Abstract
Importance
Gender affirming treatment aims to improve mental health.
Objective
To investigate longitudinal mental health outcomes in Danish transgender persons.
Design
National ...register-based cohort study in Danish transgender persons with diagnosis code of “gender identity disorder” during the period 2000-2021.
Participants
Five age-matched controls of the same sex at birth and five age-matched controls of the other sex at birth were included for each transgender person.
Main outcomes
Diagnosis codes of mental and behavioral disorders and/or prescription of psychopharmacological agents until June 2022.
Results
The cohort included 3812 transgender persons with median age (interquartile range) 19 (15; 24) years for persons assigned female at birth (AFAB, N = 1993) and 23 (19; 33) years for persons assigned male at birth (AMAB, N = 1819) and 38 120 controls. Follow up duration was up to 10 years with mean (standard deviation) 4.5 (4.3) years. In transgender persons AFAB compared to control women, the odds ratio (OR) (95% confidence interval) for mental and behavioral disorders was 6.7 (5.5; 8.1) before the index date, 9.9 (8.4; 11.7) at 1 year, 5.8 (4.4; 7.7) at 5 years, and 3.4 (2.1; 7.5) at 8 years follow up. In transgender persons AMAB compared to control men, corresponding ORs were 5.0 (4.0; 6.4), 11.3 (9.3; 13.7), 4.8 (3.5; 6.5), and 6.6 (4.2; 10.3) at 8 years follow up (all P < .001).
Conclusion
The OR for mental health disorders was higher in transgender persons compared to controls and remained elevated throughout follow up, especially in transgender persons AMAB.
Abstract
Aim: To investigate whether the effect of alcohol use disorder (AUD) on death by natural and unnatural causes, respectively, differs according to intelligence quotient (IQ) scores. Methods: ...We followed 654 955 Danish men, including 75 267 brothers, born between 1939 and 1959 from their 25th birthday, 1 January 1970, or date of conscription (whichever came last) until 31 December 2018. The exposure of AUD was defined by first registered treatment (diagnosis since 1969, prescription medicine since 1994, or other treatment since 2006), and the outcomes of death by natural and unnatural causes, respectively, were obtained from nationwide registers since 1970. Information on IQ score was retrieved at conscription from the Danish Conscription Database. Results and conclusion: In total, 86 106 men were defined with an AUD. AUD combined with the highest, middle, and lowest IQ score tertiles, respectively, were associated with a 5.90 (95% confidence interval CI 5.75; 6.01), 6.88 (95% CI: 6.73; 7.04), and 7.53 (95% CI: 7.38; 7.68) times higher hazard of death by natural causes compared with no AUD and the highest IQ score tertile. The risk of death by unnatural causes was comparable for men with AUD regardless of IQ score tertile. A within-brother analysis showed that the impact of AUD on death by natural and unnatural causes, respectively, did not vary between men with different IQ score tertiles, but were hampered by statistical uncertainty. Our study indicates a need of special focus on men with lower levels of IQ score and AUD for prevention of death by natural causes.
Short Summary: Our study investigates whether the effect of alcohol use disorder on death by natural and unnatural causes, respectively, differs according to different IQ scores among 645 955 Danish men. We find that the association between AUD and death by natural causes varies by IQ score.
Background and aims
The accuracy of a diagnosis of heart failure (HF) in hospital discharge registers is largely unknown. We aimed to determine the validity of such a diagnosis in the Swedish ...hospital discharge register.
Methods and results
In a population‐based study of 2322 middle‐aged men (the ULSAM study), 321 participants were diagnosed with HF according to the Swedish hospital discharge register, during a median follow‐up time of 29 years. A review board examined the validity of the diagnosis according to the European Society of Cardiology definition of HF.
Eighty‐two percent of the possible cases were classified as having definite HF. An echocardiographic examination increased the validity to 88%. For patients treated at an internal medicine or cardiology clinic the validity was 86% and 91%, respectively. If HF was the primary diagnosis, the validity was 95%, irrespective of clinic type.
Conclusion
The HF diagnosis in the Swedish hospital discharge register appears slightly less precise than for acute myocardial infarction and stroke. For population‐based research, only those with a primary diagnosis of HF in the hospital discharge register should be regarded as definite HF cases, or alternatively the cases should be validated individually.
The article gives the analysis of the register of cossacks in 1638 as one of the Ukrainian historical sources which contain data about the structure and special ethnic origin of the Zaporozhian Host ...before the beginning Liberation war in the middle of the 17th century. Attention is focused on the fundamentals of register formation based on the territorial principle which was initiated by the Kurukovo Agreement. The reasons for the absence of key positions such as a quartermaster (obozny), a judge (suddia) and a chancellor (pysar) in the registered army are being clarified. Information about the amount of payment for the service of Cossack officer is also valuable. The continuity of Cossack family traditions was traced, in particular through participation in the resistance to Turkish aggression and armed uprisings.
Despite being one of the most common types of fracture, there is a lack of epidemiological studies involving ankle fractures of all kinds. Since 2012, the Swedish Fracture Register (SFR) has ...prospectively collected data on surgically and non-surgically treated ankle fractures. The aim of this study is to describe the epidemiology of ankle fractures between 2012 and 2022.
All ankle fractures registered in the SFR between 1 April 2012 and 31 March 2022 in patients aged 16 years or older were included. Information on age, sex, mechanism of injury, fracture classification according to AO/OTA and high- or low-energy trauma was retrieved from the SFR.
During the study period, 56,439 patients sustained 57,443 ankle fractures. Women (61%) were more commonly affected than men (39%). The mean age at the time of injury was 55 years. Men were found to be younger at the time of injury compared with women. Women were found to sustain open fractures more frequently, whereas the men more frequently sustained high-energy trauma. The most common mechanism of injury for all ankle fractures and for each AO/OTA44 fracture group separately was a simple fall. A seasonal variation in ankle fractures was found, where the number of ankle fractures peaked during the between November and March.
This study presents the epidemiology of all AO/OTA types of ankle fractures. We have demonstrated that most ankle fractures are caused by a simple fall and occur during wintertime. Women are more commonly affected than men and are older at the time of injury. These findings indicate that age-related skeletal fragility, as well as an increasing risk of simple falls in the elderly, may be risk factors for ankle fractures. This study will contribute to the planning of primary prevention for ankle fractures.
Registri raka so ključni pri zbiranju in zagotavljanju podatkov o bremenu raka tako na populacijski kot na regionalni ravni. Bolnišnični registri raka se ukvarjajo z zbiranjem informacij o bolnikih z ...rakom, ki so obravnavani v določeni bolnišnici. Njihov glavni namen je prispevati h klinični oskrbi bolnikov z vidika učinkovitosti, kakovosti in bolnišničnega upravljanja. Bolnišnični register Onkološkega inštituta Ljubljana je bil osnovan ob ustanovitvi državnega populacijskega registra raka leta 1950 in prispeva v državni register tretjino vseh prijav. Podatki, zbrani v bolnišničnem registru, so dragoceni tudi za strokovno in raziskovalno delo Inštituta. Ena od nalog bolnišničnih registrov raka je priprava letnih poročil za vodstvo in druge uporabnike. Letno na Onkološkem inštitutu Ljubljana sprejmemo več kot 6000 novih onkoloških bolnikov. Število bolnikov se je v obdobju 2008–2016 povečalo za 16 %.
Abstract
In spite of decades of research developing a model of language and context, there is little consensus in systemic functional linguistics (SFL) about how context should be modelled and how ...language and context are related. In this paper, we review recent work in SFL which focuses on modelling register as a resource – reconceiving field as a resource for construing phenomena, tenor as a resource for negotiating social relations, and mode as a resource for composing texture. This work has a number of implications for SFL’s conception of realisation (as strata of abstraction), instantiation (as a cline of generalisation), and individuation (as a scale of belonging). For realisation it bears critically on the issue of whether or not to adopt a stratified model of context (as register and genre) and the relationship between extrinsic functionality (field, tenor, and mode) and intrinsic functionality (ideational, interpersonal, and textual metafunctions). For instantiation, it bears critically on our modelling of principles for coupling (co-selecting and arranging choices within and across languages and related modalities of communication) – for example mass, presence, and association. And for individuation, it bears critically on the perspectives of allocation (i.e. how access to meanings and their uptake is distributed across communities) and affiliation (i.e. how meanings are used to collaborate and struggle, within and between social groups). Our basic aim in this paper is to suggest a model for improving traction as far as SFL work on language in context is concerned, fully embracing a multimodal perspective on language and related modalities of communication as resources for meaning.
Scalar replacement is one of effective array access optimizations that can be applied before High-level synthesis (HLS). The successful application of scalar replacement removes local memories, and ...as a result, it decreases hardware area. In addition, scalar replacement reduces the numbers of hardware execution cycles by reducing memory access conflicts. In scalar replacement, shift registers are introduced to remove local arrays, and reuse distances corresponds to the lengths of the shift registers. Previous scalar replacement methods implement the shift registers with chains of registers, so that the hardware area becomes large when the reuse distances are large. In addition, when reuse distances are unknown at compile time, previous scalar replacement methods require multiplexers with large numbers of inputs, which further increase on hardware area. In this paper, we propose a new technique to resolve the issues. In particular, we implement the shift registers with circular buffers instead of chains of registers. Large shift registers implemented by RAM-based circular buffers are more compact than those implemented by the chains of registers. We also show that the proposed method requires no multiplexers to realize scalar replacement for loops with statically unknown reuse distances, which leads to area-efficient hardware implementation. We developed a tool that implements the method and applied the tool to the benchmark programs which require large shift registers or have statically unknown reuse distances. We found that the hardware area is reduced with the proposed method compared to the previous method without sacrificing the hardware performance. We conclude that the proposed method is an area efficient scalar replacement method for programs that have large or unknown reuse distances at compile time.
Aims/hypothesis
The prognostic role of different diabetes treatment types has not been studied in detail. We compared mortality rates among cancer patients with and without diabetes, accounting for ...diabetes treatment and diabetes duration.
Methods
This register-based study included all cancer patients diagnosed in Denmark during 1995–2009. The patients were classified into four groups according to diabetes status at the time of cancer diagnosis: no diabetes, diabetes without medication, diabetes with only oral hypoglycaemic agent (OHA) or diabetes with insulin treatment. Poisson models were used to examine the association between pre-existing diabetes in cancer patients and mortality relative to the non-diabetic cancer population.
Results
Among 426,129 patients with incident cancer, we identified 42,205 patients with diabetes prior to cancer diagnosis. Overall, cancer patients with diabetes had higher mortality rates than non-diabetic cancer patients, highest among OHA- or insulin-treated patients. For all cancers combined and diabetes duration of 2 years at cancer diagnosis, insulin-treated patients experienced the highest mortality rate ratios starting from 3.7 (95% CI 2.7, 5.1) for men and 4.4 (3.1, 6.5) for women 1 year after cancer diagnosis, increasing to 5 (3.5, 7.0) for men and 6.5 (4.2, 9.3) for women 9 years after cancer diagnosis.
Conclusions/interpretation
Our study provides strong evidence that cancer patients with pre-existing diabetes experience higher mortality than cancer patients without diabetes. The higher mortality seen among cancer patients treated with OHAs or insulin is in accordance with the existing evidence that more intensive diabetes treatment reflects a larger degree of comorbidity at the time of cancer diagnosis, and hence poorer survival.
Academic writing is often referred to as “formal,” but the teaching and assessment of formality can be challenging as formality has been conceptualized in many ways. The goal of this study is to ...explore the elusive construct of formality in the context of academic writing, especially with regard to what formality means to academic writing instructors. We used instructors’ perceptions of formality (i) to identify relationships between the use of linguistic features in academic texts and perceptions of formality and (ii) to determine the extent to which the situational characteristics of texts (e.g., differences in audience, purpose, and discipline) are related to perceptions of formality. Specifically, we asked 72 academic writing instructors to rate the formality level of 60 short academic text excerpts on a five-point scale. The excerpts were sampled from two publication types (university textbooks, journal articles) in three disciplines (psychology, biology, history). Overall, the results indicate that perceptions of formality can be explained by both linguistic features and situational characteristics. As linguistic features and situational characteristics are intertwined, differences in perceptions of formality seem to be functionally motivated. Implications for the teaching of academic writing are discussed.
•There is no consensus as to what “formal writing” means.•This study explores the multi-faceted nature of the construct of formality.•Teacher perceptions of formality are the focus of this study.•We explore how linguistic features affect teacher perceptions.•We also explore how situational characteristics of writing affect teacher perceptions.
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