Gene Therapy for Parkinson\u27s Disease

Background: Parkinson’s disease (PD) is a neurodegenerative disorder of unknown cause. The characteristic motor impairments of PD including resting tremor, rigidity, slowed movement, decreased dexterity, small handwriting, flexed posture, gait disorder, and imbalance predominantly arise from the loss of neurons in the substantia nigra region of the midbrain that produce the neurotransmitter dopamine. Dopamine replacement therapy provides temporary relief of motor symptoms, but chronic use leads to serious side effects and cannot prevent disease progression. This systematic review will focus upon gene therapy as a possible treatment for PD. Methods: An exhaustive literature search was conducted in Medline, CINAHL, Web of Science, Google Scholar, and EBMRmultifile, using the search terms gene therapy and Parkinson’s disease in combination and alone as well as terms known to be synonymous. The search was limited to the English language, clinical trials and double-blind, randomized, controlled trials. Results: Two studies were reviewed based on the inclusion and exclusion criteria delineated in the methods section. Both studies were double-blind, randomized, controlled trials and utilized sham surgery for comparison. Marks et al showed adeno-associated type-2 vector (AAV2)-neurturin delivery in the putamen was not superior to sham surgery. LeWitt et al showed AAV2-glutamic acid decarboxylase (GAD) delivery in the subthalamic nucleus was superior to sham surgery. Conclusion: This systematic review shows gene therapy may prove to be a treatment option for patients with advanced Parkinson’s disease in the future. More research and development of gene therapy are needed

Med jobb i sikte. En studie av hva som påvirker synshemmedes yrkesdeltakelse og mulighetsrom i arbeidslivet.

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Teaching In Student-Centred Active Learning Spaces: How Relational, Pedagogical, Spatial, And Technological Aspects Intertwine And Affect The Learning Environment

Higher educational institutions internationally have shown a growing interest in developing learning spaces that support student-centred learning approaches. For engineering education, this development aligns well with an increased emphasis on cross-disciplinarity and a system-thinking approach. However, research and our own experiences as teachers and evaluators of such learning spaces suggest that teachers who enter these learning spaces need support, as the complexity of the teaching situation becomes more apparent, compared to the traditional lecture hall. In this workshop, we will investigate this complexity together with the participants. Participants can expect to leave the workshop with a better understanding of: a conceptual framework that will assist the participants in navigating through the complexity of teaching in student-centred learning spaces. how to plan, implement and evaluate one’s own teaching in such learning spaces (Do’s and Dont’s). The take-home message from this workshop is an appreciation for how the relational, pedagogical, spatial, and technological aspects intertwine and affect the learning environment in spaces designed for student activity

Changes in Health Literacy during the first year following a kidney transplantation: Using the Health Literacy Questionnaire

Objectives The study aimed to identify changes in health literacy (HL) and associated variables during the first year following a kidney transplantation. Methods A total of 196 transplant recipients were included in a prospective follow-up study. The patients answered the Health Literacy Questionnaire (HLQ) at 5 days, 8 weeks, 6 and 12 months following the kidney transplantation. Mixed linear models were used to analyze changes in HL and backward elimination was used to identify variables associated with HL. Results Two main patterns of change were identified: a) HL increased during the first 8 weeks of close follow-up and b) in several domains, the positive increase from 5 days to 8 weeks flattened out from 5 days to 6 and 12 months. Self-efficacy, transplant-related knowledge, and general health were core variables associated with HL. Conclusions Overall, HL increased during the 8 weeks of close follow-up following the kidney transplantation, while 6 months seem to be a more vulnerable phase. Furthermore, low self-efficacy, less knowledge, and low self-perceived health may represent vulnerable characteristics in patients. Practical implications Future kidney transplant care should take into account patients’ access to and appraisal of health information and social support, and draw attention to potentially vulnerable groups.publishedVersio

Mortality Among Young Adults Born Preterm and Early Term in 4 Nordic Nations

IMPORTANCE Adverse long-term outcomes in individuals born before full gestation are not confined to individuals born at extreme gestational ages. Little is known regarding mortality patterns among individuals born in the weeks close to ideal gestation, and the exact causes are not well understood; both of these are crucial for public health, with the potential for modification of risk. OBJECTIVE To examine the risk of all-cause and noncommunicable diseases (NCD) deaths among young adults born preterm and early term. DESIGN, SETTING, AND PARTICIPANTS This multinational population-based cohort study used nationwide birth cohorts from Norway, Sweden, Denmark, and Finland for individuals born between 1967 and 2002. Individuals identified at birth who had not died or emigrated were followed up for mortality from age 15 years to 2017. Analyses were performed from June 2019 to May 2020. EXPOSURES Categories of gestational age (ie, moderate preterm birth and earlier [23-33 weeks], late preterm [34-36 weeks], early term [37-38 weeks], full term [39-41 weeks] and post term [42-44 weeks]). MAIN OUTCOMES AND MEASURES All-cause mortality and cause-specific mortality from NCD, defined as cancer, diabetes, chronic lung disease, and cardiovascular disease (CVD). RESULTS A total of 6 263 286 individuals were followed up for mortality from age 15 years. Overall, 339 403 (5.4%) were born preterm, and 3 049 100 (48.7%) were women. Compared with full-term birth, the adjusted hazard ratios (aHRs) for all-cause mortality were 1.44 (95% CI, 1.34-1.55) for moderate preterm birth and earlier; 1.23 (95% CI, 1.18-1.29) for late preterm birth; and 1.12 (95% CI, 1.09-1.15) for early-term birth. The association between gestational age and all-cause mortality were stronger in women than in men (P for interaction = .03). Preterm birth was associated with 2-fold increased risks of death from CVD (aHR, 1.89; 95% CI, 1.45-2.47), diabetes (aHR, 1.98; 95% CI, 1.44-2.73), and chronic lung disease (aHR, 2.28; 95% CI, 1.36-3.82). The main associations were replicated across countries and could not be explained by familial or individual confounding factors. CONCLUSIONS AND RELEVANCE The findings of this study strengthen the evidence of increased risk of death from NCDs in young adults born preterm. Importantly, the increased death risk was found across gestational ages up to the ideal term date and includes the much larger group with early-term birth. Excess mortality associated with shorter gestational age was most pronounced for CVDs, chronic lung disease, and diabetes.Peer reviewe

Diversity and anti-fungal susceptibility of Norwegian Candida glabrata clinical isolates

Publisher's version, source: http://dx.doi.org/10.3402/jom.v8.29849.BACKGROUND: Increasing numbers of immunocompromised patients have resulted in greater incidence of invasive fungal infections with high mortality. Candida albicans infections dominate, but during the last decade, Candida glabrata has become the second highest cause of candidemia in the United States and Northern Europe. Reliable and early diagnosis, together with appropriate choice of antifungal treatment, is needed to combat these challenging infections. OBJECTIVES: To confirm the identity of 183 Candida glabrata isolates from different human body sites using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and VITEK®2, and to analyze isolate protein profiles and antifungal susceptibility. The minimum inhibitory concentration (MIC) of seven antifungal drugs was determined for the isolates to elucidate susceptibility. DESIGN: A total of 183 C. glabrata isolates obtained between 2002 and 2012 from Norwegian health-care units were analyzed. For species verification and differentiation, biochemical characterization (VITEK®2) and mass spectrometry (MALDI–TOF) were used. MIC determination for seven antifungal drugs was undertaken using E-tests®. RESULTS: Using VITEK®2, 92.9% of isolates were identified as C. glabrata, while all isolates (100%) were identified as C. glabrata using MALDI-TOF. Variation in protein spectra occurred for all identified C. glabrata isolates. The majority of isolates had low MICs to amphotericin B (≤1 mg/L for 99.5%) and anidulafungin (≤0.06 mg/L for 98.9%). For fluconazole, 18% of isolates had MICs >32 mg/L and 82% had MICs in the range ≥0.016 mg/L to ≤32 mg/L. CONCLUSIONS: Protein profiles and antifungal susceptibility characteristics of the C. glabrata isolates were diverse. Clustering of protein profiles indicated that many azole resistant isolates were closely related. In most cases, isolates had highest susceptibility to amphotericin B and anidulafungin. The results confirmed previous observations of high MICs to fluconazole and flucytosine. MALDI-TOF was more definitive than VITEK®2 for C. glabrata identification

Symptom-based survey diagnoses may serve to identify more homogenous sub-groups of fatigue and postviral diseases

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