Pheochromocytomas and Paragangliomas: Genotype-Phenotype Correlations

Pheochromocytomas and paragangliomas are rare neuroendocrine tumors, with genetic background in about 40% of cases, involving more than 30 susceptibility genes. The susceptibility genes can be divided into three main molecular clusters: pseudohypoxic, kinase signaling, and Wnt signaling. Biochemical characterization of these particular tumors should be integrated into the diagnostic algorithm because it can help apply personalized medicine principles and targeted therapy. These tumors can present with very different genotype-phenotype correlations, and their characterization can help the clinical practitioner make optimal clinical management decisions and prioritize genetic testing. This chapter summarizes the most important aspects of genetics and clinical characteristics, together with new genotype-phenotype correlation data

THINK4JOBS TRAINING: Critical Thinking Training Packages for Higher Education Instructors and Labour Market Tutors

This Report presents the findings of the “Critical Thinking for Successful Jobs-Think4Jobs” Partnership regarding the development of Critical Thinking Training Packages for Higher Education Instructors and Labour Market Organisations Tutors, namely Intellectual Output II. Considering previous research findings, it is suggested that despite HE and LMO instructors’ willingness to promote CT, they both might lack conceptual as well as procedural knowledge regarding CT. In order to assume that a common understanding between HE and LMOs can be achieved to promote CT skills development effectively in future graduates, the aim of this project was to develop a training course for HE instructors as well as LMO tutors. More specifically, the project aims to strengthen University-Business Collaboration for the effective promotion, development, support and assessment of students’ CT through their transition into a professional context using apprenticeships as a privileged interface in order to “bridge the gap” between their skills and those needed by the labour market. The specific objective of the second Intellectual Output was to develop a training curriculum for Higher Education Instructors and Labour Market Organisations Tutors on how to promote, develop, support and assess students’ CT in apprenticeships curricula as well as on how to develop blended curricula using Moodle. The training aimed at reaching 30 participants from the Partnership (i.e., 15 from Higher Education and 15 from Labour Market Organisations). To reach the aforementioned objective for the delivery of the Output, five activities were originally designed: 1. Define the goals, outcomes and assessment criteria of the training packages. 2. Identify the training subjects and design the activities to be held. 3. Identify, select and/or create training resources, which will support the activities during the training packages. 4. Develop a transnational training course. 5. Delivery of the training course. University of Western Macedonia (UOWM) was the leading Organisation for the delivery of the second Intellectual Output. A Participatory Co-Design (PC-D Methodology was implemented to map the participants’ requirements and needs for the training. For the implementation of the training course, participants from both the Higher Education and the Labor Market Organisations from the five countries partake as Trainers providing various workshops focusing on experiential learning. More specifically, workshops concerned the deconstruction and reconstruction of previously held ideas regarding CT, the development of a working definition on CT for the Think4Jobs project, instructional approaches and teaching strategies that promote CT, blended learning and Moodle, the assessment of CT as well as the preparation of the Memorandum of Understanding (MoU) between HE and LMOs. Finally, a reflective session on the work carried out for the MoU and a session for the design and development of the CT blended apprenticeship curricula were scheduled. According to the registrations, on a daily basis, 35 participants engaged in the LTTA. Participants' knowledge on conceptual and procedural knowledge regarding CT, evaluation of CT, as well as blended learning, University-Business Collaboration and Moodle were evaluated in a pre-post measurement. In order to assess participants’ previous knowledge as well as the knowledge acquired during the LTTA, two online questionnaires were used. The first questionnaire (pre-measurement) was administered to participants at the beginning of the training course, while the second questionnaire (post-measurement) at the end of the LTTA (122 items for the pre-test, 130 items for the post-test, including questions about participants’ commitment during LTTA and their evaluation of the LTTA). The data collection tool consisted of seven distinct parts. The first part concerned demographic information, while the second part assessed participants’ level of perceived self-confidence in the issues addressed in the LTTA, the Moodle’s ease of use and perceived self-efficacy. Parts three to five of the tool explored participants’ conceptions regarding myths and facts about conceptual and procedural knowledge of CT, the evaluation of CT, blended learning and the University and Business Collaboration. Moreover, participants’ level of confidence about their answers was also assessed. Statistical analysis of data collected suggested that participants’ knowledge about CT, blended learning and the University and Business Collaboration increased after their participation in the LTTA. However, these results were not statistically significant. A statistically significant median increase elicited only in participants’ perceived self-confidence on the topics addressed during the LTTA, only for HE participants. Finally, the administrative and management of the implemented LTTA was evaluated highlighting that the event reached the predefined objectives and goals, met participants’ expectations and offered a high quality learning and training experience to the participants. Apart from the measurable data, a significant outcome of the LTTA was the development of a Memorandum of Understanding (MoU) between each pair of HEIs and LMOs partner per country. The MoU set a specific framework on the expected collaboration between HE and LMOs for the design-development (IO3), implementation and evaluation (IO4) of the CT blended apprenticeships curricula. The development of MoUs suggest that a common understanding on the design and delivery of CT blended apprenticeships curricula has been achieved and that UBC has been tailored to each pair of contributors. Overall, the CT training course presented in the current report has contributed to the existing research and literature in numerous ways. First, it presented a course designed to address the specific needs of its participants, by employing a PC-D approach. Second, it presented a training course that can also be applied in the future, as an intensive program aiming to enhance CT in educational and LMO settings. Third, it actively engaged HE Instructors and LMOs in a common training course, trying to reach a common understanding. Finally, the current report contributes to the literature with the exploitation of a multiple-choice instrument incorporating a Certainty Response Index identifying not only participants’ alternative concepts but also their level of confidence on aspects of CT, blended learning and UBC

THINK4JOBS TOOLKIT Ten work-based learning scenarios

The current report is the first Intellectual Output (Output 1) of the THINK4JOBS initiative, which aims at improving students’ CT skills and dispositions by promoting collaboration between Higher Education Institutions (HEIs) and Labour Market Organizations (LMOs). This is the case since according to relevant research findings, LMOs seem to expect employees to acquire CT skills in order for them to successfully address the needs of their work positions. Under this rationale, partners of the two aforementioned fields have decided to redesign and ameliorate HEI curricula by blending both HEIs and LMOs’ experience, knowledge and recommendations, while instilling this evidence into students’ apprenticeships. Apprenticeships offering practice in professional skills can actively lead to students’ understanding of their working environment and simultaneously scaffold CT development with the employment of mentoring. For this reason, the THINK4JOBS initiative exploits apprenticeships as a means of CT exploration and learning through which bridging the gap between HEIs and LMOs can be attained. Therefore, it is considered that in this fashion, students will be acquainted with the concept of CT and also be in the position of transferring it into their work settings, when entering the workplace. It should be noted that partners of the THINK4JOBS project are representatives from five disciplines (teacher training, English as a foreign language – EFL, business economics, business informatics and veterinary medicine), who formed teams between HEI and LMOs for each of these disciplines in order for ideas to be pluralized and CT to be explored across a variety of domains. The current report has a twofold aim: · to trace and map the methods and/or techniques that CT is currently employed in HEIs and LMOs’ apprenticeships and apprenticeships focusing on any possible convergent or divergent points; · to thoroughly describe and suggest work-based, learning scenarios that could bridge the gap between HEIs and LMOs’ curricula and simultaneously attempt to safeguard the requirements for graduates’ CT development and improvement. Mapping the Gap Regarding the first aim of the report, three research methods (observation, focus groups and documentary analysis) were employed in combination with three instruments (observational matrix, focus group rubric and documentary analysis rubric). Each research instrument includes a set of variables, which are majorly organized in three categories: I. Pedagogical aspects of CT development (including class objectives, teaching strategies/methods, tools/materials and evaluation regarding CT) II. CT aspects (including the ways CT is nurtured, triggered and explicitly taught during instruction) III. Implementation of CT (including elements of CT presence in these disciplines) For each variable, a set of indicators, drawing on CT and pedagogical theory was also developed in order for the aforementioned research instruments to be constructed. Stakeholders (HEI students and instructors as well as LMO tutors, employers and employees) participated in the mapping process. Data were collected during the winter semester 2020-2021 and a total of 134 participants from all partner countries participated in the focus groups discussions. Regarding the other two research methods, observation was carried out in at least three apprenticeships or courses, with at least four observation sessions for each of them. As far as it concerns the documentary analysis, documents supporting the courses/apprenticeships, which were observed, were analyzed according to the relevant rubric. Findings from each research instrument were triangulated according to each discipline and are thoroughly described in the current report in separate sections. However, some general conclusions seem to derive from a holistic approach to data analysis. Initially, it was suggested that even though a definitive “gap” between HEIs and LMOs does not seem to exist, there is a different context in CT approach since universities usually employ different learning activities focusing more on career preparation with long-term goals while LMOs follow compact and short-term, learning and teaching strategies. Additionally, findings suggested that CT is a newly-added requirement for the workplace and that HEIs and LMOs do not opt for the same terminology when referring to the concept –meaning that HEIs usually select scientific terms. Another element, which is evident is that CT in HEIs is commonly expressed through a declarative manner, while in LMOs application to specific cases follows the procedural manner. Learning Scenarios Regarding the second aim of this report, each team of HEI and LMO constructed two learning scenarios according to the findings, the sets of recommendations and the already identified educational needs. From the ten work-based scenarios developed, one from every discipline was organized in a syllabus form so that it can be further utilized for the CT blended apprenticeship curricula. This information highlights the importance of the scenarios, since they will set the stage for introducing CT at programme and course levels by utilizing Intellectual Output 3 activities to design work-based curricula for each country and dynamically enhance collaboration between HEIs and LMOs. Under this rationale, this scenario includes descriptive information about the themes, concepts, aims and learning outcomes, the duration, the teaching approach, the learning environment and the evaluation regarding both domain specific and CT related elements. First Intellectual Output Impact The current report is of major importance for the continuation of the THINK4JOBS project since it sets the stage for a sequence of activities carried out during the Second and Third Intellectual Outputs aiming at the successful application of the blended apprenticeships curricula. Besides the report’s importance for the project continuation, it may also stand as a useful Toolkit for teachers, students and employers regarding the development of CT in the workplace. In general, according to research findings, HEIs and LMOs are differently goal-oriented regarding CT and the reason for this divergence lies in the very nature and general context of the two organizations. In other words, HEIs intend to prepare students for all jobs related to a domain, while LMOs aim at preparing an employee for a specific job in a specific organization. This conclusion seems to indicate a paradox: the two organizations work in parallel but they do not share common understanding. This is the reason why the First Intellectual Output may be an invaluable means in the exploration of CT through different perspectives; actively supporting HEI and LMO collaboration in the quest for common ground

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Pros and cons of using derivatives

The global financial crises that affected the world economy starting with 2008 have at least three factors of great influence. However, the general opinion and the conclusions of researches conducted are that one of the most significant factors that is the increase dealing with more complex financial instruments, such as derivatives. The purpose of my research is to show the advantages given by using derivatives, being aware of the costs and risks associated

ADULT WOMEN WITH PAPILLARY THYROID CANCER

Differentiated thyroid cancer of papillary type have an increasing incidence on women of reproductive age but also in menopause, possible related to new triggers that act as endocrine disruptors which are more or less described until this moment or possible related to the increased accessibility to thyroid ultrasound. The incidence of non-medullary thyroid cancer in women is 3 times higher than in males so the influence of estrogens seems rational. Yet, some meta-analyses did not confirm a direct link with estrogens exposure during reproductive years. Thyroid cancer is also diagnosed in menopause which is a low estrogens status thus other risk factors should be taken into consideration; among these obesity and smoking are frequently incriminated. We aim to introduce a two cases series of adult females with differentiated thyroid carcinoma which was diagnosed from an initial routine ultrasound

ADRENAL ULTRASOUND

Ultrasound is the first step to detect an abdominal tumour at the level of adrenal. The most common scenario is related to the pelvic and abdominal ultrasound. This kind of tumour is more frequently seen in menopausal women than in premenopausal ones. We introduce a case of a menopausal woman accidentally detected at ultrasound with an adrenal mass starting from a routine gynaecological control. The use of ultrasound on adrenal masses is related to their detection and follow-up in cases when surgery is not necessar

Mammary cancer: Sneak peek to thyroid nodules

Breast cancer has a worldwide increasing incidence and once the diagnosis is done a screening is performed using method like ultrasound, computed tomography etc in order to assess disease spreading, according to the mammary malignancy’s stage. During this type of evaluation, a thyroid condition might be detected. Generally, 50-70% of adult population has a thyroid nodule of different dimensions, usually with a very low clinical relevance and a very good prognosis. If the pathogenic correlation between a thyroid nodule and the breast tumour is indeed sustained this is still a matter of debate. Our purpose is to introduce a series of subjects associating non-syndromic mammary cancer and thyroid nodules of various types. The use of thyroid ultrasound in patients with mammary cancer is mandatory. Most of thyroid nodules are incidental but some thyroid pathologies may actually be linked to breast malignancy

Testicular histological and immunohistochemical aspects in a post-pubertal patient with 5 alpha-reductase type 2 deficiency: case report and review of the literature in a perspective of evaluation of potential fertility of these patients.

International audienceBACKGROUND: Testicular morphology and immunohistochemical studies have never been reported in genetically documented adult patients with 5 alpha-reductase type 2 deficiency (5α-R2 deficiency). CASE PRESENTATION: We describe the testicular histopathology of a 17-year-old XY subject with 5α-R2 deficiency caused by the recurrent homozygous Gly115Asp loss of function mutation of the SRD5A2 gene.We also performed an immunohistochemical analysis in order to further study the relationship between seminiferous tubules structure, Sertoli cell differentiation and androgenic signaling impairment in this case. We thus evaluated the testicular expression of the anti-Müllerian hormone (AMH), androgen receptor (AR) and 3β-hydroxysteroid dehydrogenase (3βHSD). Histological analysis revealed a heterogeneous aspect with a majority (92%) of seminiferous tubules (ST) presenting a mature aspect but containing only Sertoli cells and devoid of germ cells and spermatogenesis. Focal areas of immature ST (8%) were also found. Testicular AR and 3βHSD expression were detected in adult male control, 5α-R2 deficiency and CAIS subjects. However, AMH expression was heterogeneous (detectable only in few AR negative prepubertal ST, but otherwise repressed) in the 5α-R2 deficiency, conversely to normal adult testis in which AMH was uniformly repressed and to an adult CAIS testis in which AMH was uniformly and strongly expressed. CONCLUSION: Intratesticular testosterone can repress AMH by itself, independently of its metabolism into dihydrotestosterone. We also compare our results to the few post pubertal cases of 5α-R2 deficiency with available histological testicular description, reported in the literature. We will discuss these histological findings, in the more general context of evaluating the fertility potential of these patients if they were raised as males and were azoospermic