Nonparametric Spearman Rank Correlation Research Articles

Functionality and Scar Evaluation of the Donor Site in Extended Radial Forearm Flap Phalloplasty: How Affected Is the Arm in Day-to-Day Life?

Background: The radial forearm flap remains the gold standard in phalloplasty in gender-affirming surgery due to its versatility and functional outcome, but the significant donor site morbidity and its impact on daily functioning and aesthetic perception remains understudied. This study provides valuable insights into the mid-term functional and aesthetic outcomes of the forearm in transgender individuals following radial forearm flap phalloplasty using widespread instruments for assessment scoring systems and for the evaluation of postoperative wound healing of surgical interventions in general. Methods: Between January 2013 and March 2018, a total of 47 patients underwent radial phalloplasty at AGAPLESION Markus Hospital, and 20 consented to participate in this cross-sectional, retrospective study evaluating functional and aesthetic outcomes post-radial forearm flap phalloplasty using standardized questionnaires (DASH, POSAS, and SBSES). A univariate median regression of each score was performed to determine the associations with selected variables, and correlation analyses between scores was performed using a nonparametric Spearman rank correlation. Results: Among the 20 participants, the median Quick DASH, DASH functionality, DASH sport and music, and DASH work scores indicated minimal to no functional impairment. Scar evaluations using the PSAS, OSAS, and SBSES scales showed overall patient satisfaction with minimal concerns regarding pigmentation and scar texture. Notably, an increase of 0.27 cm2 in wound surface area added one point to the DASH sport and music score (p = 0.037). Statistical analysis also demonstrated a significant correlation between functional and aesthetic assessment scores. Conclusions: The radial forearm phalloplasty donor site, evaluated by the PSAS, OSAS, and SBSES scales, leads to minimal or no functional impairment; however, the worsening of the DASH sport and music score with increasing wound surface reflects a direct relation between wound size and functional impairment.

The Association of Cerebrospinal Fluid Biomarkers of Alzheimer’s Disease with Cognitive Intra-Individual Variability

Abstract Objective Cognitive intra-individual variability (IIV) is a sensitive predictor of cognitive decline and disease severity in Alzheimer’s disease (AD). Despite its sensitivity, whether IIV is merely a psychometric artifact or disease pathology biomarker remains unknown. The present study evaluated the association between IIV and cerebrospinal fluid (CSF) biomarkers of AD. Method Participants included 422 individuals from the National Alzheimer’s Coordinating Center Unified Dataset 3.0 who completed baseline neuropsychological assessment and had CSF data. All participants were adult monolingual English speakers. Participants with vision or hearing impairments were excluded. Cases were stratified into cognitively normal (n = 267) and AD groups (n = 155; mild cognitive impairment = 50, dementia = 105). Cross-sectional IIV was calculated by obtaining the individual standard deviation (iSD) of ten cognitive tests. Finally, the coefficient of variation (CoV) was computed by dividing iSD by the participant’s overall test battery mean. Non-parametric Spearman-rank correlations were used to assess the relation between CoV and CSF biomarkers, including beta-amyloid 1–42, total tau (t-tau), and phosphorylated tau (p-tau181). Results In the AD group, CoV was positively correlated with p-tau181 (r = 0.285, p = 0.003) and t-tau (r = 0.241, p = 0.009), and negatively correlated with beta-amyloid 1–42 (r = −0.314, p < 0.001). Correlations between CoV and CSF biomarkers were not significant in the cognitively normal group for beta-amyloid 1–42 (r = 0.076, p = 0.215), p-tau181 (r = −0.014, p = 0.840), and t-tau (r = −0.046, p = 0.485). Conclusions In people with mild cognitive impairment and dementia of presumed AD etiology, cognitive IIV is associated with CSF biomarkers. These findings provide preliminary evidence that IIV is not merely a statistical artifact, but is associated with AD neuropathology.

The Strong Correlation Between Multiple Births and Preterm Birth Rates in Greece From 1991 to 2022.

Background This study aims to investigate the correlation between the rising preterm birth rate (PBR) in Greece from 1991 to 2022 and the incidence of multiple births. Methodology Official data on live births in Greece from 1991 to 2022 were sourced from the Hellenic Statistical Authority. The PBR, defined as the number of live births occurring at <37 gestational weeks, and the multiple birth rate (MBR), representing live births from multifetal gestations, were calculated per 100 total live births. The relationship between the PBR and the MBR was evaluated using the non-parametric Spearman's rank correlation coefficient (rho). This association was confirmed through linear regression models, with MBR as the independent variable and PBR as the dependent variable, calculating the beta coefficient (β) and the coefficient of determination (R-squared). Results A very strong direct positive correlation was identified between PBR and MBR throughout the study period, with a Spearman's rho of 0.950 (p < 0.001). This conclusion was further supported by the linear regression model, which yielded a β coefficient of 3.32 (95% confidence interval = 2.78 to 3.86, p < 0.001). The R-squared was 0.838, indicating that the change in MBR explained 83.8% of the rise in PBR. The strongest correlations were observed for moderate PBR (32-33 weeks) with a rho of 0.962 (p < 0.001) and late PBR (34-36 weeks) with a rho of 0.940 (p < 0.001). During the period of a steep increase in prematurity rates in the country (1991-2011), an almost perfect correlation between PBR and MBR (rho = 0.987, p < 0.001) was noted. However, in recent years (2011-2022), characterized by a marginal increase in PBR, this association diminished, with a rho of 0.655 (p = 0.021). Conclusions This analysis revealed a strong positive correlation between the PBR and MBR in Greece from 1991 to 2022, underscoring the significant impact of multiple pregnancies on the substantial increase in preterm births within the Greek population.

Elongated morphology of osteoid osteoma is associated with radiofrequency ablation failure in children.

To compare the frequency of elongated morphology of osteoid osteoma (OO) in children compared to adolescents and to determine if this elongated morphology is associated with radiofrequency ablation treatment failure. Retrospective review of first-time CT-guided radiofrequency ablation performed for presumed OO in patients < 21years old between 1990 and 2023. Children were considered 0 to 10years old, and adolescents were considered 11 to 20years old. Treatment failure was considered symptomatic recurrence requiring follow-up intervention. The largest tumor dimensions in three orthogonal planes were measured using multiplanar reformatted technology. Maximum tumor dimension, tumor volume, and eccentricity index were calculated. Elongated morphology criteria were (a) largest dimension > 10mm and (b) eccentricity index ≥ 3. Lesion locations were recorded. Statistical analyses included the chi-square test, Fisher's exact test, nonparametric Wilcoxon rank-sum test, receiver operating characteristic analysis, and Spearman's nonparametric rank correlation. Of 366 included patients (median 15years, IQR 11-18years, 254 male), there were 86 (23.5%) children, 280 (76.5%) adolescents, and 24 (6.6%) cases of treatment failure. Elongated morphology was more common in children (19.7%) than adolescents (8.6%) (p = 0.004) and associated with younger age (p = 0.009). Elongated morphology was associated with treatment failure in children (p = 0.045) but not adolescents (p > .99) or all patients (p = 0.17). Treatment failure was not associated with age, largest dimension, eccentricity index, volume, or location. Elongated morphology of OO is associated with younger age and radiofrequency ablation treatment failure in children. Identifying this morphology may assist with counseling and treatment planning.

Aquaporin 2 in Cerebral Edema: Potential Prognostic Marker in Craniocerebral Injuries.

Despite continuous medical advancements, traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Consequently, there is a pursuit for biomarkers that allow non-invasive monitoring of patients after cranial trauma, potentially improving clinical management and reducing complications and mortality. Aquaporins (AQPs), which are crucial for transmembrane water transport, may be significant in this context. This study included 48 patients, with 27 having acute (aSDH) and 21 having chronic subdural hematoma (cSDH). Blood plasma samples were collected from the participants at three intervals: the first sample before surgery, the second at 15 h, and the third at 30 h post-surgery. Plasma concentrations of AQP1, AQP2, AQP4, and AQP9 were determined using the sandwich ELISA technique. CT scans were performed on all patients pre- and post-surgery. Correlations between variables were examined using Spearman's nonparametric rank correlation coefficient. A strong correlation was found between aquaporin 2 levels and the volume of chronic subdural hematoma and midline shift. However, no significant link was found between aquaporin levels (AQP1, AQP2, AQP4, and AQP9) before and after surgery for acute subdural hematoma, nor for AQP1, AQP4, and AQP9 after surgery for chronic subdural hematoma. In the chronic SDH group, AQP2 plasma concentration negatively correlated with the midline shift measured before surgery (Spearman's ρ -0.54; p = 0.017) and positively with hematoma volume change between baseline and 30 h post-surgery (Spearman's ρ 0.627; p = 0.007). No statistically significant correlation was found between aquaporin plasma levels and hematoma volume for AQP1, AQP2, AQP4, and AQP9 in patients with acute SDH. There is a correlation between chronic subdural hematoma volume, measured radiologically, and serum AQP2 concentration, highlighting aquaporins' potential as clinical biomarkers.

Assessment of the risk of contamination by heavy metals and correlation analysis of the content of toxicants in animal feed and organic waste

Pollution of agroecosystems by heavy metals posesa signifcant threat to agricultural production in various countries of the world, including Ukraine. In the postwar period, the environmental situation will be even more complicated. Timely assessment of environmental risk using the results of laboratory analysis of the feed of dairy cows and their organic waste for the content of ecotoxicants such as cadmium and lead obtained in scientific experiments is important. Correlation analysis is one of the methods of statistical data processing that, when properly applied using modern computer software, allows you to quickly establish the strength of the relationship between indicators and its statistical signifcance. Such research methods are used by scientists from the countries of the European Union, the USA, China, and other countries. Previous studies have focused directly on the concentrations of contamination with heavy metals Cd, Pb, and other animal feed and organic waste, but have not investigated the relationship between them. Scientifc and economic experiments were conducted on dairy cows with different types of feeding. The animals were selected by the method of analogues for live weight and productivity. The diet included feed with an excess of cadmium and lead. The high biological activity of pollutants influenced their transition from ration fodder to products and organic waste. The aim of the research was to analyze the correlation dependence between the content of Cd and Pb in cow feed and their organic waste with an assessment of the risk of soil contamination by hazardous toxicants in the area of activity of agro-enterprises producing milk after the introduction of organic waste as organic fertilizer. With the help of the STATISTICA version 10.0 computer program, the Shapiro-Wilk's W test, the conformity of the obtained data of laboratory analyzes of feed and organic waste with the concentration of heavy metals, the law of "normal" distribution (Gaussian), and then the non-parametric Spearman rank correlation coefcient necessary in this case is selected for calculation. The analysis established a high r=0.66-0.75 (Cd) (р&lt;0.05), r=0.66-0.77 (Pb) (р&lt;0.05) and a very high r=0.83 (Cd) (р&lt;0.05), r=0.83 (Pb) (р&lt;0.05) correlation dependence between the content of toxicants in feed and organic waste, which allows specialists to act quickly and efectively in production conditions, confdently use the method of environmental monitoring, forecast the environmental situation, assessenvironmental risks, including those related to organic and biological farming and avoid disturbing the ecological balance of agroecosystems. Further research is aimed at correlational and regression analysis, but on other important indicators of environmental safety in veterinary, zootechnical and ecological practice, with an assessment of the relevant risks of running the livestock industry in the forest-steppe zone of Ukraine. Key words: feed, organic waste, organic fertilizers, heavy metals, cadmium, lead, correlation, ecological risk, dairy cows.

#2224 Higher serum level of indoxyl sulfate is not associated with increased abdominal aorta calcification in patients on maintenance hemodialysis

Abstract Background and Aims Vascular calcification is strongly associated with an increase in all-cause and cardiovascular mortality, especially in patients with and stage renal disease. Results of numerous experimental studies have shown direct toxic effect of microbial-derived uremic toxins on vascular endothelial and smooth muscle cells which may contribute vascular calcification. Meanwhile, the effects of these metabolites on vascular remodeling in patients receiving dialysis treatment remains largely unclear. Here we aimed to investigate the relationship between serum level of the uremic toxin indoxyl sulfate and severity of abdominal aorta calcification (AAC) in patients on maintenance hemodialysis. Method This single-center, cross-sectional study included eighty (40 men, average age – 59,7±11,8 years) clinically stable patients receiving hemodialysis treatment for 52(21,3-120) months. 13(16,3%) participants had history of smoking, 27(33,8%) were diabetic, 63(78,8%) had high blood pressure, 17(21,3%) – previous history of ischemic heart disease, including 5(6,3%) suffered a myocardial infarction. Severity of AAC was determined by lateral lumbar radiography with Kauppila scoring. The total AAC score ranged from 0 to 24 points, and a higher AAC score indicated a more pronounced degree of calcification. Routine laboratory data were collected before hemodialysis session after fasting for 12 hours. Serum concentration of indoxyl sulfate was assessed by ELISA using commercially available kit (Cloud-Clone Corp., USA). Statistical analysis was performed with IBM SPSS Statistics 26 program. Non-parametric Spearman's rank correlation method was used to evaluate the associations between the studied parameters. Value of p &amp;lt;0.05 was considered statistically significant in all tests. Results Median serum indoxyl sulfate was 2,1(1,4-3,0) μmol/l (the same parameter in relatively healthy individuals without impaired renal function is 0,1(0-0,3) μmol/l, р˂0,001). Serum levels of calcium (Ca) was 2,27(2,1-2,5) mmol/l, ionized calcium (Ca++) – 1,15(1,1-1,3) mmol/l, phosphate (P) – 1,6(1,3-2,0) mmol/l, intact parathyroid hormone (iPTH) – 303(162,2-492,8) pg/ml, total cholesterol (TH) – 4,5(3,5-5,4) mmol/l, low-density lipoprotein (LDL) – 2,6(2,0-3,3) mmol/l. AAC score in hemodialysis participants was 4,5(0,0-9,0) and significantly correlated with age (r=0,693; р˂0,001), Ca (r=0,208; р=0,04) and iPTH (r=0,418; р=0,021) but not with other indicators, including indoxyl sulfate concentration (r=0,164; р=0,147). Conclusion Our preliminary results do not allow to consider the elevated level of indoxyl sulfate as a factor contributing to increased AAC in patients on maintenance hemodialysis. Further prospective studies in larger populations should clarify the true role of indoxyl sulfate in vascular remodeling in individuals with chronic kidney disease.

Moderate intensity intermittent lifestyle physical activity is associated with better executive function in older adults.

Executive functions are among the first cognitive abilities to decline with age and age-related executive function slowing predisposes older adults to cognitive disorders and disease. Intermittent Lifestyle Physical Activity (ILPA) reflects brief, unplanned activity that occurs during routine daily activities and is operationalized as activity bouts <60s. Our understanding of short bouts of habitual physical activity and executive functions is limited. We tested the hypothesis that greater amounts of ILPA in moderate and vigorous intensity domains would be associated with better executive function in older adults. Forty older adults (26 females, 68 ± 6, >55 years; body mass index: 26.6 ± 4.3 kg/m2) completed a Trail-Making-Task and wore an activPAL 24-hr/day for 6.2 ± 1.8-days. For each intensity, total time and time spent in bouts <60 s were determined. Trail A (processing speed) and Trail B (cognitive flexibility) were completed in 25.8 ± 8.2 s and 63.2 ± 26.2 s, respectively. Non-parametric Spearman's rank correlations report that moderate ILPA (3.2 ± 3.2 min/day) and total-moderate physical activity (20.1 ± 16.0 min/day) were associated with faster Trail A (total-moderate physical activity: ρ=-0.48; moderate-ILPA: ρ = -0.50; both, p < 0.003) and Trail B time (total-moderate physical activity: ρ = 0.36; moderate-ILPA: ρ = -0.46; both, p < 0.020). However, the results show no evidence of an association with either vigorous physical activity or light physical activity (total time or ILPA bouts: all, p > 0.180). Moderate physical activity accumulated in longer bouts (>60 s) was not associated with Trail B time (p = 0.201). Therefore, more total moderate physical activity and shorter bouts (<60 s) may result in better executive functions in older adults.

Progression-free survival as a surrogate endpoint for overall survival in patients with relapsed or refractory multiple myeloma.

The goal of the research was to assess the quantitative relationship between median progression-free survival (PFS) and median overall survival (OS) specifically among patients with relapsed/refractory multiple myeloma (RRMM) based on published randomized controlled trials (RCTs). Two bibliographic databases (PubMed and Embase, 1970-2017) were systematically searched for RCTs in RRMM that reported OS and PFS, followed by an updated search of studies published between 2010 and 2022 in 3 databases (Embase, MEDLINE, and EBM Reviews, 2010-2022). The association between median PFS and median OS was assessed using the nonparametric Spearman rank and parametric Pearson correlation coefficients. Subsequently, the quantitative relationship between PFS and OS was assessed using weighted least-squares regression adjusted for covariates including age, sex, and publication year. Study arms were weighted by the number of patients in each arm. A total of 31 RCTs (56 treatment arms, 10,450 patients with RRMM) were included in the analysis. The average median PFS and median OS were 7.1 months (SD 5.5) and 28.1 months (SD 11.8), respectively. The Spearman and Pearson correlation coefficients between median PFS and median OS were 0.80 (P < 0.0001) and 0.79 (P < 0.0001), respectively. In individual treatment arms of RRMM trials, each 1-month increase in median PFS was associated with a 1.72-month (95% CI 1.26-2.17) increase in median OS. Analysis of the relationship between PFS and OS incorporating more recent studies in RRMM further substantiates the use of PFS to predict OS in RRMM.

The Effectiveness of Discharge Planning Implementation on the Quality of Life of Post Opname Patients with Heart Failure at Hospital

Background: Heart failure is a disease with a high rehospitalization rate due to patients not fulfilling recommended therapy, for example, breaking a diet, doing excessive physical activity and lack of understanding during discharge planning. This causes a decrease in the quality of life after patient is discharged. Purpose: This research aims to determine the effectiveness of discharge planning implemention on the quality of life of post-opname patients with heart failure at Bhayangkara Hospital, Kediri City. Method: The type of research used is quantitative research with a descriptive cross-sectional study design. The number of samples in this study were 31 respondents with accidental sampling technique. Results: The results of the non-parametric Spearman rank correlation test analysis obtained a value of p = 0.022 (p &lt;0.05) and a correlation coefficient of 0.411 which is moderate and has a positive direction. This shows that there is a positive relationship between the effectiveness of implementing Discharge Planning on the quality of life of post-hospitalized patients with heart failure at Bhayangkara Hospital, Kediri City. Conclusion: Discharge Planning given to patients with heart failure at Bhayangkara Hospital, Kediri City is not yet effective and needs to be improved. However, the majority of respondents have a good quality of life where respondents experience an increase in socialization, psychology, but still experience physical discomfort.

18F]FDG PET/CT Signal Correlates with Neoangiogenesis Markers in Patients with Fibrotic Interstitial Lung Disease Who Underwent Lung Biopsy: Implication for the Use of PET/CT in Diffuse Lung Diseases.

The use of [18F]FDG PET/CT as a biomarker in diffuse lung diseases is increasingly recognized. We investigated the correlation between [18F]FDG uptake with histologic markers on lung biopsy of patients with fibrotic interstitial lung disease (fILD). Methods: We recruited 18 patients with fILD awaiting lung biopsy for [18F]FDG PET/CT. We derived a target-to-background ratio (TBR) of maximum pulmonary uptake of [18F]FDG (SUVmax) divided by the lung background (SUVmin). Consecutive paraffin-embedded lung biopsy sections were immunostained for alveolar and interstitial macrophages (CD68), microvessel density (MVD) (CD31 and CD105/endoglin), and glucose transporter 1. MVD was expressed as vessel area percentage per high-power field (Va%/hpf). Differences in imaging and angiogenesis markers between histologic usual interstitial pneumonia (UIP) and non-UIP were assessed using a nonparametric Mann-Whitney test. Correlation of imaging with angiogenesis markers was assessed using the nonparametric Spearman rank correlation. Univariate Kaplan-Meier survival analysis assessed the difference in the survival curves for each of the angiogenesis markers (separated by their respective optimal cutoff) using the log-rank test. Statistical analysis was performed using SPSS. Results: In total, 18 patients were followed for an average of 41.36 mo (range, 5.69-132.46 mo; median, 30.07 mo). Only CD105 MVD showed a significantly positive correlation with [18F]FDG TBR (Spearman rank correlation, 0.556; P < 0.05, n = 13). There was no correlation between [18F]FDG uptake and macrophage expression of glucose transporter 1. CD105 and CD31 were higher for UIP than for non-UIP, with CD105 reaching statistical significance (P = 0.011). In all patients, MVD assessed with either CD105 or CD31 quantification on biopsy predicted overall survival. Patients with CD105 MVD of less than 12 Va%/hpf or CD31 MVD of less than 35 Va%/hpf had a significantly better prognosis (no deaths during follow-up in the case of CD105) than did patients with higher scores of CD105 MVD (median survival, 35 mo; P = 0.041, n = 13) or CD31 MVD (median survival, 28 mo; P = 0.014, n = 13). Conclusion: Previous work has used [18F]FDG uptake in PET/CT as a biomarker in fILD. Here, we highlight a correlation between angiogenesis and [18F]FDG TBR. We show that MVD is higher for UIP than for non-UIP and is associated with mortality in patients with fILD. These data set the scene to investigate the potential role of vasculature and angiogenesis in fibrosis.

Analysis of glomerulopathies in kidney neoplasms

Background. Malignant neoplasms, including those of the kidneys, are widespread in the world. The main treatment for kidney tumors is surgery, one of its options is nephrectomy. Malignant tumors of various localizations can lead to a variety of kidney damage. Glomerulopathies of various origins are often asymptomatic, and therefore, patients do not seek medical help. For the diagnosis of glomerulopathies, it is necessary to assess morphological changes with the formulation of an immunofluorescence reaction and electron microscopy.The aim: to analyze the clinical manifestations, frequency and structure of glomerulopathies in kidney neoplasms.Patients and Methods. The study included 141 patients. The patients underwent nephrectomy, the daily protein loss, the number of altered erythrocytes in the urine, the level of creatinine in the blood serum were determined, and the glomerular filtration rate (CKD-EPI) was calculated. Morphological evaluation of samples included immunofluorescence reaction and electron microscopy. To assess the statistical significance of the relationship between variables, Spearman's nonparametric rank correlation coefficient (Rs) was calculated. The results obtained were considered significant at p&lt;0.05. RESULTS. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies. CONCLUSION. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist Keywords: tumor, glomerulonephritis, diabetic nephropathy, glomerular filtration rate&gt; ˂ 0.05.Results. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies.Conclusion. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist.

Влияние заболеваемости женщин в период беременности, родов и послеродовой период на показатели использования коечного фонда отделений патологии беременности.

P u r p o s e : assessment of the impact of morbidity in women during pregnancy, childbirth and the postpartum period on the utilization of bed capacity in pregnancy pathology departments. Materials and methods. Based on official statistics, a comparative statistical analysis of the incidence rates of women of fertile age with the XV class of diseases ICD‑10 «Pregnancy, childbirth and the postpartum period» and indicators of the use of bed capacity in pregnancy pathology departments of St. Petersburg with indicators for the Russian Federation and the Northwestern Federal District in dynamics for 2017 was carried out. 2022. To assess the relationship between indicators, the nonparametric Spearman rank correlation method was used. Statistical data processing was carried out using the MS Office‑2016 and StatSoft-Statistica 10.0 software packages. Results. In 2017–2022, there were significant differences in the level and dynamics of the incidence of class XV diseases in women of fertile age in the metropolis and from the indicators for the Russian Federation and the Northwestern Federal District. With multidirectional dynamics of these indicators, almost the entire study period, the incidence rate of women in St. Petersburg was lower than the national and district averages, and over six years the incidence rate decreased by 30.8%. The work of pregnancy pathology beds, the average length of stay of patients on them in the metropolis were higher than the Russian and regional averages, and the turnover of beds was higher. It was revealed that in Russia and the Northwestern Federal District, the morbidity of pregnant women, women in labor and postpartum had virtually no effect on the average occupancy of a pregnancy pathology bed per year and its average downtime, and in the metropolis, with a decrease in morbidity rates, bed occupancy moderately decreased and its downtime increased. At the same time, the impact of the incidence of class XV diseases in women on the average length of stay of patients in pregnancy pathology beds in the country as a whole and in the Northwestern Federal District was more significant than in the metropolis. At the same time, the impact of morbidity among pregnant women, women in labor and postpartum in the city on the turnover of beds in this profile was less significant than on the indicators in the federal district. It was found that the decrease in morbidity had a moderately pronounced effect on reducing the length of stay of women in the city’s pregnancy pathology departments and increasing the turnover of beds. Conclusion. There are differences in the level and dynamics of morbidity indicators for pregnant women, parturients and postpartum women and indicators of the use of obstetric beds for the pathology of pregnancy in the metropolis from these indicators in Russia and the Northwestern Federal District. The incidence of women during this period has a moderate impact on the average bed occupancy per year, the average length of stay on a bed, bed turnover and the average bed idle time. The impact of a decrease in morbidity on the use of pregnancy pathology beds in the metropolis differed from Russia and the Northwestern Federal District, which was expressed in the strength and significance of the connection.

The Relationship between Nurses' Knowledge about Emergencies and Code Blue Activation Decisions

Introduction: Code Blue is a hospital system created to overcome the high death rate due to respiratory arrest and cardiac arrest in hospitals. It involves all hospital components, including medical personnel, communication systems, transportation and facilities, and infrastructure. The initial principle of handling cardiac arrest is how nurses can recognize early signs of emergency so that the decision to activate code blue can be made. Knowledge about emergencies is a basic component that nurses must have in making blue activation code decisions. However, in its application, caring for cardiac arrest sufferers carried out by nurses is often still not appropriate.&#x0D; Objective: This study aims to determine the relationship between nurses' knowledge of emergencies and the decision to activate code blue.&#x0D; Methods: This research is a quantitative research with an analytical survey method using cross-sectional research. In this study, the non-parametric Spearman rank correlation test was carried out at the. Sampling used total sampling technique and obtained 70 respondents.&#x0D; Results: There is a relationship between nurses' knowledge about emergencies and the decision to activate code blue at with a significant value of p= 0,000 (p &lt; α 0.05), r = 0.601.&#x0D; Conclusion: There is a relationship between nurses' knowledge about emergencies and the decision to activate code blue. Training resuscitation skills and increasing nurses' knowledge through regular training, workshops, or code blue simulations are recommended, especially for patient care units that rarely activate code blue.

Biomarkers of Iron Are Associated with Anterior-Pituitary-Produced Reproductive Hormones in Men with Infertility.

Approximately 16% of North American couples are affected by infertility, with 30% of cases being attributable to male factor infertility. The regulation of reproductive hormones via the hypothalamic-pituitary-gonadal axis is important for spermatogenesis and subsequently male fertility. Maintaining iron homeostasis is critical to normal reproductive physiological function. This cross-sectional study's objective was to determine the association between serum biomarkers of iron and reproductive hormones. Men experiencing infertility (n = 303) were recruited from Mount Sinai Hospital, Toronto. Serum was analyzed for iron and ferritin as biomarkers of iron status and reproductive hormones (follicle-stimulating hormone, luteinizing hormone, testosterone, estradiol, and prolactin), which were the primary outcome. Associations were determined using non-parametric Spearman's rank correlation coefficient, linear regressions, and logistic regressions. A significant independent monotonic inverse relationship between serum iron and prolactin (p = 0.0002) was found. In linear regression analyses, iron was inversely associated with luteinizing hormone (unadjusted p = 0.03, adjusted p = 0.03) and prolactin (unadjusted p = 0.001 and adjusted p = 0.003). Serum ferritin was inversely associated with both gonadotropins, follicle-stimulating hormone (adjusted p = 0.03), and luteinizing hormone (adjusted p = 0.02). These findings suggest that biomarkers of iron are associated with pituitary-produced reproductive hormones, which play a role in the hypothalamic-pituitary-gonadal signaling pathway involved in spermatogenesis, testicular testosterone production, and male fertility.

Validity of the Functional Classification of the Upper Extremities for Duchenne Muscular Dystrophy.

Some upper-limb function assessments can evaluate treatments in the non-ambulatory stage of Duchenne muscular dystrophy (DMD). The Functional Classification of the Upper Extremities (FCUE) was developed for DMD in Japan. The FCUE is easier to use than the Performance of Upper Limb (PUL) and is more detailed than the Brooke Upper Extremity Scale. This study aimed to determine the concurrent validity of FCUE with other methods of assessment for DMD. This retrospective study reviewed the medical records of 39 boys with DMD from the National Center of Neurology and Psychiatry to evaluate the concurrent validity of the FCUE and PUL using non-parametric Spearman rank correlation (ρ). We also determined the concurrent validity of the Brooke Upper Extremity Scale and PUL for comparison. The ρ value between the FCUE and PUL was -0.914 (P<0.001). The FCUE showed robust concurrent validity with the PUL. That correlation between the FCUE and Brooke Upper Extremity Scale gave a ρ value of -0.854 (P<0.001). The FCUE had a higher concurrent validity with the PUL than with the Brooke Upper Extremity Scale. The FCUE is considered a valid assessment tool of upper-limb function in boys with DMD. Selecting the best assessment method depends on the severity of the patient's condition and a balance between assessment accuracy and evaluation time.

B - 57 An Analysis of the Activities of Daily Living Questionnaire (ADLQ): Is Executive Dysfunction Associated with Functional Decline?

The ADLQ measures the ability to perform basic and instrumental activities of daily living (ADLs). Several factors, including cognition, may play a role in someone's ability to perform ADLs. The purpose of this study was to understand how executive functioning (EF) impacts abilities measured by the ADLQ. Data were retrospectively collected from a mixed sample of patients with cognitive impairment (MCI: 29; dementia: 34) who underwent neuropsychological evaluation at a private practice in the Portland, Oregon area (n = 63, mean age = 76.65, mean education = 14.92years). Patients with a history of moderate-to-severe TBI or severe psychiatric history were excluded. Six ADLQ scales and measures of EF (phonemic fluency, DKEFS Tower, Trails B, Stroop Interference) were analyzed using nonparametric Spearman's rank correlations. A p-level of 0.01 was used to reduce likelihood of type I errors. There was a negative correlation between phonemic fluency and both self-care (ρ= -0.485, p = 0.002) and shopping (ρ= -0.474, p = 0.003). There was a negative correlation between travel and performance on both Trails B (ρ= -0.490, p = 0.009) and Stroop Interference (ρ= -0.634, p = 0.000). For the above EF tests, worse performance was associated with more impairment in the associated ADLs. Other correlations were not significant. Performance on certain EF tests is associated with impairment in the domains of self-care, shopping, and travel. Executive dysfunction appears related to functional decline on the ADLQ, but further analysis using larger samples is warranted to better understand this relationship.

Changes in carotid artery texture by ultrasound and elastin features in a murine model.

In humans, arterial grayscale ultrasound texture features independently predict adverse cardiovascular disease (CVD) events and change with medical interventions. We performed this study to examine how grayscale ultrasound texture features and elastin fibers change in plaque-free segments of the arterial wall in a murine model prone to atherosclerosis. A total of 10 Apoetm1Unc/J mice (n = 5 male, n = 5 female) were imaged at 6, 16, and 24 weeks of age. Two mice were euthanized at 6 and 16 weeks and the remaining mice at 24 weeks. Texture features were extracted from the ultrasound images of the distal 1.0 mm of the common carotid artery wall, and elastin measures were extracted from histology images. Two-way analysis of variance was used to evaluate associations between week, sex, and grayscale texture features. Texture feature and elastin number comparisons between weeks were conducted using the sex-by-week two-way interaction contrasts. Sex-specific correlations between the number of elastin fibers and grayscale texture features were analyzed by conducting non-parametric Spearman's rank correlation analyses. Arterial wall homogeneity changed significantly in male mice from 6 to 24 weeks, with a mean (SD) of 0.14 (0.03) units at 6 weeks and 0.18 (0.03) units at 24 weeks (p = 0.026). Spatial gray level dependence matrices-homogeneity (SGLD-HOM) also correlated with carotid artery plaque score (rs = 0.707, p = 0.033). Elastin fibers in the region of interest decreased from 6 to 24 weeks for both male and female mice, although only significantly in male mice. The mean (SD) number of elastin fibers for male mice was 5.32 (1.50) at 6 weeks and 3.59 (0.38) at 24 weeks (p = 0.023). For female mice, the mean (SD) number of elastin fibers was 3.98 (0.38) at 6 weeks and 3.46 (0.19) at 24 weeks (p = 0.051). Grayscale ultrasound texture features that are associated with increased risk for CVD events in humans were used in a murine model, and the grayscale texture feature SGLD-HOM was shown to change in male mice from 6 weeks to 24 weeks. Structural alterations of the arterial wall (change in elastin fiber number) were observed during this time and may differ by sex.

Exaggerated High-Beta Oscillations are Associated with Cortical Thinning at the Motor Cortex in Parkinson's Disease.

Elevated β oscillations (13-35 Hz) are characteristic pathophysiology in Parkinson's Disease (PD). Cortical thinning has also been reported in the disease, however the relationship between these biomarkers of PD has not been established. By comparing electrophysiological measurements with cortical thickness, this study aims to reveal the pathoetiology of disease and symptoms in PD. Preoperative magnetic resonance imaging (MRI) and intraoperative local field potentials (LFPs) were collected from 34 subjects diagnosed with PD. Cortical surfaces were reconstructed from the images, and cortical thickness was extracted from the subregions where the recording electrode was placed in M1. LFPs were preprocessed and cleaned using a semiautomatic artifact detection algorithm, then power spectral densities (PSD) were computed and periodic and aperiodic frequency components were calculated. Nonparametric Spearman rank correlations assessed the relationship between electrophysiological components (i.e. center frequency (CF), power, bandwidth, 1/f exponent, knee), with cortical thickness. According to the CF of each subject's PSD, the cohort was split into two sub-groups: low-β peak (13-20 Hz) and high-β peak (20-35 Hz) groups. There was a significant negative correlation between power and cortical thickness only in the high-β subgroup (r=-0.48, p(corrected)=0.049). This relationship remained significant when correcting for age (r=-0.52,p=0.015), indicating that the effect of age on cortical thinning was not the determining factor. We did not find significant differences between UPDRS-III motor symptom scores for the low-and high-β subgroups. Of note is the dominance of high-β oscillatory power and its relationship with cortical thickness. As suggested by the literature, increased high-β activity during movement may be exaggerated in PD. These findings suggest that the characteristic cortical thinning in PD causes variation in electrical activity, leading to elevated high-β activity.Clinical relevance- This multimodal study provides additional insights on the pathophysiology and its relevance with morphology of Parkinson's Disease.

Evaluating the correlation of blood pressure and pulse rates of firefighters with their sociodemographic characteristics during a fire and rescue training

Introduction: Cardiac strain has become a prevalent cause of firefighters’ death. Standards and regulations set forth a framework to monitor the cardiovascular fitness of firefighters, encourage fitness and create a pathway to diagnosis or detection of disorders. The effectiveness of these standards relies on continuous evaluation of firefighters’ health and updating the protocols. Methods: This study intended to assess the physiological response of 172 firefighters in the middle east for the first time and considered the effect of body mass index, age, gender, and seasonal ambient temperature on their responses before and after a fire and rescue training. The end results should compile the behavioral patterns of firefighters from the region and help authorities to update current health monitoring standards for firefighters accordingly. Blood pressure, heart and respiratory rates were sampled for participants after one minute after when training finished. Non-Parametric statistical analysis was conducted using Nonparametric Spearman rank correlation coefficients and Kruskal-Wallis H- test to evaluate the correlation of age, gender, BMI, and seasonal temperature with participant’s physiological response. Results: This study found obesity in 20% of the sampled population with more cases among male participants. Also, in this study, the hypertension prevalence ratio found as 19.8% at baseline and 26.7% in post-training measurements. Conclusion: This study could confirm that body mass index and seasonal ambient temperature affect blood pressure, heart and ventilation rates. Heart rate significantly changes with ambient temperature. Also, the results found the gender of participants affects all physiological responses, especially heart rate.