Cultural tourism as a tool for transformation in small and medium-sized towns

Tourism scholars regularly extol the merits of tourism as a tool for economic diversification in small and medium-sized towns (SMSTs), especially those with a narrow economic base, which witness chronic social problems like high unemployment and rapid depopulation. In recent years there have been numerous case studies of tourism’s role in communities, especially those in predominantly rural and/or peripheral regions (Ioannides and Timothy, 2010; Lane, 1994; Scherf, 2021). Strangely enough, despite this research attention, most writings fail to clearly define what is precisely meant by SMSTs. For instance, some authors who write about tourism in small-town America focus on extremely small places (e.g., ones with populations under 5,000) (Davis and Morais, 2004). Others refer to SMSTs as ones whose populations range between 5,000 and 50,000 (Pecsek, 2016). Then there are those who consider towns that are even larger such as Della Lucia et al. (2017), who focused on Trento and Lecce in Italy, which respectively have populations of around 115,000 and 95,000. What emerges from most academic writings on tourism in SMSTs is that rather than focus on the population of the communities under investigation, they treat them as ones located beyond the sphere of influence of a country’s major metropolitan regions and secondary cores of economic and political power

Maxillary extrafollicular adenomatoid odontogenic tumor: root resorption and involvement of the maxillary sinus and nasal cavity

Adenomatoid odontogenic tumor (AOT) is a benign, slow-growing lesion and it is considered the fourth most common odontogenic tumor. AOT affects more frequently the young subjects with a predilection for the second and third decades of life. We present here the case of a 36-year-old man affected by large extrafollicular AOT which caused roots resorption of multiple teeth. The lesion involved the entire right maxillary bone and extended into the right maxillary sinus up to the orbital floor and the nasal cavity. Intra-oral surgical excision of the AOT and functional endoscopic sinus surgery led to complete clinical healing in absence of local recurrences

The Use of Clear Aligners in Multi-Segmental Maxillary Surgery: A Case–Control Study in Cleft Lip and Palate and Skeletal Class III Patients

Background: Maxillary hypoplasia and mandibular asymmetry may be corrected with orthognathic surgery after growth completion. For most stable results, some cases may require segmental Le Fort I osteotomies. Unfortunately, Invisalign’s software (6.0 version) still has some inherent limitations in predicting outcomes for complex surgeries. This study explores the potential of aligners, particularly in multiple-piece maxillary osteotomies in both cleft and non-cleft patients. Method: Thirteen patients who underwent pre-surgical treatment with Invisalign were retrospectively matched in terms of diagnosis, surgical procedure, and orthodontic complexity with thirteen patients treated using fixed appliances. Virtual curves following the lower arch were employed to guide the correct pre-surgical positions of the upper teeth with a simple superimposition technique. The amount of impressions required in both groups to achieve satisfactory pre-surgical alignment of the segmented arches was compared. Results: one or no refinement phases were needed in the Invisalign group to reach an acceptable pre-surgical occlusion, while the amount of pre-surgical impressions needed to reach adequate coordination with fixed appliance treatment was slightly higher (p > 0.05). Conclusions: it appears that clear aligner could serve as an effective treatment for individuals necessitating segmental Le Fort I osteotomies when aided by the suggested simple superimposition approach

A systematic review on tracheostomy decannulation: a proposal of a quantitative semiquantitative clinical score

Background: Tracheostomy is one of the most common surgical procedures performed in critical care patient management; more specifically, ventilation through tracheal cannula allows removal of the endotracheal tube (ETT). Available literature about tracheostomy care and decannulation is mainly represented by expert opinions and no certain knowledge arises from it. Methods: In lack of statistical requirements, a systematic and critical review of literature regarding tracheostomy tube removal was performed in order to assess predictor factors of successful decannulation and to propose a predictive score. We combined 3 terms and a literature search has been performed using the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via Ovid SP; EMBASE via Ovid SP; EBSCO. Abstracts were independently reviewed: for those studies fitting the inclusion criteria on the basis of the title and abstract, full-text was achieved. We included studies published from January 1, 1995 until March 31, 2014; any sort of review and expert opinion has been excluded by our survey. English language restriction was applied. Ten studies have been considered eligible for inclusion in the review and were analysed further. Results: Cough effectiveness and ability to tolerate tracheostomy tube capping are the most considered parameters in clinical practice; other parameters are taken into different consideration by many authors in order to proceed to decannulation. Among them, we distinguished between objective quantitative parameters and semi-quantitative parameters more dependent from clinician's opinion. We then built a score (the Quantitative semi Quantitative score: QsQ score) based on selected parameters coming from literature. Conclusions: On our knowledge, this review provides the first proposal of decannulation score system based on current literature that is hypothetical and requires to be validated in daily practice. The key point of our proposal is to give a higher value to the objective parameters coming from literature compared to less quantifiable clinical ones