| 1. |
- Abildgaard, Niels, et al.
(författare)
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Real-world treatment patterns and outcomes for patients with multiple myeloma in Denmark, Finland and Sweden : An analysis using linked Nordic registries
- 2024
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Ingår i: European Journal of Cancer. - : Elsevier. - 0959-8049 .- 1879-0852. ; 201
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The Health outcomes and Understanding of MyelomA multi-National Study (HUMANS) was a large-scale, retrospective study conducted across Denmark, Finland and Sweden using linked data from national registries. We describe the characteristics, treatment patterns and clinical outcomes for patients with newly diagnosed multiple myeloma (NDMM) over 2010–2018.Methods: Patients with NDMM who received MM-specific, first-line treatments, were categorised by treatment (autologous stem cell transplantation [ASCT] or a combination chemotherapy regimen based on bortezomib, lenalidomide or melphalan-prednisolone-thalidomide).Results: 11,023 patients received treatment over 2010–2018. Time between diagnosis and treatment was shortest in Denmark (0.9 months), then Sweden (2.9 months) and Finland (4.6 months). Around one third of patients underwent ASCT. Lenalidomide-based regimens were prescribed to 23–28% of patients in Denmark and Finland, versus 12% in Sweden. Patients receiving lenalidomide had the longest wait for treatment, from 3.2 months (Denmark) to 12.1 months (Sweden). Treatment persistence was highest among patients receiving melphalan-prednisolone-thalidomide (7–8 months) in Finland and Sweden and lowest among those receiving bortezomib (3.5 months) in Finland. Overall survival (OS) was longest among patients with ASCT (7–10 years). Among patients receiving chemotherapy, OS (from diagnosis/treatment initiation), varied between cohorts. In a sensitivity analysis excluding patients with smouldering MM, OS decreased for all; for patients receiving bortezomib or lenalidomide, OS from diagnosis was 40–49 and 27–54 months, respectively.Conclusions: This population-based study of patients with NDMM receiving first-line MM-specific treatment, provides real-world data on treatment patterns and outcomes to complement data from randomised clinical trials.
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| 2. |
- Abildgaard, Niels, et al.
(författare)
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Use of Linked Nordic Registries for Population Studies in Hematologic Cancers: The Case of Multiple Myeloma
- 2023
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Ingår i: Clinical Epidemiology. - : Dove Medical Press. - 1179-1349. ; 15, s. 987-999
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Linked health-care registries and high coverage in Nordic countries lend themselves well to epidemiologic research. Given its relatively high incidence in Western Europe, complexity in diagnosis, and challenges in registration, multiple myeloma (MM) wasselected to compare registries in Denmark, Finland, and Sweden.Patients and Methods: Data were obtained from four archetypal registries in each country (spanning January 2005–October 2018):National Patient Registry (NPR), Prescribed Drug Registry (PDR), Cancer Registry (CR), and Cause of Death Registry. Patients newlydiagnosed with MM who received MM-specific treatment were included. PDR/NPR treatment records were used to assess incidentNPR cases. The registration quality of MM-specific drugs in the PDR of each country was also evaluated.Results: In Denmark, only 6% of patients in the NPR were not registered in the CR; in Sweden, it was 16.9%. No systematicdifferences were identified that could explain this discrepancy. In Denmark, lenalidomide and bortezomib were registered in the NPRwith high coverage, but less expensive drugs typically given in combination with bortezomib were not covered in any of the registries.In Finland and Sweden, bortezomib records were not identified in the PDR, but some were in the NPR; other drugs had good coveragein the PDR.Conclusions: The registries evaluated in this study can be used to identify the MM population; however, given the gaps in MMregistration in the Finnish and Swedish CRs, Danish registries provide the most comprehensive datasets for research on treatmentpatterns for MM.
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| 3. |
- Ahlén Bergman, Emma, et al.
(författare)
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Increased CD4+ T cell lineage commitment determined by CpG methylation correlates with better prognosis in urinary bladder cancer patients
- 2018
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Ingår i: Clinical Epigenetics. - : BMC. - 1868-7083 .- 1868-7075. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Urinary bladder cancer is a common malignancy worldwide. Environmental factors and chronic inflammation are correlated with the disease risk. Diagnosis is performed by transurethral resection of the bladder, and patients with muscle invasive disease preferably proceed to radical cystectomy, with or without neoadjuvant chemotherapy. The anti-tumour immune responses, known to be initiated in the tumour and draining lymph nodes, may play a major role in future treatment strategies. Thus, increasing the knowledge of tumour-associated immunological processes is important. Activated CD4+ T cells differentiate into four main separate lineages: Th1, Th2, Th17 and Treg, and they are recognized by their effector molecules IFN-γ, IL-13, IL-17A, and the transcription factor Foxp3, respectively. We have previously demonstrated signature CpG sites predictive for lineage commitment of these four major CD4+ T cell lineages. Here, we investigate the lineage commitment specifically in tumour, lymph nodes and blood and relate them to the disease stage and response to neoadjuvant chemotherapy.RESULTS: Blood, tumour and regional lymph nodes were obtained from patients at time of transurethral resection of the bladder and at radical cystectomy. Tumour-infiltrating CD4+ lymphocytes were significantly hypomethylated in all four investigated lineage loci compared to CD4+ lymphocytes in lymph nodes and blood (lymph nodes vs tumour-infiltrating lymphocytes: IFNG -4229 bp p < 0.0001, IL13 -11 bp p < 0.05, IL17A -122 bp p < 0.01 and FOXP3 -77 bp p > 0.05). Examination of individual lymph nodes displayed different methylation signatures, suggesting possible correlation with future survival. More advanced post-cystectomy tumour stages correlated significantly with increased methylation at the IFNG -4229 bp locus. Patients with complete response to neoadjuvant chemotherapy displayed significant hypomethylation in CD4+ T cells for all four investigated loci, most prominently in IFNG p < 0.0001. Neoadjuvant chemotherapy seemed to result in a relocation of Th1-committed CD4+ T cells from blood, presumably to the tumour, indicated by shifts in the methylation patterns, whereas no such shifts were seen for lineages corresponding to IL13, IL17A and FOXP3.CONCLUSION: Increased lineage commitment in CD4+ T cells, as determined by demethylation in predictive CpG sites, is associated with lower post-cystectomy tumour stage, complete response to neoadjuvant chemotherapy and overall better outcome, suggesting epigenetic profiling of CD4+ T cell lineages as a useful readout for clinical staging.
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| 4. |
- Bjursten, Henrik, et al.
(författare)
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Once after a full moon : acute type A aortic dissection and lunar phases
- 2022
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Ingår i: Interactive Cardiovascular and Thoracic Surgery. - : Oxford University Press. - 1569-9293 .- 1569-9285. ; 34:1, s. 105-110
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Acute type A aortic dissection (ATAAD) is a rare but severe condition, routinely treated with emergent cardiac surgery. Many surgeons have the notion that patients with ATAAD tend to come in clusters, but no studies have examined these observations. This investigation was undertaken to study the potential association between the lunar cycle and the incidence of ATAAD.METHODS: We collected information on 2995 patients who underwent ATAAD surgery at centres from the Nordic Consortium for Acute Type A Aortic Dissection collaboration. We cross-referenced the time of surgery with lunar phase using a case-crossover design with 2 different definitions of full moon (>99% illumination and the 7-day full moon period).RESULTS: The period when the moon was illuminated the most (99% definition) did not show any significant increase in incidence for ATAAD surgery. However, when the full moon period was compared with all other moon phases, it yielded a relative risk of 1.08 [95% confidence interval (CI) 1.00-1.17, P = 0.057] and, compared to waxing moon, only the relative risk was 1.11 (95% CI 1.01-1.23, P = 0.027). The peak incidence came 4-6 days after the moon was fully illuminated.CONCLUSIONS: This study found an overrepresentation of surgery for ATAAD during the full moon phase. The explanation for this is not known, but we speculate that sleep deprivation during full moon leads to a temporary increase in blood pressure, which in turn could trigger rupture of the aortic wall. While this finding is interesting, it needs to be corroborated and the clinical implications are debateable.
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| 5. |
- Colombo, Simone, et al.
(författare)
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Mining players’ experience in computer games: Immersion affects flow but not presence
- 2023
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Ingår i: Computers in Human Behavior Reports. - : Elsevier. - 2451-9588. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Understanding how different levels of immersion influence the experiences of flow and presence can shed light on the intricate interplay between these constructs and provide valuable insights into the factors that contribute to engaging and immersive gameplay. The independent variable, immersion, was manipulated in three conditions (high, moderate, and low) in a between-subject design within the video game Minecraft. Participants were asked to complete 15 min of gameplay and then fill out the questionnaires concerning flow and presence. The experiment was conducted remotely on a video-sharing platform. Bayesian analysis revealed an effect of immersion level on flow, while no evidence of an effect was found for the experience of presence. This study provides evidence in favor of a relation between flow and immersion while supporting a presumed double dissociation of immersion from presence. Future research using a Bayesian approach is encouraged to build further knowledge on this research topic.
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| 6. |
- Eliasson, Kent, et al.
(författare)
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Do firms learn by exporting or learn to export? : Evidence from small and medium-sized enterprises
- 2012
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Ingår i: Small Business Economics. - : Springer. - 0921-898X .- 1573-0913. ; 39:2, s. 453-472
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Tidskriftsartikel (refereegranskat)abstract
- Using a matching approach, we compare the productivity trajectories of future export-entrants and matched nonentrants. Future exporters have higher productivity than do nonentrants before entry into international markets, which indicates self-selection into exports. More interestingly, we also observe a productivity increase among export-entrants relative to nonentrants before export entry. This might be explained by higher investments in physical capital prior to export entry. We find no evidence that the productivity gap between export-entrants and nonentrants continues to grow after export entry. Our results suggest that learning to export occurs but that learning by exporting does not. In contrast to previous studies on Swedish manufacturing, we focus particularly on small and medium-sized enterprises (SMEs).
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| 7. |
- Eliasson, Kent, et al.
(författare)
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Effects of foreign acquisitions on R&D and high-skill activities
- 2017
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Ingår i: Small Business Economics. - : Springer. - 0921-898X .- 1573-0913. ; 49:1, s. 163-187
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Tidskriftsartikel (refereegranskat)abstract
- Using Swedish microdata, we find no evidence for the concerns circulating in the public debate that foreign acquisitions lead to reductions in both R&D expenditures and high-skilled activities in targeted domestic firms for either MNEs or non-MNEs. Previous studies have only focused on larger firms. In this paper, we are able to study the impact on smaller firms (fewer than 50 employees), which is important because 90% of the firms acquired meet this criterion. For this group of firms, there is no information on R&D, but by using the register of educational attainment, we obtain data on the share of high skilled labor in all Swedish firms irrespective of size. Interestingly, we find that among smaller firms, foreign enterprises tend to acquire high-productive, skill-intensive firms (cherry-picking). After the acquisitions, skill upgrading appears in acquired smaller, non-MNE firms, particularly in the service sector.
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| 8. |
- Eliasson, Kent, 1967-, et al.
(författare)
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Jobs and exposure to international trade within the service sector in Sweden
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The service sector is very heterogeneous with respect to internationalization; in some industries there is international trade (or it may potentially exist), whereas other industries are non-tradable. Data on international trade in services is, however, typically very limited, making it difficult to identify in which industries there are international trade. In this paper, we partially surmount the problems with insufficient service trade statistics by calculating locational Ginis for different industries in the private business sector as well as in the public sector. The basic idea is that from the regional concentration of different activities within a country one can identify industries where there appears to be regional trade, and hence also a potential for international trade. Based on our method we find that the number of employed in tradable service appears to be at least as large as in the manufacturing sector. Remarkably, a larger share of the skilled labor exposed to international trade is working in the service sector than in manufacturing, while a majority of the less skilled labor working in tradable industries is employed in manufacturing. When it comes to employment growth, we observe that the employment has increased in tradable service, while it has fallen in the manufacturing sector (the whole sector is regarded as tradable).
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| 9. |
- Eliasson, Kent, et al.
(författare)
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Jobs and exposure to international trade within the service sector in Sweden
- 2012
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Ingår i: The World Economy. - : Wiley-Blackwell. - 0378-5920 .- 1467-9701. ; 35:5, s. 578-608
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Tidskriftsartikel (refereegranskat)abstract
- To establish in which service industries there is international trade (or it may potentially exist), we calculate locational Ginis for different industries. The basic idea is that from this measure of regional concentration of different activities within a country we can identify industries where there appears to be regional trade, and hence also a potential for international trade. Based on our method, we find that: (i) the number of employed in tradable service appears to be at least as large as in the manufacturing sector, (ii) tradable service is much more skill intensive than manufacturing, and (iii) lately, the employment in tradable service has increased substantially. We argue that the last mentioned result is consistent with the substantial growth of skilled labour in Sweden since the mid-1990s (Rybczynski effect) and factors leading to increased relative demand for skilled labour. Particularly, increased competition from and offshoring to low-wage countries seem recently to have had a considerable impact on the creation of skilled jobs and the displacement of less skilled jobs in the tradable sector in Sweden. Furthermore, we apply a similar method as for industries to identify tradable occupations. Using our classification of tradable industries and tradable occupations in a Mincer type wage equation, we find that workers in such industries and occupations receive a wage premia of 1213 per cent.
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| 10. |
- Eliasson, Kent, et al.
(författare)
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Patterns of employment, skills, and tasks within MNEs associated with offshoring
- 2022
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Ingår i: The World Economy. - : Blackwell Publishing. - 0378-5920 .- 1467-9701. ; 45:4, s. 944-970
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Tidskriftsartikel (refereegranskat)abstract
- We examine the relationship between relative demands for skills, non-routine, and non-offshorable tasks in Swedish MNE parents (onshore) and their employment shares in affiliates abroad (offshore). Our estimations suggest that increased employment shares in affiliates abroad (offshore) result in higher relative demand for skills and larger shares of non-routine tasks performed by employed that are highly educated in the parents at home (onshore). However, we do not find any evidence for that the share of non-offshorable tasks rises in the parents of Swedish MNEs when employment shares increase in their affiliates overseas. Furthermore, we estimate the relationships between absolute employment onshore (skilled and less-skilled labour) and employment in affiliates offshore (high- and low-income countries). Increased employment in affiliates in low-income countries relates negatively to the employment of less-skilled workers in manufacturing MNE parents (substitute), whereas increased employment in affiliates in high-income countries correlates positively with the employment of skilled workers in service MNE parents (complement).
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