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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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- Luyssaert, S., et al.
(författare)
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CO2 balance of boreal, temperate, and tropical forests derived from a global database
- 2007
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Ingår i: Global Change Biology. - : Wiley. - 1354-1013 .- 1365-2486. ; 13:12, s. 2509-2537
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Forskningsöversikt (refereegranskat)abstract
- Terrestrial ecosystems sequester 2.1 Pg of atmospheric carbon annually. A large amount of the terrestrial sink is realized by forests. However, considerable uncertainties remain regarding the fate of this carbon over both short and long timescales. Relevant data to address these uncertainties are being collected at many sites around the world, but syntheses of these data are still sparse. To facilitate future synthesis activities, we have assembled a comprehensive global database for forest ecosystems, which includes carbon budget variables (fluxes and stocks), ecosystem traits (e.g. leaf area index, age), as well as ancillary site information such as management regime, climate, and soil characteristics. This publicly available database can be used to quantify global, regional or biome-specific carbon budgets; to re-examine established relationships; to test emerging hypotheses about ecosystem functioning [e.g. a constant net ecosystem production (NEP) to gross primary production (GPP) ratio]; and as benchmarks for model evaluations. In this paper, we present the first analysis of this database. We discuss the climatic influences on GPP, net primary production (NPP) and NEP and present the CO2 balances for boreal, temperate, and tropical forest biomes based on micrometeorological, ecophysiological, and biometric flux and inventory estimates. Globally, GPP of forests benefited from higher temperatures and precipitation whereas NPP saturated above either a threshold of 1500 mm precipitation or a mean annual temperature of 10 degrees C. The global pattern in NEP was insensitive to climate and is hypothesized to be mainly determined by nonclimatic conditions such as successional stage, management, site history, and site disturbance. In all biomes, closing the CO2 balance required the introduction of substantial biome-specific closure terms. Nonclosure was taken as an indication that respiratory processes, advection, and non-CO2 carbon fluxes are not presently being adequately accounted for.
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- Magnani, F, et al.
(författare)
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The human footprint in the carbon cycle of temperate and boreal forests
- 2007
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Ingår i: Nature Photonics. - : Springer Science and Business Media LLC. - 1749-4885. ; 447, s. 848-850
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Tidskriftsartikel (refereegranskat)abstract
- Temperate and boreal forests in the Northern Hemisphere cover an area of about 2 times 107 square kilometres and act as a substantial carbon sink (0.6–0.7 petagrams of carbon per year)1. Although forest expansion following agricultural abandonment is certainly responsible for an important fraction of this carbon sink activity, the additional effects on the carbon balance of established forests of increased atmospheric carbon dioxide, increasing temperatures, changes in management practices and nitrogen deposition are difficult to disentangle, despite an extensive network of measurement stations2, 3. The relevance of this measurement effort has also been questioned4, because spot measurements fail to take into account the role of disturbances, either natural (fire, pests, windstorms) or anthropogenic (forest harvesting). Here we show that the temporal dynamics following stand-replacing disturbances do indeed account for a very large fraction of the overall variability in forest carbon sequestration. After the confounding effects of disturbance have been factored out, however, forest net carbon sequestration is found to be overwhelmingly driven by nitrogen deposition, largely the result of anthropogenic activities5. The effect is always positive over the range of nitrogen deposition covered by currently available data sets, casting doubts on the risk of widespread ecosystem nitrogen saturation6 under natural conditions. The results demonstrate that mankind is ultimately controlling the carbon balance of temperate and boreal forests, either directly (through forest management) or indirectly (through nitrogen deposition).
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- Bombelli, A., et al.
(författare)
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An outlook on the Sub-Saharan Africa carbon balance
- 2009
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Ingår i: Biogeosciences. - 1726-4189. ; 6:10, s. 2193-2205
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Tidskriftsartikel (refereegranskat)abstract
- This study gives an outlook on the carbon balance of Sub-Saharan Africa (SSA) by presenting a summary of currently available results from the project CarboAfrica (namely net ecosystem productivity and emissions from fires, deforestation and forest degradation, by field and model estimates) supplemented by bibliographic data and compared with a new synthesis of the data from national communications to UNFCCC. According to these preliminary estimates the biogenic carbon balance of SSA varies from 0.16 Pg C y(-1) to a much higher sink of 1.00 Pg C y(-1) (depending on the source data). Models estimates would give an unrealistic sink of 3.23 Pg C y(-1), confirming their current inadequacy when applied to Africa. The carbon uptake by forests and savannas (0.34 and 1.89 Pg C y(-1), respectively,) are the main contributors to the resulting sink. Fires (0.72 Pg C y(-1)) and deforestation (0.25 Pg C y(-1)) are the main contributors to the SSA carbon emissions, while the agricultural sector and forest degradation contributes only with 0.12 and 0.08 Pg C y(-1), respectively. Savannas play a major role in shaping the SSA carbon balance, due to their large extension, their fire regime, and their strong interannual NEP variability, but they are also a major uncertainty in the overall budget. Even if fossil fuel emissions from SSA are relative low, they can be crucial in defining the sign of the overall SSA carbon balance by reducing the natural sink potential, especially in the future. This paper shows that Africa plays a key role in the global carbon cycle system and probably could have a potential for carbon sequestration higher than expected, even if still highly uncertain. Further investigations are needed, particularly to better address the role of savannas and tropical forests and to improve biogeochemical models. The CarboAfrica network of carbon measurements could provide future unique data sets for better estimating the African carbon balance.
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- Magesacher, Thomas, et al.
(författare)
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Limits of Ultra-Wideband Communication Over Copper
- 2006
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Ingår i: Proc. Intl. Conference on Communication Technology (ICCT) 2006. - 1424408016 ; , s. 1437-1440
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Konferensbidrag (refereegranskat)abstract
- Wireline communication using the copper plant is one of the major access techniques. The shorter the wires, the larger is the frequency band that can be exploited in an economically feasible way. Several technologies using frequency bands up to 30MHz have been standardized during the last decade. Properties of the wireline channel for frequencies above 30MHz are to a large extent unexplored. This paper investigates the limits of "ultra-wideband" communication over very short copper cables in terms of exploitable bandwidth and data rate. Extrapolations of standard cable models, whose validity has been verified by means of measurements, are used for channel modeling. The CISPR 22 standard forms the basis for the analysis of ingress and egress.
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