COVID-19 and tourism: What can we learn from the past?

The impact of the COVID-19 crisis on tourism flows is without precedent in terms of speed and severity. In this paper, we try to infer a possible future scenario for the tourism sector, evaluating the medium-term effects of past pandemics on tourist arrivals. We find that pandemics lead to a persistent decline in tourist arrivals, with the effects being larger in developing and emerging countries. Interestingly, the effects are heterogeneous across countries and episodes, and depend on several economic conditions such as the overall health system performance, the severity of the shock, and the uncertainty induced by the pandemic event

COVID-19 e turismo: cosa possiamo imparare dal passato?

L'impatto della crisi pandemica causata dal COVID-19 sui flussi turistici è senza precedenti in termini di rapidità e severità. In questo articolo, cerchiamo di ipotizzare un possibile scenario futuro nel settore turistico, valutando gli effetti di medio termine delle pandemie passate sugli arrivi turistici. I risultati mostrano che le pandemie portano a un declino persistente degli arrivi turistici internazionali, con effetti più intensi nei paesi emergenti e in via di sviluppo. Inoltre, le conseguenze negative legate agli eventi pandemici sono eterogenee sia tra paesi sia tra episodi e dipendono da diverse condizioni economiche come la performance del sistema sanitario, la severità dello shock e l'incertezza indotta dall'evento pandemico

Multislice computed tomography in an asymptomatic high-risk population

Approximately 50% of all acute coronary syndromes occur in previously asymptomatic patients. This study evaluated the value of multislice computed tomography for early detection of significant coronary artery disease (CAD) in high-risk asymptomatic subjects. One hundred sixty-eight asymptomatic subjects with >or=1 major risk factor (hypertension, diabetes, hypercholesterolemia, family history, or smoking) and an inconclusive or unfeasible noninvasive stress test result (stress electrocardiography, echocardiography, or nuclear scintigraphy) were evaluated in an outpatient setting. After clinical examination and laboratory risk analysis, all patients underwent multislice computed tomographic (MSCT) coronary angiography within 1 week. In all subjects, conventional coronary angiography was also carried out. Multislice computed tomography displayed single-vessel CAD in 16% of patients, 2-vessel CAD in 7%, and 3-vessel CAD in 4%. Selective coronary angiography confirmed the results of multislice computed tomography in 99% of all patients. Sensitivity and specificity of MSCT coronary angiography were 100% and 98%, respectively, with a positive predictive value of 95% and a negative predictive value of 100%. In conclusion, MSCT coronary angiography is an excellent noninvasive technique for early identification of significant CAD in high-risk asymptomatic patients with inconclusive or unfeasible noninvasive stress test results

Universal principles of human communication: preliminary evidence from a cross-cultural communication game

The present study points to several potentially universal principles of human communication. Pairs of participants, sampled from culturally and linguistically distinct societies (Western and Japanese, N = 108: 16 Western-Western, 15 Japanese-Japanese and 23 Western-Japanese dyads), played a dyadic communication game in which they tried to communicate a range of experimenter-specified items to a partner by drawing, but without speaking or using letters or numbers. This paradigm forced participants to create a novel communication system. A range of similar communication behaviors were observed among the within-culture groups (Western-Western and Japanese-Japanese) and the across-culture group (Western-Japanese): They (a) used iconic signs to bootstrap successful communication, (b) addressed breakdowns in communication using other-initiated repairs, (c) simplified their communication behavior over repeated social interactions, and (d) aligned their communication behavior over repeated social interactions. While the across-culture Western-Japanese dyads found the task more challenging, and cultural differences in communication behavior were observed, the same basic findings applied across all groups. Our findings, which rely on two distinct cultural and linguistic groups, offer preliminary evidence for several universal principles of human communication

Polymerase chain reaction in the diagnosis and prognosis of Mediterranean visceral leishmaniasis in immunocompetent children

OBJECTIVE: To assess the usefulness of a polymerase chain reaction (PCR) assay amplifying the small subunit rRNA coding region of Leishmania species performed on peripheral blood (PB) and bone marrow (BM) aspirates for the diagnosis and follow-up of visceral leishmaniasis (VL) in children living in the Mediterranean basin. DESIGN: A prospective study was conducted on children consecutively hospitalized over a 1-year period at our Infectious Diseases Department in Sicily (Italy) presenting with fever, hepatosplenomegaly, and/or pancytopenia and a positive Leishmania serology (> or =1:40). RESULTS: Among the 14 patients hospitalized with signs and symptoms suggestive of the disease and a positive serology, we identified 10 cases of Mediterranean VL. PCR performed on PB and BM aspirates was positive in all cases and concordant with microscopy and/or culture performed on BM. Leishmania DNA was cleared from PB a median of 6 days after the start of treatment; during follow-up (median: 9 months; range: 6-12 months) 1 child relapsed. In this case, BM PCR remained positive with rapid reappearance of a positive signal also in PB. CONCLUSIONS: PB PCR allows a rapid and noninvasive parasitologic diagnosis of Mediterranean VL among immunocompetent children and is at least as sensitive as a diagnosis made on the basis of BM aspirates. The lack of disappearance from BM and the reappearance of positive PCR on PB is predictive of clinical relapse. Qualitative and semiquantitative PCR may be the standard method for monitoring response to therapy in immunocompetent childre

Toll-like receptor 2 promiscuity is responsible for the immunostimulatory activity of nucleic acid nanocarriers.

Lipopolyamines (LPAs) are cationic lipids; they interact spontaneously with nucleic acids to form lipoplexes used for gene delivery. The main hurdle to using lipoplexes in gene therapy lies in their immunostimulatory properties, so far attributed to the nucleic acid cargo, while cationic lipids were considered as inert to the immune system. Here we demonstrate for the first time that di-C18 LPAs trigger pro-inflammatory responses through Toll-like receptor 2 (TLR2) activation, and this whether they are bound to nucleic acids or not. Molecular docking experiments suggest potential TLR2 binding modes reminiscent of bacterial lipopeptide sensing. The di-C18 LPAs share the ability of burying their lipid chains in the hydrophobic cavity of TLR2 and, in some cases, TLR1, at the vicinity of the dimerization interface; the cationic headgroups form multiple hydrogen bonds, thus crosslinking TLRs into functional complexes. Unravelling the molecular basis of TLR1 and TLR6-driven heterodimerization upon LPA binding underlines the highly collaborative and promiscuous ligand binding mechanism. The prevalence of non-specific main chain-mediated interactions demonstrates that potentially any saturated LPA currently used or proposed as transfection agent is likely to activate TLR2 during transfection. Hence our study emphasizes the urgent need to test the inflammatory properties of transfection agents and proposes the use of docking analysis as a preliminary screening tool for the synthesis of new non-immunostimulatory nanocarriers.MP would like to thank the FRIA-FNRS (F3/5/5-MCF/XH/FC-17514) for its financial support. NG and MG would like to thank the Wellcome Trust (WT100321/z/12/Z) for financial support. CL is grateful to the foundation Wiener Anspach and the Marie Curie Actions (TLR4-CAT PIEF-GA-2012-326481) for financial support

Gestione sostenibile delle foreste Mediterranee e uso energetico delle biomasse forestali residuali

he book describes the reasons that led the Regional Department of Rural and Territorial Development to take part in the PROFORBIOMED Project. They can be summarized by the need to dispose of a tool for the sustainable management of all the state-owned forests of the Region. As a matter of fact, the Project aims at developing a model of sustainable forest management, through the recovery and reuse of wood scraps from ordinary silvicultural operations, to be used for the production of power and heat inside of a process adopting natural renewable energy sources. The main actions taken and the methodologies adopted are described, as well as the principles and instruments required for the setting up and execution of the work. Some of the most relevant are: the drafting of “Forest Management Plans”, the “Short Supply Chain” and the “Biomass Traceability Protocol”, together with the application of “Best Practices” of Management and the “Monitoring of impacts” caused by the woody biomass extraction procedures. The “forest – wood – energy” chain developed and proposed is exclusively related to the territory pertaining to one municipality, and with CHP plants fed with biomass exclusively produced within the territory of each municipality, in strict compliance with the “sustainable forest management” principles, as well as with the fundamental principle of “short supply chain”. For these reasons the CHP plans proposed shall be sized according to the biomass available in each municipality, with the possibility of integrating residual forest biomass with other waste wood resources potentially available in the territory and coming from prunings in agricultural activities. Therefore, the replicable model prepared and proposed by PROFORBIOMED aims at appraising from the economic point of view a waste product, such is currently considered the residual forest biomass from the forests of Sicily, and at the same time significantly improving the natural environment, thanks to the reduction in oil consumption

Distal left circumflex coronary artery flow reserve recorded by transthoracic Doppler echocardiography: a comparison with Doppler-wire

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

Prognostic significance of normalized FDG-PET parameters in patients with multiple myeloma undergoing induction chemotherapy and autologous hematopoietic stem cell transplantation: a retrospective single-center evaluation

Purpose: The purpose of this study was to determine retrospectively, through a single-center evaluation, whether FDG PET-CT normalized semi-quantitative parameters may predict response to induction chemotherapy (iChT) and hematopoietic stem cell transplantation (HSCT), as well as disease progression and progression-free survival in multiple myeloma (MM) patients, thus becoming a tool of personalized medicine. Methods: Patients undergoing iChT and HSCT with baseline and post-treatment FDG PET-CTs from January 2008 to July 2015 were included. The following baseline and post-treatment parameters were obtained: SUVmax, SUVmean, SUVpeak, MTVsum, TLGsum, rPET (lesion SUVmax/liver SUVmax) and qPET (lesion SUVpeak/liver SUVmean). Baseline-to-post-treatment changes (Δ) were also calculated. Metabolic and clinical laboratory progression or response at follow-up were noted; time-to-metabolic-progression (TMP) was defined as the interval from post-treatment scan to eventual progression at follow-up FDG PET-CTs. Possible association between each functional parameter and metabolic/clinical-laboratory progression or response was determined. Kaplan-Meier curves allowed to depict the TMP trend according to FDG PET-CT parameters. Results: Twenty-eight patients were included. Significantly higher ΔrPET and ΔqPET values were observed in ten patients with “metabolic response”, with respect to 18 patients having “metabolic progression” (median 0.62 [IQR 0.32 – 1.34] vs median 0.00 [IQR -0.25 – 0.49] for ΔrPET; P = 0.045; median 0.51 [IQR 0.32 – 1.13] vs median 0.00 [IQR -0.31 – 0.67] for ΔqPET; P = 0.035). Neither normalized nor non normalized parameters differed significantly between the 20 patients with “clinical-laboratory response” and the eight patients with “clinical-laboratory progression”. ΔrPET value lower than 0.38 and ΔqPET value lower than 0.27 predicted a significantly shorter TMP (P = 0.003 and P = 0.005, respectively). Conclusions: Normalized semi-quantitative parameters are effective in predicting persistent response to treatment and shorter TMP in patients with MM undergoing iChT and HSCT

Coronary flow reserve in stress-echo lab. From pathophysiologic toy to diagnostic tool

The assessment of coronary flow reserve by transthoracic echocardiography has recently been introduced into clinical practice with gratifying results for the diagnosis of left anterior descending artery disease simultaneously reported by several independent laboratories. This technological novelty is changing the practice of stress echo for 3 main reasons. First, adding coronary flow reserve to regional wall motion allows us to have – in the same sitting – high specificity (regional wall motion) and a high sensitivity (coronary flow reserve) diagnostic marker, with an obvious improvement in overall diagnostic accuracy. Second, the technicalities of coronary flow reserve shift the balance of stress choice in favour of vasodilators, which are a more robust hyperemic stress and are substantially easier to perform with dual imaging than dobutamine or exercise. Third, the coronary flow reserve adds a quantitative support to the exquisitely qualitative assessment of wall motion analysis, thereby facilitating the communication of stress echo results to the cardiological world outside the echo lab. The next challenges involve the need to expand the exploration of coronary flow reserve to the right and circumflex coronary artery and to prove the additional prognostic value – if any – of coronary flow reserve over regional wall motion analysis, which remains the cornerstone of clinically-driven diagnosis in the stress echo lab