Development and Validation of a Simplified Method for Analysis of SARS-CoV-2 RNA in University Dormitories

Over the course of the COVID-19 pandemic, wastewater surveillance has become a useful tool for describing SARS-CoV-2 prevalence in populations of varying size, from individual facilities (e.g., university residence halls, nursing homes, prisons) to entire municipalities. Wastewater analysis for SARS-CoV-2 RNA requires specialized equipment, expensive consumables, and expert staff, limiting its feasibility and scalability. Further, the extremely labile nature of viral RNA complicates sample transportation, especially in regions with limited access to reliable cold chains. Here, we present a new method for wastewater analysis, termed exclusion-based sample preparation (ESP), that substantially simplifies workflow (at least 70% decrease in time; 40% decrease in consumable usage compared with traditional techniques) by targeting the labor-intensive processing steps of RNA purification and concentration. To optimize and validate this method, we analyzed wastewater samples from residence halls at the University of Kentucky, of which 34% (44/129) contained detectible SARS-CoV-2 RNA. Although concurrent clinical testing was not comprehensive, student infections were identified in the 7 days following a positive wastewater detection in 68% of samples. This pilot study among university residence halls validated the performance and utility of the ESP method, laying the foundation for future studies in regions of the world where wastewater testing is not currently feasible.

Comparing Effectiveness of Treatments for Borderline Personality Disorder in Communal Mental Health Care: The Oulu BPD Study

The implementation of effective psychotherapies in community mental health care is challenging. This study aimed to create a well-structured and easily applicable treatment model for patients with severe borderline personality disorder (BPD). We integrated a schema therapy based psycho-educational group into an available individual therapy. Two groups were formed: (1) community treatment by experts (CTBE) patients (n = 24) receiving new treatment and (2) treatment as usual (TAU) patients (n = 47). Changes in symptoms were measured by Borderline Personality Disorder Severity Index-IV interview and quality of life by the 15D health-related quality of life questionnaire. After 1 year the CTBE patients showed a significant reduction in a wider range of BPD symptoms and better quality of life than TAU patients. The results of this study are encouraging. A well-structured treatment model was successfully implemented into community mental health care with improved patient adherence to treatment and superior treatment outcomes compared to TAU patients.

Serum lipids in schizophrenia and other functional psychoses: a general population northern Finland 1966 birth cohort survey

OBJECTIVE

To compare fasting serum lipid concentrations of subjects with schizophrenia with a comparison group.

METHOD

The study sample consists of 5654 members of the northern Finland 1966 birth cohort who participated in the field study with blood samples after overnight fasting and clinical examination in 1997-98. Total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides (TG) and glucose were analyzed. Analysis of variance were used for comparing differences in lipids means between diagnostic categories.

RESULTS

Mean fasting TC in subjects with schizophrenia was 20 mg/dl higher than in the comparison group. TC and TG levels in the group of other psychoses resembled the schizophrenia group.

CONCLUSION

Blood lipid levels in subjects with schizophrenia and other functional psychoses were high. As these persons are at special risk for hyperlipidemia their lipid levels should be regularly monitored, and cholesterol lowering diet, as well as medication, should be considered.

Spousal resemblance for history of major depressive episode in the previous year

BACKGROUND

There is discrepancy in findings on spousal concordance for major depression. Here we report the risk of depression and its determinants in spouses of persons with or without depression, taking into account several known risk factors for major depression.

METHODS

A random sample of non-institutionalized Finnish individual aged 15-75 years was interviewed in the 1996 National Health Care Survey. The sample included 1708 male-female spouse pairs. Major depressive episode (MDE) during the last 12 months was assessed using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form). Risk factors were assessed in the same interview.

RESULTS

Factors associating with MDE were spouse's MDE, own alcohol intoxication at least once a week and own chronic medical conditions. In addition, there was a strong association between female's current smoking and male's MDE, independently of other risk factors and spousal MDE. The association of MDE with spouses's MDE was not affected by taking into account other assessed risk factors (own or spouse's).

CONCLUSIONS

The results indicate elevated spouse concordance for MDE independent of the risk factors assessed in the present study.

Antidepressant treatment of depression in the Finnish general population

OBJECTIVE

Antidepressant use has increased in the last decade, but whether depression continues to be undertreated is unknown. The authors investigated the prevalence of antidepressant treatment and its predictors in a recent general population sample of depressed subjects.

METHOD

As part of the Finnish Health Care Survey, in 1996 a representative sample of Finns (N=5,993) aged 15-75 years underwent a standardized face-to-face interview that used the DSM-III-R criteria for major depressive episode.

RESULTS

Only 13% of subjects with a major depressive episode during the preceding 12 months (70 of 557) reported current use of an antidepressant. In logistic regression models, use of psychiatric services for depression, regular use of any other medication, more than 1 month of sick leave, and smoking were associated with antidepressant treatment.

CONCLUSIONS

Most depressed subjects in 1996 in Finland were not receiving antidepressant treatment despite the several-fold increase in antidepressant use in the 1990s.

Cigarette smoking, alcohol intoxication and major depressive episode in a representative population sample

OBJECTIVE

This study investigated the associations of cigarette smoking and alcohol intoxication with major depressive episode.

DESIGN

Major depressive episode during the past 12 months was assessed in a national representative cross sectional study using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form).

SUBJECTS

A random sample of 5993 non-institutionalised Finnish people aged 15-75 years was interviewed as a part of the 1996 Finnish Health Care Survey.

RESULTS

In logistic regression models the factors associated with major depressive episode in the past 12 months were smoking 10 or more cigarettes daily (odds ratio (OR) 2.26; 95% confidence intervals (95% CI) 1.68, 3.04) and alcohol intoxication at least once a week (OR 2.99; 95%CI 1.70, 5.25). Their effects were independent of each other, and remained significant even after adjusting for other major risk factors (marital status, education, unemployment and chronic diseases). The attributable proportion (a measure of the impact of the risk factors of the disease on the population) for daily smoking of 10 or more cigarettes was 0.15, and for alcohol intoxication at least once a week 0.04.

CONCLUSION

Cigarette smoking and alcohol intoxication seem to be important risk factors for major depressive episode. In this population the impact of smoking was greater.

The 12-month prevalence and risk factors for major depressive episode in Finland: representative sample of 5993 adults

OBJECTIVE

This study reports the 12-month prevalence of major depressive episode and its risk factors in a representative nationwide sample.

METHOD

A random sample of non-institutionalized Finnish individuals aged 15-75 years (N = 5993) was interviewed in 1996. Major depressive episode during the last 12 months was assessed using the Short Form of the University of Michigan version of the Composite International Diagnostic Interview (the UM-CIDI Short Form).

RESULTS

The population prevalence of major depressive episode was 9.3% [95% CI 8.5,10.0], and the age-adjusted prevalences for females and males were 10.9% [95% CI 9.7,12.0] and 7.2 [95% CI 6.2,8.2], respectively. In logistic regression analyses the factors associated with major depressive episode after adjustment for age were urban residency, smoking, alcohol intoxication and chronic medical conditions. In addition, being single and obese were found to be risk factors for males.

CONCLUSION

The female to male risk ratio for major depressive episode was smaller than in many previous studies. The sex-specific risk factor associations warrant further investigation into sex differences in depression.

Treatment of mental disorders in seven physicians committing suicide

Through psychological autopsy seven cases of physician suicide were studied. All seven victims received a diagnosis of current mood disorder, two of them bipolar disorder. Five had suffered a disabling physical condition. None of the victims had had adequate treatment with antidepressant or mood-stabilizing drugs, nor had they been in psychotherapy. Current adequate treatment for depression seems to be as rare among physician victims as among suicides with major depressive disorders in the population.

Treatment of Mental Disorders in Seven Physicians Committing Suicide

Through psychological autopsy seven cases of physician suicide were studied. All seven victims received a diagnosis of current mood disorder, two of them bipolar disorder. Five had suffered a disabling physical condition. None of the victims had had adequate treatment with antidepressant or mood-stabilizing drugs, nor had they been in psychotherapy. Current adequate treatment for depression seems to be as rare among physician victims as among suicides with major depressive disorders in the population.

Medical surveillance often precedes suicide among female physicians in Finland. A case-control study

Official medical surveillance among Finnish physicians who had committed suicide in 1983-1994 was investigated. Definite cases of suicide (ICD categories E950-E959) (n = 50) were compared with a living age- and sex-adjusted control group of physicians (n = 200). All National Board of Health (NBH) documents relating to official surveillance in 1983-1994 were examined. Seven cases of surveillance (three males, four females) were found among suicide cases and only one in controls, the relative odds thus being 28 (95% confidence interval 4.3 to 636). All suicide victims had had several major problems, including mental and somatic disorders and difficulties in their personal relationships. The risk of suicide was especially high among female physicians under surveillance. However, only in one case did disbarment from the medical profession seem to be a crucial factor preceding a suicide.

Suicide mortality among medical doctors in Finland: are females more prone to suicide than their male colleagues?

BACKGROUND

Suicide mortality among medical practitioners is in many countries significantly higher compared with other professionals and the general population. Differences between male and female physicians are difficult to estimate reliably because previous comparisons are mainly based on crude mortality rates.

METHODS

Age-specific mortality rates were calculated for physicians, other professionals and the general population, males and females separately, as well as standardized mortality ratios (SMR) comparing physicians with the other groups. Crude mortality rates were calculated for the specialist groups.

RESULTS

The SMR for male (female) physicians was 0.9 (2.4) compared with the general male (female) population and 2.4 (3.7) compared with other male (female) professionals. The SMR between male and female physicians was 1.2 (95% CI 0.9-1.7).

CONCLUSIONS

Our results do not support the claim that female physicians have a greater risk of suicide than their male colleagues, but are concordant with previous observations of a higher suicide rate in female physicians compared with the general population and other female professionals.

Suicides among physicians, engineers and teachers: the prevalence of reported depression, admissions to hospital and contributory causes of death

The number of admissions to hospital, reported diagnoses, prevalence of reported depression and contributory causes of death among Finnish physicians, engineers and teachers who committed completed suicide between 1986 and 1993 were studied. The data for hospital admissions with diagnoses were obtained from the Finnish Hospital Discharge Register. Thin-layer chromatography was used to detect drugs in the liver, a dual-column gas chromatographic method was used for screening and quantification of drugs in the blood sample, and a head-space chromatographic method was used to measure blood alcohol levels. Physicians had more somatic diagnoses than the reference groups, and the prevalence of reported depression was higher among females than males. A minority of the depressed subjects had been admitted to hospital, although depression was observed to be the most prevalent contributory cause of death in all of the groups studied. The physicians used solid or liquid substances, especially barbiturates, as the main method of suicide. It is possible that depression in physicians, especially in male subjects, is undertreated in psychiatric hospitals.

[Post-traumatic endophthalmitis with multiple water pathogens]

HISTORY AND SIGNS

A 37-y-old worker for a recycling company suffered from a corneal perforation by a wire which had been in contact with dirt and moisture.

THERAPY AND OUTCOME

Initially, the typical signs of an endophthalmitis were missing so that we only irrigated and instilled antibiotics into the anterior chamber. However, later on two pars-plana vitrectomies became necessary. At each operation a bacteriological examination was performed and we found four different species-Pseudomonas aeruginosa. Klebsiella oxytoca, Aeromonas caviae, Flavobacterium odoratum.

CONCLUSION

The latter two species are very rare in ophthalmology. This fact and some peculiarities in the clinical course of the patient's disease make him an unusual case. After unsuccessful irrigation of the anterior chamber vitrectomy ought to be performed immediately.

A systematic review on gender-specific suicide mortality in medical doctors

BACKGROUND

So far no comprehensive systematic review has been published about epidemiologic studies on suicides among medical practitioners. The aim here is to describe the variation of published estimates of relative risk of doctors to die from suicide.

METHOD

A systematic review of published original articles on population-based studies, registered mainly in MEDLINE and fulfilling specific methodological requirements. Incidence rates and standardised mortality ratios were calculated for male and female doctors in relation to the reference groups.

RESULTS

The estimated relative risk varied from 1.1 to 3.4 in male doctors, and from 2.5 to 5.7 in female doctors, respectively, as compared with the general population, and from 1.5 to 3.8 in males and from 3.7 to 4.5 in females, respectively, as compared with other professionals. The crude suicide mortality rate was about the same in male and female doctors.

CONCLUSION

In all studies the suicide rates among doctors were higher than those in the general population and among other academic occupational groups.

Potassium conductance of smooth muscle cells from rabbit aorta in primary culture

Vascular smooth muscle cells were obtained from rabbit aorta and were studied in primary culture on days 1-7 after seeding with electrophysiological techniques. In impalement experiments a mean membrane potential difference (PD) of -50 +/- 0.3 mV (n = 387) was obtained with Ringer-type solution in the bath. PD was depolarized by 6 +/- 0.3 mV (n = 45) and 16 +/- 2 mV (n = 5) when the bath K+ concentration was increased from the control value of 3.6 mmol/l to 13.6 and 23.6 mmol/l, respectively. Ba2+ (0.1-1 mmol/l) depolarized PD. Tetraethylammonium (TEA, 10 mmol/l) depolarized PD only slightly but significantly. Verapamil (0.1 mmol/l) and charybdotoxin (10 nmol/l) had no effect on PD. The conductance properties of these cells were further examined with the patch-clamp technique. K+ channels were spontaneously present in cell-attached patches. When the pipette was filled with 145 mmol/l KCl, a mean conductance (gK) of 209.6 +/- 4.6 mV (n = 17) was read from the current/voltage curves at a clamp voltage (Vc) of 0 mV. After excision K+ channels were found in 129 patches with inside-out and in 50 with outside-out configuration. With KCl on one and NaCl on the other side the mean gK at a Vc of 0 mV was 134.6 +/- 3.9 pS (n = 179). The mean permeability was 0.89 +/- 0.03 x 10(-12) cm3/s. With symmetrical KCl solution the mean gK was 227 +/- 6 pS (n = 17). The conductance sequence was gK much greater than gRb = gCs = gNa = 0. TEA blocked dose-dependently only from the outside (1-10 mmol/l). Lidocaine (5 mmol/l) quinidine (0.01-1 mmol/l) and quinine (0.01-1 mmol/l) blocked from both sides. Charybdotoxin (0.5-5 nmol/l) blocked only from the extracellular side. Ba2+ blocked from the cytosolic side and the inhibition was increased by depolarization and reduced by hyperpolarization. At a Vc of 0 mV a half-maximal inhibition (IC50) of 2 mumol/l was obtained. Verapamil and diltiazem blocked from both sides, verapamil with an IC50 of 2 mumol/l and diltiazem with an IC50 of 10 mumol/l. The open probability of this channel was increased by CA2+ on the cytosolic side at activities greater than 0.1 mumol/l. Half-maximal activation occurred at Ca2+ activities exceeding 1 mumol/l. The present data indicate that the vascular smooth muscle cells of rabbit aorta in primary culture possess a K+ conductance. In excised patches only a maxi K+ channel was detected. This channel has properties different from the macroscopic K+ conductance.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of depolarizing and hyperpolarizing agents on the membrane potential difference of primary cultures of rabbit aorta vascular smooth muscle cells

Vascular smooth muscle cells of rabbit aorta were enzymatically dispersed, kept in primary culture, and studied between days 1 and 7 in a bath rinsed with Ringer-like solution at 37 degrees C. The electrical membrane potential difference (PD) was measured with microelectrodes. The mean value of PD was -50 +/- 0.4 mV (n = 53). Cromakalim (BRL 34915), 1 mumol/l and 10 mumol/l, hyperpolarized the membrane potential by 9 +/- 1 mV (n = 11) and 15 +/- 1 mV (n = 53) respectively. Glibenclamide (10 mumol/l) abolished the hyperpolarizing effect of chromakalim (n = 6). Simultaneous addition of cromakalim and glibenclamide (both 10 mumol/l, n = 11) and glibenclamide itself (10 mumol/l, n = 7) had no effect on PD. In patch-clamp experiments in outside-out-oriented Ca(2+)-sensitive K+ channels, cromakalim increased the open probability (Po) only slightly and only with a cytosolic Ca2+ activity of 1 mumol/l. In all other series cromakalim had no effect on the Po of these channels. Forskolin (10 mumol/l) hyperpolarized PD by 6 +/- 1 mV (n = 13). The nucleotides UTP, ATP and ITP (10 mumol/l) depolarized PD by 12 +/- 1 mV (n = 7), 8 +/- 1 mV (n = 65) and 5 +/- 1 mV (n = 6) respectively. GTP, [alpha, beta-methylene]ATP and adenosine had no significant effect.(ABSTRACT TRUNCATED AT 250 WORDS)