El-Gitar og effektbruk : en studie rundt elektroniske hjelpemidlers på virkning avel-gitarens virkeområde

Masteroppgave i utøvende musikk, rytmisk- Universitetet i Agder 201

Thoracic Epidural Analgesia for Postoperative Pain Management in Liver Transplantation: A 10-year Study on 685 Liver Transplant Recipients

Background. Thoracic epidural analgesia (TEA) is not widely used for postoperative pain management in liver transplantation due to hepatic coagulopathy-related increased risk of inducing an epidural hematoma. However, an increasing number of patients are transplanted for other indications than the end-stage liver disease and without coagulopathy allowing insertion of an epidural catheter. Methods. This study is a retrospective observational single-center study of all adult patients undergoing first-time liver transplantation at Oslo University Hospital between January 1, 2008, and December 31, 2017. Data regarding patient characteristics were obtained from the Nordic liver transplant registry, medical records, and pain registration forms. Patients without coagulopathy (international normalized ratio 100 × 109/L) were eligible for TEA. Results. Out of 685 first-time liver transplantations in a 10-year period, 327 received TEA, and 358 did not. The median Model of End-stage Liver Disease score was lower in the TEA group than in the non-TEA-group (9 versus 17, P < 0.001), and fewer patients were hospitalized preoperatively (16 versus 127, P < 0.001). The median international normalized ratio (1.1 versus 1.6, P < 0.001) and platelet count (190 versus 78, P < 0.001) were different between the TEA and non-TEA groups. There were no serious complications related to insertion or removal of the TEA catheters. Patients in the TEA group had less pain with a mean numeric rating scale at postoperative days 0–5 of 1.4 versus 1.8 (P = 0.008). Nearly 50% of the patients were prescribed opioids when discharged from hospital (non-TEA 154 versus TEA 158, P = 0.23), and there was no difference after 1 year (P = 0.718). Conclusions. Our report revealed very good pain control with both TEA and the non-TEA modality. TEA was without any serious complications like epidural hematoma or infection/abscess in selected liver transplant recipients without severe coagulopathy. Opioid prescription at hospital discharge and by 1-year follow-up did not differ between the groups.publishedVersio

Microdialysis and CO2 sensors detect pancreatic ischemia in a porcine model

Background: Pancreatic transplantation is associated with a high rate of early postoperative graft thrombosis. If a thrombosis is detected in time, a potentially graft-saving intervention can be initiated. Current postoperative monitoring lacks tools for early detection of ischemia. The aim of this study was to investigate if microdialysis and tissue pCO2 sensors detect pancreatic ischemia and whether intraparenchymal and organ surface measurements are comparable. Methods: In 8 anaesthetized pigs, pairs of lactate monitoring microdialysis catheters and tissue pCO2 sensors were simultaneously inserted into the parenchyma and attached to the surface of the pancreas. Ischemia was induced by sequential arterial and venous occlusions of 45-minute duration, with two-hour reperfusion after each occlusion. Microdialysate was analyzed every 15 minutes. Tissue pCO2 was measured continuously. We investigated how surface and parenchymal measurements correlated and the capability of lactate and pCO2 to discriminate ischemic from non-ischemic periods. Results: Ischemia was successfully induced by arterial occlusion in 8 animals and by venous occlusion in 5. During all ischemic episodes, lactate increased with a fold change of 3.2–9.5 (range) in the parenchyma and 1.7–7.6 on the surface. Tissue pCO2 increased with a fold change of 1.6–3.5 in the parenchyma and 1.3–3.0 on the surface. Systemic lactate and pCO2 remained unchanged. The area under curve (AUC) for lactate was 0.97 (95% confidence interval (CI) 0.93–1.00) for parenchymal and 0.90 (0.83–0.97) for surface (p<0.001 for both). For pCO2 the AUC was 0.93 (0.89–0.96) for parenchymal and 0.85 (0.81–0.90) for surface (p<0.001 for both). The median correlation coefficients between parenchyma and surface were 0.90 (interquartile range (IQR) 0.77–0.95) for lactate and 0.93 (0.89–0.97) for pCO2. Conclusions: Local organ monitoring with microdialysis and tissue pCO2 sensors detect pancreatic ischemia with adequate correlation between surface and parenchymal measurements. Both techniques and locations seem feasible for further development of clinical pancreas monitoring.publishedVersio

Assessment of Intestinal Ischemia–Reperfusion Injury Using Diffuse Reflectance VIS-NIR Spectroscopy and Histology

A porcine model was used to investigate the feasibility of using VIS-NIR spectroscopy to differentiate between degrees of ischemia–reperfusion injury in the small intestine. Ten pigs were used in this study and four segments were created in the small intestine of each pig: (1) control, (2) full arterial and venous mesenteric occlusion for 8 h, (3) arterial and venous mesenteric occlusion for 2 h followed by reperfusion for 6 h, and (4) arterial and venous mesenteric occlusion for 4 h followed by reperfusion for 4 h. Two models were built using partial least square discriminant analysis. The first model was able to differentiate between the control, ischemic, and reperfused intestinal segments with an average accuracy of 99.2% with 10-fold cross-validation, and the second model was able to discriminate between the viable versus non-viable intestinal segments with an average accuracy of 96.0% using 10-fold cross-validation. Moreover, histopathology was used to investigate the borderline between viable and non-viable intestinal segments. The VIS-NIR spectroscopy method together with a PLS-DA model showed promising results and appears to be well-suited as a potentially real-time intraoperative method for assessing intestinal ischemia–reperfusion injury, due to its easy-to-use and non-invasive nature.publishedVersio

Early detection of anastomotic leakage after pancreatoduodenectomy with microdialysis catheters: an observational Study

Background Microdialysis catheters can detect focal inflammation and ischemia, and thereby have a potential for early detection of anastomotic leakages after pancreatoduodenectomy. The aim was to investigate whether microdialysis catheters placed near the pancreaticojejunostomy can detect leakage earlier than the current standard of care. Methods Thirty-five patients with a median age 69 years were included. Two microdialysis catheters were placed at the end of surgery; one at the pancreaticojejunostomy, and one at the hepaticojejunostomy. Concentrations of glucose, lactate, pyruvate, and glycerol were analyzed hourly in the microdialysate during the first 24 h, and every 2–4 h thereafter. Results Seven patients with postoperative pancreatic fistulae (POPF) had significantly higher glycerol levels (P 400 μmol/L during the first 12 postoperative hours detected patients with POPF with a sensitivity of 100% and a specificity of 93% (P < 0.001). After 24 h, lactate and lactate-to-pyruvate ratio were significantly higher (P < 0.05) and glucose was significantly lower (P < 0.05) in patients with POPF. Conclusion High levels of glycerol in microdialysate was an early detector of POPF. The subsequent inflammation was detected as increase in lactate and lactate-to-pyruvate ratio and a decrease in glucose (NCT03627559).publishedVersio

Inflammatory bowel disease in South-Eastern Norway III (IBSEN III): a new population-based inception cohort study from South-Eastern Norway

Background and aim: Modern treatment strategies for inflammatory bowel disease (IBD) are postulated to change the natural disease course. Inception cohort studies are the gold standard for investigating such changes. We have initiated a new population-based inception cohort study; Inflammatory bowel disease in South Eastern Norway III (IBSEN III). In this article, we describe the study protocol and baseline characteristics of the cohort. Methods: IBSEN III is an ongoing, population-based observational inception cohort study with prospective follow-up. Adult and pediatric patients with suspected IBD in the South-Eastern Health Region of Norway (catchment area of 2.95 million inhabitants in 2017), during the 3-year period from 2017 to 2019, were eligible for inclusion. Comprehensive clinical, biochemical, endoscopic, demographic, and patient-reported data were collected at the time of diagnosis and throughout standardized follow-up. For a portion of the patients, extensive biological material was biobanked. Results: The study included 2168 patients, of whom 1779 were diagnosed with IBD (Crohn's disease: 626, ulcerative colitis: 1082, IBD unclassified: 71). In 124 patients, there were subtle findings indicative of, but not diagnostic for, IBD. The remaining 265 patients were classified as symptomatic non-IBD controls. Conclusion: We have included patients in a comprehensive population-based IBD cohort from a catchment population of 2.95 million, and a unique biobank with materials from newly diagnosed and treatment-naïve IBD patients and symptomatic non-IBD controls. We believe this cohort will add important knowledge about IBD in the years to come.publishedVersio

Innovasjon og internasjonalisering innen eDrift og undervannsteknologi

Leverandørindustrien olje & gass er en av Norges mest kunnskapsintensive, innovative og internasjonale næringsmiljøer. Industrien legger grunnlaget for Norges viktigste næring, som bidrar med ca. 1/5 av BNP, 1/3 av statens samlede inntekter, nærmere halvparten av Norges eksportinntekter, 90 % av våre primære energibærere og sysselsetter folk fra alle landets fylker. 2004 ble et topp år for næringen og for nasjonen. Prognosene viser at 2005 kan bli et enda bedre år, og det er i dag stor og tiltagende optimisme i næringen. Alle prognoser viser imidlertid at dette ikke vil vedvare. Fra 2006 og utover forventes en betydelig reduksjon i investeringene på norsk sokkel, som er den viktigste arenaen for denne næringen. For at næringen skal kunne forbli Norges viktigste og mest verdiskapende næring også i dette århundre, betinger det et samlet løft for økt innovasjon og internasjonalisering. En må utvikle teknologi, metoder og arbeidsprosesser som øker funnraten, som kan forlenge feltenes levetid og som gjør det mulig å utvinne ressurser som med dagens metoder ikke er mulige eller økonomisk forsvarlige. Potensialet for økt verdiskaping i denne næringen er betydelig, næringsmiljøet er i front internasjonalt på mange områder, og verdiskapingen knyttet til økt internasjonalisering av norsk kompetanse, produkter og tjenester er stort.Innovasjon Norge, Rogaland Fylkeskommun

Partssamarbeid om konseptdrevet bedriftsutvikling i nettverk

Rappporten beskriver RFs aktiviteter i forbindelse med planlegging og oppstart av en forskermodul i tilknytning til NFR programmet Bedriftsutvikling 2000. Modulen vil utgjøre en regional ressursgruppe for forskning innen bedriftsutvikling, og har etablert et utviklings­samarbeid med de tre industrinettverkene TfS, TESA og SYNERGI. En hovedutfording er å tilrettelegge for et samarbeid mellom industribedrifter, hovedorganisasjonene, offentlige myndigheter og forskning om en økt integrering mellom internasjonalt anerkjente ledelses­konsepter og norske arbeidslivstradisjoner og samarbeidsformer. Dette samarbeidet inngår i målsettingen for BU 2000 om å bidra til økt verdiskaping og sikre sysselsetting ved å utvikle den kunnskap om strategier, metoder, arbeidsformer og infrastruktur som er nødvendig for å drive frem organisatoriske og interorganisatoriske utviklingsprosesser slik at et økende antall norske bedrifter kan være med i den internasjonale konkurransefronten

Forstudie: Leverandørindustri olje & gass

Leverandørindustrien olje & gass er en av Norges mest kunnskapsintensive, innovative og internasjonale næringsmiljøer. Industrien legger grunnlaget for Norges viktigste næring, som bidrar med ca. 1/5 av BNP, 1/3 av statens samlede inntekter, nærmere halvparten av Norges eksportinntekter, 90 % av våre primære energibærere og sysselsetter folk fra alle landets fylker. 2004 ble et topp år for næringen og for nasjonen. Prognosene viser at 2005 kan bli et enda bedre år, og det er i dag stor og tiltagende optimisme i næringen. Alle prognoser viser imidlertid at dette ikke vil vedvare. Fra 2006 og utover forventes en betydelig reduksjon i investeringene på norsk sokkel, som er den viktigste arenaen for denne næringen. For at næringen skal kunne forbli Norges viktigste og mest verdiskapende næring også i dette århundre, betinger det et samlet løft for økt innovasjon og internasjonalisering. En må utvikle teknologi, metoder og arbeidsprosesser som øker funnraten, som kan forlenge feltenes levetid og som gjør det mulig å utvinne ressurser som med dagens metoder ikke er mulige eller økonomisk forsvarlige. Potensialet for økt verdiskaping i denne næringen er betydelig, næringsmiljøet er i front internasjonalt på mange områder, og verdiskapingen knyttet til økt internasjonalisering av norsk kompetanse, produkter og tjenester er stort