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- Abe, O, et al.
(författare)
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Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials
- 2005
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Ingår i: The Lancet. - 1474-547X. ; 365:9472, s. 1687-1717
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Tidskriftsartikel (refereegranskat)abstract
- Background Quinquennial overviews (1985-2000) of the randomised trials in early breast cancer have assessed the 5-year and 10-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival. Here, we report the 10-year and 15-year effects. Methods Collaborative meta-analyses were undertaken of 194 unconfounded randomised trials of adjuvant chemotherapy or hormonal therapy that began by 1995. Many trials involved CMF (cyclophosphamide, methotrexate, fluorouracil), anthracycline-based combinations such as FAC (fluorouracil, doxombicin, cyclophosphamide) or FEC (fluorouracil, epirubicin, cyclophosphamide), tamoxifen, or ovarian suppression: none involved taxanes, trastuzumab, raloxifene, or modem aromatase inhibitors. Findings Allocation to about 6 months of anthracycline-based polychemotherapy (eg, with FAC or FEC) reduces the annual breast cancer death rate by about 38% (SE 5) for women younger than 50 years of age when diagnosed and by about 20% (SE 4) for those of age 50-69 years when diagnosed, largely irrespective of the use of tamoxifen and of oestrogen receptor (ER) status, nodal status, or other tumour characteristics. Such regimens are significantly (2p=0 . 0001 for recurrence, 2p<0 . 00001 for breast cancer mortality) more effective than CMF chemotherapy. Few women of age 70 years or older entered these chemotherapy trials. For ER-positive disease only, allocation to about 5 years of adjuvant tamoxifen reduces the annual breast cancer death rate by 31% (SE 3), largely irrespective of the use of chemotherapy and of age (<50, 50-69, &GE; 70 years), progesterone receptor status, or other tumour characteristics. 5 years is significantly (2p<0 . 00001 for recurrence, 2p=0 . 01 for breast cancer mortality) more effective than just 1-2 years of tamoxifen. For ER-positive tumours, the annual breast cancer mortality rates are similar during years 0-4 and 5-14, as are the proportional reductions in them by 5 years of tamoxifen, so the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis. These results combine six meta-analyses: anthracycline-based versus no chemotherapy (8000 women); CMF-based versus no chemotherapy (14 000); anthracycline-based versus CMF-based chemotherapy (14 000); about 5 years of tamoxifen versus none (15 000); about 1-2 years of tamoxifen versus none (33 000); and about 5 years versus 1-2 years of tamoxifen (18 000). Finally, allocation to ovarian ablation or suppression (8000 women) also significantly reduces breast cancer mortality, but appears to do so only in the absence of other systemic treatments. For middle-aged women with ER-positive disease (the commonest type of breast cancer), the breast cancer mortality rate throughout the next 15 years would be approximately halved by 6 months of anthracycline-based chemotherapy (with a combination such as FAC or FEC) followed by 5 years of adjuvant tamoxifen. For, if mortality reductions of 38% (age <50 years) and 20% (age 50-69 years) from such chemotherapy were followed by a further reduction of 31% from tamoxifen in the risks that remain, the final mortality reductions would be 57% and 45%, respectively (and, the trial results could well have been somewhat stronger if there had been full compliance with the allocated treatments). Overall survival would be comparably improved, since these treatments have relatively small effects on mortality from the aggregate of all other causes. Interpretation Some of the widely practicable adjuvant drug treatments that were being tested in the 1980s, which substantially reduced 5-year recurrence rates (but had somewhat less effect on 5-year mortality rates), also substantially reduce 15-year mortality rates. Further improvements in long-term survival could well be available from newer drugs, or better use of older drugs.
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- Ainsworth, Elizabeth A., et al.
(författare)
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Next generation of elevated [CO2] experiments with crops: a critical investment for feeding the future world
- 2008
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Ingår i: Plant, Cell and Environment. - : Wiley. - 0140-7791 .- 1365-3040. ; 31:9, s. 1317-1324
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Tidskriftsartikel (refereegranskat)abstract
- A rising global population and demand for protein-rich diets are increasing pressure to maximize agricultural productivity. Rising atmospheric [CO2] is altering global temperature and precipitation patterns, which challenges agricultural productivity. While rising [CO2] provides a unique opportunity to increase the productivity of C-3 crops, average yield stimulation observed to date is well below potential gains. Thus, there is room for improving productivity. However, only a fraction of available germplasm of crops has been tested for CO2 responsiveness. Yield is a complex phenotypic trait determined by the interactions of a genotype with the environment. Selection of promising genotypes and characterization of response mechanisms will only be effective if crop improvement and systems biology approaches are closely linked to production environments, that is, on the farm within major growing regions. Free air CO2 enrichment (FACE) experiments can provide the platform upon which to conduct genetic screening and elucidate the inheritance and mechanisms that underlie genotypic differences in productivity under elevated [CO2]. We propose a new generation of large-scale, low-cost per unit area FACE experiments to identify the most CO2-responsive genotypes and provide starting lines for future breeding programmes. This is necessary if we are to realize the potential for yield gains in the future.
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- Isaksson, Elisabeth, et al.
(författare)
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Two ice core δ18O records from Svalbard illustrating climate and sea ice variability over the last 400 years
- 2005
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Ingår i: The Holocene. - : SAGE Publications. - 0959-6836 .- 1477-0911. ; 15:4, s. 501-509
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Tidskriftsartikel (refereegranskat)abstract
- Ice cores from the relatively low-lying ice caps in Svalbard have not been widely exploited in climatic studies owing to uncertainties about the effect of meltwater percolation. However, results from two new Svalbard ice cores, at Lomonosovfonna and Austfonna, have shown that with careful site selection, high-resolution sampling and multiple chemical analyses it is possible to recover ice cores from which part of the annual signals are preserved, despite the considerable meltwater percolation. The new Svalbard ice cores are positioned in different parts of Svalbard and cover the past 800 years. In this paper we focus on the last 400 years. The 6180 signals from the cores are qualitatively similar over most of the twentieth century, suggesting that they record the same atmospheric signal. Prior to AD 1920, the Austfonna ice core exhibits more negative 6180 values than Lomonosovfonna, although there are intermittent decadal-scale periods throughout the record with similar values. We suggest that the differences reflect the effect of the inversion layer during the winter. The pattern in the 6180 records is similar to the Longyearbyen airtemperature record, but on an annual level the correlation is low. The Austfonna record correlates well with the temperature record from the more distant and southwesterly located Jan Mayen. A comparison of the ice-core and sea-ice records from this period suggests that sea-ice extent and Austfonna 6180 are related over the past 400 years. This may reflect the position of the storm tracks and their direct influence on the relatively low-altitude Austfonna. Lomonosovfonna may be less sensitive to such changes and primarily record free atmospheric changes instead of variations in sea-ice extent, the latter is probably a result of its higher elevation.
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- Mansy, Sheref S, et al.
(författare)
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Structure and evolutionary analysis of a non-biological ATP-binding protein.
- 2007
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Ingår i: Journal of Molecular Biology. - : Elsevier BV. - 0022-2836 .- 1089-8638. ; 371:2, s. 501-13
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Tidskriftsartikel (refereegranskat)abstract
- We present a structural and functional analysis of the evolutionary optimization of a non-biological protein derived from a library of random amino acid sequences. A series of previously described in vitro selection experiments transformed a low-affinity ancestral sequence into a stably folded, high affinity ATP binding protein structure. While the evolutionarily optimized protein differs from its ancestral sequence through the accumulation of 12 amino acid mutations, the means by which those mutations enhance the stability and functionality of the protein were not well understood. We used a combination of mutagenesis, biochemistry, and NMR spectroscopy to investigate the structural and functional significance of each mutation. We solved the three-dimensional structure of the folding optimized protein by solution NMR, which revealed a fourth strand of the beta-sheet of the alpha/beta-fold that was not observed in an earlier crystallographic analysis of a less stable version of the protein. The structural rigidity of the newly identified beta-strand was confirmed by T1, T2, and heteronuclear nuclear Overhauser enhancement (NOE) measurements. Biochemical experiments were used to examine point mutations that revert the optimized protein back to the ancestral residue at each of the 12 sites. A combination of structural and functional data was then used to interpret the significance of each amino acid mutation. The enhanced ATP affinity was largely due to the emergence of a patch of positive charge density on the protein surface, while the increased solubility resulted from several mutations that increased the hydrophilicity of the protein surface, thereby decreasing protein aggregation. One mutation may stabilize the hydrophobic face of the beta-sheet.
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- Sjögren, Björn, et al.
(författare)
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Determination of firn density in ice cores using image analysis
- 2007
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Ingår i: Journal of Glaciology. - : International Glaciological Society. - 0022-1430 .- 1727-5652. ; 53:182, s. 413-419
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Tidskriftsartikel (refereegranskat)abstract
- This study presents a simple and inexpensive method for deriving a high-resolution density proxy record for the firn part of an ice core using digital images. The image data have better resolution and are less sensitive to core quality than is density derived through di-electric profiling (DEP). Simple image analysis is thus suitable to derive a density proxy record in the firn section of ice cores drilled in the percolation or wet snow zone, and to better interpret the results of a DEP record. The images may be used as a permanent record when evaluating other types of ice-core data. Suggestions are provided to improve data quality and decrease post-processing time of the image analysis in future studies.
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