Nonparametric Spearman Correlation Research Articles

Relationship between Nutritional Status, Frailty, and Cognitive Function among Elderly at Dr. H. Moch. Ansari Saleh General Hospital Banjarmasin

The elderly often have nutritional problems. The risk of malnutrition can stimulate the prevalence of frailty and declining cognitive function in the elderly. The study aimed to analyze the relationship between nutritional status, frailty, and cognitive function in the elderly at Dr. H. Moch. Ansari Saleh Hospital Banjarmasin. This study was analytic observational using a cross-sectional method. A sample of 93 elderly was obtained using a total sampling technique according to the inclusion and exclusion criteria. The nutritional status assessment was done using the Mini Nutritional Assessment-Short Form (MNA-SF), the Edmonton Frailty Scale (EFS), and the Mini-Mental State Examination (MMSE). The results showed that the mean of Mini Nutritional Assessment score was 12.00±2.126, the average frailty score was 4.41±1.872, and the average value of cognitive function was 25.98±2.923. Data were analyzed using the Spearman's non-parametric correlation test with a 95% confidence level. The correlation test results between nutritional status and frailty obtained p=0.000 and r=-0.490. The correlation test results between nutritional status and cognitive function obtained p=0.000 and r=0.595. In short, there is a relationship between nutritional status on frailty and cognitive function in the elderly at Dr. H. Moch. Ansari Saleh General Hospital Banjarmasin, it means that the good nutritional status in the elderly, the risk of frailty syndrome will decrease and improve cognitive function.

Evaluation of developing maize microbiomes and associations among nitrogen cyclers and key fungal taxa.

More sustainable approaches to agriculture are urgently needed to protect existing resources and optimize crop yields and to provide food for a growing global human population. More sustainable agricultural practices that utilize plant-microbe relationships across cultivation are urgently needed. The main objectives of this study were to track the prokaryotic and fungal microbiomes associated with key growth stages of developing maize to evaluate the relationships among nitrogen cycling bacteria and major fungal genera including those known to contain arbuscular mycorrhizal fungi and other important taxa. Prokaryotic and fungal microbiomes associated with bulk soils, rhizosphere soils and tissues of developing maize were characterized using Illumina MiSeq sequencing. Similarities in microbiome diversity and abundance were compared to sample metadata to explore the influence of external factors on microbiome development. Correlations among target fungal taxa, bulk bacteria and nitrogen cycling bacteria were determined using non-parametric Spearman correlations. Important maize-associated fungal taxa were detected in all samples across growth stages, with Fusarium, Penicillium and Aspergillus fungi comprising up to 4.21, 4.26 and 0.28% of all fungal genera, respectively. Thirteen statistically significant correlations between nitrogen cycling genera and targeted fungal genera were also identified (rS≥0.70 or rS≤-0.70; P<0.05). This study is the first to note a strong positive association among several nitrifying bacteria and Fusarium (R=0.71; P=0.0046), Aspergillus (R=0.71; P=0.0055) and Cladosporium spcies (R=0.74; P=0.0038), suggesting the levels of soil nitrate, nitrite or nitrification intermediates may have large roles in the proliferation of important maize-associated fungi.

Evaluations of wavefront aberrations and corneal surface regularity in dry eye patients measured with OPD Scan III.

To compare the wavefront aberrations and corneal surface regularity between dry eye (DE) patients and normal subjects and assess its diagnostic performance for DE measured with OPD Scan-III. Fifty right eyes of 50 DE patients and 31 right eyes of normal subjects were included. The examinations for ocular surface including logarithm of the minimum angle of resolution best-corrected distance visual acuity (logMAR BCVA) the ocular surface disease index (OSDI), tear film break-up time (TBUT) and corneal fluorescein staining (CFS). OPD Scan-III was used to measure anterior corneal aberrations including total corneal aberrations, high order aberration (HOA), coma, trefoil, spherical aberration (SA), standard deviation of corneal power (SDP), surface regularity index (SRI) and surface asymmetry index (SAI). Statistical analysis were assessed with nonparametric tests and Spearman's correlations. All parameters were also analyzed for sensitivity, specificity, and receiver operating characteristics (ROC) curves. Wavefront aberrations parameters including total corneal aberrations, HOA, coma, trefoil, and SA in DE group were significantly higher than those in normal group (P<0.001). Corneal surface regularity parameters including SRI and SAI in DE group were significantly higher than both in normal group (P<0.05). All the wavefront aberrations parameters had significant correlations with ocular surface parameters (P<0.05). The logMAR BCVA had positive correlations with SAI and SRI (all P<0.001). CFS scores had positive correlations with SAI and SRI (all P<0.001). All the wavefront aberrations parameters showed good diagnosis sensitivity and specificity, however, the corneal regularity parameters showed only good specificity but poor sensitivity. The cut-off value selected for trefoil in diagnosis DE showed the highest area under the curve (AUC, 0.921) values as compared to the other parameters with sensitivity of 0.955 and specificity of 0.867. Wavefront aberrations and corneal surface regularity are increased in DE patients and also correlated with ocular surface parameters. Wavefront aberrations parameters have potential to be indicators to diagnosis and monitor DE.

Sustainability Performance Assessment of the Participatory Guarantee Systems (PGS): A case study in Beijing Farmers Market

Among the range of incentives that might motivate farmers to adopt more sustainable practices, focus is given on the role that institutional innovations such as PGS could play in the transition to sustainable agriculture. PGS are established by producers, consumers, local authorities and other interested stakeholders who collectively ensure that agreed sustainable agricultural practices are adopted. Despite the growing popularity, there is no an experimental assessment of sustainability performance (SP) of PGS in order to better understand the role of PGS in sustainable agriculture. The objective of this study is to (a) assess a sustainability performance of PGS comprehensively, (b) perform a systematic assessment of synergies and trade-offs between sustainability dimensions and themes and (c) quantify the real influence of the selected sustainability themes on the least evolved theme. The Sustainability Assessments of Food and Agriculture Systems (SAFA) Guidelines published by the Food and Agriculture Organization (FAO) provides a transparent and aggregated framework to encompass all aspects of sustainability as well as to understand how strength, weakness and progress could be tackled in the farming systems. This study used the indicator-based SAFA consistent SAFA Tool to assess sustainability performance (SP) of the Beijing Farmers Market (BFM) PGS in China. Based on the respective sustainability scores, the synergies and trade-offs between sustainability dimensions and themes were analyzed using the non-parametric Spearman correlation test, and a linear regression analysis was applied to identify the influence that selected sustainability themes have on a poorly rated theme. The results displayed trade-offs between economic dimension and other three sustainability dimensions, due to vulnerability theme which is a most challenging and poorly-rated theme. Whereas the holistic management, biodiversity and water themes had a significant effect (P&lt;0.05) with the capacity to decrease vulnerability level by 43.4%, 41.4% and 37.3%, respectively. Through its positive influence, social dimension enhanced the achievement of sustainability goals on other dimensions. The study further argues that with a committed and supportive consumer base PGS could become a reservoir of social capital to build a fair and sustainable community. This study presents a new perspective leading to a guideline for other PGS initiatives those early in the sustainability journey.

Perceptual and Ventilatory Responses to Hypercapnia in Athletes and Sedentary Individuals.

PurposeHypercapnic chemosensitivity traditionally captures the ventilatory response to elevated pressures of carbon dioxide in the blood. However, hypercapnia also contributes to subjective breathing perceptions, and previously we demonstrated a closer matching of perception to changes in ventilation in athletes compared to controls. Here we investigated any potential underlying hypercapnic chemosensitivity differences between groups, and explored whether these measures relate to ventilatory and perceptual responses during exercise as well as trait levels of affect.MethodsA hypercapnic challenge, incremental maximal exercise test and affective questionnaires were completed by 20 endurance athletes and 20 age-/sex-matched sedentary controls. The hypercapnic challenge involved elevating end-tidal PCO2 by 0.8% (6.1 mmHg) and 1.5% (11.2 mmHg) for 3 min each (randomised), with constant end-tidal oxygen. Ventilatory and perceptual responses to hypercapnia were compared between groups, and within each group the relationships between hypercapnic chemosensitivity (slope analyses) and exercising ventilation and perceptions were calculated using Spearman’s non-parametric correlations.ResultsWhile absolute ventilation differences during hypercapnia and exercise were observed, no group differences were found across hypercapnic chemosensitivity (slope) measures. Correlation analyses revealed the anxiety hypercapnic response was related to maximal exercise anxiety, but only in sedentary individuals.ConclusionVentilatory and perceptual hypercapnic chemosensitivity do not differ between athletes and sedentary individuals. However, ventilatory and anxiety hypercapnic chemosensitivities were related to ventilatory and anxiety responses during exercise in untrained individuals only. Athletes may employ additional strategies during exercise to reduce the influence of chemosensitivity on ventilatory and perceptual responses.

Analysis of trans-environment transitions of elemental toxicants in linden flowers

Introduction. The contamination of heavy metals in medicinal plants is regional and depends on the plant’s antropogenic influence and biological properties. The purpose of the work was to study the trans-environmental transition of elemental toxicants in linden flowers by inductively coupled plasma mass spectrometry with the influence of the Moscow region anthropogenic burden. Materials and methods. One hundred eight samples were used as objects of the research, including soil, leaves and flowers of wild and cultivated linden and broadleaf trees from 36 collection sites with different levels of anthropogenic impact. The transition of elemental toxicants from soil to linden flowers was assessed directly by comparing the gross content of elements in flowers and adjacent soils. The transition of element toxicants from the atmosphere was evaluated indirectly by comparing heavy metals concentration in the linden flowers with their contents in leaves. Results. Despite the significant influence of technogenic factors on the normalized elemental toxicants in flowers of lindens, their permitted concentrations are not exceeded. To assess the trans-environment transitions, the Spearman nonparametric correlation coefficient was calculated between the content of the analyzed elements in the morphological parts of the linden and adjacent soils. It was found that the enrichment of the morphological parts of linden with aluminium, vanadium, chromium, manganese, iron, cobalt, copper, zinc, strontium, molybdenum, barium and lead occurs through the atmosphere; there is a fair correlation between the content of manganese, iron, arsenic, molybdenum and barium in the ground and morphological parts of the plant. Nickel, copper, zinc, cadmium and lead pass from the environment to the morphological parts of the linden insignificantly, mercury is practically not absorbed by the linden. Limitations. The study was conducted in Moscow and the Moscow region during one vegetative period (June 2019). Conclusions. Linden flowers are more concentrators of manganese, copper, strontium, molybdenum, barium than leaves, and they can be used as indicators of atmospheric air pollution with these elemental toxicants.

Inverse Association Between Hypothalamic N-Acetyl Aspartate/Creatine Ratio and Indices of Body Mass in Adolescents with Obesity

BackgroundApproximately 10% of adolescents worldwide are overweight or obese, hence the urgent and universal need to elucidate possible mechanisms that lead to obesity in the adolescent population. ObjectivesWe examined the hypothalamic metabolism and its relationship with physical development in obese and eutrophic adolescents. MethodsWe performed a case-control study with 115 adolescents between 11 and 18 years of age, to compare obese (BMI z-score ≥ 2) and nonobese individuals (eutrophic controls; BMI z-score ≤ 1). The following hypothalamic metabolite ratios were examined as primary outcomes: glutamate/creatine (Cr), the sum of glutamate and glutamine/Cr, N-acetylaspartate (NAA)/Cr, myoinositol/Cr, and total choline/Cr (glycerophosphocholine + phosphocholine/Cr), quantified by magnetic resonance spectroscopy. BMI z-scores, pubertal status, and scores on the Yale Food Addiction Scale, the Binge Eating Scale, and the Child Depression Inventory were assessed as secondary outcomes. Pearson coefficients (r) or nonparametric Spearman correlation (rho) analyses were performed between hypothalamic metabolite ratios and other parameters, such as BMI z-scores, physical development, food habits, depression symptoms, and serum protein concentrations (cytokines, hormones, and neuropeptides). ResultsAdolescents with obesity showed a lower hypothalamic NAA/Cr ratio (0.70 ± 0.19) compared to their eutrophic counterparts (0.84 ± 0.20; P = 0.004). The NAA/Cr ratio was negatively correlated with BMI z-scores (r = −0.25; P = 0.03) and serum insulin (rho = −0.27; P = 0.04), C-peptide (rho = −0.26; P = 0.04), amylin (r = −0.27; P = 0.04), ghrelin (rho = −0.30; P = 0.02), and neuropeptide Y (r = −0.27; P = 0.04). Also, the NAA/Cr ratio was positively correlated with circulating IL-8 levels (rho = 0.26; P = 0.04). ConclusionsHigh BMI z-scores are associated with lower hypothalamic NAA/Cr ratios. The negative correlations found between the NAA/Cr ratio and serum cytokines, hormones, and neuropeptides suggest a broad cross-talk linking hormonal imbalances, neurohumoral alterations, and hypothalamic functions in adolescents with obesity.

Hidden association of knee-related disability with physical activities among community-dwelling older male Saudi Arabians with knee osteoarthritis

Introduction: The impact of knee osteoarthritis (OA) on physical activities of daily life was studied extensively among the elderly across the globe but not well understood in the Saudi Arabian populace with cultural consideration. This paper assessed the association between knee flexion range of motion (ROM) and ritual physical activities among elderly males due to knee OA.Methods: A cross-sectional study with a sample of 139 males aged 56–74 years diagnosed with knee OA recruited at prayer places. The subjective evaluation was carried using a disease-specific Arabic knee physical functional questionnaire Knee injury and OA Outcome Score-Physical Function Short form (KOOS-PS), and the anthropometric measure of knee flexion ROM was objectively measured by a manual goniometer.Results: The mean and standard deviation of the study sample age, height, weight, and body mass index were 66.9 ± 4.09 years, 158.4 ± 6.1 cm, 74.6 ± 7.1 kg, and 29.6 ± 1.9 kg/m2, respectively. The mean, standard deviation and median of the knee flexion ROM and Arabic-KOOS-PS Questionnaire score were 100.7 ± 7.9, 101.5 and 12.9 ± 13.7, 13.4. The non-parametric Spearman correlation coefficient between the knee stiffness and KOOS-PS physical activities resulted very strong positively correlation, r = 0.967.Conclusion: A strong positive correlation has been found between hidden knee disability and ritual physical activities among male cohorts in Saudi cultural community with knee OA

Psychometric Evaluation of a Patient Experience Questionnaire (PEQ) for Outpatient Appointments: Analysis Using Data from a U.K. National Health Service Audiology Department.

The Audiology Department at the Royal Surrey NHS Foundation Trust (RSFT), United Kingdom, developed a patient experience questionnaire (PEQ) to assess and compare patients' experiences of attending a wide range of appointments (e.g., hearing assessment, hearing aid fitting, hearing aid review, tinnitus therapy, balance assessment, and balance rehabilitation). The aim of this study was to assess the psychometric properties of the PEQ. The PEQ is a unidimensional instrument with four items that assess a patient's experience of an outpatient appointment. Retrospective cross-sectional study. Patients attending appointments for audiology services at RSFT between January and March 2020. All patients (n = 656) attending appointments for audiology services at RSFT during randomly selected days between January and March 2020 were given the questionnaire to complete themselves (PEQ-self) or to complete on their child's behalf (PEQ-parent). The factor structures for the PEQ-self and PEQ-parent were assessed separately, using confirmatory factor analysis. A multiple-causes, multiple-indicators (MIMIC) model was fitted to explore potential bias due to gender and age. Internal consistency was assessed using Cronbach's α. The bivariate correlations between PEQ scores and other variables were evaluated using the nonparametric Spearman correlation coefficient. Floor and ceiling effects were assessed using the distribution of total scores. Confirmatory factor analysis revealed that a one-factor model gave a close fit to the data for both the self and parent versions. Cronbach's α for the total score was 0.77 for the PEQ-self and 0.86 for the PEQ-parent. The MIMIC model showed no significant direct effects of age or gender for either version. Both the PEQ-self and PEQ-parent questionnaire can be reliably used to measure patients' experiences of outpatient audiology appointments. Future studies should aim to assess the psychometric properties of the PEQ-self and PEQ-parent for a range of outpatient appointments other than audiology.

Single-cell RNA sequencing analysis reveals the relationship of bone marrow and osteopenia in STZ-induced type 1 diabetic mice

IntroductionType 1 diabetes (T1D) is a multifactorial autoimmune disease. Broad knowledge about the genetics, epidemiology and clinical management of T1D has been achieved, but understandings about the cell varieties in the bone marrow during T1D remain limited. ObjectivesWe aimed to present a profile of the bone marrow cells and reveal the relationship of bone marrow and osteopenia in streptozotocin (STZ)-induced T1D mice. MethodsThe whole bone marrow cells from the femurs and tibias of healthy (group C) and STZ-induced T1D mice (group D) were collected for single-cell RNA sequencing analysis. Single-cell flow cytometry and immunohistochemistry were performed to confirm the proportional changes among bone marrow neutrophils (BM-neutrophils) (Cxcr2+, Ly6g+) and B lymphocytes (Cd19+). X-ray and micro-CT were performed to detect bone mineral density. The correlation between the ratio of BM-neutrophils/B lymphocytes and osteopenia in STZ-induced T1D mice was analyzed by nonparametric Spearman correlation analysis. ResultsThe bone marrow cells in groups C and D were divided into 12 clusters, and 249 differentially expressed genes were found. The diversity of CD45+ immune cells between groups C and D were greatly affected: the proportion of BM-neutrophils showed a significant increase while the proportion of B lymphocytes in group D showed a significant decrease. X-ray and micro-CT analyses confirmed that osteopenia occurred in group D mice. In addition, the results of single-cell flow cytometry and correlation analysis showed that the ratio of BM-neutrophils/B lymphocytes negatively correlated with osteopenia in STZ-induced T1D mice. ConclusionA single-cell RNA sequencing analysis revealed the profile and heterogeneity of bone marrow immune cells in STZ-induced T1D mice for the first time. The ratio of BM-neutrophils/B lymphocytes negatively correlated with osteopenia in STZ-induced T1D mice, which may enhance understanding for treating T1D and preventing T1D-induced osteopenia.

The Role of Maxillofacial Structure on Condylar Displacement in Maximum Intercuspation and Centric Relation.

Purpose This study is aimed at evaluating the impact of the craniofacial structure and occlusal conditions on the position of the articular heads of the mandibular condyles in the maximum intercuspal position (MIP) and comparing the centric relation (CR) and MIP of the mandibular condyles prior to orthodontic treatment. Methods The studied group consisted of 33 women and 15 men (median age of 17.75 years). Contact points of opposing teeth in the MIP were assessed by hand-held casts. Condylar displacement (CD) in three spatial planes on both sides was measured on models mounted in an articulator using a mandibular position indicator (MPI). Patients were divided into groups according to craniofacial structures (vertical and horizontal growth directions). The Mann-Whitney, Kruskal-Wallis, post hoc Dwass-Steel-Critchlow-Fligner, and Pearson's χ2 independence tests as well as Spearman's nonparametric correlations were used in the statistical analyses. Results Within the limitations of this study, no statistically significant correlation of CD with certain cephalometric measurements from a lateral cephalometric radiograph (ANB, SN-ML, and SGo/NMe) was observed. Correlation, however, was found between condylar displacement in the transverse axis and the mandibular plane angle SN-ML (p = 0.033) and also between condylar displacement in the anteroposterior axis and a midline shift of the mandible (p = 0.041). The results revealed a relationship between Angle's classification of molar position on the right side and anteroposterior CD values (p = 0.006). Conclusions Cephalometric measurements cannot be used to predict CD at the level of the condyles. Analysis of occlusal conditions of models mounted in an articulator is desirable for patients with Angle's class I and lower jaw asymmetry.

Indices of Loading and Propulsive Ability in the Gait of Patients With Chronic Stroke With Equinus Foot Deviation: A Correlation Study

In literature, indices of overall walking ability that are based on ground reaction forces have been proposed because of their ease of administration with patients. In this study, we analyzed the correlation between the indices of dynamic loading and propulsion ability of 40 chronic hemiparetic post-stroke patients with equinus foot deviation and a set of clinical assessments of ankle joint deviations and walking ability. Ankle passive and active range of motion (ROM) and triceps surae spasticity were considered, along with walking speed and three complementary scales of walking ability focusing respectively on the need for assistance on functional mobility, including balance and transfers, and the limitation in social participation. The correlation between the ground reaction force-based indices and both clinical and functional variables was carried out using the non-parametric Spearman correlation coefficient. Both indices were correlated to 8 of the 10 investigated variables, thus supporting their use. In particular, the dynamic propulsive ability was correlated with all functional scales (rho = 0.5, p < 0.01), and has the advantage of being a continuous variable. Among clinical assessments, limited ankle ROM affected walking ability the most, while spasticity did not. Since the acquisition of ground reaction forces does not require any patient prepping, the derived indices can be used during the rehabilitation period to quickly detect small improvements that, over time, might lead to the broad changes detectable by clinical scales, as well as to immediately highlight the lack of these improvements, thus suggesting adjustments to the ongoing rehabilitation approach.

Biogeochemical indicators (waters/diatoms) of acid mine drainage pollution in the Odiel river (Iberian Pyritic Belt, SW Spain).

Odiel river basin is located in the Iberian Pyritic Belt (IPB) and mostly of its tributaries are severely affected by acid mine drainage (AMD). It is originated when pyritic minerals from abandoned mines, especially mineral residues from waste rock dams, get in contact with air and water. Fifteen sampling points were chosen to analyze interactions between diatom communities and water hydrogeochemistry. Considering physicochemical characteristics, sampling points were assigned as highly, moderately, and unpolluted by AMD. No correlation was observed between ecological diversity indexes and physico-chemical parameters. However, a dependency relationship between diatom species distribution and specific pH, conductivity, redox potential, sulfate, and metal concentrations was observed. Cluster analysis based on Pearson correlation and rs values of the non-parametric Spearman correlation allowed to identify Pinnularia acidophila, Pinnularia subcapitata var. elongata, and Eunotia exigua as the main bioindicators of AMD-polluted Odiel streams. Finally, a principal component analysis led to associate the most abundant diatoms species to specific physico-chemical parameters.

The Frequency and Factors Related to Aggressive Behavior in Psychiatric Patients Controlled by a Variety of Restraint Methods

Background: Aggressive behavior of patients in psychiatric wards is one of the main challenges faced by healthcare workers. Despite the abundance of research on the frequency of aggressive behavior, not enough attention has been paid to its severity. Furthermore, limited studies have evaluated the restraint methods used to manage aggressive behaviors. Objectives: The current descriptive study aimed to compare the relationship between demographic characteristics, diagnosis of psychiatric illness, medical illness, and hospitalization characteristics with features of aggressive behavior in patients experiencing different types of restraint during hospitalization. Methods: We evaluated subjects admitted to the adult psychiatric wards of Imam Hossein and Taleghani hospitals in Tehran, Iran, in 2018. The patients were controlled by various restraint methods during hospitalization. All the patients were evaluated for the severity of aggression, which was determined utilizing the Persian version of the Modified Overt Aggression Scale (MOAS). All the data along with demographic and clinical characteristics obtained from medical records were analyzed using the Mann-Whitney and Kruskal-Wallis nonparametric test (P-value = 0.05) and Spearman correlation coefficient to describe the factors affecting the aggressive behavior of patients. Results: In this study, the prevalence of aggressive behavior was 11.7%. Among the demographic variables, gender (P-value = 0.003), education level (P-value = 0.05), and the history of aggressive behavior (P-value = 0.001) were significantly associated with the MOAS. Furthermore, as the hospitalization duration increased, the frequency of aggressive behavior decreased, and its severity intensified. Moreover, there was a significant relationship between aggression severity with admission type (P-value = 0.00), concurrent medical illness (P-value = 0.026), and substance abuse (P-value = 0.025). Conclusions: Variables affecting aggressive behavior, such as male gender, involuntary admission, and a history of aggression, might aid in the early detection of patients who may exhibit more severe aggressive behavior.

Medical Student Attitudes Toward the Use of Peer Physical Exam for Learning Fundoscopy

Abstract Background Peer physical examination learning is commonly practiced in medical schools during preclinical curricula and has been shown to improve empathy for patients. While there is literature regarding medical student attitudes toward peer physical exam learning, no studies to date have specifically examined student attitudes toward fundoscopy and dilation of the eyes for the purposes of learning fundoscopy. This study evaluates medical student preferences with regards to learning fundoscopy on peers and explores attitudes toward alternate approaches. Methods First year medical students at the Icahn School of Medicine at Mount Sinai participated in a 2-hour fundoscopy skills workshop in March 2020. Following the session, the authors administered a voluntary survey querying students on attitudes toward peer physical exam learning and its use in learning peer fundoscopy. Primary study endpoints evaluated (1) student attitudes toward the use of peer physical exam learning, (2) learning benefit of the session, including student comfort with conducting the fundoscopy exam, and (3) empathy toward patients experiencing dilation. Secondary endpoints focused on alternative teaching methods and preferences for nonmydriatic fundoscopy. Analysis of survey data was performed using nonparametric Spearman's correlations, chi-square tests, t-tests, and Mann–Whitney U tests. Results A total of 51/138 (37%) students completed the survey, with 78% indicating they felt peer physical exam learning was a helpful instructional method, including for the fundoscopic exam. The session led to improved self-rated fundoscopy skills and empathy for patients. However, when considering learning with dilation versus alternative nonmydriatic techniques, 96% of students indicated a preference for using alternative nonmydriatic techniques. Conclusion This study found that students' attitudes toward fundoscopy generally aligned with their overall peer physical exam preferences. However, they preferred not using dilation and learning with nonmydriatic fundoscopic techniques. Assessing student learning preferences and incorporating novel instructional tools can help facilitate more successful fundoscopy skills acquisition. These considerations are particularly important in the context of COVID-19 and with advances in teleophthalmology.

Implementation of new technologies in accounting and financial processes: An effectiveness assessment

Objective: The aim of this paper is to explore accountants’ views on the usage of Robotic Process Automation technology (RPA) which brings efficiency increase. Research Design &amp; Methods: An online survey has been addressed to over 500 respondents from international companies, where 160+ complete answers were received from the most important types of organizations in the business services industry. The non-parametric rho Spearman correlation coefficient and the non-parametric Kruskal-Wallis test and business case for the RPA implementation efficiency were used. Findings: Based on the research results obtained, it should be emphasized that robotization technologies which raise the efficiency of financial and accounting services make an important impact on the efficiency of modern business services sector. Application of RPA assumes replacing work of an existing employee with the use of dedicated software (software robots) to support activities, primarily repeated and uncomplicated, characterized by a low number of exceptions. Implications &amp; Recommendations: RPA application is commonly used in modern business services, particularly in the areas of Finance, Accounting, IT and Human Resources Management. By utilizing RPA technology, the effectiveness of operations increases while reducing workload, minimizing possible errors in the process. The greatest efficiency resulting from the RPA implementation was observed in the Accounts Payable department, to a lesser extent in the General Ledger department and in the Tax section. The assessment of managers in terms of the effects of RPA implementation is unequal, while for Business, IT Process Outsourcing companies (BPO / ITO), Shared Service Centers (SSC), Consulting / Advisory companies and their customers no significant differences were found. Contribution &amp; Value Added: The article presents an assessment of the effectiveness of the use of Robotic Process Automation in Process Outsourcing companies (BPO / ITO) and Shared Service Centers (SSC) operating in Poland. It is one of the first studies of this type for enterprises operating in Poland. The article uses a relatively large number of responses (160+) from the respondents. In the previous studies in the literature, the answers obtained came from a much smaller number of respondents and were conducted in the form of direct interviews. In the article, the group of respondents consists not only of managers of outsourcing companies, but also auditing companies and clients of outsourcing companies. The article also presents a financial simulation of the effectiveness of BPO / ITO and SSC using Robotic Process Automation, which additionally validates the responses obtained in the questionnaire.

ОЦЕНКА КАЧЕСТВА ЖИЗНИ ВОЕННОСЛУЖАЩИХ В ПЕРИОД ПАНДЕМИИ COVID-19

One of the important indicators characterizing current level of the Armed Forces development is life quality of military personnel. The pandemic of the new coronavirus infection Sars-CoV-2, (hereinafter referred to as NCI) affects all spheres of human life, and therefore it is relevant to study its impact on quality of life of military personnel. The purpose of the study: to give a comprehensive assessment of life quality of military personnel during the COVID-19 pandemic. Material and methods. In February-March 2022, analytical, cross-sectional study was conducted using individual data. A survey was conducted in a group of 374 military personnel serving under contract in Severodvinsk. The research tool was a short version of the WHO Quality of Life questionnaire (WHOQOL-BREF) with an additional block of questions associated with the COVID-19. To describe data, the median and interquartile range (25th and 75th percentiles) were calculated. To compare indicators between several groups of military personnel, analysis of variance using the Kraskel-Wallis criterion was used. The nonparametric Mann-Whitney criterion and Spearman correlation criterion were used to compare the variables. Assessment of impact of quality of life on social well-being was carried out by constructing a linear regression model with the inclusion as independent parameters of answers to the passport (personal details) part of the questionnaire and answers to questions related to previous diseases, by a step-by-step method of selecting criteria, using F-statistics as a selection method with an inclusion value of less than 0.05 and an exclusion value of more than 0.1. Differences were taken as reliable with a probability of error of the first type of less than 5% (p&lt;0.05). Statistical data processing was performed using the IBM SPSS Statistics ver. 25 for Windows application software package. Results. The highest score was given to the sphere characterizing physical and mental well-being (82.8%), while the lowest score was given to the sphere characterizing social well-being (75.0%), the median of the overall assessment of quality of life equaled to 103.00, the interquartile range [96.00; 108.00], the share in the highest assessment equaled to 79.2%. A posteriori analysis showed statistically significant differences in the field of self-perception between groups of servicemen who are officially married and divorced (U=2475.5, p=0.004) and in the field of microsocial support (U=2408.5, p=0.001), and in the field of social well-being between groups of servicemen who indicated in the questionnaire 12 to 20 thousand rubles as income per family member per month and those with income of more than 30 thousand rubles (U=3070.5, p=0.003). The main determinants of the sphere of social well-being of quality of life include importance of self-perception of the effectiveness of vaccination against COVID-19, side effects related to vaccination against COVID-19 and side effects associated with the new coronavirus infection. Conclusion. The study on quality of life of military personnel is a necessary component in the military healthcare system, since it allows us to quantify a subjective indicator that combines major areas of interaction with external environment and internal state of a serviceman, which directly depends upon his state of health. The obtained data indicate a statistically significant impact of the factors associated with COVID-19 on quality of life of military personnel. The study has identified a statistically significant inverse effect of side effects associated with NCI disease on responses to the question about finances to meet their needs, as well as a statistically significant inverse effect of side effects associated with vaccination from COVID-19 on responses to the question about satisfaction with conditions of the place of residence.

Immunoexpression of CXCL12 and CXCR4 in sporadic and Gorlin-Goltz syndrome-related odontogenic keratocysts.

BackgroundDifferences in the pathogenesis and biological behavior of sporadic and Gorlin-Goltz syndrome-related odontogenic keratocysts (OKCs) have been reported, but the underlying mechanisms are not fully elucidated. Chemokine CXCL12 and its main receptor CXCR4 regulate important events in the pathogenesis of several lesions. Material and MethodsThis study evaluated the immunoexpression of CXCL12 and CXCR4 in sporadic and syndromic OKCs. Twenty-two sporadic OKCs and 22 syndromic OKCs were subjected to immunohistochemistry. The percentages of cytoplasmic (CXCL12 and CXCR4) and nuclear (CXCR4) staining in epithelial and fibrous capsule cells were determined. The results were analyzed statistically using the nonparametric Mann-Whitney test and Spearman correlation test (p<0.05). ResultsHigher cytoplasmic expression of CXCL12 was observed in the epithelial lining and fibrous capsule of sporadic OKCs compared to syndromic OKCs (p<0.001). No statistically significant differences in the cytoplasmic expression of CXCR4 were observed between syndromic OKCs and sporadic OKCs (p>0.05). Compared to syndromic OKCs, sporadic OKCs exhibited higher nuclear expression of CXCR4 in the epithelial lining and lower immunoexpression in the fibrous capsule (p<0.05). In the epithelial lining of syndromic OKCs, positive correlation was observed between cytoplasmic and nuclear expressions of CXCR4 (p=0.003). In the fibrous capsule of syndromic OKCs and sporadic OKCs, cytoplasmic and nuclear expressions of CXCR4 were positively correlated (p<0.001). ConclusionsThe results suggest a potential participation of CXCL12 and CXCR4 in the development of OKCs. The heterogeneous expression of these proteins in syndromic and sporadic OKCs may reflect differences in their pathogenesis and biological behavior. Key words:Odontogenic keratocyst, CXCL12, CXCR4, Immunohistochemistry.

The Correlation between Gross Motor Function Classification System and Spasticity in Children with Cerebral Palsy

Gross Motor Function Classification System (GMFCS) was used as a criterion to classify motor function in children with cerebral palsy. Spasticity is an increase in muscle resistance to passive stretching, which is an involuntary muscle activity associated with upper motor neuron paralysis that occurs in CP children so that it interferes with their activities. The purpose of this study was to determine the relationship between GMFCS and the level of spasticity assessed by the Ashworth scale in children with cerebral palsy. The analytical research method was observational with a cross sectional approach, the independent variable was assessed on the functional scale using the GMFCS and the dependent variable was assessed for spasticity using the Ashworth scale. The research sample was CP children at YPAC Semarang city. The results of this study are that the highest GMFCS level in children with cerebral palsy at SLB YPAC Semarang City is level III and IV as much as 25.0% while the assessment of spasticity using the ashworth scale obtained ashworth level 3 as much as 58.3% while the results of the calculation of the non-parametric Spearman correlation test were obtained. p value = 0.000 (p &lt; 0.05) with a value of r = 0.837. Therefore, it can be concluded that there is a positive correlation between GMFCS and the level of spasticity assessed using the Ashworth scale in children with cerebral palsy.

Discordant Liver Fibrosis Predictors in Virologically Suppressed People Living with HIV without Hepatitis Virus Infection.

Severe liver fibrosis (LF) is associated with poor long-term liver-related outcomes in people living with HIV (PLWH). The study aimed to explore the prevalence and predictors of LF and the concordance between different non-invasive methods for the estimation of LF in HIV-infected individuals without hepatitis virus infection. We enrolled PLWH with HIV-1-RNA <50 copies/mL for >12 months, excluding individuals with viral hepatitis. LF was assessed by transient elastography (TE) (significant >6.65 kPa), fibrosis-4 (FIB-4) (significant >2.67), and AST-to-platelet ratio index (APRI) (significant >1.5). We included 234 individuals (67% males, median age 49 years, median time from HIV diagnosis 11 years, 38% treated with integrase strand transfer inhibitors). In terms of the TE, 13% had ≥F2 stage; FIB-4 score was >1.5 in 7%; and APRI > 0.5 in 4%. Higher body mass index, diabetes mellitus, detectable baseline HIV-1 RNA and longer atazanavir exposure were associated with higher liver stiffness as per TE. Predictors of higher APRI score were CDC C stage and longer exposure to tenofovir alafenamide, while HBcAb positivity and longer exposure to tenofovir alafenamide were associated to higher FIB-4 scores. Qualitative agreement was poor between FIB-4/TE and between APRI/TE by non-parametric Spearman correlation and kappa statistic. In our study, in the group of PLWH without viral hepatitis, different non-invasive methods were discordant in predicting liver fibrosis.