| 1. |
- Laubenstein, Taryn, et al.
(författare)
-
Threats to Australia's oceans and coasts : A systematic review
- 2023
-
Ingår i: Ocean and Coastal Management. - : Elsevier. - 0964-5691 .- 1873-524X. ; 231
-
Forskningsöversikt (refereegranskat)abstract
- Oceans and coasts provide important ecosystem, livelihood, and cultural values to humans and the planet but face current and future compounding threats from anthropogenic activities associated with expanding pop-ulations and their use of and reliance on these environments. To respond to and mitigate these threats, there is a need to first systematically understand and categorise them. This paper reviewed 226 articles from the period 2010-2020 on threats to Australia's oceans and coasts, resulting in the identification of a total of 307 threats. Threats were grouped into three broad categories - threats from use and extraction; environmental and human -induced threats; and policy and socio-political threats -then ranked by frequency. The most common 'threats from use and extraction' were recreational activities, non-point source pollution, and urban development; the most common 'environmental and human-induced threat' was increased temperatures; and the most common 'policy and socio-political threat' was policy gaps and failures (e.g., a lack of coastal climate adaptation policies). The identification of threats across all three categories increased over time; however, the identification of 'threats from use and extraction' increased most rapidly over the last four years (2017-2020). Threats were most often described for their impacts on environmental values (68%), followed by economic (14%), socio-cultural (12%), and Indigenous (6%) values. Only 45 of the 226 papers (20%) discussed multiple threats. The threats facing Australia's oceans and coasts are rising, cumulative, and multi-faceted, and the inherent tensions between varied uses, along with intensification of uses that derive short-term anthropogenic benefit, will continue to degrade the ecological sustainability of ocean and coastal systems if actions are not taken.
|
|
| 2. |
- Strosberg, Jonathan, et al.
(författare)
-
Impact of liver tumour burden, alkaline phosphatase elevation, and target lesion size on treatment outcomes with Lu-177-Dotatate : an analysis of the NETTER-1 study
- 2020
-
Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : SPRINGER. - 1619-7070 .- 1619-7089. ; 47:10, s. 2372-2382
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose To assess the impact of baseline liver tumour burden, alkaline phosphatase (ALP) elevation, and target lesion size on treatment outcomes with Lu-177-Dotatate. Methods In the phase 3 NETTER-1 trial, patients with advanced, progressive midgut neuroendocrine tumours (NET) were randomised to 177Lu-Dotatate (every 8 weeks, four cycles) plus octreotide long-acting release (LAR) or to octreotide LAR 60 mg. Primary endpoint was progression-free survival (PFS). Analyses of PFS by baseline factors, including liver tumour burden, ALP elevation, and target lesion size, were performed using Kaplan-Meier estimates; hazard ratios (HRs) with corresponding 95% CIs were estimated using Cox regression. Results Significantly prolonged median PFS occurred with Lu-177-Dotatate versus octreotide LAR 60 mg in patients with low (< 25%), moderate (25-50%), and high (> 50%) liver tumour burden (HR 0.187, 0.216, 0.145), and normal or elevated ALP (HR 0.153, 0.177), and in the presence or absence of a large target lesion (diameter > 30 mm; HR, 0.213, 0.063). Within the Lu-177-Dotatate arm, no significant difference in PFS was observed amongst patients with low/moderate/high liver tumour burden (P = 0.7225) or with normal/elevated baseline ALP (P = 0.3532), but absence of a large target lesion was associated with improved PFS (P = 0.0222). Grade 3 and 4 liver function abnormalities were rare and did not appear to be associated with high baseline liver tumour burden. Conclusions Lu-177-Dotatate demonstrated significant prolongation in PFS versus high-dose octreotide LAR in patients with advanced, progressive midgut NET, regardless of baseline liver tumour burden, elevated ALP, or the presence of a large target lesion. : NCT01578239, EudraCT: 2011-005049-11
|
|
