Investigating the risk of metabolic and cardiovascular comorbidities among patients with parathyroid cancer: a nationwide representative cohort study in Taiwan.

BACKGROUND: This study aimed to determine whether primary parathyroid cancer patients were associated with increased metabolic and cardiovascular comorbidities in comparison to the general population. METHODS: We used the National Taiwan Cancer Registry Database to construct a cohort of patients with parathyroid cancer from January 1, 2004, to December 31, 2019. We compared the incidence of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, coronary heart disease, and heart failure with the general population matched based on a propensity score in a one-to-five fashion. RESULTS: A total of 72 parathyroid cancer patients and 360 matched general population (mean age: 55 years; 59% women) were included, with different exclusive numbers for each metabolic and cardiovascular comorbidity cohort. The number of cases based on a total of 2347.7 person-years of observation included 53 deaths, 29 hypertension, 9 diabetes, 13 hyperlipidemia, 10 atrial fibrillation, 18 coronary artery disease, and 13 heart failure. According to multivariate analysis, parathyroid cancer remained significantly associated with diabetes [hazard ratio (HR): 9.28; 95% confidence interval (CI): 1.72-50.07], hyperlipidemia (HR: 5.86; 95% CI: 1.61-21.31), and heart failure (HR: 4.46; 95% CI: 1.18-16.84). Sub-distribution of competing mortality events and subgroup analysis showed robust evidence of metabolic and cardiovascular comorbidities. This national cohort study demonstrated that adult parathyroid cancer patients had a significantly higher incidence of diabetes mellitus, hyperlipidemia, and heart failure than the general population. CONCLUSIONS: An increased risk of metabolic and cardiac comorbidities among parathyroid cancer patients required great caution.

Association between thyroid cancer and cardiovascular disease: A meta-analysis.

Objective: To determine the association between thyroid cancer and coronary artery disease, atrial fibrillation, cerebrovascular disease, and cardiovascular disease mortality. Methods: The PubMed, Embase, and Cochrane Library databases were searched for eligible studies from inception to September 22, 2022. Keywords included "thyroid cancer", "atrial fibrillation", "coronary artery disease", "cerebrovascular disease", and "mortality". Primary outcomes included the incidence of coronary artery disease, cerebrovascular disease, atrial fibrillation, and cardiovascular disease mortality among patients with thyroid cancer. Secondary outcomes included cardiovascular disease events among those with thyroid cancer that received or did not receive radioactive iodine or lenvatinib. Estimates were pooled using fixed- and random-effects meta-analysis. Results: A total of 771,220 patients who underwent thyroidectomy in 15 studies were included. Risk for cerebrovascular disease (risk ratio [RR] 1.15 [95% confidence interval (CI) 1.10-1.21]) and atrial fibrillation [RR 1.59 (95% CI: 1.45-1.73)] were significantly increased. Risk for coronary artery disease was significantly increased [RR 1.12 (95% CI: 1.08-1.17)] in the common effect model. Cardiovascular disease mortality associated with thyroid cancer was not significant [RR 0.93 (95% CI: 0.59-1.45)]. Radioactive iodine had a neutral effect on cardiovascular disease [RR 1.00 (95% CI: 0.87-1.16)], and there was no beneficial nor harmful effect among different RAI doses. Conclusions: Thyroid cancer was significantly associated with a higher risk for cerebrovascular disease and atrial fibrillation; however, the hazard risk was not different between patients with and without radioactive iodine treatment. Thyroid cancer treatment should be individualized considering the potential harms and benefits to cardiovascular health.

Association between thyroid cancer and cardiovascular disease risk: a nationwide observation study.

Treatment with levothyroxine and radioiodine contribute alternative cardiovascular function in adults with thyroid cancer. The risks of long-term cardiovascular conditions among thyroid cancer patients is unknown. This study aimed to compare the incidence of coronary heart disease (CHD), ischemic stroke (IS), and atrial fibrillation (AF) among adults with thyroid cancer with that of the general population, especially when stratified by age (< 65 and ≥ 65 years old). This observational cohort study enrolled patients between January 1, 2011 and December 31, 2016 with a follow-up until December 31, 2018. This study analyzed the data of Taiwanese thyroid cancer patients registered on the National Taiwan Cancer Registry Database, with CHD and IS. SIR models were used to evaluate the association between thyroid cancer and CHD, IS, AF, and cardiovascular disease outcome, stratified by age and sex. SIR analyses were also conducted for both sexes, age groups (< 65, ≥ 65 years), and different follow-up years. After excluding 128 individuals (< 20 years or ≥ 85 years old) and with missing index data, 4274 eligible thyroid cancer patients without CHD history, 4343 patients without IS history, and 4247 patients without AF history were included for analysis. During the median follow-up of 3.5 (1.2) years among thyroid cancer patients, the observed number of new CHD events was 70; IS, 30; and AF, 20, respectively. The SIR was significantly higher for CHD (SIR, 1.57; 95% confidence interval [CI] 1.2-1.93) among thyroid cancer patients compared with the age- and sex-specific standardized population. However, the association between thyroid cancer and the risks of IS (SIR, 0.74; 95% CI 0.47-1), cardiovascular disease (SIR, 0.88; 95% CI 0.7-1.05), and atrial fibrillation (SIR, 0.74; 95% CI 0.42-1.06) were insignificant. Moreover, stratification by age < 65 or age ≥ 65 years old and by sex for CHD suggested that the diagnosis of thyroid cancer in the young may attenuate the CHD risk (SIR, 2.08; 95% CI 1.5-2.66), and the CVD risk was constant among both men (SIR, 1.63; 95% CI 1.03-2.24) and women (SIR, 1.53; 95% CI 1.06-1.99). The patients had persistent higher CHD risk for 5 years after cancer diagnosis. Thyroid cancer survivors have a substantial CHD risk, even at long-term follow-up, especially in those patients < 65 years old. Further research on the association between thyroid cancer and CHD risk is warranted.

Comparison of four healthy lifestyle scores for predicting cardiovascular events in a national cohort study.

The protective effect of different healthy lifestyle scores for the risk of cardiovascular disease (CVD) was reported, although the comparisons of performance were lacking. We compared the performance measures of CVDs from different healthy lifestyle scores among Taiwanese adults. We conducted a nationwide prospective cohort study of 6042 participants (median age 43 years, 50.2% women) in Taiwan's Hypertensive, Hyperglycemia and Hyperlipidemia Survey, of whom 2002 were free of CVD at baseline. The simple and weighted the Mediterranean diet related healthy lifestyle (MHL) scores were defined as a combination of normal body mass index, Mediterranean diet, adequate physical activity, non-smokers, regular healthy drinking, and each dichotomous lifestyle factor. The World Cancer Research Fund and American Institute for Cancer Research cancer prevention recommended lifestyle and Life's Simple 7 following the guideline definition. The incidence of CVD among the four healthy lifestyle scores, each divided into four subgroups, was estimated. During a median 14.3 years follow-up period, 520 cases developed CVD. In the multivariate-adjusted Cox proportional hazard models, adherence to the highest category compared with the lowest one was associated with a lower incidence of CVD events, based on the simple (hazard ratio [HR] 0.43, 95% confidence interval [CI] 0.2-0.94) and weighted MHL scores (HR 0.44, 95% CI 0.28-0.68). Additionally, age played a role as a significant effect modifier for the protective effect of the healthy lifestyle scores for CVD risk. Specifically, the performance measures by integrated discriminative improvement showed a significant increase after adding the simple MHL score (integrated discriminative improvement: 0.51, 95% CI 0.16-0.86, P = 0.002) and weighted MHL score (integrated discriminative improvement: 0.38, 95% CI 0.01-0.74, P = 0.021). We demonstrated that the healthy lifestyle scores with an inverse association with CVD and reduced CVD risk were more likely for young adults than for old adults. Further studies to study the mechanism of the role of lifestyle on CVD prevention are warranted.

Acute Diffuse Renal Tubulopathy in a Patient With Lung Cancer: A Case Report.

Immune checkpoints inhibitors (ICPIs), as either a frontline or adjuvant therapy, showed favorable outcomes among diverse malignancies. Immune-related adverse events (IRAEs) are increasingly encountered, but the kidneys are rarely affected. A 67-year-old man with stage IV squamous cell carcinoma of the lung presented with acute kidney injury and hypercalcemia secondary to bone metastasis. After an aggressive saline infusion and subcutaneous denosumab 60mg administration, his renal function and serum calcium level were recovered on day 4. Due to his intolerance to chemotherapy, immunotherapy with a monoclonal antibody targeting programmed cell death protein-1 (PD-1), pembrolizumab 2mg/kg, was used on day 4. On day 11, polyuria, non-albumin dominant proteinuria, and severe deficiencies of electrolytes (potassium 2.5 mmol/L, calcium 5.5 mg/dL, magnesium 1.3 mg/dL, and phosphate 1.5 mg/dL) along with concomitant renal wasting were developed acutely. Except for postponing the next pembrolizumab, prednisolone at 1 mg/kg/day was given on day 13. On day 27, his polyuria subsided and urine protein loss resolved. Serum levels of potassium, phosphate, calcium, and magnesium all returned within the reference range. This case highlighted that renal IRAEs, even though uncommon, could be severe and potentially life-threatening if left unrecognized and untreated. Early recognition of renal IRAEs and prompt withdrawal of ICPIs may result in lower renal morbidity.

Low-Mass Liquid Crystalline Materials Blended in Recycled Thermoplastic Polyester Elastomer for Corrosion Inhibitor Application.

In this work, the development and application of multicomponents obtained from recycled polyethylene terephthalate (r-PET) waste and monotropic liquid crystals as anticorrosion coatings are reported. The r-PET raw material was alcoholyzed and reproduced as a thermoplastic polyester elastomer (TPEE) with different amounts (n%, n = 0, 1, 3, and 5) of 1,6-hexanediamine (HDA). Then, a fluorine-containing liquid crystal (4-cyano-3-fluorophenyl 4-ethylbenzoate (4CFE)) was incorporated into the TPEE mixture via solvent blending to modify and enhance the water resistance. The adhesion behavior of the coating on glass and iron substrates was evaluated by cross-cut tests and immersion tests in aqueous NaCl. In the corrosion resistance measurements, all of the coating samples fabricated with 10 ± 1 mm thickness were less active toward electrochemical corrosion (PEF% > 99%) than the bare iron plate, indicating that our work provided better protection against corrosion of the iron plate.

Combined healthy lifestyle factors are more beneficial in reducing cardiovascular disease in younger adults: a meta-analysis of prospective cohort studies.

To determine the association between combined lifestyle factors, including healthy diet, moderate alcohol consumption, non-smoking, physical activity, and optimal weight, and cardiovascular disease (CVD) risk among younger and older adults. We conducted a literature search using PubMed, EMBASE, Cochrane Library, and EBSCO databases up to November 30, 2019 and performed dose-response analysis, subgroup analysis and meta-regression with odds ratios and 95% confidence intervals (CIs). Twenty cohort studies involving 1,090,261 participants with 46,288 cardiovascular events and mean follow-up duration of 12.33 years were included. Compared with the group with the lowest number of healthy lifestyle factors, the group with the highest number had lower CVD risk [pooled hazard ratio, 0.37 (95% CI 0.31-0.43)]. With age as an effect modifier, the lifetime risk of CVD was 0.31 (95% CI 0.24-0.41) at age 37.1-49.9 years, 0.36 (95% CI 0.30-0.45) at age 50.0-59.9 years and 0.49 (95% CI 0.38-0.63) at age 60.0-72.9 years. The hazard ratio of CVD significantly increased from 37.1 to 72.9 years of age [slope in multivariate meta-regression: 0.01 (95% CI < 0.001-0.03; p = 0.042)]. Younger adults have more cardiovascular benefits from combined healthy lifestyle factors.

Dual Colorimetric and Fluorescent Authentication Based on Semiconducting Polymer Dots for Anticounterfeiting Applications.

Semiconducting polymer dots (Pdots) have recently emerged as a novel type of ultrabright fluorescent probes that can be widely used in analytical sensing and material science. Here, we developed a dual visual reagent based on Pdots for anticounterfeiting applications. We first designed and synthesized two types of photoswitchable Pdots by incorporating photochromic dyes with multicolor semiconducting polymers to modulate their emission intensities and wavelengths. The resulting full-color Pdot assays showed that the colorimetric and fluorescent dual-readout abilities enabled the Pdots to serve as an anticounterfeiting reagent with low background interference. We also doped these Pdots into flexible substrates and prepared these Pdots as inks for pen handwriting as well as inkjet printing. We further applied this reagent in printing paper and checks for high-security anticounterfeiting purposes. We believe that this dual-readout method based on Pdots will create a new avenue for developing new generations of anticounterfeiting technologies.

Molecular Engineering and Design of Semiconducting Polymer Dots with Narrow-Band, Near-Infrared Emission for in Vivo Biological Imaging.

This article describes the design and synthesis of donor-bridge-acceptor-based semiconducting polymer dots (Pdots) that exhibit narrow-band emissions, ultrahigh brightness, and large Stokes shifts in the near-infrared (NIR) region. We systematically investigated the effect of π-bridges on the fluorescence quantum yields of the donor-bridge-acceptor-based Pdots. The Pdots could be excited by a 488 or 532 nm laser and have a high fluorescence quantum yield of 33% with a Stokes shift of more than 200 nm. The emission full width at half-maximum of the Pdots can be as narrow as 29 nm, about 2.5 times narrower than that of inorganic quantum dots at the same emission wavelength region. The average per-particle brightness of the Pdots is at least 3 times larger than that of the commercially available quantum dots. The excellent biocompatibility of these Pdots was demonstrated in vivo, and their specific cellular labeling capability was also approved by different cell lines. By taking advantage of the durable brightness and remarkable stability of these NIR fluorescent Pdots, we performed in vivo microangiography imaging on living zebrafish embryos and long-term tumor monitoring on mice. We anticipate these donor-bridge-acceptor-based NIR-fluorescent Pdots with narrow-band emissions to find broad use in a variety of multiplexed biological applications.

Peripheral neuropathology of the upper airway in obstructive sleep apnea syndrome.

Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder that leads to significant morbidity and mortality without adequate treatment. Though much emphasis on the pathogenesis of OSAS has been placed on a narrow upper airway space and associated muscular factors, possible neuropathy of the upper airway has not been fully elucidated. Increasing peer reviewed evidence suggests involvement of neurologic lesions of the upper airway in OSAS patients. In this article, we review the etiology and pathophysiology of OSAS, the evidence and possible mechanisms leading to upper airway neuropathy, and the relationship between upper airway neuropathy and OSAS. Further studies should focus on the long term effects of the upper airway neuropathy as related to the duration and severity of snoring and or apnea, and also on the potential methods of prevention and management of the neuropathy in sleep disordered breathing.

Temperature dependence of vibrational modes of CH3CC(ads) and I(ads) coadsorbed on Ag(111): ab initio molecular dynamics approach.

Ab initio molecular dynamics simulations accompanied by a Fourier transform of the dipole moment (aligned perpendicular to the surface) autocorrelation function are implemented to investigate the temperature-dependent infrared (IR) active vibrational modes of CH3C(ß)C(α)(ads) and I(ads) when coadsorbed on an Ag(111) surface at 200 and 400 K, respectively. The analytic scheme of the Fourier transform of a structural coordinate autocorrelation function is used to identify two distinguishable IR active peaks of C(ß)C(α) stretching, which are characterized by two types of dynamic motion of adsorbed CH3C(ß)C(α)(ads) at 200 K, namely, the motion of the tilted CC(ß)C(α) axis and the motion of the stand-up CC(ß)C(α) axis. These two recognisable IR active peaks of C(ß)C(α) stretching are gradually merged into one peak as a result of the dominant motion of the stand-up CC(ß)C(α) axis as the temperature increases from 200 to 400 K. The calculated intensities of the IR active peaks of the asymmetrical deformation mode of CH3 and the asymmetrical stretching mode of CH3, with their dynamic dipole moments nearly perpendicular to the CC(ß)C(α) axis, become relatively weak; however, the symmetrical deformation mode of CH3 and the symmetrical stretching mode of CH3, with their dynamic dipole moments randomly directed away from the CC(ß)C(α) axis, will not have direct correspondence between the intensities of their IR active peaks and the angle between the Ag(111) surface and the CC(ß)C(α) axis as the temperature increases from 200 to 400 K. Finally, the increased flipping from the motion of the tilted CC(ß)C(α) axis to the motion of the stand-up CC(ß)C(α) axis followed by its diffusion, resulting from the increasing temperature from 200 to 400 K or even higher, seems to be the initial event that initiates the alkyne self-coupling reaction that leads to the final production of H3CCCCCCH3.

Reorganization of functional connectivity during the motor task using EEG time-frequency cross mutual information analysis.

OBJECTIVE: This study investigates the functional organization of cortical networks during self-determinant arm movement using the time sequences of the alpha (8-12 Hz) and beta (16-25 Hz) bands. METHODS: The time-frequency cross mutual information (TFCMI) method was used to estimate the EEG functional connectivity in the alpha and beta bands for seven healthy subjects during four functional states: the resting, preparing, movement-onset, and movement-offset states. RESULTS: In the preparing state, the maintenance of the central-executive network (CEN, prefrontal-parietal connection) suppressed the motor network in the alpha band to plan the next movement, whereas the CEN was deactivated in the beta band to retain visual attention (the frontal-occipital connection). A significant decrease of the CEN in the alpha band occurred after a visual cue in the movement-onset state, followed by a significant increase in motor-network connectivity in the beta band until the movement-offset state. CONCLUSIONS: The temporal-spectral modulation mechanism allows the brain to manifest multiple functions subject to energy budget. SIGNIFICANCE: The TFCMI method was employed to estimate EEG functional connectivity and effectively demonstrate the reorganization process between four functional states.