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.

背景与目标：

BACKGROUND & AIMS: :Strain H2-LR(T), a 5-18 micro m long and 0.7 micro m wide filamentous, mesophilic, moderately halophilic, non-motile hydrogenotrophic methanogen, was isolated from marine sediment of Aarhus Bay, Denmark, 1.7 m below the sediment surface. On the basis of 16S rRNA gene comparison with sequences of known methanogens, strain H2-LR(T) could be affiliated to the genus Methanobacterium. The strain forms a distinct line of descent within this genus, with Methanobacterium oryzae (95.9 % sequence identity) and Methanobacterium bryantii (95.7 % sequence identity) as its closest relatives. The 16S rRNA-based affiliation was supported by comparison of the mcrA gene, which encodes the alpha-subunit of methyl-coenzyme M reductase. Strain H2-LR(T) grew only on H(2)/CO(2). The DNA G+C content is 34.9 mol%. Optimum growth temperature was 45 degrees C. The strain grew equally well at pH 7.5 and 8. No growth or methane production was observed below pH 5 or above pH 9. Strain H2-LR(T) grew well within an NaCl concentration range of 100 and 900 mM. No growth or methane production was observed at 1 M NaCl. At 50 mM NaCl, growth and methane production were reduced. Based on 16S rRNA gene sequence analysis, the isolate is proposed to represent a novel taxon within the genus Methanobacterium, namely Methanobacterium aarhusense sp. nov. The type strain is H2-LR(T) (=DSM 15219(T)=ATCC BAA-828(T)).

背景与目标： : H2-LR(T) 菌株，长5-18微m，宽0.7微m，丝状，嗜温，中度嗜盐，非活动的氢营养产甲烷菌，是从丹麦奥尔胡斯湾的海洋沉积物中分离出来的，沉积物表面以下1.7 m。根据16S rRNA基因与已知产甲烷菌序列的比较，菌株H2-LR(T) 可能隶属于甲烷菌属。该菌株在该属中形成了独特的血统系，其近亲是oryzae甲烷细菌 (95.9% 序列同一性) 和bryantii甲烷细菌 (95.7% 序列同一性)。通过比较mcrA基因来支持基于16S rRNA的隶属关系，该基因编码甲基辅酶M还原酶的 α 亚基。菌株H2-LR(T) 仅在H(2)/CO(2) 上生长。DNA G + C含量为34.9摩尔 %。最适生长温度为45 ℃。该菌株在pH 7.5和8下同样良好地生长。在低于pH 5或高于pH 9时未观察到生长或甲烷产生。菌株H2-LR(T) 在100和900 mM的NaCl浓度范围内生长良好。在1 M NaCl下未观察到生长或甲烷产生。在50 mM NaCl下，生长和甲烷产量降低。基于16S rRNA基因序列分析，提出了该分离株代表甲烷菌属中的一种新分类单元，即甲烷菌aarhusense 11月。类型应变是H2-LR(T) (= DSM 15219(T)= atccbaa-828(T))。

BACKGROUND & AIMS: :A questionnaire was sent to all departments of nuclear medicine in Denmark (n=20) asking for details of myocardial perfusion imaging (MPI), including the number of patients examined each year from 1997 to 2001 and the current clinical and technical practice. All (100%) departments replied, and the survey thus covers all MPI performed in Denmark during the period in question. The number of MPI studies (examined patients) was 2,531 in 1997 (0.47 MPI/1,000/year) and 4,961 (0.93 MPI/1,000/year) in 2001, which is a doubling in activity in 5 years. Nineteen (95%) of the Danish departments performed MPI in 2001, and 14 (74%) of these reported that activity had increased over the past 5 years. MPI activity was unevenly distributed between hospitals and regions. In 2001, the university hospitals in the central Copenhagen region (capital) accounted for the highest MPI activity (2.00/1,000/year), while the non-university hospitals in general had the lowest activity rate (0.73/1,000/year). The most pronounced increment found in the period was observed in the university hospitals outside Copenhagen, where activity increased by 300% from 0.44/1,000/year in 1997 to 1.33/1,000/year in 2001. All departments providing MPI used tomographic acquisition technique and all departments used technetium tracers. The more sophisticated techniques of MPI - gated acquisition, attenuation correction and iterative reconstruction - were used in 74%, 32% and 42% of departments, respectively. The stress mode in perfusion studies was dipyridamole/adenosine in 76%, exercise in 18% and dobutamine in 6%. Despite these encouraging figures, MPI activity for 2001 remained well below what is recommended by other national and international societies. The anticipated further increase in nuclear cardiology is encouraging, but the nuclear medicine community needs to address the issues that prevent it from keeping up with demand. In general, the restricted camera time and the limited number of trained personnel explain the excessive waiting lists in Denmark.

背景与目标： : 向丹麦所有核医学部门 (n = 20) 发送了一份问卷，要求提供心肌灌注成像 (MPI) 的详细信息，包括每年1997年2001年检查的患者人数以及当前的临床和技术实践。所有 (100%) 部门都作出了答复，因此调查涵盖了所涉期间在丹麦进行的所有MPI。MPI研究 (检查患者) 的数量2001年为2,531 1997年 (0.47 MPI/1,000/年) 和4,961 (0.93 MPI/1,000/年)，这在5年内增加了一倍。丹麦有19 (95%) 个部门进行了MPI 2001年，其中14 (74%) 个部门报告说，过去5年中活动有所增加。MPI活动在医院和地区之间分布不均。2001年，哥本哈根中部地区 (首都) 的大学医院的MPI活动最高 (2.00/1,000/年)，而非大学医院的活动率最低 (0.73/1,000/年)。在此期间发现的最明显的增量是在哥本哈根以外的大学医院中观察到的，那里的活动从0.44/1,000/年1997年增加到1.33/1,000/年2001年，增加了300%。提供MPI的所有部门都使用层析采集技术，所有部门都使用锝示踪剂。MPI门控采集，衰减校正和迭代重建的更复杂的技术分别用于部门的74%，32% 和42%。灌注研究中的压力模式是76% 中的双嘧达莫/腺苷，18% 中的运动和6% 中的多巴酚丁胺。尽管有这些令人鼓舞的数字，但2001年的MPI活动仍远低于其他国家和国际社会的建议。核心脏病学的预期进一步增长令人鼓舞，但核医学界需要解决阻止其跟上需求的问题。总的来说，有限的摄像时间和有限的训练有素的人员解释了丹麦过多的等候名单。

BACKGROUND & AIMS: BACKGROUND:To assess the relationship between hospital volume and early postoperative outcome the incidence and early outcome of all esophagectomies, pancreaticoduodenectomies and gastric resections in Denmark from 1996 to 2004 was described. METHODS:The National Patient Registry and discharge information from all hospital departments were analysed for all the operations due to a malignant diagnosis. All information was examined for postoperative length of stay and hospital mortality. RESULTS:During the study period 26 departments performed at least one esophageal resection, 13 departments performed at least one Whipple procedure and 37 departments performed at least one gastric resection. Four departments performed more than 20 esophageal resections per year, whereas one department performed more than 20 Whipple procedures and one more than 20 gastric resections per year. The overall mean length of stay was 21.6 days, 24 days and 18 days for esophageal, pancreatic and gastric resections, respectively, with no difference between high and low volume departments. The hospital mortality was 8.6%, 8.9% and 8.2%, respectively. CONCLUSION:The overall high mortality and long postoperative stay in patients undergoing upper gastrointestinal cancer surgery in Denmark calls for improvement by regionalisation into 3-4 departments and monitoring of results.

背景与目标：

BACKGROUND & AIMS: INTRODUCTION AND AIM:Uncontrolled asthma is a global health challenge with substantial impact on quality of life (QoL) and overall healthcare costs. Unrecognised and/or unmanaged comorbidities often contribute to presence of uncontrolled asthma. Abnormalities in breathing pattern are termed dysfunctional breathing and are not only common in asthma but also lead to asthma-like symptoms and reduced QoL, and, in keeping with this, improvement with breathing normalisation. Evidence-based guidelines recommend breathing retraining interventions as an adjuvant treatment in uncontrolled asthma. Physiotherapy-based breathing pattern modification interventions incorporating relaxation have been shown to improve asthma-related QoL in primary care patients with impaired asthma control. Despite anecdotal reports, effectiveness of breathing retraining in patients referred to secondary care with incomplete asthma control has not been formally assessed in a randomised controlled trial (RCT). We aim to investigate the effect of breathing exercises on asthma-related QoL in patients with incomplete asthma control despite specialist care. METHODS AND ANALYSIS:This two-armed assessor-blinded multicentre RCT will investigate the effect of physiotherapist-delivered breathing retraining on asthma QoL questionnaire (MiniAQLQ) in addition to usual specialist care, recruiting from seven outpatient departments and one specialised clinic representing all regions of Denmark during 2017-2019. We will include 190 consenting adults with incomplete asthma control, defined as Asthma Control Questionnaire 6-item score ≥0.8. Participants will randomly be allocated to either breathing exercise programme in addition to usual care (BrEX +UC) or UC alone. BrEX compiles three physiotherapy sessions and encouragement to perform home exercise daily. Both groups continue usual secondary care management. Primary outcome is between-group difference in MiniAQLQ at 6 months. Secondary outcomes include patient-reported outcome measures, spirometry and accelerometer. ETHICS AND DISSEMINATION:Ethics Committee, Region Zealand (SJ-552) and Danish Data Protection Agency (REG-55-2016) approved the trial. Results will be reported in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER:NCT03127059; Pre-results.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The Western Denmark Heart Registry (WDHR) has not previously been described as a research tool in clinical epidemiology. OBJECTIVES:We examined the setting, organization, content, data quality, and research potential of the WDHR. METHOD:We collected information from members of the WDHR organization, including the committee of representatives, the board, the data management group, and physicians reporting to the database. We retrieved 2008 data from the WDHR to illustrate database variables. RESULTS:The WDHR is a clinical database within a population-based health care system. It was launched on 1 January 1999 to monitor and improve the quality of cardiac intervention in Western Denmark (population: 3.3 million) and to allow for clinical and health-service research. More than 200,000 interventions, with 50-150 variables each, have been registered. The data quality is ensured by automatic validation rules at data entry combined with systematic validation procedures and random spot-checks after entry. CONCLUSIONS:The WDHR is a valuable research tool because it provides ongoing longitudinal registration of detailed patient and procedural data. The Danish national health care system enables this research because it allows complete follow-up for medical events after cardiac intervention by linkage with multiple medical databases.

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BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :Studies of occupational solvent exposures and amyotrophic lateral sclerosis (ALS) have been conflicting. We conducted a population-based case-control study of mixed occupational solvent exposures and ALS. Using the Danish National Patient Registry, we identified ALS cases in Denmark from 1982 to 2013, and matched them to 100 controls based on sex and birth year. We estimated cumulative exposures to solvents (benzene, methylene chloride, toluene, trichloroethylene, perchloroethylene, and 1,1,1-trichloroethane) via job exposure matrices and applied them to occupational history from the Danish Pension Fund. Sex-stratified conditional logistic regression analyses revealed higher adjusted odds of ALS for men with exposure to benzene (aOR = 1.20; 95% CI 1.02, 1.41) and methylene chloride (aOR = 1.23; 95% CI 1.07, 1.42). We used weighted quantile sum regression to explore combined solvent exposures and risk of ALS in exposed subjects and found increased odds of 26 to 28% in all exposure lag periods for every one-unit increase in the mixture index in men. Weights of methylene chloride predominated the mixture index in all lag periods. Our study suggests an increased risk of ALS in men exposed to multiple solvents, with the greatest influence being from methylene chloride. These findings highlight the need to utilize mixtures analysis when considering co-occurring exposures.

背景与目标： : 职业溶剂暴露和肌萎缩性侧索硬化症 (ALS) 的研究一直存在矛盾。我们对混合职业溶剂暴露和ALS进行了基于人群的病例对照研究。使用丹麦国家患者登记处，我们确定了丹麦1982年2013年的ALS病例，并根据性别和出生年份将其与100个对照进行了匹配。我们通过工作暴露矩阵估算了溶剂 (苯，二氯甲烷，甲苯，三氯乙烯，全氯乙烯和1,1，1-三氯乙烷) 的累积暴露，并将其应用于丹麦养老基金的职业史。性别分层条件logistic回归分析显示，暴露于苯 (aor   =   1.20; 95% CI 1.02，1.41) 和二氯甲烷 (aor   =   1.23; 95% CI 1.07，1.42) 的男性ALS校正几率更高。我们使用加权分位数和回归来探索暴露受试者的组合溶剂暴露和ALS风险，发现男性混合指数每增加一个单位，在所有暴露滞后期，几率增加26到28%。在所有滞后时期，二氯甲烷的重量均占混合指数的主导地位。我们的研究表明，暴露于多种溶剂的男性患ALS的风险增加，其中影响最大的是二氯甲烷。这些发现突显了在考虑同时发生的暴露时需要利用混合物分析。

BACKGROUND & AIMS: BACKGROUND:To determine the sensitivity and specificity of school nurse screening for hypermetropia and convergence insufficiency exophoria (CIE) in schoolchildren. METHODS:Near point of convergence and distance visual acuity with +2.00D lenses were measured in 2097 children (6-15 years) during standard school nurse screening in the municipality of Randers, Denmark. One hundred and ninety-four children with positive screening results (near point of convergence >10 cm and/or distance visual acuity improved or maintained with +2.00D) and 182 controls with negative screening results received a full vision assessment, including cycloplegic refraction and orthoptic evaluation. RESULTS:Sensitivity and specificity of screening was 0.75 and 0.69 for CIE and 0.59 and 0.87 for hypermetropia (≥+2.00), respectively. While precision of screening for CIE was significantly higher for symptomatic children aged 9-15 than for younger and asymptomatic children, precision of screening for hypermetropia was independent of age and presence of visually related symptoms. CONCLUSION:While precision of screening for CIE and hypermetropia (>+2.00) was low, additional vision evaluation of children older than 9 years with asthenopic symptoms identified most children with CIE with a low absolute number of false positives.

背景与目标：

BACKGROUND & AIMS: :It is common for general practitioners (GPs) to refer patients suspected of impaired liver function for laboratory tests (alkaline phosphatase, lactate dehydrogenase, bilirubin, prothrombin, aspartate aminotransferase). In a prospective multipractice study over a six-month period, including 30 GPs, 55 patients were recorded as having, for the first time, a high level of alkaline phosphatase (AP) as an isolated finding, 14 with an increase of aspartate aminotransferase (ASAT), eight with an increase of both AP and ASAT, three with an increase of ASAT, AP, and bilirubin, two with an isolated increase of lactate dehydrogenase (LDH), one with an increase of ASAT, AP, and bilirubin, combined with a low prothrombin (PP), and, finally, one patient with a low prothrombin in isolation. In most cases the tests were requested because of unspecific symptoms. The most common causes of abnormal test results were neoplasms, alcoholic liver disease, and heart failure. Thirty patients were referred to hospital for further investigations. During the same study period, 50 patients with known abnormal liver function tests were recorded, and the most common causes of these abnormalities were neoplasms, rheumatoid arthritis, and alcoholic liver disease.

背景与目标： : 全科医生 (GPs) 通常会将怀疑肝功能受损的患者转介进行实验室检查 (碱性磷酸酶，乳酸脱氢酶，胆红素，凝血酶原，天冬氨酸转氨酶)。在一项为期六个月的前瞻性多实践研究中，包括30名全科医生，55名患者首次被记录为具有高水平的碱性磷酸酶 (AP)，这是一个孤立的发现，14随着天冬氨酸氨基转移酶 (ASAT) 的增加，八个随AP和ASAT的增加而增加，三个随ASAT，AP和胆红素的增加而增加，两个随乳酸脱氢酶 (LDH) 的单独增加而增加，一个随ASAT，AP和胆红素的增加而增加。凝血酶原 (PP) 低，最后，一名患者凝血酶原低。在大多数情况下，由于非特异性症状而要求进行测试。检查结果异常的最常见原因是肿瘤，酒精性肝病和心力衰竭。30名患者被转诊到医院接受进一步调查。在同一研究期间，记录了50例已知肝功能异常的患者，这些异常的最常见原因是肿瘤，类风湿性关节炎和酒精性肝病。