Adversity in early life and pregnancy are immunologically distinct from total life adversity: macrophage-associated phenotypes in women exposed to interpersonal violence

Early childhood and pregnancy are two sensitive periods of heightened immune plasticity, when exposure to adversity may disproportionately increase health risks. However, we need deeper phenotyping to disentangle the impact of adversity during sensitive periods from that across the total lifespan. This study examined whether retrospective reports of adversity during childhood or pregnancy were associated with inflammatory imbalance, in an ethnically diverse cohort of 53 low-income women seeking family-based trauma treatment following exposure to interpersonal violence. Structured interviews assessed early life adversity (trauma exposure ≤ age 5), pregnancy adversity, and total lifetime adversity. Blood serum was assayed for pro-inflammatory (TNF-a, IL-1ß, IL-6, and CRP) and anti-inflammatory (IL-1RA, IL-4, and IL-10) cytokines. CD14+ monocytes were isolated in a subsample (n = 42) and gene expression assayed by RNA sequencing (Illumina HiSeq 4000; TruSeq cDNA library). The primary outcome was a macrophage-associated M1/M2 gene expression phenotype. To evaluate sensitivity and specificity, we contrasted M1/M2 gene expression with a second, clinically-validated macrophage-associated immunosuppressive phenotype (endotoxin tolerance) and with pro-inflammatory and anti-inflammatory cytokine levels. Adjusting for demographics, socioeconomic status, and psychopathology, higher adversity in early life (ß = .337, p = 0.029) and pregnancy (ß = .332, p = 0.032) were each associated with higher M1/M2 gene expression, whereas higher lifetime adversity (ß = −.341, p = 0.031) was associated with lower immunosuppressive gene expression. Adversity during sensitive periods was uniquely associated with M1/M2 imbalance, among low-income women with interpersonal violence exposure. Given that M1/M2 imbalance is found in sepsis, severe COVID-19 and myriad chronic diseases, these findings implicate novel immune mechanisms underlying the impact of adversity on health.publishedVersio

Counseling and surveillance of obstetric risks for female childhood, adolescent, and young adult cancer survivors: recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Female childhood, adolescent, and young adult cancer survivors have an increased risk of adverse pregnancy outcomes related to their cancer- or treatment-associated sequelae. Optimal care for childhood, adolescent, and young adult cancer survivors can be facilitated by clinical practice guidelines that identify specific adverse pregnancy outcomes and the clinical characteristics of at-risk subgroups. However, national guidelines are scarce and vary in content. Here, the International Late Effects of Childhood Cancer Guideline Harmonization Group offers recommendations for the counseling and surveillance of obstetrical risks of childhood, adolescent, and young adult survivors. A systematic literature search in MEDLINE database (through PubMed) to identify all available evidence published between January 1990 and December 2018. Published articles on pregnancy and perinatal or congenital risks in female cancer survivors were screened for eligibility. Study designs with a sample size larger than 40 pregnancies in childhood, adolescent, and young adult cancer survivors (diagnosed before the age of 25 years, not pregnant at that time) were eligible. This guideline from the International Late Effects of Childhood Cancer Guideline Harmonization Group systematically appraised the quality of available evidence for adverse obstetrical outcomes in childhood, adolescent, and young adult cancer survivors using Grading of Recommendations Assessment, Development, and Evaluation methodology and formulated recommendations to enhance evidence-based obstetrical care and preconception counseling of female childhood, adolescent, and young adult cancer survivors. Healthcare providers should discuss the risk of adverse obstetrical outcomes based on cancer treatment exposures with all female childhood, adolescent, and young adult cancer survivors of reproductive age, before conception. Healthcare providers should be aware that there is no evidence to support an increased risk of giving birth to a child with congenital anomalies (high-quality evidence). Survivors treated with radiotherapy to volumes exposing the uterus and their healthcare providers should be aware of the risk of adverse obstetrical outcomes such as miscarriage (moderate-quality evidence), premature birth (high-quality evidence), and low birthweight (high-quality evidence); therefore, high-risk obstetrical surveillance is recommended. Cardiomyopathy surveillance is reasonable before pregnancy or in the first trimester for all female survivors treated with anthracyclines and chest radiation. Female cancer survivors have increased risks of premature delivery and low birthweight associated with radiotherapy targeting the lower body and thereby exposing the uterus, which warrant high-risk pregnancy surveillance

Insomnia, Nightmare Frequency, and Nightmare Distress in Victims of Sexual Abuse: The Role of Abuse Characteristics and Perceived Social Support

The aim of the present study was to investigate the role of abuse characteristics and perceived social support in self- reported insomnia, nightmare frequency and nightmare distress in victims of sexual abuse. Method. 460 sexual abuse victims in Norway completed a questionnaire assessing abuse characteristics, perceived social support, insomnia, nightmare frequency and nightmare distress, among other things. Results. Abuse involving intercourse was positively related to insomnia symptoms, while abuse duration was associated with fulfilment of the DSM-IV diagnostic criteria of insomnia. Abuse duration and having been threatened by the perpetrator were positively related to nightmare frequency, while threats and abuse involving intercourse were positively related to nightmare distress. Finally, perceived social support was negatively related to insomnia, nightmare frequency and nightmare distress. The results are discussed in relation to existing literature and theory

Are Dutch posture verbs lexical or functional elements?

In Dutch, posture verbs like liggen ‘lie’ and staan ‘stand’ are obligatorily used in locative constructions with inanimate subjects, classifying the spatial Figure-Ground relation. Prima facie, in this use, posture verbs seem more like functional elements than like lexical verbs. This paper investigates processing of Dutch posture verbs in a reference resolution task in the visual world paradigm, to get more clarity on the nature of these verbs. We know that lexical verbs like rinkelen ‘ring’ cause anticipatory looks towards a matching target referent like telefoon ‘telephone’; and that they suppress looks to a phonological competitor like telescoop ‘telescope’. The functional property of grammatical gender on determiners (de vs. het) is less robust in directing looks. When it comes to anticipating the target referent, and suppressing looks to a phonological competitor, do posture verbs pattern with lexical verbs, or with functional elements like grammatical gender

Early association of prosodic focus with alleen ‘only’: evidence from eye movements in the visual-world paradigm

In three visual-world eye tracking studies, we investigated the processing of sentences containing different prosodic focus, such as the Dutch Ik heb alleen SELDERIJ aan de brandweerman gegeven ‘I only gave CELERY to the fireman.’ versus Ik heb alleen selderij aan de BRANDWEERMAN gegeven. ‘I only gave celery to the FIREMAN.’. Dutch focal stress is like English focal stress. Unlike previous studies (Gennari, Meroni, & Crain, 2005; Paterson et al., 2007), we report eye gaze patterns as they unfold during the utterance with early or late stress. We conclude that focus processing is fast and incremental: eye-gaze patterns start to diverge across the two conditions already as the indirect object is being heard. Our data also indicate that participants anticipate the continuation of the utterance (Altmann & Kamide, 1999; Kamide, Altmann, & Heywood, 2005; Ito & Speer, 2008) , providing further evidence for early focus processing, and that focus evaluation is proposition-based

Early association of prosodic focus with alleen ‘only’ : evidence from eye movements in the visual-world paradigm

In three visual-world eye tracking studies, we investigated the processing of sentences containing different prosodic focus, such as the Dutch Ik heb alleen SELDERIJ aan de brandweerman gegeven ‘I only gave CELERY to the fireman.’ versus Ik heb alleen selderij aan de BRANDWEERMAN gegeven. ‘I only gave celery to the FIREMAN.’. Dutch focal stress is like English focal stress. Unlike previous studies (Gennari, Meroni, & Crain, 2005; Paterson et al., 2007), we report eye gaze patterns as they unfold during the utterance with early or late stress. We conclude that focus processing is fast and incremental: eye-gaze patterns start to diverge across the two conditions already as the indirect object is being heard. Our data also indicate that participants anticipate the continuation of the utterance (Altmann & Kamide, 1999; Kamide, Altmann, & Heywood, 2005; Ito & Speer, 2008) , providing further evidence for early focus processing, and that focus evaluation is proposition-based

Are Dutch posture verbs lexical or functional elements?

In Dutch, posture verbs like liggen ‘lie’ and staan ‘stand’ are obligatorily used in locative constructions with inanimate subjects, classifying the spatial Figure-Ground relation. Prima facie, in this use, posture verbs seem more like functional elements than like lexical verbs. This paper investigates processing of Dutch posture verbs in a reference resolution task in the visual world paradigm, to get more clarity on the nature of these verbs. We know that lexical verbs like rinkelen ‘ring’ cause anticipatory looks towards a matching target referent like telefoon ‘telephone’; and that they suppress looks to a phonological competitor like telescoop ‘telescope’. The functional property of grammatical gender on determiners (de vs. het) is less robust in directing looks. When it comes to anticipating the target referent, and suppressing looks to a phonological competitor, do posture verbs pattern with lexical verbs, or with functional elements like grammatical gender