SOURCES OF HEALTHCARE WORKERS' COVID-19 INFECTIONS AND RELATED SAFETY GUIDELINES

Objectives: To evaluate the effectiveness of safety guidelines in the workplace, the authors analyzed the work-related exposure to SARS-CoV-2 and the source of COVID-19 infections among healthcare workers (HCWs), together with the use of personal protective equipment (PPE). Material and Methods: A cross-sectional prospective study was conducted in tertiary hospitals in the Uusimaa region, Finland, with 1072 volunteers being enrolled in the study from among the HCWs at the Helsinki University Hospital. Overall, 866 (80.8%) HCWs (including 588 nurses, 170 doctors, and 108 laboratory and medical imaging nurses) completed the questionnaire by July 15, 2020, with 52% of the participants taking care of COVID-19 patients. The participants answered a structured questionnaire regarding their use of PPE, the ability to follow safety guidelines, exposure to COVID-19, and the source of potential COVID-19 infections. The participants with COVID-19 symptoms were tested with the SARS-CoV-2 real-time polymerase chain reaction method. All infected participants were contacted, and their answers were confirmed regarding COVID-19 exposure. Results: In total, 41 (4.7%) participants tested positive for SARS-CoV-2, with 22 (53.6%) of infections being confirmed or likely occupational, and 12 (29.3%) originating from colleagues. In 14 cases (63.6%), occupational infections occurred while using a surgical mask, and all infections originating from patients occurred while using a surgical mask or no mask at all. No occupational infections were found while using an FFP2/3 respirator and following aerosol precautions. The combined odds ratio for working at an intensive care unit, an emergency department, or a ward was 3.4 (95% CI: 1.2-9.2, p = 0.016). Conclusions: A high infection rate was found among HCWs despite safety guidelines. Based on these findings, the authors recommend the use of FFP2/3 respirators in all patient contacts with confirmed or suspected COVID-19, along with the use of universal masking, also in personnel rooms.Peer reviewe

Early-Onset Diabetic E1-DN Mice Develop Albuminuria and Glomerular Injury Typical of Diabetic Nephropathy

The transgenic E1-DN mice express a kinase-negative epidermal growth factor receptor in their pancreatic islets and are diabetic from two weeks of age due to impaired postnatal growth of beta-cell mass. Here, we characterize the development of hyperglycaemia-induced renal injury in the E1-DN mice. Homozygous mice showed increased albumin excretion rate (AER) at the age of 10 weeks; the albuminuria increased over time and correlated with blood glucose. Morphometric analysis of PAS-stained histological sections and electron microscopy images revealed mesangial expansion in homozygous E1-DN mice, and glomerular sclerosis was observed in the most hyperglycaemic mice. The albuminuric homozygous mice developed also other structural changes in the glomeruli, including thickening of the glomerular basement membrane and widening of podocyte foot processes that are typical for diabetic nephropathy. Increased apoptosis of podocytes was identified as one mechanism contributing to glomerular injury. In addition, nephrin expression was reduced in the podocytes of albuminuric homozygous E1-DN mice. Tubular changes included altered epithelial cell morphology and increased proliferation. In conclusion, hyperglycaemic E1-DN mice develop albuminuria and glomerular and tubular injury typical of human diabetic nephropathy and can serve as a new model to study the mechanisms leading to the development of diabetic nephropathy.Peer reviewe

Immunomodulating Therapies in Acute Myocarditis and Recurrent/Acute Pericarditis

The field of inflammatory disease of the heart or "cardio-immunology " is rapidly evolving due to the wider use of non-invasive diagnostic tools able to detect and monitor myocardial inflammation. In acute myocarditis, recent data on the use of immunomodulating therapies have been reported both in the setting of systemic autoimmune disorders and in the setting of isolated forms, especially in patients with specific histology (e.g., eosinophilic myocarditis) or with an arrhythmicburden. A role for immunosuppressive therapies has been also shown in severe cases of coronavirus disease 2019 (COVID-19), a condition that can be associated with cardiac injury and acute myocarditis. Furthermore, ongoing clinical trials are assessing the role of high dosage methylprednisolone in the context of acute myocarditis complicated by heart failure or fulminant presentation or the role of anakinra to treat patients with acute myocarditis excluding patients with hemodynamically unstable conditions. In addition, the explosion of immune-mediated therapies in oncology has introduced new pathophysiological entities, such as immune-checkpoint inhibitor-associated myocarditis and new basic research models to understand the interaction between the cardiac and immune systems. Here we provide a broad overview of evolving areas in cardio-immunology. We summarize the use of new imaging tools in combination with endomyocardial biopsy and laboratory parameters such as high sensitivity troponin to monitor the response to immunomodulating therapies based on recent evidence and clinical experience. Concerning pericarditis, the normal composition of pericardial fluid has been recently elucidated, allowing to assess the actual presence of inflammation; indeed, normal pericardial fluid is rich in nucleated cells, protein, albumin, LDH, at levels consistent with inflammatory exudates in other biological fluids. Importantly, recent findings showed how innate immunity plays a pivotal role in the pathogenesis of recurrent pericarditis with raised C-reactive protein, with inflammasome and IL-1 overproduction as drivers for systemic inflammatory response. In the era of tailored medicine, anti-IL-1 agents such as anakinra and rilonacept have been demonstrated highly effective in patients with recurrent pericarditis associated with an inflammatory phenotype.Peer reviewe

EPHB2 germline variants in patients with colorectal cancer or hyperplastic polyposis

BACKGROUND: Ephrin receptor B2 (EPHB2) has recently been proposed as a novel tumor suppressor gene in colorectal cancer (CRC). Inactivation of the gene has been shown to correlate with progression of colorectal tumorigenesis, and somatic mutations have been reported in both colorectal and prostate tumors. METHODS: Here we have analyzed the EPHB2 gene for germline alterations in 101 individuals either with 1) CRC and a personal or family history of prostate cancer (PC), or 2) intestinal hyperplastic polyposis (HPP), a condition associated with malignant degeneration such as serrated adenoma and CRC. RESULTS: Four previously unknown missense alterations were observed, which may be associated with the disease phenotype. Two of the changes, I361V and R568W, were identified in Finnish CRC patients, but not in over 300 Finnish familial CRC or PC patients or more than 200 population-matched healthy controls. The third change, D861N, was observed in a UK HPP patient, but not in additional 40 UK HPP patients or in 200 UK healthy controls. The fourth change R80H, originally identified in a Finnish CRC patient, was also found in 1/106 familial CRC patients and in 9/281 healthy controls and is likely to be a neutral polymorphism. CONCLUSION: We detected novel germline EPHB2 alterations in patients with colorectal tumors. The results suggest a limited role for these EPHB2 variants in colon tumor predisposition. Further studies including functional analyses are needed to confirm this

GHG balance in drained organic forest soils – data revisited

The study is part of the SNS-120 project ‘Anthropogenic greenhouse gas emissions from organic forest soils: improved inventories and implications for sustainable management’ funded by Nordic Forest Research. http://dev.nordicforestresearch.org/sns-120/201

Rainbow paradise?:sexualities and gender diversity in Finnish schools

Abstract The Finnish education system, welfare state and Finland’s position in respect to lesbian, gay, bisexual, trans and intersex (LGBTI) human rights have been praised. In this chapter, the utopian image of Finnish education system as a ‘rainbow paradise’ is questioned. Legislation, curricula, teachers, school textbooks, experiences of non-heterosexual, trans and intersex youth as well as LGBTI human rights organisations’ work are discussed, as well as the influence of COVID-19. All are looked at from the viewpoint of heteronormativity. Even if there have been several advancements in acknowledging sexual and gender diversity within Finnish education, particularly in the area of legislation and educational policies, there are serious everyday problems in making schools safe for LGBTI students and teachers, as well as with treating everyone equally despite their sexual orientation and gender identity or expression. Teacher training, teaching and textbooks used in schools are often still heteronormative, and teachers lack tools and motivation in resisting heteronormative starting points in their work. Youth culture has changed in recent years, it has become more diverse and less judgemental towards LGBTI youth but non-heterosexual, trans and intersex students are still clearly experiencing more violence in schools than cisgender heterosexual students. The mainly heteronormative Finnish education system creates stress and mental health problems for LGBTI youth. Counselling and health care services are still not fully able to respond to their needs. The COVID-19 pandemic has only made the situation worse. In short, it will require a sustained effort to make the Finnish education system anything close to a ‘rainbow paradise’

Lahden oikoradan liityntäpysäköinnin tiedotusjärjestelmä:Esiselvitys

Työssä on selvitetty vuonna 2006 valmistuvan Lahden oikoradan liityntäpysäköinnin tiedotusjärjestelmän kokonaisuus tavoitetilanteessa ja junaliikenteen alkaessa sekä tiedotuksen kohderyhmät. Lisäksi on selvitetty liityntäpysäköinnin kysyntää ja tarjontaa Helsingin ja Lahden välillä Lahden moottoritien vaikutusalueella. Oikoradan liityntäpysäköinnin määräksi arvioitiin yhteensä noin 800 henkilöautoa vuorokaudessa vuonna 2006 ja 1110 vuonna 2025. Valtaosa liityntäpysäköintimatkoista suuntautuu aamuisin Vantaalle ja Helsinkiin, mutta myös Keravalla ja Lahdessa töissä käyviä auton ja junan yhteiskäyttö työmatkoilla voi kiinnostaa. Liityntäliikenteen käyttäjät vastaisivat enimmillään 3–7 % Lahden moottoritien liikennemääristä Mäntsälän kohdalla. Kysyntä ylittää tarjonnan Keravalla ja Haarajoen asemalla. Poikkeustilanteiden sekä uusien ja satunnaisten käyttäjien varalle on vielä tilaa erityisesti Mäntsälän asemalla. Haarajoen paikat näyttäisivät täyttyvän säännöllisillä käyttäjillä. Keravalle olisi mahdollista houkutella uusia käyttäjiä rakentamalla suunnitelmien mukaisesti lisää liityntäpysäköintipaikkoja. Tiedotusjärjestelmän ensimmäinen vaihe ehdotetaan toteutettavaksi, kun oikoradan junaliikenne käynnistyy. Tällöin käytössä olisi Internet-tiedotuspalvelu, muuttuvat opasteet ja tiedotustaulut tieverkolla, häiriötilannetiedotus radiossa sekä kiinteät opasteet. Lähtötiedot haetaan joukkoliikenteen valtakunnallisesta koontitietokannasta, Tiehallinnon liikenteenseuranta- ja tiesääjärjestelmästä, mahdollisesti toteutettavasta Lahdenväylän matka-ajanennustejärjestelmästä, junaliikenteen seurantajärjestelmästä, mahdollisesti toteutettavista liityntäpysäköintilaitosten pysäköinninseurantajärjestelmistä sekä joukkoliikenteen Matka.fipalveluportaalista. Oikoradan valmistuessa liityntäpysäköinnin markkinointikampanja yhdistetään uuden junaliikenteen markkinointiin. Liityntäpysäköinnin tiedotusjärjestelmän ensimmäisen vaiheen eli vuonna 2006 toteutettavan palvelukokonaisuuden toteuttamis- ja ensimmäisen vuoden ylläpitokustannuksiksi arvioitiin 730 000 euroa ja sen jälkeen n. 145 000 euroa vuodessa. Arvioidut hyödyt järjestelmästä olisivat n. 240 000 €/v. Liityntäpysäköinnin ja sen tiedotusjärjestelmän toteuttaminen vähentävät ruuhkautumista ja liikennemääriä, parantavat liikenteen sujuvuutta häiriötilanteissa, lisäävät junien matkustajamääriä noin 650–700 matkustajalla, joista noin 150 ajantasaisen tiedotuksen ansiosta. Lisäksi ne parantavat liikennepalvelujen imagoa sekä vähentävät liikenteen päästöjä ja tarvetta uusien pysäköintipaikkojen rakentamiseen Helsingin ja Tikkurilan keskustoissa. Ensimmäisenä tehtävänä on käynnistää yhteistyö eri toimijoiden välillä siten, että voidaan määritellä strategia liityntäpysäköinnin tiedotusjärjestelmän organisoinniksi sekä toteuttamismalli tiedotusjärjestelmän toteuttamiseksi ja ylläpitämiseksi. Ratahallintokeskus on organisoinnin käynnistämisessä avainasemassa. Muut osapuolet ovat Tiehallinto, kunnat, YTV, LVM, VR Osakeyhtiö sekä Tieyhtiö Nelostie Oy