Nonparametric Statistical Methods Research Articles

Levels of leptin and adiponectin in patients with SLE, relationship with features of the course of the disease

Annotation. The aim of the work was to establish possible differences between the levels of leptin and adiponectin in patients with systemic lupus erythematosus (SLE) and practically healthy people, as well as to identify probable patterns of changes in the levels of adipokines depending on the features of the course of the disease. We examined 79 patients with SLE and 30 practically healthy individuals of the control group. The content of leptin and adiponectin in blood serum was determined by the immunoenzymatic method according to the instructions of the manufacturer “Leptin ELISA (CAN-L-4260)” (DBC, Canada) and “Adiponectin ELISA Kit” (DBC, Canada). The SELENA-SLEDAI index was used to assess activity. Metabolic syndrome was established according to the IDF (2005) criteria. Statistical processing of the obtained results was carried out on a personal computer using the methods of parametric and non-parametric statistics using the program Statistica 12.5 (StatSoft Inc., USA) and Microsoft Excel 2016. During the study, it was found that the level of leptin was reliably 45.1% higher in patients with SLE than in the control group, which correlated with the age of the patients, the duration of the disease, the closest relationship was found with the activity of the inflammatory process according to the SLEDAI index (r=0.78) and ESR (r=0.54). SLE patients with metabolic syndrome had 60.5% higher average leptin values. According to the level of adiponectin, it is 17.8% lower in patients with SLE than in practically healthy people. With increasing age and duration of the disease, a significant decrease in the level of adiponectin was found in patients with SLE. All this determines the prospects for further research of these indicators and establishing their role in the progression of SLE.

Cognitive Disorders in Patients with Hypertension: Are There Gender Differences?

Background: Given the profound differences between women and men, there is a need to study gender as a vital variable and factor in blood pressure regulation, control, and treatment. The level of anxiety and depression, which significantly affect the psychological characteristics and patients' quality of life, and the status of the autonomic nervous system represent a rather significant layer of hypertension problems due to its specificity, accumulating its medical, social, gender, and humanitarian aspects, which are related to sexual characteristics.
 Material and Methods: The study results are based on the data of a comprehensive examination of 185 working patients with controlled hypertension (H) stage II. According to the neuro-psychological testing on MMSE, МоСА and Life Quality scales, 157 people with various severity cognitive disorders (CD) were found. There were 87 (55.4 %) women and 70 (44.6 %) men among them, and the average age [M(SD)] was 52.3 (8.2) years; the average duration of H was 10 (8-12 years). The comparison and control groups were adequate for the purpose. The standard methods of parametric and non-parametric statistics processed the obtained data. 
 Results: As a result of the study, significant differences were found in patients with hypertension and CD of both sexes compared with healthy individuals and patients with hypertension without cognitive impairment in relation to the daily blood pressure profile (VAR SBP, VAR DBP) both during the day and at night. The females, even middle-aged, with controlled hypertension but high systolic blood pressure variability, have a substantial risk of developing CD. Male patients with hypertension, even in the absence of CD, are more prone to depression, according to the HADS scale. In the presence of hypertension with CD, they are characterized by significantly worse personal-role physical and emotional functioning compared to female patients on the life quality scale. The often irresponsible attitude of men to the doctor's advice and regular antihypertensive treatment probably plays a significant role in the formation of gender differences in the quality of life of patients with hypertension and CD.
 Conclusion: It is necessary to ensure early diagnosis and monitoring of CD as a marker of brain damage due to hypertension and determine the level of anxiety and depression, which significantly affect the psychological characteristics and quality of life even of patients with controlled hypertension, regardless of gender. However, middle-aged women, even with controlled hypertension but high SBP variability, have a priority risk of CD development.

Risk of perinatal mortality among the offspring of workers employed at production with radiation hazards

Studies that address risks of perinatal mortality among the offspring of people exposed to ionizing radiation in the workplace are significant for developing hygienic standards at production facilities with radiation hazards. The purpose was to analyze perinatal mortality (stillbirths and early neonatal deaths) among the offspring of workers employed by Mayak Production Association (Mayak PA), the first atomic production facility in Russia. A retrospective analysis was performed among 25,007 children born in 1949–1973; parents of 14,580 of these children were exposed to long-term occupational radiation at Mayak PA. The study provides frequency and dynamics of perinatal mortality and comparative analysis of perinatal mortality by sex, year of birth, parental age at childbirth, and dose categories of radiation exposure. Research data were analyzed by methods of non-parametric statistics. We calculated a relative risk (RR) of perinatal mortality among the offspring of exposed and unexposed parents with 95 % CI. The rate of perinatal mortality was generally the same in both groups, 19.9 for 103 in the test group and 17.9 for 103 in the control, p > 0.05. Stillbirths among male offspring were statistically significantly more often observed in the test group due to contribution of the children with only mothers exposed to occupational radiation exposure at Mayak PA prior to conception and offspring exposed in utero. Intrauterine fetal death was observed statistically significantly more often among boys of the test group compared to controls: 2.9 against 0.9 for 103. Rates of stillbirths and perinatal mortality in the main group statistically significantly exceeded the values in the comparison group in 1949–1953: RR = 2.69 (CI: 1.46–4.95) and 2.12 (1.38–3.28) respectively. Significant statistical differences in the perinatal mortality risk were established in certain categories of preconception and intrauterine gamma-exposure. The identified peculiarities of unfavorable outcomes in the perinatal period that were detected among the offspring of Mayak PA workers could be eligible for further epidemiological monitoring. Polyetiology character of perinatal mortality requires further follow up of the cohort of the offspring born to atomic production workers.

РИСК ПЕРИНАТАЛЬНЫХ ПОТЕРЬ СРЕДИ ПОТОМКОВ ПЕРСОНАЛА РАДИАЦИОННО ОПАСНОГО ПРОИЗВОДСТВА

A retrospective analysis was performed among 25,007 children born in 1949–1973; parents of 14,580 of these children were exposed to long-term occupational radiation at Mayak PA. The study provides frequency and dynamics of perinatal mortality and comparative analysis of perinatal mortality by sex, year of birth, parental age at childbirth, and dose categories of radiation exposure. Research data were analyzed by methods of non-parametric statistics. We calculated a relative risk (RR) of perinatal mortality among the offspring of exposed and unexposed parents with 95 % CI. The rate of perinatal mortality was generally the same in both groups, 19.9 for 103 in the test group and 17.9 for 103 in the control, p > 0.05. Stillbirths among male offspring were statistically significantly more often observed in the test group due to contribution of the children with only mothers exposed to occupational radiation exposure at Mayak PA prior to conception and offspring exposed in utero. Intrauterine fetal death was observed statistically significantly more often among boys of the test group compared to controls: 2.9 against 0.9 for 103. Rates of stillbirths and perinatal mortality in the main group statistically significantly exceeded the values in the comparison group in 1949–1953: RR = 2.69 (CI: 1.46–4.95) and 2.12 (1.38–3.28) respectively. Significant statistical differences in the perinatal mortality risk were established in certain categories of preconception and intrauterine gamma-exposure. The identified peculiarities of unfavorable outcomes in the perinatal period that were detected among the offspring of Mayak PA workers could be eligible for further epidemiological monitoring. Poly-etiology character of perinatal mortality requires further follow up of the cohort of the offspring born to atomic production workers.

Restriction of the Rights and Coercion of Patients in a Psychiatric Hospital: The Opinion of People With Mental Disorders and Psychiatrists

Objectives: Restriction of the rights of patients in a psychiatric hospital, isolation and fixation, compulsory treatment, and round-the-clock monitoring are negatively perceived by them, contribute to the stigma of a psychiatric hospital, and prevent timely access to psychiatric help We assessed the opinions of patients in psychiatric hospitals and psychiatrists about coercion and violence in the provision of psychiatric care for recommendations on their prevention. Methods: An anonymous survey of psychiatrists and patients was conducted in psychiatric hospitals in three regions. Data were analyzed using descriptive and non-parametric statistical methods. Results: Psychiatrists and patients were positive about the coercive measures in the psychiatric hospital. Physical restraint was considered the prerogative of orderlies by 64.5% of psychiatrists and 35.4% of patients. According to 19.6% of doctors and 28.4% of patients, a psychiatrist can independently apply physical restraint to aggressive patients. Injections of sedative drugs by a psychiatrist personally were considered justified by 81.3% of physicians and 64.6% of patients. Most patients and physicians noted that the psychiatrist needed to be involved in the application of physical restraint to an aggressive patient. Discussion: Psychiatry is currently dominated by an archaic paternalistic model of doctor-patient relations and the delegation of additional functions of social control to psychiatrists. The introduction of a contractual model is required for more effective interaction between the psychiatrist and the patient.

Effect of components of the renin-angiotensin system, rs2106809 polymorphism of the ACE2 gene, and therapy with RAS blockers on the severity of COVID-19

Angiotensin-converting enzyme 2 (ACE2) is a key component of the renin-angiotensin system (RAS), providing counter-regulation of its effects and, simultaneously, a receptor for the SARS-CoV-2 entering. It is suggested that factors regulating the balance of the major components of RAS, including ACE2 gene polymorphism, therapy with RAS blockers (ACE inhibitors and angiotensin receptor blockers) - may affect the severity of COVID-19. The aim of the study was to investigate the effect of RAS components, the relationship of ACE2 gene polymorphism rs2106809 and ACEi/ARBs therapy with the COVID-19 severity. The study included patients with COVID-19 hospitalized in Endocrinology research centre (n = 173), who were divided into groups of moderate and severe course. Determination of RAS components was performed by ELISA, identification of polymorphism by PCR. Statistical analysis was performed using nonparametric statistical methods; differences in the distribution of genotype frequencies were assessed using Fisher's exact test χ2. The groups differed significantly in age, blood glucose levels, and inflammatory markers: leukocytes, neutrophils, IL-6, D-dimer, C-reactive protein, ferritin and liver enzymes, which correlated with the severity of the disease. When comparing patients in terms of ACE, ACE2, angiotensin II, ADAM17 there were no statistically significant differences between the groups (p=0.544, p=0.054, p=0.836, p=1.0, respectively), including the distribution by gender (in men: p=0.695, p=0.726, p=0.824, p=0.512; in women: p=0.873, p=0.196, p=0.150, p=0.937). Analysis of the distribution of AA, AG, and GG genotypes of the rs2106809 polymorphism of the ACE2 gene also revealed no differences between patients: χ2 1.35, p=0.071 in men, χ2 5.28, p=0.244 in women. There were no significant differences in the use of RAS blockers between groups with different course severity: χ2 0.208, p=0.648 for ACEi, χ2 1.15, p=0.283 for ARBs. In our study, the influence of activation of RAS components (ACE, ACE2, AT II, ADAM17) and ACE2 gene polymorphism on the severity of COVID-19 course was not confirmed. The severity of COVID-19 course correlated with the level of standard inflammatory markers, indicating the general principles of the infection as a systemic inflammation, regardless of the genetic and functional status of the RAS.

Incretin hormone responses to carbohydrate and protein/fat are preserved in adults with sulfonylurea-treated KCNJ11 neonatal diabetes.

The incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), are thought to be the main drivers of insulin secretion in individuals with sulfonylurea (SU)-treated KCNJ11 permanent neonatal diabetes. The aim of this study was to assess for the first time the incretin hormone response to carbohydrate and protein/fat in adults with sulfonylurea-treated KCNJ11 permanent neonatal diabetes compared with that of controls without diabetes. Participants were given a breakfast high in carbohydrate and an isocaloric breakfast high in protein/fat on two different mornings. Incremental area under the curve and total area under the curve (0-240 minutes)for total GLP-1 and GIP were compared between groups, using non-parametric statistical methods. Post-meal GLP-1 and GIP secretion were similar in cases and controls, suggesting this process is adenosine triphosphate-sensitive potassium channel-independent. Future research will investigate whether treatments targeting the incretin pathway are effective in individuals with KCNJ11 permanent neonatal diabetes who do not have good glycemic control on sulfonylurea alone.

Antibiotic Resistance Patterns of Staphylococcus aureus in Chicken Farms: Implications for Health Resilience in Indonesia

Health resilience refers to an individual's or a community's ability to withstand and recover from various health challenges and crises. Antibiotic resistance poses a significant threat to health resilience due to its impact on the effectiveness of antibiotics. The urgency of the issue of multidrug bacterial resistance in public health is a concern. The phenomenon discussed in this paper is related to the environment that becomes resistant to the antibiotic Staphylococcus aureus which causes high morbidity and mortality in animals such as chickens. In this study, there were three levels of antibiotic resistance based on clear zone media culture, namely resistance, intermediates, and sensitivity with each antibiotic totaling nine chicken cloacal swab samples. The purpose of this study was to determine the pattern of the significance of antibiotic resistance in S. aureus in three chicken farms in West Java Province (Bogor, Parung, and Sukabumi). This study used secondary data from previous studies and analyzed with nonparametric statistical methods using the Kruskal Wallis Test (One Way ANOVA). The results of the analysis showedalmost all gave a resistant response characterized by the absence of a clear zone in bacterial culture media treated with the same antibiotic in all chicken cloaca swab samples taken from farms in Bogor, Parung, and Sukabumi. Thus, resulting in the same resistance pattern. This indicates the pattern of the resilience of resistance in West Java is the same because the ecological conditions and living standards of the community are almost the same. These results may illustrate important concerns for the possibility of other regions in Indonesia having similar patterns of antibiotic resistance, so antibiotic use must adhere to appropriate guidelines to combat further antibiotic-resistant strains.

Exploring Relationships between Boltzmann Entropy of Images and Building Classification Accuracy in Land Cover Mapping.

Remote sensing images are important data sources for land cover mapping. As one of the most important artificial features in remote sensing images, buildings play a critical role in many applications, such as population estimation and urban planning. Classifying buildings quickly and accurately ensures the reliability of the above applications. It is known that the classification accuracy of buildings (usually indicated by a comprehensive index called F1) is greatly affected by image quality. However, how image quality affects building classification accuracy is still unclear. In this study, Boltzmann entropy (an index considering both compositional and configurational information, simply called BE) is employed to describe image quality, and the potential relationships between BE and F1 are explored based on images from two open-source building datasets (i.e., the WHU and Inria datasets) in three cities (i.e., Christchurch, Chicago and Austin). Experimental results show that (1) F1 fluctuates greatly in images where building proportions are small (especially in images with building proportions smaller than 1%) and (2) BE has a negative relationship with F1 (i.e., when BE becomes larger, F1 tends to become smaller). The negative relationships are confirmed using Spearman correlation coefficients (SCCs) and various confidence intervals via bootstrapping (i.e., a nonparametric statistical method). Such discoveries are helpful in deepening our understanding of how image quality affects building classification accuracy.

Exploring the impact of online and offline teaching methods on the cognitive abilities of medical students: a comparative study

BackgroundOnline education has become increasingly popular, but research on the effectiveness of different teaching models in developing cognitive skills is limited. This study investigated the relationship between different teaching models (online and offline) and the development of cognitive skills in clinical medicine students.MethodsSurvey data were collected from 2018 entry students who participated in online teaching and 2019 entry students in offline teaching at Xiangya School of Medicine, Central South University. National Quality Open Courses (NQROC) were provided to both groups of students. The study examined the total score of physiology final exam, score of each type of question, and NQROC learning engagement in different score segments under the two teaching models. Non-parametric statistical methods were utilized to analyze the total score of physiology final exam, score of each type of question, and the NQROC learning engagement. Spearman’s rank correlation was utilized to analyze the relationship between the score of physiology final exam and the students’ NQROC learning engagement.ResultsThe study found no statistically significant difference in the total score, short-answer questions (SAQs) score, and case study questions (CSQs) score between online and offline teaching models. However, the multiple-choice questions (MCQs) score was higher in the online teaching model (Z=-4.249, P < 0.001), suggesting that online teaching may be an effective way to improve lower-order cognitive skills among students. In contrast, low-achieving students had higher total scores (Z=-3.223, P = 0.001) and scores in both MCQs (Z=-6.263, P < 0.001) and CSQs (Z=-6.877, P < 0.001) in the online teaching model. High-achieving students in the online teaching model had higher total scores (Z=-3.001, P = 0.003) and MCQs scores (Z=-5.706, P < 0.001) but lower scores in CSQs (Z=-2.775, P = 0.006). Furthermore, students’ NQROC learning engagement was greater in the online teaching model.ConclusionsThe results of this study suggested that online teaching was not statistically significantly different from offline in cognitive domains and was more desirable than offline in strengthening lower-order cognitive skills. However, it was important to note that offline teaching may be more effective in reinforcing higher-order cognitive skills among high-achieving students. In conclusion, this study provided important insights into the effectiveness of different teaching models in developing cognitive skills among medical students and highlighted the potential benefits of online teaching in enhancing students’ lower-order cognitive skills.

Multi-scale adaptive multivariate state estimation fault detection enhancement for time-varying industrial system based on multi-output Gaussian process autoregression

Most chemical processes are time-varying and nonlinear due to load changes, product demand transitions or other causes, causing unsatisfactory performance of conventional non-parametric multivariate statistical fault detection method. In this work, a probabilistic multivariate state estimation fault detection method based on multi-output Gaussian process autoregression is first developed to overcome the linear limitation and noise information ignorance of multivariate state estimation technology-based fault detection methods. In multi-output Gaussian process regression framework, the Leave-One-Sample-Out strategy is developed to construct the dataset by leaving each historical sample from the memory matrix out as one training output in turn while regarding the corresponding remaining historical samples as one training input. Then, we design the multi-output Gaussian process autoregression model to estimate the current state of the system. Utilizing the estimation covariance information, a probabilistic index based on multivariate Kullback-Leibler divergence is developed for fault detection. Moreover, a multi-scale adaptive fault detection enhancement based on discrete multi-objective Archimedes optimization and just-in-time learning is further proposed to handle the time-varying problem. In this scheme, the memory matrix is batch-adaptively updated at monthly intervals based on discrete multi-objective Archimedes optimization to handle the slow change of system characteristics caused by equipment degradation. On the other hand, to cope with the rapid change of system characteristics caused by operation transition, the just-in-time learning is employed to select samples from the memory matrix that best match to the current system state for sample-adaptive updating. Finally, two industrial cases are used to verify the performance of the proposed method.

Hospital Cost of Inflammatory Bowel Disease and Its Determinants in a Multicenter Study From Iran.

Background: In the current era of monitoring healthcare costs for patients with inflammatory bowel disease (IBD), there has been a shift in the pattern of such costs. In this cross-sectional study conducted in three hospitals in Iran from 2015 to 2021, we aimed to assess the in-hospital costs of IBD and identify predictors of higher total hospital costs in hospitalized patients with IBD. Methods: This cross-sectional study was conducted at three hospitals in Iran. For the purpose of this study, we collected demographic and clinical information, as well as cost data for patients with IBD. Two non-parametric statistical procedures, classification and regression trees (CARTs) and quantile regression forests (QRFs), were employed to identify the main factors related to hospital costs of IBD, which served as the dependent variable in our analysis. Results: During 7 years, 930 admissions occurred in these three hospitals. 22.3% of patients (138 of 619) were readmitted, and 306 (49.4%) were male. The mean age of the patients was 33 (SD=18.9) years. A total of 454 patients (73.3%) had ulcerative colitis (UC), and 165 patients (26.7%) had Crohn's disease (CD). Hotelling and medication costs accounted for the largest share of the total hospital costs, with percentages of 30.61% and 23.40%, respectively. Length of stay (LOS) was found to be the most important variable related to hospital costs of IBD in both QRF and CART models, followed by age and year of hospital admission in QRF. Additionally, in the CART model, hospital type and year of hospital admission were also significant predictors of hospital costs for patients with IBD. Conclusion: The present study showed that LOS, age, year of admission, and the hospital where the patient is admitted are all important factors that determine hospital costs for patients with IBD. Patients admitted for 20.5 days or longer had the highest hospital costs. These findings can be used as thresholds for future DRG policies.

Impact of Rythu Bharosa Kendra’s as Perceived by the Farmers

Rythu Barosa Kendras (RBKs) in Andhra Pradesh aim to support farmers by providing various services and resources. Their impact on farmers' perception and utilisation has become crucial for the agricultural landscape. This study investigates the RBK services' impact using non-parametric statistical methods. The services of the RBK’s were finalised using face validity and multi-stage sampling techniques were employed to select a representative sample of 60 farmers. Results indicate that variables like caste and annual income were significant at 1 % whereas education, occupation, land holding and the source of information was significant at 5 %, influencing the perception of services. However, none of the variables under study affect service utilisation. Identified constraints include non-availability of seeds, fertilizers, green manure, fodder crop seeds, and micronutrients at RBK. Lack of credit-based input supply, farm machinery, equipment, tarpaulin, and cold storage/godowns, along with insufficient staff and marketing facilities, also hinder performance. The study highlights the valuable role of AEOs in shaping farmers' perceptions about agricultural services through the provision of information and knowledge. However, this perception did not directly lead to increased service utilization. Policymakers and stakeholders in the agricultural sector should focus on strengthening the AEOs' role and improving the accessibility of agricultural services to enhance productivity and development in the State.

The Effect of Acupressure Therapy on Reducing Blood Pressure in Hypertension Patients in the Work Area of the Muntok Health Center in 2022

The purpose of this study was to determine the effect of giving acupressure therapy on reducing blood pressure in hypertensive patients in the Working Area of the Muntok Health Center in 2022. This research method used a Pre-Experimental with a One Group Pretest-Posttest design. The sample used in this study were 14 people. The results of this study revealed that there was an effect of acupressure therapy on reducing blood pressure using non-parametric statistical methods and using the Wilcoxon test obtained a value of p = 0.001 (p &lt;0.05) in systolic and diastolic blood pressure, before and after acupressure therapy with an average systolic pretest blood pressure 150.71 and 127.14, while posttest diastolic 90.36 and 80.71. The conclusion of this study is that acupressure therapy is an alternative therapy that can treat patients with hypertension.

A new integral enthesial-comorbididity index of psoriatic arthritis activity

To develop an integral index of psoriatic arthritis (PsA) activity. 117 patients with PsA (M/F - 63/54) were included. Patients' age 44±11 years, psoriasis (Ps) duration - 213±153 months, PsA duration - 73.4±78.5 months. Patients underwent standard clinical examination of PsA activity: tender (out of 68) and swollen (out of 66) joint counts (TJC, SJC), LEI, tenderness of the plantar fascia (PF), skin lesion severity (BSA), presence of nail Ps, body mass index (BMI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), DAPSA, FACIT-F. Parametric and nonparametric statistic methods, correlation and ROC analysis were used. Mean DAPSA was 38±21, TJC - 14.2±10.6, SJC - 10.6±8.3, ESR - 30.5±29.5 mm/h, CRP - 23.3±29 mg/l, LEI - 1.2±1.5, FACIT-F - 32±11, BMI - 27.4±6.2 kg/m2. The following significant positive correlations were revealed: between DAPSA and BMI, patients' age, ESR, PsA and Ps duration, TJC, SJC, LEI, presence of PF enthesitis, skin lesion severity, presence of nail Ps. A negative correlation between FACIT-F and male sex was found. Based on the predictive model of parameters, the Entesial-Comorbid Index of PsA (ECIPsA) was created: 3.81×LEI+13.72×PF+0.54×Age-0.25×FACIT-F+7.36×BSA+7.94×PsA duration+5.5×Nail Ps+0.32×BMI-3.52, namely LEI - Leeds Enthesial Index; PF - pain in the PF; patient's age; FACIT-F - fatigue scale; BSA<3%=0, ≥3%=1; PsA duration≤2 years=0, >2 years=1; presence of nail Ps=1, absence=0; ECIPsA≥28 corresponds with high PsA activity according to DAPSA≥28. ROC analysis of sensitivity and specificity of the prognostic model demonstrated high correctness of the index: the area under the ROC curve was 0.768, 95% confidence interval (0.624-0.913). The new PsA activity index corresponds to the existing ones and takes into consideration the clinical heterogeneity and comorbidity of the disease.

Analysis of students’ perceptions on the Freedom of Learning - Independent Campus (MBKM) program at Chemistry study program of Ma Chung University

Considering that Indonesian education has gone through such a long journey from 1922 to 2022 now, it is necessary to have an educational program that is able to meet the demands of workers' needs in this era of globalization. In the end, the Directorate General of Higher Education, Research, and Technology designed an education policy system in the realm of higher education, namely "Freedom of Learning - Independent Campus", as an accurate strategy for optimizing academics in today's Indonesia. In this study, a survey was aimed at 40 undergraduate students of the Chemistry Study Program at Ma Chung University. Data analysis were made by quantitative approach of the nine questions succcessfully answered by students who filled out questionnaires in the online multiple choice questionnaire with a dependency test by nonparametric statistical methods. As a result, the majority of students of the Chemistry Study Program were quite enthusiastic about this new educational policy, although it was necessary to optimize all internal strategies of the study program curriculum, so that it could be in accordance with the activities designed in the "Freedom of Learning - Independent Campus" Program.

Tick-borne infections in the south of Russia: modern epidemiological situation, new approach to create “forecasting” and “explaining” morbidity models (in astrakhan rickettsiosis fever and crimean-congo hemorrhagic fever)

The article presents a description of the current tick-borne infection epidemiological situation in the south of Russia from the years 2013 to 2022, proposes a new approach to develop forecasting models for morbidity dynamics of Astrakhan rickettsial fever (ARF) and Crimean hemorrhagic fever (СCHF) in the Astrakhan region and presents data assessing 2022 explaining models for the Stavropol Territory and Astrakhan Region. Materials and methods. A comprehensive research was performed using epidemiological analysis and non-parametric statistical methods. The data assessing tick-borne infections epidemic process manifestations were retrieved from ARF and CCHF morbidity databases (developed as a project) and documents of infectious disease focus epidemiological examination provided by the departments of Rospotrebnadzor in the subjects of the Southern and North Caucasian Federal Districts. Morbidity models were developed using the Bayes theorem and Walds sequential statistical analysis, with a preliminary calculation of indicators informativeness by the Kullback method. The values of climatic factors from the database of the Center for Collective Use IKI-monitoring of the Space Research Institute of the Russian Academy of Sciences were used. Results. The results of the study indicate persistence of serious epidemiological situation regarding rickettsiosis of the tick-borne spotted fever group, Q fever, tick-borne borreliosis and CCHF in the south of Russia. Almost all tick-borne infections nosological forms in children under 14 years (including young children and infants) were widely involved in the epidemic process, which belong to patients at risk for a complicated disease course due to complicated diagnostics and treatment. The annual registration of tick-borne infections cases in the resort areas, with the subsequent occurrence of imported cases in other, including non-endemic regions poses a serious problem. The proposed forecasting models allow to predict the CСHF and ARF morbidity for each administrative district of the Astrakhan region with up to 91.7% accuracy. The explaining models CСHF accuracy for the Stavropol Territory and Astrakhan Region, when tested in 2022, was 88.5 and 83.3%, respectively, for ARF 91.7%. Conclusions. The further continuation of forecasting and explaining models verification for planning preventive measures and propose similar steps for tick-borne borreliosis and Q fever to epidemiological tick-borne infections to stabilize situation in the south of Russia.

Risk factors of local recurrence and distant metastasis and manifestations of toxicity during chemoradiation treatment of cervical cancer patients

Relevance. Cervical cancer remains one of the most common malignancies in women worldwide, despite declining mortality rates due to large-scale screening programs and increased use of the human papillomavirus vaccine in Western countries. Although chemoradiotherapy has been recognized as the standard therapy for patients with locally advanced carcinoma, one-third of patients experience recurrence, and the effect of its treatment is far from satisfactory. In addition, factors affecting prognosis for patients with cervical cancer remain controversial. In connection with the above, research devoted to the analysis of the long-term clinical consequences of cervical cancer treatment and the search for prognostic factors remains extremely relevant.&#x0D; The purpose of the work is to determine the risk factors of local and distant metastasis and manifestations of toxicity during chemoradiation treatment of cervical cancer patients.&#x0D; Materials and methods. Paper case histories of non-operated patients with locally disseminated сervical cancer (stages 2B–4А) who underwent special treatment in the clinic of the institute in the period 1999–2020 were selected from the archive of the State Organization «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine» for inclusion in the electronic database. The selection criterion was either a follow-up period of more than 1 year, or a tracked recurrence of the disease within a period of up to 1 year. The end of observation was considered either the death of the patient, or the appearance of oncological consequences of the disease, or withdrawal from observation for unknown reasons (censored observations). The WizWhy package of the Data Mining category was used to conduct the research and propose hypotheses, followed by hypothesis testing by non-parametric statistical methods using the STATISTICA and SPSS general-purpose software package. Non-parametric methods were used – Pearson’s chi-squared test and the Mann–Whitney U-test.&#x0D; Results and discussion. A number of parameters and factors that have predictive properties regarding the risk of the appearance of oncological consequences of treatment in the future have been identified. The main immediate and remote consequences of chemoradiation treatment of patients and remote somatic consequences of combined treatment were analyzed.&#x0D; Conclusions. Catamnetic data of «processed» case histories, provided they are processed by appropriate mathematical methods, are a potential source for obtaining new non-obvious knowledge. In particular, the correct analytical approach to the processing of formalized medical history data made it possible to find a number of risk factors for local and distant metastasis and manifestations of toxicity during chemoradiation treatment of non-operated patients with locally disseminated cervical cancer, which creates the basis for the development of proposals for adjusting antitumor therapy and individualized patient support.

#6332 INFLUENCE OF NUTRITIONAL STATUS ON THE INCREASE IN CARDIOVASCULAR RISK AND THE RISK OF KIDNEY DAMAGE IN COMORBIDITY OF HYPERTENSION AND COPD

Abstract Background and Aims It is widely known that obesity is a modulated additional factor in increasing cardiovascular risk in patients with hypertension. Since the number of patients with comorbidity of arterial hypertension and COPD is increasing, the question of the relationship between nutritional status and cardiovascular risk remains relevant. Purpose of the study: to determine the role of nutritional status indicators in the formation of cardiovascular risk in patients with comorbidity of hypertension and COPD. Method 101 patients were included in a cross-sectional study: 32 patients with comorbidity of hypertension and COPD (Gr I), 43 patients with hypertension (Gr II), and 26 patients with chronic obstructive pulmonary disease (Gr III). Exclusion criteria: informed consent of the patient to processing of personal data, Hypertension stage II, 1-3 degree, COPD A - C clinical groups(stable phase), age≥40 years. Exclusion criteria: age≥80 years, myocardial infarction and cerebral circulatory disorders, kidney diseases (polycystosis, developmental abnormalities, glomerulonephritis, pyelonephritis), diabetes mellitus, cancer, GFR &amp;lt; 30 ml/min. Patients underwent general clinical examination, determined nutritional status by anthropometric study and bioimpedancemetry, assessed the renal function by laboratory examination of blood. Methods of parametric and nonparametric statistics were used. Results A high cardiovascular risk in Gr I was in 22 (68,8%) patients, in Gr II - in 27 (62,9%) patients and in Gr III - in 10 (38,5%) patients. GFR in Gr I was 67,5 (57,0;77,0) ml/min, in Gr II -70.6 (57.0; 83.0) ml/min, and in Gr III - 82.5 (70.0;89.0) ml/min (p = 0.02). BMI in Gr I was 30.2 (26.5;35.0) kg/m2, in GrII - 29.7 (26.3;33.9) kg/m2, in GrIII - 26.8 (24.6;29.6) kg/m2. Percentage of adipose tissue in Gr I was 35.1 (30.0;41.7), in Gr II-38.2 (32.4;42.1) and in Gr III - 27.7 (21.0;34.1) (p = 0.01). The total muscle tissue in Gr I was 28,6 (24,6;30,6)%, in Gr II - 28,5 (25,0;31,2)%, in Gr III - 32,1 (27,8;35,3)%(p = 0.1), visceral fat in Gr I was 11,0 (8,0;14,0)%, in Gr II- 11,0 (9,0;15,0) %, in Gr III- 9,0 (6,0;13,0) %(p = 0.1); sarcopenia index in Gr I was 77,8(61,6;86,2), in Gr II- 77,8(66,1;101,8), in Gr III- 90,6(86,0;98,6)(p = 0,1). In Gr I, correlations were found: negative between GFR and high cardiovascular risk (R = -0.6), positive - between sarcopenia index, visceral fat and high cardiovascular risk (R = 0.5; 0.6), negative - between the amount of muscle tissue and high cardiovascular risk in patients (R = -0.5) (p&amp;lt;0,05). Conclusion In patients with a comorbidity of hypertension and COPD, along with an increase in the amount of adipose tissue and visceral fat, the amount of muscle tissue decreases, which leads to sarcopenic obesity. Sarcopenic obesity is associated with high cardiovascular risk and worsening of renal function, which also leads to an increased risk of cardiovascular complications.

Characterization of SHH, SOX3, WNT3A and WNT9B Proteins in Human Non-Syndromic Cleft Lip and Palate Tissue

Orofacial clefts have been associated with specific cleft candidate genes which encode regulatory proteins required for orofacial region development. Cleft candidate genes encode proteins involved with the cleft morphopathogenesis process, but their exact interactions and roles are relatively unclear in human cleft tissue. This study evaluates the presence and correlations of Sonic Hedgehog (SHH), SRY-Box Transcription Factor 3 (SOX3), Wingless-type Family Member 3A (WNT3A) and 9B (WNT9B) protein containing cells in different cleft tissue. Non-syndromic cleft-affected tissue was subdivided into three groups—unilateral cleft lip (UCL) (n = 36), bilateral cleft lip (BCL) (n = 13), cleft palate (CP) (n = 26). Control tissue was obtained from five individuals. Immunohistochemistry was implemented. The semi-quantitative method was used. Non-parametric statistical methods were applied. A significant decrease in SHH was found in BCL and CP tissue. SOX3, WNT3A and WNT9B had a significant decrease in all clefts. Statistically significant correlations were found. The significant decrease in SHH could be associated with BCL and CP pathogenesis. SOX3, WNT3A and WNT9B could have morphopathogenetic involvement in UCL, BCL, and CP. Similar correlations imply the presence of similar pathogenetic mechanisms in different cleft variations.