BACKGROUND & AIMS: OBJECTIVES:Evaluation and comparison of the performance of organized and opportunistic screening mammography. METHODS:Women attending screening mammography in Denmark in 2000. The study included 37,072 women attending organized screening. Among these, 320 women were diagnosed with breast cancer during follow-up. Opportunistic screening was attended by 2855 women with 26 women being diagnosed with breast cancer. Data on women attending screening were linked with information on cancer status. Each woman was followed with respect to diagnosis of breast cancer (invasive as well as in situ) for a period of two years. Screening outcome and cancer status during follow-up were combined to assess whether the result of the examination was true-positive, true-negative, false-positive or false-negative. Based on this classification, age-adjusted sensitivity and specificity of organized and opportunistic screening were calculated. RESULTS:Defining BI-RADS(trade mark) 4-5 as a positive screening outcome, the overall sensitivity of opportunistic screening was 33.6% and the specificity was 99.1%. Using BI-RADS(trade mark) 3-5 as positive, the sensitivity was 37.4% and the specificity was 97.9%. Organized screening (which was not categorized according to BI-RADS(trade mark)) had an overall sensitivity of 67.2% and a specificity of 98.4%. CONCLUSION:Our study showed a considerably higher sensitivity in organized screening than in opportunistic screening, while the specificity was fairly similar in the two settings. The findings support implementation of population-based breast screening programmes, as recommended in the 'European guidelines for quality assurance in breast cancer screening and diagnosis'.

背景与目标：

BACKGROUND & AIMS: :The reasons for social inequality in breast cancer survival are far from established. Our study aims to study the importance of a range of socioeconomic factors and comorbid disorders on survival after breast cancer surgery in Denmark where the health care system is tax-funded and uniform. All 25,897 Danish women who underwent protocol-based treatment for breast cancer in 1983-1999 were identified in a clinical database and information on socioeconomic variables and both somatic and psychiatric comorbid disorders was obtained from population-based registries. We used Cox proportional hazards models to estimate the association between socioeconomic position and overall survival and further to analyse breast cancer specific deaths in a competing risk set-up regarding all other causes of death as competing risks. The adjusted hazard ratio (HR) for death was reduced in women with higher education (HR, 0.91; 95% confidence interval (CI), 0.85-0.98), with higher income (HR, 0.93; 95% CI, 0.87-0.98) and with larger dwellings (HR, 0.90; 95% CI, 0.85-0.96 for women living in houses larger than 150 m(2)). Presence of comorbid disorders increased the HR. An interaction between income and comorbid disorders resulting in a 15% lower survival 10 year after primary surgery in poor women with low-risk breast cancer having comorbid conditions ( approximately 65%) compared to rich women with similar breast cancer prognosis and comorbid conditions ( approximately 80%) suggests that part of the explanation for the social inequality in survival after breast cancer surgery in Denmark lies in the access to and/or compliance with management of comorbid conditions in poorer women.

背景与目标： : 乳腺癌生存中社会不平等的原因远未确定。我们的研究旨在研究一系列社会经济因素和合并症对丹麦乳腺癌手术后生存率的重要性，丹麦的医疗保健系统由税收资助且统一。在临床数据库中确定了1983-1999年接受基于方案的乳腺癌治疗的所有25,897名丹麦妇女，并从基于人群的注册表中获得了有关社会经济变量以及躯体和精神合并症的信息。我们使用Cox比例风险模型来估计社会经济地位与总生存率之间的关联，并进一步分析了所有其他死亡原因作为竞争风险的竞争风险设置中的乳腺癌特定死亡。受过高等教育 (HR，0.91; 95% 置信区间 (CI)，0.85-0.98)，收入较高 (HR，0.93; 95% CI，0.87-0.98) 和居住较大 (HR，0.90; 95% CI，0.85-0.96居住在大于150 m(2) 的房屋中的妇女)。合并症的存在增加了HR。收入与合并症之间的相互作用导致患有合并症的低危乳腺癌的贫困妇女在初次手术后10年的生存率15% 低于患有合并症的富裕妇女 (约65%)，而患有乳腺癌预后和合并症的富裕妇女 (约80%) 表明，对社会不平等的部分解释丹麦乳腺癌手术后的生存在于较贫穷妇女获得和/或遵守合并症的管理。

BACKGROUND & AIMS: INTRODUCTION:The epidemiology of children or adolescents admitted to a Scandinavian trauma centre is largely unknown. The aim of this paper was to describe the epi-demiology and severity of potentially severely injured children and adolescents admitted to a university hospital trauma centre. METHODS:This was a descriptive study of all children and adolescents aged 0-17 admitted to the university level trauma centre at Odense University Hospital, Denmark in the 2002-2011 period. Data were extracted from the Southern Danish Trauma Register and from medical records. RESULTS:A total of 950 children and adolescents were included. The median age was 13 (range: 0-17) years. Boys accounted for 60.6% of the cases. Accidents accounted for 97.2%, violence 1.4% and self-inflicted injuries 0.4%. More than three fourths of the injuries occurred either in traffic or at home. The occurrence was greatest in the summer (34.0%), during weekends (48.9%) and in the hours between 12.00 and 20.00 (59.2%). Overall, 58.5% of the in-juries were due to traffic. Of these injuries, 39.7% were in-juries suffered by passengers in motor vehicles, 27.5% drivers/passengers of a scooter/MC, 21.8% bicyclists and 10.3% pedestrians. The median Injury Severity Score (ISS) and Abbreviated Injury Scale was 4 (range: 1-75) and 2 (range: 1-6), respectively. Head/face injuries accounted for 36.5% and injuries to the extremities for 30.9% of all injuries. A total of 153 (16.1%) suffered from severe injuries (ISS > 15). Overall, 49 (5.2%) died due to their injuries. CONCLUSIONS:Based on a local trauma register, we described the epidemiology and severity of potentially se-verely injured children and adolescents admitted to a university trauma centre. FUNDING:none. TRIAL REGISTRATION:not relevant.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Multiple sclerosis (MS) and other autoimmune diseases might cluster. Our aim was to estimate the relative risk (RR) of other autoimmune diseases among MS patients and their first-degree relatives in a population-based cohort study. METHODS:Using the Danish Multiple Sclerosis Register, the Danish Hospital Discharge Register, and the Danish Civil Registration System, we estimated RRs for 42 different autoimmune diseases in a population-based cohort of 12 403 MS patients and 20 798 of their first-degree relatives. Ratios of observed to expected numbers of autoimmune diseases, based on national sex-, age-, and period-specific incidence rates, served as measures of the RRs. RESULTS:Compared with the general population, MS patients were at an increased risk of developing ulcerative colitis (RR = 2.0 (95% confidence interval (CI): 1.4-2.8), n = 29) and pemphigoid (RR = 15.4 (CI: 8.7-27.1), n = 12) but at reduced risk of rheumatoid arthritis (RR = 0.5 (CI: 0.4-0.8), n = 28) and temporal arteritis (RR = 0.5 (CI: 0.3-0.97), n = 11). First-degree relatives of MS patients were at increased risks of Crohn's disease (RR = 1.4 (CI: 1.04-1.9), n = 44), ulcerative colitis (RR = 1.3 (CI: 0.99-1.7), n = 51), Addison's disease (RR = 3.4 (CI: 1.3-9.0), n = 4), and polyarteritis nodosa (RR = 3.7 (CI: 1.4-10.0), n = 4). CONCLUSION: PATIENTS:with MS and their first-degree relatives seem to be at an increased risk of acquiring certain other autoimmune diseases.

背景与目标：

BACKGROUND & AIMS: :Tiotropium (Spiriva is an inhaled, once-daily anticholinergic medication for chronic obstructive pulmonary disease (COPD). We conducted a population-based cohort study to examine the risk of cardiovascular and respiratory hospitalizations and mortality with tiotropium. Using the Danish healthcare registries, we identified persons >/=40 years old in three counties who were hospitalized for COPD from 1/1/1977 to 12/31/2003. Respiratory and cardiovascular medications were assessed from dispensing records. Cox regression was used to compute incidence rate ratios (RR) and 95% confidence intervals (CI) for hospitalization and death between 1/1/2002 and 12/31/2003, associated with periods of tiotropium use compared to non-use, controlling for age, gender, time since COPD, concomitant respiratory and cardiovascular medications, prior hospitalizations and Charlson comorbidity index. Among persons with COPD (10,603), 75% were >/=60 years old. Follow-up was >/=18 months for 64%. Among those exposed to tiotropium compared to periods of non-use, the RR for total and cause-specific hospitalization endpoints were not elevated except for COPD hospitalization (RR = 1.52, 95% CI: 1.29, 1.79). Mortality endpoints included total mortality (RR = 0.77, 95% CI: 0.65, 0.91), respiratory mortality (RR = 0.79, 95% CI: 0.60, 1.04), sudden death (RR = 0.71, 95% CI: 0.21, 2.34), cardiac arrest (RR = 0.74, 95% CI: 0.42, 1.32), heart failure (RR = 0.84, 95% CI: 0.41, 1.75), and myocardial infarction (RR = 1.25, 95% CI: 0.49, 3.17). Compared to periods of non-use, tiotropium was associated with reduced respiratory and overall mortality and was not associated with increased cardiac mortality. An increase in COPD hospitalization is inconsistent with clinical trial data and suggests preferential prescribing due to disease severity.

背景与目标： : 噻托溴胺 (Spiriva是一种吸入的、每日一次的抗胆碱能药物治疗慢性阻塞性肺疾病 (COPD)。我们进行了一项基于人群的队列研究，以检查噻托溴胺的心血管和呼吸系统住院风险以及死亡率。使用丹麦医疗保健登记处，我们确定了从1/1/1977到12/31/2003三个县因COPD住院的>/= 40岁的人。根据配药记录评估呼吸和心血管药物。Cox回归用于计算1/1/2002和12/31/2003之间住院和死亡的发病率比 (RR) 和95% 置信区间 (CI)，与未使用噻托溴的时间相比，控制年龄、性别、自COPD以来的时间、合并呼吸道和心血管药物、先前住院和查尔森合并症指数。在COPD患者中 (10,603)，75%>/= 60岁。64% 随访>/= 18个月。与未使用期间相比，暴露于噻托溴的患者中，除COPD住院外，总住院终点和特定原因住院终点的RR没有升高 (RR = 1.52，95% CI: 1.29，1.79)。死亡终点包括总死亡率 (RR = 0.77，95% CI: 0.65，0.91)，呼吸系统死亡率 (RR = 0.79，95% CI: 0.60，1.04)，猝死 (RR = 0.71，95% CI: 0.21，2.34)，心脏骤停 (RR = 0.74，95% CI: 0.42，1.32)，心力衰竭 (RR = 0.84，95% CI: 0.41，1.75) 和心肌梗死 (RR = 1.25，95% CI: 0.49，3.17)。噻托溴啶与呼吸系统和总体死亡率的降低相关，与心脏死亡率的增加无关。COPD住院率的增加与临床试验数据不一致，并且由于疾病的严重程度，建议优先开处方。

BACKGROUND & AIMS: :Within recent years, many precision cancer medicine initiatives have been developed. Most of these have focused on solid cancers, while the potential of precision medicine for patients with hematological malignancies, especially in the relapse situation, are less elucidated. Here, we present a demographic unbiased and observational prospective study at Aalborg University Hospital Denmark, referral site for 10% of the Danish population. We developed a hematological precision medicine workflow based on sequencing analysis of whole exome tumor DNA and RNA. All steps involved are outlined in detail, illustrating how the developed workflow can provide relevant molecular information to multidisciplinary teams. A group of 174 hematological patients with progressive disease or relapse was included in a non-interventional and population-based study, of which 92 patient samples were sequenced. Based on analysis of small nucleotide variants, copy number variants, and fusion transcripts, we found variants with potential and strong clinical relevance in 62% and 9.5% of the patients, respectively. The most frequently mutated genes in individual disease entities were in concordance with previous studies. We did not find tumor mutational burden or micro satellite instability to be informative in our hematologic patient cohort.

背景与目标： : 近年来，已经制定了许多精准癌症医学计划。其中大多数集中在实体癌上，而精准医学对血液系统恶性肿瘤患者 (尤其是在复发情况下) 的潜力却很少阐明。在这里，我们在丹麦奥尔堡大学医院进行了一项人口统计学无偏见和观察性前瞻性研究，该研究是丹麦人口10% 的转诊地点。我们开发了基于全外显子组肿瘤DNA和RNA测序分析的血液学精准医学工作流程。详细概述了所涉及的所有步骤，说明了开发的工作流程如何向多学科团队提供相关的分子信息。一组174例进展性疾病或复发的血液学患者被纳入一项非干预性和基于人群的研究，其中92例患者样本被测序。基于对小核苷酸变异体，拷贝数变异体和融合转录物的分析，我们分别在62% 和9.5% 患者中发现了具有潜在和强烈临床相关性的变异体。单个疾病实体中最常突变的基因与先前的研究一致。在我们的血液学患者队列中，我们没有发现肿瘤突变负荷或微卫星不稳定性是有用的。

BACKGROUND & AIMS: INTRODUCTION:Survival has improved among very preterm born infants, but improved treatment strategies might be associated with increasing rates of neonatal morbidity. The aim of this study was to assess survival and major morbidities among very and extremely preterm born infants treated in a Danish neonatal intensive care unit. METHODS:This was an observational cohort study including very preterm infants (gestational age (GA) < 32 weeks) born between year 2000 and 2013. Because of changes in three standard treatments from 2008, we aimed to compare survival and major neonatal morbidity between two birth-year periods: 2000-2007 and 2008-2013. RESULTS:The overall survival rate increased from 81.6% to 85.0%. In GA group 26-27 weeks, survival increased from 65% to 89% (p = 0.02). A total of 31/412 (7.5%) in the first time period and 30/280 (10.7%) in the second time period were diagnosed with bronchopulmonary dysplasia. No difference was found for necrotising entrocolitis or intraventricular haemorhage. Antibiotic treatment was similar in the two time periods, though antibiotic treatment for suspected clinical infection increased in the second time period (35.1% versus 44.1%). CONCLUSIONS:We found a significant increase in the survival rate in GA group 26-27 weeks, but no significant increase in any major morbidity when comparing the two time periods. TRIAL REGISTRATION:not relevant. FUNDING:none.

背景与目标：

BACKGROUND & AIMS: BACKGROUND/OBJECTIVES:Government guidance promote benchmarking comparing quality of care including both clinical values and patient reported outcome measures in young persons with type 1 diabetes. The aim was to test if the Nordic DISABKIDS health-related quality of life (HrQoL) modules were construct valid and measurement comparable within the three Nordic countries. METHODS:Data from three DISABKIDS validation studies in Sweden, Denmark, and Norway were compared using Rasch and the graphical log-linear Rasch modeling. Monte Carlo methods were used to estimate reliability coefficient and target was defined as the point with the lowest SE of the mean. Self-report data were available from 99 Danish (8-18 years), 103 Norwegian (7-19 years), and 131 Swedish (8-18 years) young people. RESULTS:For the DISABKIDS higher scores on most subscales were noted in the Norwegian population. The Swedish sample had a significantly higher score on the "Diabetes treatment" subscale and scores closer to optimal target than the other countries. For each country, construct validity and sensitivity were acceptable when accounting for differential item function (DIF) and local dependency (LD). Less LD and DIF were found if only Denmark and Norway were included. The combined model was reliable; however, some differences were noted in the scale translations relating to the stem and response alternatives, which could explain the discrepancies. CONCLUSION:The Nordic versions of the DISABKIDS questionnaires measures valid and reliable HrQoL both within and between countries when adjusted for DIF and LD. Adjusting the Likert scales to the same respond categories may improve comparability.

背景与目标：

BACKGROUND & AIMS: :Breakfast is considered by many to be the most important meal of the day. This study examined the intake of nutrients and foods at breakfast among Danes and the relation to the overall dietary quality. Data were derived from the Danish National Survey on Diet and Physical Activity 2011⁻2013, a cross-sectional national food consumption study. A total of 3680 participants aged 6⁻75 years were included in the analyses of breakfast consumption. The Nutrient Rich Food Index 9.3 method was used to examine the overall dietary quality of the diet. The intake of nutrients and foods at breakfast were compared across dietary quality score tertiles by ANCOVA adjusted for energy and socio economic status. Breakfast was eaten frequently by children and adults and contributed with 18⁻20% of total energy intake. Breakfast was relatively high in dietary fibre, B vitamins, calcium and magnesium and low in added sugar, total fat, sodium, vitamin A and D. A decrease in the intake of added sugar, total fat and saturated fat and an increase in the intake of dietary fibre and most micronutrients were seen across tertiles of dietary quality scores. Commonly consumed foods provided at breakfast in Denmark included bread, breakfast cereals and dairy products as well as water, coffee and juice, while intakes of fruits, vegetables, cakes and soft drinks were low.

背景与目标： : 早餐被许多人认为是一天中最重要的一餐。这项研究调查了丹麦人早餐时营养素和食物的摄入量以及与整体饮食质量的关系。数据来自丹麦全国饮食和体育活动调查2011 2013，这是一项横断面的全国食品消费研究。共有3680名年龄在6-75岁的参与者被纳入早餐消费分析。采用营养丰富的食物指数9.3方法考察了膳食的总体质量。通过ANCOVA调整了能量和社会经济地位，比较了早餐时的营养和食物摄入量，并通过饮食质量评分进行了比较。儿童和成人经常吃早餐，占总能量摄入的18 20%。早餐的膳食纤维，b族维生素，钙和镁相对较高，而糖，总脂肪，钠，维生素a和D的添加量较低。在饮食质量评分的三分位数中，添加的糖，总脂肪和饱和脂肪的摄入量减少，膳食纤维和大多数微量营养素的摄入量增加。丹麦早餐时提供的常见食物包括面包，早餐谷物和乳制品以及水，咖啡和果汁，而水果，蔬菜，蛋糕和软饮料的摄入量却很低。

BACKGROUND & AIMS: OBJECTIVES:To describe the epidemiology and clinical heterogeneity of Guillain-Barré syndrome (GBS) in Denmark and to compare a population-based cohort to prospectively included patients in the International GBS Outcome Study (IGOS). METHODS:The incidence rate (IR) of GBS in Denmark from September 2012 to December 2015, applying the National Institute of Neurological Disorders and Stroke (NINDS) diagnostic criteria, was estimated and the level of diagnostic certainty was described with the Brighton criteria. All cases registered with a diagnosis of GBS or other inflammatory neuropathies in the Danish National Hospital Registry were reviewed for diagnostic criteria and for information on treatment and clinical course. RESULTS:A total of 299 GBS cases were confirmed, corresponding to a crude IR of 1.59 (95% CI 1.42-1.78) per 100,000 per year. The Brighton criteria level 1-3 of diagnostic certainty was met in 279 (93%) of the patients. Thirty-five percent of the patients were mildly affected (GBS disability score < 3) and a correlation between high age and high disability score at nadir was found (Spearman's rank correlation coefficient 0.42, p < 0.0001). The group of 89 (30%) patients who were enrolled in IGOS had higher GBS disability score at nadir, were admitted 5 days earlier, reached nadir 4 days faster, and a larger proportion received treatment with IVIg (all p < 0.05). CONCLUSION:The epidemiology and full clinical spectrum of GBS are described in a population-based study. This includes a larger proportion of milder cases that are underrepresented in prospective cohorts such as IGOS.

背景与目标：

BACKGROUND & AIMS: :This biogeochemical, molecular genetic and lipid biomarker study of sediments ( approximately 4 m cores) from the Skagerrak (Denmark) investigated methane cycling in a sediment with a clear sulfate-methane-transition zone (SMTZ) and where CH(4) supply was by diffusion, rather than by advection, as in more commonly studied seep sites. Sulfate reduction removed sulfate by 0.7 m and CH(4) accumulated below. (14)C-radiotracer measurements demonstrated active H(2)/CO(2) and acetate methanogenesis and anaerobic oxidation of CH(4) (AOM). Maximum AOM rates occurred near the SMTZ ( approximately 3 nmol cm(-3) day(-1) at 0.75 m) but also continued deeper, overall, at much lower rates. Maximum rates of H(2)/CO(2) and acetate methanogenesis occurred below the SMTZ but H(2)/CO(2) methanogenesis rates were x 10 those of acetate methanogenesis, and this was consistent with initial values of (13)C-depleted CH(4) (delta(13)C c.-80 per thousand). Areal AOM and methanogenic rates were similar ( approximately 1.7 mmol m(-2) day(-1)), hence, CH(4) flux is finely balanced. A 16S rRNA gene library from 1.39 m combined with methanogen (T-RFLP), bacterial (16S rRNA DGGE) and lipid biomarker depth profiles showed the presence of populations similar to some seep sites: ANME-2a (dominant), ANME-3, Methanomicrobiales, Methanosaeta Archaea, with abundance changes with depth corresponding to changes in activities and sulfate-reducing bacteria (SRB). Below the SMTZ to approximately 1.7 m CH(4) became progressively more (13)C depleted (delta(13)C -82 per thousand) indicating a zone of CH(4) recycling which was consistent with the presence of (13)C-depleted archaeol (delta(13)C -55 per thousand). Pore water acetate concentrations decreased in this zone (to approximately 5 microM), suggesting that H(2), not acetate, was an important CH(4) cycling intermediate. The potential biomarkers for AOM-associated SRB, non-isoprenoidal ether lipids, increased below the SMTZ but this distribution reflected 16S rRNA gene sequences for JS1 and OP8 bacteria rather than those of SRB. At this site peak rates of methane production and consumption are spatially separated and seem to be conducted by different archaeal groups. Also AOM is predominantly coupled to sulfate reduction, unlike recent reports from some seep and gassy sediment sites.

背景与目标： : 这项对来自Skagerrak (丹麦) 的沉积物 (约4 m核心) 的生物地球化学，分子遗传和脂质生物标志物研究了具有透明硫酸盐-甲烷过渡区 (SMTZ) 的沉积物中的甲烷循环，其中CH(4) 的供应是通过扩散而不是平流，就像在更常见的研究渗漏位点一样。硫酸盐还原去除硫酸盐由下面累积的0.7 m和CH(4)。(14)C-放射性示踪剂测量显示了活性H(2)/CO(2) 和乙酸甲烷生成以及CH(4) (AOM) 的厌氧氧化。最大AOM速率发生在SMTZ附近 (在0.75 m处约3 nmol cm(-3) 天 (-1))，但总体上仍以更低的速率持续更深。H(2)/CO(2) 和乙酸甲烷生成的最大速率发生在SMTZ以下，但H(2)/CO(2) 甲烷生成的速率为x 10乙酸甲烷生成的速率，这与 (13)C耗尽的CH(4) (δ (13)C c.-80每千) 的初始值一致。面积AOM和产甲烷速率相似 (约1.7 mmol m(-2) 天 (-1))，因此，CH(4) 通量是精细平衡的。1.39 m的16S rRNA基因库与产甲烷菌 (t-rflp)，细菌 (16S rRNA DGGE) 和脂质生物标志物深度图谱相结合，表明存在与某些seep位点相似的种群: ANME-2a (显性)，ANME-3，甲烷菌，甲烷菌，随着深度的变化，相应于活性和硫酸盐还原细菌 (SRB) 的变化。低于SMTZ至约1.7 m CH(4) 逐渐变得更 (13)C耗尽 (δ (13)C -82每千)，表明CH(4) 再循环区域与 (13)C耗尽古细菌 (δ (13)C -55 ‰)。该区域的孔隙水乙酸盐浓度降低 (约为5微米)，表明H(2) 而不是乙酸盐是重要的CH(4) 循环中间体。与AOM相关的SRB (非异戊二烯醚脂质) 的潜在生物标志物在SMTZ以下增加，但这种分布反映了JS1和OP8细菌的16S rRNA基因序列，而不是SRB。在这个地点，甲烷生产和消耗的峰值速率在空间上是分开的，似乎是由不同的古细菌群体进行的。与最近一些渗漏和瓦斯沉积物站点的报道不同，AOM主要与硫酸盐的减少有关。

BACKGROUND & AIMS: Importance:Febrile seizures occur in 2% to 5% of children between the ages of 3 months and 5 years. Many affected children experience recurrent febrile seizures. However, little is known about the association between recurrent febrile seizures and subsequent prognosis. Objective:To estimate the risk of recurrent febrile seizures and whether there is an association over long-term follow-up between recurrent febrile seizures and epilepsy, psychiatric disorders, and death in a large, nationwide, population-based cohort in Denmark. Design, Setting, and Participants:This population-based cohort study evaluated data from all singleton children born in Denmark between January 1, 1977, and December 31, 2011, who were identified through the Danish Civil Registration System. Children born in Denmark who were alive and residing in Denmark at age 3 months were included (N = 2 103 232). The study was conducted from September 1, 2017, to June 1, 2019. Exposures:Hospital contacts with children who developed febrile seizures between age 3 months and 5 years. Main Outcomes and Measures:Children diagnosed with epilepsy were identified in the Danish National Patient Register and children diagnosed with psychiatric disorders were identified in the Psychiatric Central Research Register. Competing risk regression and Cox proportional hazards regression were used to estimate the cumulative and relative risk of febrile seizures, recurrent febrile seizures, epilepsy, psychiatric disorders, and death. Results:Of the 2 103 232 children (1 024 049 [48.7%] girls) in the study population, a total of 75 593 children (3.6%) were diagnosed with a first febrile seizure between 1977 and 2016. Febrile seizures were more common in boys (3.9%; 95% CI, 3.9%-4.0%) than in girls (3.3%; 95% CI, 3.2%-3.3%), corresponding to a 21% relative risk difference (hazard ratio, 1.21; 95% CI, 1.19-1.22). However, the risks of recurrent febrile seizures, epilepsy, psychiatric disorders, and death were similar in boys and girls. The risk of (recurrent) febrile seizures increased with the number of febrile seizures: 3.6% at birth, 22.7% (95% CI, 22.4%-23.0%) after the first febrile seizure, 35.6% (95% CI, (34.9%-36.3%) after the second febrile seizure, and 43.5% (95% CI, (42.3%-44.7%) after the third febrile seizure. The risk of epilepsy increased progressively with the number of hospital admissions with febrile seizures. The 30-year cumulative risk of epilepsy was 2.2% (95% CI, (2.1%-2.2%) at birth compared with 15.8% (95% CI, 14.6%-16.9%) after the third febrile seizure, while the corresponding estimates for risk of psychiatric disorders were 17.2% (95% CI, 17.2%-17.3%) at birth and 29.1% (95% CI, 27.2%-31.0%) after the third febrile seizure. Mortality was increased among children with recurrent febrile seizures (1.0%; 95% CI, 0.9%-1.0% at birth vs 1.9%; 95% CI, 1.4%-2.7% after the third febrile seizure), although this risk was associated primarily with children who later developed epilepsy. Conclusions and Relevance:A history of recurrent febrile seizures appears to be associated with a risk of epilepsy and psychiatric disorders, but increased mortality was found only in individuals who later developed epilepsy.

背景与目标：

BACKGROUND & AIMS: :A rise in community-onset Staphylococcus aureus infections has been observed in European countries. To ascertain secular trends of S. aureus infections in primary healthcare in Denmark, we conducted this register-based study in the North Denmark region, during the period 1997-2008. We identified all skin and mucosa specimens obtained by general practitioners and all prescriptions for the preferred oral anti-staphylococcal antibiotic, dicloxacillin. Repeat observations within a 12-month period were excluded prior to the calculation of age and gender standardised incidence rates per 100,000 person-years. We included 108,758 specimens, of which 42,778 (39%) yielded S. aureus. The annual incidence rate of specimens doubled during the study period, reaching 2,399 in 2008. The overall rate of S. aureus isolates increased 2-fold to a stable rate at about 850, but for isolates from children and for impetigo specimens, the increase was steeper, with a peak in 2002. A total of 156,462 dicloxacillin prescriptions had been redeemed and the annual prescription rate increased 2.5-fold, peaking at 3,714 in 2007. In conclusion, the annual rates of specimens, S. aureus infections and dicloxacillin prescriptions more than doubled in primary healthcare during the 12-year study period. A major impetigo epidemic and calls for antibiotic stewardship with increased utilisation of specimens were contributing factors.

背景与目标： : 在欧洲国家，社区发病的金黄色葡萄球菌感染有所增加。为了确定丹麦初级医疗保健中金黄色葡萄球菌感染的长期趋势，我们在1997-2008年期间在北丹麦地区进行了这项基于注册的研究。我们确定了全科医生获得的所有皮肤和粘膜标本以及首选的口服抗葡萄球菌抗生素双氯西林的所有处方。在计算每100,000人年的年龄和性别标准化发病率之前，排除了12个月内的重复观察。我们包括108,758个标本，其中42,778个 (39% 个) 产生了金黄色葡萄球菌。在研究期间，标本的年发病率翻了一番，达到2,399 2008年。金黄色葡萄球菌分离株的总比率增加了2倍，达到稳定的比率，约为850，但对于儿童分离株和脓疱疮标本，增加幅度更大，2002年达到峰值。总共赎回了156,462份双氯西林处方，年处方率增加了2.5倍，达到3,714 2007年的峰值。总之，在12年的研究期间，基层医疗机构的标本，金黄色葡萄球菌感染和双氯西林处方的年发生率增加了一倍以上。主要的脓疱疮流行和呼吁提高标本利用率的抗生素管理是促成因素。

BACKGROUND & AIMS: Introduction:The universal right to education for people with disabilities has been highlighted by the Universal Declaration on Human Rights and the Convention on the Rights of Persons with Disabilities. In this paper, we mapped policies addressing the right to education and special education needs of autistic children in Denmark, Sweden, and Finland. Methods:A policy path analysis was carried out using a scoping review as an underlying framework for data gathering. Policy mapping was performed independently by both lead authors to increase reliability. Results and discussion:The values of the Universal Declaration of Human Rights and the Convention on the Rights of Persons with Disabilities have been closely translated into the respective education systems of the countries under study, offering special education needs services and support in mainstream education with the aim of including as many children into mainstream education as possible. Even though the education systems are comparable, the approaches between the countries under study are slightly different. Denmark and Sweden have passed several policies specifically geared towards special education needs, while Finland incorporates this more in general education policy. Conclusion:All countries under study have incorporated the values of the Universal Declaration of Human Rights and the Convention on the Rights of Persons with Disabilities in their respective education systems while emphasising the need to include as many children in the mainstream system as possible.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The term 'emergency open abdominal surgery' covers a range of common procedures with high complication and mortality risks; however, previous studies have not included descriptive analyses of the patients undergoing the procedures. The aim of this study is to present a nationwide description of all patients who undergo an emergency bowel resection, ostomy placement or drainage involving laparotomy at Danish hospitals and to report the 30- and 365-day mortality risks. METHOD:We identified all of the patients in the Danish National Patient Register aged 18 + who underwent emergency open abdominal surgery in the form of a laparotomy during the period 2003-14. Using Poisson and logistic regression models, we analyzed incidence rates and mortality risk. RESULT:The sample consisted of 15,680 patients, with an overall open abdominal surgery incidence rate of 30.4 cases per 100,000 person-years. The 30-day mortality risk was 19.3% for both sexes, and increased with age (at 80-89, mortality risk was 39.4% for males and 34.5% for females). The 30-day mortality risk fell by 5.4% during the study period, from 22.2% to 16.7%. CONCLUSION:Open abdominal surgery is a common, high-risk procedure with a high incidence rate and mortality risk, especially for elderly patients. The incidence rate and mortality risk fell during the period studied. In Denmark, there is no standard post-discharge care program for patients who undergo emergency laparotomies. Our results support the need to investigate standardized post-operative follow-up and rehabilitation plans to reduce mortality.

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