Trends in the dose-response relationship between adverse childhood experiences and maladaptive metacognitive beliefs: A cross-sectional study.

BACKGROUND: Since the publication of the major research on adverse childhood experiences (ACE) at the turn of the millennium, our knowledge about the prevalence and physical and mental consequences of childhood adversities has increased substantially. In parallel, research on metacognition, which plays an important role in understanding our mental functioning, has also been on the rise. Although the adverse effects of ACEs on mental processes and the role of metacognitive deficits in the development of mental disorders are widely known, hardly any research into the interaction between these two areas has been conducted; this is what triggered our investigation. METHODS: Our research was carried out as a cross-sectional study on a sample of 304 members of the general population. We measured ACEs with the 10-item Adverse Childhood Experiences Questionnaire and maladaptive metacognitions-positive and negative metacognitive beliefs, cognitive confidence, cognitive self-consciousness, and need to control thoughts- using the Meta-Cognitions Questionnaire. The closeness of the relationship between the ACE score and metacognitions was measured using Pearson's linear correlation coefficient, while the association of ACE accumulation with metacognitive beliefs was assessed using generalized linear models. RESULTS: The most common ACE in our sample turned out to be emotional neglect (44.74%). All the examined maladaptive metacognitive beliefs correlate mildly to moderately with the number of suffered ACEs (r = 0.13-0.34), with an increase in the ACE score leading to a rise in the salience of maladaptive metacognitive beliefs. Moreover, a dose-response relationship was seen between increases in ACE scores and the overall values of metacognition, negative metacognitive beliefs, and the maladaptive metacognitive belief of the need to control thoughts. CONCLUSIONS: Our results suggest that the more ACEs were experienced in childhood, the more pronounced the dysfunctional metacognitive beliefs are. Therefore, our findings emphasize the importance of further research into the topic.

Validity and reliability of the 10-Item Adverse Childhood Experiences Questionnaire (ACE-10) among adolescents in the child welfare system.

Introduction: Multiple evidence suggests that the vast majority of children in the Child Welfare System (CWS) are victims of early, chronic, and multiple adverse childhood experiences. However, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10) has never been tested in such a particularly vulnerable population as adolescents living in the CWS. We aimed to assess the psychometric properties of the ACE-10 in a community sample of 240 Hungarian adolescents placed in family style group care (FGC) setting. Methods: Demographic data, the 10-item version of the Adverse Childhood Experiences Questionnaire (ACE-10), the Strengths and Difficulties Questionnaire (SDQ), and the HBSC Bullying Measure were used. Results: Our results showed acceptable internal consistency (α = 0.701) and item-total correlations (rpb = 0.25-0.65, p < 0.001). However, our results also reflect that item 6 ("Parental separation/divorce") is weakly correlated with both the cumulative ACE score and the rest of the questionnaire items. When item 6 is removed, the 9-item version of the ACE produces more favorable consistency results (α = 0.729). Strong and significant associations of the cumulative ACE score with emotional and behavioral symptoms and bully victimization confirm the concurrent criterion validity of both versions of the instrument. Discussion: Our findings suggest that ACE-9 and ACE-10 are viable screening tools for adverse childhood experiences in the CWS contributing to the advancement of trauma-informed care. We recommend considering the use of either the 9-item or the 10- item version in the light of the characteristics of the surveyed population. The implications and limitations are discussed.

[The impact of adverse childhood experiences on mental and somatic health in childhood and adolescence]. / Az ártalmas gyermekkori élmények hatása a mentális és szomatikus egészségre gyermek- és serdülokorban.

Multiple studies prove that children who were exposed to adverse childhood experiences within their families are increasingly at risk of various high-risk behaviours, bullying, mental and somatic disorders. In children/adolescents who undergo terrifying experiences on a repetitive, sometimes daily basis without being provided support and the basic safety they would need, all aspects of personality development will be seriously affected. Urgent action is needed in Hungary to identify these children and provide them with therapeutic support. The field of childhood adversities and their consequences has been undeservedly neglected by research, despite the fact that preventive and therapeutic interventions could be specifically designed based on this knowledge during childhood and adolescence. In our study, we present international data on the prevalence of adverse childhood experiences. We discuss in detail the association of adverse childhood experiences with biological and cognitive impairments attachment disorders, externalising and internalising disorders, somatic disorders and health risk behaviours in childhood and adolescence. Besides presenting empirical data on adverse experiences and consequences, the purpose of our publication is to raise awareness and sensitisation among professionals. Orv Hetil. 2023; 164(37): 1447-1455.

[The immediate impact of different types of cartoons on preschoolers' executive function].

OBJECTIVE: The aim of this study was to examine whether different types of cartoons (related and unrelated shifts, cuts and other formal features) immediately influence preschool-aged children's executive function (e.g. working memory, inhibition). METHODS: Participants were 29 children aged four to five years. They were assigned to watch a fast-paced cartoon that used high concentrations of perceptually salient features or an educational cartoon or draw for 10 minutes. Preschoolers' executive function was assessed via 4 tasks (Sentence repetition, Hand game, Tower of Hanoi, Multi step commands). Parents completed questionnaires regarding demographics and the media habits and executive function of the participating child. RESULTS: Using age as a covariate we found a significant main effect of intervention on the composite executive function score. The fast paced television group performed significantly worse on the executive function tasks than the drawing group. The difference between the fast-paced and the educational cartoon groups approached significance, and there was no difference between drawing and watching the slow-paced cartoon. CONCLUSION: The effects of media consumed during early childhood are mediated not only by quantity but also by the formal features of television programming. Just one episode of viewing a fast-paced cartoon has (at least a short-term) negative effect on preschoolers' executive function.

Psychometric properties of the Adverse Childhood Experiences Questionnaire 10 item version (ACE-10) among Hungarian adolescents.

Introduction: Although a number of studies have been conducted since the 1995 initiation of the ACE study to map the effects of adverse childhood experiences, few studies have examined the psychometric properties of the individual versions of the ACE questionnaire. Aims: The Adverse Childhood Experiences Questionnaire 10 item version (ACE-10) has only been tested in a single study in an adult population, while its applicability in a particularly vulnerable population, the adolescents, has not been investigated yet. Our present study aims to address this gap in an adolescent sample of 792 subjects from a non-representative general population. Methods: Besides demographic data, the Adverse Childhood Experiences Questionnaire 10 item version (ACE-10), the Strengths and Difficulties Questionnaire (SDQ), and the HBSC Symptom Checklist (HBSC-SCL) were employed. Results: Our results showed acceptable internal consistency (ɵ = 0.86, α = 0.64) and adequate internal validity (r = 0.28-0.70, p < 0.001). In addition, proper concurrent criterion validity of the questionnaire was found when tested along the SDQ and HBSC-SCL items. Conclusion: Our results demonstrate that the ACE-10 is suitable for assessing intrafamilial adverse childhood experiences in adolescents.

Adverse childhood experiences increase the risk for eating disorders among adolescents.

Purpose: Traumatic events often feature prominently in eating disorders. A questionnaire survey to assess the relation of eating disorder risk to the frequency of adverse childhood experiences (ACEs) and the possible association of eating disorder risk with a particular type of ACE was conducted in a community sample of Hungarian adolescents. Methods: Demographic and anthropometric data, risk for eating disorders (by SCOFF questionnaire), and ACEs (by ACE score calculator) were collected from 432 adolescents aged 12-17 years. Results: Adolescents who had undergone four or more ACEs were 5.7 times more likely to be in the high eating disorder risk group than those who did not report any ACEs. Cumulative maltreatment showed a greater association with overall risk for eating disorders than cumulative family dysfunction. There is an increased risk of eating disorders from emotional maltreatment (OR = 3.475), physical maltreatment (OR = 3.440), sexual maltreatment (OR = 10.973), and emotional neglect (OR = 3.331). Dysfunctional family circumstances revealed an association with household mental illness (OR = 3.401). Conclusion: Our study of the connection between eating disorder risk and ACE is the first of its kind in Central and Eastern Europe. Maltreatments had a greater role than family dysfunctions in increasing the risk of eating disorders. Our findings contribute to a more precise understanding of the role that ACEs play in eating disorders. It is important to bring to clinicians' attention the importance of ACEs in the diagnosis and therapy of eating disorders and their potentially fundamental significance for therapy.

The Role of Preharvest Natural Infection and Toxin Contamination in Food and Feed Safety in Maize, South-East Hungary, 2014-2021.

Mycotoxins originating in the preharvest period represent a less studied research problem, even though they are of the utmost practical significance in maize production, determining marketability (within EU limits), and storage ability, competitiveness, and profit rate. In this study, 18-23 commercial hybrids were tested between 2014 and 2021. Natural infection from Fusarium spp. was higher than 1.5%, and for Aspergillus spp. this was normally 0.01% or 0, much lower than would be considered as severe infection. In spite of this, many hybrids provided far higher toxin contamination than regulations allow. The maximum preharvest aflatoxin B1 was in 2020 (at 2286 µg/kg), and, in several cases, the value was higher than 1000 µg/kg. The hybrid differences were large. In Hungary, the presence of field-originated aflatoxin B1 was continuous, with three AFB1 epidemics in the 8 years. The highest DON contamination was in 2014 (at 27 mg/kg), and a detectable DON level was found in every hybrid. FUMB1+B2 were the highest in 2014 (at 45.78 mg/kg). At these low infection levels, correlations between visual symptoms and toxin contaminations were mostly non-significant, so it is not feasible to draw a conclusion about toxin contamination from ear rot coverage alone. The toxin contamination of hybrids for a percentage of visual infection is highly variable, and only toxin data can decide about food safety. Hybrids with no visual symptoms and high AFB1 contamination were also identified. Preharvest control, including breeding and variety registration, is therefore of the utmost importance to all three pathogens. Even natural ear rot and toxin data do not prove differences in resistance, so a high ear rot or toxin contamination level should be considered as a risk factor for hybrids. The toxin control of freshly harvested grain is vital for separating healthy and contaminated lots. In addition, proper growing and storage conditions must be ensured to protect the feed safety of the grain.

Novel Insights into the Inheritance of Gibberella Ear Rot (GER), Deoxynivalenol (DON) Accumulation, and DON Production.

Gibberella ear rot (GER) is an important fungal ear pathogen of maize that causes ear rot and toxin contamination. Most previous works have only dealt with the visual symptoms, but not with the toxins of GER. As food and feed safety rankings depend on toxin contamination, including deoxynivalenol (DON), without toxins, nothing can be said about the risks involved in food and feed quality. Therefore, three susceptible, three medium-susceptible, and three medium-resistant mother lines were crossed with three testers with differing degrees of resistance and tested between 2017-2020. Two plot replicates and two fungal strains were used separately. The highest heterosis was found at the GER% with a 13% increase across 27 hybrids, including 7 hybrids showing negative heterosis (a higher hybrid performance above the parental mean), with a variance ranging between 63.5 and -55.4. For DON, the mean heterosis was negative at -35%, and only 10 of the 27 hybrids showed a positive heterosis. The mean heterosis for DON contamination, at 1% GER, was again negative (-19.6%, varying between 85% and 224%). Only 17 hybrids showed heterosis, while that of the other 17 was rated higher than the parental mean. A positive significant correlation was found only for GER% and DON; the other factors were not significant. Seven hybrids were identified with positive (2) or negative (5) heterosis for all traits, while the rest varied. For DON and GER, only 13 provided identical (positive or negative) heteroses. The majority of the hybrids appeared to diverge in the regulation of the three traits. The stability of GER and DON (variance across eight data sets) did not agree-only half of the genotypes responded similarly for the two traits. The genetic background for this trait is unknown, and there was no general agreement between traits. Thus, without toxin analyses, the evaluation of food safety is not possible. The variety in degrees of resistance to toxigenic fungi and resistance to toxin accumulation is an inevitable factor.

Updating the Methodology of Identifying Maize Hybrids Resistant to Ear Rot Pathogens and Their Toxins-Artificial Inoculation Tests for Kernel Resistance to Fusarium graminearum, F. verticillioides, and Aspergillus flavus.

Resistance to toxigenic fungi and their toxins in maize is a highly important research topic, as mean global losses are estimated at about 10% of the yield. Resistance and toxin data of the hybrids are mostly not given, so farmers are not informed about the food safety risks of their grown hybrids. According to the findings aflatoxin regularly occurs at preharvest in Hungary and possibly other countries in the region can be jeopardized. We tested, with an improved methodology (two isolates, three pathogens, and a toxin control), 18 commercial hybrids (2017-2020) for kernel resistance (%), and for toxin contamination separately by two-two isolates of F. graminearum, F. verticillioides (mg/kg), and A. flavus (µg/kg). The preharvest toxin contamination was measured in the controls. Highly significant kernel resistance and toxin content differences were identified between hybrids to the different fungi. Extreme high toxin production was found for each toxic species. Only about 10-15% of the hybrids showed higher resistance to the fungal species tested and lower contamination level of their toxins. The lacking correlations between resistance to different fungi and toxins suggest that resistance to different fungi and response to toxin contamination inherits independently, so a toxin analysis is necessary. For safety risk estimation, separated artificial and natural kernel infection and toxin data are needed against all pathogens. Higher resistance to A. flavus and F. verticillioides stabilizes or improves feed safety in hot and dry summers, balancing the harmful effect of climate changes. Resistance and toxin tests during variety registration is an utmost necessity. The exclusion of susceptible or highly susceptible hybrids from commercial production results in reduced toxin contamination.

Regulatory modules of human thermogenic adipocytes: functional genomics of large cohort and Meta-analysis derived marker-genes.

BACKGROUND: Recently, ProFAT and BATLAS studies identified brown and white adipocytes marker genes based on analysis of large databases. They offered scores to determine the thermogenic status of adipocytes using the gene-expression data of these markers. In this work, we investigated the functional context of these genes. RESULTS: Gene Set Enrichment Analyses (KEGG, Reactome) of the BATLAS and ProFAT marker-genes identified pathways deterministic in the formation of brown and white adipocytes. The collection of the annotated proteins of the defined pathways resulted in expanded white and brown characteristic protein-sets, which theoretically contain all functional proteins that could be involved in the formation of adipocytes. Based on our previously obtained RNA-seq data, we visualized the expression profile of these proteins coding genes and found patterns consistent with the two adipocyte phenotypes. The trajectory of the regulatory processes could be outlined by the transcriptional profile of progenitor and differentiated adipocytes, highlighting the importance of suppression processes in browning. Protein interaction network-based functional genomics by STRING, Cytoscape and R-Igraph platforms revealed that different biological processes shape the brown and white adipocytes and highlighted key regulatory elements and modules including GAPDH-CS, DECR1, SOD2, IL6, HRAS, MTOR, INS-AKT, ERBB2 and 4-NFKB, and SLIT-ROBO-MAPK. To assess the potential role of a particular protein in shaping adipocytes, we assigned interaction network location-based scores (betweenness centrality, number of bridges) to them and created a freely accessible platform, the AdipoNET ( https//adiponet.com ), to conveniently use these data. The Eukaryote Promoter Database predicted the response elements in the UCP1 promoter for the identified, potentially important transcription factors (HIF1A, MYC, REL, PPARG, TP53, AR, RUNX, and FoxO1). CONCLUSION: Our integrative approach-based results allowed us to investigate potential regulatory elements of thermogenesis in adipose tissue. The analyses revealed that some unique biological processes form the brown and white adipocyte phenotypes, which presumes the existence of the transitional states. The data also suggests that the two phenotypes are not mutually exclusive, and differentiation of thermogenic adipocyte requires induction of browning as well as repressions of whitening. The recognition of these simultaneous actions and the identified regulatory modules can open new direction in obesity research.

BMP7 Increases UCP1-Dependent and Independent Thermogenesis with a Unique Gene Expression Program in Human Neck Area Derived Adipocytes.

White adipocytes contribute to energy storage, accumulating lipid droplets, whereas brown and beige adipocytes mainly function in dissipating energy as heat primarily via the action of uncoupling protein 1 (UCP1). Bone morphogenic protein 7 (BMP7) was shown to drive brown adipocyte differentiation in murine interscapular adipose tissue. Here, we performed global RNA-sequencing and functional assays on adipocytes obtained from subcutaneous (SC) and deep-neck (DN) depots of human neck and differentiated with or without BMP7. We found that BMP7 did not influence differentiation but upregulated browning markers, including UCP1 mRNA and protein in SC and DN derived adipocytes. BMP7 also enhanced mitochondrial DNA content, levels of oxidative phosphorylation complex subunits, along with PGC1α and p-CREB upregulation, and fragmentation of mitochondria. Furthermore, both UCP1-dependent proton leak and UCP1-independent, creatine-driven substrate cycle coupled thermogenesis were augmented upon BMP7 addition. The gene expression analysis also shed light on the possible role of genes unrelated to thermogenesis thus far, including ACAN, CRYAB, and ID1, which were among the highest upregulated ones by BMP7 treatment in both types of adipocytes. Together, our study shows that BMP7 strongly upregulates thermogenesis in human neck area derived adipocytes, along with genes, which might have a supporting role in energy expenditure.

Irisin Stimulates the Release of CXCL1 From Differentiating Human Subcutaneous and Deep-Neck Derived Adipocytes via Upregulation of NFκB Pathway.

Thermogenic brown and beige adipocytes might open up new strategies in combating obesity. Recent studies in rodents and humans have indicated that these adipocytes release cytokines, termed "batokines". Irisin was discovered as a polypeptide regulator of beige adipocytes released by myocytes, primarily during exercise. We performed global RNA sequencing on adipocytes derived from human subcutaneous and deep-neck precursors, which were differentiated in the presence or absence of irisin. Irisin did not exert an effect on the expression of characteristic thermogenic genes, while upregulated genes belonging to various cytokine signaling pathways. Out of the several upregulated cytokines, CXCL1, the highest upregulated, was released throughout the entire differentiation period, and predominantly by differentiated adipocytes. Deep-neck area tissue biopsies also showed a significant release of CXCL1 during 24 h irisin treatment. Gene expression data indicated upregulation of the NFκB pathway upon irisin treatment, which was validated by an increase of p50 and decrease of IκBα protein level, respectively. Continuous blocking of the NFκB pathway, using a cell permeable inhibitor of NFκB nuclear translocation, significantly reduced CXCL1 release. The released CXCL1 exerted a positive effect on the adhesion of endothelial cells. Together, our findings demonstrate that irisin stimulates the release of a novel adipokine, CXCL1, via upregulation of NFκB pathway in neck area derived adipocytes, which might play an important role in improving tissue vascularization.

A comprehensive framework for navigating patient care in systemic sclerosis: A global response to the need for improving the practice of diagnostic and preventive strategies in SSc.

Systemic sclerosis (SSc), the most lethal of rheumatologic conditions, is the cause of death in >50% of SSc cases, led by pulmonary fibrosis followed by pulmonary hypertension and then scleroderma renal crisis (SRC). Multiple other preventable and treatable SSc-related vascular, cardiac, gastrointestinal, nutritional and musculoskeletal complications can lead to disability and death. Vascular injury with subsequent inflammation transforming to irreversible fibrosis and permanent damage characterizes SSc. Organ involvement is often present early in the disease course of SSc, but requires careful history-taking and vigilance in screening to detect. Inflammation is potentially reversible provided that treatment intensity quells inflammation and other immune mechanisms. In any SSc phenotype, opportunities for early treatment are prone to be under-utilized, especially in slowly progressive phenotypes that, in contrast to severe progressive ILD, indolently accrue irreversible organ damage resulting in later-stage life-limiting complications such as pulmonary hypertension, cardiac involvement, and malnutrition. A single SSc patient visit often requires much more physician and staff time, organization, vigilance, and direct management for multiple organ systems compared to other rheumatic or pulmonary diseases. Efficiency and efficacy of comprehensive SSc care enlists trending of symptoms and bio-data. Financial sustainability of SSc care benefits from understanding insurance reimbursement and health system allocation policies for complex patients. Sharing care between recognised SSc centers and local cardiology/pulmonary/rheumatology/gastroenterology colleagues may prevent complications and poor outcomes, while providing support to local specialists. As scleroderma specialists, we offer a practical framework with tools to facilitate an optimal, comprehensive and sustainable approach to SSc care. Improved health outcomes in SSc relies upon recogntion, management and, to the extent possible, prevention of SSc and treatment-related complications.

Can the Cumulative Adverse Childhood Experiences (ACE) Score Actually Identify the Victims of Intrafamilial Childhood Maltreatment? Findings from a Study in the Child Welfare System.

Studies show that a significant proportion of children in the Child Welfare System (CWS) have suffered adverse childhood experiences (ACEs), which have led to well documented serious consequences. This study assessed and compared the ACE status of adolescents aged 12 to 17 placed in a family style group care (FGC) setting (n = 240) to the ACE status of adolescents living with their biological parents (n = 516). The ACE Score Calculator was employed. The populational differences in ACE scores and in the prevalence of ACEs were assessed using generalized linear and logistic regression models. Adolescents living in FGC settings reported more than five times as many multiple adverse experiences (≥4 types of ACEs) as those living with their biological parents. Adolescents living in FGC settings seem to be more willing to report family dysfunction rather than their maltreatment history and are less willing to report maltreatment. In the FGC group, a surprisingly high proportion of adolescents reported having experienced no maltreatment, which is probably highly underreported and/or unrecognised in the CWS. In fact, a high ACE score will not identify the children who have experienced direct maltreatment but will highlight the consequences of the unfavourable factors inherent in disadvantaged social situation instead.

ASC-1 transporter-dependent amino acid uptake is required for the efficient thermogenic response of human adipocytes to adrenergic stimulation.

Brown and beige adipocytes dissipate energy by uncoupling protein 1 (UCP1)-dependent and UCP1-independent thermogenesis, which may be utilized to develop treatments against obesity. We have found that mRNA and protein expression of the alanine/serine/cysteine transporter-1 (ASC-1) was induced during adipocyte differentiation of human brown-prone deep neck and beige-competent subcutaneous neck progenitors, and SGBS preadipocytes. cAMP stimulation of differentiated adipocytes led to elevated uptake of serine, cysteine, and glycine, in parallel with increased oxygen consumption, augmented UCP1-dependent proton leak, increased creatine-driven substrate cycle-coupled respiration, and upregulation of thermogenesis marker genes and several respiratory complex subunits; these outcomes were impeded in the presence of the specific ASC-1 inhibitor, BMS-466442. Our data suggest that ASC-1-dependent consumption of serine, cysteine, and glycine is required for efficient thermogenic stimulation of human adipocytes.

[The relationship of muscle dysmorphia to the body image and early maladaptive schemata created by parental behaviours].

INTRODUCTION: the purpose of our study was to investigate the link between specific traits that determine muscle dysmorphia in bodybuilders and the parental behaviours which play a role in developing these schemata, as well as the eating-disorder-specific traits which differentiate bodybuilders from the normal population. AIM: conceptualising the similarities of personality traits in case of muscle dysmorphia and eating disorders, as well as their etiology based on the schema theory. METHOD: to measure muscle dysmorphia was used the Muscle Appearance Satisfaction Scale. We explored its connec - tion with eating disorders applying the Eating Disorder Inventory and thereof with the parental behaviours was used the Young Parental Inventory. RESULTS: a number of eating-disorder-specific traits differentiate persons with muscle dysmorphic traits from the normal population. These are Drive for thinness, Body dissatisfaction, Feeling of inadequacy, Interoceptive awareness and Perfectionism. Regarding the perceived parental behaviour the father violated the child's need of autonomy, compe - tence and self-identity and the mother violated the need of boundaries and self-control. CONCLUSIONS: Based on several personality characteristics, muscle dysmorphia may be related to anorexia nervosa and bulimia nervosa. In its etiology parental care can have a role, as the father is disposed to detain the autonomy, and the expression of personal needs, while the mother demonstrates insufficient control functions, and the detention of the autonomy and the need for competency.

Assessing adverse childhood experiences, social, emotional, and behavioral symptoms, and subjective health complaints among Hungarian adolescents.

BACKGROUND: Adverse Childhood Experiences (ACEs) can have lifelong adverse impacts; they can play a role in the development of subsequent emotional, cognitive, and social impairments leading to somatic and mental difficulties, as well as health damaging behaviours. Unfortunately, there are currently no research data available in Hungary regarding the frequency of ACEs among adolescents. AIMS: A cross sectional questionnaire survey was conducted in a community sample of Hungarian adolescents to assess the frequency of ACEs and analyse their association with current social, emotional, and behavioural symptoms (SEB), and subjective health complaints (SHC). METHODS: Demographic data, ACEs, SEB and SHC status of 516 adolescents aged 12 to 17 were collected. ACEs were assessed using the ACE Score Calculator; for SEB the Strengths and Difficulties Questionnaire, and for SHC some specific items from the Health Behaviour of School Children questionnaire were employed. To analyse the relationship of ACEs to SEB and SHC logistic regression was performed. RESULTS: Our results showed that the frequency of ACEs, SEB and SHC is high among adolescents. One-fourth of the students reported ≥ 2 categories of childhood exposures, and 7.4% reported having experienced ≥ 4 types of ACEs. The most prevalent forms of child maltreatment were emotional neglect (15.5%) and emotional abuse (14.5%). The most frequent dysfunctional household condition was parental divorce or separation (23.8%), followed by household substance abuse (8.9%) and household mental illness (8.1%). Almost one-fifth of students (17.5%) reported SEB symptoms (peer relationship problems in 21.7%, emotional symptoms in 14.6%, conduct problems in 18.3%, hyperactivity in 15%). The prevalence of SHC was also high: more than half of the students experienced at least one subjective health complaint multiple times a week. Significant associations were found between ACEs and the SEB/SHC reported by students. CONCLUSIONS: Adverse childhood experiences, social, emotional, and behavioural symptoms, and SHC are common among Hungarian adolescents. The cumulation of ACEs is associated with a higher number of SEB and SHC symptoms. Therefore, prevention programmes, early recognition, risk reduction, and therapy are needed.

Methodical Considerations and Resistance Evaluation against F. graminearum and F. culmorum Head Blight in Wheat. The Influence of Mixture of Isolates on Aggressiveness and Resistance Expression.

In resistance tests to Fusarium head blight (FHB), the mixing of inocula before inoculation is normal, but no information about the background of mixing was given. Therefore, four experiments (2013-2015) were made with four independent isolates, their all-possible (11) mixtures and a control. Four cultivars with differing FHB resistance were used. Disease index (DI), Fusarium damaged kernels (FDK) and deoxynivalenol (DON) were evaluated. The isolates used were not stable in aggressiveness. Their mixtures did not also give a stable aggressiveness; it depended on the composition of mix. The three traits diverged in their responses. After the mixing, the aggressiveness was always less than that of the most pathogenic component was. However, in most cases it was significantly higher than the arithmetical mean of the participating isolates. A mixture was not better than a single isolate was. The prediction of the aggressiveness level is problematic even if the aggressiveness of the components was tested. Resistance expression is different in the mixing variants and in the three traits tested. Of them, DON is the most sensitive. More reliable resistance and toxin data can be received when instead of one more independent isolates are used. This is important when highly correct data are needed (genetic research or cultivar registration).

The Influence of the Dilution Rate on the Aggressiveness of Inocula and the Expression of Resistance against Fusarium Head Blight in Wheat.

In previous research, conidium concentrations varying between 10,000 and 1,000,000/mL have not been related to any aggressiveness test. Therefore, two Fusarium graminearum and two Fusarium culmorum isolates were tested in the field on seven genotypes highly differing in resistance at no dilution, and 1:1, 1:2, 1:4, 1:8, and 1:16 dilutions in two years (2013 and 2014). The isolates showed different aggressiveness, which changed significantly at different dilution rates for disease index (DI), Fusarium-damaged kernels (FDK), and deoxynivalenol (DON). The traits also had diverging responses to the infection. The effect of the dilution could not be forecasted. The genotype ranks also varied. Dilution seldomly increased aggressiveness, but often lower aggressiveness occurred at high variation. The maximum and minimum values varied between 15% and 40% for traits and dilutions. The reductions between the non-diluted and diluted values (total means) for DI ranged from 6% and 33%, for FDK 8.3-37.7%, and for DON 5.8-44.8%. The most sensitive and most important trait was DON. The introduction of the aggressiveness test provides improved regulation compared to the uncontrolled manipulation of the conidium concentration. The use of more isolates significantly increases the credibility of phenotyping in genetic and cultivar registration studies.

Recurrent, Severe Aphthous Stomatitis and Mucosal Ulcers as Primary Manifestations of a Novel STAT1 Gain-of-Function Mutation.

Chronic mucocutaneous candidiasis (CMC) characterized by persistent and recurrent Candida infection of the skin, nails, and the mucosa membranes has been proposed as the major infectious phenotype in patients with gain-of-function mutation of signal transducer and activator of transcription 1 (STAT1) 1. However, viral infections caused mostly by herpesviruses, and a broad range of autoimmune disorders may also be part of the clinical phenotype. We report here on a 31 years old female patient suffering from severe mucosal aphthous mucositis and ulcers and recurrent herpes simplex for decades. We found a previously unknown heterozygous sequence variant in STAT1 (c.1219C>G; L407V) affecting the DNA-binding domain of the protein in the patient and her 4 years old daughter. We found this mutation gain-of-function (GOF) by using immunoblot and luciferase assays. We detected low proportion of IL-17A-producing CD4+ T cell lymphocytes by using intracellular staining and flow cytometry. Candida-induced secretion of IL-17A and IL-22 by mononuclear cells from the patient was markedly decreased compared to controls. These data suggest that the novel mutant allele may result in impaired differentiation of CD4+ T cells to CD4+/IL-17+ cells. The clinical phenotype of the disease in this patient was unique as it was dominated primarily by severe aphthous stomatitis and ulcerative esophagitis and only partly by typical CMC resulting in diagnostic delay. We suggest that patients with severe recurrent aphthous stomatitis and esophagitis should be evaluated for STAT1 GOF mutation. Based on the broad clinical spectrum of the disease, we also suggest that CMC and CMC disease may not be an appropriate term to define clinically STAT1 GOF mutation.