Internet Pathways in Suicidality: A Review of the Evidence

The general aim of this study was to review the scientific literature concerning the Internet and suicidality and to examine the different pathways by which suicidal risks and prevention efforts are facilitated through the Internet. An online literature search was conducted using the MEDLINE and Google Scholar databases. The main themes that were investigated included pathological Internet use and suicidality, pro-suicide websites, suicide pacts on the Internet, and suicide prevention via the Internet. Articles were screened based on the titles and abstracts reporting on the themes of interest. Thereafter, articles were selected based on scientific relevance of the study, and included for full text assessment. The results illustrated that specific Internet pathways increased the risk for suicidal behaviours, particularly in adolescents and young people. Several studies found significant correlations between pathological Internet use and suicidal ideation and non-suicidal self-injury. Pro-suicide websites and online suicide pacts were observed as high-risk factors for facilitating suicidal behaviours, particularly among isolated and susceptible individuals. Conversely, the evidence also showed that the Internet could be an effective tool for suicide prevention, especially for socially-isolated and vulnerable individuals, who might otherwise be unreachable. It is this paradox that accentuates the need for further research in this field

II Diretriz Brasileira de Transplante Cardíaco

Universidade de São Paulo Faculdade de Medicina Hospital das ClínicasIIHospital de Messejana Dr. Carlos Alberto Studart GomesUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaInstituto Dante Pazzanese de CardiologiaUniversidade Federal de Minas Gerais Hospital das ClínicasFaculdade de Medicina de São José do Rio PretoPontifícia Universidade Católica do ParanáIHospital Israelita Albert EinsteinInstituto Nacional de Cardiologia, Fundação Universitária do Rio Grande do Sul Instituto de CardiologiaReal e Benemérita Sociedade de Beneficência Portuguesa, São PauloHospital Pró-Cardíaco do Rio de JaneiroSanta Casa do Rio de JaneiroUNIFESP, EPMSciEL

Transitions between the macrostate basins analyzed by projecting the initial and final configurations of individual trajectories onto the free-energy surface.

Individual trajectories are represented as subplots with the initial and final configuration shown as black and white dots respectively. Trajectories with transitions between the basins are highlighted with a magenta outline. (TIFF)</p

Efficiency of the Replica-Exchange with Solute Tempering (REST) simulations initiated from the three CaM states assessed by the energy overlap and mean exchange acceptance probability between adjacent replicas.

(TIFF)</p

Top 8 eigenvalues of the transition probability matrix calculated at varying lag-times to identify a memoryless Markovian time.

The 95% confidence intervals of the eigenvalues are shown as shaded regions. The black solid curve delimits a shaded region where the implied timescales are shorter than the lagtime. (TIFF)</p

S13 Fig -

Transition in the stacking of aromatic residues between the (A) apo- (PDB: 1CFD) and (B) holo- (PDB: 1CLL) states of calmodulin induced by the binding of Ca2+ ions. (TIFF)</p

Fig 4 -

(A) The per-residue importance in discerning the S5, S6 and S7 macrostates calculated using the supervised Random Forest method. Plots represent the mean importance values calculated from five-fold cross-validation and the standard deviations are plotted as error bars. Physiologically important residues and those with high importance values are illustrated using red dotted lines. (B) Relative C-CaM inter-residue distances compared between the S5, S6 and S7 macrostates. The important F92, V108, N111 and F141 residues identified by the Random Forest method are illustrated as dotted lines. The increased distance between the F92-F141 and F92-V108 residue pairs in S7 are highlighted as orange and cyan circles respectively. The decreased distance between the V108-F141 residues in S7 is highlighted with a black circle/ (C) Distance between center-of-mass of the N97 and E104 residues making up the Ca2+ binding site within the S5, S6 and S7 macrostates. Each violinplot spans the 5th and 95th percentile of distances and densities are weighted by the Markov state model probabilities. The median value for each macrostate is represented as a white dot. The inter-residue distances calculated from apo- (PDB: 1CFD [9]) and holo- (PDB: 1CLL [8]) calmodulin structures are shown as grey and black dotted lines respectively. The mean inter-residue distances within MD simulations [5] of apo- and holo-CaM are shown as grey and black dashed lines respectively. The standard-deviations of the residue distances within the MD simulations are shown as a shaded area.</p