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Background: Food allergen immunotherapy (FA-AIT) practice is known to vary globally. This project aims to identify and characterize European centres performing FA-AIT. Methods: An EAACI task force conducted an online survey to gather relevant information regarding FA-AIT practice and setting-specific resources after reviewing the published literature and congress abstracts throughout Europe. Results: We identified 102 FA-AIT centres in 18 countries; only Spain (n = 39) and France (n = 16) had ≥10 such centres. Overall, most facilities were hospital-based (77.5%), publicly funded (80.4%) and delivered FA-AIT as routine clinical care (80.4%). On average, departments had 3 allergists/paediatric allergists and 2 nurses. Surveyed centres had provided FA-AIT for a median of 9 years [1–24] to a median of 105 [5–2415] patients. The estimated total number of treated patients was 24875, of whom 41.3% received AIT for milk, 34.2% egg, 12.8% peanut and 11.7% other foods. Anaphylaxis to AIT doses requiring over 4–6 h of observation was reported by 70.6% of centres, ICU admissions by 10.8% and eosinophilic esophagitis by 45.1%. Quality of life and sustained unresponsiveness were evaluated in 20.6% and 54.9% of centres, respectively. The main contraindications for food AIT were severe asthma (57%-63%), eosinophilic esophagitis (56%-48%) and age below 5 years (47%-41%). Conclusions: In Europe, FA-AIT is provided mostly in clinical practice. Significant variation is seen in the number of centres per country, facility characteristics and inclusion/exclusion criteria, and in certain aspects of protocols. Potential inequality in access to AIT has been identified as well as the need for education and guidance for treatment standardization. © 2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

Degeneration of intracranial aneurysm wall is under active research and recent studies indicate an increased risk of rupture of intracranial aneurysm among patients with periodontal diseases. In addition, oral bacterial DNA has been identified from wall samples of ruptured and unruptured aneurysms. These novel findings led us to evaluate if oral diseases could predispose to pathological changes seen on intracranial aneurysm walls eventually leading to subarachnoid hemorrhage. The aim of this review is to consider mechanisms on the relationship between periodontitis and aneurysm rupture, focusing on recent evidence.

There is a positive association between parental alcohol use and the alcohol use of their offspring. It is less clear whether this relation exists at different developmental periods. The purpose of the current study was to examine the associations between parental alcohol use at two developmental periods (prenatal and adolescence) and the alcohol misuse of their offspring at two developmental periods (adolescence and young adulthood). Data from the Northern Finland Birth Cohort 1986 (NFBC1986; n = 6963; 51% of offspring were girls) were used. The NFBC1986 is a population-based study of individuals born during a 1-year period in Finland. Multi-informant (parent, teacher, and youth) and multi-method (surveys and population registers) data were collected at four developmental periods (prenatal, childhood, adolescence, and young adulthood). The findings indicated that parents’ alcohol use was stable from the prenatal period to adolescence. Mothers’ and fathers’ (based on mothers’ perceptions) alcohol use during the prenatal period and adolescence were directly related to adolescents’ heavy drinking. Prenatal alcohol use by mothers and fathers were related to young adults’ alcohol use disorder indirectly (but not directly) through mothers’ and fathers’ alcohol use during adolescence and then through adolescents’ heavy drinking. The results suggest that early and ongoing screening for alcohol use by mothers and fathers could help identify individuals at risk for heavy drinking and alcohol-related problems during adolescence and young adulthood.

Purpose: This study examined a developmental model that links affect-regulation difficulties in childhood with three dimensions of alexithymia in adolescence (difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking) and substance use and depression in adulthood, while accounting for cumulative contextual risk in childhood, and testing potential gender moderation. Methods: Multiple group path analyses were conducted using data from the Northern Finland Birth Cohort 1986 (N = 6963). Analyses used data collected during prenatal/birth, childhood, adolescence, and young adulthood periods. Results: Our examination of early precursors for alexithymia indicated that the associations of affect-regulation problems in childhood with alexithymia were stronger for girls, potentially putting girls with affect-regulation difficulties in childhood at higher risk for developing alexithymia in adolescence. The associations of cumulative contextual risk in childhood with alexithymia, substance use disorder, and depression diagnosis in adulthood were significant for both girls and boys. Our findings in regard to substance use and depression disorders revealed that alexithymia in adolescence predicted depression diagnosis in adulthood, particularly due to a contribution from the alexithymia domain of ‘difficulties identifying feelings.’ However, none of the alexithymia domains was directly associated with substance use disorder in adulthood. Conclusions: Our study contributes to research that links alexithymia with difficulties in affect regulation and cumulative contextual risk in childhood, yielding findings that may be relevant for preventive interventions.

Objective: Stroke is a frequent complication occurring early and late after surgical aortic valve replacement. There is an unmet clinical need for simple tools to assess postoperative stroke risk. We sought to assess the predictive performance of Congestive heart failure; Hypertension; Age ≥75 (doubled); Diabetes mellitus; prior Stroke, transient ischemic attack or thromboembolism (doubled); Vascular disease; Age 65 to 74; Sex category (female) (CHA₂DS₂-VASc) score in patients undergoing surgical aortic valve replacement with a bioprosthesis. Methods: Seven hundred fourteen patients undergoing isolated surgical aortic valve replacement with a bioprosthesis at 4 university hospitals were included. Data were collected retrospectively from patient records and monitored by an independent party. Results: Median follow-up time was 4.8 years. Mean CHA₂DS₂-VASc score was 4.1 ± 1.6. Low (scores, 0–1), high (scores, 2–4), and very high (scores, 5–9) CHA₂DS₂-VASc scores were observed in 39 (5.5%), 400 (56.0%), and 262 (38.5%) patients, respectively. Incidences of stroke or transient ischemic attack at 1 year were 2.6%, 4.8%, and 10.7%; at 5 years incidences were 5.2%, 14.0%, and 21.9%; and at 10 years incidence were 5.2%, 20.7%, and 37.9% for patients in low, high, and very high scores, respectively. Incidences of major bleeds at 1 year were 0%, 1.8%, and 2.7%; at 5 years incidences were 0%, 5.4%, and 8.7%; and at 10 years incidences were 0%, 9.0%, and 27.1%, respectively. Competing risk analysis showed that patients with CHA₂DS₂-VASc score of 5 through 9 had a significantly increased risk of stroke or transient ischemic attack (hazard ratio, 4.75; 95% confidence interval, 1.09–20.6; P = .037) irrespective of preoperative or new-onset in-hospital atrial fibrillation compared with low-risk patients. Conclusions: CHA₂DS₂-VASc is a valuable tool to identify patients with increased risk of stroke and major bleeding, and for whom alternative strategies for prevention of late neurologic complications should be adopted.

Background: Exposure to cumulative contextual risk within the family early in life increases children’s risk for substance involvement and related difficulties, including school failure, in adolescence and young adulthood. However, potential protective factors that buffer these risk associations are relatively untested, yet such tests are needed to improve existing preventive interventions for enhancing resilience among vulnerable children. Objectives: This study tested child reading engagement with parents at home as a moderator of cumulative family risk associations with adolescent substance use and academic performance as well as young adult substance abuse. Methods: Population register data as well as parent-report and adolescent-report data from 6,963 participants of the 1986 Northern Finland Birth Cohort study were analyzed via structural equation modeling with latent variable interactions. Results: Results showed that child reading engagement moderated the associations of cumulative family risk with both adolescent academic performance and young adult substance abuse, but not with adolescent substance use. The highest levels of academic performance were observed under conditions of low risk and high reading engagement. Interestingly, cumulative family risk had a small positive association with substance abuse when reading engagement was low and a negative association with the young adult outcome when reading engagement was high. Conclusions/Importance: Moderation tests revealed complex interaction forms that may have implications for both theory and family-based preventive interventions.

This study examined associations between cumulative contextual risk in childhood and depression diagnosis in early adulthood, testing two adolescent mediating mechanisms, alcohol use and perceived social support from family and friends, while accounting for the stability of internalizing problems over time and examining possible gender moderation. Multiple group mediation analyses were conducted using parent- and adolescent-report as well as hospital records data from the Northern Finland Birth Cohort 1986 (N = 6963). Our analyses demonstrated that the association between cumulative contextual risk in childhood and depression diagnosis in adulthood is mediated by adolescent alcohol use and perceived social support both for boys and girls. The findings highlight potentially malleable mediating mechanisms associated with depression in vulnerable youth that could be targets in selective depression preventive interventions.

Children and adolescents exposed to multiple contextual risks are more likely to have academic difficulties and externalizing behavior problems than those who experience fewer risks. This study used data from the Northern Finland Birth Cohort 1986 (a population-based study; N = 6961; 51 % female) to investigate (a) the impact of cumulative contextual risk at birth on adolescents’ academic performance and misbehavior in school, (b) learning difficulties and/or externalizing behavior problems in childhood as intervening mechanisms in the association of cumulative contextual risk with functioning in adolescence, and (c) potential gender differences in the predictive associations of cumulative contextual risk at birth with functioning in childhood or adolescence. The results of the structural equation modeling analysis suggested that exposure to cumulative contextual risk at birth had negative associations with functioning 16 years later, and academic difficulties and externalizing behavior problems in childhood mediated some of the predictive relations. Gender, however, did not moderate any of the associations. Therefore, the findings of this study have implications for the prevention of learning and conduct problems in youth and future research on the impact of cumulative risk exposure.

Purpose: Early exposure to multiple risk factors is known to predict involvement in criminal offending. The purpose of this study was to examine the processes responsible for this association. Specifically, the focus was on the capacity of adolescent educational experience to mediate the effect of childhood cumulative risk (CCR) on criminal offending, net of expected continuity in antisocial propensity, and behavior. Methods: Data from the Northern Finland Birth Cohort Study 1986 (n = 5743) were used to estimate a structural equation model to examine the hypothesized pathways. The educational pathway was captured by a latent variable (educational marginalization) consisting of indicators of low academic performance, weak school attachment, and low educational aspirations. Results: CCR had a strong positive relation with educational marginalization, which, in turn, emerged as a statistically significant predictor of having criminal record by age 19. Although continuity in antisocial behavior accounted for most of the total effect of CCR on criminal offending, one-third of it was mediated by educational marginalization. Conclusions: The results highlight the adolescent educational experience as a promising target of intervention in efforts to curb criminal careers among children at risk.

This study tested whether there are linear or nonlinear relations between prenatal/birth cumulative risk and psychosocial outcomes during adolescence. Participants (n = 6963) were taken from the Northern Finland Birth Cohort Study 1986. The majority of participants did not experience any contextual risk factors around the time of the target child’s birth (58.1%). Even in this low-risk sample, cumulative contextual risk assessed around the time of birth was related to seven different psychosocial outcomes 16 years later. There was some evidence for nonlinear effects, but only for substance-related outcomes; however, the form of the association depended on how the cumulative risk index was calculated. Gender did not moderate the relation between cumulative risk and any of the adolescent psychosocial outcomes. Results highlight the potential value of using the cumulative risk framework for identifying children at birth who are at risk for a range of poor psychosocial outcomes during adolescence.

Background: Children who experience multiple adversities, such as prenatal exposure to drugs and poverty, early in development are at increased risk for the early initiation of alcohol and cigarette use. However, studies that examine potentially malleable processes associated with substance use initiation in the context of exposure to cumulative stressors are scant. This study examined associations between cumulative contextual risk at birth and initiation of alcohol and cigarette use in adolescence, testing childhood peer marginalization and peer aggression and behavior problems as mediating mechanisms. Analyses further adjusted for fearfulness/inhibition and hyperactivity/distractibility to determine if the hypothesized mediating mechanisms were significant after accounting for temperamental characteristics associated with substance initiation. Methods: Participants were 6190 adolescents from the Northern Finland Birth Cohort 1986 Study. Data were collected on cumulative contextual risk (parent reports), substance initiation (adolescent reports), childhood peer processes and behavior problems (teacher reports), and temperamental characteristics (teacher reports). Novel discrete-time survival mediation analysis was conducted to test the hypothesized mediating mechanisms. Results: Initial analyses showed that the associations between cumulative contextual risk and both alcohol and cigarette initiation were mediated by childhood peer processes and behavior problems; however, the indirect effects became statistically non-significant after adding the temperament variables, which themselves predicted substance initiation. Conclusions: Targeting peer processes may not be an effective way to interrupt pathways leading from early contextual risk to substance initiation. Instead, early screening and intervention efforts to delay substance initiation may need to be tailored to the individual temperamental characteristics of targeted participants.

In our earlier paper, we reported carrier multiplication (CM) in colloidal InAs quantum dots (QDs) and CM in dots with a pre-population of one exciton. The occurrence of CM in relaxed InAs QDs was concluded from the results of time-resolved TeraHertz (THz). Both THz and quasi-continuous wave (quasi-CW) experiments were performed to study the CM in pre-excited dots. Recent attempts to reproduce the observations of CM using THz spectroscopy on InAs based QDs of two sizes were unsuccessful. These attempts followed transient absorption measurements in Jerusalem by one of us (S. R.) and co-workers reported elsewhere, which have not yielded evidence for CM in these QDs.

Carrier (exciton) multiplication in colloidal InAs/CdSe/ZnSe core−shell quantum dots (QDs) is investigated using terahertz time-domain spectroscopy, time-resolved transient absorption, and quasi-continuous wave excitation spectroscopy. For excitation by high-energy photons (2.7 times the band gap energy), highly efficient carrier multiplication (CM) results in the appearance of multi-excitons, amounting to 1.6 excitons per absorbed photon. Multi-exciton recombination occurs within tens of picoseconds via Auger-type processes. Photodoping (i.e., photoinjection of an exciton) of the QDs prior to excitation results in a reduction of the CM efficiency to 1.3. This exciton-induced reduction of CM efficiency can be explained by the twofold degeneracy of the lowest conduction band energy level. We discuss the implications of our findings for the potential application of InAs QDs as light absorbers in solar cells.

Carrier (exciton) multiplication in colloidal InAs/CdSe/ZnSe core-shell quantum dots (QDs) is investigated using terahertz time-domain spectroscopy, time-resolved transient absorption, and quasi-continuous wave excitation spectroscopy. For excitation by high-energy photons (~2.7 times the band gap energy), highly efficient carrier multiplication (CM) results in the appearance of multi-excitons, amounting to ~1.6 excitons per absorbed photon. Multi-exciton recombination occurs within tens of picoseconds via Auger-type processes. Photodoping (i.e., photoinjection of an exciton) of the QDs prior to excitation results in a reduction of the CM efficiency to ~1.3. This exciton-induced reduction of CM efficiency can be explained by the twofold degeneracy of the lowest conduction band energy level. We discuss the implications of our findings for the potential application of InAs QDs as light absorbers in solar cells.

The STRENCO Logic Model for Tripartite Working provides a snapshot of the feasibility of working in more co-produced ways to achieve greater inclusiveness of service users, family members, carers, experts by experience, clinicians, academics and students in relation to decision making processes, care, policy and research, which is aspired for mental health.\ud The development of the model was conceived in the context of EU policy emphasising the role of research, education and practice as co-creators in developing new approaches for working (knowledge triangle). In some countries co-production is written into national policy frameworks, whilst in others the integration of service users is limited to involvement in research projects, with the integration of service users and family members into mental health service development, delivery, evaluation and research a work in progress.\ud Whilst co-production forms part of discussions in regards to mental health services, few examples of how this can be done by involving all dimensions in the knowledge triangle currently exist. The STRENCO Logic Model for tripartite working (Figure 1) extends current evidence by providing pragmatic guidance on how to co-produce in mental health (Slay & Stephens, 2013; NDTi, 2016).\ud In making the proposal to create a Tripartite Model for working, the partners agreed and put forward a method where all stakeholders in the mental health conversation could be involved in the co-creation of knowledge and learning that might strengthen and improve competencies in mental health. An approach, drawing from the principles of participatory action research was adopted. This approach proposed the development of Communities of Practice (CoPs) comprising service users, family members, carers, experts by experience, clinicians, academics and students in each of the six partner institutions in the five countries. These CoPs fed into the central project as ‘think tanks’, both for the development of the Outputs on the project and for the running of the associated Intensive Programmes for students and teachers. Through our learning in these Communities of Practice, they have become the keystone of the STRENCO Logic Model and as a way of working.

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