Nonparametric Spearman Correlation Research Articles

Correlation between Urine Albumin Creatinin Ratio (UACR) Value to Urine Osmolality Value and Estimate Glomerular Filtration Rate (EGFR) Value on Patient with Kidney Failure

BACKGROUND : Kidney failure is one of the causes of death in the world. Laboratory tests related to kidney function are very important in the management of patients with kidney failure because they are useful in identifying any decline in kidney function, monitoring treatment and progression of kidney disease. The aim of checking the urine albumin creatinine ratio (UACR): is to assess the protein filtration function in the glomerulus. The aim of checking urine osmolality is to assess pre-renal, renal and post-renal hemodynamic status. The aim of examining the estimated glomerular filtration rate (EGFR) is to assess overall glomerular function. EGFR is the gold standard. AIMS : The aim of this research is to determine 1). the relationship between UACR values and EGFR, 2). The relationship between urine osmolality and EGFR. UACR and urine osmolality are independent variables. Meanwhile, EGFR is the dependent variable. The research sample was all chronic kidney failure in one group. Acute renal failure was made into a group and a separate analysis. METHOD : This study is a quantitative study with analytical observations through a cross sectional design using 30 samples and was conducted from May to June 2024 at the Central Laboratory Installation of Dr. Saiful Anwar Hospital, East Java Province. UACR and EGFR examination used the principle of photometric test while urine osmolality examination used the principle of electrical conductivity. The data were analyzed using the Shapiro-Wilk normality test and the Spearman non-parametric correlation test through SPSS 27. RESULT : In the normality test results, it was found that UACR and EGFR values were not normally distributed (p = <0.001) while urine osmolality values were normally distributed (p = 0.523). Spearman's non-parametric correlation test showed that there was no correlation between UACR value to urine osmolality value (p = 0.342) and EGFR value (p = 0.481). CONCLUSION : The results of this study showed no correlation between UACR value to urine osmolality value and EGFR value in patients with kidney failure.

ASSESSMENT OF ORAL BEHAVIORS AND PSYCHOSOCIAL ASPECTS OF FEDERAL POLICE OFFICERS

Objective: To evaluate the oral behaviors and psychosocial aspects of adults belonging to the Federal Police class. Methods: An observational longitudinal study was conducted with 30 adult individuals from the special group of Federal Police from the city of Curitiba, Paraná. The median age of participants was 39.70 (± 7.35) years. Quality of life, anxiety and perceived stress were assessed using the SF-36, GAD-7 and PSS-14 questionnaires respectively. Awake bruxism was evaluated using the Ecological Momentary Assessment method with the WhatsApp mobile application. Messages were sent 15 times a day, seven days a week, between 9:00 am and 7:00 pm, at random times, to choose one of five oral behaviors: teeth contact, teeth clenching, teeth grinding, mandibular bracing, and relaxed jaw muscles. Cronbach's alpha test, Shapiro-Wilk’s test, Wilcoxon's non-parametric test for paired samples, Friedman's non-parametric test for paired samples, Spearman's non-parametric correlation test, and Kruskal-Wallis non-parametric test, followed by Dunn's 2–2 comparison test were employed. Results: The most frequent oral behaviors during the week were relaxed jaw muscles (49.75 ± 29.28), teeth contact (31.50 ± 24.71), mandibular bracing (10.42± 18.99), teeth clenching (6.82 ± 8.96), and teeth grinding (1.48 ± 3.04). Quality of life was considered excellent, anxiety was low, and there was no stress. There was no correlation between stress, anxiety and quality of life and awake bruxism. Conclusion: The federal police officers evaluated showed a high frequency of awake bruxism, but the psychosocial aspects were considered excellent.

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

Despite 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.

Analysis of the relationship between upper body speed capacity and lower body strength of elite handball players specialized in winger position

Background and Study Aim. The physical demands of the winger position in elite handball require a unique combination of upper body speed and lower body strength. Therefore, identifying the optimal relationship between these two physical characteristics could improve performance for players in this role. This study aims to analyze the relationship between upper body speed capacity and lower body strength in elite handball players specializing in the winger position. Material and Methods. The study included 16 elite handball players specializing in the winger position from various teams in the National Handball League (Liga Zimbrilor). Four of these players were members of the Dinamo Bucharest team. Tests for evaluating the explosive strength of the lower limbs included the Squat Jump (SJ), Counter Movement Jump (CMJ), Counter Movement Jump with Free Arms (CMJb), and the maximum strength test (1RM) in squats. Specific technical training tests included triangular movement, a 30-meter sprint, and long-distance handball throws, focusing on speed and execution technique. Data analysis was conducted using KyPlot 6.0 software. Statistical indicators included median, standard deviation, coefficient of variation, and non-parametric Spearman correlation tests. Statistical significance was set at p < 0.05. Results. The results show no statistically significant differences in lower limb strength between high-performance handball players (HPHP) and those specialized in the winger position (PSW) across various jump and squat tests (p > 0.05). The Countermovement Jump (CMJ) test approached statistical significance (p = 0.084), while the CMJ with free arms (CMJb) and squat strength test did not show significant differences (p = 0.231 and p = 0.789, respectively). In the specific fitness tests, no significant differences were observed in the Triangle Movement test (p = 0.826), the 30-meter sprint (p = 0.404), or the handball throw test (p = 0.147). Correlation analysis indicated that squats and CMJb had positive correlations with improved performance in speed and distance tests, while CMJ showed a negative correlation with technical performance in agility tests. Conclusions. The findings suggest that lower limb strength and technical fitness are similar between elite handball players, regardless of specialization. This supports a unified training approach across player roles. However, targeted exercises like squats and CMJb may enhance specific performance aspects. These exercises improve dynamic strength and stability, which can benefit wingers' technical execution and speed.

A-073 Is there a relationship of FIB 4 with weight and insulin resistance in subjects without type 2 diabetes and with normal transaminases?

Abstract Background Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common hepatic disease, affecting 20-30% of the world's population, and is more frequent in subjects with cardiometabolic diseases. The Fibrosis-4 Index (FIB-4) is a non-invasive scoring system that helps estimate the risk of hepatic fibrosis in MASLD. It is based on age, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and platelets (PLT). MASLD is associated with high risk of insulin resistance (IR) and type 2 diabetes (DM2), and subjects with overweight or obesity are more likely to have both. In such cases the association of FIB-4 with IR and weight are evident. It is questioned whether, even in subjects without DM2 and with normal transaminases, FIB-4 could be associated with the body mass index (BMI) and the homeostasis model assessment of insulin resistance index HOMA-IR, which is the index usually used to assess IR. The objective of this study was to evaluate how FIB-4 would behave in subjects without DM2 and with normal transaminases and whether there was a correlation between FIB-4 with HOMA-IR and BMI in these subjects. Methods Authors studied the distribution of FIB-4 results and correlation of HOMA-IR and BMI with FIB-4 using the database of a clinical laboratory. We included patients aged 20-65 years, both gender, who measured fasting glucose and insulin, in the same visit, and transaminases and platelets within up to one year before or later. Were excluded hospitalized subjects, those using medications to treat DM2, dyslipidemia, subjects with blood glucose over 200 mg/dL, and AST and/or ALT above the reference range for gender and age. The methods and reference intervals were: transaminases: UVKinetic, AST < 40 U/L for men and < 32 U/L for women, ALT < 41 for men and < 33 for women; PLT: automated method, 150000-450000/µL. Glucose: hexokinase, 70 - 99 mg/dL; Insulin: electrochemiluminescence, 2-12 mcU/mL. HOMA-IR index was calculated using the equation: glucose (mg/dL) x insulin (mcIU/mL) / 405 and FIB-4 using the equation: age (years) × TGO (U/L) / [(platelets (µL) ÷1000) x √TGP (U/L))]. Shapiro Wilk test was performed to assess whether the analytes had normal distribution. To evaluate the correlation with HOMA-IR, Spearman's non-parametric correlation test was used. Results After applying the exclusion criteria and subtracting outliers 270,135 records were selected, 75% female, with 39,9 ± 10.1 years. As the parameters did not present Gaussian distribution, the results are shown in median and 25th and 75th percentiles: AST=18.9 (16-22); ALT=17.2 (13-23.3); PLT=266000 (229000-308000); glucose = 89.3 (84.2-95); insulin = 8.17 (5.52-12.8); HOMA-IR=1.81 (1.19-2.75); IMC=26.53 (23.80-29.91); FIB-4 = 0.65 (0.5 - 0.86). A weak and surprisingly negative correlation between HOMA-IR and BMI with FIB-4 was found. (HOMA-IR: r=- 0.2, p<0.001; BMI: r=- 0.1, p<0.01). Conclusions Our study showed that in a population with normal transaminases, FIB-4 had results compatible with low risk of fibrosis in subjects without DM2 even in cases with high HOMA-IR or BMI. The negative correlation was surprising and perhaps indicates that FIB-4 may not be a good predictor of liver fibrosis for this population profile.

The influence of musical experience on laparoscopic surgical skill performance: an original investigation and literature review.

As the needs and curricula of surgical residencies evolve, recent studies have focused on identifying factors that may be related to faster and more efficient surgical skill acquisition, such as experience with playing video games, sports, and other dexterous activities. The aim of this study was to elucidate the relationship between instrumental musical experience and laparoscopic surgical skill performance as well as to provide an overview of the available literature on this topic. A query from database inception to January 2023 of the PubMed database for literature discussing the association of musical experience and surgical skills was conducted. One hundred and twelve publications were sorted for relevance, yielding 16 included studies. The details of these studies were organized in a table and further analyzed. Study participants answered several questions regarding their personal instrumental musical experience and rotated through two minimally invasive surgery (MIS) skills stations. Participants received a score for each station based on level of performance. Descriptive statistics as well as non-parametric analyses and Spearman's correlations were calculated when appropriate to determine any associations between musical experience and laparoscopic surgical skill performance. One hundred individuals participated in the study. Fifty-one of the participants indicated that they played at least one musical instrument, and twelve (9.0%) of these individuals played more than one instrument. There was no statistically significant difference or correlation in scores between individuals that played an instrument and those that did not (p > 0.05). Playing a greater number of instruments did not significantly correlate with increased performance (p > 0.05). There was also no statistically significant difference or correlation in scores within the group that played instruments based on instrument type or number of years playing an instrument (p > 0.05). Experience playing musical instruments did not confer an advantage in MIS skills tested in the present study.

Spatial-temporal pattern of ecosystem services and sustainable development in representative mountainous cities: A case study of Chengdu-Chongqing Urban Agglomeration

The Sustainable Development Goals (SDGs) are essential measure for preserving the balance between human well-being and natural ecosystems. The benefit of preserving ecosystems health play a crucial role in promoting the SDGs by providing stable ecosystem services (ESs). However, the ecological health of mountainous cities is vulnerable, with relative low ecological resilience. To investigate the conflict between ecosystems and sustainable development, this study takes the Chengdu-Chongqing Urban Agglomeration as the study area. The major tasks and results in this study include: (1) using the entropy weighting method and the InVEST model, we combined remote sensing, geographic, and statistical data to quantify three types of SDGs (economic, social, environmental) and four ESs (water yield, soil conservation, habitat quality, carbon storage), and establish a localized sustainable development assessment framework that is applicable to the Chengdu-Chongqing Urban Agglomeration. The results show that from 2014 to 2020, the three types of SDGs exhibited an overall upward trend, with the lowest values occurring in 2016. The gap between different counties has narrowed, but significant regional differences still remain, indicating an unbalanced development status quo. Among the 142 counties, water yield and soil conservation values show a consistent downward trend but occupies significant interannual variations, while habitat quality and carbon storage values increases consistently each year. (2) using Spearman's nonparametric correlation analysis and multiscale geographically weighted regression model to explore the temporal variation and spatial heterogeneity of correlations between county ESs and SDGs. The results showed significant heterogeneity in the spatial trade-offs and synergies between ESs and SDGs, with two pairs of synergies weakening, seven pairs of trade-offs increasing, and the strongest negative correlation between Economic Sustainable Development Goals and habitat quality. (3) we applied the self-organizing mapping neural networks to analyze the spatial clustering characteristics of ESs-SDGs. Based on the spatial clustering effects, we divides the Chengdu-Chongqing Urban Agglomeration into four zones, and different zones have different levels of ESs and SDGs. The targeted strategies should be adopted according to local conditions. This work is of great practical importance in maintaining the stability and sustainable development of the Chengdu-Chongqing Urban Agglomeration ecosystem and provides a scientific reference for the optimal regulation of mountainous cities.

Elongated morphology of osteoid osteoma is associated with radiofrequency ablation failure in children.

To compare the frequency of elongated morphology of osteoid osteoma (OO) in children compared to adolescents and to determine if this elongated morphology is associated with radiofrequency ablation treatment failure. Retrospective review of first-time CT-guided radiofrequency ablation performed for presumed OO in patients < 21years old between 1990 and 2023. Children were considered 0 to 10years old, and adolescents were considered 11 to 20years old. Treatment failure was considered symptomatic recurrence requiring follow-up intervention. The largest tumor dimensions in three orthogonal planes were measured using multiplanar reformatted technology. Maximum tumor dimension, tumor volume, and eccentricity index were calculated. Elongated morphology criteria were (a) largest dimension > 10mm and (b) eccentricity index ≥ 3. Lesion locations were recorded. Statistical analyses included the chi-square test, Fisher's exact test, nonparametric Wilcoxon rank-sum test, receiver operating characteristic analysis, and Spearman's nonparametric rank correlation. Of 366 included patients (median 15years, IQR 11-18years, 254 male), there were 86 (23.5%) children, 280 (76.5%) adolescents, and 24 (6.6%) cases of treatment failure. Elongated morphology was more common in children (19.7%) than adolescents (8.6%) (p = 0.004) and associated with younger age (p = 0.009). Elongated morphology was associated with treatment failure in children (p = 0.045) but not adolescents (p > .99) or all patients (p = 0.17). Treatment failure was not associated with age, largest dimension, eccentricity index, volume, or location. Elongated morphology of OO is associated with younger age and radiofrequency ablation treatment failure in children. Identifying this morphology may assist with counseling and treatment planning.

The Relationship Between Maternal Nutrition During Pregnancy and Primary Tooth Caries in Stunted Toddlers: A Study at Umbulsari

Particularly during the 5th week of gestation when primary tooth enamel begins forming. Disruptions during this crucial period can lead to suboptimal enamel structure, increasing susceptibility to cavities in toddlers. A study conducted observed dental examinations of 10 stunted toddlers, all of whom exhibited dental caries. This prompted an investigation into whether maternal nutrition during pregnancy correlates with primary tooth caries in stunted toddlers. The research, a retrospective case-control study using purposive sampling of 90 respondents, utilized maternal BMI data and assessed primary tooth caries incidence. Analysis using Spearman's non-parametric correlation test indicated a significant relationship (p=0.001, r=0.351) between maternal nutritional status and primary tooth caries. Findings from the Umbulsari Community Health Center revealed that most mothers had below-normal nutritional status during pregnancy, and stunted toddlers averaged 7.3 dental caries. It was concluded that there was a relationship between maternal nutritional status during pregnancy and primary tooth caries in stunted toddlers at the Umbulsari Community Health Center with a weak correlation coefficient and the direction of correlation between variables was negative or inversely proportional.

ВЛИЯНИЕ ПРОЦЕССА ЖЕВАНИЯ НА ГЕМОДИНАМИЧЕСКИЕ ПОКАЗАТЕЛИ

Chewing has been shown to have a significant effect on systemic circulation, with circulatory responses appearing to be largely regulated by autonomic nervous activity through a more complex regulatory system than responses to other activities. However, the results of studies on the relationship between masticatory movements and changes in autonomic nervous activity and systemic circulation are still rare and contradictory. We examined changes in systemic circulation during gum chewing. Blood pressure, heart rate, and chewing electromyograms were recorded during continuous gum chewing as indicators of systemic circulation in 27 healthy subjects with normal occlusion. Nonparametric matched-sample analyzes were performed to determine the chronological changes in each variable during gum chewing, and nonparametric Spearman correlations were calculated to assess the relationship between changes in hemodynamic parameters and masticatory muscle activity. Chewing gum increased heart rate and blood pressure, indicating significant changes in sympathetic activity and vagal tone. We have identified a pronounced, statistically significant strong correlation between changes in heart rate and the magnitude of contractions of the masticatory muscles. These results suggest that changes in the activity of parts of the autonomic nervous system may be due to the trigeminal nerve reflex, which explains some of the features of the autonomic nervous regulation of chewing movements.

Aquaporin 2 in Cerebral Edema: Potential Prognostic Marker in Craniocerebral Injuries.

Despite continuous medical advancements, traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Consequently, there is a pursuit for biomarkers that allow non-invasive monitoring of patients after cranial trauma, potentially improving clinical management and reducing complications and mortality. Aquaporins (AQPs), which are crucial for transmembrane water transport, may be significant in this context. This study included 48 patients, with 27 having acute (aSDH) and 21 having chronic subdural hematoma (cSDH). Blood plasma samples were collected from the participants at three intervals: the first sample before surgery, the second at 15 h, and the third at 30 h post-surgery. Plasma concentrations of AQP1, AQP2, AQP4, and AQP9 were determined using the sandwich ELISA technique. CT scans were performed on all patients pre- and post-surgery. Correlations between variables were examined using Spearman's nonparametric rank correlation coefficient. A strong correlation was found between aquaporin 2 levels and the volume of chronic subdural hematoma and midline shift. However, no significant link was found between aquaporin levels (AQP1, AQP2, AQP4, and AQP9) before and after surgery for acute subdural hematoma, nor for AQP1, AQP4, and AQP9 after surgery for chronic subdural hematoma. In the chronic SDH group, AQP2 plasma concentration negatively correlated with the midline shift measured before surgery (Spearman's ρ -0.54; p = 0.017) and positively with hematoma volume change between baseline and 30 h post-surgery (Spearman's ρ 0.627; p = 0.007). No statistically significant correlation was found between aquaporin plasma levels and hematoma volume for AQP1, AQP2, AQP4, and AQP9 in patients with acute SDH. There is a correlation between chronic subdural hematoma volume, measured radiologically, and serum AQP2 concentration, highlighting aquaporins' potential as clinical biomarkers.

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.

Climate Influence on Blood Pressure Rhythms and Left Ventricular Parameters in Hypertensive Patients: Comparative Study.

Hypertension is a prevalent condition that significantly impacts cardiovascular health. The rhythmicity of arterial blood pressure (BP) can vary based on climatic conditions, potentially influencing the severity and outcomes of hypertensive complications. The study aims to assess the characteristics of arterial blood pressure rhythmicity in hypertensive patients and their influence on the structural parameters of the left ventricle of the heart in both temperate and subarctic regions of Russia. The study encompassed 600 randomly selected patients with arterial hypertension, categorized into two groups based on their geographic location: Group 1 comprised patients from Moscow and the Moscow region, while Group 2 included patients from the Kamchatka region. Comprehensive assessments, including cardiovascular ultra-sound, Systematic Coronary Risk Evaluation (SCORE 2 2), and the Framingham Risk Scale, were conducted for all participants. Statistical analyses included descriptive statistics, Student's t-test for comparing means, Mann-Whitney U test for non-parametric data, and Pearson and Spearman correlation analyses. P-values were calculated to assess statistical significance, with a threshold set at P < 0.05. Notably, 49% of patients residing in the subarctic region exhibited an inadequate nocturnal BP reduction (<10%). These non-dipping ABPM patterns were associated with increased diastolic BP variability and elevated Double Product (systolic BP x heart rate) compared to those with normal dipping. Furthermore, the non-dipping ABPM pattern observed in subarctic region residents demonstrated notable correlations with cardiovascular risk factors. The study reveals that patients in the subarctic region exhibit a higher prevalence of non-dipping blood pressure patterns, which is associated with increased diastolic blood pressure variability, higher nighttime blood pressure levels, and a greater incidence of left ventricular hypertrophy. These findings highlight the need for tailored diagnostic and treatment approaches to address the unique cardiovascular risks associated with different climatic conditions.

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.

Cognitive inflexibility and immunome biomarkers in children with autism spectrum disorder

Cognitive inflexibility is a transdiagnostic endophenotype that presents across a range of disorders, including autism spectrum disorder (ASD), which is maintained through adulthood, and encompasses both cognitive and behavioral rigidity. There is evidence for immune dysfunction in a subgroup of ASD, including systemic inflammation, cytokine dysregulation and anti-brain autoantibodies. Although immunome pathways are involved in ASD pathophysiology, there is little known about how they relate to symptom domains or symptom severity, and whether such biomarkers may be useful in optimizing future clinical trials. We correlated baseline clinical measures of cognitive inflexibility and resultant irritability with immunome biomarker levels in children with ASD, aged 5–18 years with ABC-I scores ≥18, CGI-S scores ≥4 and SRS-2 scores ≥66T, at Albert Einstein College of Medicine (AECOM). Non-parametric Spearman correlations and estimated multivariable regression analyses adjusting for potential confounders, including other clinical variables, race, sex, and age were completed. Strong positive correlations (rs > .70) were found between the Montefiore Einstein Rigidity Scale – Revised (MERS-R) Total Score and the pro-inflammatory cytokines IL-6 (rs=.80), granulocyte-colony stimulating factor (GCSF; rs =.72), macrophage inflammatory protein-1 alpha (MIP-1a; rs =.71). The MERS-R subscales also had moderate and strong correlations with the immunome biomarkers. The MERS-R Total Rigidity Subscale Score had a strong positive relationship with IL-6 (rs = 0.7856). Using multivariable regression analyses significant relationships were found between the MERS-R Total Rigidity Subscale Score and proinflammatory cytokine IL-18 (p = 0.02), and a nonsignificant trend was found between it and IFN-alpha2 (β = −4.982, p = 0.058). The ABC-I was significantly correlated with pro-inflammatory cytokine IL-18 (p = .013), IFN-alpha2 (p = 0.039), the anti-inflammatory cytokine IL-10 (p = 0.02), and adaptive immunity cytokine IL-2 (p = 0.041). This preliminary data is the first to examine the relationship of clinical measures of cognitive inflexibility and immunome biomarkers in children with ASD, and may provide a framework for better understanding the relationship between immunome mechanisms, cognitive inflexibility, and ASD symptomatology. Clinicaltrials.gov: NCT03202303.

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.