Sexual dysfunction in women with type 1 diabetes in Norway: A qualitative study of women’s experiences

Aim The aim of this study was to explore the experiences of sexual health and sexual challenges in women with type 1 diabetes (T1D). Methods We used a qualitative study design and conducted semistructured interviews with 15 women (26–57 years) with T1D. The participants were recruited based on their Female Sexual Function Index score that indicated sexual dysfunction. We used thematic analysis to analyse the data. Results We generated three themes, each with subthemes: (1) Diabetes is present at all times (subthemes: having diabetes is onerous, and diabetes affects the relationship with my partner); (2) various challenges related to sexual health (subthemes: experiencing reduced sexual desire and physical challenges, and challenges related to sexual health affect the relationship with my partner); and (3) diabetes may affect sexual function (subthemes: glucose levels and technical devices may have an impact on sexual function, and sexual health should be addressed in diabetes follow-up). Conclusions The women with T1D experienced different challenges related to their sexual health. The most common were reduced sexual desire, vaginal dryness and pain during intercourse. The study emphasizes the importance of addressing sexual health in diabetes follow-up to provide comprehensive health services to people with diabetes.publishedVersio

A PC-BASED SYSTEM FOR MAINTENANCE MANAGEMENT OF BUILDINGS: GENERAL DESCRIPTION

ABSTRACT Europe's rich culture in wooden buildings are rapidly degrading due to environmental impact, wrong conservation techniques and lack of resources and technological tools for appropriate conservation. These issues were addressed in the former EU-project ENV4-CT95-0110 Wood-Assess , which has been finalised . In a new EU-project MMWood (ENV4-CT-98-0796) a PC-based system for maintenance management of buildings has been developed. The project had the following objectives: To develop and validate for the SMEs an integrated Maintenance Management system for historic buildings, adapted to the needs and purposes of various user group levels. Based on the Wood-Assess concept and results the modular GIS (Geographical Information System) based system, MMWood, will specifically contain • A documentation system for outer and inner parts of buildings and components, • Soft-and hardware tools for the building inspection in the course of maintenance tasks, • An environmental risk factor assessment module, • A standardized maintenance assessment module, • A cost and maintenance planning module. Main developments from the Wood-Assess project are the inclusion of the maintenance management phase, extension of the damage atlas to include also adjoining materials in wood constructions, rendering, brick and natural stone, and a fully integrated field inspection system, allowing the user to import/export all background and recorded data between the field inspection and the total maintenance management system. In this paper some of the main results of the project are given with much of the emphasis on presenting the PC-based application, and its use in some practical examples. Detailed results from the environmental risk factor assessment module and the standardised maintenance assessment module will be given in separate papers to this Congress

Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study

Objectives Fatal complications have occurred after vaccination with ChAdOx1 nCoV-19, a vaccine against Covid-19. Vaccine-induced immune thrombotic thrombocytopenia (VITT) with severe outcome is characterized by venous thrombosis, predominantly in cerebral veins, thrombocytopenia and anti-PF4/polyanion antibodies. Prolonged headaches and cutaneous hemorrhages, frequently observed after the ChAdOx1 nCoV-19 vaccine, have therefore caused anxiety among vaccinees. We investigated whether these symptoms represent a mild form of VITT, with a potential for aggravation, e.g. in case of a second vaccination dose, or a different entity of vaccine complications Materials and methods We included previously healthy individuals who had a combination of headache and spontaneous severe cutaneous hemorrhages emerging after the 1st dose of the ChAdOx1 nCoV-19 vaccine. Twelve individuals were found to meet the inclusion criteria, and a phone interview, cerebral MRI, assessment of platelet counts, anti PF4/polyanion antibodies and other laboratory tests were performed. Results None of the symptomatic vaccinees had cerebral vein thrombosis, hemorrhage or other pathology on MRI. Platelet counts were within normal range and no anti-PF4/polyanion platelet activating antibodies were found. Moreover, vasculitis markers, platelet activation markers and thrombin generation were normal. Furthermore, almost all symptoms resolved, and none had recurrence of symptoms after further vaccination with mRNA vaccines against Covid-19. Conclusions The combination of headaches and subcutaneous hemorrhage did not represent VITT and no other specific coagulation disorder or intracranial pathology was found. However, symptoms initially mimicking VITT demand vigilance and low threshold for a clinical evaluation combined with platelet counts and D–dimer

Immune complexes, innate immunity, and NETosis in ChAdOx1 vaccine-induced thrombocytopenia

Aims - We recently reported five cases of vaccine-induced immune thrombotic thrombocytopenia (VITT) 7–10 days after receiving the first dose of the ChAdOx1 nCoV-19 adenoviral vector vaccine against corona virus disease 2019 (COVID-19). We aimed to investigate the pathogenic immunological responses operating in these patients. Methods and results - We assessed circulating inflammatory markers by immune assays and immune cell phenotyping by flow cytometry analyses and performed immunoprecipitation with anti-platelet factor (PF)4 antibody in plasma samples followed by mass spectrometry from all five patients. A thrombus was retrieved from the sinus sagittal superior of one patient and analysed by immunohistochemistry and flow cytometry. Precipitated immune complexes revealed multiple innate immune pathway triggers for platelet and leucocyte activation. Plasma contained increased levels of innate immune response cytokines and markers of systemic inflammation, extensive degranulation of neutrophils, and tissue and endothelial damage. Blood analyses showed activation of neutrophils and increased levels of circulating H3Cit, dsDNA, and myeloperoxidase–DNA complex. The thrombus had extensive infiltration of neutrophils, formation of neutrophil extracellular traps (NETs), and IgG deposits. Conclusions - The results show that anti-PF4/polyanion IgG-mediated thrombus formation in VITT patients is accompanied by a massive innate immune activation and particularly the fulminant activation of neutrophils including NETosis. These results provide novel data on the immune response in this rare adenoviral vector-induced VITT

MRI-derived g-ratio and lesion severity in newly diagnosed multiple sclerosis

Myelin loss is associated with axonal damage in established multiple sclerosis. This relationship is challenging to study in vivo in early disease. Here, we ask whether myelin loss is associated with axonal damage at diagnosis, by combining non-invasive neuroimaging and blood biomarkers. We performed quantitative microstructural MRI and single molecule ELISA plasma neurofilament measurement in 73 patients with newly diagnosed, immunotherapy naïve relapsing-remitting multiple sclerosis. Myelin integrity was evaluated using aggregate g-ratios, derived from magnetization transfer saturation (MTsat) and neurite orientation dispersion and density imaging (NODDI) diffusion data. We found significantly higher g-ratios within cerebral white matter lesions (suggesting myelin loss) compared with normal-appearing white matter (0.61 vs 0.57, difference 0.036, 95% CI 0.029 to 0.043, p < 0.001). Lesion volume (Spearman’s rho rs= 0.38, p < 0.001) and g-ratio (rs= 0.24 p < 0.05) correlated independently with plasma neurofilament. In patients with substantial lesion load (n = 38), those with higher g-ratio (defined as greater than median) were more likely to have abnormally elevated plasma neurofilament than those with normal g-ratio (defined as less than median) (11/23 [48%] versus 2/15 [13%] p < 0.05). These data suggest that, even at multiple sclerosis diagnosis, reduced myelin integrity is associated with axonal damage. MRI-derived g-ratio may provide useful additional information regarding lesion severity, and help to identify individuals with a high degree of axonal damage at disease onset. York, Martin et al. simultaneously measured g-ratio and plasma neurofilament in 73 relapsing-remitting multiple sclerosis patients at diagnosis using advanced MRI and single molecule ELISA. They demonstrate that g-ratio of cerebral white matter lesions varies at diagnosis, and show that high g-ratio of lesions is associated with elevated plasma neurofilament

Vulnerability Index: A New Approach for Preventive Conservation of Monuments

A new approach is developed for vulnerability analysis of monuments based on a matrix model and the relationships with static and structural factors, climatic conditions, air quality, urban planning and social agents for preventive conservation of cultural heritage in urban centers. The objective is to provide tools for decision-makers in the current recession to allow them to prioritize strategies for cultural heritage preservation in a town, where territorial policies are applied and regions where restoration budget is distributed. This new tool allow to classify monuments in order to prioritize restoration and is a useful tool in deeper analysis associated to risks assessment. The degradation of building materials and structures is mainly due to deterioration caused by structural instability, weathering, pollution and anthropogenic damage. The vulnerability approach of each monument (vulnerability indexes) were calculated, based on a Leopold matrix that depends on intrinsic variables and the life of the monuments. For the very first time, the influence of different deterioration agents has been balanced with a Delphi forecast based on architects¿ opinions. The result is a new pre-Artificial Intelligence tool that enables users to reproduce human reasoning to study relations between vulnerability factors, risk factors and the historical parameters of the monuments.Universidad Pablo de OlavidePostprin

Vilkår for barns lekende samspill : En empirisk undersøkelse av barns lekende samspill i møte med barnehagedagens puls og organisering

Formålet med denne studien er å vise til hvordan vilkår for barns lek kan fremstå og fortolkes, og hvordan barnas lek utfolder seg i møte med disse vilkårene. Ved å studere dette vil jeg belyse mulige sammenhenger mellom barnas lek, personalets organisering og pulsen på avdelinga. Dette er en undersøkelse tett på barnas lek. Mitt ønske er å rette oppmerksomheten mot barnas lek, der fantasi og glede kan være en del av den spontane leken. Denne oppgaven kan bidra til å synliggjøre hvilke muligheter og begrensninger som kan være tilstede når barna leker. Forskningsspørsmål oppgaven bygger på: Hvordan utfolder barna seg i lekende samspill i møte med barnehagedagens puls og organisering? Denne oppgaven bygger på et fenomenologisk hermeneutisk perspektiv. Merlau-Pontys (1994) kroppsfenomenologi er sentral i min undersøkelse. Jeg har valgt en kvalitativ metode for å kunne nærme meg barnas og personalets perspektiv. Oppgaven er todelt, og den første delen bygger på et feltarbeid, der jeg har observert barnas lek i en barnehage, i en periode på to uker, med en barnegruppe med 13 barn i alderen 2-3 år. Undersøkelsen er gjennomført med deltakende observasjon, lydopptak og feltnotater. Den andre delen bygger på en faglig samtale jeg hadde med personalet, på bakgrunn av Stimulated recall som metode. For å undersøke lekens vilkår, ble personalets betraktninger en inngang til å belyse barnehagedagens organisering. Denne undersøkelsen bidrar med et blikk på hvordan barns lekende samspill kan fremstå i en barnehage, og et bidrag til å synliggjøre barns stemme. Jeg ser en forbindelse mellom barnas lek og personalets vektlegging av sin oppgave med å organisere. Slik jeg tolker det har personalets organisering en regulerende virkning på barnas lek. Gjennom fortolkning og drøfting har jeg lagt fram perspektiver av pedagogisk relevans