Feasibility analysis of capacity expansion in Skjerka power station based on production simulation in ProdRisk.

The Norwegian energy system has traditionally had an energy surplus with a large share of hydro power. Due to increasing demand of power from large scale electrification, the power system is estimated to experience hours of national power deficient in 2030 even with moderate increase of consumption. Extensive increase of variable production renewable power from wind and solar in Northern Europe has led to increased volatility in power prices and a need for larger amounts of balancing power. This thesis will research, through a socioeconomic perspective, the feasibility of two expansion alternatives with the net present value method: a 100 MW Francis turbine expansion or 100 MW reversible pump turbine expansion. Results are obtained through simulations by the optimization program ProdRisk, given three price scenarios with varying volatility and fixed average price. Simulations results indicates increased revenue when volatility increases. Pump usage of the reversible pump turbine also increases in line with volatility and leads to larger gross energy production and revenue compared to a Francis turbine expansion of the same installed capacity. The economic analysis utilizes the revenue and energy production difference compared to a reference simulation of todays installed capacity at Skjerka power station, of 200 MW. Due to the project investment cost, the only net present values that proved to be feasible where the ones obtained from the price scenario with largest volatility. The reversible pump turbine expansion proved to be the most feasible option using the results obtained in simulations, despite having a higher investment cost compared to a Francis expansion. In addition, it has the ability to be used in pump mode, thus providing valuable balancing power for an improved transition to a power system with larger share of variable renewables

Assessing firefighters’ tourniquet skill attainment and retention – A controlled simulation-based experiment

Background: The aim of this study was to train and assess firefighters’ skill attainment in the use of tourniquets, and to assess their skill retention after three months. The purpose is to show whether firefighters can successfully apply a tourniquet after a short course based on the new national recommendation for civilian prehospital tourniquet use. Material and methods: This was a prospective experimental study. The study population was firefighters in Oslo and Tromsø, and the inclusion criterion was any on-duty firefighter. The first phase consisted of baseline pre-course testing, a short tourniquet course based on the new national tourniquet recommendation, followed by immediate retesting. The second phase consisted of retesting of skill retention after 3 months. Primary outcome was absent distal pulse (confirmed with doppler ultrasound), correct placement (i.e. 5-10cm proximal to wound) and application time. Results: There were 109 participants pre-course (T1), 105 immediately after the course (T2) and 62 participants at the three-months re-test (T3). The firefighters achieved a significantly greater proportion of successful tourniquet applications immediately after the course (91.4%, 96 of 105) as well as three months later (87.1%, 54 of 62) compared to 50.5% (55 of 109) pre-course (p=0.009). Mean application time was 59.6s (55.1-64.2) in T1, 34.9s (33.3-36.6) in T2 and 37.7s (33.9-41.4) in T3. The firefighters were significantly slower pre-course compared to both T2 (mean difference 24.7s, p<0.000) and T3 (mean difference 22.0s, p<0.000), but not between T2 and T3 (mean difference 2.7s, p=0.983). Conclusion: Firefighters are able to successfully apply a tourniquet after a 45-minute course based on the new recommendation for civilian prehospital tourniquet use. Skill retention after three months was satisfactory for both successful application and application time. We strongly recommend that tourniquets should be a part of firefighters’ hemorrhage control kit, but they should not be implemented without proper training. We recommend that tourniquet use is standardized in all prehospital medical providers across the country, including both the fire service and emergency medical service (EMS)

Hvordan kan dramapedagogisk arbeid stimulere til lek blant barn med ulik kulturell bakgrunn

Tidlig ble det klart for meg at jeg ville forske på og skrive om noe innenfor fagområdet kunst, kultur og kreativitet vi finner i Rammeplan for barnehagens innhold og oppgaver (2017). Der finner vi at: «I barnehagen skal barna få estetiske erfaringer med kunst og kultur i ulike former og organisert på måter som gir barna mulighet for utforsking, fordypning og progresjon. Barna skal støttes i å være aktive og skape egne kunstneriske og kulturelle uttrykk. Barnehagen skal legge til rette for samhørighet og kreativitet ved å bidra til at barna får være sammen om å oppleve og skape kunstneriske og kulturelle uttrykk» (Kunnskapsdepartementet, 2017, s. 50). Jeg har alltid likt å jobbe med kreative oppgaver sammen med barn i barnehagen og også hjemme med egne og andres barn. I lys av egne opplevelser og erfaringer har jeg mang en gang opplevd hvordan barn blomstrer og vokser inn i seg selv, gjennom å få uttrykke seg estetisk i prosjekt arbeid eller gjennom lek. Bakgrunnen for hvorfor jeg valgte tema for bachelor oppgaven er at jeg gjennom flere år har lagt merke til hvordan barn, gjennom sin måte å være på, hvordan de prøver å forstå livet, seg selv og andre gjennom meningsskaping, viser en musisk tilnærming til verden. Slik jeg forstår musisk tilnærming, er det hvordan vi som mennesker lever i pakt med naturen og hverandre og hvordan lyder, bevegelser og rytmer preger inn i kroppens sanseapparat (Bjørkvold, J.R, 2005, s.17). Omgivelsene spiller inn på hvordan vi utvikler oss som mennesker. Og da mener jeg hvordan menneskers liv gjennom alle sine livsfaser, fra i mors liv til døden får sine impulser fra omgivelsene, først fra mors stemme og bevegelser i mors liv og senere fra omgivelsene vi befinner oss i. Disse impulsene preger oss som mennesker og gir impulser til undring og utforsking. Og hvordan vi møter disse impulsene fra omverden, omformer dem til mening, i et samspill med de mennesker vi møter på vår dannelsesreise er hva jeg forstår som musiske ytringsformer og livsbetingelser. Barns særpreg, barnekulturen og barns ulike utforskningsformer preger slik jeg oppfatter det, barns behov for å begripe livet, omforme det til brokker av mening gjennom sine måter å finne ut av seg selv, omgivelsene og hverandre på (Bjørkvold, J.R, 2005, s. 17-25).publishedVersionBDBAC490

Symptomer og behandling av pasienter med akutt hjerteinfarkt innlagt ved Nordlandssykehuset i Bodø i 2017. Er det forskjeller mellom kvinner og menn?

Innledning: Generelt har man sett en nedgang i dødelighet ved hjerte- og karsykdommer de siste tiårene, men fortsatt er sykdomsgruppen en av de hyppigste dødsårsakene her i landet. Forskning de siste årene har funnet diskrepans mellom kjønn når det gjelder symptomer, klinikk, diagnostikk og behandling, likevel er ikke retningslinjene for hjerteinfarkt endret siden 2004. Vi ønsket derfor å studere dette nærmere, med fokus på forskjeller mellom kvinner og menn. Materiale og metode: I denne masteroppgaven har vi sett på alle pasienter med akutt hjerteinfarkt ved NLSH Bodø i 2017. Totalt ble 214 pasienter inkludert, 74 kvinner og 140 menn. Informasjon ble hentet ut fra pasientjournalsystemet DIPS. Vi har hentet ut demografiske data, type symptomer, akutt medikamentell behandling, tid før behandling, type hjerteinfarkt, trombolyse, perkutan koronar intervensjon (PCI) og sekundærprofylakse. Resultater: Brystsmerter var hovedsymptom hos 41,9 % av kvinner og 70,7 % av menn (P<0.01), mens dyspné var hovedsymptom hos 28,4 % av kvinner og 11,4 % av menn (P<0.01). Tid før behandling fra kontakt med helsevesenet var i gjennomsnitt 273 minutter for kvinner og 158 minutter for menn (P<0.01). Det var 36,5 % kvinner og 59,3 % menn som gjennomgikk PCI-behandling (P<0.01). Det var 47,3 % av kvinner og 22,9 % av menn som ble konservativt behandlet (P<0.01). Når det gjelder sekundærprofylakse fikk 60,3 % av kvinner og 76,6 % av menn dobbel platehemming (P=0.01). Statiner ble gitt til 61,6 % av kvinner og 78,8 % av menn (P<0.01) og 57,5 % av kvinner og 72,5 % av menn fikk betablokker (P=0.02). Konklusjon: Kvinner hadde andre type symptomer enn menn ved akutt hjerteinfarkt, og fikk i mindre grad optimal behandling. Funnene våre samsvarer med funn fra andre rapporter, og kan tyde på at medisinsk personell må bevisstgjøres på kjønnsforskjeller for å kunne bedre pasienthåndteringen og utjevne forskjellene i behandlingen

Assessing Firefighters' Tourniquet Skill Attainment and Retention: A Controlled Simulation-Based Experiment

Background: The aim of this study was to train and assess firefighters’ skill attainment in the use of tourniquets, and to assess their skill retention after 3 mo. The purpose is to show if firefighters can successfully apply a tourniquet after a short course based on the Norwegian national recommendation for civil prehospital tourniquet use. Methods: This is a prospective experimental study. The study population were firefighters, and the inclusion criterion was any on-duty firefighter. The first phase consisted of baseline precourse testing (T1), a 45-min course, followed by immediate retesting (T2). The second phase consisted of retesting of skill retention after 3 mo (T3). Results: A total of 109 participants at T1, 105 at T2, and 62 participants at T3. The firefighters achieved a higher proportion of successful tourniquet applications at T2 (91.4%; 96 of 105) as well as T3 (87.1%; 54 of 62) compared with 50.5% at T1 (55 of 109) (P = 0.009). Mean application time was 59.6 s (55.1-64.2) in T1, 34.9 s (33.3-36.6) in T2 and 37.7 s (33.9-41.4) in T3. Conclusion: A sample of firefighters can successfully apply a tourniquet after a 45-min course based on the 2019 Norwegian recommendation for civil prehospital tourniquet use. Skill retention after 3 mo was satisfactory for both successful application and application time

Mycobacterial Esx-3 Requires Multiple Components for Iron Acquisition

ABSTRACT The type VII secretion systems are conserved across mycobacterial species and in many Gram-positive bacteria. While the well-characterized Esx-1 pathway is required for the virulence of pathogenic mycobacteria and conjugation in the model organism Mycobacterium smegmatis, Esx-3 contributes to mycobactin-mediated iron acquisition in these bacteria. Here we show that several Esx-3 components are individually required for function under low-iron conditions but that at least one, the membrane-bound protease MycP3 of M. smegmatis, is partially expendable. All of the esx-3 mutants tested, including the ΔmycP3ms mutant, failed to export the native Esx-3 substrates EsxHms and EsxGms to quantifiable levels, as determined by targeted mass spectrometry. Although we were able to restore low-iron growth to the esx-3 mutants by genetic complementation, we found a wide range of complementation levels for protein export. Indeed, minute quantities of extracellular EsxHms and EsxGms were sufficient for iron acquisition under our experimental conditions. The apparent separation of Esx-3 function in iron acquisition from robust EsxGms and EsxHms secretion in the ΔmycP3ms mutant and in some of the complemented esx-3 mutants compels reexamination of the structure-function relationships for type VII secretion systems

A Novel Antimycobacterial Compound Acts as an Intracellular Iron Chelator

Efficient iron acquisition is crucial for the pathogenesis of Mycobacterium tuberculosis. Mycobacterial iron uptake and metabolism are therefore attractive targets for antitubercular drug development. Resistance mutations against a novel pyrazolopyrimidinone compound (PZP) that is active against M. tuberculosis have been identified within the gene cluster encoding the ESX-3 type VII secretion system. ESX-3 is required for mycobacterial iron acquisition through the mycobactin siderophore pathway, which could indicate that PZP restricts mycobacterial growth by targeting ESX-3 and thus iron uptake. Surprisingly, we show that ESX-3 is not the cellular target of the compound. We demonstrate that PZP indeed targets iron metabolism; however, we found that instead of inhibiting uptake of iron, PZP acts as an iron chelator, and we present evidence that the compound restricts mycobacterial growth by chelating intrabacterial iron. Thus, we have unraveled the unexpected mechanism of a novel antimycobacterial compound

Quinolone-isoniazid hybrids: Synthesis and preliminary in vitro cytotoxicity and anti-tuberculosis evaluation

Herein, we propose novel quinolones incorporating an INH moiety as potential drug templates against TB. The quinolone-based compounds bearing an INH moiety attached via a hydrazide–hydrazone bond were synthesised and evaluated against Mycobacterium tuberculosis H37Rv (MTB). The compounds were also evaluated for cytotoxicity against HeLa cell lines. These compounds showed significant activity (MIC90) against MTB in the range of 0.2–8 μM without any cytotoxic effects. Compounds 10 (MIC90; 0.9 μM), 11 (MIC90; 0.2 μM), 12 (MIC90; 0.8 μM) and compound 15 (MIC90; 0.8 μM), the most active compounds in this series, demonstrate activities on par with INH and superior to those reported for the fluoroquinolones. The SAR analysis suggests that the nature of substituents at positions −1 and −3 of the quinolone nucleus influences anti-MTB activity. Aqueous solubility evaluation and in vitro metabolic stability of compound 12 highlights favourable drug-like properties for this compound class

BKV Agnoprotein Interacts with α-Soluble N-Ethylmaleimide-Sensitive Fusion Attachment Protein, and Negatively Influences Transport of VSVG-EGFP

Background: The human polyomavirus BK (BKV) infects humans worldwide and establishes a persistent infection in the kidney. The BK virus genome encodes three regulatory proteins, large and small tumor-antigen and the agnoprotein, as well as the capsid proteins VP1 to VP3. Agnoprotein is conserved among BKV, JC virus (JCV) and SV40, and agnoprotein-deficient mutants reveal reduced viral propagation. Studies with JCV and SV40 indicate that their agnoproteins may be involved in transcription, replication and/or nuclear and cellular release of the virus. However, the exact function(s) of agnoprotein of BK virus remains elusive. Principal Findings: As a strategy of exploring the functions of BKV agnoprotein, we decided to look for cellular interaction partners for the viral protein. Several partners were identified by yeast two-hybrid assay, among them a-SNAP which is involved in disassembly of vesicles during secretion. BKV agnoprotein and a-SNAP were found to partially co-localize in cells, and a complex consisting of agnoprotein and a-SNAP could be co-immunoprecipitated from cells ectopically expressing the proteins as well as from BKV-transfected cells. The N-terminal part of the agnoprotein was sufficient for the interaction with a-SNAP. Finally, we could show that BKV agnoprotein negatively interferes with secretion of VSVG-EGFP reporter suggesting that agnoprotein may modulate exocytosis. Conclusions: We have identified the first cellular interaction partner for BKV agnoprotein. The most N-terminal part of BKV agnoprotein is involved in the interaction with a-SNAP. Presence of BKV agnoprotein negatively interferes with secretion of VSVG-EGFP reporter

Analysis of Longitudinal Data with Missing Values. : Methods and Applications in Medical Statistics.

Missing data is a concept used to describe the values that are, for some reason, not observed in datasets. Most standard analysis methods are not feasible for datasets with missing values. The methods handling missing data may result in biased and/or imprecise estimates if methods are not appropriate. It is therefore important to employ suitable methods when analyzing such data. Cardiac surgery is a procedure suitable for patients suffering from different types of heart diseases. It is a physical and psychical demanding surgical operation for the patients, although the mortality rate is low. Health-related quality of life (HRQOL) is a popular and widespread measurement tool to monitor the overall situation of patients undergoing cardiac surgery, especially in elderly patients with naturally limited life expectancies [Gjeilo, 2009]. There has been a growing attention to possible differences between men and women with respect to HRQOL after cardiac surgery. The literature is not consistent regarding this topic. Gjeilo et al. [2008] studied HRQOL in patients before and after cardiac surgery with emphasis on differences between men and women. In the period from September 2004 to September 2005, 534 patients undergoing cardiac surgery at St Olavs Hospital were included in the study. HRQOL were measured by the self-reported questionnaires Short-Form 36 (SF-36) and the Brief Pain Inventory (BPI) before surgery and at six and twelve months follow-up. The SF-36 reflects health-related quality of life measuring eight conceptual domains of health [Loge and Kaasa, 1998]. Some of the patients have not responded to all questions, and there are missing values in the records for about 41% of the patients. Women have more missing values than men at all time points. The statistical analyses performed in Gjeilo et al. [2008] employ the complete-case method, which is the most common method to handle missing data until recent years. The complete-case method discards all subjects with unobserved data prior to the analyses. It makes standard statistical analyses accessible and is the default method to handle missing data in several statistical software packages. The complete-case method gives correct estimates only if data are missing completely at random without any relation to other observed or unobserved measurements. This assumption is seldom met, and violations can result in incorrect estimates and decreased efficiency. The focus of this paper is on improved methods to handle missing values in longitudinal data, that is observations of the same subjects at multiple occasions. Multiple imputation and imputation by expectation maximization are general methods that can be applied with many standard analysis methods and several missing data situations. Regression models can also give correct estimates and are available for longitudinal data. In this paper we present the theory of these approaches and application to the dataset introduced above. The results are compared to the complete-case analyses published in Gjeilo et al. [2008], and the methods are discussed with respect to their properties of handling missing values in this setting. The data of patients undergoing cardiac surgery are analyzed in Gjeilo et al. [2008] with respect to gender differences at each of the measurement occasions; Presurgery, six months, and twelve months after the operation. This is done by a two-sample Student's t-test assuming unequal variances. All patients observed at the relevant occasion is included in the analyses. Repeated measures ANOVA are used to determine gender differences in the evolution of the HRQOL-variables. Only patients with fully observed measurements at all three occasions are included in the ANOVA. The methods of expectation maximization (EM) and multiple imputation (MI) are used to obtain plausible complete datasets including all patients. EM gives a single imputed dataset that can be analyzed similar to the complete-case analysis. MI gives multiple imputed datasets where all dataset must be analyzed sepearately and their estimates combined according to a technique called Rubin's rules. Results of both Student's t-tests and repeated measures ANOVA can be performed by these imputation methods. The repeated measures ANOVA can be expressed as a regression equation that describes the HRQOL-score improvement in time and the variation between subjects. The mixed regression models (MRM) are known to model longitudinal data with non-responses, and can further be extended from the repeated measures ANOVA to fit data more sufficiently. Several MRM are fitted to the data of cardiac surgery patients to display their properties and advantages over ANOVA. These models are alternatives to the imputation analyses when the aim is to determine gender differences in improvement of HRQOL after surgery. The imputation methods and mixed regression models are assumed to handle missing data in an adequate way, and gives similar analysis results for all methods. These results differ from the complete-case method results for some of the HRQOL-variables when examining the gender differences in improvement of HRQOL after surgery