Linking identity and heritage with image and a reputation for competition

Our study investigates the role of identity and heritage of a place in creating competitiveness of the place and its retailers by utilizing its image and reputation to improve its attraction to tourists. We explored the perceptions of tourists to test a conceptual model which was developed using concepts available in current academic literature. Data were collected relating to a famous retail store in London which is a popular destination. Findings from a survey of 294 store tourists visiting the store suggest that place heritage is the key to driver of competitiveness of both the retailer and place, through their image and reputation. The study has important implications for the expansion of current literature, theory development and business practices. Limitations of the study are outlined and directions for future research are considered

The role of formyl peptide receptors in permanent and low-grade inflammation: Helicobacter pylori infection as a model

Formyl peptide receptors (FPRs) are cell surface pattern recognition receptors (PRRs), belonging to the chemoattractant G protein-coupled receptors (GPCRs) family. They play a key role in the innate immune system, regulating both the initiation and the resolution of the inflammatory response. FPRs were originally identified as receptors with high binding affinity for bacteria or mitochondria N-formylated peptides. However, they can also bind a variety of structurally different ligands. Among FPRs, formyl peptide receptor-like 1 (FPRL1) is the most versatile, recognizing N-formyl peptides, non-formylated peptides, and synthetic molecules. In addition, according to the ligand nature, FPRL1 can mediate either pro-or anti-inflammatory responses. Hp(2-20), a Helicobacter pylori-derived, non-formylated peptide, is a potent FPRL1 agonist, participating in Helicobacter pylori-induced gastric inflammation, thus contributing to the related site or not-site specific diseases. The aim of this review is to provide insights into the role of FPRs in H. pylori-associated chronic inflammation, which suggests this receptor as potential target to mitigate both microbial and sterile inflammatory diseases

The challenge of perioperative pain management in opioid-tolerant patients

The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal. Clinicians are encouraged to plan perioperative pain medications and to refer these patients to psychiatrists and addiction specialists for their evaluation. The aim of this review was to give practical suggestions for perioperative management of surgical opioid-tolerant patients, together with schemes of opioid conversion for chronic pain patients assuming oral or transdermal opioids, and patients under maintenance programs with methadone, buprenorphine, or naltrexone

New Biopsy Forceps for Gastrointestinal Endoscopy

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Consumer perceptions of Sustainable Development Goals: conceptualisation, measurement, and contingent effects

The COVID-19 pandemic has caused drastic disruptions to many multinational companies’ (MNCs’) supply chain management, pushing them to relocate their manufacturing activities to their home countries, a phenomenon known as reshoring. Grounded in moral psychology theory and the resource-based view, the aims of this research are to provide an extended conceptualisation of sustainable development goal (SDG) perceptions from local consumers, develop a scale, and assess this scale in relation to the reliability and validity of consumer perception of SDG antecedents and consequences in reshoring contexts from three industries, with the help of six studies. We conceptualise these perceptions on the basis of seven components (i.e. society/community wellbeing, affordable and clean energy consumption, economic growth, responsible consumption, responsible production, sustainable industrialisation and innovation, and gender equality). Using data from three distinct industries and a sample of 1075 reshoring MNC customers, we also determine how local consumers perceive and react to reshoring initiatives geared towards achieving SDGs and advocacy. The findings offer relevant implications for both the management and research of SDGs in a reshoring context at a scale level, which we describe in the form of future research directions

AB0844 HAND GRIP STRENGTH EVALUATION IN RHEUMATOLOGIC DISEASES

Background:Handgrip muscle strength test describes the strength of the hand muscles used to grasp or grip. Currently, hand grip evaluation is often used in clinical practice, as a marker of function and disability. In fact, it has already been applied as an outcome measure in arthritis rheumatoid clinical trials, to demonstrate the benefits of several treatments [1]. However, hand disability should also be considered in all other rheumatological diseases.Objectives:The main aim of this study is to assess the handgrip muscle strength test in a rheumatological cohort of patients as compared to a control group.Methods:This is a cross-sectional pilot study. We considered eligible 35 rheumatological consecutive female patients followed at our outpatients' clinic of Internal Medicine (I Policlinico of Naples) and 35 healthy control females (HC). Both groups included only right-handed individuals. Rheumatological patients were distributed as follows: 5 rheumatoid arthritis (14,3%), 9 psoriatic arthritis (25,7%), 4 systemic lupus erythematosus (11,4%), 10 systemic sclerosis (28,6%), 4 fibromyalgia (11,4%), 3 juvenile idiopathic arthritis (8,6%). The course of disease was under optimal treatment in all patients.The type of hand grip used is the power grip, in which an object is held firmly by wrapping the fingers around it, pressing the object against the palm, and using the thumb to apply counter-pressure. We considered as either right or left hand valid measure the mean of three consecutive tests per arm. Between-groups differences were tested both by a uni- and multivariable analysis.Results:The two subgroups were homogeneously distributed for age (median age 42 yrs. [IQR 33-48] vs. 36 yrs. [IQR 30-52] in HC; p=0.902). At univariate analysis, hand grip strength was significantly lower in the rheumatological patients, both at right hand (right 19.5 kg [IQR 13.6-24.8] vs. 24.5 kg [IQR 20.8-29] in HC; p=0.004) and left hand (18.5 kg [IQR 13.9-22.5] vs. 23.7 kg [IQR 19-27.3] in HC; p=0.002), as compared to HC. This finding was further confirmed at multivariable analysis only as for the left hand (OR 0.919, 95%CI: 0.858-0.984; p=0.016).Conclusion:Rheumatological diseases are burdened by hand disability, mostly affecting daily activities performance [2,3]. Beyond an optimal disease control, our pilot study shows a decrease in left hand strength as compared to healthy controls. This might be due to a reduced use of the non-dominant hand, which may lead over time to a higher deficit of strength. As such, these patients should be prescribed to a left hand exercise to improve both mobility and strength and, consequently, hand function.References:[1]Eberhardt K, Sandqvist G, Geborek P (2008) Hand function tests are important and sensitive tools for assessment of treatment response in patients with rheumatoid arthritis. Scand J Rheumatol 37(2):109–112.[2]Feced Olmos CM, Alvarez-Calderon O, Hervás Marín D, et al. Relationship between structural damage with loss of strength and functional disability in psoriatic arthritis patients. Clin Biomech (Bristol, Avon). 2019 Aug;68:169-174. doi: 10.1016/j.clinbiomech.2019.06.009.[3]Maddali-Bongi S, Del Rosso A, Mikhaylova S, et al. Impact of hand and face disabilities on global disability and quality of life in systemic sclerosis patients. Clin Exp Rheumatol. 2014 Nov-Dec;32(6 Suppl 86):S-15-20.Disclosure of Interests:None declare

Primary Absence of Type II Endoleak is A Positive Prognostic Factor against the Risk of Late Conversion of EVAR for AAA

Introduction: The aim of this study is to analyze 12 late conversion to open surgery after Endovascular Repair of Abdominal Aortic Aneurysms (EVAR) while comparing the follow up of these cases to that of the definitely successful procedures (absence of surgical conversion, type I or III endoleaks, or presence of type II endoleaks without any aneurysmal sac enlargement) . Methods: From a series of over 300 EVAR procedures performed at our department we have selected 215 cases with a follow up ≥ 6 month and primary technical success (successful deployment of the devices and discharge of patients without neither type I nor III endoleaks). Based on the final data recorded at the end of the follow up (mean+ IQR: 38.16 months + 41), these cases were divided into three groups: group 1, with 12 cases (5.6%) which needed surgical conversion in a later stage (5 to 55 months from EVAR); group 2, with 39 cases (18.1%) with type II endoleaks without aneurysmal sac enlargement; group 3, with 164 cases (76.5%) without endoleaks. The groups were compared in relation to the following parameters: a) personal data and common atherogenic risk factor, b) diameter of the aneurysm, c) kind of the proximal fixation of the endograft (suprarenal or infrarenal), d) presence of endoleaks at the first postoperative check. We have compared the data from the three groups and we have analyzed them with chi-square test (Χ2). Results: Personal data and common atherogenic risk factor have proved no significant difference among the three groups. The incidence of the other three parameters of group 1 was compared with the incidence of these in groups 2 and 3: the mean pre-operative diameter of the aneurysm results 51 mm in group 1, 54 mm in group 2 and 55 mm in group 3 (not significant); suprarenal fixation of the prosthesis accounts for 50% in group 1, 51% in group 2 and 60% in group 3 (not significant); presence of type II endoleak at the first post-operative check was 41.6% in group 1, 56.4% in group 2 (not significant) and 9.7% in group 3 (p<0.001, compared to groups 1 and 2). Conclusion: In the EVAR procedures with primary technical success, the absence of type II endoleak at the first post-operative check represents a favorable prognostic factor against the risk of late conversion to open repair. Personal data, common atherogenic risk factor, diameter of the aneurysm and fixing type of the prosthesis don’t seem to influence the onset of this complication

Night blindness in cystic fibrosis : the key role of vitamin A in the digestive system

Vitamin A is a fundamental micronutrient that regulates various cellular patterns. Vitamin A deficiency (VAT) is a worldwide problem and the primary cause of nocturnal blindness especially in low income countries. Cystic fibrosis (CF) is a known risk factor of VAD because of liposoluble vitamin malabsorption due to pancreatic insufficiency. We describe a case of a 9-year-old girl who experienced recurrent episodes of nocturnal blindness due to profound VAD. This little girl is paradigmatic for the explanation of the key role of the gut\u2013liver axis in vitamin A metabolism. She presents with meconium ileus at birth, requiring intestinal resection that led to a transient intestinal failure with parenteral nutrition need. In addition, she suffered from cholestatic liver disease due to CF and intestinal failure-associated liver disease. The interaction of pancreatic function, intestinal absorption and liver storage is fundamental for the correct metabolism of vitamin A

Lahar risk assessment from source identification to potential impact analysis: the case of Vulcano Island, Italy

Lahars are rapid flows composed of water and volcaniclastic sediments, which have the potential to impact residential buildings and critical infrastructure as well as to disrupt critical services, especially in the absence of hazard-based land-use planning. Their destructive power is mostly associated with their velocity (related to internal flow properties and topographic interactions) and to their ability to bury buildings and structures (due to deposit thickness). The distance reached by lahars depends on their volume, on sediments/water ratio, as well as on the geometrical properties of the topography where they propagate. Here we present the assessment of risk associated with lahar using Vulcano island (Italy) as a case study. First, we estimated an initial lahar source volume considering the remobilisation by intense rain events of the tephra fallout on the slopes of the La Fossa cone (the active system on the island), where the tephra fallout is associated with the most likely scenario (e.g. long-lasting Vulcanian cycle). Second, we modelled and identified the potential syn-eruptive lahar impact areas on the northern sector of Vulcano, where residential and touristic facilities are located. We tested a range of parameters (e.g., entrainment capability, consolidation of tephra fallout deposit, friction angle) that can influence lahar propagation output both in terms of intensity of the event and extent of the inundation area. Finally, exposure and vulnerability surveys were carried out in order to compile exposure and risk maps for lahar-flow front velocity (semi-quantitative indicator-based risk assessment) and final lahar-deposit thickness (qualitative exposure-based risk assessment). Main outcomes show that the syn-eruptive lahar scenario with medium entrainment capability produces the highest impact associated with building burial by the final lahar deposit. Nonetheless, the syn-eruptive lahar scenario with low entrainment capacity is associated with higher runout and results in the highest impact associated with lahar-flow velocities. Based on our simulations, two critical infrastructures (telecommunication and power plant), as well as the main road crossing the island are exposed to potential lahar impacts (either due to lahar-flow velocity or lahar-deposit thickness or both). These results show that a risk-based spatial planning of the island could represent a valuable strategy to reduce the volcanic risk in the long term