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Agroforestry, the intentional integration of trees with crops and/or livestock, can lead to multiple economic and ecological benefits compared to trees and crops/livestock grown separately. Field experimentation has been the primary approach to understanding the tree-crop interactions inherent in agroforestry. However, the number of field experiments has been limited by slow tree maturation and difficulty in obtaining consistent funding. Models have the potential to overcome these hurdles and rapidly advance understanding of agroforestry systems. Hi-sAFe is a mechanistic, biophysical model designed to explore the interactions within agroforestry systems that mix trees with crops. The model couples the pre-existing STICS crop model to a new tree model that includes several plasticity mechanisms responsive to tree-tree and tree-crop competition for light, water, and nitrogen. Monoculture crop and tree systems can also be simulated, enabling calculation of the land equivalent ratio. The model's 3D and spatially explicit form is key for accurately representing many competition and facilitation processes. Hi-sAFe is a novel tool for exploring agroforestry designs (e.g., tree spacing, crop type, tree row orientation), management strategies (e.g., thinning, branch pruning, root pruning, fertilization, irrigation), and responses to environmental variation (e.g., latitude, climate change, soil depth, soil structure and fertility, fluctuating water table). By improving our understanding of the complex interactions within agroforestry systems, Hi-sAFe can ultimately facilitate adoption of agroforestry as a sustainable land-use practice.

This report comprises Deliverable 6.16 in the project, which contributes to the third objective as it presents field-scale evaluation of innovations, in order to adapt and evaluate agroforestry designs and practices for locations where agroforestry is currently not-widely practised or declining. The modelling of outputs at field scale to support best agroforestry practices is an ongoing activity during the AGFORWARD project. This report highlights some of the outputs which has been produced in the form of three papers (either submitted or about to be submitted to a peer-reviewed journal) or in four presentations at the Third European Agroforestry Conference in May 2016 N/A

Introduction Narcolepsy is a chronic and rare hypersomnia of central origin characterized by excessive daytime sleepiness and a complex array of symptoms as well as by several medical comorbidities. With growing pharmacological options, polytherapy may increase the possibility of a patient-centered management of narcolepsy symptoms. The aims of our study are to describe a large cohort of Italian patients with narcolepsy who were candidates for pitolisant treatment and to compare patients’ subgroups based on current drug prescription (drug-naïve patients in whom pitolisant was the first-choice treatment, switching to pitolisant from other monotherapy treatments, and adding on in polytherapy). Methods We conducted a cross-sectional survey based on Italian data from the inclusion visits of the Post Authorization Safety Study of pitolisant, a 5-year observational, multicenter, international study. Results One hundred ninety-one patients were enrolled (76.4% with narcolepsy type 1 and 23.6% with narcolepsy type 2). Most patients (63.4%) presented at least one comorbidity, mainly cardiovascular and psychiatric. Pitolisant was prescribed as an add-on treatment in 120/191 patients (62.8%), as switch from other therapies in 42/191 (22.0%), and as a first-line treatment in 29/191 (15.2%). Drug-naive patients presented more severe sleepiness, lower functional status, and a higher incidence of depressive symptoms. Conclusion Our study presents the picture of a large cohort of Italian patients with narcolepsy who were prescribed with pitolisant, suggesting that polytherapy is highly frequent to tailor a patient-centered approach.