Environmentally Assessing a Product-Service System: Bearings & Maintenance in the Pulping Industry

Compelling evidence tells us we need to change consumption and production patterns to allow for ecosystems not to collapse in the near future. This is true also for industrial actors and the products they manufacture and sell to be incorporated in other systems, manufacturing other products. Not only must manufacturing processes be radically more effective, it seems also that there is a need to consume less material goods and focus more on the utility of products then the products per se. Product-Service Systems, PSS, are put forward as a tool with this aim. The study uses a case scenario where a bearing manufacturer and a pulp mill engage in a bearing maintenance contract, identified as being a PSS. The study aims at assessing the effectiveness of that PSS. It is done in two steps; the first is a custom environmental assessment of the pulp over time for the duration of the maintenance contract so far. The second is a more in-depth, qualitative analysis of the contract structure, which is compared to literature findings on PSS that support environmental goals. The results render information on both the effectiveness of the PSS and some improvement potentials. Trends illustrate a worsening of environmental performance of the pulp production over time, but also some promising areas open for improvement. They could be addressed by internalizing the costs of products, setting explicit environmental goals and making cultural change efforts in the bearing manufacturer organisation

Environmentally Assessing a Product-Service System: Bearings & Maintenance in the Pulping Industry

Compelling evidence tells us we need to change consumption and production patterns to allow for ecosystems not to collapse in the near future. This is true also for industrial actors and the products they manufacture and sell to be incorporated in other systems, manufacturing other products. Not only must manufacturing processes be radically more effective, it seems also that there is a need to consume less material goods and focus more on the utility of products then the products per se. Product-Service Systems, PSS, are put forward as a tool with this aim. The study uses a case scenario where a bearing manufacturer and a pulp mill engage in a bearing maintenance contract, identified as being a PSS. The study aims at assessing the effectiveness of that PSS. It is done in two steps; the first is a custom environmental assessment of the pulp over time for the duration of the maintenance contract so far. The second is a more in-depth, qualitative analysis of the contract structure, which is compared to literature findings on PSS that support environmental goals. The results render information on both the effectiveness of the PSS and some improvement potentials. Trends illustrate a worsening of environmental performance of the pulp production over time, but also some promising areas open for improvement. They could be addressed by internalizing the costs of products, setting explicit environmental goals and making cultural change efforts in the bearing manufacturer organisation

Effects of the electromagnetic field used in hydrocarbon surveys on marine organisms

Controlled Source Electromagnetics (CSEM) technology has been used in the exploration for hydrocarbon reservoirs. It consists of an electric dipole source which is towed horizontally 30-50 m above the seabed or 10 m below the surface. As the electromagnetic (EM) signal propagates through the subsurface it may affect marine organisms that are electro- or magneto-sensitive. A device simulating these conditions (corresponding to three different exposure levels, low, strong, near field) was built to test the effect of EM on marine organisms in laboratory conditions.) Sandeel (Ammodytes tobianus) adults were filmed during a 15-minute near-field EM exposure but showed no significant changes in their behavior, nor any increased mortality. Haddock juveniles (Melanogrammus aeglefinus) were first exposed for 15 minutes to either one of the three EM levels then filmed and tested for magnetic orientation. None of the treatments caused mortality in fish. Juvenile haddock showed significant orientation according to the magnetic field but only after exposure to low and strong EM fields. They also showed a significantly reduced swimming speed following exposure to EM with intensities equivalent to distances of 100 (strong) and 1000 m (low) from the source with an average reduction in speed of 24%. Mean instantaneous swimming velocities of haddock decreased from 1.18 pixel/s (control) to 0.86 and 0.80 pixel/s after exposure to low and strong field levels respectively (GLM estimates), representing speed reductions of 27% and 32% after exposure to each respective level. Changes in swimming speed may affect dispersal of juveniles. However, it is unknown whether the decrease was a physiological or behavioural response. Therefore, it is not possible to make unequivocal conclusions about detrimental effects of CSEM at the population level.publishedVersio

The Long-Term Risk of Knee Arthroplasty in Patients with Arthroscopically Verified Focal Cartilage Lesions: A Linkage Study with the Norwegian Arthroplasty Register, 1999 to 2020

Background: Focal cartilage lesions are common in the knee. The risk of later ipsilateral knee arthroplasty remains unknown. The purposes of the present study were to evaluate the long-term cumulative risk of knee arthroplasty after arthroscopic identification of focal cartilage lesions in the knee, to investigate the risk factors for subsequent knee arthroplasty, and to estimate the subsequent cumulative risk of knee arthroplasty compared with that in the general population. Methods: Patients who had undergone surgical treatment of focal cartilage lesions at 6 major Norwegian hospitals between 1999 and 2012 were identified. The inclusion criteria were an arthroscopically classified focal cartilage lesion in the knee, an age of ≥18 years at the time of surgery, and available preoperative patient-reported outcomes (PROMs). The exclusion criteria were osteoarthritis or “kissing lesions” at the time of surgery. Demographic data, later knee surgery, and PROMs were collected with use of a questionnaire. A Cox regression model was used to adjust for and investigate the impact of risk factors, and Kaplan-Meier analysis was performed to estimate cumulative risk. The risk of knee arthroplasty in the present cohort was compared with that in the age-matched general Norwegian population. Results: Of the 516 patients who were eligible, 322 patients (328 knees) consented to participate. The mean age at the time of the index procedure was 36.8 years, and the mean duration of follow-up was 19.8 years. The 20-year cumulative risk of knee arthroplasty in the cartilage cohort was 19.1% (95% CI, 14.6% to 23.6%). Variables that had an impact on the risk of knee arthroplasty included an ICRS grade of 3 to 4 (hazard ratio [HR], 3.1; 95% CI, 1.1 to 8.7), an age of ≥40 years at time of cartilage surgery (HR, 3.7; 95% CI, 1.8 to 7.7), a BMI of 25 to 29 kg/m2 (HR, 3.9; 95% CI, 1.7 to 9.0), a BMI of ≥30 kg/m2 (HR, 5.9; 95% CI, 2.4 to 14.3) at the time of follow-up, autologous chondrocyte implantation (ACI) at the time of the index procedure (HR, 3.4; 95% CI, 1.0 to 11.4), >1 focal cartilage lesion (HR, 2.1; 95% CI, 1.1 to 3.7), and a high preoperative visual analog scale (VAS) score for pain at the time of the index procedure (HR, 1.1; 95% CI, 1.0 to 1.1). The risk ratio of later knee arthroplasty in the cartilage cohort as compared with the age-matched general Norwegian population was 415.7 (95% CI, 168.8 to 1,023.5) in the 30 to 39-year age group. Conclusions: In the present study, we found that the 20-year cumulative risk of knee arthroplasty after a focal cartilage lesion in the knee was 19%. Deep lesions, higher age at the time of cartilage surgery, high BMI at the time of follow-up, ACI, and >1 cartilage lesion were associated with a higher risk of knee arthroplasty.publishedVersio

Intra-operative MRI facilitates tumour resection during trans-sphenoidal surgery for pituitary adenomas

Background During trans-sphenoidal microsurgical resection of pituitary adenomas, the extent of resection may be difficult to assess, especially when extensive suprasellar and parasellar growth has occurred. In this prospective study, we investigated whether intra-operative magnetic resonance imaging (iMRI) can facilitate tumour resection. Methods Twenty patients with macroadenomas, (16 non-functioning, three growth-hormone secreting and one pharmaco-resistant prolactinoma) were selected for surgery in the iMRI. The mean tumour diameter was 27 mm (range 11–41). The mean parasellar grade, according to the Knosp classification, was 2.3. Pre-operative coronal and sagittal T1-weighted and T2-weighted images were obtained. The trans-sphenoidal tumour resection was performed at the edge of the tunnel of a Signa SP 0.5-Tesla MRI. The surgeon aimed at a radical tumour resection that was followed by a peri-operative MRI scan. When a residual tumour was visualised and deemed resectable, an extended resection was performed, followed by another MRI scan. This procedure was repeated until the imaging results were satisfactory. In all patients, we were able to obtain images to assess the extent of resection and to classify the resection as either total or subtotal. Results After primary resection, eight out of 20 cases were classified as total resections. A second resection was performed in 11 of 12 cases classified as subtotal resections, and in four of these, total resection was achieved. A third resection was performed in three of the remaining seven cases with subtotal resections, but we did not achieve total resection in any of these cases. Therefore, the use of iMRI increased the number of patients with total resection from 8/20 (40%) to 12/20 (60%). The only observed complication was a transient spinal fluid leakage. Conclusion Intra-operative MRI during trans-sphenoidal microsurgery is useful in selected patients for a safe and more complete resection. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited

The Palliative Radiotherapy and Inflammation Study (PRAIS) - protocol for a longitudinal observational multicenter study on patients with cancer induced bone pain

BackgroundRadiation therapy (RT) results in pain relief for about 6 of 10 patients with cancer induced bone pain (CIBP) caused by bone metastases. The high number of non-responders, the long median time from RT to pain response and the risk of adverse effects, makes it important to determine predictors of treatment response. Clinical features such as cancer type, performance status and pain intensity, and biomarkers for osteoclast activity are proposed as predictors of response to RT. However, results are inconsistent and there is a need for better predictors of RT response. A similar argument can be stated for the development of cachexia; there are currently no predictors that can identify patients who will develop cachexia later in the cancer disease trajectory. Experimental and preclinical studies show that pain, depression and cachexia are related to inflammation. However, it is not known if inflammatory biomarkers can predict CIBP, depression or development of cachexia.MethodsThis multicenter, multinational longitudinal observational study will include 600 adult patients receiving RT for CIBP. Demographic data, clinical variables, osteoclast and inflammatory biomarkers will be assessed before start of RT, and 3, 8, 16, 24 and 52 weeks after last course of RT. The primary aim of the study is to identify potential predictors for pain relief from RT. Secondary aims are to explore potential predictors for development of cachexia, the longitudinal relationship between pain intensity and depression, and if inflammatory biomarkers are associated with changes in pain intensity, cachexia and depression during one-year follow up.DiscussionThe immediate clinical implication of the PRAIS study is to identify potential predictive factors for a RT response on CIBP, and thereby reduce non-efficacious RT. Patient benefits are fewer hospital visits, reduced risk of adverse effects and more individualized pain treatment. The long-term clinical implication of the PRAIS study is to improve the knowledge about inflammation in relation to CIBP, cachexia and depression and potentially identify associations and mechanisms that can be targeted for treatment.Trial registrationClinicalTrials.gov NCT02107664, date of registration April 8, 2014 (retrospectively registered).Trial sponsorThe European Palliative Care Research Centre (PRC), Department of Clinical and Molecular Medicine, NTNU, Faculty of medicine and Health Sciences, Trondheim, N-7491, Norway

Upgrading and Outsourcing Norges Bank’s Settlement System

In recent years, Norges Bank has focused more strongly on its core activities as a central bank, and this has also had a bearing on its activities related to the payment system. In this article, we will review recent years’ efforts to evaluate Norges Bank’s settlement system in light of the central bank’s strategy and primary objectives. We will also provide information about the evaluation of possible models for organising the settlement system and about why Norges Bank has chosen to outsource. We will also comment on the risks inherent in such a solution and describe the implementation process