Svendborg Sygehus

Shareable abstractAI and robotic bronchoscopy boost early lung cancer detection, dual-energy CT and cardiac MRI advance pulmonary vascular imaging, evidence-based standardised ultrasound training progresses. Innovation is reshaping respiratory medicine.https://bit.ly/454pPX3

Early detection and treatment of sarcopenia are crucial for improving patient outcomes, yet current diagnostic methods often lack the accuracy, accessibility, and efficiency needed for widespread clinical use. The aim of this study was to develop an accurate, secure, and evidence-based multimodal AI model using a point-of-care ultrasound (POCUS) framework combining muscle imaging properties with physical performance for sarcopenia diagnosis. The model uses clinical data and POCUS images. Clinical data consisted of age, gender, height, weight, body mass index (BMI) and data on physical performance by Short Physical Performance Battery (SPPB) scores. SPPB scores were chosen since it is recommended by both the European Working Group of Sarcopenia in Older People 2 and the Asian Working Group for Sarcopenia. POCUS data consisted of images from the dominant thigh, focusing on the rectus femoris muscle, using longitudinal and transverse projections. Various Machine Learning (ML) and Deep Learning (DL) algorithms and multimodal architectures were tested. Explainable AI (XAI) methods, including Grad-CAM for ultrasound images and feature-attribution analysis for clinical variables, were integrated to provide transparent interpretation of the multimodal model’s diagnostic decisions. The final model was implemented as part of the Sarcopenia Artificial Intelligence Diagnostic Decision Support System (SAID DSS). Participants (24) were mostly women (63%) with a mean age of 81 years (± 5.2), (age range: 71–91 years) a mean body mass index of 26 kg/m2 (± 4.1), and mean SPPB scores of 5 (± 1.6) and 9 (± 1.6) for sarcopenic and controls. 1060 and 2414 longitudinal and transverse ultrasound events for sarcopenic and control participants, respectively, were used, demonstrating a robust dataset despite the small number of participants. Comprehensive experimental results showed that a feature-level fusion technique using a multilayer perceptron network as classifier and Xception architectures for image feature extraction demonstrated the best performance. The final model yielded a diagnostic accuracy of 85%, an F1-score of 0.85 and an area under the curve (AUC) of 0.84, higher than previous models. This study is the first to introduce a clinically oriented, AI-based multimodal model for sarcopenia detection, demonstrating improved performance over existing approaches. In addition, we provided an explanation of the decisions generated by the best-performing detection model. By integrating this model into SAID DSS, we provide a practical and scalable tool with potential for direct application in clinical workflows, supporting early and accurate identification of sarcopenia. Not applicable.

Introduction: Ultrasound elastography is increasingly used across medical imaging, yet its role in thoracic disease remains poorly defined. While both transthoracic ultrasonography (TUS) and endobronchial ultrasound (EBUS) offer real-time assessment of pleural and pulmonary structures, the diagnostic and clinical value of elastography in this context remains uncertain. Materials and Method: A systematic search of MEDLINE, EMBASE, and the Cochrane Library was conducted according to PRISMA guidelines (April 2023; updated January 2025). Original studies evaluating transthoracic or endobronchial elastography for pleural or pulmonary conditions were included. Data extraction and quality assessment were performed independently by three reviewers, with QUADAS-2 used to evaluate risk of bias. Results: Thirty studies met inclusion criteria. Twenty-eight evaluated TUS elastography and two examined EBUS. Shear wave elastography was most frequently applied, particularly for differentiating malignant from benign pleural effusion or subpleural lesions. Surface wave elastography demonstrated consistently higher stiffness values in patients with interstitial lung disease compared with healthy controls, correlating with radiological and functional disease severity. Elastography-guided pleural biopsy improved diagnostic yield compared with conventional ultrasound-guided biopsy. Overall, substantial methodological variation existed among scanning techniques, elastography modalities, reporting methods, and diagnostic thresholds, limiting cross-study comparison. Conclusions: Ultrasound elastography shows promise for evaluating pleural effusion and pulmonary lesions, procedural guidance, and interstitial lung disease possibly improving diagnostic possibilities with bedside evaluation and reducing patient exposure to radiation. However, methodological variation and limited high-quality evidence preclude clinical implementation. Standardized acquisition protocols and multicentre validation studies are necessary to define its diagnostic utility in thoracic imaging.

Nr det kommer til mistanke om lungeemboli, er internationale retningslinjer enige [1].Hvis en patient skal henvises til CT-pulmonal angiografi (CTPA), kraeves en hj praetestsandsynlighed, typisk vurderet ved Wells kriterier, eller en lav til intermediaer sandsynlighed akkompagneret af en forhjet alderskorrigeret Ddimerkoncentration. Hidtil har der dog ikke vaeret anbefalinger

We report the development of an atomic layer deposition (ALD) process for depositing titanium dioxide (TiO 2 ) nanofilms onto porous activated carbon (AC) electrodes to enhance the electrochemical performance of supercapacitors. This study investigates previously unexplored aspects of the ALD process, including the influence of precursor pulse duration and film thickness on the deposition behavior within complex porous AC structures. The deposited TiO 2 nanofilms were amorphous and exhibited excellent uniformity and conformality across the AC surface. Electrochemical measurements revealed a combination of surface redox and intercalation-type pseudocapacitance, with surface redox reactions identified as the dominant energy storage mechanism. An optimal balance between accessible surface area and film thickness was achieved at 60 ALD cycles, corresponding to a TiO 2 film thickness of approximately 2.3 nm. Under these conditions, the specific capacitance of TiO 2 -coated supercapacitors exceeded that of bare AC electrodes, owing to the additional pseudocapacitance contributed by the TiO 2 layer. These findings demonstrate an effective strategy for utilizing ALD to engineer advanced electrode materials for high-performance supercapacitors. • Interfacial decoration of TiO 2 nanofilms on AC supercapacitors via ALD technique. • Highly uniform and conformal TiO 2 nanofilms observed in SEM/cross-sectional TEM. • The TiO 2 /AC demonstrate higher capacitance during extensive charge-discharge cycles. • New insights on next generation supercapacitors based TiO 2 ALD-coated AC electrodes.

Crude oil and cadmium (Cd) are common pollutants in Ghana's coastal ecosystems, where the cyanobacterial phytoplankton Synechococcus sp. serves as the primary producer and forms the base of the marine food web alongside small grazers. We hypothesized that cadmium and crude oil would disrupt microbial community structure and function, with the strongest effects under combined exposure. This study investigates the toxic effects of Oil (2mLL-1), Cd (4.4μgL-1), and their combined impact (Cd+Oil) on functional groups within the coastal microbial community, including Synechococcus sp., heterotrophic bacteria, nanoflagellates, eukaryotic phytoplankton, ciliates, and dinoflagellates, as well as on copepod nauplii and copepodite development during six-day incubations. We observed acute toxic effects on heterotrophic ciliates and dinoflagellates, with >50% reductions in abundance within 6h and a marked decrease in diversity. Phytoplankton showed growth within the first 24h due to nutrient replenishment from the protist decay, however, their growth continued to decline after 24h, with Synechococcus being particularly sensitive to Cd and less affected by Oil. In contrast, heterotrophic bacteria increased in abundance across all treatments, likely benefiting from organic matter released during phytoplankton decay and their high adaptability. Notably, the bacterial genera Marivivens and Rhodovulum became dominant mainly in the Oil-amended treatments. Overall, the microbial groups exhibited diverse responses to the pollutants, with the combined Cd+Oil treatment exerting the strongest negative effects, while crude oil alone had the least impact. These findings highlight the vulnerability of tropical microbial food webs, typically dominated by Synechococcus and microbial grazers, to combined pollutant stress, with potential cascading effects on higher trophic levels and coastal ecosystem productivity. This highlights the need for comprehensive monitoring and conservation efforts in these globally significant, yet understudied, regions.

During the Danish transition from sail to steam, seamanship was a widely debated concept. Most politicians, sailors and educators defined seamanship as a skill that could only be properly taught on sailing ships. This ideal of seamanship was surprisingly resilient. Even though steamers soon dominated trade, sailing ships were still seen as invaluable places of education. Sailors from sailing ships were viewed as better skilled, more disciplined and tougher than those from steamships. This article aims to understand how the concept of seamanship was constructed, how it influenced educational practices and how it was used politically in the reforms of Danish maritime education during the transition from sail to steam.

Abstract Psychedelics such as psilocybin have been linked to enhanced neuroplasticity and symptom relief in affective disorders, but the neurobiological mechanisms and impact of environmen-tal context remain unclear. Here, we tested whether a single dose of psilocybin alters synap-tic density in healthy individuals and whether setting-dependent subjective experience shapes this effect. Fifteen healthy participants had a psilocybin-induced psychedelic experi-ence either inside an MRI scanner or in a therapeutic-like room. We assessed synaptic densi-ty changes by measuring the Synaptic Vesicle glycoprotein 2A in the frontal cortex and hip-pocampus with [¹¹C]UCB-J PET at baseline and one-week post-dose, and assessed subjective experiences immediately afterwards and at three months. Participants treated in the thera-peutic-like setting exhibited more intense mystical-type experiences, longer-lasting psycho-logical benefits, and greater increases in synaptic density than those dosed in the MRI scan-ner. These findings indicate that psilocybin’s neuroplastic effects are modulated by envi-ronmental context, with important implications for psychedelic-assisted therapies.

Introduction Treatment with infliximab (IFX) and adalimumab (ADL) are used in a range of inflammatory diseases. Measurement of drug levels is warranted, but can be challenged by turn-around-times at the laboratories. Consequently, point-of-care testing (POCT) technology is becoming increasingly relevant. We evaluated the precision and comparability of results obtained with ProciseDx (Biosynex) when used in outpatient gastroenterology clinics monitoring IFX and ADL. Materials and methods In this prospective multi-center study, capillary and venous blood samples were collected by trained nurses from patients with inflammatory bowel disease on maintenance therapy with either IFX or ADL. Fourteen different nurses performed blood sampling and IFX measurements using ProciseDx on 64 patients, while 11 different nurses performed ADL measurements on 48 patients. Venous samples were sent to the laboratory for routine testing using Promonitor ELISA kit on a Triturus (Grifols). Results Across all patients and all sites, a variation of 18.9% and 11.4% was observed for IFX and ADL measurements, respectively. Peak variance was in the 5–10 mg/L IFX concentration range, while peak variance for ADL measurements was above 12 mg/L. Compared to the routine ELISA, the r-value was 0.82 for IFX with a mean total deviation of 2.10 mg/L (27.1%). For ADL, the r-value was 0.91 with a mean total deviation of 2.93 mg/L (39.7%). Conclusion We find the efficacy and accuracy of the ProciseDx acceptable, but when performed by non-laboratory personnel, the differences to routine measurements are considerable and could have a clinical impact. Clinical implementation would at least require reevaluation of the therapeutic intervals.