bluuebunny/crossref_metadata_2025 huggingface dataset:
Probing the Expression of ASAP1 and FAK in nonsmall cell lung cancer and their clinicopathological significance
Authors: Zheng Qixian , Guo Ningjing , Luo Qiong , Zhang Qianyuan , Liu Haiyu , Xu Qian , Lin Tingyan , Yang Sheng , Zhang Suyun , Chen Xiangqi
Published: August 2023

Objective
This study is aimed to analyze the expression levels of ADP ribosylation factor guanylate kinase 1 (ASAP1) and focal adhesion kinase (FAK) in nonsmall cell lung cancer (NSCLC) tissues for the purpose of exploring their association with clinicopathological features of and prognosis of NSCLC.
Methods
NSCLC cancerous tissues along with its adjacent normal lung tissues, with complete clinical data, were collected for 84 cases. The expression of ASAP1 and FAK was measured by using immunohistochemical methods. The analysis was done using the results combined with clinicopathological features and prognosis.
Results
The expression of ASAP1 and FAK in NSCLC tissues was significantly higher than those in the normal lung tissues (both P < 0.05), and ASAP1 expression was positively associated with FAK expression (P < 0.001). The high expression of both proteins and consistent high expression was independent of sex (both P > 0.05). Although, it was related to age, depth of invasion, and pathological stage (both P < 0.05). The expressions of both proteins were associated with cancer recurrence (both P < 0.05). The results of a 10-year follow-up showed that the high expression and a consistently high expression of both the proteins was correlated negatively with the survival rates (both P < 0.05). Specifically, the overall survival rate was higher in patients with low FAK/ASAP1 expression as compared to patients with high FAK/ASAP1 expression. The survival rate was also found to be higher with consistent low expression of both the protein than with consistent high expression and nonuniform high expression (both P < 0.05).
Conclusion
ASAP1 and FAK are highly expressed in NSCLC tissues, which should have a synergistic effect in promoting the occurrence, development, invasion and metastasis of NSCLC, and are closely related to survival and recurrence, which is expected to be used as molecular indicator of NSCLC biological behavior and prognosis.
Impact of surface modification and organic pollution on photocatalytic denitrification efficiency of cement based fixed-bed photoreactor
Authors: tajasosi sama , Shirzad-Siboni Mehdi , Vagheei Ramazan , Barandoust Jalil
Published: August 2023

Water purification and access to drinking water is still considered one of the most important issues in the water industry, and among the many solutions that have been industrialized in this field so far, photocatalytic purification is considered a new and rapidly improving technology. In this study, for the first time, using cement composite activated with industrial photocatalyst and without the use of nanomaterials, the simultaneous treatment of two pollutants, nitrate and methylene blue (MB), plus the fixed-bed reactor efficiency in terms of energy consumption and bed activity level were compared with other researches. For this purpose, the effect of concentrations of 4, 8, and 12 mg/L of MB on denitrification and MBdegradation rate was investigated simultaneously. In this reactor, the flow rate of water passing through the reactor was selected 4 and 12 L/min. Besides, the power of acid treatment on improving the efficiency of the composite surface was investigated in two states, intact and acid treated. The obtained results showed that the efficiency of the photocatalytic surface has increased and the energy consumption required to degrade the unit amount of pollutant in water has decreased drastically. Furthermore, the microstructure of the bed surface was presented for advanced analysis. The results revealed that increasing the concentration of MB, within the applied range, did not have a significant effect on reducing denitrification rate, and on the other hand, acid treatment in all specimens led to an improvement in reactor efficiency.
Diagnostic journey for individuals with Fibrous Dysplasia / McCune Albright syndrome (FD/MAS)
Authors: Song Kaiyang , Shrestha Roshi , Delaney Heather , Vijjhalwar Rohit , Turner Alison , Sanchez Maria , Javaid Muhammad Kassim
Published: August 2023

Background
Reducing delayed diagnosis is a significant healthcare priority for individuals with rare diseases. Fibrous Dysplasia/ McCune Albright Syndrome (FD/MAS) is a rare bone disease caused by somatic activation mutations of GNASa. FD/MAS has a broad clinical phenotype reflecting variable involvement of bone, endocrine and other tissues, distribution and severity. The variable phenotype is likely to prolong the diagnostic journey for patients further.
Aim
To describe the time from symptom onset to final diagnosis in individuals living with FDMAS.
Methods
We used the UK-based RUDY research database (www.rudystudy.org), where patients self-report their diagnosis of FD/MAS. Participants are invited to complete the diagnostic journey based on the EPIRARE criteria.
Results
51 individuals diagnosed with FD/MAS were included in this analysis. 70% were female, and the median age was 51.0 years (IQR 34.5–57.5]. 12 (35%) individuals reported McCune Albright Syndrome, 11 (21.6%) craniofacial and 11(21.6%) for each of poly- and mono-ostotic FD and 6 (11.8%) did not know their type of FD/MAS. Pain was the commonest first symptom (58.8%), and 47.1% received another diagnosis before the diagnosis of FD/MAS. The median time to final diagnosis from the first symptom was two years with a wide IQR (1,18) and range (0–59 years). Only 12 (23.5%) of individuals were diagnosed within 12 months of their first symptoms. The type of FD/MAS was not associated with the reported time to diagnosis. Significant independent predictors of longer time to final diagnosis included older current age, younger age at first symptom and diagnosis after 2010.
Conclusion
Individuals with FDMAS have a variable time to diagnosis that can span decades. These data provide a baseline to assess the impact of novel NHS diagnostic networks on reducing the diagnostic odyssey.
New micro-hole zone catheter reduces residual urine and mucosal microtrauma in a lower urinary tract model
Authors: Schrøder Brit , Tentor Fabio , Miclăuș Teodora , Staerk Kristian , Andersen Thomas Emil , Spinelli Michele , Rendeli Claudia , Popolo Giulio Del , Bagi Per , Nielsen Lene Feldskov
Published: August 2023

Urinary tract infections (UTIs) are the main complication associated with clean intermittent catheterization (CIC) and are facilitated by post-void residual urine and trauma to the mucosa during voiding. The risk of UTI may be diminished by reducing the residual volumes and preventing microtrauma caused by mucosal suction through the eyelets of conventional eyelet catheters (CEC). A new micro-hole zone catheter (MHZC) was developed and tested in an ex vivo porcine lower urinary tract model and in vivo, in pigs, against a CEC. It was shown that, irrespective of the micro-hole diameter, the new catheter ensured increased flowrates and significantly lower residual volumes at the first flow-stop. Furthermore, with a micro-hole diameter of 0.4 mm, mucosal suction was virtually eliminated, regardless of the insertion depth or simulated intra-abdominal pressure mimicking sitting or standing humans. Pressure profile experiments and endoscopy studies indicated that the bladder gradually folds against the drainage tip of the new catheter, without blocking the flow, and, unlike with the CEC, sharp pressure variations and flow-stops did not occur during voiding. The MHZC outperformed the CEC in all tested scenarios and decreased residual volumes, thus potentially decreasing the risk of UTIs.
Association of Klotho with coronary artery disease in subjects with type 2 diabetes mellitus and preserved kidney function: a case-control study.
Authors: DONATE-CORREA JAVIER , Martín-Núñez Ernesto , Mora-Fernández Carmen , González-Luis Ainhoa , Martín-Olivera Alberto ,   Juan F. Navarro-González1
Published: August 2023

Aims A significant reduction in circulating Klotho levels is observed in subjects with type 2 diabetes mellitus (T2DM). In this work, we examined the relationship between Klotho levels and coronary artery disease (CAD) burden in subjects with T2DM and preserved kidney function.
Methods Cross-sectional case-control study involving 133 subjects with T2DM and 200 age-, sex- and CAD incidence-matched, non-diabetic patients undergoing nonemergency diagnostic coronary angiography. All of them non-albuminuric and with normal glomerular filtration rates. Concentrations of serum Klotho, fibroblast growth factor 23, and inflammatory markers were also measured.
Results The Klotho concentration was lower in the group with DM2 although higher in the subgroup of subjects with DM2 and significant CAD (45.6%; P=0.02). Multiple regression analysis revealed that serum Klotho was positively related with SSI values exclusively in subjects with T2DM (adjusted R2=0.153, P<0.01). Logistic regression analysis showed that Klotho was positively associated with the presence of significant CAD in the group of T2DM patients (OR: 1.001; P=0.041).
Conclusions Our data suggest that higher levels of circulating Klotho in subjects with T2DM and preserved kidney function are associated with significant CAD.
LncRNA AC100826.1 regulated PLCB1 to promote progression in non-small cell lung cancer
Authors: Dai Shenhui , Wang Qiao , Lyu Yin , Chen Zhipeng , Liu Xiucheng , Zhao Guoqing , Zhang Hao
Published: August 2023

Background
Lung cancer is the most common malignant tumors. In the research, we identified a long non-coding RNA(lncRNA) AC100826.1 (simplify to Lnc1), which was highly expressed in non-small cell lung cancer (NSCLC) tissues compared with the paracancerous tissues. we observed the critical role of Lnc1 in regulating the metastasis ability of NSCLC cells.
Methods
RNA sequencing was performed to detect differential expression levels of lncRNAs in NSCLC tissues and its paracancerous tissues. Effects of Lnc1 on cell proliferation, migration were determined by CCK-8, transwell and scratch assays. The xenograft experiment confirmed the effect of Lnc1 on NSCLC in vivo. RT-qPCR and Western blots were performed to determine the expression levels of mRNAs and proteins.
Results
The expression level of Lnc1 was related to multiple pathological results, knockdown of Lnc1 can inhibit the proliferation and metastasis abilities of NSCLC cells. silencing phospholipase C, β1(PLCB1) can reverse the promoting effects of overexpression Lnc1 on NSCLC cells proliferation and migration abilities. Besides, the Rap1 signaling pathway implicated in the regulation of Lnc1 in NSCLC metastasis.
Conclusion
Our results suggest that Lnc1 regulated the metastatic ability of NSCLC cells through targeting PLCB1/Rap1 signal pathway.
Ferroptosis-related genes, a novel therapeutic target for focal segmental glomerulosclerosis
Authors: Lin Yanbin , He Jinxuan , Mou Zhixiang , Chen Huiting , You Wenkang , Guan Tianjun , Chen Lan
Published: August 2023

Recent studies have suggested that ferroptosis participates in various renal diseases. However, its effect on focal segmental glomerulosclerosis remains unclear. This study analyzed the GSE125779 and GSE121211 datasets to identify the differentially expressed genes (DEGs) in renal tubular samples with and without FSGS. The Cytoscape was used to construct the protein-protein interaction network. Moreover, the ferroptosis-related genes (FRGs) were obtained from the ferroptosis database, while ferroptosis-related DEGs were obtained by intersection with DEGs. The target genes were analyzed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. The GSE108112 dataset was used to verify the expression of target FRGs. Besides, we built the mRNA-miRNA network regarding FRGs using the NetworkAnalyst database, and circRNAs corresponding to key miRNAs were predicted in the ENCORI database. In this study, 16 ferroptosis-related DEGs were identified between FSGS and healthy subjects, while five co-expressed genes were obtained by three topological algorithms in Cytoscape. These included the most concerned Hub genes JUN, HIF1A, ALB, DUSP1, and ATF3. The KEGG enrichment analysis indicated that FRGs were associated with mitophagy, renal cell carcinoma, and metabolic pathways. Simultaneously, the co-expressed hub genes were analyzed to construct the mRNA-miRNA interaction network and important miRNAs such as hsa-mir-155-5p, hsa-mir-1-3p, and hsa-mir-124-3p were obtained. Finally, 75 drugs targeting 57 important circRNAs and FRGs were predicted. This study identified the Hub FRGs and transcriptomic molecules from FSGS in renal tubules, thus providing novel diagnostic and therapeutic targets for FSGS.
Implementation and Evaluation of a 24/7 eICU (Enhanced ICU) Model of Care in Regional and Rural NSW ICUs
Authors: Bhonagiri Deepak , Hillman Ken , Lakshmanan Ramanthan , Shah Umesh , Harrison Reema , Ali Irshad , Nalos Marek , Sharma Anurag , parr michael , Lombardo Lein , pervez-Iqbal Maha , Singh Florence , Descaller Joseph , Featon Karen , Jones Peta , Varghese Sobha , Pulletz Mark , Gray Nicole , Hangar Gail , chen Jack , Andersen Janice
Published: August 2023

Background
The global COVID 19 pandemic was associated with an increased demand for respiratory support in Intensive Care Units (ICU) and measures were put in place in all jurisdictions to enhance ICU bed capacity. In NSW, a need was identified to enhance the capacity of rural and regional ICUs to manage large numbers of COVID19 patients if needed.
Methods
We implemented a virtual care enhanced Intensive Care Model to support 2 regional Intensive Care Units from our level 5 Intensive Care unit in June 2020. This consisted of daily review of all patients in these ICUs and availability of senior staff from the level 5 ICU for advice when needed. After the delta wave of COVID 19, we further enhanced this model to a 24/7 eICU model of care with round the clock eICU nurses. New cart computers with video and audio capacity were introduced and videoconferencing was conducted using NSW Health provided Pexip Infinity Connect. We evaluated our 24/7 eICU model of care using the quadruple aims of value-based care in NSW as well as for scalability and sustainability.
Results
Our evaluation revealed that this model of care is safe and effective, efficient with cost saving and is associated with positive clinician and patient experiences. We tested our model for scalability by supporting a third regional ICU and measured sustainability by continuing to support our two original regional ICUs throughout 2022 and to date in 2023. Our patients benefited from care closer to home and our model of care freed up ICU capacity at higher level ICUs to care for COVID19 patients and retrieval capacity for transfer of other critically ill patients In addition, there were associated health economic benefit related to decreased ICU admissions and decreased transfers out. Of note there were approximately 50% fewer transfers out associated with our study and an incremental cost effectiveness ratio of 0.14 indicating that every 14 cents spent was associated with 1 dollar saving.
Conclusions
We recommend that our eICU model of care is considered for Implementation in rural and regional ICUs or close observation units where care is provided by staff not specifically trained in Intensive Care. A single centralised collaborative eICU centre can support three to five centres if adequately resourced with technology, training and education and skilled staff.
Diagnostic Accuracy of Biomarkers in CNS-originating Extracellular Vesicles for Parkinsonian Disorders: A meta-analysis
Authors: Taha Hash Brown , Bogoniewski Aleks
Published: August 2023

Parkinsonian disorders, including Parkinson's disease (PD), multiple system atrophy (MSA), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), exhibit overlapping early-stage symptoms, complicating definitive diagnosis despite heterogeneous cellular and regional pathophysiology. Additionally, the progression and eventual conversion of prodromal conditions such as REM behavior disorder (RBD) to PD, MSA or DLB remains difficult to predict. Extracellular vesicles (EVs) are small, membrane-enclosed structures released by cells, playing a vital role in communicating cell-state-specific messages. Due to their ability to cross the blood-brain-barrier into the peripheral circulation, the measurement of biomarkers in blood-isolated putative CNS-originating EVs has become a popular diagnostic approach. However, replication and independent validation remain challenges in this field. We conducted a PRISMA-guided systematic review and meta-analysis, covering 15 studies with a total of 1,455 patients with PD, 206 MSA, 21 DLB, 172 PSP, 152 CBS, 189 RBD and 1,045 healthy controls (HCs), employing either hierarchical bivariate models or univariate models based on study size. Diagnostic accuracy was moderate for differentiating patients with PD from HCs, but revealed high heterogeneity and significant publication bias, suggesting an inflation of the perceived diagnostic effectiveness. The bias observed indicates that studies with non-significant or lower effect sizes were less likely to be published. Although results for differentiating patients with PD from MSA or PSP and CBS appeared promising, their validity is limited due to the small number of involved studies coming from the same research group. Despite initial reports, our analyses suggest that using CNS-originating EV biomarkers may not reliably differentiate patients with MSA from HCs or patients with RBD from HCs, due to their lesser accuracy and substantial variability among the studies, further complicated by potential publication bias. Our findings underscore the moderate yet unreliable diagnostic accuracy of putative CNS-originating EV biomarkers in differentiating Parkinsonian disorders, highlighting the presence of substantial heterogeneity and significant publication bias. These observations reinforce the need for larger, more standardized, and unbiased studies to validate and enhance the utility of EV biomarkers in the differential diagnosis of these conditions.
Holistic multiphysics simulation of the climatic responses of cold region pavements
Authors: Jiang Yusheng , Yu Xiong
Published: August 2023

In cold regions, the environment dynamics lead to variations of soil temperature, water content, and deformation, which are characterized by highly coupled physical interplay. The hydraulic and thermal properties of unsaturated soils are highly nonlinear, which is further complicated when subjected to freezing. This paper presents a comprehensive multiphysics coupling model to evaluate these complex processes. The model considers the behaviors of unsaturated frozen soils. It accounts for the influences of meteorological, geothermal, and hydrological factors. The model is validated through two pavement case studies using Long-Term Pavement Performance (LTPP) road section data. The first case analysis is performed for a pavement section in Vermont, and the simulation lasted for 30 days during a non-freezing season on an hourly basis. The results validated the performance of the model considering unsaturated soil behaviors. The second case study is based on a daily analysis of a pavement section in South Dakota over a freezing-thawing cycle over 194 days. The results validated the model in considering the frozen unsaturated soil behaviors. Both case studies demonstrate the performance of this comprehensive model in quantifying the spatial and temporal variations of soil temperature and water content in response to environmental stressors. The capability of the model in accurately predicting the responses of pavement to the meteorological factors unleashes the potential of this model to assess the effects of climate and climate change on cold region pavement, as well as other types of geostructures.
Treatment of antipsychotic-induced hyperprolactinemia: a systematic review of systematic reviews and meta-analyses
Authors: Jiang Qitong , Li Tian , Zhao Lei , Sun Yue , Mao Zhen , Xing Yujie , Wang Chuanyue , Bo Qijing
Published: August 2023

Background
Hyperprolactinemia is a common antipsychotic-induced adverse event in psychiatric patients, and the quality of clinical studies investigating the best treatments has varied. Thus, to better summarize the clinical evidence, we performed a systematic review of overlapping systematic reviews and meta-analyses for the treatment of antipsychotic-induced hyperprolactinemia.
Methods
The PubMed, Cochrane Library and Medline databases were searched, and studies meeting our inclusion criteria were selected. Relevant data were extracted, and a systematic review was conducted of all included studies. The quality of included studies was assessed by using PRISMA scores and AMSTAR 2 quality evaluation. Finally, the clinical evidence for appropriate treatments was summarized and discussed.
Results
Five meta-analyses published between 2013 and 2020 met the requirements for inclusion in this systematic review. The PRISMA scores of the included studies ranged from 19.5–26. AMSTAR 2 quality evaluation showed that 2 of the 5 included studies were of low quality and 3 were of very low quality. The included studies provide clinical evidence that adding aripiprazole or a dopamine agonist can effectively and safely improve antipsychotic-induced hyperprolactinemia. Two studies also showed that adjunctive metformin can reduce serum prolactin level, but more clinical trials are needed to confirm this finding.
Conclusion
Adjunctive dopamine agonists have been proven to be effective and safe for the treatment of antipsychotic-induced hyperprolactinemia. Among the researched treatments, adding aripiprazole may be the most appropriate.
Adaptation of Teaching Strategies in Kinesiology Students to Obtain Reproducible and Reliable Data in the Assessment of Maximum Inspiratory Pressure
Authors: Acuña-Rojas Ernesto , Barrera-Mora Julio , González-Cabrera Javier , Escobar-Cabello Máximo , Sol Mariano del , Valenzuela-Aedo Fernando , Lizama-Pérez Rodrigo , Muñoz-Cofré Rodrigo
Published: August 2023

Background
The reliability of the measurement of the Maximum Inspiratory Pressure (MIP), as an expression of the motor capacity of the ventilatory muscles, has been widely studied in different contexts. To reduce margins of error, it is critical that the performance is done by someone who possesses reliable qualities in their measurement actions. Transmitting these skills to young professionals in the most efficient way should be a growth horizon for the profession. The objective of this research was to determine whether specific warm-up of the inspiratory muscles produces significant changes in the undergraduate kinesiology students (UKS) and an expert kinesiologist (EK) reliability of MIP measurement in healthy subjects.
Methods
Cross-sectional and exploratory study. Participants were divided into three groups (A, B, and C), each consisting of 1 undergraduate kinesiology student (EK 1, EK 2, EK 3) plus the Kinesiologist Expert (KE), who tested all the participants of the 3 groups. The test-retest reliability of the ATS/ERS and Warm-up + ATS/ERS protocols was assessed using the intraclass correlation coefficient (ICC) with a 95% confidence interval (95% CI).
Results
The main results were i) the warm-up protocol presented the least variability in the number of repetitions performed in the MIP measurement and ii) there were no significant differences in the MIP value between the EK and the KE.
Conclusions
The application of a warm-up protocol of the inspiratory muscles before the MIP evaluation does not generate significant differences between the EK and the KE, the interobserver reliability was very good in one of the three EK and the warm-up of the inspiratory muscles. reduced the number of attempts to achieve the percentage variability suggested by the ATS/ERS. Based on this experience, it is suggested to include a warm-up in the PIM evaluation.
Association between BMI trajectories from childhood to early adulthood and the carotid Intima- Media Thickness in early adulthood: Tehran Lipid and Glucose Study
Authors: Seyedhoseinpour Amirhosein , Barzin Maryam , Mahdavi Maryam , Valizadeh Majid , Azizi Fereidoun , Hosseinpanah Farhad
Published: August 2023

Background and Aims: Childhood and adolescence overweight/obesity is an important predictor of obesity and increased long-term cardiometabolic abnormalities in adulthood. In this study, we aimed to investigate the association of body mass index (BMI) and waist circumference (WC) trajectories among children and adolescents with adulthood carotid intima-media thickness (cIMT) as a determinant of subclinical atherosclerosis.
Methods: In this prospective cohort study, 1265 participants aged 3 to 18 were followed up for 18 years. By using Latent Class Growth Analysis, three groups of BMI and WC trajectory were defined; low stable, moderate-increasing, and high-increasing. Utilizing linear regression analysis and odds ratio (OR), the association of these categories with cIMT was evaluated.
Results: Although the high-increasing BMI trajectory group was significantly associated with higher cIMT (ß=0.0464, P<0.001), moderate-increase was not (ß=0.0096, P=0.102); in reference to the low-stable BMI trajectory group. Among WC trajectory groups, both moderate- (ß=0.0177, P =0.006) and high-increasing (ß=0.0533, P <0.001), in reference to the low-stable group, were significantly associated with higher cIMT. The results did not change after adjustment for baseline BMI. The ORs of high-increasing BMI, moderate-increasing WC, and high-increasing WC trajectories were 3.24, 1.92, and 3.29, respectively for high cIMT.
Conclusion: Our study resulted that a high-increasing trajectory of childhood BMI and moderate- and high-increasing trajectories of childhood WC are associated with higher cIMT and higher risk of high-cIMT. Regular monitoring and screening of BMI and WC trajectory from childhood may improve identifying individuals with high risks of cardiovascular disease, more accurately.
The Role of Thickened Nuchal Translucency on Copy Number Variations and Pregnancy Outcomes in Northeast Coast of Fujian Province, China: A Comparison Between Traditional Karyotyping and Single Nucleotide Polymorphism Array Analysis
Authors: Cao Luoyuan , Huang Xiaomin , Dong Wenxu , Wu Qinjuan , Yang Jing , Lu Jiaojiao , Lin Pengsheng , Chen Xunyan , Zheng Xian , Zeng Xiaomei , Fu Xianguo
Published: August 2023

Background
Thickened nuchal translucency (NT; ≥2.5 mm) is closely associated with various chromosomal abnormalities, structural abnormalities, and genetic diseases. However, the cutoff value of thickened NT for invasive prenatal diagnosis remains inconsistent, and little research has been conducted on pathogenic copy number variations (CNVs) affecting the outcomes in foetuses with thickened NT. This study aimed to assess the cutoff value for thickened NT to predict aneuploid foetuses and CNVs associated with thickened NT in prenatal diagnosis to determine the characteristics of pathogenic CNVs, which would assist the genetic counselling of women with thickened NT.
Methods
Ninety pregnant women with thickened NT who underwent invasive prenatal diagnosis using traditional karyotyping and single nucleotide polymorphism (SNP) array analysis in diagnostic institutions between January 2021 and March 2023 were included. The accuracy of the thickened NT cutoff value for diagnosing aneuploid abnormalities was assessed using receiver operating characteristic (ROC) curve analysis.
Results
Karyotype analysis identified 15 chromosomal abnormalities. In addition to the 10 chromosomal abnormalities corresponding to routine karyotyping, SNP array analysis identified six patients with CNVs but normal karyotypes. ROC curves demonstrate that the NT measured between 11 and 13+ 6 weeks was associated with 0.729 area under the curve (AUC; 95% CI: 0.56–0.898, P = 0.019) with the foetal aneuploidy. The ROC curve revealed that the cutoff value of NT was 4.15 mm, which showed 50% sensitivity and 90% specificity for detecting aneuploidies. With increasing NT thickness, the probability of aneuploidy increases in the first trimester.
Conclusion
Aneuploid abnormalities and CNVs are closely related to a thickened NT, which affects pregnancy outcomes. Thickened NT and abnormal CNVs are closely related and are not only associated with chromosome aneuploidy in the first trimester. We recommend that karyotyping and SNP array analysis should be performed for prenatal diagnosis in all foetus with NT thickness > 2.5 mm, regardless of NT thickness > 3.0 or 3.5 mm to avoid the occurrence of child birth with genetic defects due to missing prenatal diagnosis.
New Approaches to the Factors Contributing to Environmental Degradation: Do Financial Institutions and Markets Matter?
Authors: tekin bilgehan , Özbay Ferhat , Rasul Tareq
Published: August 2023

The authors have requested that this preprint be removed from Research Square.
Fe-rich X-Ray Amorphous Material Records Past Climate and Persistence of Water on Mars
Authors: Feldman Anthony , Hausrath Elisabeth , Rampe Elizabeth , Tu Valerie , Peretyazhko Tanya , DeFelice Christopher , Sharp Thomas
Published: August 2023

The assemblage of secondary minerals in martian rocks can help constrain the characteristics of past surface and subsurface fluids as well as past climatic conditions. X-ray amorphous material is an important part of martian surface materials, making up 15–73 wt.% of sedimentary rocks and eolian sediments in Gale crater, Mars. This X-ray amorphous material is variably siliceous, Fe-rich, and contains volatiles, and it therefore likely contains incipient weathering products. To better understand the implications of this material for past aqueous and climatic conditions in Gale crater and elsewhere on Mars, we investigated X-ray amorphous material formation and longevity within terrestrial Fe-rich soils of different ages in terrestrial mediterranean, subarctic, and desert climates using bulk and selective dissolution methods, Rietveld refinements of powder XRD patterns, and transmission electron microscopy. Results indicate that in situ aqueous alteration is required to concentrate Fe into the clay-size material and to form abundant Fe-containing X-ray amorphous material. Cooler climates promote the formation and persistence of Fe-rich X-ray amorphous material whereas warmer climates promote the formation of crystalline secondary phases. Fe-rich X-ray amorphous material formation and persistence on Mars are therefore consistent with past cool and relatively wet environments followed by long-term cold and dry conditions.
Deficiency encephalopathy: what if it is only one symptom of a systemicinflammatory disease? A case report.
Authors: Bagnato Maria Rosaria , Pierantozzi Mariangela
Published: August 2023

Introduction
Vitamin deficiencies are systemic conditions that can involve the central nervous system, with varying clinical pictures. In particular, B vitamins are crucial for metabolism in the brain.
They may present with a subacute clinical picture and a sudden worsening. In the case of B1 deficiency with Wernicke's encephalopathy, the classic triad of symptoms is not always observed, making diagnosis more difficult. In addition to the prompt recognition of a deficiency encephalopathy, it is essential to identify the cause of the vitamin deficiency.
Deficiency of these can be traced to gastro-intestinal disorders, unbalanced diets, and alcohol abuse.
Case presentation
The clinical case below discusses an adult woman who presents acutely-subacutely with neurological disorders attributable to vitamin depletion, confusion, ataxia, aphasia and ophtalmoparesis. In addition to the diagnosis of this neurological condition, the cornerstone of this clinical case is the identification of the pathology underlying this vitamin depletion.
Conclusions
In the case of dysimmune diseases of the gastro-intestinal system that damage the ileum, a vitamin deficiency can occur. If unresolved, it can lead to severe and irreversible effects on brain function. This clinical case shows how, rarely, a neurological condition can be the most striking symptom of a neglected and undiagnosed systemic pathology. The importance of knowing and recognising these situations is crucial not only in terms of cerebral prognosis, but also for the overall well-being of the individual with respect to the underlying pathology.
Emerging topological bound states in Haldane model zigzag nanoribbons
Authors: Traverso Simone , Sassetti Maura , Ziani Niccolo Traverso
Published: August 2023

Zigzag nanoribbons hosting the Haldane Chern insulator model are considered. In this context, an unreported reentrant topological phase, characterized by the emergence of quasi zero dimensional in-gap states, is discussed. The bound states, which reside in the gap opened by the hybridization of the counter-propagating edge modes of the Haldane phase, are localized at the ends of the strip and are found to be robust against on-site disorder. These findings are supported by the behavior of the Zak phase over the parameter space, which exhibits jumps of $\pi$ in correspondence to the phase transitions between the trivial and the non-trivial phases. Setups with non-uniform parameters also show topological bound states via the Jackiw-Rebbi mechanism. All the properties reported are shown to be extremely sensitive to the strip width.
Reduction in the duration of postoperative fever following NUSS surgery during the COVID-19 pandemic
Authors: Jia An , Qiang Wang , Zhuoga Deqin , Di Yu , Zhaocong Yang , Xuming Mo
Published: August 2023

Background: Our study aimed to compare the prevalence of postoperative fever during the COVID-19 pandemic period with that of the preceding non-pandemic period.
Methods: A retrospective analysis was conducted on patients with pectus excavatum (PE) undergoing minimally invasive repair (also called NUSS procedure) at Nanjing Children’s Hospital from January 1, 2017 to March 1, 2019 (Group 2019), and from January 1, 2020 to March 1, 2021 (Group 2021). Data from a total of 284 patients, consisting of 200 (70.4%) males and 84 (29.6%) females with an average age of 9.73 ± 3.41 (range, 4 to 17) years, were collected. The presence of post-operative fever (defined as a forehead temperature of 37.5℃ or above within 72 hours post-surgery), as well as the time of operation, duration of postoperative mechanical ventilator and urinary catheter use, and length of hospitalization were all assessed in admitted patients from Group 2019 (n=144) and Group 2021 (n=140). Postoperative white blood cell (WBC), C-reactive protein (CRP) levels, and prevalence of postoperative complications (i.e., pneumothorax, pulmonary atelectasis, pneumonia, wound infection, and dehiscence) were also determined.
Result: Our results showed a statistically significant decrease in the incidence of postoperative fever within 24 to 72 hours of surgery in patients admitted from Group 2019 as compared to Group 2021 (p<0.001), as well as a decrease in peak body temperature within 72 hours (p<0.05). Meanwhile, no significant differences were observed in age and body mass index (BMI), time of operation, or duration of postoperative mechanical ventilator and urinary catheter use between the two groups (p>0.05). The average hospitalization length of Group 2021 was significantly shorter than Group 2019 (12.49 ± 2.57 vs 11.85 ± 2.19 days, p<0.05). Furthermore, while the WBC count between the two groups 24 hours after surgery showed a statistical difference (p<0.05), no differences in CRP levels or the incidence of postoperative complications were observed (p>0.05).
Conclusion: The prevalence of postoperative fever within 72 hours of surgery and the length of hospital stay for patients with PE undergoing NUSS surgery were both decreased in Group 2021. We propose that the above phenomenon may be related to increased used of personal protection equipment (such as surgical masks and filtering facepiece respirators (FFRs)) by physicians, nurses, and the patients themselves.
Ocular biometric differences between long and not long-axial length eyes
Authors: Tanaka Takahiro , Marubayashi Ayako , Nishitsuka Koichi , Obata Hiroto
Published: August 2023

This retrospective cross-sectional study aimed to measure parameters of preoperative cataract patients and examines the correlations between each parameter. The 210 subjects had their ocular axial lengths measured with OA-2000. The endpoints were ocular axial length (AL), central corneal thickness (CCT), average corneal radii (CR), white-to-white(WTW), anterior chamber depth(ACD), and lens thickness(LT). AL was mainly employed for each person. Each parameter was analyzed for correlations in a round-robin manner. Regression analyses were performed on parameters correlated with AL. The parameters correlated with AL were CR (r = 0.33, p < 0.0001), WTW (r = 0.29, p < 0.0001), ACD (r = 0.59, p < 0.0001), and LT (r = −0.30, p < 0.0001). These parameters affected AL in all single regression equations (CR (P < 0.0001), WTW (P = 0.0002), ACD (P < 0.0001), LT (P = 0.0001)). In multiple regression analyses, CR, ACD, and LT might affect AL (CR (P = 0.0002), ACD (P < 0.0001), LT (P = 0.018)). LT tended to be thinner as AL increased, while CR, WTW, and ACD tended to increase. This information will be useful in developing strategies for ophthalmic surgery.
Effectiveness of e-health intervention using smart phone app to reduce anxiety & depressive symptoms among adolescents: A cluster randomized controlled trial. (Study Protocol- NCT05865834)
Authors: Rozi Shafquat , Jamal Wafa , Alladin Neyama , Peerwani Ghazal , Farrukh Sana , Asad Nargis , Butt Zahid Ahmad , Kazi Momin
Published: August 2023

Background: As per World Health Organization, 13% of adolescents worldwide experience a mental disorder. If the increasing burden of mental health issues is not addressed in adolescence, they can culminate into established mental disorders extending to adulthood, impairing overall wellbeing, and limiting opportunities. To cater to mental health issues in adolescents at an early stage, we aim to develop and assess the effectiveness of a smartphone application for the reduction of depression and anxiety symptoms in school-going adolescents aged 12-18 years.
Methods A stratified cluster randomized controlled trial will be conducted on 200 students from different schools of Karachi, Pakistan. A two-stage cluster sampling with stratification on school type (government or private) will be employed to select schools and recruit students. The duration of the study will be 1 year. Selected schools will be randomly assigned to either an intervention (mHealth program) or control group (self-reading educational leaflets). PHQ-A, GAD-7, and WHO depression wellbeing scale for assessing depressive symptoms, anxiety symptoms, and wellbeing will be used at baseline, 1 month, and three months. GEE will be used to compare mean scores of depression, anxiety and wellbeing scores between both arms.
Discussion: There are hardly any programs in Pakistan that focus on mHealth interventions that are tailored and target anxiety and depression among adolescents. This smartphone application will stimulate autonomous motivation in adolescents by integrating all the components based on the perspectives of Pakistani adolescents. This application by addressing mental health symptoms in adolescents will benefit the community at large by limiting the burden of mental health disorders. Also, this application will improve accessibility especially in adolescents experiencing financial constraints such as lack of money or transportation to attend appointments.
Trial registration: Registered in clinicaltrial.gov under the identifier NCT05865834. Date of registration: 18.05.23.
Design and analysis of 0.64 THz metamaterial absorber for sensing applications
Authors: Kumar Anup , Yaduvanshi Rajveer Singh
Published: August 2023

The proposed work is about the design and analysis of an RF absorber at 0.64 THz. The proposed absorber has 99.99% absorptance. The incident angle sensitivity of absorber is 00 to 600. It has wide bandwidth and excellent quality factor. The absorber has been simulated by multi physics software to obtain absorptance, S11, impedance (Z11), real and imaginary permittivity and permeability, current density (J), E-fields, quality factor, higher order modes and sensitivity. The structure of absorber consists of a plus shape surrounded by two gold (Au) metal rings. It is positioned on a layer of silicon dioxide (SiO2) and is stacked with silicon. The ground plane by another layer of gold metal. The absorber is excited with shorting pins to obtain dual mode resonance at 0.64 THz and 0.80 THz. The values of absorbance on these two frequencies are 99.99% and 99%. The mathematical formulations for impedance, phase velocity and group velocity have been derived. The equivalent circuit modeling for absorber has been developed.
Accelerated Drift in Age Structured Populations:
Implications for Mutation Accumulation
Authors: Overall Andrew , Waxman David
Published: August 2023

Modern, industrial populations have demographic parameters that differ considerably from those of non-industrialised, ‘traditional’ or ‘hunter-gatherer’ populations, as well as ancestral populations. In other words, modern industrial populations have undergone a demographic transition. In this work we consider the implications of such a transition for Homo sapiens, which corresponds to a decrease in both birth and death rates, with one consequence of this transition being an increase in population size. Taking explicit account of the decreasing size of successive age-classes (e.g., fewer 50-year old females than 40-year-old females) provides useful insight into how small a genetic sample the elderly age-classes can be. The decrease of size of successive age-classes has implications for diseases of old-age, via the mode of mutation accumulation, and indicates how influential demographic transitions can be, beyond expectations based solely upon estimates of Ne. The results of simulations we present suggest that the genetic background of current laboratory model organisms, that are employed in research into age-related human diseases, may be unrepresentative of human populations and we propose that demographically transitioned captive species may provide more realistic insights into the underlying mechanisms.
Low-force human-human hand interactions induce gait changes through sensorimotor engagement instead of direct mechanical effects
Authors: Wu Mengnan , Hackney Madeleine E. , Ting Lena H.
Published: August 2023

Physical human-robot interactions (pHRI) often provide mechanical force and power to aid and alter human walking without requiring voluntary effort from the human. Alternatively, we propose that principles of physical human-human interactions (pHHI) can inspire pHRI that aids walking by engaging human sensorimotor processes. We hypothesize that low-force hand interactions can intuitively induce people to alter their own walking. Our experiment paradigm is based on partner dancing: an expert partner dancer influences novice participants to alter step frequency solely through hand interactions. Without prior instruction or training, novices decreased step frequency by 29% and increased step frequency 18% based on low forces (< 20 N) at the hands. Power transfer at the hands was 10-100x smaller than that exerted by the lower limbs to propel locomotion, suggesting that the expert did not mechanically alter the novice’s gait. Instead, the direction of hand forces and power may communicate information about desired walking patterns. Finally, the expert altered arm stiffness to match that of the novice, offering a design principle for pHRI to alter gait. Our results provide a framework for developing pHRI with wide-ranging applications, including assistive technology and physical rehabilitation, human-robot manufacturing, physical education, and recreation.
Synergistic effect of spermidine and ciprofloxacin against Alzheimer disease in male rat via ferroptosis modulation
Authors: Youssef Menna M , Mohamed Tarek M , Bakry Aza M , El-Keiy Mai M
Published: August 2023

Alzheimer's disease (AD) is a prevalent form of neurodegenerative disease with a complex pathophysiology that remains not fully understood, and the exact mechanism of neurodegeneration is uncertain. Ferroptosis, a programmed cell death mechanism mediated by iron, has been linked to the progression of degenerative diseases observed in clinical AD models. In this study, we aimed to explore the synergistic effects of spermidine and/or ciprofloxacin in combating Alzheimer's disease (AD). We investigated AD-related biomarkers, including neurotoxic Aβ, arginaseI, and serotonin.Spermidine demonstrated an anti-ferroptotic effect in the AD model, evident from the modulation of ferroptosis parameters such as hippocampus iron levels, reduced protein expression of transferrin receptor 1 (TRF1), and arachidonate 15-lipoxygenase (ALOX15). Additionally, the administration of spermidine led to a significant increase in protein expression of phosphorylated nuclear factor erythroid 2-related factor 2 (p-Nrf2) and upregulation of Cystine/glutamate transporter (SLC7A11) gene expression. Moreover, spermidine notably decreased p53 protein levels, acrolein, and gene expression of spermidine/spermine N1-acetyltransferase 1 (SAT1). The histopathological examination of hippocampus tissue corroborated these results obtained from molecular biochemical inspection. Overall, our findings suggest that spermidine and/or ciprofloxacin may offer potential benefits against Alzheimer's disease (AD) by modulating ferroptosis. Furthermore, spermidine enhanced the antioxidant efficacy of ciprofloxacin and reduced its toxic effects by increasing antioxidant enzymes, thereby enhancing its potency against oxidative stress.
Innovative Primary Care Clinic for Complex Patients Generates a Financial Benefit for Health System
Authors: Carstarphen Kathy Jo , Shawley Audrey , Li Richard , Hill Sarah , Sharma Sakshi , Wadleigh Marshall , Nehmeh Amal , Denton Gerald D
Published: August 2023

Introduction: The United States ranks far lower than other high-income countries on measures of health care affordability, efficiency, equity, and outcome. A key distinguishing feature of the US from the top-performing countries is the lack of investment in primary care systems that prioritize high quality care delivery to vulnerable populations. Methods: The MedVantage Clinic (MVC) operates within Ochsner Health System, a large academic not-for-profit health system based on a group practice model, located in the New Orleans metropolitan area. We compared cost and utilization for patients enrolled in the MVC vs a comparable control population for one year before and after the index date of program enrollment. Participants include a heterogeneous patient panel of Medicare beneficiaries with multiple comorbid conditions and barriers to care. Results: Our total estimate for the total annual resource benefit generated by the MVC in 2017–2018 is $1,224,648 (n = 189). We estimate this decreased cost of care through 1) improved documentation of hierarchical condition category (HCC) risk adjustment factor (RAF) scores 2) decreased mean per-member-per-month (PMPM) costs 3) decreased inpatient length of stay and 4) decreased mean inpatient utilization Discussion: The MVC model is rooted in providing complex, multi-morbid patients with additional resources and services in order to address intense health needs and decrease costs of care. The MVC case group generated a greater total resource benefit for health systems than the matched control group.