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- Koehler, Birgit, et al.
(författare)
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Immediate and long-term nitrogen oxide emissions from tropical forest soils exposed to elevated nitrogen input
- 2009
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 15:8, s. 2049-2066
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Tidskriftsartikel (refereegranskat)abstract
- Tropical nitrogen (N) deposition is projected to increase substantially within the coming decades. Increases in soil emissions of the climate-relevant trace gases NO and N2O are expected, but few studies address this possibility. We used N addition experiments to achieve N-enriched conditions in contrasting montane and lowland forests and assessed changes in the timing and magnitude of soil N-oxide emissions. We evaluated transitory effects, which occurred immediately after N addition, and long-term effects measured at least 6 weeks after N addition. In the montane forest where stem growth was N limited, the first-time N additions caused rapid increases in soil N-oxide emissions. During the first 2 years of N addition, annual N-oxide emissions were five times (transitory effect) and two times (long-term effect) larger than controls. This contradicts the current assumption that N-limited tropical montane forests will respond to N additions with only small and delayed increases in soil N-oxide emissions. We attribute this fast and large response of soil N-oxide emissions to the presence of an organic layer (a characteristic feature of this forest type) in which nitrification increased substantially following N addition. In the lowland forest where stem growth was neither N nor phosphorus (P) limited, the first-time N additions caused only gradual and minimal increases in soil N-oxide emissions. These first N additions were completed at the beginning of the wet season, and low soil water content may have limited nitrification. In contrast, the 9- and 10-year N-addition plots displayed instantaneous and large soil N-oxide emissions. Annual N-oxide emissions under chronic N addition were seven times (transitory effect) and four times (long-term effect) larger than controls. Seasonal changes in soil water content also caused seasonal changes in soil N-oxide emissions from the 9- and 10-year N-addition plots. This suggests that climate change scenarios, where rainfall quantity and seasonality change, will alter the relative importance of soil NO and N2O emissions from tropical forests exposed to elevated N deposition.
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- Kuhry, E., et al.
(författare)
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Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer
- 2005
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Ingår i: Surgical endoscopy. - 1432-2218. ; 19:5, s. 687-92
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: High hospital case volume has been associated with improved outcome after open operation for colorectal malignancies. METHODS: To assess the impact of hospital case volume on short-term outcome after laparoscopic operation for colon cancer, we conducted an analysis of patients who underwent laparoscopic colon resection within the COlon Cancer Laparoscopic or Open Resection (COLOR) trial. RESULTS: A total of 536 patients with adenocarcinoma of the colon were included in the analysis. Median operating time was 240, 210 and 188 min in centers with low, medium, and high case volumes, respectively (p < 0.001). A significant difference in conversion rate was observed among low, medium, and high case volume hospitals (24% vs 24% vs 9%; p < 0.001). A higher number of lymph nodes were harvested at high case volume hospitals (p < 0.001). After operation, fewer complications (p = 0.006) and a shorter hospital stay (p < 0.001) were observed in patients treated at hospitals with high caseloads. CONCLUSIONS: Laparoscopic operation for colon cancer at hospitals with high caseloads appears to be associated with improved short-term results.
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- Veldkamp, R., et al.
(författare)
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Laparoscopic resection of colon Cancer: consensus of the European Association of Endoscopic Surgery (EAES)
- 2004
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Ingår i: Surgical endoscopy. - : Springer Science and Business Media LLC. - 1432-2218 .- 0930-2794. ; 18:8, s. 1163-85
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference on the laparoscopic resection of colon cancer during the annual congress in Lisbon, Portugal, in June 2002. METHODS: A systematic review of the current literature was combined with the opinions, of experts in the field of colon cancer surgery to formulate evidence-based statements and recommendations on the laparoscopic resection of colon cancer. RESULTS: Advanced age, obesity, and previous abdominal operations are not considered absolute contraindications for laparoscopic colon cancer surgery. The most common cause for conversion is the presence of bulky or invasive tumors. Laparoscopic operation takes longer to perform than the open counterpart, but the outcome is similar in terms of specimen size and pathological examination. Immediate postoperative morbidity and mortality are comparable for laparoscopic and open colonic cancer surgery. The laparoscopically operated patients had less postoperative pain, better-preserved pulmonary function, earlier restoration of gastrointestinal function, and an earlier discharge from the hospital. The postoperative stress response is lower after laparoscopic colectomy. The incidence of port site metastases is <1%. Survival after laparoscopic resection of colon cancer appears to be at least equal to survival after open resection. The costs of laparoscopic surgery for colon cancer are higher than those for open surgery. CONCLUSION: Laparoscopic resection of colon cancer is a safe and feasible procedure that improves short-term outcome. Results regarding the long-term survival of patients enrolled in large multicenter trials will determine its role in general surgery.
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- Veldkamp, R., et al.
(författare)
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Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial
- 2005
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Ingår i: The lancet oncology. - 1470-2045. ; 6:7, s. 477-84
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The safety and short-term benefits of laparoscopic colectomy for cancer remain debatable. The multicentre COLOR (COlon cancer Laparoscopic or Open Resection) trial was done to assess the safety and benefit of laparoscopic resection compared with open resection for curative treatment of patients with cancer of the right or left colon. METHODS: 627 patients were randomly assigned to laparoscopic surgery and 621 patients to open surgery. The primary endpoint was cancer-free survival 3 years after surgery. Secondary outcomes were short-term morbidity and mortality, number of positive resection margins, local recurrence, port-site or wound-site recurrence, metastasis, overall survival, and blood loss during surgery. Analysis was by intention to treat. Here, clinical characteristics, operative findings, and postoperative outcome are reported. FINDINGS: Patients assigned laparoscopic resection had less blood loss compared with those assigned open resection (median 100 mL [range 0-2700] vs 175 mL [0-2000], p<0.0001), although laparoscopic surgery lasted 30 min longer than did open surgery (p<0.0001). Conversion to open surgery was needed for 91 (17%) patients undergoing the laparoscopic procedure. Radicality of resection as assessed by number of removed lymph nodes and length of resected oral and aboral bowel did not differ between groups. Laparoscopic colectomy was associated with earlier recovery of bowel function (p<0.0001), need for fewer analgesics, and with a shorter hospital stay (p<0.0001) compared with open colectomy. Morbidity and mortality 28 days after colectomy did not differ between groups. INTERPRETATION: Laparoscopic surgery can be used for safe and radical resection of cancer in the right, left, and sigmoid colon.
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- Ward, Philip J., et al.
(författare)
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The need to integrate flood and drought disaster risk reduction strategies
- 2020
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Ingår i: Water Security. - : Elsevier BV. - 2468-3124. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Most research on hydrological risks focuses either on flood risk or drought risk, whilst floods and droughts are two extremes of the same hydrological cycle. To better design disaster risk reduction (DRR) measures and strategies, it is important to consider interactions between these closely linked phenomena. We show examples of: (a) how flood or drought DRR measures can have (unintended) positive or negative impacts on risk of the opposite hazard; and (b) how flood or drought DRR measures can be negatively impacted by the opposite hazard. We focus on dikes and levees, dams, stormwater control and upstream measures, subsurface storage, migration, agricultural practices, and vulnerability and preparedness. We identify key challenges for moving towards a more holistic risk management approach.
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