Psychometric properties of the Ndetei–Othieno–Kathuku (NOK) Scale: A mental health assessment tool for an African setting

Background: Research suggests that psychiatric conditions in children and adolescents are highly debilitating, with sparse resources for assessment and treatment in low- and middle-income countries (LMICs). Objectives: The primary aim of this study was to evaluate the reliability, validity, and latent factor structure of an ethnographically-grounded assessment instrument for detecting common mental health complaints among rural Kenyan children and adolescents. Methods: The Ndetei–Othieno–Kathuku Scale (NOK) was delivered to 2 282 children aged 10 to 18 years old. Exploratory factor analysis identified four latent factors. This structure was confirmed in subsequent confirmatory factor analyses. External validity was explored by investigating associations among NOK factors and Youth Self-Report DSM-oriented scales. Results: Findings suggest the NOK possesses good internal reliability and a four-factor latent structure corresponding to depression, anxiety, somatic complaints, and a mixed factor. Significant associations ranging from small to medium effect sizes were noted between NOK factors and YSR DSM-oriented scales. Conclusions: Exploratory findings suggest that the NOK possesses adequate psychometric properties among this population. This ethnographically-grounded instrument may be uniquely suited to screening for mental health complaints among Kenyan children and adolescents

The Lifetime Burden of Schizophrenia as Estimated by a Government-Centric Fiscal Analytic Framework

Objective: To estimate the fiscal consequences of schizophrenia compared to the general US population using a “government perspective” fiscal analytic modeling framework capturing lost tax revenue and broader government costs in 2021. Methods: Schizophrenia was modeled from age 23 using a cohort-based Markov chain with 6-week cycles, simulating the effect of antipsychotic treatment sequences on remission and relapse. Markov states were defined using efficacy and safety outcomes from short- and long-term clinical trials. Mortality was based on US lifetables, schizophrenia-related suicide, and cardiovascular risks. A semi-Markov model with annual cycles simulated the likelihood and costs of incarceration and homelessness in community-based individuals. Lifetime fiscal consequence were estimated conditionally to survival, remission/relapse status, and likelihood of socioeconomic outcomes. Costs and life years were discounted at 3.0% annually. Uncertainty was explored in 1-way and scenario analyses. Results: Unemployment, disability, incarceration, homelessness, health care use, and productivity losses were more common in people living with schizophrenia. Schizophrenia was associated with a $1,540,042 per person lifetime fiscal loss to the government, with$56,707 per life year lived with schizophrenia. Health care costs represented 41.9% of the fiscal losses, 39.4% were due to criminal and homelessness costs, and 17.5% related to foregone tax revenue. Considering a 1.19% prevalence of schizophrenia, the estimated annual fiscal burden in the US was $173.6 billion. Conclusions: The fiscal framework illustrates how schizophrenia influences taxation and government transfer payments over time. These findings can be used to augment cost-effectiveness analyses and inform stakeholders of the fiscal impact of schizophrenia to inform priority interventions.</p

MARKET AND ASSORTMENT OF RASPBERRY PRODUCTS IN THE REPUBLIC OF SERBIA AND IN THE WORLD

This paper analyses raspberry market dynamics in the world; importance and possibilities for getting raspberry products, such as juices, concentrates, syrups, pastes and raspberry juice powder, in the higher processing stages. Considerably higher economic effects (market prices even higher than 60 EUR per kg) could be reached if these products are offered in the internal market, and especially if these products are exported. This is the reason why the overall supply of these products, aimed at winning the adequate place in the internal market as well as in the external market, despite the ever increasing competition with regard to the quantity and quality, should be derived from the production/objects which are working in accordance with HACCP standards, and it should have a recognizable trade mark and an original packaging, as a symbol of its origin and quality

Los puertos perdidos del Tinto : un enfoque multidisciplinar

Estudio sobre los puertos fluviales del río Tinto. Causas de su desaparición. Propuesta de recuparación de uno de ellos.Study on the RioTinto viver ports. Reason for the disappearance. Recovery proposal port

Multilevel Stochastic Optimization for Imputation in Massive Medical Data Records

Exploration and analysis of massive datasets has recently generated increasing interest in the research and development communities. It has long been a recognized problem that many datasets contain significant levels of missing numerical data. We introduce a mathematically principled stochastic optimization imputation method based on the theory of Kriging. This is shown to be a powerful method for imputation. However, its computational effort and potential numerical instabilities produce costly and/or unreliable predictions, potentially limiting its use on large scale datasets. In this paper, we apply a recently developed multi-level stochastic optimization approach to the problem of imputation in massive medical records. The approach is based on computational applied mathematics techniques and is highly accurate. In particular, for the Best Linear Unbiased Predictor (BLUP) this multi-level formulation is exact, and is also significantly faster and more numerically stable. This permits practical application of Kriging methods to data imputation problems for massive datasets. We test this approach on data from the National Inpatient Sample (NIS) data records, Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Numerical results show the multi-level method significantly outperforms current approaches and is numerically robust. In particular, it has superior accuracy as compared with methods recommended in the recent report from HCUP on the important problem of missing data, which could lead to sub-optimal and poorly based funding policy decisions. In comparative benchmark tests it is shown that the multilevel stochastic method is significantly superior to recommended methods in the report, including Predictive Mean Matching (PMM) and Predicted Posterior Distribution (PPD), with up to 75% reductions in error.Comment: 18 pages, 2 figure

Magnesium, Aging, and the Elderly Patient

Magnesium, beyond any doubt, plays an important role in metabolism. Alterations of magnesium levels have an impact on many organs and systems, especially during aging. We had 156 participants aged 60–93 years (average 74.7 years) in our survey. Of them, 49 were men and 107 were women. Treatment with loop diuretics (Furosemid and Bumetanide) and magnesium levels was correlated, as well as the influence of magnesium levels on life span. Serum magnesium levels were measured in patients receiving diuretics and in the control group. Also, magnesium levels were measured in patients who passed away in the course of their disease and were compared with the control group. Magnesium levels in the diuretic group (100 patients) were 0.93 ± 0.094 mmol/l, while the average levels in the control group of 56 patients were 0.89 ± 0.075 mmol/l. In 29 patients who passed away, average magnesium levels were 0.92 ± 0.078 mmol/l, while in the control group (127 patients), magnesium levels were 0.93 ± 0.083 mmol/l. The differences were not statistically significant. There were no differences in serum magnesium of the elderly persons investigated regarding age group, gender, or type of diuretics. If methods of determining ionizing magnesium in serum or intracellular magnesium are not available, normal magnesium values in the serum are to be taken with a qualified acceptance

Comparative Bioequivalence of Tablet and Capsule Formulations of Ulotaront and the Effect of Food on the Pharmacokinetics of the Tablet Form in Humans

Abstract Introduction Ulotaront (SEP-363856), a dual trace animeassociated receptor 1 (TAAR1) and 5-HT1A receptor agonist, is in phase 3 clinical development for the treatment of schizophrenia. This study evaluated the comparative bioequivalence (BE) between tablet and capsule formulations of ulotaront and the food effect (FE) on pharmacokinetics (PK) of tablet form in healthy adult human subjects. Methods The BE study applied an open-label two-period crossover design in 24 healthy volunteers. Subjects were randomly assigned (1:1) to dosing sequence AB or BA (A, 25 mg ulotaront tablet; B, 25 mg ulotaront capsule). The FE study also used an open-label randomized two-period crossover design in 20 healthy volunteers. Subjects were fasted overnight then randomly assigned (1:1) to dosing sequence AB or BA (A, fasted condition; B, fed condition). Dosing periods were separated by 1 week for both studies. Serial plasma samples from each period were collected and analyzed by LC–MS/MS. PK parameters were calculated using Phoenix WinNonlin® software. Results For the BE study, geometric mean ulotaront C max values were 93.28 and 86.98 ng/mL for tablet and capsule, respectively. C max ratio was 107.25% (90% CI 101.84–112.94%). Geometric mean ulotaront area under the plasma concentration–time curve from time 0 to infinity (AUC0–∞) values were 868.8 and 829.3 ng·h/mL for tablet and capsule, respectively. AUC0–∞ ratio was 104.76% (90% CI 100.68109.01%). For the FE study, geometric mean ulotaront C max was 157.89 and 157.95 ng/mL under fed and fasted conditions, respectively. Geometric mean ratio of C max was 99.96% (90% CI 94.48–105.77%). Geometric mean ulotaront AUC0–∞ was 1584.2 ng·h/mL fed and 1589.2 ng·h/mL fasted. Geometric mean ratio for AUC0–∞ was 99.69% (90% CI 95.02–104.58%). There was a delay in t max (median difference 1.47 h) in the fed condition. Conclusions The results showed geometric mean ratios and 90% CIs for both C max and AUC0–∞ for ulotaront were well within typical bioequivalence criteria of 80–125% for both the BE and FE studies, thereby confirming the bioequivalence of the two dosage forms and no significant food effect