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Moreover the IGF1 axis, which can be stimulated by excessive levels of circulating insulin, is one of the key pathways involved in proliferative responses in both normal and neoplastic thyroid cells (Vella et al., 2001

Additionally, low laminar flow found in smaller vessels promotes a quiescent state in ECs, while in larger vessels, higher physiological shear stress induces ECs' elongation and alignment parallel to the flow direction [208, 209]