Regulation of the complement system and immunological tolerance in pregnancy

Preeclampsia is a serious vascular complication of the human pregnancy, whose etiology is still poorly understood. In preeclampsia, exacerbated apoptosis and fragmentation of the placental tissue occurs due to developmental qualities of the placental trophoblast cells and/or mechanical and oxidative distress to the syncytiotrophoblast, which lines the placental villi. Dysregulation of the complement system is recognized as one of the mechanisms of the disease pathology. Complement has the ability to promote inflammation and facilitate phagocytosis of placenta-derived particles and apoptotic cells by macrophages. In preeclampsia, an overload of placental cell damage or dysregulated complement system may lead to insufficient clearance of apoptotic particles and placenta-derived debris. Excess placental damage may lead to sequestration of microparticles, such as placental vesicles, to capillaries in the glomeruli of the kidney and other vulnerable tissues. This phenomenon could contribute to the manifestations of typical diagnostic symptoms of preeclampsia: proteinuria and new-onset hypertension. In this review we propose that the complement system may serve as a regulator of the complex tolerance and clearance processes that are fundamental in healthy pregnancy. It is therefore recommended that further research be conducted to elucidate the interactions between components of the complement system and immune responses in the context of complicated and healthy pregnancy.Peer reviewe

Hand washing with soap and water together with behavioural recommendations prevents infections in common work environment: an open cluster-randomized trial

<p>Abstract</p> <p>Background</p> <p>Hand hygiene is considered as an important means of infection control. We explored whether guided hand hygiene together with transmission-limiting behaviour reduces infection episodes and lost days of work in a common work environment in an open cluster-randomized 3-arm intervention trial.</p> <p>Methods</p> <p>A total of 21 clusters (683 persons) were randomized to implement hand hygiene with soap and water (257 persons), with alcohol-based hand rub (202 persons), or to serve as a control (224 persons). Participants in both intervention arms also received standardized instructions on how to limit the transmission of infections. The intervention period (16 months) included the emergence of the 2009 influenza pandemic and the subsequent national hand hygiene campaign influencing also the control arm.</p> <p>Results</p> <p>In the total follow-up period there was a 6.7% reduction of infection episodes in the soap-and water arm (p = 0.04). Before the onset of the anti-pandemic campaign, a statistically significant (p = 0.002) difference in the mean occurrence of infection episodes was observed between the control (6.0 per year) and the soap-and-water arm (5.0 per year) but not between the control and the alcohol-rub arm (5.6 per year). Neither intervention had a decreasing effect on absence from work.</p> <p>Conclusions</p> <p>We conclude that intensified hand hygiene using water and soap together with behavioural recommendations can reduce the occurrence of self-reported acute illnesses in common work environment. Surprisingly, the occurrence of reported sick leaves also increased in the soap-and water-arm.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00981877">NCT00981877</a></p> <p>Source of funding</p> <p>The Finnish Work Environment Fund and the National Institute for Health and Welfare.</p

Studies on integrating solar and wind power into electricity markets

Abstract Solar and wind power are expected to play a central role in future carbon-neutral electricity generation systems based on renewable sources. However, integrating intermittent and weather-dependent production into electricity markets that are designed for well-predictable variations in demand and supply is not straightforward. This dissertation addresses three specific economic problems regarding how current electricity generation systems can cost-efficiently absorb more solar and wind power. In the first study, a residential solar panel and battery adoption model is estimated using data from Germany in 2000–2018. Drawing from adverse selection literature in contract theory, different subsidy policy combinations are examined to determine whether they would lead to any savings in governmental subsidy costs. The main finding is that combining a feed-in tariff with an investment subsidy for batteries is cost-efficient. The second study addresses the co-existence of fluctuating renewable power and nuclear power plants, which are not particularly flexible in adjusting their output power. The study examines whether the nuclear power plants’ inflexibility hinders the large uptake of solar and wind power in Germany or whether the plants’ low marginal cost of generating electricity outweighs the costs stemming from their inflexibility. The findings indicate that the inflexibility is mainly reflected in increasing balancing costs, but the solar and wind power capacity can still grow notably in the country without significant increases in these costs. The third study examines whether the recently introduced capacity market in Ireland provides an additional lever for the dominant firm in the electricity market to exercise market power. Using ex-ante simulations, the study shows that the largest firm, by taking advantage of its dominant position, can increase costs in the capacity market notably when compared to the least-cost solution. The main forms of abuse of market power would be capacity withholding to drive up the capacity payments and predatory pricing with the aim of forcing rivals to exit the market.Tiivistelmä Aurinko- ja tuulivoiman odotetaan olevan keskeisessä roolissa tulevaisuuden hiilineutraalissa uusiutuviin energialähteisiin perustuvassa sähköntuotannossa. Sääriippuvan tuotannon lisääminen sähkömarkkinoille, jotka on suunniteltu olosuhteisiin, joissa kysynnän ja tarjonnan vaihtelu on hyvin ennustettavaa, ei ole kuitenkaan ongelmatonta. Tässä väitöskirjassa tarkastellaan kolmea taloustieteellistä ongelmaa, jotka liittyvät siihen, miten nykyiseen sähköntuotantojärjestelmään saataisiin kustannustehokkaasti lisää aurinko- ja tuulivoimaa. Ensimmäisessä osatutkimuksessa estimoidaan kysyntämalli kotitalouksien aurinkopaneelijärjestelmille ja niihin liitetyille akuille käyttäen havaintoaineistoa Saksasta vuosilta 2000–2018. Soveltamalla sopimusteoriaan kuuluvaa kirjallisuutta haitallisesta valikoitumisesta tutkimuksessa tarkastellaan, voitaisiinko erilaisia tukipolitiikkamuotoja yhdistämällä säästää tuen kustannuksissa. Tutkimuksen päätulos on, että syöttötariffin yhdistäminen akkujen investointitukeen on erityisen kustannustehokasta. Toisessa osatutkimuksessa tarkastellaan, miten sään mukaan vaihteleva sähköntuotanto sopii yhteen tuotantotehon säätökyvyltään suhteellisen joustamattomien ydinvoimaloiden kanssa. Osatutkimuksen pääkysymys on, vaikeuttaisiko ydinvoimaloiden joustamattomuus aurinko- ja tuulivoiman laajaa käyttöönottoa Saksassa, vai ylittäisivätkö ydinvoiman matalien rajatuotantokustannusten hyödyt sen joustamattomuudesta aiheutuvat haitat. Osoittautuu, että joustamattomuus ilmenee markkinoilla pääasiassa kohonneina säätökustannuksina, mutta aurinko- ja tuulivoimatuotanto voisi kasvaa Saksassa vielä huomattavasti, ennen kuin näistä kustannuksista tulisi merkittäviä. Kolmannessa osatutkimuksessa tutkitaan, tarjoaako vastikään Irlannissa käyttöönotettu kapasiteettimarkkina sähkömarkkinoilla määräävässä asemassa olevalle yritykselle lisämahdollisuuden käyttää markkinavoimaa. Simulaatiot osoittavat, että markkinoiden suurin yritys voisi asemaansa hyväksikäyttäen nostaa kapasiteettimarkkinan kustannuksia merkittävästi. Keskeisimmät tavat väärinkäyttää määräävää markkina-asemaa olisivat kapasiteetin tarjoamatta jättäminen kapasiteettimaksujen nostamiseksi ja saalistushinnoittelu, jonka tarkoituksena on saada kilpailijoita poistumaan markkinoilta

The value of the nuclear power plant fleet in the German power market under the expansion of fluctuating renewables

Abstract Flexibility of a conventional power plant fleet is becoming an increasingly valuable quality in several electricity markets due to growing solar and wind power supply. Nuclear power plants are not very flexible in terms of output, but their advantage is their low variable cost of generating electricity. Using a short-term techno-economic model which incorporates both the electricity and the balancing market, we examine quantitatively whether costs incurred by nuclear units’ lower flexibility outweigh the low generation costs of nuclear power in the German power market, and investigate how this depends on the amount of fluctuating renewables. We show that, due to low negative prices stemming from inflexible baseload plants, balancing costs may increase rapidly with solar and wind power. Higher balancing and start-up costs arising from nuclear units in the fleet are still largely compensated by the nuclear units’ lower generation costs, and it is not cost-efficient to decommission nuclear units in the near future. The results suggest that it would be economically beneficial to harness the full flexibility potential of nuclear plants and curtail excess solar and wind power or include those in the negative balancing reserve

Strategic behaviour in a capacity market?:the new Irish electricity market design

Abstract The transition to a low-carbon power system requires growing the share of generation from (intermittent) renewables while ensuring security of supply. Policymakers and economists increasingly see a capacity mechanism as a way to deal with this challenge. Yet this raises new concerns about the exercise of market power by large players via the capacity auction. We present a new modelling approach that captures such strategic behaviour together with a set of ex ante empirical estimates for the new Irish electricity market design (I-SEM) — in which a single firm controls 44% of generation capacity (excluding wind). We find significant costs of strategic behaviour, even with new entry: In our baseline scenarios, procurement costs in the capacity auction are around 150–400 million EUR (or 40–100%) above the competitive least-cost solution. From a policy perspective, we also examine how market power can be measured and mitigated through auction design