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Nodal metastases in papillary thyroid microcarcinoma: prevalence and risk factors in 311 patients
No full textPapillary thyroid microcarcinoma (PTMC) is generally considered low risk due to its favourable prognosis; however, in some cases, it presents aggressive features such as lymph node metastasis and extrathyroidal extension (ETE). The aim of this study
was to investigate the pathological factors that influence prognosis in PTMC with the purpose of refining risk stratification based on our cohort of 311 cases. We performed a retrospective analysis based on anonymous data from 311 PTMC samples
(tumours ≤ 1.0 cm in size) collected between 2016 and 2024. We examined several variables, including gender, histological subtype, tumour size, ETE, lymph node metastasis, and thyroiditis. The evaluations followed the eighth edition of the
American Joint Committee on Cancer (AJCC) staging system. We used Pearson’s chi-square test for univariate analysis and binary logistic regression for multivariate analysis. A p-value less than 0.05 was considered statistically significant. In our cohort, 45 patients (14.5%) had lymph node metastases. Male sex (OR = 3.3132; 95% CI = 1.5554–7.0574; p = 0.002), age < 45 years (OR = 2.4974; 95% CI = 1.2228–5.1006; p = 0.012), multicentricity (OR = 2.9351; 95% CI = 1.4314–6.0182; p = 0.003) and vascular invasion (OR = 3.5184; 95% CI = 1.3044–9.4905; p = 0.013) are found to be independent risk factors for lymph node metastases. The tall cell histological subtype (OR = 3.897; 95% CI = 1.6649–9.122; p = 0.002) emerged as an independent predictor of ETE. Although PTMC is commonly considered an indolent neoplasm, some cases may present
aggressive features that require careful prognostic evaluation. The identification of independent risk factors may improve clinical decision-making and therapeutic strategies for patients with PTMC
Who is more willing to use a smartphone app to promote sustainable travel behavior?
No full textIn the last decade, there has been growing interest in Voluntary Travel Behavior Change (VTBC) programs that use smartphone applications to encourage people to shift from car use to more sustainable transportation modes. However, most of these programs have used small and distorted sample sizes, making it unclear who are the individuals who choose to download and use such apps. To address this gap, in the current study we investigate which objective and subjective factors could influence individuals' intention to use a VTBC application designed to promote sustainable mobility, while also examining the interplay between this intention and current travel habits. To analyze these relationships, we developed a joint Integrated Choice and Latent Variable (ICLV) model that simultaneously considers two choice dimensions: (1) current commuting mode choice, and (2) intention to adopt the VTBC application. Our analysis uses data from 3044 commuters who were invited to take part to a VTBC program in the Cagliari metropolitan area (Italy). At the aggregate level, 44.1 % of respondents expressed interest in using the VTBC application. The modeling results reveal that individuals with graduate education, monthly incomes below €2000, and bicycle ownership demonstrate higher likelihood of app adoption. Among psychological factors, Environmental Concern and Attitude toward Sustainable Mobility positively influence the intention to use the application. As far as the interaction with mode choice is concerned, public transit users show stronger intention to adopt the application. Notably, some of the variables influencing app adoption intention differ from those affecting commuting mode choice, suggesting these represent distinct behavioral processes. These findings have important policy implications, emphasizing the need to carefully consider the promotion of such to engage as many people as possible. Additionally, extra caution is required when interpreting the results of these programs and their generalizability to the entire population, due to the self-selection of participants
Enhancing IoT Service Discovery through Semantic Name-based Forwarding
No full textNamed Data Networking (NDN) has emerged as a promising communication paradigm for the Internet of Things (IoT). In NDN, application-level service names, expressed as Uniform Resource Identifiers (URIs), are used directly at the network layer to facilitate service discovery and retrieval. Forwarding decisions at each NDN router rely on the longest-prefix match between the name carried in the incoming service request and the entries in its Forwarding Information Base (FIB). However, in highly dynamic and heterogeneous IoT environments, client applications, interested in accessing a given IoT service, may not always know the exact service names in advance. Additionally, different service providers, each using distinct namespaces but offering functionally equivalent services, may be capable of fulfilling the same request. This paper explores an alternative name-based forwarding approach that leverages semantic similarity to improve the chances of successfully resolving incoming IoT service requests. When an NDN node cannot find an exact name match, it applies a semantic similarity-aware mechanism to identify the most relevant forwarding path in the FIB toward a potential IoT service provider. This approach is implemented using deep learning models for sentence embedding, seamlessly integrated into the NDN forwarding fabric. Evaluation results demonstrate that semantic-aware forwarding significantly enhances service discovery in scenarios where exact name matching fails, while maintaining low processing times
The process of angiogenesis in neurodegeneration-pathomechanisms and new therapeutic interventions
No full textObjective: Neurodegenerative diseases are a leading cause of disability worldwide, and recent evidence highlights the role of angiogenesis in their pathophysiology. This review aimed to explore molecular and metabolic links between neurodegeneration and angiogenesis, and to assess the potential of antiangiogenic drugs as therapeutic agents. Methods: A targeted literature search of experimental and clinical studies was performed, focusing on angiogenesis-related mechanisms in neurodegeneration and the effects of antiangiogenic compounds on neuronal and vascular function. Results: Antiangiogenic agents have been shown to promote synaptic plasticity, enhance neurotransmission, and exert anti-inflammatory effects. They also modulate vascular remodeling, which supports optimal cerebral blood flow and nutrient delivery to neurons. These actions may counteract key pathological processes in neurodegenerative diseases and help preserve cognitive and motor function. Conclusions: Modulation of angiogenesis represents a promising therapeutic approach in neurodegenerative disorders. Antiangiogenic drugs may address both vascular and neuronal dysfunction, offering a potential avenue for disease-modifying treatments. Further preclinical and clinical research is needed to validate their safety, efficacy, and long-term benefits
A 14-year multicentric follow-up study of atypical pemphigus variants in Italy: the VARIANT_P study
No full textBackground: The clinical, epidemiological and immunopathological profiles of atypical forms of pemphigus remain only partially known.
Objectives: To define the clinical, epidemiological and immunological characteristics, therapies and outcomes in patients with atypical pemphigus variants.
Methods: This was a 14-year multicentre retrospective observational study (VARIANT_P) on atypical variants of pemphigus across Italy. We collected demographic, immunopathological and clinical data, as well as information on comorbidities and prescribed treatments.
Results: We enrolled 61 patients [female/male sex ratio 1.77; 13 paraneoplastic pemphigus (PNP), 26 IgA pemphigus (PIgA), 22 pemphigus herpetiformis (PH)]. The median ages at onset and diagnosis were 70.6 (range 43.1-86.8) and 71.1 (range 46.9-86.9) for PNP; 62.2 (range 3.8-81.0) and 63.6 (range 4.0-82.4) for PIgA; and 49.4 (range 5.4-84.4) and 52.3 (range 5.9-85.9) for PH, respectively. The median diagnostic delay was 3.0 (range 0.0-45.6) months for PNP, 9.5 (range 1.0-140.0) months for PIgA and 2.0 (range 0-30.4) months for PH. The mortality rate was 55% (6/11) for PNP, 4% (1/26) for PIgA and 6% (1/17) for PH. Cutaneous involvement was present in all patients with PIgA and PH, and in 83% (10/12) of the patients with PNP. In contrast, oral mucosal involvement was observed in all patients with PNP with data (n = 12), but only in 8% (2/26) of those with PIgA and 21% (4/19) of those with PH. Histology, direct immunofluorescence, indirect immunofluorescence and enzyme-linked immunosorbent assay data demonstrated variable concordance with previously known data. Comorbidities included mainly solid malignancies for people with PNP, whereas cardiovascular and metabolic diseases were the most prevalent for those with PIgA and PH. Treatment mostly relied on systemic steroids and rituximab.
Conclusions: The VARIANT_P study contributes to data collection relating to atypical pemphigus variants in order to promote the development of specific therapeutical guidelines in the future
