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Cold climate and unique genetic and environmental factors may influence the prevalence of skin diseases in Greenland. However, there is a lack of epidemiological studies on skin diseases in the adult Greenlandic population. To address this unmet need a cross-sectional study, run by dermatologists from Denmark, the UK, and Switzerland estimated the prevalence and clinical manifestations of skin diseases among adults in East Greenland in May 2022. All adults ≥18 years in the town of Tasiilaq were invited, and 295 individuals aged 18–78 years participated (22.5% of the overall adult population in Tasiilaq). Two-hundred and three participants (69%) had visible signs of current skin disease, and among these, 242 cases of dermatoses were identified. The most common skin diseases were hand eczema (22.4%), lichen simplex (9.5%), discoid eczema (7.1%), psoriasis, atopic dermatitis and acne vulgaris (5.8% each). Scabies was the most frequent infectious skin disease (4.4%). No cases of skin cancer were identified. Atopic dermatitis and psoriasis presented with disease that was of limited extent and different from the classical presentations. Skin diseases showed a high prevalence among adults in East Greenland, and some of them were severe. This indicates a noteworthy public health problem that warrants better access to dermatologist support.

The present article reports the densities of planktonic sea lice (Lepeophtheirus salmonis and Caligus elongatus) in three Atlantic salmon (Salmo salar) localities, and the relationship between the abundance of adult sea lice on the salmon and the densities of planktonic sea lice stages, during a complete production cycle followed by a fallowing period. Samples were taken downstream inside and immediately outside of cages, at one locality with lice skirts and two localities without lice skirts. There were no differences in densities of planktonic sea lice in samples taken from the inside or the outside of cages for any of the localities. However, the proportion-non-zero of planktonic sea lice samples taken from inside the cage was higher during months with a temperature above 9°C (mean abundance: 0.40–2.5 individuals m–3) than months with temperature below 9°C (mean abundance: 0.02–0.21 individuals m–3, odds ratio of the proportion-non-zero: p < 0.01). Densities of planktonic sea lice correlated most strongly with temperature in the first year (τ = 0.44–0.57, p < 0.05). A significant correlation between the number of adult female lice on salmon and average density of plankton sea lice was found in the locality with lice skirts during the second year (τ = 0.43 inside cages, τ = 0.58 outside cages, both p values < 0.05). Background levels of planktonic sea lice in the succeeding fallowing period showed neither L. salmonis nor C. elongatus planktonic sea lice, suggesting that there was successful reduction of the densities of planktonic sea lice for this area during the fallowing period.

The objective of the current study was to determine the extent to which planktonic sea lice (Lepeophtheirus salmonis Krøyer, 1838 and Caligus elongatus Nordmann, 1832) were present in the biofouling on open-sea net pens used for commercial rearing of Atlantic salmon (Salmo salar L.), and to assess if biofouling organisms on nets act as barriers similar to salmon lice skirts. We have examined two possible interactions of biofouling and planktonic sea lice, the first was if biofouling could function as a microhabitat for planktonic sea lice, with resuspension of sea lice during net cleaning operations. The second interaction was if biofouling may cause a retaining effect on the transport of planktonic stages out of the net pen. These interactions were investigated at different commercial salmon farms. With only one sea louse found among the biofouling on nets and cleaner fish shelters, we found no indication that sea lice utilized biofouling as a reservoir. This was further supported by the lack of impact on the proportion of samples with sea lice and the average density of sea lice in the water following the release of biofouling material during in situ net cleaning. Furthermore, the presence of biofouling had no effect on the proportion of samples with sea lice or the average density of planktonic sea lice in the net pens. The presence of a lice skirt resulted, however, in a significantly higher proportion of samples with planktonic sea lice inside the net pen in one of the two sites utilizing lice skirts. The results of our study suggested that the presence of biofouling has no influence on the average density and proportion of samples with planktonic stages of sea lice and that planktonic sea lice do not inhabit biofouling.

The aim of this study was to develop and validate a clinical and transplant-specific prognostic score using data from a large cohort of patients with myelodysplastic syndromes reported to the European Society for Blood and Marrow Transplantation registry. A Cox model was fitted to detect clinical and transplant-related variables prognostic of outcome. Then, cross-validation was performed to evaluate the validity and consistency of the model. Seven independent risk factors for survival were identified: age ≥50 years, matched unrelated donor, Karnofsky Performance Status 1%, and platelet count ≤50 × 109/L prior to transplantation. Incorporating these factors into a four-level risk score yielded hazard ratios for death, with low-risk (score of 0-1) as reference, of 2.02 (95% CI: 1.41-2.90) for the intermediate-risk group (score of 2-3), 3.49 (95% CI: 2.45-4.97) for the high-risk group (score of 4-5), and 5.90 (95% CI: 4.01-8.67) for the very high-risk group (score of >5). The score was predictive of survival, relapse-free survival, relapse, and non-relapse mortality (P

This paper focuses on a three-year rural landscape strategy-making process, which was driven by a Danish municipality and involved a large number of stakeholders. The project was part of an action research program aimed at developing new approaches to collaborative landscape planning. Gaining experiences with such approaches was part of this aim. During the course of the project, the focus and scale of the strategy changed significantly. The process developed in interesting ways in respect to three dimensions of collaborative landscape planning: collaboration, scale, and public goods. After a brief review of the three dimensions and their links to landscape planning, the case story is unfolded in three sections: (1) The planning process, (2) the process outcome (the strategy), and (3) the aftermath in terms of critical reflections from participating planners and local stakeholders. The process and outcome of the landscape strategy-making process is discussed in the context of collaboration, scale, and public goods, including a brief outline of the lessons learned.

Cold climate and unique genetic and environmental factors may influence the prevalence of skin diseases in Greenland. However, there is a lack of epidemiological studies on skin diseases in the adult Greenlandic population. To address this unmet need a cross-sectional study, run by dermatologists from Denmark, the UK, and Switzerland estimated the prevalence and clinical manifestations of skin diseases among adults in East Greenland in May 2022. All adults ≥18 years in the town of Tasiilaq were invited, and 295 individuals aged 18–78 years participated (22.5% of the overall adult population in Tasiilaq). Two-hundred and three participants (69%) had visible signs of current skin disease, and among these, 242 cases of dermatoses were identified. The most common skin diseases were hand eczema (22.4%), lichen simplex (9.5%), discoid eczema (7.1%), psoriasis, atopic dermatitis and acne vulgaris (5.8% each). Scabies was the most frequent infectious skin disease (4.4%). No cases of skin cancer were identified. Atopic dermatitis and psoriasis presented with disease that was of limited extent and different from the classical presentations. Skin diseases showed a high prevalence among adults in East Greenland, and some of them were severe. This indicates a noteworthy public health problem that warrants better access to dermatologist support. [ABSTRACT FROM AUTHOR]

Abstract Vitiligo is described with a prevalence of 0.5%−1%. Recent studies suggest an increasing prevalence, but there is a scarcity of studies that have systematically evaluated the global incidence and prevalence. We examined the incidence and the global, regional, and country‐specific prevalence of vitiligo in the general population (PROSPERO: CRD42021261643). We systematically searched PubMed, EMBASE, and Web of Science. Each study was categorised in subgroups. The overall analysis comprised all studies, except for studies only examining children and adolescents. Pooled proportions were calculated with the DerSimonian‐Laird method for random‐effects models with 95% confidence intervals (CI). Of the 7,838 identified studies, 171 were eligible for analysis (participants n = 572,334,973). The overall incidence was 1.59 per 10,000 person‐years (95% CI: 0.70−2.83). The overall prevalence was 0.40% (95% CI: 0.37−0.44); no difference was observed between females (0.50%, 95% CI: 0.36−0.66) and males (0.49%, 95% CI: 0.35−0.65). West Asia showed the highest prevalence (0.77%, 95% CI: 0.44−1.10) and East Asia the lowest (0.12%, 95% CI: 0.10−0.14). The highest country‐specific prevalence was reported in Jordan (1.34%, 95% CI: 0.12−3.87) and the lowest in Sweden (0.19%, 95% CI: 0.08−0.34). Children and adolescents showed a lower prevalence (0.27%, 95% CI: 0.24−0.31) compared to adults (0.70%, 95% CI: 0.59−0.81). Questionnaire‐based studies showed a higher prevalence (0.73%, 95% CI: 0.52−0.98) compared to examination‐based studies (0.59%, 95% CI: 0.46−0.73) and register‐based studies (0.13%, 95% CI: 0.10−0.17). The prevalence in examination‐based studies increased from 0.40% (95% CI: 0.17−0.73) between 1943 and 1979 to 0.89% (95% CI: 0.68−1.13) between 2020 and 2023. Questionnaire‐based studies also showed an increasing prevalence, while in register‐based studies, the prevalence was continuously low. This study shows the global impact of vitiligo and how subgroup analyses influence the prevalence. The overall prevalence of vitiligo is lower than previously assumed; females and males are equally affected, and vitiligo is more common in adults.

Abstract Background The field of artificial intelligence is rapidly evolving. As an easily accessible platform with vast user engagement, the Chat Generative Pre‐Trained Transformer (ChatGPT) holds great promise in medicine, with the latest version, GPT‐4, capable of analyzing clinical images. Objectives To evaluate ChatGPT as a diagnostic tool and information source in clinical dermatology. Methods A total of 15 clinical images were selected from the Danish web atlas, Danderm, depicting various common and rare skin conditions. The images were uploaded to ChatGPT version GPT‐4, which was prompted with ‘Please provide a description, a potential diagnosis, and treatment options for the following dermatological condition’. The generated responses were assessed by senior registrars in dermatology and consultant dermatologists in terms of accuracy, relevance, and depth (scale 1–5), and in addition, the image quality was rated (scale 0–10). Demographic and professional information about the respondents was registered. Results A total of 23 physicians participated in the study. The majority of the respondents were consultant dermatologists (83%), and 48% had more than 10 years of training. The overall image quality had a median rating of 10 out of 10 [interquartile range (IQR): 9–10]. The overall median rating of the ChatGPT generated responses was 2 (IQR: 1–4), while overall median ratings in terms of relevance, accuracy, and depth were 2 (IQR: 1–4), 3 (IQR: 2–4) and 2 (IQR: 1–3), respectively. Conclusions Despite the advancements in ChatGPT, including newly added image processing capabilities, the chatbot demonstrated significant limitations in providing reliable and clinically useful responses to illustrative images of various dermatological conditions.

Objective To explore how the parents of children with atopic dermatitis and allergic diseases such as food allergy, allergic rhinoconjunctivitis, and asthma experience interactions with the Danish healthcare system over time.Design and methods A qualitative design with individual in-depth interviews. The analysis was inspired by Systematic Text Condensation.Subjects Eleven parents of children with atopic dermatitis and allergic diseases who received treatment at hospitals in the Capital Region of Denmark. The families had experiences of cross-sectoral patient care.Results Despite having the same diseases, the children’s care pathways were very different. Mapping demonstrated the intricacy of care pathways for this group of children. We identified three aspects that impacted interaction with healthcare: responsibility, tasks, and roles. The families experienced care when the distribution of tasks and responsibilities associated with treatment and system navigation were consistent with both their expectations and their actual experiences. At the same time, families frequently experienced limited collaboration between healthcare professionals resulting in perceived fragmented care and an extended role for parents as care coordinators. Families felt cared for when healthcare professionals knew both their biomedical and biographical circumstances, and adjusted the level of support and care in accordance with the families’ particular needs, expectations, and evolving competences.Conclusion We suggest that a possible pathway to improve care may be through a partnership approach as part of family-centered care, with general practitioners having a key role in helping to articulate the individual needs and expectations of each family.

Janus kinase (JAK) inhibitors block pathways involved in inflammation and immune response, making JAK inhibitors useful in the treatment of various diseases. While the efficacy of these drugs has been proven in several studies, their safety profile needs to be further investigated. In this systematic review and meta-analysis, we examined the risk of infections during treatment with oral JAK inhibitors with no concomitant treatment compared to placebo in phase 2 and 3 randomized, placebo-controlled trials. The medical databases PubMed, Web of Science, and EMBASE were searched from inception through February 2024, yielding 13,567 nonduplicate articles, of which 69 were included in the final quantitative analysis. Overall, we found that treatment with oral JAK inhibitors was associated with an increased risk of infections compared to placebo across all indications (relative risk: 1.39 [95% CI: 1.096-1.76, P = .0067]) and in dermatologic indications (relative risk: 1.46 [95% CI, 1.10-1.93, P = .0097]). Remarkably, an increased risk of herpes zoster infections was found in dermatologic indications but not in nondermatologic indications. In conclusion, we identified a significantly increased risk of developing infections during treatment with oral JAK inhibitors compared to placebo across indications. In sub-analyses, we additionally found an increased risk of herpes zoster in dermatologic indications.

Background and Purpose Dysfunctional breathing (DB) with or without an underlying medical condition is associated with impaired quality of life. DB-related symptoms can be measured with the 25-item Self Evaluation of Breathing Questionnaire (SEBQ). However, the SEBQ is not available in Danish.The aim of the present study was to translate and cross-culturally adapt the SEBQ into Danish and to assess the face validity of the Danish version of the questionnaire in individuals with DB-related symptoms.Materials and Methods The SEBQ was translated and cross-culturally adapted into Danish using an internationally acknowledged six-step forward-backward translation guideline in an interactive process with an expert committee of clinicians, translators, methodologists and the SEBQ developer. Face validity was explored through semi-structured interviews with 24 adult individuals with DB-related symptoms (age 20–70 years, female n = 14).Results The SEBQ was successfully translated and cross-culturally adapted into Danish. Three major modifications were made following the translation process and participant interviews. First, an introductory paragraph, including a recall period of the previous seven days, was added. Second, the administration of the questionnaire was changed from a paper to an electronic version. Finally, adaptations regarding semantic equivalence, especially concerning being ‘breathless’ and ‘short of breath’, were performed. The participants expressed that the final version of the SEBQ embraced their DB-related symptoms, was understandable, and easy to complete.Conclusion The SEBQ is the first available Danish questionnaire to measure DB-related symptoms, following an internationally acknowledged cross-cultural adaptation and face validity evaluation approach. This promising validation should be followed by an assessment of measurement properties in individuals with DB-related symptoms to investigate the adequacy of the SEBQ in a Danish context.

Purpose: Patients with atopic dermatitis (AD) require both skills and support to effectively manage life with the disease. Here, we developed an agenda-setting tool for consultations with patients with AD to establish a collaborative agenda that enhances patient involvement and prioritizes on self-management support.Materials and methods: Using the design thinking process, we included 64 end-users (patients and healthcare professionals (HCPs)) across the different phases of design thinking. We identified seven overall categories that patients find important to discuss during consultations, which informed the development of a tool for co-creating a consultation agenda (conversation cards, CCs).Results: Through iterative user testing of the CCs, patients perceived the cards as both inspiring and an invitation from HCPs to openly discuss their needs during consultations. Healthcare professionals have found the CCs easy to use, despite the disruption to the typical consultation process.Conclusion: In summary, the CCs provide a first-of-its-kind agenda-setting tool for patients with AD. They offer a simple and practical method to establishing a shared agenda that focuses on the patients’ needs and are applicable within real-world clinical settings.

In Alaska, the 1918–20 influenza pandemic was devastating, with mortality rates up to 90% of the population, while in other arctic regions in northern Sweden and Norway mortality was considerably lower. We investigated the timing and age-patterns in excess mortality in Greenland during the period 1918–21 and compare these to other epidemics and the 1889–92 pandemic. We accessed the Greenlandic National Archives and transcribed all deaths from 1880 to 1921 by age, geography, and cause of death. We estimated monthly excess mortality and studied the spatial-temporal patterns of the pandemics and compared them to other mortality crises in the 40-year period. The 1918–21 influenza pandemic arrived in Greenland in the summer of 1919, one year delayed due to ship traffic interruptions during the winter months. We found that 5.2% of the Greenland population died of the pandemic with substantial variability between counties (range, 0.1% to 11%). We did not see the typical pandemic age-pattern of high young-adult mortality, possibly due to high baseline mortality in this age-group or remoteness. However, despite substantial mortality, the mortality impact was not standing out relative to other mortality crises, or of similar devastation reported in Alaskan populations.

Background: Psoriasis is associated with high alcohol consumption, but the causality of this relationship is unclear. Objective: We aimed to use a Mendelian randomization approach to investigate the causal effects of alcohol on incident psoriasis. Methods: We included 102,655 adults from the prospective Copenhagen studies. All participants filled out a questionnaire on alcohol consumption, were physically examined, and had blood drawn for biochemical and genetic analyses. We created a genetic instrument based on the number of fast-metabolizing alleles in alcohol dehydrogenase 1B and alcohol dehydrogenase 1C, known to be associated with alcohol consumption, to test whether alcohol consumption was causally associated with psoriasis. Results: Observationally, we found an increased risk of incident psoriasis among individuals with high alcohol consumption compared to those with low alcohol consumption with a hazard ratio of 1.30 (95% confidence interval 1.05-1.60) in the fully adjusted model. Using genetic data to predict alcohol consumption to avoid confounding and reverse causation, we found no association between number of fast-metabolizing alleles and risk of psoriasis. Limitations: Alcohol consumption was self-reported and psoriasis was defined using the International Classification of Diseases 10th revision and 8th revision codes. Conclusion: Alcohol consumption is observationally but not causally associated with incident psoriasis.

Abstract Background Colorectal cancers (CRCs) in the Lynch syndromes have been assumed to emerge through an accelerated adenoma-carcinoma pathway. In this model adenomas with deficient mismatch repair have an increased probability of acquiring additional cancer driver mutation(s) resulting in more rapid progression to malignancy. If this model was accurate, the success of colonoscopy in preventing CRC would be a function of the intervals between colonoscopies and mean sojourn time of detectable adenomas. Contrary to expectations, colonoscopy did not decrease incidence of CRC in the Lynch syndromes and shorter colonoscopy intervals have not been effective in reducing CRC incidence. The prospective Lynch Syndrome Database (PLSD) was designed to examine these issues in carriers of pathogenic variants of the mis-match repair (path_MMR) genes. Materials and methods We examined the CRC and colorectal adenoma incidences in 3,574 path_MLH1, path_MSH2, path_MSH6 and path_PMS2 carriers subjected to regular colonoscopy with polypectomy, and considered the results based on sojourn times and stochastic probability paradigms. Results Most of the path_MMR carriers in each genetic group had no adenomas. There was no association between incidences of CRC and the presence of adenomas. There was no CRC observed in path_PMS2 carriers. Conclusions Colonoscopy prevented CRC in path_PMS2 carriers but not in the others. Our findings are consistent with colonoscopy surveillance blocking the adenoma-carcinoma pathway by removing identified adenomas which might otherwise become CRCs. However, in the other carriers most CRCs likely arised from dMMR cells in the crypts that have an increased mutation rate with increased stochastic chaotic probabilities for mutations. Therefore, this mechanism, that may be associated with no or only a short sojourn time of MSI tumours as adenomas, could explain the findings in our previous and current reports.

In this research article, the viscous, steady, and incompressible two-dimensional hybrid nanofluid flow composed of Fe3O4 and Au nanoparticles on an extending sheet has been presented. An inclined magnetic field impact is used for evaluating the impacts of various factors in that case. Furthermore, the influences of porosity, Brownian motion, thermophoresis, thermal and space-dependent heat sources, and thermal radiation factors are also used in this work. The numerical analysis is done by using the bvp4c technique. Validation of the present results confirms that the present analysis is valid. The outcomes show that the higher magnetic factor reduces velocity distribution while increasing the frictional force at the surface due to Lorentz forces which oppose the fluid flow. The friction force at the sheet’s surface is higher when the sheet stretches as compared to the case when the sheet shrinks. Increase in the magnetic factor increases the skin friction of sheet’s surface which consequently increases the rate of thermal transmission at the surface along with thermal distribution. The higher values of thermal radiation and thermal-dependent heat source increase the thermal transportation rate of sheet’s surface. Insights from this investigation can improve electronics cooling systems, vital for devices prone to overheating. Optimizing heat transfer with magnetohydrodynamic water-based hybrid nanofluids containing Fe3O4 and Au nanoparticles ensures efficient heat dissipation, enhancing device performance and longevity.

The boundary-layer flow on a shrinking/contracting sheet has abundant industrial applications, which include continuous glass casting, metal or polymer extrusions, and wire drawing. In this regard, the present analysis focuses the hybrid nanofluid flow on an exponentially extending sheet. The water-based hybrid nanofluid flow contains CoFe2O4 and TiO2 nanoparticles. Heat transfer rate analysis involves the utilization of the Cattaneo–Christov heat flux model. Moreover, the Brownian motion and thermophoresis effects are used in this novel work. The mathematical model is presented in the form of system of partial differential equations, which is then transformed into system of ordinary differential equations (ODEs) using the similarity variables. The system of ODEs is evaluated by homotopy analysis method. The variation in the flow profiles has been investigated using figures and tables. The conclusions demonstrate that the effect of magnetic parameter is 52% better for hybrid nanofluid flow than for the pure water. Conversely, the increasing magnetic parameter diminishes the thermal transfer rates for water, TiO2–H2O, CoFe2O4–H2O, and TiO2–CoFe2O4/H2O. The increasing thermophoresis parameter upsurges the thermal flow rate of nanofluids and hybrid nanofluid, while the increasing Brownian motion parameter lessens the thermal transfer rates of nanofluids and hybrid nanofluid. The increasing effect of thermophoresis parameter is 39% better for hybrid nanofluid than for the base fluid. However, the declining impression of Brownian motion factor is 48% greater for hybrid nanofluid related to pure water.

Hybrid nanofluid problems are used for augmentation of thermal transportation in various industrial applications. Therefore, the present problem is studied for the heat and mass transportation features of hybrid nanofluid caused by extending surface along with porous media. In this investigation, the authors have emphasized to analyze hybrid nanofluid flow containing diamond and copper nanoparticles on an extending surface. Furthermore, the velocity, temperature, and concentration slip constraints are adopted to examine the flow of fluid. Heat source, chemical reactivity, thermal radiation, Brownian motion and effects are taken into consideration. Nonlinear modeled equations are converted into dimensionless through similarity variables. By adopting the homotopy analysis method, the resulting equations are simulated analytically. The impacts of various emerging factors on the flow profiles (i.e., velocities, temperature, concentration, skin frictions, local Nusselt number, and Sherwood number) are shown using Figures and Tables. The major key findings reveal that the hybrid nanofluid temperature is higher but the concentration is lower for a Brownian diffusivity parameter. Moreover, increment role of heat transport is achieved due to the increment in radiation factor, thermophoresis, Brownian motion factors, and Eckert number. It has also been observed that velocity in x-direction converges in the region −0.8≤ℏf≤0.5-0.8\le {\hslash }_{\text{f}}\le 0.5, in y-direction velocity is convergent in the zone −0.6≤ℏg≤0.35-0.6\le {\hslash }_{\text{g}}\le 0.35, while temperature converges in the region −0.6≤ℏθ≤0.4-0.6\le {\hslash }_{\text{θ}}\le 0.4 and concentration converges in the region −0.5≤ℏφ≤0.4-0.5\le {\hslash }_{\text{φ}}\le 0.4.

Cancer is considered a risk factor for COVID-19 mortality, yet several countries have reported that deaths with a primary code of cancer remained within historic levels during the COVID-19 pandemic. Here, we further elucidate the relationship between cancer mortality and COVID-19 on a population level in the US. We compared pandemic-related mortality patterns from underlying and multiple cause (MC) death data for six types of cancer, diabetes, and Alzheimer’s. Any pandemic-related changes in coding practices should be eliminated by study of MC data. Nationally in 2020, MC cancer mortality rose by only 3% over a pre-pandemic baseline, corresponding to ~13,600 excess deaths. Mortality elevation was measurably higher for less deadly cancers (breast, colorectal, and hematological, 2–7%) than cancers with a poor survival rate (lung and pancreatic, 0–1%). In comparison, there was substantial elevation in MC deaths from diabetes (37%) and Alzheimer’s (19%). To understand these differences, we simulated the expected excess mortality for each condition using COVID-19 attack rates, life expectancy, population size, and mean age of individuals living with each condition. We find that the observed mortality differences are primarily explained by differences in life expectancy, with the risk of death from deadly cancers outcompeting the risk of death from COVID-19.