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Hyaluronic acid and chondroitin sulphate instillation in chronic bladder diseases:a meta-analysis
No full textOBJECTIVE: To systematically summarise and meta-analyse all uncontrolled and controlled studies evaluating the role of intravesical instillation of hyaluronic acid (HA), with or without chondroitin sulphate (ChS), in the treatment of bladder pain syndrome (BPS), recurrent urinary tract infection (rUTI) and post-radiation cystitis (pRC).METHODS: A systematic review was conducted, and a protocol was registered with PROSPERO (CRD42025640480). Studies published between 1 January 1969 and 31 August 2024 were retrieved from multiple databases. Data were analysed using random-effects and common-effects models with subgroup and sensitivity analyses.RESULTS: A total of 131 studies were retrieved, of which 30, 10 and three investigated the use of HA/ChS in patients with BPS and rUTI or pRC, respectively, and were included in the analyses.CONCLUSION: The use of HA/ChS resulted in a significant improvement in pain as well as voiding and irritative symptoms in all the investigated conditions. In addition, the treatment reduced the risk of rUTI when compared to standard care. Although limited data were available, when randomised controlled trials were investigated, the combined use of HA/ChS resulted in better outcomes and a lower infection rate compared to either placebo or standard of care (odds ratio 0.42 [95% CI 0.25; 0.49]; P < 0.0001). Finally, an improvement in sexual function and quality of life was also observed.</p
"It feels more natural for me to take a step back":Cross-cultural care in paediatric diabetes
No full textType 1 diabetes is one of the most common chronic conditions among children globally. While advances in treatment have improved outcomes, paediatric diabetes remains an intensive condition that demands ongoing care and vigilance from parents. Despite growing attention to family-centred care, fathers’ caregiving roles remain underexplored—particularly how they are shaped by cultural, institutional, and gendered expectations.This article addresses this gap by examining paternal caregiving in families managing type 1 diabetes in Denmark and Greece. Drawing on ethnographic data from clinical and domestic settings from August 2023 to July 2024, and employing a phenomenological approach, the study identifies shared patterns and culturally specific dynamics.Fathers across both sites reported a significant cognitive and emotional burden but rarely expressed this openly. Many described their roles as active and engaged yet carried out behind-the-scenes. While Danish fathers attributed this marginalization to internal family dynamics and strivings for good mothering, Greek fathers tended to frame it as a cultural and moral inevitability. Their accounts reveal how fathers strive to participate meaningfully in their child's care whilst navigating ambiguous definitions of care and who is expected to provide it.The study contributes to a more nuanced understanding of fatherhood in chronic care and offers practical implications for clinicians seeking to reduce caregiver burden. Incorporating fathers’ experiences and supporting their caregiving roles can help foster more equitable and sustainable models of paediatric diabetes care
Confinement-induced resonances for the creation of quasi-one-dimensional ultracold gases of alkali-alkaline-earth dimers
No full textWe theoretically investigate the role of confinement-induced resonances (CIRs) in low-dimensional ultracold atomic mixtures in the formation of weakly bound dimers. To this end, we examine the scattering properties of a binary atomic mixture confined by a quasi-one-dimensional (quasi-1D) potential. In this regime, the interspecies two-body interaction is modeled as an effective 1D zero-range pseudopotential, with a coupling strength g1D derived as a function of the three-dimensional scattering length a. This framework enables the study of CIRs in harmonically confined systems, with particular attention paid to the case of mismatched transverse trapping frequencies of the two atomic species. Finally, we consider the Bose-Fermi mixture of 87Rb and 87Sr and identify values of the experimentally accessible parameters for which CIRs can be exploited to create weakly bound molecules
The Wise Man From the Sea:Time and Place, Spirit and Eternity in William Heinesen's Work
No full textHuman papillomavirus genotype distribution in cervical intraepithelial neoplasia grade 2+ from childhood vaccinated women:The Trial23 cohort study
No full textBackground: The introduction of prophylactic HPV vaccination has significantly reduced vaccine-type HPV infections and is reshaping the landscape of cervical cancer prevention. As vaccinated cohorts enter screening age, understanding the genotype-specific risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) is critical for adapting screening strategies. Aim: To compare HPV genotype-specific detection rates of histologically confirmed CIN2+ between vaccinated and unvaccinated women in Denmark's Trial23 cohort, with over seven years of follow-up. Method: This population-based cohort study included 15,668 women born in 1994 who were offered HPV vaccination with the 4-valent vaccine in 2008 and entered Danish screening age in 2017 In our cohort, 95 % were vaccinated and 5 % were unvaccinated. The primary endpoints of this study were HPV-type-specific incident CIN2+ cases. The first histological biopsy sample diagnosed with CIN2+ in 2017–2023 was retrieved for HPV genotyping with the Seegene Allplex HPV28. Cox proportional hazards models estimated hazard ratios (HRs) for CIN2+ outcomes by hierarchically grouped HPV genotypes. Results: Among vaccinated women, the incidence of CIN2+ was 5.3 per 1000 person-years, compared to 12.1 per 1000 person-years in unvaccinated women (HR: 0.44; 95 % CI: 0.34–0.57). Vaccination was associated with a 95 % reduction in HPV16/18-related CIN2+ (HR: 0.05; 95 % CI: 0.03–0.09). A similar, but non-significant, trend of a 32 % risk of CIN2+ for HPV31/33/45/52/58 was found, with an adjusted HR of 0.68 (95 % CI: 0.43–1.09). For CIN2+ associated with other high-risk HPV types, the HR was 0.70 (95 % CI 0.35–1.37). Conclusion: HPV16/18 vaccination reduced the risk of HPV16/18-related CIN2+ lesions, but a substantial burden remained from non-vaccine high-risk types. The substantial protection against HPV16/18-related CIN2+ and the consequential shift in HPV genotype distribution of CIN2+ among vaccinated women underline the need for adaptation of screening strategies.</p
Exercise maintains LEAP2 levels after weight loss in females with obesity
No full textLiver-expressed antimicrobial peptide 2 (LEAP2) is an anorexigenic hormone, but its long-term decrease after diet-induced weight loss may promote weight regain. This study examined whether exercise, glucagon-like peptide-1 receptor agonist (GLP-1RA) (liraglutide), or their combination prevents the post-diet decrease in LEAP2 during 1 year of weight-loss maintenance. LEAP2 plasma levels were measured in the fasting state and during 3-h standard liquid meal tests (600 kcal) in a randomized, double-blinded, placebo-controlled trial. 128 adults with obesity were included (BMI: 36.9 ± 2.9 kg/m2), 79 females and 49 males. Sex differences were evident at data inspection. In males, fasting LEAP2 decreased during the low-calorie diet (LCD) (p < 0.001), while in females, there was a delayed decrease after 1 year in the placebo, liraglutide, and combination groups (p < 0.001 to 0.033). Interestingly, in females in the exercise group, fasting and postprandial LEAP2 levels remained high. These findings raise the possibility that exercise might preserve LEAP2 levels after weight loss in females, supporting weight-loss maintenance.</p
Association Between Intraoperative Perfusion Index and Mortality in Patients Undergoing General Anesthesia for Noncardiac Surgery:A Protocol for an Observational Study
No full textBackground: Hemodynamic derangement during general anesthesia is associated with postoperative morbidity and mortality. Current paradigms for hemodynamic management focus on optimizing macrocirculatory parameters, which may not adequately reflect or improve microcirculatory function. The peripheral perfusion index, a noninvasive measure derived from pulse oximetry, may provide an indication of tissue perfusion status. In smaller studies, the intraoperative perfusion index has been linked to postoperative complications and mortality. This retrospective cohort study will evaluate the association between intraoperative perfusion index and postoperative outcome. We hypothesize that increasing duration of low intraoperative perfusion index is associated with higher postoperative morbidity and mortality. Methods: We will conduct a retrospective cohort study including all adult patients who underwent general anesthesia for noncardiac surgery in the Capital and Zealand Regions of Denmark between 2017 and 2024. Patients will be identified through the AI and Automation in Anesthesia perioperative database, which contains granular perioperative data for all surgical procedures in this period. The primary exposure is intraoperative perfusion index, analyzed both as a continuous variable and as the area under predefined thresholds (1.5, 0.5, and 2.0). The primary outcome is 30-day all-cause mortality and the secondary outcome is a composite of postoperative complications. Associations between intraoperative perfusion index and outcomes will be evaluated using adjusted multivariable logistic regression with restricted cubic splines. Ethics and Dissemination: The Regional Health Research Ethics Committees of the Capital Region in Denmark waived the requirement for formal ethical approval of this study (F-24078050, December 12, 2024), as the study will use data exclusively from existing medical records. Results will be disseminated through peer-reviewed publication and conference presentations and reported in accordance with the STROBE guidelines.</p
Evaluating the use of prior information to individualise start item selection for the EORTC CAT core
No full textPurposeComputerized adaptive tests (CATs) provide individualised measurement, using score estimates based on the patient’s prior responses to select the next most informative item. However, as no score estimate is available at the outset, the start item is typically not individualised. The European Organisation for Research and Treatment of Cancer (EORTC) CAT Core covers 15 health-related quality of life (HRQoL) domains. We explored whether scores from one domain could be used to obtain initial score estimates and hence, individualised start items for another domain, thereby improving measurement.MethodsFor each HRQoL domain, we evaluated the ability to predict scores using each of the 14 other domains in a large international sample of cancer patients (N = 10,084). Using simulations, we compared the impact of individualised versus standard fixed start item on CAT measurement precision.ResultsAcross domains, predicted scores were within one standard deviation of the observed score in 72–89% of the assessments (mean = 83%), with predicted-observed correlations ranging 0.31–0.72 (mean = 0.55). The impact of individualised start items varied by domain and score level but typically improved reliability in the initial steps of CATs (first 3 items), particularly for patients with extreme scores.ConclusionCross-domain predictions can be used to generate initial score estimates for individualised start item selection. Simulations suggested that individualised start items lead to improvements in measurement precision, particularly for short CATs (up to 3 items) and patients with extreme scores. Individualised start items based on cross-domain predicted scores is planned to be incorporated into the EORTC CAT Core toolbox
Clinical forensic examinations and prosecution in Danish child physical abuse cases
No full textBackground: Despite the central role of forensic medical examinations in child physical abuse cases, evidence on how their findings impact prosecution is scarce. Objective: We studied the association between the dependent variable, filing of formal charges, and independent variables related to the child, suspect, and case characteristics, the acts of violence, and forensic findings, such as cutaneous lesions. Participants and setting: We included 221 children aged between four and 14 years who were reported as victims of suspected physical abuse to the Copenhagen Police between April 1, 2020 and December 31, 2022. All the children participated in a video-recorded interview and underwent a clinical forensic medical examination. Methods: Data were extracted from police reports, court documents, and forensic reports. Logistic regression models were applied. Results: Formal charges were filed in 56 cases (25 %). Children's disclosures of violence exposure were associated with the filing of formal charges, irrespective of forensic findings (abuse-related findings: OR = 5.4, 95 % CI [1.7, 16.6]; accidental/unspecific findings: OR = 3.9, 95 % CI [1.4, 10.9]). In cases where violence was undisclosed but abuse-related lesions were found, a borderline association was observed (OR = 3.2, 95 % CI [0.9, 11.8]). Conclusion: The child's disclosure of violence seems of importance for filing formal charges, and the forensic medical examination may be important in the absence of such disclosure, but this needs confirmation in larger studies. Knowledge of factors that influence prosecution decisions may contribute to secure systematic assessment of every child physical abuse case.</p