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1.
J Chem Phys ; 160(16)2024 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-38656446

RESUMO

This work describes optimizations of N-electron system wave functions by means of the simulated annealing technique within the doubly occupied configuration interaction framework. Using that technique, we minimize the energy variance of a Hamiltonian, providing determinations of wave functions corresponding to ground or excited states in an identical manner. The procedure that allows us to determine electronic spectra can be performed using treatments of restricted or unrestricted types. The results found in selected systems, described in terms of energy, spin, and wave function, are analyzed, showing the performance of each method. We also compare these results with those arising from more traditional approaches that minimize the energy, in both restricted and unrestricted versions, and with those obtained from the full configuration interaction treatment.

2.
J Chem Phys ; 159(21)2023 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-38047509

RESUMO

We introduce a generalization of the σ-SCF method to approximate noncollinear spin ground and excited single-reference electronic states by minimizing the Hamiltonian variance. The new method is based on the σ-SCF method, originally proposed by Ye et al. [J. Chem. Phys. 147, 214104 (2017)], and provides a prescription to determine ground and excited noncollinear spin states on an equal footing. Our implementation was carried out utilizing an initial simulated annealing stage followed by a mean-field iterative self-consistent approach to simplify the cumbersome search introduced by generalizing the spin degrees of freedom. The simulated annealing stage ensures a broad exploration of the Hilbert space spanned by the generalized spin single-reference states with random complex element-wise rotations of the generalized density matrix elements in the simulated annealing stage. The mean-field iterative self-consistent stage employs an effective Fockian derived from the variance, which is utilized to converge tightly to the solutions. This process helps us to easily find complex spin structures, avoiding manipulating the initial guess. As proof-of-concept tests, we present results for Hn (n = 3-7) planar rings and polyhedral clusters with geometrical spin frustration. We show that most of these systems have noncollinear spin excited states that can be interpreted in terms of geometric spin frustration. These states are not directly targeted by energy minimization methods, which are meant to converge to the ground state. This stresses the capability of the σ-SCF methodology to find approximate noncollinear spin structures as mean-field excited states.

3.
J Chem Phys ; 159(12)2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-38127377

RESUMO

In this work, we formulate the equations of motion corresponding to the Hermitian operator method in the framework of the doubly occupied configuration interaction space. The resulting algorithms turn out to be considerably simpler than the equations provided by that method in more conventional spaces, enabling the determination of excitation energies in N-electron systems under an affordable polynomial computational cost. The implementation of this technique only requires to know the elements of low-order reduced density matrices of an N-electron reference state, which can be obtained from any approximate method. We contrast our procedure against the reduced Bardeen-Cooper-Schrieffer and Richardson-Gaudin-Kitaev integrable models, pointing out the reliability of our proposal.

4.
JAMA ; 330(13): 1255-1265, 2023 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-37787793

RESUMO

Importance: The effect of continuous positive airway pressure (CPAP) on secondary cardiovascular disease prevention is highly debated. Objective: To assess the effect of CPAP treatment for obstructive sleep apnea (OSA) on the risk of adverse cardiovascular events in randomized clinical trials. Data Sources: PubMed (MEDLINE), EMBASE, Current Controlled Trials: metaRegister of Controlled Trials, ISRCTN Registry, European Union clinical trials database, CENTRAL (Cochrane Central Register of Controlled Trials), and ClinicalTrials.gov databases were systematically searched through June 22, 2023. Study Selection: For qualitative and individual participant data (IPD) meta-analysis, randomized clinical trials addressing the therapeutic effect of CPAP on cardiovascular outcomes and mortality in adults with cardiovascular disease and OSA were included. Data Extraction and Synthesis: Two reviewers independently screened records, evaluated potentially eligible primary studies in full text, extracted data, and cross-checked errors. IPD were requested from authors of the selected studies (SAVE [NCT00738179], ISAACC [NCT01335087], and RICCADSA [NCT00519597]). Main Outcomes and Measures: One-stage and 2-stage IPD meta-analyses were completed to estimate the effect of CPAP treatment on risk of recurrent major adverse cardiac and cerebrovascular events (MACCEs) using mixed-effect Cox regression models. Additionally, an on-treatment analysis with marginal structural Cox models using inverse probability of treatment weighting was fitted to assess the effect of good adherence to CPAP (≥4 hours per day). Results: A total of 4186 individual participants were evaluated (82.1% men; mean [SD] body mass index, 28.9 [4.5]; mean [SD] age, 61.2 [8.7] years; mean [SD] apnea-hypopnea index, 31.2 [17] events per hour; 71% with hypertension; 50.1% receiving CPAP [mean {SD} adherence, 3.1 {2.4} hours per day]; 49.9% not receiving CPAP [usual care], mean [SD] follow-up, 3.25 [1.8] years). The main outcome was defined as the first MACCE, which was similar for the CPAP and no CPAP groups (hazard ratio, 1.01 [95% CI, 0.87-1.17]). However, an on-treatment analysis by marginal structural model revealed a reduced risk of MACCEs associated with good adherence to CPAP (hazard ratio, 0.69 [95% CI, 0.52-0.92]). Conclusions and Relevance: Adherence to CPAP was associated with a reduced MACCE recurrence risk, suggesting that treatment adherence is a key factor in secondary cardiovascular prevention in patients with OSA.


Assuntos
Doenças Cardiovasculares , Pressão Positiva Contínua nas Vias Aéreas , Cooperação do Paciente , Apneia Obstrutiva do Sono , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Hipertensão/complicações , Modelos de Riscos Proporcionais , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/terapia , Risco , Idoso , Prevenção Secundária/métodos
5.
Healthcare (Basel) ; 11(9)2023 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-37174853

RESUMO

This study aimed to evaluate the effect of time on suicidal behavior, associated risk factors, and protective factors in early Mexican adolescents. Method: With a two-year longitudinal design, which included 18 of 34 adolescents who had previously participated in a DBT skills training program (DBT-PAHSE). The study evaluated ideation, suicide attempt, depression, emotional dysregulation, and psychological resources. Results: We observed differentiating significant differences over time in emotional dysregulation (F = 2.36 p = 0.04, η2= 0.12, ß = 0.72), affective resources (F = 3.94, p = 0.01, η2 = 0.18, ß = 0.82), and suicidal ideation. (F = 2.55, p = 0.03, η2= 0.13, ß = 0.77). In conclusion, the DBT-PAHSE program prevented deaths by suicide. It showed a reduction in emotional dysregulation up to two years after the end of treatment and maintained an increase in emotional and social resources. However, improvements are required to reduce depression over time and strengthen psychological resources.

6.
ACS Omega ; 8(15): 13993-14004, 2023 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-37091389

RESUMO

Mössbauer and X-ray photoelectron spectroscopies (XPS) are complemented with high-level quantum-chemical computations in the study of the geometric and electronic structure of the paramagnetic salt of the metallacarborane sandwich complex [Fe(1,2-C2B9H11)2]Cs = FeSanCs. Experimental 57Fe isomer shifts and quadrupole splitting parameters are compared with the theoretical prediction, with good agreement. The appearance of two sets of Cs(3d) doublets in the XPS spectrum, separated by 2 eV, indicates that Cs has two different chemical environments due to ease of the Cs(+) cation moving around the sandwich complex with low-energy barriers, as confirmed by quantum-chemical computations. Several minimum-energy geometries of the FeSanCs structure with the corresponding energies and Mössbauer parameters are discussed, in particular the atomic charges and spin population and the surroundings of the Fe atom in the complex. The Mössbauer spectra were taken at different temperatures showing the presence of a low-spin Fe atom with S = 1/2 and thus confirming a paramagnetic FeIII species.

7.
Am J Respir Crit Care Med ; 207(12): 1620-1632, 2023 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-37017487

RESUMO

Rationale: It is currently unclear which patients with obstructive sleep apnea (OSA) are at increased cardiovascular risk. Objective: To investigate the value of pulse wave amplitude drops (PWADs), reflecting sympathetic activations and vasoreactivity, as a biomarker of cardiovascular risk in OSA. Methods: PWADs were derived from pulse oximetry-based photoplethysmography signals in three prospective cohorts: HypnoLaus (N = 1,941), the Pays-de-la-Loire Sleep Cohort (PLSC; N = 6,367), and "Impact of Sleep Apnea syndrome in the evolution of Acute Coronary syndrome. Effect of intervention with CPAP" (ISAACC) (N = 692). The PWAD index was the number of PWADs (>30%) per hour during sleep. All participants were divided into subgroups according to the presence or absence of OSA (defined as ⩾15 or more events per hour or <15/h, respectively, on the apnea-hypopnea index) and the median PWAD index. Primary outcome was the incidence of composite cardiovascular events. Measurements and Main Results: Using Cox models adjusted for cardiovascular risk factors (hazard ratio; HR [95% confidence interval]), patients with a low PWAD index and OSA had a higher incidence of cardiovascular events compared with the high-PWAD and OSA group and those without OSA in the HypnoLaus cohort (HR, 2.16 [1.07-4.34], P = 0.031; and 2.35 [1.12-4.93], P = 0.024) and in the PLSC (1.36 [1.13-1.63], P = 0.001; and 1.44 [1.06-1.94], P = 0.019), respectively. In the ISAACC cohort, the low-PWAD and OSA untreated group had a higher cardiovascular event recurrence rate than that of the no-OSA group (2.03 [1.08-3.81], P = 0.028). In the PLSC and HypnoLaus cohorts, every increase of 10 events per hour in the continuous PWAD index was negatively associated with incident cardiovascular events exclusively in patients with OSA (HR, 0.85 [0.73-0.99], P = 0.031; and HR, 0.91 [0.86-0.96], P < 0.001, respectively). This association was not significant in the no-OSA group and the ISAACC cohort. Conclusions: In patients with OSA, a low PWAD index reflecting poor autonomic and vascular reactivity was independently associated with a higher cardiovascular risk.


Assuntos
Doenças Cardiovasculares , Apneia Obstrutiva do Sono , Humanos , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/complicações , Estudos Prospectivos , Fatores de Risco , Apneia Obstrutiva do Sono/complicações , Fatores de Risco de Doenças Cardíacas , Biomarcadores
8.
J Chem Phys ; 157(20): 204103, 2022 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-36456222

RESUMO

In this work, we analyze the effectiveness of different sets of well-known necessary N-representability conditions that are imposed on the variational determination of two-electron reduced density matrices corresponding to the ground and excited states of N-electron Hamiltonians within doubly occupied configuration interaction subspaces. The two-electron reduced density matrix elements are determined so that they are suitably related to those of higher-order reduced density matrices and other associated matrices, up to a given order, constituting positive semidefinite matrices. These conditions up to two-, three-, and four-order have been sequentially imposed on the variational calculation of the expectation values of the dispersion operator corresponding to several Hamiltonian models, obtaining the electronic spectra. These results have been contrasted with those arising from the full configuration interaction method, illuminating the sufficiency/insufficiency of the variational N-representability conditions applied.

9.
Depress Anxiety ; 39(12): 727-740, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35980836

RESUMO

BACKGROUND: Research is scarce on the prospective predictors of first onset suicidal thoughts and behaviors (STB) and the accuracy of these predictors in university students, particularly in low-and-middle income countries. Therefore, we assessed the 1-year incidence of STB among first-year students, a broad range of prospective predictors of STB incidence, and evaluated the prediction accuracy of a baseline multivariate risk prediction model to identify students at highest risk for STB onset over the subsequent 12 months. METHODS: Students (n = 3238) from 13 universities in Mexico completed an online survey developed for the World Mental Health International College Student Surveys in their first year and again 12 months after. We ran generalized linear models and receiver operator curves. RESULTS: The 1-year incidence of suicidal ideation, plan and attempt was 8.53%, 3.75%, and 1.16%, respectively. Predictors in final models were female sex (ideation only), minority sexual orientation (ideation only), depression, eating disorders, ADHD (ideation and plan), ongoing arguments or breakup with a romantic partner (ideation only), emotional abuse (ideation only), parental death (ideation, plan), not Catholic/Christian (ideation, plan), not having someone to rely on, psychotic experiences (plan only), and insufficient sleep (attempt only). Prediction accuracy for ideation, plan and attempt was area under the curve = 0.76, 0.81 and 0.78, respectively. Targeting the top 10% of students at highest risk could reduce STB in the subsequent year up to 36%. CONCLUSIONS: By assessing these risk/protective factors in incoming students we identified students at greatest risk for developing STB to whom suicide prevention strategies could be targeted.


Assuntos
Ideação Suicida , Tentativa de Suicídio , Feminino , Humanos , Masculino , Universidades , Incidência , Estudantes/psicologia , Fatores de Risco
10.
J Chem Phys ; 157(1): 014102, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35803816

RESUMO

In this work, we perform variational calculations of two-electron reduced density matrices corresponding to open-shell N-electron systems within the framework of the doubly occupied configuration interaction treatment, traditionally limited to studies of closed-shell systems. This has allowed us to provide a satisfactory description of molecular systems in triplet states following two methods. One of them adds hydrogen atoms at an infinite distance of the triplet system studied, constituting a singlet supersystem. The energies and reduced density matrices of the triplet system are obtained by removing the contributions of the added atoms from the singlet supersystem results. The second procedure involves variational determination of the two-electron reduced density matrices corresponding to the triplet systems by means of adequate couplings of basis-set functions. Both models have been studied by imposing N-representability conditions on the reduced density matrix calculations. Results obtained from these methods for molecular systems in triplet ground states are reported and compared with those provided by benchmark methods.

11.
Front Med (Lausanne) ; 9: 870906, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35833104

RESUMO

Introduction: Obstructive sleep apnea (OSA) severity is based on the apnea-hypopnea index (AHI). The AHI is a simplistic measure that is inadequate for capturing disease severity and its consequences in cardiovascular diseases (CVDs). Deleterious effects of OSA have been suggested to influence the prognosis of specific endotypes of patients with acute coronary syndrome (ACS). We aim to identify respiratory polygraphy (RP) patterns that contribute to identifying the risk of recurrent cardiovascular events in patients with ACS. Methods: Post hoc analysis of the ISAACC study, including 723 patients admitted for a first ACS (NCT01335087) in which RP was performed. To identify specific RP patterns, a principal component analysis (PCA) was performed using six RP parameters: AHI, oxygen desaturation index, mean and minimum oxygen saturation (SaO2), average duration of events and percentage of time with SaO2 < 90%. An independent HypnoLaus population-based cohort was used to validate the RP components. Results: From the ISAACC study, PCA showed that two RP components accounted for 70% of the variance in the RP data. These components were validated in the HypnoLaus cohort, with two similar RP components that explained 71.3% of the variance in the RP data. The first component (component 1) was mainly characterized by low mean SaO2 and obstructive respiratory events with severe desaturation, and the second component (component 2) was characterized by high mean SaO2 and long-duration obstructive respiratory events without severe desaturation. In the ISAACC cohort, component 2 was associated with an increased risk of recurrent cardiovascular events in the third tertile with an adjusted hazard ratio (95% CI) of 2.44 (1.07 to 5.56; p-value = 0.03) compared to first tertile. For component 1, no significant association was found for the risk of recurrent cardiovascular events. Conclusion: A RP component, mainly characterized by intermittent hypoxemia, is associated with a high risk of recurrent cardiovascular events in patients without previous CVD who have suffered a first ACS.

12.
Ann Am Thorac Soc ; 19(10): 1750-1759, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35442180

RESUMO

Rationale: Obstructive sleep apnea (OSA) is prevalent in patients with acute coronary syndrome (ACS) and is a cause of secondary hypertension. Objectives: To explore the long-term effects of OSA and continuous positive airway pressure (CPAP) treatment on blood pressure (BP) in patients with ACS. Methods: Post hoc analysis of the ISAACC study (Continuous Positive Airway Pressure in Patients with Acute Coronary Syndrome and Obstructive Sleep Apnea; NCT01335087) included 1,803 patients admitted for ACS. Patients with OSA (apnea-hypopnea index [AHI], ⩾15 events/h) were randomly assigned to receive either CPAP or usual care and were seen in follow-up for 1-5 years. Office BP was determined at each visit. Results: We included 596 patients without OSA, 978 patients in the usual care or poor CPAP adherence group, and 229 patients in the good CPAP adherence group. At baseline, 52% of the patients were diagnosed with hypertension. Median (25th to 75th percentile) age and body mass index were 59 (52.0 to 67.0) years and 28.2 (25.6 to 31.2) kg/m2, respectively. After a median (25th to 75th percentile) follow-up of 41.2 (18.3 to 59.6) months, BP changes were similar in the OSA and non-OSA groups. However, we observed an increase in BP in the third tertile of the AHI (AHI, >40 events/h), with a maximum difference in mean BP of +3.3 mm Hg at 30 months. Patients with OSA with good CPAP adherence (⩾4 h/night) reduced mean BP after 18 months compared with patients with usual care/poor CPAP adherence, with a maximum mean difference (95% confidence interval) of -4.7 (-6.7 to -2.7) mm Hg. In patients with severe OSA, we observed a maximum mean difference of -7.1 (-10.3 to -3.8) mm Hg. Conclusions: In patients with ACS, severe OSA is associated with a long-term increase in BP, which is reduced by good CPAP adherence. Clinical trial registered with www.clinicaltrials.gov (NCT01335087).


Assuntos
Síndrome Coronariana Aguda , Hipertensão , Apneia Obstrutiva do Sono , Síndrome Coronariana Aguda/complicações , Síndrome Coronariana Aguda/terapia , Pressão Sanguínea , Pressão Positiva Contínua nas Vias Aéreas , Humanos , Hipertensão/complicações , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/terapia
13.
J Affect Disord ; 298(Pt A): 65-68, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34715190

RESUMO

BACKGROUND: There is serious concern over the increase in mental health problems during the coronavirus disease 2019 (Covid-19) pandemic. METHODS: Based on data from two Mexican National Health and Nutrition Surveys conducted in 2018-2019 and 2020 (n = 17,925 and 4,913, respectively), we estimated the prevalence of suicide attempts among adolescents 10-19 years old in the previous year. We constructed a multivariate logistic regression model adjusted by sociodemographic characteristics and contextual variables for the Covid-19 pandemic. RESULTS: The prevalence of suicide attempts in the previous year was similar in both surveys. We found that women, youth in urban localities and individuals living in households where a family member had lost her/his job as a result of the Covid-19 contingency were more likely to attempt suicide compared to their counterparts. On the other hand, attending classes online proved to be a protective factor (aOR=0.3, 95% CI=0.1, 0.8, p = 0.022). LIMITATIONS: The principal limitation of our study concerned the restricted size of our sample for the 2020 survey wave. CONCLUSIONS: Population-level policies aimed at providing economic protection and helping youth to return to school would exert a favorable impact on the mental health and suicidal behavior of youths.


Assuntos
COVID-19 , Tentativa de Suicídio , Adolescente , Adulto , Criança , Surtos de Doenças , Feminino , Humanos , Pandemias , Fatores de Risco , SARS-CoV-2 , Ideação Suicida , Adulto Jovem
14.
Expert Rev Hematol ; 14(9): 851-865, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34424108

RESUMO

Introduction: Acute myeloblastic leukemia (AML) is the most frequent type of acute leukemia in adults with an incidence of 4.2 cases per 100,000 inhabitants and poor 5-year survival. Patients with mutations in the FMS-like tyrosine kinase 3 (FLT3) gene have poor survival and higher relapse rates compared with wild-type cases.Areas covered: Several FLT3 inhibitors have been proved in FLT3mut AML patients, with differences in their pharmacokinetics, kinase inhibitory and adverse events profiles. First-generation multi-kinase inhibitors (midostaurin, sorafenib, lestaurtinib) target multiple proteins, whereassecond-generation inhibitors (crenolanib, quizartinib, gilteritinib) are more specific and potent inhibitors of FLT3, so they are associated with less off-target toxic effects. All of these drugs have primary and acquired mechanisms of resistance, and therefore their combinations with other drugs (checkpoint inhibitors, hypomethylating agents, standard chemotherapy) and its application in different clinical settings are under study.Expert opinion: The recent clinical development of various FLT3 inhibitors for the treatment of FLT3mut AML is an effective therapeutic strategy. However, there are unique toxicities and drug-drug interactions that need to be resolved. It is necessary to understand the mechanisms of toxicity in order to recognize and manage them adequately.


Assuntos
Antineoplásicos , Leucemia Mieloide Aguda , Antineoplásicos/efeitos adversos , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/genética , Mutação , Inibidores de Proteínas Quinases/efeitos adversos , Sorafenibe/farmacologia , Sorafenibe/uso terapêutico , Tirosina Quinase 3 Semelhante a fms/genética
15.
J Chem Phys ; 154(22): 224104, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34241224

RESUMO

This work implements a variational determination of the elements of two-electron reduced density matrices corresponding to the ground and excited states of N-electron interacting systems based on the dispersion operator technique. The procedure extends the previously reported proposal [Nakata et al., J. Chem. Phys. 125, 244109 (2006)] to two-particle interaction Hamiltonians and N-representability conditions for the two-, three-, and four-particle reduced density matrices in the doubly occupied configuration interaction space. The treatment has been applied to describe electronic spectra using two benchmark exactly solvable pairing models: reduced Bardeen-Cooper-Schrieffer and Richardson-Gaudin-Kitaev Hamiltonians. The dispersion operator combined with N-representability conditions up to the four-particle reduced density matrices provides excellent results.

16.
Artigo em Inglês | MEDLINE | ID: mdl-34067094

RESUMO

Background: Suicide and suicidal behaviors were already a global public health problem, producing preventable injuries and deaths. This issue may worsen due to the COVID-19 pandemic and may differentially affect vulnerable groups in the population, including children, adolescents, and young adults. The current study evaluated the association of affective variables (depression, hopelessness, and anxiety), drug use (alcohol, tobacco, and others), emotional intelligence, and attachment with suicidal behaviors. Methods: A state-wide survey included 8033 students (51% female, 49% male; mean age of 16 years) from science and technology high-schools using a standardized questionnaire that was distributed online. Multinomial logistic regression models tested associations between suicidal behaviors and several covariates. The analyses accommodated the complex structure of the sample. Results: Approximately 21% of all students reported a suicidal behavior (11% with a low-lethality suicide attempt, 6% with self-injuries, and 4% with a high-lethality suicide attempt). Variables associated with higher odds of suicidal behavior included: female sex, depression, hopelessness, anxiety, alcohol and tobacco use, childhood trauma, and having to self-rely as issues affecting attachment, and low self-esteem. Security of attachment was associated with lower odds of suicidal behavior. Conclusions: The complexity of suicidal behavior makes it clear that comprehensive programs need to be implemented.


Assuntos
COVID-19 , Pandemias , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Fatores de Risco , SARS-CoV-2 , Ideação Suicida , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-34069426

RESUMO

OBJECTIVE: To compare the occurrence of suicide attempts across nationally representative samples of the Mexican adolescent population over the past 12 years, and to analyze its association with sociodemographic, lifestyle and mental-health indicators. METHODOLOGY: Data were drawn from the 2006, 2012 and 2018 National Health and Nutrition Surveys (n = 25,056; 21,509; and 17,925 adolescents, respectively). Estimates were based on standardized measurements. RESULTS: The estimated lifetime prevalence rates of suicide attempts were 1.1% in 2006, 2.7% in 2012, and 3.9% in 2018, indicating a 3.4-fold increase. Across the three survey periods, women yielded rates nearly three times higher than men. Lifetime prevalence grew the most among adolescents aged 13-15 years. Compared to the other respondents, the odds of lifetime suicide attempts proved seven times as high for those who had been sexually abused during their childhood, five times as high for those who had been diagnosed with a depressive disorder, three times as high for those who had suffered physical aggression and twice as high for those who had smoked 100+ cigarettes in their lifetimes and those who consumed alcohol. CONCLUSION: The sharp increase in suicide attempts in Mexico calls for an urgent public-health response via universal and targeted interventions supported by national policy and sustained federal funding.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Tentativa de Suicídio , Adolescente , Criança , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários
18.
Respiration ; 100(4): 298-307, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33550282

RESUMO

BACKGROUND: Several studies have reported an association between microRNAs (miRNAs) and hypertension or cardiovascular disease (CVD). In a previous study performed on a group of 38 patients, we observed a cluster of 3 miRNAs (miR-378a-3p, miR-100-5p, and miR-486-5p) that were functionally associated with the cardiovascular system that predicted a favorable blood pressure (BP) response to continuous positive airway pressure (CPAP) treatment in patients with resistant hypertension (RH) and obstructive sleep apnea (OSA) (HIPARCO score). However, little is known regarding the molecular mechanisms underlying this phenomenon. OBJECTIVES: The aim of the study was to perform a post hoc analysis to investigate the genes, functions, and pathways related to the previously found HIPARCO score miRNAs. METHODS: We performed an enrichment analysis using Ingenuity pathway analysis. The genes potentially associated with the miRNAs were filtered based on their confidence level. Particularly for CVD, only the genes regulated by at least 2 of the miRNAs were studied. RESULTS: We observed that the miRNAs studied regulate 200-249 molecules associated with several functions and diseases, including extracranial solid tumors and abdominal neoplasms, among others. The cardiac hypertrophy and NF-kB signaling pathways were identified as the cardiovascular pathways most influenced by these 3 miRNAs. CONCLUSIONS: The mechanisms by which CPAP treatment decreases the BP in OSA patients with RH could be related to the cardiac hypertrophy and NF-kB signaling pathways. Further investigations will be necessary to confirm these findings, contributing to the elucidation of new therapeutic targets in patients who do not respond to CPAP treatment.


Assuntos
Sistema Cardiovascular , Pressão Positiva Contínua nas Vias Aéreas , Hipertensão , MicroRNAs/metabolismo , Síndromes da Apneia do Sono , Pressão Sanguínea/genética , Sistema Cardiovascular/metabolismo , Sistema Cardiovascular/fisiopatologia , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Pressão Positiva Contínua nas Vias Aéreas/métodos , Resistência à Doença/genética , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/complicações , Hipertensão/genética , Hipertensão/fisiopatologia , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , NF-kappa B/metabolismo , Transdução de Sinais/fisiologia , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/fisiopatologia , Síndromes da Apneia do Sono/terapia
20.
Soc Psychiatry Psychiatr Epidemiol ; 56(2): 247-257, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32886133

RESUMO

PURPOSE: Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender. METHOD: The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender. RESULTS: Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder. CONCLUSION: These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.


Assuntos
Transtorno Depressivo Maior , Transtornos Mentais , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Transtornos Mentais/epidemiologia , México/epidemiologia , Prevalência , Estudantes , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Universidades
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