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Objective: To explore patients' long-term experiences with drinking alcohol after Roux-n-Y gastric bypass (RYGB) for conceptualizing what may indicate problematic drinking behavior after bariatric surgery. Study Design: Three-center, observational study. Patients: 546 adult patients undergoing RYGB in the period 2003-2009 in Norway. Main Outcome Measures: Self-reported data on drinking behavior and experiences related to alcohol collected 10-15 years after surgery. Results: Out of the 959 patients undergoing RYGB in the period, 29 were diseased and 546 participated in this follow-up study (58.7%). Focusing on suspicious changes in drinking behavior, 8.8% reported drinking more, 11.5% consumed alcohol at least twice a week, and 10.6% consumed at a minimum of 6 units of alcohol at a frequency of at least once monthly. The nature of hangovers had changed for about a third of the patients, with 21.6% reporting these to feel weaker or absent. Repeated alcoholic blackouts were reported by 11.9%. A subgroup of the patients were categorized as displaying presumed problematic drinking behavior(PPDB). Among the PPDB-men there was a significant association to having had a fall last year (6 (100.0%) PPDB-patients vs. 30 (29.7%) non-PPDB, p<.001). Among the PPDB-women, there was a significant association to having had alcohol problems prior to surgery (7 (70.0%) PPDB-patients vs. 67 (17.7%) non-PPDB, p<.001). Less significant associations to PPDB reported for explorative purposes were lack of patient education (men) (16 (26.2%) PPDB-patients vs. 8 (61.5%) non-PPDB, p=.014); more than 3 months persistent musculoskeletal pain (women) (45 (15.3%) PPDB-patients vs. 29 (24.6%) non-PPDB, p=.026); subjective problems with memory (women) (58 (20.7%) PPDB-patients vs. 10 (9.1%) non-PPDB, p=.006); and, receiving professional help for mental problems last 12 months (women) (29 (22.7%) PPDB-patients vs. 45 (14.7%) non-PPDB, p=.043). Conclusion: A subset of patients display drinking behaviors that may be consistent with postsurgical alcohol problems. Screening instruments like AUDIT may not be sufficiently specific to capture several risk behaviors occurring after bariatric surgery. [ABSTRACT FROM AUTHOR]

A comprehensive methodology is developed for the analysis of power system vulnerability with respect to energy shortage, capacity shortage, and power system failures. The basic method is risk analysis, where risk is defined in terms of the probability of events and their consequences. The objective is to identify medium- and high-risk situations that require corrective actions. The method is applied to the Nordic power system. The results show that the system is in a medium-risk state, implying the need to consider various measures. With respect to energy shortage, the probability of extremely high prices over a sustained period of time is once every ten years for today's system and similar in 2010. With respect to capacity shortage, the vulnerability is expected to deteriorate toward 2010. With respect to blackouts, the risk is related to large blackouts in southern Scandinavia, involving many consumers. There is concern with regard to the future effect of changed maintenance routines and reductions in qualified technical personnel. [ABSTRACT FROM AUTHOR]

• Complex failure of Viking Sky cruise ship, in 2019, Hustadvika, Norway. • Learning from the Viking Sky's failure through a systematic approach - CAST. • Accident/failure precursors and resilience indicators which impacted Viking Sky. • Power generation capacity of Viking Sky was under the design propulsion power. • Digital twin based condition monitoring as a preventive action in maritime industry. This article brings to attention learning from the failure - blackout, loss of propulsion and near grounding - of Viking Sky cruise ship which occurred in Hustadvika, Norway, in March 2019. Failures and accidents in the cruise ship industry attract the global media and can severely impact reputation and business performance of companies and authorities involved. A system approach investigation and analysis - CAST - was employed with the aim to maximize learning from the Viking Sky's failure through a systematic approach and to contribute to failure reduction in the cruise ship industry. Three main recommendations emerged from this study: an overview of the accident or failure precursors and resilience indicators; safety recommendations for other cruise ships; lessons and strategies of actions for the increased cruise operations in the Arctic and Antarctic areas. It was found that several accident or failure precursors, for example, a low level of lubricating oil, the failure of a turbocharger, an inoperative large diesel generator, lack of functionality for safety equipment due to bad weather, and others precursors contributed to failure and highly critical situation encountered by Viking Sky in Hustadvika. Resilience indicators such as the master's immediate decision to launch mayday, the crew preparedness, and the way how the emergency situation was handled were found to have positive impacts on critical situation of Viking Sky. This article highlights also that adaptations and improvement of standards and regulations for harsh environmental conditions can play an important role in prevention of marine accidents. Furthermore, for a better understanding of correlation between environmental loads and their effects on machinery systems, digital solutions such as digital twin for condition monitoring of cruise ships in the Polar areas are seen as possible innovative solutions yet to be fully implemented in the marine industry. [ABSTRACT FROM AUTHOR]