Subclinical thyroid dysfunction and cardiovascular diseases: 2016 update.

Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1.10-2.27), as well as increased risk of stroke, and heart failure (HF) for both higher and lower TSH. Small studies found that SHypo affects carotid intima media thickness (CIMT), diastolic function, peripheral vascular resistance, endothelial function, and lipid profile. SHyper is associated with increased risk of atrial fibrillation (AF) (HR 1.68, 95% CI 1.16-2.43) and CHD events (HR 1.21, 95% CI 0.99-1.46). The TSH threshold for initiating treatment is unclear. In the absence of large randomized controlled trials, the best evidence suggests SHypo therapy should be started at TSH ≥ 10 mIU/L, and SHyper therapy at TSH < 0.1 mIU/L. Recommendations on screening are discordant, but most guidelines advocate that thyroid function should be checked in those at risk for hypothyroidism, those over 60, and those with known CHD and HF. This review updates current evidence on the association between thyroid dysfunction and cardiovascular disease, as well as on screening and treatment of subclinical thyroid dysfunction

Computing multiparameter persistent homology through a discrete Morse-based approach

Persistent homology allows for tracking topological features, like loops, holes and their higher-dimensional analogues, along a single-parameter family of nested shapes. Computing descriptors for complex data characterized by multiple parameters is becoming a major challenging task in several applications, including physics, chemistry, medicine, and geography. Multiparameter persistent homology generalizes persistent homology to allow for the exploration and analysis of shapes endowed with multiple filtering functions. Still, computational constraints prevent multiparameter persistent homology to be a feasible tool for analyzing large size data sets. We consider discrete Morse theory as a strategy to reduce the computation of multiparameter persistent homology by working on a reduced dataset. We propose a new preprocessing algorithm, well suited for parallel and distributed implementations, and we provide the first evaluation of the impact of multiparameter persistent homology on computations

(Hydroxyphenyl)oxazoline: a Novel and Remarkably Facile Entry into the Area of Chiral Cationic Alkylzirconium Complexes Which Serve as Polymerization Catalysts

How can the entry into the area of chiral cationic alkyl derivatives of group 4 metals be simplified? We succeeded in, using readily available amino alcohols, which have been converted into chiral (hydroxyphenyl)oxazolines. These compounds have been employed in the organometallic derivatization of early transition metals

Peritumoral Lymphovascular Invasion Impacts the Incidence of Sentinel Lymph Node (Sln) Metastasis in Early Breast Cancer Patients (Pts) with Favorable Prognostic Features: a Retrospective Study on 345 Cases

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