61 research outputs found

    A multicenter epidemiological study on second malignancy in non-syndromic pheochromocytoma/paraganglioma patients in Italy

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    SIMPLE SUMMARY: As no previous studies had assessed the risk of second malignant tumors in patients with pheochromocytomas/paragangliomas (PPGLs), we aimed to evaluate whether these patients could have an increased risk of additional malignancy, comparing them with patients in the general population who had a first malignancy and developed a second malignant tumor. We demonstrated that PPGL patients had higher incidence of additional malignant tumors and the risk of developing a second malignant tumor increased with age at diagnosis. As the main tumors were prostate, colorectal and lung/bronchial cancers in males, and breast cancer, differentiated thyroid cancer and melanoma in females, our findings could have an impact on the surveillance strategy. ABSTRACT: No studies have carried out an extensive analysis of the possible association between non-syndromic pheochromocytomas and paragangliomas (PPGLs) and other malignancies. To assess >the risk of additional malignancy in PPGL, we retrospectively evaluated 741 patients with PPGLs followed-up in twelve referral centers in Italy. Incidence of second malignant tumors was compared between this cohort and Italian patients with two subsequent malignancies. Among our patients, 95 (12.8%) developed a second malignant tumor, which were mainly prostate, colorectal and lung/bronchial cancers in males, breast cancer, differentiated thyroid cancer and melanoma in females. The standardized incidence ratio was 9.59 (95% CI 5.46–15.71) in males and 13.21 (95% CI 7.52–21.63) in females. At multivariable analysis, the risk of developing a second malignant tumor increased with age at diagnosis (HR 2.50, 95% CI 1.15–5.44, p = 0.021 for 50–59 vs. 60- vs. <50-year). In patients with available genetic evaluation, a positive genetic test was inversely associated with the risk of developing a second tumor (HR 0.25, 95% CI 0.10–0.63, p = 0.003). In conclusion, PPGLs patients have higher incidence of additional malignant tumors compared to the general population who had a first malignancy, which could have an impact on the surveillance strategy

    Conversational Speech Separation: an Evaluation Study for Streaming Applications

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    Continuous speech separation (CSS) is a recently proposed framework which aims at separating each speaker from an input mixture signal in a streaming fashion. Hereafter we perform an evaluation study on practical design considerations for a CSS system, addressing important aspects which have been neglected in recent works. In particular, we focus on the trade-off between separation performance, computational requirements and output latency showing how an offline separation algorithm can be used to perform CSS with a desired latency. We carry out an extensive analysis on the choice of CSS processing window size and hop size on sparsely overlapped data. We find out that the best trade-off between computational burden and performance is obtained for a window of 5 s

    An experimental review of speaker diarization methods with application to two-speaker conversational telephone speech recordings

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    We performed an experimental review of current diarization systems for the conversational telephone speech (CTS) domain. In detail, we considered a total of eight different algorithms belonging to clustering-based, end-to-end neural diarization (EEND), and speech separation guided diarization (SSGD) paradigms. We studied the inference-time computational requirements and diarization accuracy on four CTS datasets with different characteristics and languages. We found that, among all methods considered, EEND-vector clustering (EEND-VC) offers the best trade-off in terms of computing requirements and performance. More in general, EEND models have been found to be lighter and faster in inference compared to clustering-based methods. However, they also require a large amount of diarization-oriented annotated data. In particular EEND-VC performance in our experiments degraded when the dataset size was reduced, whereas self-attentive EEND (SA-EEND) was less affected. We also found that SA-EEND gives less consistent results among all the datasets compared to EEND-VC, with its performance degrading on long conversations with high speech sparsity. Clustering-based diarization systems, and in particular VBx, instead have more consistent performance compared to SA-EEND but are outperformed by EEND-VC. The gap with respect to this latter is reduced when overlap-aware clustering methods are considered. SSGD is the most computationally demanding method, but it could be convenient if speech recognition has to be performed. Its performance is close to SA-EEND but degrades significantly when the training and inference data characteristics are less matched

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    Dexamethasone suppression test: corticosteroid receptors regulation in mononuclear leukocytes of young and aged subjects.

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    The dexamethasone suppression test (DST) is considered an indicator of the function of the adrenal pituitary axis. The effect of the steroid is mediated by its binding to corticosteroid receptors. We previously suggested that the measurement of corticosteroid receptors in lymphocytes is an index of an analogous pattern in brain. In the present study, corticosteroid Type I and Type II receptors in mononuclear leukocytes were measured in 10 elderly subjects and in 9 young adults, before and after overnight DST (1 mg). Receptors were measured by radioreceptor assay. In all the subjects, dexamethasone was able to suppress plasma cortisol. The number of Type I and Type II receptors before the test was lower in elderly subjects than in adults. In the control group, dexamethasone produced a significant depression of Type I receptors (from 267 +/- 72 to 169 +/- 71 receptors per cell), which can be interpreted as a primary involvement of Type I receptors in the response to dexamethasone; Type II receptors decreased in half the subjects (from 2849 +/- 703 to 2345 +/- 569 receptors per cell). In elderly healthy subjects, Type II receptors were also significantly decreased (from 1796 +/- 671 to 720 +/- 345). We suggest that in young subjects Type II receptors are initially up-regulated by dexamethasone, and then down-regulated, while in aged subjects an up-regulation cannot be achieved, as suggested by the higher values of plasma cortisol usually found in aging subjects
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