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St Gallen 2019 guidelines understage the axilla in lobular breast cancer : a population-based study

BACKGROUND: The St Gallen 2019 guidelines for primary therapy of early breast cancer recommend omission of completion axillary lymph node dissection (cALND), regardless of histological type, in patients with one or two sentinel lymph node (SLN) metastases. Concurrently, adjuvant chemotherapy is endorsed for luminal A-like disease with four or more axillary lymph node (ALN) metastases. The aim of t

Prediction of Postoperative Delirium After Cardiac Surgery with A Quick Test of Cognitive Speed, Mini-Mental State Examination and Hospital Anxiety and Depression Scale

Purpose: To evaluate if preoperative assessment with A Quick Test of Cognitive Speed (AQT) could increase the accuracy of predicting delirium after cardiac surgery compared to Mini-Mental State Examination (MMSE), and examine if a composite of variables, including cognitive function and depressive symptoms, could be useful to predict delirium. Patients and Methods: Cardiac surgery was performed in

Maternal exposure to cadmium during pregnancy is associated with changes in DNA methylation that are persistent at 9 years of age

Background: Cadmium (Cd) exposure during gestation has been associated with altered DNA methylation at birth, but it is not known if the changes in methylation persist into childhood. Objectives: To evaluate whether gestational Cd-related changes of DNA methylation persist from birth to 9 years of age. Methods: We studied mother–child dyads in a longitudinal cohort in rural Bangladesh. Cadmium con

Sexual harassment among employees and students at a large Swedish university : who are exposed, to what, by whom and where – a cross-sectional prevalence study

Background: Sexual harassment (SH) in the workplace is prevalent and associated with poor health. Universities are large workplaces with complex formal and informal power relations, which may influence the prevalence of SH. Although employees and students share the university context, few studies on SH have included both groups. The overall aim of the study was to investigate SH among employees an

Implementation of physical activity on prescription for children with obesity in paediatric health care (IMPA) : protocol for a feasibility and evaluation study using quantitative and qualitative methods

Background: Physical inactivity is a main cause of childhood obesity which tracks into adulthood obesity, making it important to address early in life. Physical activity on prescription (PAP) is an evidence-based intervention that has shown good effect on physical activity levels in adults, but has not been evaluated in children with obesity. This project aims to evaluate the prerequisites, determ

Prevalence and comorbidity in a Swedish adolescent community sample – gambling, gaming, substance use, and other psychiatric disorders

Background: This study investigates a broad spectrum of psychiatric disorders, substance use disorders, gambling, and internet gaming disorders in Swedish 18-year-old boys and girls with the aim of estimating the prevalence of disorders and comorbidity. Methods: We used a two-phase design with screening to detect candidates for clinical interviews. Screening included 949 adolescents (55.6% girls),

Effectiveness of first generation disease-modifying therapy to prevent conversion to secondary progressive multiple sclerosis

Background: The use of disease-modifying therapies (DMTs) in multiple sclerosis (MS) has been associated with reduced relapse rates and accumulation of disability. However, studies examining impact of DMT on risk of transition to secondary progressive MS (SPMS) leveraging population-based nationwide data are still rare. Here, we determine the population incidence of conversion to SPMS using two co

A co-created nurse-driven catheterisation protocol can reduce bladder distension in acute hip fracture patients - results from a longitudinal observational study

Background: Urinary retention is common in elderly patients undergoing acute hip fracture surgery. Avoiding overfilling the urinary bladder is important to avoid detrusor muscle damage and associated motility problems. The aim of this study was to analyse associations between the co-creation of a nurse-driven urinary catheterisation protocol and the incidence of bladder distension in patients unde

Knowledge of Human Monkeypox and Its Relation to Conspiracy Beliefs among Students in Jordanian Health Schools : Filling the Knowledge Gap on Emerging Zoonotic Viruses

Background and Objective: The recent multi-country outbreak of human monkeypox (HMPX) in non-endemic regions poses an emerging public health concern. University students in health schools/faculties represent a core knowledgeable group that can be helpful to study from a public health point of view. As future healthcare workers, assessment of their knowledge and attitude towards emerging zoonotic v

Frequent carbon input primes decomposition of decadal soil organic matter

Soil organic matter (SOM) decomposition in response to global change represents a critical uncertainty in coupled carbon (C) cycle-climate models. Much of this uncertainty arises from our limited mechanistic knowledge of the effects of organic C input frequency on SOM decomposition. Based on a three-source-partitioning isotopic approach (14C glucose addition to soil continuously labeled by C4 plan

Estimation of actual evapotranspiration : A novel hybrid method based on remote sensing and artificial intelligence

Actual evapotranspiration (AET) is one of the decisive factors controlling the water balance at the catchment level, particularly in arid and semi-arid regions, but measured data for which are generally unavailable. In this study, performance of a base artificial intelligence (AI) model, adaptive neuro-fuzzy inference system (ANFIS), and its hybrids with two bio-inspired optimization algorithms, n

Prevalence of and factors associated with early initiation of breastfeeding among women with children aged < 24 months in Kilimanjaro region, northern Tanzania : A community-based cross-sectional study

Background: Early initiation of breastfeeding offers nutritional and immunological benefits to the newborn, which is critical for health and survival. Understanding factors associated with timely initiation of breastfeeding is crucial for healthcare providers and policy-makers. This study aimed to assess the prevalence and factors associated with early initiation of breastfeeding among mothers wit

Healthcare utilization for somatic conditions among Swedish patients in opioid substitution treatment, with and without on-site primary healthcare

Background: Opioid substitution treatment (OST) populations are aging and have increased mortality and somatic morbidity compared to general populations internationally. While OST patients have poor self-rated physical health and unmet healthcare needs, documented healthcare utilization has been sparsely investigated. The aim of this study was to assess registered healthcare utilization for somati

Changes in joint cartilage aggrecan after knee injury and in osteoarthritis

Objective. To determine the concentrations of aggrecan fragments in synovial fluid from patients with knee joint injury, osteoarthritis (OA), or acute pyrophosphate arthritis (PPA; pseudogout), and to test their relative reactivity with the 846 epitope, a putative marker of cartilage aggrecan synthesis. Methods. Samples of knee joint fluid from 385 patients and 9 healthy-knee volunteers were obtai

Intact cord resuscitation versus early cord clamping in the treatment of depressed newborn infants during the first 10 minutes of birth (Nepcord III) - a randomized clinical trial

Background: Experiments have shown improved cardiovascular stability in lambs if umbilical cord clamping is postponed until positive pressure ventilation is started. Studies on intact cord resuscitation on human term infants are sparse. The purpose of this study was to evaluate differences in clinical outcomes in non-breathing infants between groups, one where resuscitation is initiated with an in

Higher versus lower blood pressure targets after cardiac arrest : Systematic review with individual patient data meta-analysis

Purpose: Guidelines recommend targeting mean arterial pressure (MAP) > 65 mmHg in patients after cardiac arrest (CA). Recent trials have studied the effects of targeting a higher MAP as compared to a lower MAP after CA. We performed a systematic review and individual patient data meta-analysis to investigate the effects of higher versus lower MAP targets on patient outcome. Method: We searched the

Salvage radiotherapy after radical prostatectomy : functional outcomes in the LAPPRO trial after 8-year follow-up

OBJECTIVE: Radical prostatectomy reduces mortality among patients with localized prostate cancer, however up to 35% of patients will experience biochemical recurrence, often treated with salvage radiotherapy. The objective of the study was to investigate long-term effects of salvage radiotherapy. METHODS: A prospective, controlled, non-randomized trial at 14 Swedish center's including 4,003 patien

False-positive recalls in the prospective Malmö Breast Tomosynthesis Screening Trial

Objectives: To evaluate the total number of false-positive recalls, including radiographic appearances and false-positive biopsies, in the Malmö Breast Tomosynthesis Screening Trial (MBTST). Methods: The prospective, population-based MBTST, with 14,848 participating women, was designed to compare one-view digital breast tomosynthesis (DBT) to two-view digital mammography (DM) in breast cancer scre

Association between obstructive sleep apnoea and cancer : a cross-sectional, population-based study of the DISCOVERY cohort

Objectives Nocturnal hypoxia in obstructive sleep apnoea (OSA) is a potential risk factor for cancer. We aimed to investigate the association between OSA measures and cancer prevalence in a large national patient cohort. Design Cross-sectional study. Settings 44 sleep centres in Sweden. Participants 62 811 patients from the Swedish registry for positive airway pressure (PAP) treatment in OSA, link