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Importance: Administration-to-birth intervals of antenatal corticosteroids (ANS) vary. The significance of this variation is unclear. Specifically, to our knowledge, the shortest effective administration-to-birth interval is unknown.Objective: To explore the associations between ANS administration-to-birth interval and survival and morbidity among very preterm infants.Design, Setting, and Participants: The Effective Perinatal Intensive Care in Europe (EPICE) study, a population-based prospective cohort study, gathered data from 19 regions in 11 European countries in 2011 and 2012 on 4594 singleton infants with gestational ages between 24 and 31 weeks, without severe anomalies and unexposed to repeated courses of ANS. Data were analyzed November 2016.Exposure: Time from first injection of ANS to delivery in hours and days.Main Outcomes and Measures: Three outcomes were studied: in-hospital mortality; a composite of mortality or severe neonatal morbidity, defined as an intraventricular hemorrhage grade of 3 or greater, cystic periventricular leukomalacia, surgical necrotizing enterocolitis, or stage 3 or greater retinopathy of prematurity; and severe neonatal brain injury, defined as an intraventricular hemorrhage grade of 3 or greater or cystic periventricular leukomalacia.Results: Of the 4594 infants included in the cohort, 2496 infants (54.3%) were boys, and the mean (SD) gestational age was 28.5 (2.2) weeks and mean (SD) birth weight was 1213 (400) g. Mortality for the 662 infants (14.4%) unexposed to ANS was 20.6% (136 of 661). Administration of ANS was associated with an immediate and rapid decline in mortality, reaching a plateau with more than 50% risk reduction after an administration-to-birth interval of 18 to 36 hours. A similar pattern for timing was seen for the composite mortality or morbidity outcome, whereas a significant risk reduction of severe neonatal brain injury was associated with longer administration-to-bi

OBJECTIVES: To evaluate the implementation of four high evidence practices for the care of very preterm infants to assess their use and impact in routine clinical practice and whether they constitute a driver for reducing mortality and neonatal morbidity.DESIGN: Prospective multinational population based observational study.SETTING: 19 regions from 11 European countries covering 850 000 annual births participating in the EPICE (Effective Perinatal Intensive Care in Europe for very preterm births) project.PARTICIPANTS: 7336 infants born between 24+0 and 31+6 weeks' gestation in 2011/12 without serious congenital anomalies and surviving to neonatal admission.MAIN OUTCOME MEASURES: Combined use of four evidence based practices for infants born before 28 weeks' gestation using an "all or none" approach: delivery in a maternity unit with appropriate level of neonatal care; administration of antenatal corticosteroids; prevention of hypothermia (temperature on admission to neonatal unit ≥36°C); surfactant used within two hours of birth or early nasal continuous positive airway pressure. Infant outcomes were in-hospital mortality, severe neonatal morbidity at discharge, and a composite measure of death or severe morbidity, or both. We modelled associations using risk ratios, with propensity score weighting to account for potential confounding bias. Analyses were adjusted for clustering within delivery hospital.RESULTS: Only 58.3% (n=4275) of infants received all evidence based practices for which they were eligible. Infants with low gestational age, growth restriction, low Apgar scores, and who were born on the day of maternal admission to hospital were less likely to receive evidence based care. After adjustment, evidence based care was associated with lower in-hospital mortality (risk ratio 0.72, 95% confidence interval 0.60 to 0.87) and in-hospital mortality or severe morbidity, or both (0.82, 0.73 to 0.92), corresponding to an estim

INTRODUCTION: Iodine is essential for the production of thyroid hormones. In pregnancy, physiological changes occur that can lead to iodine deficiency and impairment of fetal neurological development. We aimed to assess the iodine intake in pregnant women in Eastern Denmark, compare iodine levels in Eastern and Western Denmark and to identify potentially vulnerable groups.METHODS: This was a cross-sectional cohort study of pregnant Danish women (n = 240). Questionnaires and urine samples were collected at the Ultrasound Clinic, Hvidovre Hospital, Denmark, and urinary iodine concentrations (UIC) (µg/l) were measured. Predictors of iodine supplement use were examined by multivariate logistic regression models.RESULTS: The pregnant women from Eastern Denmark had a median age of 30 years and the median gestational week at which they were included in the study was week 19. The majority took iodine-containing supplements (86%). The median UIC was 118 (interquartile range (IQR): 79-196) µg/l in iodine supplement users and 82 (IQR: 41-122) µg/l in non-users (p < 0.001). Predictors of not using iodine supplement in Eastern and Western Denmark were short maternal education, non-Danish origin and pre-pregnancy obesity.CONCLUSIONS: The iodine status in Danish pregnant women was below WHO recommendations. Iodine supplement non-users are at a particular risk of iodine deficiency. Low maternal education, non-Danish origin and pre-pregnancy obesity are predictors of non-iodine supplement use. An increase in iodine fortification may be recommended to improve the iodine status in pregnant Danish women.FUNDING: none.TRIAL REGISTRATION: not relevant.

Introduction: To elucidate possible mechanisms behind the increased risk of stillbirth and infant mortality among migrants in Denmark, this study aimed to analyse characteristics of perinatal deaths at Hvidovre Hospital 2006-2010 according to maternal country of origin. Methods: We identified children born at Hvidovre Hospital who died perinatally and included the patient files in a series of case studies. Our data were linked to data from popu­lation-covering registries in Statistics Denmark. Timing, causes of death as well as social, medical and obstetric characteristics of the parents were described according to maternal country of origin. Results: This study included 125 perinatal deaths. The data indicated that intrapartum death, death caused by maternal disease, lethal malformation and preterm birth may be more frequent among non-Western than among Danish-born women. Obesity and disposition to diabetes may also be more prevalent among the non-Western women. Conclusion: The role of obesity, gestational diabetes, preeclampsia and severe congenital anomalies should be a main focus in improving our understanding the increased risk of perinatal death among non-Western migrant women in Denmark. Six of 28 perinatal deaths in the non-Western group were intrapartum deaths and warrants further concern. Funding: This project was funded by the Danish Council for Strategic Research as part of the SULIM project. Trial registration: The linkage of data from patient files to data from Statistics Denmark was approved by the Danish Data Protection Agency. Only anonymised data were used.

Die reiche Dresdner Musikkultur in Geschichte und Gegenwart hat Generationen von Musikforschern zu Untersuchungen angeregt. Unzählige Aufsätze und Monographien, Lexikonartikel und Editionen, Graduierungsarbeiten und Miszellen widmen sich den unterschiedlichsten Institutionen und Persönlichkeiten des elbestädtischen Musiklebens. Stellvertretend für solche Wortmeldungen seien die Arbeiten von Moritz Fürstenau, Richard Engländer, Irmgard Becker-Glauch, Ortrun Landmann, Manfred Fechner, Hans John und Matthias Herrmann genannt. Trotz der inzwischen vorliegenden opulenten Forschungsliteratur ist die Zahl der Desiderate und „weißen Flecken“ der Dresdner Musikhistoriographie immer noch erheblich: Was wissen wir über den Bachschüler und Haydn-Zeitgenossen Christoph Transchel, einen damals berühmten Dresdner Klavierspieler, was über den elbestädtischen Instrumentenbau im ersten Drittel des 19. Jahrhunderts, was über den Musikkritiker und zeitweisen Schumann-Freund Christian Albert Schiffner? Ja selbst die Wirkungsgeschichte von Richard Wagners Opern nach 1850 in der Uraufführungsstadt des „Tannhäuser“ ist noch weitgehend ungeschrieben. Doch bedeutet das Eingeständnis fehlender wissenschaftlicher Studien zu bestimmten Aspekten und Phänomenen der Dresdner Musikgeschichte nur die halbe Wahrheit, denn es gibt eine Spezies von Forschungsliteratur, die gleichsam im Stadium der Vorveröffentlichung stecken geblieben ist. Wir meinen die große Anzahl von studentischen Hausarbeiten und Graduierungsarbeiten, von denen sich einige oftmals mit großem Geschick und zeitlichem Aufwand mit sog. Nebenschauplätzen des Dresdner Musiklebens (und nicht nur diesem) beschäftigen, Arbeiten, die im Seminar diskutiert, dann bewertet werden und schließlich in den Institutsbibliotheken oder Schreibtischen der Dozenten verschwinden. Nochmals: Es soll hier keinem Populismus das Wort geredet werden, etwa dergestalt, sämtliche besagte Arbeiten der Öffentlichkeit zugänglich zu machen. Mitnichten: Die besten Ar

Selbstreproduktion ist eines der Kennzeichen aller lebenden Organismen. Der Zellzyklus dient der Selbstreproduktion in einzelligen Organismen. In mehrzelligen Organismen ist der Zellzyklus darüber hinaus für andere lebenswichtige Prozesse, einschließlich Immunreaktionen, unerlässlich. In dieser Arbeit wird eine Methode entwickelt mit der die Dauer der Zellzyklus Phasen bestimmt werden kann. Kenntnis über die Zellzyklusphasendauer ermöglicht vorherzusagen, wie schnell eine Population von proliferierenden Zellen wachsen wird, oder wie viele neue Zellen pro Stunde in einem Gewebe geboren werden. Im Kapitel 1 dieser Arbeit wird ein Zellzyklusmodell aufgestellt und mit experimentellen Bromdesoxyuridin Daten verglichen. Die Analyse zeigt, dass das Modell gut die experimentelle Kinetik beschreibt, hebt jedoch auch hervor dass einige der Parameter nicht identifiziert werden können. Dieses Problem wird in Kapitel 2 bearbeitet, wo zwei Ansätze erforscht werden, um den Informationsgehalt der Experimente zu erhöhen. In einem ersten Ansatz wird die Theorie der Versuchsplanung angewendet, um optimale Versuchspläne zu bestimmen. In einem zweiten Ansatz wird das übliche Bromdesoxyuridin Protokoll durch ein zweites Nukleosid erweitert. Beide Methoden verbessern in silico erheblich die Genauigkeit und Präzision der Abschätzungen. Im dritten Kapitel wird die Methodik in der Analyse der Keimzentrumsreaktion angewendet. Ein erheblicher Zufluss von Zellen in die dunkle Zone von Keimzentren wird vorhergesagt, und die Ansicht einer extrem schellen Zellteilung im Keimzentrum erscheint in dem Modell als ein Artefakt der Zellmigration., Self-reproduction is one of the distinguishing marks of living organisms. The cell cycle is the underlying process by which self-reproduction is accomplished in single-celled organisms. In multi-cellular organisms, the cell cycle is in addition indispensable for other vital processes, including immune reactions. In this thesis a method is developed that allows to estimate the time it takes for a dividing cells to complete the CC phases. Knowledge of the CC phase durations allows to predict, for example, how fast a population of proliferating cells will grow in size, or how many new cells are born per hour in a given tissue. In Chapter 1 of this thesis, a cell cycle model with delays and variability in the completion times of each phase is developed. Analytical solutions are derived to describe a common experimental technique used for cell cycle analysis, namely pulse labeling with bromodeoxyuridine (BrdU). Comparison with data shows that the model reproduces closely measured cell cycle kinetics, however also reveals that some of the parameter values cannot be identified. This problem is addressed in Chapter 2. In a first approach, the framework of D-optimal experimental designs is employed, in order to choose optimal sampling schemes. In a second approach, the prevailing protocol with a single nucleoside is modified by adding a second nucleoside analog pulse. Both methods are tested and the results suggest that experimental design can significantly improve parameter estimation. In Chapter 3, the model is applied to the germinal center reaction. A substantial influx of cells into the dark zone of germinal centers is predicted. Moreover the wide-held view of rapid proliferation in germinal centers, appears, under this model, as an artifact of cell migration.

Carina Sjöberg Brixval,1 Lau Caspar Thygesen,1 Nanna Roed Johansen,2 Christina Rørbye,3 Tom Weber,3 Pernille Due,1 Vibeke Koushede1 1National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; 2Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 3Copenhagen University Hospital, Department of Obstetrics and Gynecology, Hvidovre Hospital, Hvidovre, Denmark Background: Data from hospital-based registers and medical records offer valuable sources of information for clinical and epidemiological research purposes. However, conducting high-quality epidemiological research requires valid and complete data sources. Objective: To assess completeness and validity of a hospital-based clinical register – the Obstetric Database – using a national register and medical records as references. Methods: We assessed completeness of a hospital-based clinical register – the Obstetric Database – by linking data from all women registered in the Obstetric Database as having given birth in 2013 to the National Patient Register with coverage of all births in 2013. Validity of eleven selected indicators from the Obstetric Database was assessed using medical records as a golden standard. Using a random sample of 250 medical records, we calculated proportion of agreement, sensitivity, specificity, and positive and negative predictive values for each indicator. Two assessors independently reviewed medical records and inter-rater reliability was calculated as proportion of agreement and Cohen's κ coefficient. Results: We found 100% completeness of the Obstetric Database when compared to the Danish National Patient Register. Except for one delivery all 6,717 deliveries were present in both registers. Proportion of agreement between the Obstetric Database and medical records ranged from 91.1% to 99.6% for the eleven indicators. The validity measures ranged fr

The long term goal of this work is to further the understanding of how clustering in clouds of discrete scatterers has an effect on both forward propagating and backscattered acoustic fields. Clustering is considered to be present when there are spatially dependent correlations in the fluctuating positions of the scatterers. For example, bubble clouds created by oceanic breaking waves have been observed to exhibit clustering at a level that would have a significant impact on the forward propagating acoustic field. Clustering may also be present in fish aggregations (e.g., nearest neighbor distances, school morphologies driven by behavior, inter-school spacing), and should be considered when examining bioclutter. This work is based on a) refining theoretical approaches so that they include clustering; and b) observing clustering in the important classes of discrete volume scatterers in the ocean.