Southeast Norway Research Articles

First Report of Fusarium oxysporum f. sp. lactucae Race 1 Causing Fusarium Wilt of Lettuce in Norway.

Lettuce (Lactuca sativa L.) is produced in Norway both in field and greenhouses. In Norway, greenhouse lettuce is one of the most important vegetables grown year-round. In winter 2018, wilting symptoms were observed on soil-grown lettuce of the cultivar Frillice in a greenhouse in south east Norway (Buskerud county). Affected plants showed stunted growth, wilting of outer leaves, and brownish discoloration of vascular tissues of taproots and crowns. According to the producer, the disease led to an estimated 10% of yield losses. Fungal isolates were obtained from crowns and roots of diseased plants collected from the greenhouse in 2018 and 2019. Two single spore isolates, 231274 from 2018 and 231725 from 2019, were used in further studies. The isolates were incubated on synthetic nutrient-poor agar (SNA) at 18-20 ⁰C, and a 12 hours dark, 12 hours UV light cycle. Isolate 231274 produced abundant macro- and microconidia characteristics of Fusarium oxysporum while macroconidia were never observed in isolate 231725. On potato dextrose agar (PDA), colonies of isolate 231274 were purple in color and colonies of isolate 231725 were pinkish with abundant aerial mycelium. For PCR-assay, DNA from mycelia was extracted using Easy-DNA kit (Invitrogen). A portion of the translation elongation factor 1-α (EF1-α) gene was amplified using primers F-728F (Carbone and Kohn. 1999) and EF2 (O'Donnell et al. 1998) as described by Aas et al. 2018. Blast analysis of both sequences (accession no. MW316853 for 231274 and MW316854 for 231275) obtained a 99% homology with the sequence of Fusarium oxysporum f.sp. lactucae (FOL) race 1 strain S1 (accession no. DQ837657)(Mbofung et al. 2007). Both isolates were identified as race 1 by using specific primers Hani3' and Hanilatt3rev (Pasquali et al. 2007) as described by Cabral et al. 2014. To complete Koch's postulate, lettuce plants of the cultivar Frillice were used. Race identity was confirmed using the differential lettuce cultivars Costa Rica No.4 (resistant to FOL race 1), Banchu Red Fire (resistant to FOL races 2 and 4) and Romana Romabella (resistant to FOL races 1 and 2) (Gilardi et al. 2017) provided by the breeding company Rijk Zwaan (De Lier, The Netherlands). For inoculation, roots of six 2-weeks old seedlings per cultivar were dipped in a spore suspension (1 x 106 CFU/ml) for 1 min, while controls were dipped in distilled water. Seedlings were planted in 250 ml pots containing fertilized potting substrate, and were placed in a greenhouse with temperature ranging from 15 to 35 ⁰C and an average of 23 ⁰C. After 10 days reduced growth was observed in cultivars Frillice and Banchu Red Fire for both fungal isolates. After 25 days wilting was observed in both cultivars. Affected plants presented discoloration of vascular tissue. No difference in growth was observed between cultivars Romana Romabella and Costa Rica No. 4 and their respective controls. FOL was re-isolated from all inoculated cultivars but not from controls. The colony patterns of the recovered isolates were the same than those of the isolates used for inoculation. These results confirm that the isolate belongs to race 1. Greenhouse lettuce in Norway is mainly produced in hydroponics. FOL is here reported to cause damages in soil- grown lettuce. Nevertheless FOL in hydroponic systems has been reported in Japan (Fujinaga et al. 2003) and Thailand (Thongkamngam and Jaenaksorn 2017). Thus, the possibility of infections in hydroponics remain a big concern for lettuce production in Norway.

A nature-based solution to a landfill-leachate contamination of a confined aquifer

Remediation of groundwater from landfill contamination presents a serious challenge due to the complex mixture of contaminants discharged from landfills. Here, we show the significance of a nature-based solution to a landfill-contaminated aquifer in southeast Norway. Groundwater physicochemical parameters monitored for twenty-eight years were used as a proxy to infer natural remediation. Results show that concentrations of the major chemical variables decreased with time and distance until they tailed off. An exception to this was sulphate, which showed an increase, but apparently, exhibits a stationary phase. The water types were found to be most similar between samples from active landfill and post-closure stages, while samples from the stabilised stage showed a different water type. All the chemical parameters of samples from the stabilised stage were found to be within the Norwegian drinking water standards, except iron and manganese, which were only marginally above the limits, an indication of a possible recovery of this aquifer. The findings highlight the significance of natural attenuation processes in remediating contaminated aquifers and have significant consequences for future contamination management, where natural remediation can be viewed as an alternative worth exploring. This is promising in the wake of calls for sustainable remediation management strategies.

Validity of Case-Control Studies to Estimate Benefits from Cancer Screening

Background: Observational studies are increasingly used to estimate the effectiveness of cancer screening. However, the validity of such studies remains uncertain. Methods: 98,678 individuals were included in the Norwegian Colorectal Cancer Prevention trial, a randomized sigmoidoscopy screening trial. We used the trial data and designed case-control studies nested among individuals randomized to sigmoidoscopy and compared the results with those from intention-to-treat and per-protocol analyses to test the validity of the case-control design to estimate screening effect on colorectal cancer incidence and mortality, and all-cause mortality. We analyzed the case-control studies with the following methodologies: The logistic regression method, where we adjusted for self-selection in multivariable regression models including age, sex, comorbidity, socioeconomics and ethnicity; and the self-selection method where we adjusted for self-selection by different unscreened groups: regional - and national reference population. The trial is registered with ClinicalTrials.gov, NCT00119912. Findings: In intention-to-treat analysis of the randomized trial, sigmoidoscopy screening reduced colorectal cancer mortality by 19% (relative risk (RR) 0.81; 95% CI 0.67-0.99). When the same data were analyzed with a case-control design, the reductions varied between 44% (RR 0.56; 95% CI 0.33-0.97) and 67% (odds ratio (OR) 0.33; 95% CI 0.22-0.51) depending on the method used. While the intention-to-treat analysis showed no screening benefit on all-cause mortality (RR 1.00; 95% CI 0.97-1.03), the case-control studies suggested a benefit between 22% (RR 0.78; 95% CI 0.71-0.85) and 57% (OR 0.42; 95% CI 0.39-0.45) depending on the method used. Interpretation: Observational studies may overestimate the benefits of cancer screening and should therefore not guide screening policies. Clinical Trials: ClinicalTrials.gov, NCT00119912 Funding: The study received intramural funding from the University of Oslo and Oslo University Hospital. No external funding was provided. Declaration of Interest: None to declare. Ethical Approval: The NORCCAP trial was approved by the Ethics Committee of South-East Norway (project ID S-98052) and the Norwegian Data Protection Authority (Project ID 98/1408). The current study was approved by the NORCCAP steering committee.

No significant differences in absenteeism or academic achievements in a Norwegian multiple sclerosis case control study

BackgroundThe duration and features of the multiple sclerosis (MS) prodrome are not well defined. We aimed to ascertain whether people with a future MS diagnosis have more days of absence and perform worse in upper secondary school than age, gender and county-matched controls. MethodsUsing registry data from the southeast of Norway, we identified people with MS born ≥1978. Statistics Norway provided information on grades and days of absence in cases and matched controls. We looked at absence in the three years of upper secondary school and grades in the compulsory subjects Norwegian, English, mathematics and physical education. ResultsWe identified 107 cases with disease onset one year or more after graduation and 626 controls. There were no significant differences in absence or grades achieved in the population as a whole or in those with disease onset within four years of diagnosis, and no association between time to disease onset and days of absence or grades. ConclusionThere was no difference in days of absence or grades achieved in upper secondary school in the four years leading up to disease onset in cases compared to controls. A potential prodrome may not affect cognition enough to impact school achievements.

Restoration of Abundance and Dynamics of Coastal Fish and Lobster Within Northern Marine Protected Areas Across Two Decades

This article reviews a suite of studies conducted in a network of coastal Marine Protected Areas (MPAs) in Skagerrak, Southeast Norway. In 2006, Norway’s first lobster reserves were implemented, with the aim of protecting European lobster (Homarus gammarus) through a ban on fixed gear. A before–after control-impact paired series (BACIPS) monitoring program was initiated to evaluate effects of protection on depleted lobster populations. Experimental trapping and capture-recapture techniques were combined to track demography of populations, also including movement of individuals within and beyond MPAs and adjacent control areas. Further, population genetics and parentage studies were applied, allowing for estimation of gene flow, and novel work on sexual selection in lobsters. Additional studies have evaluated MPA effects on coastal cod (Gadus morhua), and on commercially harvested labrids (Ctenolabrus rupestrisandSymphodus melops) and anadromous brown trout (Salmo trutta). Together, these studies reported effects of protection pertaining to increased population density, survival, body size and phenotypic diversity, changes in emigration and interaction with surrounding fisheries, and alteration of selection pressure on morphological- and behavioral traits. Designation of MPAs in close collaboration with fishers and managers, long-term monitoring, inclusion of citizen science and evolving research protocols—also including fisheries data—have revealed novel effects of protection and harvesting on marine populations, thus providing substantial contributions to conservation science. Moreover, knowledge of MPA effects on coastal species has impacted harvest regulations showing the utility of MPAs as empirically documented management tools in Norway.

Early High Efficacy Treatment in Multiple Sclerosis Is the Best Predictor of Future Disease Activity Over 1 and 2 Years in a Norwegian Population-Based Registry.

Background: Moderate and high efficacy disease modifying therapies (DMTs) have a profound effect on disease activity. The current treatment guidelines only recommend high efficacy DMTs for patients with highly active MS. The objective was to examine the impact of initial treatment choice in achieving no evidence of disease activity (NEDA) at year 1 and 2.Methods: Using a real-world population-based registry with limited selection bias from the southeast of Norway, we determined how many patients achieved NEDA on moderate and high efficacy DMTs.Results: 68.0% of patients who started a high efficacy DMT as the first drug achieved NEDA at year 1 and 52.4% at year 2 as compared to 36.0 and 19.4% of patients who started a moderate efficacy DMT as a first drug. The odds ratio (OR) of achieving NEDA on high efficacy drugs compared to moderate efficacy drugs as a first drug at year 1 was 3.9 (95% CI 2.4–6.1, p < 0.001). The OR for high efficacy DMT as the second drug was 2.5 (95% CI 1.7–3.9, p < 0.001), and was not significant for the third drug. Patients with a medium or high risk of disease activity were significantly more likely to achieve NEDA on a high efficacy therapy as a first drug compared to moderate efficacy therapy as a first drug.Conclusions: Achieving NEDA at year 1 and 2 is significantly more likely in patients on high-efficacy disease modifying therapies than on moderate efficacy therapies, and the first choice of treatment is the most important. The immunomodulatory treatment guidelines should be updated to ensure early, high efficacy therapy for the majority of patients diagnosed with MS.

Subsoil compaction of a clay soil in South-East Norway and its amelioration after 5 years

1. Ad-hoc-AG Boden, 2005. Bodenkundliche Kartieranleitung (5 Auflage). Bundesanstalt für Geowissenschaften und Rohstoffe, Hannover. Google Scholar

Effects of Lake Productivity on Density and Size Structure of Pelagic Fish Estimated by Means of Echosounding in 17 Lakes in Southeast Norway.

Density estimation of pelagic fish was performed by means of single beam echosounding in 17 lakes within a period of 34 years, from 1985 to 2018. Surveys were performed repeatedly (two to fourteen times) in five lakes. The density estimates ranged from 34 to 4720 fish/ha and were significantly correlated with total phosphorus concentration. The high density in relatively phosphorus rich lakes (TP > 10 µg/L) was comprised of small fish (<20 cm) and was partly due to the higher number of pelagic fish species. The number of pelagic species varied from one, Arctic charr, in the most elevated and oligotrophic lakes, and whitefish dominated in less elevated oligotrophic lakes. In lowland lakes characterized as mesotrophic or tending to mesotrophy, smelt, vendace, and two to three cyprinids comprised the pelagic fish stock. These fish species predate zooplankton effectively, and species composition and body size of planktonic cladocerans was affected by fish density. Large species of Daphnia were lacking in lakes with high fish density, and body size of present species, D. galeata, D. cristata, and Bosmina spp. were negatively correlated with pelagic fish density.

Angling destination loyalty – A structural model approach of freshwater anglers in Trysil, Norway

ABSTRACT For many Nordic winter destinations attracting customers in the summer is a challenge. Angling is one of the summer activities that can help develop year-round tourism at a destination. Knowing which factors influence angling destination loyalty and how to manage these factors for different market segments is therefore important. We investigated how destination image, place attachment and satisfaction influenced anglers’ destination loyalty through a structural equation model. Data are from a survey of 379 tourist anglers at the popular winter destination Trysil in southeast Norway. Our results show that increasing loyalty to an angling destination managers and tourism development actors can foremost influence the image and satisfaction level of anglers. This could be done through information campaigns to anglers combined with improving angling quality. On a larger area like in Trysil one should manage for diversity in regulations to avoid marginalizing certain angler groups and create conflicts.

Patients in general practice share a common pattern of symptoms that is partly independent of the diagnosis

Objective To describe self-reported symptoms among patients in general practice and to explore the relationships between symptoms experienced by patients and diagnoses given by general practitioners. Design Doctor–patient questionnaires focusing on patients’ self-reported symptoms during the past 7 days and the doctors’ diagnoses. Setting General practices in urban and suburban areas in Southeast Norway. Subjects Forty-seven general practitioners who included 866 patients aged ≥18 years on a random day in practice. Results The most frequently reported symptoms were tiredness (46%), lower back pain (43%), neck pain (41%), headache (39%), shoulder pain (36%), and sleep problems (35%). Women had a significantly higher prevalence than men for 16 of 38 symptoms (p < 0.05). The mean number of symptoms was 7.5 (range, 0–32; women, 8.1; men, 6.5, p < 0.05). Regression analysis showed that patients who received a social security grant had 59% more symptoms than those who were employed and that people with asthenia and depression/anxiety had 44% and 23% more symptoms, respectively than those with all other diagnoses. The patterns of symptoms reported showed similar patterns across the five most prevalent diagnoses. Conclusions Patients in general practice report a number of symptoms and share a common pattern of symptoms, which appear to be partly independent of the diagnoses given. These findings suggest that symptoms are not necessarily an indication of disease. KEY POINTS Patients consulting general practitioners have a high number of self-reported symptoms. The most frequent symptoms are tiredness, lower back pain, neck pain, headache, shoulder pain, and sleep problems. Patients diagnosed with asthenia and depression/anxiety report the highest number of symptoms. Selected diagnoses show similar patterns in symptom distribution. Symptoms are not necessarily an indication of disease.

Use of two distant nesting areas as a breeding strategy of Golden Eagles (Aquila chrysaetos) in Valdres, southeast Norway

Cover photo: Golden eagle. Photo: Frode Falkenberg.&#x0D; Sixteen occupied nesting territories of Golden Eagle Aquila chrysaetos were studied between 2000 and 2020, in the southern part of the valley of Valdres, southeast Norway. Most of the study area consists of rolling hills dominated by spruce Picea abies with numerous clear-cuts. It was concluded that at least six (about 40%) of the eagle pairs in these territories move back and forth between two alternate, distant nesting areas 5.3 km apart (average). In two additional pairs, a second nesting area was considered possible. In the remaining eight, only one nesting area was found. The periods of one nesting area in use varied from 2–19 years, before moving to the other nesting area. This result was supported by panoramic mid-day surveillance of the air space between the two nesting areas during 2014–2020. The maintenance of a second core nesting area is most likely a strategy for moving to a more favourable hunting area and might be initiated by a new mate in the pair. The move might also be influenced by avoidance of a close neighbouring pair. A switch of nesting areas, as indicated by this study, could significantly affect results, when the number of eagle pairs in a certain area is counted.

Forage yield and quality estimation by means of UAV and hyperspectral imaging

This study investigated the potential of in-season airborne hyperspectral imaging for the calibration of robust forage yield and quality estimation models. An unmanned aerial vehicle (UAV) and a hyperspectral imager were used to capture canopy reflections of a grass-legume mixture in the range of 450 nm to 800 nm. Measurements were performed over two years at two locations in Southeast and Central Norway. All images were subject to radiometric and geometric corrections before being processed to ortho-images, carrying canopy reflectance information. The data (n = 707) was split in two, using half the data for model calibration and the remaining half for validation. Several powered partial least squares regression (PPLSR) models were fitted to the reflectance data to estimate fresh (FM) and dry matter (DM) yields, as well as crude protein (CP), dry matter digestibility (DMD), neutral detergent fibre (NDF), and indigestible neutral detergent fibre (iNDF) content. Prediction performance of these models was compared with the prediction performance of simple linear regression (SLR) models, which were based on selected vegetation indices and plant height. The highest prediction accuracies for general models, based on the pooled data, were achieved by means of PPLSR, with relative root-mean-square errors of validation of 14.2% (2550 kg FM ha−1), 15.2% (555 kg DM ha−1), 11.7% (1.32 g CP 100 g−1 DM), 2.4% (1.71 g DMD 100 g−1 DM), 4.8% (2.72 g NDF 100 g−1 DM), and 12.8% (1.32 g iNDF 100 g−1 DM) for the prediction of FM, DM, CP, DMD, NDF, and iNDF content, respectively. None of the tested SLR models achieved acceptable prediction accuracies.

An Examination of Training Load, Match Activities, and Health Problems in Norwegian Youth Elite Handball Players Over One Competitive Season

Talent development is integral to the policy and organizational practice of competitive sport, but has also been associated with excessive amounts of training and competition, and athlete injuries and illnesses. The lack of available prospective data on the training and match activities of youth athletes and their health problems is therefore of concern. The aim of this study was two-fold: (a) to examine the amount and frequency of training load, match activities, injury and illness incidence, and prevalence among Norwegian youth elite handball players over the course of the 2018–2019 competitive season; and (b) to explore whether the injury rates are related to the sex or competition level of players, or their membership of the youth international team. We recruited 205 handball players (64% female, 36% male), aged 15–18 years (17.2 years ± 0.9) from five different sport school programs in southeast Norway. Data were collected daily from September 2018 to May 2019, during the competitive handball season. The variables included types of athlete activities, the number of activities, the rating of perceived exertion (RPE), and the duration of training and matches. Injury and illness data were collected weekly using the Oslo Sports Trauma Research Center (OSTRC) questionnaire. The mean number of matches per week per player was 0.9 ± 1.29; the number of weekly training events was 6.1 ± 4.4; and the mean weekly session RPE was 986 ± 1 412 arbitrary units. The players reported a total of 472 injuries, and the mean number of injuries per player was 2.3 ± 2.9. The results demonstrated a 53% weekly injury prevalence, of which 38% were categorized as substantial injuries. Male players and players who participated at the highest level of senior competition and/or the youth international team reported significantly lower weekly incidences of health problems, compared to other players. Our findings showed that players enrolled in sport school programs are exposed to high training and competition loads, and that both general and substantial health problems are common. The potential implications for talent development and future research are discussed.

Autopsy findings in drivers and passengers from fatal motor vehicle collisions: limited differences in injury patterns and toxicological test results

We performed a retrospective study of the injuries and characteristics of occupant fatalities in motor vehicle collisions in southeast Norway. The goal was to provide updated knowledge of injuries sustained in modern vehicles and detect possible differences in injury pattern between drivers and passengers. Forensic autopsy reports, police, and collision investigation reports from 2000 to 2014 were studied, data extracted and analyzed.A total of 284 drivers, 80 front-seat passengers, and 37 rear-seat passengers were included, of which 67.3% died in front collisions, 13.7% in near-side impacts, 13.5% in rollovers and 5.5% in other/combined collisions. Overall, 80.5% died within one hour after the crash. The presence of fatal injuries to the head, neck, thorax and abdomen were observed in 63.6%, 10.7%, 61.6% and 27.4% respectively. All occupants with severe injuries to the head or neck had signs of direct impact with contact point injuries to the skin or skull. Injuries to the heart and spleen were less common in front-seat passengers compared to drivers. Seat belt abrasions were more common and lower extremity fractures less common in both front-seat and rear-seat passengers compared to drivers. Blood alcohol and/or drug concentrations suggestive of impairment were present in 30% of all occupants, with alcohol more often detected among front-seat passengers compared to drivers.Few driver-specific and passenger-specific patterns of injury could be identified. When attempting to assess an occupant’s seating position within a vehicle, autopsy findings should be interpreted with caution and only in conjunction with documentation from the crash scene.

Quartz dissolution associated with magnesium silicate hydrate cement precipitation

Abstract. Quartz has been replaced by magnesium silicate hydrate cement at the Feragen ultramafic body in south-east Norway. This occurs in deformed and recrystallized quartz grains deposited as glacial till covering part of the ultramafic body. Where the ultramafic body is exposed, weathering leads to high-pH (∼ 10), Mg-rich fluids. The dissolution rate of the quartz is about 3 orders of magnitude higher than experimentally derived rate equations suggest under the prevailing conditions. Quartz dissolution and cement precipitation start at intergranular grain boundaries that act as fluid pathways through the recrystallized quartz. Etch pits are also extensively present at the quartz surfaces as a result of preferential dissolution at dislocation sites. Transmission electron microscopy revealed an amorphous silica layer with a thickness of 100–200 nm around weathered quartz grains. We suggest that the amorphous silica is a product of interface-coupled dissolution–precipitation and that the amorphous silica subsequently reacts with the Mg-rich, high-pH bulk fluid to precipitate magnesium silicate hydrate cement, allowing for further quartz dissolution and locally a complete replacement of quartz by cement. The cement is the natural equivalent of magnesium silicate hydrate cement (M-S-H), which is currently of interest for nuclear waste encapsulation and for environmentally friendly building cement, but it has not yet been developed for commercial use. This study provides new insights that could potentially contribute to the further development of M-S-H cement.

Predator community and resource use jointly modulate the inducible defense response in body height of crucian carp.

Phenotypic plasticity can be expressed as changes in body shape in response to environmental variability. Crucian carp (Carassius carassius), a widespread cyprinid, displays remarkable plasticity in body morphology and increases body depth when exposed to cues from predators, suggesting the triggering of an antipredator defense mechanism. However, these morphological changes could also be related to resource use and foraging behavior, as an indirect effect of predator presence. In order to determine whether phenotypic plasticity in crucian carp is driven by a direct or indirect response to predation threat, we compared twelve fish communities inhabiting small lakes in southeast Norway grouped by four categories of predation regimes: no predator fish, or brown trout (Salmo trutta), perch (Perca fluviatilis), or pike (Esox lucius) as main piscivores. We predicted the body shape of crucian carp to be associated with the species composition of predator communities and that the presence of efficient piscivores would result in a deeper body shape. We use stable isotope analyses to test whether this variation in body shape was related to a shift in individual resource use—that is, littoral rather than pelagic resource use would favor the development of a specific body shape—or other environmental characteristics. The results showed that increasingly efficient predator communities induced progressively deeper body shape, larger body size, and lower population densities. Predator maximum gape size and individual trophic position were the best variables explaining crucian carp variation in body depth among predation categories, while littoral resource use did not have a clear effect. The gradient in predation pressure also corresponded to a shift in lake productivity. These results indicate that crucian carp have a fine‐tuned morphological defense mechanism against predation risk, triggered by the combined effect of predator presence and resource availability.

Increased Risk of Hospitalisation and Intensive Care Admission Associated With Infection With SARS-CoV-2 Variants B.1.1.7 and B.1.351 in Norway, December 2020 – May 2021

Introduction: Since their emergence, SARS-CoV-2 variants of concern (VOC) B.1.1.7 and B.1.351 have spread worldwide. We estimated the risk of hospitalisation and admission to an intensive care unit (ICU) for infections with B.1.1.7 and B.1.351 in Norway, compared to infections with non-VOC. Methods: Using linked individual-level data from national registries, we conducted a cohort study on laboratory-confirmed cases of SARS-CoV-2 in Norway diagnosed between 28 December 2020 and 2 May 2021. Variants were identified based on whole genome sequencing, partial sequencing by Sanger sequencing or PCR screening for selected targets. The outcome was hospitalisation or ICU admission. We calculated adjusted risk ratios (aRR) with 95% confidence intervals (CIs) using multivariable binomial regression to examine the association between SARS-CoV-2 variants B.1.1.7 and B.1.351 with i) hospital admission and ii) ICU admission compared to non-VOC. Results: We included 23,169 cases of B.1.1.7, 548 B.1.351 and 4,584 non-VOC. Overall 1,017 cases were hospitalised (3·6%) and 206 admitted to ICU (0·7%). B.1.1.7 was associated with a 1·9-fold increased risk of hospitalisation (aRR 95%CI 1·6–2·3) and a 1·8-fold increased risk of ICU admission (aRR 95%CI 1·2–2·8) compared to non-VOC. Among hospitalised cases, no difference was found in the risk of ICU admission between B.1.1.7 and non-VOC. B.1.351 was associated with a 2·4-fold increased risk of hospitalisation (aRR 95%CI 1·7–3·3) and a 2·7-fold increased risk of ICU admission (aRR 95%CI 1·2–6·5) compared to non-VOC. Interpretation: Our findings add to the growing evidence of a higher risk of severe disease among persons infected with B.1.1.7 or B.1.351. Control measures to reduce transmission of these VOC in society, and preparedness plans for hospital surge capacity are essential. Further studies on differences in patient trajectories and clinical characteristics among hospitalised patients infected with VOC are needed. Funding Information: The authors received no specific funding for this work. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: Ethical approval for this study was granted by Regional Committees for Medical Research Ethics - South East Norway, reference number 249509.

Vision status and reading test results in Norwegian adolescents

Uncorrected vision anomalies may cause headaches and may affect reading and academic performance. The purpose of this study was to quantify the frequency of vision anomalies, frequency of eye examinations, and use of corrective eye wear in adolescents in Norway, and to explore whether such vision anomalies affect reading test results or frequency of headaches. A cross-sectional study was performed in 436 adolescents (42.0% males) aged 16–19 years living in South-East Norway. Cycloplegic autorefraction, habitual stereoacuity, and habitual monocular amplitudes of accommodation were measured, and all participants reported the frequency of eye examinations, the use of spectacles and/or contact lens wear, and the frequency of headaches. Reading comprehension and decoding skills were evaluated for a subgroup of the participants (189 participants, 34.4% males) by their performance in national reading tests. Vision anomalies were defined as having refractive errors, poor habitual stereoacuity, or poor habitual amplitude of accommodation in at least one eye. Overall, 44.0% were classified as having a refractive error, and a total of 61.9% were measured to have vision anomalies. More frequent headaches were associated with poor habitual amplitude of accommodation when adjusted for sex (p = 0.04). The frequency of poor reading comprehension was higher in the group of adolescents with vision anomalies (n = 109, 31.2%) compared with those with no vision anomalies (n = 80, 18.8%; p = 0.05). Of those with vision anomalies, 33.5% had never had an eye examination, and 63.9% reported not wearing a correction. In Norway, there is no mandatory vision screening after 4 years of age. The results here show that a nation-wide programme of regular eye examinations and proper treatment of vision anomalies for all children and adolescents in Norway should be considered. Identifying and treating children with common eye problems in primary and secondary school will improve educational attainment and increase each child’s chances of succeeding in further education.

Self-reported Pain Associated With Screening With Digital Breast Tomosynthesis.

We aimed to investigate self-reported pain during screening with digital breast tomosynthesis (DBT). The study was approved by the Regional Committee for Medical and Health Research Ethics in the South East of Norway (2015/424). Women completed a questionnaire about experienced pain directly after the examination, August-November 2019. A numeric rating scale (NRS, 0-10) was used. Data on compression force (N), pressure (kPa), and compressed breast thickness (mm) were obtained from the Digital Imaging and Communication in Medicine header and density assessment software. Stepwise ordinary least-squares regression was used to estimate mean self-reported pain score with 95% confidence interval (CI) for values of compression force, pressure, and compressed breast thickness. The mean pain score was 1.9, whereof 19.3% (822/4266) of the women reported moderate or severe pain. The mean pain score of 2.6 (95% CI: 2.4-2.7) was observed at a compression force of 60 N, decreasing to 1.3 (95% CI: 1.2-1.4) at 130 N. The mean pain score of 1.3 (95% CI: 1.1-1.4) was at a compression pressure of 6 kPa, increasing to 2.9 (95% CI: 2.7-3.1) at 16 kPa. The mean pain score was 0.6 (95% CI: 0.4-0.6) at a compressed breast thickness of 20 mm, increasing to 2.9 (95% CI: 2.7-3.1) at 90 mm. The mean pain score was low, 1.9 on NRS, for women screened with DBT. A compression force of 60-130 N and a pressure 6-16 kPa were associated with no or mild pain.

Paradise lost — transformation of the gully landscape in South-East Norway

ABSTRACT In the last 50–60 years, agricultural intensification and later urban development have threatened the rare and valuable gully landscape formed on marine clay. We studied landscape changes in eastern Akershus county in south-east Norway, which has one of the world’s largest concentrations of marine gullies. Interpretation of aerial photos showed that about 25% of the gully area has been lost. Only 39.5% of the remaining area is original gullies, and 60.5% of the area has been affected by landscape change. The largest loss of gully area was between 1955 and 1991, mainly through land levelling and transformation to intensively managed agricultural landscape. The most densely populated areas also lost gullies to residential areas and industry. Gullies support high plant and animal diversity, and future management should be based on landscape ecological principles. Gully fragments should also be preserved to maintain connectivity between the many different habitats belonging to the gullies.