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To assess if the overall utilisation of surgery in Danish children 0-5 years of age increased in the period 1999-2018 in line with the development within specialised medical services. The epidemiology on surgical procedures is scarce. National register-based cohort study of all Danish children born 1994-2018 (n = 1,599,573) using data on surgery in public and private hospitals from The National Patient Register and data on surgery in private specialist practice from The Health Service Register. Incidence rate ratios were calculated using Poisson regression with 1999 as the reference year. During the study period 115,573 different children (7.2% of the cohort) underwent surgery. The overall incidence of surgical procedures was stable, but the use of surgery increased in neonates mainly due to an increase in frenectomy. Boys underwent more surgery than girls. In children with severe chronic disease the rate of surgery decreased in public hospitals and increased in private specialist practices. The utilisation of surgical procedures in Danish children 0-5 years of age did not increase from 1999 to 2018. The use of available register data in the present study may inspire surgeons to conduct further studies to enhance the knowledge within the area of surgical procedures.

Laryngotracheal stenosis (LTS) can be either congenital or acquired. Laryngeal stenosis is most often encountered after prolonged intubation. The mechanism for stenosis following intubation is believed to be hypertrophic scarring. Mesenchymal stem cells (MSCs) therapy has shown promising results in regenerative medicine. We aimed to systematically review the literature on MSC therapy for stenosis of the conductive airways. PubMed, EMBASE, Google Scholar and the Cochrane Library were systematically searched from January 1980-January 2017 with the purpose of identifying all studies addressing the effect of MSC therapy on the airway. We assessed effect on inflammation, fibrosis, and MSC as a component in tissue engineering for treating defects in the airway. We identified eleven studies (n = 256 animals) from eight countries evaluating the effect of MSCs as a regenerative therapy in the upper airways. The studies indicate that MSC therapy may lead to a more constructive inflammatory response as well as support tissue regeneration. There may be a favorable effect of MSCs in inhibiting inflammation and as a component in tissue engineering. Given the heterogeneous nature of the included animal studies, any clear conclusion regarding the effect of tracheal stenosis in human subjects cannot be drawn. The included preclinical studies are however encouraging for further research.

Background. Previous population-based studies have reported a temporal association between respiratory syncytial virus (RSV) infection and invasive pneumococcal disease (IPD). We examined this association at an individual level in the Danish population. Methods. Using registry information about hospitalization for RSV infection and IPD in Denmark, we conducted a prospective, population-based cohort study and examined the associations between hospitalization for RSV infection and IPD. Results. In our cohort, no persons aged ⩾2 years experienced IPD within 30 days after hospitalization for RSV infection. Among children aged <2 years, children who were hospitalized for RSV infection had a significantly increased risk of IPD during the 30 days after hospitalization, compared with those who were not hospitalized for RSV infection (adjusted rate ratio, 7.1; 95% confidence interval, 3.6–14.3). Likewise, hospitalization for a non-RSV respiratory infection increased the risk of IPD during the 30 days after hospitalization (adjusted rate ratio, 4.5; 95% confidence interval, 2.0–10.0). IPD did not increase the risk of hospitalization for RSV infection among children aged <2 years. Conclusions. Both recent hospitalization for RSV infection and recent hospitalization for non-RSV respiratory infection increased the risk of IPD among Danish children aged <2 years.

Background. Denmark's systems of registry-based data offer a unique opportunity to examine, on a population basis, risk factors for invasive pneumococcal disease (IPD) relating to perinatal and crowding exposures among children. The main objective of this study was to identify the role of familial and day care factors in the risk of IPD among unvaccinated infants and children. Methods. A total of 1381 children aged 0–5 years old who experienced IPD were identified from a national surveillance program of IPD in Denmark. Risk factors were assessed in a matched, nested, case-control study that assigned 10 population control subjects to every case patient. Exposure information was obtained from several population-based, person-identifiable Danish registries. Results. Preterm birth and low birth weight significantly increased the risk of IPD among infants. In infants 0–5 months of age, the risk of IPD was high among infants who had older siblings, compared with infants of the same age who had no older siblings (adjusted rate ratio [aRR], 3.38; 95% confidence interval, 2.11–5.42), whereas the aRR was low (aRR, 0.56; 95% confidence interval, 0.47–0.65) in children aged 6–23 months. Day care attendance, compared with home care, increased the aRR of IPD 0–2 months after enrollment in a day care program (aRR, 2.28; 95% confidence interval, 1.73–3.00), whereas the aRR was 0.70; (95% confidence interval, 0.46–1.06) ≥6 months after enrollment in children aged 6–23 months. Conclusions. During infancy (age, 0–6 months), risk of IPD is associated with low birth weight, presumably because of lower levels of passively acquired maternal antibody. During early childhood, exposure to other young children (either siblings or through day care attendance) is clearly associated with IPD, but natural exposure appears to occur rapidly and confer durable immunity.

Background. Little is known about how chronic conditions other than prematurity, heart disease, and Down syndrome affect the risk and severity of hospitalization for respiratory syncytial virus (RSV). We assess the risk and severity of RSV hospitalization in children with chronic conditions in this register-based, population-based cohort study. Methods. Data on RSV tests, maternal smoking, siblings, single parenthood, mode of delivery, gestational age at birth, major surgery, asthma diagnosis, chronic conditions, and hospitalization and discharge dates were obtained from the Danish RSV database, the National Patient and Birth Registries, and the Civil Registration System. Statistics. Cox regression models were used to estimate incidence rate ratios (IRRs) for RSV hospitalization between groups stratified by sex and date of birth. Duration of RSV hospitalization was analyzed in a linear regression and reported as geometric mean ratios. Results. A total of 391 983 children aged 0—23 months were included in the analysis. A total of 10 616 (2.7%) had a diagnosis for chronic disease. IRRs (95% confidence intervals) for RSV hospitalization in children with any congenital or acquired chronic condition were 2.18 (2.01—2.36) and 2.25 (1.94—2.61), respectively. Several new risk factors for RSV hospitalization, including malformations, interstitial lung disease, neuromuscular disease, liver disease, chromosomal abnormalities, congenital immunodeficiencies, and inborn errors of metabolism, were identified. Duration of RSV hospitalization was increased in many chronic conditions. Conclusions. Chronic disease per se is an important risk factor for RSV hospitalization.

ObjectiveTo assess if the overall utilisation of surgery in Danish children 0-5 years of age increased in the period 1999-2018 in line with the development within specialised medical services. The epidemiology on surgical procedures is scarce.MethodsNational register-based cohort study of all Danish children born 1994-2018 (n = 1,599,573) using data on surgery in public and private hospitals from The National Patient Register and data on surgery in private specialist practice from The Health Service Register. Incidence rate ratios were calculated using Poisson regression with 1999 as the reference year.ResultsDuring the study period 115,573 different children (7.2% of the cohort) underwent surgery. The overall incidence of surgical procedures was stable, but the use of surgery increased in neonates mainly due to an increase in frenectomy. Boys underwent more surgery than girls. In children with severe chronic disease the rate of surgery decreased in public hospitals and increased in private specialist practices.ConclusionThe utilisation of surgical procedures in Danish children 0-5 years of age did not increase from 1999 to 2018. The use of available register data in the present study may inspire surgeons to conduct further studies to enhance the knowledge within the area of surgical procedures.

Background. Pneumococcal infections have historically played a major role in terms of morbidity and mortality. We explored historical trends of invasive pneumococcal disease (IPD) and pneumococcal serotypes in a population exposed to limited antibiotic selective pressure and conjugate pneumococcal vaccination (PCV). Methods. Retrospective cohort study based on nationwide laboratory surveillance data on IPD collected uninterruptedly in Denmark during 1938–2007. Changes in the reported incidence and trends of pneumococcal serotypes were explored using nonlinear regression analysis. Results. There were 25,502 IPD cases included in our study. The median incidence of IPD increased from 2.8 cases per 100,000 population (interquartile range [IQR], 1.5–2.6) during the first 4 decades to 15.7 cases per 100,000 population (IQR, 7–20.4) during the 1980s and 1990s, mainly attributed to an increase in the number of bacteremia cases. The incidence of meningitis remained relatively stable, with a median of 1.3 cases per 100,000 population (IQR, 0.9–1.6). The proportions of serotypes/groups 4 and 9 increased; the proportion of serotype 18C decreased; the proportions of serotypes 6, 7F, 14, and 23F remained stable; and serotype 2 nearly disappeared. Before the 1960s, serotypes 1, 2, 3, and 5 presented peaks every 2–3 years, becoming less frequent during the 1970s with peaks every 7–10 years. Between 20% and 90% of IPD in children <5 years were caused by PCV serotypes during the last 4 decades. Cases of IPD caused by serotype 19A increased before introduction of PCV. Between 1993 and 2007, the level of resistance to macrolides and β-lactams was ⩽6%. Conclusions. The epidemiology of IPD and single serotypes has constantly changed over the past 7 decades. PCV serotypes appeared to dominate the pneumococcal population.

In order to provide an estimation of the direct and indirect benefits of pneumococcal vaccination with three protein-conjugate pneumococcal vaccines (PCV) we described the epidemiology and mortality from invasive pneumococcal disease (IPD) in Denmark between 2000 and 2005. Approximately 1080 cases were registered annually during the period. The overall incidence of IPD increased significantly, from 15.4 cases per 100,000 population in 2000 to 20.7 cases per 100,000 in 2005 ( p < 0.01), mainly due to an increase in bacteraemia cases. The serotype coverage in children under 5 years varied from 64% to 91% depending on the PCV used. The mean mortality proportion after IPD was 18%, with approximately 190 deaths annually. One to two deaths among children younger than 5 years and approximately 50 deaths related to IPD caused by vaccine serotypes among older age groups could be prevented annually by introducing a PCV. Approximately 70% of all deaths occurred in adults over 65 years, underlining the need for protection against IPD in this age group.

Background. Pneumococcal infections have historically played a major role in terms of morbidity and mortality. We explored historical trends of invasive pneumococcal disease (IPD) and pneumococcal serotypes in a population exposed to limited antibiotic selective pressure and conjugate pneumococcal vaccination (PCV). Methods. Retrospective cohort study based on nationwide laboratory surveillance data on IPD collected uninterruptedly in Denmark during 1938–2007. Changes in the reported incidence and trends of pneumococcal serotypes were explored using nonlinear regression analysis. Results. There were 25,502 IPD cases included in our study. The median incidence of IPD increased from 2.8 cases per 100,000 population (interquartile range [IQR], 1.5–2.6) during the first 4 decades to 15.7 cases per 100,000 population (IQR, 7–20.4) during the 1980s and 1990s, mainly attributed to an increase in the number of bacteremia cases. The incidence of meningitis remained relatively stable, with a median of 1.3 cases per 100,000 population (IQR, 0.9–1.6). The proportions of serotypes/groups 4 and 9 increased; the proportion of serotype 18C decreased; the proportions of serotypes 6, 7F, 14, and 23F remained stable; and serotype 2 nearly disappeared. Before the 1960s, serotypes 1, 2, 3, and 5 presented peaks every 2–3 years, becoming less frequent during the 1970s with peaks every 7–10 years. Between 20% and 90% of IPD in children <5 years were caused by PCV serotypes during the last 4 decades. Cases of IPD caused by serotype 19A increased before introduction of PCV. Between 1993 and 2007, the level of resistance to macrolides and β-lactams was <6%. Conclusions. The epidemiology of IPD and single serotypes has constantly changed over the past 7 decades. PCV serotypes appeared to dominate the pneumococcal population.

Currently, energy storage technologies are becoming essential in the transition of replacing fossil fuels with more renewable electricity production means. Among storage technologies, redox flow batteries (RFBs) can represent a valid option due to their unique characteristic of decoupling energy storage from power output. To push RFBs further into the market, it is essential to include low-cost materials such as new generation membranes with low ohmic resistance, high transport selectivity, and long durability. This work proposes a composite membrane for vanadium RFBs and a method of preparation. The membrane was prepared starting from two polymers, meta-polybenzimidazole (6 μm) and porous polypropylene (30 μm), through a gluing approach by hot-pressing. In a vanadium RFB, the composite membrane exhibited a high energy efficiency (~84%) and discharge capacity (~90%) with a 99% capacity retention over 90 cycles at 120 mA·cm−2, exceeding commercial Nafion® NR212 (~82% efficiency, capacity drop from 90% to 40%) and Fumasep® FAP-450 (~76% efficiency, capacity drop from 80 to 65%).