| 1. |
- Anand, Aseem, et al.
(författare)
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Assessing Radiographic Response to 223Ra with an Automated Bone Scan Index in Metastatic Castration-Resistant Prostate Cancer Patients
- 2020
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Ingår i: Journal of Nuclear Medicine. - : Society of Nuclear Medicine. - 0161-5505 .- 2159-662X .- 1535-5667. ; 61:5, s. 671-675
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Tidskriftsartikel (refereegranskat)abstract
- For effective clinical management of patients being treated with 223Ra, there is a need for radiographic response biomarkers to minimize disease progression and to stratify patients for subsequent treatment options. The objective of this study was to evaluate an automated bone scan index (aBSI) as a quantitative assessment of bone scans for radiographic response in patients with metastatic castration-resistant prostate cancer (mCRPC). Methods: In a multicenter retrospective study, bone scans from patients with mCRPC treated with monthly injections of 223Ra were collected from 7 hospitals in Sweden. Patients with available bone scans before treatment with 223Ra and at treatment discontinuation were eligible for the study. The aBSI was generated at baseline and at treatment discontinuation. The Spearman rank correlation was used to correlate aBSI with the baseline covariates: alkaline phosphatase (ALP) and prostate-specific antigen (PSA). The Cox proportional-hazards model and Kaplan-Meier curve were used to evaluate the association of covariates at baseline and their change at treatment discontinuation with overall survival (OS). The concordance index (C-index) was used to evaluate the discriminating strength of covariates in predicting OS. Results: Bone scan images at baseline were available from 156 patients, and 67 patients had both a baseline and a treatment discontinuation bone scan (median, 5 doses; interquartile range, 3-6 doses). Baseline aBSI (median, 4.5; interquartile range, 2.4-6.5) was moderately correlated with ALP (r = 0.60, P < 0.0001) and with PSA (r = 0.38, P = 0.003). Among baseline covariates, aBSI (P = 0.01) and ALP (P = 0.001) were significantly associated with OS, whereas PSA values were not (P = 0.059). After treatment discontinuation, 36% (24/67), 80% (54/67), and 13% (9/67) of patients demonstrated a decline in aBSI, ALP, and PSA, respectively. As a continuous variable, the relative change in aBSI after treatment, compared with baseline, was significantly associated with OS (P < 0.0001), with a C-index of 0.67. Median OS in patients with both aBSI and ALP decline (median, 134 wk) was significantly longer than in patients with ALP decline only (median, 77 wk; P = 0.029). Conclusion: Both aBSI at baseline and its change at treatment discontinuation were significant parameters associated with OS. The study warrants prospective validation of aBSI as a quantitative imaging response biomarker to predict OS in patients with mCRPC treated with 223Ra.
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| 2. |
- Fransson, Per, et al.
(författare)
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Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer (HYPO-RT-PC) : patient-reported quality-of-life outcomes of a randomised, controlled, non-inferiority, phase 3 trial
- 2021
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Ingår i: The Lancet Oncology. - : Elsevier. - 1470-2045 .- 1474-5488. ; 22:2, s. 235-245
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The HYPO-RT-PC trial compared conventionally fractionated radiotherapy with ultra-hypofractionated radiotherapy in patients with localised prostate cancer. Ultra-hypofractionation was non-inferior to conventional fractionation regarding 5-year failure-free survival and toxicity. We aimed to assess whether patient-reported quality of life (QOL) differs between conventional fractionation and ultra-hypofractionation up to 6 years after treatment in the HYPO-RT-PC trial.METHODS: HYPO-RT-PC is a multicentre, open-label, randomised, controlled, non-inferiority, phase 3 trial done in 12 centres (seven university hospitals and five county hospitals) in Sweden and Denmark. Inclusion criteria were histologically verified intermediate-to-high-risk prostate cancer (defined as T1c-T3a with one or two of the following risk factors: stage T3a; Gleason score ≥7; and prostate-specific antigen 10-20 ng/mL with no evidence of lymph node involvement or distant metastases), age up to 75 years, and WHO performance status 0-2. Participants were randomly assigned (1:1) to conventional fractionation (78·0 Gy in 39 fractions, 5 days per week for 8 weeks) or ultra-hypofractionation (42·7 Gy in seven fractions, 3 days per week for 2·5 weeks) via a minimisation algorithm with stratification by trial centre, T-stage, Gleason score, and prostate-specific antigen. QOL was measured using the validated Prostate Cancer Symptom Scale (PCSS) and European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire (EORTC QLQ-C30) at baseline, the end of radiotherapy, months 3, 6, 12, and 24 after radiotherapy, every other year thereafter up to 10 years, and at 15 years. The primary endpoint (failure-free survival) has been reported elsewhere. Here we report QOL, a secondary endpoint analysed in the per-protocol population, up to 6 years after radiotherapy. The HYPO-RT-PC trial is registered with the ISRCTN registry, ISRCTN45905321.FINDINGS: Between July 1, 2005, and Nov 4, 2015, 1200 patients were enrolled and 1180 were randomly assigned (conventional fractionation n=591, ultra-hypofractionation n=589); 1165 patients (conventional fractionation n=582, ultra-hypofractionation n=583) were included in this QOL analysis. 158 (71%) of 223 patients in the conventional fractionation group and 146 (66%) of 220 in the ultra-hypofractionation group completed questionnaires at 6 years. The median follow-up was 48 months (IQR 25-72). In seven of ten bowel symptoms or problems the proportion of patients with clinically relevant deteriorations at the end of radiotherapy was significantly higher in the ultra-hypofractionation group than in the conventional fractionation group (stool frequency [p<0·0001], rush to toilet [p=0·0013], flatulence [p=0·0013], bowel cramp [p<0·0001], mucus [p=0·0014], blood in stool [p<0·0001], and limitation in daily activity [p=0·0014]). There were no statistically significant differences in the proportions of patients with clinically relevant acute urinary symptoms or problems (total 14 items) and sexual functioning between the two treatment groups at end of radiotherapy. Thereafter, there were no clinically relevant differences in urinary, bowel, or sexual functioning between the groups. At the 6-year follow-up there was no difference in the incidence of clinically relevant deterioration between the groups for overall urinary bother (43 [33%] of 132 for conventional fractionation vs 33 [28%] of 120 for ultra-hypofractionation; mean difference 5·1% [95% CI -4·4 to 14·6]; p=0·38), overall bowel bother (43 [33%] of 129 vs 34 [28%] of 123; 5·7% [-3·8 to 15·2]; p=0·33), overall sexual bother (75 [60%] of 126 vs 59 [50%] of 117; 9·1% [-1·4 to 19·6]; p=0·15), or global health/QOL (56 [42%] of 134 vs 46 [37%] of 125; 5·0% [-5·0 to 15·0]; p=0·41).INTERPRETATION: Although acute toxicity was higher for ultra-hypofractionation than conventional fractionation, this long-term patient-reported QOL analysis shows that ultra-hypofractionation was as well tolerated as conventional fractionation up to 6 years after completion of treatment. These findings support the use of ultra-hypofractionation radiotherapy for intermediate-to-high-risk prostate cancer.
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| 3. |
- Olivecrona, Henrik, et al.
(författare)
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A new CT method for measuring cup orientation after total hip arthroplasty : A study of 10 patients
- 2004
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 75:3, s. 252-260
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Tidskriftsartikel (refereegranskat)abstract
- Background It is difficult to assess the orientation of the acetabular component on routine radiographs. We present a method for determining the spatial orientation of the acetabular component after total hip arthroplasty (THA) using computed tomography. Patients and methods Two CT-scans, 10 min apart, were obtained from each of 10 patients after THA. Using locally developed software, two independent examiners measured the orientation of the acetabular component in relation to the pelvis. The measurements were repeated after one week. To be independent of the patient position during scanning, the method involved two steps. Firstly, a 3D volumetric image of the pelvis was brought into a standard pelvic orientation, then the orientation of the acetabular component was measured. The orientation of the acetabular component was expressed as operative anteversion and inclination relative to an internal pelvic reference coordinate system. To evaluate precision, we compared measurements across pairs of CT volumes between observers and trials. Results Mean absolute interobserver angle error was 2.3degrees for anteversion (range 0-6.6degrees), and 1.1degrees for inclination (range 0-4.6degrees). For interobserver measurements, the precision, defined as one standard deviation, was 2.9degrees for anteversion, and 1.5degrees for inclination. A Student's West showed that the overall differences between the examiners, trials, and cases were not significant. Data were normally distributed and were not dependent on examiner or trial. Interpretation We conclude that the implant angles of the acetabular component in relation to the pelvis could be detected repeatedly using CT, independently of patient positioning.
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| 4. |
- Widmark, Anders, et al.
(författare)
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Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer : 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial
- 2019
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 394:10196, s. 385-395
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hypofractionated radiotherapy for prostate cancer has gained increased attention due to its proposed high radiation-fraction sensitivity. Recent reports from studies comparing moderately hypofractionated and conventionally fractionated radiotherapy support the clinical use of moderate hypofractionation. To date, there are no published randomised studies on ultra-hypofractionated radiotherapy. Here, we report the outcomes of the Scandinavian HYPO-RTPC phase 3 trial with the aim to show non-inferiority of ultra-hypofractionation compared with conventional fractionation.Methods: In this open-label, randomised, phase 3 non-inferiority trial done in 12 centres in Sweden and Denmark, we recruited men up to 75 years of age with intermediate-to-high-risk prostate cancer and a WHO performance status between 0 and 2. Patients were randomly assigned to ultra-hypofractionation (42.7 Gy in seven fractions, 3 days per week for 2.5 weeks) or conventional fractionated radiotherapy (78.0 Gy in 39 fractions, 5 days per week for 8 weeks). No androgen deprivation therapy was allowed. The primary endpoint was time to biochemical or clinical failure, analysed in the per-protocol population. The prespecified non-inferiority margin was 4% at 5 years, corresponding to a critical hazard ratio (HR) limit of 1.338. Physician-recorded toxicity was measured according to the Radiation Therapy Oncology Group (RTOG) morbidity scale and patient-reported outcome measurements with the Prostate Cancer Symptom Scale (PCSS) questionnaire. This trial is registered with the ISRCTN registry, number ISRCTN45905321.Findings: Between July 1, 2005, and Nov 4, 2015, 1200 patients were randomly assigned to conventional fractionation (n=602) or ultra-hypofractionation (n=598), of whom 1180 (591 conventional fractionation and 589 ultra-hypofractionation) constituted the per-protocol population. 1054 (89%) participants were intermediate risk and 126 (11%) were high risk. Median follow-up time was 5.0 years (IQR 3.1-7.0). The estimated failure-free survival at 5 years was 84% (95% CI 80-87) in both treatment groups, with an adjusted HR of 1.002 (95% CI 0.758-1.325; log-rank p=0.99). There was weak evidence of an increased frequency of acute physician-reported RTOG grade 2 or worse urinary toxicity in the ultra-hypofractionation group at end of radiotherapy (158 [28%] of 569 patients vs 132 [23%] of 578 patients; p=0.057). There were no significant differences in grade 2 or worse urinary or bowel late toxicity between the two treatment groups at any point after radiotherapy, except for an increase in urinary toxicity in the ultra-hypofractionation group compared to the conventional fractionation group at 1-year follow-up (32 [6%] of 528 patients vs 13 [2%] of 529 patients; (p=0.0037). We observed no differences between groups in frequencies at 5 years of RTOG grade 2 or worse urinary toxicity (11 [5%] of 243 patients for the ultra-hypofractionation group vs 12 [5%] of 249 for the conventional fractionation group; p=1.00) and bowel toxicity (three [1%] of 244 patients vs nine [4%] of 249 patients; p=0.14). Patient-reported outcomes revealed significantly higher levels of acute urinary and bowel symptoms in the ultra-hypofractionation group compared with the conventional fractionation group but no significant increases in late symptoms were found, except for increased urinary symptoms at 1-year follow-up, consistent with the physician-evaluated toxicity.Interpretation: Ultra-hypofractionated radiotherapy is non-inferior to conventionally fractionated radiotherapy for intermediate-to-high risk prostate cancer regarding failure-free survival. Early side-effects are more pronounced with ultra-hypofractionation compared with conventional fractionation whereas late toxicity is similar in both treatment groups. The results support the use of ultra-hypofractionation for radiotherapy of prostate cancer. Copyright (C) 2019 Elsevier Ltd. All rights reserved.
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| 5. |
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| 6. |
- Beckman, Björn, 1938-, et al.
(författare)
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Globalization, imperialism and resistance : an introduction
- 2007
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Ingår i: Globalization, imperialism and resistance. - Stockholm : Politics of Development Group (PODSU), Department of Political Science, Stockholm University. - 9789163316098 ; , s. 1-13
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
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| 8. |
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| 9. |
- Beckman, Claes, 1962-, et al.
(författare)
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Verifying 3G licence requirements when every dB is worth a billion
- 2006
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Ingår i: First European Conference on Antennas & Propagation. - 9789290929376 ; , s. 1-4
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Konferensbidrag (refereegranskat)abstract
- In the year 2000, the Swedish Telecom regulator: “Post&Telestyrelsen”, PTS, granted in a “beauty contest” four licenses for operations of 3G systems. To verify the coverage and the license requirements, PTS, has developed a test procedure where the field strength of the primary Common Pilot Channel, CPICH, is measured in a drive test. Designing such a test constitutes a number of challenges mainly due to the fact that in 3G the accuracy in the measurement needs to be extremely high since even a small systematic error of ~1dB could in Sweden have the consequence that each operator would have to build an extra +1000 sites at a staggering cost of ~1billion SEK!The present paper gives an overview of the considerations behind the design of the test method used for verification of the 3G licence requirements in Sweden.
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| 10. |
- Beckman, Claes, 1962-, et al.
(författare)
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Verifying 3G License Requirements : some Preliminary Swedish Results
- 2008
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Ingår i: The 68th IEEE Vehicular Technology Conference. - : IEEE. - 9781424417216 ; , s. 1-4
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Konferensbidrag (refereegranskat)abstract
- In the year 2000, the Swedish Telecom regulator “Post&Telestyrelsen” (PTS) granted in a “beauty contest” four licenses for operation of 3G mobile networks. Through this process, the licensees committed themselves to cover 8.860.000 inhabitants of the Swedish population. In order to verify the coverage and confirm compliance with the license requirements, PTS, developed a test procedure in close collaboration with the licensees. The present paper gives an overview of the considerations behind the design of the test method and presents some preliminary results. Today all Swedish 3G operators comply with the licence requirement and it is concluded that a method for verifying the requirement accepted by the licensees is an important tool for successful licensing of spectrum and fulfilment of licensing obligations.
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| 11. |
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| 12. |
- Beckman, William A, et al.
(författare)
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TRNSYS, the most complete solar energy system modeling and simulation software
- 1994
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Ingår i: Renewable energy. - 0960-1481 .- 1879-0682. ; 5:1-4, s. 486-488
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Tidskriftsartikel (refereegranskat)abstract
- The five computer programs TRNSYS, PRESIM, TRNSED, ONLINE, and PREBID have been put together into a program package which is the most complete solar energy system modeling and simulation software that is available today.
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| 13. |
- Bengtsson, Olof, 1969-
(författare)
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Design and Characterization of RF-Power LDMOS Transistors
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In mobile communication new applications like wireless internet and mobile video have increased the demand of data-rates. Therefore, new more wideband systems are being implemented. Power amplifiers in the base-stations that simultaneously handle these wideband signals for many terminals (handhelds) need to be highly linear with a considerable band-width. In the past decade LDMOS has been the dominating technology for use in these RF-power amplifiers. In this work LDMOS transistors possible to fabricate in a normal CMOS process have been optimized and analyzed for RF-power applications. Their non-linear behavior has been explored using load-pull measurements. The mechanisms of the non-linear input capacitance have been analyzed using 2D TCAD simulations. The investigation shows that the input capacitance is a large contributor to phase distortion in the transistor. Computational load-pull TCAD methods have been developed for analysis of RF-power devices in high-efficiency operation. Methods have been developed for class-F with harmonic loading and for bias-modulation. Load-pull measurements with drain-bias modulation in a novel measurement setup have also been conducted. The investigation shows that the combination of computational load-pull of physical transistor structures and direct measurement evaluation with modified load-pull is a viable alternative for future design of RF-power devices. Simulations and measurements on the designed LDMOS shows a 10 to 15 % increase in drain efficiency in mid-power range both in simulations and measurements. The computational load-pull method has also been used to investigate the power capability of LDMOS transistors on SOI. This study indicates that either a low-resistivity or high-resistivity substrate should be used in manufacturing of RF-power LDMOS transistors on SOI to achieve optimum efficiency. Based on a proper substrate selection these devices exhibit a 10 % higher drain-efficiency mainly due to lower dissipated power in the devices.
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| 14. |
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| 15. |
- Björeland, Ulrika, et al.
(författare)
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Hyaluronic acid spacer in prostate cancer radiotherapy : dosimetric effects, spacer stability and long-term toxicity and PRO in a phase II study
- 2023
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Ingår i: Radiation Oncology. - : BioMed Central (BMC). - 1748-717X. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Perirectal spacers may be beneficial to reduce rectal side effects from radiotherapy (RT). Here, we present the impact of a hyaluronic acid (HA) perirectal spacer on rectal dose as well as spacer stability, long-term gastrointestinal (GI) and genitourinary (GU) toxicity and patient-reported outcome (PRO).METHODS: In this phase II study 81 patients with low- and intermediate-risk prostate cancer received transrectal injections with HA before external beam RT (78 Gy in 39 fractions). The HA spacer was evaluated with MRI four times; before (MR0) and after HA-injection (MR1), at the middle (MR2) and at the end (MR3) of RT. GI and GU toxicity was assessed by physician for up to five years according to the RTOG scale. PROs were collected using the Swedish National Prostate Cancer Registry and Prostate cancer symptom scale questionnaires.RESULTS: There was a significant reduction in rectal V70% (54.6 Gy) and V90% (70.2 Gy) between MR0 and MR1, as well as between MR0 to MR2 and MR3. From MR1 to MR2/MR3, HA thickness decreased with 28%/32% and CTV-rectum space with 19%/17% in the middle level. The cumulative late grade ≥ 2 GI toxicity at 5 years was 5% and the proportion of PRO moderate or severe overall bowel problems at 5 years follow-up was 12%. Cumulative late grade ≥ 2 GU toxicity at 5 years was 12% and moderate or severe overall urinary problems at 5 years were 10%.CONCLUSION: We show that the HA spacer reduced rectal dose and long-term toxicity.
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| 16. |
- Björeland, Ulrika, et al.
(författare)
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Impact of neoadjuvant androgen deprivation therapy on magnetic resonance imaging features in prostate cancer before radiotherapy
- 2021
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Ingår i: Physics and Imaging in Radiation Oncology. - : Elsevier. - 2405-6316. ; 17, s. 117-123
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: In locally advanced prostate cancer (PC), androgen deprivation therapy (ADT) in combination with whole prostate radiotherapy (RT) is the standard treatment. ADT affects the prostate as well as the tumour on multiparametric magnetic resonance imaging (MRI) with decreased PC conspicuity and impaired localisation of the prostate lesion. Image texture analysis has been suggested to be of aid in separating tumour from normal tissue. The aim of the study was to investigate the impact of ADT on baseline defined MRI features in prostate cancer with the goal to investigate if it might be of use in radiotherapy planning.Materials and methods: Fifty PC patients were included. Multiparametric MRI was performed before, and three months after ADT. At baseline, a tumour volume was delineated on apparent diffusion coefficient (ADC) maps with suspected tumour content and a reference volume in normal prostatic tissue. These volumes were transferred to MRIs after ADT and were analysed with first-order -and invariant Haralick -features.Results: At baseline, the median value and several of the invariant Haralick features of ADC, showed a significant difference between tumour and reference volumes. After ADT, only ADC median value could significantly differentiate the two volumes.Conclusions: Invariant Haralick -features could not distinguish between baseline MRI defined PC and normal tissue after ADT. First-order median value remained significantly different in tumour and reference volumes after ADT, but the difference was less pronounced than before ADT.
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| 17. |
- Björeland, Ulrika, et al.
(författare)
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Inter-fraction movements of the prostate and pelvic lymph nodes during IGRT
- 2018
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Ingår i: Journal of radiation oncology. - : Springer. - 1948-7894 .- 1948-7908. ; 7:4, s. 357-366
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Tidskriftsartikel (refereegranskat)abstract
- Objectivities: The aim of this study was to evaluate inter-fraction movements of lymph node regions that are commonly included in the pelvic clinical target volume (CTV) for high-risk prostate cancer patients. We also aimed to evaluate if the movements affect the planning target volumes. Methods: Ten prostate cancer patients were included. The patients underwent six MRI scans, from treatment planning to near end of treatment. The CTV movements were analyzed with deformable registration technique with the CTV divided into sections. The validity of the deformable registration was assessed by comparing the results for individual lymph nodes that were possible to identify in all scans. Results: Using repetitive MRI, measurements showed that areas inside the CTV (lymph nodes) in some extreme cases were as mobile as the prostate and not fixed to the bones. The lymph node volumes closest to the prostate did not tend to follow the prostate motion. The more cranial lymph node volumes moved less, but still independently, and they were not necessarily fixed to the pelvic bones. In 95% of the cases, the lymph node motion in the R-L direction was 2-4mm, in the A-P direction 2-7mm, and in the C-C direction 2-5mm depending on the CTV section. Conclusion: Lymph nodes and prostate were most mobile in the A-P direction, followed by the C-C and R-L directions. This movement should be taken into account when deciding the margins for the planning target volumes (PTV).
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| 18. |
- Björeland, Ulrika, 1974-
(författare)
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MRI in prostate cancer : implications for target volume
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Prostate cancer (PCa) is the most common cancer among men, with 10 000 new cases per year in Sweden [1]. To diagnose PCa, magnetic resonance imaging (MRI) is used to identify and classify the disease. The patient’s treatment strategy depends on PCa classification and clinical data, which are weighted together into a risk group classification from 1–5. For patients with higher risk classes (>3), radiotherapy together with hormone therapy is a common treatment option [2].In radiotherapy (RT), individual treatment plans are created based on the patient’s anatomy. These plans are based on computed tomography (CT), often supplemented with MRI images. MRI and CT complement each other, as MRI has better soft tissue contrast and CT has better bone contrast. Based on the images, the volumes to be treated (target) and the volumes to be avoided (risk organs) are defined. Prostate RT is complex, and there are uncertainties regarding the patient's internal movements and how the patient is positioned before each treatment. To account for these uncertainties, the radiation field is expanded (extended margins to target) to ensure that the treatment volume receives its radiotherapy. RT is most often given in fractions. Fractionation, dose, and treatment volume depend on the patient’s risk category. The treatment area can be, for example, only prostate, prostate with extra radiation dose (boost) to an intraprostatic tumour, or prostate with lymph node (LN) irradiation. LN irradiation is most often given for preventive purposes for PCa with a risk classification >4, which means no cancer has been identified, but any microscopic spread to the LNs is being treated profylactically.In RT, target identification is essential both in the treatment planning images (CT/MRI) and at treatment. Studies have shown that PCa often re-occurs in or near the volume of the dominant (often largest) intraprostatic tumour [3, 4], and this volume is relevant for boosting. For patients treated with hormone therapy before radiotherapy, tumour identification is complicated. Hormones change the tumour characteristics, affecting the image contrast and making the tumour difficult to identify. To study this, we investigated whether texture analysis could identify the tumour volume after hormone therapy (paper II). However, even with texture analysis, the tumour was difficult to identify. A follow-up study examined whether the image information in MRI images taken before hormone therapy could indicate how the treatment fell out (paper IV). However, no correlation was seen between image features and the progression of PCa.Identifying the target and correctly positioning the patient for each treatment fraction is the most important procedure in radiotherapy. The prostate is a mobile organ; therefore, intraprostatic fiducial markers are inserted before treatment planning to reduce positioning uncertainties. Each radiotherapy session begins with an X-ray image where the markers are visible, and the radiation can be delivered based on the markers' position. The markers are also used as guidance for large target volumes, such as for prostate with LN irradiation. With better knowledge of the prostate and LN movements, the margins can potentially be reduced, followed by reduced radiation dose to healthy tissue and therefore reduced side effects for patients. Movements in the radiotherapy volume were the focus of paper I. Using MRI images, the movements of the prostate and LNs were measured during the course of radiotherapy, and we found that LN movement is independent of the movement of the prostate and that the movement varies in the target volume.In addition to the recurrence of PCa in the tumour area, there is an increased risk of recurrence in the prostate periphery close to the rectum. Since the rectum and prostate are in contact for some patients, RT must be adapted to make rectum side effects tolerable. One way to increase the distance between the prostate and the rectum is to inject a gel between the two organs. The distance makes it easier to achieve a better dose distribution to the PCa. This idea resulted in paper III, where patients were given a gel between the prostate and rectum. MRI was used to check the stability of the gel during the course of RT and was evaluated together with long-term follow-up of the patient’s well-being and acceptance of the gel. We found that the radiation dose to the rectum was lower with a spacer, although the spacer was not completely stable during treatment.
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| 19. |
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| 20. |
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| 21. |
- Einarsdottir, Elisabet, et al.
(författare)
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The genetic population structure of northern Sweden and its implications for mapping genetic diseases.
- 2007
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Ingår i: Hereditas. - : Springer Science and Business Media LLC. - 1601-5223 .- 0018-0661. ; 144:5, s. 171-180
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Tidskriftsartikel (refereegranskat)abstract
- The northern Swedish population has a history of admixture of three ethnic groups and a dramatic population growth from a relatively small founder population. This has resulted in founder effects that together with unique resources for genealogical analyses provide excellent conditions for genetic mapping of monogenic diseases. Several recent examples of successful mapping of genetic factors underlying susceptibility to complex diseases have suggested that the population of northern Sweden may also be an important tool for efficient mapping of more complex phenotypes. A potential factor contributing to these effects may be population sub-isolates within the large river valleys, constituting a central geographic characteristic of this region. We here provide evidence that marriage patterns as well as the distribution of gene frequencies in a set of marker loci are compatible with this notion. The possible implications of this population structure on linkage- and association based strategies for identifying genes contributing risk to complex diseases are discussed.
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| 22. |
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| 23. |
- Eskilsson, Anna, 1977-
(författare)
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På plats i historien : Studier av hembygsföreningar på 2000-talet
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Local heritage societies were established in Sweden for about a hundred years ago. The societies responded to the large changes of industrialisation, emigration and urbanisation during that time. Today there are about 2 000 societies with almost half a million members altogether. Why do people turn to local heritage societies today? The image of them, associated with folklore costumes and quaint old cottages, is not consistent with the extensive activity in the 21st century. That raises questions that have not been clarified in previous research. The aim of this thesis is to find out what today's local heritage societies do, as well as to investigate what their meanings are for people and the local society. Thereby the intention is to contribute to an understanding of their present extent and endurance over time.The activities of three local heritage societies in and around the city of Linköping are mapped out in this thesis. The survey shows extensive and very broad activities that are well adjusted to present time. The traditional image has become rigid, but in parts it is accurate since the activities are still dominated by local use of history., which also contributes to their extent and continuity. Place and history as common ground is something universal: The need for people to be oriented in time and space contributes to the persistence of the local heritage societies. At the same time there seems to be something strong in society today which contributes to their extent.The thesis shows that the societies can have knowledge-generating, ideological, existential and social meaning. Through the local heritage society people can learn about, evaluate and gain feelings for the place. The society also contributes to strengthening the power of togetherness in the local community as a part of the civilian society. The multifaceted meaning of the activities makes it possible for the societies to keep or even strengthen their attraction, especially among the large group of retired people.
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| 24. |
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| 25. |
- Govsyeyev, Nicholas, et al.
(författare)
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Etiology and outcomes of amputation in patients with peripheral artery disease in the EUCLID trial
- 2022
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Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 75:2, s. 660-670e3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Amputation remains a frequent and feared outcome in patients with peripheral artery disease (PAD). Although typically characterized as major or minor on the extent of tissue loss, the etiologies and outcomes after amputation by extent are not well-understood. In addition, emerging data suggest that the drivers and outcomes of amputation in patients with PAD may differ in those with and without diabetes mellitus (DM).Methods: The EUCLID trial randomized 13,885 patients with symptomatic PAD, including 5345 with concomitant diabetes, to ticagrelor or clopidogrel and followed them for long-term outcomes. Amputations were prospectively reported by trial investigators. Their primary and contributing drivers were adjudicated using safety data, including infection, ischemia, or multifactorial etiologies. Outcomes following major and minor amputations were analyzed, including recurrent amputation, major adverse limb events, adverse cardiovascular events, and mortality. Multivariable logistic regression models were used to identify independent predictors of minor amputations. Analyses were performed overall and stratified by the presence or absence of DM at baseline.Results: Of the patients randomized, 398 (2.9%) underwent at least one lower extremity nontraumatic amputation, for a total of 511 amputations (255 major and 256 minor) over a median of 30 months. A history of minor amputation was the strongest independent predictor for a subsequent minor amputation (odds ratio, 7.29; 95% confidence interval, 5.17-10.30; P <.001) followed by comorbid DM (odds ratio, 4.60; 95% confidence interval, 3.16-6.69; P <.001). Compared with patients who had a major amputation, those with a minor amputation had similar rates of subsequent major amputation (12.2% vs 13.6%), major adverse limb events (15.1% vs 14.9%), and major adverse cardiovascular events (17.6% vs 16.3%). Ischemia alone was the primary driver of amputation (51%), followed by infection alone (27%), and multifactorial etiologies (22%); however, infection was the most frequent driver in those with DM (58%) but not in those without DM (15%).Conclusions: Outcomes after amputation remain poor regardless of whether they are categorized as major or minor. The pattern of amputation drivers in PAD differs by history of DM, with infection being the dominant etiology in those with DM and ischemia in those without DM. Greater focus is needed on the prognostic importance of minor amputation and of the multifactorial etiologies of amputation in PAD. Nomenclature with anatomical description of amputations and eliminating terms "major" or "minor" would seem appropriate.
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| 26. |
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| 27. |
- Jong, Miek C., 1968-, et al.
(författare)
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A randomized controlled pilot study assessing feasibility and safety of a wilderness program for childhood, adolescent, and young adult cancer survivors : the WAYA study
- 2023
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe majority of childhood, Adolescent and Young Adult (AYA) cancer survivors sufers from long-lasting health issues following cancer treatment. It is therefore critical to explore efective health promotion strategies to address their needs. Exposure to nature is a promising approach to support the needs of young cancer survivors. This study investigated whether it is feasible to conduct a randomized controlled trial (RCT) of a wilderness program for childhood and AYA cancer survivors.MethodsEligible participants were aged 16–39 years, had a cancer diagnosis, and met minimal criteria. Seventy-one individuals expressed interest and 59 were randomized to either a wilderness or a holiday program. The wilderness program involved an 8-day expedition including backpacking, sea kayaking, gorge climbing, camping, bush-craft skills, and mindfulness-practices. It was followed by a 4-day basecamp after 3 months. The comparison was an 8-day holiday program at a Spa-hotel followed by a 4-day holiday program at the same hotel after 3 months. Primary outcome was study feasibility and safety.ResultsUltimately, 19 AYAs participated in the wilderness and 23 in the holiday program. All completed the study at one-year follow-up. Participants were mostly female (70%) and represented diverse cancers. Clinical characteristics were similar between study arms excepting greater age at cancer diagnosis in the wilderness program (age 19.1 vs. 12.5; p=0.024). Program adherence and data completeness was high (>90%) in both arms. Adverse Efects (AEs) in the wilderness vs. the holiday program were similar (Relative Risk: 1.0, 95% Confdence Interval 0.8–1.3). The most frequent AE was tiredness, all were mild to moderate in severity, and serious AEs were not reported. Nature connectedness signifcantly increased over time in the wilderness program participants, but not in the holiday program (p<0.001). No diferences were found between the two study arms regarding quality of life, self-esteem, or self-efcacy.ConclusionIt is feasible to conduct a RCT and a supervised wilderness adventure is equally safe for childhood and AYA cancer survivors as a holiday program. This pilot study lays the foundation for a larger RCT to investigate the efectiveness of wilderness programs on the health of young cancer survivors.
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| 28. |
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| 29. |
- Munksgaard Persson, Matilda, et al.
(författare)
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HIF-2 alpha Expression Is Suppressed in SCLC Cells, Which Survive in Moderate and Severe Hypoxia When HIF-1 alpha Is Repressed
- 2012
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Ingår i: American Journal of Pathology. - : Elsevier. - 0002-9440 .- 1525-2191. ; 180:2, s. 494-504
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Tidskriftsartikel (refereegranskat)abstract
- Small cell lung carcinoma (SCLC) is extremely aggressive and frequently metastasizes widely in its early stage. Because tumor hypoxia is related to aggressive tumor behavior and the hypoxic adaptation of SCLC is poorly documented, we stained SCLC tumors arranged in a tissue microarray for hypoxia-inducible factor (HIF)-1 alpha and HIF-2 alpha proteins. We found an overall lack of HIF-2 alpha protein expression, which was confirmed in large tumor sections. HIF-1 alpha protein was strongly expressed in most tumors, frequently adjacent to necrotic regions. In concordance, cultured SCLC but not non-small cell lung carcinoma cells showed no or extremely low levels of HIF-2 alpha mRNA and no HIF-2 alpha protein at hypoxia. HIF-1 alpha was stabilized after 4 hours at hypoxia, and its accumulation increased up to 96 hours. SCLC cells survived well and showed net proliferation and low cell death in modest (1% oxygen) and severe (0.1% oxygen) hypoxia. HIF-1 alpha repression virtually did not influence cell death or viability despite reduced levels of hypoxia-inducible genes, such as BNIP3 and BNIP3L. At 1% oxygen no increased autophagy (LC3B-II activation) or NF-kappa B signaling were detected, whereas the unfolded protein response was activated at severe hypoxia. Our data indicate that HIFs are not exclusively required for SCLC cell survival at modest or severe hypoxia and that additional, yet uncharacterized, hypoxia-driven adaptation pathways may become activated.
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| 30. |
- Ovaskainen, Louise, 1981-
(författare)
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Superhydrophobic coatings of wax and polymers sprayed from supercritical solutions
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The possibility of using supercritical carbon dioxide (scCO2) as the primary solvent in a spray process for producing superhydrophobic surfaces have been examined in this work. Using scCO2 as solvent will have considerably lower environmental impact compared to an organic solvent since scCO2 is considered a green solvent as it is non-toxic, non-flammable and recyclable. To be able to work at the pressures needed to reach the supercritical state of carbon dioxide, a high-pressure technique called rapid expansion of supercritical solutions (RESS) has been used to produce the coatings. Fluorinated compounds are often used when producing superhydrophobic coatings due to their intrinsic water repellent properties, but generally these compound do not degrade in nature. Due to this, a wax and a biodegradable polymer have been used as the coating materials in this work.Two RESS set-ups were used to spray a polymer from solutions of scCO2 and acetone. The first system was based on a continuous flow of the solvent mixture and the polymer particles were collected on silica surfaces. Some of the coatings had superhydrophobic properties and the limitation with this technique was the loss of particles between the nozzle and the surface. In the second set-up, RESS was combined with electrostatic deposition (ED) to improve the particle collection. Different processing parameters were examined and most of the RESS-ED sprayed surfaces were superhydrophobic. This was demonstrated by high contact angles against water, low contact angle hysteresis and low tilt angles at which a water droplet rolls off the surface. It was also shown that the surface structures created when spraying using RESS-ED induced the important two-level roughness that was needed to achieve superhydrophobicity. A semi-continuous process for scaling-up the RESS system when spraying the wax has been developed. Temperature and pressure was investigated to find the highest solubility of the wax in scCO2, and 250 bar and 67 °C resulted in the largest amount of sprayed wax. It was also shown that the system is suitable for spray-coating the wax on different substrates such as glass, paper, aluminium etc. since all of these surfaces showed superhydrophobic properties. The wear resistance of the coatings were examined by different methods. Scratch resistance, vertical compression and the friction between the surface and a finger were analysed. The polymer coated surfaces showed a larger robustness compared with the wax surfaces in the scratch tests. The superhydrophobicity was lost for the wax coatings exposed to compression loads above 59 kPa and in the frictions test, one finger stroke over the coating destroyed the surface roughness. Finally, the wax surfaces were investigated as coating barriers to protect steel from corrosion. The superhydrophobic coating was stable up to 10 days before corrosion of the steel started.
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| 31. |
- Rönningås, Ulrika, et al.
(författare)
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Signs and symptoms in relation to progression, experiences of an uncertain illness situation in men with metastatic castration-resistant prostate cancer : A qualitative study
- 2022
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Ingår i: European Journal of Cancer Care. - : Wiley-Blackwell. - 0961-5423 .- 1365-2354. ; 31:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Signs and symptoms are important in monitoring prostate cancer, but there is a lack of understanding about the men's interpretation of signs and symptoms in relation to disease progression in advanced phases of the disease. The aim was to illuminate the experience of signs and symptoms in relation to disease progression in men with metastatic castration-resistant prostate cancer (mCRPC).METHOD: Thirty longitudinal interviews were conducted with 11 men undergoing life-prolonging treatment for mCRPC. Conventional content analysis was used.RESULTS: The results illuminate an uncertainty that the men experience when interpreting signs and symptoms. The overarching theme was The experience of an uncertain illness situation within the framework of progression, with four subthemes: Symptoms triggering thoughts about disease progression; Making sense of signs, also in the absence of symptoms; Making sense of symptoms during treatment; Progression triggering thoughts about the remainder of life.CONCLUSION: In the uncertain illness situation, the men strive to make sense of signs and symptoms based on previous experiences and in relation to disease progression. Understanding the men's perspectives on signs and symptoms in this late phase may help health care professionals communicate about disease progression considering the balance between treatment outcome and quality of life.
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| 32. |
- Rönningås, Ulrika, et al.
(författare)
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Symptoms and quality of life among men starting treatment for metastatic castration-resistant prostate cancer : a prospective multicenter study
- 2024
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Ingår i: BMC Palliative Care. - : BioMed Central (BMC). - 1472-684X. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Men with metastatic castration-resistant prostate cancer (mCRPC) have an incurable disease. Along with prolonging life, symptom management is one of the main goals with treatment. This is also important from a palliative care perspective where the life prolonging outcomes should be balanced with quality of life (QoL) in this late phase. It is also essential in symptom management to view different dimensions of symptoms, for example how severe or distressing symptoms are, to support best QoL. Therefore, more knowledge is needed about the symptom experience when these treatments are initiated and thus the aim of this study was to describe different dimensions of symptoms in men with mCRPC starting their first-line of life-prolonging treatment, and to describe the association between symptom burden and QoL.METHODS: Baseline data from a prospective longitudinal study of 143 men with mCRPC starting their first-line life-prolonging treatment were used. Symptoms were measured using the Memorial Symptom Assessment Scale (MSAS) and global QoL was measured by the EORTC QLQ C-30. Data was analyzed using descriptive- and multivariable linear regression analyses.RESULTS: On average, the men had more than 10 symptoms (range 0-31 of 33). 50% or more reported sweats, lack of energy, pain, problems with sexual activity and sexual desire. The symptoms they reported as most severe, or most distressing were not always the ones that were reported as most frequent. There was an association between QoL and physical symptoms, and also between QoL, and analgesic use and prostate-specific antigen (PSA) values.CONCLUSION: Even if some men with mCRPC report many symptoms, the dimensions of severity and distress levels vary, and the most frequent symptoms was not always the most burdensome or distressing. There was an association between high physical symptom burden and QoL, suggesting that it is not the number of symptoms that affects QoL but rather the subjective perceived impact of the physical symptoms experienced. The knowledge of how men with mCRPC experience and perceive their symptoms may help health care professionals in symptom management aiming to improve QoL, which is a cornerstone in integrating early palliative care.
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| 33. |
- Skogh, Ann-Charlott Docherty, et al.
(författare)
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Variation in Calvarial Bone Healing Capacity : A Clinical Study on the Effects of BMP-2-Hydrogel or Bone Autograft Treatments at Different Cranial Locations
- 2013
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Ingår i: The Journal of craniofacial surgery (Print). - 1049-2275 .- 1536-3732. ; 24:2, s. 339-343
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bone morphogenetic protein-2 (BMP-2) together with a suitable carrier is an attractive option that may be used for craniofacial bone reconstruction. In this prospective randomized study, a hyaluronan-based hydrogel with BMP-2 was used to achieve bone healing in standardized critical-size cranial defects in humans after neurosurgery. Methods: Twelve patients were randomized into the treatment group (N = 6) or control group (N = 6). In the treatment group, holes made during craniotomy were treated with hydrogel with BMP-2, 250 mu g/mL, or hydrogel without BMP-2. In the remaining hole/s in the same patient, Spongostan (Ethicon) alone or Tisseel (Baxter) mixed with autologous bone matrix were used as negative and positive controls, respectively. In the control group, the holes were treated with Spongostan or Tisseel mixed with bone autograft. Bone healing was assessed with CT scans after 3 and 6 months. Bone areas in treated defects were measured and statistical analysis was performed. Results: Independent of location, bone healing in defects treated with Tisseel with autograft, hydrogel alone, or hydrogel with BMP-2 was significantly increased compared to negative control (P < 0.001, P = 0.002, and P = 0.005, respectively). In general, all defects healed significantly better in the frontal bone as compared to parietal-temporal location, except for defects treated with Tisseel and autograft, which healed well independently of location. No local or systemic side effects, including excessive bone overgrowth or inflammatory reaction, were seen in treated patients. Conclusions: Tissue engineering of bone with hyaluronan-based hydrogel shows good healing of cranial defects, comparable with bone autografts. The hydrogel itself may represent a novel alternative to autologous bone transplants in craniofacial bone repair. The study also reveals a general superior healing capacity in the frontal bone as compared to parietal/temporal bones.
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| 34. |
- Sun, Sun, et al.
(författare)
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Is ultra-hypo-fractionated radiotherapy more cost-effective relative to conventional fractionation in treatment of prostate cancer? A cost–utility analysis alongside a randomized HYPO-RT-PC trial
- 2023
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Ingår i: European Journal of Health Economics. - : Springer. - 1618-7598 .- 1618-7601. ; 24, s. 237-246
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Tidskriftsartikel (refereegranskat)abstract
- Background: Economic evidence for comparing low fraction with ultra-hypo fractionated (UHF) radiation therapy in the treatment of intermediate-to-high-risk prostate cancer (PC) is lacking, especially in Europe. This study presents an economic evaluation performed alongside an ongoing clinical trial.Aim: To investigate up to 6 years’ follow-up whether conventional fractionation (CF, 78.0 Gy in 39 fractions, 5 days per week for 8 weeks) is more cost-effective than UHF (42.7 Gy in 7 fractions, 3 days per week for 2.5 weeks inclusive of 2 weekends) radiotherapy in treatment for patients with intermediate-to-high-risk PC.Method: HYPO-RT-PC trial is an open-label, randomized, multicenter (10 in Sweden; 2 in Denmark) phase-3 trial. Patients from Sweden (CF 434; UHF 445) were included in this study. The trial database was linked to the National Patient Registry (NPR). Costs for inpatient/non-primary outpatient care for each episode were retrieved. For calculating Quality-adjusted life years (QALYs), the EORTC QLQ-C30 questionnaire was mapped to the EQ-5D-3L index. Multivariable regression analyses were used to compare the difference in costs and QALYs, adjusting for age and baseline costs, and health status. The confidence interval for the difference in costs, QALYs and incremental cost-effectiveness ratio effectiveness ratio (ICER) was estimated by the bootstrap percentile method.Results: No significant differences were found in ICER between the two arms after 6 years of follow-up.Conclusion: The current study did not support that the ultra-hypo-fractionated treatment was more cost-effective than the conventional fraction treatment up to the sixth year of the trial.
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| 35. |
- Sundberg, Björn, et al.
(författare)
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TEMA: Kristina Lugn m.fl.
- 2006
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Innehåll: Björn Sundberg: Vad är Kristina Lugn egentligen? Margareta Wirmark: Kristina Lugn, vardagspratets dramatiker Lars Elleström: Epifenomenalism eller psykosomatik? Kropp, kropp och själ i Kristina Lugns Hej och ha det så bra! Åsa Beckman: "Du ska få ett panoramafönster i barnbidrag" - ett poetiskt testamente av Kristina Lugn Hans Färnlöf: Godtyckligt eller konsekvent berättande? Reflektioner kring motiveringen i Rött och svart av Stendahl Ingemar Haag: Litteraturen om intet - några tankar kring förhållandet mellan litteratur och etik Dan Landmark: Slaget om jaget - reflektioner kring självbiografin Monica Loeb: Jeanette Armstrong - visionär okanagan poet Anna Chryssafis: Medeltida översättningsproblematik. En studie med exempel från Jean de Meung - nydanande översättare från slutet av 1200-talet
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| 36. |
- Wennberg, Charlotte, et al.
(författare)
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Structure, genomic DNA typing and kinetic characterization of the D allozyme of placental alkaline phosphatase
- 2002
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Ingår i: Human Mutation. - : Hindawi Limited. - 1059-7794 .- 1098-1004. ; 19:3, s. 258-267
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Tidskriftsartikel (refereegranskat)abstract
- The D allozyme of placental alkaline phosphatase (PLAP) displays enzymatic properties at variance with those of the common PLAP allozymes. We have deduced the amino acid sequence of the PLAP D allele by PCR cloning of its gene, ALPP. Two coding substitutions were found in comparison with the cDNA of the common PLAP F allele, i.e., 692C>G and 1352A>G, which translate into a P209R and E429G substitution. A single nucleotide primer extension (SNuPE) assay was developed using PCR primers that enable the amplification of a 1.9 kb PLAP fragment. Extension primers were then used on this PCR fragment to detect the 692C>G and 1352A>G substitution. The SNuPE assay on these two nucleotide substitutions enabled us to distinguish the PLAP F and D alleles from the PLAP S/I alleles. Functional studies on the D allozyme were made possible by constructing and expressing a PLAP D cDNA, i.e., [Arg209, Gly429]PLAP, into wild-type Chinese hamster ovary cells. We determined the kcat and Km, of the PLAP S, F, and D allozymes using the non-physiological substrate p-nitrophenylphosphate at an optimal pH (9.8) as well as two physiological substrates, i.e., pyridoxal-5-phosphate and inorganic pyrophosphate at physiological pH (7.5). We found that the biochemical properties of the D allozyme of PLAP are significantly different from those of the common PLAP allozymes. These biochemical findings suggest that a suboptimal enzymatic function by the PLAP D allozyme may be the basis for the apparent negative selective pressure of the PLAP D allele. The development of the SNuPE assay will enable us to test the hypothesis that the PLAP D allele is subjected to intrauterine selection by examining genomic DNA from statistically informative population samples.
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| 37. |
- Westerberg, Marcus, et al.
(författare)
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Different assumptions about missingness in registration of metastatic status have important implications for following trends in cancer presentation
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: We assessed approaches for handling missing M stage when estimating incidence trends of metastatic prostate cancer at diagnosis (M1) in Sweden. Study design and setting: We used different implementations of deterministic- and multiple imputation to handle missing M stage and estimate the age-standardized incidence of M1. Each method was assessed by studying adjusted survival of men with known and imputed M stage.Results: Missing data in M stage was high (66%) and varied over calendar time and risk groups. The estimated incidence of M1 differed greatly depending on the method of imputation, however all indicated a downward trend. A combination of deterministic imputation and multiple imputation produced adjusted survival curves for men with imputed M stage that best resembled the survival curves for men with known M stage. Conclusions: Deterministic imputation of missing M stage to M0 among men with low risk of metastatic disease in combination with multiple imputation appeared to the best method to estimate incidence of metastatic prostate cancer. Simply substituting missing M stage with M0 most likely underestimates the true incidence of M1. Inclusion of key clinical variables is important to generate plausible imputations. It is important to include data on use of imaging to handle missing M stage appropriately and assess potential bias of a chosen imputation method.
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| 38. |
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| 39. |
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| 40. |
- Witell, Lars, 1972-, et al.
(författare)
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Value creation in service-based states of business relationships
- 2019
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Ingår i: Service Innovation for Sustainable Business. - Singapore : World Scientific. - 9789813273382 - 9789813273375 ; , s. 281-305
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The following sections are included: Introduction Value and Value Drivers in a Relationship Context Methodology Results Conclusions Appendix: An Overview of the Conceptualization of Value Drivers References
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| 41. |
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| 42. |
- Åkerman, Johan, 1966-
(författare)
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Lokala fack i globala företag : Electrolux verkstadsklubb i Motala och koncernfacket 1925-1985
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Since the 1970's the union movement has regarded international business as a threat to union interests, democratic values and national independence. The union movement has mentioned two methods of defence against influence of international businesses: to introduce societal restrictions on a national or international level and to establish international (corporate) group unions. At the same time it is important to note that international entrepreneurship has occurred much earlier than 1970. The overall aim with this dissertation is to study labour union practice in an international corporate group in the years 1925-1985.The main sources of information are collected from the union archives, which are located in Folkrörelsearkivet in Motala. The Electrolux local union in Motala was founded in 1925, the same year as the corporation started in Motala. Despite the fact that the group structure was affecting the activity at the corporation to a considerable degree, the local union did not take interest in these questions until the 1960's. The jointwork council agreement and the council that was established in Motala were crucial to lift the perspective of the local union to also include group issues. The Electrlux group union was founded in 1946, initiated by the local union in Motala. The primary motive for this was to create a new forum where traditional union issues could be pursued towards the group management. During the 197o's and the 198o's the group union activities changed. There aretwo explanations for this change. The Electrolux group was expanding drastically, new and bigger companies were purchased and the group extended its product areas. The other explanation is the vast changes in labour-market policy that occurred in Sweden at this time. In that way the group union increased their insight in the group activities, and also improved their prerequisites for organising their activity. The group union extended its activity to embrace also the Nordic countries. The dissertation shows that the Electrolux group union had large difficulties meeting the challenges generated by the group structure. This was mainly caused by a number of structural obstacles. Union division; the national differences regarding organisation, culture, language and ideology were too big. There were also structural obstacles for the solidarity between the union organisations. Solidarity with colleagues collided with national and regional egoism. The union structure was also an obstacle. Irrespective of the organisation of the national unions, from line of business, political view or occupation it was obvious that international corporations were organised based on a different principal.
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