Nonparametric Research Articles

Construction of A Geographically Weighted Nonparametric Regression Model Fit Test

One of the approach of Geographically Weighted Regression (GWR) models is the Geographically Weighted Nonparametric Regression (GWNR) has more parameters than the GWR model. Models with more parameters usually have better match values, which is an advantage, while models with fewer parameters have the advantage of being easier to use and interpret. However, a model with more parameters should be used if it is proven to be significantly superior. Therefore, the purpose of this study was to develop a hypothesis test of goodness of fit test for GWNR model. The goodness of fit test was performed for the real data. We found that the GWNR model was more suitable than the mixed nonparametric regression model. Some highlights of the proposed method are:• A new model for GWR to overcome the unknown regression function by using mixed estimator spline truncated and fourier series at nonparametric regression• Goodness of fit for GWNR to testing the model fit between the mixed nonparametric regression model and GWNR• Applied goodness of fit test to poverty data in Sulawesi Island and infant mortality in East Java

Patient Consent for Medical Student Pelvic Exams under Anesthesia: An Exploratory Retrospective Chart Review.

We conducted an exploratory retrospective chart review of electronic consent forms at a single academic medical center using contingency tables, logistic regression, and nonparametric tests to explore relationships between patient and physician characteristics and consent. We identified and downloaded electronic consent forms for a census of 4,000 patients undergoing gynecologic surgery from September 2020 through calendar year 2022. Forms were linked to anonymized medical record information. Of the 4,000 patients, 142 (3.6%) were removed from analysis because consent forms were incomplete. Of 3,858 patients, 308 (8.0%) were asked for EUA consent more than once, 46 of whom were not consistent. Overall, 3,308 (85.7%) patients consented every time asked, and 550 (14.2%) refused or limited EUA consent at least once. Nine patients limited their consent to female students, and two patients refused medical student participation at all. We performed exploratory multiple logistic regression analyses exploring differences in rates of consent across patient and physician demographic groups. We find that some patients are more likely than others to refuse a pelvic EUA, magnifying the dignitary harm from a nonconsensual invasion of intimate bodily integrity and perpetuating historic wrongs visited upon vulnerable people of color and religious minorities. Patients' rights to respect and control over their bodies require that physicians take seriously the ethical obligation to inform their patients and ask them for permission.

Differences between criminal offender versus non-offender female patients with schizophrenia spectrum disorder: a retrospective cohort study.

The purpose of this study was to investigate the difference between offender female patients (OFS) and non-offender female patients (NOFS) with schizophrenia spectrum disorder (SSD).The patients in this study were admitted to the university psychiatry in Zurich Switzerland between 1982 and 2016. Demography, psychopathology, comorbidity, and treatment differences were analyzed using binary statistics to compare 31 OFS and 29 matching NOFS with SSD. The Fisher's exact test was used for categorical data variables in small size samples and the Mann-Whitney-U-Test for nonparametric test variables, adjusted with theBenjamini and Hochberg method.The results indicate that the NOFS were cognitively more impaired, they were more likely to have had antipsychotic drugs prescribed (NOFS; 100%, OFS: 71%, OR 1.41, 95% CI 1.13-1.77, p=0.022) and their medication compliance was higher (NOFS: 84.6%, OFS: 4.5%, OR 0.09, 95% CI 0.00-0.08, p=0.000). In contrast, the OFS had completed compulsory school less oftenand the were observed to be more often homeless and socially isolated (OFS: 72.4%, NOFS: 34.6%, OR 4.96, 95% CI 1.58-15.6, p=0.026), self-disorders (OFS: 51.6%, NOFS: 11.1%, OR 8.53, 95% CI 2.12-34.32, p=0.011), delusions (OFS: 96.8%, NOFS: 63%, OR 17.65, 95% CI 2.08-149.99, p=0.014) and substance use disorder (51.6%, OR 0.27, 95% CI 0.09-0.85, p=0.039). Clinicians treating female offender patients with SSD should focusmore on the treatment for substance use disorder, medication and early recognition of the illness for preventative purposes.

Neurotourism Insights: Eye Tracking and Galvanic Analysis of Tourism Destination Brand Logos and AI Visuals

This pioneering study explores the intersection between Neurotourism, defined as the integration of neurosciences in tourism, and the perception of tourism Brand Personality (BP) through the advanced use of psychophysiology techniques, specifically Eye-Tracking (ET) and Galvanic Skin Response (GSR). It analyses how tourism destination brand logos/combination marks and images generated by artificial intelligence (AI) influence consumer attention and emotional response. Focusing on the five dimensions of BP proposed by Aaker (1997) - sincerity, excitement, sophistication, competence, and ruggedness - this study highlights significant differences in how men and women process and react to brand values associated with specific cities. Employing a rigorous methodological approach and the application of non-parametric statistical analyses, the findings reveal distinct patterns of visual attention and emotional responses across genders, emphasising the importance of considering BP in the marketing and design of tourism destination brand logos/combination marks. This work not only advances theoretical understanding of tourist consumer behaviour but also offers relevant practical implications for tourism marketing and destination management.

Acute neural effects of the mood stabiliser lamotrigine on emotional processing in healthy volunteers: a randomised control trial.

Lamotrigine is an effective mood stabiliser, largely used for the management and prevention of depression in bipolar disorder. The neuropsychological mechanisms by which lamotrigine acts to relieve symptoms as well as its neural effects on emotional processing remain unclear. The primary objective of this current study was to investigate the impact of an acute dose of lamotrigine on the neural response to a well-characterised fMRI task probing implicit emotional processing relevant to negative bias. 31 healthy participants were administered either a single dose of lamotrigine (300 mg, n = 14) or placebo (n = 17) in a randomized, double-blind design. Inside the 3 T MRI scanner, participants completed a covert emotional faces gender discrimination task. Brain activations showing significant group differences were identified using voxel-wise general linear model (GLM) nonparametric permutation testing, with threshold free cluster enhancement (TFCE) and a family wise error (FWE)-corrected cluster significance threshold of p < 0.05. Participants receiving lamotrigine were more accurate at identifying the gender of fearful (but not happy or angry) faces. A network of regions associated with emotional processing, including amygdala, insula, and the anterior cingulate cortex (ACC), was significantly less activated in the lamotrigine group compared to the placebo group across emotional facial expressions. A single dose of lamotrigine reduced activation in limbic areas in response to faces with both positive and negative expressions, suggesting a valence-independent effect. However, at a behavioural level lamotrigine appeared to reduce the distracting effect of fear on face discrimination. Such effects may be relevant to the mood stabilisation effects of lamotrigine.

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

BackgroundPromoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors.MethodsMD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed.ResultsA sample of 1485 participants (median (IQR) age 21.0 (19.0–22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen.ConclusionsEncouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

Trends in youth risk behaviours and firearm injury in the USA over 20 years

BackgroundFirearm injuries are the leading cause of death in children and adolescents in the USA. We hypothesised that high rates of risky behaviour in high school students are associated with...

The sun's position at birth is unrelated to subjective well‐being: Debunking astrological claims

AbstractBeliefs linking zodiac signs to personality traits, life outcomes, and well‐being remain widespread across various cultures. This study examined the relationship between Western zodiac signs and subjective well‐being in a nationally representative American sample from the General Social Survey (N = 12,791). Well‐being was measured across eight components: general unhappiness, depressive symptoms, psychological distress, work dissatisfaction, financial dissatisfaction, perceived dullness of one's life, self‐rated health, and unhappiness with marriage. Parametric and nonparametric analyses consistently revealed no robust associations between zodiac signs and any of the well‐being variables, regardless of whether demographic factors were controlled for. The effect sizes were negligible, accounting for 0.3% or less of the variance in well‐being, demonstrating that zodiac signs lack predictive power for well‐being outcomes. An additional analysis revealed that astrological signs were no more predictive of than random numbers. Thus, a randomly generated number between 1 and 12 is statistically as predictive of one's well‐being as one's zodiac sign. These findings challenge popular astrological claims about the influence of zodiac signs on well‐being and quality of life.

Floristic Diversity and Green-Tree Retention in Intensively Managed Temperate Forests: A Case Study in Puebla, Mexico

Clearcutting has tended to simplify forest structure and species composition, with potential negative consequences for biodiversity. Retention forestry emerged as an alternative to minimize this concern in intensively managed forests. In central Mexico, this approach was first implemented a decade ago in temperate forests, but an examination of its effects on floristic diversity and composition is non-existent. We evaluated and compared richness, diversity, and floristic composition among harvested, retention, and conserved areas in a conifer-dominated forest of central Mexico, with various parametric and non-parametric analyses. Species’ ecological and structural importance was also evaluated. We recorded 138 species, 95 genera, and 44 families of plants. Harvested areas listed the most species (99) with herb dominance, tree homogeneity, and the highest number of exotics. Retention and conserved areas’ floristic composition was similar, with the presence of epiphytes and terrestrial orchids, considered indicators of conservation. The retention areas recorded rare and endangered species, tree heterogeneity, and juveniles of structural species of temperate forests. Conserved areas showed a greater number of structural mature elements and exclusive species, though there was a smaller species number (75). We demonstrated that retention forestry is achieving its goal by maintaining the structural elements, habitats, and plant diversity of the temperate forests analyzed.

Impact of phase-correction of late-gadolinium enhancement images on quantification of scar metrics and in-silico VT-modelling in patients with an ischemic cardiomyopathy

Abstract Background Late gadolinium enhancement (LGE) is used to perform tissue characterization and has become the cornerstone to guide treatment of ventricular tachyarrhythmia (VT). Traditionally, LGE acquisition is reconstructed in two distinct forms: non-phase corrected magnitude (MIR) and phase-corrected inversion recovery (PSIR) images. However, the influence of MIR vs. PSIR on the quantification of scar metrics and the repercussion on estimating myocardial arrhythmogenicity have not been comprehensively explored. Aim This study investigated the influence of PSIR and MIR LGE on the quantification of scar metrics in a randomly selected cohort of patients with ischemic cardiomyopathy who had undergone imaging prior to ICD implantation and had received device therapy during follow-up. In addition, this study assessed how these image variations affect functional estimation of arrhythmogenicity using computational modelling. Methods ADAS 3D LV was used to generate scar maps from 2D PSIR and MIR LGE images in 10 patients. The extent of variation in scar-characteristics was evaluated by quantifying the borderzone (BZ), scar core, and conduction corridors. Electrical simulations were performed on the patient-specific anatomical models using the Virtual Induction and Treatment of Arrhythmias (VITA) framework. VITA was used to assess the electrical vulnerability of potential reentrant channels and provided the number of inducible VTs and their corresponding round-trip-time (RTT), an equivalent of VT cycle-length. Results Scar quantification using PSIR LGE resulted in a significantly larger BZ (22.1±23.7g vs. 6.2±2.7g, p &amp;lt;.001) and scar core (43.5±21.5g vs. 10.5±4g, p =.047). Furthermore, both the absolute number (6.8±4 vs. 3.4±1.5, p = .031) and weight (13±13.1g vs. 1.4±0.8g, p =.018) of conduction corridors were also higher using PSIR. VTs were inducible in 8 PSIR-models and 7 MIR-models. Despite large differences in scar characteristics, VITA metrics were not significantly different between PSIR and MIR derived models. Although, the absolute number of inducible VTs were larger for PSIR (6.2±5.4 vs. 3.4±3.1), non-parametric testing using Wilcoxon signed-rank test did not demonstrate a significant difference (Z = -1.334, p =.139). A comparable, non-significant difference was observed for mean- (117±78 vs. 79±60, p =.257) and max-RTT (181±141 vs. 120±103, p =.294) between PSIR and MIR derived models. Conclusion PSIR resulted in significantly larger BZ, scar core area, and conduction corridors. While the absolute, VITA-derived estimation of myocardial arrhythmogenicity, including inducible VTs and RTT, were higher in the PSIR-based quantification, these differences did not reach statistical significance. These results highlight important differences between two clinically applied image reconstruction techniques for the assessment of arrhythmogenic substrate, emphasizing the need for additional investigation and refinement of scar quantification techniques.

For the rural curious: mixed methods evaluation of a rural pharmacy practice elective

BackgroundAs of 2020, 20% of people residing in the United States of America (U.S.) lived in rural communities. Despite rural residents tending to be older, poorer, and having greater disease burden than their urban counterparts, the number of rural primary care providers continues to decline. Nearly 66% of U.S. Primary Care Health Professional Shortage Areas are designated as rural. Pharmacists can help address this shortage of rural primary care providers, often serving as providers of first-contact care; however, only 12% of U.S. pharmacists practice in rural communities. To help address this gap, in 2022 an elective Rural Pharmacy course was created at the University of Minnesota College of Pharmacy by a faculty member who has rural practice experience.MethodsThe course combines formal lectures, guest presentations by rural pharmacists and student interviews with additional rural pharmacists. For the 42 students enrolled in the course in 2022 and 2023, non-parametric statistics were used to compare the percentage of students who were raised in rural communities or who otherwise had extensive exposure to rural, and compare student interest ratings (1 to 7) about practicing/living rural at the beginning and end of the course. Students also wrote end-of-course reflection papers, commenting on the course and their interviews with rural pharmacists.ResultsAcross both years, 45% of the enrolled students had previous experience in rural communities. The net change in Rural Interest scores among students completing both questionnaires was + 5 in 2022 and + 2 in 2023, both non-significant differences. The largest shifts in student interest were from “Not Sure” at the start of the course to “Interested” or “Not Interested” at the end of the course, and from “Interested” to “Very Interested.” In their reflection papers nearly 60% of students reported being most impressed by their interviews with rural pharmacists.ConclusionsA course addressing the benefits and challenges of practicing pharmacy in rural communities was well-received by pharmacy students. Even students who have little interest in living in a rural community can benefit from being introduced to rural culture, enabling them to provide more culturally-responsive care for patients from rural communities.

An insight from homogeneity testing of long-term rainfall datasets over East Java, Indonesia

Robust, reliable, and trustworthy ground observation datasets are the preliminary requirement for assessing the impact of climate change over regions. Principal testing to assess the quality of ground observation rely on the missing data and homogeneity result. The study used 40 years of monthly rainfall documented from different topographical features in the monsoonal region of East Java, Indonesia. The test included annual rainfall, early rainy season (October-November-December), and primary rain season (January-February-March). The homogeneity of rainfall determined by absolute technique: Pettitt’s test, the Standard Normal Homogeneity Test, the Buishand Rank Test, and the von Neumann Ratio. Among the time series, October-November-December observation results in better homogeneity. However, the rainfall datasets during primary rainy season showed the worst homogeneity. By performing annual and seasonal homogeneity test from 67 rainfall stations: 5 stations out of data length required, 5% stations ‘rejected’, 11% ‘suspect’, 11% ‘doubtful’, and 73% were ‘trusted’. Therefore, a total of 45 stations can be used as metadata for relative comparison and 7 stations can be considered to be useful for analysis despite ‘doubtful’. The remaining 10 stations need careful consideration to be used for future water management. Change point detected particularly between the year of 1997 through 2000. Pettitt’s test has outstanding results in the case of extreme climatic anomaly, but less sensitive of continuous abrupt change. The von Neumann test could detect abnormal data, but was not suitable for datasets containing few extreme values. The insights from homogeneity testing were: a) it is important to remove any outliers in the datasets before conducting homogeneity testing, b) both parametric and nonparametric homogeneity tests should be performed, and c) comparisons should be made with surrounding rainfall stations. Comparison with trusted long-term rainfall data is valuable for stations labeled as ‘doubtful’ or ‘suspect’ to mitigate false detections in individual homogeneity tests. The identified ‘useful’ rainfall data can then serve as reference stations for relative homogeneity tests. These findings suggest that reference stations should be assessed within similar rainfall zones.

Prolonged intermittent theta burst stimulation targeting the left prefrontal cortex and cerebellum does not affect executive functions in healthy individuals

Repetitive transcranial magnetic stimulation (rTMS) for alleviating negative symptoms and cognitive dysfunction in schizophrenia commonly targets the left dorsolateral prefrontal cortex (LDLPFC). However, the therapeutic effectiveness of rTMS at this site remains inconclusive and increasingly, studies are focusing on cerebellar rTMS. Recently, prolonged intermittent theta-burst stimulation (iTBS) has emerged as a rapid-acting form of rTMS with promising clinical benefits. This study explored the cognitive and neurophysiological effects of prolonged iTBS administered to the LDLPFC and cerebellum in a healthy cohort. 50 healthy participants took part in a cross-over study and received prolonged (1800 pulses) iTBS targeting the LDLPFC, cerebellar vermis, and sham iTBS. Mixed effects repeated measures models examined cognitive and event-related potentials (ERPs) from 2-back (P300, N200) and Stroop (N200, N450) tasks after stimulation. Exploratory non-parametric cluster-based permutation tests compared ERPs between conditions. There were no significant differences between conditions for behavioural and ERP outcomes on the 2-back and Stroop tasks. Exploratory cluster-based permutation tests of ERPs did not identify any significant differences between conditions. We did not find evidence that a single session of prolonged iTBS administered to either the LDLPFC or cerebellum could cause any cognitive or ERP changes compared to sham in a healthy sample.

Exploring Resistant Sources of Chickpea against Fusarium oxysporum f. sp. ciceris in Dryland Areas

Fusarium wilt is a fungal disease that has a significant impact on chickpeas worldwide. This study examined the response of 58 chickpea genotypes to Fusarium wilt. The experiment was conducted over two growing seasons at the Sararoud and Maragheh research stations at the Drylands Agricultural Research Institute of Iran. Genotype resistance was screened through wilt incidence records and nonparametric stability statistic evaluation. The identified resistant genotypes were then evaluated in the greenhouse for their response to four isolates of Fusarium oxysporum f. sp. ciceris (races 1/BC, 2, 4, and 6). Out of 58 genotypes, 32 exhibited moderate resistance, while 24 showed strong resistance abilities. Under warmer conditions, disease severity was higher, with scores at the Sararoud location being higher than those at the Maragheh location. Of the total genotypes across all locations and years, 41.4% were resistant, 55.17% were moderately resistant, 1.72% were susceptible, and 1.72% were highly susceptible. The nonparametric stability measures S(1), S(2), and S(3) identified FLIP 05-42C and FLIP 05-43C as stable and resistant genotypes. The study found that Azad/Hashem K3 was stable based on the non-parametric stability measure S(6). Other resistant genotypes were identified using stability parameters NP(1), NP(3), and NP(4), while FLIP 05-104C was identified by NP(2). The genotypes selected by nonparametric stability parameters showed resistance against at least two Fusarium oxysporum f. sp. ciceris races. The screening method and nonparametric stability statistics used in this study were effective in identifying sources of resistance to Fusarium oxysporum f. sp. ciceris.

Feasibility Analysis of ECG-Based pH Estimation for Asphyxia Detection in Neonates

Birth asphyxia is a potential cause of death that is also associated with acute and chronic morbidities. The traditional and immediate approach for monitoring birth asphyxia (i.e., arterial blood gas analysis) is highly invasive and intermittent. Additionally, alternative noninvasive approaches such as pulse oximeters can be problematic, due to the possibility of false and erroneous measurements. Therefore, further research is needed to explore alternative noninvasive and accurate monitoring methods for asphyxiated neonates. This study aims to investigate the prominent ECG features based on pH estimation that could potentially be used to explore the noninvasive, accurate, and continuous monitoring of asphyxiated neonates. The dataset used contained 274 segments of ECG and pH values recorded simultaneously. After preprocessing the data, principal component analysis and the Pan–Tompkins algorithm were used for each segment to determine the most significant ECG cycle and to compute the ECG features. Descriptive statistics were performed to describe the main properties of the processed dataset. A Kruskal–Wallis nonparametric test was then used to analyze differences between the asphyxiated and non-asphyxiated groups. Finally, a Dunn–Šidák post hoc test was used for individual comparison among the mean ranks of all groups. The findings of this study showed that ECG features (T/QRS, T Amplitude, Tslope, Tslope/T, Tslope/|T|, HR, QT, and QTc) based on pH estimation differed significantly (p &lt; 0.05) in asphyxiated neonates. All these key ECG features were also found to be significantly different between the two groups.

Spatio-temporal trends in long-term seasonal groundwater level of South-western Punjab using non-parametric statistical tests.

To manage groundwater resources and develop an action plan, it is crucial to understand the long-term behavior of groundwater level (GWL) fluctuations. In this study, Geographic Information System (GIS) and non-parametric statistical tests were applied for detecting long-term (1973 to 2020) spatio-temporal variations and trends in GWL from 137 observation wells evenly distributed across the south-western part of Punjab. This region has experienced significant changes in GWL over the decades. The non-parametric statistical tests included Mann-Kendall (MK), Sens's SlopeEstimator (SSE), and Innovative Trend Analysis (ITA). The study observed significant trends in GWL fluctuations before and after monsoon. The MK and SSE tests showed a statistically increasing trend in observation wells with about 65.7% and 67.2% increase before and after monsoon, respectively. The innovative trend analysis (ITA) also revealed a statistically increasing trend in observation wells with an increase of about 63.5% and 65.7% pre and post-monsoon season, respectively. The results indicate lowering of GWL in the northern districts of southwestern Punjab, while the southern districts experience rising GWLs. This discrepancy can be attributed to diverse agricultural activities and reduced over-exploitation of groundwater in the southern district due to soil salinity and the presence of brackish groundwater. These findings provide valuable insights into the dynamics of GWL in the studied region, highlighting notable trends associated with seasonal variations.

#2214 Incidence, risk factors and outcome of calciphylaxis in Iceland

Abstract Background and Aims Calciphylaxis is a rare and serious medical condition that primarily affects patients with end-stage kidney disease (ESKD). The disorder is characterized by calcium deposition in blood vessels and soft tissues, resulting in skin ulceration and tissue necrosis. The aim of the study was to investigate the incidence, risk factors, and outcomes of calciphylaxis in Iceland. Method This was a retrospective case-control study that included individuals diagnosed with calciphylaxis in 1990-2022. Patients were identified by searching electronic medical records (EMR) for the ICD-10 diagnosis codes E83.5 and L94.2, SNOMED histology codes T01000-T03900 in combination with M55400, M55500 or M54000-M54200, documented sodium thiosulfate (STS) therapy, and by consultation with practicing nephrologists. Data on medical history, medication use, and survival were obtained from EMR. A control group of ESKD patients was matched (1:1) based on age, sex, and duration of dialysis. Total annual incidence was calculated per 1,000,000 population of Iceland each year, and for ESKD patients per 10,000 dialysis patients at the end of each year. Poisson regression was used to estimate changes in incidence. Groups were compared using non-parametric tests and survival estimated by Kaplan-Meier method and Cox regression. Results Twenty-one cases of calciphylaxis were identified, of which 18 (86%) had ESKD. The average incidence was 2/1,000,000/year. For ESKD patients, the median (interquartile range, IQR) age was 69 (66-75) years, and 50% were women. Three patients (17%) had not yet initiated dialysis at the time of diagnosis and the median duration of dialysis was 0.12 (IQR 0.0-2.8) years. The average incidence of calciphylaxis was 75 per 10,000 dialysis patients/year, increasing by 9.0% annually (Fig. 1). No significant differences between calciphylaxis cases and controls were observed for comorbid diseases or other risk factors. The median body mass index of cases was 29.5 (IQR 27.1-33.7) compared with 27.6 (IQR 24.3-30.6) kg/m2 in controls (p=0.20), and 50% of cases and 22% of controls (p=0.16) were on warfarin treatment at diagnosis. Fifteen patients received treatment with sodium thiosulfate (STS). Three of 6 patients received STS therapy before 2016 and all 12 patients after 2016. One-year mortality of ESKD patients with calciphylaxis was 44%. The median survival was 134 days in 1990-2016, increasing to 644 days after 2016. Survival difference between cases and controls was significant (p=0.04) by log rank test, while adjusted Cox regression did not show a statistically significant association between calciphylaxis and death (HR 2.0 (95% CI, 0.67-6.1)). Conclusion The incidence of calciphylaxis in Iceland seems to be increasing and is high compared to incidence rates reported in other countries. Survival, although poor, appears to have improved in recent years. The small sample size is a limitation and further research will require collaborative efforts to generate large patient samples.

#2155 Evaluating the health-related quality of life of patients undergoing haemodialysis: highlights from a multicentric nationwide study

Abstract Background and Aims Haemodialysis (HD) represents the most common renal replacement therapy for end-stage renal disease worldwide. Despite recent advances in HD the health-related quality of life (HRQoL) should be monitored in conjunction with clinical variables to optimize a comprehensive treatment. Method From June to July 2022, all patients from 47 clinics were included. Among other key relevant clinical variables, HRQoL was assessed by using the Kidney Disease Quality of Life Short Form (KDQOL-SF™ 1.3).It`s generic part is summarised in the physical component summary (PCS) and mental component summary (MCS). The specific part evaluates 11 domains: symptom/problem list; effects of kidney disease on daily life; burden of kidney disease; work status; cognitive function; quality of social interactions; sexual function; sleep; social support; dialysis staff encouragement; and patient satisfaction. All scores range from 0 (worst) to 100 (best). To ensure comparability of results, mean ± SD values are outlined, even though non-parametric tests were used to test associations. Results A total of 3,595 patients (67.3% male) completed the KDQOL (out of 4259 HD patients treated during study period). Most of them (67.18%) were over 60yo of age, and 65.67% had a severe comorbidity index score. In addition, 50.54% had a native AV fistula and only 3.92% were incident HD. PCS scores reported were higher in over 75yo (47.68 ± 10.63) rather than normative population (40.16 ± 11.62), indicating an overall good physical function. However, MCS values (33.17 ± 9.36) were indicative of substantial impact. Gender differences were noted across almost all disease-specific and generic domains (all p &amp;lt; 0.05). Severe comorbidity scores were associated with lower scores in certain renal specific domains and MCS. Finally, incident HD patients reported lower satisfaction and poorer perceived overall health (p-values = 0.001). Conclusion Although PCS scores reported were reasonable, a remarkable impact on mental health was found. Moreover, a differential impact of patient's HRQoL was captured based on gender and other variables highlighting the need of individualised evaluation and management of HD patients.

#1024 Lung ultrasound in 28 versus 8 places and volume status in chronic hemodialysis patients

Abstract Background and Aims Overhydration is considered a significant risk factor for cardiovascular and all-cause mortality in end-stage kidney disease patients. Measurement of total and extracellular water with bioelectrical impedance analysis (BIA), inferior vena cava diameter (IVCd) measurement, and circulating pro-B-type natriuretic peptide (proBNP) levels have previously been tested as possible indicators of volume status in hemodialysis (HD) patients, with BIA showing the most potential. Recently, it has been shown that lung ultrasound (LUS)-guided volume depletion is an effective strategy for relieving lung congestion in chronic HD patients. The aim of our study was to determine whether performing LUS on only 8 places was comparable to the regular 28 places. Method LUS was performed on 29 randomly selected patients before their regular HD procedure in 28 regular places and correlated with 8 places (4 on each side). In addition, BIA with a body composition monitor (BCM) was performed, IVCd was measured using ultrasound and serum NT-proBNP value was determined. Statistical analysis was performed using a commercially available SPSS® for Windows® (version 29.0; Chicago, IL, USA). Spearman's non-parametric test was used to determine a correlation between variables. P-values less than 0.05 were considered statistically significant. Results We included 29 chronic HD patients, 15 male (51.7 %), with a mean age of 66.3 ± 12.5 years and a median dialysis vintage of 53.0 (95% CI (40.9, 100.6)) months. Most patients (96.6 %) had a functional arteriovenous fistula, whereas only one patient (3.4 %) was dialysed using a Hickman catheter. A very strong, directly proportional correlation was found between performing LUS in 28 and 8 places (ρ=0.909; p&amp;lt;0.001). A significant moderate correlation was also found between both LUS in 28 and 8 places and systolic blood pressure (ρ=0.503; p=0.005 and ρ=0.467; p=0.011, respectively) (Table 1). Neither of the LUS methods statistically correlated with other tested volume markers – overhydration, intracellular and extracellular volume measured with BIA, IVCd in inspiration and expiration and IVC index, or serum NT-proBNP levels. Conclusion In our study, we found a very strong, positive, and significant correlation between performing LUS in 28 regular places and 8 places. Both also moderately correlated with systolic blood pressure. However, we did not find a statistically significant correlation between LUS and other tested volume markers.

#1860 Oral semaglutide in diabetic kidney transplant recipients: Evaluating effectiveness and safety

Abstract Background and Aims Glucagon-like peptide 1 receptor agonists (GLP1-RA) have demonstrated cardiovascular and renal benefits in obese diabetic patients. However, the evidence for oral semaglutide in kidney transplant (KT) patients is very limited. Our study aims to analyze the effectiveness and safety of oral semaglutide in diabetic KT patients. Method Retrospective cohort study of KT with diabetes who started oral semaglutide in 3 Spanish hospitals (Puerta del Mar University Hospital, Jerez de la Frontera University Hospital and Puerto Real University Hospital) between December 2021 and December 2023. None of them had previously received subcutaneous GLP1-RA. Clinical and demographic variables were analyzed. Glomerular filtration rate (eGFR), proteinuria, and weight were collected at the start of the treatment and after 6 and 12 months. We analyze glycemic control, blood pressure, lipid profile and trough level, dose and C/D ratio of tacrolimus. Acute rejections (AR), de novo donor-specific antibodies (dnDSA) and adverse effects were documented. Parametric and non-parametric tests were performed according to the normality of the sample. Results In this period, 22 KT with DM started treatment with oral Semaglutide, of which 16 patients completed follow-up for 6 months and 11 patients for 1 year. Fourteen (63.6%) had developed post-transplant DM. The mean age was 61 years, and 77% were men. The mean baseline estimated glomerular filtration rate (eGFR) was 46.1 ml/min/1.73 m2, the baseline body mass index was 34.7 kg/m2 and the median KT vintage was 45 months. Three patients were on treatment with SGLT2i at the start of the drug. Variables compared during the follow-up are shown in Table 1. Four patients (18%) suffered gastrointestinal side effects. No dnDSA were documented during follow-up. One episode of AR was documented after drug initiation. Conclusions We show the longest series of oral semaglutide in KT patients. Our results support that it can be a good option for managing DM in KT, especially in obese patients.