Davide Costa

This study explores how patients interpret vascular risk through the intersecting lenses of disease type and gender. Drawing on qualitative interviews with 28 patients in Italy diagnosed with peripheral arterial disease (PAD) or chronic venous disease (CVD), the analysis examines how individuals construct meanings around symptoms, risk, and care. Findings reveal a hierarchy of vascular risk in which arterial disease is perceived as life-threatening and generates vigilance, anxiety, and intensive self-monitoring, whereas venous disease is often normalized and trivialized within everyday life. Gender further shapes these perceptions: men tend to minimize symptoms and delay care, while women demonstrate greater bodily attentiveness and concern. Theoretically, the study advances the concept of a socially constructed hierarchy of vascular risk, showing how culturally differentiated meanings of disease severity intersect with gendered embodiment to shape risk perception, symptom interpretation, and healthcare engagement. By integrating sociological theories of risk, biographical disruption, and gendered embodiment within the study of vascular disease, the analysis extends risk scholarship to an underexplored clinical domain and demonstrates how biomedical risk is translated into socially differentiated lived experience.

Carotid artery stenosis (CAS) is a major cause of ischemic stroke, yet little is known about how social determinants of health (SDHs) shape patients’ experiences beyond biomedical risk factors. This qualitative study explored how individuals living with CAS perceive the influence of SDHs across their illness trajectory. Semi-structured interviews were conducted with 30 adults receiving care at two Italian vascular surgery units. Data were analyzed using reflexive thematic analysis, guided deductively by the Centers for Disease Control and Prevention (CDC) five-domain SDH framework. Participants described CAS as an experience embedded within broader social conditions rather than solely a vascular disease. Economic resources influenced access to healthcare, healthy lifestyles, and treatment adherence; fragmented healthcare pathways, geographical barriers, and limited continuity of care complicated disease management; health literacy shaped understanding of the disease and engagement in self-management; neighborhood characteristics affected opportunities for prevention and physical activity; and family and community support represented essential resources for coping and navigating healthcare. These determinants interacted throughout the illness trajectory rather than operating independently. The findings indicate that effective CAS management extends beyond clinical treatment and requires integrating SDH assessment into routine vascular care to support person-centered management, strengthen treatment engagement, and reduce health inequalities.

Peripheral vascular diseases encompass an extraordinarily heterogeneous spectrum of disorders, ranging from highly prevalent atherosclerotic and venous conditions to uncommon vascular syndromes, anatomical variants, and vascular tumors

The English /t/ is among the most phonetically variable consonants in contemporary English, exhibiting multiple realizations that are shaped by linguistic, historical, and sociocultural factors. Although individual variants such as alveolar flapping, T-glottaling, unreleased /t/, and aspirated /t/ have been extensively investigated, existing research has largely examined these phenomena in isolation. This conceptual review integrates ev-idence from phonetics, sociophonetics, variationist sociolinguistics, linguistic anthro-pology, and communication studies to provide a comprehensive interpretation of English /t/ as a socially meaningful linguistic resource. The review first summarizes the principal phonetic realizations and traces their historical evolution across British and American English. It then critically examines how variation in /t/ is associated with major social determinants, including socioeconomic status, education, gender, age, regional identity, and communicative context. Building upon this interdisciplinary synthesis, the article proposes the concept of Linguistic Social Biomarkers and introduces the Theory of Lin-guistic Social Biomarkers (TLSB) as a conceptual framework for interpreting socially meaningful phonetic variation at the population level. Rather than functioning as de-terministic markers of individual identity, linguistic social biomarkers are understood as probabilistic indicators of broader processes of social organization, identity construction, and cultural change. This framework extends the sociological interpretation of pronun-ciation and provides a foundation for future interdisciplinary research on language, so-ciety, and human behavior.

This article introduces the concept of Normative Phonetic Inclusiveness (NPI), defined as the degree to which a speech community recognizes multiple phonetic realizations of the same phonological category as equally legitimate within a shared linguistic norm. Using the Dutch rhotic (/r/) system as an exploratory case, the paper argues that the sociolinguistic significance of phonetic variation extends beyond its role as a marker of social identity to include the social organization of linguistic legitimacy. Contemporary Dutch accommodates a wide range of rhotic realizations without systematically privileging a single variant, providing an opportunity to examine how linguistic communities regulate diversity within a stable normative framework. Rather than proposing a causal relationship between pronunciation and broader cultural values, the article suggests that linguistic norms and other social norms emerge within the same historical and institutional ecology. Drawing on sociolinguistics and classical sociological theories of norms, the study conceptualizes NPI as a property of speech communities rather than individual speakers and distinguishes it from established concepts such as phonetic variation, linguistic prestige, and language ideology. The Dutch case serves as a theoretically motivated illustration for developing a broader framework of linguistic legitimacy, with the aim of stimulating future comparative research on how different speech communities organize the acceptance of phonetic diversity.

Background: Chronic vascular wounds are increasingly recognized as complex conditions shaped not only by vascular pathology but also by social determinants of health (SDHs). While research has focused primarily on patient outcomes, limited attention has been paid to how providers experience socially contextualized wound chronicity. Objective: To explore how wound care professionals understand, experience, and respond to SDHs influencing chronic vascular wound healing, and how these dynamics affect professional identity, moral distress, and workforce sustainability. Methods: A qualitative study was conducted using semi-structured interviews with 22 wound care professionals (home care nurses and hospital-based specialist nurses) in Calabria, Italy. Participants held post-graduate training in wound care and at least 1 year of clinical experience. Interviews were analyzed using reflexive thematic analysis following Braun and Clarke's six-phase approach. Results: Five interrelated themes emerged: recognition of upstream social inequalities; structural barriers embedded in clinical practice; invisible advocacy and emotional labor; moral distress linked to constrained professional agency; and implications for professional identity and retention. Providers reframed non-adherence as structurally produced and described chronic wounds as embodied expressions of inequality. Conclusion: Chronic vascular wounds function as visible markers of social inequality. Addressing healing disparities requires integrating SDHs into clinical frameworks and supporting providers facing structurally generated moral and organizational strain.

Transgender individuals face unique challenges in vascular health due to the complex interactions between gender identity, psychosocial determinants of health, and medical interventions such as gender-affirming hormone therapy (GAHT). Growing evidence indicates that transgender populations may exhibit distinct patterns of vascular disease risk compared with cisgender individuals; however, available data remain limited and heterogeneous. A narrative review of the literature was conducted using major biomedical databases to identify studies examining the vascular and cardiovascular effects of gender-affirming hormone therapy in transgender individuals. This review provides a comprehensive overview of vascular health in transgender people, with particular attention to both venous and arterial disease. We summarize current epidemiological evidence on vascular outcomes and explore biological mechanisms through which exogenous sex hormones, including estrogens, anti-androgens, and testosterone, may influence endothelial function, vascular remodeling, inflammation, and coagulation pathways. Specific emphasis is placed on venous disorders, such as thromboembolic disease and chronic venous disease (CVD), as well as arterial conditions, including chronic peripheral arterial disease (PAD). In addition, we discuss the contribution of traditional vascular risk factors, minority stress, disparities in healthcare access, and social determinants of health in shaping vascular risk profiles. Clinical implications for vascular risk assessment, prevention strategies, and long-term monitoring in transgender individuals receiving GAHT are addressed. Finally, key knowledge gaps and priorities for future research are identified, underscoring the need for robust, longitudinal studies to support personalized and evidence-based vascular care in transgender populations.

Contrast-induced nephropathy (CIN), now more accurately referred to as contrast-induced acute kidney injury (CI-AKI), remains a major cause of hospital-acquired acute kidney injury (AKI) and is associated with increased morbidity and mortality, particularly in high-risk patients. This condition occurs following the intravascular administration of iodinated radiocontrast media (RCM), especially in individuals with pre-existing chronic kidney disease (CKD), diabetes mellitus, heart failure, advanced age, or exposure to high contrast volumes. The pathophysiology of CI-AKI is multifactorial and involves renal hemodynamic alterations, direct tubular toxicity, oxidative stress, inflammatory activation, and endothelial dysfunction, ultimately leading to tubular injury and reduced glomerular filtration rate (GFR). Traditional diagnostic markers such as serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) are limited by low sensitivity and delayed response, prompting growing interest in novel biomarkers, including cystatin C (CysC), β-2 microglobulin (β-2M), Interleukin-18 (IL-18), Kidney Injury Molecule-1 (KIM-1), Neutrophil Gelatinase-Associated Lipocalin (NGAL), and osteopontin (OPN), which allow earlier detection and risk stratification. Preventive strategies remain the cornerstone of management and include optimizing hydration protocols, minimizing contrast dose, selecting low- or iso-osmolar agents, and individualized risk assessments. Despite extensive research into pharmacological and procedural interventions, no effective treatment for established CI-AKI exists, underscoring the critical importance of prevention and ongoing investigation into safer contrast agents and innovative prophylactic approaches.

Vascular diseases (VD) remain a leading global cause of morbidity and mortality, often developing silently before manifesting as severe complications like stroke or ischemia. Traditional diagnostic imaging provides essential anatomical data but frequently fails to capture the dynamic molecular processes underlying vascular pathology. This narrative review summarizes current evidence regarding Extracellular Vesicles (EVs), including exosomes, microvesicles, and apoptotic bodies, as emerging biomarkers and mediators in vascular conditions. The review evaluates the biological mechanisms of EVs across several disorders, including arterial aneurysms, peripheral artery disease, carotid stenosis, and venous thromboembolism. Findings indicate that EVs concentration and molecular cargo, particularly microRNAs and proteins, reflect the physiological state of parent cells, offering a “liquid biopsy” for vascular inflammation, endothelial dysfunction, and plaque vulnerability. Furthermore, the review explores the therapeutic potential of stem cell-derived EVs in promoting angiogenesis and tissue repair in chronic vascular ulcers. Despite these advances, the review concludes that the clinical implementation of EV-based diagnostics faces significant hurdles, primarily due to the lack of standardized isolation and characterization methods. Addressing these methodological challenges is crucial for translating EV research into routine clinical practice.