Arne Stray-Pedersen

• Andersen, Jintana Bunpan; Strand, Janne Maren; Stray-Pedersen, Asbjørg; Abrahamsen, Tore Gunnar; Stray-Pedersen, Arne & Flægstad, Trond [Show all 9 contributors for this article] (2026). Unmasking immunodeficiency in sudden infant deaths: no evidence of hidden immune disorders. Frontiers in Immunology. 17. doi: 10.3389/fimmu.2026.1860011. Full text in Research Archive Show summary

  Introduction Sudden infant death syndrome (SIDS) remains a leading cause of post-neonatal mortality, yet its underlying mechanisms are largely unknown. Evidence suggests that immune dysfunction may play a role in a subset of cases. However, the role of inborn errors of immunity (IEI), particularly severe combined immunodeficiency (SCID), has not been systematically explored. We aimed to study their potential role in SIDS and infant deaths from infectious disease. Methods We obtained mortality data for 2012–2017 from The Norwegian Cause of Death Registry and identified eligible infants by reviewing ICD-10 codes for infection-related deaths or SIDS. The medical history and autopsy reports were reviewed and infants with predisposition to infection were excluded. Genetic testing was performed on biobanked newborn dried blood spot samples following the protocol for identifying SCID/IEI in live-born infants. Results The study population consisted of 79 infants, of which 66% ( n  = 52) died of SIDS and 34% ( n  = 27) due to infection. The majority of the infants in both groups had at least one genetic IEI-related variant, but no findings were clearly pathogenic. Variants of uncertain significance in autosomal dominant disease genes were identified in 18% ( n  = 14). Heterozygous pathogenic variants in autosomal recessive genes were identified in 23% ( n  = 18). Risk factor variants were identified in 42% ( n  = 33), including two mannose-binding lectin 2 polymorphisms with alleles more frequently observed in the infection group compared to the general population. Discussion No missed cases of SCID/IEI were identified among infants who died from infections or SIDS. Yet a significant proportion of the cohort may carry genetic predispositions due to the presence of immune-related genetic variants. Even in the absence of overt immunodeficiency, these findings may reflect a latent vulnerability interacting with physiological and environmental factors.

• Vollmer-Sandholm, Mary Jo; Myhre, Arne Kristian; Myhre, Mia Cathrine; Albæk, Ane Ugland & Stray-Pedersen, Arne (2026). Characteristics of Pediatric Cases Presenting for Concerns of Abusive Head Trauma in Norway. Child Protection and Practice. 9. doi: 10.1016/j.chipro.2026.100296. Full text in Research Archive Show summary

  Background Abusive head trauma (AHT) is a frequent cause of severe and fatal head injury in young children. There are few published studies on AHT from Scandinavia. Objective To describe the characteristics of AHT in Norway and examine whether documented prior concerns could have enabled earlier identification and prevention. Participants and Setting Retrospective study of children aged <4 years admitted with head injury and reported to the police for suspected AHT between 2003–2019. Based on medicolegal investigation, cases were classified as deemed inflicted or indeterminate. Methods Mixed-methods retrospective chart review of medicolegal case files, including medical records and police investigation reports, focusing on demographics, medical and social history, and circumstances around the time of presentation to care. Findings Of 77 children (median age 4 months; 64% male), 55 were deemed inflicted and 22 indeterminate. Inflicted cases had typically more severe injuries and poorer outcomes, with low GCS on admission and 15% mortality. In 78% of all cases no history of trauma was initially offered and in 65% there was delay before seeking care. At least one prior concern related to illness, injuries or parental coping was documented before the head injury in 55% of cases, more often in inflicted (62%) than indeterminate AHT (36%; P = 0.04). In 32% of cases there appeared to have been opportunities to intervene prior to the injury. Conclusion Most AHT cases present without a reported trauma history and with delay in seeking care. Prior concerns about the child's well-being are common, indicating potential for prevention.

• Hutchinson, Kim; Stray-Pedersen, Arne; Dankelman, Jenny; Seth, Ajay & Loeve, Arjo J. (2025). Comparing the kinematics related to inflicted head injury between violent shaking of a 6-week-old and a 1-year-old infant surrogate. Royal Society Open Science. 12(11). doi: 10.1098/rsos.251251. Full text in Research Archive Show summary

  Annually, 14–41 per 100 000 infants get mildly to lethally injured or severely disabled through violent shaking. The incidence and mortality of inflicted head injury by shaking trauma (IHI-ST) are highest in the early months and decrease with age. This may partly be due to the age-related physical characteristics of infants. Younger, smaller infants are more vulnerable owing to their size and material properties. In addition, from basic biomechanics, it is expected that larger or heavier infants may be more difficult to fiercely shake and will exhibit different motion patterns when being shaken violently. Therefore, the aim of this study was to compare the kinematics of shaking a smaller versus a larger infant dummy. We recorded the kinematics of two dummies, representing a 6-week-old and a 1-year-old, while they were violently shaken by volunteers. We found that participants induced higher head and torso accelerations when shaking the 6-week-old, than with the 1-year-old dummy. Moreover, higher peak sagittal angular accelerations coincide with smaller radii of rotation in the 6-week-old than in the 1-year-old. Because it has been suggested in the literature that sagittal angular acceleration of the head is an important mechanism in inducing the injuries associated with IHI-ST; the results of this study show that shaking a smaller/younger infant is more likely to cause the kinematics possibly responsible for IHI-ST.

• Isern, Cecilie Benedicte; Bahr, Roald; Flønes, Malin; Jorstad, Harald; Kramer-Johansen, Jo & Mjøs, Ingrid [Show all 8 contributors for this article] (2025). Out-of-hospital cardiac arrest in Norwegians aged 12–49 years: nationwide analysis of preceding symptoms and risk factors related to aetiology and pre-arrest exercise habits. BMJ Open sport & exercise medicine. 11, p. 1–12. doi: 10.1136/bmjsem-2025-002505. Full text in Research Archive Show summary

  Background Out-of-hospital cardiac arrest (OHCA) in the young is a tragic event. Regular exercise reduces cardiovascular disease (CVD) risk but, at certain intensities and volumes, is associated with increased OHCA risk. Understanding symptoms, risk factors and aetiology is central for primary prevention. Objective Assess symptoms and risk factors related to OHCA aetiology in young Norwegians, and the role of exercise volume. Method We obtained data from the Norwegian Cardiac Arrest Registry (2015–2017), medical records, autopsy reports and questionnaires. Inclusion criteria were ages 12–49 years and OHCA of presumed cardiac aetiology. Results Data from 134 individuals (81 survivors, 53 deceased) showed that CVD symptoms were present during both rest/everyday activity and exercise in most victims, and were reported by more survivors than by next-of-kin of the deceased (78% vs 60%). Only 12% had symptoms just during exercise. Ischaemic heart disease was the leading cause (58% in males vs 38% in females), followed by structural, non-ischaemic heart disease. Sudden unexpected death syndrome (SUDS) was most common in individuals aged ≤35 years. Risk factors were present in 74%, with family history for CVD most prevalent (51%) and overweight in at least 33%. There were no significant differences in symptoms, risk factors or OHCA aetiology related to exercise volume prior to OHCA. Conclusion Symptoms and CVD risk factors were prevalent in young Norwegians suffering OHCA regardless of exercise volume. Ischaemic heart disease was the leading cause of OHCA. We suggest evaluating symptoms carefully and addressing risk factors to prevent OHCA in young Norwegians regardless of exercise habits.

• Opdal, Siri Hauge; Stray-Pedersen, Arne; Eidahl, Johanna; Vege, Åshild; Ferrante, Linda & Rognum, Torleiv Ole (2025). The vicious spiral in Sudden Infant Death Syndrome. Frontiers in Pediatrics. 13. doi: 10.3389/fped.2025.1487000. Full text in Research Archive Show summary

  Sudden Infant Death Syndrome (SIDS) is the sudden and unexpected death of an otherwise healthy infant less than 1 year of age where the cause of death remains unexplained after a thorough post-mortem investigation and evaluation of the circumstances. Epidemiological, clinical, biochemical, immunological and pathological evidence indicates that three factors must coincide for SIDS to occur: a vulnerable developmental stage of the immune system and central nervous system in the infant, predisposing factors, and external trigger events. This model is referred to as the fatal triangle or triple risk hypothesis. The concept of a vicious spiral in SIDS, starting with the fatal triangle and ending in death, is proposed as a model to understand the death mechanism. The vicious spiral is initiated by a mucosal infection and immune activation in the upper respiratory and digestive tracts, increased production of cytokines, and an overstimulation of the immature and rapidly developing immune system. A second trigger is the prone sleeping position, which may lead to rebreathing and hypercapnia, in addition to intensify the immune stimulation. In susceptible infants, this induces an aberrant cytokine production that affects sleep regulation, induces hyperthermia, and disrupts arousal mechanisms. In turn, this initiates downregulation of respiration and hypoxemia, which is worsened by nicotine. Inefficient autoresuscitation results in severe hypoxia and accumulation of hypoxic markers which, if not prevented by a normally functioning serotonergic network, contribute to a self-amplifying vicious spiral that eventually leads to coma and death. The purpose of this review is to summarize the research that underpins the concept of the vicious spiral.

• Vollmer-Sandholm, Mary Jo; Myhre, Arne Kristian; Albæk, Ane Ugland & Stray-Pedersen, Arne (2024). Child Maltreatment: To Report or Not to Report? It’s More Complex than That. International Journal on Child Maltreatment: Research, Policy and Practice. ISSN 2524-5236. 7, p. 529–551. doi: 10.1007/s42448-024-00212-0. Full text in Research Archive Show summary

  Child maltreatment (CM) is a widespread problem, contributing to health and societal difficulties often throughout the lifespan. Healthcare professionals (HCPs) who see potential warning signs for CM are responsible for protecting the child from future harm, which may involve alerting the authorities. The decision-making is challenging as unwarranted reporting may lead to mistrust and not benefit the child. We sought to explore what factors might influence HCPs’ decisions to report suspected CM in a Norwegian sample. Using a cross-sectional survey among HCPs in Norwegian hospitals with pediatric wards, we presented five case vignettes describing different probabilities of CM and variables assessing experience, knowledge, and confidence. A total of 382 HCPs completed the survey. Despite recognizing warning signs for CM in the case vignettes, a large proportion were reluctant to report to authorities. Recognition of CM and expressed willingness to report four or all five of the case vignettes (high reporters) was associated with the profession, knowledge, experience, and confidence in handling CM cases. Expressed confidence in performing physical examinations for physical or sexual abuse and talking with parents about abuse was significantly associated with high reporting (OR 2.3 to 17.8). Qualitative data further supported the role of self-efficacy. In summary, reporting to the authorities is an important but complex aspect in cases of suspected CM, but many HCPs relate that they fail to do so. This study indicates reporting suspicion of CM is correlated with self-efficacy and knowledge among HCPs, which should inform educational, social, and policy decisions.

• Eidahl, Johanna; Rognum, Torleiv Ole; Stray-Pedersen, Arne & Opdal, Siri Hauge (2023). Brain water content in sudden unexpected infant death. Forensic Science, Medicine, and Pathology. ISSN 1547-769X. 19(4), p. 507–516. doi: 10.1007/s12024-023-00584-8. Full text in Research Archive Show summary

  Abstract The extensive and rapid development of the human brain during the first years of life complicates the postmortem diagnosis of brain edema in infancy. The aim of this study was to describe brain water content, the brain weight/body weight ratio, and the brain weight/head circumference ratio throughout the first years of life. Furthermore, we examined the relationship between these parameters and rs2075575 in the AQP4 gene. Our hypothesis was that dysregulated water homeostasis might be a risk factor for sudden infant death syndrome (SIDS), which may be reflected by increased water content in the brain. The study included 90 subjects with sudden unexpected death &lt; 4 years of age: 22 cases of sudden infant death syndrome, 11 cases of sudden unexplained death in childhood, 47 cases of death due to disease, and 10 cases of accident/violent death. Brain water content, brain weight/body weight ratio, and brain weight/head circumference ratio were investigated according to corrected age, diagnosis group, attempt to resuscitate, and presence of brain edema. We found that brain water content and brain weight/body weight ratio were significantly reduced with increasing age, while brain weight/head circumference were increased. Brain weight/head circumference was correlated with brain water content. Cases with brain edema had a significantly higher brain weight/head circumference than the non-edematous cases. No differences were found between the diagnosis groups for any of the investigated parameters. In summary, the findings contribute to the current body of knowledge regarding brain growth during the first months of life.

• Petrovich, Polina; Berve, Per-Olav Stefferud; Roald, Borghild; Kongsgård, Håvard Wahl; Stray-Pedersen, Arne & Kramer-Johansen, Jo [Show all 7 contributors for this article] (2023). Injuries associated with mechanical chest compressions and active decompressions after out-of-hospital cardiac arrest: A subgroup analysis of non-survivors from a randomized study. Resuscitation Plus. 13:100362, p. 1–7. doi: 10.1016/j.resplu.2023.100362. Full text in Research Archive Show summary

  Background Both skeletal and visceral injuries are reported after cardiopulmonary resuscitation (CPR). This subgroup analysis of a randomized clinical study describes/compares autopsy documented injury patterns caused by two mechanical, piston-based chest compression devices: standard LUCAS® 2 (control) and LUCAS® 2 with active decompression (AD, intervention) in non-survivors with out-of-hospital cardiac arrest (CA). Method We compared injuries documented by autopsies (medical/forensic) after control and intervention CPR based on written relatives consent to use patients’ data. The pathologists were blinded for the device used. The cause of CA and injuries reported were based on a prespecified study autopsy template. We used Pearson's chi-squared test and logistic regression analysis with an alpha level of 0.05. Results 221 patients were included in the main study (April 2015–April 2017) and 207 did not survive. Of these, 114 (55%, 64 control and 50 intervention) underwent medical (N = 73) or forensic (N = 41) autopsy. The cause of CA was cardiac 53%, respiratory 17%, overdose/intoxication 14%, ruptured aorta 10%, neurological 1%, and other 5%. There were no differences between control and intervention in the incidence of rib fractures (67% vs 72%; p-value = 0.58), or sternal fractures (44% vs 48%; p-value = 0.65), respectively. The most frequent non-skeletal complication was bleeding (26% of all patients) and intrathoracic was the most common location. Ten of the 114 patients had internal organ injuries, where lungs were most affected. Conclusion In non-survivors of OHCA patients, the most frequent cause of cardiac arrest was cardiogenic. Skeletal and non-skeletal fractures/injuries were found in both control and intervention groups. Bleeding was the most common non-skeletal complication. Internal organ injuries were rare.

• Breen, Jan Mario; Næss, Pål Aksel; Hansen, Trond Boye; Gaarder, Aslaug Christine; Klemmetsen, Harald & Stray-Pedersen, Arne (2022). Young adults in motor vehicle collisions in Norway: user safety errors observed in majority of cases with severe or fatal injuries. Forensic Science, Medicine, and Pathology. ISSN 1547-769X. 18(4), p. 456–469. doi: 10.1007/s12024-022-00541-x. Full text in Research Archive Show summary

  Abstract Purpose We performed a multidisciplinary investigation of young adults involved in motor vehicle collisions (MVCs) to elucidate injury mechanisms and the role of passive safety equipment such as seat belts and airbags. Methods MVCs resulting in death or serious injuries to the driver or passengers aged 16–24 years in southeastern Norway during 2013–2016 were investigated upon informed consent. We assessed the crash scene, the motor vehicle (MV) interior and exterior, and analyzed data from medical records, forensic autopsies and reports from police and civil road authorities. Results This study included 229 young adult occupants involved in 212 MVCs. The Maximum Abbreviated Injury Scale (MAIS) score was ≥2 in 111 occupants, of which 22 were fatalities. In 59% (65/111) of the cases with MAIS score ≥2 injuries, safety errors and occupant protection inadequacies were considered to have contributed to the injury outcome. Common errors were seatbelt non-use and misuse, carrying insecure luggage, and the seat back being too reclined. MAIS score ≥2 head/neck injuries were observed in side impacts despite correct seatbelt use, related to older MVs lacking side airbag curtains. The independent risk factors for MAIS score ≥2 injuries included not using a seatbelt, driving under the influence of alcohol or drugs, nighttime driving, side impacts, heavy collision partner, and MV deformation. Conclusion User safety errors (not using a seatbelt, seatbelt misuse, excessive seat-back reclining, and insecure cargo) and a lack of occupant protection in older MVs resulted in young adults sustaining severe or fatal injuries in MVCs.

• Wiedmann, Markus; Skattør, Thor Håkon; Stray-Pedersen, Arne; Romundstad, Luis Georg; Antal, Ellen-Ann & Marthinsen, Pål Bache [Show all 16 contributors for this article] (2021). Vaccine Induced Immune Thrombotic Thrombocytopenia Causing a Severe Form of Cerebral Venous Thrombosis With High Fatality Rate: A Case Series. Frontiers in Neurology. 12:721146, p. 1–7. doi: 10.3389/fneur.2021.721146. Full text in Research Archive Show summary

  During a 2-week period, we have encountered five cases presenting with the combination of cerebral venous thrombosis (CVT), intracerebral hemorrhage and thrombocytopenia. A clinical hallmark was the rapid and severe progression of disease in spite of maximum treatment efforts, resulting in fatal outcome in for 4 out of 5 patients. All cases had received ChAdOx1 nCov-19 vaccine 1–2 weeks earlier and developed a characteristic syndrome thereafter. The rapid progressive clinical course and high fatality rate of CVT in combination with thrombocytopenia in such a cluster and in otherwise healthy adults is a recent phenomenon. Cerebral autopsy findings were those of venous hemorrhagic infarctions and thrombi in dural venous sinuses, including thrombus material apparently rich in thrombocytes, leukocytes and fibrin. Vessel walls were free of inflammation. Extra-cerebral manifestations included leech-like thrombi in large veins, fibrin clots in small venules and scattered hemorrhages on skin and membranes. CVT with thrombocytopenia after adenovirus vectored COVID-19 vaccination is a new clinical syndrome that needs to be recognized by clinicians, is challenging to treat and seems associated with a high mortality rate.

• Eidahl, Johanna; Stray-Pedersen, Arne; Rognum, Torleiv Ole & Opdal, Siri Hauge (2021). Aquaporin 4 expression in the hippocampus in sudden infant death syndrome and sudden unexplained death in childhood. Journal of Chemical Neuroanatomy. ISSN 0891-0618. 115:101962, p. 1–6. doi: 10.1016/j.jchemneu.2021.101962. Full text in Research Archive Show summary

  Aquaporin 4 (AQP4) is the main membrane water channel in the brain involved in regulating water homeostasis. The water distribution in neural tissue is often dysregulated after hypoxic neural injury. Previous research has indicated that victims of sudden infant death syndrome (SIDS) and sudden unexplained death in childhood (SUDC) have an underlying brain dysfunction that impairs their critical arousal response to hypoxic stress during sleep. The aim of this study was to determine the expression levels of AQP4 in the hippocampus in SIDS/SUDC cases and controls, and compare the findings with AQP4 genotypes that previously have been shown to be associated with SIDS. Immunochemical staining and morphometry were used to evaluate the density of AQP4-positive astrocytes in 30 SIDS/SUDC cases and 26 controls. AQP4-positive cells were counted in grids covering three layers in the hippocampus, which revealed that their count in any of the layers did not differ significantly between cases and controls. A decline in AQP4 expression was observed for infants older than 12 weeks. The AQP4 expression was lower in infants and children with the rs2075575 CT/TT genotype than in those with the CC genotype. This study indicates that AQP4 expression may be influenced by both age and genotype in infants. The role of AQP4 in the pathogenesis of SIDS remains to be elucidated.

• Osberg, Silje; Kalstad, Trine Giving & Stray-Pedersen, Arne (2021). Norwegian parents avoid placing infants in prone sleeping positions but frequently share beds in hazardous ways. Acta Paediatrica. ISSN 0803-5253. p. 1–7. doi: 10.1111/apa.15797. Full text in Research Archive Show summary

  Aim Campaigns to prevent prone sleeping and other modifiable risk factors have greatly reduced the incidence of sudden infant death syndrome in Norway. Sleep-related infant deaths still occur sporadically and may be preventable. We studied infants’ sleeping environments and whether parents followed safe sleep recommendations. Methods Parents with infants up to 12 months of age were invited to complete an online questionnaire from May to December 2018. It was publicised by health centres and on websites and social media. Results We received 4886 responses and 4150 met the age criteria and were included. Just under two-thirds (62.7%) reported routine bed-sharing, and this practice was associated with increased nocturnal breastfeeding, single parents and having more than one child. A small number of infants under six months were occasionally placed prone when they were laid down to sleep (2.1%) and 29.7% were placed on their side. Nearly three-quarters (72.6%) of the 2330 parents with infants under six months of age reported previous high-risk behaviour, such as sleeping together on a sofa or bed-sharing after smoking or drinking. Conclusion Norwegian parents rarely used prone sleeping positions for infants. However, bed-sharing was common, including high-risk scenarios such as smoking, alcohol use and sofas.

• Stray-Pedersen, Arne; Strisland, Frode; Rognum, Torleiv Ole; Schiks, Luuk Antoon Hubertus & Loeve, Arjo J. (2021). Violent Infant Surrogate Shaking: Continuous High-Magnitude Centripetal Force and Abrupt Shift in Tangential Acceleration May Explain High Risk of Subdural Hemorrhage. Neurotrauma Reports. 2(1), p. 224–231. doi: 10.1089/neur.2021.0013. Full text in Research Archive Show summary

  Violent shaking is believed to be a common mechanism of injury in pediatric abusive head trauma. Typical intracranial injuries include subdural and retinal hemorrhages. Using a laboratory surrogate model we conducted experiments evaluating the head motion patterns that may occur in violent shaking. An anthropomorphic test device (ATD; Q0 dummy) matching an infant of 3.5 kg was assembled. The head interior was equipped with accelerometers enabling assessment of three-axial accelerations. Fifteen volunteers were asked to shake the surrogate vigorously holding a firm grip around the torso. We observed the volunteers performing manual shaking of the surrogate at a median duration of 15.5 sec (range 5–54 sec). Typical acceleration/deceleration patterns were produced after 2–3 shakes with a steady-state shaking motion at a pace of 4–6 cycles (back and forth) per second. Mean peak sagittal tangential accelerations at the vertex were 45.7g (range 14.2–105.1g). The acceleration component in the orthogonal direction, the radial acceleration, fluctuated around a negative mean of more than 4g showing that the surrogate head was continuously subjected to centripetal forces caused by rotations. This surrogate experiment showed that violent shaking may induce high peak tangential accelerations and concomitantly a continuous high-magnitude centripetal force. We hypothesize that the latter component may cause increased pressure in the subdural compartment in the cranial roof and may cause constant compression of the brain and possibly increased stretching or shearing of the bridging veins. This may contribute to the mechanism accountable for subdural hematoma in abusive head trauma.

• Opdal, Siri Hauge; Ferrante, Linda; Rognum, Torleiv Ole & Stray-Pedersen, Arne (2021). Aquaporin-1 and aquaporin-9 gene variations in sudden infant death syndrome. International journal of legal medicine (Print). ISSN 0937-9827. 135(3), p. 719–725. doi: 10.1007/s00414-020-02493-9. Full text in Research Archive Show summary

  Abstract Several studies have indicated that a vulnerability in the development and regulation of brain function is involved in sudden infant death syndrome (SIDS). The aim of this study was to investigate the genes encoding the brain aquaporins (AQPs) AQP1 and AQP9 in SIDS. The hypothesis was that specific variants of these genes are part of the genetic vulnerability predisposing infants to sudden unexpected death. The study included 168 SIDS cases with a median age of 15.5 (range 2–52) weeks and 372 adolescent/adult deceased controls with a median age of 44 (range 11–91) years. In the AQP1 gene, the rs17159702 CC/CT genotypes were found to be associated with SIDS ( p = 0.02). In the AQP9 gene, the combination of a TT genotype of rs8042354, rs2292711 and rs13329178 was more frequent in SIDS cases than in controls ( p = 0.03). In the SIDS group, an association was found between genetic variations in the AQP1 gene and maternal smoking and between the 3xTT combination in the AQP9 gene and being found lifeless in a prone position. In conclusion, this study adds further evidence to the involvement of brain aquaporins in SIDS, suggesting that specific variants of AQP genes constitute a genetic predisposition, making the infant vulnerable to sudden death together with external risk factors and probably other genetic factors.

• Vollmer-Sandholm, Mary Jo; Myhre, Arne Kristian; Otterman, Gabriel; Lydersen, Stian & Stray-Pedersen, Arne (2021). Amongst Norwegian paediatricians there is little agreement in management of cases of suspected child maltreatment. Acta Paediatrica. ISSN 0803-5253. 110(10), p. 2865–2872. doi: 10.1111/apa.16017. Full text in Research Archive Show summary

  Aim Child maltreatment is not unusual in our society but little is known about the medical management of cases in the Nordic countries. This study investigated physician knowledge and practice in cases of suspected physical and sexual abuse and neglect. Methods Using a patient vignette questionnaire, we assessed paediatrician knowledge and clinical decision-making on paediatric wards at 17 hospitals in Norway. Experts and non-experts in child maltreatment responded to the survey which described six potential cases of physical and sexual abuse and neglect. Results A total of 156 paediatricians, 67% of whom were female and with a mean age of 40, responded. There was a high level of unanimity in recognition of abuse, but wide variation and little consensus in clinical decision-making and adherence to national guidelines, with Fleiss kappa ranging from −0.002 to 0.468. In cases involving physical abuse concerns in infants and toddlers, less than half of all paediatricians reported they would order a full radiologic skeletal survey and head MRI/CT imaging, and less than 30% would plan follow-up consultations. Conclusion This study shows little agreement in the paediatric management of child maltreatment cases. These findings suggest the need for a national plan ensuring appropriate paediatric care for maltreated children.

• Breen, Jan Mario; Næss, Pål Aksel; Gaarder, Christine & Stray-Pedersen, Arne (2021). Autopsy findings in drivers and passengers from fatal motor vehicle collisions: limited differences in injury patterns and toxicological test results. Forensic Science, Medicine, and Pathology. ISSN 1547-769X. 17(2), p. 235–246. doi: 10.1007/s12024-021-00359-z. Full text in Research Archive Show summary

  Abstract 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.

• Stray-Pedersen, Arne; Vollmer-Sandholm, Mary Jo; Aukland, Stein Magnus; Due-Tønnessen, Bernt J.; Grøgaard, Jens B. & Haugen, Olav H. [Show all 10 contributors for this article] (2021). Re-evaluation of abusive head trauma in Norway appears flawed. Acta Paediatrica. ISSN 0803-5253. p. 1–5. doi: 10.1111/apa.16069. Full text in Research Archive
• Godt, Johannes Jakob Clemens; Johansen, Cathrine K.; Martinsen, Anne Catrine Trægde; Schulz, Anselm; Brøgger, Helga Maria & Jensen, Kristin [Show all 8 contributors for this article] (2021). Iterative reconstruction improves image quality and reduces radiation dose in trauma protocols; A human cadaver study. Acta Radiologica Open. 10(10), p. 1–11. doi: 10.1177/20584601211055389. Full text in Research Archive Show summary

  Background: Radiation-related cancer risk is an object of concern in CT of trauma patients, as these represent a young population. Different radiation reducing methods, including iterative reconstruction (IR), and spilt bolus techniques have been introduced in the recent years in different large scale trauma centers. Purpose: To compare image quality in human cadaver exposed to thoracoabdominal computed tomography using IR and standard filtered back-projection (FBP) at different dose levels. Material and methods: Ten cadavers were scanned at full dose and a dose reduction in CTDIvol of 5 mGy (low dose 1) and 7.5 mGy (low dose 2) on a Siemens Definition Flash 128-slice computed tomography scanner. Low dose images were reconstructed with FBP and Sinogram affirmed iterative reconstruction (SAFIRE) level 2 and 4. Quantitative image quality was analyzed by comparison of contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR). Qualitative image quality was evaluated by use of visual grading regression (VGR) by four radiologists. Results: Readers preferred SAFIRE reconstructed images over FBP at a dose reduction of 40% (low dose 1) and 56% (low dose 2), with significant difference in overall impression of image quality. CNR and SNR showed significant improvement for images reconstructed with SAFIRE 2 and 4 compared to FBP at both low dose levels. Conclusions: Iterative image reconstruction, SAFIRE 2 and 4, resulted in equal or improved image quality at a dose reduction of up to 56% compared to full dose FBP and may be used a strong radiation reduction tool in the young trauma population.

• Lomia, Nino; Berdzuli, Nino; Pestvenidze, Ekaterine; Sturua, Lela; Sharashidze, Nino & Kereselidze, Maia [Show all 10 contributors for this article] (2020). Socio-Demographic Determinants of Mortality from Chronic Noncommunicable Diseases in Women of Reproductive Age in the Republic of Georgia: Evidence from the National Reproductive Age Mortality Study (2014). International Journal of Women's Health. 12, p. 89–105. doi: 10.2147/IJWH.S235755. Full text in Research Archive Show summary

  Purpose: Worldwide, noncommunicable diseases (NCDs) are the leading cause of premature death of women, taking the highest toll in developing countries. This study aimed to identify key socio-demographic determinants of NCD mortality in reproductive-aged women (15– 49 years) in Georgia. Materials and Methods: The study employed the verbal autopsy data from the second National Reproductive Age Mortality Survey 2014. Univariate and multivariate logistic regression models were fitted to explore the association between each risk factor and NCD mortality, measured by crude and adjusted odds ratio (AOR) with respective 95% confidence intervals (95% CI). Results: In the final sample of 843 women, 586 (69.5%) deaths were attributed to NCDs, the majority of which occurred outside a hospital (72.7%) and among women aged 45– 49 years (46.8%), ethnic Georgians (85.2%), urban residents (60.1%), those being married (60.6%), unemployed (75.1%) or having secondary and higher education (69.5%), but with nearly equal distribution across the wealth quintiles. After multivariate adjustment, the odds of dying from NCDs were significantly higher in women aged 45– 49 years (AOR=17.69, 95% CI= 9.35 to 33.50), those being least educated (AOR=1.55, 95% CI= 1.01 to 2.37) and unemployed (AOR=1.47, 95% CI= 1.01 to 2.14) compared, respectively, to their youngest (15– 24 years), more educated and employed counterparts. Strikingly, the adjusted odds were significantly lower in “other” ethnic minorities (AOR=0.29, 95% CI= 0.14 to 0.61) relative to ethnic Georgians. Contrariwise, there were no significant associations between NCD mortality and women’s marital or wealth status, place of residence (rural/urban) or place of death. Conclusion: Age, ethnicity, education, and employment were found to be strong independent predictors of young women’s NCD mortality in Georgia. Further research on root causes of inequalities in mortality across the socioeconomic spectrum is warranted to inform equity- and life course-based multisectoral, integrated policy responses that would be conducive to enhancing women’s survival during and beyond reproduction.

• Chotta, Nikolas Albert Sagumo; Msuya, Sia E.; Mgongo, Melina Bernard; Hashim, Tamara Hussein & Stray-Pedersen, Arne (2020). Mother’s Knowledge on HIV, Syphilis, Rubella, and Associated Factors in Northern Tanzania: Implications for MTCT Elimination Strategies. International Journal of Pediatrics. ISSN 1687-9740. 2020:7546954, p. 1–11. doi: 10.1155/2020/7546954. Full text in Research Archive Show summary

  Background . Infections transmitted from mother to child (MTCT) during pregnancy, childbirth, and breastfeeding contribute significantly to the high infant and childhood morbidity and mortality in sub-Saharan African countries. The most significant and preventable of these include HIV, syphilis, and rubella. To achieve elimination, mothers need to be aware of and to understand effective preventive measures against these infections. Lack of comprehensive knowledge on transmission and prevention of MTCT infections is one of the factors hindering achievement of the elimination goals for these infections. The aim of this study was to assess the knowledge of HIV, syphilis, rubella, and associated factors among mothers in the Kilimanjaro region of Tanzania. Methods . We conducted a community-based cross-sectional study in three districts of the Kilimanjaro region from September to October 2016. The study involved mothers with children up to five years of age. Data collection involved the use of a questionnaire, administered by face-to-face interviews. Logistic regression analysis was used to assess predictors of mothers’ knowledge on MTCT infections. Results . A total of 618 mothers were recruited, with a mean age of 29.6 (SD 7.6) years. The overall knowledge on MTCT infections was low. The highest level of knowledge on MTCT infections was regarding HIV (89.2%). Fewer mothers had knowledge of syphilis (27.8%). Rubella was the least known; only 12% of mothers were aware of rubella infection. District of residence and having knowledge of syphilis were predictors for rubella knowledge, while for syphilis knowledge, significant predictors were age group, occupation, and those having knowledge on HIV and rubella. Predictors for HIV knowledge were residential district, having a mobile phone, and those having knowledge of syphilis and rubella. Conclusions . This study confirmed that mothers have low overall knowledge on MTCT infections. To achieve the MTCT elimination goals, targeted interventions to improve knowledge among women of childbearing age are recommended.

• Parekh, Utsav; Chariot, Patrick; Dang, Catherine; Stray-Pedersen, Arne; Druid, Henrik & Sajantila, Antti (2020). A roadmap to the safe practice of forensic medicine in the COVID-19 pandemic. Journal of Forensic and Legal Medicine. ISSN 1752-928X. 76:102036, p. 1–8. doi: 10.1016/j.jflm.2020.102036. Full text in Research Archive
• Lomia, Nino; Berdzuli, Nino; Sharashidze, Nino; Sturua, Lela; Pestvenidze, Ekaterine & Kereselidze, Maia [Show all 9 contributors for this article] (2020). Socio-demographic determinants of road traffic fatalities in women of reproductive age in the republic of georgia: Evidence from the national reproductive age mortality study (2014). International Journal of Women's Health. 12, p. 527–537. doi: 10.2147/IJWH.S244437. Full text in Research Archive Show summary

  Purpose: Globally and in the European region, the road traffic injuries (RTI) have emerged as a major public health and development problem, killing the most productive adult members of a population, including women. This study aimed to identify the key socio-demographic determinants of premature and avoidable RTI mortality in reproductive-aged women (15– 49 years) in Georgia. Materials and Methods: The study employed verbal autopsy data from the second national reproductive age mortality survey (RAMOS 2014). Univariate and multivariate logistic regression models were fitted using the Firth method to assess the crude and adjusted effects of each individual level socio-demographic factor on the odds of RTI-attributed death, with corresponding 95% confidence intervals (COR and AOR, 95% CI). Results: Of 843 women aged 15– 49 years, 78 (9.3%) were the victims of fatal traffic crashes. After multivariate adjustment, the odds of dying from RTI were significantly higher in women aged 15– 29 years (AOR=7.73, 95% CI= 4.20 to 14.20), those being employed (AOR=2.11, 95% CI= 1.22 to 3.64) and the wealthiest (AOR=2.88, 95% CI= 1.44 to 5.77) compared, respectively, to their oldest (40– 49 years), unemployed and poorest counterparts. Conversely, there were no statistically significant ethnic, marital, rural/urban, and educational disparities in women’s RTI fatalities. Overall, motorized four-wheeler occupants (78.2%), particularly passengers (71.8%), appeared to be the most common victims of fatal road injuries than pedestrians (20.5%). Alarmingly, the vast majority (85.9%) of any type of road users died instantly at the scene of collision, as compared to deaths en route to hospital (1.3%) or in hospital (11.5%). Conclusion: Age, employment, and wealth status appeared to be the strong independent predictors of young women’s RTI mortality in Georgia. Future comprehensive research would be advantageous for further deciphering the differential impact of social determinants on traffic-induced fatalities, as a vital platform for evidence-based remedial actions on this predictable and preventable safety hazard.

• Breen, Jan Mario; Næss, Pål Aksel; Hansen, Trond Boye; Gaarder, Christine & Stray-Pedersen, Arne (2020). Serious motor vehicle collisions involving young drivers on Norwegian roads 2013–2016: Speeding and driver-related errors are the main challenge. Traffic Injury Prevention. ISSN 1538-9588. 21(6), p. 382–388. doi: 10.1080/15389588.2020.1770237. Full text in Research Archive Show summary

  Objective: Motor vehicle collisions (MVCs) are a leading cause of death and acute disability among young adults worldwide. We performed a prospective study of young drivers involved in severe MVCs, investigating the critical events leading up to a collision with an emphasis on driver-related factors and collision culpability. Methods: A study was conducted in southeastern Norway of all drivers younger than 25 years who were involved in high-energy MVCs resulting in immediate hospitalization during 2013–2016. Collision investigators evaluated the exterior and interior of the motor vehicle (MV) within 24 h. Complementary information was obtained from interviews of collision victims, ambulance personnel and witnesses, from police reports, and medical records. Results: There were 145 young drivers included during a 3-year study period, representing an estimated incidence of 29 per 100,000 drivers with registered driving licenses. Ninety-two percent (133/145) were considered culpable of initiating the MVC, and only 2% of the critical factors preceding the collision were not related to the driver. There were 74% (108/145) males, the median MV (motor vehicle) age age was 14 years, and 86% (125/145) of the MVs were passenger cars. The MVCs predominantly occurred on rural roads (90%, 130/145). Among the culpable drivers, speeding behavior was the main predisposing factor in 80% (106/133) of the collisions. Driving at excessive speed was associated with single-vehicle collisions (87%, 74/85) and the presence of passengers (89%, 56/63). Compared to nonculpable drivers, culpable drivers were more often younger than 21years (66% vs 33%, p = 0.031), had obtained their license less than 2 years previously (68% vs 20%, p = 0.004), and were more likely to have been drinking or using drugs (27% vs 0%, p = 0.039). The overall rate of seatbelt use was 79% (114/145). Conclusion: The vast majority of injury-causing MVCs involving young drivers are initiated by those drivers. These incidents are characterized by male drivers with little driving experience who are operating old cars on rural roads at excessive speeds. Driving under the influence of alcohol or drugs is also not uncommon. These issues should be targeted in future preventive measures.

• Bøylestad, Lillian; Stray-Pedersen, Arne; Vege, Åshild; Osberg, Silje & Rognum, Torleiv Ole (2020). Death‐scene investigations contribute to legal protection in unexpected child deaths in Norway. Acta Paediatrica. ISSN 0803-5253. 109(12), p. 2627–2635. doi: 10.1111/apa.15284. Full text in Research Archive Show summary

  Aim This study reviewed cases of sudden unexpected child deaths in Norway to determine the significance of death‐scene investigations (DSIs) in establishing cause and manner of death, and thereby it is relevance to legal protection. Methods Data from forensic autopsy reports and DSIs were collected and analysed for cases of unexpected deaths in children below 4 years of age in Norway during 2010‐2016. Results Out of 141 cases, the death scene was investigated as a voluntary procedure in 75 cases and by the police in 41 cases. The cause of death remained unexplained in 81/141 (57%) of the cases, of which 46/141 (33%) met the criteria for sudden infant death syndrome (SIDS) or sudden unexplained death in early childhood (SUDC). The manner of death was determined in 102/141 (72%). Voluntary DSI increased the ability to rule out accidental suffocation, facilitated evaluations of environmental risk factors and enabled detection of possible neglect. Conclusion Death‐scene investigations illuminate uncertainty about the cause of death, especially in grey‐area cases where accidental suffocation, neglect or abuse is suspected. Knowledge about the course of events and the cause of death enhances both the child's and the caregiver's legal protection. Death‐scene investigations should therefore be mandatory.

• Chotta, Nikolas Albert Sagumo; Mgongo, Melina Bernard; Uriyo, Jacqueline; Msuya, Sia E; Stray-Pedersen, Babill & Stray-Pedersen, Arne (2019). Awareness and Factors Associated with Health Care Worker’s Knowledge on Rubella Infection: A Study after the Introduction of Rubella Vaccine in Tanzania. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 16:1676(10), p. 1–10. doi: 10.3390/ijerph16101676. Full text in Research Archive Show summary

  Background Congenital rubella syndrome is a global health problem. The incidence is much higher in Africa and Southeast Asia than the rest of the world, especially in countries where universal rubella vaccination has not been implemented. Healthcare worker’s knowledge on rubella infection and the rubella vaccine is of utmost importance in achieving and maintaining vaccination coverage targets. This study aimed to assess health care workers knowledge on rubella infection in Kilimanjaro Tanzania, after the introduction of a rubella vaccination. Methods This was a health facility-based cross sectional study. It was conducted in three districts of the Kilimanjaro region between August and October 2016. The study involved eligible health care workers in selected health facilities. An interview guide was used for collecting information by face-to-face interviews. Multivariate analysis was used to assess factors associated with rubella knowledge among healthcare workers. Results A total of 126 health care workers were interviewed. An acceptable level of knowledge was considered if all five questions about rubella were correctly answered. Only 26.4% (n = 31) answered all questions correctly. In multivariate analysis education level and working department were predictors of rubella knowledge; health care workers with an advanced diploma had an adjusted odds ratio (AOR) of 7.7 (95% Confidence interval; CI: 1.4, 41.0), those with a university degree (AOR: 10; 95% CI: 2.4; 42.5) and health care workers in the outpatient department (AOR: 0.06; 95% CI: 0.04; 0.29). Conclusions Our study confirmed that health care worker’s knowledge on rubella infection was low in the areas where rubella vaccination had been introduced. We recommend continuous education and supportive supervision post vaccine introduction in order to increase healthcare worker’s knowledge on rubella infection, congenital rubella syndrome and prevention through sustained high vaccination coverage.

• Chotta, Nikolas Albert Sagumo; Mgongo, Melina Bernard; Msuya, Sia Emmanueli; Nyombi, Balthazar Melchior; Uriyo, Jacqueline & Stray-Pedersen, Babill [Show all 7 contributors for this article] (2019). Prevalence and factors associated with HIV and syphilis infection among children aged 0-36 months in Kilimanjaro, Tanzania: A community-based cross-sectional study. Tropical Medicine and Health. ISSN 1348-8945. 47(1). doi: 10.1186/s41182-019-0183-4. Full text in Research Archive Show summary

  Background Childhood mortality is high in sub-Saharan Africa. Mother-to-child transmission (MTCT) of HIV and congenital syphilis are among significant causes. Dual elimination of these two infections is one of the international goals. Community-based studies on the burden of HIV and syphilis among children will contribute to fine-tuning the interventions to achieve the elimination goal. This study aims to describe the prevalence of HIV and syphilis among children aged 0–36 months and associated factors in northern Tanzania. Methods This was a community-based cross-sectional study, which was conducted in all the seven districts of Kilimanjaro region. Multistage sampling was used, and a total of 2452 children aged 0 to 36 months and their primary caretakers were enrolled. Interviews were conducted with the mother/caretaker, and dried blood samples were collected from the children and processed for laboratory diagnosis of HIV and syphilis. HIV ELISA was first performed on all the samples. Positive samples of children < 18 months were confirmed using PCR. Results The prevalence of HIV among 2452 children aged 0–36 months was 1.7% (n = 42). There was a significant difference in the distribution of HIV by age of the child, maternal antenatal attendance, and breastfeeding history. The prevalence of syphilis was 0.4% (n = 10). Five of the children were more than 1 year old. All children with a positive test for syphilis were from Moshi rural district, and their mothers consumed alcohol. No child was co-infected with HIV and syphilis. Conclusions Though the prevalence of the two infections was low, detecting syphilis in children suggests a missed opportunity in screening women during pregnancy. The region may be on track with the goal to achieve dual elimination of mother-to-child transmitted HIV and syphilis. However, efforts are needed to reduce missed opportunities for screening women for syphilis and HIV early in pregnancy and retesting at 3rd trimester/delivery. Strategies to improve testing for HIV-exposed children are needed.

• Eidahl, Johanna; Opdal, Siri Hauge; Rognum, Torleiv Ole & Stray-Pedersen, Arne (2019). Postmortem evaluation of brain edema: An attempt with measurements of water content and brain-weight-to-inner-skull-circumference ratio. Journal of Forensic and Legal Medicine. ISSN 1752-928X. 64, p. 1–6. doi: 10.1016/j.jflm.2019.03.003. Full text in Research Archive Show summary

  Introduction Postmortem evaluations of cerebral edema typically involve examinations of macroscopic features such as the presence of pressure signs and compression of the ventricles. Global massive edema is easily detectable in an autopsy, but less-extensive edema may be difficult to diagnose. Aim The aim of this study was to compare measurements of brain water contents, postmortem CT radiodensity and brain weight to skull size in edematous and nonedematous brains in order to develop an objective method for postmortem evaluations of brain edema. Method Fifty-four subjects autopsied at Oslo University Hospital underwent a standard forensic postmortem examination, including a computed axial tomography (CT) scan, measurement of brain weight, and macroscopic evaluation of the brain. CT images were used to roughly measure the inner skull circumference. The water content of the brain was determined by excising samples of approximately 1 g of brain tissue from eight different areas of the brain surface, drying them, and measuring their percentage water content. Results The main finding was a significant relationship between brain weight and inner skull circumference, with the ratio between these two parameters being significantly higher in cases with severe postmortem brain edema than in cases with very little or no brain edema. The water content did not differ significantly between the edema and nonedema cases. There were no significant changes in radiodensity. Conclusion This indicates that the brain-weight-to-inner-skull-circumference ratio may serve as a good marker for severe brain edema in postmortem diagnostics, whereas measurements of water content can be misleading.

• Völgyes, David; Martinsen, Anne Catrine Trægde; Stray-Pedersen, Arne; Waaler, Dag & Pedersen, Marius (2018). A Weighted Histogram-Based Tone Mapping Algorithm for CT images. Algorithms. 11(8), p. 1–20. doi: 10.3390/a11080111. Full text in Research Archive Show summary

  Computed Tomography (CT) images have a high dynamic range, which makes visualization challenging. Histogram equalization methods either use spatially invariant weights or limited kernel size due to the complexity of pairwise contribution calculation. We present a weighted histogram equalization-based tone mapping algorithm which utilizes Fast Fourier Transform for distance-dependent contribution calculation and distance-based weights. The weights follow power-law without distance-based cut-off. The resulting images have good local contrast without noticeable artefacts. The results are compared to eight popular tone mapping operators.

• Völgyes, David; Martinsen, Anne Catrine Trægde; Stray-Pedersen, Arne; Waaler, Dag & Pedersen, Marius (2018). Image De-Quantization Using Plate Bending Model. Algorithms. 11(8). doi: 10.3390/a11080110. Full text in Research Archive Show summary

  Discretized image signals might have a lower dynamic range than the display. Because of this, false contours might appear when the image has the same pixel value for a larger region and the distance between pixel levels reaches the noticeable difference threshold. There have been several methods aimed at approximating the high bit depth of the original signal. Our method models a region with a bended plate model, which leads to the biharmonic equation. This method addresses several new aspects: the reconstruction of non-continuous regions when foreground objects split the area into separate regions; the incorporation of confidence about pixel levels, making the model tunable; and the method gives a physics-inspired way to handle local maximal/minimal regions. The solution of the biharmonic equation yields a smooth high-order signal approximation and handles the local maxima/minima problems.

• Völgyes, David; Pedersen, Marius; Stray-Pedersen, Arne; Waaler, Dag & Martinsen, Anne Catrine Trægde (2018). Applicability of a clinical cardiac CT protocol in post mortem studies. Journal of Forensic Radiology and Imaging. ISSN 2212-4780. 12, p. 25–30. doi: 10.1016/j.jofri.2018.01.003. Full text in Research Archive Show summary

  Objective Confirmation whether an optimized clinical cardiac CT scan protocol is also optimal for post mortem cardiac CT scans without iodine contrast or the reconstruction parameters should be changed. Materials and methods 27 CT volumes (three cases for three recon- struction kernel with three different iterative reconstruction settings) were graded by six readers in order to find the optimal reconstruction parame- ters. The scans were performed on a Siemens Definition Flash CT scanner using 120 kV tube potentials. Results The study has shown that from the investigated options the softest cardiac kernel with the strongest iterative reconstruction were pre- ferred by the readers (I26 Safire 3). Conclusion The results indicate that the scan protocol which was adopted from clinical practice is applicable in forensic radiology too even though iodine contrast agent was not administered.

• Chotta, Nikolas Albert Sagumo; Mgongo, Melina Bernard; Uriyo, Jacqueline; Msuya, Sia Emmanueli; Stray-Pedersen, Babill & Stray-Pedersen, Arne (2017). Rubella sero-prevalence among children in Kilimanjaro region: A community based study prior to the introduction of rubella vaccine in Tanzania. Italian Journal of Pediatrics. ISSN 1720-8424. 43:63, p. 1–7. doi: 10.1186/s13052-017-0379-3. Full text in Research Archive Show summary

  Background Childhood rubella infection is a mild, self-limiting illness. Rubella infection among pregnant women however, is a major public health concern. Depending on gestation age, it may result in fetal death, stillbirth or a new-born with congenital rubella syndrome (CRS). Maternal antibodies protect young infants from rubella infection and lifelong immunity is acquired by vaccination or post-rubella infection. This study aims at characterizing rubella infection and its epidemiology in the Kilimanjaro region, prior to the introduction of the rubella vaccine in Tanzania. Methods This was a population based cross-sectional study, covering all the seven districts in Kilimanjaro region, North-eastern Tanzania. The study population included children of 0 to 36 months of age and their mothers/primary caretakers. A multistage sampling method was used to obtain a representative sample of the children. Interviews were conducted using a structured questionnaire. Dried blood spot (DBS) samples were taken from eligible children. Rubella specific IgG antibodies were detected from eluted serum by enzyme-linked immunosorbent assay (ELISA). Descriptive statistics were used to summarize the data, the difference between groups was tested by Fishers exact test or chi square test as appropriate. Univariate and multivariate analysis was used, with rubella sero-positive groups as dependent variables and the socio-demographic, children, paediatric and parental factors as independent variables, the Odds ratio and their 95% confidence intervals were calculated to assess the strength of association between the dependent and independent variables. A p value less than 0.05 was considered significant. Results The overall rubella sero-prevalence was 1.8%. Rural residence was associated with greater risk for rubella infection. Other family characteristic did not predict rubella infection. Conclusions This study highlights the low natural immunity to rubella among children prior to the introduction of rubella vaccine in Tanzania. Our research underscores the need for an effective rubella vaccination program to prevent CRS. More epidemiologic and immunologic studies are needed to guide the vaccination deployment and administration strategy in Tanzania.

• Opdal, Siri Hauge; Vege, Åshild; Stray-Pedersen, Arne & Rognum, Torleiv Ole (2017). The gene encoding the inwardly rectifying potassium channel Kir4.1 may be involved in sudden infant death syndrome. Acta Paediatrica. ISSN 0803-5253. 106(9), p. 1474–1480. doi: 10.1111/apa.13928. Full text in Research Archive
• Bilo, Robert A. C.; Banaschak, Sibylle; Herrmann, Bernd; Karst, Wouter A.; Kubat, Bela & Nijs, Hubert G.T. [Show all 9 contributors for this article] (2017). Using the table in the Swedish review on shaken baby syndrome will not help courts deliver justice. Acta Paediatrica. ISSN 0803-5253. 106(7), p. 1043–1045. doi: 10.1111/apa.13857. Full text in Research Archive
• Volgyes, David; Pedersen, Marius; Stray-Pedersen, Arne; Waaler, Dag & Martinsen, Anne Catrine Trægde (2017). How different iterative and filtered back projection kernels affect computed tomography numbers and low contrast detectability. Journal of computer assisted tomography. ISSN 0363-8715. 41(1), p. 75–81. doi: 10.1097/RCT.0000000000000491. Full text in Research Archive
• Breen, Jan Mario; Næss, Pål Aksel; Gjerde, Hallvard; Gaarder, Christine & Stray-Pedersen, Arne (2017). The significance of preexisting medical conditions, alcohol/drug use and suicidal behavior for drivers in fatal motor vehicle crashes: a retrospective autopsy study. Forensic Science, Medicine, and Pathology. ISSN 1547-769X. 14(1), p. 4–17. doi: 10.1007/s12024-017-9934-x. Full text in Research Archive
• Rognum, Torleiv Ole & Stray-Pedersen, Arne (2016). Veitrafikkulykker. In Rognum, Torleiv Ole (Eds.), Lærebok i rettsmedisin 3. utgave. Gyldendal Akademisk. ISSN 9788205494176. p. 225–238. Full text in Research Archive
• Stray-Pedersen, Arne & Rognum, Torleiv Ole (2016). Barnemishandling. In Rognum, Torleiv Ole (Eds.), Lærebok i rettsmedisin 3. utgave. Gyldendal Akademisk. ISSN 9788205494176. p. 336–348. Full text in Research Archive
• Rognum, Torleiv Ole; Holmen, Sigve; Musse, Musse Ahmed; Dahlberg, Pål Skage; Stray-Pedersen, Arne & Saugstad, Ola Didrik [Show all 7 contributors for this article] (2016). Estimation of time since death by vitreous humor hypoxanthine, potassium, and ambient temperature. Forensic Science International. ISSN 0379-0738. 262, p. 160–165. doi: 10.1016/j.forsciint.2016.03.001. Full text in Research Archive
• Stray-Pedersen, Arne (2016). Medisinsk aldersvurdering av barn og unge voksne. In Rognum, Torleiv Ole (Eds.), Lærebok i rettsmedisin 3. utgave. Gyldendal Akademisk. ISSN 9788205494176. p. 163–167. Full text in Research Archive
• Stray-Pedersen, Arne (2016). Radiologi i rettsmedisin. In Rognum, Torleiv Ole (Eds.), Lærebok i rettsmedisin 3. utgave. Gyldendal Akademisk. ISSN 9788205494176. p. 159–163. Full text in Research Archive
• Stray-Pedersen, Arne (2016). Organisering av rettsmedisin i de nordiske land. Hvor går norsk rettsmedisin? In Rognum, Torleiv Ole (Eds.), Lærebok i rettsmedisin 3. utgave. Gyldendal Akademisk. ISSN 9788205494176. p. 423–425. Full text in Research Archive
• Rognum, Torleiv Ole; Vege, Åshild; Stray-Pedersen, Arne; Ferrante, Linda; Bøylestad, Lillian & Opdal, Siri Hauge (2016). Krybbedød. In Rognum, Torleiv Ole (Eds.), Lærebok i rettsmedisin 3. utgave. Gyldendal Akademisk. ISSN 9788205494176. p. 178–196. Full text in Research Archive
• Stray-Pedersen, Arne (2014). Suicide in children and adolescents: A case report of the possible suicide of a 7 year old girl and presentation of data from a forensic autopsy material in Norway. Scandinavian Journal of Forensic Science. ISSN 1503-9552. 20(1), p. 9–12. doi: 10.2478/sjfs-2014-0001. Full text in Research Archive
• Skjerven-Martinsen, Marianne; Næss, Pål Aksel; Hansen, Trond Boye; Gaarder, Christine; Lereim, Inggard & Stray-Pedersen, Arne (2014). A prospective study of children aged <16 years in motor vehicle collisions in Norway: Severe injuries are observed predominantly in older children and are associated with restraint misuse. Accident Analysis and Prevention. ISSN 0001-4575. 73, p. 151–162. doi: 10.1016/j.aap.2014.09.004. Full text in Research Archive
• Arnestad, Marianne; Eldor, Kari Beate Boye; Stray-Pedersen, Arne; Bachs, Liliana & Karinen, Ritva Anneli (2014). Suicide due to cyclizine overdose. Journal of Analytical Toxicology. ISSN 0146-4760. 38(2), p. 110–112. doi: 10.1093/jat/bkt100. Full text in Research Archive
• Martinsen, Marianne Skjerven; Næss, Pål Aksel; Hansen, Trond Boye; Staff, Trine & Stray-Pedersen, Arne (2013). Observational study of child restraining practice on Norwegian high-speed roads: Restraint misuse poses a major threat to child passenger safety. Accident Analysis and Prevention. ISSN 0001-4575. 59, p. 479–486. doi: 10.1016/j.aap.2013.07.023. Full text in Research Archive
• Stray-Pedersen, Arne; Omland, Sigrid; Nedregaard, Bård; Klevberg, Sjur & Rognum, Torleiv Ole (2011). An infant with subdural hematoma and retinal hemorrhages: does von Willebrand disease explain the findings? Forensic Science, Medicine, and Pathology. ISSN 1547-769X. 7(1), p. 37–41. doi: 10.1007/s12024-010-9176-7. Full text in Research Archive
• Skjerven-Martinsen, Marianne; Næss, Pål Aksel; Hansen, Trond Boye; Rognum, Torleiv Ole; Lereim, Inggard & Stray-Pedersen, Arne (2011). In-depth evaluation of real-world car collisions: fatal and severe injuries in children are predominantly caused by restraint errors and unstrapped cargo. Traffic Injury Prevention. ISSN 1538-9588. 12(5), p. 491–499. doi: 10.1080/15389588.2011.596868. Full text in Research Archive
• Rognum, Torleiv Ole; Wille-Sveum, Lisbeth; Arnestad, Marianne; Stray-Pedersen, Arne & Vege, Åshild (2010). Death scene investigation in sudden death in infant and small children. The Norwegian experiment. Scandinavian Journal of Forensic Science. ISSN 1503-9552. 16(1), p. 20–23. Full text in Research Archive
• Opdal, Siri Hauge; Vege, Åshild; Stray-Pedersen, Arne & Rognum, Torleiv Ole (2010). Aquaporin-4 Gene Variation and Sudden Infant Death Syndrome. Pediatric Research. ISSN 0031-3998. 68(1), p. 48–51. Full text in Research Archive
• Hegstad, Solfrid; Stray-Pedersen, A; Olsen, Linda Helen; Olsen, Lars Jørgen K.; Vege, Å & Rognum, TO [Show all 8 contributors for this article] (2009). Determination of cotinine in pericardial fluid and whole blood by liquid chromatography-tandem mass spectrometry. Journal of Analytical Toxicology. ISSN 0146-4760. 33(4), p. 218–222. Full text in Research Archive
• Stray-Pedersen, Arne; Vege, Åshild; Opdal, Siri Hauge; Moberg, Sara & Rognum, Torleiv Ole (2009). Surfactant protein A and D gene polymorphisms and protein expression in victims of sudden infant death. Acta Paediatrica. ISSN 0803-5253. 98(1), p. 62–68. doi: 10.1111/j.1651-2227.2008.01090.x. Full text in Research Archive
• Stray-Pedersen, Arne; Vege, Åshild; Stray-Pedersen, Asbjørg; Holmskov, U & Rognum, Torleiv Ole (2008). Post-neonatal drop in alveolar SP-A expression: Biological significance for increased vulnerability to SIDS? Pediatric Pulmonology. ISSN 8755-6863. 43. doi: 10.1002/ppul.20750. Full text in Research Archive
• Stray-Pedersen, Arne; Vege, Åshild & Rognum, Torleiv Ole (2008). Helicobacter pylori antigen in stool is associated with SIDS and sudden infant deaths due to infectious disease. Pediatric Research. ISSN 0031-3998. 64, p. 405–410. Full text in Research Archive
• Bajanowski, Thomas; Vege, Åshild; Byard, Roger W; Krous, Henry F; Arnestad, Marianne & Bachs, Liliana Casulleras [Show all 30 contributors for this article] (2007). Sudden infant death syndrome (SIDS)- Standardised investigations and classification: Recommendations. Forensic Science International. ISSN 0379-0738. 165(2-3), p. 129–143. doi: 10.1016/j.forsciint.2006.05.028. Full text in Research Archive
• Stray-Pedersen, Arne; Gaustad, Peter; Stray-Pedersen, Babill & Rognum, Torleiv Ole (2007). Detection rate of Helicobacter pylori stool antigen in newborn infants and small children. Journal of Perinatal Medicine. ISSN 0300-5577. 35, p. 155–158. doi: 10.1515/JPM.2007.040. Full text in Research Archive
• Stray-Pedersen, Arne & Rognum, Torleiv Ole (2006). Shaken baby syndrome: commentary on current debate. Scandinavian Journal of Forensic Science. ISSN 1503-9552. 12(2), p. 79–83. Full text in Research Archive
• Stray-Pedersen, Arne; Arnestad, Marianne; Vege, Åshild; Sveum, Lisbeth & Rognum, Torleiv Ole (2005). Samsoving og krybbedød. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 125(21), p. 2919–2921. Full text in Research Archive
• Stray-Pedersen, Arne; Aaberge, Ingeborg Aase S.; Früh, A & Abrahamsen, T.G (2005). Pneumococcal conjugate vaccine followed by pneumococcal polysaccharide vaccine;immunogenicity in patients with ataxiatelangiectasia. Clinical and Experimental Immunology. ISSN 0009-9104. 140, p. 507–516. Full text in Research Archive
• deLange, Charlotte; Stray-Pedersen, Arne; Borthne, Arne & Rognum, Torleiv Ole (2004). Radiological investigation of SUDI. Scandinavian Journal of Forensic Science. ISSN 1503-9552. 10, p. 74–74. Full text in Research Archive
• Stray-Pedersen, Arne; Jonsson, T.; Heiberg, A; Lindman, CR; Widing, E & Aaberge, Ingeborg Aase S. [Show all 8 contributors for this article] (2004). The impact of an early truncating founder ATM mutaion on Immunoglobulins,spesifc antibodies and lymphocyte populations in ataxia-telangiectasia patients and their parents. Clinical and Experimental Immunology. ISSN 0009-9104. p. 179–186. Full text in Research Archive
• Stray-Pedersen, Arne; Arnestad, Marianne; Opdal, Siri Hauge; Vege, Åshild; Rognum, Torleiv Ole & Byard, RW (2004). Globally accepted definition and diagnostic criteria - crucial for solving the SIDS enigma. Scandinavian Journal of Forensic Science. ISSN 1503-9552. 10, p. 70–71. Full text in Research Archive

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• Gravensteen, Ida Kathrine & Stray-Pedersen, Arne (2025). Gi oss en egen spesialitet! Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 145(4). doi: 10.4045/tidsskr.25.0013. Full text in Research Archive
• Stray-Pedersen, Arne (2025). Lik på lik på lik, uten navn. p. 8–11. Full text in Research Archive
• Stray-Pedersen, Arne (2020). Ubalansert om filleristing. Rettsmedisinere må ta stilling til om alvorlige skader hos barn kan være påført ved vold. Alternative forklaringer eksisterer, men de må også bevisprøves. Full text in Research Archive
• Stray-Pedersen, Arne (2020). Hold hodet kaldt, og hjertet varmt. Full text in Research Archive
• Stray-Pedersen, Arne; Møller, Claus; Lange, Charlotte de; Due-Tønnessen, Bernt Johan; Grøgaard, Jens & Haugen, Olav H. [Show all 18 contributors for this article] (2019). Legers rolle ved mistanke om alvorlig barnemishandling. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 139(2), p. 126–128. doi: 10.4045/tidsskr.18.0922. Full text in Research Archive
• Aukland, Stein Magnus; Møller, Claus & Stray-Pedersen, Arne (2019). Derfor må legen prioritere barnets beste fremfor taushetsplikt. Full text in Research Archive
• Rognum, Torleiv Ole; Vege, Åshild; Stray-Pedersen, Arne & Bøylestad, Lillian (2018). A Scandinavian Perspective. In Duncan, JR & Byard, RW (Ed.), SIDS - Sudden infant and early childhood Death: The past, the present and the future.. University of Adelaide Press. ISSN 9781925261677. p. 421–429. Full text in Research Archive
• Rognum, Torleiv Ole; Holmen, Sigve; Opdal, Siri Hauge; Musse, Musse Ahmed; Saugstad, Ola Didrik & Stray-Pedersen, Arne (2018). Evaluation of confidence of time of death estimation by measurement of hypoxanthine and potassium sampled at the scene of death. Full text in Research Archive
• Opdal, Siri Hauge; Ferrante, Linda; Vege, Åshild; Stray-Pedersen, Arne & Rognum, Torleiv Ole (2018). May unfavorable gene polymorfisms induce ineffective autoresuscitation, hypoxia and brain edema in SIDS? Full text in Research Archive
• Stray-Pedersen, Arne (2018). Blødninger, brudd, sår. Barn med skader som kan gi mistanke om mishandling. Aftenposten (morgenutg. : trykt utg.). ISSN 0804-3116. Full text in Research Archive
• Breen, Jan Mario; Næss, Pål Aksel; Gjerde, Hallvard; Gaarder, Christine & Stray-Pedersen, Arne (2018). Drivers and passengers in fatal motor vehicle collisions: The significance of alcohol/drugs, pre-existing medical conditions and seat belt use. Full text in Research Archive Show summary

  Background: Drivers and passengers represent the largest number of fatalities on the road. To “learn from the dead” aiming to prevent future fatalities, we analyzed the significance of pathology, injuries and toxicological findings in fatal occupants motor vehicle collisions (MVCs). Methods: Forensic autopsy records of MVC occupants in southeast Norway from 2000 through 2014 were studied retrospectively. Data from individual police and collision investigation reports were also collected and analyzed. Results: In total, 406 drivers and 150 passengers had undergone forensic autopsy in the study period, suggesting an autopsy rate of approximately 45%. Eighty-four percent of the drivers were males and 50% had worn seatbelts. Totally 9% of the drivers died from natural causes, 9% were suicides, 65% were culpable accidental deaths, 14% were nonculpable deaths, and 3% were undetermined deaths. Alcohol and/or drugs that indicated impairment at the time of the collision were detected in 50% of culpable drivers aged 35 years and younger. Medical conditions, mostly cardiovascular pathology suggestive of sudden incapacitation prior to the accident were present in 70% of culpable drivers older than 55 years. The 37 natural deaths were all males and died of cardiovascular disease. In 117 passenger fatalities the occupant’s position in the vehicle could be established. Fifty-three percent were males and 62% had used seatbelts. Female passengers used seat belt more frequently than males (p < 0.05). Alcohol above 0.5 g/kg was detected in 30% of front seat passengers of which most were younger than 35 years of age and the fatal accident had occurred during night-time. Multiple injuries involving several body regions and isolated head injuries were the most common causes of death in all occupant groups. With regard to injury patterns no significant differences between drivers, front seat and rear seat passengers were observed. Conclusions: Suicides and natural deaths constitute both significant proportions of MVC fatalities and may be misclassified unless a full inquest including an autopsy is performed. A substantial proportion of young drivers are killed in accidental collisions that may have occurred as a result of either alcohol/drug impairment. Pre-existing medical conditions, most commonly cardiovascular disease, may play a role in fatal crashes involving drivers of older age. The high proportion of alcohol detection and relatively low frequency of belt use among both driver and passenger fatalities highlight the need to continue preventive campaigns and targeted legal action against unsafe driving.

• Stray-Pedersen, Arne & Rognum, Torleiv Ole (2018). Shaking and abusive head trauma – a need for Nordic collaboration. Full text in Research Archive Show summary

  Each year, estimated 20-30 infants and children below 3 years of age are admitted to Norwegian hospitals with severe head injuries. In approx 50 % of the cases the recognized injuries cannot be explained by the history provided by the care-takers, thus raising a suspicion of abuse. In such cases forensic medical experts are called upon by the courts to determine the level of certainty that the injuries in fact may be due to abusive violence and ensure other explanations e.g. birth trauma or unidentified disease have been ruled out. Subdural hematoma is the most common finding in these cases, often in conjunction with retinal hemorrhages, in some cases also encephalopathy. Fractures and bruises occur in several cases. Reports from witnessed unquestionable accidents have proven that such injuries may result from fall from large heights. It has long been recognized that other forms of inflicted blunt force violence involving repeated shaking and various impacts may explain the injuries in abusive head trauma cases. The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) in 2016 questioned the evidence that shaking may cause the triad combination of injuries: subdural hematoma, brain injuryand retinal hemorrhages. The SBU report has had tremendous impact on court cases and is commonly interpreted that there is a lack of evidence that shaking of infants –if it even occurs- may cause any harm to the child. The SBU quest for evidence was based on a search in published data with perpetrator confessions using a categorical approach defining infant shaking injuries only by the precence of the three components of the triad. However, the injuries most indicative of shaking are multiple rib fractures and metaphyseal lesions of the long bones. Interestingly, such injures occur rarely alone but are accompanied by one, two or all three components of the triad. Perpetrator confessions in abusive head trauma cases are rare and must be interpreted with caution. We have been involved in the forensic investigation of five cases with perpetrator confessions of repeated shaking as the main injurious event. All cases involved the presence of subdural hematoma, retinal hemorrhages and brain injury – as well as other injuries and indications of abuse. We advocate a Nordic cooperation in forensic evaluation and research studies of abusive head trauma in order reduce the confusion raised by the SBU report and the implications it may have with regard to child safety.

• Bøylestad, Lillian; Vege, Åshild; Stray-Pedersen, Arne; Osberg, Silje; Olufsen, Catherine & Rognum, Torleiv Ole (2015). Death scene investigation in sudden unexpected deaths in infants and small children in Norway. Scandinavian Journal of Forensic Science. 21(1), p. 45–45. Full text in Research Archive
• Breen, Jan Mario; Næss, Pål Aksel; Hansen, Trond Boye; Gaarder, Christine & Stray-Pedersen, Arne (2015). A prospective in-depth study of real-world car collisions involving youth and young adults. Full text in Research Archive
• Breen, Jan Mario; Næss, Pål Aksel; Gaarder, Christine & Stray-Pedersen, Arne (2015). Case characteristics and injury mechanisms in motor vehicle accidents in South East Norway from 2000 to 2014: An autopsy study. Journal of local and global health science. ISSN 2306-0441. 2(2). doi: 10.5339/jlghs.2015.itma.12. Full text in Research Archive
• Osberg, Silje; Vege, Åshild; Rognum, Torleiv Ole; Bøylestad, Lillian; Olufsen, Catherine & Stray-Pedersen, Arne (2015). External causes of sudden unexpected death in infancy an early childhood in Southeast Norway. Scandinavian Journal of Forensic Science. 21(1). Full text in Research Archive
• Stray-Pedersen, Arne; Osberg, Silje; Martinsen, Anne Catrine Trægde & Rognum, Torleiv Ole (2015). Implementation of CT imaging in post mortem forensic examination. Scandinavian Journal of Forensic Science. 21(1). Full text in Research Archive
• Stål, Karl-Oskar; Breen, Jan Mario & Stray-Pedersen, Arne (2015). Bicyclists killed in traffic in Southeast Norway 2000-2014. Scandinavian Journal of Forensic Science. 21(1). Full text in Research Archive
• Stray-Pedersen, Arne & Rognum, Torleiv Ole (2014). Når døden tjener livet. Full text in Research Archive
• Stray-Pedersen, Arne; Rogde, Sidsel; Ormstad, Kari; Vege, Åshild; Delavaris, Gerd Jorunn & Skjerven-Martinsen, Marianne [Show all 14 contributors for this article] (2012). Forensic medical examination after the July 22nd 2011 terror attack. Full text in Research Archive
• Blechingberg, Anna; Mardal, Kent-Andre; Strisland, Frode; Sundnes, Joakim; Rognum, Torleiv & Vege, Åshild [Show all 8 contributors for this article] (2010). The Baby Justicia Project: Biomechanical Investigations of the Shaken Baby Syndrome (SBS). Full text in Research Archive
• Hegstad, Solfrid; Stray-Pedersen, Arne; Olsen, Linda Helen; Vege, Åshild; Rognum, Torleiv & Mørland, Jørg [Show all 7 contributors for this article] (2008). Determination of cotinine in pericardial fluid and whole blood by liquid chromatography-tandem mass spectrometry. Full text in Research Archive
• Stray-Pedersen, Arne; Hegstad, Solfrid; Vege, Åshild; Christophersen, Asbjørg S.; Mørland, Jørg & Rognum, Torleiv (2008). Measurement of the nicotine metabolite cotinine in SIDS: Bed-sharing infants have 4 times higher cotinine levels infants who slept in own cot. Full text in Research Archive
• Stray-Pedersen, Arne (2008). Vold mot barn. Full text in Research Archive
• Stray-Pedersen, Arne (2008). Hodeskader hos barn. Oss foreldre imellom. ISSN 0803-4826. 21(4), p. 37–37. Full text in Research Archive
• Stray-Pedersen, Arne (2006). Undersøkelser og funn ved barnemishandling. Full text in Research Archive
• Stray-Pedersen, Arne (2006). Innate immunity - implications for SIDS. Full text in Research Archive
• Stray-Pedersen, Arne & Rognum, Torleiv Ole (2006). Shaken baby syndrome: how to cope with biomechanics analysis. Full text in Research Archive
• Stray-Pedersen, Arne (2006). Rettsmedisinske undersøkelser av barn utsatt for vold. Full text in Research Archive
• Stray-Pedersen, Arne (2006). Innate immunity and SIDS. Full text in Research Archive
• Rognum, Torleiv Ole; Vege, Åshild; Arnestad, Marianne; Stray-Pedersen, Arne & Opdal, Siri Hauge (2006). Clues pointing to the possibility of bacterial involvement in SIDS. Full text in Research Archive
• Stray-Pedersen, Arne (2006). Shaken baby syndrom. Full text in Research Archive
• Stray-Pedersen, Arne (2006). Shaken baby syndrome - finnes det? Full text in Research Archive
• Stray-Pedersen, Arne (2006). Er det farlig å sove sammen med spedbarn? Tidsskrift for jordmødre. ISSN 0040-7089. Full text in Research Archive
• Stray-Pedersen, Arne; Ånestad, Gabriel; Arnestad, Marianne; Vege, Åshild & Rognum, Torleiv Ole (2004). No increase in SIDS during respiratory virus epidemics. Full text in Research Archive
• Volgyes, David; Pedersen, Marius; Martinsen, Anne Catrine Trægde; Waaler, Dag & Stray-Pedersen, Arne (2018). Image quality in forensic CT imaging. Norges teknisk-naturvitenskapelige universitet. ISSN 9788232633791. Full text in Research Archive Show summary

  What factors affect the diagnostic image quality in forensic computed tomography (CT) imaging? In this thesis I briefly present the main steps from CT scanning to diagnostics. The thesis is built on four core papers. The first paper focuses on reconstructions of a quality control phantom measurement series. Objective image quality descriptors (contrast to noise ratio (CNR), mean CT numbers) are used for comparisons. Besides the reported objective measurements, some unexpected properties are identified, for instance, decreasing CNR when low level of iterative reconstruction is used. The second paper evaluates the applicability of an in vivo CT protocol in post mortem imaging. Radiographers and radiographer students are asked to score nine reconstruction alternatives from three post mortem cardiac cases. The results indicate that in this case the in vivo protocol is applicable in post mortem conditions. Images not only have to be measured, but also have to be presented. The third paper proposes a tone mapping approach which can compress the dynamic range of the CT image while preserves local contrast. Traditionally, a CT volume is read several times using different intensity windows. This contribution might reduce the number of required readings of the same volume, and could improve visualization of multiple pathologies in a single image. The fourth paper tackles a classic image processing problem, the de-quantization problem. The appearance of false contours might be both disturbing and misleading. If false contours are already present in an image, e.g. due to aggressive denoising, this approach might reduce or eliminate them. These four contributions are the core of this thesis, augmented with non peer reviewed contributions.

• Skjerven-Martinsen, Marianne; Stray-Pedersen, Arne & Næss, Pål Aksel (2014). Child occupants in motor vehicle collisions. Universitetet i Oslo. ISSN 9788282648523. Full text in Research Archive
• Stray-Pedersen, Arne (2008). Clues to understanding sudden infant death : a role for Helicobacter pylori and innate immunity? Universitetet i Oslo. Full text in Research Archive Show summary

  In this thesis in pediatric forensic medicine, a series of experimental studies was performed in order to investigate Helicobacter pylori infection and innate immunity in infancy with special regard to Sudden infant death syndrome, SIDS. <br> By a commercial ELISA test, the prevalence of H. pylori carriage in stool of 249 healthy children between 0 and 3 years of age was investigated. A high detection rate was found in neonates related to mode of delivery, indicating that transfection from mother to child is likely. In infants older than one week of age, the H. pylori carriage rate was 8%. In a subsequent study of 160 victims of sudden death, H. pylori carriage was significantly associated with SIDS and infections: 25% of the SIDS victims and 53% of the infants who died from infectious disease were H. pylori positive. Moreover, H. pylori carriage in SIDS victims was associated with central immune response, assessed by high Interleukin-6 levels in cerebrospinal fluid. <br> Surfactant protein A (SP-A), surfactant protein D (SP-D) and mannose-binding lectin (MBL) are proteins of innate immunity involved in the first-line defense against microbial agents. By immunohistochemistry, a method was established to enable semi-quantitative evaluation of SP-A and SP-D expression in post-mortem tissues from fetal to adult life. In lung tissue, an unpredicted drop in SP-A expression was demonstrated in infants between 1 week and 5 months of age, corresponding with the peak period for SIDS. This drop may imply that down-regulation of SP-A occurs in normal post-natal development. Later genotyping of the SP-A, SP-D and MBL genes revealed no significant association between genetic polymorphisms and SIDS compared to explained infant deaths. <br> Thesis conclusion: During a vulnerable age period in post-natal life, H. pylori infection may add to the microbial load and trigger the death mechanism in SIDS. A drop in SP-A expression may contribute to this vulnerability.

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