Metabolic syndrome score as an indicator in a predictive nomogram for lymph node metastasis in endometrial cancer.

BACKGROUND: Lymph node metastasis (LNM) is an important factor affecting endometrial cancer (EC) prognosis. Current controversy exists as to how to accurately assess the risk of lymphatic metastasis. Metabolic syndrome has been considered a risk factor for endometrial cancer, yet its effect on LNM remains elusive. We developed a nomogram integrating metabolic syndrome indicators with other crucial variables to predict lymph node metastasis in endometrial cancer. METHODS: This study is based on patients diagnosed with EC in Peking University People's Hospital between January 2004 and December 2020. A total of 1076 patients diagnosed with EC and who underwent staging surgery were divided into training and validation cohorts according to the ratio of 2:1. Univariate and multivariate logistic regression analyses were used to determine the significant predictive factors. RESULTS: The prediction nomogram included MSR, positive peritoneal cytology, lymph vascular space invasion, endometrioid histological type, tumor size > = 2 cm, myometrial invasion > = 50%, cervical stromal invasion, and tumor grade. In the training group, the area under the curve (AUC) of the nomogram and Mayo criteria were 0.85 (95% CI: 0.81-0.90) and 0.77 (95% CI: 0.77-0.83), respectively (P < 0.01). In the validation group (N = 359), the AUC was 0.87 (95% CI: 0.82-0.93) and 0.80 (95% CI: 0.74-0.87) for the nomogram and the Mayo criteria, respectively (P = 0.01). Calibration plots revealed the satisfactory performance of the nomogram. Decision curve analysis showed a positive net benefit of this nomogram, which indicated clinical value. CONCLUSION: This model may promote risk stratification and individualized treatment, thus improving the prognosis.

A Qualitative Exploration of the Psychological Experience of Patients Hospitalized With COVID-19.

This qualitative study describes the psychological experience of patients hospitalized with COVID-19. These patients went through 3 psychological stages: extremely uncertainties during the initial diagnostic stage, complicated feelings of negativity during the treatment stage, and positive growth in the recovery stage. It is important for nurses to provide holistic care.

Variations in disease burden of laryngeal cancer attributable to alcohol use and smoking in 204 countries or territories, 1990-2019.

BACKGROUND: Alcohol consumption and smoking are the leading risk factors for laryngeal cancer (LC). Understanding the variations in disease burden of LC attributable to alcohol use and smoking is critical for LC prevention. METHODS: Disease burden data of LC were retrieved from the Global Burden of Disease Study 2019. We used estimated average percentage change (EAPC) to measure the temporal trends of the age-standardized mortality rate (ASMR) of LC. RESULTS: Globally, while the ASMR of LC decreased by 1.49% (95% CI, 1.41-1.57%) per year between 1990 and 2019, the number of deaths from LC has increased 41.0% to 123.4 thousand in 2019. In 2019, 19.4 and 63.5% of total LC-related deaths were attributable to alcohol use and smoking worldwide, respectively. The ASMR of alcohol- and smoking-related LC decreased by 1.78 and 1.93% per year, whereas the corresponding death number has increased 29.2 and 25.1% during this period, respectively. The decreasing trend was more pronounced in developed countries. In some developing countries, such as Guinea and Mongolia, the LC mortality has shown an unfavorable trend. CONCLUSION: The ubiquitous decrease in LC mortality was largely attributed to the smoking control and highlighted the importance of smoking control policies. However, the disease burden of LC remained in increase and more effective strategies are needed to combat the global increase of alcohol consumption.

Trial marriage model-Female mate choice under male interference.

In sexually reproducing animals, the process of mate choice by females is often mixed with the process of male-male competition. Current models of female male choice focus mainly on how females identify the higher quality of males, but neglect the effect of male-male competition on the mate choice of females. Therefore, it remains controversial what is the relative importance of two processes in forming a social bond. We propose a new 'trial marriage' model for females' mate choice. The model assumes that females unconditionally accept any male they first encounter as their mating partner, and then conditionally switch mates to a new male of higher quality than their current partner when male-male competition occurs. This model was tested in the green weevil Hypomeces squamosus by exploring how females switched mates when males' mating interference was experimentally induced. The likelihood that females switched mates, as well as their conditional acceptance criteria of a new mate, was both raised with the intensity of males' mating interference that was manipulated in an enhanced encounter rate experiment, and in male introduction or stepwise removal experiments. These experimental findings confirm that a 'trial marriage' strategy occurs during females' mate choice. Compared with other strategies, it is more beneficial for females to choose a better mate without paying the costs of identifying males as suggested by the 'trial marriage' strategy. More importantly, using the current partner quality as the conditional acceptance threshold of new mates, females can choose better males in future encounters with potential mates. In the green weevils, males' preference for larger females and the higher possibility of the largest male winning an interference are mixed together when males' mating interference reaches a higher intensity. Therefore, the consequence of a male interference will determine which male could be chosen by a female. Under this condition, conditional acceptance of the winner becomes the most beneficial strategy of females in choosing their mates. We thus suggest that the 'trial marriage' strategy would be more efficient when males' mating interference becomes the determinant factor of females' mate choice.

Anti-N-Methyl-D-Aspartic Acid Receptor 2 (Anti-NR2) Antibody in Neuropsychiatric Lupus Serum Damages the Blood-Brain Barrier and Enters the Brain.

BACKGROUND Brain microvessel endothelial cells constitute an important component in the blood-brain barrier. Cell-culture-based models of the blood-brain barrier (BBB) have been extensively applied in pharmacology, pathology and physiology. This study investigated effects of anti-N-methyl-D-aspartic acid receptor 2 (anti-NR2), N-methyl-D-aspartic acid (NMDA) receptor antibodies, NMDA receptor antagonists, and NMDA receptor agonists on brain microvessel endothelial cell models, and verified the effect of anti-NR2 antibody on the BBB as a receptor agonist. MATERIAL AND METHODS The primary brain microvessel endothelial cells were isolated and cultured, and an in vitro BBB model was established based on microvessel endothelial cells. Anti-NR2 antibody, glutamic acid, ifenprodil, and memantine were added in the BBB model to analyze changes in transepithelial electrical resistance (TEER) and to examine the permeability of the brain microvessel endothelial cell model. RESULTS The results showed that TEER values were significantly decreased by the addition of anti-NR2 antibody and glutamate, but were significantly increased by the addition of ifenprodil and memantine. TEER values showed no changes when treated by anti-NR2 antibody and ifenprodil, as well as anti-NR2 antibody and memantine. When dexamethasone was added, the TEER values increased by 23.8%, 39.4%, and 29.6% by treating with anti-NR2 antibody, positive cerebrospinal fluid, and positive serum, respectively. CONCLUSIONS Our findings show that anti-NR2 antibody in neuropsychiatric lupus serum can damage the BBB and enter the brain.

Sample-to-cutoff ratios using Architect HIV Ag/Ab Combo: The influence with the results of supplemental tests and optimal cutoff value to predict HIV infection.

BACKGROUND: The Architect HIV Ag/Ab Combo has excellent performance for HIV screening; however, the false-positive rate (FPR) was high in low HIV prevalence setting. OBJECTIVES: The purpose of this study was to analyze the influence of sample-to-cutoff (s/co) ratios by Architect HIV Ag/Ab Combo with the results of confirmatory test and explore the potential utility of s/co to predict HIV infection. METHODS: A retrospective review on Architect HIV Ag/Ab Combo reactive results was performed at a teaching hospital in Xi'an. The s/co values in different groups, that is, true positives (TP) and false positives (FP), different Western blotting (WB) bands among WB-positive cases, were compared. The receiver operating characteristic curve (ROC) analysis was used to determine the optimal cutoff value for predicting HIV infection. RESULTS: During the study period, 219 out of 84 702 patients were reactive by ARCHITECT with a 0.0992% of HIV prevalence and a 56.25% of FPR. The mean s/co ratios in TP were significantly higher than that in FP (458.15 vs 3.11, P < 0.0001). Among the WB-positive cases, the s/co ratios increased significantly with the increase in the number of bands, P = 0.0065. The optimal cutoff (24.44) by ROC analysis can provide the highest sum of sensitivity (100%) and specificity (100%) with no FP results. CONCLUSIONS: For Architect HIV Ag/Ab Combo, the FPR is reduced when s/co ratios increase, and the s/co ≥24.44 may be reliable to predict HIV infection.

Two-stage microbial conversion of crude glycerol to 1,3-propanediol and polyhydroxyalkanoates after pretreatment.

With increasing demand for biodiesel, crude glycerol as a by-product in biodiesel production has been generated and oversupplied. This study, therefore, explored the pretreatment and a subsequent two-stage microbial system to convert crude glycerol into high value-added products: 1,3-propanediol (1,3-PDO) and polyhydroxyalkanoates (PHAs). After pretreatment, long chain fatty acids (LCFAs) could be effectively removed from crude glycerol to eliminate the inhibition effects on subsequent microbial process. In the anaerobic fermentation, when fed treated crude glycerol increased from 20 g/L to 100 g/L, 1,3-PDO yield decreased from 0.438 g/g to 0.345 g/g and accompanied carboxylic acids shifted from acetate and lactate dominant to lactate overwhelmingly dominant. Meanwhile, the relative abundance of Clostridiales sustained around 50% but Enterobacteriales increased from 19% to 53%. Further fed glycerol increase to 140 g/L resulted in severe substrate inhibition, which could be relieved by intermittent feeding. In aerobic process, glycerol anaerobic digestion effluent (ADE) was fed to the consortium of Bacillus megaterium and Corynebacterium hydrocarbooxydans for selectively consumption of carboxylic acids and residual glycerol from 1,3-PDO to produce PHAs as a secondary high value-added product. The consortium accumulated maximum 8.0 g/L poly (3-hydroxybutyrate) (PHB), and 1,3-PDO purity increased from initial 27.7% to almost 100% when fed with 100 g/L glycerol ADE. Overall, this study provided comprehensive and insightful information on microbial conversion of crude glycerol to high value-added products after pretreatment.

Luteimonas rhizosphaerae sp. nov., isolated from the rhizosphere of Triticum aestivum L.

A Gram-stain-negative, rod-shaped bacterium, strain 4-12T, was isolated from the rhizosphere of Triticum aestivum L. from the Xiaokai River irrigation area, China. The isolate grew optimally at 30 °C, pH 7.5-8.0 and with 1.0 % (w/v) NaCl. Based on the 16S rRNA gene sequence and phylogenetic analysis, strain 4-12T belonged to the genus Luteimonas with the highest degree of 16S rRNA gene sequence similarity to Luteimonas tolerans UM1T (97.68 %), followed by Luteimonas terrae THG-MD21T (97.67 %), Lysobacter panaciterrae Gsoil 068T (97.21 %) and Luteimonas aestuarii B9T (97.16 %). However, the DNA-DNA relatedness values between strain 4-12T and closely related Luteimonas strains were well below 40 %. The average nucleotide identity and the Genome-to-Genome Distance Calculator also showed low relatedness (below 95 and 70 %, respectively) between strain 4-12T and the type strains in genus Luteimonas. Ubiquinone-8 was the predominant quinone. The major fatty acids were iso-C15 : 0, iso-C11 : 0, iso-C17 : 0 and iso-C17 : 1ω9c. Polar lipids were dominated by diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol and unidentified phospholipids. The DNA G+C content was 69.5 %. According to the phenotypic, genetic and chemotaxonomic data, strain 4-12T is considered to represent a novel species in the genus Luteimonas, for which the name >Luteimonas rhizosphaerae sp. nov. is proposed, with strain 4-12T (=CCTCC AB 2016261T=KCTC 52585T) as the type strain.

Multiple geophysical surveys for old landfill monitoring in Singapore.

One-dimensional boring presents limitations on mapping the refuse profile in old landfills owning to waste heterogeneity. Electrical imaging (EI) and multiple-analysis of surface wave (MASW) were hereby deployed at an old dumping ground in Singapore to explore the subsurface in relation to geotechnical analysis. MASW estimated the refuse boundary with a higher precision as compared to EI, due to its endurance for moisture variation. EI and MASW transection profiles suggested spots of interest, e.g., refuse pockets and leachate mounds. 3D inversion of EI and MASW data further illustrated the transformation dynamics derived by natural attenuation, for instance the preferential infiltration pathway. Comparison of geophysical surveys at different years uncovered the subterranean landfill conditions, indicating strong impacts induced by aging, precipitation, and settlement. This study may shed light on a characterization framework of old landfills via combined geophysical models, thriving landfill knowledge with a higher creditability.

Determination of urine-derived odorous compounds in a source separation sanitation system.

Source separation sanitation systems have attracted more and more attention recently. However, separate urine collection and treatment could induce odor issues, especially in large scale application. In order to avoid such issues, it is necessary to monitor the odor related compounds that might be generated during urine storage. This study investigated the odorous compounds that emitted from source-separated human urine under different hydrolysis conditions. Batch experiments were conducted to investigate the effect of temperature, stale/fresh urine ratio and urine dilution on odor emissions. It was found that ammonia, dimethyl disulfide, allyl methyl sulfide and 4-heptanone were the main odorous compounds generated from human urine, with headspace concentrations hundreds of times higher than their respective odor thresholds. Furthermore, the high temperature accelerated urine hydrolysis and liquid-gas mass transfer, resulting a remarkable increase of odor emissions from the urine solution. The addition of stale urine enhanced urine hydrolysis and expedited odor emissions. On the contrary, diluted urine emitted less odorous compounds ascribed to reduced concentrations of odorant precursors. In addition, this study quantified the odor emissions and revealed the constraints of urine source separation in real-world applications. To address the odor issue, several control strategies are recommended for odor mitigation or elimination from an engineering perspective.

Enhanced Shewanella biofilm promotes bioelectricity generation.

Electroactive biofilms play essential roles in determining the power output of microbial fuel cells (MFCs). To engineer the electroactive biofilm formation of Shewanella oneidensis MR-1, a model exoelectrogen, we herein heterologously overexpressed a c-di-GMP biosynthesis gene ydeH in S. oneidensis MR-1, constructing a mutant strain in which the expression of ydeH is under the control of IPTG-inducible promoter, and a strain in which ydeH is under the control of a constitutive promoter. Such engineered Shewanella strains had significantly enhanced biofilm formation and bioelectricity generation. The MFCs inoculated with these engineered strains accomplished a maximum power density of 167.6 ± 3.6 mW/m(2) , which was ∼ 2.8 times of that achieved by the wild-type MR-1 (61.0 ± 1.9 mW/m(2) ). In addition, the engineered strains in the bioelectrochemical system at poised potential of 0.2 V vs. saturated calomel electrode (SCE) generated a stable current density of 1100 mA/m(2) , ∼ 3.4 times of that by wild-type MR-1 (320 mA/m(2) ).

Enzymatic-reaction induced production of polydopamine nanoparticles for sensitive and visual sensing of urea.

Dopamine (DA) has attracted extensive interest due to not only its important roles in physiological and pathological processes, but also its prospective applications in chemistry and materials science. In this work, we demonstrate that the urease catalytic reaction is an effective new approach for a better control of DA polymerization to polydopamine nanoparticles (PDA NPs). And we further develop an original and novel method for sensitive and visual sensing of urea through spectroscopic or particle size analysis. The detection is based on DA polymerization to PDA NPs that can be controlled by the reaction rate of urease-catalyzed urea hydrolysis, correspondingly, correlated with the varied urea concentration. The composition, morphologies and sizes of the resulting PDA NPs are characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and dynamic light scattering (DLS) spectroscopy, respectively. Under optimal reaction conditions, the UV absorbance of DA polymerization at 400 nm shows a good response towards urea detection over a range of 1 × 10(-7) to 1 × 10(-3) M with a limit of detection (LOD) of 100 nM (S/N = 3). Moreover, the sizes of the resulting PDA NPs increase linearly with urea concentration from 5 × 10(-6) to 1 × 10(-4) M. The newly developed assay allows the enzymatic-reaction driven PDA NPs to be used for quantitative detection of urea with many advantages, e.g. simple preparation, easy visualization, good sensitivity, wide detection range and low interference, in particular, no complex sensor-fabrication required.

Mapping refuse profile in Singapore old dumping ground through electrical resistivity, S-wave velocity and geotechnical monitoring.

The purpose of this study was to track the refuse profile in Lorong Halus Dumping Ground, the largest landfill in Singapore, by electrical resistivity and surface wave velocity after 25 years of closure. Data were analyzed using an orthogonal set of plots by spreading 24 lines in two perpendicular geophone-orientation directions. Both geophysical techniques determined that refuse boundary depth was 13 ± 2 m. The refuse boundary revealed a certain degree of variance, mainly ascribed to the different principle of measurements, as well as the high heterogeneity of the subsurface. Discrepancy was higher in spots with greater heterogeneity. 3D analysis was further conducted detecting refuse pockets, leachate mounding and gas channels. Geotechnical monitoring (borehole) confirmed geophysical outcomes tracing different layers such as soil capping, decomposed refuse materials and inorganic wastes. Combining the geophysical methods with borehole monitoring, a comprehensive layout of the dumping site was presented showing the hot spots of interests.

Co-composting of horticultural waste with fruit peels, food waste, and soybean residues.

Horticultural waste was co-composted with fruit peels, food waste, and soybean residues individually to evaluate the effects of these easily available organic wastes in Singapore on the composting process and product quality. Each co-composting material was mixed with horticultural waste in the wet weight ratio of 1:1 and composted for 46 days. Results showed that all co-composting materials accelerated the degradation of total carbon and resulted in higher nutrients of nitrogen (N), phosphorous (P), and potassium (K) in the final product compared with horticultural waste alone. Mixture with fruit peels achieved the fastest total carbon loss; however, did not reach the minimum required temperature for pathogen destruction. The end product was found to be the best source for K and had a higher pH that could be used for the remediation of acidic soil. Food waste resulted in the highest available nitrate (NO3-N) content in the end product, but caused high salt content, total coliforms, and slower total carbon loss initially. Soybean residues were found to be the best co-composting material to produce compost with high N, P, and K when compared with other materials due to the highest temperature, fastest total carbon loss, fastest reduction in C/N ratio, and best conservation of nutrients.

Runx1-deficient afferents impair visceral nociception, exacerbating dextran sodium sulfate-induced colitis.

Colitis is a group of inflammatory and auto-immune disorders that affect the tissue lining of the gastrointestinal (GI) system. Studies of chemically-induced animal models of colitis have indicated that nociceptive afferents or neuropeptides have differing effects on GI inflammation. However, the molecular mechanisms involved in visceral pain and the role of visceral sensory afferents involved in the modulation of colitis remains unclear. A previous study demonstrated that Runx1, a Runt domain transcription factor, is restricted to nociceptors. In these neurons, Runx1 regulates the expression of numerous ion channels and receptors, controlling the lamina-specific innervation patterns of nociceptive afferents in the spinal cord. Moreover, mice that lack Runx1 exhibit specific defects in thermal and neuropathic pain. To examine the function of Runx1 in visceral nociception, we employed double-transgenic mice (WntCre: Runx1(F/F)), in which the expression of Runx1 was specifically disrupted in the sensory neurons. To determine the role of Runx1 in visceral pain sensation, the WntCre: Runx1(F/F) mice and their control littermates (Runx1(F/F)) were treated using dextran sodium sulfate (DSS) to induce colitis. The results indicated that disrupted Runx1 in the sensory afferents resulted in: (1) impairment of the visceral pain sensation in murine DSS-induced colitis; (2) exacerbating the phenotypes in murine DSS-induced colitis; (3) a differential effect on the production of pro- and anti-inflammatory cytokines in the colon tissues isolated from mice treated using DSS and 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis; and (4) alteration of the distribution of lymphocytes and mast cells in mucosa. These results show that the function of Runx1 in sensory afferents is vital for modulating visceral pain and the neuro-immune axis.

Urban nutrient recovery from fresh human urine through cultivation of Chlorella sorokiniana.

High rate food consumption in urban cities causes vast amounts of nitrogen and phosphorus used in agriculture to end up in urban wastewaters. To substantially recover these nutrients, source-separated human urine should be targeted. The present study was to investigate the feasibility of recovering nitrogen and phosphorus in urine via microalgae cultivation. In concentrated urine, urea hydrolysis and precipitation occur rapidly, making microalgal growth difficult and nutrient recovery ineffective. However, when fresh urine was added as nutrient stock for 1-day growth requirement, biomass of Chlorella sorokiniana grew from 0.44 to 0.96 g L(-1) utilising 62.64 mg L(-1) of N and 10.64 mg L(-1) of P, achieving 80.4% and 96.6% recoveries, respectively in a 1-day non-sterile cultivation cycle. Overall, microalgae grown with urine added as nutrient supplement show no signs of inferiority as compared to those grown in recipe medium BG11 in terms of mass and chlorophyll a growth rates as well as resulting lipids (36.8%) and energy contents (21.0 kJ g(-1)).

Environmental life cycle assessment of different domestic wastewater streams: policy effectiveness in a tropical urban environment.

To enhance local water security, the Singapore government promotes two water conservation policies: the use of eco-friendly toilets to reduce yellow water (YW) disposal and the installation of water efficient devices to minimize gray water (GW) discharge. The proposed water conservation policies have different impacts on the environmental performance of local wastewater management. The main purpose of this study is to examine and compare the impacts of different domestic wastewater streams and the effectiveness of two water conservation policies by means of life cycle assessment (LCA). LCA is used to compare three scenarios, including a baseline scenario (BL), YW-reduced scenario (YWR) and GW-reduced scenario (GWR). The BL is designed based on the current wastewater management system, whereas the latter two scenarios are constructed according to the two water conservation policies that are proposed by the Singapore government. The software SIMPARO 7.3 with local data and an eco-invent database is used to build up the model, and the functional unit is defined as the daily wastewater disposal of a Singapore resident. Due to local water supply characteristics, the system boundary is extended to include the sewage sludge management and tap water production processes. The characterization results indicate that the GWR has a significant impact reduction (22-25%) while the YWR has only a 2-4% impact reduction compared with the BL. The contribution analysis reveals that the GW dominates many impact categories except eutrophication potential. The tap water production is identified as the most influential process due to its high embodied energy demand in a local context. Life cycle costing analysis shows that both YWR and GWR are financially favorable. It is also revealed that the current water conservation policies could only achieve Singapore's short-term targets. Therefore, two additional strategies are recommended for achieving long-term goals. This study provides a comprehensive and reliable environmental profile of Singapore's wastewater management with the help of extended system boundary and local data. This work also fills the research gap of previous studies by identifying the contribution of different wastewater streams, which would serve as a good reference for source-separating sanitation system design.

Highly efficient secondary dewatering of dewatered sewage sludge using low boiling point solvents.

Secondary dewatering of dewatered sludge is imperative to make conventional drying and incineration of sludge more economically feasible. In this study, a secondary dewatering of dewatered sludge with selected solvents (i.e. acetone and ethanol) followed by vacuum filtration and nature drying was investigated to achieve in-depth dewatering. After the entire secondary dewatering process, the sludge was shown to be odourless and the organic matter content was greatly retained. Increased mean particle size of sludge after solvent contact improved solid-liquid separation. With an acetone/sludge ratio of 3:1 (mL:g) in solvent contact and subsequent nature drying at ambient temperature after 24 h, the moisture content of sludge can be reduced to a level less than 20%. It is found that the polysaccharides were mainly precipitated by acetone, whereas the release ratios of protein and DNA were increased significantly as the added acetone volumes were elevated. During nature drying, accumulated evaporation rates of the sludge after solvent contact were 5-6 times higher than original dewatered sludge. Furthermore, sludge after acetone contact had better nature drying performance than ethanol. The two-stage dewatering involves solvent contact dewatering and solvent enhanced evaporation dewatering. Through selecting an appropriate solvent/sludge ratio as well as economical solvents and minimizing the solvent loss in a closed-pilot system, this dewatering process can be competitive in industrial applications. Therefore, this solvent-aided secondary dewatering is an energy-saving technology for effective in-depth dewatering of dewatered sludge and subsequent sludge utilization.

Associations between genomic aberrations, increased nuchal translucency, and pregnancy outcomes: a comprehensive analysis of 2,272 singleton pregnancies in women under 35.

Objectives: Regarding increased nuchal translucency (NT), the cutoff values used are heterogeneous in clinical practice, this study aims to assess the efficacy of prenatal detection for chromosomal abnormalities and pregnancy outcomes in fetuses with varying NT thicknesses, in order to provide data that supports informed prenatal diagnosis and genetic counseling for such cases. Methods: We included 2,272 pregnant women under 35 with singleton pregnancies who underwent invasive prenatal diagnosis between 2014 and 2022. The cohort comprised 2,010 fetuses with increased NT (≥2.5 mm) and 262 fetuses with normal NT but exhibiting a single soft marker. Prenatal diagnoses were supported by chromosomal microarray (CMA) and copy number variation sequencing (CNV-seq) analyses. Results: The detection rates of numerical chromosomal abnormalities were 15.4% (309/2,010) and 17.3% (297/1,717) in the NT ≥2.5 and ≥ 3.0 groups, respectively. Pathogenic/likely pathogenic CNV incidence increased with NT thickness (χ2 = 8.60, p < 0.05), peaking at 8.7% (22/254) in the NT 4.5-5.4 mm group. Structural defects were found in 18.4% of fetuses with NT values between 2.5 mm and 2.9 mm. Chromosomal abnormality rates in the isolated increased NT groups of 2.5-2.9 mm and 3.0-3.4 mm were 6.7% (16/239) and 10.0% (47/470), respectively, with no statistical significance (χ2 = 2.14, p > 0.05). Fetuses with NT thickness between 2.5 and 2.9 mm combined with the presence of soft markers or non-lethal structural abnormalities exhibited a significantly higher chromosomal abnormality risk (19.0%) compared to fetuses with isolated increased NT ranging from 3.5 to 4.4 mm (13.0%). Pregnancy termination rates increased with NT thickness (χ2 = 435.18, p < 0.0001), ranging from 12.0% (30/249) in the NT 2.5-2.9 mm group to 87.0% (141/162) in the NT ≥ 6.5 mm group. Conclusion: CMA or CNV-seq exhibited good performance in identifying genomic aberrations in pregnancies with increased NT thickness. NT ranging from 2.5 mm to 2.9 mm elevated the risk of fetal chromosomal abnormalities, particularly when combined with other soft markers.

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Precipitation in the plum rain period accounts for 40%-50% of annual precipitation in the monsoon region. To clarify the temporal variability of the isotopic composition of precipitation during the plum rain period from event to interannual time scale and identify the influencing factors, we analyzed the isotopic composition of precipitation and its influencing factors in Nanjing from 2015 to 2022. By using the Hybrid Single-particle Lagran-gian Integrated Trajectory (HYSPLIT) model with specific humidity analysis, we investigated the water vapor source and influencing factors. The results showed that 1) the isotopic abundance of atmospheric precipitation was depleted in the summer and enriched in winter. dx was lower in summer and higher in winter. The isotopic abundance of precipitation from the plum rain was depleted compared to mean value of the whole-year. 2) There was no significant correlation between δ2H and δ18O of the plum rain (precipitation) with local meteorological factors. However, dx was lower in light rain, reflecting the effect of sub-cloud evaporation. The average dx was higher during plum rain period in years with more total plum rain precipitation. 3) The low-latitude South China Sea and the western Pacific Ocean source area provided water vapor for the plum rain. The shift of moisture source region led to abrupt changes in precipitation isotopes. Our results could provide data support for studies on precipitation isotopes in the monsoon region, as well as a reference point for further understanding the precipitation mechanism of the plum rain and stu-dying the seasonal variability of atmospheric circulation in the East Asian monsoon region.