Norwegian paediatric habilitation centres judge their own competence on cerebral visual impairment as limited

Aim: Cerebral visual impairment (CVI), a frequently occurring functional impairment in children with neurodevelopmental disorders, leads to communicative, social and academic challenges. In Norway, children with neurodevelopmental disorders are assessed at paediatric habilitation centres. Our aims were to explore how CVI is identified, how paediatric habilitation centres assess their CVI competence and the reported prevalence of CVI among children with cerebral palsy. Methods: An electronic questionnaire was sent to all 19 Norwegian paediatric habilitation centre leaders in January 2022. The results were analysed quantitatively and qualitatively. The prevalence of CVI among children with cerebral palsy was estimated using register-based data. Results: The questionnaire was answered by 17. Only three judged their habilitation centre as having sufficient competence on CVI. None of the centres used screening questionnaires systematically, and 11 reported that CVI assessment was not good enough. Awareness that a child may have CVI typically occurred during examinations for other diagnoses. The prevalence of CVI among children with cerebral palsy was only 8%, while CVI status was unknown in 33%. Conclusion: Better knowledge and assessment of CVI at Norwegian paediatric habilitation centres are needed. CVI appears to be often overlooked in children with neurodevelopmental disorders.publishedVersio

Perception of nonverbal emotional communication in cross-cultural terapeutic work.

The following study address the research question “What implications could crosscultural variations in perception of nonverbal emotional expressions have for therapeutic work? To answer the research question we have chosen to do a systematic literature review in the databases PsychInfo and Web of Science, related to cultural variations in perception of emotional nonverbal signals. Together with information from the theoretical part of the paper, the findings from the literature, a total of 21 articles, was used to draw implications for crosscultural therapeutic work. The literature address different topics. One of these relates to whether perception of nonverbal signals are universal or culture-specific. Findings from the literature also suggest that individuals within one culture have an ingroup-advantage when it comes to perception of nonverbal expressions. Some studies theorize about why this is. The literature also indicate that cross-cultural sensitivity of nonverbal, emotional perception can be taught. The therapeutic implications are discussed consecutively, and a summary is given in the conclusion. Central aspects of the implications are related to increased cross-cultural knowledge and how to promote culture-sensitivity.I denne oppgaven belyses problemstillingen “på hvilken måte har krysskulturelle variasjoner i persepsjon av nonverbale emosjonelle uttrykk implikasjoner for terapeutisk arbeid?”. For å besvare problemstillingen har vi valgt å gjennomføre et systematisk litteratursøk i databasene PsychInfo og Web of Science, relatert til kulturell variasjon i persepsjon av nonverbale emosjonelle uttrykk. Funnene fra litteratursøket, totalt 21 artikler, ble brukt sammen med informasjon fra den teoretiske delen av oppgaven for å diskutere implikasjoner for terapeutisk arbeid i en krysskulturell setting. Litteraturen belyste noen sentrale funn, deriblant indikasjoner for- og imot hvorvidt persepsjon av nonverbale signaler kan antas å være universelle eller kulturspesifikke. Videre finner vi studier hvor forskerne finner støtte for at det forekommer en inngruppefordel med tanke på gjenkjenning av nonverbale signaler, og studier som undersøker hva som kan ligge til grunn for dette. Det fremkommer også i litteraturen indisier for at det er mulig å lære seg til å bli mer sensitiv for krysskulturelle nonverbale signaler. De terapeutiske implikasjonene drøftes fortløpende i diskusjonsdelen for deretter å sammenfattes i konklusjonen. Sentrale aspekter ved implikasjonene er relatert til økt krysskulturell kunnskap og hvordan fremme kultursensitivitet.Hovedoppgave psykologprogrammetPROPSY31

Persepsjon av emosjonell nonverbal kommunikasjon i krysskulturelt terapeutisk arbeid.

The following study address the research question “What implications could crosscultural variations in perception of nonverbal emotional expressions have for therapeutic work? To answer the research question we have chosen to do a systematic literature review in the databases PsychInfo and Web of Science, related to cultural variations in perception of emotional nonverbal signals. Together with information from the theoretical part of the paper, the findings from the literature, a total of 21 articles, was used to draw implications for crosscultural therapeutic work. The literature address different topics. One of these relates to whether perception of nonverbal signals are universal or culture-specific. Findings from the literature also suggest that individuals within one culture have an ingroup-advantage when it comes to perception of nonverbal expressions. Some studies theorize about why this is. The literature also indicate that cross-cultural sensitivity of nonverbal, emotional perception can be taught. The therapeutic implications are discussed consecutively, and a summary is given in the conclusion. Central aspects of the implications are related to increased cross-cultural knowledge and how to promote culture-sensitivity

Initial experience with positron emission tomography/computed tomography in addition to computed tomography and magnetic resonance imaging in preoperative risk assessment of endometrial cancer patients

Objective: Improved preoperative evaluation of lymph node status could potentially replace lymphadenectomy in women with endometrial cancer. PET/CT was routinely implemented in the preoperative workup of endometrial cancer at St Olav's University Hospital in 2016. Experience with PET/CT is limited, and there is no consensus about the use of PET/CT in the diagnostic workup of endometrial cancer. The aim of the study was to evaluate the diagnostic accuracy of PET/CT compared to standard CT/MRI in identifying lymph node metastases in endometrial cancer with histologically confirmed lymph node metastases as the standard of reference. We especially wanted to look at PET/CT as a supplement to the sentinel lymph node algorithm in the detection of paraaortic lymph nodes. Study design: A retrospective study included all women undergoing surgery for endometrial cancer from January 2016 through July 2019 at St Olav's University Hospital. Clinical data, results of CT, MRI, and PET/CT, and histopathological results were analyzed. Results: Among 185 patients included, 27 patients (15 %) had lymph node metastases. 17 (63 %) had pelvic lymph node metastases, one (4 %) had isolated paraaortic lymph node metastases, and 9 (33 %) had lymph node metastases in both the pelvis and the paraaortic region. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for the detection of lymph node metastases were 63 %, 98 %, 85 %, 94 %, and 93 %, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT/MRI were 41 %, 98 %, 73 %, 91 %, and 90 %, respectively (p = 0.07). For the 26 pelvic lymph node metastases, PET/CT had a sensitivity of 58 %, compared to 42 % for CT/MRI (p = 0.22). PET/CT detected all 10 paraaortic lymph node metastases, for a sensitivity of 100 %, compared to 50 % for CT/MRI (p = 0.06). Conclusions: PET is superior to CT/MRI for detection of lymph node metastases in endometrial cancer, particularly in detecting paraaortic lymph node metastases. The ability of preoperative PET to exclude paraaortic lymph node metastases may strengthen the credibility of the sentinel lymph node algorithm

Injisering som første del i salteprosessen

Det er gjennomført forsøk både i småskala og storskala hvor injisering har vært benyttet som første del i salteprosessen. I forsøkene er forhold som lakestyrke, lakemengde injisert og temperatur i laken testet ut. Utbytte og flere kvalitetsparametre er evaluert i alle forsøkene. Resultatene viser at injisering med ulike trykk og lakestyrker har direkte innflytelse på utbytte som saltfisk. Høye lakestyrker gir gode utbytter. Økt trykk gir bedre utbytte inntil en øvre grense hvor utbyttet reduseres igjen. Temperatur i laken påvirker ikke saltfiskutbyttet. Kvaliteten ble lite påvirket i forsøkene. Bruk av for høye trykk og injisering av for mye lake medførte imidlertid økt spalting i muskelen. Injisert fisk tørket like godt som fisk som var pickelsaltet + lake. Fisk som lå i kar tre uker før tørrsalting, tørket bedre enn fisken som lå to uker i kar. Det som er mest nærleggende å videreføre innen arbeidet med injisering er å teste ut effektene av ulike nåletyper og ulike maskiner. Det bør også prioriteres å få bekreftet resultatene med tørkehastighet. Prosjektet er finansiert med forskningsmidler fra FHF, Faggruppe for klippfisk og saltfisk.Injisering som første del i salteprosessenpublishedVersio

Placental inflammation in pre-eclampsia by Nod-like receptor protein (NLRP)3 inflammasome activation in trophoblasts

Pre‐eclampsia is associated with increased levels of cholesterol and uric acid and an inflamed placenta expressing danger‐sensing pattern recognition receptors (PRRs). Crystalline cholesterol and uric acid activate the PRR Nod‐like receptor protein (NLRP)3 inflammasome to release interleukin (IL)‐1β and result in vigorous inflammation. We aimed to characterize crystal‐induced NLRP3 activation in placental inflammation and examine its role in pre‐eclampsia. We confirmed that serum total cholesterol and uric acid were elevated in pre‐eclamptic compared to healthy pregnancies and correlated positively to high sensitivity C‐reactive protein (hsCRP) and the pre‐eclampsia marker soluble fms‐like tyrosine kinase‐1 (sFlt‐1). The NLRP3 inflammasome pathway components (NLRP3, caspase‐1, IL‐1β) and priming factors [complement component 5a (C5a) and terminal complement complex (TCC)] were co‐expressed by the syncytiotrophoblast layer which covers the placental surface and interacts with maternal blood. The expression of IL‐1β and TCC was increased significantly and C5a‐positive regions in the syncytiotrophoblast layer appeared more frequent in pre‐eclamptic compared to normal pregnancies. In‐vitro activation of placental explants and trophoblasts confirmed NLRP3 inflammasome pathway functionality by complement‐primed crystal‐induced release of IL‐1β. This study confirms crystal‐induced NLRP3 inflammasome activation located at the syncytiotrophoblast layer as a mechanism of placental inflammation and suggests contribution of enhanced NLRP3 activation to the harmful placental inflammation in pre‐eclampsia

Real-world data on niraparib maintenance treatment in patients with non-gBRCA mutated platinum-sensitive recurrent ovarian cancer

Objectives The aim of this study was to provide real-world efficacy and safety data on niraparib maintenance treatment in patients with non-germline (gBRCA)1/2 mutated platinum-sensitive recurrent ovarian cancer. Methods This retrospective multi-center cohort study included 94 platinum-sensitive recurrent ovarian cancer patients without known gBRCA1/2 mutation treated in an individual patient access program in Norway. The primary outcome was time from start of niraparib treatment to first subsequent treatment. Secondary endpoints included progression-free survival, safety, and tolerability. Results After median follow-up of 13.4 months (95% confidence interval (CI) 10.0 to 16.8), 68.1% had progressed and 22.3% had died. Of the entire cohort, 61.7% had commenced a new line of treatment, and 24.5% were still receiving niraparib. The median duration of niraparib treatment was 5.0 months (range 0.4 to 27.3), and the median time to first subsequent treatment was 10.7 months (95% CI 8.4 to 13.0). Patients with elevated CA125 prior to start of niraparib had shorter time to first subsequent treatment (7.3 months, 95% CI 4.2 to 10.3) than patients with normalized CA125 (12.2 months, 95% CI 10.9 to 13.7 (p=0.002). Patients who started on individual dose based on weight and platelet counts had fewer dose reductions (p<0.001) and interruptions (p=0.02). Conclusion In a real-world setting, niraparib maintenance treatment in patients with non-gBRCA1/2 mutated recurrent platinum-sensitive ovarian cancer showed effectiveness comparable with published phase III studies and acceptable safety. Individualized dosing is essential to minimize adverse events. CA125 levels at start of niraparib treatment may help to estimate the individual prognosis.publishedVersio

Cholesterol crystals and NLRP3 mediated inflammation in the uterine wall decidua in normal and preeclamptic pregnancies

Preeclampsia is a hypertensive and inflammatory pregnancy disorder associated with cholesterol accumulation and inflammation at the maternal-fetal interface. Preeclampsia can be complicated with fetal growth restriction (FGR) and shares risk factors and pathophysiological mechanisms with cardiovascular disease. Cholesterol crystal mediated NLRP3 inflammasome activation is central to cardiovascular disease and the pathway has been implicated in placental inflammation in preeclampsia. Direct maternal-fetal interaction occurs both in the uterine wall decidua and at the placental surface and these aligned sites constitute the maternal-fetal interface. This study aimed to investigate cholesterol crystal accumulation and NLRP3 inflammasome expression by maternal and fetal cells in the uterine wall decidua of normal and preeclamptic pregnancies. Pregnant women with normal (n = 43) and preeclamptic pregnancies with (n = 28) and without (n = 19) FGR were included at delivery. Cholesterol crystals were imaged in decidual tissue by both second harmonic generation microscopy and polarization filter reflected light microscopy. Quantitative expression analysis of NLRP3, IL-1β and cell markers was performed by immunohistochemistry and automated image processing. Functional NLRP3 activation was assessed in cultured decidual explants. Cholesterol crystals were identified in decidual tissue, both in the tissue stroma and near uterine vessels. The cholesterol crystals in decidua varied between pregnancies in distribution and cluster size. Decidual expression of the inflammasome components NLRP3 and IL-1β was located to fetal trophoblasts and maternal leukocytes and was strongest in areas of proximity between these cell types. Pathway functionality was confirmed by cholesterol crystal activation of IL-1β in cultured decidual explants. Preeclampsia without FGR was associated with increased trophoblast dependent NLRP3 and IL-1β expression, particularly in the decidual areas of trophoblast and leukocyte proximity. Our findings suggest that decidual accumulation of cholesterol crystals may activate the NLRP3 inflammasome and contribute to decidual inflammation and that this pathway is strengthened in areas with close maternal-fetal interaction in preeclampsia without FGR

Cholesterol crystals and NLRP3 mediated inflammation in the uterine wall decidua in normal and preeclamptic pregnancies

Preeclampsia is a hypertensive and inflammatory pregnancy disorder associated with cholesterol accumulation and inflammation at the maternal-fetal interface. Preeclampsia can be complicated with fetal growth restriction (FGR) and shares risk factors and pathophysiological mechanisms with cardiovascular disease. Cholesterol crystal mediated NLRP3 inflammasome activation is central to cardiovascular disease and the pathway has been implicated in placental inflammation in preeclampsia. Direct maternal-fetal interaction occurs both in the uterine wall decidua and at the placental surface and these aligned sites constitute the maternal-fetal interface. This study aimed to investigate cholesterol crystal accumulation and NLRP3 inflammasome expression by maternal and fetal cells in the uterine wall decidua of normal and preeclamptic pregnancies. Pregnant women with normal (n = 43) and preeclamptic pregnancies with (n = 28) and without (n = 19) FGR were included at delivery. Cholesterol crystals were imaged in decidual tissue by both second harmonic generation microscopy and polarization filter reflected light microscopy. Quantitative expression analysis of NLRP3, IL-1β and cell markers was performed by immunohistochemistry and automated image processing. Functional NLRP3 activation was assessed in cultured decidual explants. Cholesterol crystals were identified in decidual tissue, both in the tissue stroma and near uterine vessels. The cholesterol crystals in decidua varied between pregnancies in distribution and cluster size. Decidual expression of the inflammasome components NLRP3 and IL-1β was located to fetal trophoblasts and maternal leukocytes and was strongest in areas of proximity between these cell types. Pathway functionality was confirmed by cholesterol crystal activation of IL-1β in cultured decidual explants. Preeclampsia without FGR was associated with increased trophoblast dependent NLRP3 and IL-1β expression, particularly in the decidual areas of trophoblast and leukocyte proximity. Our findings suggest that decidual accumulation of cholesterol crystals may activate the NLRP3 inflammasome and contribute to decidual inflammation and that this pathway is strengthened in areas with close maternal-fetal interaction in preeclampsia without FGR