Transformational Procurement—The Past And Future Of Global And Local Public Purchasing—Views From The Expert Community On What Public Money Did And Will Still Need To Buy

This short piece discusses a (rather informal) survey of approximately two dozen public procurement experts (including University professors, consultants, national regulators, multilateral development bank members, and lawyers; all chosen primarily based upon their prior dealings with Professor Piga). The survey looks back (or, in other words, at where we\u27ve been) and forward (or, in other words, where we\u27re going.) The results of the survey were originally presented at the Global Revolution XI Conference at the University of Nottingham in June of 2022

correlation between fissured fibrous cap and contrast enhancement preliminary results with the use of cta and histologic validation

BACKGROUND AND PURPOSE: Previous studies demonstrated that carotid plaques analyzed by CTA can show contrast plaque enhancement. The purpose of this preliminary work was to evaluate the possible association between the fissured fibrous cap and contrast plaque enhancement. MATERIALS AND METHODS: Forty-seven consecutive (men = 25; average age = 66.8 ± 9 years) symptomatic patients studied by use of a multidetector row CT scanner were prospectively analyzed. CTA was performed before and after contrast and radiation doses were recorded; analysis of contrast plaque enhancement was performed. Patients underwent carotid endarterectomy en bloc; histologic sections were prepared and evaluated for fissured fibrous cap and microvessel attenuation. The Mann-Whitney test was performed to evaluate the differences between the 2 groups. A multiple logistic regression analysis was performed to assess the effect of fissured fibrous cap and microvessel attenuation on contrast plaque enhancement. Receiver operating characteristic curve and area under the curve were also calculated. RESULTS: Twelve patients had fissured fibrous cap. In 92% (11/12) of fissured fibrous cap–positive plaques, we found contrast plaque enhancement, whereas in 69% (24/35) of the plaques without fissured fibrous cap contrast plaque enhancement was found. The Mann-Whitney test showed a statistically significant difference between the contrast enhancement in plaques with fissured fibrous cap (Hounsfield units = 22.6) and without fissured fibrous cap (Hounsfield units = 12.9) ( P = .011). On the regression analysis, both fissured fibrous cap and neovascularization were associated with contrast plaque enhancement ( P = .0366 and P = .0001). The receiver operating characteristic curve confirmed an association between fissured fibrous cap and contrast plaque enhancement with an area under the curve of 0.749 ( P = .005). CONCLUSIONS: The presence of fissured fibrous cap is associated with contrast plaque enhancement. Histologic analysis showed that the presence of fissured fibrous cap is associated with a larger contrast plaque enhancement compared with the contrast plaque enhancement of plaques without fissured fibrous cap

Integrated geophysical and aerial sensing methods for archaeology: A case history in the Punic site of Villamar (Sardinia, Italy)

In this paper, the authors present a recent integrated survey carried out on an archaeological urban site, generally free of buildings, except some temporary structures related to excavated areas where multi-chamber tombs were found. The two methods used to investigate this site were thermal infrared and ground penetrating radar (GPR). The thermography was carried out with the sensor mounted under a helium balloon simultaneously with a photographic camera. In order to have a synthetic view of the surface thermal behavior, a simplified version of the existing night thermal gradient algorithm was applied. By this approach, we have a wide extension of thermal maps due to the balloon oscillation, because we are able to compute the maps despite collecting few acquisition samples. By the integration of GPR and the thermal imaging, we can evaluate the depth of the thermal influence of possible archaeological targets, such as buried Punic tombs or walls belonging to the succeeding medieval buildings, which have been subsequently destroyed. The thermal anomalies present correspondences to the radar time slices obtained from 30 to 50 cm. Furthermore, by superimposing historical aerial pictures on the GPR and thermal imaging data, we can identify these anomalies as the foundations of the destroyed building

Free and Enzymatically Hydrolysed Volatile Compounds of Sweet Wines from Malvasia and Muscat Grapes (Vitis vinifera L.) Grown in Sardinia

The aroma of Muscat of Sorso-Sennori and Malvasia di Bosa wines obtained from grapes grown in Sardinia wasevaluated by instrumental analysis. Gas chromatography/mass spectrometry was used to identify and quantifythe content of free and bound volatile compounds. The odour activity value (OAV) was also calculated. Higheralcohols and esters were quantitatively the largest group of free volatile compounds in both wines, while terpeneswere the main class of bound volatiles. A total of 52 free and 26 bound volatiles were detected. Malvasia di Bosasweet wine had a higher content of alcohols, esters and acids in comparison to Muscat of Sorso-Sennori, whichwas richer in some terpenes, like nerol, geraniol and geranic acid, and also in bound volatile compounds. Atotal of 12 compounds were above the OAV. The main aroma-active compounds of Muscat were 3-methylbutylacetate (banana), ethyl octanoate and hexanoate (fruity), and linalool (flowery), Malvasia wine was characterisedparticularly by ethyl octanoate and by 3-methylbutyl acetate

Effect of Bottle Storage on Colour, Phenolics and Volatile Composition of Malvasia and Moscato White Wines

The effect of bottle storage on the colour, phenolics and volatile composition of Malvasia and Muscat winesobtained from grapes grown in Sardinia was evaluated. Colour was evaluated by UV-VIS spectrophotometryand by tristimulus colorimetry. Polyphenols were analysed by UV-VIS spectrophotometry and HPLCDAD.GC/MS was used to identify and quantify the content of free and bound volatile compounds. Asexpected, the absorbance values at 420 nm increased significantly for both wines during storage, due tooxidative browning, while difference in colour (DE*) from the beginning of storage and after 18 monthswas more intense in the Muscat wine than in the Malvasia wine. A significant decrease was observed indifferent phenolic compounds over time, especially in the Malvasia wine. In-bottle storage for 18 monthsat 20°C in the dark resulted in a significant decrease in all the classes of free and bound volatiles. Thesefinding enhance knowledge regarding the effects of bottle storage on Muscat and Malvasia wines. Thisis of interest because, rather surprisingly, this topic has been poorly investigated in relation to these twovarieties

Effetto di alcuni trattamenti preliminari sulle cinetiche di essiccamento di frutti di olivo

Olive fruits (Olea europea sativa Hoffm. and Link) of two Sardinian cultivars, after being harvested at full maturation stage, were calibrated and subjected to several preliminary treatments, in order to break the peel, before being dehydrated. Dehydration was carried out at 60°C with a constant flow rate. Fruits were placed on trays according to a completely randomised design. Dehydration kinetics were computed by taking fruits during dehydration, while changes in some chemical-physical parameters (pH, water activity and colour) were assessed by sampling at the start and at the end of the drying step. Results will be discussed. Frutti eli olivo (Olea europea sativa Hoffm. and Link) di due varietà sarde, dopo la raccolta allo stadio di completa invaiatura, sono stati calibrati e hanno subito una serie di trattamenti preliminari, atti a favorire la rottura dell'epicarpo, prima di essere sottoposti ad un processo di essiccamento. La disidratazione è stata condotta alla temperatura di 60°C ed a flusso d'aria costante, disponendo i frutti delle tesi secondo un piano completamente randomizzato. Ad intervalli prestabiliti durante l'essiccamento sono stati effettuati dei prelievi di frutti, al fine di determinare le cinetiche di essiccamento, mentre per la determinazione delle variazioni di alcuni parametri chimico-fisici (pH, attività dell'acqua e colore) è stato fatto un campionamento ad inizio ed a fine processo. Nel presente contributo saranno discussi i dati relativi alla sperimentazione

Clinical patterns of disease: From early systemic lupus erythematosus to late-onset disease

Systemic lupus erythematosus (SLE) is a complex disease with an insidious clinical presentation. In up to half of the cases, SLE onset is characterized by clinical and serological manifestations that, although specific, are insufficient to fulfill the classification criteria. This condition, called incomplete SLE, could be as challenging as the definite and classifiable SLE and requires to be treated according to the severity of clinical manifestations. In addition, an early SLE diagnosis and therapeutic intervention can positively influence the disease outcome, including remission rate and damage accrual. After diagnosis, the disease course is relapsing-remitting for most patients. Time in remission and cumulative glucocorticoid exposure are the most important factors for prognosis. Therefore, timely identification of SLE clinical patterns may help tailor the therapeutic intervention to the disease course. Late-onset SLE is rare but more often associated with delayed diagnosis and a higher incidence of comorbidities, including Sjogren's syndrome. This review focuses on the SLE disease course, providing actionable strategies for early diagnosis, an overview of the possible clinical patterns of SLE, and the clinical variation associated with the different age-at-onset SLE groups

Semiautomated and automated algorithms for analysis of the carotid artery wall on computed tomography and sonography: a correlation study.

Objectives—The purpose of this study was to compare automated and semiautomated algorithms for analysis of carotid artery wall thickness and intima-media thickness on multidetector row computed tomographic (CT) angiography and sonography, respectively, and to study the correlation between them. Methods—Twenty consecutive patients underwent multidetector row CT angiographic and sonographic analysis of carotid arteries (mean age, 66 years; age range, 59–79 years). The intima-media thickness of the 40 carotid arteries was measured with novel and dedicated automated software analysis and by 4 observers who manually calculated the intima-media thickness. The carotid artery wall thickness was automatically estimated by using a specific algorithm and was also semiautomatically quantified. The correlation between groups was calculated by using the Pearson ρ statistic, and scatterplots were calculated. We evaluated intermethod agreement using Bland-Altman analysis. Results—By comparing automated carotid artery wall thickness, automated intima-media thickness, semiautomated carotid artery wall thickness, and semiautomated intima-media thickness analyses, a statistically significant association was found, with the highest values obtained for the association between semiautomated and thickness analyses(Pearson ρ = 0.9; 95% confidence interval, 0.82–0.95; P = 0.0001). The lowest values were obtained for the association between semiautomated intima-media thickness and automated carotid artery wall thickness analyses (Pearson ρ = 0.44; 95% confidence interval, 0.15–0.66; P = 0.0047). In the Bland-Altman analysis, the better results were obtained by comparing the semiautomated and automated algorithms for the study of intima-media thickness, with an interval of –16.1% to +43.6%. Conclusions—The results of this preliminary study showed that carotid artery wall thickness and intima-media thickness can be studied with automated software, although the CT analysis needs to be further improved

Assessment and personalised advice for fatigue in systemic lupus erythematosus using an innovative digital tool: the Lupus Expert system for the Assessment of Fatigue (LEAF) study

Background Fatigue is reported as the most prevalent symptom by patients with systemic lupus erythematosus (SLE). Fatigue management is complex due to its multifactorial nature. The aim of the study was to assess the usefulness of an innovative digital tool to manage fatigue in SLE, in a completely automated manner. Methods The «Lupus Expert System for Assessment of Fatigue» (LEAF) is free digital tool which measures the intensity and characteristics of fatigue and assesses disease activity, pain, insomnia, anxiety, depression, stress, fibromyalgia and physical activity using validated patient-reported instruments. Then, LEAF automatically provides personalised feedback and recommendations to cope with fatigue. Results Between May and November 2022, 1250 participants with SLE were included (95.2% women, median age 43yo (IQR: 34-51)). Significant fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue <34) was reported by 78.9% of patients. In univariate analysis, SLE participants with fatigue were more likely to be women (p=0.01), perceived their disease as more active (p<0.0001), had higher levels of pain (p<0.0001), anxiety (p<0.0001), depression (p<0.0001), insomnia (p<0.0001), stress (p<0.0001) and were more likely to screen for fibromyalgia (p<0.0001), compared with patients without significant fatigue. In multivariable analysis, parameters independently associated with fatigue were insomnia (p=0.0003), pain (p=0.002), fibromyalgia (p=0.008), self-reported active SLE (p=0.02) and stress (p=0.045). 93.2% of the participants found LEAF helpful and 92.3% would recommend it to another patient with SLE. Conclusion Fatigue is commonly severe in SLE, and associated with insomnia, pain, fibromyalgia and active disease according to patients' perspective. Our study shows the usefulness of an automated digital tool to manage fatigue in SLE