Prognostic indicators of survival for patients with oral cavity squamous cell carcinoma in Norway. Outcomes in a retrospective, multicenter cohort, with special focus on oral tongue squamous cell carcinoma, 2005-2009

Oral cavity cancer (OCC) is the most frequent of head and neck cancers, most being squamous cell carcinomas (SCC). Within the oral cavity, the oral tongue is the most common site of cancer. These cancers are very aggressive, with poor survival. The treatment decision is based upon classifications of tumor (T), lymph node (N), and metastasis (M), although tumors with the same classification may act differently in aggressiveness. Treatment of these patients would be primary site surgery, with additional neck-dissection for many. Postsurgical radiotherapy may be added, rarely chemotherapy. The tumor growth pattern may predict the aggressiveness of the tumor, and thereby supplement the TNM classification in treatment decision. There is no established tumor growth pattern in use today that differentiates between those who need an additional neck-dissection and radiotherapy or chemotherapy; this may lead to overtreatment or undertreatment. This study investigated retrospectively a cohort of OCC from 2005-2009, which was called the Norwegian oral cancer (NOROC) study. We used data from the national Cause of Death Registry to calculate survival outcome. Spearman bivariate calculation was used to investigate correlations between the variables. Log-Rank univariate analyses were used to give Kaplan-Meier survival curves. Cox regression was used in multivariate analyses to determine which variables best predicted survival outcome. We found 535 primary treatment-naïve oral cavity SCC. Median age at diagnosis was 67 years; five-year disease-specific survival was 52%. Our data show that high-risk Human Papilloma Virus was not detected in oral tongue (OT) SCC. Growth patterns of tumor depth of invasion (DOI), tumor budding, and WHO differentiation and lympocytic infiltate in a combined histo-score, can predict the aggressiveness. Tumor DOI is already implemented in the new TNM classification. We suggest that other risk-patterns we found can be added to TNM classification for individualized treatment

Determinantene av Bankenes Rentemargin i Norge : The Determinants of Bank Interest Margins in Norway

Avhandlingen ser på hvilke faktorer som påvirker rentemarginen til bankene i den norske banksektoren. Rentemarginen er sentral ettersom den avgjør kostnadene til finanseringen fra banksektoren. Dersom rentemarginen blir for høy kan det føre til reduksjon av økonomisk vekst, mens en reduksjon av rentemarginen kan føre til en ustabil banksektor. For kartlegging av hvilke faktorer som påvirker rentemarginen benyttes to modeller. Første modellen, laget av Ho & Saunders (1981), kalles tostegsmodellen. Den andre modellen er laget av McShane & Sharpe (1985) og blir kalt singelstegsmodellen. Modellene ble konstruert på 80-tallet, men har senere blitt utviklet gjennom endringer av variablene for å oppnå høyere signifikansnivå og koeffisienter. Begge modellene er utviklet for å se nærmere på rentemarginen, men har derimot forskjellige framgangsmåter. Datagrunnlaget som er benyttet for utredningen er på 115 banker i perioden 2009-2014. Resultatet indikerer at større banker tar en høyere rentemargin og effektive banker tar en mindre rentemargin. Resultatet kan virke motstridene med tanke på at store banker bør være mest effektiv gjennom stordriftsfordeler, derimot er empirisk teori splittet rundt effekten av stordriftsfordelene i banksektoren. En mulig forklaring kan være at store banker har andre faktorer som gir dem muligheten til å ta ut en høyere margin. Selv om størrelse har vist seg å ha en betydning for rentemarginen, indikerer resultatene at effektivitet er den mest sentrale faktoren. De optimale tiltakene vil være tiltak som tar for seg både størrelse og effektiviteten sammen, men effektivitet har mest påvirkningspotensiale. For å øke effektiviteten må myndighetene fokusere på lønn og administreringskostander. Mens tiltak for å håndtere størrelse vil være rettet mot å effektivisere de store bankene, eller på andre måter endre strukturen til bankene for å fremheve effektivitet.nhhma

Litterær kompetanse i et virtuelt klasserom. En undersøkelse av en digital litterær samtale (DLS).

I en tid der hele utdanningssektoren står ovenfor tidenes største pedagogiske omveltning som følge av Covid-19, opplever mange lærere det som utfordrende og vanskelig å få til en digital undervisningspraksis som skaper interaksjon, vitebehov, mestring og samspill. Hensikten med dette prosjektet er å vise hvordan en kan arbeide med litteratur i et virtuelt klasserom for å utvikle elevenes litterære kompetanse, og er derfor et didaktisk bidrag til et felt som er relativt ferskt. I en forlengelse av dette er det også hensiktsmessig å se på hvorvidt elevene skal lese hele verk eller utdrag i klasserommet. Jeg argumenterer for at elevene gjennom lesing av hele verk får øve på å utvikle en mer helhetlig forståelse, og videre oppøver evnen til å tolke et verk hermeneutisk. Forskningsspørsmålet belyses gjennom en kvalitativ undersøkelse av en digital litterær samtale (DLS) om romanen Svart belte (2015) av Marianne Clementine Håheim, gjennomført i én klasse fra en videregående skole i den nordlige landsdelen. For å få en dypere innsikt i funnene er datamaterialet kategorisert etter syv kjennetegn på litterær kompetanse. I arbeidet med kategoriseringen støtter jeg meg til utvalgte analytiske verktøy og begreper fra både Sheridan Blau (2003) og Örjan Torell (2001). Analysen viser at elevene i stor grad evner å produsere egne tolkninger, samtidig som de spiller på hverandres utsagn underveis i dialogen. Et fåtall av elevene var villige til å utsette konklusjonen eller innrømme at de ikke kom noen vei i tolkningen sin, mens noen få viste tegn til å gi opp relativt tidlig i tolkningsarbeidet. En del av elevene stilte spørsmål til gruppemedlemmene sine i løpet av samtalen, men det var gjerne i sammenheng med at samtalen døde ut. Overraskende nok var det kun én elev som viste intellektuell sjenerøsitet gjennom evnen til å innrømme feil, og bruken av fagspråk var sprikende. Et interessant funn er at de gruppene som deltok sist i DLS også er de som viser flere trekk på litterær kompetanse. Gjennom DLS som metode kan en variere litteraturundervisningen også i et virtuelt klasserom, samtidig som en ivaretar det faglige fellesskapet og læringsutbyttet til elevene. Selv om det empiriske grunnlaget er relativt lite, kan det likevel vise en mulig metode for å utvikle litterær kompetanse i digital undervisning

Three chords and the truth – writing modern country songs about a Norwegian reality

Masteroppgave i musikk- og ensembleledelse - Nord universitet, 202

Design Aspects on Winding of an MgB₂ Superconducting Generator Coil

AbstractGenerators based on superconducting rotor coils are considered for future large off-shore wind turbines for their low weight and compact design, and for their possibility to reduce costs. In the 10-20 K temperature range, MgB2 superconductors carry current densities 100 times higher than standard copper conductors at room temperature at one tenth of the wire cost per unit carried current. In the framework of the European project INNWIND.EU, an MgB2 superconducting generator pole will be designed, built and tested. Some of the design aspects of this work with emphasis on the winding process and associated coil insulation are discussed. An overall high current density in the coil is of crucial importance to obtain clear benefits compared to conventional solutions. The wire itself may be the most important parameter in that respect. However, the overall current density of the coil is also influenced by the thickness of the turn-to-turn electrical insulation. Here we discuss the impact of the insulation and suggest the use of a one-step winding process, employing wet-winding, where the applied epoxy also constitutes the insulation layer between turns. In this way the coil is densified by approximately 10% compared to the use of an additional, dedicated, electrical insulation like Kapton for wet-winding or glass-fibre for dry-winding followed by vacuum impregnation. We show the results of a trial winding of 500 m of MgB2 superconducting wire into a double pancake coil using the wet-winding technique. The coil is tested for contacts between the turns to evaluate the suggested one-step wet-winding process

The Practically Wise Medical Teacher: Medical Education at the University of Tromsø – A Norwegian Case

Source at https://www.hsj.gr/.This article addresses the issue of teaching quality in medical education and investigates what characterizes a professionally competent or practically wise medical teacher through the use of longitudinal data from interviews with 40 medical students. In discussing the findings, Aristotle’s concepts of episteme, techne and phronesis, and theoretical perspectives on professionalism and quality in teaching are applied. The findings highlight that one is either a practically wise medical teacher or a technical medical teacher. The practically wise medical teacher typically focuses on reflection, experience, participation, formative assessment and discussion in an atmosphere of good relations, which stimulate teaching and learning. The technical medical teacher, on the contrary, knows very little about the students and treats them as onlookers in clinical settings. The analysis results indicate that being a practically wise medical teacher requires a perception of what characterizes professionalism in medical education, the ability to use formative assessment and role model consciousness. These findings underline the importance of a good supervisor–learner relationship, which promotes medical teachers’ teaching competence and knowledge of professionalism. The findings also indicate the importance of faculty development in order to improve teaching quality at both the individual and system levels

Fabrication of a scaled MgB2 racetrack demonstrator pole for a 10 MW direct drive wind turbine generator

Field windings made of MgB2 wires or tapes are considered for their potential to reduce volume, weight and cost of large offshore wind turbine generators. To gain experience of how to use this relatively new material in full-scale generators, tests of different winding methodologies and techniques are needed. In this paper, we describe in detail the steps used to wind a racetrack coil with a length of 1 m and a width of 0.5 m out of 4.5 km of MgB2 superconducting tape. The width corresponds to a full-scale pole of a 10 MW generator, whereas the length of the straight section is shorter than the corresponding full-scale pole. The coil was built up of 10 double pancake coils. Each double pancake coil was wet-wound using a semi-automatic winding process, where Stycast 2850 was applied directly to the MgB2 tape without any other dedicated electrical insulation. The strengths and weaknesses of the winding process are discussed and compared to the dry-winding method.acceptedVersio

Fabrication of a scaled MgB2 racetrack demonstrator pole for a 10 MW direct drive wind turbine generator

Field windings made of MgB2 wires or tapes are considered for their potential to reduce volume, weight and cost of large offshore wind turbine generators. To gain experience of how to use this relatively new material in full-scale generators, tests of different winding methodologies and techniques are needed. In this paper, we describe in detail the steps used to wind a racetrack coil with a length of 1 m and a width of 0.5 m out of 4.5 km of MgB2 superconducting tape. The width corresponds to a full-scale pole of a 10 MW generator, whereas the length of the straight section is shorter than the corresponding full-scale pole. The coil was built up of 10 double pancake coils. Each double pancake coil was wet-wound using a semi-automatic winding process, where Stycast 2850 was applied directly to the MgB2 tape without any other dedicated electrical insulation. The strengths and weaknesses of the winding process are discussed and compared to the dry-winding method.acceptedVersio

Tumor budding score predicts lymph node status in oral tongue squamous cell carcinoma and should be included in the pathology report

Background - The majority of oral cavity cancers arise in the oral tongue. The aim of this study was to evaluate the prognostic value of tumor budding in oral tongue squamous cell carcinoma, both as a separate variable and in combination with depth of invasion. We also assessed the prognostic impact of the 8th edition of the American Joint Committee on Cancer’s TNM classification (TNM8), where depth of invasion (DOI) supplements diameter in the tumor size (T) categorization. Methods - Patients diagnosed with primary oral tongue squamous cell carcinoma were evaluated retrospectively. Spearman bivariate correlation analyses with bootstrapping were used to identify correlation between variables. Prognostic value of clinical and histopathological variables was assessed by Log rank and Cox regression analyses with bootstrapping using 5-year disease specific survival as outcome. The significance level for the hypothesis test was 0.05. Results - One-hundred and fifty patients had available material for microscopic evaluation on Hematoxylin and Eosin-stained slides and were included in the analyses. Reclassification of tumors according to TNM8 caused a shift towards a higher T status compared to the previous classification. The tumor budding score was associated with lymph node metastases where 23% of the patients with low-budding tumors had lymph node metastases, compared with 43% of those with high-budding tumors. T-status, lymph node status, tumor budding, depth of invasion, and the combined tumor budding/depth of invasion score were all significantly associated with survival in univariate analyses. In multivariate analyses only N-status was an independent prognosticator of survival. Conclusion - Reclassification according to TNM8 shifted many tumors to a higher T-status, and also increased the prognostic value of the T-status. This supports the implementation of depth of invasion to the T-categorization in TNM8. Tumor budding correlated with lymph node metastases and survival. Therefore, information on tumor budding can aid clinicians in treatment planning and should be included in pathology reports of oral tongue squamous cell carcinomas

Evaluation Challenges in the Validation of B7-H3 as Oral Tongue Cancer Prognosticator

B7-H3 was the only molecule identified with prognostic potential from a recent systematic review of the prognostic value of immune checkpoints in oral cancer. We aimed to validate this finding in a multicenter international cohort. We retrospectively retrieved 323 oral tongue squamous cell carcinoma (OTSCC) samples from three different countries (Brazil, Finland, and Norway) for immunostaining and scoring for B7-H3. We evaluated tumor immunogenicity by analyzing the amount of tumor-infiltrating lymphocytes and divided the tumors into immune hot and cold. To increase the reliability of the results, both digital and manual visual scoring were used. Survival curves were constructed based on the Kaplan-Meier method, and the Cox proportional hazard model was utilized for univariate and multivariate survival analysis. B7-H3 expression was not significantly associated with overall or disease-specific survival in the whole OTSCC cohort. When divided into immune hot and cold tumors, high B7-H3 expression was significantly associated with poor disease-specific and overall survival in the immune hot group, depending on the scoring method and the country of the cohort. This was achieved only in the univariate analysis. In conclusion, B7-H3 was a negative prognosticator for OTSCC patient survival in the subgroup of immune hot tumors, and was not validated as a prognosticator in the full cohort. Our findings suggest that the immune activity of the tumor should be considered when testing immune checkpoints as biomarkers.Peer reviewe