Effect of the intraoperative head hypsokinesis on sore throat after thyroid surgery: a randomized controlled trial.

PURPOSE: Postoperative sore throat (POST) after thyroidectomy is a major concern.A roll is typically inserted under the shoulder to achieve head hypsokinesis and neck extension to better expose the surgical site during thyroid surgery. However, POST and impaired voice function have been attributed to neck overextension. This study aimed to explore the rational angle of head hypsokinesis that both reduced sore throat intensity and protects voice function after thyroid surgery. METHODS: A total of 210 patients who underwent thyroidectomy were enrolled and randomized into high-tilt (Group H) and low-tilt angle groups (Group L). The primary outcome was the incidence of POST 6 h after surgery. Secondary outcomes included the severity of postoperative pharyngeal pain, voice function, swallowing pain, and coughing. RESULTS: The incidence of POST 6 h after thyroidectomy was significantly lower in Group L than that in Group H. In addition, the intensity of postoperative sore throat and swallowing pain was more severe in Group H. A lower degree of head hypsokinesis in Group L prevented transient postoperative voice injury. CONCLUSIONS: A lower degree of head hypsokinesis effectively mitigated sore throat severity after thyroidectomy and improved postoperative voice function. REGISTER INFORMATION: The trial was registered in the Chinese Clinical Trial Registry on 21 June 2022 (ChiCTR2200061329). The trial is registered at https://www.chictr.org.cn/showproj.html?proj=166254 .

A Lifestyle Monitoring System for Older Adults Living Independently Using Low-Resolution Smart Meter Data.

BACKGROUND: Monitoring the lifestyles of older adults helps promote independent living and ensure their well-being. The common technologies for home monitoring include wearables, ambient sensors, and smart household meters. While wearables can be intrusive, ambient sensors require extra installation, and smart meters are becoming integral to smart city infrastructure. Research Gap: The previous studies primarily utilized high-resolution smart meter data by applying Non-Intrusive Appliance Load Monitoring (NIALM) techniques, leading to significant privacy concerns. Meanwhile, some Japanese power companies have successfully employed low-resolution data to monitor lifestyle patterns discreetly. SCOPE AND METHODOLOGY: This study develops a lifestyle monitoring system for older adults using low-resolution smart meter data, mapping electricity consumption to appliance usage. The power consumption data are collected at 15-min intervals, and the background power threshold distinguishes between the active and inactive periods (0/1). The system quantifies activity through an active score and assesses daily routines by comparing these scores against the long-term norms. Key Outcomes/Contributions: The findings reveal that low-resolution data can effectively monitor lifestyle patterns without compromising privacy. The active scores and regularity assessments calculated using correlation coefficients offer a comprehensive view of residents' daily activities and any deviations from the established patterns. This study contributes to the literature by validating the efficacy of low-resolution data in lifestyle monitoring systems and underscores the potential of smart meters in enhancing elderly people's care.

Transcriptome Analysis Revealed Potential Genes of Skeletal Muscle Thermogenesis in Mashen Pigs and Large White Pigs under Cold Stress.

Pigs are susceptible to cold stress due to the absence of brown fat caused by the partial deletion of uncoupling protein 1 during their evolution. Some local pig breeds in China exhibit potential cold adaptability, but research has primarily focused on fat and intestinal tissues. Skeletal muscle plays a key role in adaptive thermogenesis in mammals, yet the molecular mechanism of cold adaptation in porcine skeletal muscle remains poorly understood. This study investigated the cold adaptability of two pig breeds, Mashen pigs (MS) and Large White pigs (LW), in a four-day cold (4 °C) or normal temperature (25 °C) environment. We recorded phenotypic changes and collected blood and longissimus dorsi muscle for transcriptome sequencing. Finally, the PRSS8 gene was randomly selected for functional exploration in porcine skeletal muscle satellite cells. A decrease in body temperature and body weight in both LW and MS pigs under cold stress, accompanied by increased shivering frequency and respiratory frequency, were observed. However, the MS pigs demonstrated stable physiological homeostasis, indicating a certain level of cold adaptability. The LW pigs primarily responded to cold stress by regulating their heat production and glycolipid energy metabolism. The MS pigs exhibited a distinct response to cold stress, involving the regulation of heat production, energy metabolism pathways, and robust mitochondrial activity, as well as a stronger immune response. Furthermore, the functional exploration of PRSS8 in porcine skeletal muscle satellite cells revealed that it affected cellular energy metabolism and thermogenesis by regulating ERK phosphorylation. These findings shed light on the diverse transcriptional responses of skeletal muscle in LW and MS pigs under cold stress, offering valuable insights into the molecular mechanisms underlying cold adaptation in pigs.

Luteolin inhibits the proliferation, adhesion, migration and invasion of choroidal melanoma cells in vitro.

Choroidal melanoma is a devastating disease that causes visual loss and a high mortality rate due to metastasis. Luteolin, a potential anticancer compound, is widely found in natural plants. The aim of this study was to evaluate the antiproliferative, antiadhesive, antimigratory and anti-invasive effects of luteolin on choroidal melanoma cells in vitro and to explore its potential mechanism. Cell counting kit-8 (CCK-8) assays, 5-ethynyl-2'-deoxyuridine (EdU) assays, Cell adhesion, migration, and invasion assays were performed to examine the inhibitory effects of luteolin on cell cell viability, proliferation, adhesion, migration and invasion capacities, respectively. Considering the correlation between Matrix metalloenzymes and tumor metastasis, Enzyme-linked immunosorbent assays (ELISAs) were used to assess matrix metalloproteases MMP-2 and MMP-9 secretion. Western blotting was performed to detect p-PI3K P85, Akt, and p-Akt protein expression. The cytoskeletal proteins vimentin were observed with cell immunofluorescence staining. Luteolin can inhibit OCM-1 cell proliferation, migration, invasion and adhesion and C918 cell proliferation, migration, and invasion through the PI3K/Akt signaling pathway. Therefore, Luteolin may have potential as a therapeutic medication for Choroidal melanoma.

[Project to Reduce Cases of Drug-Resistant Strain Colonization in the Intensive Care Unit Using a Chlorhexidine Gluconate Bath].

BACKGROUND: Drug-resistant strains of bacteria are associated with severe consequences such as bacteremia, shock, and death, and increase hospital stay durations and medical health expenses. Therefore, reducing the spread of drug-resistant strains is a priority concern. PURPOSE: This project was developed to reduce the number of colonization cases of drug-resistant strains and subsequently increase the quality of care provided in our intensive care unit. RESOLUTIONS: In this project, a chlorhexidine gluconate (CHG) bath standard protocol and CHG bath skill checklist were established, education and training courses were planned, a regular bed curtain replacement schedule and sink cleaning protocols were implemented, and regular audits were conducted. RESULTS: Immediately following project implementation (October - December 2018), the average monthly cases of Vancomycin-resistant enterococci colonization decreased from 6.08 to 4.33, and the average monthly cases of multi-drug resistant Acinebacter baumannii colonization decreased from 4.08 to 1.33. Furthermore, between January and July 2019, the average monthly cases of colonization for the abovementioned bacteria numbered 4 and 0.86, respectively, which met the level of reduction targeted in this project. CONCLUSIONS: The results of this project indicate that implementing CHG bed baths is effective in reducing the incidence of drug resistant strain colonization and rate of related infections in patients. CHG bed baths should be applied clinically to improve the quality of intensive care.

Assessing the spatial distribution of cervical spinal cord activity during tactile stimulation of the upper extremity in humans with functional magnetic resonance imaging.

Dermatomal maps are a mainstay of clinical practice and provide information on the spatial distribution of the cutaneous innervation of spinal nerves. Dermatomal deficits can help isolate the level of spinal nerve root involvement in spinal conditions and guide clinicians in diagnosis and treatment. Dermatomal maps, however, have limitations, and the spatial distribution of spinal cord sensory activity in humans remains to be quantitatively assessed. Here we used spinal cord functional MRI to map and quantitatively compare the spatial distribution of sensory spinal cord activity during tactile stimulation of the left and right lateral shoulders (i.e. C5 dermatome) and dorsal third digits of the hands (i.e., C7 dermatome) in healthy humans (n â€‹= â€‹24, age â€‹= â€‹36.8 â€‹± â€‹11.8 years). Based on the central sites for processing of innocuous tactile sensory information, we hypothesized that the activity would be localized more to the ipsilateral dorsal spinal cord with the lateral shoulder stimulation activity being localized more superiorly than the dorsal third digit. The findings demonstrate lateralization of the activity with the left- and right-sided stimuli having more activation in the ipsilateral hemicord. Contradictory to our hypotheses, the activity for both stimulation sites was spread across the dorsal and ventral hemicords and did not demonstrate a clear superior-inferior localization. Instead, the activity for both stimuli had a broader than expected distribution, extending across the C5, C6, and C7 spinal cord segments. We highlight the complexity of the human spinal cord neuroanatomy and several sources of variability that may explain the observed patterns of activity. While the findings were not completely consistent with our a priori hypotheses, this study provides a foundation for continued work and is an important step towards developing normative quantitative spinal cord measures of sensory function, which may become useful objective MRI-based biomarkers of neurological injury and improve the management of spinal disorders.

Eye movement performance and clinical outcomes among female athletes post-concussion.

BACKGROUND: Most post-concussion eye movement (EM) research involves predominantly male samples. We evaluated pro- (PRO; reflexive shift of visual attention to target) and anti- (ANTI; executive control of visual attention away from target) computer-based saccade task performance among female, collegiate athletes with recent concussion (CON) versus healthy-control athletes (HC). We evaluated the relationship between EM performance and post-concussion outcomes. We hypothesized ANTI performance would differ among CON and HC due to greater executive control demands, and that EM performance (both tasks) would be associated with clinical outcomes in CON. METHODS: 16 CON (assessed 4-10 days post-injury [M = 6.87, SD = 2.15 days]) and 16 age-matched HC athletes were recruited. General linear mixed modeling and Pearson's correlations were used. RESULTS: On ANTI, CON demonstrated higher error rate [F(1,2863) = 12.650, p<.001] and shorter latency on error trials [F(1,469) = 5.976, p=.015] relative to HC. Multiple EM measures were associated with clinical outcomes: PRO duration predicted days to symptom remission (r=.44, p <.05); ANTI error rate was associated with symptom burden on the day of testing (r=.27, p <.05). CONCLUSION: This study demonstrates promising utility of EM measures to detect cognitive control and sensorimotor effects of concussion among female athletes and their use as a prognostic indicators of recovery.

Nasogastric tube decompression is unnecessary in patients undergoing laparoscopic nephroureterectomy for localized upper tract urothelial carcinoma.

BACKGROUND/PURPOSE: This study investigates the safety and feasibility to perform laparoscopic nephroureterectomy (LNU) for upper tract urothelial carcinoma (UTUC) without routine nasogastric tube (NGT) decompression. METHODS: The hospital-based samples comprised of 100 consecutive UTUC patients receiving elective LNU performed by two experienced surgeons. The nationwide data was based on LHID2005 composed of one million beneficiaries randomly selected from the Taiwan National Health Insurance Research Database to identify patients with the diagnoses of UTUCs receiving LNUs. We then compared baseline characteristics, peri-operative data, convalescence parameters and complications between two groups stratified by use of NGT tube. RESULTS: The hospital-based samples composed of 50 subjects with NGT and 50 without. There were no significant differences in baseline characteristics between two groups. Peri-operative and convalescence parameters were similar when comparing no NGT versus NGT: blood loss of 206 vs. 165 mL; operative time of 180.5 vs.181.1 min; days to intake was 2.1 vs.1.7 days; and hospital stay of 7.8 vs. 7.5 days (all p > 0.05). The nationwide study samples comprised 140 subjects, of which 72 were with NGT and 68 were with no NGT. The baseline data, complications and length of hospital stay were similar between two groups. CONCLUSION: Surgery-naïve patients with localized UTUC received LNU without peri-operative NGT is safe and feasible.

A novel rhodamine-based Hg2+ sensor with a simple structure and fine performance.

An excellent spectral sensor for Hg2+ named 2-(2-((2-aminoethyl)thio)ethyl)-3',6'-bis(diethylamino)spiro[isoindoline-1,9'-xanthen]-3-one (RMTE) was achieved by a one-step reaction between rhodamine B and thiobisethylamine. RMTE could detect Hg2+ in nearly pure water reversibly and highly selectively, indicated by a new increasing absorption peak at 561 nm and 170-fold enhanced fluorescence at 578 nm coupled with remarkable visual and fluorescence color changes. When the Hg2+ concentration ([Hg2+]) varied from 0 to 120 µM, the absorbance and fluorescence intensity of the RMTE solution responded linearly to [Hg2+] with the detection limits of 2.08 and 0.14 µM, respectively. RMTE could work in ecologically and biologically favorable pH values of 6.41-8.33. The binding mode of RMTE toward Hg2+ was 1 : 1. RMTE could monitor Hg2+ in environmental water and living cells effectively with low cytotoxicity.

A New Reactive 1,8-Naphthalimide Derivative for Highly Selective and Sensitive Detection of Hg2.

A 1,8-naphthalimide derivative with a reactive aliphatic hydroxyl was designed and synthesized as a fluorescent probe. Its structure was characterized by IR, 1H NMR, 13C NMR, LC-MS and HPLC. The probe showed high selectivity and sensitivity to Hg2+ over other metal ions such as Pb2+, Na+, K+, Cd2+, Cr3+, Zn2+, Cu2+, Ni2+, Ca2+, Fe3+, Fe2+, Co2+, Mn2+ and Mg2+ in MeCN/H2O (15/85, v/v). The increase in fluorescence intensity was linearly proportional to the concentration of Hg2+ in the range of 18-40 µM with a detection limit of 1.38 × 10-7 mol/L. The probe could work in a pH span of 4.3-9.0 and respond to Hg2+ quickly with strong anti-interference ability. Job's plot suggested a 1:2 complex of the probe and Hg2+.

Intrahemispheric Perfusion in Chronic Stroke-Induced Aphasia.

Stroke-induced alterations in cerebral blood flow (perfusion) may contribute to functional language impairments and recovery in chronic aphasia. Using MRI, we examined perfusion in the right and left hemispheres of 35 aphasic and 16 healthy control participants. Across 76 regions (38 per hemisphere), no significant between-subjects differences were found in the left, whereas blood flow in the right was increased in the aphasic compared to the control participants. Region-of-interest (ROI) analyses showed a varied pattern of hypo- and hyperperfused regions across hemispheres in the aphasic participants; however, there were no significant correlations between perfusion values and language abilities in these regions. These patterns may reflect autoregulatory changes in blood flow following stroke and/or increases in general cognitive effort, rather than maladaptive language processing. We also examined blood flow in perilesional tissue, finding the greatest hypoperfusion close to the lesion (within 0-6 mm), with greater hypoperfusion in this region compared to more distal regions. In addition, hypoperfusion in this region was significantly correlated with language impairment. These findings underscore the need to consider cerebral perfusion as a factor contributing to language deficits in chronic aphasia as well as recovery of language function.

Functional magnetic resonance imaging of the cervical spinal cord during thermal stimulation across consecutive runs.

The spinal cord is the first site of nociceptive processing in the central nervous system and has a role in the development and perpetuation of clinical pain states. Advancements in functional magnetic resonance imaging are providing a means to non-invasively measure spinal cord function, and functional magnetic resonance imaging may provide an objective method to study spinal cord nociceptive processing in humans. In this study, we tested the validity and reliability of functional magnetic resonance imaging using a selective field-of-view gradient-echo echo-planar-imaging sequence to detect activity induced blood oxygenation level-dependent signal changes in the cervical spinal cord of healthy volunteers during warm and painful thermal stimulation across consecutive runs. At the group and subject level, the activity was localized more to the dorsal hemicord, the spatial extent and magnitude of the activity was greater for the painful stimulus than the warm stimulus, and the spatial extent and magnitude of the activity exceeded that of a control analysis. Furthermore, the spatial extent of the activity for the painful stimuli increased across the runs likely reflecting sensitization. Overall, the spatial localization of the activity varied considerably across the runs, but despite this variability, a machine-learning algorithm was able to successfully decode the stimuli in the spinal cord based on the distributed pattern of the activity. In conclusion, we were able to successfully detect and characterize cervical spinal cord activity during thermal stimulation at the group and subject level.

Lateralization of cervical spinal cord activity during an isometric upper extremity motor task with functional magnetic resonance imaging.

The purpose of this study was to use an isometric upper extremity motor task to detect activity induced blood oxygen level dependent signal changes in the cervical spinal cord with functional magnetic resonance imaging. Eleven healthy volunteers performed six 5minute runs of an alternating left- and right-sided isometric wrist flexion task, during which images of the cervical spinal cord were acquired with a reduced field-of-view T2*-weighted gradient-echo echo-planar-imaging sequence. Spatial normalization to a standard spinal cord template was performed, and group average activation maps were generated in a mixed-effects analysis. The task activity significantly exceeded that of the control analyses. The activity was lateralized to the hemicord ipsilateral to the task and reliable across the runs at the group and subject level. Finally, a multi-voxel pattern analysis was able to successfully decode the left and right tasks at the C6 and C7 vertebral levels.

Assessing intracranial vascular compliance using dynamic arterial spin labeling.

Vascular compliance (VC) is an important marker for a number of cardiovascular diseases and dementia, which is typically assessed in the central and peripheral arteries indirectly by quantifying pulse wave velocity (PWV), and/or pulse pressure waveform. To date, very few methods are available for the quantification of intracranial VC. In the present study, a novel MRI technique for in-vivo assessment of intracranial VC was introduced, where dynamic arterial spin labeling (ASL) scans were synchronized with the systolic and diastolic phases of the cardiac cycle. VC is defined as the ratio of change in arterial cerebral blood volume (ΔCBV) and change in arterial pressure (ΔBP). Intracranial VC was assessed in different vascular components using the proposed dynamic ASL method. Our results show that VC mainly occurs in large arteries, and gradually decreases in small arteries and arterioles. The comparison of intracranial VC between young and elderly subjects shows that aging is accompanied by a reduction of intracranial VC, in good agreement with the literature. Furthermore, a positive association between intracranial VC and cerebral perfusion measured using pseudo-continuous ASL with 3D GRASE MRI was observed independent of aging effects, suggesting loss of VC is associated with a decline in perfusion. Finally, a significant positive correlation between intracranial and central (aortic arch) VC was observed using an ungated phase-contrast 1D projection PWV technique. The proposed dynamic ASL method offers a promising approach for assessing intracranial VC in a range of cardiovascular diseases and dementia.

An easily Prepared Fluorescent pH Probe Based on Dansyl.

A novel fluorescent pH probe from dansyl chloride and thiosemicarbazide was easily prepared and fully characterized by (1)H NMR, (13)C NMR, LC-MS, Infrared spectra and elemental analysis. The probe exhibited high selectivity and sensitivity to H(+) with a pK a value of 4.98. The fluorescence intensity at 510 nm quenched 99.5 % when the pH dropped from 10.88 to 1.98. In addition, the dansyl-based probe could respond quickly and reversibly to the pH variation and various common metal ions showed negligible interference. The recognition could be ascribed to the intramolecular charge transfer caused by the protonation of the nitrogen in the dimethylamino group.

Clinical investigation of metabolic syndrome in the female elderly occupational population.

PURPOSE: To explore prevalence of metabolic syndrome (MetS) and factors associated with its components in the elderly female occupational population in Taipei, Taiwan. METHODS: A total of 1,589 healthy subjects voluntarily and 65 years or above admitted to a teaching hospital for a physical check-up in 2010. Demographic and blood sample results were collected. RESULTS: The mean age of the study participants is 74.8 ± 6.7 years. The prevalence of MetS is 40.5 % (95 % CI 38.1-42.9 %). After adjustment for confounding factors, the older age, higher body mass index, and higher serum uric acid are the most significant risk factors related to MetS. CONCLUSION: The prevalence of MetS is related to obesity and elevated serum uric acid. Promoting this population with controlled obesity and health improvement for renal function is important.

Factors related to the time to cryptorchidism surgery--a nationwide, population-based study in Taiwan.

BACKGROUND/PURPOSE: Current guidelines recommend that the optimal timing for cryptorchidism surgery is by the age of 12 months. This study investigated the trend of surgical timing and examined the factors associated with time to surgery for cryptorchidism in Taiwan by using a nationwide, population-based database. METHODS: The present study utilized the Longitudinal Health Insurance Database 2005, a subset of the National Health Insurance Research Database, which contains data on all paid medical benefit claims over the period 1997-2007 for a subset of 1 million beneficiaries randomly drawn from 22.72 million individuals enrolled in the National Health Insurance program in 2005. We analyzed the timing of surgery in boys younger than 18 years with diagnosis of cryptorchidism. RESULTS: We identified 547 boys who underwent surgery under 18 years of age. Approximately 79.2% of study participants received surgery after the age of 12 months. A multivariate analysis showed that several factors were significantly associated with time to surgery: age of the physician making the diagnosis, age of the surgeon performing the surgery, age of the patient at the first diagnosis of cryptorchidism, and number of previous clinic visits with the diagnosis of cryptorchidism and urbanization level of the patient's residence. CONCLUSION: A surprisingly high rate (79.2%) of all study participants underwent surgery beyond the optimal timing. Certain doctor and patient factors were associated with time to cryptorchidism surgery. Improving the alertness and education of parents and specialists may lead to earlier surgeries.

[The synergetic effects of nitric oxide and nicotinic acetylcholine receptor on learning and memory of rats].

The aim of the present study is to explore the interaction of nitric oxide (NO) and nicotinic acetylcholine receptor (nAChR) on learning and memory of rats. Rats were intracerebroventricularly (i.c.v.) injected with L-arginine (L-Arg, the NO precursor) (L-Arg group) or choline chloride (CC, an agonist of α7nAChR) (CC group), and with combined injection of L-Arg and CC (L-Arg+CC group), and methyllycaconitine (MLA, α7nAChR antagonist) or N(ω)-nitro-L-arginine methylester (L-NAME, nitric oxide synthase inhibitor) i.c.v. injected first and followed by administration of L-Arg combined with CC (MLA+L-Arg+CC group or L-NAME+L-Arg+CC group), respectively, and normal saline was used as control (NS group). The learning and memory ability of rats was tested with Y-maze; the level of NO and the expressions of neuronal nitric oxide synthase (nNOS) or α7nAChR in hippocampus were measured by NO assay kit, immunohistochemistry or Western blot. The results showed that compared with L-Arg group or CC group, the rats' learning and memory behavioral ability in Y-maze was observably enhanced and the level of NO, the optical density of nNOS-like immunoreactivity (LI) or α7nAChR-LI in hippocampus were significantly increased in L-Arg+CC group; Compared with L-Arg+CC group, the ability of learning and memory and the level of NO as well as the expressions of nNOS-LI or α7nAChR-LI were obviously decreased in MLA+L-Arg+CC group or in L-NAME+L-Arg+CC group. In conclusion, i.c.v. administration of L-Arg combined with CC significantly improved the action of the L-Arg or CC on the content of NO and the nNOS or α7nAChR expressions in hippocampus along with the learning and memory behavior of rats; when nNOS or α7nAChR was interrupted in advance, the effects of L-Arg combined with CC were also suppressed. The results suggest that there are probably synergistic effects between NO and nAChR on learning and memory.

Focal tDCS of auditory cortex in chronic tinnitus: A randomized controlled mechanistic trial.

OBJECTIVE: The goal of this pilot study was to understand how focal transcranial direct current stimulation (tDCS) targeting auditory cortex changes brain function in chronic tinnitus using magnetic resonance imaging (MRI). METHODS: People with chronic tinnitus were randomized to active or sham tDCS on five consecutive days in this mechanistic trial (n = 10/group). Focal 4x1 tDCS (central anode, surround cathodes) targeted left auditory cortex, with single-blind 2 mA current during twenty-minute sessions. Arterial spin-labeled and blood oxygenation level dependent MRI occurred immediately before and after the first tDCS session, and tinnitus symptoms were measured starting one week before the first tDCS session and through four weeks after the final session. RESULTS: Acute increases in cerebral blood flow and functional connectivity were noted in auditory cortex after the first active tDCS session. Reduced tinnitus loudness ratings after the final tDCS session correlated with acute change in functional connectivity between an auditory network and mediodorsal thalamus and prefrontal cortex. Reduced tinnitus intrusiveness also correlated with acute change in connectivity between precuneus and an auditory network. CONCLUSIONS: Focal auditory-cortex tDCS can influence function in thalamus, auditory, and prefrontal cortex, which may associate with improved tinnitus. SIGNIFICANCE: With future refinement, tDCS targeting auditory cortex could become a viable intervention for tinnitus.

The association between ambient air pollution exposure and connective tissue sarcoma risk: a nested case-control study using a nationwide population-based database.

A nationwide population-based database was utilized in a nested case-control study to explore the association between ambient air pollution exposure and the likelihood of developing connective tissue sarcoma. The study examined 280 cases of connective tissue sarcoma diagnosed between 2000 and 2012. A random sample of 1120 control subjects was selected from a subpopulation of claim records without a connective tissue sarcoma diagnosis in a 1:4 ratio. The control subjects were selected based on similar characteristics as the connective tissue sarcoma patients, including gender, birth year, and the year of diagnosis of the case group with medical records. Risk factors for connective tissue sarcoma were collected for analysis. Our data on exposure to air pollutants was collected from Taiwan's Air Quality Monitoring Network, which has been gathering air quality data from a growing network of sampling stations (now 76) throughout the country since 1997. It was discovered that the risk of connective tissue sarcoma was significantly increased by the Charlson comorbidity index (CCI), elevated levels of specific air pollution indices (e.g., total hydrocarbons (THC), fine particulate matter (PM2.5), and O3_8 (the annual mean of the daily maximum 8-h average concentration of O3), the High Pollutant Standards Index (hPSI) (the percentage of days in a given year in Taiwan where the PSI exceeds 100), and an insurable monthly wage over US$1100. Further investigation is needed to explore the involvement of these air pollutants in the formation of connective tissue sarcoma.