Use of the ultrasound-based total malignancy score in the management of thyroid nodules

Giovanni Guido Pompili,Silvia Tresoldi,Anna Ravell,Alessandra Primolevo,Giovanni Di Leo,Gianpaolo Carrafiello 대한초음파의학회 2018 ULTRASONOGRAPHY Vol.37 No.4

Purpose: The purpose of this study was to validate the role of the total malignancy score (TMS)in identifying thyroid nodules suspicious for malignancy through the sum of their ultrasoundfeatures. Methods: The local ethical committee approved this prospective observational study. Weexamined 231 nodules in 231 consecutive patients (164 females and 67 males; age range, 20 to87 years; median age, 59 years; interquartile range, 48 to 70 years) who underwent ultrasoundfollowed by fine-needle aspiration cytology (FNAC). The nodules were further classified usingthe TMS, which considers ultrasound features (number, echogenicity, structure, halo, margins,Doppler signal, calcifications, and growth), and the Bethesda System for Reporting ThyroidCytopathology (TBSRTC), which considers cytological features. Patients with non-negativenodules (TBSRTC categories III to VI) underwent histological analysis, repeated FNAC, or 2years of regular ultrasound follow-up. The associations between the final diagnosis, each of theultrasound features, and the TMS were estimated using the chi-square test, the Mann-WhitneyU test, and multivariate logistic regression. A receiver operating characteristic (ROC) curve wasused to evaluate the diagnostic accuracy of the TMS. Results: On ultrasound, 47% of the nodules (108 of 231) had a TMS <3, 18% (42 of 231) hada TMS of 3, and 35% (81 of 231) had a TMS >3. The FNAC results of 85% of the nodules (196of 231) were benign, while 15% (35 of 231) had non-negative results. Hypoechogenicity, solidstructure, the presence of microcalcifications, and the number of nodules were independentpredictors of the final diagnosis, and the diagnostic accuracy of the TMS was good (area underthe ROC curve, 0.82). Conclusion: The TMS system is simple to use, reliable, easily reproducible, and closely reflectsmalignancy risk. Based on our results, FNAC could be limited to nodules with a TMS ≥3 withoutmissing any cases of carcinoma.

Understanding the Complex of Suicide in Depression: from Research to Clinics

Laura Orsolini,Roberto Latini,Maurizio Pompili,Gianluca Serafini,Umberto Volpe,Federica Vellante,Michele Fornaro,Alessandro Valchera,Carmine Tomasetti,Silvia Fraticelli,Marco Alessandrini,Raffaella La 대한신경정신의학회 2020 PSYCHIATRY INVESTIGATION Vol.17 No.3

Objective Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15–17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians. Methods A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of ‘Major Depressive Disorder’ and ‘Suicide’ as following: ((suicide [Title/Abstract]) AND (major depressive disorder [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way. Results Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators. Conclusion The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.

Full-Duplex Underwater Acoustic Communications via Self-Interference Cancellation in Space

Hsieh, Yung-Ting,Qi, Zhuoran,Pompili, Dario 한국통신학회 2023 Journal of communications and networks Vol.25 No.2

Traditionally, underwater acoustic communicationsare half-duplex (HD), i.e., the hydrophones and transducersoperate in non-overlapping time-slots/frequency-bands in one di-rection. To double the spectral efficiency into the full-duplex (FD)mode, which transmit and receive signals simultaneously, a self-interference cancellation (SIC) technique in space is introducedand deployed. Specifically, a novel underwater acoustic system isproposed to perform FD-SIC efficiently via an integrated designcombining underwater acoustic vector sensor (AVS) and phasedarray transducer (PAT) to realize the spatial SIC. The energyfocusing function of the beamformer (BF) helps PAT avoid selfand mutual spatial interference. The AVS keeps updating thedirection of arrival information to let BF adjust the steeringangle via an adaptive protocol. The field-programmable gatearray (FPGA) Direction of Arrival Estimation (DOA) estimationis done by a 12-element AVS, run-time is 1.22×10−4 s byMUSIC method, which is promising for real-time applications. Inthis work, phase-shift keying (PSK) and PSK-based orthogonalfrequency-division multiplexing (OFDM) are deployed as theFD transmission modulation methods in the spacial SIC. Theproposal is evaluated and verified via both simulations andemulations in real underwater acoustic channels collected in theGulf of La Spezia, Italy, and it is able to achieve 59 dB SIC whilemodulating with binary phase-shift keying (BPSK) with carrierwave frequency 80 kHz and AVS steering angle −5◦. Moreover,it has at least 37 dB SIC within the steering angle region.

Sensory Processing Disorders are Associated with Duration of Current Episode and Severity of Side Effects

Gianluca Serafini,Batya Engel-Yeger,Gustavo H. Vazquez,Maurizio Pompili,Mario Amore 대한신경정신의학회 2017 PSYCHIATRY INVESTIGATION Vol.14 No.1

Objective: Longer duration of untreated illness, longer duration of current episode, and the severity of medication side effects may negatively impact on the perceived disability and psychosocial impairment of patients with major affective and anxiety disorders. Studies also suggested the involvement of sensory perception in emotional and psychopathological processes. The present study aimed to examine the relationship between Sensory Processing Disorders (SPD), duration of untreated illness and current illness episode, and the severity of side effects related to psychoactive medications. Methods: The sample included 178 participants with an age ranging from 17 to 85 years (mean=53.84±15.55). Participants were diagnosed with unipolar Major Depressive Disorder (MDD) (50%), Bipolar Disorder (BD) (33.7%), and Anxiety disorders (16.3%). They completed a socio-demographic questionnaire, the Udvalg for Kliniske Undersøgelser (UKU), and Adolescent/Adult Sensory Profile (AASP) questionnaire. Results: Longer duration of current episode correlated with greater registration of sensory input and lower avoidance from sensory input among unipolar patients; with lower registration of sensory input, and higher tendency for sensory sensitivity/avoidance among bipolar participants; with lower sensory sensitivity/avoidance among anxiety participants, respectively. Also, mean UKU total scores correlated with lower sensory sensitivity among bipolar individuals. Conclusion: SPD expressed in either hypo/hyper sensitivity may serve to clinically characterize subjects with major affective and anxiety disorders.