Northern Denmark Research Articles

A Within-Subject Before-After Study of the Impact of Antidepressants on Hemoglobin A1c and Low-Density Lipoprotein Levels in Type 2 Diabetes

Data on the effect of treatment with antidepressant drugs on metabolic control in diabetes are sparse. In this controlled within-subject before-after study, the impact of initiation and discontinuation of antidepressant treatment on hemoglobin A1c (HbA1c) and low-density lipoprotein (LDL) levels in type 2 diabetes was estimated. All individuals with newly developed type 2 diabetes (first HbA1c ≥ 6.5%) between 2000 and 2016 in Northern and Central Denmark were identified using register-based health care data. Among these, we identified individuals initiating and discontinuing antidepressant treatment. Using a within-subject before-after design, we examined HbA1c and LDL in the 16 months leading up to and the 16 months after antidepressant treatment initiation or discontinuation, respectively. For comparison, we ran similar time trend analyses in a reference population of age- and sex-matched type 2 diabetes individuals not receiving antidepressant treatment. Mean HbA1c decreased after initiation of antidepressant treatment (-0.16%; 95% confidence interval [CI], -0.18 to -0.13%). In the reference population, no material change in HbA1c over time (-0.03%; 95% CI, -0.04 to -0.01%) was seen. Mean LDL decreased not only in antidepressant initiators (-0.17 mmol/L; 95% CI, -0.19 to -0.15 mmol/L) but also in the reference population (-0.15 mmol/L; 95% CI, -0.16 to -0.13 mmol/L). Among antidepressant discontinuers, there was also a decrease in HbA1c (-0.32%; 95% CI, -0.37 to -0.28%), with no change in the reference population (-0.02%; 95% CI, -0.04 to 0.00%). Decreases in LDL were found both in antidepressant discontinuers (-0.09 mmol/L; 95% CI, -0.14 to -0.04 mmol/L) and in the reference population (-0.16 mmol/L0; 95% CI, -0.18 to -0.13 mmol/L). Antidepressant treatment in type 2 diabetes may have a beneficial effect on glycemic control, as the decrease in HbA1c after discontinuation of antidepressants likely reflects remission of depression. Conversely, antidepressant treatment does not seem to affect LDL levels.

Use and quality of point-of-care microscopy, urine culture and susceptibility testing for urinalysis in general practice

Objective: To describe the use and quality of point-of-care (POC) microscopy, urine culture and susceptibility testing performed in general practice in Northern Denmark from 2013 to 2018. Design: Descriptive study Setting: General practices receiving a fee for examining urine samples. Subjects: Simulated urine samples containing uropathogenic bacteria distributed by the organisation for improvement of microbiological quality (MIKAP). Main outcome measures: Percentage of use and correct answers for microscopy, culture and susceptibility testing. Results: A total of 5361 samples were analysed by the use of microscopy (39.7%), culture (66.0%) and/or susceptibility testing (76.5%). For culture, Flexicult SSI urinary kittm (87.6%) demonstrated the highest percentage of correct answers followed by chromogenic agar (85.1%) and 2-plate dipslide (85.2%). Mueller Hinton agar with tablets had the highest percentage of correct answers for susceptibility testing of most bacterial strains (84.6%), followed by Flexicult (77.2%). Furthermore, susceptibility testing with tablets (range: 76.1–84.6%) was found to be more accurate than discs (range: 72.9–75.5%). Overall, the highest percentage of correct answers was obtained when examining urine samples containing Escherichia coli: Microscopy (78.3%), culture (87.0%) and susceptibility testing (range: 84.3–90.7%). Conclusion: The quality of POC testing in general practice was high when examining urine samples containing the most common uropathogen E. coli. Surprisingly, susceptibility testing was more frequently used than culture. This approach may compromise the treatment decision as only cultures contribute with information about the flora composition and bacterial quantification. Interestingly, microscopy was the least used method even though the result may be reached within a few minutes. Key points The quality of POC tests (microscopy, urine culture, susceptibility testing) performed in general practice was high when examining urine containing E. coli, whereas difficulties were observed for samples including S. saprophyticus or K. pneumoniae. Susceptibility testing was more often performed than urine culture, which indicates a problem as only urine cultures contribute with information about the flora composition and bacterial quantification.

Discovery of a novel powdery mildew (Blumeria graminis) resistance locus in rye (Secale cereale L.)

Powdery mildew is one of the most destructive diseases in the world, causing substantial grain yield losses and quality reduction in cereal crops. At present 23 powdery mildew resistance genes have been identified in rye, of which the majority are in wheat-rye translocation lines developed for wheat improvement. Here, we investigated the genetics underlying powdery mildew resistance in the Gülzow-type elite hybrid rye (Secale cereale L.) breeding germplasm. In total, 180 inbred breeding lines were genotyped using the state-of-the-art 600 K SNP array and phenotyped for infection type against three distinct field populations of B. graminis f. sp. secalis from Northern Germany (2013 and 2018) and Denmark (2020). We observed a moderate level of powdery mildew resistance in the non-restorer germplasm population, and by performing a genome-wide association study using 261,406 informative SNP markers, we identified a powdery mildew resistance locus, provisionally denoted PmNOS1, on the distal tip of chromosome arm 7RL. Using recent advances in rye genomic resources, we investigated whether nucleotide-binding leucine-rich repeat genes residing in the identified 17 Mbp block associated with PmNOS1 on recent reference genomes resembled known Pm genes.

Dirofilaria spp. and Angiostrongylus vasorum: Current Risk of Spreading in Central and Northern Europe.

In the past few decades, the relevance of Dirofilaria immitis and Dirofilaria repens, causing cardiopulmonary and subcutaneous dirofilariosis in dogs and cats, and of Angiostrongylus vasorum, causing canine angiostrongylosis, has steadily increased in Central and Northern Europe. In this review, a summary of published articles and additional reports dealing with imported or autochthonous cases of these parasites is provided for Central (Austria, Czechia, Germany, Hungary, Luxemburg, Poland, Slovakia, Slovenia, and Switzerland) and Northern (Denmark, Finland, Iceland, Norway, and Sweden) Europe. Research efforts focusing on Dirofilaria spp. and A. vasorum have varied by country, and cross-border studies are few. The housing conditions of dogs, pet movements, the spread of competent vectors, and climate change are important factors in the spread of these nematodes. Dogs kept outside overnight are a major factor for the establishment of Dirofilaria spp. However, the establishment of invasive, diurnal, synanthropic, competent mosquito vectors such as Aedes albopictus may also influence the establishment of Dirofilaria spp. The drivers of the spread of A. vasorum remain not fully understood, but it seems to be influenced by habitats shared with wild canids, dog relocation, and possibly climatic changes; its pattern of spreading appears to be similar in different countries. Both Dirofilaria spp. and A. vasorum merit further monitoring and research focus in Europe.

Seojeon Byungwon, Jutlandia, and NORMASH: UN's Scandinavian Allies at the Korean War and Beyond (1950s-1960s).

The Korean War (1950–1953) was one of the most calamitous and brutal wars in modern history. It was fought by the post-colonial people of the peninsula, and it culminated in the creation of two ideologically opposed states, but the three years’ military clash in East Asia (or the Far East) is often labelled simply as a “Forgotten War” in the West including North America. The ensuing ethnic division has been interpreted through the various geopolitical lenses of military strategy, politics, international relations, and power games. What about the situation of casualties? Which particular nations in the United Nations (UN) dispatched medical aid for the treatment of war victims? How did the Scandinavian allies participate the non-European war? What were their unique characteristics among non-military supporting nations? What legacy they left for the post-war Koreans? This paper explores the military-historical backgrounds by which each of the following Northern European nation, namely, Sweden, Denmark, and Norway, decided to send unarmed skilled personnel to aid South Korea. The paper argues the social voluntarism of the neutral group in the critical insight that the field activities of Swedish Seojeon Byungwon, Danish Jutlandia, and Norwegian NORMASH individually promoted the Red Cross spirit of advanced humanitarianism on the top of mandatory duty, in giving special attention on children (orphans), women, civilians, POWs, and medical education, as well as the post-war collaboration for the initial Korean public health system in the 1960s.

Reablement professionals\u2019 perspectives on client characteristics and factors associated with successful home-based reablement: a qualitative study

BackgroundTo understand what is needed to achieve a successful Danish home-based reablement service from the perspective of reablement professionals.MethodsSemi-structured interviews and observations were conducted with nine professionals within a municipal visitation unit in the Northern Denmark Region. Thematic analysis was used to analyze the interviews.ResultsFour major themes emerged during this study: “Heterogeneity of clients and mixed attitudes towards the reablement intervention”, “Shared understanding and acknowledging the need for help as the first step in reablement”, “Commitment and motivation are essential for successful reablement”, and “Homecare helpers as most important team players”. The findings indicate that the clients had both mixed characteristics and attitudes about participating in the reablement intervention. Essential factors for successful reablement included a shared understanding of the reablement intervention, commitment, and motivation in terms of client involvement and staff group collaboration.ConclusionsShared understanding of the reablement intervention, commitment, and motivation was found to be essential factors and the driving forces in relation to successful reablement.

Evaluation of idealized large-eddy simulations performed with the Weather Research and Forecasting model using turbulence measurements from a 250 m meteorological mast

Abstract. We investigate the ability of the Weather Research and Forecasting model to perform large-eddy simulation of canonical flows. This is achieved through comparison of the simulation outputs with measurements from sonic anemometers on a 250 m meteorological mast located at Østerild, in northern Denmark. Østerild is on a flat and rough area, and for the predominant wind directions, the atmospheric flow can be considered to be close to homogeneous. The idealized simulated flows aim at representing atmospheric boundary layer turbulence under unstable, neutral, and stable stability conditions at the surface, which are statistically significant conditions observed at Østerild. We found that the resolved fields from the simulations appear to have the characteristics of the three stability regimes. Vertical profiles of observed mean wind speeds and direction are well reproduced by the simulations, with the largest differences under near-neutral conditions, where the effect of the subgrid-scale model is evident on the vertical wind shear close to the surface. Vertical profiles of observed eddy fluxes are also well reproduced by the simulations, with the largest differences for the three velocity component variances under stable stability conditions, although nearly always within the observed variability. With regards to turbulent kinetic energy, we find good agreement between observations and simulations at all vertical levels. Simulated and observed velocity spectra match very well and show very similar behavior with height and with atmospheric stability within the low-frequency interval; at the effective resolution, the simulated spectra show the typical drop-off of finite differences. Our findings demonstrate that these idealized simulations reproduce the characteristics of atmospheric stability regimes often observed at a high turbulent and flat site within a direction sector, where the air flows over nearly homogeneous land.

Pots for socks. Commodity itineraries in the North Atlantic during the 17th and 18th centuries

SUMMARY: A discussion of trade in the North Atlantic during the 17th and 18th centuries is explored through the movement of commodities from mainland Europe to Iceland, specifically pottery vessels. The paper reconstructs the journeys of three cooking pots from different places in northern Germany and Denmark and along the way, attempts to situate these journeys within the social and cultural contexts through which they pass. In tracking these object itineraries, it is argued that the pots are caught up in fragmented spaces, where the varied material properties of the objects change in significance. In this way, our paper attempts to both revive and reinvent an economic dimension to historical archaeology, to conjoin terrestrial and maritime archaeology, and finally to stimulate more work on the early modern period for this region.

Fra grænselandet mellem to kulturer

Fra grænselandet mellem to kulturer

The longevity of pockmarks – A case study from a shallow water body in northern Denmark

Pockmarks or crater-like depressions formed due to fluid venting, is a well-known geological phenomenon. On a global scale, pockmarks expel a significant amount of fluids and greenhouse gasses to the marine environment and the atmosphere. Despite pockmarks being well-studied, the longevity and history of activity are rarely addressed. In this study, we analyse more than twenty nearshore seafloor depressions of varying morphology and size in the shallow waters of the western Limfjord in northern Denmark. By using high-resolution seismo-acoustic and sediment core data, we characterize the morphology and sediments of the pockmarks. We further use 14C-dating and pore water analyses to address the timing and activity of the depressions. Our results show that the depressions coincide with submarine groundwater discharge areas and hence represent freshwater pockmarks. The pockmarks most likely formed initially due to two eruptive events of thermogenic light oil/gas ca. 2000 and 900 yrs. BP, both triggered by relative sea-level fall. Freshwater seepage continues to sustain and develop the pockmark morphology and we show that pockmarks grow by collapse of pockmark walls and amalgamation of discrete erosive seepage sites at the bottom. The episodic expulsions of thermogenic fluids and the continuous seepage of freshwater probably prolonged the longevity of the studied pockmarks and further demonstrates the complex nature of pockmark formation and activity. While thermogenic and biogenic gas escape to the surface, on the global scale, is relevant for the greenhouse gas budget, the outflow of groundwater which may or may not be polluted is relevant with respect to the geochemistry, biota and productivity of the receiving marine environment especially in shallow water settings.

Metformin use and long-term risk of benign prostatic hyperplasia: a population-based cohort study

ObjectiveTo assess whether metformin use affects risk of benign prostatic hyperplasia (BPH) by comparing the risk of BPH in men with type 2 diabetes who initiated first-line treatment with either...

Community-Acquired Escherichia coli Bacteremia after Age 50 and Subsequent Incidence of a Cancer Diagnosis: A Danish Population-Based Cohort Study.

Community-acquired bacteremia (CAB) with Escherichia coli may signal occult cancer. This might differ between phylogenetic groups. We conducted a population-based cohort study in northern Denmark (1994-2013) to examine whether E. coli CAB after age 50 is associated with incident cancer. We followed patients from their bacteremia diagnosis date to identify subsequent gastrointestinal, hepatobiliary, and urinary tract cancer diagnoses. We calculated 1- and 5-year cumulative cancer incidence. We compared the observed incidence with that expected based on national cancer incidence rates, and computed standardized incidence ratios (SIR) at 0-<1 year and ≥1 year. In a subcohort, we assessed the prevalence of phylogenetic groups. Among 2,735 patients with E. coli CAB, 173 later were diagnosed with cancer. The 1-year cumulative incidence of a gastrointestinal or hepatobiliary tract cancer was 1.9%, and the 0-<1-year SIR was 5.44 [95% confidence interval (CI), 4.06-7.14]. For urinary tract cancer, the corresponding estimates were 1.0% and 3.41 (95% CI, 2.27-4.93). All individual cancers occurred more often than expected during the first year following E. coli CAB, but thereafter the relative risks declined toward unity. Still, the ≥1-year SIR for colorectal cancer remained 1.4-fold elevated, and the SIR for liver, pancreas, gallbladder, and biliary tract cancer was 2-fold elevated. The prevalence of phylogenetic groups was similar among patients with and without cancer. Gastrointestinal, hepatobiliary, and urinary tract cancer may debut with E. coli CAB. Owing to the high incidence of E. coli bacteremia, cancers missed at the time of bacteremia diagnosis represent a clinically significant problem.

Monetary Hegemony and its Implications for Small, Open Economies

The paper uses historical data on interest rates from 1920 to 2016 to explore whether a world rate of interest exists and whether a monetary hegemon affects it. The first principal component of long-term interest rates accounts for 75% of the variation in a matrix of 17 countries and proxies for the world rate of interest. The U.S. played the role of a hegemon, influencing long-term bond rates. After the introduction of the euro in 1999, interest rates in most European countries followed German interest rates but German rates followed U.S. rates even more than before the introduction of the euro. In two countries on the northern periphery, Denmark and Sweden, interest rates shadow German rates and the low rates have contributed to rising house prices and rising mortgage debt. Independent monetary policy calls for targeted controls on capital flows.

Meadow, marsh and lagoon: Late Holocene coastal changes and human–environment interactions in northern Denmark

This paper presents a study of past coastline dynamics and their consequences for prehistoric societies living in the glacio‐isostatically uplifted central Limfjord area, northern Denmark. The consequences of the gradual relative sea level (RSL) changes have been investigated to develop a local RSL curve, study settlement patterns on newly exposed marine foreland, and estimate changes in the area and quality of grazing and forage for livestock. This was achieved by a multidisciplinary approach involving existing regional and local beach ridges dated by optically stimulated luminescence, a comprehensive database of archaeological finds, and extrapolation based on a digital elevation model. The beach‐ridge dates suggested a near‐linear local RSL change in the study area of ~1.2±0.2 m per 1000 years for the last 3000 years. Based on this, a palaeo‐coastline development model was produced that correlated well with a comprehensive database of archaeological finds. The model indicates that (i) few human settlements moved to the newly exposed marine foreland prior to modern times, though clusters of burial mounds (barrows) suggest that some of the new lands were colonized during the Late Roman Iron Age until 400 CE, (ii) winter‐flooded marine foreland with high‐quality livestock grazing increased steadily until c. 750 CE and then remained stable at approximately 150 km2, and (iii) due to high salinity of the inundating water, the palaeo‐Limfjord probably had Wadden Sea‐like fertile saltmarshes until c. 1 CE. The improved chronologies yield a better understanding of the spatial and temporal prehistoric human–nature interactions in the study area. The findings highlight the need for accurate local RSL curves in order to interpret concomitant terrestrial environment drivers and trajectories, and thereby understand causal relationships and consequences for prehistoric human–environment interactions in coastal areas.

Incident psychopharmacological treatment and psychiatric hospital contact in individuals with newly developed type 2 diabetes - a register-based cohort study.

To investigate the association between newly developed type 2 diabetes (T2D) and incident psychopharmacological treatment and psychiatric hospital contact. Via Danish registers, we identified all 56640 individuals from the Central and Northern Denmark Regions with newly developed T2D (defined by the first HbA1c measurement ≥6.5%) in 2000-2016 as well as 315694 age- and sex-matched controls (without T2D). Those having received psychopharmacological treatment or having had a psychiatric hospital contact in the 5 years prior to the onset of T2D were not included. For this cohort, we first assessed the 2-year incidence of psychopharmacological treatment and psychiatric hospital contact. Secondly, via Cox regression, we compared the incidence of psychopharmacological treatment/psychiatric hospital contact among individuals with T2D to propensity score-matched controls - taking a wide range of potential confounders into account. Finally, via Cox proportional hazards regression, we assessed which baseline (T2D onset) characteristics were associated with subsequent psychopharmacological treatment and psychiatric hospital contact. A total of 8.3% of the individuals with T2D initiated psychopharmacological treatment compared to 4.6% of the age- and sex-matched controls. Individuals with T2D were at increased risk of initiating psychopharmacological treatment compared to the propensity score-matched controls (HR = 1.51, 95% CI = 1.43-1.59), whereas their risk of psychiatric hospital contact was not increased to the same extent (HR = 1.14, 95% CI = 0.98-1.32). Older age, somatic comorbidity, and being divorced/widowed were associated with both psychopharmacological treatment and psychiatric hospital contact following T2D. Individuals with T2D are at elevated risk of requiring psychopharmacological treatment.

The impact of hospital-diagnosed depression or use of antidepressants on treatment initiation, adherence and HbA1c/LDL target achievement in newly diagnosed type 2 diabetes.

We aimed to assess whether current antidepressant therapy or a history of hospital-diagnosed depression affects diabetes treatment initiation, adherence, and HbA1c and LDL-cholesterol target achievement. In this register-based study, we included all individuals from Central and Northern Denmark with newly diagnosed type 2 diabetes, defined as a first-ever HbA1c measurement of ≥48mmol/mol (6.5%), between 2000 and 2016. Individuals either diagnosed with depression at a psychiatric hospital in the 2years prior to their diabetes diagnosis or currently receiving treatment with an antidepressant were compared with individuals with type 2 diabetes, but without depression treatment or previous history of depression. Outcome measures included initiation of glucose-lowering drugs and lipid-modifying agents, adherence to these medications (medication possession ratio >80%), and HbA1c (<53mmol/mol [7%]) and LDL-cholesterol (<2.6mmol/l) target achievement. The assessment of association between depression or antidepressant treatment and these outcomes was conducted using regression analyses with adjustment for potential confounders. We included a total of 87,650 individuals with first-ever HbA1c-diagnosed type 2 diabetes, of whom 0.9% (n = 784) had hospital-diagnosed depression and 11.4% (n = 9963) currently received antidepressant treatment. Compared with those without depression treatment, treatment with an antidepressant was associated with increased likelihood of glucose-lowering drug initiation (HR 1.39 [95% CI 1.34, 1.44]) and adherence (OR 1.27 [95% CI 1.18, 1.36]), lipid-modifying agent initiation (HR 1.17 [95% CI 1.11, 1.23]) and adherence (OR 1.25 [95% CI 1.09, 1.43]), and achievement of LDL (OR 1.08 [95% CI 1.03, 1.14]) but not HbA1c target (OR 0.99 [95% CI 0.93, 1.06]). The findings were similar for individuals who had hospital-diagnosed depression. In individuals with newly diagnosed type 2 diabetes, antidepressant treatment and depression were associated with improved diabetes treatment quality. Graphical abstract.

ИНДИКАЦИОННЫЙ ОБЗОР ОБЪЯВЛЕНИЙ ПРЕДУПРЕЖДАЮШИЕ ПО ПОВОДУ ДИСКРИМИНАЦИИ В ОБЛАСТИ ТРУДОУСТРОЙСТВА

Employment discrimination is a form of discrimination realised by employers with a focus on race, gender, religion, national origin, physical or mental disability and age. Employment discrimination can reduce the productivity of employees, cause them to have negative perceptions of the organization, negatively affect corporate loyalty and even cause work accidents that may cause serious injuries or even deaths in the workplace. In order to prevent such discrimination to a certaian extent public spot advertisements are prepared by official and non-official institutions to prevent discrimination in the workplaces and it is aimed to raise public awareness on employment discrimination. In this study, it was tried to put forward what messages were given and how to form awareness in public spot advertisements prepared in the international field against employment discrimination. In the spots offered by 3 different institutions from Northern European countries, Finland and Denmark, to show the discrimination to the public, attention has been paid to ensure that there are basic points of discrimination such as race, religion, disabled and gender, all of which are the basic general types of discrimination. For this purpose, public spot advertisements of three different institutions determined by using purposive sampling method were examined in light of Swiss Linguist Ferdinand de Saussure's Indicators Model and French Anthropologist Claude Lévi-Strauss's Binary Contrast Model. In the findings of the study, it was revealed that the sense of sadness was formed for the employees who were discriminated in the workplaces and it was aimed to form sensitivity in the society for the employees with the feeling of sadness.

Risk of Anemia in Patients with Newly Identified Chronic Kidney Disease - A Population-Based Cohort Study.

PurposeAnemia is prevalent in patients with chronic kidney disease (CKD), but the longitudinal risk of anemia in patients with newly identified CKD is unknown. We therefore examined the risks of experiencing anemia in persons with newly identified CKD.Patients and MethodsThis cohort study included adult patients with newly identified CKD stages 3–5 defined by an estimated glomerular filtration rate (eGFR) level <60 mL/min/1.73m2 (at least two measurements ≥90 days apart) ascertained from a population-based registry with complete laboratory test results in Northern Denmark (population ~2.2 million) during 2009–2016. We calculated 1) cumulative incidence (risk) of anemia [hemoglobin <12/<13 g/dl in women/men] by CKD stage, and 2) adjusted hazard ratios (HRs) of anemia using Cox regression analyses.ResultsWe identified 55,940 distinct individuals with newly identified CKD stages 3–5 and no prevalent anemia [n=41,958 patients in stage 3a, n=17,875 in stage 3b, n=5182 in stage 4, and n=931 in stage 5]. After one year, 42.3% (95%-confidence interval [CI]: 41.9–42.7) of patients with CKD stages 3–5 had newly measured anemia, increasing to 67.7% (95%-CI: 67.2–68.2) after five years. The absolute and relative anemia risk increased markedly with higher CKD stages. The adjusted HR of any anemia was 5.42 (95%-CI: 5.09–5.77) in patients with CKD stage 5 compared to patients with CKD stage 3a.ConclusionPatients with newly identified CKD stages 3–5 have a substantial risk of anemia, increasing with higher CKD stages. This study underlines that clinical awareness of anemia risk is important in patients with newly identified or progressed CKD.

Renin-angiotensin system blockers and 1-year mortality in patients with post-operative acute kidney injury.

Angiotensin-converting enzyme inhibitor (ACE-I) and angiotensin-receptor blocker (ARB) users may be associated with increased mortality in patients with post-operative acute kidney injury (AKI), but data are limited. We studied whether users of ACE-I/ARBs with AKI after colorectal cancer surgery (CRC) were associated with increased 1-year mortality after AKI. This population-based cohort study in Northern Denmark included patients with AKI within 7days after CRC surgery during 2005-2014. From reimbursed prescriptions, patients were classified as ACE-I/ARB current, former, or non-users. We computed the cumulative 30-day and 1-year mortality after AKI with 95% confidence intervals (95% CI) using the Kaplan-Meier method (1-survival function). Hazard ratios (HRs) comparing mortality in current and former users with non-users were computed by Cox proportional hazards regression analyses, controlling for potential confounders. We identified 10713 CRC surgery patients. A total of 2000 patients had AKI and were included. Thirty-day mortality was 16.5% (95% CI 13.7-19.8), 16.2% (95% CI 11.3-22.8), and 13.4% (95% CI 11.6-15.4) for current, former, and non-users. Adjusted HR was 1.26 (95% CI 0.96-1.65) and 1.19 (95% CI 0.78-1.82) for current and former users compared with non-users. One-year mortality rates were 26.4% (95% CI 22.9-30.4), 29.8% (95% CI 23.2-37.8), and 24.7% (95% CI 22.4-27.2) in current, former, and non-users. Compared with non-users, the adjusted 1-year HR for death in current and former users were 1.29 (95% CI 0.96-1.73) and 1.11 (95% CI 0.91-1.35). Based on our findings, current users of ACE-I/ARB may possibly have a small increase in mortality rate in the year after post-operative AKI, although the degree of certainty is low.

Temperature changes across the Paleocene-Eocene Thermal Maximum – a new high-resolution TEX86 temperature record from the Eastern North Sea Basin

The Paleocene-Eocene Thermal Maximum (PETM; ∼55.9 Ma) was a hyperthermal event associated with large carbon cycle perturbations, sustained global warming, and marine and terrestrial environmental changes. One possible trigger and/or source of the carbon release that initiated the PETM is the emplacement of the North Atlantic Igneous Province (NAIP). This study focuses on an expanded section of marine clays and diatomite on Fur Island in northern Denmark, where the entire PETM sequence has been identified by a negative ∼4.5‰ δ13CTOC excursion. This remarkably well-preserved section also contains >180 interbedded ash layers sourced from the NAIP, making it an ideal site for investigating the correlations between large-scale volcanism and environmental changes. This study provides a new and complete high-resolution TEX86-derived sea-surface temperature (SST) reconstruction over the entire PETM and the post-PETM section (up to about 54.6 Ma). The palaeothermometry record indicates an apparent short-lived cooling episode in the late Paleocene, followed by a pronounced temperature response to the PETM carbon cycle perturbations with a ∼10°C SST increase during the PETM onset (up to ∼33°C). Extreme SSTs fall shortly after the PETM onset, and continue to decrease during the PETM body and recovery, down to anomalously cool SSTs post-PETM (∼11–23°C). Both phases of potential cooling coincide with proxies of active NAIP volcanism, suggesting a causal connection, although several overprinting non-thermal factors complicate interpretations of the TEX86 values. Indices of effusive and explosive NAIP volcanism are largely absent from the Danish stratigraphy during the PETM body, though a re-emergence toward the end of the PETM suggest NAIP volcanism might have played a role in the PETM termination in the North Sea. This new SST record completes the previous fragmented view of climate changes at this globally important PETM site, and indicates large temperature variations in the North Sea during the earliest Eocene that are possibly linked to NAIP volcanism.