Blunted autonomic responses to emotional stimuli in alcoholism: relevance of impulsivity

La dependencia al alcohol está asociada con anormalidades en el procesamiento de las emociones y comportamientos impulsivos en la búsqueda de alcohol. Sin embargo, pocos estudios han analizado las respuestas emocionales hacia estímulos motivacionalmente relevantes en personas dependientes al alcohol usando medidas tanto autonómicas como subjetivas. En este estudio se analizó la tasa cardiaca (TC), la conductancia de la piel (CP) y las respuestas subjetivas a estímulos emocionales cotidianos en individuos dependientes al alcohol, y su asociación con la impulsividad y el consumo de alcohol. La TC y la CP fueron registradas en 28 participantes dependientes al alcohol y en 31 participantes sanos durante la visualización pasiva de imágenes emocionales placenteras, desagradables y neutras. Posteriormente, los participantes evaluaron valencia, activación y dominancia de las imágenes y completaron la Escala de Impulsividad de Barratt. Los participantes dependientes mostraron respuestas reducidas en TC y CP, tanto hacia las imágenes emocionales positivas como negativas. En el caso de la CP, estas respuestas se asociaron a la impulsividad. Los participantes dependientes al alcohol mostraron una disociación entre las respuestas fisiológicas y subjetivas, con unas respuestas autonómicas disminuidas y unas respuestas subjetivas normales. Estos resultados sugieren que los individuos dependientes al alcohol tienen problemas en utilizar el feedback fisiológico emocional al responder a estímulos emocionales relevantes, y proporcionan una evidencia inicial de la contribución de la impulsividad a los déficits de procesamiento emocional en esta población. Estos resultados son congruentes con el papel clave que juega la experiencia emocional y la impulsividad en el abuso de sustancias.Alcohol dependence is associated with abnormalities in the processing of emotional signals and impulsive alcohol-seeking behaviours, and these alterations compromise the effectiveness of treatment approaches. However, there is a lack of studies linking the experience of emotions to everyday motivationally relevant stimuli in alcohol-dependent individuals using both autonomic and selfreport measures. We analysed heart rate (HR), skin conductance (SC) and subjective emotional reactivity to everyday affective stimuli in alcohol-dependent individuals, and their associations with impulsivity and degree of alcohol consumption. SC and HR were continuously monitored in 28 alcohol-dependent individuals and in 31 non-alcohol healthy controls during passive viewing of pleasant, unpleasant, and neutral emotional pictures. Participants assessed the pictures for valence, arousal, and dominance and completed the Barratt Impulsiveness Scale. Alcohol-dependent individuals showed reduced HR and SC reactivity to both positive and negative emotional stimuli. In the case of SC, this blunted response was associated with impulsivity. Furthermore, alcohol-dependents displayed decoupled physiological and subjective responses, with blunted autonomic responses and normal subjective reports regarding emotional stimuli. Our findings indicate that alcohol-dependent individuals failed to use emotional autonomic feedback in response to natural, emotionally relevant stimuli, and provide initial evidence of the contribution of impulsivity to emotional processing deficits in this population. These results are in keeping with the proposed key role played by emotional experience and impulsivity in substance abuse

Impaired Decoding of Fear and Disgust Predicts Utilitarian Moral Judgment in Alcohol-Dependent Individuals

The definitive version is available at www3.interscience.wiley.comBackground: Recent studies of moral reasoning in patients with alcohol use disorders have indicated a “utilitarian” bias, whereby patients are more likely to endorse emotionally aversive actions in favor of aggregate welfare (e.g., throwing a dying person into the sea to keep a lifeboat of survivors afloat). Here, we investigate the underlying psychological and neuropsychological processes. Methods: Alcohol-dependent individuals (n = 31) and healthy comparison participants (n = 34) completed a validated moral judgment task, as well as measures of impulsivity, mood symptoms (anxiety and depression), and emotional face recognition. Results: Alcohol-dependent individuals were more likely to endorse utilitarian choices in personal moral dilemmas compared with controls and rated these choices as less difficult to make. Hierarchical regression models showed that poorer decoding of fear and disgust significantly predicted utilitarian biases in personal moral dilemmas, over and above alcohol consumption. Impulsivity and mood symptoms did not predict moral decisions. Conclusions: These findings suggest that impaired fear and disgust decoding contributes to utilitarian moral decision-making in alcohol-dependent individuals.This work is supported by the “Red de Trastornos Adictivos”, RETICS Program, Instituto de Salud Carlos III, Spanish Ministry of Health (PI: AVG) and the Junta de Andaluc ıa under the Research Project P07.HUM 03089 (PI: MPG). MCP is funded by FPU predoctoral research grant (AP 2008-01848) from Spanish Ministry of Education and Science

Are batterers different from other criminals? An fMRI study

Intimate partner violence (IPV) is a complex and global phenomenon that requires a multi-perspective analysis. Nevertheless, the number of neuroscientific studies conducted on this issue is scarce as compared with studies of other types of violence, and no neuroimaging studies comparing batterers to other criminals have been conducted. Thus, the main aim of this study was to compare the brain functioning of batterers to that of other criminals when they are exposed to IPV or general violence pictures. An fMRI study was conducted in 21 batterers and 20 other criminals while they observed IPV images (IPVI), general violence images (GVI) and neutral images (NI). Results demonstrated that batterers, compared with other criminals, exhibited a higher activation in the anterior and posterior cingulate cortex and in the middle prefrontal cortex and a decreased activation in the superior prefrontal cortex to IPVI compared to NI. The paired t-test comparison between IPVI and GVI for each group showed engagement of the medial prefrontal cortex, the posterior cingulate and the left angular cortices to IPVI in the batterer group only. These results could have important implications for a better understanding of the IPV phenomenon

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

The Lysosome and Intracellular Signalling.

In addition to being the terminal degradative compartment of the cell's endocytic and autophagic pathways, the lysosome is a multifunctional signalling hub integrating the cell's response to nutrient status and growth factor/hormone signalling. The cytosolic surface of the limiting membrane of the lysosome is the site of activation of the multiprotein complex mammalian target of rapamycin complex 1 (mTORC1), which phosphorylates numerous cell growth-related substrates, including transcription factor EB (TFEB). Under conditions in which mTORC1 is inhibited including starvation, TFEB becomes dephosphorylated and translocates to the nucleus where it functions as a master regulator of lysosome biogenesis. The signalling role of lysosomes is not limited to this pathway. They act as an intracellular Ca2+ store, which can release Ca2+ into the cytosol for both local effects on membrane fusion and pleiotropic effects within the cell. The relationship and crosstalk between the lysosomal and endoplasmic reticulum (ER) Ca2+ stores play a role in shaping intracellular Ca2+ signalling. Lysosomes also perform other signalling functions, which are discussed. Current views of the lysosomal compartment recognize its dynamic nature. It includes endolysosomes, autolysosome and storage lysosomes that are constantly engaged in fusion/fission events and lysosome regeneration. How signalling is affected by individual lysosomal organelles being at different stages of these processes and/or at different sites within the cell is poorly understood, but is discussed

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Toma de decisiones morales en drogodependencias: aproximación neuropsicológica

Tesis Univ. Granada. Departamento de Personalidad, Evaluación y Tratamiento Psicológic

Juicios morales en drogodependencias

Introducción. El juicio moral es un constructo relevante para la comprensión de las adicciones por implicar la integración de procesos cognitivos y emocionales y por su repercusión sobre la conducta social y legal de los consumidores. Objetivo. Investigar los juicios morales de policonsumidores de sustancias que siguen tratamiento en una comunidad terapéutica. Material y métodos. Participaron 32 varones policonsumidores de sustancias y 32 no consumidores que completaron la versión española de la batería de dilemas morales de Moore. Resultados. Los resultados mostraron que los juicios morales de los policonsumidores difieren significativamente del grupo no consumidor, siguiendo un patrón utilitarista en el que se asume una conducta emocionalmente aversiva en favor de un beneficio mayor (por ejemplo, matar a una persona para salvar un mayor número de vidas). Conclusiones. Este hallazgo sugiere la existencia de una alteración en la toma de decisiones morales en la población de policonsumidores, que podría estar relacionada con los problemas psicosociales y legales (tráfi co de drogas, robo, etc.) que se asocian a esta población.Ministerio de Educación, Cultura y DeporteJunta de Andalucía.Depto. de Psicología Social, del Trabajo y DiferencialFac. de PsicologíaTRUEpu