are at higher risk for ventricular arrhythmias and sudden cardiac death (SCD). According to current international guidelines, left ventricular ejection fraction (LVEF) <= 35% represents the main indication for prophylactic implantable cardioverter defibrillator (ICD) implantation in patients with DCM. However, LVEF lacks sensitivity and specificity as a risk marker for SCD. It has been seen that the majority of patients with DCM do not actually benefit from the ICD implantation and, on the contrary, that many patients at risk of SCD are not identified as they have preserved or mildly depressed LVEF. Therefore, the use of LVEF as unique decision parameter does not maximize the benefit of ICD therapy. Multiple risk factors used in combination could likely predict SCD risk better than any single risk parameter. Several predictors have been proposed including genetic variants, electric indexes, and volumetric parameters of LV. Cardiac magnetic resonance (CMR) can improve risk stratification thanks to tissue characterization sequences such as LGE sequence, parametric mapping, and feature tracking. This review evaluates the role of CMR as a risk stratification tool in DCM patients referred for ICD

Effective nonapical left ventricular pacing with quadripolar leads for cardiac resynchronization therapy

Background: Current guidelines recommend avoiding apical left ventricular (LV) pacing for cardiac resynchronization therapy (CRT). Aims: We investigated the feasibility of nonapical pacing with the current quadripolar LV lead technology. Methods: We analyzed consecutive patients who received CRT with an LV quadripolar lead. The post­­implantation position of each electrode of the LV lead was designated as basal, mid, or apical. The pacing capture threshold (PCT) and phrenic nerve stimulation (PNS) threshold were assessed for each electrode. Results: We enrolled 168 patients. A total of 8 CRT defibrillators were from Biotronik (with Sentus OTW QP leads), 98 were from Boston Scientific (with 21 Acuity X4 Spiral and 77 Acuity X4 Straight leads), and 62 from St. Jude Medical (with Quartet leads). The median (interquartile range) number of electrodes at nonapical segments per patient was 3 (1–4) with Biotronik Sentus leads, 4 (3–4) with spiral ­design Boston Scientific leads, 4 (3–4) with straight Boston Scientific leads, and 3 (3–4) with St. Jude Medical Quartet leads (P = 0.045). Three patients (38%) with Biotronik Sentus leads, 21 (100%) with spiral ­design Boston Scientific leads, 69 (90%) with straight ­design Boston Scientific leads, and 49 (79%) with St. Jude Medical Quartet leads (P &lt; 0.001) had at least 1 electrode located at nonapical segments linked with a PNS ­PCT safety margin of more than 2 V. During the 6­month follow ­up, PNS was detected in 4 patients and was eliminated with reprogramming. No significant changes in PCT were detected during follow ­up. Conclusions: Quadripolar leads allowed nonapical pacing with acceptable electrical parameters in the majority of CRT recipients, although differences were found among the currently available devices

Highlighting the Drivers of Italian Diversified Farms Efficiency: A Two-Stage DEA-Panel Tobit Analysis

Farm diversification is an important phenomenon in agricultural systems and rural development in Europe, pursuing economic, social and environmental goals. For the sustainability of diversified farms, it is important to analyse some drivers affecting farm efficiency, for instance, socio-economic, technical and policy drivers. The efficiency performance of a panel of Italian farms practising other gainful activities in the period 2012&ndash;2017 was investigated and regressed against the drivers that mostly affects farm performances. FADN data and a two-step approach were used. An output-oriented Data Envelopment Analysis was applied; in the second step, efficiency scores were used as a dependent variable in a panel Tobit regression analysis used to determine differences in the significance of drivers. Social, economic, technical and policy drivers were considered as explanatory variables. Results show margins for improving farms performances. The incidence of the output from other gainful activities has been proven to positively affect farms efficiencies, while intermediate costs are the most negatively impacting factor. As regards policy variables and implications, the significance of localization in mountain disadvantaged territories further supports the relevance of EU subsidies in less-favoured areas. Managerial implications in terms of technical, structural and economic indicators can be drawn from study findings