ITER collective Thomson scattering-Preparing to diagnose fusion-born alpha particles (invited).

The ITER Collective Thomson scattering (CTS) diagnostic will measure the dynamics of fusion-born alpha particles in the burning ITER plasma by scattering a 1 MW 60 GHz gyrotron beam off fast-ion induced fluctuations in the plasma. The diagnostic will have seven measurement volumes across the ITER cross section and will resolve the alpha particle energies in the range from 300 keV to 3.5 MeV; importantly, the CTS diagnostic is the only diagnostic capable of measuring confined alpha particles for energies below ∼1.7 MeV and will also be sensitive to the other fast-ion populations. The temporal resolution is 100 ms, allowing the capture of dynamics on that timescale, and the typical spatial resolution is 10-50 cm. The development and design of the in-vessel and primary parts of the CTS diagnostic has been completed. This marks the beginning of a new phase of preparation to maximize the scientific benefit of the diagnostic, e.g., by investigating the capability to contribute to the determination of the fuel-ion ratio and the bulk ion temperature as well as integrating data analysis with other fast-ion and bulk-ion diagnostics.

Fast production of microwave component prototypes by additive manufacturing and copper coating.

We present a novel method for efficient production of prototypes of microwave components by fused depositing modeling, also known as 3D plastic printing, and vapor deposition coating of a 1 µm copper layer. We demonstrate that the properties of the components follow the predicted performance for low power microwave propagation. The production method offers new opportunities for cheap and efficient production of mock-ups and prototypes of advanced-geometry components for tests with low-power microwaves.

Trends in the use of patient-reported outcome measures for inguinal hernia repair: a quantitative systematic review.

PURPOSE: To quantitatively assess the use of patient-reported outcome measures in studies involving patients undergoing inguinal hernia repair. METHODS: We performed a systematic literature search in Medline and EMBASE. We included all studies published between 2000 and 2019 that involved > 5 patients receiving inguinal hernia repair and evaluated a postoperative patient-reported outcome measure. Studies were stratified in 5-year intervals. We extracted data on which patient-reported outcome measure was used, its time of administration, study design, and the size and composition of the study population. Data were presented using descriptive statistics. RESULTS: We included 929 studies that covered 81 different patient-reported outcome measures. Of these, the Short-Form 36 was the most commonly used generic instrument (14%), the Carolinas Comfort Scale was the most commonly used hernia-specific instrument (5%), and the Visual Analogue Scale was the most commonly used domain-specific instrument (70%). There was a proportional decrease in the use of generic instruments, from 24% of studies in 2000-2004 to only 14% of studies in 2015-2019. Conversely, there was an increase in the use of hernia-specific instruments, from 0% in 2000-2004 to 18% in 2015-2019. CONCLUSIONS: There is heterogeneity in the use of patient-reported outcome measures in the field of inguinal hernia research. The use of hernia-specific instruments is increasing, the use of generic instruments is decreasing, and the use of domain-specific instruments remains consistently high. This study serves as a repository of all available patient-reported outcome measures relevant to patients undergoing inguinal hernia repair.

Adhesive bowel obstruction: Incidence, recurrence and 30-day mortality in Danish women 1984-2013 - A national cohort study.

BACKGROUND: Adhesive bowel obstruction is a serious complication to abdominal surgery. It is unknown whether incidence and mortality rates have changed as new surgical procedures were introduced. METHODS: In a nationwide cohort of Danish women from 1984 to 2013, incidence of adhesive bowel obstruction and 30 days mortality were presented as standardized rates. Impact of treatment was analyzed by Cox regression and recurrent disease characterized by Kaplan Meyer estimates. RESULTS: Incidence of adhesive bowel obstruction increased 50% among women with no prior abdominal surgery. These women had 3-5 times lower incidence than those with a surgical record. 30-day mortality rate was 13%, highest in patients treated non-operatively. The mortality declined in recent years. Recurrent disease had lower mortality rates compared to the first episode. CONCLUSIONS: The incidence of adhesive bowel obstruction increased during the last 30 years, mortality after the first episode is high, while recurrent disease shows declining mortality rates.

High complication rates during and after repeated Lichtenstein or laparoscopic inguinal hernia repairs in the same groin: a cohort study based on medical records.

PURPOSE: Performing two anterior or two posterior inguinal hernia repairs in the same groin contradict guidelines. Nevertheless, there can be indications for using the same approach at reoperation, and information on complications other than the risk of a third repair and chronic pain is lacking in the literature. The aim was to assess intraoperative events and postoperative complications after two Lichtenstein repairs or laparoscopic inguinal hernia repairs in the same groin. METHODS: This nationwide cohort study included patients that had received two Lichtenstein repairs (Lichtenstein-Lichtenstein) or two laparoscopic (Laparoscopy-Laparoscopy) inguinal hernia repairs in the same groin. Patients were identified in the Danish Hernia Database and outcomes were identified in medical records during a period of 6 years. Outcomes were intraoperative events that deviated from a standard repair and 1-year postoperative complications classified according to the Clavien-Dindo classification. Outcomes were reported separately for the two cohorts. RESULTS: Among the included 102 Lichtenstein reoperations, 27% of the repairs had intraoperative events, with drain placement being most common (10%). Half of the reoperations resulted in complications where infection (15%) and hematoma (12%) were most frequent. Among the 58 laparoscopic reoperations, 16% had an intraoperative event where bleeding requiring clips was most common (10%). Half of the reoperations resulted in a complication with surgery in general anesthesia in the same groin area being the most frequent complication (9%). CONCLUSIONS: Intraoperative events and 1-year postoperative complications were high for both Lichtenstein-Lichtenstein and Laparoscopy-Laparoscopy, and the results therefore support guidelines that recommend another approach at reoperation.

Socioeconomic status and risk of intensive care unit admission with sepsis.

BACKGROUND: A recent study showed higher risk of bacteremia among individuals with low socioeconomic status (SES). We hypothesized that patients with a low SES have a higher risk of intensive care unit (ICU) admission with sepsis compared to patients with higher SES. METHODS: This was a case-control study on patients with sepsis admitted to the ICU at Aarhus University Hospital, Denmark (2008-2010). Three hundred eighty-three sepsis patients were matched on sex, age, and zip code with controls retrieved from the background population. SES was defined as highest accomplished educational level, yearly income, cohabitation status, and occupation. The odds ratio (OR) of being admitted with sepsis to the ICU was calculated using conditional logistic regression, adjusting for the Charlson Comorbidity Index and the remaining socioeconomic variables. RESULTS: The adjusted odds of being admitted to the ICU with sepsis were significantly higher among individuals living alone (OR 1.72, 95% confidence interval (CI) 1.33-2.24, P < 0.001) compared to individuals living with a cohabitant. Individuals outside the labor force had an adjusted OR of 3.50 (CI 2.36-5.18, P < 0.001) compared to individuals in the labor force. Individuals with a medium level of education had an increased risk of admission to the ICU with sepsis compared to a high level of education (adjusted OR 1.43, CI 1.02-2.00, P = 0.04). There was no significant association between income and risk of ICU admission with sepsis after adjustment. CONCLUSION: Individuals living alone, being outside the labor force, or having a medium level of education had significantly higher risk of ICU admission with sepsis.

Paradoxical increase in nasal airway resistance after topical nasal decongestion - does it really exist? A retro- and prospective study.

OBJECTIVE: To explore the prevalence and reproducibility of paradoxically increased nasal airway resistance after decongestion of the nasal mucosa as well as to identify patient-related factors associated with it. DESIGN: Retrospective analysis of all rhinomanometric measurements carried out at one ENT department in Sweden in the time between 1990 and 2010. In the baseline material, 207 of 4435 patients (4.7%) showed a paradoxically increased nasal airway resistance >20%. A follow-up rhinomanometry was performed in patients eligible for the study. SETTING: Secondary care centre. PARTICIPANTS: Patients with paradoxically increased nasal airway resistance >20% who returned a complete questionnaire and had not undergone any nasal- or sinus surgery. Thirty-six patients (33-72 years) were eligible for the study. MAIN OUTCOME MEASURES: All patients answered a questionnaire and underwent rhinoscopy. Nasal airway resistance before and after decongestion with 0.1% xylometazoline hydrochloride was assessed by active anterior rhinomanometry. RESULTS: Twelve of thirty-six patients (33%) showed a paradoxically increased nasal airway resistance in the follow-up rhinomanometry. No patient-related factors were identified. CONCLUSION: The results indicate the existence and reproducibility of paradoxically increased nasal airway resistance.

Who are the cancer survivors? A nationwide study in Denmark, 1943-2010.

BACKGROUND: No nationwide studies on social position and prevalence of comorbidity among cancer survivors exist. METHODS: We performed a nationwide prevalence study defining persons diagnosed with cancer 1943-2010 and alive on the census date 1 January 2011 as cancer survivors. Comorbidity was compared by social position with the non-cancer population. RESULTS: Cancer survivors composed 4% of the Danish population. Somatic comorbidity was more likely among survivors (OR 1.59, 95% CI 1.57-1.60) and associated with higher age, male sex, short education, and living alone among survivors. CONCLUSIONS: Among cancer survivors, comorbidity is common and highly associated with social position.

Effects of antegrade and retrograde machine perfusion preservation on cardiac function after transplantation in canines.

INTRODUCTION: Most studies investigating machine perfusion preservation for heart transplantation perfuse through the aortic root (antegrade), but the coronary sinus (retrograde) is a potential option. We hypothesized that retrograde machine perfusion provides better functional protection than static storage, while avoiding the potential irregular perfusion seen when aortic insufficiency occurs with antegrade perfusion. MATERIALS AND METHODS: Eighteen canine donor hearts were arrested, procured, and stored in modified Celsior solution for 4 hours by using either static storage at 0°C to 4°C (n = 6) or machine perfusion preservation at 5°C via the aortic root (antegrade, n = 6) or coronary sinus (retrograde, n = 6). Lactate and myocardial oxygen consumption were measured in perfused hearts. Hearts were reimplanted and reperfused for 6 hours with hourly function calculated by using the preload recruitable stroke work (PRSW) relation. Myocardial water content was determined at the end of the experiment. RESULTS: Storage lactate levels and myocardial oxygen consumption were comparable in both perfused groups. The PRSW was increased immediately after bypass in the antegrade group (120.6 ± 19.1 mm Hg) compared with the retrograde (75.0 ± 11.3 mm Hg) and static (78.1 ± 10.5 mm Hg) storage groups (P < .05). At the end of reperfusion, PRSW was higher in the retrograde group (69.8 ± 7.4 mm Hg) compared with the antegrade (40.1 ± 6.8 mm Hg) and static (39.9 ± 10.9 mm Hg) storage groups (P < .05). Myocardial water content was similar among groups. CONCLUSIONS: Both antegrade and retrograde perfusion demonstrated excellent functional preservation, at least equivalent to static storage. Initial function was superior in the antegrade group, but the retrograde hearts displayed better function late after reperfusion. Neither perfused group developed significant edema. Machine perfusion preservation is a promising technique for improving results of cardiac transplantation.

Treatment with a topical glucocorticoid, budesonide, reduced the variability of rhinomanometric nasal airway resistance.

BACKGROUND: Previous rhinomanometry studies have shown significant long-term variability of the nasal airway resistance and questioned the clinical validity of rhinomanometry. RESEARCH QUESTION: Could treatment with a topical glucocorticoid, budesonide, influence the long-term variability of active anterior rhinomanometry? METHODS: Eight healthy volunteers participated in an unblinded controlled trial without, and later with, nasal budesonide once a day for 5 months. Their nasal airway resistance was measured every two weeks with active anterior rhinomanometry before and after decongestion with xylometazoline hydrochloride. In addition, subjective nasal obstruction was evaluated on a Visual Analogue Scale before each measurement. The participants had a year earlier been investigated with rhinomanometry every two weeks during 5 months but without budesonide treatment. We compared the variability of nasal airway resistance during the two periods with and without treatment with topical budesonide. RESULTS: Budesonide significantly reduced mean nasal airway resistance and the standard deviation of the mean after decongestion for 6 of 8 participants. The mean reduction of the nasal airway resistance was 40% for the decongested nasal cavity compared to the period without treatment with nasal budesonide. Subjective nasal obstruction assessed by Visual Analogue Scale was reduced in 3 of the 8 participants. CONCLUSION: The variability of nasal airway resistance was significantly reduced by treatment with topical budesonide for 6 out of 8 healthy volunteers participating in an unblinded repeated 5 month trial where the participants served as their own controls.

Socioeconomic position and survival after cervical cancer: influence of cancer stage, comorbidity and smoking among Danish women diagnosed between 2005 and 2010.

BACKGROUND: In an attempt to decrease social disparities in cancer survival, it is important to consider the mechanisms by which socioeconomic position influences cancer prognosis. We aimed to investigate whether any associations between socioeconomic factors and survival after cervical cancer could be explained by socioeconomic differences in cancer stage, comorbidity, lifestyle factors or treatment. METHODS: We identified 1961 cases of cervical cancer diagnosed between 2005 and 2010 in the Danish Gynaecological Cancer database, with information on prognostic factors, treatment and lifestyle. Age, vital status, comorbidity and socioeconomic data were obtained from nationwide administrative registers. Associations between socioeconomic indicators (education, income and cohabitation status) and mortality by all causes were analysed in Cox regression models with inclusion of possible mediators. Median follow-up time was 3.0 years (0.01-7.0). RESULTS: All cause mortality was higher in women with shorter rather than longer education (hazard ratio (HR), 1.46; 1.20-1.77), among those with lower rather than higher income (HR, 1.32; 1.07-1.63) and among women aged<60 years without a partner rather than those who cohabited (HR, 1.60; 1.29-1.98). Socioeconomic differences in survival were partly explained by cancer stage and less by comorbidity or smoking (stage- and comorbidity-adjusted HRs being 1.07; 0.96-1.19 for education and 1.15; 0.86-1.52 for income). CONCLUSION: Socioeconomic disparities in survival after cervical cancer were partly explained by socioeconomic differences in cancer stage. The results point to the importance of further investigations into reducing diagnosis delay among disadvantaged groups.

Polarizer design for millimeter-wave plasma diagnostics.

Radiation from magnetized plasmas is in general elliptically polarized. In order to convert the elliptical polarization to linear polarization, mirrors with grooved surfaces are currently employed in our collective Thomson scattering diagnostic at ASDEX Upgrade. If these mirrors can be substituted by birefringent windows, the microwave receivers can be designed to be more compact at lower cost. Sapphire windows (a-cut) as well as grooved high density polyethylene windows can serve this purpose. The sapphire window can be designed such that the calculated transmission of the wave energy is better than 99%, and that of the high density polyethylene can be better than 97%.

Psychiatric disorders in women with fertility problems: results from a large Danish register-based cohort study.

STUDY QUESTION: Do women who don't succeed in giving birth after an infertility evaluation have a higher risk of psychiatric disorders compared with women who do? SUMMARY ANSWER: The results indicated that being unsuccessful in giving birth after an infertility evaluation could be an important risk factor for psychiatric disorders. WHAT IS KNOWN ALREADY: Several studies have investigated the association between fertility treatment and psychological distress, but the results from these studies show substantial variation and lack of homogeneity that may be due to methodological limitations. STUDY DESIGN, SIZE AND DURATION: A retrospective cohort study was designed using data from a cohort of 98 320 Danish women evaluated for fertility problems during 1973-2008 and linked to several Danish population-based registries. All women were followed from the date of first infertility evaluation until date of hospitalization for the psychiatric disorder in question, date of emigration, date of death or 31 December 2008, whichever occurred first. Owing to the precise linkage between the infertility cohort and the Danish population-based registries, using the unique Danish personal identification number, virtually no women were lost to follow-up. PARTICIPANTS/MATERIALS, SETTING AND METHODS: Information on reproductive status for all women in the infertility cohort was obtained by linkage to the Danish Medical Birth Registry. A total of 53 547 (54.5%) women gave birth after the initial infertility evaluation, whereas 44 773 (45.5%) women did not gave birth after the evaluation. To determine psychiatric disorders diagnosed in the women after enrolment in the infertility cohort, the cohort was linked to the Danish Psychiatric Central Registry. A total of 4633 women were hospitalized for a psychiatric disorder. The Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for the association between parity status after the initial infertility evaluation and risk of hospitalization for various groups of psychiatric disorders, including 'all mental disorders' and six main discharge subgroups labelled: 'alcohol and intoxicant abuse', 'schizophrenia and psychoses', 'affective disorders', 'anxiety, adjustment and obsessive compulsive disorders', 'eating disorder' and 'other mental disorders'. MAIN RESULTS AND THE ROLE OF CHANCE: The incidence rate for all mental disorders was 393 cases per 100 000 person-years among women who did not succeed in giving birth after the infertility evaluation but only 353 cases per 100 000 person-years among women who succeeded in giving birth after the infertility evaluation. Women not giving birth after the infertility evaluation had an increased risk of hospitalization for all mental disorders (HR 1.17, 95% CI 1.11; 1.25), alcohol and intoxicant abuse (HR 2.02, 95% CI 1.69; 2.41), schizophrenia and psychoses (HR 1.46, 95% CI 1.17; 1.82) and other mental disorders (HR 1.42, 95% CI 1.27; 1.58) compared with women who gave birth after the infertility evaluation. In contrast, the risk of affective disorders (HR 0.90, 95% CI 0.81; 0.99) was decreased among women not giving birth after the infertility evaluation. Finally, the risk of anxiety, adjustment and obsessive compulsive disorders (HR 1.07, 95% CI 0.97; 1.17) as well as of eating disorders (HR 1.40, 95% CI 0.88; 2.22) was not significantly affected by parity status after the infertility evaluation. LIMITATIONS, REASON FOR CAUTION: As only psychiatric conditions warranting hospitalization could be included in the present study, the true incidence of all psychiatric disorders among women with fertility problems is likely to be somewhat underestimated. Furthermore, since detailed information on fertility treatment was not available for all cohort members the association between different modalities of assisted reproductive techniques and risk of psychiatric disorders was not assessed. WIDER IMPLICATIONS OF THE FINDINGS: Clinicians and other healthcare personnel involved in diagnosis and treatment of women with fertility problems should be aware of the potential risk modification of psychiatric disorders associated with unsuccessful fertility treatment. Hence, our results may point to new aspects of follow-up of women with fertility problems who are unsuccessful in giving birth in order to prevent or identify and treat these possible psychological side effects. STUDY FUNDING/COMPETING INTEREST(S): The study was supported by the Danish Cancer Society (award number: 96 222 54). All authors report no conflicts of interest.

Socioeconomic position, treatment, and survival of non-Hodgkin lymphoma in Denmark--a nationwide study.

BACKGROUND: Not all patients have benefited equally from the advances in non-Hodgkin lymphoma (NHL) survival. This study investigates several individual-level markers of socioeconomic position (SEP) in relation to NHL survival, and explores whether any social differences could be attributed to comorbidity, disease and prognostic factors, or the treatment given. METHODS: This registry-based cohort study links clinical data on prognostic factors and treatment from the national Danish lymphoma database to individual socioeconomic information in Statistics Denmark including 6234 patients diagnosed with NHL in 2000-2008. RESULTS: All-cause mortality was 40% higher in NHL patients with short vs higher education diagnosed in the period 2000-2004 (hazard ratio (HR)=1.40 (1.27-1.54)), and 63% higher in the period 2005-2008 (HR=1.63 (1.40-1.90)). Further, mortality was increased in unemployed and disability pensioners, those with low income, and singles. Clinical prognostic factors attenuated, but did not eliminate the association between education and mortality. Radiotherapy was less frequently given to those with a short education (odds ratio (OR)= 0.84 (0.77-0.92)), low income (OR=0.80 (0.70-0.91)), and less frequent to singles (OR=0.79 (0.64-0.96)). Patients living alone were less likely to receive all treatment modalities. CONCLUSION: Patients with low SEP have an elevated mortality rate after a NHL diagnosis, and more advanced disease at the time of diagnosis explained a part of this disparity. Thus, socioeconomic disparities in NHL survival might be reduced by improving early detection among patients of low SEP.

The importance of side difference in nasal obstruction and rhinomanometry: a retrospective correlation of symptoms and rhinomanometry in 1000 patients.

OBJECTIVES: The correlation between subjective and objective outcomes of nasal obstruction is still a matter of controversy. The aim of this study was to determine the minimal level of side difference in nasal airway resistance (NAR measured by Broms'v(2)) between the two nasal cavities, which could be discerned subjectively by the patient on a visual analogue scale (VAS). Nasal airway resistance was calculated from rhinomanometric measurements of nasal airflow and transnasal pressure after decongestion of the nasal mucosa. DESIGN: A retrospective study. SETTING: ENT department, Vaxjo Central Hospital, Sweden. PARTICIPANTS: We studied 1000 active anterior rhinomanometries from patients with nasal obstructions. MAIN OUTCOME MEASURES: We compared the side difference of nasal airway resistance with the side difference of VAS estimated immediately prior to the rhinomanometry. Each measurement was performed after nasal decongestion. RESULTS: When the difference in nasal airway resistance between the two nasal cavities was larger than 20° (Broms'v(2)) or R(2) > 0.36 Pa/cm(3) /s, we found a significant correlation between side differences of the objective measurement and the subjective assessment (VAS). With a nasal airway resistance side difference over 20°, an additional 20° difference corresponded to a 0.9 centimetre average VAS change. The more obstructed side of the nose could be determined by VAS in 823 (82.3%) of 1000 patients. Yet, 177 (17.7%) patients had a paradoxical sensation of nasal obstruction with the low resistance side of the nose experienced as the most congested side. CONCLUSION: A significant correlation between the side differences of nasal airway resistance and VAS can serve as a supplement to rhinoscopy in decisions about nasal surgery. This study also showed that in 17.7% of patients, there was a negative correlation between subjective and objective evaluations of nasal airway resistance. But in this group, the nasal airway resistance side difference was mostly under 20°.

Socioeconomic position, stage of lung cancer and time between referral and diagnosis in Denmark, 2001-2008.

INTRODUCTION: We investigated the association between socioeconomic position, stage at diagnosis, and length of period between referral and diagnosis in a nationwide cohort of lung cancer patients. METHODS: Through the Danish Lung Cancer Register, we identified 18,103 persons diagnosed with lung cancer (small cell and non-small cell) in Denmark, 2001-2008, and obtained information on socioeconomic position and comorbidity from nationwide administrative registries. The odds ratio (OR) for a diagnosis of advanced-stage lung cancer (stages IIIB-IV) and for a diagnosis >28 days after referral were analysed by multivariate logistic regression models. RESULTS: The adjusted OR for advanced-stage lung cancer was reduced among persons with higher education (OR, 0.92; 95% confidence interval (CI), 0.84-0.99), was increased in persons living alone (OR, 1.06; 95% CI, 1.01-1.13) and decreased stepwise with increasing comorbidity. Higher education was associated with a reduced OR for >28 days between referral and diagnosis as was high income in early-stage patients. Male gender, age and severe comorbidity were associated with increased ORs in advanced-stage patients. INTERPRETATION: Differences by socioeconomic position in stage at diagnosis and in the period between referral and diagnosis indicate that vulnerable patients presenting with lung cancer symptoms require special attention.

Effect of pyruvate and HEPES on rat lung allograft acidosis and cell death after long-term hypothermic storage.

BACKGROUND: We have previously demonstrated that adding pyruvate to Perfadex increased graft metabolism during 24-hour storage and improved reperfusion lung function. This increased metabolism was associated with progressively lower pH of the storage solution during the preservation interval. OBJECTIVE: To determine whether more effective pH regulation would result in further improvements in lung survival after hypothermic storage. MATERIALS AND METHODS: Rat lungs were stored for 24 hours in Perfadex, Perfadex with HEPES (N-2-hydroxyethylpiperazine-propanesulfonic acid) buffer, pyruvate-modified Perfadex, and pyruvate-modified Perfadex with HEPES. Change in pH in the storage solution was measured. Structural lung injury was evaluated using hematoxylin-eosin stained tissue sections. Cell death was quantified by measuring necrotic cells using trypan blue exclusion and apoptotic cells via the TUNEL (terminal deoxynucleotide transferase-mediated deoxyuridine triphosphate nick-end labeling) assay. RESULTS: Lungs stored in Perfadex demonstrated the greatest degree of cell death. Lungs in the Pyruvate group exhibited decreased cell death despite greater acidosis. The addition of HEPES reduced cell death and preservation solution acidosis in both Perfadex and pyruvate-modified Perfadex (P < .05). Almost all cell death resulted from necrosis. Adding pyruvate to the preservation solution increases acid formation during storage, but decreases cell death. HEPES ameliorates this acidosis and decreases allograft cell destruction. CONCLUSION: Increasing the preservation solution buffering capacity may be a simple strategy for improving lung preservation for transplantation.

Socioeconomic status and non-melanoma skin cancer: a nationwide cohort study of incidence and survival in Denmark.

BACKGROUND: The two main types of non-melanoma skin cancer differ with the pattern of exposure to ultraviolet radiation (UVR): basal cell carcinoma (BCC) appears to be more closely related to intermittent solar exposure and sunburn, while the risk for squamous cell carcinoma (SCC) is a result of lifetime cumulated exposure to UVR. As these exposures may differ by social position, we investigated its role in the risk for and survival after BCC and SCC diagnosed in Denmark in 1994-2006 with follow-up through 2006. METHODS: The analyses were based on 52,166 cases of BCC and 5033 cases of SCC in a cohort of 3.7 million people born between 1925 and 1976 and residing in Denmark in 1992-2006. Information on cancer cases and socioeconomic indicators were obtained from population-based registries. We used log-linear Poisson regression models to estimate incidence rate ratios and cumulative relative survival to estimate survival up to 10 years after the first incident cases of BCC and SCC. RESULTS: High socioeconomic status, measured by both education and disposable income, was strongly associated with a higher risk for BCC, whereas there was no association between SCC and educational level and only a weak association with income. In general, relative survival after BCC was better than after SCC; the pattern of survival was not affected by socioeconomic indicators. CONCLUSIONS: The observed pattern of social status and risk for non-melanoma skin cancer differed substantially for the two cancer types, supporting the hypothesis that they may have different aetiologies.

Importance of organ preservation solution composition in reducing myocardial edema during machine perfusion for heart transplantation.

OBJECTIVE: Machine perfusion preservation has been used experimentally to extend the storage interval of donor hearts. We previously demonstrated that machine perfusion with glucose-supplemented Celsior preservation solution led to superior reperfusion function but resulted in increased myocardial edema compared with conventional static preservation. We hypothesized that other solutions that contain an oncotic agent, such as University of Wisconsin Machine Perfusion Solution (UWMPS), might reduce graft edema development while maintaining myocardial oxidative metabolism during long-term storage. METHODS: Canine hearts were stored and perfused in a perfusion preservation device (LifeCradle; Organ Transport Systems) after cardioplegic arrest and donor cardiectomy. Hearts were perfused either with glucose-supplemented Celsior (which lacks an oncotic agent) or UWMPS (which contains hydroxyethyl starch) at 5 degrees C in the perfusion device over 10 hours. Oxygen consumption (MVO(2)), lactate accumulation, regional flow distribution, and myocardial water content were measured. RESULTS: Hearts in both groups continued to extract oxygen over the entire perfusion interval. Lactate accumulation was minimal in both groups. Both solutions delivered perfusate evenly to all regions of myocardium. Heart weight increase (Celsior 31.3 +/- 4.3%, UWMPS -3.3 +/- 1.9%) and final myocardial water content (Celsior 80.2 +/- 1.3%, UWMPS 75.9 +/- 0.3%) were higher in the Celsior group (P < .005). CONCLUSIONS: Donor hearts can be supported by a perfusion device over relatively extended storage intervals. These organs continue to undergo oxidative metabolism with little lactate accumulation. An oncotic agent appears to be important in limiting increases in myocardial water content. UWMPS appears to be superior for perfusion preservation of myocardium by reducing edema development during storage.

[Does the subjective assessment of roughness correlate with a computer-aided measurement of irregularity index?]. / Objektiv gemessene Stimmlippenschwingungsirregularität vs. subjektiver Eindruck der Rauigkeit.

For routine clinical purposes dysphonic voices are assessed using the GRBAS scale or analogues. An objective measurement often includes jitter measurements. Here we raised the question of whether roughness estimates correlate with a computer-aided measurement of the vocal fold cycle irregularity in 78 patients who read a standard text ("Nordwind und Sonne"). The samples were evaluated by 19 speech and voice therapy students according to the degree of roughness. The irregularity index was calculated according to the procedures suggested by Fourcin. Data were subjected to correlation analysis. A significant correlation was found between the irregularity index and the subjective roughness scaling. These data indicate that objective measurements of vibratory cycle irregularity during text reading can be used for clinical purposes in addition to subjective roughness scaling.