Nonparametric Research Articles

A Kernel approach for extending nonparametric multivariate analysis of variance in high-dimensional settings

AbstractThe nonparametric multivariate analysis of variance (NPMANOVA) testing procedure has been proven to be a valuable tool for comparing groups. In the present paper, we propose a kernel extension of this technique in order to effectively confront high-dimensionality, a recurrent problem in many fields of science. The new method is called kernel multivariate analysis of variance (KMANOVA). The basic idea is to take advantage of the kernel framework: we propose to project the data from the original data space to a Hilbert space generated by a given kernel function and then perform the NPMANOVA method in the reproducing kernel Hilbert space (RKHS). Dispersion of the embedded points can be measured by the distance induced by the inner product in the RKHS but also by many other distances best suited in high-dimensional settings. For this purpose, we study two promising distances: a Manhattan-type distance and a distance based on an orthogonal projection of the embedded points in the direction of the group centroids. We show that the NPMANOVA method and the KMANOVA method with the induced distance are essentially equivalent. We also show that the KMANOVA method with the other two distances performs considerably better than the NPMANOVA method. We illustrate the advantages of our approach in the context of genetic association studies and demonstrate its usefulness on Alzheimer’s disease data. We also provide a software implementation of the method that is available on GitHub https://github.com/8699vicente/Kmanova.

AN ANALYSIS OF THE HEALTH LITERACY LEVELS OF STUDENTS IN A PUBLIC UNIVERSITY'S FACULTY OF HEALTH SCIENCES

Aim: This study aimed to assess the health literacy levels of students in the Faculty of Health Sciences at a public university and to investigate the relationships and differences between participants' sociodemographic characteristics and their health literacy levels. Methods: The study employed a quantitative, descriptive, cross-sectional, and correlational research design. Data were gathered through face-to-face surveys, utilizing a socio-demographic data form and the THLS-32 scale. Data analysis was conducted using IBM SPSS 22.00. Descriptive statistics, including frequency distributions, percentages, standard deviations, and arithmetic means, were calculated. The Kolmogorov-Smirnov test was used to evaluate the normality of data distribution, which revealed a non-normal distribution. As a result, non-parametric tests (Mann-Whitney U Test and Kruskal-Wallis H Test) were applied. Correlation analyses were performed using Spearman’s Rho coefficient, and statistical significance was evaluated at a 95% confidence interval with a 5% margin of error. Results: The findings indicated that 66.3% of participants exhibited sufficient or excellent health literacy levels. Female students had significantly higher TS-AI perceptions than male students. Health Management (HM) students demonstrated higher health literacy levels compared to Emergency Aid and Disaster Management (EADM) students. The highest literacy levels were observed among final-year students, and students with social security had higher TS perceptions than those without. Conclusion: The study concluded that the health literacy levels of students in the Faculty of Health Sciences were generally high, with significant differences based on gender, department, academic year, and social security status. These findings suggest a need for targeted strategies to improve health literacy, particularly among students in certain departments and those without social security

Features of hematological indices in cataract in the dynamics of surgical treatment

BACKGROUND: Cataract is one of the most common ophthalmologic diseases leading to blindness. AIM: To study the features of hematological indices in men over 40 years old with different types of cataract before and after surgical treatment. MATERIAL AND METHODS: The examination groups included 25 patients (25 eyes) with opacities localized in the cortical substance of the lens, 19 (19 eyes) with total opacities, 26 (26 eyes) with nuclear opacities, 30 (30 eyes) with subcapsular opacities; of these, 43 patients (43 eyes) had initial cataract, 39 (39 eyes) — immature, 18 (18 eyes) — mature cataract. The control group consisted of 30 people. All study participants underwent a complete ophthalmologic examination and assessment of hematological indices. The following integral hematological indices were calculated using generally accepted formulas: lymphocyte index (lymphocytes/neutrophils); leukocyte intoxication index; neutrophil/lymphocyte ratio index; neutrophil/monocyte ratio index; lymphocyte/monocyte ratio index; lymphocyte/eosinophil ratio index; leukocyte ratio and erythrocyte sedimentation rate index. Statistical analysis was performed using the Statistica 10 package. The Kruskal–Wallis and Mann–Whitney nonparametric tests were used to assess differences in the groups. The critical level of statistical significance when testing scientific hypotheses was p 0.05. RESULTS: At all stages of cataract maturity, before and after surgery, unidirectional changes in the hematological indices were revealed: the lymphocyte and eosinophil ratio decreased (1.4–2.0; p=0.01), the neutrophils and monocytes (1.3–2.1; p=0.04), lymphocytes and monocytes (1.4–2.5; p=0.02) ratios, leukocytes and erythrocyte sedimentation rate (2.9–6.8; p=0.01) increased. In immature cataract, the intoxication index according to the hematological indices increased by 2 times in the dynamics of surgical treatment. At the same time, multidirectional changes in the hematological indices were revealed in cortical and subcapsular opacities of the lens, unidirectional changes — in nuclear and total opacities. CONCLUSION: Patients with nuclear and total cataracts have the greatest number of disturbances in the ratio of cell populations according to hematological indices, therefore they constitute a risk group for the development of complications.

Longitudinal analysis of urinary I-FABP in extremely preterm infants that develop necrotizing enterocolitis.

Intestinal fatty acid binding protein (I-FABP) is an intestinal epithelial protein detectable in infants with necrotizing enterocolitis (NEC). The longitudinal behavior of I-FABP following NEC or its association with gastrointestinal or neurodevelopmental outcomes is unknown. In this secondary analysis of the Preterm Erythropoietin Neuroprotection Trial, we compared infants with and without NEC. Urine I-FABP concentrations in matched infants (n = 70) were measured serially using ELISA and compared using paired analysis. In infants with NEC, the associations of I-FABP levels with short-term outcomes and neurodevelopmental outcomes at 22-26 months corrected age were determined using non-parametric analysis. Infants with NEC were more likely to have cholestasis, death or severe neurodevelopmental impairment, cerebral palsy, and lower Bayley-III motor scores. Baseline urinary I-FABP levels were similar between groups. When compared to controls, infants with NEC had urinary I-FABP concentrations that were higher at diagnosis (median 11 vs 2.6 ng/ml, p = 0.006) and lower post-NEC (median 1 vs 5 ng/ml, p = 0.002). Diagnosis I-FABP levels were not associated with gastrointestinal or neurodevelopmental outcomes at 22-26 months corrected age. In extremely preterm infants, urinary I-FABP was elevated at NEC diagnosis and lower post-NEC compared to matched controls. I-FABP levels were not associated with adverse gastrointestinal or neurodevelopmental outcomes. Urinary intestinal fatty acid binding protein (I-FABP) levels are increased at diagnosis of NEC and fall to below baseline after NEC in extremely preterm infants. Urine I-FABP levels at NEC diagnosis are not associated with cholestasis, intestinal stricture or obstruction, need for additional intestinal surgery after NEC, or neurodevelopmental outcomes at 22-26 months corrected age. Urine I-FABP levels may be useful in the diagnosis of NEC. Diagnostic I-FABP levels do not predict short-term gastrointestinal or neurodevelopmental outcomes after NEC.

Determinants of Domestic Violence during Pregnancy: A Case-Control Study

Background: Due to the importance of the issue and the fact that up-to-date studies in this topic have not been conducted in Yazd city, the present research was conducted to investigate and determine the intensity and frequency of domestic violence among pregnant women. Methods: This was a cross-sectional and descriptive study and sampling was done by simple random method. pregnant women referred to health centers in Yazd in 2021 participated in the study. For the study, 246 pregnant women were selected from 3 health centers in Yazd city in 2021. The tool used for the study was the standard questionnaire known as the Revised Conflict Tactics Scales (CTS2). This questionnaire was utilized to assess domestic violence, measures of dispute resolution, and demographic characteristics. After inputting the data into the SPSS version 26, Mann-Whitney and Kruskal-Wallis non-parametric statistical tests were used for data analysis. Results: The results showed that the average age of women was 31.47 ± 7.68 with a minimum age of 17 and a maximum of 55. The severity and frequency of the types of violence were measured, and the types of violence in the extreme state related to physical, mental, sexual, and verbal violence and resulting in physical injury were found to be 10%, 25%, 7%, 10%, and 19% respectively. Violence against pregnant mothers showed a significant relationship with the economic status of the family, the age of the mother's marriage, the education level of the parents, and the duration of their marriage (p<0.001). One of the most important variables affecting the severity and frequency of violence against pregnant women was the economic status of the family (p<0.001). Conclusion: The findings of this study show a connection between education level, economic status, and the prevalence of domestic violence. It is suggested to prioritize the development of diverse communication and problem-solving skills, as well as education related to family behavior on a wider scope.

Multi-Level Thresholding Color Image Segmentation Using Modified Gray Wolf Optimizer

The success of image segmentation is mainly dependent on the optimal choice of thresholds. Compared to bi-level thresholding, multi-level thresholding is a more time-consuming process, so this paper utilizes the gray wolf optimizer (GWO) algorithm to address this issue and enhance accuracy. To acquire the optimal thresholds at different levels, we modify the GWO (MGWO) in terms of leader selection, position update, and mutation. We also use the Otsu method and Kapur entropy as objective functions. The performance of MGWO is compared with other color image segmentation algorithms on ten images from the BSD500 dataset in terms of objective values, variance, signal-to-noise ratio (PSNR), structural similarity index measure (SSIM), and feature similarity index (FSIM). Experimental and non-parametric statistical analyses demonstrate that MGWO performs excellently in the multi-level thresholding segmentation of color images.

Assessment of early attention in an Italian cohort of preschooler preterm children using the Early Childhood Attention Battery.

This cross-sectional monocentric study aims to utilize the Early Childhood Attention Battery to investigate early attention patterns in young preterm children and ascertain the extent to which their attentional abilities diverge from those of term peers. Inclusion criteria encompassed gestational age < 34 weeks, with assessments conducted between 3 and 5 years 11 months. Exclusion criteria included major brain lesions, significant motor or behavioral disorders, and intellectual functioning with IQ < 70. Preterm raw scores converted to scaled scores and percentiles. Frequency analysis compared preterm scores to norms. Non-parametric tests assessed significance between scaled scores and subgroups (age, gestational age, sex, birth weight). One hundred nineteen preterm patients were enrolled in the study between November 2016 and June 2023. Comparisons with published norms showed lower mean scores across all subtests and domains for preterm children. A notable proportion of assessments (13-40%) fell below the 5th percentile, with the dual task item in sustained attention being the highest (40%). Sex did not predict differences, except for auditory sustained and visual search subtests. Gestational age did not correlate with abnormal scores, consistent with previous studies. The prevalence of assessments below the 5th percentile highlights preterm children's vulnerability to attention issues. The test's sensitivity to attention deficits in preterm populations suggests its potential in identifying at-risk children early for tailored interventions. The battery effectively detects attentional deficits in preterm children. Early detection and targeted insights support tailored educational interventions. By focusing on specific attention skills, the battery guides clinicians in choosing individualized or group activities based on areas most affected. • Attention is often impaired in preterm children but it is not systematically investigated before school age. The ECAB is a tool specifically designed for preschool children. • Using the ECAB we evidenced a different level of attention between pre-term and term-born children at preschool age.

Active-Matrix Metalloproteinase-8, Myeloperoxidase in Relation With Periodontics, Preterm Birth.

To investigate serum, placental levels of active-matrix metalloproteinase-8 (aMMP-8), myeloperoxidase (MPO) in preterm-birth with/without pre-eclampsia and term counterparts in relation with clinical periodontal parameters. Clinical periodontal measurements were recorded. Serum and placenta samples were collected during 173 full-term (FT), pre-term (PT) or pre-term complicated by pre-eclampsia (PTPE) deliveries. aMMP-8 levels were measured by IFMA. MPO levels in the serum and placenta samples were determined by ELISA. Data were tested using non-parametric tests. PTBE group exhibited higher full-mouth probing depth and clinical attachment loss values than the other two groups (p < 0.05). Percentages of sites with plaque and bleeding on probing were lower in the PTBE group than in the other groups (p < 0.05). Serum aMMP-8 and MPO concentrations were higher in PTPE group than in the other groups (p < 0.05). Placenta aMMP-8 level was higher in the control group than in the PTPE group (p < 0.05). There was no significant difference between the groups in the placenta MPO levels (p > 0.05). Within the limits of this cross-sectional study, it may be suggested that serum aMMP-8 and MPO concentrations together with placenta aMMP-8 levels may be associated with and reflect adverse pregnancy outcomes. Clinical periodontal findings did not reveal significant associations with these proteolytic and oxidative biomarkers.

Environmental knowledge influencing pro-environmental behavior among university students: a serial mediation and MGA approach

Purpose The study aims to investigate the mediating role played by environmental attitude and environmental sensitivity in the influence of environmental knowledge on pro-environmental behavior. Specifically, the study examined whether both environmental attitude and environmental sensitivity act as serial mediators between environmental knowledge and pro-environmental behavior. This study also explored whether there are gender differences in how environmental knowledge affects pro-environmental behavior through environmental attitude and environmental sensitivity. Design/methodology/approach A survey tool was distributed to university students in the northern region of India who had studied environmental studies as a compulsory subject during one of their semesters in their higher education program. A total of 558 responses were analyzed through nonparametric partial least squares multigroup analysis using PLS-SEM. Findings The results indicated that environmental knowledge significantly affected pro-environmental behavior. Moreover, environmental attitude and environmental sensitivity played significant mediating roles between environmental knowledge and pro-environmental behavior. Additionally, the results showed that the serial mediation effect of environmental attitude and environmental sensitivity in the relationship between environmental knowledge and pro-environmental behavior was significant. However, the findings did not show any significant gender difference in how environmental knowledge influences pro-environmental behavior, mediated serially by environmental attitude and environmental sensitivity. Originality/value Although vast literature is available on the relationship between environmental knowledge and pro-environmental behavior, a few studies have shown environmental attitude and environmental sensitivity as mediators. In addition, this study fills the gap in the existing research by exploring how environmental attitude and sensitivity serially mediate the nexus between environmental knowledge and pro-environmental behavior, particularly across genders.

Evaluating Wheat Cultivation Potential in Ethiopia Under the Current and Future Climate Change Scenarios

Land suitability analyses are crucial for identifying sustainable areas for agricultural crops and developing appropriate land use strategies. Thus, the present study aims to analyze the current and future land suitability for wheat (Triticum aestivum L.) cultivation in Ethiopia. Twelve variables including soil properties, climate variables, and topographic characteristics were used in the evaluation of land suitability. Statistical methods such as Rotated Empirical Orthogonal Functions (REOF), Coefficient of Variation (CV), correlation, and parametric and non-parametric trend analyses were used to analyze the spatiotemporal variability in current and future climate data and identified significant patterns of variability. For future projections of land suitability and climate, this study employed climate models from the Coupled Model Intercomparison Project Phase 6 (CMIP6) framework, downscaled using regional climate model version 4.7 (RegCM4.7) under two different Shared Socioeconomic Pathway (SSP) climate scenarios: SSP1 (a lower emission scenario) and SSP5 (a higher emission scenario). Under the current condition, during March, April, and May (MAM), 53.4% of the country was suitable for wheat cultivation while 44.4% was not suitable. In 2050, non-suitable areas for wheat cultivation are expected to increase by 1% and 6.9% during MAM under SSP1 and SSP5 climate scenarios, respectively. Our findings highlight that areas currently suitable for wheat may face challenges in the future due to altered temperature and precipitation patterns, potentially leading to shifts in suitable areas or reduced productivity. This study also found that the suitability of land for wheat cultivation was determined by rainfall amount, temperature, soil type, soil pH, soil organic carbon content, soil nitrogen content, and elevation. This research underscores the critical importance of integrating spatiotemporal climate variability with future projections to comprehensively assess wheat suitability. By elucidating the implications of climate change on wheat cultivation, this study lays the groundwork for developing effective adaptation strategies and actionable recommendations to enhance management practices. The findings support the county’s commitment to refining agricultural land use strategies, increasing wheat production through suitability predictions, and advancing self-sufficiency in wheat production. Additionally, these insights can empower Ethiopia’s agricultural extension services to guide farmers in cultivating wheat in areas identified as highly and moderately suitable, thereby bolstering production in a changing climate.

40 Hz Binaural Beats entrainment enhances the mood and cognition of medical students

Many medical students experience psychological distress from high academic demands, potentially harming their performance and mental health. Binaural beats (BB) stimulation, particularly gamma band entrainment, has been suggested to enhance neural communication, cognition, and reduce anxiety. This study aimed to determine whether 40 Hz BB could improve cognitive performance and mood in medical students. Forty participants, selected based on the inclusion criteria of good health, normal hearing, and no mental illness were recruited considering factors such as all sessions availability and consent. Participants listened to BB for 15 minutes, three times a week, over three consecutive weeks. Electroencephalogram recordings confirmed that 40 Hz BB induced gamma neural oscillations in the brain. Emotional states were assessed using the 32-item Brunel Mood Scale (BRUMS) with ratings on a 5-point Likert scale, whereas cognitive function was measured with the Stroop test, based on reaction time in milliseconds. Pre- and post-BB comparisons and gender-related differences were analyzed using paired and unpaired t-tests or appropriate non-parametric tests. The results showed that listening to BB significantly reduced negative emotions (p < 0.001) and enhanced positive emotions (p < 0.001), while also improving cognitive performance. However, the effects of BB were gender-specific, with female students showing greater improvements in ‘happiness’ and ‘calmness,’ (p < 0.001), while males experienced more pronounced enhancements in cognitive performance (p < 0.001). Additionally, time-dependent effects of BB were also observed. Therefore, 40 Hz BB seems to be an effective tool for helping students manage their challenges calmly and more efficiently.

Impact of integrating traditional care with the modern healthcare system in reducing tuberculosis diagnosis delays in Ethiopia: a clustered randomized controlled study.

Diagnosis and treatment initiation delays for tuberculosis (TB) are significant challenges in resource-limited settings. These delays can result in poor treatment outcomes, disease transmission, and increased costs. This study aimed to assess the effect of integrating traditional care with modern healthcare systems on reducing TB diagnosis delay. A cluster randomized controlled trial was conducted among TB patients, with 510 participants, 255 individuals were assigned to the intervention group and 255 to the control group. Training in the intervention group was provided for both traditional and modern healthcare providers in three rounds to enhance their knowledge, attitudes, and skills in TB screening and referral. A non-parametric independent sample test was used to compare the baseline and end-line data. The effect size was determined using Cohen's d. To account for individual and cluster-level variations, a mixed-effect parametric survival model was employed. Furthermore, conditional (fixed only) and marginal (random effects) graphs were used to compare between the intervention and control groups. A total of 510 participants were included in the baseline study, with a similar number of participants included in the endline study. In the intervention group, the delay in diagnosis was 4.185 per 1000 person-days post-intervention, compared to 4.608 per 1000 person-days pre-intervention. In the control group, the delay for diagnosis was 4.759 per 1000 person-days pre-intervention and 5.031 per 1000 person-days post-intervention. The median time to diagnosis was 135days. The non-parametric comparison showed that the intervention significantly reduced patient delays in the intervention group compared to the control group (p = 0.006), with a Cohen's d effect size of 0.246. The intervention also significantly reduced diagnosis delay in the intervention group compared to the control group (p = 0.036), with a Cohen's d effect size of 0.187. The diagnosis of TB was accelerated by 1.076 times due to the integration of traditional care with the modern healthcare system in the intervention group compared to the control group (δ: 1.076; 95% CI 1.021, 1.134). The involvement of traditional care providers in TB control programs significantly reduced diagnosis delays in Ethiopia. These findings suggest the need for integrating traditional care with modern healthcare systems for the effective prevention of TB in high-burden countries. Clinical trial registration ClinicalTrials.gov ID: NCT05236452.

Sensemaking of wave–particle duality in a scientific outreach minicourse: a study based in self-regulation

Abstract On the Internet, Quantum Mechanics is an area of physics that is shrouded in misinterpretations. In this scenario, scientific outreach may serve as an instrument for disseminating scientific knowledge. Especially in this context, it is important that people’s learning encompasses more than the meanings of concepts and laws, involving aspects related to the ‘why’ and ‘for what purpose’ the knowledge was and is constructed. We consider these aspects as components of the sense, the connotative and subjective dimension of conceptual learning which encompasses a positioning of an individual towards a concept and its relevance in the physics framework. Motivated by this, in the present study, we investigated the senses ascribed to the concept of wave–particle duality (WPD) by 121 participants in a two-day (five-hour) science outreach minicourse in the double-slit experiment. Drawing on the ideas of Franco et al (2023, Cadernos de Pesquisa do Programa de Pós-graduação em Ensino de Física da UFRGS (Research Notebooks from the Postgraduate Program in Physics Teaching at UFRGS), Pimenta Cultural Editors S/A), we posit sensemaking as a type of cognitive effort to overcome a situation, viewed as a self-regulatory phenomenon wherein individuals self-observe, self-evaluate, and self-react to the situation to achieve a certain goal. In addition to identifying the senses attributed to the concept of WPD, we assessed the relationships between these senses and participants’ performance in a standardized test of this concept, as well as their educational background and field of study. Data were collected using questionnaires answered before and at the end of the course. The senses ascribed to the concept of WPD were investigated through similarity and cluster analysis based on responses to essay questions. The relationships among these senses, questionnaire performance, and educational background were evaluated using non-parametric statistical tests. We infer two senses attributed to wave–particle duality: (1) WPD is a basic and fundamental concept that impacts the way we comprehend the essence of nature, and (2) WPD is a very advanced concept restricted to the field of Quantum Mechanics. A statistically significant correlation (0.26 was identified between the senses attributed and participants’ performance on the standardized test, suggesting that the sense ascribed to a concept and performance in questions requiring its mobilization are overlapping elements but constitute two distinct dimensions of learning that need to be assessed simultaneously.

HPB SO10 - Evaluation of the impact of an Enhanced Recovery Pathway on clinical outcomes after Pancreaticoduodenectomy

Abstract Background Southampton General Hospital (SGH) is a high-volume HPB centre with a well-established Enhanced Recovery After Surgery pathway (ERAS). Despite the morbidity associated with pancreatic surgery, there is a large body of evidence supporting the use of a multi-modal approach to accelerate patient recovery. Within SGH, ERAS is utilised for all patients undergoing Pancreaticoduodenectomy (PD). Initial assessment of the pathway in SGH demonstrated a reduction in length of stay. Since its implementation, ERAS has been modified to optimise the pathway. The aim of this study was to assess whether the impact of ERAS had progressed over time. Method Single centre retrospective analysis of patients undergoing open PD from 2007-2023. Pancreatic reconstruction was with pancreaticojejunostomy. Pre and Post ERAS data were analysed. Post ERAS data was subdivided into Early, Middle and Late implementation time phases. Length of Stay, Complications (Clavien-Dindo Grade 3 and above), Readmissions and Mortality were all examined. Non-parametric data analysis was undertaken with Kruskal-Wallis, Spearman rank correlation and Wilcoxon rank-sum tests. Significance further assessed with Multi-variate regression (MVR). All Data were analysed using STATA. Results Overall, 861 patients underwent an open PD, the yearly volume increasing with time. Mean age was 66 years, which did not change with time. With ERAS implementation, Median Length of Stay (LOS) fell 13 to 9 days (p&amp;lt;0.01) and there was no statistically significant increase in Grade 3 complications or Readmissions (p=0.931, p=0.163). Grade 3 complications increased LOS (p&amp;lt;0.01). Increased age led to a small increase in LOS (p&amp;lt;0.01). Median LOS across Early, Middle and Late ERAS periods was 10, 9 and 9 respectively. LOS did not consistently demonstrate a statistically significant improvement across ERAS phases (MVR p=0.387, K-Wallis p&amp;lt;0.05). Conclusion The implementation of ERAS significantly reduced the median LOS for patients undergoing PD, without increasing their risk of complications or readmissions. This benefit has also been safely maintained across the period of its implementation.

Can spatial planning in the Polish Carpathians be enforced? How spatial chaos indicators depict a gap between scientific knowledge and practice

AbstractDespite their strategic hydrological importance for neighbouring areas, the Polish Carpathians are experiencing spatial chaos, which may weaken their adaptability to the progressive climate change. The article attempts to answer the question of whether spatial planning, which is supposed to guarantee spatial order, fulfils its role and whether the knowledge of the natural conditions of spatial development is respected in the spatial planning process. Using GIS techniques, up to 238 communes were analysed in terms of their spatial coverage, the degree of scattered settlement, and the violation of natural barriers by location of buildings in areas that are threatened with mass movements or floods; by settlement on excessively inclined slopes and in areas with adverse climatic conditions. Spearman non-parametric rank correlation analysis and the multidimensional Principal Component Analysis (PCA) technique were performed to investigate relations between spatial chaos indicators and the planning situation. The analysis of the data has revealed that spatial planning does not fulfil its role. Serious errors in location of buildings have been noted even though the communes are covered by local spatial development plans. Scientific knowledge is not sufficiently transferred into planning documents, and bottom-up initiatives cannot replace systemic solutions. There is a need for strengthening the role of environmental studies documents in the spatial planning system. This would facilitate the transfer of scientific knowledge into the planning process and help to protect mountain areas. The development of a special spatial strategy for the Polish Carpathians in compliance with the Carpathian Convention is also recommended.

Assessment and role of physical activity as a factor affecting subjective perception of students' satisfaction

The paper aims to provide analysis of Slovak university students’ physical activity during state-ordered distance learning in the academic year 2021/2022 (the COVID-19 pandemic). The data were obtained in form of a questionnaire survey. In the analytical part, the focus is on weekly time that students devoted to regular exercise and quantification of physical activity versus subjective perception of selected physical and psychological satisfaction and health indicators. To meet the paper’s objectives, a two-sample t-test was used to test statistical significance of differences between men and women, and parametric and non-parametric correlation analysis methods. In terms of age structure majority of students falls into young adults’ category, in which physical activity has only a small positive effect on the subjective perception of satisfaction. Majority of students exercised on average up to 50 minutes per week, which is less than weekly physical activity during regular face-to-face lessons of Physical Education.

Double Materiality Approach and Sustainable Business Model Paradigm: A Three-Fold Analysis

Adopting the United Nations 2030 Agenda for Sustainable Development, governments commit to the 17 goals and 169 associated targets in areas of critical importance for humanity and planet, while companies manifest a growing interest in playing a significant role to SDGs prioritisation. Researchers, policymakers, stakeholders, and analysts are all preoccupied about responsible ways of redesigning the business model to mitigate the growing concerns, such as companies’ failures, global multidimensional crisis, and sustainability-related issues. Under the light of institutional theory, legitimacy theory, stakeholder theory, the aim of this research is to investigate how environmental, social and governance (ESG) policies and practices included in a sustainable business model may respond to the double materiality approach in order to contribute to a balance among divergent interests of managers, investors, and other stakeholders. The financial materiality is conceptualized using ESG data, that mainly targets investor’s needs. Stakeholder materiality, is concerned with external impact of companies, embodied in societal-level outcomes measured as the number of SDGs addressed in corporate reporting. In this study, company-year data are collected from Refinitiv Eikon database, starting with 2015, until current reporting period and analysed using frequency, univariate and correlation analyses. Based on Levene homogeneity, the ANOVA parametric t-test results are validated by Mann-Whitney Wilcoxon and Krushkal Wallis non-parametric tests. Three main research questions are responded. First, the findings examine and discuss the evolution of sustainability reporting measured with ESG scores, decomposed by the three pillars and ten categories, along with the SDGs prioritisation. Second, statistically significant differences in ESG and SDGs variables reported by various groups clustered on industry-related corporate characteristics are discussed. Third, the significant associations between ESG measures and SDGs are analysed from the double materiality perspective. The study contributes to the academic and practical understanding of the evolving business model under normative dimension of institutional theory, incorporating the decision to engage in current sustainability frameworks and policies.

Effectiveness study of learning algorithms in supply chains of a dairy business

Objective: To develop a control system to prevent over-response of the supply chain of a dairy business. Methodology: The following methods were used: DQN, Double DQN, Dueling DQN, and Dueling Double DQN to determine the distribution of demand: normal and uniform. Results: Results were calculated based on stability in learning (the last 10,000 episodes). It was observed that the means of DQN and DDQN were very similar. To validate whether the performance of the Dueling DQN algorithm is better than that of the DQN algorithm, a non-parametric test was performed to compare the mean rank of two related samples and to determine if there are differences between them. The p values ​​were 5.83e−38 and 0.000 for the Normal and Uniform distributions, respectively. Conclusions: The algorithm with the best results is Dueling DQN, with an average total cost of 151.27 units for the demand with a normal distribution and an average of 155.3 units for the demand with a uniform distribution. This method has less variability once convergence is achieved

Abstract 4135746: Assessing Coronary Artery Disease Severity: Leveraging Inflammatory Markers As a Prognostic Indicators

Introduction: Cardiovascular disease continues to be the leading cause of death and a significant cause of morbidity in the United States. In recent years, there has been increased interest in the role of inflammation in predicting and modifying the risk of coronary artery disease. Of the multitude of inflammatory markers studied subsequently, two of the most easily and widely obtained is the neutrophil to lymphocyte ratio (NLR) and the monocyte to lymphocyte ratio (MLR), which can be calculated from a complete blood count with differential. Multiple retrospective studies have demonstrated that the NLR and MLR have been used to diagnose ACS, predict mortality at a year after ACS, and risk stratify patients prior to percutaneous coronary intervention. Research Question: Are the NLR/MLR useful tools in predicting the severity of coronary artery disease (CAD) in patients admitted to a tertiary medical center in Southern Nevada for ACS between 2021 and 2023? Methods: A sample of n=344 patients was used to examine the potential significance of NLR/MLR to diagnose ACS and for predicting CAD severity. Traditional diagnostic test evaluation was used for determining CAD with a ratio of NLR=3.5 + MLR=0.35 (data medians) as the cut-off value. Patient risk group status (1:low risk to 4:high risk) was used as a binary outcome to test NLR/MLR between low and high risk groups using a nonparametric MWW test of medians. Additionally, ROC analysis was used to estimate an optimized cut-off for NLR/MLR as determined by AUC. Results: Results demonstrate for predicting ACS using the median NLR, sensitivity=88.07; specificity=14.88; PPV=52.01; NPV=54.35), LR(+)=1.03 and LR(-)= 0.80, using the median MLR results showed sensitivity=87.28; specificity=14.11; PPV=50.84; NPV=52.17, LR(+)=1.01 and LR(-)= 0.90. Subpopulation analysis demonstrated a statistically significant difference in NLR between “high risk ACS” vs “Low Risk ACS” (p&lt;0.001). Examination of the ROC curve for predicting the high-risk group suggested an optimized cutoff of NLR=3.7; however, AUC was only 0.617, and sensitivity and specificity were not improved compared to using the median NLR. Conclusion: Our findings suggest that an NLR greater than 3.7 may indicate multivessel involvement or proximal/left main disease in CAD patients. However, due to its low specificity and AUC, NLR alone cannot reliably distinguish between single-vessel and multivessel CAD.

Comparison Between Tracheal Wash and Bronchoalveolar Lavage Cytology for the Assessment of Exercise-Induced Pulmonary Hemorrhage (EIPH) in Racehorses

Exercise-Induced Pulmonary Hemorrhage (EIPH) is a common pulmonary disease among racehorses, diagnosed by the detection of blood in the trachea after strenuous exercise or the presence of hemosiderophages in the bronchoalveolar lavage fluid (BALF). Although the latter is considered the most sensitive method to diagnose EIPH, it is perceived as a less practical and more invasive procedure compared to tracheal wash (TW) collection among racehorse trainers. The present retrospective study aimed to verify the agreement between Tracheal wash and BALF cytology in assessing EIPH in racehorses. For this purpose, cytological data from 172 patients regarding hemosiderophage percentage, hemosiderin score, and percentage of recent, intermediate, and old EIPH were reviewed, and the simplified Total Hemosiderin Score (sTHS) was calculated. Non-parametric statistical tests were used to assess the difference and the correlation between TW and BALF. The two cytological methods strongly agreed in evaluating EIPH in racehorses for hemosiderophage percentage (ρ = 0.89, p &lt; 0.001), hemosiderin score (k = 0.63, p &lt; 0.001), sTHS (ρ = 0.87, p &lt; 0.001), percentage of recent EIPH (ρ = 0.95, p &lt; 0.001), intermediate EIPH (ρ = 0.92, p &lt; 0.001), and old EIPH (ρ = 0.85, p &lt; 0.001). In conclusion, TW showed to be a reliable method, which might substitute BALF in assessing EIPH in racehorses.