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Jørgen G Bramness,1– 3 Susmita Pandey,1 Jenny Skumsnes Moe,1,3 Helge Toft,4 Lars Lien,1,4 Fredrik A Walby,5 Martin Øverlien Myhre,5 Ingeborg Bolstad1,4 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; 2Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Oslo, Norway; 3Institute of Clinical Medicine, UiT – The Arctic University of Norway, Tromsø, Norway; 4Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway; 5National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, NorwayCorrespondence: Jørgen G Bramness, Norwegian Institute of Public Health, P.O.Box 222, Oslo, 0213, Norway, Email jobr@fhi.noBackground: Patients with alcohol use disorder (AUD) have an increased risk of suicide. Neuroimmunological measures, such as cytokines, are shown to deviate in people with attempted suicide. Few studies have investigated this among AUD patients.Patients and Methods: One-hundred and fourteen patients undergoing residential treatment for AUD were interviewed on lifetime suicide attempts (SA) along with several other background variables and clinical characteristics. Serum blood samples were drawn for analysis of cytokines.Results: Thirty-one patients (27%) reported at least one SA. These patients had more symptoms of current affective disorders and more severe dependence. In bivariate analysis only IL-6 and IL-10 appeared to be associated with lifetime SA but without reaching statistical significance. In multivariate linear regression, adjusting for sex, nicotine use, somatic illness, and the use of anti-inflammatory drugs, IL-6 was associated to SA (p = 0.033).Conclusion: The cytokine IL-6 has repeatedly been found to be associated with suicidality. The present study concurs with this role of IL-6 in a naturalistic observational study of AUD patients.Keywords: alcohol use disorder, suicide attempted, cytokines, interleukins

Jørgen G Bramness,1– 3 Susmita Pandey,1 Jenny Skumsnes Moe,1,3 Helge Toft,1,4 Lars Lien,1,4 Ingeborg Bolstad1,4 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; 2Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Oslo, Norway; 3Institute Clinical of Medicine, UiT – The Arctic University of Norway, Tromsø, Norway; 4Department of Health Studies, Inland Norway University of Applied Sciences, Elverum, NorwayCorrespondence: Jørgen G Bramness, Norwegian Institute of Public Health, P.O.Box 222, Oslo, 0213, Norway, Email jobr@fhi.noIntroduction: Delirium tremens (DT) occurs after stopping prolonged, high alcohol intake and may be life-threatening if untreated. We need to know about clinical correlates of DT in order to provide the best clinical care.Methods: At admission to inpatient treatment a cohort of 114 alcohol use disorder (AUD) patients were interviewed and examined concerning psychiatric diagnosis and symptoms, trauma experiences and alcohol related measures and if they had experienced DT.Results: Twenty-four percent of the patients reported a life-time experience of DT. These patients were predominantly males and had lower educational level. More of the patients in the DT than the non-DT group reported at least one suicide attempt, were diagnosed with PTSD, and dropped out of treatment. Also, having parents with alcohol problems was more common among these patients, and they reported a longer duration of problematic drinking and a higher number of drinks needed to feel an effect of drinking. In the multivariable adjusted analysis only a diagnosis of PTSD (OR=5.71; 95% confidence interval (CI): 1.34– 24.31) and duration of problematic drinking with a 6% increase in risk for every year (OR=1.06; 95% CI: 1.01– 1.11) remained significant risk factors for having DT experience.Discussion and conclusion: Having experienced DT was more prevalent in the current investigation than in earlier studies. Patients that had experienced DT seemed to have more serious AUD, especially signified by a longer duration of drinking. These patients seemed to have many clinical disadvantages including more drop-out and higher suicide rate. PTSD could be a risk factor for DT but may also follow the DT experience.Keywords: alcohol use disorder, delirium tremens, treatment, PTSD

Helge Toft,1,2 Jørgen G Bramness,1,3,4 Lars Lien1,2 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; 2Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway; 3Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway; 4Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwayCorrespondence: Helge Toft, Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, P.O. Box 104, Brumunddal, 2381, Norway, Email helge.toft@gmail.comBackground: Patients with combined depression symptoms and post-traumatic stress disorder (PTSD) often exhibit high levels of circulating inflammatory biomarkers as either a cause or consequence of their disease. We aimed to investigate how cytokines and depression symptoms develop with one-year follow-up and compare them with non-PTSD patients.Methods: The study had a longitudinal design with one-year follow-up measurements in an inpatient treatment setting at a psychiatric center in Norway. PTSD diagnoses were set using the Mini International Neuropsychiatric Interview (MINI). The first three measurements were at baseline (T0), halfway (T1) and at discharge (T2) from a 12-week main stay, followed by a final measurement one year after discharge (T3). Serum blood samples were collected on all four occasions. The Beck Depression Inventory-II (BDI-II) was administered at T0, T2 and T3.Results: Levels of interleukin-6 (IL-6) and interleukin-10 (IL-10) in PTSD patients were higher than in patients without PTSD at T0 (p = 0.005 and 0.042). The PTSD patients had a higher average level of IL-10 across all four measurements (B = 1.62, Standard Error (SE) = 0.78, p = 0.037). The IL-10 levels in PTSD patients declined from T0 to T3 (p = 0.039). The PTSD patients were more depressed than non-PTSD patients at T3 (p = 0.019).Conclusions: The levels of IL-10 and IL-6 in PTSD patients more closely resembled the levels in non-PTSD patients at one-year follow-up, despite level of depression being unchanged in the PTSD patients. This calls into question the close relationship between level of circulating cytokines and depressive symptoms, at least in PTSD patients. Further research is needed to investigate what appears to be a complex relationship between immune markers and depression in patients with PTSD.Keywords: PTSD, cytokines, inflammation, depression, longitudinal

Susmita Pandey,1,2 Ingeborg Bolstad,1 Lars Lien,1,3 Jørgen G Bramness1,4,5 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Department of Health and Social Science, Innlandet University of Applied Science, Elverum, Norway; 4Department of Clinical Medicine, UiT – Norway’s Arctic University, Tromsø, Norway; 5Norwegian Institute of Public Health, Oslo, NorwayCorrespondence: Susmita Pandey Email susmita.research@gmail.comBackground: Patients with alcohol use disorders (AUD) vary significantly in many clinically important characteristics making them a heterogenous group. AUD patients with comorbid antisocial personality disorder (ASPD) form an important sub-group, and studies indicate that these patients may have poorer treatment outcomes. Therefore, we aimed to investigate the characteristics of AUD inpatients with comorbid ASPD and identify predictors of early relapse or treatment drop-out in these patients.Methods: In a longitudinal study of AUD patients (n = 113; 30 females; aged 27 to 72 years) in treatment at three residential rehabilitation clinics in Norway, we used interviews and self-report questionnaires to collect data on alcohol use, mental health, and trauma experience. In addition, we assessed biochemical parameters. The patients were followed up at 6 weeks to identify early relapse or drop-out.Results: Prevalence of ASPD among AUD patients was 15%. AUD patients with comorbid ASPD were exclusively male, of younger age, and reported more childhood trauma, and adult attention-deficit-hyperactivity-disorder symptoms. They reported more hazardous drinking behavior and more often had dependence on substances in addition to alcohol. The presence of ASPD did not predict early relapse or drop-out. However, early relapse or drop-out in ASPD patients was associated with childhood and adult trauma, younger age of drinking debut, and higher baseline prolactin levels.Conclusion: AUD patients with ASPD had different clinical characteristics to other AUD patients and they had specific predictors of early relapse or drop-out. Our findings indicate that the early relapse or drop-out among AUD patients with ASPD may be attributed to environmental and possibly biological vulnerability. However, further studies with larger sample size are warranted to confirm these preliminary associations.Keywords: alcohol use disorder, antisocial personality disorder, relapse, drop-out

Helge Toft,1,2 Jørgen G Bramness,1,3 Lars Lien,1,4 Dawit S Abebe,1,5 Bruce E Wampold,6,7 Terje Tilden,6 Knut Hestad,4,8,9 Sudan Prasad Neupane1,10 1Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Ottestad, Norway; 2Institute of Clinical Medicine, University of Oslo, Oslo, Norway; 3Institute of Clinical Medicine, UiT, Norway's Arctic University, Tromsø, Norway; 4Department of Health Studies, Inland Norway University of Applied Sciences, Elverum, Norway; 5Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway; 6Research Institute, Modum Psychiatric Center, Vikersund, Norway; 7Department of Counseling Psychology, University of Wisconsin-Madison, Madison, WI, USA; 8Department of Research, Innlandet Hospital Trust, Brumunddal, Norway; 9Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; 10Norwegian Center for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway Background: A reciprocal relationship between activated innate immune system and changes in mood and behavior has been established. There is still a paucity of knowledge on how the immune system responds during psychiatric treatment. We aimed to explore circulating cytokines and assess psychiatric symptom severity scores during 12 weeks of inpatient psychiatric treatment. Methods: The study was a longitudinal assessment of 124 patients (88 women and 36 men) in treatment at Modum Psychiatric Center, Norway. The patient sample comprised a mixed psychiatric population of whom 39 were diagnosed with posttraumatic stress disorder (PTSD). Serum blood samples for cytokine analysis and measures of mental distress using Global Severity Index were collected at admission (T0), halfway (T1), and before discharge (T2). Other factors assessed were age, gender, and the use of antidepressants and anti-inflammatory drugs. Multilevel modeling was used for longitudinal analyses to assess the repeated cytokine samples within each patient. Results: Overall level of IL-1RA was higher in PTSD patients when compared to those without PTSD (P=0.021). The level of IL-1β, MCP-1, and TNF-α increased over time in PTSD compared to non-PTSD patients (P=0.025, P=0.011 and P=0.008, respectively). All patients experienced reduced mental distress as measured by self-reported Global Severity Index scores. Stratified analysis showed that PTSD patients who used anti-inflammatory drugs had higher levels of IL-1β (P=0.007) and TNF-α (P=0.049) than PTSD patients who did not use such drugs. Conclusion: The study indicates that traumatized patients may have a distinct neuroimmune development during recovery. Their activated immune system shows even further activation during their rehabilitation despite symptom reduction. Keywords: cytokines, trauma, inflammation, PTSD, immune activation

Dina Sami Khalifa,1,2 Kari Glavin,3 Espen Bjertness,1 Lars Lien4,51Department of Community Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway; 2Faculty of Health Sciences, Ahfad University for Women, Omdurman, Sudan; 3Diakonova University College, Oslo, 4National Advisory Board on Dual Diagnosis, Innlandet Hospital Trust, Hamar, 5Department of Public Health, Hedmark University College, Elverum, NorwayPurpose: Postnatal depression (PND) rates in low-resource countries have reached levels between 4.9% and 59%. Maternal mental health has not been researched in Sudan, and there are no existing statistics on prevalence or significant risk factors for PND. Consequently, no screening test has been validated to screen for PND at the primary health care level. This study investigates the 3 months prevalence of PND and validates the Edinburgh Postnatal Depression Scale (EPDS) against the Mini-International Neuropsychiatric Interview (MINI).Methodology: Pregnant Sudanese women in the second and third trimesters were recruited to the study during routine antenatal care visits in two major maternity hospitals in Khartoum state. They were screened for PND at 3 months postpartum using the EPDS. Test positive women were matched with test negative women according to nearest date of birth. A clinical psychologist verified their depression status using the MINI.Results: The follow-up rate was 79%. At a cutoff point of ≥12, the 3 months prevalence of PND was 9.2%. The sensitivity and specificity of the EPDS were 89% and 82%, respectively. The EPDS and MINI showed a strong positive relationship (odds ratio =36). The positive predictive value and negative predictive value, using this study’s prevalence, were 33% and 98.7%, respectively. The receiver operator characteristic analysis showed an area under the curve of 0.89. The cut-off point ≥12 was the most acceptable point as it had the lowest number needed to diagnose (1.4) and a false-positive rate of 18%.Conclusion: The EPDS is a valid tool for screening for PND on a Sudanese population. It was accepted, easily administered, and understood by postnatal women. Health care personnel, especially village midwives, should be trained on screening and referral of depressed women for clinical evaluation and management. Due to limited resources available in Sudan, shorter screening tests need to be validated in the future.Keywords: Edinburgh Postnatal Depression Scale, Sudan, Epidemiology, Sensitivity, specificity, developing countries

Siv Elin Mathisen,1 Kari Glavin,2 Lars Lien,3 Per Lagerløv4 1Diakonhjemmet Hospital, Department of Psychiatry, Oslo, 2Diakonova University College, Department of Nursing, Oslo, 3National Center for Dual Diagnosis, Innlandet Hospital Trust and Hedmark University College, Elverum, 4Department of General Practice/Family Medicine, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway Introduction: Postpartum depression is a prevalent disorder with negative consequences for women, infants, and the family as a whole. Most studies of this disorder have been conducted in Western countries, and studies from developing countries are few. In this paper, we report the first – as far as we are aware – study of the prevalence and risk factors associated with postpartum depressive symptoms in Argentina. Materials and methods: The study participants were 86 women attending 6 week check-ups, (range 4–12 weeks) postpartum at a private health care center in the metropolitan area of Buenos Aires. The women completed the Edinburgh Postnatal Depression Scale (EPDS) and a questionnaire collecting demographic and obstetric data. Data were described as proportions (percentages). Differences between proportions were assessed with chi-squared tests. To control for possible confounders, we fitted bivariate logistic regression models in which the dependent variable was an EPDS sum score of

We probe chemotaxis of single neurons, induced by signalling molecules which were optically delivered from liposomes in the neighbour-hood of the cells. We implemented an optical tweezers setup combined with a micro-dissection system on an inverted microscope platform. Molecules of Netrin-1 protein were encapsulated into micron-sized liposomes and manipulated to micrometric distances from a specific growth cone of a hippocampal neuron by the IR optical tweezers. The molecules were then released by breaking the liposomes with UV laser pulses. Chemotaxis induced by the delivered molecules was confirmed by the migration of the growth cone toward the liposome position. Since the delivery can be manipulated with high temporal and spatial resolution and the number of molecules released can be controlled quite precisely by tuning the liposome size and the solution concentration, this technique opens new opportunities to investigate the effect of physiological active compounds as Netrin-1 to neuronal signalling and guidance, which represents an important issue in neurobiology.

Background: Itch as the most common symptom in dermatology has been shown to be related to psychological factors such as stress, anxiety and depression. Moreover, associations were found between perceived stigmatization and itch. However, studies investigating the differences between patients with dermatoses with and without itch regarding perceived stress, stigmatization, anxiety and depression are missing. Therefore, one of the aims of the second study of the European Society for Dermatology and Psychiatry (ESDaP study II) was to investigate these relationships in a large cohort of patients with different itchy dermatoses. Results: 3399 patients with 14 different itchy dermatoses were recruited at 22 centres in 17 European countries. They filled in questionnaires to assess perceived stigmatization, stress, signs of clinically relevant anxiety or depression, itch‐related quality of life, the overall health status, itch duration, frequency and intensity. The most significant association between the severity of itching and the perception of stress was observed among individuals with rosacea (correlation coefficient r = 0.314). Similarly, the strongest links between itch intensity and experiences of stigmatization, anxiety, and depression were found in patients with seborrheic dermatitis (correlation coefficients r = 0.317, r = 0.356, and r = 0.400, respectively). Utilizing a stepwise linear regression analysis, it was determined that within the entire patient cohort, 9.3% of the variation in itch intensity could be accounted for by factors including gender, levels of anxiety, depression, and perceived stigmatization. Females and individuals with elevated anxiety, depression, and perceived stigmatization scores reported more pronounced itch intensities compared to those with contrary attributes. Conclusion: This study underscores the connection between experiencing itch and its intensity and the psychological strain it places on individuals. Consequently, psychological interventions should encompass both addressing the itch itself and the interconnected psychological factors. In specific cases, it becomes imperative for dermatologists to direct individuals towards suitable healthcare resources to undergo further psychological assessment. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to assess the economic impacts of the European Union’s Carbon Border Adjustment Mechanism (CBAM) on Vietnam. Design/methodology/approach – We constructed a general equilibrium model to assess the economic impacts of the CBAM on the macroeconomic indicators of Vietnam. We also constructed a generic partial equilibrium model to provide a zoomed-in view of the impact on each group of CBAM-targeted commodities, which is not possible in the general equilibrium model. Both the general equilibrium and the partial equilibrium models were calibrated with publicly available data and a high number of value sets of hyperparameters to estimate the variations of the estimated impacts. Findings – The results suggest that the current form of the EU’s CBAM is unlikely to produce substantial effects on the overall economy of Vietnam, mainly because the commodities affected by it represent a small portion of Vietnam’s exports. However, at the sectoral level, the CBAM can reduce production outputs and export values of steel, aluminium, and cement. Social implications – The CBAM by itself may not lead to significant decreases in greenhouse gas emissions, but it could provide a rationale for implementing carbon pricing strategies, which might result in more significant economic effects and help in reducing greenhouse gas emissions. This highlights the necessity of supplementary policies to tackle global climate change. Originality/value – We constructed economic models to evaluate the impacts of the European Union’s Carbon Border Adjustment Mechanism on Vietnam, both at the macroeconomic level and zooming in on directly impacted groups of commodities.

Abstract Prenatal exposure to toxins can adversely affect long-term health outcomes of the offspring. Though chemotherapeutics are now standard of care for treating cancer patients during pregnancy, certain compounds are known to cross the placenta and harm placental tissue. The consequences for the fetus are largely unexplored. Here we examined the responses of newborn cord blood mononuclear cells in tissue culture to two chemotherapeutic drugs, cyclophosphamide and epirubicin, when either directly exposed to these drugs, or indirectly after crossing a placenta trophoblast bilayer barrier. Cord blood mononuclear cells exposed to the conditioned media obtained from cyclophosphamide-exposed trophoblast barriers showed a significant 2.4-fold increase of nuclear ROS levels compared to direct exposure to cyclophosphamide. Indirect exposure to epirubicine-exposed trophoblast barriers not only enhanced nuclear ROS levels but also significantly increased the fraction of cord blood cells with double strand breaks, relative to directly exposed cells. Neither apoptosis nor proliferation markers were affected in cord mononuclear blood cells upon direct or indirect exposure to cyclophosphamide or epirubicin. Our data suggests that trophoblast cells exposed to cyclophosphamide or epirubicine may induce an indirect ‘bystander’ effect and can aggravate genotoxicity in the fetal compartment.

Abstract Extracellular vesicles (EVs) contain a plethora of biomolecules, including nucleic acids, with diverse diagnostic and therapeutic application potential. Although reverse transcription‐quantitative PCR (RT‐qPCR) is the most widely applied laboratory technique to evaluate gene expression, its applicability in EV research is challenged by the lack of universal and stably present reference genes (RGs). In this study, we identify, validate and establish SNRPG, OST4, TOMM7 and NOP10 as RGs for the normalization of EV‐associated genes by RT‐qPCR. We show the stable presence of SNRPG, OST4, TOMM7 and NOP10 in multiple cell lines and their secreted EVs (n = 12) under different (patho)physiological conditions as well as in human‐derived biofluids (n = 3). Enzymatic treatments confirm the presence of SNRPG, OST4, TOMM7 and NOP10 inside EVs. In addition, the four EV‐associated RGs are stably detected in a size‐range of EV subpopulations. RefFinder analysis reveals that SNRPG, OST4, TOMM7 and NOP10 are more stable compared to RGs established specifically for cultured cells or tissues such as HMBS, YWHAZ, SDHA and GAPDH. In summary, we present four universal and stably present EV‐associated RGs to enable normalization and thus steer the implementation of RT‐qPCR for the analysis of EV‐associated RNA cargo for research or clinical applications.

This work investigated the impact of chicken egg size, including surface area and initial weight, on the effectiveness of cassava starch-based gel coating during storage at room temperature. The quality of a total of 540 fresh eggs in four different sizes (S, M, L and XL) was evaluated over a 4-week storage period at 25 ± 1 °C (60–65% RH). In this research, images from a scanning electron microscope revealed that the coatings maintained their integrity across all egg sizes, effectively covering pores and cracks throughout storage. The application of gel coating reduced weight loss and preserved the Haugh unit and yolk index, extending freshness by 1–2 weeks compared with uncoated eggs at 25 °C. The results indicated that the performance of the coating varied with egg size. Statistical analysis revealed that the surface area and initial weight of the egg significantly impacted the effectiveness of the coating in preserving quality (p < 0.001). Eggs with larger surface areas exhibited a reduced protective effect of the coating, resulting in higher weight loss and lower retention of Haugh unit and yolk index compared with the coated eggs with smaller surface areas. The coating application was more effective in preserving the Haugh unit of eggs with higher initial weights. Overall, the surface area and the initial weight of the egg should be considered as key factors to ensure optimal coating performance.