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by Carlos Miguel Sirvent-Ruiz, María Miranda, María de la Villa Moral-Jiménez
BackgroundWithdrawal from addiction treatment is a frequent but difficult-to-predict contingency. We clarify and contextualize the concept of dropouts in addiction treatment, as well as the external and internal elements that most frequently lead to such dropouts. The main instruments used to measure dropout are summarized, after which a new tool, Predictors of Dropout from Addiction Treatment (PDAT) scale, is presented. The PDAT consists of four factors: 1) Motivation: desire to recover and to actively engage in current treatment; 2) Craving: longing for the use of substances and/or the substance addiction environment; 3) Problem awareness: level of insight, or degree of knowledge, and ability to objectify the problem and the disease, with the renunciations and limitations that this entails; and 4) Dysphoria: dyade inner restlessness – moodiness, i.e., emotional disturbance and depressive anticipation that precedes treatment withdrawal.
MethodsThe sample consisted of 243 addicted subjects in residential treatment, ranging in age from 18 to 63 years (average = 38.43, standard deviation = 10.95), who completed an initial 26-item PDAT questionnaire. The factor structure of the PDAT was determined by factor analysis. Mixed effects logistic regressions and receiver operating characteristics curve (ROC) analyses were applied to assess the predictive validity of the PDAT. Results: The 13-item PDAT showed adequate reliability and convergent and discriminant validity, with both the general scale and each of its factors having predictive validity 7 and 15 days after administration.
ConclusionThe scale is a useful instrument with proven clinical efficacy and brevity of application. In addition, its four factors are useful for targeting interventions based on the unbalanced factors.
by Pedro Tadao Hamamoto Filho, Maria de Lourdes Marmorato Botta Hafner, Zilda Maria Tosta Ribeiro, Alba Regina de Abreu Lima, Leandro Arthur Diehl, Neide Tomimura Costa, Maria Cristina de Andrade, Samira Yarak, Patrícia Moretti Rehder, Júlio César Moriguti, Angélica Maria Bicudo
BackgroundIt has been proposed that the school origin of items for cross-institutional Progress Tests (PTs) may introduce a bias in favour of students from the same school, posing a potential threat to the validity and reliability of PT results and cross-institutional comparisons. The aim of this study was to examine whether origin bias is present in a Brazilian cross-institutional PT examination.
MethodsThis study conducted a cross-sectional analysis of seven schools affiliated with the oldest PT consortium in Brazil, utilising a pooled analysis of differences in students’ performance concerning self and non-self items. A proportional meta-analysis of the items’ rate differences and confidence intervals with random effects was performed, providing an odds ratio (OR) for self and non-self items. Differences between the two groups of items were assessed by scrutinising whether the OR and 95% confidence intervals overlapped.
ResultsThe findings indicated no discernible differences in psychometric indices based on the school responsible for item creation. Three schools consistently demonstrate superior performance on items authored by their faculty, however, these they also excelled on non-self items. Furthermore, an overlap in the 95% confidence intervals for both self and non-self items was observed across all seven schools.
ConclusionsIn contrast to prior reports, this study revealed the absence of origin bias, suggesting that adoption of best practices in blueprinting, item writing, and editing may have played a role in mitigating such bias.
by Abdallah Tageldein Mansour, Safaa I. Khater, Hemmat M. Eissa, Helal F. Al-Harthi, Areej A. Eskandrani, Mohammed Ageeli Hakami, Wafa S. Alansari, Amirah Albaqami, Hanan M. Alharbi, Tarek Khamis, Doaa Ibrahim
The medicinal application of pomegranate peel extract enriched with polyphenols (PPE) as a therapeutic strategy for managing inflammatory bowel diseases (IBD) is still limited. Integrating pomegranate peel extract (PPE) into an effective nanocarrier system could enhance its mechanistic actions, potentially aiding in the remission of colitis. Therefore, this approach aimed to enhance PPE’s stability and bioavailability and investigate mitigating impact of pomegranate peel extract-loaded nanoparticles (PPE-NPs) in a colitis model. Colonic injury was induced by 5% dextran sulfate sodium (DSS) and efficacy of disease progression after oral administration of PPE-NPs for 14 days was assessed by evaluating clinical signs severity, antioxidant and inflammatory markers, expressions of endoplasmic reticulum associated genes and histopathological and immunostaining analysis in colonic tissues. Clinical signs and disease activity index were effectively reduced, and the levels of fecal calprotectin were decreased in groups treated with PPE-NPs compared to DSS group. The colitic group showed a significant increase (P IL-17, TNF-α, and IL-1β (increased up to 2.99, 4.36 and 4.90 respectively unlike PPE-NPsIII that recorded reduced levels of CRP, MPO and NO (8,96, 78.30 and 123 nmol/g tissue respectively) and much lower (P CHOP, JUNK, ATF6, BIP, and Elf-2) and immunostaining expression regulation of key markers regulating autophagy (Beclin-2) in this group. The histopathological changes in the colon were less severe in the PPE-NPs received groups (especially at the level of 150 mg/kg) compared to DSS group. Collectively, these findings suggest that the nanoencapsulation of PPE enhances its effectiveness in promoting recovery of colonic tissue damage and achieving remission of colitis.by Eugénie M. Kamabu, Justin L. Paluku, William P. Howlett, Abid M. Sadiq, Eliada B. Nziku, Doreen T. Eliah, Ibrahim Ali Ibrahim Muhina, Fuad H. Said, Tumaini E. Mirai, Elifuraha W. Mkwizu, Furaha S. Lyamuya, Elichilia R. Shao, Kajiru G. Kilonzo, Venance P. Maro, Sarah J. Urasa, Nyasatu G. Chamba
BackgroundAmong acute stroke patients (ASPs), diabetes mellitus (DM) is associated with a higher risk of death, functional dependency, and recurrence. This study aimed to determine the impact of DM on the 30-day mortality among admitted ASPs in northern Tanzania.
Materials and methodsThis was a hospital-based prospective cohort study performed among ASPs with and without DM who were admitted to Kilimanjaro Christian Medical Centre from November 2022 to May2023. ASPs were followed for 30 days after the onset of an acute stroke to identify the primary outcome, which was all-cause mortality. Descriptive statistics, logistic regression, and survival analysis were conducted,
ResultsOut of 213 ASP, 82 (38.5%) had DM. The overall crude mortality rate was 46.9%. ASPs with DM had a higher mortality rate of 53.7% compared with those without DM (42.7%). A higher proportion of acute stroke patients with DM (84.1%) had a poor outcome (mRS 3-6) (p = 0.038). DM was statistically non-significant for 30-day mortality (aHR 1.56; 95% CI: 0.73–3.32; p = 0.252). However, fever (p = 0.005), severe admission Glasgow coma scale (p = 0.005), severe stroke (p = 0.008), elevated serum creatinine (p = 0.008), and an abnormal respiratory pattern (p = 0.042), were predictors of 30-day mortality,
ConclusionThis study demonstrated a high mortality in ASPs. Although DM did not have a significant impact on 30-day mortality, other factors, such as altered mental state, stroke severity, fever, elevated creatinine, and abnormal respiration, need to be accounted for that may have a significant impact on the mortality in ASPs. These findings highlight the significant burden of DM in stroke patients and underscore the importance of early diagnosis and treatment of ASPs, in the hopes of improving clinical practice and guidelines and reducing morbidity and mortality in Tanzania.
by Isabela Bittencourt Basso, Pedro Felipe de Jesus Freitas, Aline Xavier Ferraz, Ana Julia Borkovski, Ana Laura Borkovski, Rosane Sampaio Santos, Rodrigo Nunes Rached, Erika Calvano Küchler, Angela Graciela Deliga Schroder, Cristiano Miranda de Araujo, Odilon Guariza-Filho
Characteristics of the mandible structures have been relevant in anthropological and forensic studies for sex prediction. This study aims to evaluate the coronoid process, condyle, and sigmoid notch patterns in sex prediction through supervised machine learning algorithms. Cephalometric radiographs from 410 dental records of patients were screened to investigate the morphology of the coronoid process, condyle, and sigmoid notch and the Co-Gn distance. The following machine learning algorithms were used to build the predictive models: Decision Tree, Gradient Boosting Classifier, K-Nearest Neighbors (KNN), Logistic Regression, Multilayer Perceptron Classifier, Random Forest Classifier, and Support Vector Machine (SVM). A 5-fold cross-validation approach was adopted to validate each model. Metrics such as area under the curve (AUC), accuracy, recall, precision, and F1 Score were calculated for each model, and ROC curves were constructed. All tested variables demonstrated statistical significance (p
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