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Contrasting Risk Profiles for Suicide Attempt and Suicide Using Danish Registers and Genetic Data
No full textIMPORTANCE Not all individuals who die by suicide have a history of nonfatal suicide attempt (SA); however, little is known about the extent to which the genetic and environmental etiologies of SA and suicide are shared or distinct. OBJECTIVE To examine shared and distinct risk factors for SA and suicide, focusing on clinically diagnosed health conditions and genetic factors. DESIGN, SETTING, AND PARTICIPANTS For health conditions, a nested case-control study was performed using data from the Danish registers. For genetic factors, a case-control analysis framework was used, with individual genotypes retrieved from the iPSYCH2015 dataset, which was nested within the entire Danish population. Individuals older than 10 years were included to minimize the risk of misclassification for SA and suicide. Data were analyzed from January 2024 to April 2025. EXPOSURES Twenty-eight health conditions and 35 polygenic scores (PGSs) for complex traits. MAIN OUTCOMES AND MEASURES The primary outcomes were SA, suicide, and cumulative SA burden. Associations between health conditions and the risk of SA and suicide were assessed using conditional logistic regression. PGSs for complex traits were calculated using LDpred2-auto, and their associations with SA and suicide were evaluated via logistic regression. To assess whether effect sizes differed significantly between SA and suicide, bayesian model-based classification and Cochran Q test were applied. RESULTS A total of 81 713 cases of SA (50 512 [61.8%] female; mean [SD] age, 32.3 [14.9] years), with 408 490 age-matched controls (252 525 [61.8%] female; mean [SD] age, 32.3 [14.9] years), and 9362 cases of suicide (2360 [25.2%] female; mean [SD] age, 45.1 [14.6] years), along with 46 749 matched controls (11 796 [25.2%] female; mean [SD] age, 45.1 [14.6] years) who were alive at the date of the case’s death, were included in the health conditions analysis. The PGS analysis included 8221 cases of SA (5944 [72.3%] female; mean [SD] age, 19.7 [4.4] years) and 225 cases of suicide (80 [35.6%] female; mean [SD] age, 24.6 [5.0] years). Chronic diseases (eg, dyslipidemia or hearing problems) showed stronger associations with SA, while severe conditions (eg, cancer) were more strongly associated with suicide. Suicide was influenced only by PGSs for mental disorders, whereas SA was associated with both psychiatric and broader health-related genetic risk factors. Notably, dose-response associations were observed for most health conditions and PGSs in relation to cumulative SA burden. CONCLUSIONS AND RELEVANCE A broad range of health conditions and genetic factors were associated with increased risk of both outcomes; however, their shared and distinct risk factors suggest that SA and death by suicide are not solely differentiated by liability severity.</p
An enhanced fracture risk evaluation model (FREM) using national health data on morbidity and medications
No full textOsteoporosis is a major health concern in older individuals. Efficient case-finding is essential for timely risk assessment and treatment for high-risk patients. To prevent fractures and reduce the risk of subsequent disability, approaches offering clinically sufficient sensitivity with acceptable specificity are warranted. Although pharmaceutical osteoporosis treatment is effective, it is often diagnosed at a late stage, for instance, following a fracture. The aim of this study was to extend the existing Fracture Risk Evaluation Model (FREM), which identifies individuals at risk of an imminent (1-yr) major osteoporotic fracture (MOF) based on administrative health data. This extension (FREMVer2) included data on morbidity and medications and evaluated age-specific risk cut-offs to enhance the risk assessment of MOF and hip fracture (HF) risk, respectively. We included the entire population of Denmark aged ≥45 yr at baseline (2022; N = 2 493 180), not previously diagnosed with osteoporosis or receiving osteoporosis treatment. The cohort was divided into 4 groups stratified by sex and age (<65 yr, ≥65 yr). Each of the 4 groups was randomly split into a 60% development, a 20% model validation, and a 20% cut-off validation cohort. All diagnoses from Danish hospitals and filled prescriptions from Danish pharmacies from 2007 to 2021 were used as possible predictors for MOF. These predictors correspond to information that in Denmark is automatically transferred to general practitioner's electronic health records; hence, prediction would be possible in general practice. Models were constructed by logistic regression with LASSO regularization, determining the preferred regularization hyper parameter by cross-validation and forcing categorical age to be included. Across subgroups, the models obtained poor to acceptable area under the curves (AUCs) of 0.656-0.714 for MOF, and acceptable AUCs of 0.728-0.764 for HFs. Additionally, the models achieved sensitivities of around 80% or higher in almost all subgroups. This performance, together with the available predictors, makes FREMver2 a feasible decision support system as a step toward an opportunistic screening program in health care settings with access to administrative data
Integrating institutional theory into a construction management course: a scaffolding perspective and implications for engineering education
No full textThe integration of social sciences and humanities (SSH) into science, technology, engineering, and mathematics (STEM) education is increasingly recognised as essential for preparing students to address complex, real-world problems. This study explores how institutional theory, a SSH theory rooted in sociology, can be integrated into engineering education through the concept of scaffolding. The research is situated in a graduate-level construction management course and focuses on the implementation of SSH theory within a STEM curriculum. Findings indicate that aligning scaffolding with SSH learning objectives, combining collaborative and individual learning artifacts, and iteratively adapting course design can enhance students’ ability to link abstract theory with real-world analysis. Nevertheless, students defaulted to descriptive reasoning and deductive categorisation, reflecting entrenched STEM thinking patterns. The study concludes that intentional scaffolding, reflexive course adaptation, and repeated opportunities for interpretative analysis provide a transferable model for integrating SSH theory, such as institutional theory, into engineering education
Development of a treatment planning protocol for the multi-centre reirradiation CURE Lung trial
No full textIntroduction: High-dose lung cancer reirradiation is promising but associated with high toxicity risk. Development of and adherence to consensus guidelines will support safe use. Materials and methods: Literature review and live workshops were conducted to develop treatment planning guidelines in preparation for the Scandinavian CURE Lung trial. Relevant OARs, dose metrics, constraints, and priorities were considered. For six high-dose reirradiation lung cancer cases, the physical 3D dose distribution of previous treatment was mapped to current CT. The cases were distributed to eight radiotherapy centres, which optimised plans on current CT respecting equieffective cumulative dose constraints. Mapped previous dose and current dose were rescaled to EQD2Gy (α/β = 3 Gy, spinal cord: α/β = 2 Gy), summed by each centre, and reviewed centrally. After cases 1–4 were completed, prioritisation between OAR constraints and target coverage was clarified. Results: Consensus agreement on guidelines for treatment planning, equieffective cumulative dose constraints, and priorities was established. For cases 1–3, centres complied with constraints. For case 4, covering PTV while respecting OAR constraints was difficult, and major variations were identified, underscoring the need for clearer prioritisation guidance. Consensus was reached to prioritise OAR constraints, and centres re-optimised case 4 accordingly. For cases 5 and 6, all centres underdosed PTV, to comply with OAR constraints. Generally, considerable variation in cumulative OAR doses was observed. Conclusions: A treatment planning protocol was developed. The pre-trial multi-centre treatment planning study identified and resolved key missing guidance to facilitate common conception of consensus guidelines. Feasibility and compliance with the proposed equieffective cumulative dose constraints were established.</p
Opinion:A 2025 review of chiropractic spinal manipulation for headaches was bound for null results
No full textIntroduction: A systematic review by Ceballos-Laita et al. in 2025 published in the European Journal of Integrative Medicine (DOI: 10.1016/j.eujim.2025.102462) concluded the effectiveness of chiropractic spinal manipulation for cervicogenic, tension-type, and migraine headaches was uncertain, with very low evidence certainty. We highlight limitations in the review's methods which were bound to lead to a null result that undermine its validity. Conclusion: Methodological flaws, including, post-hoc protocol deviations, heterogeneity, inconsistencies and potential bias cast doubt on the review's findings. Clinicians and stakeholders should interpret its results cautiously, considering existing meta-analyses examining spinal manipulation for specific headache types and populations.</p
Catheter-based treatment for patients with acute pulmonary embolism
No full textCatheter-based therapies such as catheter-direceted thrombolysis, ultrasound-assisted thrombolysis, and mechanical embolectomy are emerging as alternatives for intermediate-high risk pulmonary embolism, offering targeted treatment with reduced bleeding risk. Early studies show promising outcomes but evidence remains limited. Ongoing randomized trials, including HI-PEITHO and PEERLESS II, aim to clarify efficacy and safety. Until results are available, treatment should be guided by individual risk assessment, local expertise, and centre capabilities, as argued in this review
The benthic environment of the Aleutian Trench region:Sediment provenance, organic carbon sources and deposition dynamics
No full textSedimentological, mineralogical, chronological and basic biogeochemistry document that the Aleutian Trench region consists of four distinct regions, each with their respective benthic habitat, deposition dynamics, and material sourcing: the Northern Aleutian Slope (NS), Aleutian Trench – Axis (AT-A), Aleutian Trench – South Slope (AT-SS), and Southern Aleutian Slope (SS). The carbon pool is characterized by pyrolysis derived hydrogen and oxygen indices (HI and OI), radionuclides (Δ14C) and stable isotopes (δ13C-values), clearly varying among the respective regions. The NS has elevated total organic carbon (TOC) content, including distinct imprint of fresh, marine-derived organics originating from upwelling in the Gulf of Alaska with subsequent westward transport by the Alaskan Stream, sustaining high remineralization rates, with well-defined infaunal burrow structures in the sediment. Stations at the AT-A have a 2.5–24.1 cm thick, glacially derived fluid mud layer (FML) deprived of infauna, blanketing the original sediment surface. Chronological markers document that the infilling of the FML happened since the mid 1950′s and now extends to at least one fifth of the entire Aleutian Trench axis. The FML contains a mixture of fresh, marine-derived and recalcitrant terrigenous organics, with elevated microbial mineralization rates, presumably enhanced by microbial priming and efficient microbial degradation of otherwise recalcitrant organics. The AT-SS and SS have low TOC contents, exhibit very low microbial remineralization rates, with only sparse infaunal imprints. Our investigations document that the Aleutian Trench forms a unique hadal environment, while simultaneously confirming that hadal trenches generally act as depocenters with intensified microbial activity, sustained by various sources of organics.</p
Thyroid Hormone Treatment for Hypercholesterolemia in Euthyroid Patients:Results From a European Survey of Thyroid Specialists
No full textObjective: A relationship among hypothyroidism and lipid disorders is well established. However, current evidence and guidelines do not support the use of thyroid hormones (TH) in euthyroid patients with hyperlipidaemia as potential harms are considerable. This European survey investigated the use of TH in euthyroid patients with severe hypercholesterolemia as a complementary treatment. Design: Data were derived from the THESIS (Treatment of Hypothyroidism in Europe by Specialists) project that surveyed TH use. Univariable and multivariable analyses were used to explore associations. Results: Out of 17,232 invitations, 5695 (33.0%) valid responses were received, and of these, 328 (5.8%) stated that TH are indicated in euthyroid patients with severe hypercholesterolemia. Univariable analyses disclosed significant differences and associations: (a) more non-endocrinologists (8.9%) than endocrinologist (5.4%) used TH (p < 0.001), (b) the number of hypothyroid patients treated per year was inversely related to use of TH (p = 0.024), (c) members of international endocrine/thyroid societies were more likely to use TH than non-members (p < 0.001), (d) significant variations by country and geographical region (p < 0.001), and (e) inverse relationship between gross national income per capita (GNIPC) and TH use (p < 0.001). Multivariable analyses yielded significant associations between use of TH, and male gender, specialty and GNIPC (p < 0.001). Conclusions: This study suggests that a small but noteworthy minority of European thyroid specialists may be using TH to treat of severe hypercholesterolemia in euthyroid patients. If confirmed, this finding highlights the importance of raising awareness among thyroid specialists, professional societies, and healthcare providers to ensure adherence to evidence-based practices.</p
A novel in situ benthic photorespirometer for estimating photosynthesis rates of benthic primary producers
No full textWe developed a novel benthic photorespirometer (BP) to overcome limitations of existing benthic incubation chambers for in situ photosynthesis–irradiance (P–I) curve analysis, including prolonged measurement times, uneven light distribution, and poor sealing. The BP integrates an artificial light source, an oxygen optode sensor, and a neoprene skirt to enable rapid P–I curve construction through 2-h incubations. Field tests at four coastal sites in Korea validated uniform light delivery and thermal stability during incubation, which are essential for reliable measurements. The compact and rigid design allowed single-operator deployment with minimal habitat disturbance, while the neoprene skirt ensured effective sealing across diverse substrates, including uneven rocky bottoms. Single deployments yielded reproducible oxygen responses and community-specific P–I curves under uniform light conditions, reflecting distinct photosynthetic characteristics among benthic algal communities and demonstrating the BP's capability to assess benthic photosynthesis. These results validate the BP as a reliable, field-deployable tool for high-resolution assessment of benthic primary production in coastal ecosystems.</p
A Case Against the Feasibility of AI Consciousness (AIC)
No full textThis paper argues against the feasibility of AI Consciousness (AIC), discussing recent claims that large language models and advanced AI architectures could one day possess phenomenal consciousness. While proponents draw on computational functionalism and models like Global Workspace Theory to support the idea of AIC, we challenge this view by highlighting the ontological and phenomenological conditions of consciousness. We argue that consciousness, as viewed through classical phenomenology and critical accounts of embodiment and embeddedness, is a transcendental precondition for experience. Thus, consciousness cannot emerge in silicon-based systems because it is irreducibly lived, embodied, and first-personal