Comparison of adsorption-extraction (AE) workflows for improved measurements of viral and bacterial nucleic acid in untreated wastewater.

The lack of standardized methods and large differences in virus concentration and extraction workflows have hampered Severe Acute Respiratory Syndrome (SARS-CoV-2) wastewater surveillance and data reporting practices. Numerous studies have shown that adsorption-extraction (AE) method holds promise, yet several uncertainties remain regarding the optimal AE workflow. Several procedural components may influence the recovered concentrations of target nucleic acid, including membrane types, homogenization instruments, speed and duration, and lysis buffer. In this study, 42 different AE workflows that varied these components were compared to determine the optimal workflow by quantifying endogenous SARS-CoV-2, human adenovirus 40/41 (HAdV 40/41), and a bacterial marker gene of fecal contamination (Bacteroides HF183). Our findings suggest that the workflow chosen had a significant impact on SARS-CoV-2 concentrations, whereas it had minimal impact on HF183 and no effect on HAdV 40/41 concentrations. When comparing individual components in a workflow, such as membrane type (MF-Millipore™ 0.45 µm MCE vs. Isopore™ 0.40 µm), we found that they had no impact on SARS-CoV-2, HAdV 40/41, and HF183 concentrations. This suggests that at least some consumables and equipment are interchangeable. Buffer PM1 + TRIzol-based workflows yielded higher concentrations of SARS-CoV-2 than other workflows. HF183 concentrations were higher in workflows without chloroform. Similarly, higher homogenization speeds (5000-10,000 rpm) led to increased concentrations of SARS-CoV-2 and HF183 but had no effect on HAdV 40/41. Our findings indicate that minor enhancements to the AE workflow can improve the recovery of viruses and bacteria from the wastewater, leading to improved outcomes from wastewater surveillance efforts.

Exploring the vertical transport of microplastics in subsurface environments: Lab-scale experiments and field evidence.

Microplastics (MPs) defined as smaller 5 mm plastic particles have received increasing attention due to their global occurrence and potential toxicity. This study investigated the effects of environmental factors (rainfall intensity, 13 and 29 mm/h) and MP characteristics (morphology (fiber, flake, and film), polymer type (polypropylene (PP), polyethylene terephthalate (PET), and polystyrene (PS)) and size (100-300, 300-500, and 500-1000 µm)) on the vertical transport of MP in unsaturated soil conditions using lab-scale column experiments. Additionally, the occurrence and characteristics of MP detected in soil/sediment (total 13 samples) and groundwater samples (total 6 samples) were explored in the field study. Laboratory-scale column experiments revealed that heavy rainfall intensity (29 mm/h) increased the degree of MP vertical transport in unsaturated soil conditions and MP fibers showed the greatest vertical mobility among the various morphologies of MPs assessed. For the polymer type and size, the lighter PP polymer or the larger size of MP (500-1000 µm) showed higher mobility. In the field study, a statistical difference in MP abundance was observed depending on the population density and degree of urban development in both soil and groundwater samples. Comparing to the two different types of environmental media samples obtained from the same site, there was a significant difference in the composition of polymer types present while statistically no difference in MP abundance was observed between the two media samples (i.e., soil or sediment and groundwater). In addition, MP fibers and polyethylene (PE) were predominantly detected in our two study areas. These results suggest that various types of MP can pass through the unsaturated zone by water infiltration, even if it takes a long time to reach groundwater. Overall, we found that the degree of vertical transport of the MPs was highly sensitive to environmental conditions and MP characteristics.

Validating a single-question depression measure among older adults.

BACKGROUND: A single-item depression measure may not be adequate in capturing the complex entity of mental health, despite wide use of this indicator in community studies. This study evaluated the accuracy of a single-question depression measure in comparison to two composite indices-the Center for Epidemiologic Studies Depression Scale (CESD) and the Geriatric Depression Scale (GDS). MATERIALS AND METHODS: A total of 800 elderly participants ranging from 60 to 89 years of age and residing in Seoul were recruited using a multistage sampling scheme in 2015. The survey was conducted by trained interviewers with a constructed questionnaire. Reliability and validity measures such as the Kappa index, sensitivity, specificity, PPV, NPV, and AUC were used to evaluate the accuracy of the single question measure. Socio-demographic group differences in accuracy were compared by age, sex, marital status, education, employment, and financial status. RESULTS: The prevalence of depression by a single-question measure was much lower than those of CESD and GDS (5.5%, 12.3%, and 12.1%, respectively). The sensitivity of the single-item measure, based on CESD and GDS, was extremely low at 30.6% and 36.1%. In the subgroup analysis, however, there was a marked educational discrepancy in all accuracy measures; in sensitivity, people with a university degree or higher showed about 2.4 times higher sensitivity than those having only a primary school education. CONCLUSIONS: The results show that a single-question depression measure should be used with caution. In addition, the single-question measure could substantially underestimate depression among the risk group of older adults.

Facilitators of and Barriers to Gastric Cancer Screening Among Korean Americans.

BACKGROUND: Gastric cancer is the most highly prevalent cancer among Korean Americans, occurring at a higher rate than among other Asian Americans and non-Latino Whites. However, little is known about the culturally specific barriers to gastric cancer screening among Korean Americans. OBJECTIVE: The aim of this study was to explore facilitators of and barriers to gastric cancer screening among Korean Americans. METHODS: In this qualitative focus group study, a convenience sample of 50 Korean Americans aged 21 to 75 years was recruited from the Puget Sound area of Washington with the assistance of Korean churches. Five focus groups of 6 to 8 and 1 focus group of 13 were conducted in a church, a café, and an apartment community center. The focus group discussions lasted approximately 30 minutes to 1 hour. Directed content analysis was used to analyze the data. RESULTS: Facilitators included exposure to Korean media, history and prevalence of gastric problems, perceptions concerning positive aspects of the healthcare system in South Korea, physician recommendations, technology, and church health fair. Barriers included a lack of knowledge, finance/lack of health insurance, fear of test results, perceptions of an inconvenient American healthcare system, a lack of knowledge of American healthcare providers on culturally related health risks, a dislike of medical procedures, and no preventive measures. CONCLUSIONS: Sociocultural facilitators and barriers add new knowledge in a field with scarce information available. IMPLICATIONS FOR PRACTICE: The study findings lay the groundwork for developing culturally relevant interventions that enhance healthcare providers' awareness while empowering Korean Americans to prevent gastric cancer.

Association between restriction of activity related to chronic diseases and suicidal ideation in older adults in Korea.

AIM: The aim of the present study was to show an association between restricted activity related to chronic diseases and suicidal ideation (SI) in elderly Korean adults after adjusting for age, sex, mental health status, socioeconomic position and health behavior factors. METHODS: The study sample included 3545 Korean men (n=1473) and women (n=2073), aged over 65 years from the 2007-2009 Korea National Health and Nutrition Examination Survey carried out by the Ministry of Health and Welfare of Korea. Participants were classified into two groups based on whether they had previously experienced suicidal thoughts. Restricted activity was related to chronic conditions, such as cardiovascular diseases, cerebrovascular accident and so on. We analyzed the data using Student's t-test or χ(2) -test. Multiple logistic regression analysis was used to determine the association between restricted activity as the independent variable and SI as the dependent variable after adjustment for confounders. RESULTS: The proportion of participants with SI population was 29.1%. People with SI reported a significantly higher proportion of restrictive activity (62.3%) than those who did not have SI (34.5%). The adjusted risk excess (OR) of SI was statistically significant with regard to restricted activity (2.11, 95% CI 1.65-2.70; 2.85, 95% CI 1.95-4.15) in males; 1.69 (95% CI 1.22-2.34) in females after adjustment for potential confounders. In particular, women who lived alone showed high adjusted OR (1.50, 95% CI 1.01-2.24). CONCLUSIONS: Statistical analyses from this community-based, random sample drawn from a selected sample of the elderly Korean population showed that restricted activity appears to be significantly associated with SI.

Area deprivation, individual socioeconomic position and smoking among women in South Korea.

BACKGROUND: The objective of this study was to examine how area deprivation and individual socioeconomic position affect smoking among women using national survey data. METHODS: Smoking and individual sociodemographic characteristics were gathered from the Third Korea National Health and Nutrition Examination Survey, 2005. The Carstairs index was derived for each area using the 2005 census data. The data were analysed using multilevel logistic regression models. RESULTS: After adjusting for age and marital status, low education and manual jobs were significantly associated with a higher likelihood of smoking. In addition, the effect of manual jobs on smoking was modified by area deprivation. When individual occupation and area deprivation were examined together, results indicated that women with manual occupation had much greater odds of smoking when they lived in the least-deprived areas (OR, 4.03; CI, 2.00 to 8.14) than did women with manual job who lived in the middle- or most-deprived areas (OR, 2.19; CI, 1.15 to 4.16), compared to the reference group (housewives in the middle- or most-deprived areas). CONCLUSION: The results of the present study show that among Korean women, manual work is associated with smoking, and the association is strongest among those living in the least-deprived areas. This interaction between manual work and area deprivation resulted in a higher smoking prevalence among women in affluent urban areas.

Use of ozone-based processes for the removal of pharmaceuticals detected in a wastewater treatment plant.

Ozone (O3)-based processes (O3, O3/H2O2, and O3/UV) were investigated for the removal of pharmaceuticals in real wastewater using a bench-scale experimental setup. An ozone dose of 6 mg/L (contact time = 10 minutes) was found to reduce the concentration of most pharmaceuticals detected in secondary effluent. Caffeine, N,N-Diethyl-meta-toluamide (DEET), and cyclophosphamide were removed with efficiencies of 84, 89, and 46%, respectively, even with a contact time of 15 minutes (O3 dose = 6 mg/L). In the case of the ozone process alone, the concentration of bromate ion in the effluent increased with longer contact time. On the other hand, it was found that the O3/H202 and O3/UV processes can be used as alternative processes for effective removal of pharmaceuticals, while leaving a low residual concentration of dissolved ozone in the system, thereby preventing bromate formation. Water

Photodegradation characteristics of PPCPs in water with UV treatment.

The degradation characteristics of PPCPs commonly found in surface water under UV treatment were examined for 30 kinds of PPCPs using a UV/Lamp1 that emits light at a wavelength of 254 nm and a UV/Lamp2 that emits light at 254 nm and 185 nm in pure water. When a UV dose of some 230 mJ/cm(2) was introduced to the 30 PPCPs, photodegradation rates of about >3% (theophylline) to 100% (diclofenac) and about >15% (clarithromycin) to 100% (diclofenac) were observed for UV/Lamp1 and UV/Lamp2, respectively. This study also showed that UV/Lamp2, which photolyzes water molecules and generates OH radicals, is more effective for PPCP removal than UV/lamp1. It was postulated that the degradation rates of sulfamethoxazole, sulfamonomethoxine, sulfadimethoxine and sulfadimidine, all, including sulfamethoxazole, derived from sulfanilamide, under UV/Lamp1 resulted mainly from the bond-breaking reactions occurring between -SO(2)- and its side atoms, the C-S bond and the N-H bond. Some PPCPs with amide bonds, such as cyclophosphamide and DEET, were highly resistant to photodegradation by UV/Lamp1. AOPs (Advanced oxidation processes) such as the UV/H(2)O(2) or UV/O(3) processes should therefore be considered for their potential to remove these substances effectively.

Gender, precarious work, and chronic diseases in South Korea.

OBJECTIVE: In view of the growing number of nonstandard workers in South Korea, this study examined whether nonstandard workers reported poorer health compared to standard workers and assessed whether there were gender differences in the association between employment status and chronic health outcomes. METHOD: Data were taken from a representative-weighted sample of 1,563 men and 1,045 women aged 20-64, from the 2001 National Health and Nutrition Examination Survey. Nonstandard employment included part-time work, temporary work, and day labor. Self-rated health and self-reported chronic disease conditions were used as health measures. MAIN RESULTS: Nonstandard employment was significantly associated with higher risk of self-rated health and chronic conditions after adjusting for socioeconomic position (education, occupational class, and income) and health behaviors (cigarette smoking, alcohol consumption, regular exercise, and health examinations). However, the pattern in the relation between nonstandard work and specific health problems greatly differed by gender. Among men, nonstandard work arrangements were significantly associated with musculoskeletal disorders (OR 1.97, 95% CI 1.24-3.19) and liver disease (OR 2.83, 95% CI 1.27-6.32). Among women, nonstandard employment was related to mental disorders (OR 3.25, 95% CI 1.40-7.56). CONCLUSION: The findings clearly indicate the need for further study of the observed associations, particularly prospective and analytical studies.

[Socioeconomic inequalities in preventive services among the elderly: results from medical checkup, cancer check, and BP check].

OBJECTIVES: Due to the assumptions of homogeneity as well as challenges in the socioeconomic position of the elderly, they have been relatively neglected in studies of health inequalities. Therefore, this study was conducted to investigate the social inequalities in preventive services among elderly men and women. METHODS: Data were obtained from a nationally representative sample of 342 men and 525 women aged 65 and over collected during the 2001 National Health and Nutrition Examination Survey. Age adjusted proportions and logistic regression were used to identify the social patterning of preventive services among elderly Koreans using various social position indicators. RESULTS: The findings of this study generally supported the presence of social gradients in preventive services among the Korean elderly. The likelihood of using the service becomes progressively higher with social position. Educational level, income, and self-rated living status were significantly associated with increased medical checkups and cancer checks. In addition, logistic regression detected educational inequalities only among older women receiving BP checks. After being stratified based on health status and chronic disease status, social disparities still existed when educational level and self-rated living status were considered. Among unhealthy individuals, place of residence was observed as a barrier to medical checkups. CONCLUSIONS: This study demonstrated strong and consistent associations between socioeconomic position and preventive services among the elderly in Korea. The results indicate that public health strategies should be developed to reduce the barriers to preventive services encountered by the elderly.

The relationship between nonstandard working and mental health in a representative sample of the South Korean population.

In light of escalating job insecurity due to increasing numbers of nonstandard workers, this study examined the association between nonstandard employment and mental health among South Korean workers. We analyzed a representative weighted sample of 2086 men and 1194 women aged 20-64 years, using data from the 1998 Korean National Health and Nutrition Examination Survey. Nonstandard employment included part-time work, temporary work, and daily work. Mental health was measured with indicators of self-reported depression and suicidal ideation. Based on age-adjusted prevalence of mental health, nonstandard employees were more likely to be mentally ill compared to standard employees. Furthermore, nonstandard work status was associated with poor mental health after adjusting for socioeconomic position (education, occupational class, and income) and health behaviors (smoking, alcohol consumption, and exercise). However, the pattern of the relationship between nonstandard work and mental health differed by gender. Female gender was significantly associated with poor mental health. Although males tended to report more suicidal ideation, this difference was not statistically significant. Considering the increasing prevalence of nonstandard working conditions in South Korea, the results call for more longitudinal research on the mental health effects of nonstandard work.

Delayed maturation of interstitial cells of Cajal in meconium obstruction.

BACKGROUND/PURPOSE: The etiology of meconium obstruction without cystic fibrosis is unclear. Interstitial cells of Cajal (ICC) function as pacemakers in gut motility and may play a role in the pathophysiology of the disease. METHODS: The ICC were examined by immunohistochemical staining with anti-c-kit antibody in the bowel walls of 6 neonates who had meconium obstruction without cystic fibrosis, and the results were compared with specimens from normal neonates (n = 2). RESULTS: Six patients underwent ileostomy between 2 and 15 days after birth, and 5 of them presented with microcolon. Ganglion cells were present in the ileum and colon. Whereas ICC were evenly distributed in the control specimens, they were not seen at the time of ileostomy in the colons of 2 patients, and the other 4 showed scanty distribution in muscle layers. However, ileum showed normal distribution of ICC in all patients. The ileostomies were closed between 39 and 104 days of age, and the ICC distribution was changed to a normal pattern in the colons of all 6 patients. Their bowel movements were restored to normal after closure. CONCLUSION: The findings of this study suggest that delayed maturity of ICC may be a cause of meconium obstruction without cystic fibrosis.