Nonparametric Spearman Correlation Research Articles

Age Estimation Based on Computed Tomography Analysis of the Scapula.

Background and Objectives: Age estimation from skeletal remains and in living individuals is an important issue for human identification, and also plays a critical role in judicial proceedings for migrants. Forensic analysis of ossification centers is the main evaluation method for age estimation, and ossification degree can be determined using computed tomography analysis. The purpose of this study is to investigate the applicability of CT (computed tomography) in the analysis of left scapula ossification centers, for forensic age estimation in Turkish society. Materials and Methods: We analyzed six ossification centers of the left scapula and these ossification centers are the coracoid, subcoracoid, coracoid apex, acromial, glenoid, and inferior angle ossification centers. A pediatric radiologist analyzed these six ossification centers of the scapula by using a staging method defined by Schmeling et al. in 2004. Two months after the first assessment, 20 randomly selected cases was reanalyzed by the first observer and by another pediatric radiologist. Correlation between the age and ossification stage was assessed using Spearman's nonparametric correlation test. Linear regression analysis was performed using a backwards model. Cohen's kappa coefficient was used for evaluating interobserver and intraobserver variability. Results: In this retrospective study, 397 (248 male and 149 female) cases were evaluated. Ages ranged between 7.1 and 30.9. The mean age was 19.83 ± 6.49. We determined a positive significant correlation between the age and the ossification stages of ossification centers analyzed in both sexes. In each ossification center, except inferior angle, all of the stage 1 and 2 cases in both sexes were under 18 years old. Intraobserver and interobserver evaluations showed that reproducibility and consistency of the method was relatively good. Conclusions: The present study indicated that CT analysis of scapula ossification centers might be helpful in forensic age assessment of living individuals and dry bones.

The altered TBI fecal microbiome is stable and functionally distinct.

Patients who suffer a traumatic brain injury (TBI) often experience chronic and sometimes debilitating sequelae. Recent reports have illustrated both acute and long-term dysbiosis of the gastrointestinal microbiome with significant alterations in composition and predicted functional consequences. Working with participants from past research, metagenomic stability of the TBI- associated fecal microbiome (FMB) was evaluated by custom qPCR array comparing a fecal sample from 2015 to one collected in 2020. Metatranscriptomics identified differently expressed bacterial genes and biochemical pathways in the TBI FMB. Microbiota that contributed the largest RNA amounts identified a set of core bacteria most responsible for functional consequences of the TBI FMB. A remarkably stable FMB metagenome with significant similarity (two-tail Spearman nonparametric correlation p < 0.001) was observed between 2015 and 2020 fecal samples from subjects with TBI. Comparing the 2020 TBI FMB metagenome to FMBs from healthy controls confirmed and extended the dysbiotic genera and species. Abundance differences between average TBI and healthy FMBs revealed Bacteroides caccae, B. uniformis, Blautia spp., Collinsella spp., Dialister spp., and Ordoribacter spp. were significantly different. Functionally, the Parabacteroides genus contributed the highest percentage of RNA sequences in control FMBs followed by the Bacteroides genus as the second highest contributor. In the TBI FMB, the Corynebacterium genus contributed the most RNA followed by the Alistipes genus. Corynebacterium and Pseudomonas were distinct in the top 10 contributing genera in the TBI FMB while Parabacteroides and Ruminococcus were unique to the top 10 in controls. Comparing RNA profiles, TBI samples had ∼1.5 fold more expressed genes with almost 700 differently expressed genes (DEGs) mapped to over 100 bacterial species. Bioinformatic analysis associated DEGs with pathways led identifying 311 functions in the average TBI FMB profile and 264 in the controls. By average profile comparison, 30 pathways had significantly different abundance (p < 0.05, t-test) or were detected in >80% of the samples in only one of the cohorts (binary distinction). Functional differences between TBI and healthy control FMBs included amino acid metabolism, energy and carbon source usage, fatty acid metabolism, bacterial cell wall component production and nucleic acid synthesis and processing pathways. Together these data shed light on the functional consequences of the dysbiotic TBI FMB decades after injury.

Differentiating anorexia nervosa and atypical anorexia nervosa with absolute weight cut-offs results in a skewed distribution for premorbid weight among youth.

Anorexia nervosa (AN) and atypical AN are conceptualized as distinct illnesses, despite similar characteristics and sequelae. Whereas DSM-5 differentiates youth with AN and atypical AN by the presence of clinical 'underweight' (i.e., 5th BMI percentile for age-and-sex (BMI%)), we hypothesized that using this weight cut-off to discern diagnoses creates a skewed distribution for premorbid weight. Participants included hospitalized youth with AN (n = 165, 43.1%) and atypical AN (n = 218, 56.9%). Frequency analyses and chi-square tests assessed the distribution of premorbid BMI z-scores (BMIz) for diagnosis. Non-parametric Spearman correlations and Stepwise Linear regressions examined relationships between premorbid BMIz, admission BMIz, and weight loss in kg. Premorbid BMIz distributions differed significantly for diagnosis (p < .001), with an underrepresentation of 'overweight/obesity' (i.e., BMI% ≥ 85th) in AN. Despite commensurate weight loss in AN and atypical AN, patients with premorbid 'overweight/obesity' were 8.31 times more likely to have atypical AN than patients with premorbid BMI% < 85th. Premorbid BMIz explained 57% and 39% of the variance in admission BMIz and weight loss, respectively. Findings support a homogenous model of AN and atypical AN, with weight loss predicted by premorbid BMI in both illnesses. Accordingly, premorbid BMI and weight loss (versus presenting BMI) may better denote the presence of an AN-like phenotype across the weight spectrum. Findings also suggest that differentiating diagnoses with BMI% < 5th requires that youth with higher BMIs lose disproportionately more weight for an AN diagnosis. This is problematic given unique treatment barriers experienced in atypical AN. Anorexia nervosa (AN) and atypical AN are considered distinct conditions in youth, with differential diagnosis hinging upon a presenting weight status of 'underweight' (i.e., BMI percentile for age-and-sex (BMI%) < 5th). In our study, youth with premorbid 'overweight/obesity' (BMI% ≥ 85th) disproportionately remained above this threshold, despite similar weight loss. Coupled with prior evidence for commensurate characteristics and sequelae in both diagnoses, we propose that DSM-5 differentiation of AN and atypical AN inadvertently reinforces weight stigma and may contribute to treatment disparities in atypical AN.

Analysis of glomerulopathies in kidney neoplasms

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

Characteristics of specific training in elite handball players specialized in goalkeeper position

Background and Study Aim. Elite handball goalkeepers undergo intensive training for reflexes and advanced techniques. They develop mental toughness to handle the pressure and responsibility at key moments of the game. Thus, they protect the goal of the team. This study aims to investigate and highlight the specific training characteristics of elite handball players specialized in the goalkeeper position. Material and Methods. The best 4 goalkeepers specialized in elite handball in Romania, aged between 22 and 33 years, were selected. Specific motor tests were used: Test 1 - Jumps 15 seconds; Test 2 – Reaction speed to visual stimulus; Test 3 – Execution speed. Technical tests were used: Test specific to goalkeeper, Triangle moving, The Ten Jump, Ball throwing, Standing long jump, Passes to a fixed point; The Cooper test. To improve specific training, there were applied strategies for training optimization which include stretching for mobility, segmental muscle strength, goalkeeping specific exercises and plyometrics. The nonparametric Spearman’s correlation coefficient was used to evaluate the relationship between technical training and motor skills parameters. The statistical significance level was set at p&lt;0.05. Results. The performance of elite handball players specializing in goalkeeper position highlighted significant improvements in the Jumps 15 sec test. Contact time decreased by 0.13 seconds while the jump height increased by 0.55 cm, showing improved efficiency and power. In the Reaction speed to visual stimulus test, waiting time and reaction time decreased considerably, while the foot rising height increased. In the right and left leg Execution speed test, the differences observed reveal individual adaptations. The overall time is low in the right foot and there is a significant increase in the left foot. The nonparametric Spearman correlation analysis showed the relationship between the indices of technical fitness tests and the strength and speed motor skills. During Test 1 - Jumps 15 sec - 49 correlations were identified, of which 5.36% were statistically significant, highlighting strong connections between certain parameters. The analysis of Test 2 showed 56 correlations, but the lack of statistical significance reveals the absence of connections between the technical tests and the parameters of reaction speed manifestation. Regarding Test 3, a number of 28 correlations were identified. The lack of statistical significance suggests the absence of significant correlations between the technical tests and the execution speed. Conclusions. The performances of elite handball goalkeepers show significant improvements in motor and technical skills, highlighting the effectiveness of specific training and its adaptability. The progress in jumping and reaction speed indicates essential improvements for goalkeeping success, emphasizing the necessity for personalized and holistic training.

International survey of radiocephalic arteriovenous fistula: ISRAF survey.

The objective of this survey was to encompass the full scope of international practice, entailing all technical, non-technical, preoperative stratification and functional maturation (FM) of RCAVF. The survey contained n = 19 questionnaires with n = 46 variables completed by n = 85 providers from n = 21 nations across n = 5 continents. The numerical values were subjected to mean with standard error whereas the nominal data to a non-parametric (Kruskal-Wallis & Spearman correlation test) and analysis of variance (ANOVA). The test of homogeneity, & probability was reported 95% confidence intervals (CI) alongside error plots. Furthermore, a decision and higher attribute tree model was constructed based on current survey for higher FM in RCAVF. FM is independently associated with volume of surgeon per year (procedures performed) (p < 0.01) [High Volume: 73% (95% CI, 68-77%) versus Average volume: 63% (95% CI, 59-66%) vs Low volume: 56% (95% CI, 51-61%)]. FM increased by 8% with every 20 more procedures per group of surgeons on end point of FM. Amongst continents: Australia, America, Asia and South America demonstrated higher FM to Africa & Europe (p < 0.05). UK possessed a lower FM 58% (95% CI, 48-68%) in comparison to the world & Europe respectively [65% (95% CI, 61-70%) vs 61% (95% CI, 58--65%)]. There was a positive causal link between angle of anastomosis at 30-76° (p < 0.01), longitudinal & S-shaped incision & arteriotomy length of 3 & 4 mm to higher FM (p < 0.05). FM in RCAVF is independently & incrementally associated with the volume of surgeon per year. There is a diverse inclusion, exclusion and technical approach in RCAVF creation. This survey advocates the importance of international collaboration and/or registry in assimilation, consolidate and development of consensus.

Methotrexate and Non-Surgical Periodontal Treatment Change the Oral-Gut Microbiota in Rheumatoid Arthritis: A Prospective Cohort Study.

This study evaluated the changes in the composition of oral-gut microbiota in patients with rheumatoid arthritis (RA) caused by methotrexate (MTX) and non-surgical periodontal treatment (NSPT). Assessments were performed at baseline (T0), 6 months after MTX treatment (T1), and 45 days after NSPT (T2). The composition of the oral and gut microbiota was assessed by amplifying the V4 region of the 16S gene from subgingival plaques and stools. The results of the analysis of continuous variables were presented descriptively and non-parametric tests and Spearman's correlation were adopted. A total of 37 patients (27 with periodontitis) were evaluated at T0; 32 patients (24 with periodontitis) at T1; and 28 patients (17 with periodontitis) at T2. MTX tended to reduce the alpha diversity of the oral-gut microbiota, while NSPT appeared to increase the number of different species of oral microbiota. MTX and NSPT influenced beta diversity in the oral microbiota. The relative abundance of oral microbiota was directly influenced by periodontal status. MTX did not affect the periodontal condition but modified the correlations that varied from weak to moderate (p < 0.05) between clinical parameters and the microbiota. MTX and NSPT directly affected the composition and richness of the oral-gut microbiota. However, MTX did not influence periodontal parameters.

Specificity of frequency-spatial organization of brain activity in coronary heart disease associated with self-assessment of emotion control in men and women

BACKGROUND: Deficit in the regulation of emotional stress is considered as an important factor in the development of coronary heart disease (CHD). The functions of assessment and regulation of emotions are performed by the structures of the prefrontal cortex and amygdala, the activation and interaction of which differs in men and women. In this regard, the question of the gender specificity of the cortical mechanisms of emotional regulation associated with coronary artery disease is relevant. AIM: To find out the significance of self-assessment of emotional control of behavior (EC) in the frequency-spatial organization of brain activity in men and women with CHD. METHODS: The study was performed in a cardiology clinic involving 56 men (61.2±8.5 years) and 19 women (67.4±4.8 years) diagnosed with CHD. To analyze the frequency-spatial organization of the resting EEG, we used 64-channel EEG recording and calculation of the power of rhythms in six frequency ranges from 4 to 30 Hz using a fast Fourier transform. Spearman's non-parametric correlation analysis was used to determine the correlation of EC as a personality trait according to the questionnaire of emotional intelligence and EEG power indicators. RESULTS: Correlation analysis of EC and average EEG power indicators revealed positive relationships in the range of 4–13 Hz in the group of men and negative in the group of women (0.19 rs 0.28 and –0.20 rs –0.40, respectively; p 0.030). The regional specificity of the detected effect was characterized by a significant relationship between EC and the power of theta 2, alpha 1, 2, presented in the anterior part of the cortex with the dominance of the left hemisphere in men, but in the posterior part of both hemispheres — in women, and the latter effect was limited by theta 2 and alpha 1 frequency. CONCLUSION: The results of the performed analysis of the relationship of EC and regional indicators of resting EEG power in the 6–13 Hz range indicate different forms of control of the emotional state in women and men with CHD.

Emotional Regulation and Toxic Relationships in Late Teens Who Date

Introduction: In dating individuals will be faced with problems in relationships where not a few individuals solve them with acts of violence. Dating violence is an indication that refers to a toxic relationship. Objective:  to test whether emotional regulation is related to the level of toxic relationships in dating relationships in late adolescents dating in Bekasi City.  Method: This study uses a quantitative approach with a correlational method. The instruments used to collect the data were the emotion regulation scale and the toxic relationship scale. The data were analyzed by non-parametric test techniques using spearman non-parametric correlation test. Result and Discussion:  A result of -0.483** and a significance result of &lt;0.001 (p&lt;0.01). Conclusions: This study shows the correlation of the two significant variables and produces a negative correlation direction. The higher a person's emotional regulation, the lower the level of toxic relationships, and vice versa. 

How the Spreading and Intensity of Interictal Epileptic Activity Are Associated with Visuo-Spatial Skills in Children with Self-Limited Focal Epilepsy with Centro-Temporal Spikes.

This paper investigates brain-behaviour associations between interictal epileptic discharges and cognitive performance in a population of children with self-limited focal epilepsy with centro-temporal spikes (SeLECTS). Sixteen patients with SeLECTS underwent an extensive neuropsychological assessment, including verbal short-term and episodic memory, non-verbal short-term memory, attentional abilities and executive function. Two quantitative EEG indices were analysed, i.e., the Spike Wave Index (SWI) and the Spike Wave Frequency (SWF), and one qualitative EEG index, i.e., the EEG score, was used to evaluate the spreading of focal SW to other parts of the brain. We investigated associations between EEG indices and neuropsychological performance with non-parametric Spearman correlation analyses, including correction for multiple comparisons. The results showed a significant negative correlation between (i) the awake EEG score and the Block Tapping Test, a visuo-spatial short-term memory task, and (ii) the sleep SWI and the Tower of London, a visuo-spatial planning task (pcorr < 0.05). These findings suggest that, in addition to the usual quantitative EEG indices, the EEG analysis should include the qualitative EEG score evaluating the spreading of focal SW to other parts of the brain and that neuropsychological assessment should include visuo-spatial skills.

EXTRAMURAL ENGLISH AND ADULT EFL LEARNERS’ PHONOLOGICAL AWARENESS

This study examines the duration of adult EFL learners’ extramural English activities related to their phonological awareness. For this purpose, (Indonesian, N = 32, 3 males and 29 females) learners participated in the study. After analyzing the questionnaires and the phonological awareness test using the non-parametric (Spearman) correlation, the result showed a strong positive correlation between the amount of time the adult EFL learners spend for spoken and written extramural English activities and their phonological awareness ability. The extramural English activities they mainly engage in are dealing with technology. The findings call for future research examining the effect of extramural English on phonological awareness and other possible English components or skills.

Automated analysis of the total choline resonance peak in breast proton magnetic resonance spectroscopy.

The aim of the current study was to compare the performance of fully automated software with human expert interpretation of single-voxel proton magnetic resonance spectroscopy (1H-MRS) spectra in the assessment of breast lesions. Breast magnetic resonance imaging (MRI) (including contrast-enhanced T1-weighted, T2-weighted, and diffusion-weighted imaging) and 1H-MRS images of 74 consecutive patients were acquired on a 3-T positron emission tomography-MRI scanner then automatically imported into and analyzed by SpecTec-ULR 1.1 software (LifeTec Solutions GmbH). All ensuing 117 spectra were additionally independently analyzed and interpreted by two blinded radiologists. Histopathology of at least 24 months of imaging follow-up served as the reference standard. Nonparametric Spearman's correlation coefficients for all measured parameters (signal-to-noise ratio [SNR] and integral of total choline [tCho]), Passing and Bablok regression, and receiver operating characteristic analysis, were calculated to assess test diagnostic performance, as well as to compare automated with manual reading. Based on 117 spectra of 74 patients, the area under the curve for tCho SNR and integrals ranged from 0.768 to 0.814 and from 0.721 to 0.784 to distinguish benign from malignant tissue, respectively. Neither method displayed significant differences between measurements (automated vs. human expert readers, p > 0.05), in line with the results from the univariate Spearman's rank correlation coefficients, as well as the Passing and Bablok regression analysis. It was concluded that this pilot study demonstrates that 1H-MRS data from breast MRI can be automatically exported and interpreted by SpecTec-ULR 1.1 software. The diagnostic performance of this software was not inferior to human expert readers.

Antiphospholipid antibody carriers and patients with quiescent antiphospholipid syndrome show persistent subclinical complement activation.

Complement activation has been advocated as one mechanism by which antiphospholipid antibodies (aPLs) can induce thrombosis. In patients with catastrophic aPL syndrome or re-thrombosis, enhanced complement activation was shown, even in quiescent phase of the disease. We aimed to assess complement activation and to investigate its association to clinical variables in aPL positive patients with a favorable disease course. Subjects with at least two consecutive positive aPL antibody results obtained ≥12 weeks apart were enrolled. They were subjects without history of thrombosis or pregnancy morbidity (aPL carriers), patients with pregnancy morbidity alone (OAPS), and/or with arterial, venous, or small-vessel thrombosis (TAPS); all patients should have been free of symptoms for ≥2 years. Patients affected with systemic autoimmune diseases were excluded. Healthy age and sex-matched subjects were included as controls. Plasma C5a and C5b-9 levels were assessed by commercially available ELISA assays. Non-parametric Mann-Whitney test and Spearman's correlation were applied. Thirty-seven OAPS, 38 TAPS, 42 aPL carriers, and 30 healthy subjects were enrolled. Median C5a and C5b-9 levels were significantly higher in quiescent aPL positive patients (OAPS, TAPS, aPL carriers) compared with controls: C5a ng/ml 10.61 (IQR 6.87-15.46) vs 4.06 (2.66-7.35), p< 0.001; C5b-9 ng/ml 283.95 (175.8-439.40) vs 165.90 (124.23-236.8), p< 0.001. Similar C5a and C5b-9 levels were observed in OAPS and TAPS patients and aPL carriers. A positive correlation between C5b-9 median levels and the number of aPL positive tests was found (p= 0.002). The persistence of aPL antibodies is associated to a persistent subclinical activation of the complement cascade.

Spearman-like correlation measure adjusting for covariates in bivariate survival data.

We propose an extension of Spearman's correlation for censored continuous and discrete data that permits covariate adjustment. Previously proposed nonparametric and semiparametric Spearman's correlation estimators require either nonparametric estimation of the bivariate survival surface or parametric assumptions about the dependence structure. In practice, nonparametric estimation of the bivariate survival surface is difficult, and parametric assumptions about the correlation structure may not be satisfied. Therefore, we propose a method that requires neither and uses only the marginal survival distributions. Our method estimates the correlation of probability-scale residuals, which has been shown to equal Spearman's correlation when there is no censoring. Because this method relies only on marginal distributions, it tends to be less variable than the previously suggested nonparametric estimators, and the confidence intervals are easily constructed. Although under censoring, it is biased for Spearman's correlation as our simulations show, it performs well under moderate censoring, with a smaller mean squared error than nonparametric approaches. We also extend it to partial (adjusted), conditional, and partial-conditional correlation, which makes it particularly relevant for practical applications. We apply our method to estimate the correlation between time to viral failure and time to regimen change in a multisite cohort of persons living with HIV in LatinAmerica.

Factors associated with infections by multidrug-resistant bacteria in Hospital "Vicente Corral Moscoso", Cuenca, 2018-2019

BACKGROUND: Bacterial resistance constitutes a set of processes that allow microorganisms to adapt to a hostile environment, paradoxically driven by antimicrobials, through the process of selective pressure, which results in the ineffectiveness of therapeutic measures, triggering an increase in morbidity and mortality rates and greater expenditure of medical resources; therefore, the aim of this study is to determine the factors associated with infections caused by multidrug-resistant bacteria at Hospital "Vicente Corral Moscoso" in the city of Cuenca-Ecuador. METHODS: retrospective case-control study, with a sample of 147 cases of hospitalized patients with infections by multiresistant bacterial agents randomly chosen, and 147 control patients with infections by multisensitive bacterial agents matched by age and sex. The studied variables were: age, sex, hospital service, origin of the biological sample, infectious bacterial agent, mechanism of resistance and risk factors. The probability of association between the variables was calculated by means of the Odds Ratio, with a confidence interval (CI) of 95% and significance level of p&lt; 0.05, calculated by McNemar's test. RESULTS: there was a slight predominance of male sex and age of 60 years or more in this sample of 294 patients. Most cultures (32%) were from sputum samples. The most frequently isolated bacterial agent was E. coli. The most common mechanism of resistance was the production of extended-spectrum beta-lactamases (54%). The statistically significant associated factors with infections by multidrug-resistant bacteria were: the presence of central venous catheter (OR: 3.35, CI: 1.71-6.75, p˂0. 001), previous hospitalization (OR: 2.43, CI: 1.33-4.5, p=0.0003), mechanical ventilation (OR: 3.16 CI: 1.21-9.68, p=0.014) and previous antibiotic therapy (OR: 5.58, CI: 2.60-12.61, p˂0.001). CONCLUSION: The most frequently isolated bacteria were E. coli. The most common mechanism of resistance was the production of extended-spectrum beta-lactamases. This study determined the statistically significant association between infections by multidrug-resistant bacteria and the following factors: the presence of central venous catheter, previous hospitalization, history of mechanical ventilation and previous antibiotic therapy.&lt; jats:p&gt; &lt;/jats:abstract&gt; &lt;publication_date media_type='print'&gt; &lt;month&gt;08&lt;/month&gt; &lt;day&gt;22&lt;/day&gt; &lt;year&gt;2023&lt;/year&gt; &lt;/publication_date&gt; &lt;publication_date media_type='online'&gt; &lt;month&gt;08&lt;/month&gt; &lt;day&gt;07&lt;/day&gt; &lt;year&gt;2023&lt;/year&gt; &lt;/publication_date&gt; &lt;pages&gt; &lt;first_page&gt;11&lt;/first_page&gt; &lt;last_page&gt;16&lt;/last_page&gt; &lt;/pages&gt; &lt;doi_data&gt; &lt;doi&gt;10.14410/2023.15.1.ao.0&lt;/doi&gt; &lt;resource&gt;https://revistamedicahjca.iess.gob.ec/ojs2/index.php/HJCA2/article/view/36&lt;/resource&gt; &lt;/doi_data&gt; &lt;/journal_article&gt; &lt;!-- ============== --&gt; &lt;journal_article publication_type='full_text'&gt; &lt;titles&gt; &lt;title&gt;Colostomía Trephine vs Convencional en pacientes con obstrucción intestinal de etiología tumoral en el Instituto Oncológico Nacional Dr. Juan Tanca Marengo SOLCA, Guayaquil – Ecuador&lt;/title&gt; &lt;original_language_title&gt;Trephine Colostomy vs Conventional Colostomy in patients with intestinal obstruction of malignant etiology at Instituto Oncológico Nacional Dr. Juan Tanca Marengo SOLCA, Guayaquil - Ecuador&lt;/original_language_title&gt; &lt;/titles&gt; &lt;contributors&gt; &lt;person_name sequence='first' contributor_role='author'&gt; &lt;given_name&gt;Juan Bernardo&lt;/given_name&gt; &lt;surname&gt;Pazmiño Palacios&lt;/surname&gt; &lt;ORCID&gt;https://orcid.org/0000-0002-4743-7627&lt;/ORCID&gt; &lt;/person_name&gt; &lt;person_name sequence='additional' contributor_role='author'&gt; &lt;given_name&gt;Luis Andrés&lt;/given_name&gt; &lt;surname&gt;Idrovo Murillo&lt;/surname&gt; &lt;ORCID&gt;https://orcid.org/0000-0003-1393-012X&lt;/ORCID&gt; &lt;/person_name&gt; &lt;person_name sequence='additional' contributor_role='author'&gt; &lt;given_name&gt;Fernando David&lt;/given_name&gt; &lt;surname&gt;Miñan Arana&lt;/surname&gt; &lt;ORCID&gt;https://orcid.org/0000-0001-8203-6848&lt;/ORCID&gt; &lt;/person_name&gt; &lt;/contributors&gt; &lt;jats:abstract xml:lang='en'&gt; &lt;jats:p&gt;BACKGROUND: 60% of large bowel obstructions are caused by cancer. The prevalence of malignant bowel obstruction globally varies between 3 and 15 %. Ostomy-related complication rates vary between 21% and 60%. At Instituto Oncologico Nacional Dr. Juan Tanca Marengo, in the city of Guayaquil, intestinal obstruction due to malignant etiology is among the 3 main surgical causes in the surgery service. The surgical alternatives to solve the obstructive condition are conventional colostomy or Trephine colostomy. The aim of this research was to compare colostomy by Trephine technique versus colostomy by laparotomy technique as a derivative method in patients with intestinal obstruction of malignant etiology. METHODS: A descriptive retrospective study was conducted, including 142 patients who underwent derivative treatment (colostomy) for intestinal obstruction of confirmed oncological cause, at Instituto Oncológico Nacional Dr. Juan Tanca Marengo SOLCA, in a period of 36 months from January 2015 - December 2017. The following variables were included: surgical technique (conventional colostomy and Trephine colostomy), age, sex, tumor location, surgical time and complications. The Chi-square test was used, with a significance level of 95%, considering statistical significance with a p value of less than 0.05. RESULTS: The most common age of presentation of malignant obstruction was between 41 - 65 years, in both groups. The most affected sex in both groups was female. The main tumor location was at the level of the anus and rectum in both groups (58%). The surgical time was longer in the group that underwent conventional colostomy, in 84% of the patients the time was longer than 120 minutes, in comparison with the group that underwent Trephine colostomy, in which the surgical time was less than 120 minutes in 61% of the patients (X2 = 31.77, p&lt;0.0001). Complications were more common in the conventional colostomy (75%), the most frequent being abscesses, followed by periostomal infection and necrosis; in comparison with the Trephine colostomy, in which the frequency of complications was 16.7%, the most common being bleeding, prolapse and stenosis (X2=45.694, p &lt;0.0001). CONCLUSION: Surgical time is significantly shorter when performing colostomy with the Threpine technique (p &lt;0.0001); likewise, the percentage of complications obtained with this method is much lower (p &lt;0.0001) compared to conventional colostomy.&lt; jats:p&gt; &lt;/jats:abstract&gt; &lt;publication_date media_type='print'&gt; &lt;month&gt;08&lt;/month&gt; &lt;day&gt;22&lt;/day&gt; &lt;year&gt;2023&lt;/year&gt; &lt;/publication_date&gt; &lt;publication_date media_type='online'&gt; &lt;month&gt;08&lt;/month&gt; &lt;day&gt;07&lt;/day&gt; &lt;year&gt;2023&lt;/year&gt; &lt;/publication_date&gt; &lt;pages&gt; &lt;first_page&gt;17&lt;/first_page&gt; &lt;last_page&gt;21&lt;/last_page&gt; &lt;/pages&gt; &lt;doi_data&gt; &lt;doi&gt;10.14410/2023.15.1.ao.03&lt;/doi&gt; &lt;resource&gt;https://revistamedicahjca.iess.gob.ec/ojs2/index.php/HJCA2/article/view/37&lt;/resource&gt; &lt;/doi_data&gt; &lt;/journal_article&gt; &lt;!-- ============== --&gt; &lt;journal_article publication_type='full_text'&gt; &lt;titles&gt; &lt;title&gt;Estudio observacional: Participación en ocupaciones y calidad de vida en personas con lupus eritematoso sistémico&lt;/title&gt; &lt;original_language_title&gt;Observational study: Occupational participation and quality of life in people with systemic lupus erythematosus&lt;/original_language_title&gt; &lt;/titles&gt; &lt;contributors&gt; &lt;person_name sequence='first' contributor_role='author'&gt; &lt;given_name&gt;David&lt;/given_name&gt; &lt;surname&gt;Vázquez Abadía&lt;/surname&gt; &lt;ORCID&gt;https://orcid.org/0000-0003-2729-9842&lt;/ORCID&gt; &lt;/person_name&gt; &lt;person_name sequence='additional' contributor_role='author'&gt; &lt;given_name&gt;Iván de Rosende&lt;/given_name&gt; &lt;surname&gt;Celeiro&lt;/surname&gt; &lt;ORCID&gt;https://orcid.org/0000-0002-4569-2050&lt;/ORCID&gt; &lt;/person_name&gt; &lt;person_name sequence='additional' contributor_role='author'&gt; &lt;given_name&gt;María Dolores&lt;/given_name&gt; &lt;surname&gt;Sánchez Maldonado&lt;/surname&gt; &lt;ORCID&gt;https://orcid.org/0000-0002-7443-9855&lt;/ORCID&gt; &lt;/person_name&gt; &lt;/contributors&gt; &lt;jats:abstract xml:lang='en'&gt; &lt;jats:p&gt;BACKGROUND: Lupus is a chronic, multisystemic health condition; its manifestations have special impact on the quality of life and occupational performance of people who suffer from it. Therefore, the present research, related to this topic, has been developed in the autonomous community of Galicia-Spain, in the population of users of the autonomous association of Systemic Lupus Erythematosus, known as AGAL; whose aim was to find the relationship between occupational performance, evaluated through validated tools, and the variables: fatigue, pain and quality of life, in patients with this pathology. METHODS: an observational, descriptive, cross-sectional study was carried out. The study universe consisted of all patients between 18 and 65 years of age, with a diagnosis of SLE, residing in any of the provinces of the Autonomous Community of Galicia, members of AGAL. Each participant underwent a structured interview in which different standardized tools were applied, aimed to evaluate occupational performance, level of fatigue, perception of pain in daily life and the level of quality of life perceived by the participants. Spearman's rho nonparametric correlation coefficient was used to study the possible relationship between the variables. In all tests, a p value of less than 0.05 was considered statistically significant. RESULTS: The mean age of the sample was 50.5 years, 90.9% were female. The mean number of years elapsed since SLE diagnosis was 21 years (SD 11.9). 59.1% of the participants perceived their health as "fair" or "poor"; also more than half of the patients said that they had to stop performing some daily activities due to their physical or emotional health condition. The great majority of participants presented difficulties in daily occupations (basic, instrumental, work/educational, leisure, social participation) due to pain (86.4%). CONCLUSION: The level of fatigue and the level of pain are statistically significantly and positively associated with the performance of basic and instrumental occupations and functioning at work and/or education. Fatigue level has a statistically significant and positive correlation with impairment in social life, leisure and free time activities, family relationship and normal life in general. As the person's difficulties in carrying out basic and instrumental occupations, work and/or study related activities and social participation increase, the level of quality of life related to the physical and emotional health of the participants decreases.

Humoral and cellular immunity in three different types of COVID-19 vaccines against SARS-CoV-2 variants in a real-world data analysis.

An effective vaccine response is currently a critical issue in the control of COVID-19. Little is known about humoral and cellular immunity comparing protein-based vaccine with other types of vaccines. The relevance of basal immunity to antibody production is also unknown. Seventy-eight individuals were enrolled in the study. The primary outcome were the level of spike-specific antibodies and neutralizing antibodies measured by ELISA. Secondary measures included memory T cells and basal immunity estimated by flow cytometry and ELISA. Correlations for all parameters were calculated using the nonparametric Spearman correlation method. We observed that two doses of mRNA-based Moderna mRNA-1273 (Moderna) vaccine produced the highest total spike-binding antibody and neutralizing ability against the wild-type (WT), Delta, and Omicron variants. The protein-based MVC-COV1901 (MVC) vaccine developed in Taiwan produced higher spike-binding antibodies against Delta and Omicron variants and neutralizing ability against the WT strain than the adenovirus-based AstraZeneca-Oxford AZD1222 (AZ) vaccine. Moderna and AZ vaccination produced more central memory T cells in PBMC than the MVC vaccine. However, the MVC vaccine had the lowest adverse effects compared to the Moderna and AZ vaccines. Surprisingly, the basal immunity represented by TNF-α, IFN-γ, and IL-2 prior to vaccination was negatively correlated with the production of spike-binding antibodies and neutralizing ability. This study compared memory T cells, total spike-binding antibody levels, and neutralizing capacity against WT, Delta, and Omicron variants between the MVC vaccine and the widely used Moderna and AZ vaccines, which provides valuable information for future vaccine development strategies.

Nonparametric Bayesian Networks as a Tool of Multiscale Time Series Analysis and Remote Sensing Data Integration

Introduction. Nonparametric Bayesian networks are a promising tool for analyzing, visualizing, interpreting and predicting the structural and dynamic characteristics of complex systems. Modern interdisciplinary research involves the complex processing of heterogeneous data obtained using sensors of various physical nature. In the study of the forest fund, both methods of direct dendrological measurements and methods of remote observation using unmanned aerial vehicles are widely used. Information obtained using these methods must be analyzed in conjunction with hydrometeorological monitoring data.Aim. Investigation of the possibility of automating the monitoring of the well-being of the forest fund based on the integration of ground survey data, remote multispectral measurements and hydrometeorological observations using the mathematical apparatus of nonparametric Bayesian networks.Materials and methods. To assess the long-term joint dynamics of natural and climatic indicators and the radial growth of trees, a modified method of multiscale cross-correlation analysis was used with the removal of the background trend described by the moving average model. Relationships between various indicators were estimated based on the unconditional and conditional nonparametric Spearman correlation coefficients, which were used to reconstruct and parameterize the nonparametric Bayesian network.Results. A multiscale nonparametric Bayesian network was constructed to characterize both unconditional and conditional statistical relationships between parameters obtained from remote sensing, hydroclimatic and dendrological measurements. The proposed model showed a good quality of the plant fund state forecasting. The correlation coefficients between the observed and predicted indicators exceed 0.6, with the correlation coefficient comprising 0.77 when predicting the growth trend of annual tree rings.Conclusion. The proposed nonparametric Bayesian network model reflects the relationship between various factors that affect the forest ecosystem. The Bayesian network can be used to assess risks and improve environmental management planning.

Women's Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor.

This study aimed to assess knowledge about non-pharmacological pain-relief methods in labor among women who have given birth at least once. This cross-sectional study was conducted using an online survey among 466 adult women. The minimum sample size was estimated based on the number of labor admissions in the year before the study in Poland. The survey included questions about respondents' sociodemographics and knowledge of pain-relief methods. The knowledge score was calculated using the sum of correct answers. Non-parametric Spearman's correlation, Kruskal-Wallis and Wilcoxon variance tests were used. Antenatal classes (313/68.9%) and the Internet (248/54.6%) were the most common sources of knowledge. The most popular pharmacological pain-relief methods included epidural anesthesia (386/85.0%) and nitrous oxide (301/66.3%). Massage and breathing techniques were the most commonly known non-pharmacological methods (405/89.2% and 400/88.1%, respectively). The knowledge score about non-pharmacological methods was significantly higher as compared to the pharmacological methods score (rc = 0.85; p < 0.001). Respondents' age correlated with knowledge about non-pharmacological methods (rs = -0.10,p = 0.026) but did not correlate with knowledge about pharmacological methods. Educational level correlated with knowledge about pharmacological (rs = -0.13,p = 0.007) and non-pharmacological (rs = 0.14, p = 0.003) methods concerning pain relief in labor. No correlation was found between respondents' knowledge and gravidity, number of vaginal or cesarean deliveries, and hospital referral levels for previous deliveries. Our findings support the need to implement educational programs to increase evidence-based knowledge about pain-relief methods during labor in women.

Determinants of hyperphosphatemia and its relation with hemoglobin levels among hemodialysis patients in two hospitals from Syria: a prospective cross-sectional study.

A prospective cross-sectional study was conducted among 146 HD patients from two HD centers in Syria, between June 2021 and March 2022. All patients at least 18 years old on maintenance HD were enrolled. The threshold of phosphorus (phos) level was divided by the upper normal range among HD patients (5.5mg/dl). We used parametric and nonparametric statistics, the Pearson and Spearman correlations with simple and multiple linear regressions between study variables. 36.9% of patients had a serum phos level of 5.5 or less (norm phos group), and 63.1% of patients had a serum phos level higher than 5.5 (high phos group). Also, 60.9% of patients had hemoglobin (Hb) less than 10g/dl, and 40.4% of patients had Hb at least 10g/dl. Age, type of HD access, phos binders (P-binders), parathyroid hormone (PTH), and calcium (Ca) showed significant effects on phos levels. Most patients were using arteriovenous fistula (AVF) (89.7%) as a HD access, and the meantime on HD was higher in the norm phos group compared to the high phos group. In a multivariate and univariate logistic regression analysis, hyperphosphatemia increased with increasing urea (Ur) and creatinine (Cr) levels, while the odds declined with increasing time on HD. Hb did not show a significant relation with phos by using several statistical methods. A high prevalence of hyperphosphatemia and anemia was encountered among this sample of HD patients from Syria. There was no correlation between phos and Hb levels in contrast to previous conflicting studies, which mandates future studies to evaluate this correlation and further efforts to determine the range of phos that could have a benefit on anemia with respect to other comorbidities.

Dynamics of CD4+ T-Cells and Neutralizing Antibody Responses to Three Consecutive Doses of Inactivated COVID-19 Vaccines in PLWH.

Comprehensive characterization of safety and immune responses to vaccines is crucial for the prevention and treatment of COVID-19 among people living with HIV (PLWH). This study aimed to investigate the dynamic changes in SARS-CoV-2-specific CD4+ T-cell subsets and neutralizing antibody after three consecutive doses of inactivated COVID-19 vaccines (BBIBP-CorV) among PLWH. The blood samples were collected from 165 PLWH, including 66 PLWH in the 3-month interval between the second and third dose (cohort 1) and 99 PLWH in the 5-month interval (cohort 2). Blood collection for immunogenicity analysis was performed at 1-month post-2nd vaccination, pre-3rd vaccination, and within 2-month post-3rd vaccination. Wilcoxon matched-pairs signed-rank test was applied to compare the SARS-CoV-2-specific CD4+ T cell subsets and neutralizing antibody level at different time points. The relationship among CD4+ T-cells, Tregs subpopulations and SARS-CoV-2-specific neutralizing antibody level were evaluated with Spearman non-parametriccorrelationtest. No serious adverse reactions were found among PLWH. After two-dose or three-dose inactivated COVID-19 vaccination, the absolute counts of CD4+ T-cells and Tregs subpopulations (CD4+CD25HighCD127Low Tregs, CD45RA+ rTregs and CD45RO+ eTregs) increased in two cohorts. Satisfactory SARS-CoV-2-specific neutralizing antibody responses to the third-dose vaccination were found in two cohorts, including significantly enhanced neutralizing antibody level and high neutralizing antibody seroconversion rate. In addition, SARS-CoV-2-specific neutralizing antibody level were positively associated with the absolute counts of CD4+ T-cells and Tregs subpopulations as well as the frequency of CD45RO+ eTregs in PLWH after three doses of vaccinations. The three doses of inactivated COVID-19 vaccination were both safe and effective to increase SARS-CoV-2-specific CD4+ T-cells and neutralizing antibody in two PLWH cohorts with different inoculation intervals.