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BACKGROUND: Tuberous sclerosis complex (TSC) is a rare multisystem autosomal dominant disorder caused by pathogenic variants in either the TSC1 or TSC2 gene. Common manifestations of TSC have been grouped into major and minor clinical diagnostic criteria and assessed in clinical routine workup. However, case studies point towards the existence of rare disease manifestations and to the potential as

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BACKGROUND Recurrent cervical cancer is a life-threatening disease, with limited treatment options available when disease progression occurs after first-line combination therapy. METHODS We conducted a phase 3, multinational, open-label trial of tisotumab vedotin as second- or third-line therapy in patients with recurrent or metastatic cervical cancer. Patients were randomly assigned, in a 1:1 rat

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Background: The Scandinavian Neurotrauma Committee guideline (SNC-16) was developed and published in 2016, to aid clinicians in management of pediatric head injuries in Scandinavian emergency departments (ED). The objective of this study was to explore determinants for use of the SNC-16 guideline by Swedish ED physicians. Methods: This is a nationwide, cross-sectional, web-based survey in Sweden.

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BACKGROUND: The widespread use of intramedullary nails (IMNs) compared with sliding hip screws (SHSs) in extracapsular hip fractures (AO/OTA 31-A1, 31-A2, 31-A3) has been questioned because of a higher complication rate, although the outcome might have improved through more recent implant designs and the learning curve. This study aimed to investigate if there is a difference with regard to the cu

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Background: Adolescent pregnancy and associated neonatal mortality are major global health challenges. In low-income settings where 90% of the 21 million global adolescent pregnancies occur, half are unintended and a fifth experience unsafe abortion. In Kenya, Uganda, and Tanzania, the survival patterns of neonates born to adolescents are unclear.Objectives: To assess survival patterns among neona

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Biogeochemical cycling of silicon (Si) in the Barents Sea is under considerable pressure from physical and chemical changes, including dramatic warming and sea ice retreat, together with a decline in dissolved silicic acid (DSi) concentrations of Atlantic inflow waters since 1990. Associated changes in the community composition of phytoplankton blooms will alter the material comprising the deposit

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BACKGROUND: Lead exposure has been associated with increased incidence of adverse clinical cardiovascular outcomes. Atherosclerosis has been suggested as one of the underlying mechanisms, and findings from experimental studies support this, but human data are scarce. OBJECTIVES: Our objective was to determine the association between environmental lead exposure based on blood lead (B-Pb) concentrat

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Nudging has been discussed in the context of policy and public health, but not so much within healthcare. This scoping review aimed to assess the empirical evidence on how nudging techniques can be used to affect the behavior of healthcare professionals (HCPs) in clinical settings. A systematic database search was conducted for the period January 2010-December 2020 using the PRISMA extension for S

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Background: Environmental exposures to industrial chemicals, including perfluoroalkyl substances (PFAS), may play a role in bone development and future risk of osteoporosis. However, as prospective evidence is limited, the role of developmental PFAS exposures in bone density changes in childhood is unclear. The objective of this study was to estimate associations between serum-PFAS concentrations

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Background: This study aimed to evaluate whether an increasing grade of obesity is associated with inferior outcomes after lumbar disc herniation (LDH) surgery. Methods: We retrieved data from the Swedish register for spine surgery regarding patients aged 20–64 who underwent LDH surgery from 2006–2016 and had preoperative and one-year postoperative data. A total of 4156 patients were normal weight

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Background. The urokinase plasminogen activator (uPA) system is involved in tissue remodelling processes and is up-regulated in many types of malignancies. We investigated whether serum levels of different forms of soluble uPA receptor (suPAR) are associated with survival and in particular with prostate cancer and cardiovascular disease mortality. Methods. Using time-resolved fluorescence immunoas

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Coronavirus disease (COVID-19) booster doses decrease infection transmission and disease severity. This study aimed to assess the acceptance of COVID-19 vaccine booster doses in low, middle, and high-income countries of the East Mediterranean Region (EMR) and its determinants using the health belief model (HBM). In addition, we aimed to identify the causes of booster dose rejection and the main so

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Background Fidanacogene elaparvovec, an adeno-associated virus (AAV) gene-therapy vector for hemophilia B containing a high-activity human factor IX variant (FIX-R338L/FIX-Padua), was associated with sustained factor IX activity in a phase 1-2a study. Methods We conducted a phase 3 open-label study of fidanacogene elaparvovec at a dose of 5×1011 vector genome copies per kilogram of body weight. Me

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OBJECTIVES: The efficacy of long-term opioid therapy (LTOT) in treating patients with chronic non-cancer pain (CnCP) is questionable, and the potential risks of adverse effects are well established. The aims were as follows: (1) compare characteristics in patients exposed to LTOT vs non-exposed. (2) Regarding opioid-exposed patients, describe characteristics of patients with risk factors for opioi

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Motivation: Pollinators play a crucial role in maintaining Earth's terrestrial biodiversity. However, rapid human-induced environmental changes are compromising the long-term persistence of plant-pollinator interactions. Unfortunately, we lack robust, generalisable data capturing how plant-pollinator communities are structured across space and time. Here, we present the EuPPollNet (European Plant-

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Background: Desmoplastic melanoma (DM) is a rare subtype, accounting for less than 5% of primary cutaneous invasive melanomas. DM often arises in chronically sun-exposed skin, in older individuals. While the incidence of cutaneous melanoma has increased globally, trends specific to DM are less documented and studies on survival outcomes for DM are inconsistent. Objectives: To study patient and tum

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Independent estimation and verification of fossil CO2 emissions on a regional and national scale are crucial for evaluating the fossil CO2 emissions and reductions reported by countries as part of their nationally determined contributions (NDCs). Top-down methods, such as the assimilation of in situ and satellite observations of different tracers (e.g., CO2, CO, Δ14CO2, XCO2), have been increasing

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BACKGROUND: In 2013, it was discovered that a subset of the population in Ronneby, Sweden was exposed to high levels of perfluorinated compounds (PFAS) from drinking water that had been provided by the local Brantafors waterworks and was contaminated by fire-fighting foam from a nearby airport. The start and time-course of population exposures are not known.OBJECTIVE: To investigate the start of P

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Background and Aims The long-term outcomes of percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and multivessel disease remain debated. Methods The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry

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Background: Butaro Cancer Center of Excellence (BCCOE) was founded to serve Rwanda’s rural low-income population, providing subsidized cancer diagnosis and treatment with transport stipends for the lowest-income patients. We examined whether travel distance to BCCOE was associated with advanced-stage diagnoses and treatment completion. Methods: We conducted a retrospective cohort study using medic