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- Abrahamsson, Per-Anders, et al.
(författare)
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Factors Predicting the Off-treatment Duration in Patients with Prostate Cancer Receiving Degarelix as Intermittent Androgen Deprivation Therapy
- 2017
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Ingår i: European Urology Focus. - : Elsevier BV. - 2405-4569. ; 3:4-5, s. 470-479
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intermittent androgen deprivation therapy (IAD) is commonly used in prostate cancer because of the benefits of the off-treatment period (OTP). The off-treatment time for patients depends on cancer progression, often measured as a rise in prostate-specific antigen (PSA). Objective: To evaluate if certain factors can predict OTP duration following 7-mo degarelix therapy. Design, setting, and participants: This multivariable analysis included 191 prostate cancer patients with baseline PSA 4–50 ng/ml or PSA doubling time <24 mo entering the first OTP with PSA ≤4 ng/ml and testosterone <0.5 ng/ml. OTP continued until disease progression, measured as PSA >4 ng/ml. Despite a study-defined OTP maximum of 24 mo, a 50% failure rate was not observed within certain strata. A Weibull distribution was used to estimate median time to PSA >4 ng/ml adjusted for the following variables: age; baseline (or end of induction period [EOI]) PSA; baseline testosterone; cancer stage/previous curative treatment; and Gleason score. According to the results and the utility of these factors in clinical practice, the model was reduced in a stepwise manner. Time to testosterone recovery (testosterone >0.5 and >2.2 ng/ml) was estimated in a similar manner. Results: The full five-factor model showed that baseline PSA (p < 0.0001), age (p = 0.004), prostate cancer stage/previous therapy (p = 0.023), and baseline testosterone (p = 0.039) influenced OTP. A reduced two-factor model (baseline PSA, age) showed that only baseline PSA influenced OTP (p < 0.0001), and patients with baseline PSA ≤4 ng/ml had the longest OTP. In addition, EOI PSA (p < 0.0001) and age (p = 0.050) significantly influenced OTP. The times to testosterone >0.5 and >2.2 ng/ml were longer for older patients and those with lower baseline testosterone levels. Conclusion: Patients with lower baseline and EOI PSA, and older patients can stay off therapy longer and therefore may benefit more from degarelix IAD. These factors may help in proposing an algorithm to predict the OTP and optimise visit frequency. Patient summary: We describe extended analysis results for a trial in which patients with prostate cancer received intermittent androgen deprivation treatment. Prostate-specific antigen levels at baseline and at the end of the induction period, as well as older age, predicted the duration of the off-treatment period. Testosterone recovery was slower in older patients and in patients who had lower pretreatment testosterone levels. These factors may help in deciding whether to choose continuous or intermittent treatment as a strategy. Trial registration: Clinicaltrials.gov NCT00801242 Age and prostate-specific antigen levels before and at the end of active treatment seem to predict off-treatment duration for degarelix as intermittent androgen deprivation treatment (ADT). This information could be valuable in proposing an algorithm to predict the off-treatment period, optimise visit schedules, and set the restart sate for ADT.
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| 2. |
- Fridholm, Tobias, 1980-
(författare)
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Working Together : Exploring Relational Tensions in Swedish Academia
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study explores the basic social conditions for high-quality university research, and focuses on research in science and technology in Sweden. Swedish research policy has adopted more of a market perspective on academic research and its role in society. This has meant the promotion of competition between researchers, increased focus on efficiency at universities, and attempts to make academia harmonize more with industry and other actors. How do such policies affect the variety of perspectives within the academic system? How do they affect the positions and identities of individual academics? These issues are discussed through the concept of "relational tensions". Relational tensions refer to social strains arising when interacting actors have different perspectives. Relational tensions can stimulate creativity, but may also cause unproductive conflicts. The discussion is underpinned by interviews with university researchers and a case study of Uppsala BIO-X, a program to commercialize university research in biotechnology. Typical cases of relational tensions are identified. These concern both interpersonal relations and differences between organized science and industry. A notable observation concerns potential frustration of individual academics, as competition and efficiency tends to make their positions and identities more contested. Researchers cope with relational tensions in three identified ways: socialization, seclusion, and lateral authority. Socialization is natural and often necessary, but reduces the variety of perspectives. Seclusion serves to retain variety and independence, but reduces interaction with others. Lateral authority is to formally or informally lend a researcher more authority, which improves the chance of maintaining a variety of perspectives without reducing interaction. The sustained usefulness of academic research arguably depends on its ability to foster and communicate a variety of perspectives. Hence, (i) promoting lateral authority seems fruitful within academia and in relations between academia and industry, and (ii) encouraging competition and efficiency may to some extent be counterproductive.
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| 5. |
- Lagerholm, Magnus, 1973-
(författare)
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Kunskap och innovation i ett moget kluster : En ekonomisk-geografisk studie av aluminiumindustrin i Småland-Blekinge
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis aims at understanding mechanisms behind knowledge generation and learning in a mature cluster by analysing firms in south-east Sweden engaged in the development and manufacturing of aluminium products. The point of departure is in concepts and assumptions related to spatially concen-trated systems of similar and related firms and industries, such as agglomera-tions, clusters or innovation systems.Three sets of empirical analyses have been conducted: a mail survey, a series of in-depth interviews and a register-based analysis. The analyses focus on three themes: inter-firm relations, the embeddedness of the clustered firms in the region, and the role of labour and labour mobility in cluster development. It is shown that also in a rather mature and low-tech cluster, firm competi-tiveness rests on continuous knowledge upgrading and innovation. In general terms, firms in this cluster do have business relations with other firms at all different spatial scales. While there are manifold buyer-supplier relations within the cluster, most firms have their most important linkages outside the region. The firms regard themselves as part of a cluster and various mecha-nisms contribute to this. There is a strong sense of trust and loyalty, and this applies in particular to those engaged either in some of the more organized supplier networks or the regional cluster initiative Aluminiumriket. Finally, the cluster does not seem to constitute a very fluid labour market for special-ised skills. Labour mobility between firms in this particular cluster seems to be fairly low.
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| 8. |
- Malmberg, Anders, 1956-, et al.
(författare)
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Population age structure – An underlying driver of national, regional and urban economic development
- 2023
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Ingår i: ZFW - Advances in Economic Geography. - : Walter de Gruyter. - 2748-1956 .- 2748-1964. ; 67:4, s. 217-233
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Tidskriftsartikel (refereegranskat)abstract
- This paper argues that population age structure plays a significant role alongside institutional, technological, political, and cultural factors when it comes to explaining shifts in urban, regional and national economic development. The paper demonstrates how demographic transitions lead to changes in population age structure which in turn correlate with global shifts in economic development from 1950 onwards. It then analyzes the role of population age structure at the sub-national level by reviewing some prominent cases of regional and urban shifts in Western Europe and North America. Population size, population density and migration have always been an integrated part of economic geography, and the consequences of ageing in national and regional economies are increasingly being studied. The specific role of population age structure as a driver of economic development has, however, so far largely been ignored in the field.
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| 10. |
- Persson, Bo-Eric, et al.
(författare)
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Serum alkaline phosphatase levels in men with prostate cancer treated with a gonadotropin-releasing hormone agonist or antagonist
- 2015
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Ingår i: Journal of Clinical Oncology. - Lakarhuset, Uppsala, Sweden. Uppsala Univ, Uppsala, Sweden. Univ Colorado, Aurora, CO USA. Ferring Pharmaceut, Copenhagen, Denmark.. - 0732-183X .- 1527-7755. ; 33:15
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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