Acute nasal breathing lowers diastolic blood pressure and increases parasympathetic contributions to heart rate variability in young adults.

There is growing interest in how breathing pace, pattern, and training (e.g., device-guided or -resisted breathing) affect cardiovascular health. It is unknown whether the route of breathing (nasal vs. oral) affects prognostic cardiovascular variables. Because nasal breathing can improve other physiological variables (e.g., airway dilation), we hypothesized that nasal compared with oral breathing would acutely lower blood pressure (BP) and improve heart rate variability (HRV) metrics. We tested 20 adults in this study [13 females/7 males; age: 18(1) years, median (IQR); body mass index: 23 ± 2 kg·m-2, means ± SD]. We compared variables between nasal- and oral-only breathing (random order, five min each) using paired, two-tailed t tests or Wilcoxon signed-rank paired tests with significance set to P < 0.05. We report the median (interquartile range) for diastolic BP and means ± SD for all other variables. We found that nasal breathing was associated with a lower mean BP (nasal: 84 ± 7 vs. oral: 86 ± 5 mmHg, P = 0.006, Cohen's d = 0.70) and diastolic BP [nasal: 68(8) vs. oral: 72(5) mmHg, P < 0.001, Rank-biserial correlation = 0.89] but not systolic BP (nasal: 116 ± 11 vs. oral: 117 ± 9 mmHg, P = 0.48, Cohen's d = 0.16) or heart rate (HR; nasal: 74 ± 10 vs. oral: 75 ± 8 beats·min-1, P = 0.90, Cohen's d = 0.03). We also found that nasal breathing was associated with a higher high-frequency (HF) contribution to HRV (nasal: 59 ± 19 vs. oral: 52 ± 21%, P = 0.04, Cohen's d = 0.50) and a lower low frequency-to-HF ratio at rest (nasal: 0.9 ± 0.8 vs. oral: 1.2 ± 0.9, P = 0.04, Cohen's d = 0.49). These data suggest that nasal compared with oral breathing acutely 1) lowers mean and diastolic BP, 2) does not affect systolic BP or heart rate, and 3) increases parasympathetic contributions to HRV.NEW & NOTEWORTHY There is growing interest in how breathing pace, pattern, and training (e.g., device-guided or -resisted breathing) affect prognostic cardiovascular variables. However, the potential effects of the breathing route on prognostic cardiovascular variables are unclear. These data suggest that nasal compared with oral breathing 1) lowers mean and diastolic blood pressure (BP), 2) does not affect systolic BP or heart rate (HR), and 3) increases parasympathetic contributions to heart rate variability (HRV). These data suggest that acute nasal breathing improves several prognostic cardiovascular variables.

Evaluation of Coating Thickness Using Lift-Off Insensitivity of Eddy Current Sensor.

Defect detection in ferromagnetic substrates is often hampered by nonmagnetic coating thickness variation when using conventional eddy current testing technique. The lift-off distance between the sample and the sensor is one of the main obstacles for the thickness measurement of nonmagnetic coatings on ferromagnetic substrates when using the eddy current testing technique. Based on the eddy current thin-skin effect and the lift-off insensitive inductance (LII), a simplified iterative algorithm is proposed for reducing the lift-off variation effect using a multifrequency sensor. Compared to the previous techniques on compensating the lift-off error (e.g., the lift-off point of intersection) while retrieving the thickness, the simplified inductance algorithms avoid the computation burden of integration, which are used as embedded algorithms for the online retrieval of lift-offs via each frequency channel. The LII is determined by the dimension and geometry of the sensor, thus eliminating the need for empirical calibration. The method is validated by means of experimental measurements of the inductance of coatings with different materials and thicknesses on ferrous substrates (dual-phase alloy). The error of the calculated coating thickness has been controlled to within 3% for an extended lift-off range of up to 10 mm.

Combustion products generated in simulated industrial fires.

Studies of firefighter exposure to combustion products have focused predominantly on real or simulated residential structure fires, with few investigations considering industrial fire scenarios. This study measured the atmospheric concentrations of a variety of volatile organic compounds (VOCs), acid gases, and polycyclic aromatic hydrocarbons (PAHs) produced during fires in simulated industrial premises, as well as the deposition of PAHs onto the structural firefighting ensembles worn by the firefighters involved in extinguishment activities. Ingress of these combustion products into the structural firefighting ensembles during firefighting was also measured. Benzene concentrations of up to 23 mg/m3 and total PAH concentrations ranging from 1.7 to 8.6 mg/m3 were observed in personal air samples collected outside the structural firefighting ensembles, as well as a variety of acid gases including hydrogen chloride and hydrogen cyanide. Most combustion products detected outside the structural firefighting ensembles were also detected inside the ensembles, although often at much lower concentrations. The degree of protection observed was not uniform across all the combustion products investigated, with lower levels of protection found for gaseous combustion products such as benzene, xylene, hydrogen cyanide, and hydrochloric acid as compared with PAHs. Deposition of a variety of PAH compounds was observed on the outer surface of the structural firefighting ensembles, with total PAH concentrations ranging from 161 to 347 ng/cm2. While similar combustion products are involved in firefighter exposures during residential and industrial fires, deposition rates of PAHs, may be substantially higher during industrial firefighting. This research provides evidence supporting fireground decontamination measures for management of contamination of structural firefighting ensembles and equipment worn or carried by firefighters during firefighting activities. Further research is required to investigate the potential for dermal deposition of PAHs during actual industrial fire responses, and characterize which stages of fire and firefighting operations contribute the most to firefighters' exposure to particular contaminants.

Protecting Spin Coherence in a Tunable Heisenberg Model.

Using an ensemble of atoms in an optical cavity, we engineer a family of nonlocal Heisenberg Hamiltonians with continuously tunable anisotropy of the spin-spin couplings. We thus gain access to a rich phase diagram, including a paramagnetic-to-ferromagnetic Ising phase transition that manifests as a diverging magnetic susceptibility at the critical point. The susceptibility displays a symmetry between Ising interactions and XY (spin-exchange) interactions of the opposite sign, which is indicative of the spatially extended atomic system behaving as a single collective spin. Images of the magnetization dynamics show that spin-exchange interactions protect the coherence of the collective spin, even against inhomogeneous fields that completely dephase the noninteracting and Ising systems. Our results underscore prospects for harnessing spin-exchange interactions to enhance the robustness of spin squeezing protocols.

16Up: Outline of a Study Investigating Wellbeing and Information and Communication Technology Use in Adolescent Twins.

The '16Up' study conducted at the QIMR Berghofer Medical Research Institute from January 2014 to December 2018 aimed to examine the physical and mental health of young Australian twins aged 16-18 years (N = 876; 371 twin pairs and 18 triplet sets). Measurements included online questionnaires covering physical and mental health as well as information and communication technology (ICT) use, actigraphy, sleep diaries and hair samples to determine cortisol concentrations. Study participants generally rated themselves as being in good physical (79%) and mental (73%) health and reported lower rates of psychological distress and exposure to alcohol, tobacco products or other substances than previously reported for this age group in the Australian population. Daily or near-daily online activity was almost universal among study participants, with no differences noted between males and females in terms of frequency or duration of internet access. Patterns of ICT use in this sample indicated that the respondents were more likely to use online information sources for researching physical health issues than for mental health or substance use issues, and that they generally reported partial levels of satisfaction with the mental health information they found online. This suggests that internet-based mental health resources can be readily accessed by adolescent Australians, and their computer literacy augurs well for future access to online health resources. In combination with other data collected as part of the ongoing Brisbane Longitudinal Twin Study, the 16Up project provides a valuable resource for the longitudinal investigation of genetic and environmental contributions to phenotypic variation in a variety of human traits.

Exposures to air contaminants in compartment fire behavior training (CFBT) using particleboard fuel.

Firefighters are exposed to a variety of combustion products during operational fires but also during live-fire training. As part of an on-going project investigating firefighter operational and training environments, this study measured the atmospheric concentrations of volatile organic compounds and acid gases outside and inside the structural firefighting ensembles worn by instructors during compartment fire behavior training using particleboard as a fuel. Atmospheric concentrations of benzene, formaldehyde, and hydrogen cyanide within the firefighting environment were observed to exceed Australian workplace exposure standards; although, the use of self-contained breathing apparatus throughout the training meant that atmospheric concentrations measured were not representative of firefighter inhalation exposures. Concentrations of air contaminants inside the structural firefighting ensembles during compartment fire behavior training were substantially lower than outside the ensembles, and much lower than those documented as potentially causing acute toxic effects in humans by dermal absorption from vapor. Although this study is focused on the generation of air contaminants in compartment fires, dermal absorption in these types of training environments may still constitute a potential route of low-level exposure to some combustion products.

The Anorexia Nervosa Genetics Initiative: Study description and sample characteristics of the Australian and New Zealand arm.

OBJECTIVES: Anorexia nervosa is a severe psychiatric disorder with high mortality rates. While its aetiology is poorly understood, there is evidence of a significant genetic component. The Anorexia Nervosa Genetics Initiative is an international collaboration which aims to understand the genetic basis of the disorder. This paper describes the recruitment and characteristics of the Australasian Anorexia Nervosa Genetics Initiative sample, the largest sample of individuals with anorexia nervosa ever assembled across Australia and New Zealand. METHODS: Participants completed an online questionnaire based on the Structured Clinical Interview Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) eating disorders section. Participants who met specified case criteria for lifetime anorexia nervosa were requested to provide a DNA sample for genetic analysis. RESULTS: Overall, the study recruited 3414 Australians and 543 New Zealanders meeting the lifetime anorexia nervosa case criteria by using a variety of conventional and social media recruitment methods. At the time of questionnaire completion, 28% had a body mass index ⩽ 18.5 kg/m2. Fasting and exercise were the most commonly employed methods of weight control, and were associated with the youngest reported ages of onset. At the time of the study, 32% of participants meeting lifetime anorexia nervosa case criteria were under the care of a medical practitioner; those with current body mass index < 18.5 kg/m2 were more likely to be currently receiving medical care (56%) than those with current body mass index ⩾ 18.5 kg/m2 (23%). Professional treatment for eating disorders was most likely to have been received from general practitioners (45% of study participants), dietitians (42%) and outpatient programmes (42%). CONCLUSIONS: This study was effective in assembling the largest community sample of people with lifetime anorexia nervosa in Australia and New Zealand to date. The proportion of people with anorexia nervosa currently receiving medical care, and the most common sources of treatment accessed, indicates the importance of training for general practitioners and dietitians in treating anorexia nervosa.

Analysis of outcomes for single-incision laparoscopic surgery (SILS) right colectomy reveals a minimal learning curve.

BACKGROUND: Single-incision right colectomy has emerged as a safe and feasible alternative to standard laparoscopic resection. As with any new surgical approach, definition of the number of procedures required to optimize the technique is an important goal. Data on this learning curve for single-incision right colectomy are lacking; therefore, we report the outcomes of consecutive single-incision right colectomies to identify the procedural learning curve. METHODS: We retrospectively reviewed consecutive single-incision right colectomies performed by a single surgeon from May 2010 to May 2013. Patients were evaluated in groups of ten to minimize individual patient variability and selection bias. Demographics and peri-operative outcomes among groups were evaluated using ANOVA or Kruskal-Wallis. Statistical improvement was assessed between groups using Student T tests or Mann-Whitney U tests. RESULTS: Seventy consecutive single-incision right colectomies were performed during the study period. There were no differences in patient demographics over the course of the experiences, suggesting that the selection bias did not influence the outcomes. There was a statistical improvement in operative time after the first 10 cases (103 vs. 130 min, p = 0.01). A second statistical improvement in operative time occurred after 40 cases (97 vs. 114 min, p = 0.03). There was no statistical improvement in estimated blood loss, lymph node harvest, conversion rate, length of stay, or post-operative morbidity throughout the experience. CONCLUSIONS: Analysis of our large series of consecutive cases indicates that for a surgeon trained in advanced laparoscopic techniques and given adequate case volume, the outcomes from the procedure are quickly optimized with a minimal learning curve. Operative time is optimized following 40 procedures. Identification of the learning curve is critical for surgeons wishing to implement a single-incision approach and to ensure that the outcomes are optimized prior to thorough comparison with standard laparoscopic or open approaches.

Structural Fire Fighting Ensembles: Accumulation and Off-gassing of Combustion Products.

Firefighters may be exposed to toxic combustion products not only during fire fighting operations and training, but also afterwards as a result of contact with contaminated structural fire fighting ensembles. This study characterized the deposition of polycyclic aromatic hydrocarbons (PAHs) onto structural fire fighting ensembles and off-gassing of combustion products from ensembles after multiple exposures to hostile structural attack fire environments. A variety of PAHs were deposited onto the outer layer of structural fire fighting ensembles, with no variation in deposition flux between new ensembles and already contaminated ensembles. Contaminants released from ensembles after use included volatile organic compounds, carbonyl compounds, low molecular weight PAHs, and hydrogen cyanide. Air samples collected in a similar manner after laundering of ensembles according to manufacturer specifications indicated that laundering returns off-gassing concentrations of most of the investigated compounds to pre-exposure levels. These findings suggest that contamination of firefighter protective clothing increases with use, and that storage of unlaundered structural fire fighting ensembles in small, unventilated spaces immediately after use may create a source of future exposure to toxic combustion products for fire fighting personnel.

Firefighting instructors' exposures to polycyclic aromatic hydrocarbons during live fire training scenarios.

Cumulative exposures of firefighting instructors to toxic contaminants generated from live-fire training potentially far exceed firefighter exposures arising from operational fires. This study measured the atmospheric concentrations of polycyclic aromatic hydrocarbons (PAHs) outside and inside the structural firefighting ensembles worn by instructors during five live fire training evolutions. In addition, the contamination of ensembles by deposition of PAHs was characterized. Concentrations of polycyclic aromatic hydrocarbons outside the instructors' structural firefighting ensembles during the training evolutions ranged from 430 µg/m(3) to 2700 µg/m(3), and inside the structural firefighting ensembles from 32 µg/m(3) to 355 µg/m(3). Naphthalene, phenanthrene and acenaphthylene dominated the PAHs generated in the live fire evolutions, but benzo[a]pyrene was the greatest contributor to the toxicity of the PAH mixture both inside and outside the structural firefighting ensembles. Deposition of PAHs onto the structural firefighting ensembles was measured at between 69 and 290 ng/cm(2), with phenanthrene, fluoranthene, pyrene, and benzo[a]anthracene detected on all samples. These findings suggest that firefighting instructor exposures to PAHs during a single live-fire training evolution are comparable with exposures occurring in industrial settings over a full shift. Further research is required to investigate the importance of various potential routes of exposure to PAHs as a result of ingress and deposition of PAHs in/on structural firefighting ensembles.

Iliac venous pressure estimates central venous pressure after laparotomy.

BACKGROUND: Central venous pressure (CVP) is traditionally obtained through subclavian or internal jugular central catheters; however, many patients who could benefit from CVP monitoring have only femoral lines. The accuracy of illiac venous pressure (IVP) as a measure of CVP is unknown, particularly following laparotomy. METHODS: This was a prospective, observational study. Patients who had both internal jugular or subclavian lines and femoral lines already in place were eligible for the study. Pressure measurements were taken from both lines in addition to measurement of bladder pressure, mean arterial pressure, and peak airway pressure. Data were evaluated using paired t-test, Bland-Altman analysis, and linear regression. RESULTS: Measurements were obtained from 40 patients, 26 of which had laparotomy. The mean difference between measurements was 2.2 mm Hg. There were no significant differences between patients who had laparotomy and nonsurgical patients (P = 0.93). Bland-Altman analysis revealed a bias of 1.63 ± 2.44 mm Hg. There was no correlation between IVP accuracy and bladder pressure, mean arterial pressure, or peak airway pressure. CONCLUSIONS: IVP is an adequate measure of CVP, even in surgical patients who have had recent laparotomy. Measurement of IVP to guide resuscitation is encouraged in patients who have only femoral venous catheter access.

Impact of a parent-based interdisciplinary intervention for mothers on adjustment in children newly diagnosed with cancer.

OBJECTIVE: To determine if maternal distress predicts child adjustment outcomes or if child adjustment outcomes predict maternal distress among children newly diagnosed with cancer, and if a parent-focused intervention has downstream effects on child adjustment. METHODS: Mothers (n = 52) were randomly assigned to a clinic-based, interdisciplinary intervention for parents of children newly diagnosed with cancer. Measures of maternal distress and child adjustment were collected at baseline, posttreatment, and follow-up. RESULTS: A lagged relationship was identified between maternal distress and child internalizing symptoms, but not externalizing symptoms. The parent intervention reduced child internalizing and externalizing symptoms at follow-up. Only the child internalizing symptoms effect was mediated by reduced maternal distress. The child externalizing symptoms effect was mediated by unobserved parent factors. CONCLUSIONS: This study provides support for illness adjustment and coping models that emphasize the role of parent factors in driving child adjustment outcomes and is encouraging for future parent-focused intervention research.

Degree of external genital malformation at birth in children with a disorder of sex development and subsequent caregiver distress.

PURPOSE: We determined whether the degree of genital malformation at birth in children with a disorder of sex development is related to subsequent caregiver distress, specifically symptoms of depression and anxiety. MATERIALS AND METHODS: A total of 66 caregivers of children with disorders of sex development were recruited from 3 centers that specialize in disorders of sex development medicine. The caregivers completed the Beck Depression Inventory, 2nd Edition and the Beck Anxiety Inventory. The child's Prader score at birth was determined by the child's treating pediatric endocrinologist and/or pediatric urologist at each institution. RESULTS: Results from the current study revealed that for caregivers of male children, under masculinization of the child's genitals at birth was significantly related to higher levels of subsequent caregiver depression. In contrast, over masculinization of the genitals of female children at birth was unrelated to caregiver depression or anxiety. CONCLUSIONS: These findings suggest that caregivers of male children with disorders of sex development may be at increased risk for psychological distress and could benefit from family based psychosocial interventions.

Dysautonomia after pediatric brain injury.

AIM: Dysautonomia after brain injury is a diagnosis based on fever, tachypnea, hypertension, tachycardia, diaphoresis, and/or dystonia. It occurs in 8 to 33% of adults with brain injury and is associated with poor outcome. We hypothesized that children with brain injury with dysautonomia have worse outcomes and prolonged rehabilitation, and sought to determine the prevalence of dysautonomia in children and to characterize its clinical features. METHOD: We developed a database of children (n = 249, 154 males, 95 females; mean [SD] age 11 years 10 months [5 y 7 mo]) with traumatic brain injury, cardiac arrest, stroke, infection of the central nervous system, or brain neoplasm admitted for rehabilitation to The Children's Institute of Pittsburgh between 2002 and 2009. Dysautonomia diagnosis, injury type, clinical signs, length of stay, and Functional Independence Measure for Children (WeeFIM) testing were extracted from medical records, and analysed for differences between groups with and without dysautonomia. RESULTS: Dysautonomia occurred in 13% of children with brain injury (95% confidence interval 9.3-18.0%), occurring in 10% after traumatic brain injury and 31% after cardiac arrest. The combination of hypertension, diaphoresis, and dystonia best predicted a diagnosis of dysautonomia (area under the curve = 0.92). Children with dysautonomia had longer stays, worse WeeFIM scores, and improved less on the score's motor component (all p ≤ 0.001). INTERPRETATION: Dysautonomia is common in children with brain injury and is associated with prolonged rehabilitation. Prospective study and standardized diagnostic approaches are needed to maximize outcomes.

Comparison of self-reported and audiometrically-measured hearing loss in the Australian Defence Force.

OBJECTIVE: To investigate the relationship between self-reported and audiometrically-measured hearing loss in a sample of Australian Defence Force personnel. DESIGN: Responses to a question regarding hearing problems were compared with contemporaneous audiometric data. STUDY SAMPLE: 3335 members of the Australian Defence Force for whom anonymised medical records were available. RESULTS: The sensitivity of self-report data to identify higher-frequency hearing loss was lower than sensitivity at other frequencies, and positive predictive values were moderate to poor at all frequencies. Performance characteristics of self-report compared with audiometric data also varied with age, sex, and rank. CONCLUSIONS: While self-report hearing loss data have good performance characteristics for estimating prevalence of hearing loss as defined by audiometric criteria, this study indicates that the usefulness of self-report data in identifying individuals with hearing loss may be limited in this population.

Parenting characteristics of female caregivers of children affected by chronic endocrine conditions: a comparison between disorders of sex development and type 1 diabetes mellitus.

Rearing a child with a chronic illness is stressful and can potentially affect parenting style, which may result in poorer outcomes for children. The purpose of this study was to compare parenting characteristics of female caregivers rearing children with a disorder of sex development (DSD) to female caregivers rearing children with type 1 diabetes mellitus (T1DM). Caregivers of both groups were matched according to age and compared on measures of stress and parenting practices. Both groups demonstrated significant levels of stress and negative parenting practices. Children with T1DM and male children with non-life-threatening DSD were perceived as more vulnerable by their caregivers. Better understanding of parenting experiences of female caregivers rearing children with DSD, particularly male children, will facilitate the development of individualized interventions to ameliorate negative parenting practices and stress, with the long-term goal of improved health outcomes for their children.

Self-reported tinnitus and ototoxic exposures among deployed Australian Defence Force personnel.

The objective of this study was to investigate the effect of chemical and environmental exposures during deployment on tinnitus among Australian Defence Force personnel previously deployed to Bougainville and East Timor. Participants were asked to self-report recent occurrence and severity of "ringing in the ears," and identify any chemical and environmental exposures during their deployment. Self-reported exposure to loud noises, heavy metals, intense smoke, engine exhaust, solvents and degreasing agents, and chemical spills increased the risk of self-assessed moderate or severe tinnitus. Daily exposure to 4 or more ototoxic factors was associated with 2- to 4-fold increase in the risk. In addition to loud noises, chemical exposures may also play a role in the development of tinnitus among Australian Defence Force personnel serving overseas.

Cohort profile: the Australian genetics of depression study.

PURPOSE: Depression is the most common psychiatric disorder and the largest contributor to global disability. The Australian Genetics of Depression study was established to recruit a large cohort of individuals who have been diagnosed with depression at some point in their lifetime. The purpose of establishing this cohort is to investigate genetic and environmental risk factors for depression and response to commonly prescribed antidepressants. PARTICIPANTS: A total of 20 689 participants were recruited through the Australian Department of Human Services and a media campaign, 75% of whom were female. The average age of participants was 43 years±15 years. Participants completed an online questionnaire that consisted of a compulsory module that assessed self-reported psychiatric history, clinical depression using the Composite Interview Diagnostic Interview Short Form and experiences of using commonly prescribed antidepressants. Further voluntary modules assessed a wide range of traits of relevance to psychopathology. Participants who reported they were willing to provide a DNA sample (75%) were sent a saliva kit in the mail. FINDINGS TO DATE: 95% of participants reported being given a diagnosis of depression by a medical practitioner and 88% met the criteria for a lifetime depressive episode. 68% of the sample report having been diagnosed with another psychiatric disorder in addition to depression. In line with findings from clinical trials, only 33% of the sample report responding well to the first antidepressant they were prescribed. FUTURE PLANS: A number of analyses to investigate the genetic architecture of depression and common comorbidities will be conducted. The cohort will contribute to the global effort to identify genetic variants that increase risk to depression. Furthermore, a thorough investigation of genetic and psychosocial predictors of antidepressant response and side effects is planned.

PPD ACT: an app-based genetic study of postpartum depression.

Postpartum depression (PPD) is one of the most frequent complications of childbirth and particularly is suited to genetic investigation as it is more homogenous than major depression outside of the perinatal period. We developed an iOS app (PPD ACT) to recruit, consent, screen, and enable DNA collection from women with a lifetime history of PPD to sufficiently power genome-wide association studies. In 1 year, we recruited 7344 women with a history of PPD and have biobanked 2946 DNA samples from the US. This sample of PPD cases was notably severely affected and within 2 years of their worst episode of PPD. Clinical validation was performed within a hospital setting on a subset of participants and recall validity assessed 6-9 months after initial assessment to ensure reliability of screening tools. Here we detail the creation of the PPD ACT mobile app including design, ethical, security, and deployment considerations. We emphasize the importance of multidisciplinary collaboration to correctly implement such a research project. Additionally, we describe our ability to customize the PPD ACT platform to deploy internationally in order to collect a global sample of women with PPD.

Nineteen and Up study (19Up): understanding pathways to mental health disorders in young Australian twins.

PURPOSE: The Nineteen and Up study (19Up) assessed a range of mental health and behavioural problems and associated risk factors in a genetically informative Australian cohort of young adult twins and their non-twin siblings. As such, 19Up enables detailed investigation of genetic and environmental pathways to mental illness and substance misuse within the Brisbane Longitudinal Twin Sample (BLTS). PARTICIPANTS: Twins and their non-twin siblings from Queensland, Australia; mostly from European ancestry. Data were collected between 2009 and 2016 on 2773 participants (age range 18-38, 57.8% female, 372 complete monozygotic pairs, 493 dizygotic pairs, 640 non-twin siblings, 403 singleton twins). FINDINGS TO DATE: A structured clinical assessment (Composite International Diagnostic Interview) was used to collect lifetime prevalence of diagnostic statistical manual (4th edition) (DSM-IV) diagnoses of major depressive disorder, (hypo)mania, social anxiety, cannabis use disorder, alcohol use disorder, panic disorder and psychotic symptoms. Here, we further describe the comorbidities and ages of onset for these mental disorders. Notably, two-thirds of the sample reported one or more lifetime mental disorder.In addition, the 19Up study assessed general health, drug use, work activity, education level, personality, migraine/headaches, suicidal thoughts, attention deficit hyperactivity disorder (ADHD) symptomatology, sleep-wake patterns, romantic preferences, friendships, familial environment, stress, anorexia and bulimia as well as baldness, acne, asthma, endometriosis, joint flexibility and internet use.The overlap with previous waves of the BLTS means that 84% of the 19Up participants are genotyped, 36% imaged using multimodal MRI and most have been assessed for psychological symptoms at up to four time points. Furthermore, IQ is available for 57%, parental report of ADHD symptomatology for 100% and electroencephalography for 30%. FUTURE PLANS: The 19Up study complements a phenotypically rich, longitudinal collection of environmental and psychological risk factors. Future publications will explore hypotheses related to disease onset and development across the waves of the cohort. A follow-up study at 25+years is ongoing.