Explore the vast range of titles available.

Approximately 30% of seminoma (SEM) patients present with moderately elevated human chorionic gonadotropin (hCG) levels at first diagnosis. In case of high hCG serum levels, the presence of a non-SEM component, i.e. choriocarcinoma (CC), may be assumed. To characterize cases described as pure seminoma with high serum hCG levels, tissue samples and DNA were analyzed. Patient files from an international registry were screened for patients with SEM and extraordinarily high hCG serum levels. IHC and qRT-PCR analysis was performed for markers of SEM, embryonal carcinoma (EC) and CC/trophoblast cells. The cell lines TCam-2 (SEM), 2102EP, NCCIT, NT2/D1 (EC) and JAR, JEG3 and BeWo (CC) were included for comparison. Of 1031 SEM patients screened, 39 patients (3.7%) showed hCG serum levels > 1000 U/l. Of these, tumor material for IHC and RNA for qRT-PCR was available from n = 7 patients and n = 3 patients, respectively. Median pre-orchiectomy serum hCG level was 5356 U/l (range: 1224–40909 U/L). Histopathologically, all investigated samples were classified as SEM with syncytiotrophoblast sub-populations. SEM cells were SALL4+ / OCT3/4+ / D2-40+, while syncytiotrophoblast cells were hCG+ / GATA3+ / p63+ and SOX2−/CDX2−. qRT-PCR analysis detected trophoblast stem cell markers CDX2, EOMES and TFAP2C as well as the trophectoderm-specifier TEAD4, but not GATA3. Additionally, SOX17 and PRAME, but not SOX2, were detected, confirming the pure SEM-like gene expression signature of the analyzed samples. In conclusion, excessively increased hCG serum levels can appear in patients with pure SEM. To explain detectable hCG serum levels, it is important to diagnose the subtype of a SEM with syncytiotrophoblasts.

Front-of-pack nutrition labelling is an important policy tool for public health. The Nutri-Score classifies foods according to nutritional quality from A (high quality) to E (low quality). We have previously identified inconsistencies between Nutri-Score and the Norwegian food-based dietary guidelines. The objective was to propose revisions to the Nutri-Score 2023 algorithms and determine if the revised algorithms better align with the Nordic Nutrition Recommendations 2023 (NNR2023) and the Keyhole label. Items in the Norwegian pre-packed foods databases Tradesolution ( = 26,033) and Unil ( = 577) were classified using the Nutri-Score 2023 algorithms. To address carbohydrate quality, a penalty for low-fibre content was introduced, and the sugar scale compressed. The protein cap was removed for fish products to reward their nutritional quality. To improve the scoring of high-fat foods, the scale for saturated fat was extended, fat content determined the inclusion in the algorithm for fats, rather than food categories, and favourable fat quality in oils was rewarded through a fat quality component. Data from the databases guided the identification of specific thresholds. The distribution of Nutri-Score was calculated before and after applying the revisions. In total, 5.5% of all products received a less favourable Nutri-Score with the revised carbohydrate quality components. Most refined pastas and flour shifted shifted from A to B or C, whilst whole grain pasta largely remained A. Sugar-rich breakfast cereals shifted from B to C or D. For fish, 11% (1% of all products) were moved from D or E to C or D. The variation in scores for cheese and creams increased. Around 5% of all products were affected by the revisions related to fat quality. The proposed revisions make the Nutri-Score more coherent with the NNR2023 and the Keyhole label. The proposed revisions also hold relevance for other European countries and should therefore be considered in the next revision of the Nutri-Score.

Assuring the safety of muscle foods and seafood is based on prerequisites and specific measures targeted against defined hazards. This concept is augmented by ‘interventions’, which are chemical or physical treatments, not genuinely part of the production process, but rather implemented in the framework of a safety assurance system. The present paper focuses on ‘Cold Atmospheric pressure Plasma’ (CAP) as an emerging non-thermal intervention for microbial decontamination. Over the past decade, a vast number of studies have explored the antimicrobial potential of different CAP systems against a plethora of different foodborne microorganisms. This contribution aims at providing a comprehensive reference and appraisal of the latest literature in the area, with a specific focus on the use of CAP for the treatment of fresh meat, fish and associated products to inactivate microbial pathogens and extend shelf life. Aspects such as changes to organoleptic and nutritional value alongside other matrix effects are considered, so as to provide the reader with a clear insight into the advantages and disadvantages of CAP-based decontamination strategies.

Viral contamination of edible bivalves is a major food safety issue. We studied the virucidal effect of a cold atmospheric plasma (CAP) source on two virologically different surrogate viruses [a double-stranded DNA virus (Equid alphaherpesvirus 1, EHV-1), and a single-stranded RNA virus (Bovine coronavirus, BCoV)] suspended in Dulbecco’s Modified Eagle’s Medium (DMEM). A 15 min exposure effectuated a statistically significant immediate reduction in intact BCoV viruses by 2.8 (ozone-dominated plasma, “low power”) or 2.3 log cycles (nitrate-dominated, “high power”) of the initial viral load. The immediate effect of CAP on EHV-1 was less pronounced, with “low power” CAP yielding a 1.4 and “high power” a 1.0 log reduction. We observed a decline in glucose contents in DMEM, which was most probably caused by a Maillard reaction with the amino acids in DMEM. With respect to the application of the virucidal CAP treatment in oyster production, we investigated whether salt water could be sanitized. CAP treatment entailed a significant decline in pH, below the limits acceptable for holding oysters. In oyster slurry (a surrogate for live oysters), CAP exposure resulted in an increase in total nitrogen, and, to a lower extent, in nitrate and nitrite; this was most probably caused by absorption of nitrate from the plasma gas cloud. We could not observe a change in colour, indicative for binding of NOx to haemocyanin, although this would be a reasonable assumption. Further studies are necessary to explore in which form this additional nitrogen is deposited in oyster flesh.

Background Generic substitution has been implemented in many countries, but knowledge about patients’ attitudes, beliefs and experiences is still sparse. Aim To assess associations between generic switching and patients’ attitudes, beliefs and experiences with previous generic switching. Design and setting A cross-sectional study comprising questionnaire responses from 2,476 randomly selected patients aged 20 years or older and living in the Region of Southern Denmark, who had redeemed substitutable drugs. Methods The questionnaire included items on beliefs about medicine, views on generic medicine and confidence in the healthcare system. Only prescriptions issued by the general practitioners were included. For each patient, we focused on one purchase of a generically substitutable drug (index drug). Patients were identified by means of a dispensing database. Results Earlier generic switches within the index ATC code were statistically significantly associated with experience of a generic switch (adjusted OR 5.93; 95 % CI 4.70–7.49). Having had more than five earlier switches within other ATC codes and having negative views on generic medicines reduced the odds of experiencing a generic switch. No associations were found between generic substitution and gender, drug group, number of different drugs used by the patient, confidence in the health care system and beliefs about medicine in general. Conclusion Patients who had once experienced a generic switch were more likely to accept a future generic switch within the same ATC code. Negative views on generic medicines were negatively associated with switching, while beliefs about medicine and confidence in the healthcare system had no influence.

Background: The tendency of general practitioners (GPs) to conduct home visits is considered an important aspect of practices’ accessibility and quality of care. Aims: To investigate whether GPs’ tendency to conduct home visits affects 30-day readmission or death after hospitalisation with chronic obstructive pulmonary disease. Methods: All Danish patients first-time hospitalised with COPD during the years 2006–2008 were identified. The association between the GP’s tendency to conduct home visits and the time from hospital discharge until death or all-cause readmission was analysed by means of Cox regression adjusted for multiple patient and practice characteristics. Results: The study included 14,425 patients listed with 1,389 general practices. Approximately 31% of the patients received a home visit during the year preceding their first COPD hospitalisation, and within 30 days after discharge 19% had been readmitted and 1.6% had died without readmission. A U-shaped dose–response relationship was found between GP home visit tendency and readmission-free survival. The lowest adjusted risk of readmission or death was recorded among patients who were listed with a general practice in which >20–30% of other listed first-time COPD-hospitalised patients had received a home visit. The risk was higher if either 0% (hazard rate ratio 1.18 (1.01–1.37)) or >60% (hazard rate ratio 1.23 (1.04–1.44)) of the patients had been visited. Conclusion: A moderate GP tendency to conduct home visits is associated with the lowest 30-day risk of COPD readmission or death. A GP’s tendency to conduct home visits should not be used as a unidirectional indicator of the ability to prevent COPD hospital readmissions. Chronic obstructive pulmonary disease: Home visits by general practitioners Hospital readmission rates for patients with chronic lung disease are moderately affected by whether or not doctors make home visits. Chronic obstructive pulmonary disease (COPD), a serious lung condition particularly affecting the elderly, is one of the most common reasons for repeated hospitalisations. To determine whether home visits by general practitioners (GPs) lower COPD hospital readmission and patient survival rates, Jesper Lykkegaard at the University of Southern Denmark and co-workers analysed data from 14,425 COPD patients aged over 45 from 1,389 GP surgeries, who were first admitted to Danish hospitals between 2006 and 2008. Compared with patients from surgeries where GPs made home visits to 20-30% of their COPD patients, patients from surgeries where GPs made either more or fewer home visits had up to 20% higher risk of readmission or death.

Background Reporting of symptoms which may signal cancer is the first step in the diagnostic pathway of cancer diseases. Cancer alarm symptoms are common in the general population. Public awareness and knowledge of cancer symptoms are sparse, however, and many people do not seek medical help when having possible cancer symptoms. As social inequality is associated with cancer knowledge, cancer awareness, and information-seeking, our hypothesis is that social inequality may also exist in the general population with respect to reporting of cancer alarm symptoms. The aim of this study was to investigate possible associations between socioeconomic and demographic determinants and reporting of common cancer alarm symptoms. Methods A cross-sectional questionnaire survey was performed based on a stratified sample of the Danish general population. A total of 13 777 randomly selected persons aged 20 years and older participated. Our main outcome measures were weighted prevalence estimates of self-reporting one of the following cancer alarm symptoms during the preceding 12 months: a lump in the breast, coughing for more than 6 weeks, seen blood in urine, or seen blood in stool. Logistic regression models were used to calculate unadjusted and adjusted odds ratios with 95% confidence intervals for the associations between each covariate and reporting of cancer alarm symptoms. Results A total of 2 098 (15.7%) of the participants reported one or more cancer alarm symptoms within the preceding 12 months. Women, subjects out of the workforce, and subjects with a cancer diagnosis had statistically significantly higher odds of reporting one or more cancer alarm symptoms. Subjects with older age and subjects living with a partner had lower odds of reporting one or more cancer alarm symptoms. When analysing the four alarm symptoms of cancer separately most tendencies persisted. Conclusions Socioeconomic and demographic determinants are associated with self-reporting of common cancer alarm symptoms.

Background Poor adherence to medical treatment may have considerable consequences for the patients' health and for healthcare costs to society. The need to understand the determinants for poor adherence has motivated several studies on socio-demographics and comorbidity. Few studies focus on the association between risk attitude and adherence. The aim of the present study was to estimate associations between patients' adherence to statin treatment and different dimensions of risk attitude, and to identify subgroups of patients with poor adherence. Methods Population-based questionnaire and register-based study on a sample of 6393 persons of the general. Danish population aged 20-79. Data on risk attitude were based on 4 items uncovering health-related as well as financial dimensions of risk attitude. They were collected through a web-based questionnaire and combined with register data on redeemed statin prescriptions, sociodemographics and comorbidity. Adherence was estimated by proportion of days covered using a cut-off point at 80 %. Results For the dimension of health-related risk attitude, \"Preference for GP visit when having symptoms\", risk-neutral and risk-seeking patients had poorer adherence than the risk-averse patients, OR 0.80 (95 %-CI 0.68-0.95) and OR 0.83 (95 %-CI 0.71-0.98), respectively. No significant association was found between adherence and financial risk attitude. Further, patients in the youngest age group and patients with no CVD were less adherent to statin treatment. Conclusion We find some indication that risk attitude is associated with adherence to statin treatment, and that risk-neutral and risk-seeking patients may have poorer adherence than risk-averse patients. This is important for clinicians to consider when discussing optimal treatment decisions with their patients. The identified subgroups with the poorest adherence may deserve special attention from their GP regarding statin treatment.