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The pathogenesis of sarcopenia is multifactorial, including changes in the endocrine system. Easy-to-perform screening tests can guide the diagnosis of sarcopenia and the rehabilitation therapeutic conduct, which can act on many physiopathological links. This study was conducted over a period of 5 months, from April to August 2022, and included 84 patients hospitalized for a period of 10 days in the Balneal and Rehabilitation Sanatorium Techirghiol for complex physiotherapy, which included balneotherapy. In dynamics, both at admission and discharge, specific screening tests for sarcopenia (SARC-F questionnaire, grip strength, testing muscle strength at the level of the quadriceps, sit-to-stand tests (the time required for five consecutive rises and the number of rises performed in 30 s)) and the Visual Analogue Scale (VAS) for pain were performed. The study was conducted according to the norms of deontology and medical ethics. Results: A significant proportion of patients had a positive result in at least one of the tests for the screening of sarcopenia syndrome. The most eloquent results were obtained from the statistical analysis of the following parameters evaluated at admission: the SARC-F questionnaire and the sit-to-stand test—the number of rises in 30 s. In terms of dynamics, after performing the complex rehabilitation treatment, the patients recorded improvements in the established screening tests and improvements in pain symptoms evaluated with the help of the VAS. Conclusions: Sarcopenia, a pathology developed with aging, is frequently encountered among adults. In the future, it is important to perform screening for sarcopenia in both endocrinology and medical rehabilitation clinics. Good management of sarcopenia can influence therapeutic conduct and can prevent complications, improving the functional capacity and the quality of life of the patients.

ABSTRACT Increasingly sensitive diagnostic methods, better understanding of molecular pathophysiology, and well-conducted prospective studies have changed the current approach to patients with thyroid cancer, requiring the implementation of individualized management. Most patients with papillary thyroid carcinoma (PTC) are currently considered to have a low risk of mortality and disease persistence/recurrence. Consequently, current treatment recommendations for these patients include less invasive or intensive therapies. We used the most recent evidence to prepare a position statement providing guidance for decisions regarding the management of patients with low-risk PTC (LRPTC). This document summarizes the criteria defining LRPTC (including considerations regarding changes in the TNM staging system), indications and contraindications for active surveillance, and recommendations for follow-up and surgery. Active surveillance may be an appropriate initial choice in selected patients, and the criteria to recommend this approach are detailed. A section is dedicated to the current evidence regarding lobectomy versus total thyroidectomy and the potential pitfalls of each approach, considering the challenges during long-term follow-up. Indications for radioiodine (RAI) therapy are also addressed, along with the benefits and risks associated with this treatment, patient preparation, and dosage. Finally, this statement presents the best follow-up strategies for LRPTC after lobectomy and total thyroidectomy with or without RAI.

Introduction. Low back pain has a direct and proportional impact on function and a general one on the quality of life. The present study aims to evaluate the functional impact of low back pain using specific self-assessment tools as indexes of appreciation and epidemiological correlations of potential risk factors involved. The conceptual model of our research is based on the importance of correlating symptoms with clinical assessment, using scales of pain, disability, quality of life, and determination of epidemiological correlations of these areas and the determined factors of the pathology. Material and method. The study group is made up of 106 cases with clinical diagnostic of low back pain, admitted from 28 September 2020 to 28 March 2021, at Balneal and Rehabilitation Sanatorium of Techirghiol. After performing anamnesis, general clinical examination, specific neuro-musculo-skeletal examination, the patients filled the surveys highlighting the impact of their low back pain on functionality and disability deriving from it. The survey included the Oswestry Disability Index, the Functional Independence Measure (FIM) instrument and the Visual analog scale (VAS) score evaluated at the moment of hospitalization and at discharge. Statistical analysis of data was carried out and correlations between variables resulting from study were highlighted. The study was conducted according to the norms of deontology and medical ethics. The authors declare no conflict of interest. Results and discussions. Lumbar pathology is common in patients who are hospitalized for a complex balneary-physical-kinetic treatment at Balneal and Rehabilitation Sanatorium of Techirghiol. About 80% of patients who have addressed to our unit in which the study was conducted, have presented low back pain. The majority of patients were females, representing 57,55% of the total number. Regarding the patients’ age, 58,5% of them were in the 50-70 years interval. The study reveals a major positive impact of our treatment on spinal symptomatology, an effect pointed out by the relevant statistical differences between the admittance and discharge VAS scores(p

Introdução: Nosso grupo tem demonstrado evidências da relação entre os herpesvírus e a carcinogênese tireoidiana. O Herpes Simplex Vírus tipo 2 (HSV-2), um dos agentes infecciosos de maior prevalência mundial, tem se destacado nessa associação com o carcinoma diferenciado da tireoide (CDT) já que se aloja em linfonodos cervicais. Objetivo: Comparar a incidência de anticorpos da classe das IgG humanas para HSV-2 em soro de pacientes com nódulos tireoidianos benignos malignos com um grupo controle. Método: Para identificar a soroprevalência da infecção pelo HSV-2 em pacientes com CDT, analisamos a presença de anticorpos anti-HSV 2 utilizando o kit detecção da imunoglobulina G (HerpeSelect® 2 IgG -Focus Diagnostics, EUA) com alta especificidade para HSV-2 em 300 amostras sorológicas, sendo 150 pacientes com nódulos benignos e malignos da tireoide (131 mulheres e 19 homens, 42,34 ± 10,90 anos), onde 65 eram nódulos benignos (48 bócios, 17 AF) e 85 eram nódulos malignos (29 MCPT e 56 CPT); e 150 soros controles (21 homens e 129 mulheres e média de (45,0 ± 11,0 anos). Resultados: A soropositividade para HSV-2 foi observada em 37 (25%) dos pacientes com nódulos tireoidianos e em 32 (21%) dos controles (p = 0,5122). A taxa de soropositividade foi semelhante em pacientes com nódulos tireoidianos benignos (28%) e malignos (22%; p = 0,4522), e entre mulheres (12,2%) e homens (16,5%; p = 0,3415). Conclusão: Embora a soroprevalência de HSV-2 tenda a ser maior nos pacientes com nódulos tireoidianos do que na população sem nódulos, não foi possível correlacionar a presença do HSV-2 com tamanho dos nódulos, tipo histológico ou qualquer característica clínica, ou de evolução dos pacientes. Cálculo de tamanho amostral sugere que necessitamos de mais amostras, pois nosso poder de cálculo ainda é de 43%. Estamos providenciando o aumento da nossa casuística para confirmar possível correlação do HSV-2 com pacientes com nódulos tireoidianos malignos.

The immune response is remodeled with aging in a process called immunosenescence. Some immunologists conceive immunosenescence as an adaptation of immunity to the aged immune-environment rather than a merely collapsed reactivity of immune cells against microbes and tumor cells. Others believe on an uninterrupted activation of the innate immune system with aging, leading to a low grade, sterile and chronic proinflammatory state called inflammaging. For instance, it is possible that chronic infection by cytomegalovirus leads to persistent production of viral load. This phenomenon offers periodic stimuli to the immune system that ultimately contribute to the remodeling of the immune response. If investigating immunosenescence at the cellular level is already a difficult task, considering the population level is much more complex. However, by studying immunosenescence at the population level, we can extract valuable results with viable applications. While studies with animal models allow scientists to deepen their understanding of the mechanisms of immunosenescence, studying large populations can bring practical innovations to medicine and the health system. Many researchers and funders have dedicated themselves to producing methods for the evaluation of immunosenescence on a large scale, aiming to elucidate new mechanisms by which diseases are established in the elderly. The description of how the immune response is remodeled with aging emerges as a new tool to identify the subset of subjects in which unhealthy aging is a matter of time, to help better individualize clinical management and select patients who may benefit. of early interventions. This review focuses on functional assays as valuable methods for measuring the remodeling of the immune response with aging and discuss their clinical impact. We also recall fundamental concepts for understanding the aging process of the immune response. In addition, we highlight future prospects for immunosenescence research.

Abstract We have read with great interest the article entitled “Identification of an immune-related signature indicating the dedifferentiation of thyroid cells” by Wang et al. Their data reinforce our own previous results, here compiled. Anaplastic thyroid carcinoma had higher stromal scores, immune scores and enrichment of most immune cells than the control groups, suggesting that the immune microenvironment may correlate with differentiation status in thyroid cancer. We previously demonstrated that the differentiation status expressed by the pattern of protein expression may be related to the profile of immune cell infiltration of differentiated thyroid carcinoma. Wang et al. also explored the differences between the high-risk and low-risk score groups of samples. Among the distinct signaling pathways enriched in the high-risk score group, the epithelial to mesenchymal transition, TNFα signaling, and some common immune-related signaling pathways, including the IL-6/JAK/STAT3 pathway, interferon alpha response, interferon gamma response and inflammatory response were observed with high normalized enrichment score. We also investigated the IL-6 protein immune-histochemical expression in a retrospective study of 114 patients with papillary thyroid carcinoma and 39 patients with follicular thyroid carcinoma. We also obtained samples of 14 normal thyroid tissues from autopsies, 50 goiters and 43 follicular adenoma. We found IL-6 more frequently positive among malignant tumors than non-malignant samples. We demonstrated that IL-6 positivity was associated with infiltration of CD3 + cells, CD16 + cells and CD68 + macrophages. In addition, IL-6 expression was associated with infiltration of activated lymphocytes such as Granzyme B + cells and CD69 + cells. IL-6 positivity was not associated with infiltration of CD4+, CD8+, CD20+, FOXP3+, CD25 + cells but IL-6 was associated with tumor expression of PD-L1, FOXP3, IL-17, COX2, IL-1β, IL-10, CD134, IL-23. In summary, Wang et al. beautiful data reinforce the seminal idea that the immune landscape is closely related to the differentiation status of the tumor. This concept may help select individuals who deserve more careful attention, an essential point in the management of patients with mostly indolent tumors such as those of the thyroid. In fact, our results, here compiled, were obtained with immune-histochemistry, a routine laboratory technique that offers the possibility of simpler and practical execution.

This paper concerns the benefits of the active boundary layer control methods. The main focus was studying the effectiveness of suction control for a laminar flow over an airfoil. However, injection normal to or along the wall was also approached using two numerical methods. For different values and distributions of the velocity control magnitude, a systematic comparison was done. Having the results of the laminar flow, a linear stability analysis based on the small disturbance theory was carried out obtaining both the neutral stability curves and the transition point. In the end, for each case, results were presented with the corresponding observations. Additionally, a study on the dependency of the separation point with respect to the injection velocity magnitude was done.

ABSTRACT Objective: Abnormalities involving the TGFB1 gene and its receptors are common in several types of cancer and often related to tumor progression. We investigated the role of single nucleotide polymorphisms (SNP) in the susceptibility to cancer, their impact on its features, as well as the role of mRNA expression of these genes in thyroid malignancy. Materials and methods: We genotyped TGFB1, TGFBR1, and TGFBR2 SNPs in 157 papillary thyroid cancer (PTC) patients and 200 healthy controls. Further, we investigated RNA samples of 47 PTC and 80 benign nodules, searching for differential mRNA expression. Results: SNPs rs1800472 and rs1800469 were associated with characteristics of PTC aggressiveness. Effect predictor software analysis of nonsynonymous SNP rs1800472 indicated increasing protein stability and post-translational changes. TGFB1 mRNA expression was upregulated in PTC and downregulated in benign samples, differentiating malignant from benign nodules (p

Homemade culture is what is born from the interaction between art and home, between artists, hosts and audience, the living product generated in and by the domestic space. The personal dwellings are used as exhibition or performative spaces by the young curators who do not own any gallery or artists who are not willing to align esthetically and politically to the mainstream culture. Although neither financial, nor (intense) self-promotional purposes are pursued, they use their personal space in order to get noticed or just to make their art to a close circle of people who share the same values. The domestic space feature has a decisive influence on the structure, frequency, type of public and, of course, the content of the event. The homemade culture activities are directly dependent on the drive, the aims, the energy fluctuations of the hosts. I became interested in this topic because in December 2008, I opened an apartment theater in my own home. In 2010, I started studying similar initiatives around the world. I set out to highlight and describe these manifestations in order to reveal the existence of a sociocultural phenomenon not yet studied.

Endocrine-disrupting and carcinogenic effects of glyphosate have long been suspected, but little is known about the effect of compounds used in real life at different concentrations, neither in normal nor in thyroid tumor cells. As cancer cells may have different sensitivities and the effect of the product containing glyphosate may be different from that produced by the active ingredient alone, including the Acceptable Occupational Exposure Level (AOEL=160µg/L) and the Acceptable Daily Intake (ADI=830µg/L) determined by ANVISA, we used two human thyroid-derived cell lines, Nthy-ori 3-1 (from normal follicular cells) and TPC-1 (from papillary carcinoma), to test 15 different concentrations of Roundup® Original DI. Trypan blue (TB), CCK-8 and BrdU assays were used to evaluate cytotoxicity, metabolic activity and proliferation with 24h and 48h exposures in technical and biological triplicates. TB showed an important toxic effect, especially after 24h of exposure, in both cell lines. The AOEL concentration caused the death of 43% and 50% of the Nthy-ori and TPC-1 cells, respectively, in 24 h, while ADI resulted in 35% and 58% of cell death. After 48h of exposure, AOEL and ADI caused a lower number of dead Nthy-ori (33% and 18%) and TPC-1 (33% and 37%) cells, respectively, suggesting that the toxic effect of the product disappears and/or both strains have repair mechanisms that protect them from longer exposures. On the other hand, the CCK-8 assay showed that small concentrations of Roundup have a proliferative effect: 6.5µg/L increased the number of both Nthy-ori and TPC-1 cells at 24h, and the BrdU assay confirmed the stimulatory effect with a 321% increase in the absorbance of Nthy-ori cells at 48h. The herbicide produced even more frequent increases in the BrdU absorbance of TPC-1 cells, mainly at 24h. We conclude that thyroid cells exposed to Roundup present a nonmonotonic dual dose–response curve. Low concentrations of the pesticide, considered acceptable, cause significant cell death but also have an important proliferative effect, especially on TPC-1 cells. This herbicide, widely used around the world, may play a role in the increased incidence rate of thyroid nodules and cancer that has been observed in recent decades.

ContextAlthough the overt hyperthyroidism treatment during pregnancy is mandatory, unfortunately, few studies have evaluated the impact of treatment on reducing maternal and fetal outcomes.ObjectiveThis study aimed to demonstrate whether treatment to control hyperthyroidism manifested during pregnancy can potentially reduce maternal-fetal effects compared with euthyroid pregnancies through a systematic review with meta-analysis.Data SourceMEDLINE (PubMed), Embase, Cochrane Library Central, LILACS/BIREME until May 2021.Study SelectionStudies that compared, during the gestational period, treated women with hyperthyroidism versus euthyroid women. The following outcomes of this comparison were: pre-eclampsia, abruptio placentae, fetal growth retardation, gestational diabetes, postpartum hemorrhage, low birth weight, stillbirth, spontaneous abortions, premature birth.Data ExtractionTwo independent reviewers extracted data and performed quality assessments. Dichotomous data were analyzed by calculating risk differences (DR) with fixed and random effect models according to the level of heterogeneity.Data SynthesisSeven cohort studies were included. The results of the meta-analysis indicated that there was a lower incidence of preeclampsia (p=0.01), low birth weight (p=0.03), spontaneous abortion (p

ABSTRACT Subclinical hypothyroidism (Shypo) is an increasingly frequent condition in common medical practice. Its diagnosis continues to pose a challenge since a series of non-thyroidal and temporary conditions can elevate serum TSH levels. In addition, the consequences of Shypo are still up for debate. Although detrimental cardiovascular effects have been consistently demonstrated in the young, they are less evident in older adults (65-79 years), and even more so in the oldest old (≥80 years). In the absence of evidence of any benefits of treating Shypo in patients’ clinical manifestations and unfavorable outcomes, the most effective decision-making approach should include a thorough investigation of the patient's condition integrating all relevant clinical data, such as TSH levels, age, quality of life, comorbidities, cardiovascular risk, safety, and personal preferences. The decision-making process needs to take into account the risk of levothyroxine overtreatment and the resulting adverse consequences, such as reduction of bone mineral density, heart failure, and atrial fibrillation. Hence, current evidence suggests that individuals with TSH > 10 mU/L, who test positive for TPO Ab or are symptomatic may benefit from levothyroxine treatment. However, a more cautious and conservative approach is required in older (≥65 years of age), and oldest-old (≥80 years) patients, particularly those with frailty, in which the risk of treatment can outweigh potential benefits. The latter may benefit from a wait-and-see approach.

Abstract Background The NEK serine/threonine protein kinases are involved in cell cycle checkpoints, DNA damage repair, and apoptosis. Alterations in these pathways are frequently associated with cell malignant cellular transformations. Thyroid cancer is the most common malignant tumour in the endocrine system. Despite good treatment methods, the number of cases has increased significantly in recent years. Here, we studied the expression of NEK1, NEK2, NEK3, and NEK5 in different types of normal and malignant tissues, using tissue microarray analysis, and identified NEKs as potential markers in thyroid malignancy. Methods The studied cases comprised multiple cancer tissue microarrays, including breast, colon, esophagus, kidney, lung, pancreas, prostate, stomach, thyroid and uterine cervix, as well as 281 patients who underwent thyroid resection for thyroid cancer or thyroid nodules. The expression of NEK1, NEK2, NEK3, and NEK5 was analyzed by immunohistochemistry. The expression pattern was evaluated in terms of intensity by two methods, semiquantitative and quantitative, and was compared between normal and cancer tissue. Results We analysed the expression of each member of the NEK family in a tissue-dependent manner. Compared to normal tissue, most of the evaluated proteins showed lower expression in lung tumour. However, in the thyroid, the expression was higher in malignant tissue, especially for NEK 1, NEK3 and NEK5. Concerning characteristics of the thyroid tumour, such as aggressiveness, NEK1 expression was higher in tumours with multifocality and in patients with lymph node metastasis. NEK3 expression was stronger in patients with stage II, that involved metastasis. NEK5, on the other hand, showed high expression in patients with invasion and metastasis and in patients with tumour size > 4 cm. Furthermore, this work, demonstrated for the first time a high specificity and sensitivity of over-expression of NEK1 in classical and follicular variants of papillary thyroid cancer and NEK3 in tall-cell papillary thyroid cancer. Conclusion Taken together, the NEK protein kinases emerge as important proteins in thyroid cancer development and may help to identify malignancy and aggressiveness features during diagnosis. Trial registration This study was retrospectively registered. www.accamargo.org.br/cientistas-pesquisadores/comite-de-etica-em-pequisa-cep.

Introduction: Samples classified as indeterminate correspond to 10-20% of cytologies obtained by fine needle biopsy of thyroid nodules, preventing an adequate distinction between benign and malignant lesions and leading to diagnostic thyroidectomies that often prove unnecessary, as most cases are benign. Furthermore, although the vastmajority of patients with differentiated thyroid cancer (DTC) have such a good prognosis that active surveillance is permitted as an initial therapeutic option, relapses are not rare, and a non-negligible number of patients experience poor outcomes. MicroRNAs(miR)emergeaspotentialbio markers capable of helping to define more precise management of patients in all these situations. Methods: Aiming to investigate the clinical utility of miR-146b-5p in the diagnostic of thyroid nodules and evaluating its prognostic potential in a realworld setting, we studied 89 thyroid nodule samples, correlating miR-146b-5p expression with clinical tools such as the 8th edition from the American Joint Committee on Cancer (AJCC/UICC) and the American Thyroid Association Guideline Stratification Systems for the rate of recurrence (RR). Results: miR-146b-5p expression levels distinguished benign from malignant thyroid FNA samples (p< 0.0001). For indeterminate nodules, overexpression of miR-146b-5p with a cut-off of 0.497 was able to diagnose malignancy with a 90% accuracy; specificity=87.5%; sensitivity=100%. An increased expression of miR-146b-5p was associated with greater RR (p=0.015). A cut-off of 2.21 identified cases with more vascular involvement (p=0.013) and a cut-off of 2.420 was associated with a more advanced TNM stage (p-value=0.047). Discussion: We demonstrated that miR-146b5p expression in FNA samples is able to differentiate benign frommalignant indeterminate nodules and is associatedwith an increased risk of recurrence andmortality, suggesting that this single miRNAmay be a useful diagnostic and prognostic marker in the personalized management of DTC patients. [ABSTRACT FROM AUTHOR]

The current study analyzes the results of some research on social anxiety and the perception of control over anxiogenic events (PCEA) among students from the Faculty of Education Sciences - substitute teaching staff and students preparing for the teaching profession, aiming to identify the differences in these variables according to gender, field, stage of professionalization. The following were assumed: differences in the dimensions of social anxiety (distress and avoidance) and the perception of control over anxiogenic events depending on: the field of activity, gender, the level of perception of control over anxiogenic events (PCEA). The study included 168 adult students at the Faculty of Education Sciences from "Dimitrie Cantemir" Christian University of Bucharest, out of which 92 work in the education field (substitute teaching staff), and 76 in other fields of activity. The members of the research group are between 20 and 55 years old (M=37.66, DS=8.59), and in terms of gender - 12 participants are male, 156 are female. [ABSTRACT FROM AUTHOR]

The paper is a continuation of the efficiency and accuracy analysis of different high order numerical schemes previously published by the authors [1-3]. After the analysis of advection equation and the scalar conservation equation for different initial conditions and for different convex and non-convex conservative fluxes, we further investigated the one-dimensional conservation equation. This paper focuses on a new comparison of the behavior of the most known Weighted Essentially Non-Oscillatory (WENO) type numerical schemes for shock tube problem. We consider nine different Riemann Problems. Analytical solutions are provided for almost all different initial Riemann conditions. A third-order TVD Runge–Kutta (TVDRK3) scheme was adopted for advancing the solution in time. The motivation of this assessment is related to filling a gap in the specialized literature characterized by the bias towards presenting only cases favorable to a certain method. Our purpose is to present objectively the capacity of each method for solving one-dimensional conservation law problem. Unfortunately, not all the schemes identify accurately the position of the shocks or rarefaction waves and some of them even do not converge to a solution for different Riemann initial conditions.

Aerodynamic optimization is a very actual problem in aircraft design and airfoils are basic two-dimensional shape forming cross sections of wings. Traditionally, the airfoil geometry if defined by a very large number of coordinates. Nowadays, in order to simplify the optimization, the airfoil geometry is approximated by a parametrization, which enables to reduce the number of needed parameters to as few as possible, while effectively controlling the major aerodynamic features. The present work has been done on the Class-Shape function Transformation method (CST) [1, 2]. Also, the paper introduces the concept of Genetic Algorithm (GA) to optimize a NACA airfoil for specific conditions. A Matlab program has been developed to implement CS into the Global Optimization Toolkit. The pressure distribution lift and drag coefficients of the airfoil geometries have been calculated using two programs. The first one is an in-house code based on the Hess-Smith [3] panel technique and on the boundary layer integral equations, while the second is an XFOIL program. The optimized airfoil has improved aerodynamic characteristics as compared to the original one. The optimized airfoil is validated using the Ansys-Fluent commercial code.

The evaluation of the tunnel correction remains an actual problem, especially for the effect of tunnel walls. Even if the experimental campaign meets the basic similitude criteria (Mach, Reynolds etc.), the wall effect on the measured data is always present. Consequently, the flow correction due the limited by walls must be evaluated. Solid wall corrections refer to the aerodynamic interference between the experimental model and the walls of the wind tunnel. This interaction affects the measured forces and implicitly the angle of attack. Usually, these effects are introduced through semi-empirical correction factors which change the global measured forces. The present paper refers to the mathematical and numerical modeling of aerodynamic interferences between the experimental model and the solid walls based on the potential flow model. The main goal is to asses a method allowing an estimate of the corrections for each configuration with a minimum computational resource.