The International ADHD in Substance Use Disorders Prevalence (IASP) study:background, methods and study population

<p>Attention deficit/hyperactivity disorder (ADHD) is an increasingly recognized comorbid condition in subjects with substance use disorders (SUDs).</p><p>This paper describes the methods and study population of the International ADHD in Substance Use Disorders Prevalence (IASP) study. Objectives of the IASP are to determine the prevalence of ADHD in adult treatment seeking patients with SUD in different countries and SUD populations, determine the reliability and validity of the Adult ADHD Self-report Scale V 1.1 (ASRS) as ADHD screening instrument in SUD populations, investigate the comorbidity profile of SUD patients with and without ADHD, compare risk factors and protective factors in SUD patients with and without a comorbid diagnosis of ADHD, and increase our knowledge about the relationship between ADHD and the onset and course of SUD.</p><p>In this cross-sectional, multi-centre two stage study, subjects were screened for ADHD with the ASRS, diagnosed with the Conner's Adult ADHD Diagnostic Interview for DSM-IV (CAADID), and evaluated for SUD, major depression, bipolar disorder, anti social personality disorder and borderline personality disorder.</p><p>Three thousand five hundred and fifty-eight subjects from 10 countries were included. Of these 40.9% screened positive for ADHD.</p><p>This is the largest international study on this population evaluating ADHD and comorbid disorders. Copyright (c) 2013 John Wiley & Sons, Ltd.</p>

The science case and challenges of spaceborne sub-millimeter interferometry: the study case of TeraHertz Exploration and Zooming-in for Astrophysics (THEZA)

Ultra-high angular resolution in astronomy has always been an important vehicle for making fundamental discoveries. Recent results in direct imaging of the vicinity of the super-massive black hole in the nucleus of the radio galaxy M87 by the millimeter VLBI system Event Horizon Telescope (EHT) and various pioneering results of the Space VLBI mission RadioAstron provided new momentum in high angular resolution astrophysics. In both mentioned cases, the angular resolution reached the values of about 10−20 microrcseconds (0.05−0.1 nanoradian). Angular resolution is proportional to the observing wavelength and inversely proportional to the interferometer baseline length. In the case of Earth-based EHT, the highest angular resolution was achieved by combining the shortest possible wavelength of 1.3 mm with the longest possible baselines, comparable to the Earth’s diameter. For RadioAstron, operational wavelengths were in the range from 92 cm down to 1.3 cm, but the baselines were as long as ∼350,000 km. However, these two highlights of radio astronomy, EHT and RadioAstron do not”saturate” the interest to further increase in angular resolution. Quite opposite: the science case for further increase in angular resolution of astrophysical studies becomes even stronger. A natural and, in fact, the only possible way of moving forward is to enhance mm/sub-mm VLBI by extending baselines to extraterrestrial dimensions, i.e. creating a mm/sub-mm Space VLBI system. The inevitable move toward space-borne mm/sub-mm VLBI is a subject of several concept studies. In this presentation we will focus on one of them called TeraHertz Exploration and Zooming-in for Astrophysics (THEZA), prepared in response to the ESA’s call for its next major science program Voyage 2050 (Gurvits et al. 2021). The THEZA rationale is focused at the physics of spacetime in the vicinity of super-massive black holes as the leading science drive. However, it will also open up a sizable new range of hitherto unreachable parameters of observational radio astrophysics and create a multi-disciplinary scientific facility and offer a high degree of synergy with prospective “single dish” space-borne sub-mm astronomy (e.g., Wiedner et al. 2021) and infrared interferometry (e.g., Linz et al. 2021). As an amalgam of several major trends of modern observational astrophysics, THEZA aims at facilitating a breakthrough in high-resolution high image quality astronomical studies

Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

BackgroundLess invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models.MethodThe S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models-POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade-receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities.ResultsA 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p &lt; 0.001; 30-day mortality: AUC 0.94, p &lt; 0.001; in-hospital major morbidity: AUC 0.73, p &lt; 0.001; 30-day major morbidity: AUC 0.70, p &lt; 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a 'Chole-POSSUM' score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96-97% negative predictive value for major complications.ConclusionsThe Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action.Trial Registration: ClinicalTrial.gov NCT04995380

Prospective validation of the Israeli Score for the prediction of common bile duct stones in patients with acute calculous cholecystitis

Background: Existing guidelines for predicting common bile duct stones (CBDS) are not specific for acute calculous cholecystitis (ACC). This paper is a posthoc analysis of the S.P.Ri.M.A.C.C study aiming to prospectively validate on a large independent cohort of patients the Israeli Score (IS) in predicting CBDS in patients with ACC. Methods: The S.P.Ri.M.A.C.C. study is an observational multicenter prospective study endorsed by the World Society of Emergency Surgery (WSES). Between September 1st, 2021, and September 1st, 2022, 1201 participants were included. The Chi-Square test was used to compare categorical data. A Cochran-Armitage test was run to determine whether a linear trend existed between the IS and the presence of CBDS. To assess the accuracy of the prediction model, the receiver operating characteristic (ROC) curve was generated, and the area under the ROC curve (AUC) was calculated. Logistic regression was run to obtain Odds Ratio (OR). A two-tailed p < 0.05 was considered statistically significant. Results: The rate of CBDS was 1.8% in patients with an IS of 0, 4.2% in patients with an IS of 1, 24.5% in patients with 2 and 56.3% in patients with 3 (p < 0.001). The Cochran-Armitage test of trend showed a statistically significant linear trend, p < 0.001. Patients with an IS of 3 had 64.4 times (95% CI 24.8–166.9) higher odds of having associated CBDS than patients with an IS of 0. The AUC of the ROC curve of IS for the prediction of CBDS was 0.809 (95% CI 0.752–0.865, p < 0.001). By applying the highest cut-off point (3), the specificity reached 99%, while using the lowest cut-off value (0), the sensitivity reached 100%. Conclusion: The IS is a reliable tool to predict CBDS associated with ACC. The algorithm derived from the IS could optimize the management of patients with ACC