Attachment and substance use in adolescence: A review of conceptual and methodological aspects

Attachment is currently considered one of the major risk and/ or protective factors for substance use in adolescence. This paper reviews the most important studies published in the last 30 years in this field, focusing on the conceptual and methodological issues that may be making it more difficult to draw conclusions about the impact of attachment – especially attachment to parents – on substance use among youths. In general, the results indicate that secure attachment or stronger attachment between parents and children acts as a protective factor against drug use, even though there is a great variability in relation to the concept of addiction and its assessment. Secondly, most of the research reviewed also covers other factors that may be conditioning the influence of attachment to parents on children’s drug use and which would explain, at least in part, the disparity of the results from different studies. Notable among such factors would be individual characteristics (such as sex, age or self-esteem) and the influence of other sources of attachment, including peers and their circumstances (such as their drug use). Finally, we discuss the importance of taking into account the mentioned conceptual and methodological considerations aspects in research on attachment as a risk and/or protective factor for drug use in adolescence. El apego se considera actualmente uno de los mayores factores de riesgo y/o protección para el consumo de sustancias en la adolescencia. El presente trabajo revisa los estudios más importantes que se han publicado en los últimos 30 años al respecto, centrándose en aquellas cuestiones conceptuales y metodológicas que pueden estar dificultando concluir qué impacto ejerce el apego, sobre todo el apego a los padres, en el consumo de sustancias de los jóvenes. Los resultados indican, en general, que el apego seguro o un mayor apego entre padres e hijos actúa como factor de protección frente al consumo de drogas, si bien existe una gran variabilidad en torno al concepto de apego y su evaluación. En segundo lugar, la mayor parte de los estudios revisados incluyen además otros factores que pueden estar condicionando la influencia del apego a los padres en el consumo de drogas de los hijos y que explicarían, al menos en parte, la disparidad de los resultados en los distintos estudios. Entre estos factores destacarían las características individuales (como el sexo, la edad o la autoestima de los individuos), y la influencia de otras fuentes de apego, como los iguales y sus circunstancias, como por ejemplo el consumo de drogas por parte de éstos. Finalmente, se discute la importancia de tener en cuenta dichas consideraciones conceptuales y metodológicas en la investigación del apego como factor de riesgo y/o protección frente al consumo de drogas en la adolescencia

Concurrent validity of the Alcohol Purchase Task for measuring the reinforcing efficacy of alcohol: an updated systematic review and meta-analysis

Background and aims: An early meta-analysis testing the concurrent validity of the Alcohol Purchase Task (APT), a measure of alcohol''s relative reinforcing value, reported mixed associations, but predated a large number of studies. This systematic review and meta-analysis sought to: (1) estimate the relationships between trait-based alcohol demand indices from the APT and multiple alcohol indicators, (2) test several moderators and (3) analyze small study effects. Methods: A meta-analysis of 50 cross-sectional studies in four databases (n = 18 466, females = 43.32%). Sex, year of publication, number of APT prices and index transformations (logarithmic, square root or none) were considered as moderators. Small study effects were examined by using the Begg–Mazumdar, Egger''s and Duval & Tweedie''s trim-and-fill tests. Alcohol indicators were quantity of alcohol use, number of heavy drinking episodes, alcohol-related problems and hazardous drinking. APT indices were intensity (i.e. consumption at zero cost), elasticity (i.e. sensitivity to increases in costs), Omax (i.e. maximum expenditure), Pmax (i.e. price associated to Omax) and breakpoint (i.e. price at which consumption ceases). Results: All alcohol demand indices were significantly associated with all alcohol-related outcomes (r = 0.132–0.494), except Pmax, which was significantly associated with alcohol-related problems only (r = 0.064). The greatest associations were evinced between intensity in relation to alcohol use, hazardous drinking and heavy drinking and between Omax and alcohol use. All the tested moderators emerged as significant moderators. Evidence of small-study effects was limited. Conclusions: The Alcohol Purchase Task appears to have concurrent validity in alcohol research. Intensity and Omax are the most relevant indices to account for alcohol involvement

Screening mutations in myosin binding protein C3 gene in a cohort of patients with Hypertrophic Cardiomyopathy

<p>Abstract</p> <p>Background</p> <p><it>MyBPC3 </it>mutations are amongst the most frequent causes of hypertrophic cardiomyopathy, however, its prevalence varies between populations. They have been associated with mild and late onset disease expression. Our objectives were to establish the prevalence of <it>MyBPC3 </it>mutations and determine their associated clinical characteristics in our patients.</p> <p>Methods</p> <p>Screening by Single Strand Conformation Polymorphisms (SSCP) and sequencing of the fragments with abnormal motility of the <it>MyBPC3 </it>gene in 130 unrelated consecutive HCM index cases. Genotype-Phenotype correlation studies were done in positive families.</p> <p>Results</p> <p>16 mutations were found in 20 index cases (15%): 5 novel [D75N, V471E, Q327fs, IVS6+5G>A (homozygous), and IVS11-9G>A] and 11 previously described [A216T, R495W, R502Q (2 families), E542Q (3 families), T957S, R1022P (2 families), E1179K, K504del, K600fs, P955fs and IVS29+5G>A]. Maximum wall thickness and age at time of diagnosis were similar to patients with <it>MYH7 </it>mutations [25(7) vs. 27(8), p = 0.16], [46(16) vs. 44(19), p = 0.9].</p> <p>Conclusions</p> <p>Mutations in <it>MyBPC3 </it>are present in 15% of our hypertrophic cardiomyopathy families. Severe hypertrophy and early expression are compatible with the presence of <it>MyBPC3 </it>mutations. The genetic diagnosis not only allows avoiding clinical follow up of non carriers but it opens new possibilities that includes: to take preventive clinical decisions in mutation carriers than have not developed the disease yet, the establishment of genotype-phenotype relationship, and to establish a genetic diagnosis routine in patients with familial HCM.</p

Positively selected amino acid replacements within the RuBisCO enzyme of oak trees are associated with ecological adaptations

Phylogenetic analysis by maximum likelihood (PAML) has become the standard approach to study positive selection at the molecular level, but other methods may provide complementary ways to identify amino acid replacements associated with particular conditions. Here, we compare results of the decision tree (DT) model method with ones of PAML using the key photosynthetic enzyme RuBisCO as a model system to study molecular adaptation to particular ecological conditions in oaks (Quercus). We sequenced the chloroplast rbcL gene encoding RuBisCO large subunit in 158 Quercus species, covering about a third of the global genus diversity. It has been hypothesized that RuBisCO has evolved differentially depending on the environmental conditions and leaf traits governing internal gas diffusion patterns. Here, we show, using PAML, that amino acid replacements at the residue positions 95, 145, 251, 262 and 328 of the RuBisCO large subunit have been the subject of positive selection along particular Quercus lineages associated with the leaf traits and climate characteristics. In parallel, the DT model identified amino acid replacements at sites 95, 219, 262 and 328 being associated with the leaf traits and climate characteristics, exhibiting partial overlap with the results obtained using PAML

Role of age and comorbidities in mortality of patients with infective endocarditis

Purpose: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Methods: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015. Patients were stratified into three age groups:<65 years, 65 to 80 years, and = 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. Results: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 = 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients =80 years who underwent surgery were significantly lower compared with other age groups (14.3%, 65 years; 20.5%, 65-79 years; 31.3%, =80 years). In-hospital mortality was lower in the <65-year group (20.3%, <65 years;30.1%, 65-79 years;34.7%, =80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%, =80 years; p = 0.003).Independent predictors of mortality were age = 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI = 3 (HR:1.62; 95% CI:1.39–1.88), and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared, the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. Conclusion: There were no differences in the clinical presentation of IE between the groups. Age = 80 years, high comorbidity (measured by CCI), and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Correct High-Level Synthesis: a Formal Perspective

This paper presents a formal synthesis system which delegates the design space exploration to non-formal, and potentially incorrect, high level synthesis tools. W ith a quadratic complexity, our system obtains either a truly correct-by-construction design, since the formal design process constitutes itself the verification process, or demonstrates that the solution found by the conventional tool was incorrect

Growth rates in two natural populations of Gasterosteus aculeatus in northwestern Spain: relationships with other life history parameters

Tasas de crecimiento en dos poblaciones naturales de Gasterosteus aculeatus en el noroeste de España: relación con otros parámetros vitales Se analizaron las tasas de crecimiento de dos poblaciones naturales de Galicia (noroeste de España) del pez espinoso Gasterosteus aculeatus, cuyo ciclo biológico es estrictamente anual. Para ello, se utilizó una función no lineal para conjuntos de datos de longitud por edad: el modelo de crecimiento de von Bertalanffy. Estas poblaciones europeas periféricas tienen las tasas de crecimiento más altas (k en el modelo de von Bertalanffy > 0,4 mes–1, en promedio) conocidas para esta especie. A partir de los parámetros del modelo de von Bertalanffy, se calcularon las tasas de mortalidad instantánea y de fecundidad de cada población, y se observó que las tasas de mortalidad de las poblaciones gallegas son de 2 a 2,3 veces superiores a las observadas en general en Gasterosteidae. La combinación de la fertilidad y la mortalidad produjo diferentes valores óptimos intermedios de eficacia biológica para las hembras maduras de cada población. En términos generales, estas diferencias encontradas en rasgos vitales con respecto a otras poblaciones estudiadas de pez espinoso se pueden interpretar como adaptaciones locales a un clima de tipo mediterráneo con un valor alto de grados–día. Por tanto, estas poblaciones situadas en los límites de la zona de distribución de la especie pueden estar localmente adaptadas a condiciones ambientales muy específicas y pueden ser de interés en los ámbitos de la ecología y la conservación

Morning surge, dipping, and sleep-time blood pressure as prognostic markers of cardiovascular risk

The recently reported Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares (MAPEC) study of 3344 subjects, with baseline BP ranging from normotension to sustained hypertension, and evaluated at least annually by 48-hour ABPM for a median duration of 5.6 years, found that a large MBPS was associated with a significantly lower CVD risk, in line with the lower risk associated with increased BP dipping. Furthermore, when the asleep BP mean was jointly incorporated with either the morning BP surge or awake BP mean in the same adjusted Cox regression model, only the asleep BP significantly predicted both total and major CVD events (CVD death, myocardial infarction, and stroke); findings were identical for the 607 MAPEC study patients with type 2 diabetes mellitus