Preparation of oxygen-sensitive proteins for high-resolution cryoEM structure determination using (an)aerobic blot-free vitrification.

High-quality grid preparation for single-particle cryogenic electron microscopy (cryoEM) remains a bottleneck for routinely obtaining high-resolution structures. The issues that arise from traditional grid preparation workflows are particularly exacerbated for oxygen-sensitive proteins, including metalloproteins, whereby oxygen-induced damage and alteration of oxidation states can result in protein inactivation, denaturation, and/or aggregation. Indeed, 99% of the current structures in the EMBD were prepared aerobically and limited successes for anaerobic cryoEM grid preparation exist. Current practices for anaerobic grid preparation involve a vitrification device located in an anoxic chamber, which presents significant challenges including temperature and humidity control, optimization of freezing conditions, costs for purchase and operation, as well as accessibility. Here, we present a streamlined approach that allows for the (an)aerobic vitrification of oxygen-sensitive proteins using an automated aerobic blot-free grid vitrification device - the SPT Labtech chameleon. This robust workflow allows for high-resolution structure determination of dynamic, oxygen-sensitive proteins, of varying complexity and molecular weight.

Machine learning approaches to cryoEM density modification differentially affect biomacromolecule and ligand density quality.

The application of machine learning to cryogenic electron microscopy (cryoEM) data analysis has added a valuable set of tools to the cryoEM data processing pipeline. As these tools become more accessible and widely available, the implications of their use should be assessed. We noticed that machine learning map modification tools can have differential effects on cryoEM densities. In this perspective, we evaluate these effects to show that machine learning tools generally improve densities for biomacromolecules while generating unpredictable results for ligands. This unpredictable behavior manifests both in quantitative metrics of map quality and in qualitative investigations of modified maps. The results presented here highlight the power and potential of machine learning tools in cryoEM, while also illustrating some of the risks of their unexamined use.

Tuning ice thickness using the chameleon for high-quality cryoEM data collection.

Advances in single-particle cryogenic electron microscopy (cryoEM) now allow for routine structure determination of well-behaved biological specimens to high-resolution. Despite advances in the electron microscope, direct electron detectors, and data processing software, the preparation of high-quality grids with thin layers of vitreous ice containing the specimen of interest in random orientations remains a critical bottleneck for many projects. Although numerous efforts have been dedicated to overcoming hurdles frequently encountered during specimen vitrification using traditional blot-and-plunge specimen preparation techniques, the development of blot-free grid preparation devices provide a unique opportunity to carefully tune ice thickness, particle density, and specimen behavior during the vitrification process for improvements in image quality. Here, we describe critical steps of high-quality grid preparation using a SPT Labtech chameleon, evaluation of grid quality/ice thickness using the chameleon software, high-throughput imaging in the electron microscope, and recommend steps for troubleshooting grid preparation when standard parameters fail to yield suitable specimen.

Normal and malaligned talonavicular fusion alters cadaveric foot pressure and kinematics.

Talonavicular (TN) fusion is a common treatment for TN arthritis or deformity correction. There is incongruous evidence regarding remaining motion at the talocalcaneal and calcaneocuboid joints after TN fusion. Additionally, the effects of a malaligned TN fusion are not well understood and alignment of the fusion may be important for overall foot integrity. This project assessed the kinematic and kinetic effects of neutral and malaligned TN fusions. Ten cadaveric feet were tested on a gait simulator in four conditions: unfused, fused in neutral, fused in varus, and fused in valgus. The fusions were simulated with external fixation hardware. An eight-camera motion analysis system and a 10-segment foot model generated kinematic data, and a pressure mat captured pressure data. Simulated TN fusion was achieved in eight feet. From unfused to fused-neutral, range of motion (ROM) was not eliminated in the adjacent joints, but the positions of the joints changed significantly throughout stance phase. Furthermore, the ROM increased at the tibiotalar joint. Plantar pressure and center of pressure shifted laterally with neutral fusion. The malalignments marginally affected the ROM but changed joint positions throughout stance phase. Pressure patterns were shifted laterally in varus malalignment and medially in valgus malalignment. The residual motion and the altered kinematics at the joints in the triple joint complex after TN fusion may subsequently increase the incidence of arthritis. Clinical significance: This study quantifies the effects of talonavicular fusion and malalignment on the other joints of the triple joint complex.

Consumer Interaction with Sustainability Labelling on Food Products: A Narrative Literature Review.

Sustainability labelling on food products can help consumers make informed purchasing decisions and support the urgent transition to sustainable food systems. While there is a relatively robust body of evidence on health and nutrition labelling, less is known about the effectiveness of sustainability labelling in facilitating sustainable food choices. This paper investigates the impact of sustainability labelling on consumer understanding, attitudes, and behaviour to support a more nuanced, detailed, and holistic understanding of the evidence. Using a narrative literature review methodology, the paper assesses studies covering environmental, social, and/or animal welfare aspects of sustainability labelling on food products. We found that consumer understanding of sustainability information is often limited, which could hinder behaviour change. While sustainability labelling can influence consumer attitudes and purchasing behaviours, evidence from real consumer settings tends to show small effect sizes. Consumers are generally willing to pay more for sustainability-labelled products, and organic labelling often leads to the highest reported willingness to pay. The review emphasises the importance of trust, suggesting a preference for labelling backed by governments or public authorities. Sustainability labelling that uses intuitively understandable cues has an increased impact, with visual aids such as traffic light colours showing promise. We conclude that further research is needed in real-world settings, using representative populations and exploring the influence of demographic factors, values, and attitudes.

Evaluating the impact of skill development for drowning prevention: a relationship-building approach to community engagement.

OBJECTIVE: Evaluate the impact of a broadened theoretical and empirical model of community engagement aimed at coastal drowning prevention via relationship building between lifeguards and beachgoers through the delivery of skill development sessions on the beach. SETTING: A lifeguard-patrolled beach in Lorne, Victoria, Australia, during the 2023 peak summer holiday season. METHODS: In total, 12 skill development sessions were delivered by teams of lifeguards and risk researchers to beachgoers. Sessions were codesigned by the research team and shared with lifeguards beforehand to review and include lifeguards' interpretations of localised risk during delivery. In total, 85 survey interviews were conducted with self-selecting beachgoers post participation. RESULTS: In total, 79 participants (93%) enjoyed participating in the session(s) and 77 participants (91%) reported learning something new. Learning how to identify rip current (n=59) and escape a rip current (n=40) were the two most commonly learnt skills. Participants' intended changes in future beachgoing behaviours (n=46) include asking lifeguards at patrolled beaches how to identify site-specific (rip current) risk (n=11) and attempting to identify a rip current before entering the water (n=10). The spillover effects of participation include sharing what participants had learnt with family and friends. CONCLUSIONS: Creating a dialogic model of collaboration via participatory community engagements between lifeguards and researchers with the beachgoing public can successfully prompt learning drowning prevention skills. These skills are required when navigating dynamic coastal hazards at unpatrolled beaches. Supporting lifeguards and life-savers to provide skill development expands the ways that life-saving services can engage the public, including measurement of lifeguards' contributions to coastal drowning prevention.

The Expanded Exercise Addiction Inventory (EAI-3): Towards Reliable and International Screening of Exercise-Related Dysfunction.

Exercise addiction (EA) refers to excessive exercise, lack of control, and health risks. The Exercise Addiction Inventory (EAI) is one of the most widely used tools in its assessment. However, the cross-cultural psychometric properties of the EAI could be improved because it misses three pathological patterns, including guilt, exercise despite injury, and experienced harm. Therefore, the present study tested the psychometric properties of the expanded EAI (EAI-3) in a large international sample. The EAI-3 was administered to 1931 physically active adult exercisers speaking five languages (Chinese, German, Italian, Japanese, and Turkish) and other measures for obsessive-compulsive behavior, eating disorders, and personality traits. The assessment structure and reliability of the EAI-3 were tested with factorial analyses and through measurement invariance across languages and sex. Finally, a cutoff point for dysfunction-proneness was calculated. The EAI-3 comprised two factors, reflecting the positive and pathological sides of exercise. The structure had excellent reliability and goodness-of-fit indices and configural and metric invariances of the scale were supported. However, three items caused violations in scalar invariance. The results of partial measurement invariance testing suggested an adequate fit for the data. Following sensitivity and specificity analysis, the EAI-3's cutoff score was 34 out of a maximum score of 48. This preliminary study suggests that the EAI-3 is a promising tool for screening EA in an international sample, with a robust and reliable structure comparable across languages and sex. In addition, the proposed cutoff could pave the way toward a consensus on a threshold to screen for EA.

Effects of environmental impact and nutrition labelling on food purchasing: An experimental online supermarket study.

Nutrition labels and ecolabels can support consumers to make healthier and more sustainable choices, and the former is now widespread. But there is no information on the impact of ecolabels in the presence of nutrition labels. The aims of this study were primarily to examine whether (1) ecolabels are effective at promoting sustainable purchasing behaviour if presented alongside nutrition labels; (2) and secondarily, whether nutrition labels are effective at promoting healthier purchasing if presented alongside ecolabels. Participants (N = 2730) visited an experimental online supermarket platform, and were randomised to see products with (1) environmental impact labels only; (2) nutrition (NutriScore) labels only; (3) both environmental and nutrition labels; (4) no labels. Linear regressions compared the mean environmental impact scores (EIS; primary outcome) and health scores of products in participants' shopping baskets across each condition. Compared to control (no labels) there were significant reductions in the EIS when environmental impact labels were presented: Alone (-1.3, 95%CI: -2.3 to -0.4) or With nutrition labels (-2.0, 95%CI: -2.9 to -1.0), with no evidence of differences in effectiveness between these two conditions. There was no evidence of an impact of nutrition labels on either the EIS or the healthiness of purchases, both when nutrition labels were shown alone and when ecolabels were also present. Environmental impact labels may be effective at encouraging more sustainable purchases alone or when used alongside nutrition labels. This adds to the evidence base on the feasibility and effectiveness of environmental impact labelling as an important measure to change dietary behaviour to improve planetary health.

Evaluation of OPTIMISE (Online Programme to Tackle Individual's Meat Intake Through Self-regulation): Cohort Study.

BACKGROUND: There is an urgent need to reduce society's meat consumption to help mitigate climate change and reduce noncommunicable diseases. OBJECTIVE: This study aimed to investigate changes in meat intake after participation in an online, multicomponent, self-regulation intervention. METHODS: We conducted a pre-post observational study among adult meat eaters in the United Kingdom who signed up to a website offering support based on self-regulation theory to reduce meat consumption. The program lasted 9 weeks (including a 1-week baseline phase, a 4-week active intervention phase, and a 4-week maintenance phase), comprising self-monitoring, goal setting, action planning, and health and environmental feedback. Meat intake was estimated during weeks 1, 5, and 9 using a 7-day meat frequency questionnaire. We analyzed the change in mean daily meat intake from baseline to week 5 and week 9 among those reporting data using a hierarchical linear mixed model. We assessed changes in attitudes toward meat consumption by questionnaire and considered the acceptability and feasibility of the intervention. RESULTS: The baseline cohort consisted of 289 participants, of whom 77 were analyzed at week 5 (26.6% of the baseline sample) and 55 at week 9 (71.4% of the week 5 sample). We observed large reductions in meat intake at 5 and 9 weeks: -57 (95% CI -70 to -43) g/day (P<.001) and -49 (95% CI -64 to -34) g/day (P<.001), respectively. Participants' meat-free self-efficacy increased, meat-eating identities moved toward reduced-meat and non-meat-eating identities, and perceptions of meat consumption as the social norm reduced. Participants who completed the study reported high engagement and satisfaction with the intervention. CONCLUSIONS: Among people motivated to engage, this online self-regulation program may lead to large reductions in meat intake for more than 2 months, with promising signs of a change in meat-eating identity toward more plant-based diets. This digital behavior change intervention could be offered to complement population-level interventions to support reduction of meat consumption.

Awareness without learning: A preliminary study exploring the effects of beachgoer's experiences on risk taking behaviours.

Most drowning deaths on Australian beaches occur in locations not patrolled by lifeguards. At patrolled locations, where lifeguards supervise flagged areas in which beachgoers are encouraged to swim between, the incidence of drowning is reduced. To date, risk prevention practices on coasts focus on patrolled beaches, deploying warning signs at unpatrolled locations with the aim of raising public awareness of risk. What remains unexplored is the potential for learning and behaviour change that can transfer from patrolled to unpatrolled beaches through beachgoer's experiences and interactions with lifeguards. The aim of this preliminary study is to explore the risk perceptions of beachgoers at a patrolled beach to establish if and how their experiences of beach risk and interactions with lifeguards affect their behaviours. Data was collected in Gerroa, Australia by engaging 49 beachgoers using a mixed survey-interview methodology. Results show that beachgoers are aware that they should 'swim between the flags', but many did not know the basis for the positioning of safety flags. A key finding is that beachgoer's express a clear desire for a skills-based model of community engagement that enables learning with lifeguards. This demonstrates a reflective public that desires skill-development, which may transfer from patrolled to unpatrolled beaches to affect broader risk reduction on the Australian coast. Learning how to avoid site-specific rip hazards with lifeguards at the beach presents a promising, and previously unexplored model for beach drowning risk prevention that has the potential to affect behaviour at unpatrolled beaches, providing an empirically-supported alternative to prevailing deficit-based awareness raising methods.

Acceptability of policies to reduce consumption of red and processed meat: A population-based survey experiment.

Policies to reduce meat consumption are needed to help achieve climate change targets, and could also improve population health. Public acceptability can affect the likelihood of policy implementation. This study estimated the acceptability of policies to reduce red and processed meat consumption, and whether acceptability differed when policies were framed as benefitting health or the environment. In an online experiment, 2215 UK adults rated the acceptability of six policies, presented in a randomised order. Prior to rating policies, participants were randomised to one of two framing conditions, with policy outcomes described either as benefitting health or the environment. Regression models examined differences in the primary outcome - policy acceptability (rated on a 7-point scale) - by framing. Labels were the most accepted policy (48% support), followed by a media campaign (45%), reduced availability (40%) and providing incentives (38%). Increasing price (27%) and banning advertising (26%) were the least accepted. A substantial proportion of participants neither supported nor opposed most policies (26-33%), although this fell to 16% for increasing price. There was no evidence that framing policy benefits from a health or environment perspective influenced acceptability (-0.06, 95%CIs: 0.18,0.07). Fewer than half of the UK sample expressed support for any of six policies to reduce meat consumption, regardless of framing measures as benefitting health or the environment. Conversely, fewer than half expressed opposition, with the exception of price, suggesting considerable scope to influence public opinion in support of meat reduction measures to meet environmental and health goals.

Online Screening and Personalized Education to Identify Post-Deployment Mental Health Need and Facilitate Access to Care.

INTRODUCTION: Reserve and National Guard (RNG) service members face increased risks for psychological and behavioral problems and are unlikely to seek mental health (MH) care after returning from military deployments. This article examines an online intervention (Web-Ed) with regard to participation, screening results, satisfaction, and intent to seek follow-up MH care, with comparisons by gender and post-deployment MH care receipt. MATERIALS AND METHODS: This was a cross-sectional study of 414 RNG service members (214 women and 200 men), who returned from deployments to or in support of the Iraq or Afghanistan wars within the prior 36 months. Participants completed Web-Ed, which includes screening, personalized education, and links to Veterans Health Administration health care. RESULTS: Positive post-deployment screening proportions, Web-Ed satisfaction, and intent to seek follow-up care were similar for men and women. Few had received MH care (33% women; 24% men), yet most screened positive on at least one screen (69% women; 72% men). Most indicated that they would recommend Web-Ed to other veterans (71% women; 67% men) and that they received useful information they may not have received otherwise (52% women; 53% men) regardless of gender or prior MH care. Almost half (40% women; 48% men) planned to seek further assessment from a health care provider as a direct result of Web-Ed. CONCLUSIONS: Efforts to facilitate access to MH care among post-deployed RNG veterans should be ongoing, regardless of the length of time since deployment, Veterans Affairs enrollment status, prior MH care receipt, or gender. Online screening and personalized education engage veterans who have not sought MH care and provide new information to those who have.

Relationships between personality traits and disordered eating among Chinese female exercisers: the role of symptoms of exercise dependence and obsessive-compulsiveness.

BACKGROUND: Although numerous studies have examined associations between personality traits and eating disorders in females, few studies have been conducted on female exercisers. Given the high risk of disordered eating in female exercisers, this study investigated the associations between the Big Five personality traits and disordered eating in female exercisers, and further explored the potential mediators, namely exercise dependence symptoms, and obsessive-compulsive symptoms underlying this association. METHODS: A total of 295 female exercisers aged between 18 to 67 years (M =  22.11, SD =  6.65) participated in this study. RESULTS: Negative and statistically significant correlations between conscientiousness (r = - 0.17, p < 0.01), emotional stability (r = - 0.27, p < 0.001) and agreeableness (r = - 0.18, p < 0.01) and disordered eating were observed in our sample of female exercisers. The multiple mediation analyses revealed that exercise dependence symptoms and obsessive-compulsive symptoms mediate the relationship between conscientiousness (ß = 0.016, CI = [0.003, 0.031]), emotional stability (ß = -0.012, CI = [- 0.028, - 0.002]), and disordered eating in female exercisers, whereas obsessive-compulsive symptoms (ß = - 0.041, CI = [- 0.088, - 0.001]) but not exercise dependence symptoms are a mediator of the relationship between agreeableness and disordered eating. CONCLUSIONS: Our findings can be used to improve the screening procedures for eating disorders in female exercisers as they contribute to a better understanding of the psychological mechanisms that underlie the associations between the Big Five personality traits and disordered eating.

Only a few studies have examined the associations between personality traits and disordered eating in female exercisers which, in turn, limits our current knowledge about this research topic. Given the high risk of disordered eating in female exercisers, this study investigated the associations between the Big Five personality traits (i.e., extraversion, agreeableness, conscientiousness,  emotion stability, and openness to experience) and disordered eating in female exercisers, and further explored the potential mediators, namely exercise dependence symptoms and obsessive­compulsive symptoms underlying this association. A total of 295 female exercisers aged between 18 to 67 years participated in this study. We found that in female exercisers, the level of conscientiousness, emotional stability, and agreeableness are significantly and negatively associated with the level of disordered eating. Additionally, emotional stability and conscientiousness were related to exercise dependence and obsessive­compulsive symptoms among female exercisers and could lead to disordered eating. These findings can be used to improve screening procedures for eating disorders in female exercisers as they contribute to a better understanding of the psychological mechanism underlying the associations between the Big Five personality traits and disordered eating.

Effects of environmental impact labels on the sustainability of food purchases: Two randomised controlled trials in an experimental online supermarket.

Providing consumers with product-specific environmental impact information for food products (ecolabels) may promote more sustainable purchasing, needed to meet global environmental targets. Two UK studies investigated the effectiveness of different ecolabels using an experimental online supermarket platform. Study 1 (N = 1051 participants) compared three labels against control (no label), while Study 2 (N = 4979) tested four designs against control. Study 1 found significant reductions in the environmental impact score (EIS) for all labels compared to control (labels presented: values for four environmental indicators [-3.9 percentiles, 95%CIs: -5.2,-2.6]; a composite score [taking values from A to E; -3.9, 95%CIs: -5.2,-2.5]; or both together [-3.2, 95%CIs: -4.5,-1.9]). Study 2 showed significant reductions in EIS compared to control for A-E labels [-2.3, 95%CIs: -3.0,-1.5], coloured globes with A-E scores [-3.2, 95%CIs:-3.9,-2.4], and red globes highlighting 'worse' products [-3.2, 95%CIs:-3.9,-2.5]. There was no evidence that green globes highlighting 'better' products were effective [-0.5, 95%CIs:-1.3,0.2]. Providing ecolabels is a promising intervention to promote the selection of more sustainable products.

Structures of the nitrogenase complex prepared under catalytic turnover conditions.

The enzyme nitrogenase couples adenosine triphosphate (ATP) hydrolysis to the multielectron reduction of atmospheric dinitrogen into ammonia. Despite extensive research, the mechanistic details of ATP-dependent energy transduction and dinitrogen reduction by nitrogenase are not well understood, requiring new strategies to monitor its structural dynamics during catalytic action. Here, we report cryo-electron microscopy structures of the nitrogenase complex prepared under enzymatic turnover conditions. We observe that asymmetry governs all aspects of the nitrogenase mechanism, including ATP hydrolysis, protein-protein interactions, and catalysis. Conformational changes near the catalytic iron-molybdenum cofactor are correlated with the nucleotide-hydrolysis state of the enzyme.

Weakening the N-H Bonds of NH3 Ligands: Triple Hydrogen-Atom Abstraction to Form a Chromium(V) Nitride.

Weakening and cleaving N-H bonds is crucial for improving molecular ammonia (NH3) oxidation catalysts. We report the synthesis and H-atom-abstraction reaction of bis(ammonia)chromium porphyrin complexes Cr(TPP)(NH3)2 and Cr(TMP)(NH3)2 (TPP = 5,10,15,20-tetraphenyl-meso-porphyrin and TMP = 5,10,15,20-tetramesityl-meso-porphyrin) using bulky aryloxyl radicals. The triple H-atom-abstraction reaction results in the formation of CrV(por)(≡N), with the nitride derived from NH3, as indicated by UV-vis and IR and single-crystal structural determination of Cr(TPP)(≡N). Subsequent oxidation of this chromium(V) nitrido complex results in the formation of CrIII(por), with scission of the Cr≡N bond. Computational analysis illustrates the progression from CrII to CrV and evaluates the energetics of abstracting H atoms from CrII-NH3 to generate CrV≡N. The formation and isolation of CrV(por)(≡N) illustrates the stability of these species and the need to chemically activate the nitride ligand for atom transfer or N-N coupling reactivity.

Effectiveness of an Online Programme to Tackle Individual's Meat Intake through SElf-regulation (OPTIMISE): A randomised controlled trial.

PURPOSE: A reduction in meat intake is recommended to meet health and environmental sustainability goals. This study aimed to evaluate the effectiveness of an online self-regulation intervention to reduce meat consumption. METHODS: One hundred and fifty one adult meat eaters were randomised 1:1 to a multi-component self-regulation intervention or an information-only control. The study lasted 9 weeks (1-week self-monitoring; 4-week active intervention; and 4-week maintenance phase). The intervention included goal-setting, self-monitoring, action-planning, and health and environmental feedback. Meat intake was estimated through daily questionnaires in weeks 1, 5 and 9. The primary outcome was change in meat consumption from baseline to five weeks. Secondary outcomes included change from baseline to nine weeks and change in red and processed meat intake. We used linear regression models to assess the effectiveness of all the above outcomes. RESULTS: Across the whole sample, meat intake was 226 g/day at baseline, 118 g/day at five weeks, and 114 g/day at nine weeks. At five weeks, the intervention led to a 40 g/day (95%CI - 11.6,- 67.5, P = 0.006) reduction in meat intake, including a 35 g/day (95%CI - 7.7, - 61.7, P = 0.012) reduction in red and processed meat, relative to control. There were no significant differences in meat reduction after the four-week maintenance phase (- 12 g/day intervention vs control, 95% CI 19.1, - 43.4, P = 0.443). Participants said the intervention was informative and eye-opening. CONCLUSION: The intervention was popular among participants and helped achieve initial reductions in meat intake, but the longer-term reductions did not exceed control. TRIAL REGISTRATION: ClinicalTrials.gov NCT04961216, 14th July 2021, retrospectively registered.

Manual Blot-and-Plunge Freezing of Biological Specimens for Single-Particle Cryogenic Electron Microscopy.

Imaging biological specimens with electrons for high-resolution structure determination by single-particle cryogenic electron microscopy (cryoEM) requires a thin layer of vitreous ice containing the biomolecules of interest. Despite numerous technological advances in recent years that have propelled single-particle cryoEM to the forefront of structural biology, the methods by which specimens are vitrified for high-resolution imaging often remain the rate-limiting step. Although numerous recent efforts have provided means to overcome hurdles frequently encountered during specimen vitrification, including the development of novel sample supports and innovative vitrification instrumentation, the traditional manually operated plunger remains a staple in the cryoEM community due to the low cost to purchase and ease of operation. Here, we provide detailed methods for using a standard, guillotine-style manually operated blot-and-plunge device for the vitrification of biological specimens for high-resolution imaging by single-particle cryoEM. Additionally, commonly encountered issues and troubleshooting recommendations for when a standard preparation fails to yield a suitable specimen are also described.

Has COVID-19 Complicated Eating Disorder Treatment? An Examination of Comorbidities and Treatment Response Before and During the COVID-19 Pandemic.

Objective: Recent evidence suggests psychosocial stressors stemming from coronavirus disease 2019 (COVID-19) exposure and public health recommendations and policies have exacerbated eating disorder symptoms. Consequentially, eating disorder acuity has increased during the COVID-19 pandemic. Currently, it is still unclear how the COVID-19 pandemic may be impacting individuals receiving treatment for eating disorders at higher levels of care. The purpose of this study was to examine the impact of COVID-19 on eating disorder symptoms and associated outcomes in a sample of individuals receiving eating disorder treatment compared to individuals receiving treatment in 2019.Methods: Blinded outcomes data from 272 adults who completed treatment at an eating disorder treatment center between April and October of 2019 (pre-COVID-19 group) and 2020 (COVID-19 group) were examined. Repeated measures analyses of variance with Bonferroni correction were used to examine differences in outcome variables and treatment response.Results: Fewer participants reported trauma in 2020, but symptoms were more severe when present. A significant interaction effect for treatment (eg, admission, discharge) and year (eg, pre-COVID-19, COVID-19) was found for eating disorder and trauma symptoms. Moreover, trauma symptom scores were higher in 2020 than in 2019. The interaction among year, trauma, and treatment was significant (F3,268 = 2.11, P = .027, η2 = 0.034), indicating that individuals with severe trauma in 2020 reported less eating disorder symptom score reduction.Conclusions: Results extend understanding of effects during the COVID-19 pandemic on treatment-seeking individuals with eating disorders. Clinical implications suggest that greater attention to trauma when screening eating disorder patients and selecting treatment approaches are needed, particularly during the COVID-19 pandemic.