Norske departementer i skjæringspunktet mellom politikk og fag

De siste tiårene har sett en kraftig vekst i kommunikasjonsmedarbeidere og en klar vekst i politikere i de norske departementene. Over tid kan dette utfordre fagavdelingenes faglige integritet, deres evne til å gi faglig uavhengige råd, og sikre at alle sider av en sak blir tilstrekkelig belyst før beslutning fattes. På lengre sikt kan dette underminere departementenes faglige legitimitet, og dessuten peke i retning av et system, hvor det ikke bare er den politiske ledelse som må skiftes ut ved valg

Existing data sources for clinical epidemiology: The clinical laboratory information system (LABKA) research database at Aarhus University, Denmark

This paper provides an introduction to the clinical laboratory information system (LABKA) research database in Northern and Central Denmark. The database contains millions of stored laboratory test results for patients living in the two Danish regions, encompassing 1.8 million residents, or one-third of the country’s population. More than 1700 different types of blood test analyses are available. Therefore, the LABKA research database represents an incredible source for studies involving blood test analyses. By record linkage of different Danish registries with the LABKA research database, it is possible to examine a large number of biomarkers as predictors of disease risk and prognosis and as markers of disease severity, and to evaluate medical treatments regarding effectiveness and possible side effects. Large epidemiological studies using routinely stored blood test results for individual patients can be performed because it is possible to link the laboratory data to high-quality individual clinical patient data in Denmark

Tre nye arter af bier for den danske fauna (Hymenoptera, Apoidea)

Since the latest update of the checklist on bees known from Denmark, the following three species have been added as new to the country: Colletes halophilus Verhoeff, 1943 (Colletidae), Nomada obscura Zetterstedt, 1838 (Apidae) and Xylocopa violacea (Linnaeus, 1758) (Apidae). The national checklist hereby includes 286 bee species, but more species will probably be found in the future, as the wild bee fauna in Denmark has never been thoroughly investigated

Tumor Ulceration, Reduced Infiltration of CD8-Lymphocytes, High Neutrophil-to-CD8-Lymphocyte Ratio and Absence of MC Virus are Negative Prognostic Markers for Patients with Merkel Cell Carcinoma

(1) Background: Merkel cell carcinoma (MCC) is caused by the Merkel cell polyomavirus and UV radiation. Understanding of the underlying biology is limited, but identification of prognostic markers may lead to better prognostic stratification for the patients. (2) Methods: Ninety patients diagnosed with MCC (1996–2012) were included. Virus status was estimated by polymerase chain reaction (qPCR) and immunohistochemistry (IHC). Ulceration status, PD-L1, cd66b neutrophils, cd8 lymphocytes and biomarkers of vascularization (cd34 endothelial cells) and migration (e-cadherin) were estimated by IHC and analyzed with digital pathology. (3) Results: Virus was present in 47% of patient samples and correlated with lower E-cadherin expression (p = 0.0005), lower neutrophil-to-CD8 lymphocyte ratio (N:CD8 ratio) (p = 0.02) and increased PD-L1 expression (p = 0.03). Ulceration was associated with absence of virus (p = 0.03), increased neutrophil infiltration (p < 0.0001) and reduced CD8 lymphocyte infiltration (p = 0.04). In multivariate analysis, presence of virus (p = 0.01), ulceration (p = 0.05) and increased CD8 lymphocyte infiltration (p = 0.001) showed independent prognostic impacts on MCC-specific survival. (3) Conclusions: In this study, we found that a high N:CD8 ratio, ulceration, virus-negative status and absence of CD8 lymphocytes are negative prognostic markers. Accurate prognostic stratification of the patients may be important in the clinical setting for determination of adjuvant treatment

Appropriateness of referrals from primary care for lumbar MRI

BACKGROUND: International guidelines do not recommend routine imaging, including magnetic resonance imaging (MRI), and seek to guide clinicians only to refer for imaging based on specific indications. Despite this, several studies show an increase in the use of MRI among patients with low back pain (LBP) and an imbalance between appropriate versus inappropriate use of MRI for LBP. This study aimed to investigate to what extent referrals from general practice for lumbar MRI complied with clinical guideline recommendations in a Danish setting, contributing to the understanding and approaches to lumbar MRI for all clinicians managing LBP in the primary sector. MATERIALS AND METHODS: From 2014 to 2018, all referrals for lumbar MRI were included from general practitioners in the Central Denmark Region for diagnostic imaging at a public regional hospital. A modified version of the American College of Radiology Imaging Appropriateness Criteria for LBP was used to classify referrals as appropriate or inappropriate, based on the unstructured text in the GPs’ referrals. Appropriate referrals included fractures, cancer, symptoms persisting for more than 6 weeks of non-surgical treatment, previous surgery, candidate for surgery or suspicion of cauda equina. Inappropriate referrals were sub-classified as lacking information about previous non-surgical treatment and duration. RESULTS: Of the 3772 retrieved referrals for MRI of the lumbar spine, 55% were selected and a total of 2051 referrals were categorised. Approximately one quarter (24.5%) were categorised as appropriate, and 75.5% were deemed inappropriate. 51% of the inappropriate referrals lacked information about previous non-surgical treatment, and 49% had no information about the duration of non-surgical treatment. Apart from minor yearly fluctuations, there was no change in the distribution of appropriate and inappropriate MRI referrals from 2014 to 2018. CONCLUSION: The majority of lumbar MRI referrals (75.5%) from general practitioners for lumbar MRI did not fulfil the ACR Imaging Appropriateness Criteria for LBP based on the unstructured text of their referrals. There is a need for referrers to include all guideline-relevant information in referrals for imaging. More research is needed to determine whether this is due to patients not fulfilling guideline recommendations or simply the content of the referrals

A Flexible Autonomous Robotic Observatory Infrastructure for Bentho-Pelagic Monitoring

This paper presents the technological developments and the policy contexts for the project “Autonomous Robotic Sea-Floor Infrastructure for Bentho-Pelagic Monitoring” (ARIM). The development is based on the national experience with robotic component technologies that are combined and merged into a new product for autonomous and integrated ecological deep-sea monitoring. Traditional monitoring is often vessel-based and thus resource demanding. It is economically unviable to fulfill the current policy for ecosystem monitoring with traditional approaches. Thus, this project developed platforms for bentho-pelagic monitoring using an arrangement of crawler and stationary platforms at the Lofoten-Vesterålen (LoVe) observatory network (Norway). Visual and acoustic imaging along with standard oceanographic sensors have been combined to support advanced and continuous spatial-temporal monitoring near cold water coral mounds. Just as important is the automatic processing techniques under development that have been implemented to allow species (or categories of species) quantification (i.e., tracking and classification). At the same time, real-time outboard processed three-dimensional (3D) laser scanning has been implemented to increase mission autonomy capability, delivering quantifiable information on habitat features (i.e., for seascape approaches). The first version of platform autonomy has already been tested under controlled conditions with a tethered crawler exploring the vicinity of a cabled stationary instrumented garage. Our vision is that elimination of the tether in combination with inductive battery recharge trough fuel cell technology will facilitate self-sustained long-term autonomous operations over large areas, serving not only the needs of science, but also sub-sea industries like subsea oil and gas, and mining