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Post-colonoscopy colorectal cancer and the association with endoscopic findings in the Danish colorectal cancer screening programme
Get PDFObjective Colorectal cancer (CRC) is the third most common cancer in Denmark, with a 5-year mortality of 40%. To reduce CRC incidence and mortality, a faecal immunochemical test (FIT)-based screening programme was introduced in 2014. Adenoma detection rate (ADR) is an established quality marker inversely associated with post-colonoscopy CRC (PCCRC), but evidence mainly stems from non-FIT populations. Using ADR in a FIT-based setting may be costly due to histopathological examination. Alternative markers like polyp detection rate (PDR) and sessile serrated lesion detection rate (SDR) could be viable but lack evidence for their association with PCCRC. Methods We conducted a nationwide cohort study of 77 009 FIT-positive participants undergoing colonoscopy (2014-2017). National registry data on CRC outcomes were linked, and endoscopy units were grouped by ADR, PDR and SDR levels. Poisson regression adjusted for age, sex and comorbidities was used to assess PCCRC risk. Results Among 70 009 colonoscopies within 6 months of FIT positivity, 4401 (92.7%) had CRC, while 342 (7.2%) were PCCRC cases. PCCRC risk was inversely associated with ADR, PDR and SDR. High ADR endoscopy units had a 35% lower PCCRC risk than low ADR units. Similar associations were found for PDR and SDR, with high SDR units showing a 33% lower PCCRC risk than low SDR units. Conclusions ADR, PDR and SDR predict PCCRC risk, with SDR emerging as a feasible, cost-efficient quality marker in FIT-based screening. This study supports SDR as a primary performance indicator in future protocols.</p
Lessons learned about new energy consumer roles and smart technologies in relation to inequality and ethics:Research and policy recommendations
Get PDFA low-carbon transition of the energy system is vital and will require major alterations in everyday practices. This includes a transition to renewable energy and linking energy production and consumption, through prosumption, individually or in energy communities, as well as by using smart technology to give consumers information about energy production and to help control energy demand according to production. With the use of smart technology and different types of price incentives, however, there is risks of contributing to inequality in society related to socioeconomics as well as to gender. In looking for other drivers of this transition than economy and technology, it is relevant to include the role ethical consumption can play in collectively changing norms of what is needed to live a good life. The project eCAPE, supported by an EU ERC-advanced grant sat out to explore these issues. Through several PhD and postdoc projects, as well as senior researcher involvement, we have investigated these aspects of the energy transition and contributed new theory development, empirical insights as well as policy recommendations. Taking a practice theory approach, we acknowledge that collective practice rather than individual consumers is at the centre of understanding the social world. Though, with our specific interest in inequality and the role of ethics we also found it necessary to enlarge what previously were mainstream understandings within theories of practice. This paper aims to summarise the empirical findings of eCAPE in relation to inequality, gender, ethics and smart technology in the energy transition, as well as the theory developments we have provided. Finally, the paper summarises the main policy recommendation across the more than 25 peer-reviewed publications from the project.A low-carbon transition of the energy system is vital and will require major alterations in everyday practices. This includes a transition to renewable energy and linking energy production and consumption, through prosumption, individually or in energy communities, as well as by using smart technology to give consumers information about energy production and to help control energy demand according to production. With the use of smart technology and different types of price incentives, however, there is risks of contributing to inequality in society related to socioeconomics as well as to gender. In looking for other drivers of this transition than economy and technology, it is relevant to include the role ethical consumption can play in collectively changing norms of what is needed to live a good life. The project eCAPE, supported by an EU ERC-advanced grant sat out to explore these issues. Through several PhD and postdoc projects, as well as senior researcher involvement, we have investigated these aspects of the energy transition and contributed new theory development, empirical insights as well as policy recommendations. Taking a practice theory approach, we acknowledge that collective practice rather than individual consumers is at the centre of understanding the social world. Though, with our specific interest in inequality and the role of ethics we also found it necessary to enlarge what previously were mainstream understandings within theories of practice. This paper aims to summarise the empirical findings of eCAPE in relation to inequality, gender, ethics and smart technology in the energy transition, as well as the theory developments we have provided. Finally, the paper summarises the main policy recommendation across the more than 25 peer-reviewed publications from the project
Environmental impact of brine from desalination plants on marine benthic diatom diversity
Get PDFBenthic diatoms are sensitive indicators of environmental conditions at the seabed. In this study, benthic diatom communities at two brine outfall sites of reverse osmosis (RO) seawater desalination plants in Larnaca and Dhekelia, Cyprus, were investigated using a classical, microscopy-based approach and environmental DNA metabarcoding. In general, the diversity of diatoms measured by both methods (microscopy and eDNA metabarcoding), increased by distance from the brine discharge. Increased TOC and nutrient enrichment at brine outfalls contributed to decreased diatom diversity at the Larnaca outfalls, but the diatom diversity at Dhekelia was not driven by abiotic factors. The diatom communities at the outfalls were shown to be distinct and showed temporal variation across the sampling seasons with eDNA metabarcoding, but this was the case only for Dhekelia with microscopy. The results highlight the effect of local biogeography and different brine mixing methods on diatom diversity. The results revealed that conventional morphological methods and eDNA metabarcoding rarely leads to similar conclusions. However, the complementary results emphasise that more information can be derived when combining the methods for biodiversity impact assessments.</p
DEVELOPMENT OF A PATIENT-CENTERED AND EVIDENCE-BASED INTERVENTION FOLLOWING TRANSIENT ISCHEMIC ATTACK BY EXPLORING PROGNOSIS AND IMPACT
No full textThe Future of Scientific Advice in Denmark [in Danish]
Get PDFDenne rapport fremlægger resultaterne af en international kortlægning af erfaringer med forskningsbaseret rådgivning i politiske beslutningsprocesser. Anvendelse af forskningsbaseret viden i politik er i stigende grad kommet på dagsordenen blandt fonde, universiteter og myndigheder. Mange af de lande, Danmark normalt sammenligner sig med, har aktive mekanismer til formidling og mobilisering af forskningsviden i politiske processer. Forskningsbaseret viden og evidens kan kvalificere dialogen om politiske prioriteringer, sikre en bred faglig belysning af problemer og øge kvaliteten af den offentlige administration. Det gavner både lovgivningen og legitimiteten i den demokratiske beslutningsproces
Data Driven Method for Product and Component Sorting for Remanufacturing
No full textAs industries embrace circular production to increase sustainability, effective methods for managing End-of-Life (EOL) products have become increasingly critical. This paper introduces a novel approach to support decision-making in the handling of returned products, focusing on the recovery and refurbishment of components for reuse in remanufacturing. The proposed method utilizes Bill of Materials (BOM) data to assess the probability of component reusability and calculates the economic viability of disassembly and refurbishment. By conducting evaluations at both the product and component levels, the framework facilitates precise and efficient grading of EOL products.</p
Only What’s Needed:Frugal Smart Systems for Resilience in Manufacturing
No full textManufacturing systems across industries are increasingly exposed to uncertainties that threaten their resilience and competitiveness. To address these challenges, manufacturers are integrating digital and smart technologies into production processes to enhance system intelligence, predictability and reconfigurability. However, many legacy (brownfield) systems struggle to leverage these technologies effectively. This paper adopts a systems engineering perspective to compare the concepts of frugal, resilient, and smart systems, aiming to identify the requirements for designing resource-efficient and adaptable manufacturing systems. Building on this conceptual foundation, a method for mapping and visualization of essential functions within brownfield systems is introduced. It enables the identification of minimal reconfiguration efforts needed to maintain performance under uncertainty. An illustrative example shows the application of the method to brownfield assembly systems, supporting strategic interventions for resilience enhancement. The work provides both a conceptual framework and a practical tool to support resilient reconfiguration and resource-efficient operation in manufacturing.</p
From Code to Production:A Quantitative Analysis of SaaS Characteristics for MaaS Development
No full textThis paper explores the conceptual transfer of Software-as-a-Service (SaaS) principles to the emerging domain of Manufacturing-as-a-Service (MaaS). While SaaS has become a mature and widely adopted model in software distribution, its structured application within cloud-based manufacturing remains underexplored. Through a bibliometric analysis of 65 academic publications retrieved from Scopus, this study identifies ten recurring SaaS characteristics, spanning infrastructure (e.g., cloud deployment and data security), service operations (e.g., performance monitoring and SLAs), and user/business interface (e.g., subscription pricing and UX design). Their relevance to MaaS contexts is examined through a content mapping procedure and synthesized into a three-layer capability framework. The results reveal a growing yet fragmented body of research addressing this translational potential, with conceptual gaps in areas such as service integration, pricing models, and modularity. A visual framework is proposed to support the adaptation of SaaS logic into MaaS environments, offering a structured foundation for future research on digital servitization and industrial service ecosystems.</p
SAPIEN 3 versus Myval transcatheter heart valves for transcatheter aortic valve implantation (COMPARE-TAVI 1):a multicentre, randomised, non-inferiority trial
No full textBackground: Transcatheter aortic valve implantation (TAVI) is a guideline-directed treatment for severe aortic stenosis and degenerated aortic bioprostheses. When new transcatheter heart valve (THV) platforms for TAVI are launched, they should be compared with best-in-practice contemporary THVs for their short-term and long-term performance. The COMPARE-TAVI 1 trial was designed to provide a head-to-head comparison of the SAPIEN 3 or SAPIEN 3 Ultra THVs and the Myval or Myval Octacor THVs. Methods: This multicentre, all-comers, randomised, non-inferiority trial was done at three university hospitals in Denmark. Eligible patients were aged 18 years or older, scheduled for transfemoral TAVI, and eligible for treatment with SAPIEN 3 THVs or Myval THVs. Patients were randomly assigned (1:1) to treatment with SAPIEN 3 (29 mm diameter) or SAPIEN 3 Ultra (20 mm, 23 mm, or 26 mm diameter) THVs or Myval or Myval Octacor THVs (20–32 mm diameter). The TAVI procedure was performed according to local practice and under local anaesthesia unless leaflet laceration was performed. The primary endpoint was a composite of death, stroke, moderate or severe aortic regurgitation, or moderate or severe haemodynamic THV deterioration at 1 year according to Third Valve Academic Research Consortium criteria. All patients assigned to THV treatment were included in the intention-to-treat analysis, and all patients who were treated as randomly assigned were included in the per-protocol analysis. With an expected event rate of 13%, the prespecified non-inferiority margin was 5·3%. This trial is registered with ClinicalTrials.gov, NCT04443023, and is closed to accrual. Findings: Between June 15, 2020, and Nov 3, 2023, 1031 patients were enrolled. Enrolment was paused twice because of patent-related legal proceedings. Of 1031 patients, 517 patients were randomly assigned to SAPIEN 3 THVs and 514 to Myval THVs. The median patient age was 81·6 years (IQR 77·6–85·0), and 415 (40%) of 1031 patients were female and 616 (60%) were male. The primary endpoint occurred in 67 (13%) of 517 patients randomly assigned to SAPIEN 3 THVs versus 71 (14%) of 514 patients randomly assigned to Myval THVs (risk difference –0·9% [one-sided upper 95% CI 4·4%]; pnon-inferiority=0·019). Interpretation: Myval THVs were non-inferior to SAPIEN 3 THVs in terms of a 1-year composite endpoint of death, stroke, moderate or severe aortic regurgitation, or moderate or severe haemodynamic THV deterioration. Funding: Meril Life Sciences, Vingmed Denmark, the Danish Heart Foundation, and the Central Denmark Region.</p
