Total thyroidectomy associated to chemotherapy in primary squamous cell carcinoma of the thyroid

Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignant disease with rapid fatal prognosis. The onset is generally characterized by sudden bilateral latero-cervical lymphadenopathy. The Authors report patient of 58-year-old who referred for evaluation of rapidly aggravating bilateral latero-cervical lymphadenopathy. The US highlighted the presence of a hypoechoic nodular lesion characterized by peri and intra-nodular vascularization. Multilayer CT showed diffused involvement of mediastinal and bilateral latero-cervical lymph nodes, with no evidence of primary pulmonary neoplasia or elsewhere. The patient underwent total thyroidectomy. The peri-isthmic tissue was removed due to the presence of a small roundish formation, that was due to lymph node metastasis at histological examination. Histological diagnosis: PSCCT. The immunohistochemical panel of the thyroid lesion was indispensable for the differential diagnosis between PSCCT, medullary carcinoma, anaplastic carcinoma, and thyroid metastasis of neoplasia with unknown primitiveness. The patient underwent chemotherapeutic treatment with Carboplatin and Paclitaxel with modest improvement of dysphagia symptoms and reduction of 10-15% of the target lesions. The clinical course was characterized by loco-regional progression of the disease with exitus in 10 months after diagnosis. Survival and quality of life after surgical therapy and chemotherapy were like that of patients undergoing only chemotherapy. Due to the extreme rarity of the neoplasia, 60 cases described in Literature, no exclusive guidelines are reported for PSCCT. More extensive case studies are needed to evaluate the effects of total thyroidectomy with intent R0/R1 on improving survival and quality of life of patients with PSCCT

Hearts of Darkness: the inside out probing of black holes

Classical black holes shield us from the singularities that inevitably appear in general relativity. Singularity regularization being one of the main landmarks for a successful theory of quantum gravity, quantum black holes are not obliged to hide their inner core from the outside world. Notwithstanding the aforesaid, it is often implicitly assumed that quantum gravity effects must remain confined to black hole interiors. In this essay, we argue in the opposite direction, discussing theoretical evidence for the existence of strong correlations between the physics inside and outside nonsingular black holes. We conclude that astronomical tests of the surroundings of black holes can provide invaluable information about their so-far unexplored interiors

Opening the Pandora's box at the core of black holes

We present a geometric classification of all spherically symmetric spacetimes that could result from singularity regularization, using a kinematic construction that is both exhaustive and oblivious to the dynamics of the fields involved. Due to the minimal geometric assumptions underlying it, this classification encompasses virtually all modified gravity theories, and any theory of quantum gravity in which an effective description in terms of an effective metric is available. The first noteworthy conclusion of our analysis is that the number of independent classes of geometries that can be constructed is remarkably limited, with no more than a handful of qualitatively different possibilities. But our most remarkable result is that this catalogue of possibilities clearly demonstrates that the degree of internal consistency and the strength of deviations with respect to general relativity are strongly, and positively, correlated. Hence, either quantum fluctuations of spacetime come to the rescue and solve these internal consistency issues, or singularity regularization will percolate to macroscopic (near-horizon) scales, radically changing our understanding of black holes and opening new opportunities to test quantum gravity

On the Inner Horizon Instability of Non-Singular Black Holes

Regular black holes represent a conservative model in which the classical singularity is replaced by a non-singular core without necessarily modifying the spacetime outside the trapping horizon. Given the possible lack of phenomenological signatures, it is crucial to study the consistency of the model. In this short work, we review the physical mechanism leading to the instability of the central core, arguing that that non-perturbative backreation is non-negligible and must be taken into account to provide a meaningful description of physical black holes

Seismic Vulnerability Analysis of a Coupled Tank-Piping System by Means of Hybrid Simulation and Acoustic Emission

AbstractIn order to shed light on the seismic response of complex industrial plants, advanced finite element models should take into account both multicomponents and relevant coupling effects. These models are usually computationally expensive and rely on significant computational resources. Moreover, the relationships between seismic action, system response and relevant damage levels are often characterized by a high level of nonlinearity, which requires a solid background of experimental data. Vulnerability and reliability analyses both depend on the adoption of a significant number of seismic waveforms that are generally not available when seismic risk evaluation is strictly site-specific. In addition, detection of most vulnerable components, i.e., pipe bends and welding points, is an important step to prevent leakage events. In order to handle these issues, a methodology based on a stochastic seismic ground motion model, hybrid simulation and acoustic emission is presented in this paper. The seismic model is able to generate synthetic ground motions coherent with site-specific analysis. In greater detail, the system is composed of a steel slender tank, i.e., the numerical substructure, and a piping network connected through a bolted flange joint, i.e., the physical substructure. Moreover, to monitor the seismic performance of the pipeline and harness the use of sensor technology, acoustic emission sensors are placed through the pipeline. Thus, real-time acoustic emission signals of the system under study are acquired using acoustic emission sensors. Moreover, in addition to seismic events, also a severe monotonic loading is exerted on the physical substructure. As a result, deformation levels of each critical component were investigated; and the processing of acoustic emission signals provided a more in-depth view of the damage of the analysed components

Inner horizon instability and the unstable cores of regular black holes

Regular black holes with nonsingular cores have been considered in several approaches to quantum gravity, and as agnostic frameworks to address the singularity problem and Hawking’s information paradox. While in a recent work we argued that the inner core is destabilized by linear perturbations, opposite claims were raised that regular black holes have in fact stable cores. To reconcile these arguments, we discuss a generalization of the geometrical framework, originally applied to Reissner-Nordtsröm black holes by Ori, and show that regular black holes have an exponentially growing Misner-Sharp mass at the inner horizon. This result can be taken as an indication that stable nonsingular black hole spacetimes are not the definitive endpoint of a quantum gravity regularization mechanism, and that nonperturbative backreation effects must be taken into account in order to provide a consistent description of the quantum-gravitational endpoint of gravitational stellar collapse

The Endocannabinoid System: A Putative Role in Neurodegenerative Diseases

BACKGROUND: Following the characterization of the chemical structure of D9-tetrahydrocannabinol (THC), the main psychoactive constituent of marijuana, researchers have moved on with scientific valuable explorations. OBJECTIVES: The aim of this review is to highlight the role of endocannabinoid system in neurodegenerative diseases. MATERIALS AND METHODS: The article is a critical analysis of the most recent data currently present in scientific literature on the subject; a qualitative synthesis of only the most significant articles has been performed. RESULTS: In central nervous system, endocannabinoids show a neuromodulatory function, often of retrograde type. This way, they play an important role in synaptic plasticity and in cognitive, motor, sensory and affective processes. In addition, in some acute or chronic pathologies of central nervous system, such as neurodegenerative and neuroinflammatory diseases, endocannabinoids can perform a pro-homeostatic and neuroprotective function, through the activation of CB1 and CB2 receptors. Scientific evidence shows that an hypofunction or a dysregulation of the endocannabinoid system may be responsible for some of the symptoms of diseases such as multiple sclerosis, amyotrophic lateral sclerosis, Huntington’s, Parkinson’s and Alzheimer’s diseases. CONCLUSIONS: The important role played by endocannabinoid system promises interesting developments, in particular to evaluate the effectiveness of new drugs in both psychiatry and neurology