Social Sustainable Education in a Refugee Camp

The main objective of this article is to discuss how an Early Childhood Education and Care (ECEC) institution in a refugee camp can promote social sustainable education. By giving empirical examples of innovative pedagogical ideas and practices inside a Greek ECEC institution, this article argues that concepts of formation are ways to promote social sustainable education. The article draws on data from an ECEC institution in which both the children living in a refugee camp and Greek children are located together. With nature as a neutral cultural mediator, serving as a pedagogical framework, children can make new experiences based on participation, equality and mutual respect. Data were produced through field observations, semi-structured interviews and one group interview from March 2019 until September 2019. The empirical data reveal three dimensions that we suggest work as markers for social sustainable pedagogical practice: the importance of nature and play as a facilitator for children’s activities; the importance of participation and equality; and the importance of commitment to the community. The findings are discussed in relation with theoretical concepts of formation, with a particular focus on children as active agents and the value of experiences, and the importance of highly qualified educators.publishedVersio

Predicting NOx emissions from wood stoves using detailed chemistry and computational fluid dynamics

-The present paper addresses NOx emissions from wood stoves through a computational fluid dynamics (CFD) modeling approach. The most significant route for NOx formation in traditional biomass combustion applications is the fuel NOx mechanism. The formation of fuel NOx is very complex and sensitive to fuel composition and combustion conditions. Thus, accurate predictions of fuel NOx formation in wood stoves, which constitute a wide range of compositions and states, rely heavily on the use of chemical kinetics with sufficient level of details. In the present work we use CFD together with three gas phase reaction mechanisms; one detailed mechanism consisting of 81 species and 1401 reactions, and two skeletal mechanisms with 49 and 36 species respectively to predict NOx emissions from wood stoves. The results show that; using the detailed mechanism as reference the 49-specie reaction mechanism predict similar results whilst the 36-specie mechanism overpredicts the total amount of fixed nitrogen emissions (NO, NO2, N2O, HCN, NH3) whilst underpredicting NOx emissions. Furthermore, the results indicate that even in these small-scale applications, air staging can be used to reduce the NOx emissions

CDR2L Is the Major Yo Antibody Target in Paraneoplastic Cerebellar Degeneration

The pathogenesis of Yo‐mediated paraneoplastic cerebellar degeneration (PCD) is unclear. We applied cerebrospinal fluid and serum from PCD patients as well as CDR2 and CDR2L antibodies to neuronal tissue, cancer cell lines, and cells transfected with recombinant CDR2 and CDR2L to elucidate which is the major antigen of Yo antibodies. We found that Yo antibodies bound endogenous CDR2L, but not endogenous CDR2. However, Yo antibodies can bind the recombinant CDR2 protein used in routine clinical testing for these antibodies. Because Yo antibodies only bind endogenous CDR2L, we conclude that CDR2L is the major antigen of Yo antibodies in PCD.publishedVersio

A cerebellar degeneration-related protein 2-like cell-based assay for anti-Yo detection in patients with paraneoplastic cerebellar degeneration

Background and purpose Commercially available tests for Yo antibody detection have low specificity for paraneoplastic cerebellar degeneration (PCD) because these assays use cerebellar degeneration-related protein 2 (CDR2) as the antigen, not CDR2-like (CDR2L). We aimed to test the hypothesis that use of a CDR2L cell-based assay (CBA), as an additional screening technique, would increase the accuracy of Yo-PCD diagnosis. Methods An in-house CBA to test for anti-CDR2L antibodies was developed and used to screen sera from 48 patients with confirmed anti-Yo-associated PCD. Fifteen non-Yo PCD patients, 22 patients with ovarian cancer without neurological syndromes, 50 healthy blood donors, 10 multiple sclerosis, 15 Parkinson's disease, and five non-paraneoplastic ataxic patients were included as controls. Sera were also tested by western blot analysis using recombinant CDR2 and CDR2L proteins developed in house, by the commercially available line immunoassays from Ravo Diagnostika and Euroimmun, and by the CDR2 CBA from Euroimmun. Results The CDR2L CBA identified all 48 patients with Yo-PCD. No CDR2L CBA reaction was observed in any of the control sera. The western blot technique had lower sensitivity and specificity as sera from eight and six of the 48 Yo-PCD patients did not react with recombinant CDR2 or CDR2L, respectively. Conclusions The CDR2L CBA is highly reliable for identification of Yo-PCD. Although our findings indicate that, currently, the combination of CDR2 and CDR2L yields the most reliable test results, it remains to be evaluated if a test for single anti-CDR2L positivity will serve as a sufficient biomarker for Yo-PCD diagnosis.publishedVersio

Automatic Unsupervised Clustering of Videos of the Intracytoplasmic Sperm Injection (ICSI) Procedure

The in vitro fertilization procedure called intracytoplasmic sperm injection can be used to help fertilize an egg by injecting a single sperm cell directly into the cytoplasm of the egg. In order to evaluate, refine and improve the method in the fertility clinic, the procedure is usually observed at the clinic. Alternatively, a video of the procedure can be examined and labeled in a time-consuming process. To reduce the time required for the assessment, we propose an unsupervised method that automatically clusters video frames of the intracytoplasmic sperm injection procedure. Deep features are extracted from the video frames and form the basis for a clustering method. The method provides meaningful clusters representing different stages of the intracytoplasmic sperm injection procedure. The clusters can lead to more efficient examinations and possible new insights that can improve clinical practice. Further on, it may also contribute to improved clinical outcomes due to increased understanding about the technical aspects and better results of the procedure. Despite promising results, the proposed method can be further improved by increasing the amount of data and exploring other types of features

Feasibility of implementing a surgical patient safety checklist: prospective cross-sectional evaluation

Background The World Health Organization’s Global Patient Safety Action Plan 2021–2030 call for attention to patient and family involvement to reduce preventable patient harm. Existing evidence indicates that patients’ involvement in their own safety has positive effects on reducing hospitalisation time and readmissions. One intervention reported in the literature is the use of checklists designed for patients’ completion. Studies on such checklists are small scale, but they are linked to reduction in length of hospital stay and readmissions. We have previously developed and validated a two-part surgical patient safety checklist (PASC). This study aims to investigate the feasibility of the PASC usage and implementation prior to its use in a large-scale clinical trial. Methods This is a prospective cross-sectional feasibility study, set up as part of the design of a larger stepped-wedge cluster randomised controlled trial (SW-CRCT). Descriptive statistics were used to investigate patient demographics, reasons for not completing the PASC and percentage of PASC item usage. Qualitative patient interviews were used to identify barriers and drivers for implementation. Interview was analysed through content analysis. Results Out of 428 recruited patients, 50.2% (215/428) used both parts of PASC. A total of 24.1% (103/428) of the patients did not use it at all due to surgical or COVID-19-related cancellations. A total of 19.9% (85/428) did not consent to participate, 5.1% (22/428) lost the checklist and 0.7% (3/428) of the patients died during the study. A total of 86.5% (186/215) patients used ≥ 80% of the checklist items. Barriers and drivers for PASC implementation were grouped into the following categories: Time frame for completing the checklist, patient safety checklist design, impetus to communicate with healthcare professionals and support throughout the surgical pathway. Conclusions Elective surgical patients were willing and able to use PASC. The study further revealed a set of barriers and drivers to the implementation. A large-scale definitive clinical-implementation hybrid trial is being launched to ascertain the clinical effectiveness and scalability of PASC in improving surgical patient safety.publishedVersio

Experiences and management strategies of Norwegian GPs during the COVID-19 pandemic: a longitudinal interview study

Objective: When the COVID-19 pandemic reached Norway, primary health care had to reorganize to ensure safe patient treatment and maintain infection control. General practitioners (GPs) are key health care providers in the municipalities. Our aim was to explore the experiences and management strategies of Norwegian GPs during the COVID-19 pandemic - over time, and in the context of a sudden organizational change. Design: Longitudinal qualitative interview study with two interview rounds. The first round of interviews was conducted from September–December 2020, the second round from January–April 2021. In the first interview round, we performed eight semi-structured interviews with GPs from eight municipalities in Norway. In the second round, five of the GPs were re-interviewed. Consecutive interviews were performed 2–4 months apart. To analyze the data, we used thematic analysis. Results: The COVID-19 pandemic required GPs to balance several concerns, such as continuity of care and their own professional efforts. Several GPs experienced challenges in the collaboration with the municipality and in relation to defining their own professional position. Guided by The Norwegian Association of General practitioners, The Norwegian College of General Practice and collegial support, they found viable solutions and ended up with a feeling of having adapted to a new normal. Conclusions: Although our study demonstrates that the GPs adapted to the changing conditions, the current municipal health care models are not ideal. There is a need for clarification of responsibilities between GPs and the municipality to facilitate a more coordinated future pandemic response