Predictive Modeling of Adolescent Cannabis Use From Multimodal Data

Predicting teenage drug use is key to understanding the etiology of substance abuse. However, classic predictive modeling procedures are prone to overfitting and fail to generalize to independent observations. To mitigate these concerns, cross-validated logistic regression with elastic-net regularization was used to predict cannabis use by age 16 from a large sample of fourteen year olds (N=1,319). High-dimensional data (p = 2,413) including parent and child psychometric data, child structural and functional MRI data, and genetic data (candidate single-nucleotide polymorphisms, SNPs ) collected at age 14 were used to predict the initiation of cannabis use (minimum six occasions) by age 16. Analyses were conducted separately for males and females to uncover sex-specific predictive profiles. The performance of the predictive models were assessed using the area under the receiver-operating characteristic curve ( ROC AUC ). Final models returned high predictive performance (generalization mean ROC AUCmales=.71, mean ROC AUCfemales=.81) and contained psychometric features common to both sexes. These common psychometric predictors included greater stressful life events, novelty-seeking personality traits of both the parent and child, and parental cannabis use. In contrast, males exhibited distinct functional neurobiological predictors related to a response- inhibition fMRI task, whereas females exhibited distinct neurobiological predictors related to a social processing fMRI task. Furthermore, the brain predictors exhibited sex- specific effects as the brain predictors of cannabis use for one sex failed to predict cannabis use for the opposite sex. These sex-specific brain predictors also exhibited drug- specific effects as they failed to predict binge-drinking by age 16 in an independent sample of youths. When collapsed across sex, a gene-specific analysis suggested that opioid receptor genetic variation also predicted cannabis use by age 16. Two SNPs on the gene coding for the primary mu-opioid receptor exhibited genetic risk effects, while one SNP on the gene coding for the primary delta-opioid receptor exhibited genetic protective effects. Taken together, these results demonstrate that adolescent cannabis use is reliably predicted in males and females from shared and unique biobehavioral features. These analyses also underscore the need for refined predictive modeling procedures as well as sex-specific inquiries into the etiology of substance abuse. The sex-specific risk-profiles uncovered from these analyses might inform potential etiological mechanisms contributing to substance abuse in adolescence as all predictors were measured prior to the onset of cannabis use

Biobehavioral Predictors Of Cannabis Use In Adolescence

Cannabis use initiated during adolescence may precipitate lasting consequences on the brain and behavioral health of the individual. However, research on the risk factors for cannabis use during adolescence has been largely cross-sectional in design. Despite the few prospective studies, even less is known about the neurobiological predictors. This dissertation improves on the extant literature by leveraging a large longitudinal study to uncover the predictors of cannabis use in adolescent samples collected prior to exposure. All data were drawn from the IMAGEN study and contained a large sample of adolescents studied at age 14 (N=2,224), and followed up at age 16 and 19. Participants were richly characterized using psychosocial questionnaires, structural and functional MRI, and genetic measurements. Two hypothesis-driven studies focused on amygdala reactivity and two data-driven studies across the feature domains were completed to characterize cannabis use in adolescence. The first study was cross-sectional and identified bilateral amygdala hyperactivity to angry faces in a sample reporting cannabis use by age 14 (n=70). The second study determined this amygdala effect was predictive of cannabis use by studying a sample of cannabis-naïve participants at age 14 who then used cannabis by age 19 (n=525). A dose-response relationship was observed such that heavy cannabis users exhibited higher amygdala reactivity. Exploratory analyses suggested amygdala reactivity decreased from age 14 to 19 within the cannabis sample, although statistical significance was not found. In the third study, data-driven machine learning analyses predicted cannabis initiation by age 16 separately for males (n=207) and females (n=158) using data from all feature domains. These analyses identified a sparse set of shared psychosocial predictors, whereas the identified brain predictors exhibited sex- and drug-specificity. Additional analyses predicted initiation by age 19 and identified a sparse set of psychosocial predictors for females only (n=145). The final study improved on drug-specificity by performing differential prediction analyses between matched samples of participants who initiated cannabis+binge drinking vs. binge drinking only by age 16 (males n=178; females n=148). A sparse subset of psychosocial predictors identified in the third study was reproduced, and novel brain predictors were identified. Those analyses were unique as they compared two machine learning algorithms, namely regularized logistic regression and random forest analyses. These studies substantiated the use of both hypothesis- and data-driven prediction analyses applied to large longitudinal datasets. They also addressed common issues related to human addiction research by examining sex-differences and drug-specificity. Critically, these studies uncovered predictors of use in samples collected prior to cannabis-exposure. The identified predictors are therefore disentangled from consequences of use. Results from all studies inform etiological mechanisms influencing cannabis use in adolescence. These findings can also be used to stratify risk in vulnerable adolescents and inform targets for interventions designed to curb use

Russian nationalism and political stability in the USSR

Includes bibliographical reference

White Paper AGA: Drug Development for Eosinophilic Esophagitis

Since first characterized in 2 small case series in the early 1990s, eosinophilic esophagitis (EoE) has emerged as a commonly identified cause of esophageal symptoms in children and adults. Although several highly effectively dietary, pharmacologic, and endoscopic therapies have been reported, none is currently approved by either the US Food and Drug Administration (FDA) or European regulatory authorities. Evolving diagnostic criteria have challenged drug development, in particular the recognition of complex interactions with the most prevalent esophageal disorder, gastroesophageal reflux disease (GERD). Heterogeneity in the clinical presentations of affected children and adults has created difficulties with uniform inclusion criteria and the development of disease-specific, patient-reported outcome (PRO) instruments. Furthermore, controversies regarding the appropriate therapeutic endpoints of EoE have impeded the design of clinical trials. Despite these obstacles, collaborative efforts by investigators, industry, the FDA, and patient advocacy groups have resulted in substantial progress in drug development in EoE over the past 2 decades. The purpose of this article is to summarize discussions on EoE based on the 2016 Drug Development Conference sponsored by the Center for Diagnostics and Therapeutics of the American Gastroenterological Association

Accumulation of p53 protein in normal, dysplastic, and neoplastic Barrett's oesophagus

Accumulation of p53 protein was determined by immunohistochemisty in archival material of biopsy specimens from 102 patients with Barrett's oesophagus with different grades of dysplasia, in 24 oesophageal adenocarcinomas associated with Barrett's oesophagus, and in 23 cases of metaplatic epithelium adjacent to these carcinomas. Immunostaining for the p53 protein was found in 23/102 (23 per cent) cases of the Barrett's oesophagus biopsies and in 12/23 (52 per cent) cases of Barrett's oesophagus adjacent to adenocarcinoma. Significant correlations were found between the grade of dysplasia and p53 immunoreactivity in both Barrett's biopsies without adenocarcinoma (P<0.001) and Barrett's oesophagus adjacent to adenocarcinoma (P<0.05). In the adenocarcinomas, intense nuclear immunohistochemical staining for p53 was diffusely or focally present in 20/24 (83 per cent) of the specimens. In Barrett's oesophagus, p53 is a progression marker with high expression in high-grade dysplasia (89 per cent) and adenocarcinoma (83 per cent)

Cannabis use in early adolescence: evidence of amygdala hypersensitivity to signals of threat

Cannabis use in adolescence may be characterized by differences in the neural basis of affective processing. In this study, we used an fMRI affective face processing task to compare a large group (n = 70) of 14-year olds with a history of cannabis use to a group (n = 70) of never-using controls matched on numerous characteristics including IQ, SES, alcohol and cigarette use. The task contained short movies displaying angry and neutral faces. Results indicated that cannabis users had greater reactivity in the bilateral amygdalae to angry faces than neutral faces, an effect that was not observed in their abstinent peers. In contrast, activity levels in the cannabis users in cortical areas including the right temporal-parietal junction and bilateral dorsolateral prefrontal cortex did not discriminate between the two face conditions, but did differ in controls. Results did not change after excluding subjects with any psychiatric symptomology. Given the high density of cannabinoid receptors in the amygdala, our findings suggest cannabis use in early adolescence is associated with hypersensitivity to signals of threat. Hypersensitivity to negative affect in adolescence may place the subject at-risk for mood disorders in adulthood

Functional connectivity evidence of cortico-cortico inhibition in temporal lobe epilepsy.

Epileptic seizures can initiate a neural circuit and lead to aberrant neural communication with brain areas outside the epileptogenic region. We focus on interictal activity in focal temporal lobe epilepsy and evaluate functional connectivity (FC) differences that emerge as function of bilateral versus strictly unilateral epileptiform activity. We assess the strength of FC at rest between the ictal and non-ictal temporal lobes, in addition to whole brain connectivity with the ictal temporal lobe. Results revealed strong connectivity between the temporal lobes for both patient groups, but this did not vary as a function of unilateral versus bilateral interictal status. Both the left and right unilateral temporal lobe groups showed significant anti-correlated activity in regions outside the epileptogenic temporal lobe, primarily involving the contralateral (non-ictal/non-pathologic) hemisphere, with precuneus involvement prominent. The bilateral groups did not show this contralateral anti-correlated activity. This anti-correlated connectivity may represent a form of protective and adaptive inhibition, helping to constrain epileptiform activity to the pathologic temporal lobe. The absence of this activity in the bilateral groups may be indicative of flawed inhibitory mechanisms, helping to explain their more widespread epileptiform activity. Our data suggest that the location and build up of epilepsy networks in the brain are not truly random, and are not limited to the formation of strictly epileptogenic networks. Functional networks may develop to take advantage of the regulatory function of structures such as the precuneus to instantiate an anti-correlated network, generating protective cortico-cortico inhibition for the purpose of limiting seizure spread or epileptogenesis