Tourette syndrome and nutritional implications

Gilles de la Tourette syndrome (GTS) is a neurodevelopmental disorder defined by multiple motor tics and at least one sound tic. Various behavioural symptoms are associated with GTS, especially obsession and compulsion behaviours (OCBs), attention-deficit/hyperactivity disorder (ADHD) and poor impulse control. These comorbid conditions have a high impact on patients quality of life, including eating attitudes and body image perception. Nutritional implications, together with sleepiness and sexual asthenia, are the principal side effects of the pharmacological therapy. Actually, drugs may compromise the nutritional status of patients producing appetite increase, dry mouth, constipation, glucose and lipid metabolism abnormalities, metabolic syndrome, mild transient dysphagia and nausea. About 40% of GTS patients experience hyperphagia because of drug side effects, OCBs, ADHD, or poor impulse control. Consequently, in these cases an overweight status can occur, complicating the management of the symptoms. Therefore, an increase body weight should be considered one of the most relevant factors increasing GTS drug-related bad compliance, which may consequently cause in some patients the discontinuation/interruption of the pharmacological therapy

An extended hybrid magnetohydrodynamics gyrokinetic model for numerical simulation of shear Alfv\'en waves in burning plasmas

Adopting the theoretical framework for the generalized fishbonelike dispersion relation, an extended hybrid magnetohydrodynamics gyrokinetic simulation model has been derived analytically by taking into account both thermal ion compressibility and diamagnetic effects in addition to energetic particle kinetic behaviors. The extended model has been used for implementing an eXtended version of Hybrid Magnetohydrodynamics Gyrokinetic Code (XHMGC) to study thermal ion kinetic effects on Alfv\'enic modes driven by energetic particles, such as kinetic beta induced Alfv\'en eigenmodes in tokamak fusion plasmas

Misfat al-‘Abriyin, Oman. Designing for Sustainable Heritage Tourism Development: Master Plan and Implementation

This heritage management and tourism development project at Misfat Al-‘Abriyin, a partially inhabited mountain oasis southwest of Muscat, is the first realised in Oman based on a cohesive regional strategy and settlement masterplan. In 2014 the ArCHIAM Research Centre was commissioned by Oman’s Ministry of Tourism to produce a Heritage and Tourism Development Plan for this settlement. An interdisciplinary team elaborated a detailed strategy and masterplan for the preservation and development of the oasis. Phase-1 of the masterplan implementation, funded by Bank Muscat, incorporated ideas from community workshops on the restoration, rebuilding and adaptive reuse of an information point/shop, bakery, restaurant, civic space and residents’ parking. The key questions explored, through design, how: • tourism-led heritage management of Omani mountain oases should be approached; • social history, cultural understandings and community input can inform and shape master-planning and design; • sustainable development can drive urban and architectural heritage rehabilitation; • contemporary design aspirations and use can be integrated with conservation demands. Extensive fieldwork resulted in detailed urban/architectural survey and ethnographic documentation. Ethnographic study of the ancient water infrastructure, cultural and social practices, privacy and expatriate labour occupancy, along with tribal social history and morphological studies shaped the masterplan as well as the Phase-1 components. A regional study of natural, archaeological and urban heritage sites proposed a networked strategy for tourism. Traffic volume and tourism economics analysis led to a tourist ‘gateway site’ downhill. A review of technologies for renewable energy production suggested to take Misfat entirely off-grid. The architectural designs have demonstrated how contemporary programme, material and architectonic aspirations can be brought into dialogue with the restored ‘old’. In November 2020 the project was inaugurated jointly by Ministry of Heritage and Tourism and Bank Muscat. It has been globally disseminated through public lectures and talks, and widely covered by the press and social media

Nonlinear dynamics of beta induced Alfv\'en eigenmode driven by energetic particles

Nonlinear saturation of beta induced Alfv\'en eigenmode, driven by slowing down energetic particles via transit resonance, is investigated by the nonlinear hybrid magnetohyrodynamic gyro-kinetic code (XHMGC). Saturation is characterized by frequency chirping and symmetry breaking between co- and counter-passing particles, which can be understood as the the evidence of resonance-detuning. The scaling of the saturation amplitude with the growth rate is also demonstrated to be consistent with radial resonance detuning due to the radial non-uniformity and mode structure

Marketing a tourism industry in late stage decline: The case of the Isle of Man

Qualitative interviews in the Isle of Man uncovered local perceptions of a tourism industry in late stage decline. Social impacts of decline are pronounced including facilities loss, cultural changes and a heightening of perceived peripherality: which taken together undermine local identity. Tourists are welcomed as they help to affirm the pride residents have in their island in creating a more active atmosphere, provide social interaction opportunities and to combat negative stereotyping. Thus findings emphasise the diverse, unique and persistent benefits of tourism in the Isle of Man, despite its decline. Destination marketing recommendations are therefore made to better address the experiences and desires of communities experiencing decline

Correction of hypovitaminosis D improved global longitudinal strain earlier than left ventricular ejection fraction in cardiovascular older adults after orthopaedic surgery

Background Cardiovascular diseases and insufficient levels of vitamin D are risk factors for adverse surgical outcomes, and they are both commonly present among older adults undergoing orthopaedic surgery. Giving the cardiovascular effects of vitamin D, pre-operative diagnosis of hypovitaminosis D would be a valuable step for the implementation of supplementation protocols. We investigated if the normalization of serum 25 [OH] D could ameliorate cardiac performance of older adults suffering from cardiovascular diseases. Methods We enrolled 47 older adults scheduled for major orthopaedic surgery and suffering from hypovitaminosis D. Patients underwent 6-months calcifediol supplementation with a starting dose at first post-operative day of 50 \u3bcg/die in liquid preparation. Down-Titration to 20 \u3bcg/die at 3-months assessment was planned. Cardiac performance was evaluated by measuring left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) during pre-operative assessments and at 1-month, 3-months, 6-months follow-ups. Results Six months of calcifediol supplementation were associated with a significant improvement of both LVEF (+ 3.94%; 95% CI: -4.0789 to -0.8232; P < 0.01) and GLS (+ 18.56%; Z = -5.895; P < 0.0001). Conclusions Calcifediol supplementation normalized serum 25 [OH] D concentration after 1-month treatment. GLS offered better insights into myocardial contractile amelioration than LVEF, thus being useful for detecting earlier subclinical changes that may anticipate hemodynamic modifications