Vision vs. Evaluation – Case Studies of Light Rail Planning in Denmark

Light rail transit (LRT) is a popular public transport mode used to upgrade the public transport system and support urban development strategies. Despite the seemingly poorer socio-economic return of LRT in cost benefit analyses (CBA) compared to bus rapid transit (BRT) systems, LRT solutions are often chosen over BRT. Several studies show that the decisions to build such systems have not primarily been based on the socio-economic feasibility of the systems. Rather, they are often justified in terms of the branding value and positive image for public transportation, as well as the perceived ability to reduce road congestion and stimulate urban development. Drawing on Actor Network Theory (ANT), the paper analyses how LRT systems have been applied in a Danish context and the role that the CBA has played in this process. The results show that conventional socio-economic factors in CBA, such as travel time savings, play a relatively minor role compared to the larger urban transformation visions that LRT projects are embedded in

Sorafenib in Advanced Hepatocellular Carcinoma: A Nationwide Retrospective Study of Efficacy and Tolerability

Background. Advanced HCC is a clinical challenge with limited treatment options. The multikinase inhibitor sorafenib is the first and only agent showing a survival benefit in these patients. In this study we evaluate the efficacy and tolerability of sorafenib in an unselected patient population. Furthermore we explore the role of alpha-fetoprotein (αFP) as a potential biomarker for treatment efficacy and correlation to survival. Methods. Seventy-six patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib between 2007 and 2009 were included. Followup was until 2011. Results. Patients in PS 0-1 had a median overall survival (mOS) of 6.2 months, compared to 1.8 months in patients with poorer PS (P=0.005). Child-Pugh A patients had a mOS of 6.6 months versus 3.6 months among patients in Child-Pugh B or C (P=0.0001). Serum αFP ≥ 200 at baseline was prognostic for a shorter survival. All patients with radiologically verified tumor response and baseline αFP ≥ 200 experienced a significant decline in αFP within the first four weeks of treatment. Conclusion. The survival of patients with advanced HCC treated with sorafenib is dependent on performance status and liver function. Treatment of patients with compromised liver function and poor performance status cannot be recommended. The correlation between αFP and objective tumor response warrants further investigation