Lower cutoff levels in screening programs have led to an increase in the proportion of detected cases with transient hypothyroidism, leading to increase of the overall incidence of primary congenital hypothyroidism (CH) in several countries. We have performed retrospective evaluation on the data from 251,008 (96.72%) neonates screened for thyroid-stimulating hormone (TSH) level in dried blood spot specimens taken 48 hours after birth, between 2002 and 2015, using DELFIA method. A TSH value of 15 mIU/L was used as the cutoff point until 2010 and 10 mIU/L thereafter. Primary CH was detected in 127 newborns (1/1976) of which 81.1% had permanent and 18.9% had transient CH. The incidence of primary CH was increased from 1/2489 until to 2010 to 1/1585 thereafter (p=0.131). However, the incidence of permanent CH was slightly increased (p=0.922), while the transient CH incidence had 8-fold increasing after lowering the TSH cutoff level (p<0.001). In cases with permanent CH, we observed lower frequency for thyroid dysgenesis (82.7 vs. 66.7%) and higher frequency for normal in-situ thyroid gland (17.3 vs. 33.3%), for the period with reduced TSH cutoff value. Our findings support the impact of lower TSH cutoff on the increasing incidence of congenital hypothyroidism.

Rapid development of high-throughput omics technologies generates an increasing interests in algorithms for cutoff point identification. Existing cutoff methods and tools identify cutoff points based on association of continuous variables with another variable, such as phenotype, disease state or treatment group. These approaches are not applicable for descriptive studies in which continuous variables are reported without known association with any biologically meaningful variables. The most common shape of the ranked distribution of continuous variables in high-throughput descriptive studies corresponds to a biphasic exponential/super-exponential curve, where the first phase includes big number of variables with values slowly growing with rank and the second phase includes smaller number of variables rapidly growing with rank. This study describes an easy algorithm to identify the boundary between these phases to be used as a cutoff point. The major assumption of that approach is that small number of variables with high values dominate biological system and determine its major processes and functions. This approach was tested on three different datasets: genes in the human cerebral cortex, mammalian genes sensitive to chemical exposures, and proteins expressed in human heart. In every case, the described cutoff identification method produced shortlists of variables (genes, proteins) highly relevant for dominant functions/pathways of the analyzed biological systems. Thus, our described method for cutoff identification may be used to prioritize variables for a focused functional analysis, in situations where other methods of dichotomization of data are inaccessible.

We propose a conceptual model for the closeness parameter $\epsilon$, which characterizes exotic compact objects (ECOs). To estimate $\epsilon$, a thin spherical dust shell is considered, which gravitationally contracts from a specific position $r(t_{0})$ to near its gravitational radius $r(t_{2})=r_{s} + \epsilon$, in a finite time $t_{2}$, measured in the frame of a fiducial observer (FIDO). For an external observer, the shell’s kinematics is characterized by two clearly distinguishable phases: one of rapid contraction, where the shell is far away from the gravitational radius, $r(t_{0})\gg r_{s}$, and a second phase quasi-stationary, $r(t)\sim r_{s}$, where all of the shell’s mass is concentrated around the associated horizon, such that for a FIDO, a black hole (BH)is undistinguishable from a shell configured as a black shell (BS). \\ In the semi-classical approximation $E\ll \kappa_{0}l_{p}^{2}$ and tends to zero when the observation time of collapse $t_{2}$, measured by FIDO, tends to infinity; $\kappa_{0}$ and $l_{p}$ are surface gravity and Planck length, respectively. The quantum effects are significant when $\epsilon\ll r(t_{2})$ and $\epsilon$ tends to $\kappa_{0}l_{p}^{2}$. \\ Without knowing details on quantum gravity, parameter $\epsilon$ is calculated, which, in general, allows distinguishing the ECOs from BHs. Specifically, a BS (ECO) is undistinguishable from a BH.

Background: In recent years, the abusive use of the smartphone has reached a situation that could be considered pathological, although there is no such classification in the DSM-IV. In this sense, different instruments to assess this problematic use or addiction to the smartphone are used. Among them, we found the SPAI, which has been validated in the Spanish language. The main difficulty of these scales is to establish a cut-off point that determines such mobile addiction. On the other hand, self-perception has been used in different addictions as a predictor of the problem. Aim: The objective of this study is to establish the cutting point in the scores of the SPAI scale validated in Spanish, using as a referent the self-perception of addiction values. Methods: A receiver operating characteristics (ROC) analysis was carried out, establishing as the cut-off point the one that presented a higher value of Youden J, indicative of its sensitivity and specificity. Results: 2598 participants from the university community completed the SPAI-Spain questionnaire. When using the self-perception of smartphone addiction as the benchmark value, a score of 44 has been established as the cutting point of the SPAI questionnaire, with a Youden J corresponding to 0.416. Conclusions: The implementation of a cut-off point of the SPAI questionnaire makes it an instrument that allows early identification of those individuals at risk of addiction as well as the establishment of preventive and/or intervention measures.

The two-scale method (TSM) is an effective approach to simulate electromagnetic (EM) scattering from rough sea surface, to interpret physical interaction of EM wave with rough sea surfaces. The sea surface roughness spectrum and the cutoff wavenumber are two key factors affecting the accuracy of TSM simulation. This paper takes the geophysical model functions (GMFs) of different band as reference, and quantitatively studies the two factors based on the numerical simulation of different polarization backscattering coefficients. The numerical simulation demonstrates that Apel spectrum is more suitable for the backscattering simulation in C/X/Ku-band, and the optimal cutoff wavenumbers are also derived for TSM simulation of EM scattering in C/X/Ku-band. Then an empirical model function of optimal cutoff wavenumbers with respect to frequency, incident angle and wind speed are obtained with regression method. Finally, the simulation results with the new model function of cutoff wavenumber are compared with the GMF and measured data in different bands and they are all consistent. Moreover, a physical explanation for the optimal cutoff wavenumber is also given.

Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke disordered eating and unhealthy lifestyles, resulting in adverse cardiometabolic events (e.g., hypertension and obesity) in certain groups, which may implicate the treatment of this complex condition. The diagnostic criteria of PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Simultaneously, four-, five-, and six-dimensional structures of the Impact of Event Scale-Revised (IES-R), a popular PTSD measure, seem to be more robust than the original three-dimension structure. Within the context of COVID-19, this instrumental study used a convenience sample of 58 dental healthcare workers (HCWs) from Russia (mean age = 44.1±12.2 years, 82.8% females) to examine the criterion and predictive validity of two IES-R structures: the IES-R3 and the IES-R6 (with the added symptoms of numbing, sleep disturbance, and irritability). The subscales of the two IES-R structures expressed good internal consistency, strong correlations with the PTSD Symptom Scale (PSS), hypertension diagnosis, and high body mass index (BMI). In receiver-operating characteristic (ROC) curve analysis, all IES-R models perfectly predicted the PSS (all area under the curve (AUC) >0.9, p values <0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale significantly predicted high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, significantly predicted hypertension. In conclusion, both IES-R structures can reliably measure PTSD symptoms. The IES-R, hyperarousal, and intrusion may be credible criterion variables for predicting high BMI within PTSD while the intrusion and avoidance subscales may reflect the cardiovascular consequences associated with PTSD more reliably than the IES-R itself. The IES-R subscales may predict cardiometabolic adversities in PTSD, signifying a need for proper assessment of lifestyle and the application of dietary and exercise interventions in order to lower physical morbidity in PTSD. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts is pivotal to validate the results (e.g., in specific groups such as those with confirmed traumatic exposure and comorbid mood dysfunction).

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 &amp; 0.91, p values = 0.001, 95% CI: 0.80-0.92 &amp; 0.87 to 0.94, sensitivity = 0.85 &amp; 0.87, specificity = 0.73 &amp; 0.83, Youden index = 0.58 &amp; 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.

This paper presents a new method to model the nonlinear behaviour of masonry double curvature structures, possibly reinforced by composite materials, by means of conventional elasto-plastic analyses. It is meant to be used in professional design, especially for assessment and retrofitting purposes, therefore based on the exploitation of the simplest nonlinear Finite Elements available in a commercial software, namely trusses with elasto-fragile and elasto-ductile behaviour (Cutoff Bars). The numerical static nonlinear analyses are carried out by considering elastic hexahedral elements for bricks and lumping nonlinearities on joints. These have been assumed in turn elastic-brittle and elastic-plastic by using 1D elements, respectively Point Contacts, under No-Tension Material hypothesis, and Cutoff Bars, assigning small tensile resistance to the material. The reinforcement, realised with FRP hooping strips, has been successfully modelled in a similar fashion, i.e. by applying perfectly bonded elastic-plastic Cutoff Bars at the extrados of the dome, where the debonding is accounted for in a conventional way limiting the tensile strength according to Italian Standards indications. The procedure is validated against benchmark models with the same geometry, using experimental data and more refined structural model results for comparison.

The survival analysis of the Cancer Genome Atlas (TCGA) dataset is a well-known method to discover the gene expression-based prognostic biomarkers of head and neck squamous cell carcinoma (HNSCC). A cutoff point is usually used in survival analysis for the patients' dichotomization in the continuous gene expression. There is some optimization software for cutoff determination. However, the software's predetermined cutoffs are usually set at the median or quantiles of gene expression value to perform the analyses. There are also few clinicopathological features available on their pre-processed data sets. We applied an in-house workflow, including data retrieving and pre-processing, feature selection, sliding-window cutoff selection, Kaplan-Meier survival analysis, and Cox proportional hazard modeling for biomarker discovery. In our approach for the TCGA HNSCC cohort, we scanned human protein-coding genes to find optimal cutoff values. After adjustment with confounders, the clinical tumor stage and the surgical margin involvement are independent risk factors for patients' prognosis. According to the resulting tables with Bonferroni-adjusted P value under the optimal cutoff and the hazard ratio, three biomarker candidates, CAMK2N1, CALML5, and FCGBP, are significantly associated with the patients' overall survival. We validated this discovery by using the other independent HNSCC dataset (GSE65858). Thus, we suggest the transcriptomic analysis could help for biomarker discovery.