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More than half of patients with opioid use disorder for chronic non-cancer pain (CNCP) reduced their dose through a progressive opioid withdrawal supported by a rotation to buprenorphine and/or tramadol. The aim of this research is to analyse the long-term effectiveness of opioid deprescription taking into account the impact of sex and pharmacogenetics on the inter-individual variability. A cross-sectional study was carried out from October 2019 to June 2020 on CNCP patients who had previously undergone an opioid deprescription (n = 119 patients). Demographic, clinical (pain, relief and adverse events) and therapeutic (analgesic use) outcomes were collected. Effectiveness (< 50 mg per day of morphine equivalent daily dose without any aberrant opioid use behaviour) and safety (number of side-effects) were analysed in relation to sex differences and pharmacogenetic markers impact [OPRM1 genotype (rs1799971) and CYP2D6 phenotypes]. Long-term opioid deprescription was achieved in 49 % of the patients with an increase in pain relief and a reduction of adverse events. CYP2D6 poor metabolizers showed the lowest long-term opioid doses. Here, women showed a higher degree of opioid deprescription, but increased use of tramadol and neuromodulators, as well as an increased number of adverse events. Long-term deprescription was successful in half of the cases. Understanding sex and gender interaction plus a genetic impact could help to design more individualized strategies for opioid deprescription.

The dropout rate of university engineering studies is correlated with the absence of retention of freshman in the basic subjects. The aim of this work is to determine the effect of cooperative learning and the characteristics of students on learning, persistence, and academic performance. We have performed a study of learning, persistence and academic performance in an engineering physics course, comparing two groups with different teaching, one traditional and the other through cooperative learning. In addition, we have analysed the influence of the characteristics of the students on the results and the perceptions of the students regarding the teaching. The students of the cooperative learning group had a normalised average gain in the Force Concept Inventory that was 72.7% higher, a significantly higher persistence, and a final grade similar to that of the group receiving traditional teaching. The previous education and the size of the community of origin of the students had a significant effect on the persistence of the students. The perceptions of the subject and lecturer were similar in both groups.

Under an area-level random regression coefficient Poisson model, this article derives small area predictors of counts and proportions and introduces bootstrap estimators of the mean squared errors (MSEs). The maximum likelihood estimators of the model parameters and the mode predictors of the random effects are calculated by a Laplace approximation algorithm. Simulation experiments are implemented to investigate the behavior of the fitting algorithm, the predictors, and the MSE estimators with and without bias correction. The new statistical methodology is applied to data from the Spanish Living Conditions Survey. The target is to estimate the proportions of women and men under the poverty line by province. [ABSTRACT FROM AUTHOR]