Sustainable cycle-tourism for society: Integrating multi-criteria decision-making and land use approaches for route selection

Cycle tourism is a sustainable active vacation, which is quickly growing in recent years. Although it has several benefits for society and users (e.g., social connections, amusement, and physical and mental health), cycle tourism requires an adequate route network to enjoy destinations with historical and landscape peculiarities. Past literature mainly investigated motivations and preferences for cycle tourists and proposed optimisation methods in planning routes. However, applying assessment methods for prioritising cycle-tourist routes is a seldom-explored topic. This study aims to address this gap by applying an integrated method for evaluating and prioritising cycle routes, searching for a compromise between route characteristics, service provided to users, and natural and building contexts crossed. It jointly includes Multi-Criteria Decision Methods (MCDMs) and a land use approach: AHP determines the weights of criteria and parameters describing cycle routes; GIS elaborates spatial analysis of parameters; ELECTRE I and VIKOR help find a compromise solution amongst different cycle routes. The integrated method involved a panel of experts to collect data, and it is applied to the wide-study area of Franciacorta (Italy). Some comparisons with other MCDMs are made to justify the results. The findings could support multi-institutions prioritising cycle route alternatives in deciding their building

Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis

Aim: This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention). Materials and Methods: A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome. Results: Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03–0.96; I2: 0%), and lower marginal bone level (MBL) changes (OR = –0.36 mm; 95% CI: −0.65 to −0.07; I2: 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24–0.75; I2: 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50–9.45; I2: 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = –1.18; 95% CI: −1.85 to −0.51; I2: 69%) and lower MBL changes (MD = –0.25; 95% CI: −0.45 to −0.05; I2: 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive. Conclusions: Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs

Influence of Culture Conditions on In Vitro Asymbiotic Germination of Anacamptis longicornu and Ophrys panormitana (Orchidaceae)

This study is the first approach to in vitro asymbiotic germination of two species of Sicilian threatened terrestrial orchids, Anacamptis longicornu and Ophrys panormitana. Seeds were collected in the wild and cultured in two different media—Orchimax medium (OM) and Murashige and Skoog (MS)—and exposed to different photoperiods and temperatures to evaluate the best conditions for the specific stages of development. The germination of A. longicornu was very high on OM (95.5%) and lower on MS medium (21.4%), whereas O. panormitana germinated only on OM medium, with significantly lower percentages (12.0%), compared with A. longicornu. This difference is caused by variation in quality and quantity of nutrients used, primarily by nitrogen source. The results show that temperature and photoperiod widely affect seed germination and development. Although further investigations on asymbiotic and symbiotic germination are needed for the improvement of conservation of Mediterranean terrestrial orchids, our results contribute to the conservation of this group of plants

Antimicrobial Challenge in Acute Care Surgery

The burden of infections in acute care surgery (ACS) is huge. Surgical emergencies alone account for three million admissions per year in the United States (US) with estimated financial costs of USD 28 billion per year. Acute care facilities and ACS patients represent boost sanctuaries for the emergence, development and transmission of infections and multi-resistant organisms. According to the World Health Organization, healthcare-associated infections affected around 4 million cases in Europe and 1.7 million in the US alone in 2011 with 39,000 and 99,000 directly attributable deaths, respectively. In this scenario, antimicrobial resistance arose as a public-health emergency that worsens patients’ morbidity and mortality and increases healthcare costs. The optimal patient care requires the application of comprehensive evidence-based policies and strategies aiming at minimizing the impact of healthcare associated infections and antimicrobial resistance, while optimizing the treatment of intra-abdominal infections. The present review provides a snapshot of two hot topics, such as antimicrobial resistance and systemic inflammatory response, and three milestones of infection management, such as source control, infection prevention, and control and antimicrobial stewardship

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

Avaliação da toxicidade da sulfametazina em organismos aquáticos.

Resumo: Dentre os fármacos, o grupo dos antibióticos, entre eles as sulfonamidas, é considerado um dos mais importantes. Estes compostos são extensivamente utilizados na medicina humana, veterinária e na aquicultura, com o propósito de prevenir ou tratar infecções microbianas. Essas substâncias podem acumular-se no solo, sofrer lixiviação ou, ainda, ser transportada via escoamento superficial para os corpos hídricos. A fim de alcançar um maior entendimento sobre os efeitos das sulfonamidas, avaliou-se a toxicidade aguda da sulfametazina utilizando-se duas espécies de invertebrados aquáticos (Daphnia similis e Artemia salina) e o peixe (Piaractus mesopotamicus). Foram determinados os valores de concentração efetiva media (CE50-48h), relacionada à imobilidade dos microcrustáceos equivalente a 77,5-48h e >1000 mg L-¹ para D. similis e A. salina, respectivamente. Para o peixe P. mesopotamicus, não houve efeito letal. Considerando-se que estes compostos são administrados em doses elevadas, a avaliação do seu impacto em toda biota aquática parece aconselhável. Os valores, portanto auxiliam para o estabelecimento de concentrações máximas permissíveis de sulfametazina nos corpos de água. Abstract: Among the drugs, the group of antibiotics, including sulfonamides, is considered one of the most important. These compounds are extensively used in human, veterinary medicine and aquaculture, with the purpose of preventing or treating microbial infections. These substances can build up in the soil, leachate or even be transported via superficial runoff to water bodies. In order to achieve a better understanding of the effects of sulfonamides, the acute toxicity of sulfamethazine was evolved using two species of aquatic invertebrates (Daphnia similis and artemia salina) and fish (Piaractus mesopotamicus). Determined the average effective concentration values were (EC50-48h), related to immobility of microcrustaceans equivalent to 77.5-48h and>1000 mg L -1 for D. similis and A. salina, respectively. For the fish P. mesopotamicus not lethal effect was found. Considering that these compounds are administered in high doses, to assess their impact on aquatic biota all seems advisable. values thus help to establish allowable maximum concentrations of sulfamethazine in water bodies

Evaluating alternative fuels for a bus fleet: An Italian case

A current topic that has surfaced among Public Transport Companies (PTCs) is the selection of alternative fuels for their bus fleets. Both European and Italian regulations are pushing toward abandoning diesel fuel and the consolidation of alternative traction power sources, such as battery-electric vehicles, fuel-cell electric vehicles, and hydrogen-electric vehicles. The literature has provided some approaches toward assessing this selection such as multicriteria-decision-methods in some countries in the world. However, not enough specific attention has been paid to cost criteria, experts involved, and the type of service required. This paper intends to address these gaps by applying an integrated method, which includes: (i) the Analytical Hierarchy Process (AHP) to define the weights of criteria; (ii) the ELimination Et Choix Traduisant la REalitè I (ELECTRE I) to find a good compromise solution among the fuel alternatives and (iii) a simple Weighted Sum Model (WSM) to refine ranking. This integrated method was applied in Italy involving a panel of experts from whom the data was collected. Different fuel alternatives for both urban and interurban services and with and without funding are discussed. The results provide a useful tool supporting PTC policies, which aims to rationalise and prioritise bus fuel alternatives when deciding on fleet renewal

Association entre la dégénérescence maculaire liée à l’âge et les parodontites

Purpose: To evaluate the association between age-related macular degeneration (AMD) and periodontal disease, two frequent conditions in the elderly, with some risk factors in common. Methods: Single center, pilot, case-control study performed in a center specialized in the diagnosis and management of AMD. Periodontal status was evaluated in 43 AMD patients and 19 controls. Fundus examination and a complete periodontal examination were performed in all subjects. Results: AMD patients have a greater percentage of 3–4 mm clinical attachment loss compared to controls (47% vs. 38%, [P = 0.039]). However, no significant difference was found between the groups with regard to the prevalence of severe periodontitis. Conclusions: These results suggest an association between AMD and attachment loss characteristic of periodontal disease and support the need for larger prospective studies to elucidate the relationships between these 2 highly prevalent and potentially severe diseases

Periodontitis assessed with a new screening tool and oral health-related quality of life: cross-sectional findings among general-population adults

Introduction: Periodontitis, as a chronic, multifactorial inflammatory disease, has complex relationships with other diseases and ultimately with well-being. The aim of this cross-sectional study was to investigate the association between self-report periodontitis, as measured with the recently developed and validated modified Periodontal Screening Score (mPESS), and oral health-related quality of life (OHRQol) in a large population-based sample derived from the French NutriNet-Santé e-cohort. Methods: The sample was composed of 32,714 adults (75.5% women) with a mean age of 48.8 ± 13.9 years. Periodontitis was assessed based on age, smoking, and oral health status data obtained in 2011–2012, which allowed calculating the mPESS. An mPESS ≥ 5 was used to identify individuals at risk of severe periodontitis (main exposure). OHRQoL was measured with the Oral Health Impact Profile (OHIP-14) (main outcome) and the total score was dichotomized for analysis. Multivariable logistic regression analyses, considering physical health status, dietary and lifestyle confounding variables, were performed. Results: Overall, 6407 participants (19.6%) were at a high risk of severe periodontitis. A total of 7383 participants (22.6%) presented a relatively poor OHRQoL (OHIP-14 > 8, highest quartile). In the multivariable model, each of the following variables was independently and significantly associated with lower OHRQoL: older age (50–64 years), female sex, obesity, snacking between meals, frequent consumption of soft drinks and sweets/chocolate, risk of severe periodontitis, and having < 20 natural teeth were significantly. An mPESS ≥ 5 showed the highest odds for relatively poor OHRQoL (OR = 3.45; 95% CI 3.21–3.72). Conclusion: The results support the association between periodontitis and OHRQoL in non-clinical samples. The use of mPESS could be tested in future prevention programs aiming at improving OHRQoL

Effectiveness of implant-supported fixed partial denture in patients with history of periodontitis: A systematic review and meta-analysis

Aim: This systematic review investigates the effectiveness of implant-supported fixed partial denture (IS-FPD) in patients with history of periodontitis (HP) vs. patients with no history of periodontitis (NHP). Methods: A literature search was performed on different databases on May 2020. Prospective and retrospective studies assessing survival (primary outcome), success and biological/mechanical complications of IS-FPDs in HP vs. NHP patients at ≥1 year after implant loading were evaluated. Meta-analyses were conducted by estimating hazard ratio (HR), risk ratio (RR) and standardized mean differences (SMD) with 95% confidence intervals (CI) using random effect models. Results: Of the initially identified 4096 articles, 349 underwent a full-text evaluation. Finally, 17 were included. Pooled data analyses showed that overall implant survival was significantly higher in the NHP than the HP group (HR = 2.06; 95% CI = 1.37–3.09; I2 = 0%). This difference was noted when follow-up ≥5 years. The risk of peri-implantitis was higher in HP than NHP patients (RR = 3.3; 95% CI = 1.31–8.3; I2 = 0%), whereas the mean marginal bone level change over time was not different between the groups (SMD = −0.16 mm; 95% CI = −1.04–0.73; I2 = 98%). Conclusions: In partially edentulous patients receiving IS-FPDs, a history of periodontitis is associated with poorer survival rate and higher risk of peri-implantitis during a 5–10 years period after implant loading