Masculine depression and its problem behaviors: use alcohol and drugs, work hard, and avoid psychiatry!

The gender role influences vulnerability to mental illness. Substance use, even critical in scale, is perceived as masculine, just like hard (over-)work, while not seeking help. With the ongoing separation between gender and sex, masculine norms become more relevant also to females' mental health. The male depression concept highlights the role of male symptoms in affective disorders. However, the empirical evidence is still limited. Here, we use the denomination 'masculine depression' to open the category for female patients and tested substance use patterns, health services' utilization, and working hours as predictors in a case-control study of 163 depressed in-patients (44% women; masculine vs. non-masculine depression according to a median split of the Male Depression Rating Scale-22) and 176 controls (51% women). We assessed higher depression severity in patients with masculine (vs. non-masculine) depression. Masculine depression (vs. non-masculine depression and vs. no depression) was predicted by more frequent and critical use of alcohol (including binge drinking), tobacco, and illicit drugs, and by longer working times. Moreover, fewer health services contacts due to mental complaints during the previous year were associated with masculine (vs. non-masculine) depression. Alarmingly, even critical substance misuse was not significantly associated with more frequent health services contacts; however, the higher the depression severity, the more contacts the patients reported. Here, we provide evidence that patients with masculine depression are highly burdened and undertreated, which applies equally to female and male patients. This study identified promising targets to establish specialized care offers.

A next generation targeted amplicon sequencing method to screen for insecticide resistance mutations in Aedes aegypti populations reveals a rdl mutation in mosquitoes from Cabo Verde.

Aedes mosquito vectors transmit many viruses of global health concern, including dengue, chikungunya and Zika. These vector-borne viral diseases have a limited number of treatment options, and vaccines vary in their effectiveness. Consequently, integrated vector management is a primary strategy for disease control. However, the increasing emergence and spread of insecticide resistance is threatening the efficacy of vector control methods. Identifying mutations associated with resistance in vector populations is important to monitor the occurrence and evolution of insecticide resistance and inform control strategies. Rapid and cost-effective genome sequencing approaches are urgently needed. Here we present an adaptable targeted amplicon approach for cost-effective implementation within next generation sequencing platforms. This approach can identify single nucleotide polymorphisms (SNPs) and small insertions and deletions (indels) in genes involved in insecticide resistance in Aedes aegypti mosquitoes. We designed and tested eleven amplicons, which included segments of the ace-1 (carbamate target), the Voltage-Gated Sodium Channel (vgsc; pyrethroids, DDT and organochlorines), and rdl (dieldrin) genes; thereby covering established knockdown resistance (kdr) mutations (e.g., S989P, I1011M/V, V1016G/I and F1534C), with the potential to identify novel ones. The amplicon assays were designed with internal barcodes, to facilitate multiplexing of large numbers of mosquitoes at low cost, and were sequenced using an Illumina platform. Our approach was evaluated on 152 Ae. aegypti mosquitoes collected in Cabo Verde, an archipelago with a history of arbovirus outbreaks. The amplicon sequence data revealed 146 SNPs, including four non-synonymous polymorphisms in the vgsc gene, one in ace-1 and the 296S rdl mutation previously associated with resistance to organochlorines. The 296S rdl mutation was identified in 98% of mosquitoes screened, consistent with the past use of an organochlorine compound (e.g., DDT). Overall, our work shows that targeted amplicon sequencing is a rapid, robust, and cost-effective tool that can be used to perform high throughput monitoring of insecticide resistance.

Respiratory Syncytial Virus Associated Hospitalizations in Infants of 33 to 42 Weeks' Gestation: Does Gestational Age Matter?

BACKGROUND: To evaluate rates and characteristics of respiratory syncytial virus hospitalizations (RSV-H) in infants of 33 to 42 weeks of gestational age (GA). PATIENTS: All infants with a history of neonatal hospitalization and a GA of 33 to 42 weeks born between 2005 and 2015 and follow-up at least over one RSV season (first year of life). Infants with congenital heart disease and other congenital anomalies were excluded. METHODS: Retrospective single-center cohort STROBE compliant study. Data were collected regarding demographic data and re-hospitalization characteristics due to respiratory illness and due to RSV infection; and data were compared between moderate-late preterm, near term, term, and post term infants, respectively. RESULTS: A total of 81.656 live born infants were registered in our catchment area with gestational age from 33 to 42 weeks during the study period; and 2188 of 2356 preterm infants and 1004 of 1168 term infants with history of neonatal hospitalization were included for analysis. Rehospitalizations due to respiratory illness occurred in 301 preterm (13.8%) and 136 term (13.5%) infants for 381 and 183 times, respectively. In total 84 of 3192 infants (2.6%) were tested RSV positive, 61 of 2188 preterm (2.8%) and 23 of 1004 term (2.3%). Preterm infants without history of neonatal hospitalization had a RSV hospitalization (RSV-H) rate of 1.7% (61/3488) and term infants of 1.3% (967/74.644) that were significantly lower compared to study infants (p=0.004 and 0.002, respectively). Moderate and late preterm (2.8%), near term (3.1%) and post term (3.5%) infants had significantly higher RSV-H rates compared to term infants (1.2%). Risk factors for RSV-H in preterm infants included discharge during RSV season (4.2 vs. 2.0%, p=0.017) and presence of older siblings (4.2 vs. 2.1%, p=0.023), in term infants presence of older siblings (p=0.019). The course of RSV disease did not differ between groups. DISCUSSION: Interestingly, we did not observe decreasing RSV-H rates with increasing GA. Term infants represented the group with lowest RSV-H rates. Neonatal hospitalization was a risk factor for RSV-H for both preterm and term infants. Near term infants do more resemble the late preterm than term infants regarding RSV-H rates. CONCLUSION: We found comparable higher RSV-H rates in all groups compared to term infants without differences in the course of disease and identified neonatal hospitalization as an independent risk factor.