| 1. |
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| 2. |
- Johansson, Karl-Axel, et al.
(author)
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The quality assurance process for the ARTSCAN head and neck study - a practical interactive approach for QA in 3DCRT and IMRT.
- 2008
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In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 87:2, s. 290-9
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Journal article (peer-reviewed)abstract
- AIM: This paper describes the quality assurance (QA) work performed in the Swedish multicenter ARTSCAN (Accelerated RadioTherapy of Squamous cell CArcinomas in the head and Neck) trial to guarantee high quality in a multicenter study which involved modern radiotherapy such as 3DCRT or IMRT. MATERIALS AND METHODS: The study was closed in June 2006 with 750 randomised patients. Radiation therapy-related data for every patient were sent by each participating centre to the QA office where all trial data were reviewed, analysed and stored. In case of any deviation from the protocol, an interactive process was started between the QA office and the local responsible clinician and/or physicist to increase the compliance to the protocol for future randomised patients. Meetings and workshops were held on a regular basis for discussions on various trial-related issues and for the QA office to report on updated results. RESULTS AND DISCUSSION: This review covers the 734 patients out of a total of 750 who had entered the study. Deviations early in the study were corrected so that the overall compliance to the protocol was very high. There were only negligible variations in doses and dose distributions to target volumes for each specific site and stage. The quality of the treatments was high. Furthermore, an extensive database of treatment parameters was accumulated for future dose-volume vs. endpoint evaluations. CONCLUSIONS: This comprehensive QA programme increased the probability to draw firm conclusions from our study and may serve as a concept for QA work in future radiotherapy trials where comparatively small effects are searched for in a heterogeneous tumour population.
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| 3. |
- Eriksson, Daniel, et al.
(author)
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GWAS for autoimmune Addison’s disease identifies multiple risk loci and highlights AIRE in disease susceptibility
- 2021
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In: Nature Communications. - : Nature Publishing Group. - 2041-1723. ; 12:1
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Journal article (peer-reviewed)abstract
- Autoimmune Addison's disease (AAD) is characterized by the autoimmune destruction of the adrenal cortex. Low prevalence and complex inheritance have long hindered successful genetic studies. We here report the first genome-wide association study on AAD, which identifies nine independent risk loci (P < 5 × 10-8). In addition to loci implicated in lymphocyte function and development shared with other autoimmune diseases such as HLA, BACH2, PTPN22 and CTLA4, we associate two protein-coding alterations in Autoimmune Regulator (AIRE) with AAD. The strongest, p.R471C (rs74203920, OR = 3.4 (2.7-4.3), P = 9.0 × 10-25) introduces an additional cysteine residue in the zinc-finger motif of the second PHD domain of the AIRE protein. This unbiased elucidation of the genetic contribution to development of AAD points to the importance of central immunological tolerance, and explains 35-41% of heritability (h2).
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| 4. |
- Gad, Helge, et al.
(author)
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MTH1 inhibition eradicates cancer by preventing sanitation of the dNTP pool
- 2014
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In: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 508:7495, s. 215-221
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Journal article (peer-reviewed)abstract
- Cancers have dysfunctional redox regulation resulting in reactive oxygen species production, damaging both DNA and free dNTPs. The MTH1 protein sanitizes oxidized dNTP pools to prevent incorporation of damaged bases during DNA replication. Although MTH1 is non-essential in normal cells, we show that cancer cells require MTH1 activity to avoid incorporation of oxidized dNTPs, resulting in DNA damage and cell death. We validate MTH1 as an anticancer target in vivo and describe small molecules TH287 and TH588 as first-in-class nudix hydrolase family inhibitors that potently and selectively engage and inhibit the MTH1 protein in cells. Protein co-crystal structures demonstrate that the inhibitors bindin the active site of MTH1. The inhibitors cause incorporation of oxidized dNTPs in cancer cells, leading to DNA damage, cytotoxicity and therapeutic responses in patient-derived mouse xenografts. This study exemplifies the non-oncogene addiction concept for anticancer treatment and validates MTH1 as being cancer phenotypic lethal.
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| 5. |
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| 6. |
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| 7. |
- Andersson, Swen-Olof, et al.
(author)
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Managing localized prostate cancer by radical prostatectomy or watchful waiting: Cost analysis of a randomized trial (SPCG-4)
- 2011
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In: SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY. - : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 45:3, s. 177-183
-
Journal article (peer-reviewed)abstract
- Objective. The cost of radical prostatectomy (RP) compared to watchful waiting (WW) has never been estimated in a randomized trial. The goal of this study was to estimate long-term total costs per patient associated with RP and WW arising from inpatient and outpatient hospital care. Material and methods. This investigation used the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial, comparing RP to WW, and included data from 212 participants living in two counties in Sweden from 1989 to 1999 (105 randomized to WW and 107 to RP). All costs were included from randomization date until death or end of follow-up in July 2007. Resource use arising from inpatient and outpatient hospital costs was measured in physical units and multiplied by a unit cost to come up with a total cost per patient. Results. During a median follow-up of 12 years, the overall cost in the RP group was 34% higher (p andlt; 0.01) than in the WW group, corresponding to euroa,not sign6123 in Sweden. The difference was driven almost exclusively by the cost of the surgical procedure. The cost difference between RP and WW was two times higher among men with low (2--6) than among those with high (7--10) Gleason score. Conclusion. In this economic evaluation of RP versus WW of localized prostate cancer in a randomized study, RP was associated with 34% higher costs. This difference, attributed exclusively to the cost of the RP procedure, was not overcome during extended follow-up.
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| 8. |
- Asplund, Kjell, et al.
(author)
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The Riks-Stroke story : building a sustainable national register for quality assessment of stroke care
- 2011
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In: International Journal of Stroke. - : SAGE Publications. - 1747-4930 .- 1747-4949. ; 6:2, s. 99-108
-
Journal article (peer-reviewed)abstract
- Background Riks-Stroke, the Swedish Stroke Register, is the world's longest-running national stroke quality register (established in 1994) and includes all 76 hospitals in Sweden admitting acute stroke patients. The development and maintenance of this sustainable national register is described. Methods Riks-Stroke includes information on the quality of care during the acute phase, rehabilitation and secondary prevention of stroke, as well as data on community support. Riks-Stroke is unique among stroke quality registers in that patients are followed during the first year after stroke. The data collected describe processes, and medical and patient-reported outcome measurements. The register embraces most of the dimensions of health-care quality (evidence-based, safe, provided in time, distributed fairly and patient oriented). Result Annually, approximately 25 000 patients are included. In 2009, approximately 320 000 patients had been accumulated (mean age 76-years). The register is estimated to cover 82% of all stroke patients treated in Swedish hospitals. Among critical issues when building a national stroke quality register, the delicate balance between simplicity and comprehensiveness is emphasised. Future developments include direct transfer of data from digital medical records to Riks-Stroke and comprehensive strategies to use the information collected to rapidly implement new evidence-based techniques and to eliminate outdated methods in stroke care. Conclusions It is possible to establish a sustainable quality register for stroke at the national level covering all hospitals admitting acute stroke patients. Riks-Stroke is fulfilling its main goals to support continuous quality improvement of Swedish stroke services and serve as an instrument for following up national stroke guidelines.
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| 9. |
- Berndt, Sonja I., et al.
(author)
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Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture
- 2013
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In: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 45:5, s. 501-U69
-
Journal article (peer-reviewed)abstract
- Approaches exploiting trait distribution extremes may be used to identify loci associated with common traits, but it is unknown whether these loci are generalizable to the broader population. In a genome-wide search for loci associated with the upper versus the lower 5th percentiles of body mass index, height and waist-to-hip ratio, as well as clinical classes of obesity, including up to 263,407 individuals of European ancestry, we identified 4 new loci (IGFBP4, H6PD, RSRC1 and PPP2R2A) influencing height detected in the distribution tails and 7 new loci (HNF4G, RPTOR, GNAT2, MRPS33P4, ADCY9, HS6ST3 and ZZZ3) for clinical classes of obesity. Further, we find a large overlap in genetic structure and the distribution of variants between traits based on extremes and the general population and little etiological heterogeneity between obesity subgroups.
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| 10. |
- Cuddington, John T, et al.
(author)
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Optimal policy rules and regime switching in disequilibrium models
- 1985
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In: Journal of Public Economics. - : Elsevier BV. - 0047-2727 .- 1879-2316. ; 27:2, s. 247-254
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Journal article (peer-reviewed)abstract
- This paper emphasizes the need to search for globally optimal policy levels (for public production, say) in fix-price disequilibrium analysis. Regime-specific rules are inadequate. They ignore the fact that moving a policy towards its optimal level may move the economy from its initial disequilibrium regime to a different regime where the rule no longer applies.
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| 11. |
- Cuddington, John T., et al.
(author)
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Optimum Tariffs, Revenue-Maximizing Tariffs and Unemployment : A General Disequilibrium Analysis
- 1983
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Reports (other academic/artistic)abstract
- This paper uses recently developed non-Walrasian equilibrium models of open economies to characterize the optimum tariff under both Classical and Keynesian Unemployment regimes. The existing literature concentrates on the former. Keynesian unemployment has notbeen considered, presumably because of the difficulty integrating macroeconomic models of unemployment and microeconomic policy analyses in the presence of domestic distortions. Interestingly, the optimum tariff under either type of unemployment may lie above the revenue-maximizing tariff in contrast to the well-known result obtained in the Walrasian equilibrium context.
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| 12. |
-
Current issues in environmental economics
- 1995. - 1
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Editorial collection (other academic/artistic)abstract
- Eight papers discuss the contingent valuation method and experimental methods that can be used to value environmental assets, and show how altruistic concerns can be handled in evaluations of environmental change. Papers focus on current issues in the design, administration, and analysis of contingent valuation surveys; the interpretation of responses in contingent valuation surveys; preference uncertainty, optimal designs, and spikes; valuing changes in health; an experimental economics perspective on whether real environmental benefits can be estimated; current issues in resource accounting; environment-economy interactions in a computable general equilibrium model of Sweden; and intertemporal equilibrium modeling of energy and environmental policies. Contributors are mainly economists. Johansson and Kristrom are at the Stockholm School of Economics. Maler is at the Beijer Institute of Ecological Economics. Index.
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| 13. |
- Eriksson, David, et al.
(author)
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Apoptotic signalling in HeLa Hep2 cells following 5 Gy of cobalt-60 gamma radiation
- 2009
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In: Anticancer Research. - 0250-7005 .- 1791-7530. ; 29:11, s. 4361-4366
-
Journal article (peer-reviewed)abstract
- BACKGROUND: The apoptotic signalling pathways involved in the delayed type of apoptosis occurring in HeLa Hep2 cells following radiation were investigated. MATERIALS AND METHODS: HeLa Hep2 cells were exposed to 5 Gy of cobalt-60 radiation. The activation of caspase-2, caspase-8, caspase-9 and effector caspase-3 was investigated by caspase assay plates and Western blots. Cleavage of poly (ADP-ribose) polymerase (PARP) was analysed on Western blots. HeLa Hep2 cells were irradiated with or without preincubation with inhibitors of protein synthesis (cycloheximide, CHX) and caspases, followed by TUNEL staining and caspase assay plate evaluation. RESULTS: Initiator caspases-2, -8, -9, and effector caspase-3, were found to be activated and PARP cleaved following irradiation. CHX completely inhibited the caspase activation and the associated apoptosis. Pretreatment with caspase-2 inhibitor indicated that caspase-2 was involved in the execution of the apoptosis. CONCLUSION: Activation of the apoptotic signalling pathways following irradiation of HeLa Hep2 cells includes components from the intrinsic as well as the extrinsic pathways and seems to require de novo protein synthesis.
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| 14. |
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| 15. |
- Eriksson, David, et al.
(author)
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Cell cycle disturbances and mitotic catastrophes in HeLa Hep2 cells following 2.5 to 10 Gy of ionizing radiation.
- 2007
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In: Clin Cancer Res. - 1078-0432. ; 13:18 Pt 2, s. 5501s-5508s
-
Journal article (peer-reviewed)abstract
- PURPOSE: Experimental radioimmunotherapy delivering absorbed doses of 2.5 to 10 Gy has been shown to cause growth retardation of tumors. The purpose of this study was to elucidate the sequential molecular and cellular events occurring in HeLa Hep2 cells exposed to such doses. METHODS: Dose-response curves, activation of cell cycle checkpoints, and mitotic behavior were investigated in HeLa Hep2 cells following 2.5- to 10-Gy irradiation by carrying out 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays, Western blots, fluorescence-activated cell sorting analysis, and immunofluorescence stainings. Terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labeling staining was used to detect apoptosis. RESULTS: A G2-M arrest was shown by fluorescence-activated cell sorting analysis. p53 and p21 were found to be up-regulated but were not immediately related to the arrest. The G2-M arrest was transient and the cells reentered the cell cycle still containing unrepaired cellular damage. This premature entry caused an increase of anaphase bridges, lagging chromosomal material, and multipolar mitotic spindles as visualized by propidium iodide staining and immunofluorescence staining with alpha-tubulin and gamma-tubulin antibodies. Furthermore, a dose-dependent significant increase in centrosome numbers from 12.6+/-6.6% to 67+/-5.3% was identified as well as a dose-dependent increase of polyploid cells from 2.8+/-1.3% to 17.6+/-2.1% with the highest absorbed dose of 10 Gy. These disturbances caused the cells to progress into mitotic catastrophe and a fraction of these dying cells showed apoptotic features as displayed by terminal deoxyribonucleotidyl transferase-mediated dUTP nick end labeling staining 5 to 7 days after irradiation. CONCLUSION: An absorbed dose of 2.5 to 10 Gy was shown to force HeLa Hep2 cells into mitotic catastrophe and delayed apoptosis. These might be important cell death mechanisms involved in tumor growth retardation following radioimmunotherapy of solid tumors.
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| 16. |
- Eriksson, David, et al.
(author)
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Combined low dose radio- and radioimmunotherapy of experimental HeLa Hep 2 tumours.
- 2003
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In: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 30:6, s. 895-906
-
Journal article (peer-reviewed)abstract
- Radiation therapy of malignant tumours can be delivered by external beam radiation (RT) or radioimmunotherapy (RIT), using nuclides attached to monoclonal antibodies (mAbs). These treatment modalities have now been combined in order to investigate putative therapeutic advantages and elucidate the biological responses involved. Nude mice were transplanted subcutaneously on the back with human HeLa Hep2 tumour cells. RT (3x5 Gy) and/or 100 microg (131)I-labelled mAb H7, against placental alkaline phosphatase, or (131)I-labelled mAb TS1, against cytokeratin, was administered separately or in combination (specific activity of 120-200 MBq/mg antibody). Significant tumour growth retardation was observed both with RT alone and with RIT alone. Combining these regimens enhanced the therapeutic effects further, and a significant reduction in tumour volume could be demonstrated. The tumours were subjected to extensive histochemical and immunohistochemical investigations in order to elucidate changes in biology and histology within them. The following stainings were used: haematoxylin-eosin (morphology), Ki67 (proliferation), M30 (apoptosis), TUNEL (apoptosis) and endoglin (vascularisation). Tumours in the control group grew fast, with an average tumour doubling time of 9 days. These tumours contained large viable tumour cell masses displaying vast proliferation zones of Ki67-positive tumour cells, as well as necrotic regions and small amounts of connective tissue. Apoptotic cells could be identified both with M30 and TUNEL staining. When RT was applied, the growth rate was significantly reduced (doubling time 19 days) and typical alterations in morphology were seen, with a relative increase in connective tissue and a decrease in necrotic regions. Apoptotic cells were identified and a decrease in cell density was also observed. When RIT alone was applied, the growth parameters indicated a longer lasting growth reduction, especially when TS1 was used separately or in combination with H7. The histological appearances of these tumours were somewhat different from the RT-treated tumours, with a larger portion of intratumoural cysts. These tumours also presented a reduced tumour cell density. Dramatic effects were observed when RT was combined with RIT, with a pronounced growth reduction seen in all combination treatment groups. Pronounced tumour volume reduction was also evident in both the RT + RIT ((131)I-TS1) group and RT + RIT ((131)I-TS1/(131)I-H7) group, and in some animals no tumour remained at all. The morphology of the tumour remnants at day 22 was chaotic with a drastically changed histology, with presence of abundant cysts, low fractions of Ki67-positive cells, reduction in cell density, increased amounts of connective tissue and a decrease in necrotic regions. Again, apoptotic cells could be identified, scattered throughout the viable regions. Combining RT and RIT seems to generate an efficient treatment with convincing and long-lasting tumour growth inhibition, which is reflected in a highly aberrant histology within the tumour. Results obtained in this study indicate that both necrosis and apoptosis may be involved in the process leading to this efficient therapy of epithelially derived tumours.
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| 17. |
- Eriksson, David, et al.
(author)
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Iodine-131 induces mitotic catastrophes and activates apoptotic pathways in HeLa Hep2 cells
- 2008
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In: Cancer Biotherapy and Radiopharmaceuticals. - : Mary Ann Liebert Inc. - 1084-9785 .- 1557-8852. ; 23:5, s. 541-549
-
Journal article (peer-reviewed)abstract
- Iodine-131 (131I) has been used both in unconjugated form and conjugated to antibody derivates (i.e., radioimmunotherapy; RIT) to treat malignant diseases. The mechanisms by which 131I-irradiation causes growth retardation are, however, inadequately understood. The aim of this study was to elucidate the sequential molecular and cellular events that initiate cell death in HeLa Hep2 cells exposed to 131I. In this paper, HeLa Hep2 cells were found to display a transient G2-M arrest following irradiation, but then reentered the cell cycle still containing unrepaired cellular damage. An increase of multipolar mitotic spindles, as well as a significant increase in centrosome numbers from 8.8% +/- 1.9% in controls to 54.7% +/- 2.2% in irradiated cells, was observed (p < 0.0001). A subsequent failure of cytokinesis caused the cells to progress into mitotic catastrophe. This was accompanied by the formation of giant cells with multiple nuclei, multilobulated nuclei, and an increased frequency of polyploidy cells. A fraction of the cells also displayed apoptotic features, including the activation of initiator caspases-2, -8, -9, and effector caspase-3, as well as cleavage of poly(ADP-ribose) polymerase, a cell-death substrate for active caspase-3. These findings demonstrate that mitotic catastrophes and the activation of a delayed type of apoptosis might be important mechanisms involved in cell death following the RIT of solid tumors with -emitting radionuclides, such as 131I.
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| 18. |
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| 19. |
- Hammar, Per, et al.
(author)
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Unrecognized myocardial infarctions assessed by cardiovascular magnetic resonance are associated with the severity of the stenosis in the supplying coronary artery
- 2015
-
In: Journal of Cardiovascular Magnetic Resonance. - : BioMed Central. - 1097-6647 .- 1532-429X. ; 17
-
Journal article (peer-reviewed)abstract
- Background: A previous study has shown an increased prevalence of late gadolinium enhancement cardiovascular magnetic resonance (LGE CMR) detected unrecognized myocardial infarction (UMI) with increasing extent and severity of coronary artery disease. However, the coronary artery disease was evaluated on a patient level assuming normal coronary anatomy. Therefore, the aims of the present study were to investigate the prevalence of UMI identified by LGE CMR imaging in patients with stable angina pectoris and no known previous myocardial infarction; and to investigate whether presence of UMI is associated with stenotic lesions in the coronary artery supplying the segment of the myocardium in which the UMI is located, using coronary angiography to determine the individual coronary anatomy in each patient.Methods: In this prospective multicenter study, we included patients with stable angina pectoris and without prior myocardial infarction, scheduled for coronary angiography. A LGE CMR examination was performed prior to the coronary angiography. The study cohort consisted of 235 patients (80 women, 155 men) with a mean age of 64.8 years.Results: UMIs were found in 25 % of patients. There was a strong association between stenotic lesions (>= 70 % stenosis) in a coronary artery and the presence of an UMI in the myocardial segments supplied by the stenotic artery; it was significantly more likely to have an UMI downstream a stenosis >= 70 % as compared to <70 % (OR 5.1, CI 3.1-8.3, p < 0.0001). 56 % of the UMIs were located in the inferior and infero-lateral myocardial segments, despite predominance for stenotic lesions in the left anterior descending artery.Conclusion: UMI is common in patients with stable angina and the results indicate that the majority of the UMIs are of ischemic origin due to severe coronary atherosclerosis. In contrast to what is seen in recognized myocardial infarctions, UMIs are predominately located in the inferior and infero-lateral myocardial segments.
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| 20. |
- Hedlund, Pe rOlov, et al.
(author)
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Significance of pretreatment cardiovascular morbidity as a risk factor during treatment with parenteral oestrogen or combined androgen deprivation of 915 patients with metastasized prostate cancer: Evaluation of cardiovascular events in a randomized trial
- 2011
-
In: Scandinavian Journal of Urology and Nephrology. - London : Informa Healthcare. - 0036-5599 .- 1651-2065. ; 45:5, s. 346-353
-
Journal article (peer-reviewed)abstract
- Objective. This study aimed to evaluate prognostic risk factors for cardiovascular events during treatment of metastatic prostate cancer patients with high-dose parenteral polyoestradiol phosphate (PEP, Estradurin (R)) or combined androgen deprivation (CAD) with special emphasis on pretreatment cardiovascular disease. Material and methods. Nine-hundred and fifteen patients with T0-4, Nx, M1, G1-3, hormone- naive prostate cancer were randomized to treatment with PEP 240 mg i.m. twice a month for 2 months and thereafter monthly, or to flutamide (Eulexin (R)) 250 mg per os three times daily in combination with either triptorelin (Decapeptyl (R)) 3.75 mg i.m. per month or on an optional basis with bilateral orchidectomy. Pretreatment cardiovascular morbidity was recorded and cardiovascular events during treatment were assessed by an experienced cardiologist. A multivariate analysis was done using logistic regression. Results. There was a significant increase in cardiovascular events during treatment with PEP in patients with previous ischaemic heart disease (p = 0.008), ischaemic cerebral disease (p = 0.002), intermittent claudication (p = 0.031) and especially when the whole group of patients with pretreatment cardiovascular diseases was analysed together (p andlt; 0.001). In this group 33% of the patients had a cardiovascular event during PEP treatment. In the multivariate analysis PEP stood out as the most important risk factor for cardiac complications (p = 0.029). Even in the CAD group there was a significant increase in cardiovascular events in the group with all previous cardiovascular diseases taken together (p = 0.036). Conclusions. Patients with previous cardiovascular disease are at considerable risk of cardiovascular events during treatment with high-dose PEP and even during CAD therapy. Patients without pretreatment cardiovascular morbidity have a moderate cardiovascular risk during PEP treatment and could be considered for this treatment if the advantages of this therapy, e. g. avoidance of osteopenia and hot flushes and the low price, are given priority.
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| 21. |
- Holmberg, Lars, et al.
(author)
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A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer
- 2002
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In: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 347:11, s. 781-789
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Radical prostatectomy is widely used in the treatment of early prostate cancer. The possible survival benefit of this treatment, however, is unclear. We conducted a randomized trial to address this question. METHODS: From October 1989 through February 1999, 695 men with newly diagnosed prostate cancer in International Union against Cancer clinical stage T1b, T1c, or T2 were randomly assigned to watchful waiting or radical prostatectomy. We achieved complete follow-up through the year 2000 with blinded evaluation of causes of death. The primary end point was death due to prostate cancer, and the secondary end points were overall mortality, metastasis-free survival, and local progression. RESULTS: During a median of 6.2 years of follow-up, 62 men in the watchful-waiting group and 53 in the radical-prostatectomy group died (P=0.31). Death due to prostate cancer occurred in 31 of 348 of those assigned to watchful waiting (8.9 percent) and in 16 of 347 of those assigned to radical prostatectomy (4.6 percent) (relative hazard, 0.50; 95 percent confidence interval, 0.27 to 0.91; P=0.02). Death due to other causes occurred in 31 of 348 men in the watchful-waiting group (8.9 percent) and in 37 of 347 men in the radical-prostatectomy group (10.6 percent). The men assigned to surgery had a lower relative risk of distant metastases than the men assigned to watchful waiting (relative hazard, 0.63; 95 percent confidence interval, 0.41 to 0.96). CONCLUSIONS: In this randomized trial, radical prostatectomy significantly reduced disease-specific mortality, but there was no significant difference between surgery and watchful waiting in terms of overall survival.
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| 22. |
- Holmgren, Kristina, 1977-, et al.
(author)
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KNOGA. Fossilfri framdrift för tunga långväga godstransporter på väg : kostnadsfördelning och risker för olika aktörer (Executive summary)
- 2021
-
Reports (other academic/artistic)abstract
- Användningen av förnybar energi i transportsektorn behöver öka för att vi ska nå de svenska klimatmålen om minskade växthusgasutsläpp från inrikes transporterna med 70 procent till 2030, och nettonollutsläpp från samtliga sektorer till 2045. Ökningen av förnybara drivmedel behöver ske i alla segment och över hela fordonsflottan.Idag används främst diesel som drivmedel för tunga långväga godstransporter på väg men det finns alternativ för fossilfri framdrift. Denna studie har kvantifierat kostnadsstrukturer och analyserat riskfördelning mellan olika aktörer för fossilfria framdriftstekniker för tunga långväga godstransporter på väg och jämfört dem med alternativet att fortsätta använda diesel som drivmedel. Följande tekniker är inkluderade i studien: biobränslen (flytande och gasformiga), batterielektriska fordon (BEV), elvägar (tre olika tekniker), vätgasdrivna bränslecellsfordon (H2-FCEV) samt elektrobränslen. Beräkningar görs för år 2030 och 2045. Från de fem huvudkategorierna för fossilfri framdrift har ett antal representativa motortekniker, bränsleproduktionstekniker och råvaror valts ut för att analyseras i detalj. Detta har resulterat i ett trettiotal olika fossilfria alternativ till dagens användning av fossil diesel
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| 23. |
- Holmgren, Kristina, 1977-, et al.
(author)
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KNOGA. Fossilfri framdrift för tunga långväga transporter på väg : Kostnadsfördelning och risker för olika aktörer
- 2021
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Reports (other academic/artistic)abstract
- För att nå de svenska klimatmålen om att minska växthusgasutsläppen från inrikes transporter (undantaget flyget) med 70% till 2030 och om att nå nettonollutsläpp för samtliga sektorer till 2045behöver användningen av förnybar energi i transportsektorn öka. Denna studie kvantifierar kostnadsstrukturer och analyserar riskfördelning mellan olika aktörer förfossilfria framdriftstekniker för tunga långväga godstransporter på väg. Följande tekniker är inkluderade i studien: biobränslen (flytande och gasformiga), elfordon med batterier (BEV), elvägar (tre olika tekniker), vätgasdrivna bränslecellsfordon samt elektrobränslen.denna studie görs också en jämförelse avseende de olika framdrivningsteknikernas växthusgas-utsläpp där bränsle/energianvändning, batteriproduktion (för tekniker med elektrisk framdrivning) och elvägsinfrastruktur inkluderas.Analyserna görs för två typer av lastbilar: HGV40 och HGV60. HGV40 är en tung lastbil med en tillåten bruttovikt om max 40 ton som används inom hela Europa. HGV60 är en lastbil med en tillåten bruttovikt om max 60 ton som står för merparten av transportarbetet med lastbil i Sverige, men som bara är tillåten i ett fåtal andra europeiska länder. Beräkningar görs för år 2030 och 2045.7Kostnader för de olika teknikalternativen redovisas i vad vi i denna studie har valt att kalla relativ mobilitetskostnad. Den relativa mobilitetskostnaden inkluderar: fordonens investeringskostnader, service och reparationer av fordon samt drivmedelskostnader. Drivmedelskostnaderna består av produktions-och distributionskostnader för drivmedel, där distributionskostnaderna inkluderar bådedirekta kostnader för distribution av drivmedel från produktionsanläggning till pump, samt investeringskostnader och underhåll för distributionsinfrastruktur (d.v.s. underhåll för elväg, ladd-infrastruktur eller tankstation). Genom att tydligt presentera de olika delarnas bidrag till den relativa mobilitetskostnaden erhålls en bild av hur kostnaderna för de olika framdrivningsteknikerna fördelar sig mellan fordonsinvestering, service och reparation av fordon, drivmedelsproduktions-kostnader och distributionsinfrastruktur. Alla kostnader beräknas utan skatter och avgifter. En ana-lys som visar påverkan på den relativa mobilitetskostnaden då man belastar alternativen med en CO2e-kostnad för bränsle/energianvändningen inkluderas också i studienStudiens sammanställning av hinder och risker för de olika alternativen baseras på kostnadsana-lysen, växthusgasjämförelsen och en litteraturgenomgång med fokus på ekonomiska, tekniska, infrastrukturrelaterade risker men också miljöpåverkan och tillgång på råvaror.
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| 24. |
- Johannesson, Magnus, et al.
(author)
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A note on prevention versus cure
- 1997
-
In: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 41:3, s. 181-187
-
Journal article (peer-reviewed)abstract
- The aim of this study is to test if the general Swedish population prefers saving lives through prevention or acute care. A trade-off question of a choice between saving lives through prevention or acute care was administered in a Swedish population sample. Based on the answers we estimate the median number of lives saved in acute care that is judged equivalent to saving one life through prevention. According to the results 1.2 – 1.4 lives saved in acute care is judged equivalent to saving one life through prevention. Thus our results indicate that lives saved through prevention and cure are given about the same value by the median respondent. Individuals seem to focus on the size of the health benefits rather than whether the health benefits are achieved through prevention or cure.
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| 25. |
- Johannesson, Magnus, et al.
(author)
-
An experimental comparison of dichotomous choice contingent valuation questions and real purchase decisions
- 1998
-
In: Applied economics. - : Taylor & Francis Ltd. - 1466-4283 .- 0003-6846. ; 30:5, s. 643-647
-
Journal article (peer-reviewed)abstract
- The results of an experiment comparing the dichotomous choice contingent valuation approach with real purchase decisions for a consumer good are reported. In addition to comparing the standard DC CV approach with real decisions, the hypothesis is tested that a more conservative interpretation of the DC approach, where only absolutely sure yes responses are counted as yes responses, correctly predicts real purchase decisions. The results show that the hypothetical yes responses overestimate the real yes responses and that the hypothetical absolutely sure yes responses underestimate the real yes responses.
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| 26. |
- Johannesson, Magnus, et al.
(author)
-
Is the valuation of a QALY gained independent of age? Some empirical evidence
- 1997
-
In: Journal of health economics. - : Elsevier Sequoia S.A. - 1879-1646 .- 0167-6296. ; 16:5, s. 589-599
-
Journal article (peer-reviewed)abstract
- To carry out cost-effectiveness analyses with life-years or quality-adjusted life-years (QALYs) gained as effectiveness measures has become increasingly popular in economic evaluations of health care. Cropper et al. (1994) have used survey data to estimate the trade-off between saving lives at different ages. They found that saving eleven 60-year-olds was judged equivalent to saving one 30-year-old. Individuals thus placed more weight on saving young persons than implied by the use of life-years gained as an effectiveness measure. A study based on the same approach as used by Cropper et al. aims to estimate the trade-off between saving lives at different ages. In contrast to Cropper et al. (1994), the study also calculates life-years and QALYs at different ages to estimate the trade-off between life-years and QALYs gained at different ages.
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| 27. |
- Johannesson, Magnus, et al.
(author)
-
On the Value of Changes in Life Expectancy: Blips versus Parametric Changes
- 1997
-
In: Journal of risk and uncertainty. - : Springer Nature. - 1573-0476 .- 0895-5646. ; 15:3, s. 221-239
-
Journal article (peer-reviewed)abstract
- We estimate the value of a 'blip', i.e. an immediate small reduction, in the hazard rate for a random sample of Swedes. Since the risk reduction is age-independent (2 'extra saved lives' out of 10,000 during the next year), we can examine how the value of a statistical life varies with age. We also show how blip data can be used to obtain a lower bound for the value of a permanent change in an individual's hazard rate. The value of a life exhibits an inverted-U shape with respect to age, peaking at the age of 40, and lies within the $3 to $7 million interval where most reasonable estimates are clustered according to Viscusi's (1992) survey.
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| 28. |
- Johannesson, Magnus, et al.
(author)
-
Quality of life and the WTP for an increased life expectancy at an advanced age
- 1997
-
In: Journal of public economics. - : Elsevier B.V. - 1879-2316 .- 0047-2727. ; 65:2, s. 219-228
-
Journal article (peer-reviewed)abstract
- In this study we report an attempt to measure the value adult Swedes impute to an increased survival probability at high ages. A rating scale between the worst possible quality of life (= 1) and the best possible quality of life (= 10) is used to indicate the quality of life a person expects to achieve at an advanced age. We find a highly significant correlation between this quality measure and the insurance premium a person is willing to pay in exchange for a programme increasing the expected length of life by one year, conditional on having survived until the age of 75 years. The (maximum) insurance premium the average person is willing to pay for such a programme is less than $1500. The willingness to pay increase with a person's age, but at a low rate. The implied average marginal rate of time preference is about 1 percent.
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| 29. |
- Johannesson, Magnus, et al.
(author)
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Saving Lives in the Present versus Saving Lives in the Future--Is There a Framing Effect?
- 1997
-
In: Journal of risk and uncertainty. - : Springer Nature. - 1573-0476 .- 0895-5646. ; 15:2, s. 167-176
-
Journal article (peer-reviewed)abstract
- To estimate the discount rate for lives saved in the future a number of studies have been carried out on the trade-off between saving lives now and in the future. A telephone survey is administered to about 1,700 individuals to test if the framing of the question affects the estimated trade-off. In one sample the question is framed as saving 100 lives today versus saving x future lives and in one sample the question is framed as saving 100 future lives versus saving y live today. The result shows that the framing has a major impact on the trade-off.
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| 30. |
- Johannesson, Magnus, et al.
(author)
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The discounting of lives saved in future generations - Some empirical results
- 1996
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In: Health economics. - : Wiley. - 1099-1050 .- 1057-9230. ; 5:4, s. 329-332
-
Journal article (peer-reviewed)abstract
- The aim of this note is to estimate the discount rates that individuals in the present generation in Sweden use to discount lives saved in future generations at different points in time. A binary survey question, where individuals choose between saving lives in their own generation versus saving lives in future generations, was administered in a general population sample of 850 individuals. Three time horizons of 20, 50 and 100 years were used in three different subsamples. Logistic regression analysis was used to estimate the discount rate. The estimated annual discount rate is 25% for the 20 year time horizon, 12% for the 50 year time horizon and 8% for the 100 year time horizon.
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| 31. |
- Johannesson, Magnus, et al.
(author)
-
The economics of ageing: on the attitude of Swedish people to the distribution of health care resources between the young and the old
- 1996
-
In: Health policy (Amsterdam). - : Elsevier Ireland Ltd. - 1872-6054 .- 0168-8510. ; 37:3, s. 153-161
-
Journal article (peer-reviewed)abstract
- The Swedish Priorities Investigation [1] proposes that no account should be taken of a patient's age when allocating health care resources. Measures to save an old person's life are to be given the same priority as measures to save a young person's life. In the present study it is shown that the attitude of the Swedish population to this age-related problem is dramatically different from that laid down in the priorities investigation. On average, people are willing to sacrifice thirty-five 70-year-olds to save one 30-year-old. It is also shown that a measure which increases life-expectancy by 1 year, conditional on having survived until the age of 75 years, is given a low weighting. The (maximum) insurance premium the average Swede is willing to pay for such a programme is about £700.
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| 32. |
- Johannesson, Magnus, et al.
(author)
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The value of changes in health risks: a review
- 1998
-
In: Regulating Chemical Accumulation in the Environment. - : Cambridge University Press. - 9780511535994 - 0511535996 - 9780521593106 - 9780521088565 - 0521088569 - 0521593107 ; , s. 101-120
-
Book chapter (other academic/artistic)abstract
- There is a large and fast-growing literature on th economic value of changes in health risks. The theoretical foundations for willingness-to-pay (WTP) measures of risk changes have been explored and seem quite solid (see, for example, Jones-Lee. 1976: Rosen, 1988; Viscusi, 1992, 1993; Johansson, 1995). There are also quite a few empirical studies of the value of changes in health risks. In fact, several different methods, based on behaviour either in actual markets or in hypothetical or constructed markets, have been used to estimate the value of what is known as 'statistical life'. This chapter is structured as follows. In the first section we introduce a simple model in order to provide definitions of the value of changes in health risks and other concepts which are used in later sections. We then go on to present the empirical methods which have been used to estimate the value of risk changes. Available empirical results are summarised, and we also provide a brief comparison of the value of a statistical life according to different methods and studies. The chapter ends with a few remarks on the evaluation of changes in groundwater quality.
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| 33. |
- Johannesson, Magnus, et al.
(author)
-
The Value of Private Safety versus the Value of Public Safety
- 1996
-
In: Journal of risk and uncertainty. - : Kluwer Academic Publishers. - 1573-0476 .- 0895-5646. ; 13:3, s. 263-275
-
Journal article (peer-reviewed)abstract
- In this study, one group of respondents is offered to purchase a safety device to be installed in their cars, while another group is offered a public safety program (improved road quality) which results in the same size risk reduction. In terms of the value of a statistical life, our results are very reasonable. However, the WTP for the private safety device is higher than the WTP for the public safety measure. Drawing on a model developed by Jones-Lee (1991), we show that some types of altruists may, but need not, be willing to pay more for a private risk reduction than for a uniform risk reduction of the same magnitude. Still, our empirical results are surprising, and further empirical research seems warranted.
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| 34. |
- Johannesson, Magnus, et al.
(author)
-
To Be, or Not to Be, That Is the Question: An Empirical Study of the WTP for an Increased Life Expectancy at an Advanced Age
- 1996
-
In: Journal of Risk and Uncertainty. - : Kluwer Academic Publishers. - 1573-0476 .- 0895-5646. ; 13:2, s. 163-174
-
Journal article (peer-reviewed)abstract
- This study reports an attempt to measure the value of an increased survival probability at advanced ages. It turns out that the average willingness to pay for a program which would increase the expected length of life by one year, conditional on having survived to the age of 75 years, is lower than $1,500. The willingness to pay increases with a person's age, but at a low and seemingly constant rate (1-4 percent per year). Copyright 1996 by Kluwer Academic Publishers
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| 35. |
- Johannesson, Magnus, et al.
(author)
-
Valuing changes in health: theoretical and empirical issues
- 1995. - 1
-
In: Current issues in environmental economics. - Manchester : Manchester University Press. - 0719038456 - 9780719038457 ; , s. 78-97
-
Book chapter (other academic/artistic)abstract
- Attempts to place a monetary value on health changes is an important field for both environmental economists and health economists. Typically, a change in environmental quality has direct or indirect impact on human health, which forces the environmental economist to try to assess the value of health changes. For the health economist, evaluating a medical treatment requires that the benefits of the treatment somehow are valued in monetary terms. In both cases risk or uncertainty pertains to the effects. A pollution treatment plant and a medical treatment both shift the probability that individuals will experience a particular health state.
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| 36. |
- Johannesson, Magnus, et al.
(author)
-
Willingness to pay for antihypertensive therapy - further results
- 1993
-
In: Journal of health economics. - 1879-1646 .- 0167-6296. ; 12:1, s. 95-108
-
Journal article (peer-reviewed)abstract
- A measurement experiment regarding willingness to pay for antihypertensive therapy is reported. A new type of binary willingness to pay question is used, that allows for different degrees of certainty with respect to the responses. Mean willingness to pay is derived from a simple expected utility model and estimated using maximum likelihood methods. The estimated parameters are highly significant, with predicted signs, and imply a mean willingness to pay of about SEK 800 ($130) per month. The explanatory power of the equation that only includes 'certain' yes/no responses is, as expected, much higher than that of the equation where only 'uncertain' responses are included.
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| 37. |
- Johannesson, Magnus, et al.
(author)
-
Willingness to pay for lipid lowering: a health production function approach
- 1993
-
In: Applied economics. - : Chapman & Hall Ltd. - 1466-4283 .- 0003-6846. ; 25:8, s. 1023-1031
-
Journal article (peer-reviewed)abstract
- This Paper reports the results of an experiment of measuring willingness to pay (WTP) for lipid lowering. WTP is derived from a theoretical model of health risk reductions, using a health production function approach. A survey of about 700 persons randomized into a lipid lowering trial in Sweden is used to estimate WTP. The willingness to give up time (WTGT) to take part in a lipid lowering programme is also measured in the survey, to assess its relationship to WTP. The response rates on the WTP and WTGT qusetions are 94% and 96%, respectively, and the patients are on average perpared to pay about Skr 350 per month or devote about 5 h of leisure time per week to get normal lipid levels. The Correlation of WTP and WTGT is 0.45 and highly significant. The results of regression of WTP and WTGT are in accordance with the theoretical predictions with a higher valuation for a greater perceived difference in health status with and without treatment. The income elasticity is also positive as expected.
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Johansson, Per-Olov, et al.
(author)
-
A note on how to undertake a cost-benefit analysis in monetary and environmental units
- 2010
-
Reports (other academic/artistic)abstract
- In this note we discuss two alternative ways of undertaking a social cost-bene t analysis. One approach is the conventional one where ben- e ts and costs are expressed in monetary units. The other approach uses an environmental asset as the payment vehicle. The properties of the two approaches are discussed and the measurement problems are stressed.
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| 42. |
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| 43. |
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| 44. |
- Johansson, Per-Olov, et al.
(author)
-
Comment on Burgess and Zerbe: On bank market power and the social discount rate
- 2011
-
In: Journal of Benefit-Cost Analysis. - : Cambridge University Press (CUP). - 2152-2812 .- 2194-5888. ; 2, s. 1-6
-
Other publication (peer-reviewed)abstract
- In this note we discuss how to estimate the social discount rate when banks have market power. Some data from Sweden are used to illustrate the approach. If other investments are crowded out, the implied social discount rate is around 7 percent, i.e. more or less equal to the one suggested by Burgess and Zerbe (2011) for the U.S. but similar to those often used in the EU (3-4 percent) if private consumption is crowded out by the considered investment.
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| 45. |
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| 46. |
- Johansson, Per-Olov, et al.
(author)
-
Current issues in environmental economics: Introduction
- 1995. - 1
-
In: Current issues in environmental economics. - Manchester : Manchester University Press. - 0719038456 - 9780719038457 ; , s. 1-9
-
Book chapter (other academic/artistic)abstract
- Environmental economics is a rapidly expanding branch of the discipline. This is at least in part due to an increasing awareness of the seriousness of the world's environmental problems. Such recognition creates a demand for economic evaluations of environmental change. There has also been a shift in the supply curve. One reason for economists being increasingly interested in environmental issues is that such issues pose important theoretical and empirical challenges. Another reason for increased attention being paid to environmental economics is that economists are human beings too and hence also may be concerned about our common future.
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| 47. |
- Johansson, Per-Olov
(author)
-
Defining the value of a statistical life: reply
- 2002
-
In: Journal of health economics. - : Elsevier. - 1879-1646 .- 0167-6296. ; 21:1, s. 177-178
-
Journal article (other academic/artistic)abstract
- In general, empirical estimates of a statistical life (VSL) are biased. However, as pointed out by Blomqvist (2001), a true blip in the hazard rate can be used to obtain an exact estimate of the VSL. The question remains whether individuals and markets are able to value such short drops in the hazard rate.
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| 48. |
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| 49. |
- Johansson, Per-Olov, et al.
(author)
-
Elcertifikat: En gratislunch för kapitalägare?
- 2019
-
In: Timbro briefing papers.
-
Other publication (other academic/artistic)abstract
- Genom elcertifikatsystemet subventioneras ny förnybar elproduktion av elkonsumenterna.Ett antal olika argument har framförts för att motivera subventioner av förnyelsebar el. Argument som att subventionerna stimulerar den teknologiska utvecklingen, skapar fler arbetstillfällen och ger säkrare eltillförsel har mycket svagt, om ens något, stöd i den akademiska litteraturen.Samhällsekonomiska utvärderingar av subventioner pekar mot att de medför merkostnader för folkhushållet. Det gäller i Europa såväl som i Nordamerika.Det svenska elcertifikatsystemet har även i ett försiktigt basscenario medfört både betydande omfördelningar från elkonsumenter till ägare av vissa typer av kraftverk och merkostnader för elproduktionen i landet.Om syftet med elcertifikatsystemet varit att uppnå ett visst antal terawattimmar förnyelsebar el så hade marknaden uppnått det målet senare men till en lägre kostnad för det svenska folkhushållet.
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| 50. |
- Johansson, Per-Olov, et al.
(author)
-
Emissions trading and taxes an application to airport investment appraisals
- 2017
-
In: Journal of Transport, Economics and Policy. - : University of Bath, School of Management. - 0022-5258. ; 51:4, s. 249-265
-
Journal article (peer-reviewed)abstract
- A key issue in a cost–benefit assessment of an expansion of an airport is its impact on emissions of greenhouse gases. Both taxes and tradable permits can be used to put a price tag on emissions, but practitioners disagree on how to handle permits. Therefore, the paper offers a section clarifying how to handle permits in cost–benefit analysis, with a more formal treatment in the Appendix. The paper also discusses the impact on the outcome of the evaluation of alternative assumptions regarding how greenhouse gases are internalised. Both optimal Pigouvian taxes and tradable permits are considered.
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