University of Oslo
  • Oslo, Oslo, Norway
Recent publications
Zu den wenig beachteten Opfern der NS-Diktatur gehören tuberkulosekranke Menschen. Das liegt nicht zuletzt daran, dass Fälle von gezielter Patientenvernachlässigung, physischer Gewalt und schließlich Mord nach 1945 juristisch nicht belangt wurden, soweit es deutsche Opfer betraf. Patrick Bernhard fragt nach den Gründen dafür und zeigt auf der Basis neu erschlossener Quellen, dass dies mit dem Unwillen zusammenhing, Verbrechen zu ahnden, die nicht in Konzentrationslagern oder als genuin nationalsozialistisch begriffenen Institutionen begangen worden waren. So kann man das Vorgehen der beteiligten Juristen als erfolgreichen Versuch begreifen, den Nationalsozialismus und die in seinem Namen begangenen Verbrechen einzuhegen und sie auf bestimmte Tatkomplexe, Täter und Tatorte zu begrenzen. Der Aufsatz verweist damit auch darauf, wie in der westdeutschen Gesellschaft „Normalität“ konstruiert wurde.
  • Sarina Thomas
    Sarina Thomas
  • Cristiana Tiago
    Cristiana Tiago
  • Børge Solli Andreassen
    Børge Solli Andreassen
  • [...]
  • Guy Ben-Yosef
    Guy Ben-Yosef
To facilitate diagnosis on cardiac ultrasound (US), clinical practice has established several standard views of the heart, which serve as reference points for diagnostic measurements and define viewports from which images are acquired. Automatic view recognition involves grouping those images into classes of standard views. Although deep learning techniques have been successful in achieving this, they still struggle with fully verifying the suitability of an image for specific measurements due to factors like the correct location, pose, and potential occlusions of cardiac structures. Our approach goes beyond view classification and incorporates a 3D mesh reconstruction of the heart that enables several more downstream tasks, like segmentation and pose estimation. In this work, we explore learning 3D heart meshes via graph convolutions, using similar techniques to learn 3D meshes in natural images, such as human pose estimation. As the availability of fully annotated 3D images is limited, we generate synthetic US images from 3D meshes by training an adversarial denoising diffusion model. Experiments were conducted on synthetic and clinical cases for view recognition and structure detection. The approach yielded good performance on synthetic images and, despite being exclusively trained on synthetic data, it already showed potential when applied to clinical images. With this proof-of-concept, we aim to demonstrate the benefits of graphs to improve cardiac view recognition that can ultimately lead to better efficiency in cardiac diagnosis.
  • Lisa Kausch
    Lisa Kausch
  • Sarina Thomas
    Sarina Thomas
  • Holger Kunze
    Holger Kunze
  • [...]
  • Klaus H. Maier-Hein
    Klaus H. Maier-Hein
Surgical treatment of complicated knee fractures is guided by real-time imaging using a mobile C-arm. Immediate and continuous control is achieved via 2D anatomy-specific standard views that correspond to a specific C-arm pose relative to the patient positioning, which is currently determined manually, following a trial-and-error approach at the cost of time and radiation dose. The characteristics of the standard views of the knee suggests that the shape information of individual bones could guide an automatic positioning procedure, reducing time and the amount of unnecessary radiation during C-arm positioning. To fully automate the C-arm positioning task during knee surgeries, we propose a complete framework that enables (1) automatic laterality and standard view classification and (2) automatic shape-based pose regression toward the desired standard view based on a single initial X-ray. A suitable shape representation is proposed to incorporate semantic information into the pose regression pipeline. The pipeline is designed to handle two distinct standard views with one architecture. Experiments were conducted to assess the performance of the proposed system on 3528 synthetic and 1386 real X-rays for the a.-p. and lateral standard. The view/laterality classificator resulted in an accuracy of 100%/98% on the simulated and 99%/98% on the real X-rays. The pose regression performance was \(d\theta _{a.-p}=5.8\pm 3.3^\circ ,\,d\theta _{lateral}=3.7\pm 2.0^\circ \) on the simulated data and \(d\theta _{a.-p}=7.4\pm 5.0^\circ ,\,d\theta _{lateral}=8.4\pm 5.4^\circ \) on the real data outperforming intensity-based pose regression.
  • Nikolay Nikolov
    Nikolay Nikolov
  • Arnor Solberg
    Arnor Solberg
  • Radu Prodan
    Radu Prodan
  • [...]
  • Dumitru Roman
    Dumitru Roman
The emerging concept of big data pipelines provides relevant solutions and is one of the main enablers of telemedicine. We present a data pipeline for remote patient monitoring and show a real-world example of how data pipelines help address the stringent requirements of telemedicine.
  • Asad Abbas
    Asad Abbas
  • Talia Gonzalez-Cacho
    Talia Gonzalez-Cacho
  • Danica Radovanović
    Danica Radovanović
  • [...]
  • Guillermina Benavides Rincón
    Guillermina Benavides Rincón
The aim of this book chapter is to empirically explore the mediating role of students’ social media engagement and their ability to think critically. To achieve the aim of the study, we designed a Google Form online survey with questions related to (1) the use of social media, (2) engagement, and (3) critical thinking by the deployment of digital literacy skills. We collected data using convenience sampling techniques. Sixty-seven undergraduate Architecture and Civil engineering students from Tecnologico de Monterrey, Puebla Campus of Mexico volunteered to participate in the study. After data collection, we applied a mediation test by using the “medmod” module of Jamovi software. Results from the data analysis support all proposed hypotheses and also affirm that engagement is partially mediated between the use of social media and the critical thinking skills of undergraduate Architecture and Civil engineering students. Therefore, this study confirms that the use of social media-based course activities is helpful for university students to engage with other peers by deploying digital literacy skills to analyze, share, and communicate relevant information and knowledge about specific topics within the relevant course structure.
  • Danica Radovanović
    Danica Radovanović
It is more than ever relevant to address the present digital transformation challenges in society to understand, regenerate, renew, and strive in the (digital)future. In the current digital landscape, the revolution and revelation are in the online sphere: online work, online socialization, online learning, e-commerce, e-government, and all that on the remote. In this landscape, digital literacy plays a crucial empowering and enabling role. This conceptual essay explores an ongoing dialectic of socio-technological participation in the online world and the gaps that hinder participation, and provides an overview of Digital Literacy and Inclusion: Stories, Platforms, Communities. Digital literacy and digital inclusion are explored through the theoretical and practical implications, digital literacy textures through the filter of education, and convergent practices that showcase the digital literacy initiatives applied through communities of practice around the globe. As we are witnessing the emerging technologies such as artificial intelligence, automation, and augmented reality, their growth raises important questions about our current legal systems, policies, and advocacy strategies and how they can mitigate the human rights risks that may be affected by these technologies. Technology needs to help us make better decisions and improve our livelihoods, especially in the other half of the world that is not connected to the internet. The book addresses important nuances and raises salient issues.
An interhemispheric asymmetry of thermospheric Oxygen (O) to Nitrogen (N 2 ) column density ratio (∑O/N 2 ) variations was observed by the Global‐scale Observations of the Limb and Disk (GOLD) during the 3‐5 November 2021 geomagnetic storm. ∑O/N 2 depletion is more equatorward in the local morning than in the local afternoon in the northern hemisphere (NH), while more equatorward in the local afternoon than the local morning in the southern hemisphere (SH). The Thermosphere Ionosphere Electrodynamics General Circulation Model (TIE‐GCM) simulations reproduced the observed ∑O/N 2 asymmetry. The impacts of interplanetary magnetic field (IMF) east‐west component (B y ) on the interhemispheric asymmetry of ∑O/N 2 depletion was investigated. Comparisons of simulation results with and without real B y show that the dominant positive IMF B y results in the Joule heating maximum occurring in the local afternoon of NH and local morning in the SH during the storm initial phase, which generates the corresponding ∑O/N 2 changes. Additionally, the IMF B y during this storm are more crucial in the SH than in the NH. Without B y , equatorward penetration of the ∑O/N 2 depletion in GOLD FOV are almost same in the SH. However, in the NH, there is still more equatorward depletion in the local morning than the local afternoon without B y . This article is protected by copyright. All rights reserved.
Advances in micro-scale imaging techniques, such as X-ray microtomography, have provided new insights into a broad range of porous media processes. However, direct imaging of flow and transport processes remains challenging due to spatial and temporal resolution limitations. Here, we investigate the use of dynamic three-dimensional neutron imaging to image flow and transport in Bentheim sandstone core samples before and after in-situ calcium carbonate precipitation. First, we demonstrate the applicability of neutron imaging to quantify the solute dispersion along the interface between heavy water and a cadmium aqueous solution. Then, we monitor the flow of heavy water within two Bentheim sandstone core samples before and after a step of in-situ mineral precipitation. The precipitation of calcium carbonate is induced by reactive mixing of two solutions containing CaCl2 and Na2CO3, either by injecting these two fluids one after each other (sequential experiment) or by injecting them in parallel (co-flow experiment). We use the contrast in neutron attenuation from time-lapse tomograms to derive three-dimensional fluid velocity field by using an inversion technique based on the advection-dispersion equation. Results show mineral precipitation induces a wider distribution of local flow velocities and leads to alterations in the main flow pathways. The flow distribution appears to be independent of the initial distribution in the sequential experiment, while in the co-flow experiment, we observed that higher initial local fluid velocities tended to increase slightly following precipitation. These findings suggest that neutron imaging is a promising technique to investigate dynamics processes in porous media.
  • Bárbara de la Peña Avalos
    Bárbara de la Peña Avalos
  • Romain Tropée
    Romain Tropée
  • Pascal H. G. Duijf
    Pascal H. G. Duijf
  • Eloïse Dray
    Eloïse Dray
The Eyes Absent (EYA) family of proteins is an atypical group of four dual-functioning protein phosphatases (PP), which have been linked to many vital cellular processes and organogenesis pathways. The four family members of this PP family possess transcriptional activation and phosphatase functions, with serine/threonine and tyrosine phosphatase domains. EYA4 has been associated with several human cancers, with tumor-suppressing and tumor-promoting roles. However, EYA4 is the least well-characterized member of this unique family of PP, with its biological functions and molecular mechanisms in cancer progression, particularly in breast cancer, still largely unknown. In the present study, we found that the over-expression of EYA4 in breast tissue leads to an aggressive and invasive breast cancer phenotype, while the inhibition of EYA4 reduced tumorigenic properties of breast cancer cells in vitro and in vivo. Cellular changes downstream of EYA4, including cell proliferation and migration, may explain the increased metastatic power of breast cancer cells over-expressing EYA4. Mechanistically, EYA4 prevents genome instability by inhibiting the accumulation of replication-associated DNA damage. Its depletion results in polyploidy as a consequence of endoreplication, a phenomenon that can occur in response to stress. The absence of EYA4 leads to spontaneous replication stress characterized by the activation of the ATR pathway, sensitivity to hydroxyurea, and accumulation of endogenous DNA damage as indicated by increased γH2AX levels. In addition, we show that EYA4, specifically its serine/threonine phosphatase domain, plays an important and so far, unexpected role in replication fork progression. This phosphatase activity is essential for breast cancer progression and metastasis. Taken together, our data indicate that EYA4 is a novel potential breast cancer oncogene that supports primary tumor growth and metastasis. Developing therapeutics aimed at the serine/threonine phosphatase activity of EYA4 represents a robust strategy for killing breast cancer cells, to limit metastasis and overcome chemotherapy resistance caused by endoreplication and genomic rearrangements.
  • Juliane E. Kämmer
    Juliane E. Kämmer
  • Karin Ernst
    Karin Ernst
  • Kim Grab
    Kim Grab
  • [...]
  • Wolf E. Hautz
    Wolf E. Hautz
When making complex decisions, such as a medical diagnosis, decision makers typically gather, analyze, and synthesize (integrate) information. In a previous study, we showed that delegating such complex decisions to collaborating pairs increases decision quality substantially compared to that of individuals, without requiring different information gathering. Given the higher costs associated with teamwork, however, it is of great practical interest to understand when in the process the performance benefits of teams may arise, so that particular subtasks can be delegated to teams when most appropriate. We thus conducted an experimental study in which fourth‐year medical students ( n = 109) worked either in pairs or alone on two separate subtasks of the diagnostic process: (1) analyzing diagnostic test results (e.g., X‐rays) and (2) integrating previously interpreted test results into diagnoses. Linear mixed‐effects models revealed a small benefit of collaborating pairs over individuals in both subtasks. We conclude that collaborating with a peer may pay off both when analyzing information and when integrating it into a diagnosis as it provides the opportunity to correct each other's errors and to make use of a greater knowledge base. These findings encourage the strategic use of collaboration with a colleague when making complex decisions. Further research into the underlying processes is needed.
  • Solveig K. Smedsland
    Solveig K. Smedsland
  • Ragnhild S. Falk
    Ragnhild S. Falk
  • Kristin V. Reinertsen
    Kristin V. Reinertsen
  • [...]
  • Kathrine F. Vandraas
    Kathrine F. Vandraas
Background Long‐term breast cancer survivors (BCSs) may experience several late effects (LEs) simultaneously. This study aimed to identify subgroups of 8‐year BCSs with higher burden of LEs who could benefit from closer survivorship care, explore variables associated with higher symptom burden, and describe how symptom burden may affect general functioning. Methods All Norwegian women aged 20 to 65 years when diagnosed with stage I‐III breast cancer in 2011 and 2012 were invited ( n = 2803). The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire/BR23, the Fatigue Questionnaire, Assessment of Survivor Concerns, and Scale for Chemotherapy Induced Long‐term Neurotoxicity were used to assess 10 common LEs and general functioning. Using latent class analysis, subgroups of BCSs with similar burden of LEs were identified. Multinominal regression analysis were performed to examine variables associated with higher symptom burden. Results The final sample consisted of 1353 BCSs; 46% had low, 37% medium, and 17% high symptom burden. Younger age, short education, axillary dissection, higher systemic treatment burden, higher body mass index, and physical inactivity were associated with higher symptom burden. General functioning scores were lower, and the proportion on disability pension were higher among BCSs in the two most burdened subgroups compared with those in the low burden subgroup. Conclusion More than half of long‐term BCSs suffered from medium or high symptom burden and experienced impaired general functioning compared with BCS with low symptom burden. Younger age and systemic treatment were important risk factors for higher symptom burden. BCSs at risk of higher symptom burdens should be identified and offered closer and extended survivorship care.
Winter is a key driver of ecological processes in freshwater, marine and terrestrial ecosystems, particularly in higher latitudes. Species have evolved various adaptive strategies to cope with food limitations and the cold and dark wintertime. However, human‐induced climate change and other anthropogenic stressors are impacting organisms in winter in unpredictable ways. In this paper, we show that global change experiments investigating multiple stressors have predominantly been conducted during summer months. However, effects of anthropogenic stressors sometimes differ between winter and other seasons, necessitating comprehensive investigations. Here, we outline a framework for understanding the different effects of anthropogenic stressors in winter compared to other seasons and discuss the primary mechanisms that will alter ecological responses of organisms (microbes, animals and plants). For instance, while the magnitude of some anthropogenic stressors can be greater in winter than in other seasons (e.g. some pollutants), others may alleviate natural winter stress (e.g. warmer temperatures). These changes can have immediate, delayed or carry‐over effects on organisms during winter or later seasons. Interactions between stressors may also vary with season. We call for a renewed research direction focusing on multiple stressor effects on winter ecology and evolution to fully understand, and predict, how ecosystems will fare under changing winters. We also argue the importance of incorporating the interactions of anthropogenic stressors with winter into ecological risk assessments, management and conservation efforts.
Background Greater Trochanteric Pain Syndrome (GTPS) is a common chronic musculoskeletal condition that may affect physical function, quality of life and sleep. The Victorian Institute of Sport Assessment-Gluteal questionnaire (VISA-G) has been developed as a Patient-Reported Outcome Measurement (PROM) to address pain, everyday activities, physical activities, and difficulty with weight bearing activities. The aim of the study was to test the reliability, validity and floor and ceiling effects of the Norwegian version of the VISA-G (VISA-G-Norwegian) in a population with GTPS in a specialist health care setting. Methods This psychometric evaluation of the VISA-G-Norwegian questionnaire were conducted with a prospective observational design. The VISA-G was translated into Norwegian following recommended guidelines. A subgroup repeated the VISA-G-Norwegian a week after the initial submission. For the reliability, the Intraclass Correlation Coefficient (ICC 2.1 ), Standard Error of the Measurement (SEM) and the Smallest Detectable Change (SDC 95% ) were calculated. Internal consistency was measured using a Cronbach´s alpha. Floor and ceiling effects were evaluated, and construct validity was assessed with three a priori hypotheses. Results 78 participants were included in the study of which 47 stable participants undertook the test-retest reliability arm of the study. The ICC 2.1 for the total score was 0.85 (95% CI 0.68, 0.92), SEM was 6.6 points and SDC 95% 18.4 points. Cronbach`s alpha was 0.77 (95% CI 0.69, 0.84). No floor or ceiling effects were found in the total score, but ceiling effect was found in three of the eight items. For construct validity, one of the three hypotheses were confirmed. VISA-G-Norwegian correlated to the modified Harris Hip Score (mHHS), Oswestry Disability Questionnaire (ODI) and Numeric Pain Rating Scale (NPRS), 0.64, -0.75 and − 0.63 respectively. Conclusion The VISA-G-Norwegian has acceptable reliability and validity, despite ceiling effect of individual items. The large SDC 95% should be considered when measuring change in similar cohorts with GTPS. For a potential future version, it would be recommended to consider response options for questions with ceiling effect and the comprehensibility of question eight. Trial registration Registered at the 28/02/2020 (NCT04289922).
In this essay, I examine Kant’s interpretation of Rousseau through the lens of Reflection 6593. This Reflection deserves scrutiny because it serves as a bridge between Kant’s well-known engagement with Rousseau in the mid-1760s and his later discussions of the vocation of the human being in the lectures on ethics and anthropology. Through a close reading of R 6593, I argue that the Reflection offers the earliest evidence of Kant’s philosophy of history and its integration into his treatment of the human vocation. This change, I propose, is instigated by Rousseau’s “Abstract” of St. Pierre’s Perpetual Peace . I conclude that R 6593 is a crucial indicator of Kant’s evolving views on Rousseau and shows his enduring importance for understanding the formation of Kant’s mature political thought.
To study the effects of one or two repeated subgingival instrumentations (RSI) in achieving the endpoints of therapy (EoT) in open pockets [residual probing pocket depth (PPD) ≥ 6 mm and PPD 4–5 mm with bleeding on probing (BoP)] after steps I-II of therapy. Twenty-five patients (3,552 total sites; 1,450 open pockets) with stage III-IV periodontitis received steps I-II of periodontal therapy and were re-evaluated after 4–6 weeks (T1). Residual pockets received RSI at T1 and at 3 months (T2). EoT (PPD < 4 or PPD < 6 BoP-) rate at T1, T2 and 6 months (T3) was computed. The number of needed surgeries and treatment costs were calculated. At T1, 67.6% of open pockets achieved EoT. At residual PPD ≥ 6 mm at T1 (n = 172), one and two RSI resulted in 33.1% and 45.9% of EoT at T2 and T3, respectively. At residual PPD 4–5 mm with BoP at T1 (n = 298), one and two RSI resulted in 66.8% and 72.1% of EoT at T2 and T3, respectively. PPD at T1 predicted EoT after RSI in both cases, while tooth type only in residual PPD 4–5 mm BoP + . At T1, mean number of surgeries per patient and associated costs were significantly higher than after one/two RSI. RSI may achieve EoT in residual PPD 4–5 mm BoP + and PPD ≥ 6 mm in a considerable number of cases. These findings may support the administration of one/two cycles of RSI prior to surgical approach. identification number: NCT04826926.
Background In sub-Saharan Africa, less than 1% of treatment-eligible chronic hepatitis B (CHB) patients receive antiviral therapy. Experiences from local CHB programs are needed to inform treatment guidelines and policies on the continent. Here, we present 5-year results from one of the first large-scale CHB treatment programs in sub- Saharan Africa. Methods Adults with CHB were enrolled in a pilot treatment program in Addis Ababa, Ethiopia, in 2015. Liver enzymes, viral markers, and transient elastography were assessed at baseline and thereafter at 6-month intervals. Tenofovir disoproxil fumarate was initiated based on the European Association for the Study of the Liver (EASL) crite- ria, with some modifications. Survival analysis was performed using the Kaplan–Meier method. Results In total, 1303 patients were included in the program, of whom 291 (22.3%) started antiviral therapy within the initial 5 years of follow-up. Among patients on treatment, estimated 5-year hepatocellular carcinoma- free survival was 99.0% in patients without cirrhosis at baseline, compared to 88.8% in patients with compensated cirrhosis, and 54.2% in patients with decompensated cirrhosis (p < 0.001). The risk of death was significantly higher in patients with decompensated cirrhosis at baseline (adjusted hazard ratio 44.6, 95% confidence interval 6.1–328.1) and in patients older than 40 years (adjusted hazard ratio 3.7, 95% confidence interval 1.6–8.5). Liver stiffness declined significantly after treatment initiation; the median change from baseline after 1, 3, and 5 years of treatment was − 4.0 kPa, − 5.2 kPa, and − 5.6 kPa, respectively. Conclusions This pilot program demonstrates the long-term benefits of CHB therapy in a resource-limited setting. The high mortality in patients with cirrhosis underscores the need for earlier detection of CHB and timely initiation of antiviral treatment in sub-Saharan Africa.
Background The European-funded Health Effects of Cardiac Fluoroscopy and Modern Radiotherapy in Pediatrics (HARMONIC) project is a multicenter cohort study assessing the long-term effects of ionizing radiation in patients with congenital heart disease. Knowledge is lacking regarding the use of ionizing radiation from sources other than cardiac catheterization in this cohort. Objective This study aims to assess imaging frequency and radiation dose (excluding cardiac catheterization) to patients from a single center participating in the Norwegian HARMONIC project. Materials and methods Between 2000 and 2020, we recruited 3,609 patients treated for congenital heart disease (age < 18 years), with 33,768 examinations categorized by modality and body region. Data were retrieved from the radiology information system. Effective doses were estimated using International Commission on Radiological Protection Publication 60 conversion factors, and the analysis was stratified into six age categories: newborn; 1 year, 5 years, 10 years, 15 years, and late adolescence. Results The examination distribution was as follows: 91.0% conventional radiography, 4.0% computed tomography (CT), 3.6% diagnostic fluoroscopy, 1.2% nuclear medicine, and 0.3% noncardiac intervention. In the newborn to 15 years age categories, 4–12% had ≥ ten conventional radiography studies, 1–8% underwent CT, and 0.3–2.5% received nuclear medicine examinations. The median effective dose ranged from 0.008–0.02 mSv and from 0.76–3.47 mSv for thoracic conventional radiography and thoracic CT, respectively. The total effective dose burden from thoracic conventional radiography ranged between 28–65% of the dose burden from thoracic CT in various age categories (40% for all ages combined). The median effective dose for nuclear medicine lung perfusion was 0.6–0.86 mSv and for gastrointestinal fluoroscopy 0.17–0.27 mSv. Because of their low frequency, these procedures contributed less to the total effective dose than thoracic radiography. Conclusion This study shows that CT made the largest contribution to the radiation dose from imaging (excluding cardiac intervention). However, although the dose per conventional radiograph was low, the large number of examinations resulted in a substantial total effective dose. Therefore, it is important to consider the frequency of conventional radiography while calculating cumulative dose for individuals. The findings of this study will help the HARMONIC project to improve risk assessment by minimizing the uncertainty associated with cumulative dose calculations. Graphical Abstract
Background Oxidation Resistance 1 (OXR1) gene is a highly conserved gene of the TLDc domain-containing family. OXR1 is involved in fundamental biological and cellular processes, including DNA damage response, antioxidant pathways, cell cycle, neuronal protection, and arginine methylation. In 2019, five patients from three families carrying four biallelic loss-of-function variants in OXR1 were reported to be associated with cerebellar atrophy. However, the impact of OXR1 on cellular functions and molecular mechanisms in the human brain is largely unknown. Notably, no human disease models are available to explore the pathological impact of OXR1 deficiency. Results We report a novel loss-of-function mutation in the TLDc domain of the human OXR1 gene, resulting in early-onset epilepsy, developmental delay, cognitive disabilities, and cerebellar atrophy. Patient lymphoblasts show impaired cell survival, proliferation, and hypersensitivity to oxidative stress. These phenotypes are rescued by TLDc domain replacement. We generate patient-derived induced pluripotent stem cells (iPSCs) revealing impaired neural differentiation along with dysregulation of genes essential for neurodevelopment. We identify that OXR1 influences histone arginine methylation by activating protein arginine methyltransferases (PRMTs), suggesting OXR1-dependent mechanisms regulating gene expression during neurodevelopment. We model the function of OXR1 in early human brain development using patient-derived brain organoids revealing that OXR1 contributes to the spatial–temporal regulation of histone arginine methylation in specific brain regions. Conclusions This study provides new insights into pathological features and molecular underpinnings associated with OXR1 deficiency in patients.
Importance Individuals with a mental disorder experience substantial health disparity and are less likely to participate in cervical screening and human papillomavirus vaccination. Additionally, this population may benefit less from tertiary cancer prevention. Objective To compare clinical characteristics and survival patterns between patients with cervical cancer with and without a preexisting diagnosis of a mental disorder at the time of cervical cancer diagnosis. Design, Setting, and Participants This cohort study obtained data from Swedish population-based (Swedish Cancer Register, Swedish Cause of Death Register, Swedish Total Population Register, Swedish Patient Register, and Swedish Longitudinal Integration Database for Health Insurance and Labor Market Studies) and quality registries (Swedish Quality Register of Gynecologic Cancer and Swedish National Cervical Screening Register) on patients with cervical cancer. Patients who were included in the analysis were identified using the Swedish Cancer Register and were diagnosed with cervical cancer between 1978 and 2018. The Swedish Patient Register was used to identify patients with mental disorders using codes from the International Classification of Diseases, Eighth Revision and Ninth Revision and the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. Because data on clinical characteristics at the time of cancer diagnosis were available for only for part of the study population, 2 patient groups were created: those with cervical cancer diagnosed from 2002 to 2016 and all patients diagnosed with cervical cancer (1978-2018). Data analyses were carried out between March and September 2022. Exposure Clinical diagnoses of a mental disorder, including substance abuse, psychotic disorders, depression, anxiety, stress-related disorders, attention-deficit/hyperactivity disorder, autism, and intellectual disability, prior to cervical cancer. Main Outcomes and Measures Death due to any cause or due to cervical cancer as ascertained from the Swedish Cause of Death Register. Results The sample included 20 177 females (mean [SD] age, 53.4 [17.7] years) diagnosed with cervical cancer from 1978 to 2018. In a subgroup of 6725 females (mean [SD] age, 52.2 [18.0] years) with cervical cancer diagnosed from 2002 to 2016, 893 (13.3%) had a preexisting diagnosis of a mental disorder. Compared with patients with no preexisting mental disorder diagnosis, those with a preexisting mental disorder had a higher risk of death due to any cause (hazard ratio [HR], 1.32; 95% CI, 1.17-1.48) and due to cervical cancer (HR, 1.23; 95% CI, 1.07-1.42). These risks were lower after adjustment for cancer characteristics at the time of cancer diagnosis (death due to any cause: HR, 1.19 [95% CI, 1.06-1.34] and death due to cervical cancer: HR, 1.12 [95% CI, 0.97-1.30]). Risk of death was higher for patients with substance abuse, psychotic disorders, or mental disorders requiring inpatient care. Among patients with cervical cancer diagnosed from 1978 to 2018, the estimated 5-year survival improved continuously during the study period regardless of preexisting diagnosis of a mental disorder status. For example, in 2018, the estimated 5-year overall survival proportion was 0.66 (95% CI, 0.60-0.71) and 0.74 (95% CI, 0.72-0.76) for patients with and without a preexisting diagnosis of a mental disorder, respectively. Conclusions and Relevance Findings of this cohort study suggest that patients with cervical cancer and a preexisting diagnosis of a mental disorder have worse overall and cervical cancer–specific survival than patients without a preexisting mental disorder diagnosis, which may be partly attributable to cancer and sociodemographic characteristics at diagnosis. Hence, individuals with mental disorders deserve special attention in the tertiary prevention of cervical cancer.
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Harald Osmundsen
  • Department of Oral Biology
PB 1048 Blindern, NO-0316, Oslo, Oslo, Norway