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The decrease in food enjoyment is a major factor why patients suffer from depression when having anosmia, or total loss of smell. While we have some knowledge about how food preferences and attitudes change with dysosmia, these findings are limited because other factors such as culture are not factored in. It is likely that the culture in which an anosmic patient identifies with will influence how their smell loss impacts their relationship with food. This study examined the current attitudes within the United States and Germany towards foods, focusing on the comparison between anosmic patients (N = 53) and those with a healthy sense of smell (N = 121). A survey was used to collect free responses for liking on a variety of foods (N = 15) that were also rated for their overall liking. Additionally, individuals rated and ranked their liking for sensory attributes in relation to their enjoyment of food. Free responses were classified into categories and subcategories, the frequency of those responses were then compared across groups. The patient population of each culture gave lower importance to aroma and flavor; however, the U.S.A. patient population showed a larger decrease from their healthy counterparts. Furthermore, anosmic patients from the U.S.A. showed less overall liking towards the food stimuli compared to their healthy counterparts, while no such effect observed among the German population. Reasons to enjoy a food were largely explained by the culture, and patients within a culture took on different compensation strategies which we use to explain their effectiveness., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

While it is widely accepted that texture is a multimodal in nature, little research has been published regarding how we use senses other than touch to assess texture. In beverages, humans use texture (i.e. viscosity) information to estimate calories and expected satiety. This study was designed to compare and contrast the sensitivity of humans to changes in viscosity and their ability to estimate satiety through different sensory modalities. Milk samples of varying viscosities were constructed, and 49 participants were asked to perform a series of 2-alternative forced choice tests and identify which sample was thicker. Sensitivity to viscosity changes across different sensory modalities was determined by having each participant consume the samples, listen to the samples pouring, and observe clear vials of the samples. Using vision, participants were notably less sensitive to changes in viscosity when compared to hearing or oral tactile sensations. Interestingly, oral tactile sensations and hearing were almost identical in their viscosity difference thresholds (0.346 cP and 0.360 cP, respectively). Similar patterns were observed when the participants were asked to estimate how full they expected to be after consuming beverage stimuli varying in viscosity. Expected caloric values and satiation were found to change with thickness level when participants were assessing the stimuli through the auditory or tactile modalities. However, these measures of expected caloric value and satiation did not change as a function of viscosity for visual assessment, suggesting the assessment of caloric density and satiation are linked to specific sensory modalities' ability to detect viscosity. This study highlights the relative importance of vision, auditory, and touch to forming our sensory judgements regarding viscosity and subsequent satiety estimations., (Copyright © 2018. Published by Elsevier Ltd.)

The recent development of metropolitan cities, especially in Europe, requires an effective integrated management of city services, infrastructure, and communication networks at a metropolitan level. A preliminary step towards a proper organizational and management strategy of the metropolitan city is the analysis, benchmarking and optimization of the metropolitan areas through a set of indicators coherent with the overall sustainability objective of the metropolitan city. This paper proposes the use of the Analytic Hierarchy Process multi-criteria decision making technique for application in the smart metropolitan city context, with the aim of analysing the sustainable development of energy, water and environmental systems, through a set of objective performance indicators. Specifically, the 35 indicators defined for the Sustainable Development of Energy, Water and Environment Systems Index framework are used. The application of the approach to the real case study of four metropolitan areas (Bari, Bitonto, Mola, and Molfetta) in the city of Bari (Italy) shows its usefulness for the local government in benchmarking metropolitan areas and providing decision indications on how to formulate the sustainable development strategy of the metropolitan city. Based on the Analytic Hierarchy Process characteristics, the results highlight that although one specific area (Mola in the considered case) is globally ranked at the first place, it is only ranked first with respect to some dimensions. Such a result has strong implications for the metropolitan city's manager who has the possibility to identify and implement targeted actions, which may be designed ad hoc to improve specific dimensions based on the current state of the city, thus maximizing the efficiency and effectiveness of the actions undertaken for the sustainable development of energy, water and environmental systems of the whole metropolitan city., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Biological significance of food components suggests that preferences for basic tastes should be similar across cultures. On the other hand, cultural factors play an important role in diet and can consequently influence individual preference for food. To date, very few studies have compared basic tastes preferences among populations of very diverse environmental and cultural conditions, and research rather did not involve traditional populations for whom the biological significance of different food components might be the most pronounced. Hence, our study focused on basic taste preferences in three populations, covering a broad difference in diet due to environmental and cultural conditions, market availability, dietary habits and food acquirement: 1) a modern society (Poles, n = 200), 2) forager-horticulturalists from Amazon/Bolivia (Tsimane', n = 138), and 3) hunter-gatherers from Tanzania (Hadza, n = 85). The preferences for basic tastes were measured with sprays containing supra-threshold levels of sweet, sour, bitter, salty, and umami taste solutions. We observed several interesting differences between participating societies. We found that Tsimane' and Polish participants liked the sweet taste more than other tastes, while Hadza participants liked salty and sour tastes more than the remaining tastes. Further, Polish people found bitter taste particularly aversive, which was not observed in the traditional societies. Interestingly, no cross-cultural differences were observed for relative liking of umami taste - it was rated closely to neutral by members of all participating societies. Additionally, Hadza showed a pattern to like basic tastes that are more common to their current diet than societies with access to different food sources. These findings demonstrate the impact of diet and market availability on preference for basic tastes., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Even after publication of the 2011 update of GOLD report, some fundamental questions in the management of COPD are still open and this may weaken the applicability of these guidelines in everyday clinical practice., Objective: To assess the level of consensus amongst Italian respirologists on different topics related to diagnosis, monitoring and role of bronchodilator therapy in COPD, by using the Delphi technique., Methods: A Delphi study was undertaken between July and November 2011, when two questionnaires were consecutively sent to a panel of experts to be answered anonymously. After each round, the data were aggregated at group level of question topics and structured feedback was given to the panel., Results: A first-round questionnaire was sent to 208 pulmonologists randomly selected from different Italian regions. The 132 respondents (63% of those initially selected) were from northern (53%), central (19%) and southern (28%) Italy. A second-round questionnaire was sent to all the first-round respondents, and a response was received from 110 of them (83%). The main topics that reached the pre-defined cut off for consensus (67% or more) were: a) bronchodilator therapy with long-acting bronchodilators could be beneficial in patients with airflow limitation even in the absence of symptoms, b) in patients not fully controlled with one long-acting bronchodilator, maximizing bronchodilation (i.e. adding another bronchodilator with a different mechanism of action) is the preferable option; and c) the use of inhaled corticosteroids (ICSs) as add on therapy should be considered in severe patients with frequent exacerbations., Conclusions: Italian specialists agree on several aspects of the diagnosis and treatment of COPD and expert opinion could support everyday decision process in the management of COPD., (Copyright © 2012 Elsevier Ltd. All rights reserved.)