Envisioning the future: creating sustainable, healthy and resilient BioCities

Numerous challenges – from population increase to climate change – threaten the sustainable development of cities and call for a fundamental change of urban development and green-blue resource management. Urban forests are vital in this transition, as they provide various ecosystem services and allow to re-shape and re-think cities. Based on a Europe-wide community effort with diverse experts centered around urban forests and urban greening, we propose five key research fields to generate the knowledge required to unlock fundamental changes in urban development and green-blue resource management: circular bioeconomy, climate resilience, governance, social and human environment, and biodiversity. To support the design of greener, cooler, more inclusive and resilient cities, all these research fields require inter- and transdisciplinary collaboration, engaging stakeholders in transforming urban engagement and functioning. We summarise main inter-, trans- und multidisciplinary research paths for each field and the cross-cutting knowledge areas that can help to address the challenges many cities face (e.g., modelling and assessment of the urban microclimate). For transforming cities further knowledge is needed on e.g., urban innovation, transition, participation, and more. Finally, we address how the identified research gaps can be implemented (e.g., international coordinated research effort, interdisciplinary networks)

Envisioning the future—Creating sustainable, healthy and resilient BioCities

Numerous challenges – from population increase to climate change – threaten the sustainable development of cities and call for a fundamental change of urban development and green-blue resource management. Urban forests are vital in this transition, as they provide various ecosystem services and allow to re-shape and re-think cities. Based on a Europe-wide community effort with diverse experts centered around urban forests and urban greening, we propose five key research fields to generate the knowledge required to unlock fundamental changes in urban development and green-blue resource management: circular bioeconomy, climate resilience, governance, social and human environment, and biodiversity. To support the design of greener, cooler, more inclusive and resilient cities, all these research fields require inter- and transdisciplinary collaboration, engaging stakeholders in transforming urban engagement and functioning. We summarise main inter-, trans- and multi-disciplinary research paths for each field and the cross-cutting knowledge areas that can help to address the challenges many cities face (e.g., modelling and assessment of the urban microclimate). For transforming cities further knowledge is needed on e.g., urban innovation, transition, participation, and more. Finally, we address how the identified research gaps can be implemented (e.g., international coordinated research effort, interdisciplinary networks).</p

Diagnostic Accuracy of Copeptin in the Differential Diagnosis of the Polyuria-polydipsia Syndrome: A Prospective Multicenter Study

CONTEXT The polyuria-polydipsia syndrome comprises primary polydipsia (PP) and central and nephrogenic diabetes insipidus (DI). Correctly discriminating these entities is mandatory, given that inadequate treatment causes serious complications. The diagnostic "gold standard" is the water deprivation test with assessment of arginine vasopressin (AVP) activity. However, test interpretation and AVP measurement are challenging. OBJECTIVE The objective was to evaluate the accuracy of copeptin, a stable peptide stoichiometrically cosecreted with AVP, in the differential diagnosis of polyuria-polydipsia syndrome. DESIGN, SETTING, AND PATIENTS This was a prospective multicenter observational cohort study from four Swiss or German tertiary referral centers of adults >18 years old with the history of polyuria and polydipsia. MEASUREMENTS A standardized combined water deprivation/3% saline infusion test was performed and terminated when serum sodium exceeded 147 mmol/L. Circulating copeptin and AVP levels were measured regularly throughout the test. Final diagnosis was based on the water deprivation/saline infusion test results, clinical information, and the treatment response. RESULTS Fifty-five patients were enrolled (11 with complete central DI, 16 with partial central DI, 18 with PP, and 10 with nephrogenic DI). Without prior thirsting, a single baseline copeptin level >21.4 pmol/L differentiated nephrogenic DI from other etiologies with a 100% sensitivity and specificity, rendering a water deprivation testing unnecessary in such cases. A stimulated copeptin >4.9 pmol/L (at sodium levels >147 mmol/L) differentiated between patients with PP and patients with partial central DI with a 94.0% specificity and a 94.4% sensitivity. A stimulated AVP >1.8 pg/mL differentiated between the same categories with a 93.0% specificity and a 83.0% sensitivity. LIMITATION This study was limited by incorporation bias from including AVP levels as a diagnostic criterion. CONCLUSION Copeptin is a promising new tool in the differential diagnosis of the polyuria-polydipsia syndrome, and a valid surrogate marker for AVP. Primary Funding Sources: Swiss National Science Foundation, University of Basel

Plasma Apelin Concentrations in Patients With Polyuria-Polydipsia Syndrome

Abstract Context: Apelin and arginine vasopressin are antagonists in the regulation of body fluid and osmotic homeostasis. There are no data about apelin levels in patients with polyuria-polydipsia syndrome (PPS). Objective: To investigate plasma apelin levels and plasma apelin to copeptin ratios in patients with PPS and healthy volunteers using copeptin as a surrogate marker for arginine vasopressin. Design, Participants, and Setting: We included 41 patients with PPS in this post hoc analysis of a prospective study performed in tertiary care hospitals in Switzerland and Germany and 113 healthy volunteers as a control group. Outcome Measures: Plasma apelin and copeptin levels were measured in 15 patients with complete central diabetes insipidus (DI), seven patients with complete nephrogenic DI, 19 patients with primary polydipsia (PP), and 113 healthy volunteers. Results: Plasma apelin levels were highest in patients with complete nephrogenic DI (413 pmol/L; interquartile range, 332-504 pmol/L; P = .01) and lower in patients with PP (190 [172-215] pmol/L; P .9) was similar to healthy volunteers (57 [37-102] pmol/pmol). In contrast, the apelin to copeptin ratio was higher in patients with complete central DI (89 [73-135] pmol/pmol; P = .02) and lower in patients with complete nephrogenic DI (7 [6-10] pmol/pmol; P < .001) compared to healthy volunteers. Conclusion: In PP, normal plasma apelin to copeptin ratio attests a normal water homeostasis. In contrast, in patients with central or nephrogenic DI, the increased or decreased apelin to copeptin ratio, respectively, reflects a disturbed osmotic and body fluid homeostasis

Research Agenda: Biocities of the future

call for the preparation of a Green Book of Biocities and a Research Agenda for Biocities of the Future. The Research Agenda is intended as a foundational document for further research and initiatives to be undertaken by the new EFI Biocities Facility launched in 2022 in Rome (Italy). A number of conditions, developments and critical notions form the backdrop to this study: • the continuing pattern of migration to cities globally, and related urbanization patterns and processes; • the interrelationships of cities and the urban realm to global problems (and global solutions); • the fact that cities are inherently complex, that the urban issue is multifaceted, and that solutions are by consequence interrelated and demand interdisciplinary attention; • that the cities of tomorrow face an increasing number of challenges, and are of an increasing diversity; • that cities have been, and are expected to remain, crucibles of development and innovation in areas of technology, economics, culture, society and politics; • that forests, greenspace and the natural world can become central to a paradigm shift in understanding, ordering and acting in the (bio)city of the future; • that the notion of a Biocity resonates with similar initiatives such as eco-urbanism, nature-based solutions and green cities, but aims to critically extend and enlarge on these concepts through the involvement of more diverse branches of research and practice, their effective integration and contextualization, and through the exploration of novel cross-cutting perspectives. The overall objective of the agenda is to contribute towards transforming existing cities to Biocities and provide a framework for new urban developments. Biocities can be defined from the perspective of ‘desirable futures’ (based on a vision developed by the parallel work of another project consortium on the Green Book of Biocities). Critical variables that impact future pathways towards Biocities and point towards areas for further action and research include: (i) degrees of political stability; compatibility of political systems to principles; political commitment to principles; flexibility and adaptability of regulatory and legislative systems; degree of inclusion and participation of communities; (ii) volatility of economic conditions internationally, nationally and locally; predisposition of communities and governments to expand value concepts beyond the monetary; (iii) willingness and capacity of urban communities to adapt to systemic changes required of certain principles; awareness of motivations behind transitions to various principles; migration patterns, the future of work, demographic trends; (iv) development of necessary technological innovations; uptake of technology; (v) availability of natural resources; speed of anthropogenic impacts on planetary boundaries. On the basis of these critical variables, scenarios reveal to what extent the Biocity goals may be reached, resulting in a first set of overarching research challenges, which include: reconciling different perceptions by getting and keeping interest groups involved; interoperability between green space management and urban development; funding and implementation; impacting culture and behaviour towards transformation. Learning from these overarching themes, five key topic areas are identified as a framework for elaboration of a research agenda to facilitate the transition to Biocities: (1) circular bioeconomy, (2) climate resilience, (3) governance, (4) social and human environment, and (5) biodiversity. Our results show that various challenges arise from different perspectives in these topic areas, such as life-cycle management, cultural change, prioritisation of sustainable approaches, urban carbon storage, infrastructural adaptation, bio-resilience, participation, cross-sectoral planning, systemic integration of health and wellbeing, and spatial sustainability. Further, several knowledge areas and research gaps emerge that need to be addressed from the social sciences and humanities, as well as from ecology, civil engineering, architecture and spatial planning and design. Examples include: conceptual research on the circular bioeconomy and urban biodiversity; modelling of the urban microclimate, local health impacts and global supply chain effects; methodologies and standards for impact assessment and participatory planning; historical and contextual research on green, blue and grey infrastructure across cities. For the implementation of greener, cooler and more resilient cities, further knowledge is needed on urban innovation, transition, participation, inequality, inclusiveness management, health and human wellbeing, suitable policies and strategies and the science-policy interface. The implementation of the Research Agenda will require five pathways: (i) an international coordinated research effort, (ii) interdisciplinary networks, (iii) integration of other initiatives, (iv) conceptual capacity building and (v) support for emerging disciplines. The implementation of the Research Agenda is expected to contribute to the Sustainable Development Goals in an urban context, as well as to support the Green Deal Strategy of the European Commission and the promotion of One Health