Personality and risk of hospital diagnosed mental disorder: a 35 years' prospective study.

PURPOSE: The present study examined the prospective association of neuroticism, extraversion and psychoticism with risk of hospital diagnosed mental disorder, examining intelligence as a potential confounder of this association. METHODS: A total of 1118 Danish men and women completed the Eysenck personality questionnaire at the mean age of 27 years. Information on psychiatric diagnoses was obtained by linking the study population to the national Danish psychiatric registers, and risk of diagnoses associated with each personality trait was examined using multiple Cox regression in models including the three personality traits unadjusted and adjusted for intelligence. Participants with diagnosis from a psychiatric department prior to the personality assessment were excluded. RESULTS: In total, 122 participants were diagnosed with a mental disorder during follow-up. Neuroticism significantly predicted risk of anxiety-, adjustment-, personality- and alcohol and substance abuse diagnoses. Extraversion did not significantly predict any diagnosis type, while psychoticism predicted a combined category of mood and anxiety diagnoses. Despite intelligence being a significant predictor of the majority of the included diagnoses, adjusting for intelligence did not substantially influence any trait-disorder associations. CONCLUSION: The results confirm high neuroticism as a prospective vulnerability factor for mental disorder and indicate high psychoticism to be a potential risk factor for mood and anxiety disorders. These associations are not confounded by intelligence.

Diagnosis and prevalence of diabetic polyneuropathy: a cross-sectional study of Danish patients with type 2 diabetes.

BACKGROUND AND PURPOSE: Diabetic polyneuropathy (DPN) is a common complication of diabetes. Using the Toronto criteria for diabetic polyneuropathy and the grading system for neuropathic pain, the performance of neuropathy scales and questionnaires were assessed by comparing them to a clinical gold standard diagnosis of DPN and painful DPN in a cohort of patients with recently diagnosed type 2 diabetes. METHODS: A questionnaire on neuropathy and pain was sent to a cohort of 5514 Danish type 2 diabetes patients. A sample of 389 patients underwent a detailed clinical examination and completed neuropathy questionnaires and scales. RESULTS: Of the 389 patients with a median diabetes duration of 5.9 years, 126 had definite DPN (including 53 with painful DPN), 88 had probable DPN and 53 had possible DPN. There were 49 patients with other causes of polyneuropathy, neuropathy symptoms or pain, 10 with subclinical DPN and 63 without DPN. The sensitivity of the Michigan Neuropathy Screening Instrument questionnaire to detect DPN was 25.7% and the specificity 84.6%. The sensitivity of the Toronto Clinical Neuropathy Scoring System, including questionnaire and clinical examination, was 62.9% and the specificity was 74.6%. CONCLUSIONS: Diabetic polyneuropathy affects approximately one in five Danish patients with recently diagnosed type 2 diabetes but neuropathic pain is not as common as previously reported. Neuropathy scales with clinical examination perform better compared with questionnaires alone, but better scales are needed for future epidemiological studies.

Associations between functional polymorphisms and response to biological treatment in Danish patients with psoriasis.

Biological agents including anti-tumor necrosis factor (anti-TNF; adalimumab, infliximab, etanercept) and anti-interleukin-12/13 (IL12/23; ustekinumab) are essential for treatment of patients with severe psoriasis. However, a significant proportion of the patients do not respond to a specific treatment. Pharmacogenetics might be a way to predict treatment response. Using a candidate gene approach, 62 mainly functional single-nucleotide polymorphisms (SNPs) in 44 different genes were evaluated in 478 Danish patients with psoriasis undergoing 376 series of anti-TNF treatment and 230 series of ustekinumab treatment. Associations between genetic variants and treatment outcomes (drug survival and Psoriasis Area Severity Index reduction) were assessed using logistic regression analyses (crude and adjusted for gender, age, psoriatic arthritis and previous treatment). After correction for multiple testing controlling the false discovery rate, six SNPs (IL1B (rs1143623, rs1143627), LY96 (rs11465996), TLR2 (rs11938228, rs4696480) and TLR9 (rs352139)) were associated with response to anti-TNF treatment and 4 SNPs (IL1B (rs1143623, rs1143627), TIRAP (rs8177374) and TLR5 (rs5744174)) were associated with response to ustekinumab treatment (q<0.20). The results suggest that genetic variants related to increased IL-1ß levels may be unfavorable when treating psoriasis with either anti-TNF or ustekinumab, whereas genetic variants related to high interferon-γ levels may be favorable when treating psoriasis with ustekinumab.

Prognostic factors associated with mortality in patients with septic arthritis: a descriptive cohort study.

OBJECTIVES: To evaluate the 30-day mortality rate of septic arthritis (SA) in adults in Funen, central Denmark, and to explore whether, at the time of SA presentation, risk factors for the 30-day mortality rate could be revealed. Our secondary objective was to describe the microbiological aetiologies, systemic signs of inflammation, and co-morbidity. METHOD: A descriptive study identifying patients with SA from central Denmark, during the period 2006-2013, by the use of joint fluid culture data retrieved from the electronic database at the Department of Clinical Microbiology, Odense University Hospital. Patients with a positive joint fluid culture were considered eligible and their medical records were examined. RESULTS: We identified 215 patients with SA, mean age 64.8 years. At presentation, mean C-reactive protein (CRP) was 204 mg/L, mean white blood cell count (WBC) 11.9 × 109/L, and mean body temperature 37.6°C. A total of 101 patients (47%) had a prosthetic joint, 46 (21%) had an inflammatory joint disease, and 24 (11%) had diabetes mellitus (DM). Staphylococcus aureus was the most common pathogen (104 patients, 48.4%). The 30-day mortality rate was 9.3% and the significant risk factor for death was liver disease at time of presentation [odds ratio (OR) 40.40, 95% confidence interval (CI) 5.38-303]. The other factors tested such as age > 65 years, elevated temperature, rheumatoid arthritis (RA), prostheses, and diabetes mellitus (DM) did not reach statistical significance. CONCLUSIONS: In our sample of patients with SA, we found a 30-day mortality rate in almost one in 10 adults. Among possible explanations, our study indicates that liver disease is a clinically relevant risk factor.

Plasma volume reduction and hematological fluctuations in high-level athletes after an increased training load.

The time course of plasma volume (PV) reduction following an increased training load period is unknown and was investigated. The accompanying fluctuations in [Hb] and OFF-hr score were analyzed in the Athlete Biological Passport. Further, whether fluctuations in plasma albumin, soluble transferrin receptors (sTfR), and pro-atrial natriuretic peptide (proANP) concentrations correlate with PV fluctuations was investigated. Eleven high-level competitive cyclists were investigated for 3 weeks. After initial measurements in week 1, training load was increased ~250% in week 2 followed by a reversion to baseline training load in week 3. PV and hematological variables were determined frequently during all weeks. The higher training load in week 2 increased (P<.001) PV 10%, while [Hb] and OFF-hr score decreased ~6% (P<.01) and ~16% (P<.001), respectively. PV and [Hb] returned to baseline within 2 and 4 days after week 2, respectively, while OFF-hr score remained reduced for 6 days. Further, one and three atypical blood profiles of the ABP occurred during weeks 2 and 3, respectively. Individual changes in albumin, sTfR, and proANP only correlated weakly (R2 <.20) with PV fluctuations. In conclusion, PV and [Hb] fluctuations caused by an elevated training load period were reverted within 2 and 4 days after returning to baseline training load, respectively, while OFF-hr remained altered for 6 days. Furthermore, some atypical blood profiles were induced during and subsequent to the increased training load, demonstrating the importance of knowledge on naturally occurring hematological fluctuations. Finally, concentrations of albumin, sTfR, and proANP could not explain PV fluctuations.

Extreme mobility enhancement of two-dimensional electron gases at oxide interfaces by charge-transfer-induced modulation doping.

Two-dimensional electron gases (2DEGs) formed at the interface of insulating complex oxides promise the development of all-oxide electronic devices. These 2DEGs involve many-body interactions that give rise to a variety of physical phenomena such as superconductivity, magnetism, tunable metal-insulator transitions and phase separation. Increasing the mobility of the 2DEG, however, remains a major challenge. Here, we show that the electron mobility is enhanced by more than two orders of magnitude by inserting a single-unit-cell insulating layer of polar La(1-x)Sr(x)MnO3 (x = 0, 1/8, and 1/3) at the interface between disordered LaAlO3 and crystalline SrTiO3 produced at room temperature. Resonant X-ray spectroscopy and transmission electron microscopy show that the manganite layer undergoes unambiguous electronic reconstruction, leading to modulation doping of such atomically engineered complex oxide heterointerfaces. At low temperatures, the modulation-doped 2DEG exhibits Shubnikov-de Haas oscillations and fingerprints of the quantum Hall effect, demonstrating unprecedented high mobility and low electron density.

Modelling gastric evacuation in gadoids feeding on crustaceans.

A mechanistic, prey surface-dependent model was expanded to describe the course and rate of gastric evacuation in predatory fishes feeding on crustacean prey with robust exoskeletons. This was accomplished by adding a layer of higher resistance to the digestive processes outside the inner softer parts of a prey cylinder abstraction and splitting up the prey evacuation into two stages: an initial stage where the exoskeleton is cracked and a second where the prey remains are digested and evacuated. The model was parameterized for crustaceans with different levels of armour fed to Atlantic cod Gadus morhua or whiting Merlangius merlangus and recovered from the stomachs at different post-prandial times. The prey species were krill Meganyctiphanes norvegica; shrimps and prawns Crangon crangon, Pandalus borealis, Pandalus montagui and Eualus macilentus; crabs Liocarcinus depurator and Chionoecetes opilio. In accordance with the apparent intraspecific isometric relationship between exoskeleton mass and total body mass, the model described stage duration and rate of evacuation of the crustacean prey independently of meal and prey sizes. The duration of the first stage increased (0-33 h) and the evacuation rate of both stages decreased (by a half) with increasing level of the crustacean armament in terms of chitin and ash. A common, interspecific parameterization of the model within each of the categories krill, shrimp and crab can probably be used if the contents of chitin and ash are similar among prey species per prey category. The model offers a simple way for estimating evacuation rates from stomach content data in order to obtain food consumption rates of wild fishes, provided that information about digestion stage of crustacean prey is available.

The diet of whiting Merlangius merlangus in the western Baltic Sea.

The diet of whiting Merlangius merlangus in the western Baltic Sea was investigated and compared to the diet in the southern North Sea. Clupeids were important prey in both areas, but especially in the western Baltic Sea where they constituted up to 90% of the diet of larger individuals. Gobies, brown shrimps and polychaetes were the main prey of juveniles in the western Baltic Sea, while a wider range of species were consumed in the North Sea. The shift to piscivory occurred at smaller sizes in the western Baltic Sea and the fish prey consumed was proportionately larger than in the southern North Sea. Estimates of prey abundance and food intake of M. merlangus are required to evaluate its predatory significance in the western Baltic Sea, but its diet suggests that it could be just as significant a fish predator here as in the southern North Sea.

Hypoxia increases exercise heart rate despite combined inhibition of ß-adrenergic and muscarinic receptors.

Hypoxia increases the heart rate response to exercise, but the mechanism(s) remains unclear. We tested the hypothesis that the tachycardic effect of hypoxia persists during separate, but not combined, inhibition of ß-adrenergic and muscarinic receptors. Nine subjects performed incremental exercise to exhaustion in normoxia and hypoxia (fraction of inspired O2 = 12%) after intravenous administration of 1) no drugs (Cont), 2) propranolol (Prop), 3) glycopyrrolate (Glyc), or 4) Prop + Glyc. HR increased with exercise in all drug conditions (P < 0.001) but was always higher at a given workload in hypoxia than normoxia (P < 0.001). Averaged over all workloads, the difference between hypoxia and normoxia was 19.8 ± 13.8 beats/min during Cont and similar (17.2 ± 7.7 beats/min, P = 0.95) during Prop but smaller (P < 0.001) during Glyc and Prop + Glyc (9.8 ± 9.6 and 8.1 ± 7.6 beats/min, respectively). Cardiac output was enhanced by hypoxia (P < 0.002) to an extent that was similar between Cont, Glyc, and Prop + Glyc (2.3 ± 1.9, 1.7 ± 1.8, and 2.3 ± 1.2 l/min, respectively, P > 0.4) but larger during Prop (3.4 ± 1.6 l/min, P = 0.004). Our results demonstrate that the tachycardic effect of hypoxia during exercise partially relies on vagal withdrawal. Conversely, sympathoexcitation either does not contribute or increases heart rate through mechanisms other than ß-adrenergic transmission. A potential candidate is α-adrenergic transmission, which could also explain why a tachycardic effect of hypoxia persists during combined ß-adrenergic and muscarinic receptor inhibition.

Oral cyclosporine A treatment is feasible after myeloablative conditioning in allogeneic hematopoietic stem cell transplantation.

WHAT IS KNOWN AND OBJECTIVE: The target level and route of administration of cyclosporine A (CsA) differ between transplantation centres. It is unclear whether oral CsA is sufficient to maintain target level of CsA. CASE SUMMARY: We retrospectively analysed data from 48 adult patients, who underwent myeloablative hematopoietic stem cell transplantation. Twenty-one patients (44%) tolerated CsA orally throughout the transplantation period without increased incidence of acute graft versus host disease(aGVHD). Low concentration of CsA in week 2 was associated with increased incidence of aGVHD. WHAT IS NEW AND CONCLUSION: Oral administration of CsA is safe, less time-consuming and economically advantageous. Close monitoring of CsA concentration is important.

Measurement of unique magnetic and superconducting phases in oxygen-doped high-temperature superconductors La(2-x)Sr(x)CuO(4+y).

We present a combined magnetic neutron scattering and muon spin rotation study of the nature of the magnetic and superconducting phases in electronically phase separated La(2-x)Sr(x)CuO(4+y), x=0.04, 0.065, 0.09. For all samples, we find long-range modulated magnetic order below T(N) is approximately equal to Tc=39 K. In sharp contrast to oxygen-stoichiometric La(2-x)Sr(x)CuO(4), we find that the magnetic propagation vector as well as the ordered magnetic moment is independent of Sr content and consistent with that of the "striped" cuprates. Our study provides direct proof that superoxygenation in La(2-x)Sr(x)CuO(4+y) allows the spin stripe ordered phase to emerge and phase separate from superconducting regions with the hallmarks of optimally doped oxygen-stoichiometric La(2-x)Sr(x)CuO(4).

Structure and magnetic properties of Cu3Ni2SbO6 and Cu3Co2SbO6 Delafossites with honeycomb lattices.

The crystal structures of two Delafossites, Cu3Ni2SbO6 and Cu3Co2SbO6, are determined by high-resolution synchrotron powder X-ray diffraction. The Ni and Co are ordered with respect to Sb in the layer of edge sharing octahedra, forming magnetic layers with honeycomb geometry. High-resolution electron microscopy confirms ordering, and selected-area electron diffraction patterns identify examples of the stacking polytypes. Low temperature synthetic treatments result in disordered stacking of the layers, but heating just below their melting points results in nearly fully ordered stacking variants. The major variant in both cases is a monoclinic distortion of a 6-layer Delafossite polytype, but a significant amount of a 2-layer polytype is also present for the Ni case. The antiferromagnetic ordering with transitions, at 22.3 and 18.5 K for Ni and Co variants, respectively, is investigated by temperature and field dependent magnetization, as well as specific heat. The sharp magnetic transitions support the presence of well developed 2:1 ordering of the Co:Sb or Ni:Sb ions in the honeycomb layers. Neutron diffraction measurements at 4 K are used to determine the magnetic structures. For both the Ni and Co phases, the propagation vector is k = [100], and can be described as alternating ferromagnetic chains in the metal-oxide plane giving an overall antiferromagntic "zigzag" alignment. While orientation of the magnetic moments of the Co is along the b-axis, the Ni moments are in the ac plane, approximately parallel to the stacking direction. Bulk magnetization properties are discussed in terms of their magnetic structures.

Trimethoprim use in early pregnancy and the risk of miscarriage: a register-based nationwide cohort study.

The antibiotic trimethoprim acts as a folate antagonist. Since trophoblasts are very sensitive to drugs that interfere with the folic acid cycle and thereby inhibit DNA synthesis, use of trimethoprim during the first trimester could be associated with miscarriage. A nationwide cohort study including all women in Denmark with a registered pregnancy between 1997 and 2005 was conducted. We used nationwide registers to identify all women giving birth, having a record of miscarriage or induced abortion. Data on exposure to trimethoprim were obtained from the National Prescription Register. Cox proportional hazard regression analysis with exposure to trimethoprim as a time-dependent variable was used to estimate the risk of miscarriage. The adjusted hazard ratio of having a miscarriage after exposure to trimethoprim in the first trimester compared to non-exposure was 2∙04 (95% confidence interval 1∙43-2∙91). Our results indicate that trimethoprim exposure in the first trimester is associated with a doubling of the hazard of miscarriage.

Prey exoskeletons influence the course of gastric evacuation in Atlantic cod Gadus morhua.

This study examined the effects of prey exoskeleton characteristics on gastric evacuation patterns in Atlantic cod Gadus morhua. Three distinct stages were highlighted in the gastric evacuation of crustacean prey characterized by a robust exoskeleton. The experiments confirmed that the three shrimp species, Pandalus borealis, Pandalus montagui and Eualus macilentus, and the crab Chionoecetes opilio, were evacuated from the stomach at different rates. The duration of all stages increased with increasing ash (and carbonate) content of the fresh prey. Thickness, chemical composition and morphology of the prey exoskeleton all affected gastric evacuation: duration of initial delay, overall evacuation rate and a decreased evacuation rate at the end of the process. The power exponential function (PEF), with its shape parameter, described the course of evacuation for these prey types well, especially the initial delay. The PEF does not, however, allow describing evacuation by the current stomach content mass independent of meal size, which limits its usefulness in estimating consumption rates of wild G. morhua. To predict and describe gastric evacuation of prey with a robust exoskeleton, it is therefore suggested that the square-root function be expanded with an initial lag phase, coupled to the mechanistically based cylinder model of gastric evacuation.

Quantum spin liquid in frustrated one-dimensional LiCuSbO4.

A quantum magnet, LiCuSbO4, with chains of edge-sharing spin-1/2 CuO6 octahedra is reported. While short-range order is observed for T<10 K, no zero-field phase transition or spin freezing occurs down to 100 mK. Specific heat indicates a distinct high-field phase near the 12 T saturation field. Neutron scattering shows incommensurate spin correlations with q=(0.47±0.01)π/a and places an upper limit of 70 µeV on any spin gap. Exact diagonalization of 16-spin easy-plane spin-1/2 chains with competing ferro- and antiferromagnetic interactions (J1=-75 K, J2=34 K) accounts for the T>2 K data.

Spin ½ Delafossite honeycomb compound Cu5SbO6.

Cu(5)SbO(6) is found to have a monoclinic, Delafossite-derived structure consisting of alternating layers of O-Cu(I)-O sticks and magnetic layers of Jahn-Teller distorted Cu(II)O(6) octahedra in an edge sharing honeycomb arrangement with Sb(V)O(6) octahedra. This yields the structural formula Cu(I)(3)Cu(II)(2)Sb(V)O(6). Variants with ordered and disordered layer stacking are observed, depending on the synthesis conditions. The spin ½ Cu(2+) ions form dimers in the honeycomb layer. The magnetic susceptibility measured between 5 and 300 K is characteristic of the presence of a singlet-triplet spin gap of 189 K. High resolution synchrotron X-ray diffraction studies indicate that changes in the intra- or interdimer distances between 300 and 20 K, such as might indicate an increase in strength of the Peierls-like distortion through the spin gap temperature, if present, are very small. A comparison to the NaFeO(2)-type Cu(2+) honeycomb compounds Na(3)Cu(2)SbO(6) and Na(2)Cu(2)TeO(6) is presented.

Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near-maximal stroke volume or zero fluid balance?

BACKGROUND: We aimed to investigate whether fluid therapy with a goal of near-maximal stroke volume (SV) guided by oesophageal Doppler (ED) monitoring result in a better outcome than that with a goal of maintaining bodyweight (BW) and zero fluid balance in patients undergoing colorectal surgery. METHODS: In a double-blinded clinical multicentre trial, 150 patients undergoing elective colorectal surgery were randomized to receive fluid therapy after either the goal of near-maximal SV guided by ED (Doppler, D group) or the goal of zero balance and normal BW (Zero balance, Z group). Stratification for laparoscopic and open surgery was performed. The postoperative fluid therapy was similar in the two groups. The primary endpoint was postoperative complications defined and divided into subgroups by protocol. Analysis was performed by intention-to-treat. The follow-up was 30 days. The trial had 85% power to show a difference between the groups. RESULTS: The number of patients undergoing laparoscopic or open surgery and the patient characteristics were similar between the groups. No significant differences between the groups were found for overall, major, minor, cardiopulmonary, or tissue-healing complications (P-values: 0.79; 0.62; 0.97; 0.48; and 0.48, respectively). One patient died in each group. No significant difference was found for the length of hospital stay [median (range) Z: 5.00 (1-61) vs D: 5.00 (2-41); P=0.206]. CONCLUSIONS: Goal-directed fluid therapy to near-maximal SV guided by ED adds no extra value to the fluid therapy using zero balance and normal BW in patients undergoing elective colorectal surgery.

Influences of potential predictor variables on gastric evacuation in Atlantic cod Gadus morhua feeding on fish prey: parameterization of a generic model.

The parameter values of a generic model of gastric evacuation were estimated from evacuation data on Atlantic cod Gadus morhua fed meals of four fish prey: herring Clupea harengus, sprat Sprattus sprattus, lesser sandeel Ammodytes tobianus and dab Limanda limanda. The effects on evacuation of photoperiod and pre-experimental treatment of prey were also tested. Freshly killed A. tobianus were evacuated from the stomach of G. morhua at a rate similar to the value estimated from conspecifics kept deep-frozen and subsequently thawed prior to the evacuation experiment. The evacuation rate in G. morhua exposed to continuous light did not differ from the rate obtained from fish maintained under a 12L:12D photoperiod. The evacuation rates estimated from the latter fish in the dark and light periods, respectively, were likewise similar. These results indicate that the resistance of prey to the digestive processes is not altered significantly by the pre-experimental treatment of prey and that there is no diurnal variation per se in the rate of evacuation for G. morhua. Therefore, it is believed that the present parameterization of the evacuation model should prove especially useful for studying the role of G. morhua as a top predator in natural systems.

Does the cylinder model of gastric evacuation predict observed evacuation of mixed meals of prey of contrasting geometries in a piscivorous fish?

The simple surface abstraction of the cylinder model (each prey as well as the total stomach contents is considered a cylinder that is gradually reduced by successive peeling off its curved side) was challenged by data on evacuation of a meal composed of three sandeels Ammodytes tobianus and a dab Limanda limanda fed to Atlantic cod Gadus morhua. While the body shape of A. tobianus comes close to that of a cylinder, the flatfish L. limanda takes a discoid form. As opposed to a modified form of the cylinder model, where the contrasting geometries of the fish prey were implemented, the simple, original cylinder model held the potential to predict evacuation of the individual prey types as well as the total stomach contents. Thus, the present study adds significantly to the increasing evidence that points to the generic nature of the model and its implicit square root function. Also, the present study corroborated a basic assumption that the variability of evacuation data not accounted for by the cylinder model primarily can be ascribed to the intraspecific variation in gastric performance of the predator.