A Novel Approach to Determining Violence Risk in Schizophrenia: Developing a Stepped Strategy in 13,806 Discharged Patients

Clinical guidelines recommend that violence risk be assessed in schizophrenia. Current approaches are resource-intensive as they employ detailed clinical assessments of dangerousness for most patients. An alternative approach would be to first screen out patients at very low risk of future violence prior to more costly and time-consuming assessments. In order to implement such a stepped strategy, we developed a simple tool to screen out individuals with schizophrenia at very low risk of violent offending. We merged high quality Swedish national registers containing information on psychiatric diagnoses, socio-demographic factors, and violent crime. A cohort of 13,806 individuals with hospital discharge diagnoses of schizophrenia was identified and followed for up to 33 years for violent crime. Cox regression was used to determine risk factors for violent crime and construct the screening tool, the predictive validity of which was measured using four outcome statistics. The instrument was calibrated on 6,903 participants and cross-validated using three independent replication samples of 2,301 participants each. Regression analyses resulted in a tool composed of five items: male sex, previous criminal conviction, young age at assessment, comorbid alcohol abuse, and comorbid drug abuse. At 5 years after discharge, the instrument had a negative predictive value of 0.99 (95% CI = 0.98–0.99), meaning that very few individuals who the tool screened out (n = 2,359 out of original sample of 6,903) were subsequently convicted of a violent offence. Screening out patients who are at very low risk of violence prior to more detailed clinical assessment may assist the risk assessment process in schizophrenia

Strategic framework for unmanned aerial systems integration in public organisations in the Dominican Republic disaster management context

This is an accepted manuscript of an article published by Elsevier in International Journal of Disaster Risk Reduction, available online at: https://doi.org/10.1016/j.ijdrr.2021.102088 The accepted version of the publication may differ from the final published version.In the Caribbean region, there is a significant yearly number of natural events incidents. The impact of those events has affected the well-being, social and economic structures of the countries in this region. The investment in disaster management strategies is a fundamental decision to the region for improving capabilities, understanding the liabilities, dealing with the disaster stages, and integrating systems and tools to obtain greater results in resilience strategies. Therefore, information technology and robotics have played an effective role bringing innovation to the traditional approaches by improving the capabilities of personnel and serves as a catalyst to rapid data collection tools for effective decision-making during disastrous situation, as has been the case of the Dominican Republic. The organic adoption process of Unmanned Aerial System (UAS) has represented a large step forward regarding this matter. Examples of the adoption process occurs based on their flexibility in their regulatory context, funding investments in testing the applications of UAS, such as surveying, delivering medical samples and spray disinfection during the COVID-19 pandemic. However, there are only some mature applications that address a future-proofing concept as well as the integration into a typical institutional workflow. Therefore, this paper aims to be an introductory guide for decision and policymakers, educators and technicians to reduce the scepticism, lack of knowledge and know-how in the adoption of reliable, practical and effective tools by providing a combination of theories from socio-technical systems (socio-technical change impact model (SCI)) and organizational level (technology-organizational-environmental) frameworks of the UAS adoption process for natural events, tasks and critical roles in disaster management taking into account the Dominican Republic context. Qualitative cases of studies were evaluated from nine (9) professionals related to disaster management in the Dominican Republic, and a semi-structured interview were used to approach the adoption process of Unmanned Aerial System (UAS) in these organisations

Double Strain-Promoted Macrocyclization for the Rapid Selection of Cell-Active Stapled Peptides.

Peptide stapling is a method for designing macrocyclic alpha-helical inhibitors of protein-protein interactions. However, obtaining a cell-active inhibitor can require significant optimization. We report a novel stapling technique based on a double strain-promoted azide-alkyne reaction, and exploit its biocompatibility to accelerate the discovery of cell-active stapled peptides. As a proof of concept, MDM2-binding peptides were stapled in parallel, directly in cell culture medium in 96-well plates, and simultaneously evaluated in a p53 reporter assay. This in situ stapling/screening process gave an optimal candidate that showed improved proteolytic stability and nanomolar binding to MDM2 in subsequent biophysical assays. α-Helicity was confirmed by a crystal structure of the MDM2-peptide complex. This work introduces in situ stapling as a versatile biocompatible technique with many other potential high-throughput biological applications