Modeling tourism flows through gravity models: A quantile regression approach

Gravity models are widely used to study tourism flows. The peculiarities of the segmented international demand for agritourism in Italy is examined by means of novel approach: a panel data quantile regression. We characterize the international demand for Italian agritourism with a large dataset, by considering data of thirty-three countries of origin, from 1998 to 2010. Distance and income are major determinants, but we also found that mutual agreements and high urbanization rates in countries of origin are associated with larger flows of incoming tourists

Modeling tourism flows through gravity models: A quantile regression approach

Gravity models are widely used to study tourism flows. The peculiarities of the segmented international demand for agritourism in Italy is examined by means of novel approach: a panel data quantile regression. We characterize the international demand for Italian agritourism with a large dataset, by considering data of thirty-three countries of origin, from 1998 to 2010. Distance and income are major determinants, but we also found that mutual agreements and high urbanization rates in countries of origin are associated with larger flows of incoming tourists

Physiological quality of citrandarins, Poncirus trifoliata and Sunki mandarin seeds

Rangpur lime is the rootstock most used in Brazil, mainly due to its resistance to drought; however, it is susceptible to several diseases, requiring the search for other rootstocks tolerant to factors limiting citrus cultivation. In addition, the Brazilian legislation stipulates that citrus seeds can only be commercialized with at least 50% germination rate. Thus, the aim of this work was to evaluate the physiological quality of seeds of seven citrus rootstocks. The following citrus fruits were harvested: Poncirus trifoliata, Sunki mandarin and their hybrids –citrandarins (70, 106, 254, 299 and 310). Fruit mass, diameter and height were measured. Seeds were extracted from fruits, counting the number of normal seeds (not aborted). Seeds were dried up to 20% water content and stored for 3, 6, 9 and 12 months. The physiological quality of seeds was evaluated before storage (time 0) up to 12 months of storage. The quality of Poncirus trifoliata, Sunki mandarin and citrandarins 70, 106, 254, 299 and 310 seeds was reduced during storage. However, their germination rate remained above 50%, evidencing that seeds of all rootstocks could be marketed until 12 months of storage. The new rootstocks tested have seeds with physiological quality compatible with their parents, in compliance with current legislation.Rangpur lime is the rootstock most used in Brazil, mainly due to its resistance to drought; however, it is susceptible to several diseases, requiring the search for other rootstocks tolerant to factors limiting citrus cultivation. In addition, the Brazilian legislation stipulates that citrus seeds can only be commercialized with at least 50% germination rate. Thus, the aim of this work was to evaluate the physiological quality of seeds of seven citrus rootstocks. The following citrus fruits were harvested: Poncirus trifoliata, Sunki mandarin and their hybrids –citrandarins (70, 106, 254, 299 and 310). Fruit mass, diameter and height were measured. Seeds were extracted from fruits, counting the number of normal seeds (not aborted). Seeds were dried up to 20% water content and stored for 3, 6, 9 and 12 months. The physiological quality of seeds was evaluated before storage (time 0) up to 12 months of storage. The quality of Poncirus trifoliata, Sunki mandarin and citrandarins 70, 106, 254, 299 and 310 seeds was reduced during storage. However, their germination rate remained above 50%, evidencing that seeds of all rootstocks could be marketed until 12 months of storage. The new rootstocks tested have seeds with physiological quality compatible with their parents, in compliance with current legislation

High CTLA-4 expression correlates with poor prognosis in thymoma patients

Thymomas, tumors that arise from epithelial cells of the thymus gland, are the most common neoplasms of the anterior mediastinum, with an incidence rate of approximately 2.5 per million/year. Cytotoxic T Lymphocyte Antigen 4 (CTLA-4 or CD152) exerts inhibitory activity on T cells, and since its oncogenic role in the progression of different types of tumors, it has emerged as a potential therapeutic target in cancer patients. In this study, we assessed the expression of CTLA-4 both at mRNA and protein levels in paraffin embedded-tissues from patients with thymomas. Furthermore, we evaluated the relationship between CTLA-4 expression and the clinical-pathologic characteristics and prognosis in patients with thymomas. Sixty-eight patients with median age corresponding to 62 years were included in this analysis. Thymomas were classified accordingly to the WHO and Masaoka-Koga for histochemical analysis and for prognostic significance. A statistical difference was found between CTLA-4 mRNA levels in human normal thymus compared with thymoma specimens. CTLA-4 expression was statistically found to progressively increase in A, B1, B2, AB and it was maximal in B3 thymomas. According to Masaoka-Koga pathological classification, CTLA-4 expression was lower in I, IIA and IIB, and higher in invasive III and IV stages. By confocal microscopy analysis we identified the expression of CTLA-4 both in tumor cells and in CD45+ tumor-infiltrating leukocytes, mainly in B3 and AB thymomas. Finally, CTLA-4 overexpression significantly correlates with reduced overall survival in thymoma patients and in atypical thymoma subgroup, suggesting that it represents a negative prognostic factor

In children allergic to ragweed pollen, nasal inflammation is not influenced by monosensitization or polysensitization

BACKGROUND: In patients polysensitized to pollen allergens, the priming effect, by which the sensitivity of the nasal mucosa to an allergen is increased by the previous exposure to another allergen, is a known phenomenon. This study was aimed at evaluating the degree of nasal inflammation, assessed by nasal cytology, in children with allergic rhinitis (AR) from ragweed pollen according to being monosensitized or polysensitized. METHODS: The study included 47 children. Of them, 24 suffered from AR caused by sensitization to grass pollen and ragweed pollen (group A) and 23 were sensitized only to ragweed pollen (group B). In all patients, the severity of AR was assessed according to the Allergic Rhinitis and Its Impact on Asthma guidelines, and comorbidities were also evaluated. RESULTS: In group A, 16.7% of children had a mild intermittent AR, 4.2% a moderate-to-severe intermittent, 33.3% a mild persistent, and 45.8% a moderate-to-severe persistent; in group B, 26.1% of children had a mild intermittent AR, 0% a moderate-to-severe intermittent, 52.2% a mild persistent, and 21.7% a moderate-to-severe persistent. No significant difference was detected in the number of the considered comorbidities between the two groups. The cell counts of neutrophils, eosinophils, lymphocytes/plasma cells, and mast cells were high but not significantly different in the two groups. CONCLUSION: These findings show that the degree of nasal inflammation found in children with ragweed-induced AR is not influenced by additional allergy to grass pollen and confirm the previously reported absence of priming effect in ragweed allergy

Multiregional sequencing of IDH-WT glioblastoma reveals high genetic heterogeneity and a dynamic evolutionary history

Glioblastoma is one of the most common and lethal primary neoplasms of the brain. Patient survival has not improved significantly over the past three decades and the patient median survival is just over one year. Tumor heterogeneity is thought to be a major determinant of therapeutic failure and a major reason for poor overall survival. This work aims to comprehensively define intra- and inter-tumor heterogeneity by mapping the genomic and mutational landscape of multiple areas of three primary IDH wild-type (IDH-WT) glioblastomas. Using whole exome sequencing, we explored how copy number variation, chromosomal and single loci amplifications/deletions, and mutational burden are spatially distributed across nine different tumor regions. The results show that all tumors exhibit a different signature despite the same diagnosis. Above all, a high inter-tumor heterogeneity emerges. The evolutionary dynamics of all identified mutations within each region underline the questionable value of a single biopsy and thus the therapeutic approach for the patient. Multiregional collection and subsequent sequencing are essential to try to address the clinical challenge of precision medicine. Especially in glioblastoma, this approach could provide powerful support to pathologists and oncologists in evaluating the diagnosis and defining the best treatment option

Metabolic-imaging of human glioblastoma live tumors: A new precision-medicine approach to predict tumor treatment response early

Glioblastoma (GB) is the most severe form of brain cancer, with a 12-15 month median survival. Surgical resection, temozolomide (TMZ) treatment, and radiotherapy remain the primary therapeutic options for GB, and no new therapies have been introduced in recent years. This therapeutic standstill is primarily due to preclinical approaches that do not fully respect the complexity of GB cell biology and fail to test efficiently anti-cancer treatments. Therefore, better treatment screening approaches are needed. In this study, we have developed a novel functional precision medicine approach to test the response to anticancer treatments in organoids derived from the resected tumors of glioblastoma patients

A machine-learning based bio-psycho-social model for the prediction of non-obstructive and obstructive coronary artery disease

Background: Mechanisms of myocardial ischemia in obstructive and non-obstructive coronary artery disease (CAD), and the interplay between clinical, functional, biological and psycho-social features, are still far to be fully elucidated. Objectives: To develop a machine-learning (ML) model for the supervised prediction of obstructive versus non-obstructive CAD. Methods: From the EVA study, we analysed adults hospitalized for IHD undergoing conventional coronary angiography (CCA). Non-obstructive CAD was defined by a stenosis < 50% in one or more vessels. Baseline clinical and psycho-socio-cultural characteristics were used for computing a Rockwood and Mitnitski frailty index, and a gender score according to GENESIS-PRAXY methodology. Serum concentration of inflammatory cytokines was measured with a multiplex flow cytometry assay. Through an XGBoost classifier combined with an explainable artificial intelligence tool (SHAP), we identified the most influential features in discriminating obstructive versus non-obstructive CAD. Results: Among the overall EVA cohort (n = 509), 311 individuals (mean age 67 ± 11 years, 38% females; 67% obstructive CAD) with complete data were analysed. The ML-based model (83% accuracy and 87% precision) showed that while obstructive CAD was associated with higher frailty index, older age and a cytokine signature characterized by IL-1β, IL-12p70 and IL-33, non-obstructive CAD was associated with a higher gender score (i.e., social characteristics traditionally ascribed to women) and with a cytokine signature characterized by IL-18, IL-8, IL-23. Conclusions: Integrating clinical, biological, and psycho-social features, we have optimized a sex- and gender-unbiased model that discriminates obstructive and non-obstructive CAD. Further mechanistic studies will shed light on the biological plausibility of these associations. Clinical trial registration: NCT02737982

The Sex-Specific Detrimental Effect of Diabetes and Gender-Related Factors on Pre-admission Medication Adherence Among Patients Hospitalized for Ischemic Heart Disease: Insights From EVA Study

Background: Sex and gender-related factors have been under-investigated as relevant determinants of health outcomes across non-communicable chronic diseases. Poor medication adherence results in adverse clinical outcomes and sex differences have been reported among patients at high cardiovascular risk, such as diabetics. The effect of diabetes and gender-related factors on medication adherence among women and men at high risk for ischemic heart disease (IHD) has not yet been fully investigated.Aim: To explore the role of sex, gender-related factors, and diabetes in pre-admission medication adherence among patients hospitalized for IHD.Materials and Methods: Data were obtained from the Endocrine Vascular disease Approach (EVA) (ClinicalTrials.gov Identifier: NCT02737982), a prospective cohort of patients admitted for IHD. We selected patients with baseline information regarding the presence of diabetes, cardiovascular risk factors, and gender-related variables (i.e., gender identity, gender role, gender relations, institutionalized gender). Our primary outcome was the proportion of pre-admission medication adherence defined through a self-reported questionnaire. We performed a sex-stratified analysis of clinical and gender-related factors associated with pre-admission medication adherence.Results: Two-hundred eighty patients admitted for IHD (35% women, mean age 70), were included. Around one-fourth of the patients were low-adherent to therapy before hospitalization, regardless of sex. Low-adherent patients were more likely diabetic (40%) and employed (40%). Sex-stratified analysis showed that low-adherent men were more likely to be employed (58 vs. 33%) and not primary earners (73 vs. 54%), with more masculine traits of personality, as compared with medium-high adherent men. Interestingly, women reporting medication low-adherence were similar for clinical and gender-related factors to those with medium-high adherence, except for diabetes (42 vs. 20%, p = 0.004). In a multivariate adjusted model only employed status was associated with poor medication adherence (OR 0.55, 95%CI 0.31–0.97). However, in the sex-stratified analysis, diabetes was independently associated with medication adherence only in women (OR 0.36; 95%CI 0.13–0.96), whereas a higher masculine BSRI was the only factor associated with medication adherence in men (OR 0.59, 95%CI 0.35–0.99).Conclusion: Pre-admission medication adherence is common in patients hospitalized for IHD, regardless of sex. However, patient-related factors such as diabetes, employment, and personality traits are associated with adherence in a sex-specific manner

Enhancing the foreign demand for agritourism

Tourism is a major economic activity in Italy, and a growing sector in a vast majority of Countries. In particular, agritourism is a rapidly evolving sector. Studies on agritourism are increasing in number, although studies on determinants of the international demand for agritourism are still limited. We explore the international demand for agritourism in Italian structures by mean of a pan-el data approach. We underline the peculiarities of the international demand for agritourism, and the main determinants of small and large flows of foreign tourists. In order to enhance the attractiveness of agri-tourism, entrepreneurs and policymakers should focus their attention on targeted marketing campaigns that need to take into account the Countries of origin. Our paper aims at moving toward this goal