Dupilumab in the treatment of severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP): A multicentric observational Phase IV real-life study (DUPIREAL)

Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant morbidity and reduced health-related quality of life. Findings from clinical trials have demonstrated the effectiveness of dupilumab in CRSwNP, although real-world evidence is still limited. Methods This Phase IV real-life, observational, multicenter study assessed the effectiveness and safety of dupilumab in patients with severe uncontrolled CRSwNP (n = 648) over the first year of treatment. We collected data at baseline and after 1, 3, 6, 9, and 12 months of follow-up. We focused on nasal polyps score (NPS), symptoms, and olfactory function. We stratified outcomes by comorbidities, previous surgery, and adherence to intranasal corticosteroids, and examined the success rates based on current guidelines, as well as potential predictors of response at each timepoint. Results We observed a significant decrease in NPS from a median value of 6 (IQR 5–6) at baseline to 1.0 (IQR 0.0–2.0) at 12 months (p < .001), and a significant decrease in Sino-Nasal Outcomes Test-22 (SNOT-22) from a median score of 58 (IQR 49–70) at baseline to 11 (IQR 6–21; p < .001) at 12 months. Sniffin' Sticks scores showed a significant increase over 12 months (p < .001) compared to baseline. The results were unaffected by concomitant diseases, number of previous surgeries, and adherence to topical steroids, except for minor differences in rapidity of action. An excellent-moderate response was observed in 96.9% of patients at 12 months based on EPOS 2020 criteria. Conclusions Our findings from this large-scale real-life study support the effectiveness of dupilumab as an add-on therapy in patients with severe uncontrolled CRSwNP in reducing polyp size and improving the quality of life, severity of symptoms, nasal congestion, and smell

New Tools for Mechanical Thinning of Apricot Fruitlets

In this study, the thinner machine with yellow rod equipment was tested in relation to tree branch length and orientation in April 2019, in a narrow-canopied apricot orchard of Emilia Romagna Region, Italy. The trees were mechanically thinned with manual finishing, and comparative tests were carried out simultaneously with the ordinary hand thinning (control). Three groups of two plants were identified as replication for a total of six plants per row. Three rows were checked, considering field uniformity average. The branches were grouped into four classes according to their length: <30 cm, 30–60 cm, 60–90 cm and >90 cm. Branch inclination on the plant, radial or longitudinal with respect to the row, was evaluated. Fruit number before the thinning, after the first and the second machine intervention, after three days of the mechanical thinning and after the hand finishing was recorded. This experience showed satisfactory results in terms of thinning efficiency and reduced damage to both fruits and branches, as a function of the class length and insertion point in the main branch of the plant. Thinning efficiency was always kept above 37% of the left load after hand finishing, and on average between the treatments close to 44%. Fruit damages always remained below the economic thresholds to marketable production or to the plant

Agroecological Service Crops Drive Plant Mycorrhization in Organic Horticultural Systems

Mycorrhizal symbiosis represents a valuable tool for increasing plant nutrient uptake, affecting system biodiversity, ecosystem services and productivity. Introduction of agroecological service crops (ASCs) in cropping systems may determine changes in weed community, that can affect the development of the mycorrhizal mycelial network in the rhizosphere, favoring or depressing the cash crop mycorrhization. Two no-till Mediterranean organic horticultural systems were considered: one located in central Italy, where organic melon was transplanted on four winter-cereals mulches (rye, spelt, barley, wheat), one located in southern Italy (Sicily), where barley (as catch crop) was intercropped in an organic young orange orchard, with the no tilled, unweeded systems taken as controls. Weed “Supporting Arbuscular Mycorrhiza” (SAM) trait, weed density and biodiversity indexes, mycorrhization of coexistent plants in the field, the external mycelial network on roots were analyzed by scanning electron microscopy, crop P uptake, yield and quality were evaluated. We verified that cereals, used as green mulches or intercropped, may drive the weed selection in favor of the SAM species, and promote the mycelial network, thus significantly increasing the mycorrhization, the P uptake, the yield and quality traits of the cash crop. This is a relevant economic factor when introducing sustainable cropping practices and assessing the overall functionality of the agroecosystem

Effects of water deficits on whole tree water use efficiency of orange

To study the effects of water deficits on water use efficiency (WUE) of citrus trees, whole tree transpiration and CO2 assimilation were measured in a semi-arid environment during the summer of 2012. Young orange trees >Valencia Late>, either water stressed (DI) and well-irrigated (C), were monitored in selected days using a gas exchange chamber. Tree transpiration was also measured on a continuous basis with sap flow sensors. The water restriction reduced the transpiration of the DI treatment down to 60% of the maximum potential (treatment C) during the peak of water stress. The instantaneous WUE ranged between 1.7 and 79gCO2L-1H2O and was tightly related to the vapour pressure deficit. Differences in instantaneous WUE due to water stress were insignificant. On a daily basis, WUE ranged between 4.9 (7 August) and 8.8 (7 June) gL-1 for the daytime period; and between 4.0 and 8.2gL-1 for the 24h period. As water stress was imposed on the DI treatment, a trend of increasing WUE in DI relative to C was observed, reaching, in the maximum stress period, a difference, of 13-15% (daytime) and 20-22% (24h) although not statistically significant. Partial rewatering returned the WUE to similar values in both treatments. An analysis of the differences in the diurnal patterns of transpiration suggests that the increase in WUE due to water stress in citrus is achieved indirectly by shifting the overall carbon assimilation towards the morning hours of lower evaporative demand. © 2014 Elsevier B.V.This work was financially supported by the projects CONSOLIDER-RIDECO CSD2006-00067 and AGL2009-13105 of the Spanish Ministry of Science and Education, partly through European Union ERDF funds.Peer Reviewe

Effect of different management strategies on soil quality of citrus orchards in Southern Italy

Twenty-six soil samples were collected from 13 paired orchards (organically vs. conventionally managed) homogeneous for age, rootstock and cultivars, belonging to the Eastern Sicily Organic Citrus farm Network. The soil quality was evaluated by chemical and biochemical indicators. The total organic C, humification parameters and isoelectric focusing of extracted organic matter were measured to quantify the size of relevant soil C pools. In addition, C turnover was evaluated by determining microbial C mineralization, C microbial biomass and by calculating the mineralization and metabolic quotient (qCO2). The results obtained demonstrated that organic citrus soils were characterized by a general increase in all the organic matter pools, which means a greater C supply for soil metabolic processes. This observed trend did not directly influence the organic matter turnover, indicating that the organic approach could act as a soil C-sink. The soil microflora of organically managed soils showed an improved efficiency in use of energy and organic resources, corresponding to an increased ability of soils under organic management to sustain biological productivity in the long term

Hemp Sowing Seed Production: Assessment of New Approaches in North-Italy

Bottlenecks occur as the cultivated area increases and the inappropriate mechanization methods hinder the stable supply of seeds for hemp multiplication. Moreover, the seeds ripen scalarly, and a timely stabilization is required to impede a germinability reduction. The study coupled the delayed sowing of a non-specific hemp variety to a harvesting system allowing for the collection of seeds with other threshing fractions. The final goal was the identification of an innovative route integrating agronomic and mechanical aspects for the improvement of the supply chain of seed production. To this aim, harvesting trials were carried out on the variety Futura sowed at the end of June in North Italy and were collected with a combine equipped with a separator developed for the recovery of threshing residues. The shortening of the growth cycle did not affect the plant height (173 cm on average). The effective working time of the combine was 57% of the total working time and the field efficiency was 1.14 ha h−1, a good performance considering that in our work the seeds was threshed simultaneously to the harvest operation. Seed losses were found to be mostly at the expense of the mowing and threshing system (sector B) but remained below 5%. The separation system allowed for the rescue of 492.20 kg ha−1 (DW basis) of high-value threshing residues

Participatory Research towards Food System Redesign: Italian Case Study and Perspectives

Industrial agriculture and its requirement for standardized approaches is driving the world towards a global food system, shrinking the role of farmers and shifting decision-making power. On the contrary, a holistic perspective towards a new food-system design could meet the needs of a larger share of stakeholders. Long-term experiments are crucial in this transition, being the hub of knowledge and the workshop of ‘participation in’ and ‘appropriation of’ the research in agriculture over a long term. We present a methodology applied during the creation of a small network of organic farmers in Italy and detail the steps of the co-innovation process implemented. After a context analysis of the area to define the type of research and degree of participation, three steps were performed: (1) Identification of stakeholders; (2) dialogic identification of common activities; and (3) validation and feedback from participants. In the first participatory step, five organic farms were engaged for the second and third steps. We organized meetings to discuss future plans, facilitating the interaction process between farmers and researchers. These activities led to: (i) the definition of a research protocol based on farmers’ research needs for a new long-term experiment; (ii) committing farmers to take an active role in the research; and (iii) hosting experimental satellite trials in their own farms

Agroecological Practices and Agrobiodiversity: A Case Study on Organic Orange in Southern Italy

The integration of Agroecological Service Crops (ASCs) into agroecosystems can provide several ecological services, such as nutrient cycling and disease and weed management. A two-year experiment on an organic orchard was carried out to compare barley (B) and horse bean (HB) ASCs with a control without ASC (Cont) in combination with fertilizers. Their effects on soil fertility and weed- and soil-borne fungi communities were evaluated by direct measurements, visual estimation, and indicators computation. A Principal Component Analysis (PCA) was used to identify latent patterns and redundancy among variables, whereas a correlation analysis was used to discriminate the compared systems within the PCA matrix. The empirical results of this study put in evidence the correlation among soil, weed, and fungal variables. A slight contribution of fertilizers on the system’s variability was observed, whereas a clear effect of ASCs was highlighted. The systems differed in weed communities, with the lowest density associated to B and the highest to Cont. B showed the highest fungal diversity, with changes in community compared to HB. HB showed a contribution on soil fertility, being associated to organic matter increase and N availability, and evidencing mixed impacts on soil quality and ecosystem functioning. Overall, the above-ground diversity and below-ground community results were inter-correlated

Effectiveness of Dupilumab in the Treatment of Patients with Uncontrolled Severe CRSwNP: A “Real-Life” Observational Study in Naïve and Post-Surgical Patients

Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) represents 25–30% of all CRS cases, and in the most severe forms it is associated with a poor quality of life and a high rate of nasal polyps’ recurrence after surgery. Dupilumab has been suggested as a treatment option for severe CRSwNP. Methods: Patients with severe CRSwNP receiving dupilumab from January 2021 were followed up at 1, 3, 6, 9 and 12 months from the first administration and were considered for this study. At baseline and at each follow-up, patients underwent nasal endoscopy and completed the Sinonasal Outcome Test (SNOT)-22, a Visual Analogue Scale (VAS) for smell/nasal obstruction, the Nasal Congestion Score and the Asthma Control Test. Peak nasal inspiratory flow (PNIF), a smell test, nasal cytology and blood eosinophilia were also evaluated. Results: Forty-seven patients were included in the study. Of these, 33 patients had a history of previous surgery (ESS) and had recurrent nasal polyps, while 14 patients were naïve to nasal surgery. Both subjective and objective parameters improved after biological treatment and were correlated with each other (p < 0.05), except for the SNOT-22 and the nasal polyp’s score. No correlations were found between nasal and blood eosinophilia. No differences were observed when comparing the post-surgical and the naïve groups. Conclusions: Dupilumab improves nasal obstruction and the sense of smell and reduces the level of local inflammation in severe CRSwNP patients in a similar way in both naïve and post-surgical patients

Solving Phosphites Emergency In Organic Fruit And Vegetables: The Participatory Biofosf Project

Quality and safe food is an imperative in organic production. Recently, in EU market some organic fruits and vegetables were positive (>0.01 mg/kg) to phosphonic acid (i.e., phosphite), despite fosetyl-Al or phosphite are not allowed as plant protection products in Reg. EC n.889/2009. In 2016, the Italian Ministry of Agricolture funded the BIOFOSF project to the Council for Agricultural Research and Economics, which promoted a partecipatory approach among researchers, farmers and control bodies for solving this issue. The endogenous production of phophonic acid was not observed, while it was evidenced that its origin is due only to external inputs. A contamination of some plant protection products (PPP) and organic fertilizers allowed in organic farming was found, thus suggesting a deep revision of their official control system