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Disease recurrence in surgically treated lung adenocarcinoma (AC) remains high. New approaches for risk stratification beyond tumor stage are needed. Gene expression-based AC subtypes such as the Cancer Genome Atlas Network (TCGA) terminal-respiratory unit (TRU), proximal-inflammatory (PI) and proximal-proliferative (PP) subtypes have been associated with prognosis, but show methodological limitations for robust clinical use. We aimed to derive a platform independent single sample predictor (SSP) for molecular subtype assignment and risk stratification that could function in a clinical setting. Two-class (TRU/nonTRU=SSP2) and three-class (TRU/PP/PI=SSP3) SSPs using the AIMS algorithm were trained in 1655 ACs (n = 9659 genes) from public repositories vs TCGA centroid subtypes. Validation and survival analysis were performed in 977 patients using overall survival (OS) and distant metastasis-free survival (DMFS) as endpoints. In the validation cohort, SSP2 and SSP3 showed accuracies of 0.85 and 0.81, respectively. SSPs captured relevant biology previously associated with the TCGA subtypes and were associated with prognosis. In survival analysis, OS and DMFS for cases discordantly classified between TCGA and SSP2 favored the SSP2 classification. In resected Stage I patients, SSP2 identified TRU-cases with better OS (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.18-0.49) and DMFS (TRU HR = 0.52; 95% CI = 0.33-0.83) independent of age, Stage IA/IB and gender. SSP2 was transformed into a NanoString nCounter assay and tested in 44 Stage I patients using RNA from formalin-fixed tissue, providing prognostic stratification (relapse-free interval, HR = 3.2; 95% CI = 1.2-8.8). In conclusion, gene expression-based SSPs can provide molecular subtype and independent prognostic information in early-stage lung ACs. SSPs may overcome critical limitations in the applicability of gene signatures in lung cancer.

The year 2000 the Sami languages were recognized as official minority languages in Sweden, which among other things mean that there is a government decision to provide the means for their further existence. The purpose of this thesis is to discuss the role of the Swedish public libraries in revitalizing the South Sami language. This is an important topic to address, since the South Sami language faces serious threats today. Furthermore, the role of the public libraries in revitalizing the minority languages due to the Swedish engagement is not yet defined. The study focuses on Jämtlands läns bibliotek, a choice based on the fact that this library is located in a region with a large South Sami population. In the light of existing policy documents, and up-to-date research results dealing with the South Sami language situation, we made an interview study based on three distinct questions at issue. These deals with the responsibility of the library, the present work at the library, and the future work of the library. In answering these questions at issue, we made eight interviews with strategically selected persons; four librarians and four Samis. Since there is no established library praxis regarding the routines to revitalize threatened languages in Sweden, the purpose was to let the informants themselves contribute to the definition of the phenomenon’s at hand. Our conceptual frameworks were Kenneth Hyltenstam´s theories on language processes, Dorte Skot-Hansen´s & Marianne Andersen´s categorization of the different functions of the library, and Mikael Stigendal´s perspective on the librarian’s role in integration. Our results show that there is a gap between what the librarians perceived as immediate demand, and the real needs of the South Sami group; a gap which the library in the light of it´s educating commission has a responsibility to bridge. The results also show that the library´s work today concerning this matter is inadequate, and that the library rec, Folkbiblioteken och de nationella minoriteterna