Uncovering genetic and non-genetic biomarkers specific for exudative age-related macular degeneration : significant association of twelve variants

Age-related Macular Degeneration (AMD) represents one of the most sightthreatening diseases in developed countries that substantially impacts the patients' lifestyle by compromising everyday activities, such as reading and driving. In this context, understanding the prevalence, burden, and population-specific risk/ protective factors of AMD is essential for adequate health care planning and provision. Our work aimed to characterize exudative AMD in Italian population and to identify the susceptibility/protective factors (genetic variants, age, sex, smoking and dietary habits) which are specific for the onset of disease. Our study involved a cohort of 1976 subjects, including 976 patients affected with exudative AMD and 1000 control subjects. In particular, the sample cohort has been subjected to a large genotyping analysis of 20 genetic variants which are known to be associated with AMD among European and Asiatic populations. This analysis revealed that 8 genetic variants (CFH, ARMS2, IL-8, TIMP3, SLC16A8, RAD51B, VEGFA and COL8A1) were significantly associated with AMD susceptibility. Successively, we performed a multivariate analysis, considering both genetic and non-genetic data available for our sample cohort. The multivariate analysis showed that age, smoking, dietary habits and sex, together with the genetic variants, were significantly associated with AMD in our population. Altogether, these data represent a starting point for the set-up of adequate preventive and personalized strategies aimed to decrease the burden of disease and improve the patients' quality of life

THE IMPROVED DIASORIN Q-LAMP ASSAY FOR THE ACCURATE AND ULTRA-FAST DETECTION OF COMMON AND RARE ISOFORMS OF THE BCR-ABL1 TRANSLOCATION

The molecular detection of BCR-ABL1 transcripts by RT-PCR is mandatory for the diagnosis of Ph+ Leukemias at onset. Recently a faster and reliable assay based on the Q-LAMP technology developed by DiaSorin has entered in laboratory routine. This assay detects in one hour BCR-ABL1 p190 (e1a2) and p210 (e13a2, e14a2) isoforms. In this study, we evaluated the new improved Q-LAMP formulation designed to detect also less frequent isoforms of the BCR-ABL1 transcripts p190 and p210 (e1a3, e13a3, e14a3). In addition, clinical studies demonstrated that the assay is capable of detecting also the rare isoform p230 (e19a2, e19a3). Methods: The new Q-LAMP technology consists in a multiplex assay for the differential detection of p190 and p210 transcripts and the amplification of the GUSB endogenous RNA. The assay has been tested on 185 clinical samples including 95 p210 positive (57 e13a2 and 28 e14a2, 8 e13a3 and 2 e14a3), 38 p190 positive (33 e1a2 and 5 e1a3) and 50 BCR-ABL1 negative samples. Additional 2 p230 rare isoforms were also included in this study. All samples were previously tested by RT-PCR, considered as the reference method. Results: The new BCR-ABL Q-LAMP assay showed 100% concordance with the RT-PCR, with an expected delayed amplification time for rare isoforms respect to the common ones. The average amplification time of p210 common isoforms were 22,24 and 25,03 min compared to the p210 and p190 rare isoforms that showed 26,54 and 36,84 min, respectively. The 2 p230 (e19a2) rare isoforms were also tested and resulted valid although, due to the very long transcript, they showed a very high average amplification time (50 and 48 min). Moreover, we observed an interesting discrimination between the e13a2 and the e14a2 isoforms in terms of amplification times (20,21 versus 26,36 min) likely associated to the different length of the two transcripts, with low coefficients of variability (0,15 and 0,11 respectively). Conclusions: The enhanced BCR-ABL Q-LAMP assay well proved to detect both common and uncommon isoforms of the BCR-ABL1 translocation. This improved performances, combined with the speed and the close tube format, allow laboratories to optimize their workflow and represent a reliable solution for molecular diagnosis of Philadelphia Positive Leukemias

A process-based perspective of smart tourism destination governance

The tourism management literature has recently shown increasing interest in exploring the potential offered by the smart tourism destination initiative, conceived as the integrated use of ICT solutions for achieving greater efficiency and sustainability, enriching the tourist experience and boosting destination competitiveness. However, innovative technologies risk to be ineffective without adequate governance structures that are required to ensure the effective coordination and integration of tourism firms, government and communities in implementing a holistic smart-oriented development plan for destinations. This paper aims to integrate the recent smart approach with the destination governance theory to develop a governance process framework for smart tourism destinations. The framework explains how the smart approach can inform the planning and implementation of smart development goals, and specifically how smartness principles, tools and methods can be applied to increase the sustainable competitiveness of destinations beyond the mere technology dimension, making explicit the role of collaborative structures, user-driven services, social innovation and local community involvement. At the theoretical level, the paper offers an integrative perspective for designing and implementing effective smart tourism destination governance structures and processes. In practical terms, the framework can be viewed as a flexible tool in the hands of destination managers and policy makers: it shows how to match the design of governance structures and processes with the specific destination context and how to exploit “smart dimensions” for its development by relying on an incremental logic based on subsequent, interdependent stages

Post Covid-19: a pathway towards sustainable development in the Mediterranean region

The 21st century will be remembered as the century of the Covid-19 pandemic, a catastrophic event that has produced a devastating impact on the lives of all humanity. An unprecedented health emergency that hit hard all sectors of the global economy, having caused an exceptional shock on supply and demand, but also a profound situation of uncertainty that led to a reduction in consumption of goods and services (Gokhan et al., 2021; Boone et al., 2020; Gössling et al., 2020). The United Nations World Tourism Organization (2020) argues that “tourism is one of the most affected sectors”, being highly vulnerable to disturbances caused by natural events in terms of localized phenomena such as earthquakes, fires, volcanic explosions, tsunamis or floods, as well as global events such as disease pandemics (Ma et al., 2020; Butler, 2017; Laws, Prideaux & Chon, 2007; Ritchie, 2004, 2009). According to Rogerson and Baum (2020) the COVID-19 epidemic has generated profound changes in both the demand and supply of tourism sector. On the one hand, concerns about personal health and safety became accelerating factors in the tourists’ decision-making process . On the other hand, the blockage of flows, the closure of borders, travel and mobility restrictions, isolation of communities, and social distancing, has put the tourism industry in front of an unprecedented challenge in a very short time, requiring new business models (Fotiadis et al., 2021; Park et al., 2021; Bartik et al., 2020; Chia-Lin Chang et al. 2020; Cooper & Alderman, 2020; Hall et al., 2020; Jamal & Budke, 2020; Seraphin, 2020). At the same time, if the tourism crisis is a result of the pandemic, it is also true that the uncontrolled development of tourism is one of the cause of the Covid-19 disease (e.g., Sigala, 2020): it has contributed to increasing the level of global interconnections; it has generated pollution, and waste, acting negatively on climate change; it has contributed to sustain the values of capitalism in the decision-making process of people and companies, as well as in political formulations. In this context, the Mediterranean region is among the most affected by the crisis, especially the countries located on both sides, which represent almost 1/3 of the overall income of international tourism (UNWTO, 2021). In these areas, rethinking tourism represents a necessity for a sector of vital importance for local communities and small businesses. It is, therefore, essential to start a process of redefinition and planning of the future of tourism for the countries of the Mediterranean region, so as to secure and sustain their competitiveness in a global and uncertain scenario (Ateljevic, 2020; Baum & Hai, 2020; Bianchi, 2020; Everingham & Chassagne, 2020; Huijbens, 2020; Ioannides & Gyamóthi, 2020; Tremblay-Huet, 2020; Romagosa 2020; Tomassini & Carvagnaro 2020; Carr, 2020; Higgins-Desbiolles, 2020). However, in order to seize concretely the opportunities of this historical moment, it is mandatory to redesign the model of tourism development and prepare tourism recovery plans putting on the foreground the the transition towards more sustainable and resilient economies. Coherently to the UN Sustainable Development Goals and to the World Commission on Environment and Development, being sustainable focuses on “the ability to satisfy the needs of the present without compromising the ability of future generations to satisfy their own needs” ((1987, p.43). According to this approach, tourism should be critically reconsidered, re-focusing on the needs of all stakeholders. It should restart in compliance with the triple bottom line aimed at promoting a structural transformation of the sector and a more solid and sustainable development, reinvigorating trust, restoring the environment, and promoting institutional innovation (Brouder et al., 2020). On this point, two opposite approaches have been proposed in the scientific literature. Some authors (Gössling et al., 2020; Rogerson & Baum 2020) underline the expectations of companies to return "as normal" and to compensate for turnover losses through financial measures offered by various governments. Hall et al. (2020), for example, highlight the importance of the resilience of the tourism business and the political intervention that can support the recovery, without any commitment from stakeholders to sustainable climate change mitigation requirements. The resilience of tourism will depend on the level of consumer confidence, the government's economic interventions and restrictions on mobility, social distance and isolation requirements. On the contrary, some scholars explain how the pandemic has contributed to the growth of a “global consciousness” that is more in harmony with the United Nations Sustainable Development Goals (Galvani et al., 2020). To them, the crisis offers a “moment of transformation” and an opportunity to better address the objectives of inclusion, sustainability and responsibility. In this perspective, Ioannides & Gyamóthi (2020) see the crisis as a chance to escape the unsustainable trajectory of pre-COVID global tourism and offers the prospect of a community-centered framework as a potential mechanism for tourism growth (Higgins-Desbiolles, 2020). Embracing this perspective, major players in the hospitality sector have underlined their commitment to a global transition towards a more sustainable and resilient future (Sharma aet al., 2021; Ioannides & Gyimóthy, 2020). The future development of tourism should consider various environmental aspects such as pollution, the ecosystem and biodiversity, the use of natural resources, recreational activities and waste management; at the same time, it should aim at pursuing a social impact, i.e. maximizing the welfare and quality of life of citizens. Rogerson & Baum (2020) point out that a transformation of tourism in this direction implies a commitment of all actors to equity (Benjamin et al., 2020), a path towards transformative e-tourism (Gretzel et al., 2020), and the absorption of different cultural values able to guarantee development at community level (Carr, 2020). The pandemic and the need to redesign tourism have imposed a reset on the agendas of researchers and academics, so that they can generate new valuable knowledge for the tourism sector informing it about how to transform its activities and make appropriate use of available resources (Villac´e-Molinero et al., 2021). A portfolio of existing conceptual and theoretical frameworks can be a valuable resource to stimulate research and carry out new studies promoting new ideas, models, approaches and paradigms. In this respect, scholars and researchers have a great responsibility: to contribute to re-orienting tourism - both from the supply and demand perspectives - towards a truly sustainable and resilient profile, suitable for a turbulent, dynamic and challenging future (Gursoy & Chi 2020; Ramagosa 2020; Sigala, 2020). Starting from these assumptions, the aim of the first volume of the book series “Tourism Studies in the Mediterranean Region” is to offer new and critical perspectives on sustainable development in the Mediterranean countries and islands and provide ground evidence about how sustainable development research and practice can support the “new normal” of tourism and the structural transformation of the sector that is needed in light of the pandemic disease. The focus will be on the future shape of tourism after the COVID-19 and the evolutionary trajectories of this sector both at the level of business and at the level of destinations in its transition towards more resilient and sustainable tourism economies

Tourism Studies on the Mediterranean Region (Vol.3) "Evolving the perspectives on the value of gastronomy for Mediterranean destination development"

Gastronomy has always been closely linked with tourism. Travellers at first re-garded food on holiday as a necessity and a secondary element of regional cul-ture to enjoy during culinary experiences at restaurants (Hall and Mitchell, 2001; Quan and Wang, 2004). With the expansion of global travel, gastronomy became a significant asset to attract tourists to specific destinations and offer them en-gaging, novel and memorable experiences (Richards, 2021). Gastronomy tour-ism, therefore, gained increasing attention within the academia (Hjalager and Richards, 2002; Ellis et al., 2018) and among tourism suppliers, food producers and policymakers (OECD, 2012; UNWTO, 2012). The growing interest from trav-ellers – boosted since 2010 – led to an increasing sophistication of the gastro-nomic practice. New proposals and attractions appeared in the market, changing the way of experiencing local gastronomy, which was limited to purchasing food, tastings and visits to local producers (Garibaldi, 2017; Richards, 2021). Today, gastronomy tourism encompasses a variety of experiences that deal with pleas-ure (Therkelsen, 2015), socialisation (Fernandes, 2021), involvement (Garibaldi, 2021), and learning (Ignatov and Smith, 2006). They allow travellers to gain knowledge of the cultural, social, and economic practices related to the produc-tion and consumption of food and, definitively, to get a sense of the place and the society. We should consider gastronomy tourism a more varied and dynamic set of experiences based on the place's unique (food and non-food) aspects con-tinuously evolving through the interactions between the travellers and the local community. In the last three years, the tourist's consumption has changed. The COVID-19 pandemic, the changed geopolitical context, the inflationary pressure and the higher cost of living have led consumers to adapt their holiday plans and seek new travel options (Booking.com, 2022; American Express Travel, 2023; Ernst and Young, 2023). Gastronomic proposals are still among the preferred experi-ences while travelling. For example, enjoying natural/rural landscapes and gas-tronomic experiences are the two most preferred activities by European tourists for their holidays between June and November 2023 (European Travel Commis-sion, 2023). Given the current (and evolving) evolving scenario, where does the future of gas-tronomy tourism lie? By reviewing the academic literature and market studies (see Garibaldi, 2023a), we can identify four major driving forces that will shape the discourses of this practice