Natural vitamin C intake and the risk of head and neck cancer : a pooled analysis in the International Head and Neck Cancer Epidemiology Consortium

Evidence of associations between single nutrients and head and neck cancer (HNC) is still more limited and less consistent than that for fruit and vegetables. However, clarification of the protective mechanisms of fruit and vegetables is important to our understanding of HNC etiology. We investigated the association between vitamin C intake from natural sources and cancer of the oral cavity/pharynx and larynx using individual-level pooled data from ten case-control studies (5,959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. After harmonization of study-specific exposure information via the residual method, adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using unconditional multiple logistic regression models on quintile categories of 'non-alcohol energy-adjusted' vitamin C intake. In the presence of heterogeneity of the estimated ORs among studies, we derived those estimates from generalized linear mixed models. Higher intakes of vitamin C were inversely related to oral and pharyngeal (OR = 0.54, 95% CI: 0.45-0.65, for the fifth quintile category versus the first one, p for trend<0.001) and laryngeal cancers (OR = 0.52, 95% CI: 0.40-0.68, p for trend = 0.006), although in the presence of heterogeneity among studies for both sites. Inverse associations were consistently observed for the anatomical subsites of oral and pharyngeal cancer, and across strata of age, sex, education, body mass index, tobacco, and alcohol, for both cancer sites. The inverse association of vitamin C intake from foods with HNC may reflect a protective effect on these cancers; however, we cannot rule out other explanations.

Vitamin E intake from natural sources and head and neck cancer risk : a pooled analysis in the International Head and Neck Cancer Epidemiology consortium.

BACKGROUND: Evidence for the possible effect of vitamin E on head and neck cancers (HNCs) is limited. METHODS: We used individual-level pooled data from 10 case-control studies (5959 cases and 12 248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium to assess the association between vitamin E intake from natural sources and cancer of the oral cavity/pharynx and larynx. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models applied to quintile categories of nonalcohol energy-adjusted vitamin E intake. RESULTS: Intake of vitamin E was inversely related to oral/pharyngeal cancer (OR for the fifth vs the first quintile category=0.59, 95% CI: 0.49-0.71; P for trend <0.001) and to laryngeal cancer (OR=0.67, 95% CI: 0.54-0.83, P for trend <0.001). There was, however, appreciable heterogeneity of the estimated effect across studies for oral/pharyngeal cancer. Inverse associations were generally observed for the anatomical subsites of oral and pharyngeal cancer and within covariate strata for both sites. CONCLUSION: Our findings suggest that greater vitamin E intake from foods may lower HNC risk, although we were not able to explain the heterogeneity observed across studies or rule out certain sources of bias.

Three Essays on International Trade and the Labor Market

The thesis is made of three independent chapters interested in the impact of globalization on workers in industrialized countries. The dissertation is especially focused on identifying the causal impact of international trade on workers' mobility, wages, and employment with both a short- and medium-term perspective. The first paper explores the relation between intra-industry trade (IIT) expansion and associated worker flows, taking the latter as an indicator of labor-market adjustment costs. Being the first study to combine theoretical simulations and a novel identification strategy, we find that both theoretical and empirical analyses are consistent with the "smooth adjustment hypothesis", according to which IIT expansion is less disruptive than inter-industry trade expansion. The study therefore lends support to the use of IIT indices as first-pass proxies for the adjustment effects of trade expansion. The second chapter contrasts the impact of increased import competition coming from China and the European Union (EU) on workers in the United Kingdom over a 15-year period. The most salient findings show that increased imports from China had significantly negative effects on workers' earnings, wages and employment. In contrast, larger imports from the EU are associated with positive worker-level outcomes, which is largely explained by the fact that increased imports from the EU were mostly offset by increased same-industry exports to the EU. Besides, we find that increased imports from China exert additional pressure on workers through spillovers to employment and wages in downstream industries. Finally, the last chapter is focused on the impact of exposure to trade and real exchange rate shocks on wages for Swiss manufacturing workers. A particular attention is made to consistently estimate the causal effect in using a two-step gravity-type identification strategy. The study shows that the impact of trade and exchange rate movements is concentrated among high-skilled workers almost exclusively.

Expanding to institutionally different countries. Reasons, Firm International Experience, and Entry Mode Choice

We examine entry mode choice and its consequences when a multinational enterprise (MNE) expands into an institutionally different country. We argue that discussions of entry mode should distinguish between informal (e.g., culture) and formal (e.g., laws) institutions, and should take into account not just the home country of the MNE and its distance to the focal host country, but the MNE's overall footprint and experience across the world in general, especially in countries with an institutional structure that is similar to that of the focal host country. Specifically, we argue that firms with experience in countries with different informal institutions will be more likely to enter via acquisitions than firms without such experience, that such experience will not matter as much in the case of formal institutions, and that such firms will exit more quickly when they enter via equity alliances than through full acquisitions. We also distinguish between balanced and unbalanced alliances and argue that balanced alliances will be more enduring, but only when the host country is culturally (not legally) different from the other countries where the MNE has experience. Our arguments suggest that entry mode should be conditioned on a firm's experience in other markets, and that intercountry differences in formal versus informal institutions have distinct influences on entry mode.

Variation in Current Management of Term and Late-preterm Neonates at Risk for Early-onset Sepsis: An International Survey and Review of Guidelines.

BACKGROUND: Uncertainty about the presence of infection results in unnecessary and prolonged empiric antibiotic treatment of newborns at risk for early-onset sepsis (EOS). This study evaluates the impact of this uncertainty on the diversity in management. METHODS: A web-based survey with questions addressing management of infection risk-adjusted scenarios was performed in Europe, North America, and Australia. Published national guidelines (n = 5) were reviewed and compared with the results of the survey. RESULTS: 439 Clinicians (68% were neonatologists) from 16 countries completed the survey. In the low-risk scenario, 29% would start antibiotic therapy and 26% would not, both groups without laboratory investigations; 45% would start if laboratory markers were abnormal. In the high-risk scenario, 99% would start antibiotic therapy. In the low-risk scenario, 89% would discontinue antibiotic therapy before 72 hours. In the high-risk scenario, 35% would discontinue therapy before 72 hours, 56% would continue therapy for 5-7 days, and 9% for more than 7 days. Laboratory investigations were used in 31% of scenarios for the decision to start, and in 72% for the decision to discontinue antibiotic treatment. National guidelines differ considerably regarding the decision to start in low-risk and regarding the decision to continue therapy in higher risk situations. CONCLUSIONS: There is a broad diversity of clinical practice in management of EOS and a lack of agreement between current guidelines. The results of the survey reflect the diversity of national guidelines. Prospective studies regarding management of neonates at risk of EOS with safety endpoints are needed.

Internet, Law and Politics. A decade of transformations.

Proceedings of Internet, Law and Politics. A decade of transformations.

Oncobiguanides: Paracelsus" law and nonconventional routes for administering diabetobiguanides for cancer treatment

The dose makes the poison, the common motto of toxicology first expressed by Paracelsus more than 400 years ago, may effectively serve to guide potential applications for metformin and related biguanides in oncology. While Paracelsus' law for the dose-response effect has been commonly exploited for the use of some anti-cancer drugs at lower doses in non-neoplastic diseases (e.g., methotrexate), the opposite scenario also holds true; in other words, higher doses of non-oncology drugs, such as anti-diabetic biguanides, might exert direct anti-neoplastic effects. Here, we propose that, as for any drug, there is a dose range for biguanides that is without any effect, one corresponding to"diabetobiguanides" with a pharmacological effect (e.g., insulin sensitization in type 2 diabetes, prevention of insulin-dependent carcinogenesis, indirect inhibition of insulin and growth factor-dependent cancer growth) but with minimal toxicity and another corresponding to 'oncobiguanides' with pharmacological (i.e., direct and strong anticancer activity against cancer cells) as well as toxic effects. Considering that biguanides demonstrate a better safety profile than most oncology drugs in current use, we should contemplate the possibility of administering biguanides through non-conventional routes (e.g., inhaled for carcinomas of the lung, topical for skin cancers, intravenous as an adjunctive therapy, rectal suppositories for rectal cancer) to unambiguously investigate the therapeutic value of high-dose transient biguanide exposure in cancer. Perhaps then, the oncobiguanides, as we call them here, could be viewed as a mechanistically different type of anti-cancer drugs employed at doses notably higher than those used chronically when functioning as diabetobiguanides

The history of Lapland : wherein are shewed the original manners, habits, marriages, conjurations, &c. of that people : written by John Scheffer, professor of law and rhetoric at Upsal in Sweden.

Added engraved title page: The history of Lapland.

Quantitative Sustainability Disclosure –An international comparison and its impact on investor valuation

This research focuses on the link between quantitative sustainability disclosure and information asymmetry. It builds upon previous research which links information asymmetry with voluntary disclosure. Stakeholders from the financial services sector claim that sustainability disclosure needs to be more numerical and comparable between companies. This research covers 111 firms from Denmark, Finland, the Netherlands and Sweden from non-service industries and studies how quantitative their sustainability disclosure is, and whether or not there is a negative relation with information asymmetry. The results support the hypotheses, where two out of three information asymmetry proxies have a significant negative relation with quantitative disclosure. Size is supported as a moderating factor. Quantitativity also proves to have a significant link with third party sustainability ratings. The direct link between quantitativity and cost of capital is not however supported.

Entrepreneurship, Service Innovation, International Expansion and Performance in SMEs: Empirical Evidence from Finnish ICT Industry

The thesis aims to clarify the mixed results of prior literature regarding the performance impacts of entrepreneurship and human capital through service innovation and international expansion. The thesis examines the factors affecting degree of internationalization (DOI) and performance in ICT SMEs. These factors are entrepreneurial orientation (EO), human capital and service innovation (SI). The data was collected via questionnaire from Finnish ICT SMEs. The results suggest that EO consist of three dimensions that have different impact in DOI and SI. Also DOI has inverted U-shaped relationship with international performance, whereas DOI-profitability relationship is linear. The results of the study suggest that SMEs should not blindly increase their DOI, and that strategic focus is important.

Opportunistisen sopimusrikkomuksen ongelmasta, erityisesti Suomen vahingonkorvaus- ja rikoslainsäädännön näkökulmasta tarkasteltuna. Law and Economics -näkökulma.

Tämä pro gradu -tutkielma käsittelee opportunistisen sopimusrikkomuksen ongelmaa erityisesti Suomen vahingonkorvaus- ja rikoslainsäädännön näkökulmasta tarkasteltuna. Tutkielman lähestymistapa on oikeustaloustieteellinen (engl. Law and Economics). Opportunistisella sopimusrikkomuksella tarkoitetaan toimintaa, jossa sopimusosapuoli rikkoo sopimuksen tarkoituksellisesti, pyrkimyksenään tällä toiminnalla saavuttaa enemmän hyötyä kuin sopimuksessa pysymällä. Opportunistinen sopimusrikkomus on mahdollista toteuttaa tilanteessa, jossa sopimusasetelma itsessään antaa mahdollisuuden enemmän hyödyn saavuttamiseen rikkomus toteuttamalla kuin sopimus asianmukaisesti täyttämällä. Suomalaisessa vahingonkorvausjärjestelmässä sovelletaan sopimusrikkomusten osalla positiivisen sopimusedun mukaista vahingonkorvausta, joka hyvittää rikotulle osapuolelle sopimussuhteeseen ryhtymisestä syntyneet kustannukset sekä sopimusrikkomuksen johdosta saamatta jääneen tuoton. Positiivisen sopimusedun soveltaminen ei kuitenkaan ole opportunistisen sopimusrikkomuksen ehkäisemiseksi riittävää, sillä opportunistisesti toimiva sopimusosapuoli voi jäädä rikkomuksensa johdosta voitolle vielä sen jälkeenkin, kun kärsineelle osapuolelle on jo positiivista sopimusetua noudattaen korvattu sopimussuhteessa syntyneet kustannukset sekä rikkomuksen johdosta saamatta jäänyt tuotto. Keskeinen ongelma koskien opportunististen sopimusrikkomustilanteiden syntyä onkin juuri vallitsevan sääntelyn liiallinen keskittyminen rikotun osapuolen kärsimän vahingon kompensoimiseen, ei rikkomustilanteiden synnyn ennaltaehkäisemiseen. Suomen vahingonkorvausjärjestelmää tulisi kehittää suuntaan, jossa järjestelmä paremmin ennaltaehkäisisi opportunististen sopimusrikkomustilanteiden syntyä. Common law -oikeusjärjestelmässä käytössä olevan disgorgement principle -suuntaisen ajattelun, jossa korvauksen perustana toimisi rikkomuksella saatu hyöty kärsityn vahingon sijaan, omaksuminen olisi yksi mahdollinen kehityskulku. Olennaista olisi kuitenkin se, että järjestelmää kehitettäisiin suuntaan, jossa rikkomus ei enää voisi tulla rikkojalle kannattavaksi. Opportunistisen toiminnan kannustimet tulisi lainsäädäntöä tarkistamalla poistaa. Tällä olisi sekä sopimusinstituutiota turvaavaa että vaihdantaa edistävää vaikutusta.

Etelä- ja Itä-Kiinan meret aluekiistojen ja valtakamppailun näyttämönä

Etelä- ja Itä-Kiinan meret ovat maailman liikennöidyimpiä – ja kiistellyimpiä – merialueita. Merialueita ympäröivät valtiot ovat ajautuneet kiistelemään jopa pinnanalaisista karikoista, mutta miksi? Aluekiistojen taustalta löytyy useita geo-poliittisia tekijöitä ja valtioiden intressien ristiriitaisuus tekee kiistoista hankalia ratkaista. Alueen suurvalta Kiina on modernisoinut asevoimiaan ja Yhdysvallat pyrkii yhteistyöhön Kiinaa ympäröivien maiden kanssa sekoittaen entisestään alueen voimasuhteita.