The role of red meat in type 1 diabetes risk remains unclear. We examined whether maternal and early-life red meat intake is associated with the development of type 1 diabetes and whether such associations are modified by genetic susceptibility. We analysed data from 15,717 children participating in the All Babies In Southeast Sweden (ABIS) cohort, followed for type 1 diabetes diagnosis via national registers until the age of 24-26 years. Dietary intake was assessed through food frequency questionnaires during pregnancy and at ages 1, 2.5 and 5 years. Cox models estimated adjusted HRs and 95% CIs for type 1 diabetes in relation to red meat, including beef, pork and sausage, analysed as high vs low intake frequency and per serving/week. Analyses were stratified by HLA risk genotype and family history of type 1 diabetes. Frequency of red meat intake during pregnancy or at age 1 was not associated with type 1 diabetes risk. The corresponding HRs per serving/week were 0.98 (95% CI 0.90, 1.07) and 0.98 (95% CI 0.88, 1.08), respectively. In type-specific analyses, higher frequency of beef intake at age 5 was associated with an increased risk of type 1 diabetes (HR 1.29 [95% CI 1.05, 1.58]), with a similar tendency for exposure at age 2.5 (HR 1.12 [95% CI 0.93, 1.36]). The association at age 5 was evident among children with high-risk HLA genotypes (HR 1.40 [95% CI 1.11, 1.78]) or a family history of type 1 diabetes (HR 1.56 [95% CI 1.08, 2.26]). In contrast, no statistically significant association was observed among children with low-risk HLA genotypes (HR 0.34 [95% CI 0.10, 1.19]) or without a family history of type 1 diabetes (HR 1.20 [95% CI 0.92, 1.56]). No associations were found for higher frequency of beef consumption during pregnancy or at age 1, nor for pork and sausage at any age. Childhood beef consumption may contribute to type 1 diabetes development in genetically at-risk individuals. Further research is needed to confirm this finding and clarify underlying mechanisms.

Introduction Spinal cord injury (SCI) causes substantial disability and healthcare burden. While Austrian data are available for traumatic SCI, incidence and causes of non-traumatic SCI have not been reported previously. This study aims to determine the incidence and causes of traumatic and non-traumatic SCI in Salzburg, Austria, from 2013 to 2023. Methods We retrospectively screened hospital databases from Salzburg County Hospitals (SALK) and the regional trauma hospital (AUVA) using an ICD-based algorithm. This hospital network captures the majority of SCI care in the region; however, cases managed exclusively outside this network may not be captured. Cases were included if SCI was confirmed by MRI or medical documentation and the index event occurred during 2013–2023. Data were extracted into a validated REDCap instrument. Incidence was calculated for Salzburg residents; non-resident cases were analyzed separately for healthcare burden. Results A total of 587 SCI cases were identified, including 99 traumatic (16.8%) and 488 non-traumatic (83.2%). The average incidence was 9.7/100,000/year (traumatic: 1.6; non-traumatic: 8.1). The cohort had a median age of 62 years; male-to-female ratio was 2.96 for traumatic and 1.02 for non-traumatic cases. Falls (52.5%) were the leading traumatic cause, followed by transport (24.2%) and sports injuries (19.2%). Multiple sclerosis (24.8%) was the most frequent non-traumatic etiology, followed by degenerative disorders, neoplasms, and infections. Nearly half of all lesions were cervical, with C5–C8 most commonly affected. From 2020 onward, SCI incidence declined sharply, temporally coinciding with the COVID-19 pandemic. Conclusion SCI incidence in Salzburg (9.7/100,000) was higher than earlier Austrian estimates due to inclusion of non-traumatic cases, which comprised over 80% of all SCIs. Falls and degenerative/inflammatory conditions were major contributors. Preventive strategies should address both traumatic and non-traumatic causes, and a prospective national registry is warranted.

The use of high-flow oxygen therapy (HFOT) compared with standard low-flow oxygen therapy (LFOT) may improve outcomes in people with oxygen-dependent chronic respiratory failure (CRF). The primary aim of this multicentre trial was to evaluate HFOT in addition to LFOT, compared with regular LFOT in people with CRF due to chronic obstructive pulmonary disease (COPD) or interstitial lung disease (ILD). Registry-based randomised controlled trial (R-RCT) of people on LFOT for CRF due to COPD (n = 270) and ILD (n = 40), at ten Swedish secondary care centres within the Swedish Register for Respiratory Failure (Swedevox). People with ongoing LFOT are randomised in a 1:1 ratio to standard treatment with LFOT (control) or LFOT with added HFOT during nighttime and at the patient's discretion daytime (intervention). HFOT is provided using the ResMed Lumis HFT system and the AcuCare HFNC Cannula. Primary outcome is time to first hospitalisation or death up to 1 year in people with COPD. Secondary outcomes include symptoms, health-related outcomes (HRQL), health-economics, adverse events, and to explore the effects of HFOT in people with CRF due to ILD. Outcome data will be obtained from national registries and from patient questionnaires at 3 and 12months. This R-RCT will combine the advantages of a prospective randomised trial and large clinical national registries to improve the evidence-based use of long-term oxygen therapy. Recruitment started in June 2024 and is ongoing. ClinicalTrials.gov, ID: NCT06247397. Registered 2024-02-07.

Transcatheter pulmonary valve implantation in patients with repaired tetralogy of Fallot: International evidence and the current status in Japan.

Evidence of whether smoking affects the risk for SARS-CoV-2 infection is mixed. We aimed to clarify the inconsistencies in previous findings and whether the association is potentially causal using different Mendelian randomization (MR) methods. We examined associations between smoking traits (initiation, cessation, and intensity) and SARS-CoV-2 infection in multivariable logistic regression, and one-sample and two-sample MR analyses. The study included n = 47,506 female and n = 28,229 male study subjects from the Norwegian Mother, Father, and Child Cohort Study (MoBa) with questionnaire data and genotype information. SARS-CoV-2 infection status was obtained by data linkage to the national health registry MSIS. We found no clear evidence of an association between smoking initiation and SARS-CoV-2 infection (multivariable regression: OR 1.08, 95% CI 0.96 to 1.20, one-sample multivariable MR analysis: OR 1.02, 95% CI 0.96 to 1.09, two-sample MR: OR 1.10 (95% CI 1.06 to 1.13). Also, we found no clear evidence of an association with smoking intensity (multivariable regression: OR 0.78, 95% CI 0.62 to 0.96, one-sample multivariable MR: OR 1.04, 95% CI 0.76 to 1.42, two-sample MR: OR 1.01, 95% CI 0.95 to 1.09, per 1 SD increase in number of cigarettes per day). Nor was there any association with smoking cessation. These findings did not change after accounting for educational level, BMI or risk-taking behavior in multivariable MR analyses. We did not find robust evidence of causal associations between smoking and SARS-CoV-2 infection. Our investigation of potential violations to MR assumptions highlights the limitations of this approach to examine infection risk associated with smoking.

Frailty and One Year Survival in Patients Admitted to the Intensive Care Unit Following a Medical Emergency Team Review: A Retrospective Registry-Based Study.

The inclusion of Spinal Cord Injury (SCI) in the Global Burden of Diseases (GBD) study in 2016 as a distinct entity represented a significant milestone in recognizing and quantifying its global health impact. The study's purpose was to quantify the discrepancies between SCI incidence rates estimated by the GBD and those reported in published literature to assess the external validity of GBD outputs at the country level and propose methodological refinements to improve their utility for policymakers, clinicians, and global health stakeholders. We compared GBD 2016, 2019, and 2021 country-level SCI incidence estimates with data from 10 systematic reviews and a scoping search in Embase. Studies were eligible for inclusion if they explicitly reported both case counts and incidence rates of SCI at the country level. Two authors checked the data for accuracy and reliability purposes. We categorized studies into two periods-pre-2000 and 2000 to 2024-to align with key GBD benchmark years: 1990 for pre-2000 data, and 2016, 2019, and 2021 for post-2000 data. A meta-analysis calculated SCI incidence rates for each country across two timeframes (pre-2000 and 2000-2024). We then computed a discrepancy ratio (DR) by dividing GBD estimates by literature-based rates, categorizing discrepancies as low (DR < 2), moderate (2 to < 5), substantial (5 to < 10), or significant (DR > 10). Further analysis explored countries with national registries, the impact of pre-hospital mortality, and GBD's SCI definition and reporting methodology. In our analysis of 30 countries, we identified a high proportion of significant (50%) and substantial (23.4%) discrepancies relative to GBD 2016 estimates. When compared against GBD 2021 data, significant discrepancies decreased to 6.6%, though substantial discrepancies rose to 50%; indicating an overall improvement but persistent overestimation. Japan, South Africa, Taiwan, and Tanzania showed low discrepancies, while Denmark, France, Italy, and Spain continued to have significant discrepancies in GBD 2021. We identified three key areas for GBD improvement: unclear inclusion of non-traumatic SCI, lack of incidence stratification by severity, and omission of sports-related SCI as a distinct etiology. Early GBD SCI estimates were often overestimates, but continuous methodological refinements are leading to better alignment with real-world data. Future GBD reports should further enhance interpretability by integrating injury severity data and a more granular breakdown of SCI aetiologies. .

Safety-Net Kidney Transplantation After Heart Transplantation: Early Real-World Outcomes Under the New Policy.

Novel association of HLA-DQA1 and HLA-DPB1 alleles with Acute myeloid leukemia susceptibility in (Central Asian) Kazakhstani Population: A Case-Control study.

A clinical rule-based indicator to identify recurrence of colorectal cancer after curative resection using linked routinely collected national data.

SSRI use during pregnancy and maternal depression - a nationwide birth cohort study on risks to the mother and the newborn.

Analysis on workforce availability, education and training needs for medical physics experts to ensure quality and safety of medical applications involving ionising radiation in the EU - Status and recommendations from the EU-REST project.

In-hospital complications after gastrectomy in relation to long-term survival in gastric adenocarcinoma: a population-based cohort study.

This study examined the association between post-admission complications and 120-day mortality using data from a national hip fracture registry. A sub-analysis explored the impact of improved complication registration on these associations. We conducted a cohort study including patients (1 January 2018 to 31 December 2023) from the Dutch Hip Fracture Audit (DHFA). Ten complications (anaemia, delirium, fall incident, heart failure, pneumonia, pressure ulcer, pulmonary embolism (PE), renal dysfunction, urinary tract infection, wound infection) were assessed. From 2018 to 2019, seven hospitals were recruited for additional data collection for the DHFA to improve and develop quality indicators. A multivariate Cox regression model was used to calculate the hazard ratio (HR) between complications and mortality at 30, 60, and 120 days. Subgroup analysis assessed the effect of better registration. A total of 86,524 patients were included, with a median age of 81 years (IQR 72 to 87). The overall complication rate was 25.7% (n = 22,210), anaemia was the most common complication (n = 8,027; 9.3%), followed by delirium (n = 7,836; 9.1%). In subgroup analysis, project hospitals had a higher overall complications rate (38.8% vs 27.4%; p < 0.001). After adjustment for confounders, at 30 days, heart failure (HR 2.45 (95% CI 2.15 to 2.75)), delirium (HR 1.28 (95% CI 1.19 to 1.38)), PE (HR 2.62 (95% CI 2.11 to 3.27)), renal dysfunction (HR 2.20 (95% CI 1.96 to 2.47)), and pneumonia (HR 2.35 (95% CI 2.15 to 2.56)) were significantly associated with an increased hazard of death. In the subgroup analysis, fewer complications were associated with an increased hazard of death in the project hospitals in comparison to the non-project hospitals. Five complications were significantly associated with an increased risk of mortality at 30 and 60 days. These findings highlight the importance of closely monitoring and managing complications. Improved registration practices in project hospitals were linked to fewer complications that showed a relation with mortality. Complications without a clear association with mortality may be more suitable for short-cycle in-hospital feedback rather than a national audit.

Objective family burden of diabetes is associated with increased risk of hospital diagnosis of covid-19: A prospective cohort study from the Malmö diet and cancer study.

Routinely collected health data on 10-year genitourinary and gastrointestinal morbidity after ultra-hypofractionated versus conventionally fractionated radiotherapy for localised prostate cancer in the randomised, non-inferiority, phase 3 trial HYPO-RT-PC.

This study presents the most comprehensive evaluation to date of non-melanoma skin cancer (NMSC) risk in the UK National Registry for Radiation Workers, examining separately both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The cohort includes 172,452 workers with over 5.3 million person-years of follow-up (1955-2011) and a mean cumulative dose of 24.9 mSv. Cumulative external radiation was assessed using the personal dose equivalent Hp(10), and Poisson regression estimates the excess relative risk per Sievert (ERR/Sv) of skin cancer incidence. A total of 5748 NMSC cases were identified (4288 BCC, 818 SCC). BCC showed good evidence of a linear dose-response (ERR/Sv = 0.85, 95% CI: 0.39-1.39; p <.001), but this weakened after adjusting for anatomical location as a proxy for ultraviolet radiation (UVR) exposure (ERR/Sv = 0.15; 95% CI: -0.17-0.54; p = 0.28). However, BCC risk remained elevated among workers who were monitored for internal exposure and those workers first employed before 1960, both of whom experienced higher doses and longer follow-up. SCC showed only limited evidence of a radiation dose-response (ERR/Sv = 0.87; 95% CI: 0.03-2.05; p = 0.04), driven largely by a small number of cases at high dose, and lost significance after adjustment for anatomical location. Most BCC and SCC tumors occurred on sun-exposed areas, with notably higher BCC risks on the upper limbs. These findings highlight the importance of accounting for UVR exposure in occupational radiation studies of skin cancer and support further research with individual UVR exposure data and skin dose data to better quantify these risks.

Race and Sex Interplay in Female African American Patients with Peripheral Arterial Disease of the Lower Extremities Undergoing Arterial Revascularization.

Despite favourable survival prognosis, the main concern for ductal carcinoma insitu (DCIS) is local recurrence, especially progression to invasive cancer. This study identified factors associated with breast events following DCIS treatment. Women with unilateral DCIS between 2000 and 2022 were identified from New Zealand Breast Cancer Foundation National Register. The primary endpoint was cumulative incidence of invasive breast cancer, ipsilateral (iIBC) or contralateral (iCBC). Secondary endpoints included ipsilateral breast event (IBE), insitu or invasive, and any breast event (IBE or CBC). Fine-Gray models were used to identify the associated factors and estimate subdistribution hazard ratios (sHRs). Among 5740 patients followed for a median duration of 4.8 years, the 5- and 10-year cumulative risks were 3.0% (95% CI, 2.4%, 3.5%) and 6.6% (95% CI, 5.7%, 7.6%) for iIBC, and 2.7% (95% CI, 2.2%, 3.3%) and 6.3% (95% CI, 5.4%, 7.3%) for iCBC, respectively. A higher risk of iIBC was observed in women aged under 45 at diagnosis (sHR, 1.81; 95% CI: 1.18, 2.79) or had DCIS size > 20 mm (sHR, 1.42; 1.05, 1.93), and a lower risk in those who received additional RT after BCS (HR: 0.61; 0.44, 0.84) or mastectomy (sHR, 0.21; 0.13, 0.32). Similar associations were observed for IBE and any breast event, for which surgical margin < 2 mm was also associated with a higher risk. Having surgery at a private facility, where higher-risk patients were likely to be treated, was associated with a higher risk of iCBC. DCIS size, surgical approach, and age at diagnosis influenced the risk of breast events after DCIS, which may be considered in efforts to improve treatment strategies for higher-risk women.

Congenital heart disease (CHD) is associated with daily stressors, including medical and physical limitations, as well as reduced social participation, necessitating psychological adjustment. Emotion regulation may be a key factor in this process and could explain variability in life satisfaction among individuals with CHD. However, emotion regulation has not been systematically investigated in this population. A total of 1187 adults (aged 18 to 85; 60.2% female) from the German National Register for Congenital Heart Defects were classified into simple, moderate, or complex CHD severity groups and completed self-report measures of emotion regulation, mental and general health, and life satisfaction. Rumination, suppression, and avoidance were negatively associated with life satisfaction, mental health, and general health, whereas reappraisal, acceptance, problem solving, and social support showed positive associations (life satisfaction: r =-0.20 to 0.34, p <.001; mental health: r =-0.38 to 0.28, p =.19 to<.001; general health: r =-0.10 to 0.16, p =.19 to<.001). Simple slope analyses indicated that rumination predicted poorer general health at simple and moderate, but not complex, severity levels, when controlling for age, sex, relationship, and employment status. Suppression ability was linked to better general health only in complex CHD. Emotion regulation seems to be a critical factor in well-being outcomes among individuals with CHD. Findings highlight the importance of addressing emotion regulation skills in psychological interventions for this population.