Structured reporting for fibrosing lung disease: a model shared by radiologist and pulmonologist

Objectives: To apply the Delphi exercise with iterative involvement of radiologists and pulmonologists with the aim of defining a structured reporting template for high-resolution computed tomography (HRCT) of patients with fibrosing lung disease (FLD). Methods: The writing committee selected the HRCT criteria\ue2\u80\u94the Delphi items\ue2\u80\u94for rating from both radiology panelists (RP) and pulmonology panelists (PP). The Delphi items were first rated by RPs as \ue2\u80\u9cessential\ue2\u80\u9d, \ue2\u80\u9coptional\ue2\u80\u9d, or \ue2\u80\u9cnot relevant\ue2\u80\u9d. The items rated \ue2\u80\u9cessential\ue2\u80\u9d by < 80% of the RP were selected for the PP rating. The format of reporting was rated by both RP and PP. Results: A total of 42 RPs and 12 PPs participated to the survey. In both Delphi round 1 and 2, 10/27 (37.7%) items were rated \ue2\u80\u9cessential\ue2\u80\u9d by more than 80% of RP. The remaining 17/27 (63.3%) items were rated by the PP in round 3, with 2/17 items (11.7%) rated \ue2\u80\u9cessential\ue2\u80\u9d by the PP. PP proposed additional items for conclusion domain, which were rated by RPs in the fourth round. Poor consensus was observed for the format of reporting. Conclusions: This study provides a template for structured report of FLD that features essential items as agreed by expert thoracic radiologists and pulmonologists

The transformation of marketing and business organisation : 19th century Europe

The book describes the transformation of marketing functions in Europe during the 19th century through the analysis of a large number of business cases. It describes the change from traditional forms of commercial organisation, such as the merchant system and local distribution networks, into new forms of direct marketing and distribution. In the new firm, the entrepreneur took decisions on both the production and the commercialisation phases of the business and introduced new marketing methods such as branding, and direct promotion. The book highlights the factors that fostered the change by looking at impact of socio-economic conditions in which firms operated, but it also looks at the role of product innovation in encouraging entrepreneurs to explore new marketing frontiers. The process of transformation is described through the main steps that took place at different times across countries and sectors, and it is illustrated in its core patterns.Published version of EUI PhD thesis, 200

Competitive strategies, commercial organization and the growth of marketing services : Europe : 19th and 20th centuries

Defence date: 4 December 2006Examining Board: Prof. Giovanni Federico (EUI) supervisor ; Prof. Bartolomé Yun Casalilla (EUI) ; Prof. Marc Casson (University of Reading) ; Prof. Albert Carreras (Pompeu Fabra University)First made available online on 14 May 201

Enhanced particle acceleration in a pulsar wind interacting with a companion

International audiencePulsar winds have been shown to be preferred sites of particle acceleration and high-energy radiation. Numerous studies have been conducted to better characterize the general structure of such relativistic plasmas in isolated systems. However, many pulsars are found in binary systems and there are currently no ab initio models available that would include both the pulsar magnetosphere and the wind of the pulsar in interaction with a spherical companion. We investigate the interaction between a pulsar wind and a companion to probe the rearrangement of the pulsar wind, assess whether it leads to an enhancement of particle acceleration, and predict the high-energy radiative signature that stems from this interaction. We perform two-dimensional equatorial particle-in-cell simulations of an inclined pulsar surrounded by a spherical, unmagnetized, perfectly conducting companion settled in its wind. We find that the presence of the companion significantly alters the structure of the wind. When the companion lies beyond the fast magnetosonic point, a shock is established and the perturbations are advected in a cone behind the companion. We observe an enhancement of particle acceleration due to forced reconnection as the current sheet reaches the companion surface. Hence, high-energy synchrotron radiation is also amplified. The orbital light curves display two broad peaks reaching up to 14 times the high-energy pulsed flux emitted by an isolated pulsar magnetosphere. These effects increase with the growth of the companion size and with the decrease of the pulsar-companion separation. The present study suggests that a pulsar wind interacting with a companion induces a significant enhancement of high-energy radiation that takes the form of an orbital-modulated hollow cone of emission, which should be detectable by galactic-plane surveys, possibly with long-period radio transient counterparts

Multiomics approach for patient stratification and novel target identification in metastatic clear cell renal carcinoma (Meet-URO 31)

Background: The choice of the best treatment in first line metastatic clear-cell renal cell carcinoma (mccRCC) patients is becoming an issue, since no biomarkers are available to guide the treatment allocation strategy. Recently there has been a great deal of interest in Artificial Intelligence (AI) systems and their ability to process heterogeneous data for both classification and prediction purposes. An additional fields of interest in genitourinary oncology are also liquid biopsy and radiomics. Non-invasive liquid biopsy methods are able to detect and characterize circulating cell-free DNA (cfDNA), extracellular vesicles (EV) associated RNAs and circulating tumor cells (CTCs) and to allow longitudinal evaluation of tumor evolution whereas radiomics may provide a novel approach to develop predictive tools by correlating imaging features to tumor characteristics including histology, tumor grade, genetic patterns and molecular phenotypes, as well as clinical outcomes. We hypothesize that AI can be used to integrate data obtained from radiomics, genomic and transcriptomic analysis of CT scan, neoplastic tissues and circulating cell-free DNA or microvescicle-associated RNA with the purpose of defining an optimal allocation strategy for patients with mccRCC undergoing first-line therapy and identifying novel targets in mccRCC. Methods: This is a multicenter Italian prospective translational study evaluating transriptomic, genomics and radiomics in treatment-naïve advanced ccRCC patients. Subjects will be screened to identify a total of 100 patients eligible for the study, candidate to receive first-line treatment as per investigator’s choice according to clinical practice. Tumoral tissue, plasma samples and radiological exams will be collected at baseline, at 3 months, at the time of first radiological evaluation and at disease progression (PD) to provide a comprehensive molecular profile and radiomic features extrapolation, respectively. AI systems will be used to build a genomic-radiomic profile of patients to correlate to treatment response. The planned sample size of 100 patients will allow an exploratory analysis of the prognostic and predictive performance of the "multiomic" classifier, to be subsequently validated in a larger expansion cohort of patients. Through the above research we are confident to provide proof of concept that AI is able to combine the information from genomics, transcriptomic and radiomics to provide an opportunity for a molecularly driven patients' stratification, aiming to choose the ideal first-line systemic treatment for each patient. Enrollment has already begun and the trial has enrolled 15 of the planned 100 patients. Clinical trial information: NCT05782400

Emptiness: Capitalism without people in the Latvian countryside

In Latvian towns and villages, post‐Soviet capitalism has produced a palpable change that locals describe as “emptiness.” People point to empty houses and apartments, and they list friends and relatives who have left. They fear school closures and the cancellation of transportation routes. They imagine the future as an entirely different world, one in which they will play no part. As a social formation, emptiness consists of (1) an observable reality wherein places rapidly lose their constitutive elements (people, infrastructure, services, social networks, and the future); (2) a way of life that emerges in response to such changes, which seem irreversible; and (3) an emic interpretive framework for making sense of the new reality. Emptiness in Latvia is symptomatic of post–Cold War spatiotemporal arrangements of power wherein capital and the state increasingly abandon people and places

Patterns of Long COVID Symptoms: A Multi-Center Cross Sectional Study

Background: Long COVID has become a burden on healthcare systems worldwide. Research into the etiology and risk factors has been impeded by observing all diverse manifestations as part of a single entity. We aimed to determine patterns of symptoms in convalescing COVID-19 patients. Methods: Symptomatic patients were recruited from four countries. Data were collected regarding demographics, comorbidities, acute disease and persistent symptoms. Factor analysis was performed to elucidate symptom patterns. Associations of the patterns with patients’ characteristics, features of acute disease and effect on daily life were sought. Results: We included 1027 symptomatic post-COVID individuals in the analysis. The majority of participants were graded as having a non-severe acute COVID-19 (N = 763, 74.3%). We identified six patterns of symptoms: cognitive, pain-syndrome, pulmonary, cardiac, anosmia-dysgeusia and headache. The cognitive pattern was the major symptoms pattern, explaining 26.2% of the variance; the other patterns each explained 6.5–9.5% of the variance. The cognitive pattern was higher in patients who were outpatients during the acute disease. The pain-syndrome pattern was associated with acute disease severity, higher in women and increased with age. The pulmonary pattern was associated with prior lung disease and severe acute disease. Only two of the patterns (cognitive and cardiac) were associated with failure to return to pre-COVID occupational and physical activity status. Conclusion: Long COVID diverse symptoms can be grouped into six unique patterns. Using these patterns in future research may improve our understanding of pathophysiology and risk factors of persistent COVID, provide homogenous terminology for clinical research, and direct therapeutic interventions