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Temporal Trends in the Association Between Female Sex and Ischemic Stroke Among Patients With Atrial Fibrillation
Get PDFBACKGROUND: Female sex has historically been associated with higher risk of ischemic stroke in patients with atrial fibrillation. However, contemporary European studies suggest this association may have attenuated and become nonsignificant over recent years. This study aims to characterize temporal trends in cardiovascular outcomes in a large, global cohort of patients with atrial fibrillation.METHODS: Nonanticoagulated patients with newly diagnosed atrial fibrillation were identified from a global federated research network (TriNetX) between 2000 and 2019. One-year ischemic stroke risk and risk ratios were calculated for women versus men. Secondary outcomes included all-cause death, myocardial infarction, heart failure, and dementia. Cohorts were compared before and after adjustment for age and comorbidities.RESULTS: Overall, 1 204 852 patients were included (44% women). Unadjusted risk of ischemic stroke increased in women (1.75% to 4.24%) and men (1.13% to 3.55%) from 2000-2004 to 2015-2019, while all-cause death decreased over the same periods (women, 10.36% to 7.79%; males, 10.76% to 7.59%). After adjustment, female sex remained independently associated with higher risk of ischemic stroke, although the risk decreased over time (2000-2004: risk ratio, 1.54 [95% CI, 0.94-2.51]; 2015-2019: risk ratio, 1.09 [95% CI, 1.06-1.13]). After adjustment, male sex was associated with risk of all-cause death and myocardial infarction, while risk of dementia and heart failure was similar between sexes.CONCLUSIONS: Between 2000 and 2019, the risk of ischemic stroke increased among nonanticoagulated patients with atrial fibrillation. While the association between female sex and ischemic stroke decreased over time, female sex remained associated with a higher stroke risk in 2015 to 2019 after adjustment.</p
Detailed mapping of mesothelioma cases in Denmark to identify areas with elevated risk: a nationwide population-based study
Get PDFOBJECTIVES: Previous studies mapping pleural mesothelioma in Denmark have found that the risk varies between Danish regions. However, evaluating disease risk for such relatively large geographical units ignores any heterogeneity within the unit and can thus diminish more local spikes in risk, missing smaller areas of excess risk. In this study, we examined the distribution of pleural mesothelioma in Denmark on an unprecedented detailed scale, mapping cases to each of the Danish parishes. METHODS: We identified individuals diagnosed with pleural mesothelioma between 1990 and 2021 in the Danish Cancer Registry. Considering age- and sex-standardized incidence rate ratios (IRR), we used a conditional autoregressive random effects model to smooth IRR across parishes. Parishes with a smoothed parish-to-national IRR >1.25 or >2.0 with a posterior probability of >95% were flagged as parishes with an excess risk of pleural mesothelioma. RESULTS: We identified 3105 incident cases of pleural mesothelioma in the study period. A total of 74 and 14 parishes were flagged with IRR significantly above 1.25 and 2.0, respectively. These parishes had posterior mean smoothed IRR of 1.82-4.13. CONCLUSIONS: We provided a detailed mapping of pleural mesothelioma cases in Denmark and found five distinct areas, each covering several parishes, with a significantly elevated risk. All these areas were in the proximity of previous asbestos-using industries.</p
Risk of tuberculosis disease among patients with inflammatory bowel disease and inflammatory rheumatic disease treated with biologics in Denmark:a nationwide cohort study
No full textOBJECTIVES: This nationwide retrospective cohort study estimates tuberculosis (TB) disease risk in adults and children with inflammatory bowel disease (IBD) and inflammatory rheumatic disease (IRD) treated with immunosuppressive biologics in Denmark, including temporal trends and risk stratification by TB infection status and country of birth.METHODS: Patients diagnosed with IBD or IRD from 1994 to 2018 were identified using the Danish National Patient Registry. Treatments with biologics and diagnoses of TB disease were determined through International Classification of Diseases, 10th Revision codes and microbiological records. Patient demographics, interferon-gamma release assay (IGRA) results, and drug use data were collected from national databases. Poisson regression was used to calculate TB incidence rates (IRs) and assess associations with biologic treatment, IGRA status, country of birth, age, and sex.RESULTS: During 553 551 person-years of follow-up, 117 patients with TB disease were identified, with 71 cases occurring in biologic-naïve patients and 46 in biologic-treated individuals. The crude IR was 39.3 of 100 000 person-years (95% CI, 29.4-52.4) for biologic-treated individuals, compared with 12.4 of 100 000 person-years (95% CI, 9.2-16.8) for naive patients, yielding an IR ratio (IRR) of 3.2 (95% CI, 2.0-4.9). The TB risk was higher in IGRA-positive patients (vs. negative, IRR 45.0, 95% CI, 12.0-168.2) and those born in intermediate (vs. low-incidence country, IRR 7.9, 95% CI, 3.3-18.9) or high TB incidence countries (vs. low-incidence country, IRR 7.5, 95% CI, 2.9-19.1).DISCUSSION: The elevated risk of TB disease in patients with IRD and IBD treated with biologics is strongly associated with IGRA positivity and country of birth. These findings highlight the importance of comprehensive baseline TB risk assessment and patient education in combination with personalized follow-up to guide preventive strategies in this population.</p
Standing Firm Against the Stickiness of Care:The Absent Presence of Gender in a Gender-Neutral Parenting Course
No full textThis article examines how expectant and new Danish parents are positioned within gendered frameworks in universal-access parenting courses. We argue that these courses, despite claims of gender-neutrality, reproduce gender as an absent-present history. On the one hand, the discourse of shared parenting remains prominent, emphasizing the equal importance of both parents. On the other hand, unequal ideals of fatherhood vis-à-vis motherhood continue to persist. Notably, fathers are, to some extent, positioned as needing specialized “father-friendly” support, while mothers are guided towards intrasubjective evaluation, aligning with normative ideals of “intensive motherhood”. These gendered framings create not only a “stickiness of care”—capturing how both the practical and emotional responsibilities of caregiving cling disproportionately to mothers— but also generate “sticky emotions” that adhere differently across gender. While emotions such as autonomy and playfulness tend to “stick” to fatherhood, feelings of inadequacy and self-doubt are more readily attached to motherhood. However, moments of resistance also emerge. Some mothers refuse to engage in the intrasubjective self-evaluation, instead asserting their own authority and rejecting the framing of mothers as emotionally vulnerable. Following this, we propose the concept of “standing firm feminism” to capture how mothers may assert self-reliance in the face of institutionalized maternal ideals
Congruency effects in the retrieval task of the synesthesia Stroop, even for briefly learned letter-color associations
No full textGrapheme-color synesthesia is a neurological phenomenon in which graphemes evoke specific color experiences. This study investigates whether the color-naming and retrieval tasks of the synesthesia Stroop produce congruency effects that reliably index the synesthetic experience compared to non-synesthete controls. Experiment 1 compared 18 associator grapheme-color synesthetes and 18 non-synesthete controls. The non-synesthete group memorized five letter-color pairings before performing both a color-naming and a retrieval tasks. While a congruency effect was observed in the color-naming task for synesthetes only, both groups demonstrated congruency effects in the retrieval task. Furthermore, associator synesthetes showed larger congruency effects during the color-naming compared to the retrieval task, a pattern originally attributed to projector synesthetes. Experiment 2 examined whether associator synesthetes would also exhibit congruency effects for non-synesthetic letter-color pairings. Following a brief exposure to a novel letter-color association, synesthetes exhibited a congruency effect solely in the retrieval task, mirroring the findings from non-synesthetes in Experiment 1. These results align with MacLeod and Dunbar's continuum of automaticity, suggesting that congruency effects emerge when retrieval processes are less automatized than color-naming ones. Moreover, the presence of congruency effects in both synesthetes and non-synesthetes indicates that the retrieval task may not differentiate synesthetic experiences from briefly memorized associations. These findings question the utility of the retrieval task of the synesthesia Stroop as an objective tool for distinguishing synesthetes from non-synesthetes. It also reinforces the need for refined paradigms that better capture the perceptual properties underlying synesthesia
Personalized environmental control systems (PECS):A systematic review of performance evaluation methods for thermal comfort, air quality and energy
No full textPersonalized Environmental Control Systems (PECS) can improve both comfort and energy efficiency by shifting indoor climate control toward localized, occupant-tailored comfort, unlike conventional systems that condition entire, partly unoccupied spaces uniformly. Despite their potential, the absence of standardized assessment and reporting methods, and the diversified PECS technical specifics hinder consistent performance evaluation practices. Conducted in the framework of IEA EBC's Annex 87, this review, based on the PRISMA statement, provides a comprehensive overview of existing methods and indicators used to evaluate the performance of PECS, specifically targeting thermal and air quality domains. A novel three-layered classification approach was applied to categorize PECS types, and reviewed studies were grouped into four methodological categories: building simulation, CFD, chamber, and field studies. The review identifies methods’ usage trends, benefits, and limitations. Among 302 reviewed papers, more than half (61 %) adopt controlled laboratory tests, while CFD is the most used simulation method (68.6 % of simulation studies). Field studies are a minority, highlighting the limited implementation of PECS in real-world scenarios. Simulations are cost effective in rapidly prototyping and developing PECS. However, the insights they provide into PECS performance are limited by either model resolution constraints or high complexity. Comfort evaluations do not consider individual occupant differences nor behavior inherent to PECS. It is through experiments that knowledge can be gained on realistic occupant responses. However, they can be resource intensive and require careful planning. This review provides best practice guidelines to assist researchers in improving quality reporting of their methods.</p
Speech Prediction in ANC Headphones for Improved Attenuation:New Methods and Perceptual Study
Get PDFIn environments such as open offices and co-working spaces, the adverse effects of speech as a primary source of ambient noise extend beyond mere annoyance, contributing to reduced productivity, increased workload and stress. When dealing with speech, active noise control (ANC) systems have difficulties arising from constraints within the ANC system alongside the non-stationary nature of speech. These constraints require the optimal filters to be non-causal, creating a prediction problem. The non-causality is due to the delay incurred by, e.g., digital processing or acoustic propagation paths. To deal with this, we propose prediction-based feedforward ANC for headphone applications with improved voiced speech attenuation. The proposed methods leverage various aspects of speech characteristics and structure, including an optimal linear prediction (LP) scheme based on short- and long-term speech correlations, sparse LP modelling, harmonic and harmonic-chirp model-based prediction to account the non-stationarity of speech, and multiple-frequency ANC with harmonic decomposition of speech. Simulation results demonstrate the superior performance of the proposed methods compared to conventional adaptive feedforward ANC across a wide range of delays, spanning from 1 to 60 samples at a sampling frequency of 48 kHz (0.02 – 1.25 ms). The proposed methods achieve attenuation improvements of up to 8 dB and significantly extend attenuation to higher frequencies. Results from the perceptual study assessing subjective satisfaction with prediction-based ANC reveal that the artifacts from speech prediction have a more significant impact on satisfaction compared to attenuation
