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Sandøe P, Hansen HO, Bokkers EAM, Enemark PS, Forkman B, Haskell MJ, Hedman FL, Houe H, Mandel R, Nielsen SS, de Olde EM, Palmer C, Vogeler CS, Christensen T. Dairy cattle welfare - the relative effect of legislation, industry standards and labelled niche production in five European countries. Animal 2023; 17:101009. [PMID: 37952301 DOI: 10.1016/j.animal.2023.101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 11/14/2023] Open
Abstract
The only common European Union (EU) legislation set up specifically to ensure the welfare of dairy cattle is for calves. As a consequence, there is wide diversity in how dairy cattle welfare is ensured in EU countries. A few countries have legal requirements for dairy cattle welfare, while in others, it is left to industry standards or niche production requirements, typically linked to various premium labels. In this paper, we compared animal welfare provisions in dairy cattle production across five countries with different combinations of legislative and other approaches: Denmark, Germany, the Netherlands, Sweden, and the United Kingdom. Firstly, we aimed to map the diversity of animal welfare initiatives. Secondly, we used the Benchmark method of expert valuations and weightings of the relative importance of individual welfare provisions. We found that Denmark and Sweden have the highest level of dairy cattle welfare provisions as measured by the Benchmark method, partly due to high legislative welfare requirements, followed by the United Kingdom, which has an extensive industry standard with very high uptake. Germany and the Netherlands, on the other hand, have lower levels of documented welfare provisions, and correspondingly a Benchmark score closer to a baseline defined by legal requirements at EU level. We also found differences in what elements of animal welfare were focussed on. Some initiatives emphasised fulfilling the social needs of cattle, while others focused more on space and freedom to move. Also, the countries with the highest Benchmark score had a relatively high level of production of organic and other specialty dairy products. We found the effect of national legislation or ambitious industry standards on dairy cattle welfare to be much larger than previous studies have found in either pigs or poultry. At a time when the EU is considering stepping up its efforts to improve animal welfare in terms of common minimum standards, the results of this study could have important policy implications. The diversity in the level of dairy cattle welfare standards found across countries may speak in favour of having shared minimum standards, both at EU level and globally. However, even among countries with a similar Benchmark score, we found a difference in the kinds of welfare provisions at work, which may make full harmonisation of standards more challenging.
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Affiliation(s)
- P Sandøe
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark; Department of Veterinary and Animal Sciences, University of Copenhagen, Grønnegårdsvej 8, 1870 Frederiksberg C, Denmark.
| | - H O Hansen
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - E A M Bokkers
- Animal Production Systems Group, Wageningen University & Research, PO Box 338, 6700AH Wageningen, the Netherlands
| | - P S Enemark
- Arla Foods, Sønderhøj 14, 8260 Viby J, Denmark
| | - B Forkman
- Department of Veterinary and Animal Sciences, University of Copenhagen, Grønnegårdsvej 8, 1870 Frederiksberg C, Denmark
| | - M J Haskell
- SRUC (Scotland's Rural College), West Mains Road, Edinburgh EH9 3JG, United Kingdom
| | - F Lundmark Hedman
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, P.O. Box 234, SE-532 23 Skara, Sweden
| | - H Houe
- Department of Veterinary and Animal Sciences, University of Copenhagen, Grønnegårdsvej 8, 1870 Frederiksberg C, Denmark
| | - R Mandel
- Department of Veterinary and Animal Sciences, University of Copenhagen, Grønnegårdsvej 8, 1870 Frederiksberg C, Denmark
| | - S S Nielsen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Grønnegårdsvej 8, 1870 Frederiksberg C, Denmark
| | - E M de Olde
- Animal Production Systems Group, Wageningen University & Research, PO Box 338, 6700AH Wageningen, the Netherlands
| | - C Palmer
- Department of Philosophy, Texas A&M University, College Station, TX 77843, USA
| | - C S Vogeler
- Chair of Comparative Public Administration and Policy Analysis, University of Speyer, Postfach 1409, 67324 Speyer, Germany
| | - T Christensen
- Department of Food and Resource Economics, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
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Dersjant-Li Y, Christensen T, Knudsen S, Bello A, Toghyani M, Liu SY, Selle PH, Marchal L. Effect of increasing dose level of a novel consensus bacterial 6-phytase variant on phytate degradation in broilers fed diets containing varied phytate levels. Br Poult Sci 2021; 63:395-405. [PMID: 34739328 DOI: 10.1080/00071668.2021.2000586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
1. The effect of increasing the dose level of a novel consensus bacterial 6-phytase variant on apparent ileal digestibility (AID) of phosphorus (P), phytic acid (inositol hexa-phosphate, IP6) and ileal IP6 degradation profile was studied in diets containing varying phytate-P (PP) levels.2. Ross 308, one-day-old males (n=1,800) were allocated to cages (20 birds/cage, six cages/treatment) in a completely randomised design employing a 3 × 5 factorial arrangement (three PP levels: 2.45 (low) 2.95 (medium) and 3.45 g/kg (high); five dose levels of phytase (PhyG): 0, 500, 1,000, 2,000 and 4,000 FTU/kg). Phased diets were based on wheat, corn, soybean meal, rapeseed meal and rice bran (d 0 to 10; 2.60 g/kg digestible P, 7.6 g/kg calcium (Ca); d 11 to 21; 2.10 g/kg digestible P, 6.4 g/kg Ca). Ileal digesta was collected on d 21 for determination of P, IP6 and IP-esters content. Data were analysed by factorial ANOVA; means separation was achieved using Tukey's HSD test.3. Increasing PP reduced AID of IP6 and sum of IP3-6 (%) (P<0.05) but absolute P-release (g/kg diet) above NC was increased (P<0.05) at high vs. low PP. Increasing phytase dose exponentially increased (P<0.001) AID IP6, sum of IP3-6 (%) and digestible IP3-6-P g/kg diet (P<0.001). AID P was increased but there was an interaction with PP level (P<0.001). Ileal accumulation of IP5-3-P was universally low with PhyG at ≥1,000 FTU/kg (<0.06 g/100g DM). At 2,000 and 4,000 FTU/kg, AID IP6 was 97.2, 92.7, 92.6% and 100, 97.2, 97.1%, respectively, at low, medium and high PP. At 2,000 FTU/kg, phytate-P release estimated as the increase (above NC) in ileal digestible sum of IP3-6-P in the diet was 2.26, 2.59 and 3.10 g/kg in low, medium and high PP, respectively.4. The data demonstrated that the novel phytase was effective in breaking down phytate to low IP-esters in diets with varied PP content but the optimal dose level for maximising P-release may differ in diets with varying PP content.
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Affiliation(s)
- Y Dersjant-Li
- Danisco Animal Nutrition (IFF), Willem Einthovenstraat 4, 2342 BH Oegstgeest, The Netherlands
| | - T Christensen
- Danisco Animal Nutrition (IFF), Edwin Rahrs Vej 38, DK-8220, Brabrand, Denmark
| | - S Knudsen
- Danisco Animal Nutrition (IFF), Edwin Rahrs Vej 38, DK-8220, Brabrand, Denmark
| | - A Bello
- Danisco Animal Nutrition (IFF), Willem Einthovenstraat 4, 2342 BH Oegstgeest, The Netherlands
| | - M Toghyani
- School of Life and Environmental Science, Faculty of Science, The University of Sydney, NSW 2006, Australia
| | - S Y Liu
- School of Life and Environmental Science, Faculty of Science, The University of Sydney, NSW 2006, Australia
| | - P H Selle
- School of Life and Environmental Science, Faculty of Science, The University of Sydney, NSW 2006, Australia
| | - L Marchal
- Danisco Animal Nutrition (IFF), Willem Einthovenstraat 4, 2342 BH Oegstgeest, The Netherlands.,Animal Nutrition Group, Wageningen University & Research, Wageningen, The Netherlands
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Bjornsboe K, Jakobsen MU, Bysted A, Fagt S, Christensen T, Joergensen T. Impact of Danish ban of industrial produced trans fatty acids on serum cholesterol levels 1993-2006. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Industrially produced trans fatty acids (ITFA) increase the LDL:HDL ratio and hereby the risk of cardiovascular disease (CVD). Therefore, ITFA has been reduced in Western Europe over the last decades but is still high in Eastern Europe and in subgroups of the EU population. Regulatory interventions are the only way to minimize ITFA intake for all. The Danish ITFA ban (2004) can elucidate the impact of elimination of ITFA on CVD. In Denmark cardiac mortality declined by 70% through 1980-2009. Data on ITFA intake and blood lipids from the 1990s, where the average Danish ITFA intake was about 3 g/d, and up to today are needed to study the correlation between intake of ITFA and serum cholesterol (CHOL). The Danish food composition databank has been updated with TFA intake values. Hereby the correlation between ITFA intake and CHOL level in Denmark from 1993 -2006 can be investigated.
Methods
Ecological analyses of ITFA and CHOL in participants from 3 cohorts: Diet, Cancer and Health (1993-1997); n = 57,054; 50-64 yrInter99 (1999-2001); n = 6,784, 30-60 yrHealth 2006 (2006); n = 3,471, 18-69 yr
Results
ITFA-intake was 0.02 g/d in Inter99. Data will be extended to include ITFA intake data of all cohorts as well as age adjusted correlations with CHOL.
Mean CHOL all men (n = 31,675) declined from 6.3 ± 1.0 in 1993 to 5.4± 1.0 in 2006
Mean CHOL all women (n = 34,675) declined from 6.6 ± 1.5 in 1993 to 5.4± 1.1 in 2006
Similar declines were found in participants without self-reported hypercholesterolemia:
Mean CHOL men (n = 28,999) declined from 6.1 ± 0.9 in 1993 to 5.1± 1.0 in 2006
Mean CHOL women (n = 32,593) declined from 6.5 ± 1.5 in 1993 to 5.2± 1.1 in 2006
There was a significant decrease in CHOL (p < 0.0001) from 1993, where average Danish intake of ITFA was about 3 g/d to 2006 where ITFA was banned
Conclusions
Data show a non-treatment related significant decline in CHOL. Data from 2000 and 2006 are collected in younger populations, which may explain lower CHOL levels.
Key messages
Cholesterol decline significantly in Danish participants simultaneously with ITFA elimination. Results are important for decision makers in countries which consider ITFA regulation.
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Affiliation(s)
- K Bjornsboe
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - M U Jakobsen
- The National Food Institute, DTU, Lyngby, Denmark
| | - A Bysted
- The National Food Institute, DTU, Lyngby, Denmark
| | - S Fagt
- The National Food Institute, DTU, Lyngby, Denmark
| | | | - T Joergensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
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Birk Nielsen L, Knoop A, Berg T, Christensen T. Dual HER2 blockade in first line treatment of metastatic breast cancer – a population-based real world study. Breast 2019. [DOI: 10.1016/s0960-9776(19)30236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Dale GH, Svendsen KB, Gjelstrup MC, Christensen T, Houen G, Nielsen E, Bek T, Petersen T. Incidence of neuromyelitis optica spectrum disorder in the Central Denmark Region. Acta Neurol Scand 2018; 137:582-588. [PMID: 29359475 DOI: 10.1111/ane.12903] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Neuromyelitis optica (NMO)/NMO spectrum disorder (NMOSD) may be misdiagnosed as multiple sclerosis. The aim of this study was to (i) to measure AQP4-IgG in patients who fulfilled the clinical and radiological criteria of NMOSD in the Central Denmark Region and (ii) to estimate the incidence of NMOSD in the region, according to both the 2006 Wingerchuk criteria and the 2015 International Panel for NMO Diagnosis criteria. MATERIALS AND METHODS Medical records of all patients diagnosed with a demyelinating disorder in the region from 1 January 2012 to 31 December 2013 were reviewed. Patients were classified as having (i) "NMO" if the 2006 criteria were met, (ii) "NMOSD with AQP4-IgG" or (iii) "NMOSD without/unknown AQP-IgG" if the new 2015 NMOSD criteria were met. Patients with core symptoms were invited to provide a blood sample for AQP4-IgG analysis with an enzyme-linked immunosorbent assay and a cell-based indirect immunofluorescence assay. RESULTS In 191 patients with core symptoms, one met the 2015 NMOSD with AQP4-IgG criteria. Two patients met the 2006 NMO and 2015 NMOSD without/unknown AQP4-IgG criteria. Among 108 patients providing a blood sample, all were seronegative. The estimated incidence of NMO (2006 criteria) and NMOSD (2015 criteria) was 0.08 and 0.12 per 100 000 person-years, respectively. CONCLUSION NMO/NMOSD is a rare disease in the Central Denmark Region, with a considerably lower incidence rate than previously estimated in a neighbouring region.
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Affiliation(s)
- G. H. Dale
- Department of Neurology; Aarhus University Hospital; Aarhus Denmark
- Department of Biomedicine; Aarhus University; Aarhus Denmark
| | - K. B. Svendsen
- Department of Neurology; Aarhus University Hospital; Aarhus Denmark
| | - M. C. Gjelstrup
- Department of Biomedicine; Aarhus University; Aarhus Denmark
| | - T. Christensen
- Department of Biomedicine; Aarhus University; Aarhus Denmark
| | - G. Houen
- Department of Autoimmunology and Biomarkers; Statens Serum Institut; Copenhagen Denmark
| | - E. Nielsen
- Department of Neuroradiology; Aarhus University Hospital; Aarhus Denmark
| | - T. Bek
- Department of Ophthalmology; Aarhus University Hospital; Aarhus Denmark
| | - T. Petersen
- Department of Neurology; Aarhus University Hospital; Aarhus Denmark
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Dale GH, Bacher Svendsen K, Gjelstrup MC, Christensen T, Houen G, Nielsen E, Bek T, Petersen T. Response to "Epidemiology of neuromyelitis optica spectrum disorder''. Acta Neurol Scand 2018; 137:628-629. [PMID: 29732541 DOI: 10.1111/ane.12937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G H Dale
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - K Bacher Svendsen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - M C Gjelstrup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - T Christensen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - G Houen
- Department of Autoimmunology and Biomarkers, Statens Serum Institut, Copenhagen, Denmark
| | - E Nielsen
- Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
| | - T Bek
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - T Petersen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
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Abstract
Several lines of investigation have provided strong indications for an association between the immune-mediated, neurologic disease multiple sclerosis (MS) and human endogenous retroviruses (HERVs). Whether the relationship is causal is yet to be established. Endogenous retroviruses are pathogenic-in other species than the human. Several aspects of the activation and involvement of specific HERV families (HERV-H/F and HERV-W/MSRV) have been documented, both for cells in the periphery and in the central nervous system. Specific HERV-encoded genes and certain gene products (envelope proteins, Envs) appear strongly associated with the disease and have pathogenic potential. Most HERV sequences are non-functional, whereas some HERV loci have coding potential but remain quiescent in non-pathological conditions, so the importance of regulatory pathways and epigenetics involved in regulating HERV activation, de-repression, and also involvement of retroviral restriction factors, is emerging. Disease intervention by means of antiretrovirals has potential as a novel therapeutic strategy in MS treatment; this is compounded by the apparently reduced risk of MS in HIV infection as a consequence of therapy. Extensive studies of HERVs, their role in neurologic diseases, and their potential as therapeutic targets are needed.
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Affiliation(s)
- T. Christensen
- Department of Biomedicine; Aarhus University; Aarhus Denmark
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Zhao L, Cozzo AJ, Johnson AR, Christensen T, Freemerman AJ, Bear JE, Rotty JD, Bennett BJ, Makowski L. Lack of myeloid Fatp1 increases atherosclerotic lesion size in Ldlr -/- mice. Atherosclerosis 2017; 266:182-189. [PMID: 29035781 DOI: 10.1016/j.atherosclerosis.2017.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 09/07/2017] [Accepted: 10/06/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Altered metabolism is an important regulator of macrophage (MΦ) phenotype, which contributes to inflammatory diseases such as atherosclerosis. Broadly, pro-inflammatory, classically-activated MΦs (CAM) are glycolytic while alternatively-activated MΦs (AAM) oxidize fatty acids, although overlap exists. We previously demonstrated that MΦ fatty acid transport protein 1 (FATP1, Slc27a1) was necessary to maintain the oxidative and anti-inflammatory AAM phenotype in vivo in a model of diet-induced obesity. The aim of this study was to examine how MΦ metabolic reprogramming through FATP1 ablation affects the process of atherogenesis. We hypothesized that FATP1 limits MΦ-mediated inflammation during atherogenesis. Thus, mice lacking MΦ Fatp1 would display elevated formation of atherosclerotic lesions in a mouse model lacking the low-density lipoprotein (LDL) receptor (Ldlr-/-). METHODS We transplanted bone marrow collected from Fatp1+/+ or Fatp1-/- mice into Ldlr-/- mice and fed chimeric mice a Western diet for 12 weeks. Body weight, blood glucose, and plasma lipids were measured. Aortic sinus and aorta lesions were quantified. Atherosclerotic plaque composition, oxidative stress, and inflammation were analyzed histologically. RESULTS Compared to Fatp1+/+Ldlr-/- mice, Fatp1-/-Ldlr-/- mice exhibited significantly larger lesion area and elevated oxidative stress and inflammation in the atherosclerotic plaque. Macrophage and smooth muscle cell content did not differ by Fatp1 genotype. There were no significant systemic alterations in LDL, high-density lipoprotein (HDL), total cholesterol, or triacylglyceride, suggesting that the effect was local to the cells of the vessel microenvironment in a Fatp1-dependent manner. CONCLUSIONS MΦ Fatp1 limits atherogenesis and may be a viable target to metabolically reprogram MΦs.
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Affiliation(s)
- Liyang Zhao
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Alyssa J Cozzo
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Amy R Johnson
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Taylor Christensen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Alex J Freemerman
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - James E Bear
- Lineberger Cancer Center, Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Jeremy D Rotty
- Lineberger Cancer Center, Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Brian J Bennett
- USDA Western Human Nutrition Research Center, Davis, CA 95616, USA
| | - Liza Makowski
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA; University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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Biltoft-Jensen A, Holmgaard Nielsen T, Hess Ygil K, Christensen T, Fagt S. Accuracy of food photographs for quantifying food servings in a lunch meal setting among Danish children and adults. J Hum Nutr Diet 2017; 31:131-140. [PMID: 28656744 DOI: 10.1111/jhn.12490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Visual aids, such as food photographs, are widely used in estimating food quantities in dietary surveys. The present study aimed to assess how accurately Danish adults and children can estimate food portion sizes using 37 series of photographs illustrating four to six different portion sizes under real-life conditions; determine whether adults were more accurate than children; and estimate the error caused by using portion size photographs to estimate weights of foods consumed in macronutrient calculation. METHODS Six hundred and twenty-two adults and 109 children were recruited in three workplace canteens and in two schools, respectively, to estimate their lunchtime portions based on photographs. Participants were instructed to keep the foods separated on their plate when taking lunch. Participants thereafter estimated their own portions by looking at the relevant series of photographs. The actual food portions were then weighed. RESULTS The proportion of correct estimations was 42% overall (range 19-77%). The mean difference (%) between estimated and actual weight was 17% (range 1-111%). Small portion size photographs were more often used correctly compared to larger portion photographs. Children had as many correct estimations as adults, although they overestimated portions more. Participants using fractions of (or more than) one photograph to estimate the portion of a food had significantly larger errors. When calculating the macronutrient content of a weekly menu using the estimated portion sizes, protein had the largest error (29%). CONCLUSIONS When used in a real-life situation, the portion size photographs validated in the present study showed a certain inaccuracy compared to the actual weights.
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Affiliation(s)
- A Biltoft-Jensen
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - T Holmgaard Nielsen
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - K Hess Ygil
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - T Christensen
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - S Fagt
- Division for Risk Assessment and Nutrition, The National Food Institute, Technical University of Denmark, Søborg, Denmark
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Elliott A, Højlund M, Mørk T, Christensen T, Jeppesen R, Madsen N, Viuff A, Hjorth P, Nielsen J, Munk-Jørgensen P. QTc Interval in individuals with schizophrenia receiving antipsychotic as monotherapy or polypharmacy. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionAntipsychotics are associated with the polymorphic ventricular tachycardia, Torsade's de pointes, which in worst case can lead to sudden cardiac death. The QTc interval is used as a clinical proxy for Torsade's de pointes. QTc interval is prolonged by monotherapy with antipsychotic, but it is unknown if the QTc interval is prolonged further with antipsychotic polypharmacy.ObjectivesTo investigate the associations between QTc interval and antipsychotic mono- and polypharmaceutical treatment, respectively, in schizophrenic patients.AimsTo learn more about the impact of antipsychotics on the QTc interval.MethodsAn observational cohort study of unselected patients with schizophrenia visiting outpatient facilities in the Region of Central Jutland, Denmark. Patients were enrolled from January 2013 through March 2015 with follow-up until June 2015. Data was collected from clinical interviews and clinical case records.ResultsECGs were available in 58 patients receiving antipsychotic treatment. We observed no difference in average QTc interval for the whole sample of patients receiving monotherapy or polypharmacy (P = 0.29). However, women presented longer QTc-interval on polypharmacy than on monotherapy (P = 0.01).ConclusionWe recommend an increased focus on monitoring the QTc interval in woman with schizophrenia receiving antipsychotics as polypharmacy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Lehan Mackin M, Loew N, Gonzalez A, Tykol H, Christensen T. Parent Perceptions of Sexual Education Needs for Their Children With Autism. J Pediatr Nurs 2016; 31:608-618. [PMID: 27554640 DOI: 10.1016/j.pedn.2016.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/01/2016] [Accepted: 07/06/2016] [Indexed: 11/19/2022]
Abstract
UNLABELLED Primary responsibility for sexual education for adolescents with autism spectrum disorder falls on parents who have reported a lack of professional and material support. The purpose of this study was to 1) describe parent perceptions of sexual education needs of their children aged 14-20 with an autism spectrum disorder diagnosis and 2) determine parent-preferred mechanisms of delivery for tailored educational intervention strategies. DESIGN AND METHODS The study aims were accomplished by a qualitative research design using focus groups and telephone interviews assisted by a structured interview guide. Study methods and analysis were guided by social marketing principles. RESULTS A total of 15 parents (5 participated in 1 focus group and 10 completed individual interviews) acknowledged their primary role in providing sexual education for their children and confirmed a need for resources to assist them in this role. All parents in this study found that some level of sexual education was necessary and important and that all children had been introduced to sexual information but in varying degrees. Topic preferences included those that would increase the recognition of healthy relationships, provide a measure of self-protection, and ameliorate undesirable consequences of sexual activity. Parents were knowledgeable about how their children best learned and suggested future interventions use technology interfaces with engaging displays and allow for individualized content. CONCLUSION AND IMPLICATIONS These findings highlight a need for additional research and enhanced clinical services to ensure that adolescents with autism spectrum disorder have their informational needs met, are able to avoid risks, and have the greatest capacity for a healthy sexuality as they transition to adulthood.
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Affiliation(s)
| | - Nicole Loew
- The University of Iowa College of Nursing, Iowa City, IA
| | | | - Hannah Tykol
- The University of Iowa College of Nursing, Iowa City, IA
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Christensen T, Neubauer B. Increased Arterial Wall Stiffness and Thickness in Medium-Sized Arteries in Patients with Insulin-Dependent Diabetes Mellitus. Acta Radiol 2016. [DOI: 10.1177/028418518802900308] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
By means of ultrasonography, arterial wall stiffness, arterial wall thickness, and the elastic modulus of the common femoral artery were estimated in a group of 19 young insulin-dependent diabetics. The ultrasound technique for determination of these parameters is described as well as the echo-anatomy of the arterial wall. In accordance with a previous investigation a significant rise in arterial wall stiffness was found. Furthermore, there was a highly significant correlation between the stiffness and the thickness of the arterial wall. The elastic modulus also correlated to the stiffness. It is concluded that the diabetic macroangiopathy is characterized by an increased stiffness of the arterial wall caused by increased thickness as well as by progressive alterations of the elastic characteristics of the wall tissue. Possible pathogenetic reasons are discussed.
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Abstract
By means of an ultrasonographic technique the systolic and diastolic diameters of the common femoral artery were investigated in a group of 50 young insulin-dependent diabetics selected as being free from late diabetic complications and atherosclerotic involvement. After correction for normal physiologic variations there was no correlation of arterial diameters to duration of diabetes and no statistical difference in relation to a control group. It is known that there is a progressive increase of the arterial wall thickness in medium-sized arteries in diabetes. Therefore, it is concluded that there is a corresponding dilatation of the arteries. The reasons for this dilatation are discussed from a biophysical point of view. Furthermore, it is concluded that the increased arterial wall stiffness caused by an increasing elastic modulus and thickness reflects the earliest changes in the diabetic macroangiopathy. Occlusions and narrowing seem only to exist in patients with severe late diabetic complications.
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Svaland MG, Christensen T, Lundorf E. Comparison of the Safety of Standard and Triple Dose Gadodiamide Injection in MR Imaging of the Central Nervous System. Acta Radiol 2016. [DOI: 10.1177/028418519403500416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Gadodiamide injection was administered intravenously to 49 patients with known or suspected CNS lesions undergoing MR imaging. Two parallel groups were used to evaluate the efficacy and safety of single doses of 0.1 (25 patients) and 0.3 (24 patients) mmol/kg b.w. The principal measures of efficacy were diagnostic yield of MR and the overall contrast enhancement. Adverse events and serum bilirubin were the main safety parameters. Contrast enhancement of the lesion was observed for 16 patients in each dose group. Thirteen patients in the 0.1 and 17 in the 0.3 mmol/kg group had their diagnosis amended following the postcontrast image, but only one patient in each dose group had their management affected by new information from the postcontrast image. The overall diagnostic utility of gadodiamide injection was good, but there were no differences between the 2 doses studied in this respect. No injection-associated discomfort or other adverse events were reported. No clinically important changes in serum bilirubin, or other parameters of blood chemistry, or hematology were observed. Overall, the safety profile of gadodiamide injection 0.3 mmol/kg b.w. in this study was similar to that of 0.1 mmol/kg b.w.
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Abstract
The arterial wall stiffness in the common femoral artery was determined by means of an ultrasound technique in 47 ***insulin-dependent diabetics and 24 controls aged 20 to 39 years. They were all without vascular symptoms and signs, and were selected in such a way that they were thought to be free of age correlated changes. Furthermore, patients in potential risk groups, as for arterial disease of non-diabetic type, were excluded. The arterial wall stiffness was significantly increased in the diabetic group as compared with a control group. Furthermore, there was a significant correlation to the diabetic duration. Possible pathogenetic reasons are discussed.
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Abstract
Large soft tissue tumors — 5 cm or greater — or deep-seated tumors have a greater risk of being malignant than smaller and superficially located tumors (9). In a period of 2 years 43 consecutive patients with lipomatous tumors 5 cm in diameter or greater were examined with MR imaging. The MR findings were correlated to histologic features and diagnosis. Twenty-six tumors were classic lipomas both on MR and at microscopy; 8 lipomas showed other features — some of them raising suspicion of malignancy at MR; all, however, were histologically benign. Nine tumors were considered malignant at MR imaging; all 9 proved to be malignant by microscopy.
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Jeppesen RM, Christensen T, Vestergaard CH. Changes in the utilization of psychiatric hospital facilities in Denmark by patients diagnosed with schizophrenia from 1970 through 2012: The advent of 'revolving door' patients. Acta Psychiatr Scand 2016; 133:419-25. [PMID: 26748617 DOI: 10.1111/acps.12549] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The Danish psychiatric system has gone through several structural changes in the last four decades. The deinstitutionalization of the mental healthcare system was implemented in Denmark in the late 1970s with the intention of increasing out-patient treatment. One of the aims in the reorganization was to treat the patient in the local environment rather than during long-term hospitalization. This study focuses on the changes in the utilization of hospital facilities. METHOD Using register data from secondary healthcare treatment of patients diagnosed with schizophrenia in Denmark 1970-2012, we analysed the development in the use of hospital facilities. RESULTS Our major finding was a 220% increase between 1970 and 2012 in the total number of hospital admissions due to schizophrenia each year, while at the same time the number of annual schizophrenia bed days was reduced by 76%. Furthermore, the readmission rate within a year after discharge with a diagnosis of schizophrenia reached 70% in 2012 compared to 51% in 1970. Finally, the total bed occupancy continued to rise over the four decades and has exceeded 100% in several years since 1999. CONCLUSION The findings indicate that the reorganization of the Danish mental healthcare system has created a problem of 'revolving door' schizophrenia patients' who since the 1970s have been increasingly hospitalized but for shorter periods. Possible explanations of the findings are premature discharge of patients with schizophrenia due to lack of beds or/and that community psychiatry has not been providing adequate relapse prevention.
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Abstract
OBJECTIVES Clinical deterioration and death among patients with acute stroke are often preceded by detrimental changes in physiological parameters. Systematic and effective tools to identify patients at risk of deterioration early enough to intervene are therefore needed. The aim of the study was to investigate whether the aggregate weighted track and trigger system early warning score (EWS) can be used as a simple observational tool to identify patients at risk and predict mortality in a population of patients with acute stroke. MATERIALS AND METHODS Patients admitted with acute stroke at the Copenhagen University Hospital, Nordsjaellands Hospital, Denmark, from May to September 2012 were enrolled in a retrospective cohort study (n = 274). Vital signs were measured immediately after admission and consistently during the hospitalization period. Based on the vital signs, a single composite EWS was calculated. Death within 30 days was used as outcome. Area under the receiver operating characteristics curve (AUROC) and a Kaplan-Meier curve were computed to examine the prognostic validity of EWS. RESULTS A total of 24 patients (8.8%) died within 30 days. The prognostic performance was high for both the EWS at admission (AUROC 0.856; 95% CI 0.760-0.951; P-value < 0.001) and the maximal EWS measured (AUROC 0.949; 95% CI 0.919-0.980; P-value < 0.001). Mortality rates were lowest for admission EWS 0-1 (2%) and highest for admission EWS ≥ 5 (63%). CONCLUSIONS Early warning score is a simple and valid tool for identifying patients at risk of dying after acute stroke. Readily available physiological parameters are converted to a single score, which can guide both nurses and physicians in clinical decision making and resource allocation.
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Affiliation(s)
- J. Liljehult
- Department of Neurology; Copenhagen University Hospital; Nordsjaellands Hospital; Hillerød Denmark
| | - T. Christensen
- Department of Neurology; Copenhagen University Hospital; Nordsjaellands Hospital; Hillerød Denmark
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Salisbury J, Zhang L, Trushin S, Christensen T, Trushina E. Altered brain energetics causes mitochondrial fission arrest in Alzheimer’s disease. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Herrmann S, Duedahl-Olesen L, Christensen T, Olesen P, Granby K. Dietary exposure to volatile and non-volatile N-nitrosamines from processed meat products in Denmark. Food Chem Toxicol 2015; 80:137-143. [DOI: 10.1016/j.fct.2015.03.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 03/10/2015] [Accepted: 03/11/2015] [Indexed: 01/23/2023]
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22
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Sharir T, Pinskiy M, Brodkin B, Rochman A, Prochorov V, Bojko A, Merzon K, Pardes A, Ghotbi A, Hasbak P, Christensen T, Engstroem T, Lassen M, Kjaer A, Ficaro E, Murthy V, Corbett J, Zoccarato O, Marcassa C, Matheoud R, Savi A, Indovina L, Ren Kaiser S, Bom MJ, Van Der Zee P, Cornel J, Van Der Zant F, Knol R, Pizzi MN, Roque A, Fernandez-Hidalgo N, Cuellar-Calabria H, Gonzalez-Alujas M, Oristrell G, Rodriguez-Palomares J, Tornos P, Aguade-Bruix S, Berezin A, Kremzer A, Gautier M, Legallois D, Belin A, Agostini D, Manrique A. Moderated Poster Session 2: Sunday 3 May 2015, 15:30-16:30 * Room: Moderated Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Zhao L, Freemerman A, Johnson AR, Sundaram S, Christensen T, Bennett BJ, Makowski L. Abstract 175: Lack of Macrophage GLUT1-Mediated Glucose Metabolism Increases Atherosclerotic Lesion Instability. Arterioscler Thromb Vasc Biol 2015. [DOI: 10.1161/atvb.35.suppl_1.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Macrophages play a key role in the pathogenesis of atherosclerosis. Metabolic programs powered by glucose or lipid enable macrophages to elicit pro- or anti-inflammatory responses, respectively. Although the chronic inflammatory feature of atherosclerosis has been well-established, the role of macrophage substrate metabolism in atherogenesis remains unclear. We previously demonstrated that macrophages with elevated GLUT1-mediated glucose metabolism have an increased inflammatory response. Therefore, we created a novel macrophage GLUT1-deficient murine model by crossing GLUT1 floxed to LysM-Cre mice. Recent work suggests that lack of GLUT1 reduces the pro-inflammatory response and the ability for GLUT1-/- macrophages to polarize to the classically activated state in vitro. Therefore, the objective of this study was to examine how macrophage metabolic reprogramming affects the development of atherosclerosis. We hypothesized that macrophages with restricted glucose metabolism due to lack of glucose transporter GLUT1 will have reduced pro-inflammatory activation during atherogenesis. We transplanted bone marrow from Glut1MΦfl/fl or Glut1MΦ-/- mice into Ldlr-/- mice and fed mice a Western diet for 12 weeks. Glut1MΦfl/fl Ldlr-/- or Glut1MΦ-/- Ldlr-/- chimeric mice did not exhibit significant differences in body weight, body composition, blood pressure, fasting blood glucose, or triacylglycerol and LDL and HDL cholesterol. Digital histology analysis of Oil Red O stained slides indicated that deleting macrophage GLUT1 did not affect total lesion area in aortic root; however, mice with blunted glucose metabolism displayed more and larger necrotic cores. Ongoing studies are investigating apoptosis and phagocytic capacity of macrophages with and without GLUT1 to elucidate the roles of macrophage glucose metabolism on the morphology of atherosclerotic lesion. In summary, we observed that mice lacking macrophage GLUT1 developed increased necrotic cores in lesions of the aorta root relative to mice with wild type macrophage GLUT1 which suggests that maintenance of atherosclerotic lesion stability may be regulated by glucose-dependent mechanisms.
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Affiliation(s)
- Liyang Zhao
- Nutrition, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alex Freemerman
- Nutrition, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Amy R Johnson
- Nutrition, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sneha Sundaram
- Nutrition, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Brian J Bennett
- Genetics, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Liza Makowski
- Nutrition, Univ of North Carolina at Chapel Hill, Chapel Hill, NC
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Evans M, Wolden M, Gundgaard J, Chubb B, Christensen T. Cost-effectiveness of insulin degludec compared with insulin glargine in a basal-bolus regimen in patients with type 1 diabetes mellitus in the UK. J Med Econ 2015; 18:56-68. [PMID: 25271378 DOI: 10.3111/13696998.2014.971160] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the cost-effectiveness of insulin degludec (IDeg) vs insulin glargine (IGlar) as part of a basal-bolus treatment regimen in adults with T1DM, using a short-term economic model. METHODS Data from two phase III clinical studies were used to populate a simple and transparent short-term model. The costs and effects of treatment with IDeg vs IGlar were calculated over a 12-month period. The analysis was conducted from the perspective of the UK National Health Service. Sensitivity analyses were conducted to assess the degree of uncertainty surrounding the results. The main outcome measure, the incremental cost-effectiveness ratio (ICER), was the cost per quality-adjusted life-year (QALY). RESULTS IDeg is a cost-effective treatment option vs IGlar in patients with T1DM on a basal-bolus regimen. The base case ICER was estimated at £16,895/QALY, which is below commonly accepted thresholds for cost-effectiveness in the UK. Sensitivity analyses demonstrated that the ICER was stable to variations in the majority of input parameters. The parameters that exerted the most influence on the ICER were hypoglycemia event rates, daily insulin dose, and disutility associated with non-severe nocturnal hypoglycemic events. However, even under extreme assumptions in the majority of analyses the ICERs remained below the commonly accepted threshold of £20,000-£30,000 per QALY gained. CONCLUSIONS This short-term modeling approach accommodates the treat-to-target trial design required by regulatory bodies, and focuses on the impact of important aspects of insulin therapy such as hypoglycemia and dosing. For patients with T1DM who are treated with a basal-bolus insulin regimen, IDeg is a cost-effective treatment option compared with IGlar. IDeg may be particularly cost-effective for sub-groups of patients, such as those suffering from recurrent nocturnal hypoglycemia and those with impaired awareness of hypoglycemia.
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Affiliation(s)
- M Evans
- University Hospital Llandough , Cardiff , UK
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Kaiser M, Gaber A, Evans M, Christensen T, Korsholm K, Brod M. Einfluss schwerer Hypoglykämien auf die gesundheitsbezogene Lebensqualität (HRQoL) bei Insulin-behandelten Patienten mit Typ 1 und Typ 2 Diabetes. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Evans M, Wolden M, Gundgaard J, Chubb B, Christensen T. Cost-effectiveness of insulin degludec compared with insulin glargine for patients with type 2 diabetes treated with basal insulin - from the UK health care cost perspective. Diabetes Obes Metab 2014; 16:366-75. [PMID: 24373113 DOI: 10.1111/dom.12250] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 08/27/2013] [Accepted: 12/12/2013] [Indexed: 12/01/2022]
Abstract
AIMS The aim of this analysis was to evaluate the cost-effectiveness of insulin degludec (IDeg) versus insulin glargine (IGlar) in adults with type 2 diabetes mellitus (T2DM) who are considered appropriate for treatment with a basal insulin analogue, using a short-term economic model. METHODS Meta-analysis data from three phase III clinical studies were used to populate a simple and transparent short-term model. The costs and effects of treatment with IDeg versus IGlar were calculated over a 12-month period. The analysis was conducted from the perspective of the UK National Health Service. Sensitivity analyses were conducted to assess the degree of uncertainty surrounding the results. RESULTS IDeg is a cost-effective treatment option versus IGlar in patients with T2DM using basal insulin. Base case incremental cost-effectiveness ratios (ICERs) were estimated at £15,795 per quality-adjusted life-year (QALY) and £13,078 per QALY, which are below commonly accepted thresholds for cost-effectiveness. Sensitivity analyses demonstrated that hypoglycaemia event rates had an important effect on the results. With higher event rates for non-severe hypoglycaemia IDeg was less costly and more effective than IGlar (dominant). Conversely, using lower event rates for severe hypoglycaemia generated higher ICERs. Using hypoglycaemia rates from a subgroup of patients who experienced ≥1 hypoglycaemic event per year IDeg was highly cost-effective versus IGlar; with estimated ICERS of £4887 and £2625 per QALY. CONCLUSIONS This short-term modelling approach allows the economic evaluation of newer insulin analogues when advanced long-term modelling based on HbA1c differences is inappropriate. For patients with T2DM who are considered appropriate for treatment with a basal insulin analogue, IDeg is a cost-effective treatment option compared with IGlar and offers additional benefits to subgroups of patients, such as those suffering from recurrent hypoglycaemia.
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Affiliation(s)
- M Evans
- University Hospital Llandough, Cardiff, UK
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27
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Hansen T, Scholten B, Hasbak P, Christensen T, Ghotbi A, Kjaer A, Rossing P. P3.3 CARDIAC 82RB-PET/CT REVEALS MICROVASCULAR DYSFUNCTION IN ASYMPTOMATIC PATIENTS WITH TYPE 2 DIABETES. Artery Res 2014. [DOI: 10.1016/j.artres.2014.09.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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28
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Lassen AD, Beck A, Leedo E, Andersen EW, Christensen T, Mejborn H, Thorsen AV, Tetens I. Effectiveness of offering healthy labelled meals in improving the nutritional quality of lunch meals eaten in a worksite canteen. Appetite 2013; 75:128-34. [PMID: 24373732 DOI: 10.1016/j.appet.2013.12.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 11/12/2013] [Accepted: 12/01/2013] [Indexed: 10/25/2022]
Abstract
Healthier meal selections at restaurants and canteens are often limited and not actively promoted. In this Danish study the effectiveness of a healthy labelling certification program in improving dietary intake and influencing edible plate waste was evaluated in a quasi-experimental study design. Employees from an intervention worksite canteen and a matched control canteen were included in the study at baseline (February 2012), after completing the certification process (end-point) and six month from end-point (follow-up) (total n=270). In order to estimate nutrient composition of the consumed lunch meals and plate waste a validated digital photographic method was used combining estimation of food intake with food nutrient composition data. Food satisfaction was rated by participants using a questionnaire. Several significant positive nutritional effects were observed at the intervention canteen including a mean decrease in energy density in the consumed meals from 561kJ/100g at baseline to 368 and 407kJ/100g at end-point and follow-up, respectively (P<0.001). No significant changes were seen with regard to food satisfaction and plate waste. In the control canteen no positive nutritional effects were observed. The results of the study highlight the potential of using healthy labelling certification programs as a possible driver for increasing both the availability and awareness of healthy meal choices, thereby improving dietary intake when eating out.
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Affiliation(s)
- A D Lassen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Denmark; Division of Nutrition, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860 Søborg, Denmark.
| | - A Beck
- EFFECT, Nutrition Research Unit, Herlev University Hospital, Herlev, Denmark
| | - E Leedo
- EFFECT, Nutrition Research Unit, Herlev University Hospital, Herlev, Denmark
| | - E W Andersen
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, Denmark
| | - T Christensen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Denmark
| | - H Mejborn
- Division of Nutrition, National Food Institute, Technical University of Denmark, Denmark
| | - A V Thorsen
- Division of Nutrition, National Food Institute, Technical University of Denmark, Denmark
| | - I Tetens
- Division of Nutrition, National Food Institute, Technical University of Denmark, Denmark
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Møller-Larsen A, Brudek T, Petersen T, Petersen EL, Aagaard M, Hansen DT, Christensen T. Flow cytometric assay detecting cytotoxicity against human endogenous retrovirus antigens expressed on cultured multiple sclerosis cells. Clin Exp Immunol 2013; 173:398-410. [PMID: 23656307 DOI: 10.1111/cei.12133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2013] [Indexed: 01/08/2023] Open
Abstract
Damage of target cells by cytotoxicity, either mediated by specific lymphocytes or via antibody-dependent reactions, may play a decisive role in causing the central nervous system (CNS) lesions seen in multiple sclerosis (MS). Relevant epitopes, antibodies towards these epitopes and a reliable assay are all mandatory parts in detection and evaluation of the pertinence of such cytotoxicity reactions. We have adapted a flow cytometry assay detecting CD107a expression on the surface of cytotoxic effector cells to be applicable for analyses of the effect on target cells from MS patients expressing increased amounts of human endogenous retrovirus antigens. MS patients also have increased antibody levels to these antigens. The target cells are spontaneously growing peripheral blood mononuclear cells (PBMCs) of B cell lineage, expressing human endogenous retrovirus HERV epitopes on their surface. Polyclonal antibodies against defined peptides in the Env- and Gag-regions of the HERVs were raised in rabbits and used in antibody-dependent cell-mediated cytotoxicity (ADCC) -assays. Rituximab® (Roche), a chimeric monoclonal antibody against CD20 expressed primarily on B cells, was used as control antibody. Without antibodies this system is suitable for analyses of natural killer cell activity. In optimization of the assay we have used effector lymphocytes from healthy donors. The most effective effector cells are CD56(+) cells. CD8(+) T cells also express CD107a in ADCC. Using the adapted assay, we demonstrate significant ADCC activity to target cells expressing HERV epitopes, and additionally a low level of NK activity.
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Affiliation(s)
- A Møller-Larsen
- Department of Biomedicine, Aarhus University, Aarhus C, Denmark
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30
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Roe M, Bell S, Oseredczuk M, Christensen T, Westenbrink S, Pakkala H, Presser K, Finglas P. Updated food composition database for nutrient intake. ACTA ACUST UNITED AC 2013. [DOI: 10.2903/sp.efsa.2013.en-355] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Freemantle N, Evans M, Christensen T, Wolden ML, Bjorner JB. A comparison of health-related quality of life (health utility) between insulin degludec and insulin glargine: a meta-analysis of phase 3 trials. Diabetes Obes Metab 2013; 15:564-71. [PMID: 23451759 PMCID: PMC4298030 DOI: 10.1111/dom.12086] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 01/15/2013] [Accepted: 02/22/2013] [Indexed: 01/25/2023]
Abstract
AIM To evaluate health-related quality of life (health utility) scores in patients with diabetes receiving insulin degludec (IDeg) or insulin glargine (IGlar). METHODS Patient-level data from six, randomized, controlled, open-label, multicentre, confirmatory, treat-to-target trials of 26- or 52 weeks' duration were pooled in this analysis. The Short Form 36 (SF-36) version-2 health questionnaire was completed by patients at baseline and end-of-trial. SF-36 scores for 4001 individual patients were then mapped onto the EuroQol-5D health utility scale, which has a range from -0.59 (a state worse than death) to 1.00 (perfect health). RESULTS IDeg treatment exhibited a significant improvement in health status of 0.005 (CI: 0.0006; 0.009) points compared with IGlar (p < 0.024). Gender, region, trial and age also had a significant influence on estimated utility scores as did baseline utility scores, p < 0.05. Prior to the removal of interaction variables a difference of 0.008 points was observed, p < 0.045. Previous insulin treatment did not have an impact on the final outcome. CONCLUSION This study shows that IDeg is associated with a modest, but statistically significant, improvement in health utility compared with IGlar in patients with diabetes.
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Affiliation(s)
- N Freemantle
- Department of Primary Care and Population Health, UCL Medical School, London, UK.
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Brod M, Wolden M, Christensen T, Bushnell DM. A nine country study of the burden of non-severe nocturnal hypoglycaemic events on diabetes management and daily function. Diabetes Obes Metab 2013; 15:546-57. [PMID: 23350726 PMCID: PMC3662999 DOI: 10.1111/dom.12070] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 01/14/2013] [Accepted: 01/14/2013] [Indexed: 11/28/2022]
Abstract
AIMS The purpose of this study was to explore the burden and impact of non-severe nocturnal hypoglycaemic events (NSNHEs) on diabetes management, patient functioning and well-being in order to better understand the role that NSNHEs play in caring for persons with diabetes and facilitate optimal diabetes treatment management strategies. METHODS A 20-min survey assessing the impact of NSNHEs was administered to patients with self-reported diabetes age 18 or older via the Internet in nine countries (USA, UK, Germany, Canada, France, Italy, Spain, The Netherlands and Sweden) who experienced an NSNHE in the last month. Questions captured reasons for and length of the event, and impacts on diabetes management, daily function, sleep and well-being. RESULTS A total of 20 212 persons with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) were screened of which 2108 respondents were eligible. Respondents initiated, on average, an additional 3.6 glucose monitoring tests, and did not resume usual functioning for an average of 3.4 hours after the NSNHE. Of the respondents using insulin, 15.8% decreased their insulin dose over an average of 3.6 days. NSNHEs also impacted sleep, with 10.4% not returning to sleep that night. Next day functioning was affected with 60.3% (n = 1273) feeling the need to take a nap and/or rest (with 65.5% of those actually taking a nap/rest) and 40.2% (n = 848) wanting to go to bed earlier than usual. A total of 21.4% were restricted in their driving the next day. These events also resulted in decreased well-being with 39.6% of respondents feeling 'emotional low' the following day. CONCLUSIONS NSNHEs have serious consequences for patients. Greater attention to patient and physician education regarding the burden of NSNHEs and incorporation of corrective actions in treatment plans is needed to facilitate patients reaching optimal glycaemic control.
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Affiliation(s)
- M Brod
- The Brod Group, Mill Valley, CA 94941, USA.
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Freemantle N, Meneghini L, Christensen T, Wolden ML, Jendle J, Ratner R. Insulin degludec improves health-related quality of life (SF-36® ) compared with insulin glargine in people with Type 2 diabetes starting on basal insulin: a meta-analysis of phase 3a trials. Diabet Med 2013; 30:226-32. [PMID: 23199058 PMCID: PMC3579236 DOI: 10.1111/dme.12086] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 10/30/2012] [Accepted: 11/27/2012] [Indexed: 01/20/2023]
Abstract
AIM To compare the effect of insulin degludec and insulin glargine on health-related quality of life in patients with Type 2 diabetes starting on insulin therapy. METHODS Patient-level data from three open-label, randomized, treat-to-target trials of 26 or 52 weeks' duration were pooled using a weighted analysis in conjunction with a fixed-effects model. Insulin-naive patients received either insulin degludec (n = 1290) or insulin glargine (n = 632) once daily, in combination with oral anti-diabetic drugs. Glycaemic control was assessed via HbA(1c) and fasting plasma glucose concentrations. Rates of hypoglycaemia, defined as plasma glucose < 3.1 mmol/l (< 56 mg/dl), were recorded. Health-related quality of life was evaluated using the 36-item Short Form (SF-36(®) ) version 2 questionnaire. Statistical analysis was performed using a generalized linear model with treatment, trial, anti-diabetic therapy at baseline, gender, region and age as explanatory variables. RESULTS Insulin degludec was confirmed as non-inferior to insulin glargine based on HbA(1c) concentrations. In each trial comprising the meta-analysis, fasting plasma glucose and confirmed overall and nocturnal (00.01-05.59 h) hypoglycaemia were all numerically or significantly lower with insulin degludec vs. insulin glargine. At endpoint, the overall physical health component score was significantly higher (better) with insulin degludec vs. insulin glargine [+0.66 (95% CI 0.04-1.28)], largely attributable to a difference [+1.10 (95% CI 0.22-1.98)] in the bodily pain domain score. In the mental domains, vitality was significantly higher with insulin degludec vs. insulin glargine [+0.81 (95% CI 0.01-1.59)]. CONCLUSIONS Compared with insulin glargine, insulin degludec leads to improvements in both mental and physical health status for patients with Type 2 diabetes initiating insulin therapy.
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Affiliation(s)
- N Freemantle
- Department of Primary Care and Population Health, UCL Medical School, London, UK
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Pakkala H, Presser K, Christensen T. Using Google Analytics to measure visitor statistics: The case of food composition websites. International Journal of Information Management 2012. [DOI: 10.1016/j.ijinfomgt.2012.04.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Boon P, Te Biesebeek J, Sioen I, Huybrechts I, Moschandreas J, Ruprich J, Turrini A, Azpiri M, Busk L, Christensen T, Kersting M, Lafay L, Liukkonen KH, Papoutsou S, Serra-Majem L, Traczyk I, De Henauw S, Van Klaveren J. Long-term dietary exposure to lead in young European children: comparing a pan-European approach with a national exposure assessment. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2012; 29:1701-15. [DOI: 10.1080/19440049.2012.709544] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zeratsky K, Christensen T, McMahon M. Prevention of Obesity at Employee Wellness Center. J Acad Nutr Diet 2012. [DOI: 10.1016/j.jand.2012.06.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Biltoft-Jensen A, Trolle E, Christensen T, Islam N, Andersen LF, Egenfeldt-Nielsen S, Tetens I. WebDASC: a web-based dietary assessment software for 8-11-year-old Danish children. J Hum Nutr Diet 2012; 27 Suppl 1:43-53. [DOI: 10.1111/j.1365-277x.2012.01257.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kataria M, Bateman I, Christensen T, Dubgaard A, Hasler B, Hime S, Ladenburg J, Levin G, Martinsen L, Nissen C. Scenario realism and welfare estimates in choice experiments--a non-market valuation study on the European water framework directive. J Environ Manage 2012; 94:25-33. [PMID: 21890260 DOI: 10.1016/j.jenvman.2011.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 08/03/2011] [Accepted: 08/09/2011] [Indexed: 05/31/2023]
Abstract
Using choice experiment data for economic valuation we analyse how disbelief in survey information could affect the retrieved welfare estimates. We distinguish between two types of survey information to the respondents. The first type of information concerns the current environmental status of a water body. This information is provided prior to the valuation questions and the corresponding beliefs in the provided information are also elicited before valuation. The second type of information concerns the proposed improvements in the environmental status of the water body. We find that average welfare measures differ considerably according to whether respondents who disagree with the status quo levels and find proposed scenarios unlikely are included or not.
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Affiliation(s)
- M Kataria
- National Environmental Research Institute, University of Aarhus, Frederiksborgvej 399, 4000 Roskilde, Denmark.
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Grankvist J, Fisker R, Iyer V, Fründ E, Simonsen C, Christensen T, Stenbygaard L, Ewertz M, Larsson EM. MRI and PET/CT of patients with bone metastases from breast carcinoma. Eur J Radiol 2012; 81:e13-8. [DOI: 10.1016/j.ejrad.2010.10.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 10/14/2010] [Accepted: 10/20/2010] [Indexed: 11/25/2022]
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Christensen T, Bisgaard CF, Wiborg O. Biomarkers of anhedonic-like behavior, antidepressant drug refraction, and stress resilience in a rat model of depression. Neuroscience 2011; 196:66-79. [PMID: 21889970 DOI: 10.1016/j.neuroscience.2011.08.024] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 08/04/2011] [Accepted: 08/12/2011] [Indexed: 01/08/2023]
Abstract
The aim of the present study was to identify potential biomarkers for depression in the search for novel disease targets and treatment regimens. Furthermore, the study includes a search for biomarkers involved in treatment resistance and stress resilience in order to investigate mechanisms underlying antidepressant drug refraction and stress-coping strategies. Depression-related transcriptomic changes in gene expression profiles were investigated in laser-captured microdissected (LCM) rat hippocampal granular cell layers (GCL) using the chronic mild stress (CMS) rat model of depression and chronic administration of two selective serotonin reuptake inhibitors (SSRIs), escitalopram and sertraline. CMS rats were segregated into diverging groups according to behavioral readouts, and under stringent constraints, the associated differential gene regulations were analyzed. Accordingly, we identified four genes associated with recovery, two genes implicated in treatment resistance, and three genes involved in stress resilience. The identified genes associated with mechanisms of cellular plasticity, including signal transduction, cell proliferation, cell differentiation, and synaptic release. Hierarchical clustering analysis confirmed the subgroup segregation pattern in the CMS model. Thus antidepressant treatment refractors cluster with anhedonic-like rats, and, interestingly, stress-resilient rats cluster with rats undergoing antidepressant-mediated recovery from anhedonia, suggesting antidepressant mechanisms of action to emulate endogenous stress-coping strategies.
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Affiliation(s)
- T Christensen
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
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Samuelsen JT, Kopperud HM, Holme JA, Dragland IS, Christensen T, Dahl JE. Role of thiol-complex formation in 2-hydroxyethyl- methacrylate-induced toxicity in vitro. J Biomed Mater Res A 2010; 96:395-401. [DOI: 10.1002/jbm.a.32993] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 09/23/2010] [Accepted: 10/12/2010] [Indexed: 01/25/2023]
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De Neve M, Sioen I, Boon P, Arganini C, Moschandreas J, Ruprich J, Lafay L, Amiano P, Arcella D, Azpiri M, Busk L, Christensen T, D’addezio L, Fabiansson S, Hilbig A, Hirvonen T, Kersting M, Koulouridaki S, Liukkonen KH, Oltarzewski M, Papoutsou S, Rehurkova I, Ribas-Barba L, Serra-Majem L, Tornaritis M, Trolle E, Van Klaveren J, Verger E, Walkiewicz A, Westerlund A, De Henauw S, Huybrechts I. Harmonisation of food categorisation systems for dietary exposure assessments among European children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2010; 27:1639-51. [DOI: 10.1080/19440049.2010.521957] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pakkala H, Christensen T, Martínez de Victoria I, Presser K, Kadvan A. Harmonised information exchange between decentralised food composition database systems. Eur J Clin Nutr 2010; 64 Suppl 3:S58-63. [DOI: 10.1038/ejcn.2010.212] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Christensen T, Bisgaard C, Nielsen H, Wiborg O. Transcriptome differentiation along the dorso–ventral axis in laser-captured microdissected rat hippocampal granular cell layer. Neuroscience 2010; 170:731-41. [DOI: 10.1016/j.neuroscience.2010.07.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Revised: 07/02/2010] [Accepted: 07/06/2010] [Indexed: 12/31/2022]
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Abstract
The monitoring of food additives and recent dietary surveys carried out in Denmark have earlier been used to estimate the intake of sweeteners and nitrite in relation to acceptable daily intakes. The ubiquitous use of the preservatives benzoic and sorbic acids raises the question of the magnitude of the intake of these preservatives in relation to acceptable daily intakes. This area is explored in this paper. The content of benzoic and sorbic acids in all food groups, where they are allowed, was monitored in Denmark 17 times between 2001 and 2006 with a total of 1526 samples. Transgressions of maximum limits, illegal use or declaration faults were found in about 3% of samples. From repeated investigations on fat-based foods (salads and dressings), marmalade and stewed fruit, it is concluded that the amounts used in industry have been relatively stable throughout the whole period, although limited data for marmalade show some variation. Most foods in the categories soft drinks, dressings, fat-based salads, pickled herrings, and marmalade contain benzoic and sorbic acid, and sliced bread also contains in some cases sorbic acid. The median daily intake and intake distribution of benzoic and sorbic acids were calculated with data from the Danish National Survey of Dietary Habits and Physical Activity (age from 4 to 75 years) conducted in 2000-2004 with 5785 participants. The median intakes of both benzoic acid and sorbic acid are well below the acceptable daily intakes of 0-5 and 0-25 mg kg(-1) body weight (bw) day(-1) for benzoic and sorbic acid, respectively. However, the 90th percentile based on the average of the samples with a content of benzoic acid is higher than the acceptable daily intake for both men and women, with the highest value of 16 mg kg(-1) bw day(-1) for both boys and girls in the 4-6-year-old age group. Based on the average of all samples, the 95th percentile is over the acceptable daily intake for men up to 34 years and for women up to 24 years, and the 90th percentile for men up to 18 years and for women up to 10 years. Soft drinks, salads and dressings are the main contributors to benzoic acid intake. The sorbic acid intake based on the average of all samples is well below the acceptable daily intake. However, for the intake based on the average of samples with content, the 95th percentile exceeds the acceptable daily intake. This is caused by the dominating contribution to the intake of sorbic acid from sliced bread, but since only seven out of 42 samples have added sorbic acid, the calculation based on the average of samples with content will exaggerate the intake. With a built-in safety factor of 100 in the acceptable daily intakes and judging from the literature, the high intakes of benzoic acid should not cause any concern for ill-effects. However, there must be a reason to reconsider the maximum limits especially for benzoic acid in soft drinks, dressings and salads and for sorbic acid in sliced bread.
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Affiliation(s)
- T Leth
- Food Chemistry, National Food Institute, DTU, Søborg, Denmark.
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Bannink E, Djurhuus CB, Christensen T, Jøns K, Hokken-Koelega A. Adult height and health-related quality of life after growth hormone therapy in small for gestational age subjects. J Med Econ 2010; 13:221-7. [PMID: 20438400 DOI: 10.3111/13696998.2010.484323] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To estimate health-related quality of life (HRQoL) in non-growth hormone deficient (GHD) small for gestational age (SGA) children before and after growth hormone (GH) treatment to adult height (AH). METHODS This was a multicentre, two-arm trial. Following an initial 2-year double-blind study period, patients entered a 2-year extension period followed by treatment to AH. At baseline patients were randomised to GH (0.033 or 0.067 mg/kg/day) and continued treatment at that dose until AH. Height was assessed at baseline and 3-monthly intervals to AH (height velocity <2 cm/year). Height standard deviation score (SDS) before and after GH therapy was mapped onto estimated HRQoL scores up to AH. RESULTS Of the 79 children randomised into the study 53 were non-GHD (defined as peak GH >20 mU/L [peak 24-h GH value and peak arginine tolerance test]). At baseline these children had a mean (mean [+/-SD]) height SDS of -3.2 (0.7), height velocity SDS -0.6 (1.2) and age, 8.1 (1.9) years. Estimated HRQoL scores were significantly (p < 0.001) increased from baseline at AH (ΔHRQoL, 95% CI) (0.033 mg/kg/day, 0.112 [0.092, 0.132]; 0.067 mg/kg/day, 0.115 [0.094, 0.136]). HRQoL was not different between treatment groups. A significant gain in AH, relative to an SGA reference population, was reported in GH-treated patients. Mean (95% CI) ΔAH SDS (0.033 mg/kg/day, +1.4 [1.1, 1.6]. 0.067 mg/kg/day, +1.7[1.4, 2.0]). LIMITATIONS The analysis assumes HRQoL can be mapped onto height SDS. CONCLUSIONS GH treatment in short children born SGA without signs of persistent catch-up growth was associated with significant improvement in HRQoL and normalisation of AH.
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Affiliation(s)
- E Bannink
- Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
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Vernier JP, Pommereau JP, Garnier A, Pelon J, Larsen N, Nielsen J, Christensen T, Cairo F, Thomason LW, Leblanc T, McDermid IS. Tropical stratospheric aerosol layer from CALIPSO lidar observations. ACTA ACUST UNITED AC 2009. [DOI: 10.1029/2009jd011946] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
A survey was undertaken regarding the extent to which optical radiation is used in cosmetic treatments and the compliance with national regulations. Questionnaires were sent to 65 clinics, and 23 of these were later inspected. Only one of 41 class 4 lasers had been reported to the authorities according to the regulations prior to the survey. Among sources other than lasers, intense pulsed light (IPL) sources were the most frequent. Although qualified health personnel should be in charge of the treatment, it was observed that 30% of the clinics did not fulfil this requirement. Deviations with respect to personnel training, availability of written procedures, protective equipment and warning signs were frequently observed. The results give rise to concern about the safety of patients and employees.
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Affiliation(s)
- T Christensen
- Norwegian Radiation Protection Authority, PO Box 55, NO-1332 Østerås, Norway.
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Gumez L, Guillot S, Benoit R, Beny J, Hawse J, Subramaniam M, Spelberg T, Christensen T, Pichon C, Bensamoun S. Internal structure analysis of tendon fibres with Fourier transform infrared spectroscopy, microspectroscopy and X-ray photoelectron spectroscopy. Comput Methods Biomech Biomed Engin 2009. [DOI: 10.1080/10255840903081149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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