Degradation risk assessment: understanding the impacts of climate change on geoheritage

Several factors and processes, both natural and anthropogenic, can threaten the integrity of any geosite, leading to their degradation. For this reason, geoheritage degradation risks should be considered a fundamental step in any geoconservation strategy, all the more when the aim is to tackle the effects of climate change. The present work proposes a quantitative methodology for the degradation risk assessment of geosites by considering the extrinsic factors that can damage the geoheritage. The methodology has been tested on the Maltese Islands, where considerable previous research has been undertaken in order to highlight the international significance of the Maltese landscapes. Three criteria to assess the degradation risk are proposed: natural vulnerability, anthropogenic vulnerability and public use. For each criterion, several parameters have been identified in order to propose a detailed numerical evaluation. The results show that the degradation risk of geosites is mainly related to negligence and lack of knowledge of its inherent geological heritage, and which leads to public misuse and mismanagement of the geosites. The results give an overview of the condition of the geosites and provide information for the design and management of suitable protection measures, especially in the light of future threats related to climate change.Project “Training new generations on geomorphology, geohazards and geoheritage through Virtual Reality Technologies” (GeoVT), funded by the Erasmus+ Programme, KA220 (Agreement number: 2021-1-SE01-KA220-HED-000032142). The research has also benefitted from the FAR2021 Project of the University of Modena and Reggio Emilia (Project responsible: Paola Coratza

Geoheritage as a tool for environmental management : a case study in Northern Malta (Central Mediterranean Sea)

The recognition, selection and quantitative assessment of sites of geological and geomorphological interest are fundamental steps in any environmental management focused on geoconservation and geotourism promotion. The island of Malta, in the central Mediterranean Sea, despite having a steadily increasing growth in population and tourism, still conserves geological and geomorphological features of great relevance and interest, both for their contribution to the understanding of the geological processes acting through time on landscape and for their aesthetic importance. The present work proposes an inventory for northern Malta, through three main stages, with the outcome of a final list of geosites that have the potential to be recognized as both natural heritage and tourist resources with potential economic benefits. In particular, the assessment methodology applied combines scientific value and additional and use-values, showing the links existing between geoheritage and other aspects of nature and culture of the sites. The results provide useful knowledge for the definition of strategies aimed at the development of a sustainable and responsible tourism.peer-reviewe

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Indagini ambientali volte all’individuazione di siti e forme del paesaggio potenzialmente identificabili come Geoparchi Mondiali UNESCO

Il tema del patrimonio geologico ha riscosso un gran interesse nel mondo scientifico nell’arco degli ultimi trent’anni, portando ad una serie di ricerche ed iniziative in tutto il mondo. Nonostante il crescente interesse, soltanto poche nazioni presentano un inventario del patrimonio geologico nazionale e la conoscenza del patrimonio geologico è generalmente frammentata ed incompleta, mostrando la necessità di strategie di geoconservazione. Un ruolo importante in questo campo è giocato dalla rete di Geoparchi Mondiali UNESCO, definiti come singole aree geografiche i cui siti e paesaggi di valore geologico internazionale vengono gestiti secondo un concetto olistico di protezione, educazione, sviluppo sostenibile. La presente ricerca di dottorato ha previsto l’individuazione e la valutazione di siti di interesse geologico e geomorfologico - geositi - attraverso quattro passaggi principali, con il risultato di una lista finale di geositi, nell’ambito dell’interesse espresso dal Ministero dell’Ambiente maltese. La metodologia di valutazione applicata combina patrimonio geologico con patrimonio culturale, il quale è in parte determinato dal contesto geomorfologico nel quale è inserito. La valutazione di caratteristiche geologiche è essenzialmente basata sul valore scientifico e dalla valutazione di valori addizionali che valorizzano la connessione tra patrimonio geologico e patrimonio culturale e naturalistico, come richiesto dalle direttive UNESCO per l’applicazione come Geoparco UNESCO. In aggiunta, questa tesi presenta una nuova metodologia quantitativa che permette di valutare il rischio di degrado connesso ai geositi, il quale è fondamentale per individuare le principali minacce alla loro integrità e per effettuare un corretto piano di monitoraggio e gestione. La metodologia è basata su tre criteri principali (i) vulnerabilità naturale, (ii) vulnerabilità antropica e (iii) uso pubblico. Questo approccio è importante per considerare gli effetti del cambiamento climatico che sono già in atto e il loro futuro impatto sui geositi. L’individuazione e valutazione di geositi e l’applicazione della nuova metodologia sul rischio di degrado sono state effettuate sull’arcipelago di Malta, situato nel cuore del Mediterraneo. Le Isole Maltesi, nonostante i crescenti livelli di popolazione e turismo, conservano paesaggi e siti di interesse geologico, spesso accompagnati da un elevato valore estetico. Scogliere, baie, spiagge sabbiose, sinkholes, grotte marine e terrestri sono alcuni degli eccezionali elementi geologici che concorrono alla creazione di paesaggi spettacolari che attirano un elevato numero di visitatori. Questi siti sono per lo più situati sulla costa dove il turismo è la principale attività economica. L’attività umana e i processi naturali possono causare impatti negativi che possono interessare direttamente i geositi e le aree circostanti. Malta è stata considerata come la perfetta area di studio poiché, nonostante la presenza di un ricco patrimonio geologico, manca di un inventario nazionale di geositi e per l’interesse mostrato dalla Commissione Nazionale UNESCO. Questa ricerca fornisce approfondimenti per la definizione di strategie mirate alla conservazione del patrimonio geologico e ad un turismo sostenibile e responsabile, che valorizzi anche il fiorente patrimonio geologico. Un turismo più attento e controllato, che sensibilizzi anche gli abitanti dell’isola al tema della sostenibilità, è di estrema importanza per il fatto che le Isole Maltesi presentano la maggior densità di popolazione di tutta Europa ed un considerevole flusso turistico che porta a un’elevata pressione antropica. Per concludere, la ricerca ha contribuito alla gestione dell’area di studio, anche in vista della sua candidatura come Geoparco Mondiale UNESCO.During the last 30 years there has been a growing scientific interest in topics related to geoheritage and a large set of related initiatives have emerged all around the world. Despite the increasing attention, only few countries have a national geoheritage inventory and the present knowledge about geological heritage is generally dispersed and incomplete justifying the establishment of a geoconservation strategy. An important role on this field is played by the UNESCO Global Geoparks, identified as single areas that comprise sites with international geological significance managed with a holistic concept of protection, education and sustainable development. This PhD research has foreseen the recognition and assessment of sites of geological and geomorphological interest, geosites, through four main stages, with the outcome of a final list of geosites, in the frame of the expression of interest made by the Ministry of Environment of Malta. The assessment methodology applied combines geological heritage with landscape cultural components that are partly determined by the geomorphological context in which they are inserted. The evaluation of geological features is essentially based on the scientific value considering different criteria, but additional values are also considered such as the links between geological heritage and all other aspects of the area's natural, cultural and intangible heritages, as required by the UNESCO guidelines to the application as UNESCO Geopark. Furthermore, this thesis presents an innovative quantitative methodology to assess the risk of degradation of geosites, fundamental to understand the threats affecting them and to schedule a correct monitoring and management plan to conserve the geoheritage relevance. The methodology is based on three main criteria (i) natural vulnerability, (ii) anthropic vulnerability and (iii) public use. The risk-based approach proposed is also important to tackle the effects of climate change already in act and to assess their future impact on the geosites. The recognition and assessment of geosites and the application of the new degradation risk methodology have been conducted on the Maltese Islands, located in the centre of the Mediterranean Sea. The archipelago, despite having a steadily increasing growth in population and tourism, still conserves geological and geomorphological features of great relevance and interest both for their contribution to the understanding of the geological processes acting through time on landscapes and for their aesthetic importance. Coastal cliffs, bays, sandy beaches, sinkholes, caves are some of the most outstanding geological and geomorphological features of the Maltese Islands, creating an outstanding landscape which is an attraction for a number of visitors. These are mostly concentrated in coastal areas, where the main economic activity is tourism. Human activities and natural processes may cause negative impacts that act directly on specific sites of particular value or large areas of the territory. Malta was considered the most suitable location to conduct the research due to the fact that, despite the rich geological heritage, lacks a complete national inventory of geosites and in relation to interest shown also by the UNESCO National Commission. This research provides insights for the definition of strategies aimed at the conservation of geoheritage elements and the development of a sustainable and responsible tourism, which also enhances the rich geological heritage of these areas, by encouraging the knowledge and understanding the landscape and its evolution. Such measures are of current relevance, due to the fact that the Maltese Islands have the highest population density in Europe and annually receive a considerable tourist influx, which result in a high degree of human pressure. In addition, the research has contributed to the management of the studied area, also in the view of a UNESCO Geopark nomination

Emancipatory Social Science Today. Le questioni, il dibattito, le pratiche

Focalizzandosi sui nessi tra riflessioni teoriche ed esperienze di ricerca empirica di tipo espressamente partecipativo, collaborativo, collettivo, il volume intende offrire una visione d’insieme sullo stato della ricerca nell’ambito della Emancipatory Social Science, Riflettendo la varietà di prospettive, approcci e strumenti utilizzati. I contributi qui raccolti attraversano percorsi di ricerca eterogenei – dal carcere ai movimenti sociali antirazzisti, dal mondo della precarietà all’interno dell’accademia alle migrazioni postcoloniali – che condividono una scelta metodologica precisa: la ricerca scientifica come pratica collettiva ed emancipatoria

Glucocorticoids prescribing practices in systemic sclerosis: an analysis of the EUSTAR database

To estimate the long-term exposure to glucocorticoids (GC), the factors associated with, and the variations in prescribing practices over time and across recruiting countries

Smoking in Systemic Sclerosis: a Longitudinal European Scleroderma Trials and Research Group Study

Objective: Data on the role of tobacco exposure in systemic sclerosis (SSc; scleroderma) severity and progression are scarce. We aimed to assess the effects of smoking on the evolution of pulmonary and skin manifestations, based on the European Scleroderma Trials and Research group database. Methods: Adult SSc patients with data on smoking history and a 12\u201324-month follow-up visit were included. Associations of severity and progression of organ involvement with smoking history and the Comprehensive Smoking Index were assessed using multivariable regression analyses. Results: A total of 3,319 patients were included (mean age 57 years, 85% female); 66% were never smokers, 23% were ex-smokers, and 11% were current smokers. Current smokers had a lower percentage of antitopoisomerase autoantibodies than previous or never smokers (31% versus 40% and 45%, respectively). Never smokers had a higher baseline forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) ratio than previous and current smokers (P < 0.001). The FEV1/FVC ratio declined faster in current smokers than in never smokers (P = 0.05) or ex-smokers (P = 0.01). The baseline modified Rodnan skin thickness score (MRSS) and the MRSS decline were comparable across smoking groups. Although heavy smoking (>25 pack-years) increased the odds of digital ulcers by almost 50%, there was no robust adverse association of smoking with digital ulcer development. Conclusion: The known adverse effect of smoking on bronchial airways and alveoli is also observed in SSc patients; however, robust adverse effects of smoking on the progression of SSc-specific pulmonary or cutaneous manifestations were not observed. \ua9 2018, American College of Rheumatolog