The Coronavirus Pandemic and Lessons Learned in Preschools in Norway, Sweden and the United States: OMEP Policy Forum.

The novel coronavirus, also known as COVID-19, has moved rapidly across the world in 2020. This article reports on the recent consequences of the pandemic for early childhood education in Sweden, Norway, and the United States. The authors illustrate the effects of the pandemic on preschools in their countries, against a backdrop of frequent changes in infection and mortality rates, epidemiological understandings, government strategies, and mitigation strategies regarding preschool closures. Teachers report their experiences and actions in specific early childhood education settings, across the three national contexts. These experiential snapshots identify program priorities, parents' and children's reactions, and the commitment and concerns of teachers. The conversations reveal culturally situated similarities of early childhood educational practices but also differences across contexts. Teachers report on the challenges of their experiences but also benefits for their practice and how they engage with children and their families. Ideas about future preparedness for such pandemics are also discussed.

Le nouveau coronavirus, également connu sous le nom de COVID-19, s'est déplacé rapidement à travers le monde en 2020. Cet article rend compte des conséquences récentes de la pandémie pour l'éducation de la petite enfance en Suède, en Norvège et aux États-Unis. Les auteurs analysent les effets de la pandémie sur les établissements préscolaires dans leurs pays, dans un contexte de changements fréquents des taux d'infection et de mortalité, de compréhension épidémiologique, de stratégies gouvernementales et de stratégies d'atténuation au regard des fermetures d'établissements préscolaires. Les enseignants font part de leurs expériences et de leurs actions dans des milieux spécifiques d'éducation de la petite enfance, dans les trois contextes nationaux. Ces instantanés expérientiels identifient les priorités du programme, les réactions des parents et des enfants, ainsi que l'engagement et les préoccupations des enseignants. Les conversations révèlent des similitudes culturelles des pratiques éducatives en éducation de la petite enfance, mais aussi des différences selon les contextes. Les enseignants rendent compte de défis de leurs expériences, mais aussi de bénéfices pour leur pratique et de la façon dont ils interagissent avec les enfants et leurs familles. Des idées sur la préparation future à de telles pandémies sont également discutées.

El nuevo virus corona, conocido también como COVID-19, se ha movido rápidamente por todo el mundo en el 2020. Este artículo informa sobre las consecuencias de la pandemia sobre la educación temprana en Suecia, Noruega, y los Estados Unidos. Los autores muestran los efectos de la pandemia en los establecimientos preescolares en sus países en un contexto de cambios frecuentes de las tasas de infección y mortalidad, entendimientos epidemiológicos, estrategias gubernamentales, y estrategias de mitigación relacionadas con el cierre de los recintos preescolares. Los maestros reportan sus experiencias y acciones en ambientes específicos de la educación temprana, en los tres contextos nacionales. Estas impresiones instantáneas experimentales identifican las prioridades del programa, las reacciones de los padres y niños, y el compromiso y preocupaciones de los maestros. Las conversaciones revelan similitudes culturalmente situadas de las prácticas en la educación temprana, pero también revelan diferencias entre contextos. Los maestros reportan sobre los desafíos de sus experiencias, pero también sobre los beneficios de su práctica y cómo se relacionan con los niños y sus familias. También se discuten ideas sobre la preparación para futuras pandemias.

ZNF385B and VEGFA are strongly differentially expressed in serous ovarian carcinomas and correlate with survival.

BACKGROUND: The oncogenesis of ovarian cancer is poorly understood. The aim of this study was to identify mRNAs differentially expressed between moderately and poorly differentiated (MD/PD) serous ovarian carcinomas (SC), serous ovarian borderline tumours (SBOT) and superficial scrapings from normal ovaries (SNO), and to correlate these mRNAs with clinical parameters including survival. METHODS: Differences in mRNA expression between MD/PD SC, SBOT and SNO were analyzed by global gene expression profiling (n = 23), validated by RT-qPCR (n = 41) and correlated with clinical parameters. RESULTS: Thirty mRNAs differentially expressed between MD/PD SC, SBOT and SNO were selected from the global gene expression analyses, and 21 were verified (p<0.01) by RT-qPCR. Of these, 13 mRNAs were differentially expressed in MD/PD SC compared with SNO (p<0.01) and were correlated with clinical parameters. ZNF385B was downregulated (FC = -130.5, p = 1.2×10(-7)) and correlated with overall survival (p = 0.03). VEGFA was upregulated (FC = 6.1, p = 6.0×10(-6)) and correlated with progression-free survival (p = 0.037). Increased levels of TPX2 and FOXM1 mRNAs (FC = 28.5, p = 2.7×10(-10) and FC = 46.2, p = 5.6×10(-4), respectively) correlated with normalization of CA125 (p = 0.03 and p = 0.044, respectively). Furthermore, we present a molecular pathway for MD/PD SC, including VEGFA, FOXM1, TPX2, BIRC5 and TOP2A, all significantly upregulated and directly interacting with TP53. CONCLUSIONS: We have identified 21 mRNAs differentially expressed (p<0.01) between MD/PD SC, SBOT and SNO. Thirteen were differentially expressed in MD/PD SC, including ZNF385B and VEGFA correlating with survival, and FOXM1 and TPX2 with normalization of CA125. We also present a molecular pathway for MD/PD SC.

Mammalian target of rapamycin is a biomarker of poor survival in metastatic serous ovarian carcinoma.

The AKT signaling pathway is crucial for cancer cell survival. The objective of this study was to analyze the expression and clinical role of this pathway in serous ovarian carcinoma. Phospho-AKT and phospho-mammalian target of rapamycin protein expression was studied in 269 ovarian carcinomas (159 effusions, 38 primary carcinomas, 72 solid metastases) using immunohistochemistry. The association between AKT, mammalian target of rapamycin, and DJ-1 in effusions was quantitatively analyzed using flow cytometry. AKT phosphorylation status in effusions was further studied using Western blotting. Phospho-AKT and phospho-mammalian target of rapamycin were detected in the majority of tumors at all anatomical sites. Phospho-AKT expression in effusions was higher in grade 3 versus grades 1 and 2 tumors (P = .013). Flow cytometry analysis showed association between AKT, mammalian target of rapamycin, and DJ-1 expression (P < .001). Higher phospho-AKT Thr308/pan-AKT ratio by Western blotting was associated with more advanced International Federation of Gynecology and Obstetrics stage (P = .018) and a trend for poor response to chemotherapy at first disease recurrence (P = .051). Higher phospho-mammalian target of rapamycin protein expression in effusions by immunohistochemistry was associated with poor progression-free survival for patients with postchemotherapy effusions (P = .005). Phospho-mammalian target of rapamycin was an independent predictor of poor progression-free survival for patients with postchemotherapy effusions (P = .03). The association between activated AKT and mammalian target of rapamycin expression and clinicopathologic parameters of aggressive disease, including shorter patient survival, provides further evidence regarding the central role of this signaling pathway in ovarian carcinoma.

Assessment of endoglin and calprotectin as potential biomarkers in ovarian carcinoma and borderline tumors of the ovary.

OBJECTIVE: The objective of the study was to analyze circulating endoglin concentration in ovarian carcinoma and evaluate a prognostic role for calprotectin and endoglin in effusions in advanced-stage disease. STUDY DESIGN: Preoperative plasma concentration of endoglin from women with benign ovarian tumors (n = 71), borderline ovarian tumors (BOT, n = 39), and ovarian carcinomas (n = 89) was analyzed with an enzyme-linked immunosorbent assay, as were endoglin and calprotectin concentrations in effusions from 164 women with advanced-stage ovarian carcinoma. RESULTS: Median endoglin plasma concentration was higher in the BOT group as compared with both control and invasive carcinoma groups (4.9 vs 4.5 and 4.3 ng/mL, P = .04 and P = .02), whereas the difference between the control and invasive group was not statistically significant (4.5 vs 4.3 ng/mL, P = .08). Endoglin and calprotectin effusion concentrations did not correlate with survival. CONCLUSION: Circulating endoglin is not elevated in advanced ovarian carcinoma. This is in contrast to the situation in breast and gastric cancer.

Circulating calprotectin in ovarian carcinomas and borderline tumors of the ovary.

OBJECTIVE: Recent studies indicate that circulating calprotectin may serve as a biomarker in some cancers. We investigated whether this is the case for ovarian neoplasms. STUDY DESIGN: Calprotectin was analyzed with an enzyme-linked immunosorbent assay in EDTA-plasma collected prior to surgery from women with ovarian carcinomas (n = 89), borderline ovarian tumors (BOT, n = 39), and benign ovarian tumors (n = 71). Serum CA 125 was analyzed in the same study population. RESULTS: Median plasma calprotectin concentration was elevated in ovarian carcinoma, compared with controls, as well as compared with BOT (both P < .001). A positive correlation was found between CA 125 and calprotectin concentrations in ovarian carcinoma. Receiver operating characteristic curves demonstrated a larger area under the curve for CA 125 (0.85) as compared with calprotectin (0.70). CONCLUSION: Plasma calprotectin is elevated in invasive ovarian cancer, but when used as a tumor marker, it is inferior to CA 125.

Surgery of borderline tumors of the ovary: retrospective comparison of short-term outcome after laparoscopy or laparotomy.

BACKGROUND: Laparoscopic management of borderline ovarian tumors is controversial. OBJECTIVE: To retrospectively compare outcome after surgery by laparoscopy or laparotomy for borderline tumors. METHODS: Ovarian tumors from all women operated at Ullevål University Hospital during a five-year period were re-evaluated histologically. Patients with borderline FIGO (International Federation of Gynaecology and Obstetrics) stage I tumors were retrospectively compared regarding surgery outcome following laparoscopy or laparotomy. RESULTS: Histological re-evaluation revealed only 3 misclassifications in 608 patients. Borderline tumors represented 36% of epithelial ovarian malignancies. The 107 borderline stage I included 52 serous, 53 mucinous, and 2 endometrioid tumors. Thirty-eight patients were operated on primarily by laparoscopy and 69 by laparotomy (including 14 women starting with laparoscopy). In the laparoscopy group, more women were premenopausal (63% versus 35%, p=0.01) and median tumor diameter was smaller (8.6 versus 16.4 cm, p<0.001) as compared to the laparotomy group. When tumor diameter exceeded 10 cm, intraoperative tumor rupture was significantly more frequent during laparoscopy than during laparotomy (p=0.01). Less postoperative complications were seen after laparoscopic operations (p=0.034), but laparoscopic surgeries were less extensive, without hysterectomy, as compared to laparotomy. During the 14-78 months follow-up time, no relapse occurred in either group. After fertility-sparing surgery, there was no statistical significant difference regarding successful pregnancies between the two groups. CONCLUSIONS: Laparoscopic treatment of borderline ovarian tumors is feasible if tumor is of moderate size (diameter below 10 cm), gives fewer complications, and shorter hospital stay. Long-term follow-up of larger materials is needed to determine the ultimate recurrence risk as well as fertility rates.

The activated nerve growth factor receptor p-TrkA is selectively expressed in advanced-stage ovarian carcinoma.

The objective of this study was to compare the expression of the nerve growth factor (NGF) receptors TrkA and p75 in ovarian borderline tumors, International Federation of Gynecology and Obstetrics (FIGO) stage I carcinomas and advanced-stage (FIGO stage III-IV) carcinomas, and to assess a possible association between NGF receptor expression and mitogen-activated protein kinase (MAPK) activation in borderline tumors and FIGO stage I carcinomas. Sections from 119 borderline tumors, 57 FIGO stage I invasive ovarian carcinomas, and 56 advanced-stage carcinomas were evaluated for expression of activated phospho-TrkA (p-TrkA) and p75 using immunohistochemistry. MAPK activation was analyzed in stage I carcinomas and borderline tumors using phospho-specific antibodies against the extracellular-regulated kinase (p-ERK), the high osmolarity glycerol response kinase (p-p38), and the c-jun amino-terminal kinase (p-JNK). p-TrkA membrane expression was significantly more frequent in advanced-stage carcinomas compared with both borderline and stage I carcinomas (P < .001). p75 membrane expression was comparable in the 3 groups (P > .05). p-ERK and p-p38 expression was comparable in borderline and stage I carcinomas, whereas p-JNK was more frequently expressed in stage I ovarian carcinomas (P < .001). NGF receptor expression showed no association with MAPK activation in borderline and stage I carcinomas. In conclusion, expression of biologically active p-TrkA receptor at the cell membrane is up-regulated along tumor progression in ovarian carcinoma, whereas p75 expression remains unaltered. These data provide further evidence regarding the clinical role of p-TrkA in ovarian carcinoma. NGF receptors probably signal via MAPK-independent pathways in ovarian carcinoma.

The AP-2gamma transcription factor is upregulated in advanced-stage ovarian carcinoma.

OBJECTIVE: To analyze the expression of the AP-2gamma transcription factor in ovarian borderline tumors, early-stage ovarian carcinoma and advanced-stage ovarian carcinoma, and to evaluate its prognostic role in advanced-stage tumors. METHODS: Sections from 14 normal ovaries, 75 borderline tumors, 22 FIGO stage I invasive ovarian carcinomas, and 306 advanced-stage (FIGO stages II-IV) ovarian carcinomas (42 primary tumors, 62 solid metastases, 202 effusions) were evaluated for expression of the transcription factor AP-2gamma using immunohistochemistry. Sixty-three effusions and two cell lines (SKOV-3 and OVCAR-3) were additionally studied using immunoblotting. The prognostic role of AP-2gamma in advanced-stage carcinomas was analyzed. RESULTS: AP-2gamma was detected in the nucleus of tumor cells in 28/75 (37%) borderline tumors, 13/22 (59%) FIGO stage I carcinomas, and 255/306 (83%) advanced-stage carcinomas (P < 0.001, Chi-square test). Benign ovaries were uniformly negative. Expression was largely limited to carcinoma cells in effusions. Solid lesions and effusions from advanced-stage carcinomas showed comparable expression. Immunoblotting showed AP-2gamma expression in 59/61 effusions and both cell lines. AP-2gamma expression did not correlate with survival. CONCLUSIONS: AP-2gamma expression is upregulated in advanced-stage ovarian carcinoma compared to early-stage carcinomas, borderline tumors, and the ovarian surface epithelium, and AP-2gamma is specifically localized to cancer cells in effusions, suggesting a role in tumor progression. The lack of predictive value for this transcription factor in advanced-stage disease may be related to its frequent expression.

[Intractable postpartum haemorrhage treated with selective arterial embolization]. / Alvorlig post partum-blødning behandlet med selektiv arteriell embolisering.

BACKGROUND: Postpartum haemorrhage is a major contributor to maternal morbidity and mortality. MATERIAL AND METHODS: In this case report we present a patient with intractable postpartum haemorrhage, successfully treated with selective arterial embolisation of the uterine arteries. RESULTS AND INTERPRETATION: In most cases, primary postpartum haemorrhage can be managed with conservative treatment involving uterine massage, uterotonic drugs and uterine/vaginal packing. With persistent bleeding, vascular ligation or hysterectomy may be needed. Surgical treatment may be technically difficult and may fail to control haemorrhage. For these reasons, selective arterial embolisation of the uterine arteries represents an interesting alternative that allows preservation of future fertility.