The domino-effect of trade barriers : a quantitative study of the conditions for Swedish lumber products on the Chinese market

Den internationella virkesmarknaden går sannolikt en spännande framtid till mötes och det råder delade meningar hur denna kommer se ut. Optimister menar att träkonsumtionen i världen kommer öka tillsammans med den ökande miljömedvetenheten och satsningar på träkonstruktioner samt nya träbaserade material är framtiden. Samtidigt menar pessimisterna att dagens turbulenta världspolitiska arena med nationalistiska och protektionistiska vindar kan skapa en stor ovisshet för den internationella trävarumarknaden. Syftet med studien är att undersöka hur handelshinder, i form av höjda tullavgifter på importerade sågade barrträvaror på 30 % av varuvärdet, från Kanada till USA påverkar Sveriges konkurrensförhållanden på den kinesiska importmarknaden för sågade barrträvaror. Exportdata för sågade trävaror från FAO, SCB och Martinsons har använts som uppsatsens grunddata. Datat analyseras med hjälp av trendanalys, samt med en Autoregressive integrated moving average, ARIMA-modell. Utfallet av studien gav två huvudsakliga utfall, ett för respektive modell. Ett införande av skyddstullar mot Kanada förväntas enligt trendanalysen inte påverka exporten till USA nämnvärt, men en svag minskning handeln sinsemellan förväntas ske fram till 2021. Att Kinas behov av sågade barrträvaror trots det fortsätter att öka innebär möjligheten till ökad virkesexport för svenska företag till Kina. I ARIMA-analysen spås Kanadas export till USA, trots skyddstullar, öka och Kinas importbehov förväntas öka snabbare än Kanadas exportutbud. Ett underskott på Kinas importmarknad genererar möjligheter för svenska aktörer att vinna marknadsandelar. Oavsett tullar eller ej indikerar resultatet en ökad exportvolym av sågade barrträvaror för Sverige och Martinsons mellan 2015–2021.How the international market for sawn wood will look in the future is a disputed topic. There are different opinions on the Swedish future prospect on the market. Optimists argue that the world's wood consumption will increase, partly because of the environmental awareness is more widespread, and also that wooden constructions and new innovative wood based materials are considered to be the future. Meanwhile, pessimists believe that the turbulent political situation in the world with cold winds of nationalism and protectionism causes uncertainty on the international lumber market. The aim with this essay is to examine how financial tolls, of 30% of product value on the import of coniferous sawn wood from Canada to the USA, affect the market conditions for Swedish coniferous sawn wood exporters on the Chinese import market. Export data from FAO, SCB and Martinsons have been used as data input. The data has been analyzed with a trend analysis, together with an Autoregressive integrated moving average, and so called ARIMA-model. This study generated two main outcomes, one for each model. An introduction of tolls against Canada is not expected to affect the export to USA significantly according to the trend analysis, but a slight decrease in sawn wood trade is expected to 2021 between the two countries. China’s need of sawn wood products is predicted to increase, which could imply the possibility for increased export from Swedish exporting companies. A deficit on China’s import market generates possibilities for Swedish stakeholders to gain market shares. According to the ARIMA-analysis, despite the introduction of tolls, the export of lumber from Canada to USA is predicted to increase, and also the need of import in China is forecasted to increase faster than the possible export supply from Canada. As well as in the trend analysis, that could give Swedish companies opportunities to expand their market shares. Regardless tolls or not, the result from the ARIMA-model indicates an increased export of sawn coniferous wood from Sweden and Martinsons between 2015 and 2021

A retrospective study of extracolonic, non-endometrial cancer in Swedish Lynch syndrome families

BackgroundLynch Syndrome is an autosomal dominant cancer syndrome caused by pathogenic germ-line variants in one of the DNA-mismatch-repair (MMR) genes MLH1, MSH2, MSH6 or PMS2. Carriers are predisposed to colorectal and endometrial cancer, but also other cancer types. The purpose of this retrospective study was to characterize the tumour spectrum of the Swedish Lynch syndrome families.MethodsData were obtained from genetically verified 235 Lynch families from five of the six health care regions in Sweden. The material was stratified for gender, primary cancer, age and mutated gene and the relative proportions of specific cancer types were compared to those in the general population.ResultsA total of 1053 family members had 1493 cancer diagnoses of which 1011 were colorectal or endometrial cancer. Individuals with pathogenic variants in MLH1 and MSH2 comprised 78% of the cohort. Among the 482 non-colorectal/non-endometrial cancer diagnoses, MSH2 carriers demonstrated a significantly increased proportion of urinary tract, gastric, small bowel, ovarian and non-melanoma skin cancer compared to the normal population. MLH1 carriers had an elevated proportion of gastrointestinal cancers (gastric, small bowel, pancreas), while MSH6 carriers had more ovarian cancer than expected. Gastric cancer was predominantly noted in older generations.ConclusionLynch syndrome confers an increased risk for multiple cancers other than colorectal and endometrial cancer. The proportions of other cancers vary between different MMR genes, with highest frequency in MSH2-carriers. Gender and age also affect the tumour spectrum, demonstrating the importance of additional environmental and constitutional parameters in determining the predisposition for different cancer types

Low-Dose Oral Ketamine for Procedural Analgesia in Pediatric Cancer Patients Undergoing Lumbar Puncture at a Resource-Limited Cancer Hospital in India

Aim: The aim of this study was to evaluate the therapeutic efficacy and safety profile of orally administered low-dose ketamine for procedural pain management in pediatric cancer patients undergoing lumbar puncture (LP) in a resource-limited hospital setting. Methods: Patients between 4 and 15 years of age, with leukemia, undergoing LP were asked to participate. The study was designed as a two-armed blinded placebo-controlled trial where 0.8 mg/kg (bodyweight) of ketamine mixed in juice was given 30 minutes before the procedure to Group K (ketamine) compared with placebo, only juice, to Group P (placebo). In addition, topical analgesia (EMLA®) was given according to established standard of care. Patients and caregivers assessed the pain using the Wong-Baker Faces Pain Rating Scale. Results: A total number of 52 patients, equally distributed between Group K and Group P, were included in the study. The placebo-controlled group had significantly higher self-reported pain score than the group receiving ketamine (p = 0.046), as well as in caregiver-assessed pain (p = 0.033). Only three incidents of mild adverse effects were reported. Conclusion: Low-dose oral ketamine can be safely administered for procedural analgesia in pediatric cancer patients undergoing LP in a resource-limited hospital setting and have significant pain-reducing effect compared with placebo

Swedish National Multicenter Study on Head and Neck Cancer of Unknown Primary : Prognostic Factors and Impact of Treatment on Survival

Introduction Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established. Objective The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation. Methods A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients' medical records from 2008 to 2012. Results Two-hundred and sixty HNCUP patients were included. The tumors were HPVpositive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age (p < 0.001), performance status (p = 0.036), and N stage (p = 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups. Conclusions Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and ( chemo) radiation and primary (chemo

Merged testing for colorectal cancer syndromes and re-evaluation of genetic variants improve diagnostic yield : Results from a nationwide prospective cohort

Approximately 5% of patients with colorectal cancer (CRC) have a Mendelian predisposition for the disease. Identification of the disease-causing genetic variant enables carrier testing and tailored cancer prevention within affected families. To determine the panorama and genetic variation of Mendelian CRC syndromes among referrals at the cancer genetics clinics in Sweden, 850 patients clinically selected for CRC genetic investigation were included in a prospective study that tested for all major hereditary polyposis and nonpolyposis CRC conditions. Genetically defined syndromes were diagnosed in 11% of the patients. Lynch syndrome was predominant (n = 73) followed by familial adenomatous polyposis (n = 12) and MUTYH-associated polyposis (n = 8); the latter of which two patients presented with CRC before polyposis was evident. One patient with a history of adolescent-onset CRC and polyposis had biallelic disease-causing variants diagnostic for constitutional mismatch repair deficiency syndrome. Post-study review of detected variants of unknown clinical significance (n = 129) resulted in the reclassification of variants as likely benign (n = 59) or as diagnostic for Lynch syndrome (n = 2). Our results reveal the panorama of Mendelian CRC syndromes at the cancer genetics clinics in Sweden and show that unified testing for polyposis and nonpolyposis CRC conditions as well as regular reexamination of sequence data improve the diagnostic yield.Funding Agencies|health-care regions in Sweden</p

Health-related quality of life among tonsillar carcinoma patients in Sweden in relation to treatment and comparison with quality of life among the population

Background: The health-related quality of life (HRQOL) of tonsillar carcinoma survivors was explored to investigate any HRQOL differences associated with tumor stage and treatment. The survivors' HRQOL was also compared to reference scores from the population. Methods: In this exploratory cross-sectional study patients were invited 15 months after their diagnosis and asked to answer two quality of life questionnaires (EORTC QLQ- C30, EORTC QLQ- HN35), 405 participated. Results: HRQOL was associated with gender, with males scoring better than females on a few scales. Patients' HRQOL was more associated with treatment than tumor stage. Patients' HRQOL was worse than that in an age- and sex-matched reference group from the normal population, the largest differences were found for problems with dry mouth followed by problems with sticky saliva, senses, swallowing and appetite loss. Conclusions: The tonsillar carcinoma patients had a worse HRQOL compared to the general population one year after treatment

A national study of health-related quality of life in patients with cancer of the base of the tongue compared to the general population and to patients with tonsillar carcinoma

Background: This exploratory, registry-based, cross-sectional study aimed to evaluate patients' health-related quality of life (HRQOL) in a subsite of oropharyngeal cancer: cancer of the base of the tongue (CBT). Methods: CBT patients, treated with curative intent, completed the EORTC QLQ-C30 and QLQ-H&N35 questionnaires 15 months after diagnosis. The HRQOL of CBT patients was compared to reference scores from the general population and to that of tonsillar carcinoma patients. Results: The 190 CBT patients scored significantly worse than members of the general population on most scales. CBT patients with human papilloma virus (HPV)-positive tumors had significantly better HRQOL on 8 of 28 scales than HPV-negative patients. Compared to 405 tonsillar carcinoma patients, CBT patients had significantly worse HRQOL on 8 of the 28 scales, the majority local head and neck related problems. Conclusion: One year after treatment, CBT patients' HRQOL was significantly worse in many areas compared to that of the general population and slightly worse than that of tonsillar carcinoma patients

Clinical and immunological characteristics of autoimmune addison disease : A nationwide swedish multicenter study

Context: Studies of the clinical and immunological features of autoimmune Addison disease (AAD) are needed to understand the disease burden and increased mortality. Objective: To provide upgraded data on autoimmune comorbidities, replacement therapy, autoantibody profiles, and cardiovascular risk factors. Design, Setting, and Participants: A cross-sectional, population-based study that included 660 AAD patients from the Swedish Addison Registry (2008-2014). When analyzing the cardiovascular risk factors, 3594 individuals from the population-based survey in Northern Sweden, MONICA (monitoring of trends and determinants of cardiovascular disease), served as controls. Main Outcome Measures: The endpoints were the prevalence of autoimmune comorbidities and cardiovascular risk factors. Autoantibodies against 13 autoantigens were determined. Results: The proportion of 21-hydroxylase autoantibody-positive patients was 83%, and 62% of patients had ≥1 associated autoimmune diseases, more frequently coexisting in females (P < 0.0001). AAD patients had a lower body mass index (P < 0.0001) and prevalence of hypertension (P = 0.027) compared with controls. Conventional hydrocortisone tablets were used by 89% of the patients, with a mean dose of 28.1 ± 8.5 mg/d. The mean hydrocortisone equivalent dose normalized to the body surface was 14.8±4.4 mg/m2/d. A greater hydrocortisone equivalent dose was associated with a greater incidence of hypertension (P = 0.046). Conclusions: Careful monitoring of AAD patients is warranted to detect associated autoimmune diseases. Contemporary Swedish AAD patients did not have an increased prevalence of overweight, hypertension, type 2 diabetes mellitus, or hyperlipidemia. However, high glucocorticoid replacement doses could be a risk factor for hypertension