"Hadde det ikke vært for ho Astrid, så vet jeg ikke hvordan det hadde gått" Foresattes beskrivelser av fellesnevnere for en god spesialundervisning i den videregående skolen for elever med autismespekterforstyrrelser

Forsking som foreligger om spesialundervisning i skolen, tenderer mot å ha fokus på det som ikke fungerer. Denne masteroppgaven har til hensikt å beskrive hva som kjennetegner god spesialundervisning. Søkelyset rettes mot foresattes opplevelser av spesialundervisning og på praksis som erfares som fungerende for elever som har autismespekterforstyrrelser i videregående skole. Problemstillingen er som følgende: «Hvilke fellesnevnere beskriver foresatte på en god spesialundervisning for elever med autismespekterforstyrrelser i den videregående skolen?» Det begrepsmessige rammeverket består av teori om spesialundervisning, autismespekterforstyrrelser og foreldresamarbeid. Tangens (2012) teori om skolelivskvalitet er valgt som hovedteori for drøfting av funn. Problemstillingen blir belyst gjennom en kvalitativ metode og hermeneutisk tilnærming. Informantene er strategisk valgt ut fra sine erfaringer med austismespekterforstyrrelser. Fire foresatte til barn med austismespekterforstyrrelser og en ung mann som selv har en mild form for autisme, har gjennom semistrukturerte intervju bidratt med sine erfaringer av spesialundervisning. Analysen av datamaterialet er gjort med utgangspunkt i tematisk analyse. Resultatet i denne studien indikerer at spesialundervisning kan fungere for elever som har autismespekterforstyrrelser. Informantene signaliserte at suksessfaktorer er et godt foreldresamarbeid, trygge relasjoner, samt faglig og menneskelig kompetanse hos lærere. Funnene viser at teorien om skolelivskvalitet kan gi en forståelse for spesialundervisning av elever med autismespekterforstyrrelser. Integrering er nedfelt som fundament i norsk skole, men var ikke en faktor som var avgjørende for om spesialundervisningen ble oppfattet som positivt. Undersøkelse av integrering som nøkkelen til suksess for alle elever med spesielle behov, bør følges opp av videre forskning

The Effect of Biological Treatment on Fatigue in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis

Background: Fatigue is a frequent complaint in patients with inflammatory bowel disease. Biological drugs have demonstrated beneficial effects on some extraintestinal manifestations, but the effect on fatigue is not clear. Objective: This study investigated the effects of biological and small molecule drugs approved for inflammatory bowel disease on fatigue. Methods: We performed a systematic review and meta-analysis of randomized, placebo-controlled trials reporting Federal Drug Agency (FDA)-approved biological and small molecule drugs for use in ulcerative colitis and Crohn’s disease in which measures of fatigue were recorded before and after treatment. Only induction studies were included. Maintenance studies were excluded. We searched Embase (Ovid), Medline (Ovid), PsycINFO (Ovid), Cinahl (EBSCOhost), Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov in May 2022. Risk of bias was analyzed using the Cochrane risk-of-bias tool. Standardized mean difference was used to measure the treatment effect. Results: A total of seven randomized controlled trials composed of 3835 patients were included in the meta-analysis. All of the studies included patients with moderately to severely active ulcerative colitis or Crohn’s disease. The studies used three different generic fatigue instruments: the Functional Assessment of Chronic Illness Therapy-Fatigue and the Short Form 36 Health Survey Vitality Subscale versions 1 and 2. Overall treatment with biological or small molecule agents showed a beneficial effect compared with placebo, with a standardized mean difference of 0.25 (95% confidence interval 0.15–0.34, p < 0.001). The effect was independent of type of drug or subtype of inflammatory bowel disease. Discussion: The risk of bias was considered to be low for all domains except for missing outcome data. Even though the included studies were of high methodological quality, the review is limited by the small number of studies included and that the available studies were not designed to evaluate fatigue specifically. Conclusion: Biological and small molecule drugs used in inflammatory bowel disease have a consistent, though small, beneficial effect on fatigue.publishedVersio

Fatigue: a frequent and biologically based phenomenon in newly diagnosed celiac disease

Fatigue is increasingly recognized as a major complaint in patients with chronic inflammatory and autoimmune diseases. Although fatigue is assumed to represent a significant problem in celiac disease, existing knowledge is scarce, and opinions are conflicting. This study aimed to investigate the prevalence and severity of fatigue in patients with newly diagnosed celiac disease and compare it with healthy control subjects. Ninety patients with newly diagnosed celiac disease were compared with 90 age- and sex-matched healthy subjects. The primary endpoints were fatigue severity as measured by: the fatigue Visual Analog Scale (fVAS), the Fatigue Severity Scale (FSS), and the inverted Vitality subscale of the MOS36 (SF-36vs). Higher scores indicate more severe fatigue. Clinically relevant fatigue was determined using predefined cut-off values. Secondary endpoints were the associations between fatigue, and sex, age, depression, pain, and selected biochemical variables. The median (IQR) fVAS-scores were 43.0 (18.0–64.5) in patients, and 9.0 (2.0–16.0) in the control group (p < 0.001); and the FSS scores 3.8 (2.0–4.8) in patients, and 1.4 (1.0–1.9) in control subjects (p < 0.001). Inverted SF-36vs scores had a mean (SD) value of 58.8 (23.6) in patients, and 29.7 (14.3) in healthy subjects (p < 0.001). The presence of clinically relevant fatigue ranged from 41 to 50% in patients. Increased fatigue severity was associated with female sex, younger age, and elevated pain and depression scores, but not with levels of selected biochemical variables, including hemoglobin. Fatigue is a severe and frequent phenomenon in patients with untreated celiac disease.publishedVersio

"Hadde det ikke vært for ho Astrid, så vet jeg ikke hvordan det hadde gått" Foresattes beskrivelser av fellesnevnere for en god spesialundervisning i den videregående skolen for elever med autismespekterforstyrrelser

Forsking som foreligger om spesialundervisning i skolen, tenderer mot å ha fokus på det som ikke fungerer. Denne masteroppgaven har til hensikt å beskrive hva som kjennetegner god spesialundervisning. Søkelyset rettes mot foresattes opplevelser av spesialundervisning og på praksis som erfares som fungerende for elever som har autismespekterforstyrrelser i videregående skole. Problemstillingen er som følgende: «Hvilke fellesnevnere beskriver foresatte på en god spesialundervisning for elever med autismespekterforstyrrelser i den videregående skolen?» Det begrepsmessige rammeverket består av teori om spesialundervisning, autismespekterforstyrrelser og foreldresamarbeid. Tangens (2012) teori om skolelivskvalitet er valgt som hovedteori for drøfting av funn. Problemstillingen blir belyst gjennom en kvalitativ metode og hermeneutisk tilnærming. Informantene er strategisk valgt ut fra sine erfaringer med austismespekterforstyrrelser. Fire foresatte til barn med austismespekterforstyrrelser og en ung mann som selv har en mild form for autisme, har gjennom semistrukturerte intervju bidratt med sine erfaringer av spesialundervisning. Analysen av datamaterialet er gjort med utgangspunkt i tematisk analyse. Resultatet i denne studien indikerer at spesialundervisning kan fungere for elever som har autismespekterforstyrrelser. Informantene signaliserte at suksessfaktorer er et godt foreldresamarbeid, trygge relasjoner, samt faglig og menneskelig kompetanse hos lærere. Funnene viser at teorien om skolelivskvalitet kan gi en forståelse for spesialundervisning av elever med autismespekterforstyrrelser. Integrering er nedfelt som fundament i norsk skole, men var ikke en faktor som var avgjørende for om spesialundervisningen ble oppfattet som positivt. Undersøkelse av integrering som nøkkelen til suksess for alle elever med spesielle behov, bør følges opp av videre forskning

Single-cell RNA sequencing analyses : interference by the genes that encode the B-cell and T-cell receptors

B and T cells are integral parts of the immune system and are implicated in many diseases, e.g. autoimmunity. Towards understanding the biology of B and T cells and subsets thereof, their transcriptomes can be analyzed using single-cell RNA sequencing. In some studies, the V(D)J transcripts encoding the variable regions of the B- and T-cell antigen receptors have been removed before the analyses. However, a systematic analysis of the effects of including versus excluding these genes is currently lacking. We have investigated the effects of these transcripts on unsupervised clustering and down-stream analyses of single-cell RNA sequencing data from B and T cells. We found that exclusion of the B-/T-cell receptor genes prior to unsupervised clustering resulted in clusters that represented biologically meaningful subsets, such as subsets of memory B and memory T cells. Furthermore, pseudo-time and trajectory inference analyses of early B-lineage cells resulted in a developmental pathway from progenitor to immature B cells. In contrast, when the B-/T-cell receptor genes were not removed, with the PCs used for clustering consisting of up to 70% V-genes, this resulted in some clusters being defined exclusively by V-gene segments. These did not represent biologically meaningful subsets; for instance in the early B-lineage cells, these clusters contained cells representing all developmental stages. Thus, in studies of B and T cells, to derive biologically meaningful results, it is imperative to remove the gene sequences that encode B- and T-cell receptors.CC BY-NC 4.0Corresponding author: Inga-Lill Mårtensson, Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Tel.:+46(0)703640068; E-mail: [email protected] work was supported by the Swedish Research Council, grants 2018-03128 and 2021-01150 (ILM) and 2016-01576 (IG); the Swedish Cancer Foundation, grant 19 0464 (ILM); the Swedish Childhood Cancer Fund, grants PR2018-0170 and PR2020-0147 (ILM), and TJ2019-0098 (AC); Assar Gabrielsson’s Foundation, FB21-104 (AC); Patient Association for Rheumatic Diseases, R-94129 (ILM) and R-940945 (IG); ALF (agreement between the Government of Sweden and the County Councils), ALFGBG-719631 (IG); Adlerbertska stiftelsen (TS); and the IngaBritt och Arne Lundbergs Foundation (ILM, IG)</p

A close-up on the expanding landscape of CD21-/low B cells in humans

Memory B cells (MBCs) are an essential part of our immunological memory. They respond fast upon re-encountering pathogens and can differentiate into plasma cells that secrete protective antibodies. The focus of this review is on MBCs that lack, or express low levels of, CD21, hereafter referred to as CD21-/low. These cells are expanded in peripheral blood with age and during chronic inflammatory conditions such as viral infections, malaria, common variable immunodeficiency, and autoimmune diseases. CD21-/low MBCs have gained significant attention; they produce disease-specific antibodies/autoantibodies and associate with key disease manifestations in some conditions. These cells can be divided into subsets based on classical B-cell and other markers, e.g. CD11c, FcRL4, and Tbet which, over the years, have become hallmarks to identify these cells. This has resulted in different names including age-associated, autoimmune-associated, atypical, tissue-like, tissue-resident, tissue-restricted, exhausted, or simply CD21-/low B cells. It is however unclear whether the expanded 'CD21-/low' cells in one condition are equivalent to those in another, whether they express an identical gene signature and whether they have a similar function. Here, we will discuss these issues with the goal to understand whether the CD21-/low B cells are comparable in different conditions.CC BY 4.0Correspondence: Inga-Lill Mårtensson, Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg 40530, Sweden. Email: [email protected] 19 July 2022; Revised 5 October 2022; Accepted for publication 14 November 2022Funding has been received from: the Swedish Research Council 2018-03128 and 2021-01150 (ILM), 2016-00288 (IG), the Patient Association for Rheumatic Diseases R-94129 (ILM), R-940945 (IG), the Swedish Cancer Foundation 19 0464 (ILM), the Childhood Cancer Foundation PR2018-0170 (ILM), and the ALF agreement between the Swedish government and the county councils ALFGBG-965435 (IG), ALFGBG-277797 (ILM).</p