Background Beyond the controlled setting of trials, scarce information exists on the burden, predictors, and outcomes associated with elevated hs CRP (high‐sensitivity C‐reactive protein) in “real‐world” patients with myocardial infarction ( MI ). Methods and Results We included all‐coming MI survivors undergoing hs CRP testing >30 days after an MI during routine health care in Stockholm, Sweden (2006–2011). hs CRP tests measured during hospitalization/emergency department visits, followed by antibiotics or indicative of acute illness, were excluded, together with patients with ongoing/recent cancer, chronic infections, or immunosuppression. Inflammation was defined over a 3‐month baseline window and associated with subsequent death and major adverse cardiovascular events (composite of MI, ischemic stroke, or cardiovascular death). Included were 17 464 patients (63% men; mean age, 72.6 years) with a median hs CRP level of 2.2 (interquartile range, 1.0–6.0) mg/L and a median of 2.2 (interquartile range, 0.8–4.9) years since their MI . Most (66%) had hs CRP ≥2 mg/L, and 40% had hs CRP >3 mg/L. Lower hemoglobin, lower estimated glomerular filtration rate, and comorbidities (eg, heart failure, peripheral vascular disease, stroke, atrial fibrillation, diabetes mellitus, and rheumatoid diseases) were associated with higher odds of hs CRP ≥2 mg/L. Conversely, previous percutaneous coronary intervention, ongoing renin‐angiotensin blockade, and statins were associated with lower hs CRP ≥2 mg/L odds. Patients with hs CRP ≥2 mg/L were at higher risk of major adverse cardiovascular events (n=3900; adjusted hazard ratio, 1.28; 95% CI, 1.18–1.38) and death (n=4138; adjusted hazard ratio, 1.42; 95% CI, 1.31–1.53). Results were robust across subgroups of patients and after exclusion of events occurring during the first 6 to 12 months. On a continuous scale, the association between hs CRP and outcomes was linear until hs CRP >5 mg/L, plateauing thereafter. Conclusions Most patients with MI exhibit elevated hs CRP levels. Besides identifying populations at high‐inflammatory risk, this study extends the prognostic validity of this biomarker from trial evidence to real‐world healthcare settings.

This is an author produced version of a paper published in Preventive Veterinary Medicine. This paper has been peer-reviewed but may not include the final publisher proof-corrections or pagination. Orthopaedic, or other, injuries in sports medicine can be quantified using the 'days-lost to 27 training' concept. Both the training regimen and the surface used in training and racing can 28 affect the health of racehorses. Our aim was to associate 'days-lost to training' in elite-level 29show-jumpers to horse characteristics, training and management strategies, and the time spent 30 working on various training and competition surfaces. We designed a longitudinal study of 31 professional riders in four European countries. Data were recorded using training diaries. 32Reasons for days-lost were classified into non-acute and acute orthopaedic, medical, hoof-33 related, and undefined. We produced descriptive statistics of training durations, relative to 34 type of training, surfaces used, and days-lost. We created zero-inflated negative-binomial 35 random-effects models using the overall days-lost as outcome. In the whole dataset, duration 36 variables related to training surfaces were analysed as independent. The Swedish data only 37were also used to test whether duration variables were related to competition surfaces. 38Thirty-one riders with 263 horses provided data on 39,028 days at risk. Of these, 2357 (6.0%) 39were days-lost (55% and 22% of these were due to non-acute and acute orthopaedic injuries, 40 respectively) in 126 horses. 41In the all-country model, controlling for season, a significant variable was country. 42Switzerland and the UK had lower incidence-rate ratios (IR) compared to Sweden (IRs 0.2 43 and 0.03, respectively). Horses with previous orthopaedic problems had almost a doubled IR 44 (1.8) of days-lost due to orthopaedic injury, compared to baseline. If the horse had jumping 45 training more than 1 minute per day at risk the IRs were 6.9-7 (compared to less than this 46 amount of time); this was, however, likely an effect of a small baseline. Variation in training 47 was a protective factor with a dose-response relationship; the category with the highest 48 variation had an IR of 0. horses. Limited training use of sand surface was a risk-factor (IR 2.2; >4≤12 min/day at risk), 54 compared to not training on sand. Training/competing on sand-wood was a protective factor 55 (IRs 0.4-0.5) compared to not using this surface. 56 57

Background COVID‐19 can cause severe disease with need of treatment in the intensive care unit (ICU) for several weeks. Increased knowledge is needed about the long‐term consequences. Methods This is a single‐center prospective follow‐up study of COVID‐19 patients admitted to the ICU for respiratory organ support between March and July 2020. Patients with invasive ventilation were compared with those with high‐flow nasal oxygen (HFNO) or non‐invasive ventilation (NIV) regarding functional outcome and health‐related qualify of life. The mean follow‐up time was 5 months after ICU discharge and included clinical history, three well‐validated questionnaires about health‐related quality of life and psychological health, pulmonary function test, 6‐minute walk test (6MWT) and work ability. Data were analyzed with multivariable general linear and logistic regression models with 95% confidence intervals. Results Among 248 ICU patients, 200 patients survived. Of these, 113 patients came for follow‐up. Seventy patients (62%) had received invasive ventilation. Most patients reported impaired health‐related quality of life. Approximately one third suffered from posttraumatic stress, anxiety and depression. Twenty‐six percent had reduced total lung capacity, 34% had reduced 6MWT and 50% worked fulltime. The outcomes were similar regardless of ventilatory support, but invasive ventilation was associated with more bodily pain (MSD ‐19, 95% CI: ‐32 to ‐5) and <80% total lung capacity (OR 4.1, 95% CI: 1.3‐16.5). Conclusion Among survivors of Covid‐19 who required respiratory organ support, outcomes 5 months after discharge from ICU were largely similar among those requiring invasive compared to non‐invasive ventilation.

Introduction Young people with type 1 diabetes and their parents need to receive person‐centered education to be able to manage their diabetes. Guided Self‐Determination‐Young (GSD‐Y) is a person‐centered communication and reflection education model that can be used in educational program for young people with type 1 diabetes. Objective To evaluate whether GSD‐Y leads to improved glycaemic control, increased self‐perceived health and health‐related quality of life, fewer diabetes‐related family conflicts, and improved self‐efficacy in a group‐based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents. Methods This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for 12 months. The intervention group (n = 37) attended seven group training sessions over a period of 5 months, using the GSD‐Y model, the control group received standard care. Variables evaluated were HbA1c, self‐perceived health, health‐related quality of life, family conflicts, self‐efficacy, and usage of continuous glucose monitoring. Results When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at 12 months, favoring the intervention group (62 vs 70 mmol/mol, P = .009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after 12 months (P = .019). The intervention showed no effect on self‐perceived health, health‐related related quality of life, family conflicts, or self‐efficacy. Conclusions An intervention with GSD‐Y may have an effect on glycaemic control. The content of the GSD‐Y groups may serve as a model for person‐centered care in adolescents with type 1 diabetes.