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Background: Differentiated thyroid carcinoma (DTC), mainly papillary (PTC), at low risk of recurrence is currently managed with active surveillance strategies or less aggressive surgeries. However, total thyroidectomy with 131I treatment is still performed both if these tumors are diagnosed before or occasionally after surgery. This real-life study aimed to evaluate the rate of biochemical, structural, and functional events in a large series of consecutive DTCs at low risk of recurrence treated by total thyroidectomy, but not with 131I, in a medium–long-term follow-up. Patients and Methods: We evaluated clinical–pathologic data of 383 consecutive patients (2006–2012) with unifocal DTC [T1a/b(s)] at low risk of recurrence, treated with total thyroidectomy but without lymph node dissection and 131I treatment after surgery. We evaluated if structural, biochemical, and functional events were detected during the follow-up. Results: Females accounted for 75.7% of our study group, and the median age was 50 years. The median tumor dimension was 0.4 cm (range 0.1–1.2). Most of the patients had a unifocal T1a tumor (98.9%), and 73.6% had a classic variant of PTC. We divided the patients according to the absence (group A—n = 276) or presence (group B—n = 107) of interfering TgAb at first control after surgery. After a median follow-up of 10 years, no structural events were detected. Sixteen out of three hundred and eighty-three (4.2%) patients developed biochemical events: 12/276 (4.3%) in group A and 4/107 (3.7%) in group B. The median time elapsed from surgery to detecting a biochemical event was 14.5 and 77.5 months in groups A and B, respectively. No patients performed additional treatments and were followed up with an active surveillance strategy. Conclusions: This study confirmed that patients with DTC at low risk of recurrence showed an excellent outcome in a medium long-term follow-up since no structural events were diagnosed. Significant variations in Tg/TgAb were detected in a few cases, all managed with an active surveillance strategy without the need for other treatments. Therefore, a relaxed follow-up with neck ultrasound and Tg/TgAb measurement is enough to early identify those very unusual cases of recurrence.

Atrial fibrillation significantly increases the risk of thromboembolic events, necessitating anticoagulation for stroke prevention. However, patients with a history of intracranial hemorrhage pose unique management challenges, particularly regarding the use of anticoagulants and the need for dual antiplatelet therapy following procedures like percutaneous coronary intervention. In addition, the occurrence of bradyarrhythmias often necessitates pacing, underscoring the importance of innovative strategies such as left atrial appendage closure devices and leadless pacemakers to manage atrial fibrillation effectively while minimizing hemorrhagic risks. A 61-year-old man with permanent atrial fibrillation, recent intracerebral hemorrhage, and bradycardia presented with dizziness and recurrent syncopal episodes. During hospitalization, he underwent coronary angiography and percutaneous coronary intervention with drug-eluting stent placement in the left anterior descending and right coronary arteries. Due to anticoagulation risks, he subsequently underwent left atrial appendage closure with the LAmbre™ device and received an Aveir™ leadless pacemaker. Both procedures were successful, and he was discharged in stable condition. This case highlights how a combination of left atrial appendage closure, leadless pacing, and coronary intervention provided effective stroke prevention, heart rate control, and ischemic management in a high-risk atrial fibrillation patient. These strategies avoided the prolonged use of anticoagulants while addressing the patient’s cardiovascular and hemorrhagic risk.

BackgroundRecently, environmental pollution has become a significant concern for human, animal, and environmental health, fitting within the “One Health” framework. Among the various environmental contaminants, per- and polyfluoroalkyl substances (PFASs) have gathered substantial attention due to their persistence, bioaccumulation, and adverse health effects. This study aimed to compare the levels of 12 PFASs in the fur, liver, and muscle of wild roe deer to evaluate the feasibility of using fur as a non-invasive biomonitoring matrix.MethodsA total of 20 male and 20 female roe deer aged between 12 and 24 months were randomly sampled from a hunting area in Northern Italy. Samples of fur, muscle, and liver were collected post-mortem, and PFAS concentrations were measured using a validated UHPLC-HRMS method.Results and discussionThe results indicated significant differences in PFAS concentrations among the three matrices. Fur, although easier to sample and store, showed highly variable PFAS levels, with different detection frequencies compared to the muscle and liver. PFASs such as PFHxA were more frequently detected in fur than in the liver and muscle, while compounds such as PFBA, PFPeA, PFHpA, PFDA, PFHxS, 6-2 FTS, and 8-2 FTS were less frequently detected in fur. In conclusion, while fur presents many practical advantages for biomonitoring, such as non-invasive sampling and stability, its use is complicated by varying detection frequencies and concentration levels. These aspects, together with the use of a single sampling technique, can be considered a limitation of the study. Notably, compounds such as PFOA, PFNA, and PFOS showed partially similar detection frequencies across the matrices, suggesting potential interest for further research. This study offers new perspectives on the use of fur for environmental monitoring, highlighting the need for more extensive research to understand the relationship between PFAS concentrations in fur and other biological matrices. Future studies should focus on methodological improvements in extraction and quantification techniques for PFASs in fur to enhance their reliability as a biomonitoring tool.

This study investigates the potential of fluorescence characteristics of dissolved organic matter (DOM) to identify sediment organic matter (OM) sources in shallow lakes. Spectral analyses were performed on water and alkali extractable organic matter (WEOM and AEOM) from Lake Taihu sediments. The lake was divided into seven distinct regions: R1 and R2 strongly influenced by inflowing rivers, R3 and R4 were characterized by submerged macrophytes, and R5-R7 were dominated by cyanobacterial blooms. The investigation illustrated that the highest values of water and alkali extractable organic carbon (WEOC and AEOC) were found in region R4. Specifically, the Humification Index (HIX) values consistently exceeded 2.0 in the northwest regions, contrasting with values predominantly below 1.0 in most southeastern regions. Moreover, the Fluorescence Index (FI) of WEOM in regions R5, R6 and R7 reached 2.10, markedly higher than the values observed in other regions. The horizontal distribution of the four spectrographic indices of AEOM exhibited partial similarity to the distribution pattern of WEOM. Although the WEOC content marginally trailed AEOC, there was a significant correlation between WEOM and AEOM in three indices including slope ratio (SR), HIX and FI. The identification of sources implied that organic matter in sediments of regions R1 and R2 originated from terrestrial sources, while regions R3 and R4 were largely derived from submerged macrophyte and the regions R5-R7 were notably impacted by cyanobacteria-derived organic matters. Notably, the identification results aligned perfectly with the distribution of inflowing rivers, cyanobacterial blooms and submerged macrophyte coverage within Taihu Lake, underscoring the potential use of dissolved organic matter's spectral characteristics for organic matter source analysis within sediments. Synopsis: This study identifies distinct sources and spatial distributions of organic matter in Lake Taihu's sediments, using fluorescence characteristics to highlight influences from terrestrial input, submerged macrophytes, and cyanobacterial blooms.

The demand for light olefins, including ethylene, propylene, and butene, continues to grow as they serve as essential intermediates for numerous chemical products. Traditional production methods rely heavily on fossil resources, raising concerns about environmental impact and resource depletion. As the global focus shifts towards sustainability and carbon neutrality, researchers are exploring alternative and renewable feedstocks, such as biomass and waste, to produce light olefins. This review paper provides an in-depth analysis of the recent advancements and strategies employed in the production of light olefins directly and indirectly from biomass and waste via thermochemical processes. Emphasis is placed on the role of catalysis in these approaches, covering catalyst types, applications, and performance. Furthermore, this review explores process intensification approaches as potential avenues for enhancing the efficiency and sustainability of olefin production. By presenting a holistic view of the current state of olefin production from recovered feedstocks, this work aims to contribute to the development of greener and more sustainable bio-based industries, ultimately fostering a transition towards a circular economy and mitigating the environmental impact of the petrochemical industry.

Parathyroid lipoadenoma is an uncommon type of parathyroid adenoma and a rare cause of primary hyperparathyroidism (PHPT). The rarity of this entity, the difficult detection on imaging and the resemblance with normal parathyroid tissue microscopically makes its diagnosis difficult. We reported the case of an asymptomatic 48-year-old male treated for amiodarone-induced thyrotoxicosis and incidental sporadic PHPT, that supplements and supports the rare literature data concerning the knowledge, diagnosis, and treatment of parathyroid lipoadenoma.

IntroductionPrimary hyperparathyroidism (PHPT) is a common endocrine disorder in which surgery is the only curative therapy. Ectopic parathyroid adenoma in the pyriform sinus resulting from a pathological migration of parathyroid glands along the embryological development is a rare cause of PHPT. We describe a case of a persistent primary hyperparathyroidism after previous unsuccessful surgery due to an ectopic parathyroid adenoma within the pyriform sinus and we review the previous reports on this issue.Case presentationA 62-year-old woman was referred for persistent hypercalcemia following unsuccessful cervical exploratory surgery. Cervical ultrasound did not detect any parathyroid abnormalities. At variance, 99mTc-sestamibi SPECT/CT and CT scan of the neck identified a parathyroid adenoma in the left pyriform sinus, which was confirmed by endoscopy. The patient was successfully treated by transoral robotic resection and the pathology confirmed a parathyroid adenoma.ConclusionsThe ectopic parathyroid adenoma in the pyriform sinus is so uncommon that only fourteen cases have been reported. However, the pyriform sinus should be considered a possible location of ectopic parathyroid glands, especially in the setting of persistent or recurrent PHPT after parathyroid surgery.

BackgroundTyrosine kinase inhibitors (TKIs) and immunotherapy have been proposed for advanced metastatic anaplastic thyroid cancer (ATC). We report a case of BRAF V600E-mutated ATC in which lenvatinib (L) plus pembrolizumab (P) enabled neoadjuvant treatment.Case presentationA male patient aged 65 years presented with a rapidly enlarging left latero-cervical mass. Fine needle aspiration was suggestive of ATC. Surgical consultation excluded radical surgery. While awaiting molecular profile analysis and considering the fast evolution of the disease, treatment with L and P was started. L was started at a dose of 14 mg daily, while P was started at the standard regimen (200 mg every 3 weeks). After 1 month, computerized tomography showed a reduction in the mass with almost complete colliquative degeneration, and the carotid artery wall was free from infiltration. Radical surgery was performed. Histology confirmed papillary thyroid cancer (PTC) in the left lobe and ATC with extensive necrosis in the left latero-cervical lymph node metastasis. The margins were free of tumors (R0). A BRAF V600E mutation was present in both PTC and ATC. At the 1-year follow-up, the patient was free of disease.ConclusionL and P in combination also appeared to be effective as a neoadjuvant treatment for BRAF V600E-mutated ATC. This combination treatment could be used when there is an opportunity for complete resection of the cancer, and as soon as possible. The intermediate dose of 14 mg of L appeared to be well tolerated and effective.

Biomass is an abundant renewable energy resource that can be converted into carbon-based biofuels. Pyrolysis is a thermochemical process that allows the rapid conversion of residual biomass and biowaste into bio-oil, a liquid biofuel with a high energy density. Hydrodeoxygenation (HDO) is a catalytic process in which typically high-pressure hydrogen is used to remove oxygen mainly through dehydration, decarboxylation and decarbonylation reactions from the oxygenated compounds of bio-oil. The objective of this work is to evaluate the process of hydrodeoxygenation under mild conditions, i.e. atmospheric pressure, quantifying the hydrogen consumption and the degree of deoxygenation. The organic fraction of the pyrolysis oil of spent coffee grounds has been processed in a packed-bed reactor in a semi-continuous regime. The performance of two different MoO3/NiO alumina-supported catalysts were evaluated at 350°C and LHSV of 0.5. The results showed a high upgraded oil yield (72-87 w/w %), limited gas production (up to 1 w/w%) and a limited coking (12-26 % w/w). GC-MS analysis of upgraded oil showed a significant reduction of hydrocarbons molecular weight, as well as caffeine, fatty acids and furans relative concentration, while pyridines, phenolics and ketones were still very abundant. The measured hydrogen consumption was very limited (up to 1g/L bio-oil), suggesting that increasing pressure would be beneficial for higher degree of deoxygenation.

The analytical study described in this work, based on NIR spectroscopy with a handheld device, allowed the development of a chemometric prediction model that has been validated for the objective evaluation of the ripening of olive drupes. The miniaturized, portable NIR spectrometer is proposed here as an easy-to-use sensor able to estimate the best harvesting time for ripening of olive drupes. The MicroNIR/chemometrics approach was developed for on-site identification of olive drupe ripening directly on plants, avoiding collection and successive laboratory analysis steps. A supporting parallel characterization by chromatographic techniques validated the spectroscopic prediction. The novelty of this approach consists in the possibility of investigating the olive drupe maturation point by collecting spectra in the near-infrared region and processing them using a chemometric model. The fast and accurate device allows one to easily follow the spectrum profile changes of olive drupes during ripening, thus preserving the fruits from being harvested too early or too late. The results of this study demonstrate the possibility of using the MicroNIR/chemometrics approach to determine the optimal ripening time of olives regardless of the plant variety, age and cultivation location. The results consequently demonstrated that the MicroNIR/chemometrics approach can be proposed as a new method to perform on-site evaluation of ripening by a single-click device. It can be conveniently used by any operator, who does not necessarily have to be expert but must simply be trained to use spectroscopy and a prediction model.

Background: Second 131I treatment is commonly performed in clinical practice in patients with differentiated thyroid cancer and biochemical incomplete or indeterminate response (BiR/InR) after initial treatment. Objective: The objective of the is study is to evaluate the clinical impact of the second 131I treatment in BiR/InR patients and analyze the predictive factors for structural incomplete response (SiR). Patients and methods: One hundred fifty-three BiR/InR patients after initial treatment who received a second 131I treatment were included in the study. The clinical response in a short- and medium- long-term follow-up was evaluated. Results: After the second 131I treatment (median 8 months), 11.8% patients showed excellent response (ER), 17% SiR, while BiR/InR persisted in 71.2%. Less than half (38.5%) of SiR patients had radioiodine-avid metastases. Patients who, following the second 131I treatment, experienced SiR had larger tumor size and more frequently aggressive histology and vascular invasion than those experienced BiR/InR and ER. Also, the median values of thyroglobulin on levothyroxine therapy (LT4-Tg), Tg peak after recombinant human TSH stimulation (rhTSH-Tg) and thyroglobulin antibodies (TgAb) were significantly higher in patients who developed SiR. At last evaluation (median: 9.9 years), BiR/ InR persisted in 57.5%, while 26.2% and 16.3% of the patients showed ER and SiR, respectively. About half of BiR/InR patients (71/153 (46.4%)) received further treatments after the second 131I treatment. Conclusions: Radioiodine-avid metastatic disease detected by the second 131I is an infrequent finding in patients with BiR/InR after initial treatment. However, specific pathologic and biochemical features allow to better identify those cases with higher probability of developing SiR, thus improving the clinical effectiveness of performing a second 131I treatment.

Background and purposeThis study aimed to investigate the factors that influence physiotherapists’ decision in choosing restorative or compensatory rehabilitation during gait training in people with neurological disorders (PwNDs) and the different treatments used in the approaches.MethodsThis cross-sectional analysis used the baseline data from an observational cohort study. We analyzed data from 83 PwNDs (65 people after stroke, 5 with multiple sclerosis, and 13 with Parkinson’s disease) who underwent at least 10 sessions of physiotherapy (PT) focusing on gait function. Performance was quantified using the modified Dynamic Gait Index (MDGI), three impairment domains of Fugl–Meyer Assessment for lower extremity (mFM-LL), Activities-specific Balance Confidence (ABC), modified Barthel Index (mBI), Mini-Mental State Examination (MMSE), and Motivational Index (MI). Forty-three physiotherapists completed a treatment report form categorizing the rehabilitation approach and specifying treatments used (e.g., resistance training and proprioceptive exercises).ResultsFifty-six subjects underwent restorative rehabilitation approach. The univariate predictors of restorative approach were being in the subacute phase with a disease onset of less than 180 days, (odds ratio [95%CI]; 3.27[1.19–9.24]), mFM-LL (1.25[1.11–1.44]), MMSE (0.85[0.67–1.00]), and number of sessions (1.03[1–1.01]). The backward stepwise analysis revealed an association between restorative and subacute phase (36.32[4.11–545.50]), mFM-LL (3.11[1.55–9.73]), mBI (1.79[1.08–3.77]), MMSE (0.46[0.25–0.71]), and the interaction between mFM-LL and mBI (0.99[0.98–1.00]). No statistically significant association between treatments used and approach was found (p = 0.46).Discussion and conclusionThe restorative approach was more commonly used to improve gait. The main variables associated with this approach were: being in the subacute phase of the disease, a low level of impairment, and a high level of functional independence at baseline. However, few differences were found between the treatments used for the restorative or compensatory approaches, as similar PT treatments were used for both.

Limited or absent activity of the enzyme α-galactosidase A (α-Gal A), due to mutation in the related gene on the X chromosome, leads to the development of a rare hereditary and genetic disease known as Fabry disease (FD). This pathology involves a progressive accumulation in various organs of the substrates of the enzyme e.g., globotriaosylceramide (Gb3) and its deacylated form, globotriaosylsphingosine (Lyso-Gb3), suggesting these molecules as biomarkers of Fabry disease. The present paper describes the development of an analytical strategy for the identification and quantification of Gb3 and Lyso-Gb3, in serum and blood samples by using liquid chromatography (LC) coupled to mass spectrometry in multiple reaction monitoring (MRM/MS) ion mode. The best experimental conditions were obtained by extracting the glycolipids with chloroform/methanol/H2O (2/1/0.3) and by separating them on a C4 column with a linear gradient (A: H2O with 2 mM ammonium formate. B: methanol with 1 mM ammonium formate, both acidified with 0.2% formic acid). The best transitions (a combination of precursor and fragment ions—m/z) were 786.8 m/z > 268.3 m/z for Lyso-GB3, 1137.3 m/z > 264.3 m/z for Gb3, 1039.3 m/z > 264.4 m/z for N-heptadecanoyl-ceramide trihexoside, and 843.5 m/z > 264.3 m/z for N-glycinated lyso-ceramide trihexoside, the latter being used as an internal standard. The developed method provided a reliable, fast, and effective procedure for direct measurements of GB3 and Lyso-GB3 in serum and blood for diagnosis of Fabry disease, suggesting this method as a complementary assay to the current enzymatic test. Therefore, this approach could open new insights into the clinical diagnostics of lysosomal storage disorders.

The interest in the quality control of the raw materials, intermediates, and final products, as well as production methods, of beer has increased significantly in recent decades due to the needs and expectations of consumers. Increasing in the industrialization and globalization of beer supply chains led to a need for novel analytical tools suitable for the rapid and reliable characterization of the materials involved. In this study, an ultracompact instrument operating in the NIR region of the spectrum, microNIR, was tested for the chemical investigation of barley malts. The essential raw materials for brewing require careful control since they deeply affect the characteristic flavor and taste of the final products. Therefore, a robust prediction model able to classify base and specialty barley malts was developed starting from NIR measurements. Soft Independent Class Analogy (SIMCA) was selected as the chemometric technique for the optimization of two prediction models, and ground and sieved materials were investigated using spectroscopy. The microNIR/chemometric approach proposed in this study permitted the correct prediction of the malt samples included in the external validation set, providing false positive and false negative rates no higher than 3.41% and 0.25%, respectively, and confirming the feasibility of the novel analytical platform.

The formation and evolution of management gullies is a highly intense process of soil erosion often overlooked in policies and river basin strategies. Despite the worldwide spread of the phenomenon, our ability to assess and simulate gullying and its impacts remains limited; therefore, predicting the development and evolution of these river reaches represents a significant challenge, especially in areas where the loss of productive soil or the hazards linked to landslides or floods represent critical factors. Our study demonstrates how an exclusively morphometric approach, based on the construction of the hypsometric curve and applied to small hydrographic basins that are lithologically homogeneous and hierarchized according to the Strahler classification method, is able to predict the triggering height of the gullies; this height corresponds to the mean elevation of the basin and the inflection point of the hypsometric curve itself, confirming the hypothesis that this point coincides with the point at which a sudden change in surface runoff energy occurs, The study also shows that the portion of the basin necessary to trigger these intense erosive processes is always within a small range, regardless of the size and morphology (slope) of the basin itself. Such an approach, which is quick and relatively easy to apply, could help develop hydrogeological hazard mitigation practices in land planning projects.

IntroductionGoiter is a common problem in clinical practice, representing a large part of clinical evaluations for thyroid disease. It tends to grow slowly and progressively over several years, eventually occupying the thoracic inlet with its lower portion, defining the situation known as retrosternal goiter. Total thyroidectomy is a standardized procedure that represents the treatment of choice for all retrosternal goiters, but when is performed for such disease, a higher risk of postoperative morbidity is variously reported in the literature. The aims of our study were to compare the perioperative and postoperative outcomes in patients with cervical goiters and retrosternal goiters undergoing total thyroidectomy.MethodsIn our retrospective, multicentric evaluation we included 4,467 patients, divided into two groups based on the presence of retrosternal goiter (group A) or the presence of a classical cervical goiter (group B).ResultsWe found statistically significant differences in terms of transient hypoparathyroidism (19.9% in group A vs. 9.4% in group B, p

Papillary thyroid cancer (PTC) is a common endocrine malignancy, and its incidence is reported to be constantly increasing. BRAF mutation is detected in approximately 44% of PTCs, and the most common BRAF mutation is thymine (T) to adenine (A) missense mutation in nucleotide 1796 (T1796A, V600E). Although BRAFV600E represents 95% of all BRAF mutations, uncommon BRAF mutations have been reported in thyroid carcinomas and represent an alternative mechanism of BRAF activation with unclear clinical significance. We report a novel non-V600E mutation (c.1799_1812delinsAT, p.V600_W604delinsD), identified preoperatively with next-generation sequencing (NGS) on the material obtained with fine-needle aspiration cytology (FNAC) performed on a thyroid nodule cytologically suspicious for malignancy in a 35-year-old male patient. The presence of this new variant of BRAF mutation was subsequently confirmed in the postoperative phase by direct Sanger sequencing. In conclusion, we report a new non-V600E variant previously undetected in papillary thyroid cancer. In addition, this case report shows that the NGS technique on cytological tissue allows to detect the presence of rare mutations, thus increasing the diagnostic specificity of molecular analysis.