Study protocol for ACTIVE study:safety and feasibility evaluation of external ventricular drainage with ACTIVE fluid exchange in intraventricular hemorrhage-a phase 2, multi-center, randomized controlled trial

Background: Primary intraventricular hemorrhage (IVH) or IVH secondary to intracerebral (ICH) and subarachnoid hemorrhage (SAH) are known to have a very poor prognosis, with an expected mortality between 50 and 80% (Hinson et al. Current Neurology and Neuroscience Reports 10:73–82, 2010). Clearance of IVH might improve patient outcome. Methods: The study is designed as an investigator-initiated, comparative, prospective, multi-center, 1:1 randomized phase 2 trial evaluating the efficacy and safety of active irrigation in external ventricular drainage (intervention arm—IRRAflow) compared to passive external ventricular drainage (control arm—EVD). The trial will enroll 58 patients with primary or secondary IVH. Major eligibility criteria include age ≥18 years of age, IVH documented on head CT or MRI scan (Graeb score ≥3), need of cerebrospinal fluid drainage, deterioration of consciousness or medical sedation at the time of enrollment, and indication for active treatment evaluated by the treating physicians. Exclusion criteria included patients with fixed and dilated pupils and pregnant or nursing women. The primary endpoint of the study is catheter occlusion evaluated by time to first observed occlusion from VC placement. Secondary endpoints include clearance of ventricular blood as measured by head CT scan, rates of catheter-related infection and shunt dependency, length of intensive care unit stay, functional status—Extended Glascow Outcome Scale (eGOS) and modified Rankin scale (mRS) at discharge to rehabilitation and 90 days—and mortality rates at 30 days and 90 days. Discussion: With no standardized treatment for IVH and a poor prognosis, new treatments are needed. IVH patients often need CSF drainage to treat hydrocephalus and to decrease ICP. Standard treatment with passive external ventricular drainage is related to an increased risk of infections which is found in up to 22% of treated cases. The passive VC is known to have a risk of occlusion and is seen in 19–47% of the cases. We hypothesize that the use of active fluid change using the IRRAflow system will be safe and feasible and will reduce the occlusion and infection rates in patients with IVH. Trial registration: ClicalTrials.gov NCT05204849. Registered 15 December 2021.</p

Vagus Nerve Cross-Sectional Area in Patients With Parkinson's Disease—An Ultrasound Case-Control Study

Background: Vagal parasympathetic neurons are prone to degeneration in Parkinson's disease (PD). High-resolution ultrasound can precisely estimate the cross-sectional (CSA) area of peripheral nerves. Here, we tested the hypothesis that vagus CSA is reduced in PD.Methods: We included 56 healthy controls (HCs) and 63 patients with PD. Using a high-end ultrasound system equipped with a high-frequency transducer, five images were obtained of each nerve. The hypoechoic neuronal tissue was delineated offline with dedicated software and the CSA extracted.Results: In the initial PD vs. HC comparison, no statistically significant differences were observed in mean left vagus CSA (HC: 1.97 mm2, PD: 1.89 mm2, P = 0.36) nor in mean right vagus CSA (HC: 2.37 mm2, PD: 2.23 mm2, P = 0.17). The right vagus CSA was significantly larger than the left vagus CSA in both groups (P &lt; 0.0001). Females were overrepresented in the HC group and presented with generally smaller vagus CSAs. Consequently, sex-adjusted CSA was significantly smaller for the right vagus nerve of the PD group (P = 0.041), but not for the left.Conclusion: A small but significant reduction in sex-adjusted right vagus CSA was observed in patients with PD. The left vagus CSA was not significantly reduced in patients with PD. Ultrasound may not be a suitable method to detecting vagal axonal loss in individual patients

Visual Representations of Gender in English Foreign Language Textbooks and 10th Graders’ Reflections on Gender Equality and Visual Literacy

Master's thesis in Literacy Studies.This thesis presents a class of 10th graders ability to reflect on gender equality and visual representations, and how well four English Foreign Language (EFL) textbooks promote the Norwegian Curriculum’s general aim on gender equality through visual representations. These EFL textbooks were produced for lower secondary school, and were frequently used in EFL classrooms in Norway at the time that the study took place. Visual representations are known to communicate on the same premises as texts, and it has been argued that messages communicated through photographs are more likely to be accepted as truthful re-presentation of the world, compared to the written word. Thus, visual representations are believed by viewers to communicate objective messages. However, visual representations can be carriers of ideologies and myths on the same premises as written texts. As 10th graders are the targeted readers of the EFL textbooks, their abilities to analyse visual representations to reveal hidden meanings were investigated. They were also questioned on their thoughts and beliefs regarding gender equality in general, and also regarding the visual representations used in the EFL textbooks. This was done to investigate whether there were any differences to what the pupils were taught explicitly through their education, and what the visual representations might implicitly teach them. The information was gathered through questionnaires. A visual content analysis was conducted to gather information regarding the visual representations from the four EFL textbooks. This was based on coders created from the theoretical framework by Kress and van Leeuwen. These coders were ‘the gaze’, ‘vertical angle’, ‘horizontal angle’ and ‘size of frame’. The aim of the analysis was to investigate whether the visual representations supported or contradicted the general aim of promoting gender equality. Thus, categories as gender stereotyping, roles and occupations, power relationships and identification were also investigated. Visual representations of men and women were analysed through quantitative and qualitative semiotic analyses, and the results were compared. The results of the research on the 10th graders signified that there is a difference between what is explicitly taught through school, and what could be implicitly taught through visual representations. The 10th graders were positive and reflected when it came to gender equality in general, but they failed to draw connections to gender inequality being communicated through visual representations. However, the instruction given on semiotic analysis awakened a general interest for analysing visual representations, and the general concepts of Kress and van Leeuwen’s visual grammar were easily grasped by the pupils. Further instruction on critical literacy could benefit the pupils in their future life as citizens in an increasingly visual world. The visual content analysis revealed that there are still more visual representations of men compared to women in the four EFL textbooks investigated. Women are more frequently depicted in stereotypical roles, and are awarded less power than men. These results indicate that there are hidden ideologies and myths and these are communicated through the visual representations, which could be troubling for the 10th graders to identify with, as they contradict their beliefs on Norwegian society being gender equated. Subsequently, it could be argued that the results to a large degree contradict the general aim of LK06 to promote gender equality

High-Fat Feeding During Gestation and Nursing Period have Differential Effects on the Insulin Secretory Capacity in Offspring from Normal Wistar Rats

Restriction of protein or energy intake during gestation or early life is linked to developmental defects in the endocrine pancreas and insulin resistance. AIMS: To study whether a saturated fatty acid-rich diet during gestation and/or after the weaning period may be detrimental to the insulin secretory capacity later in life. STUDY DESIGN: Female Wistar rats were fed diets rich in carbohydrate (CHO) or saturated fat (SAFA) during pregnancy. The male offspring were split into five subgroups: after birth group 1 (control) continued on CHO and group 3 on SAFA. Group 2 continued on the CHO diet during the nursing period but changed to SAFA post weaning. Group 4 continued on SAFA, but changed to CHO post weaning. For group 5 the offspring of mothers given a SAFA diet were changed to nursing mothers on a CHO diet immediately after birth, and continued on the same diet post weaning. After 14 wk, the islets of Langerhans were isolated for determination of insulin secretory capacity in static incubation and dynamic perifusion experiments. RESULTS: We found a negative correlation (Coef: -3.1, 95% CI: -6.1 to -0.0, p < 0.05) between a diet rich in saturated fat fed to mothers during gestation and a positive correlation (Coef: 4.4, 95% CI: 0.9 to 7.8, p = 0.01) between nursing mothers’ diet and the capability to secrete insulin in the offspring. CONCLUSION: Our results indicate the importance of applying a nutrient-balanced diet during pregnancy and the nursing period on the later insulin secretory capacity in the offspring

Magnetic levitation system: Design, prototyping and testing of a digital PID-controller

Denne bacheloroppgaven handler om design, utvikling og bygging av en magnetisk levitasjonsplattform samt posisjonsregulering av en leviterende magnet ved hjelp av en digital PID-regulator. For å oppnå dette har en matematisk modell blitt utviklet for å beskrive systemet. Modellen er basert på en eksisterende modell av et ekvivalent analogt system som har blitt utvidet til å beskrive det nye, digitale systemet. For å tilpasse den nye modellen måtte de nye komponentene modelleres. Modellen har også blitt implementert i Matlab og har blitt brukt til å simulere systemet. Dette inkluderer analyse av stabilitet og likevektspunkt, RGA- og kondisjonstallanalyse, linearisering og simulering av et PID-regulert system. Modellen og simuleringene ligger til grunn for designet og byggingen av den nye magnetiske levitasjonsplattformen. Systemet ble designet med tanke på at det skulle være modulært, hvor forskjellige magnetkonfigurasjoner enkelt kunne testes ut. Designprosessen innebar design og kutting av modulære pleksiglassplater samt design og oppkobling av en elektrisk krets. Implementeringen av den digitale PID-regulatoren ble gjort på en Teensy mikrokontroller. Reguleringssystemet ble designet som et 3x3 MIMO-system med tre PID-regulatorer i parallell. Posisjonen til den svevende magneten blir målt ved bruk av hall-effekt-sensorer. Når et funksjonelt system var bygget ble det forsøkt stabilisert ved å justere inn PID-regulatoren. Dessverre ble systemet aldri stabilt, og regulatoren klarte ikke holde den svevende magneten i lufta i mer enn 20 sekunder på det meste. Etter mye analyse og diskusjon av det nåværende systemet er konklusjonen at det er mange grunner til at systemet ikke ble stabilt, blant annet det permanente magnetfeltet, elektromagnetene, støyfiltreringen samt tids- og budsjettrestriksjoner

Magnetic levitation system: Design, prototyping and testing of a digital PID-controller

Denne bacheloroppgaven handler om design, utvikling og bygging av en magnetisk levitasjonsplattform samt posisjonsregulering av en leviterende magnet ved hjelp av en digital PID-regulator. For å oppnå dette har en matematisk modell blitt utviklet for å beskrive systemet. Modellen er basert på en eksisterende modell av et ekvivalent analogt system som har blitt utvidet til å beskrive det nye, digitale systemet. For å tilpasse den nye modellen måtte de nye komponentene modelleres. Modellen har også blitt implementert i Matlab og har blitt brukt til å simulere systemet. Dette inkluderer analyse av stabilitet og likevektspunkt, RGA- og kondisjonstallanalyse, linearisering og simulering av et PID-regulert system. Modellen og simuleringene ligger til grunn for designet og byggingen av den nye magnetiske levitasjonsplattformen. Systemet ble designet med tanke på at det skulle være modulært, hvor forskjellige magnetkonfigurasjoner enkelt kunne testes ut. Designprosessen innebar design og kutting av modulære pleksiglassplater samt design og oppkobling av en elektrisk krets. Implementeringen av den digitale PID-regulatoren ble gjort på en Teensy mikrokontroller. Reguleringssystemet ble designet som et 3x3 MIMO-system med tre PID-regulatorer i parallell. Posisjonen til den svevende magneten blir målt ved bruk av hall-effekt-sensorer. Når et funksjonelt system var bygget ble det forsøkt stabilisert ved å justere inn PID-regulatoren. Dessverre ble systemet aldri stabilt, og regulatoren klarte ikke holde den svevende magneten i lufta i mer enn 20 sekunder på det meste. Etter mye analyse og diskusjon av det nåværende systemet er konklusjonen at det er mange grunner til at systemet ikke ble stabilt, blant annet det permanente magnetfeltet, elektromagnetene, støyfiltreringen samt tids- og budsjettrestriksjoner

The Diterpene Glycoside, Rebaudioside A, Does not Improve Glycemic Control or Affect Blood Pressure After Eight Weeks Treatment in the Goto-Kakizaki Rat

The plant, Stevia rebaudiana Bertoni (SrB), has been used for the treatment of diabetes in traditional medicine. Previously, we have demonstrated that long-term administration of the glycoside stevioside has insulinotropic, glucagonostatic, anti-hyperglycemic and blood pressure-lowering effects in type 2 diabetic animal models. The aim of this study was to elucidate if long-term administration of rebaudioside A, another glycoside isolated from the plant SrB, could improve glycemic control and lower blood pressure in an animal model of type 2 diabetes. We divided male Goto-Kakizaki (GK) rats into two groups which were fed a standard laboratory chow diet for eight weeks. The diet was supplemented with oral rebaudioside A (0.025 g/kg BW/day) in the experimental group. Blood glucose, weight, blood pressure and food intake were measured weekly. Animals were equipped with an intra-arterial catheter, and at week eight the conscious rats underwent an intra-arterial glucose tolerance test (IAGTT) (2.0 g/kg BW). During the IAGTT, the level of glucose, glucagon, and insulin responses did not differ significantly between the two groups. Fasting levels of glucose, glucagon, insulin or levels of blood lipids did not differ between the groups throughout the study period. We observed no effect on blood pressure or weight development. In conclusion, oral supplementation with rebaudioside A (0.025 g/kg BW/day) for eight weeks did not influence blood pressure or glycemic control in GK rats. Rebaudioside A failed to show the beneficial effects in diabetic animals previously demonstrated for stevioside

Best practice guidelines for blunt cerebrovascular injury (BCVI)

Blunt cerebrovascular injury (BCVI) is a non-penetrating injury to the carotid and/or vertebral artery that may cause stroke in trauma patients. Historically BCVI has been considered rare but more recent publications indicate an overall incidence of 1–2% in the in-hospital trauma population and as high as 9% in patients with severe head injury. The indications for screening, treatment and follow-up of these patients have been controversial for years with few clear recommendations. In an attempt to provide a clinically oriented guideline for the handling of BCVI patients a working committee was created. The current guideline is the end result of this committees work. It is based on a systematic literature search and critical review of all available publications in addition to a standardized consensus process. We recommend using the expanded Denver screening criteria and CT angiography (CTA) for the detection of BCVI. Early antithrombotic treatment should be commenced as soon as considered safe and continued for at least 3 months. A CTA at 7 days to confirm or discard the diagnosis as well as a final imaging control at 3 months should be performed

Best practice guidelines for blunt cerebrovascular injury (BCVI) :

Blunt cerebrovascular injury (BCVI) is a non-penetrating injury to the carotid and/or vertebral artery that may cause stroke in trauma patients. Historically BCVI has been considered rare but more recent publications indicate an overall incidence of 1–2% in the in-hospital trauma population and as high as 9% in patients with severe head injury. The indications for screening, treatment and follow-up of these patients have been controversial for years with few clear recommendations. In an attempt to provide a clinically oriented guideline for the handling of BCVI patients a working committee was created. The current guideline is the end result of this committees work. It is based on a systematic literature search and critical review of all available publications in addition to a standardized consensus process. We recommend using the expanded Denver screening criteria and CT angiography (CTA) for the detection of BCVI. Early antithrombotic treatment should be commenced as soon as considered safe and continued for at least 3 months. A CTA at 7 days to confirm or discard the diagnosis as well as a final imaging control at 3 months should be performed