Differences in Patterns of Stimulant Use and Their Impact on First-Episode Psychosis Incidence: An Analysis of the EUGEI Study.

BACKGROUND: Use of illegal stimulants is associated with an increased risk of psychotic disorder. However, the impact of stimulant use on odds of first-episode psychosis (FEP) remains unclear. Here, we aimed to describe the patterns of stimulant use and examine their impact on odds of FEP. METHODS: We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP. FINDINGS: Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries. INTERPRETATION: Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.

HIV infection prevalence and associated risk factors in people who inject drugs in Medellin / Prevalencia de infección por VIH y factores de riesgo asociados, en personas que se inyectan drogas en la ciudad de Medellín

Introduction: the availability of high purity and low-cost drugs has increased the use of intravenous substances, which makes it a public health problem due to its association with HIV infection. Objective: to identify the factors associated with HIV infection in people who inject drugs. Materials and methods: a cross-sectional descriptive study was carried out between December 2017 and January 2018 in Medellin, Colombia. We use the sampling conducted by the respondent (RDS). Results: They have recruited 224 subjects, 86.2% were men, 82.0% were single and 67.0% belonged to the subsidized or linked health system. The prevalence of HIV infection was 3.6%. This study found that 38.8% of consumers have shared needles and syringes with up to three people, representing a risk of infection of 5.07 times, compared to those who do not share (RPc = 5.07 95% CI: 1.19-21.55), and if this practice is carried out with a close friend, the probability increases to almost double (10.69) (RPc = 10.69 IC 95%: 2.26-50.61) (p <0.05). Conclusion: Given the low prevalence of HIV, it is vital to develop and implement public policies whose objective is to create prevention programs that ultimately lead to the reduction of infection in this population.

Introducción: La disponibilidad de drogas con una alta pureza y un bajo costo, ha aumentado el consumo de sustancias por vía intravenosa; llevándolo a ser considerado como un problema de salud pública, por su asociación con la presencia de infección por VIH. Se estima que existen aproximadamente 16 millones de consumidores de drogas intravenosas en el mundo y en Colombia, 15.000. Objetivo: identificar los factores asociados con la infección por VIH en personas que se inyectan drogas. Materiales y métodos: estudio descriptivo transversal, realizado (diciembre 2017/ enero 2018) Medellín - Colombia, se utilizó la metodología Respondent Driven Sampling (RDS). Resultados: Fueron reclutados 224 participantes, un 86,2% fueron hombres, el 82,0% eran solteros, el (67,0%) pertenecía al régimen de salud subsidiado o vinculado. Con relación a la prevalencia de infección por VIH esta fue del 3,6%. Este estudio encontró que el 38,8% de los consumidores había compartido agujas y jeringas con hasta tres personas, lo cual representa una probabilidad de 5,07 veces de contraer la infección comparado con aquellos que no comparten (RPc=5,07 CI95% 1,19-21,55), si esta práctica se hace con un amigo cercano dicha probabilidad aumenta a casi el doble 10,69 (RPc= 10,69 CI95% 2,26-50,61), (p<0,05). Conclusión: Ante la baja prevalencia de VIH, es necesario, el desarrollo e implementación de políticas públicas que tengan como objetivo la creación de programas de prevención que finalmente, lleven a la reducción de la infección en esta población.

Development of an early intervention programme for adolescents with emotion dysregulation and their families: Actions for the treatment of adolescent personality (ATraPA).

AIM: Borderline personality disorder and severe emotion dysregulation in adolescence is a major public health concern. Dialectical Behaviour Therapy is a promising treatment for suicidality in adolescents. The aim of this work is to present an adaptation of this intervention to the Spanish national health system, Actions for the Treatment of Adolescent Personality (ATraPA). METHOD: Data consists of a description of the different ATraPA subprogrammes, including interventions for adolescents aged 13 to 17 and their families. Participants were referred to ATraPA from different hospitals within the region of Madrid, Spain. RESULTS: ATraPA has been developed as an intensive outpatient treatment and it comprises different subprogrammes. ATraPA-TAI is an intensive outpatient treatment, including a skills-based group, individual therapy and email therapy. ATraPA-FAL is a psychoeducational intervention for families, including emotion regulation strategies for parents themselves. Finally, the Alternatives Group is offered to adolescents during the hospital admission, with the aim of promoting alternative coping skills. The group of therapists provides a support network to the professionals involved in ATraPA. CONCLUSIONS: ATraPA has been successfully implemented in a Child and Adolescent Psychiatry Service within the Spanish national health system. Future studies should address the efficacy of ATraPA using a controlled design.

Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use.

Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = -0.3, 95% CI = [-0.5; -0.2]) and never-users (Mdiff = -0.4, 95% CI = [-0.6; -0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.

Smoking does not impact social and non-social cognition in patients with first episode psychosis.

BACKGROUND: Many studies having shown significant improvements in non-social and social cognitive performance in smoking FEP patients compared to non-smoking FEP patients. The findings are controversial. This study analyzed the effects of tobacco use on non-social and social cognitive function in a large group of FEP patients and a matched healthy control group. METHODS: A sample of 335 patients with FEP and 253 healthy controls was divided into four subgroups: control tobacco users (CTU), control non-tobacco users (CNTU), patient tobacco users (PTU) and patient non-tobacco users (PNTU). Demographic variables, tobacco use variables (presence or absence, frequency and duration of tobacco use), neurocognitive (non-social) performance and social cognition were assessed. RESULTS: Comparison of 4 subgroups in non-social cognitive function revealed significant differences after controlling for covariables in executive functions (F=13.45; p≤0.001) and working memory domains (F=4.30; p=0.005). CTU and CNTU subgroups scored higher in all the domains compared to the PTU and the PNTU subgroups respectively. Social cognitive function was also significantly different within the four subgroups, with control subgroups showing better social cognition than patient subgroups. Significant differences in the executive functions domain were observed when comparing PTU and CTU groups (F=19.60; p≤0.001). No significant differences were revealed in the comparison between the patient groups. CONCLUSIONS: This large study suggests that tobacco use in FEP patients is not related to better non-social or social cognitive performance.

Origin of the Excellent Performance of Ru on Nitrogen-Doped Carbon Nanofibers for CO2 Hydrogenation to CH4.

Carbon materials have rarely been used as support for CO2 methanation, which is usually carried out using catalysts supported on metal oxides. Here, it is shown that Ru nanoparticles supported on nitrogen-doped carbon nanofibers (NCNF) provide competitive CH4 production rate and stability compared to Al2 O3 -supported catalysts. Contrary to the general belief about the inert nature of carbon supports, it is demonstrated that NCNF is a non-innocent spectator in CO2 methanation due to its ability to store a high amount of COad reaction intermediates. This explains the excellent catalytic behaviour afforded by this unconventional catalyst support.

Desarrollo profesional en investigación traslacional en neurociencias y salud mental: educación y formación dentro del Centro de Investigación Biomédica en Red en Salud Mental / Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health

Aumenta el número de redes de investigación colaborativas en salud mental y con ello la importancia de los programas de formación como parte esencial de la especialización de sus miembros. A continuación revisamos de un modo crítico la implementación específica de un programa de formación en investigación traslacional en salud mental y neurociencias en el Centro de Investigación Biomédica en Red en Salud Mental, con el fin de informar sobre la integración estratégica de la investigación básica dentro de la práctica clínica y lograr un impacto positivo en los sistemas de salud mental y la sociedad. Se examinan las actividades de formación y los programas específicos desarrollados por la red de investigación, así como los desafíos de su implementación. El Centro de Investigación Biomédica en Red en Salud Mental ha centrado su formación a través de diferentes actividades que han dado lugar al desarrollo de un máster interuniversitario y a un programa de posgrado en Investigación en Salud Mental, certificado por la Agencia Nacional de Evaluación de la Calidad y Acreditación. La consolidación de los programas de formación dentro del Centro de Investigación Biomédica en Red en Salud Mental ha supuesto un avance considerable para la formación de los investigadores, a fin de satisfacer las necesidades actuales de competencia en materia de investigación. El máster constituye una oportunidad única para el desarrollo de las habilidades necesarias en investigación en neurociencia y salud mental dentro del marco oficial de los programas universitarios en España (AU)

The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain (AU)

Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health.

The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain.

Carbon nanofibers modified with heteroatoms as metal-free catalysts for the oxidative dehydrogenation of propane.

Carbon nanofibres (CNFs) were modified with B and P by an ex situ approach. In addition, CNFs doped with N were prepared in situ using ethylenediamine as the N and C source. After calcination, the doped CNFs were used as catalysts for the oxidative dehydrogenation of propane. For B-CNFs, the effects of boron loading and calcination temperature on B speciation and catalytic conversion were studied. For the same reaction temperatures and conversions, B- and P-doped CNFs exhibited higher selectivities to propene than pristine CNFs. The N-CNFs were the most active but the least selective of the catalysts tested here. Our results also show that the type of P precursor affects the selectivity to propene and that CNFs modified using triphenylphosphine as the precursor provided the highest selectivity at isoconversion.

Control of nitrogen insertion during the growth of nitrogen-containing carbon nanofibers on cordierite monolith walls.

A well attached coating of nitrogen-functionalised carbon nanofibers (N-CNFs) has been prepared on the walls of cordierite monolith channels. It is formed via concurrent decomposition of ethane and ammonia catalysed by nickel nanoparticles dispersed on alumina coated cordierite monolith. N-CNF/monoliths synthesis employing several growth temperatures and NH(3) compositions was exhaustively characterised by Raman, XPS, elemental analysis and TEM. Synthesis conditions affected profoundly content and type of nitrogen functionality, enabling its fine tuning. N-CNFs surface chemistry and microstructure differed remarkably from its N-free counterparts.

Genomic screening of fibroblast growth-factor receptor 2 reveals a wide spectrum of mutations in patients with syndromic craniosynostosis.

It has been known for several years that heterozygous mutations of three members of the fibroblast growth-factor-receptor family of signal-transduction molecules-namely, FGFR1, FGFR2, and FGFR3-contribute significantly to disorders of bone patterning and growth. FGFR3 mutations, which predominantly cause short-limbed bone dysplasia, occur in all three major regions (i.e., extracellular, transmembrane, and intracellular) of the protein. By contrast, most mutations described in FGFR2 localize to just two exons (IIIa and IIIc), encoding the IgIII domain in the extracellular region, resulting in syndromic craniosynostosis including Apert, Crouzon, or Pfeiffer syndromes. Interpretation of this apparent clustering of mutations in FGFR2 has been hampered by the absence of any complete FGFR2-mutation screen. We have now undertaken such a screen in 259 patients with craniosynostosis in whom mutations in other genes (e.g., FGFR1, FGFR3, and TWIST) had been excluded; part of this screen was a cohort-based study, enabling unbiased estimates of the mutation distribution to be obtained. Although the majority (61/62 in the cohort sample) of FGFR2 mutations localized to the IIIa and IIIc exons, we identified mutations in seven additional exons-including six distinct mutations of the tyrosine kinase region and a single mutation of the IgII domain. The majority of patients with atypical mutations had diagnoses of Pfeiffer syndrome or Crouzon syndrome. Overall, FGFR2 mutations were present in 9.8% of patients with craniosynostosis who were included in a prospectively ascertained sample, but no mutations were found in association with isolated fusion of the metopic or sagittal sutures. We conclude that the spectrum of FGFR2 mutations causing craniosynostosis is wider than previously recognized but that, nevertheless, the IgIIIa/IIIc region represents a genuine mutation hotspot.

Contaminación industrial con solventes orgánicos como causa de teratogénesis / Teratogenesis caused by industrial organic solvent occupational exposure

Objetivo: Dara a conocer un nuevo síndrome teratogénico en humanos y su comprobación en animales de experimentación. Material y métodos. Se realizó un estudio longitudinal que abarcó los tres campos de la investigación médica: epidemiológico, clínico y experimental. El estudio epidemiológico constó de tres fases; la primera fue un estudio de campo, la segunda uno de casos y controles y la tercera uno de epidemiología genética, cuyo objetivo fue dilucidar las posibles causas de malformaciones congénitas y retraso psicomotor, de varios pacientes que acudieron a los servicios médicos municipales. El estudio clínico se llevó a cabo en el Hospital General "Dr. Manuel Gea González", en la Ciudad de México, a fin de realizar valoración integral a los pacientes detectados en el estudio epidemiológico y ofrecerles el tratamiento pertinente. Por último, se realizó el estudio experimental en ratas, a fin de corroborrar el efecto teratogénico de los agentes detectados en el estudio epidemiológico. Resultados. Se detectaron 44 pacientes con un fenotipo peculiar y retraso mental variable, todos hijos de ex obreros de una maquiladora que estuvieron en contacto directo y sin protección laboral con solventes orgánicos (metilcelosolve y etilenglico). En el estudio clínico se delineó un síndrome, no descrito previamente, consistente en facies peculiar, alteraciones musculoesqueléticas, de los órganos de los sentidos y retraso mental. En el estudio experimental se demostró que tanto el metilcelosolve como el etilenglicol producían alteraciones craneofaciales, musculoesqueléticas y del sistema nervioso central, lo que corrobora el efecto teratogénico de dichos solventes. Conclusiones. Los resultados de este estudio llevaron a establecer la existencia de un nuevo síndrome teratogénico en humanos, producido por el metilcelosolve y el etilenglicol, cuya capacidad teratogénica no había sido informada

Objective. To inform of a new teratogenic syndrome in human beings and its confirmation in rats. Material and Methods. The study comprised three phases: a field study; a case-control study; and a genetic epidemiology study, aiming at identifying the causes of the occurrence of congenital malformations and psychomotor retardation in the city of Matamoros, Tamaulipas. The second-phase clinical multidisciplinary study was carried out at a general hospital, to conduct a comprehensive evaluation of patients identified during the first phase and offer them the necessary treatment. The third-phase experimental study was done in rats in order to confirm the teratogenic effect of the agents detected in the first phase. Results. A total of 44 patients had a peculiar phenotype and mental retardation of varying degrees, all children of ex-workers of the same factory who were in direct contact, without protection, with organic solvents (methyl cellosolve and ethylene glycol). In the clinical study a syndrome was delineated, previously unreported, consisting of a peculiar facies, mental retardation, and musculo-skeletal and sensorial abnormalities. In the experimental study it was demonstrated that both methyl cellosolve and ethylene glycol cause cranio-facial,musculo-skeletal and central nervous system abnormalities, which confirmed the teratogenic effect of these solvents. Conclusions. The results of this study establish the existence of a new teratogenic syndrome in humans, produced by methyl cellosolve and ethylene glycol, whose teratogenic capacity had not been reported previously.

Displasia cráneo-fronto-nasal. Delineación del espectro fenotípico en 43 pacientes y estudio de 7 casos familiares / Craneofrontonasal dysplasia. Delineation of the phenotypic expression in 43 patients and study of 7 families cases

Introducción. La displasia craneofrontonasal es un síndrome malformativo donde coexisten craneosinostosis e hipertelorismo y anomalías extracraneales en pacientes femeninos, cuyo mecanismo hereditario está aún en discusión. Material y métodos. Se estudió clínica, radiológica y citogenéticamente a 43 pacientes afectados, incluyendo 7 casos familiares, lo que permitió el estudio del patrón hereditario. Resultados. Se demostró que el espectro clínico completo incluye hallazgos no reportados o cuya frecuencia se ha descrito como menor: cabello crespo, rizado, de origen no familiar y de inicio tardío; fisuras faciales pterigium colli y/o axilar, clavículas anómalas, hipoplasia mamaria inilareral y acortamiento ispilateral de la extremidad pélvica; se corroboraron radiográficamente las fisuras faciales y las alteraciones esqueléticas óseas. Se describen formas frustras o de afección mínima en mujeres. El cariotipo fue normal en todos los casos. Conclusiones. El estudio familiar detectó formas mínimas, además de expresión diferencial en ambos sexos, y que el gen responsable está localizado en el cromosoma X