Modulating pro-fibrotic macrophages using yeast beta-glucan microparticles prepared by Pressurized Gas eXpanded liquid (PGX) Technology®.

Pro-fibrotic M2-like macrophages are widely implicated in the pathogenesis and progression of lung fibrosis due to their production of pro-fibrotic growth factors and cytokines. Yeast beta-glucan (YBG) microparticles have shown potential as immunomodulators that can convert macrophage polarization from a pro-fibrotic phenotype to an anti-fibrotic phenotype through the engagement of the Dectin-1 receptor. However, the processing conditions used to fabricate YBG microparticles can lead to unpredictable immunomodulatory effects. Herein, we report the use of Pressurized Gas eXpanded liquids (PGX) Technology® to fabricate YBG (PGX-YBG) microparticles with higher surface areas, lower densities, and smaller and more uniform size distributions compared to commercially available spray-dried YBGs. PGX-YBG is shown to activate Dectin-1 more efficiently in vitro while avoiding significant TLR 2/4 activation. Furthermore, PGX-YBG microparticles effectively modulate M2-like fibrosis-inducing murine and human macrophages into fibrosis-suppressing macrophages both in vitro as well as in ex vivo precision-cut murine lung slices, suggesting their potential utility as a therapeutic for addressing a broad spectrum of fibrotic end-point lung diseases.

Mendelian randomization analysis of maternal coffee consumption during pregnancy on offspring neurodevelopmental difficulties in the Norwegian Mother, Father and Child Cohort Study (MoBa).

BACKGROUND: Previous observational epidemiological studies have suggested that coffee consumption during pregnancy may affect fetal neurodevelopment. However, results are inconsistent and may represent correlational rather than causal relationships. The present study investigated whether maternal coffee consumption was observationally associated and causally related to offspring childhood neurodevelopmental difficulties (NDs) in the Norwegian Mother, Father and Child Cohort Study. METHODS: The observational relationships between maternal/paternal coffee consumption (before and during pregnancy) and offspring NDs were assessed using linear regression analyses (N = 58694 mother-child duos; N = 22 576 father-child duos). To investigate potential causal relationships, individual-level (N = 46 245 mother-child duos) and two-sample Mendelian randomization (MR) analyses were conducted using genetic variants previously associated with coffee consumption as instrumental variables. RESULTS: We observed positive associations between maternal coffee consumption and offspring difficulties with social-communication/behavioral flexibility, and inattention/hyperactive-impulsive behavior (multiple testing corrected p < 0.005). Paternal coffee consumption (negative control) was not observationally associated with the outcomes. After adjusting for potential confounders (smoking, alcohol, education and income), the maternal associations attenuated to the null. MR analyses suggested that increased maternal coffee consumption was causally associated with social-communication difficulties (individual-level: beta = 0.128, se = 0.043, p = 0.003; two-sample: beta = 0.348, se = 0.141, p = 0.010). However, individual-level MR analyses that modelled potential pleiotropic pathways found the effect diminished (beta = 0.088, se = 0.049, p = 0.071). Individual-level MR analyses yielded similar estimates (heterogeneity p = 0.619) for the causal effect of coffee consumption on social communication difficulties in maternal coffee consumers (beta = 0.153, se = 0.071, p = 0.032) and non-consumers (beta = 0.107, se = 0.134, p = 0.424). CONCLUSIONS: Together, our results provide little evidence for a causal effect of maternal coffee consumption on offspring NDs.

A nationwide analysis of 350 million patient encounters reveals a high volume of mental-health conditions in primary care.

How many primary-care encounters are devoted to mental-health conditions compared with physical-health conditions? Here we analyzed Norway's nationwide administrative primary-care records, extracting all doctor-patient encounters occurring during 14 years (2006-2019) for the population aged 0-100 years. Encounters were recorded according to the International Classification of Primary Care. We compared the volume of mental-health encounters against volumes for conditions in multiple different body systems. A total of 4,875,722 patients generated 354,516,291 encounters. One in 9 encounters (11.7%) involved a mental-health condition. Only musculoskeletal conditions accounted for a greater share of primary-care physicians' attention. The volume of mental-health encounters in primary care equaled encounters for infections, cardiovascular and respiratory conditions and exceeded encounters for pain, injuries, metabolic, digestive, skin, urological, reproductive and sensory conditions. Primary-care physicians frequently treat complex mental-health conditions in patients of every age. These physicians may have a more important role in preventing the escalation of mental-health problems than heretofore appreciated.

Eating Problems Among Adolescent Boys and Girls Before and During the Covid-19 Pandemic.

OBJECTIVE: Studies suggest that adolescents reported more eating problems during the pandemic. Using a population-based sample, we compared eating problems-and how they associate with a range of personal characteristics and genetic factors-among adolescents before (June 2017-April 2020) versus during (April 2020-December 2022) the pandemic. METHOD: Based on a preregistered analysis plan, we used cross-sectional data collected from 22,706 14-16-year-olds over 6 years (55% during the pandemic) in the Norwegian Mother, Father, and Child Cohort. We used measurement invariance analyses to compare the level of eating restraint and body concern before and during the pandemic, and multi-group structural equation models to estimate pre-pandemic and pandemic patterns of associations. RESULTS: Pandemic responders generally reported more eating problems than pre-pandemic responders, specifically on dieting and body dissatisfaction. However, after adjusting for a general linear increase in eating problems across all 6 years of data collection, the pandemic itself seems to be associated with more eating problems only among girls, reporting more eating restraints (meanΔ = 0.14 [CI: 0.07, 0.20]) and body concern (meanΔ = 0.17 [CI: 0.11, 0.23]). Associations between eating problems and a range of other characteristics did not differ across the pandemic and pre-pandemic groups. CONCLUSIONS: There was a general increase in eating problems among 14-16-year-olds over time. Adjusting for this trend, the pandemic seems to exacerbate problems among girls. Although the mechanisms are unclear, our results point to factors susceptible to change that could have been intensified during the pandemic (e.g., screen time, mental distress). Our results highlight the importance of recognizing sex-specific differences in eating problems.

Pilot study on neonicotinoids in Finnish waterbirds: no detectable concentrations in common goldeneye (Bucephala clangula) plasma.

Neonicotinoids have been detected in farmland-associated birds and exposure to these insecticides has been linked to adverse effects. Even though neonicotinoids are mobile and persistent and have been detected in surface waters and aquatic invertebrates, there is a considerable lack of knowledge on their occurrence in waterbirds. Here we investigated the occurrence of seven neonicotinoids and some of their transformation products (imidacloprid, thiacloprid, thiamethoxam, acetamiprid, clothianidin, dinotefuran, nitenpyram, 6-chloronicotinic acid, hydroxy-imidacloprid, imidacloprid-urea, imidacloprid-olefin, thiamethoxam-urea, thiacloprid-amide, acetamiprid-acetate, and acetamiprid-desmethyl) in blood plasma of 51 incubating female common goldeneyes (Bucephala clangula). We collected samples from five different regions from southern to northern Finland encompassing rural and urban settings in coastal and inland areas. Surprisingly, none of the targeted neonicotinoids was found above the limit of detection in any of the samples. As neonicotinoid concentrations in wild birds can be very low, a likely reason for the nil results is that the LODs were too high; this and other possible reasons for the lack of detection of neonicotinoids in the goldeneyes are discussed. Our results suggest that neonicotinoid exposure in their breeding areas is currently not of major concern to female goldeneyes in Finland. Even though this study did not find any immediate danger of neonicotinoids to goldeneyes, further studies including surface water, aquatic invertebrates, and other bird species could elucidate potential indirect food chain effects.

From mother to egg: Variability in maternal transfer of trace elements and steroid hormones in common eider (Somateria mollissima).

The Baltic Sea is among the most polluted seas worldwide with elevated concentrations of trace elements (TEs). TEs can induce negative effects on organisms and may be transferred to eggs causing endocrine-disrupting effects on embryos. The Baltic Sea population of common eider (Somateria mollissima) has declined over the last thirty years, but the potential contribution of TEs to this decline is understudied. The aim of this study was to assess maternal transfer of TEs during the incubation period. Associations between TEs and steroid hormone concentrations in eggs (androstenedione, testosterone, pregnenolone and progesterone) were also investigated. Ten nests from Bengtskär (Finland) were monitored, for which hens at the beginning and end of the egg-laying were blood-sampled and their clutches were collected. Red blood cells from females (n = 10) and homogenized eggs (n = 44) were analyzed for 10 TEs (As, Ca, Cd, Cu, Hg, Mg, Ni, Pb, Se and Zn). Maternal and egg concentrations were correlated for Cu, Hg and Se (R2 = 0.51, R2 = 0.51, R2 = 0.52, respectively and all p-values ≤0.01). Three eggs had the highest Pb concentrations (1.43-2.24 µg g-1 ww) ever reported for this species. Although maternal and egg Pb concentrations were not significantly correlated, those eggs were laid by the same female, also having the highest Pb concentration (3.4 µg g-1 ww). Most blood TE concentrations in females were below known toxicity limits, except for Pb where 20 % of 10 females (including one outlier) had concentrations above the toxicity limit reported for subclinical poisoning in Anatini (> 0.2 µg g-1 ww). Steroid hormones in eggs were interrelated, but not correlated to TEs. Overall, the results call for more urgent research into the origin and consequences of high Pb concentrations and continued monitoring of the common eider populations in the Baltic Sea.

The diminishing association between adolescent mental disorders and educational performance from 2006-2019.

Background: A rising prevalence of adolescent mental disorders in the Western world has been widely reported, raising concerns for adolescent development and well-being. Mental disorders are known to negatively impact educational performance. Yet it remains uncertain whether the relationship between mental disorders and educational outcomes has also changed over time and if the change is more pronounced among high compared to low performing students. The aims of this paper are to (1) describe the change over time in the prevalence of common mental disorders in adolescence; (2) determine whether the change in prevalence of common mental disorders differs between high and low performing students; and (3) assess whether the associations between mental health disorders and educational performance have changed over time. Methods: To address these issues, this study examines potential shifts in the associations between diagnoses of ADHD and internalizing disorders and educational performance among 843,692 Norwegian students graduating from lower secondary education between 2006 and 2019. We utilize population-wide register data on ADHD and internalizing disorders from primary and specialist care combined with educational outcomes. Results: Our analysis revealed a marked rise in ADHD prevalence, from 1.0% in 2006 to 2.6% in 2019. Concurrently, diagnoses of internalizing disorders also increased from 1.9% to 4.2%. This increasing trend in diagnoses spanned across all high school grade point average (GPA) categories, thereby not supporting the notion that the rise is predominantly observed among high-performing adolescents. Importantly, the strength of the associations of internalizing disorders and ADHD with GPA diminished significantly over time. For instance, the difference between the average GPA standardized score for boys with and without an ADHD diagnosis shrunk from 1.0 in 2006 to 0.73 in 2019. Conclusions: We discuss various potential explanations for this observation and suggest that changes in diagnostic thresholds is a contributing factor.

Intermittent escitalopram treatment and reactive aggression in women with premenstrual irritability and anger: A crossover study.

BACKGROUND: Selective serotonin reuptake inhibitors (SSRI) are the primary treatment for premenstrual mood symptoms and particularly effective in reducing reactive aggression in the forms of irritability and anger. The present study examined whether behavioral responses in laboratory measures of reactive aggression are influenced by medication with the SSRI escitalopram in women reporting high levels of premenstrual irritability/anger. METHODS: Participants (N = 34) rated the cardinal mood symptoms of premenstrual dysphoric disorder over three menstrual cycles. During the second and third cycles, participants received escitalopram (20 mg) or placebo in a single-blind, cross-over design. In the luteal phase of the intervention cycles, participants completed two aggression tasks: The Anger-Infused Ultimatum Game (AI-UG) and the Point Subtraction Aggression Paradigm (PSAP). Additionally, they rated expression and control of anger using the State-Trait Anger Expression Inventory-2 (STAXI-2) once in the luteal phase and once in the follicular phase. RESULTS: While irritability/anger was reduced in the treatment (vs. placebo) cycle, no effect of escitalopram was detected in the PSAP. Escitalopram decreased reactive aggressive behavior in the AI-UG but only for a subset of participants who experienced a sharp premenstrual rise in outwardly expressed anger and/or did not experience a premenstrual rise in inwardly expressed anger. LIMITATIONS: The participants' symptoms were based on the severity of only premenstrual irritability/anger, limiting the generalizability to the broader group of PMDD patients. CONCLUSION: The results suggest that the behavioral consequences of severe premenstrual irritability/anger are not easily captured by traditional measures of reactive aggression and underline the importance of considering individual differences in symptom expression.

Preliminary Danish Norms for the Odense Child Trauma Screening (OCTS).

The Odense Child Trauma Screening (OCTS) is Danish story stem screening tool applicable for assessment of preschoolers and young children in risk of being traumatized. Having shown initial evidence of validation, Danish norms are needed to strengthen the clinical assessment with the OCTS by serving as a baseline comparison for assessment of potentially traumatized children. We tested 169 children from the Danish general population aged 4-8 with the OCTS and investigated sex and age differences in play-based behavior and narrative representations. Caregivers reported electronically on child demographic information, psychosocial functioning, and history of trauma exposure using The Strengths and Difficulties Questionnaire (SDQ) and The Diagnostic Infant and Preschool Assessment (DIPA) trauma list. Across the 145 scores of the OCTS coding scheme, significant sex and age differences were only found in five and sixteen scores respectively. In the five codes where significant sex differences were observed, boys' normative scores were higher. No significant sex differences were found in the partial story scores or the OCTS total score. Three significant age differences in partial story and OCTS total scores emerged with 4-year-olds scoring higher than 6-8-year-olds. We further found 13 significant age differences in code scores with higher scores among the youngest of the two groups in question suggesting that scores tend to decrease along older age. Few significant sex and age differences were found in children's OCTS play-based behavior and narrative representations. Indicative of few sex and age biases of the OCTS coding scheme and stories, results suggest that the OCTS can be applied across the intended target group of children aged 4 to 8 years. As higher scores were found in the younger age groups, clinicians should be attentive to age in certain codes of the OCTS coding scheme in their assessment of children in clinical practice. The preliminary normative scores must be interpreted and clinically applied with caution due to our non-representative sample and lack of analyses on factors potentially influencing children's responses to the OCTS (e.g., developmental, contextual, cultural factors). Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-024-00616-7.

Testing maternal effects of vitamin-D and omega-3 levels on offspring neurodevelopmental traits in the Norwegian Mother, Father and Child Cohort Study.

BACKGROUND: Maternal vitamin-D and omega-3 fatty acid (DHA) deficiencies during pregnancy have previously been associated with offspring neurodevelopmental traits. However, observational study designs cannot distinguish causal effects from confounding. METHODS: First, we conducted Mendelian randomisation (MR) using genetic instruments for vitamin-D and DHA identified in independent genome-wide association studies (GWAS). Outcomes were (1) GWAS for traits related to autism and ADHD, generated in the Norwegian mother, father, and child cohort study (MoBa) from 3 to 8 years, (2) autism and ADHD diagnoses. Second, we used mother-father-child trio-MR in MoBa (1) to test causal effects through maternal nutrient levels, (2) to test effects of child nutrient levels, and (3) as a paternal negative control. RESULTS: Associations between higher maternal vitamin-D levels on lower ADHD related traits at age 5 did not remain after controlling for familial genetic predisposition using trio-MR. Furthermore, we did not find evidence for causal maternal effects of vitamin-D/DHA levels on other offspring traits or diagnoses. In the reverse direction, there was evidence for a causal effect of autism genetic predisposition on lower vitamin-D levels and of ADHD genetic predisposition on lower DHA levels. CONCLUSIONS: Triangulating across study designs, we did not find evidence for maternal effects. We add to a growing body of evidence that suggests that previous observational associations are likely biased by genetic confounding. Consequently, maternal supplementation is unlikely to influence these offspring neurodevelopmental traits. Notably, genetic predisposition to ADHD and autism was associated with lower DHA and vitamin-D levels respectively, suggesting previous associations might have been due to reverse causation.

Children's and parents' attitudes to and knowledge about HPV vaccination following a targeted information intervention.

The aim of this study was to investigate Swedish children's and parents' attitudes and knowledge about human papillomavirus (HPV) vaccination a year after gender-neutral HPV vaccination was introduced in Sweden's national immunization program (NIP). Additional information about HPV and vaccine was provided in the extended immunazation program. In total, 276 parents and 206 children from 22 School Health Services responded to a web-based survey. Results showed that half of the children and about a third of the parents received additional Public Health Agency information about HPV vaccination, and a majority were satisfied. Parents considered HPV vaccination being important for their children's health, and both children and parents considered it important to vaccinate all genders against HPV. Both children and parents rated school nurses as most reliable source of HPV vaccination information. Teachers were also a common source of HPV and HPV vaccination information for children. Further research among teachers in Sweden is needed to explore their knowledge and abilities to inform students and parents about HPV and vaccination.

Mental illness and COVID-19 vaccination: a multinational investigation of observational & register-based data.

Individuals with mental illness are at higher risk of severe COVID-19 outcomes. However, previous studies on the uptake of COVID-19 vaccination in this population have reported conflicting results. Using data from seven cohort studies (N = 325,298) included in the multinational COVIDMENT consortium, and the Swedish registers (N = 8,080,234), this study investigates the association between mental illness (defined using self-report measures, clinical diagnosis and prescription data) and COVID-19 vaccination uptake. Results from the COVIDMENT cohort studies were pooled using meta-analyses, the majority of which showed no significant association between mental illness and vaccination uptake. In the Swedish register study population, we observed a very small reduction in the uptake of both the first and second dose of a COVID-19 vaccine among individuals with vs. without mental illness; the reduction was however greater among those not using psychiatric medication. Here we show that uptake of the COVID-19 vaccine is generally high among individuals both with and without mental illness, however the lower levels of vaccination uptake observed among subgroups of individuals with unmedicated mental illness warrants further attention.

Is there consensus on child violence exposure measures? A study of six recommended instruments.

Background: International research has established that children and adolescents are at high risk for being exposed to violence. A systematic review published in 2023 recommended six child and adolescent self-report violence against children (VAC) measures, based on their psychometric properties, in a systematic COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) review. However, the degree of overlap and heterogeneity was not part of the analysis.Objective: To compare the six measures with respect to item overlap and differences concerning specification of exposure dimensions.Method: A content analysis of the original 174 items resulted in a reduction to 38 unique items. These items were organized visually in a co-occurrence circle using an adapted version of Fried's R code. Furthermore, a pairwise comparison of event lists was performed using the Jaccard index.Results: There was a modest overlap among the six measures. Only one item was present in all six measures, only two items were present in four measures, and 78% of the items were present in just one or two measures. The overall overlap between the six measures was 25%.Conclusions: The lack of overlap among measures reflects a heterogeneity of definitions and purposes. It also impedes progress in research, as comparisons between various studies are difficult to make in a valid and reliable way. The lack of consensus also delays efficient political initiatives, because solid, consensual knowledge about the prevalence of VAC does not exist.

Violence against children (VAC) is a high political and professional priority. A recent systematic review recommended six self-report measures based on their psychometric qualities.The VAC items were very diverse. A content analysis reduced the original 174 items to 38 unique items. A Jaccard index showed an overlap of 25%.The lack of consensus in definitions and applied measures impedes progress in research and delays important political, prophylactic initiatives.

Kinematic changes in dairy cows with induced hindlimb lameness: transferring methodology from the field of equine biomechanics.

Lameness is a common issue on dairy farms, with serious implications for economy and animal welfare. Affected animals may be overlooked until their condition becomes severe. Thus, improved lameness detection methods are needed. In this study, we describe kinematic changes in dairy cows with induced, mild to moderate hindlimb lameness in detail using a "whole-body approach". Thereby, we aimed to identify explicable features to discriminate between lame and non-lame animals for use in future automated surveillance systems. For this purpose, we induced a mild to moderate and fully reversible hindlimb lameness in 16 dairy cows. We obtained 41 straight-line walk measurements (containing > 3 000 stride cycles) using 11 inertial measurement units attached to predefined locations on the cows' upper body and limbs. One baseline and ≥ 1 induction measurement(s) were obtained from each cow. Thirty-one spatial and temporal parameters related to limb movement and inter-limb coordination, upper body vertical displacement symmetry and range of motion (ROMz), as well as pelvic pitch and roll, were calculated on a stride-by-stride basis. For upper body locations, vertical within-stride movement asymmetry was investigated both by calculating within-stride differences between local extrema, and by a signal decomposition approach. For each parameter, the baseline condition was compared with induction condition in linear mixed-effect models, while accounting for stride duration. Significant difference between baseline and induction condition was seen for 23 out of 31 kinematic parameters. Lameness induction was associated with decreased maximum protraction (-5.8%) and retraction (-3.7%) angles of the distal portion of the induced/non-induced limb respectively. Diagonal and lateral dissociation of foot placement (ratio of stride duration) involving the non-induced limb decreased by 8.8 and 4.4%, while diagonal dissociation involving the induced limb increased by 7.7%. Increased within-stride vertical displacement asymmetry of the poll, neck, withers, thoracolumbar junction (back) and tubera sacrale (TS) were seen. This was most notable for the back and poll, where a 40 and 24% increase of the first harmonic amplitude (asymmetric component) and 27 and 14% decrease of the second harmonic amplitude (symmetric component) of vertical displacement were seen. ROMz increased in all these landmarks except for TS. Changes in pelvic roll main components, but not in the range of motion of either pitch or roll angle per stride, were seen. Thus, we identified several kinematic features which may be used in future surveillance systems. Further studies are needed to determine their usefulness in realistic conditions, and to implement methods on farms.

Which diagnoses and arguments regarding severe mental disorder do forensic psychiatric experts in Sweden consider in different cases? A qualitative vignette study.

The decision-making process of experts in forensic psychiatric investigations (FPI) is complex and reasoning regarding psychiatric diagnosis and severe mental disorder (SMD, the judicial concept central to legal exemption in Swedish law) has severe ramifications. Nevertheless, the qualitative aspects of FPI experts' decision-making process have seldom been studied systematically. METHOD: The participants (N = 41) were FPI experts: forensic psychiatrists (n = 15), forensic psychologists (n = 15) and forensic social workers (n = 11). Using three case vignettes and qualitative content analysis, it was explored how case-specific characteristics could affect which hypotheses FPI experts generated regarding a) psychiatric diagnosis and b) severe mental disorder and c) which information sources they required. Each case vignette described a diagnostically ambiguous case but indicated emphasis on: psychotic symptoms (case 1); personality disorder symptoms (case 2) and neurodevelopmental disorder symptoms (case 3). RESULTS: Experts reasoned in a similar manner regarding generating hypotheses and required information, but also in a case-adapted manner. Experts considered various diagnostic alternatives, and some (e.g. psychosis) were mentioned for all three cases. Other diagnoses were only suggested as hypotheses in certain cases (e.g. case 3: intellectual disability). DISCUSSION: In Sweden, a core basis for SMD is psychotic-like functioning, and psychosis was suggested as a hypothesis for all three cases. Experts reasoned in similar ways regarding SMD in all cases, considering various perspectives for and against SMD. Some case-specific arguments for and against SMD adapted to the psychopathological circumstances were found. These could be related to aspects of the SMD concept that become important to ascertain when the type of psychopathology indicated in the case vignette was present; for example, ascertaining reality monitoring for a person with potential delusions of being followed by a criminal gang requires investigation of criminal history and related conflicts. Taken together, FPI-experts considered a broad range of psychiatric diagnoses in various cases. Their reasoning regarding SMD was both based on general and case-specific (or psychopathology-specific) factors.

History of childhood maltreatment associated with hospitalization or death due to COVID-19: a cohort study.

BACKGROUND: Childhood maltreatment (CM) has been indicated in adverse health outcomes across the lifespan, including severe infection-related outcomes. Yet, data are scarce on the potential role of CM in severe COVID-19-related outcomes as well as on mechanisms underlying this association. METHODS: We included 151,427 individuals in the UK Biobank who responded to questions on the history of CM in 2016 and 2017 and were alive on January 31, 2020. Binomial logistic regression models were performed to estimate the association between a history of CM and severe COVID-19 outcomes (i.e. hospitalization or death due to COVID-19), as well as COVID-19 diagnosis and vaccination as secondary outcomes. We then explored the potential mediating roles of socio-economic status, lifestyle and pre-pandemic comorbidities, and the effect modification by polygenic risk score for severe COVID-19 outcomes. RESULTS: The mean age of the study population at the start of the pandemic was 67.7 (SD = 7.72) years, and 56.5% were female. We found the number of CM types was associated with the risk of severe COVID-19 outcomes in a graded manner (pfor trend < 0.01). Compared to individuals with no history of CM, individuals exposed to any CM were more likely to be hospitalized or die due to COVID-19 (odds ratio [OR] = 1.54 [95%CI 1.31-1.81]), particularly after physical neglect (2.04 [1.57-2.62]). Largely comparable risk patterns were observed across groups of high vs. low genetic risks for severe COVID-19 outcomes (pfor difference > 0.05). Mediation analysis revealed that 50.9% of the association between CM and severe COVID-19 outcomes was explained by suboptimal socio-economic status, lifestyle, and pre-pandemic diagnosis of psychiatric disorders or other chronic medical conditions. In contrast, any CM exposure was only weakly associated with COVID-19 diagnosis (1.06 [1.01-1.12]) while significantly associated with not being vaccinated for COVID-19 (1.21 [1.13-1.29]). CONCLUSIONS: Our results add to the growing knowledge base indicating the role of childhood maltreatment in negative health outcomes across the lifespan, including severe COVID-19-related outcomes. The identified factors underlying this association represent potential intervention targets for mitigating the harmful effects of childhood maltreatment in COVID-19 and similar future pandemics.

Social support utilization's effect on post-traumatic stress symptoms: a Danish cross-sectional study of 383 ambulance personnel.

Introduction: Social support is considered an important factor in prevention of mental illness. However, little is known about the association between ambulance personnel's use of multiple types of social support and post-traumatic stress symptoms (PTSS). This study aims to assess if number of used social support types predicts PTSS for ambulance personnel. Apart from assessing the main effect of social support utilization, we were interested in investigating if social support utilization moderated the effect of frequency of critical events on PTSS. Materials and methods: A total of 383 ambulance personnel completed a survey consisting of validated questionnaires. Hierarchical multiple linear regression analyses were performed to assess the association between frequency of traumatic exposure and utilization of social support and PTSS as outcome variable. Results: Higher number of utilized social support types was associated with higher levels of PTSS (ß = 0.15, p <.001). When serving as a moderator of the association between frequency of exposure to critical incidents and PTSS, social support utilization had a significant and positive interaction effect (ß = 0.26, p = .049). 307 participants had used 2 or 3 types of informal support during the past year, whereas 81 had used 2 or 3 types of formal support. Conclusion: To our knowledge, this is the first study investigating the relationship between utilization of multiple, concurrent social support types and PTSS. This study suggests that to understand the effects of social support among ambulance personnel, it is necessary to assess the utilization of multiple concurrent support types, contributing factors to social support use, and different patterns of social support utilization that constitutes professional life in ambulance work.

An evaluation of the Ultimatum Game as a measure of irritability and anger.

The Ultimatum Game is an effective tool for understanding how social decision-making is influenced by emotions in both research and clinical settings. Previous findings have shown that the Ultimatum Game can evoke negative emotions, especially anger and aggression. In a sample of non-clinical adults (N = 143) we evaluated the sensitivity of an anger-infused version of the Ultimatum Game to individual differences in anger and irritability. Findings showed significant relationships between anger and aggressive behaviors in the Ultimatum game, but no association between irritability and aggressive behavior were observed. This indicates that the anger-infused Ultimatum Game is a promising method for studying individual differences in trait anger and anger expression. However, the relationship between decision-making in the anger-infused Ultimatum Game and irritability is less straight forward and needs further investigation. Therefore, when studying the behavioral responses of irritability, it would be beneficial to capture other behaviors beyond aggressive responses.