A Straightforward Framework for Road Network Screening to Lombardy Region (Italy)

It is not possible to deal with sustainable mobility without considering road safety as a key element: Target 3.6 of the Sustainable Development Goals aims at halving the number of road deaths by 2030. To do so, further effort and effective tools are required for road authorities, to implement improvement measures and enhance road safety for all. Road network screening (RNS) is the first step of the whole Road Infrastructure Safety Management (RISM) System process. It is applied to a wide scale to assess the safety performance of the whole road network and identify the worst performing roads (or sites). The literature is quite rich with RNS models and methods, which have greatly improved, recently. Moreover, although many national frameworks on road safety have been issued over time, some barriers remain, specifically related to data quality, such as accurate crash location, which is mainly used to integrate crash data with other databases. In addition, most of these frameworks adopted partial indexes to identify black spots and presented results using fixed maps for visualization. This paper fills these gaps by the proposal of a straightforward operational framework to perform RNS, based on a simple and flexible rationale to integrate raw crash, traffic, and road data. Specifically, the framework: (i) manages crash location data, without relying on plane or geographical coordinates, which are missing or inaccurate and still are a crucial issue in many European countries such as Italy; (ii) adopts an adjusted accident cost rate index that integrates frequency and severity of crashes as well as a measurement of exposure; (iii) introduces variable maps that show the results at different jurisdiction levels. A relevant case study demonstrates the usefulness of this framework using 30,000+ crash data of the whole non-urban road network of the Lombardy Region (Northern Italy). Road authorities could adopt this framework to perform an accurate safety screening on the overall regional road network. Moreover, this framework could be implemented in a road traffic safety managerial system to better prioritise safety interventions within a tight budget and help achieve sustainable development targets

Fare inspection in proof-of-payment transit networks: A review

In proof-of-payment transit systems worldwide, fare inspection is the most widely adopted strategy against fare evasion from transit authorities and public transport companies. Although these actors attempt to make the inspectors’ work as easy, effective, and equitable as possible, several issues need to be analysed according to a unifying approach, i.e., “How, where and when to inspect”, “Who and why evades the fare”, “How many and how to distribute inspectors” as well as improve the inspectors’ effectiveness. Since no study exists in the literature investigating all these issues together, this paper aims to fill this gap with a review of several key papers that covered the full spectrum of relevant literature which, whole or partially, focused on fare inspection. Results show fare inspection is a beneficial strategy against fare evasion, but there are still many challenges and research limits that should be overcome in the years ahead. A possible research agenda is provided. It calls for specific options (i.e., data collection and fare evasion risk in hotspot definition, digital support and bottom-up approaches, size of inspection staff and scheduling of inspectors under realistic conditions and follower responses, effectiveness of actions focused on the visibility of fare inspection, managing interactions between fare inspectors and passengers) and integrated approaches (i.e., linking the planning, organisation, and activities of fare inspection with who and why evade). Nevertheless, even if this review may not be conclusive, these results support a unifying literature development on fare inspection

Bridge's vehicular loads characterization through Weight-In-Motion (WIM) systems. The case study of Brescia

The growing traffic flow and the increase in transported masses negatively affect infrastructural safety. Several authors have characterized traffic loads on bridges in the American and Chinese context using Weigh-in-Motion (WIM) systems. Conversely, very few studies have been carried out in Europe and, as far as the authors know, none in Italy. This study covers this gap by providing a statistical analysis of raw WIM data collected on a main bridge near the city of Brescia (Italy). First, the traffic flow and the characteristics of vehicles were gathered by a WIM device. Second, some descriptive statistics were performed by computing the probabilistic distributions of numerous vehicular attributes. Third, as a novelty element, a K-means based Clustering technique was adopted on a wide set of vehicular features to detect heavy vehicle clusters. The results showed the existence of three main clusters: two predominately composed by lightly overloaded ordinary vehicles and construction machinery, respectively, and one by mass exceptional vehicles. This study considers a broader set of vehicular parameters than previous ones and then, provides a deeper understanding. Moreover, it shows that axle mass limits violations are noteworthy among mass exceptional vehicles in Italy highlighting the need of improving weight enforcement. These knowledges will be crucial for a rational organisation of the existing assets

Uncommon Blepharitis

Blepharitis is a common chronic inflammatory condition affecting the eyelid margins; the pathophysiology of blepharitis is complex and not fully understood. The disease is anatomically divided into anterior (inflammation of eyelashes) and posterior (meibomian gland dysfunction) types. Diagnosis relies on clinical examination, revealing characteristic features like scurf, vascular changes, and meibomian gland dysfunction. The main goals of blepharitis treatment are symptom relief, recurrence prevention, and complication risk minimization. Treatment options include lid hygiene, topical and systemic antibiotics, topical corticosteroids, and omega-3 supplements. However, it is important to highlight reported cases of blepharitis as side effects of systemic therapies, particularly in the context of chemotherapy, bortezomib, cetuximab, TNFα inhibitors, and dupilumab. It is crucial to monitor patients undergoing such treatments regularly and attentively in order to promptly set up adequate supportive therapy. Of even more importance is future research on the pathophysiological mechanisms responsible for the occurrence of these ocular side effects in order to find a nosological cure for the issue

Preventing and Managing Iatrogenic Dry Eye Disease during the Entire Surgical Pathway: A Study Focusing on Patients Undergoing Cataract Surgery

Patient expectations for cataract surgery are continuously increasing, and dry eye disease (DED) represents a major cause of patient dissatisfaction in eye surgery. The present opinion paper aims to provide useful insights to improve the entire pathway of a patient undergoing cataract surgery, from the preoperative setting to the postoperative one. The available evidence from main clinical trials published on this topic is presented in association with experience-based points of view by the authors. Ocular surface disease (OSD) is common in patients presenting for cataract surgery, and more than half of these patients have DED and meibomian gland dysfunction (MGD), even in the absence of symptoms. Therefore, there is a need to encourage preoperative assessments for the risk of DED development or worsening in all patients as a routine approach to cataract surgery. New all-in-one diagnostic machines allow for fast and noninvasive screening of the ocular surface status. Once a preoperative diagnosis of DED/OSD is reached, ocular surface optimization should be obtained before surgery. In the case of unresolved OSD, the decision to delay surgery should be considered. The surgical procedure can be optimized by avoiding large incisions, limiting microscope light intensity and exposure, and avoiding an aspirating speculum or preserved eye drops. Postoperatively, the continued avoidance of preserved agents is advisable, as well as a limited exposure to epitheliotoxic antibiotics and nonsteroidal anti-inflammatory drugs. Short-term, preservative-free, soft corticosteroids may be useful for patients with extensive or persistent inflammation

Comparing the vibrational behaviour of e-kick scooters and e-bikes: Evidence from Italy

E-kick scooters are currently among the most popular emerging electric-powered Personal micro–Mobility Vehicles (e-PMVs) and have recently been equated to e-bikes. However, even if the dynamic behaviour of e-bikes is well studied, much less has been done to understand the behaviour of e-kick scooters. Furthermore, comparisons between the two vehicles have rarely been investigated and only based on mechanical models. This study covers this gap by proposing a novel framework that evaluates the vibrational behaviours of both vehicles when driven by different users and exposed to the pavement irregularities, using both real and simulated data. The experimental data are collected equipping an e-kick scooter and an e-bike with Inertial Measurement Units, and then processed by ISO 2631–1 method to obtain an objective evaluation of the comfort. Next, the experimental data are expanded to include uncertainty applying a Monte Carlo Simulation based on a two-layer feed-forward Artificial Neural Network. Afterwards, several statistical analyses are performed to understand the key factors affecting the vibrational magnitude (and their extent) for each vehicle. This framework was tested in an Italian city (Brescia) along urban paths with five different pavement surfaces. The results showed that the e-kick scooter appears to be globally more solicited than the e-bike in terms of vibrational magnitude. Moreover, pavement surface, sensor position, user gender, user height, and travel speed are identified as crucial factors explaining the vibrational magnitude for both vehicles. The overall findings challenge the recent European regulations that equated e-kick scooters with bikes. These findings may help public administrations in planning the circulation of e-bikes and e-kick scooters in cities and recommend that manufacturers improve the e-kick scooter design by including shock absorbers to increase comfort

Measuring Safety Performance in the extra-urban Road Network of Lombardy Region (Italy)

Road Network Screening (RNS) is a process to evaluate the safety performance of the whole road network and identify worst performing roads. Currently, literature provides many models and methods for RNS. Moreover, several frameworks of RNS were issued at the European National Level over time. However, even if sophisticated models and methods could be preferable for their computational accuracy, they may be far from the capabilities of practitioners. In addition, other issues such as availability of operative attributes and data quality and processing persist. For instance, accurate crash location, which is crucial for detailed analyses of high crash rates at some locations, is still an issue: many road administrations pointed out that coordinates miss or are inaccurate in many cases. Within this context, this paper proposes a straightforward operational framework to evaluate safety performance for RNS, using a flexible rationale that integrates crash, traffic, and road data, respectively. More precisely, this framework: (a) handles crash location data without using spatial coordinates; (b) computes the crash rate index at different administrative levels; (c) shows results by Geographic Information System (GIS) maps. This framework is applied to the whole extra-urban road network of the Lombardy Region (Northern Italy) using 30.000+ crash data provided by the Regional Institute for Lombardy Policy Support (PoliS). Road authorities could adopt this framework to perform an accurate safety screening on the road network aimed at rational planning of safety interventions

Kinematic performance of micro-mobility vehicles during braking: experimental analysis and comparison between e-kick scooters and bikes

According to the Italian legislation, e-kick scooters and bikes are considered a single category of vehicles and can travel on the same infrastructures with the same rules; however, their kinematic behavior is very different. The adoption of a bike as a vehicle for covering short distances i.e., within 5 km is widely known both at the kinematic level and for its use by users. Conversely, e-kick scooters are "unknown" vehicles both for their kinematic characteristics and for their use by users. A handful of studies have shown how the behavior of e-kick scooters and bikes is very different; however, there are not many studies that analyze the different kinematic behavior of e-kick scooters and bikes. This study presents an experimental analysis that evaluates braking behavior by comparing e-kick scooters and traditional bikes according to several vehicle speeds. These analyzes help build a probabilistic mathematical model for estimating the stopping space of e-kick scooters and bikes. The availability of this model is crucial for the design of safe intersections between cycle paths and roads intended for motor vehicle traffic. Moreover, this model may reveal insights that could challenge the recent European regulations that equated e-kick scooters as bikes

A practical approach to the use of low molecular weight heparins in VTE treatment and prophylaxis in children and newborns.

Low-molecular weight heparins are currently the most commonly used anticoagulants in children and newborns. However, since thrombotic complications rarely occur outside large children’s hospitals, physicians often encounter some practical problems inmanaging these treatments when a pediatric thrombosis specialist is not available. The drug of choice is enoxaparin, due to its favorable FXa/FIIa ratio and the availability of pharmacokinetic and pharmacodynamic data. The treatment of acute thrombosis should be started with two daily injections but when compliance is an issue, a single daily administration schedule could be chosen for secondary prophylaxis ensuring careful measurement of the post 24-hour anti-FXa activity. Furthermore, a subcutaneous device may be a useful tool and a topical dermal anesthetic could be effective in controlling pain without affecting anti-FXa levels. In neonate and toddlers, where mini doses are frequently needed, the dead space of syringes and needles could represent an issue and therefore the use of insulin syringes without dead space is advisable,while a dilution of the drug is useful with other syringes. This article derives froma nonsystematic review of the available literature, with special attention to recent international guidelines and expert recommendations, combined to authors’ clinical practice in large tertiary pediatric hospitals and will provide concise and practical information for the use of low-molecular weight heparin in childhood and infancy in a sort of “answering frequently asked questions.

A comparative cycling path selection for sustainable tourism in Franciacorta. An integrated AHP-ELECTRE method

Cycle tourism is a form of sustainable itinerant tourism expanding in Italy and the rest of the world, with prospects for growth in coming years. Europe and North America have already developed a wide range of cycling infrastructures tied to tourism experiences. Benefits induced are generally recognised: first, it is a sustainable solution that increases local economics while conserving the environment; second, it guarantees advantages on social connections, amusement, and physical and mental health. However, it requires an adequate network to enjoy destinations as historical and landscape peculiarities. Currently, literature provides some methods for planning itineraries dedicated to cycle tourism. Despite that, there is less attention on how evaluating existing or already planned tourist itineraries. This study covers this gap, by applying an integrated method to assess bicycle connections for tourism experiences within municipalities. Since this evaluation may contain many conflicting criteria (e.g., preferences of public administrator, technical and economic viability) and possible alternatives, this study frames the method as a multi-criteria decision-making problem (MCDM). Specifically, at first, the Analytical Hierarchy Process (AHP) is adopted to calculate weights for each criterium; next, the ELimination Et Choix Traduisant la REalitè (ELECTRE) method is applied to provide a (possible) priority ranking of cycling tourist paths among alternatives, by computing indices of discordance and concordance between pairs of alternatives. The framework is applied to the Franciacorta area (North-East Italy), a national and international tourist relevance territory encompassing 22 municipalities. This study may be useful for public administrators to rationalise and prioritise cycling routes