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McDonald RI, Aronson MFJ, Beatley T, Beller E, Bazo M, Grossinger R, Jessup K, Mansur AV, Puppim de Oliveira JA, Panlasigui S, Burg J, Pevzner N, Shanahan D, Stoneburner L, Rudd A, Spotswood E. Denser and greener cities: Green interventions to achieve both urban density and nature. People and Nature 2023. [DOI: 10.1002/pan3.10423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Robert I. McDonald
- Center for Sustainability Science, The Nature Conservancy in Europe Berlin Germany
- CUNY Institute for Demographic Research New York New York USA
- Humboldt University Berlin Germany
| | - Myla F. J. Aronson
- Department of Ecology, Evolution, and Natural Resources Rutgers, The State University of New Jersey New Brunswick New Jersey USA
| | - Timothy Beatley
- School of Architecture University of Virginia Charlottesville Virginia USA
| | - Erin Beller
- Real Estate & Workplace Services Sustainability Team Google Mountain View California USA
| | - Micaela Bazo
- Urban Nature Lab San Francisco Estuary Institute Richmond California USA
| | - Robin Grossinger
- Urban Nature Lab San Francisco Estuary Institute Richmond California USA
| | - Kelsey Jessup
- The Nature Conservancy in California San Francisco California USA
| | - Andressa V. Mansur
- Department of Anthropology University of Georgia Athens Georgia USA
- Institute for Resilient Infrastructure Systems University of Georgia Athens Georgia USA
| | | | | | - Joe Burg
- Urban Nature Lab San Francisco Estuary Institute Richmond California USA
| | - Nicholas Pevzner
- Department of Landscape Architecture, Weitzman School of Design University of Pennsylvania Philadelphia Pennsylvania USA
| | - Danielle Shanahan
- Zealandia Centre for People and Nature Wellington New Zealand
- Te Herenga Waka Victoria University of Wellington Wellington New Zealand
| | - Lauren Stoneburner
- Urban Nature Lab San Francisco Estuary Institute Richmond California USA
| | - Andrew Rudd
- UN‐Habitat, Two United Nations Plaza New York New York USA
| | - Erica Spotswood
- Urban Nature Lab San Francisco Estuary Institute Richmond California USA
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Shumilova O, Zak D, Datry T, von Schiller D, Corti R, Foulquier A, Obrador B, Tockner K, Allan DC, Altermatt F, Arce MI, Arnon S, Banas D, Banegas‐Medina A, Beller E, Blanchette ML, Blanco‐Libreros JF, Blessing J, Boëchat IG, Boersma K, Bogan MT, Bonada N, Bond NR, Brintrup K, Bruder A, Burrows R, Cancellario T, Carlson SM, Cauvy‐Fraunié S, Cid N, Danger M, de Freitas Terra B, Girolamo AMD, del Campo R, Dyer F, Elosegi A, Faye E, Febria C, Figueroa R, Four B, Gessner MO, Gnohossou P, Cerezo RG, Gomez‐Gener L, Graça MA, Guareschi S, Gücker B, Hwan JL, Kubheka S, Langhans SD, Leigh C, Little CJ, Lorenz S, Marshall J, McIntosh A, Mendoza‐Lera C, Meyer EI, Miliša M, Mlambo MC, Moleón M, Negus P, Niyogi D, Papatheodoulou A, Pardo I, Paril P, Pešić V, Rodriguez‐Lozano P, Rolls RJ, Sanchez‐Montoya MM, Savić A, Steward A, Stubbington R, Taleb A, Vorste RV, Waltham N, Zoppini A, Zarfl C. Simulating rewetting events in intermittent rivers and ephemeral streams: A global analysis of leached nutrients and organic matter. Glob Chang Biol 2019; 25:1591-1611. [PMID: 30628191 PMCID: PMC6850495 DOI: 10.1111/gcb.14537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/07/2018] [Indexed: 06/01/2023]
Abstract
Climate change and human pressures are changing the global distribution and the extent of intermittent rivers and ephemeral streams (IRES), which comprise half of the global river network area. IRES are characterized by periods of flow cessation, during which channel substrates accumulate and undergo physico-chemical changes (preconditioning), and periods of flow resumption, when these substrates are rewetted and release pulses of dissolved nutrients and organic matter (OM). However, there are no estimates of the amounts and quality of leached substances, nor is there information on the underlying environmental constraints operating at the global scale. We experimentally simulated, under standard laboratory conditions, rewetting of leaves, riverbed sediments, and epilithic biofilms collected during the dry phase across 205 IRES from five major climate zones. We determined the amounts and qualitative characteristics of the leached nutrients and OM, and estimated their areal fluxes from riverbeds. In addition, we evaluated the variance in leachate characteristics in relation to selected environmental variables and substrate characteristics. We found that sediments, due to their large quantities within riverbeds, contribute most to the overall flux of dissolved substances during rewetting events (56%-98%), and that flux rates distinctly differ among climate zones. Dissolved organic carbon, phenolics, and nitrate contributed most to the areal fluxes. The largest amounts of leached substances were found in the continental climate zone, coinciding with the lowest potential bioavailability of the leached OM. The opposite pattern was found in the arid zone. Environmental variables expected to be modified under climate change (i.e. potential evapotranspiration, aridity, dry period duration, land use) were correlated with the amount of leached substances, with the strongest relationship found for sediments. These results show that the role of IRES should be accounted for in global biogeochemical cycles, especially because prevalence of IRES will increase due to increasing severity of drying events.
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Affiliation(s)
- Oleksandra Shumilova
- Leibniz‐Institute of Freshwater Ecology and Inland Fisheries (IGB)BerlinGermany
- Institute of BiologyFreie Universität Berlin (FU)BerlinGermany
- Department of CivilEnvironmental and Mechanical EngineeringTrento UniversityTrentoItaly
| | - Dominik Zak
- Institute of BiologyFreie Universität Berlin (FU)BerlinGermany
- Institute of Landscape Ecology and Site EvaluationUniversity of RostockRostockGermany
- Department of BioscienceAarhus UniversitySilkeborgDenmark
| | - Thibault Datry
- IRSTEAUR RIVERLYCentre de Lyon‐VilleurbanneVilleurbanne CedexFrance
| | - Daniel von Schiller
- Department of Plant Biology and EcologyFaculty of Science and TechnologyUniversity of the Basque Country (UPV/EHU)BilbaoSpain
| | - Roland Corti
- IRSTEAUR RIVERLYCentre de Lyon‐VilleurbanneVilleurbanne CedexFrance
| | - Arnaud Foulquier
- Laboratoire d’Écologie Alpine (LECA)UMR CNRS‐UGA‐USMB 5553Université Grenoble AlpesGrenobleFrance
| | - Biel Obrador
- Department of Evolutionary Biology, Ecology and Environmental SciencesFaculty of BiologyBiodiversity Research Institute (IRBIO)University of BarcelonaBarcelonaSpain
| | - Klement Tockner
- Leibniz‐Institute of Freshwater Ecology and Inland Fisheries (IGB)BerlinGermany
- Institute of BiologyFreie Universität Berlin (FU)BerlinGermany
- Austrian Science Fund (FWF)ViennaAustria
| | | | - Florian Altermatt
- Department of Evolutionary Biology and Environmental StudiesUniversity of ZurichZürichSwitzerland
| | - María Isabel Arce
- Leibniz‐Institute of Freshwater Ecology and Inland Fisheries (IGB)BerlinGermany
- Centre of Edaphology and Applied Biology of Segura (CEBAS‐CSIC)MurciaSpain
| | - Shai Arnon
- Zuckerberg Institute for Water ResearchThe Jacob Blaustein Institutes for Desert ResearchBen‐Gurion University of the NegevBeershebaIsrael
| | - Damien Banas
- Université de Lorraine ‐ UR AFPAVandoeuvre‐Les‐NancyFrance
| | - Andy Banegas‐Medina
- Faculty of Environmental Science and EULA‐Chile CenterUniversidad de ConcepciónConcepciónChile
| | - Erin Beller
- Department of GeographyUniversity of CaliforniaBerkeleyCalifornia
| | - Melanie L. Blanchette
- Mine Water and Environment Research Centre (MiWER)School of ScienceEdith Cowan UniversityPerthAustralia
| | | | - Joanna Blessing
- Department of Environment and ScienceQueensland GovernmentBrisbaneQldAustralia
| | | | - Kate Boersma
- Department of BiologyUniversity of San DiegoSan DiegoCalifornia
| | - Michael T. Bogan
- School of Natural Resources and the EnvironmentUniversity of ArizonaTucsonArizona
| | - Núria Bonada
- Grup de Recerca Freshwater Ecology, Hydrology and Management (FEHM)Departament de Biologia EvolutivaEcologia i Ciències AmbientalsInstitut de Recerca de la Biodiversitat (IRBio)Universitat de BarcelonaBarcelonaSpain
| | - Nick R. Bond
- Centre for Freshwater EcosystemsLa Trobe UniversityWodongaVic.Australia
| | - Kate Brintrup
- Faculty of Environmental Science and EULA‐Chile CenterUniversidad de ConcepciónConcepciónChile
| | - Andreas Bruder
- Laboratory of Applied MicrobiologyUniversity of Applied Sciences and Arts of Southern SwitzerlandBellinzonaSwitzerland
| | - Ryan Burrows
- Australian Rivers InstituteGriffith UniversityNathanQldAustralia
| | - Tommaso Cancellario
- Department of Environmental BiologyBiodiversity Data Analytics and Environmental Quality GroupUniversity of NavarraPamplonaSpain
| | - Stephanie M. Carlson
- Department of Environmental Science, Policy, and ManagementUniversity of CaliforniaBerkeleyCalifornia
| | | | - Núria Cid
- Grup de Recerca Freshwater Ecology, Hydrology and Management (FEHM)Departament de Biologia EvolutivaEcologia i Ciències AmbientalsInstitut de Recerca de la Biodiversitat (IRBio)Universitat de BarcelonaBarcelonaSpain
| | | | | | - Anna Maria De Girolamo
- Water Research Institute – National Research Council (IRSA‐CNR)Montelibretti (Rome)Italy
| | - Ruben del Campo
- Leibniz‐Institute of Freshwater Ecology and Inland Fisheries (IGB)BerlinGermany
- Department of Ecology and HydrologyRegional Campus of International Excellence ‘Campus Mare Nostrum’ – University of MurciaMurciaSpain
| | - Fiona Dyer
- Institute for Applied EcologyUniversity of CanberraBruceCanberra ACTAustralia
| | - Arturo Elosegi
- Department of Plant Biology and EcologyFaculty of Science and TechnologyUniversity of the Basque Country (UPV/EHU)BilbaoSpain
| | - Emile Faye
- Centre International de Recherche en Agronomie pour le DéveloppementCIRADUPR HortSysMontpellierFrance
| | - Catherine Febria
- School of Biological SciencesUniversity of CanterburyChristchurchNew Zealand
- Great Lakes Institute for Environmental ResearchUniversity of WindsorWindsorCanada
| | - Ricardo Figueroa
- Faculty of Environmental Science and EULA‐Chile CenterUniversidad de ConcepciónConcepciónChile
| | - Brian Four
- INRAUAR 1275 DEPT EFPACentre de recherche de NancyChampenouxFrance
| | - Mark O. Gessner
- Leibniz‐Institute of Freshwater Ecology and Inland Fisheries (IGB)BerlinGermany
- Department of EcologyBerlin Institute of Technology (TU Berlin)BerlinGermany
| | - Pierre Gnohossou
- Faculté d'AgronomieDépartement d'Aménagement et de Gestion des Ressources NaturellesUniversité de ParakouParakouBenin
| | - Rosa Gómez Cerezo
- Department of Ecology and HydrologyRegional Campus of International Excellence ‘Campus Mare Nostrum’ – University of MurciaMurciaSpain
| | - Lluís Gomez‐Gener
- Department of Ecology and Environmental ScienceUmeå UniversityUmeåSweden
| | - Manuel A.S. Graça
- MARE – Marine and Environmental Sciences CentreDepartment of Life SciencesUniversity of CoimbraCoimbraPortugal
| | - Simone Guareschi
- Department of Ecology and HydrologyRegional Campus of International Excellence ‘Campus Mare Nostrum’ – University of MurciaMurciaSpain
| | - Björn Gücker
- Department of GeosciencesFederal University of São João del‐ReiSão João del‐ReiBrazil
| | - Jason L. Hwan
- Department of Environmental Science, Policy, and ManagementUniversity of CaliforniaBerkeleyCalifornia
| | | | - Simone Daniela Langhans
- Department of ZoologyUniversity of OtagoDunedinNew Zealand
- BC3‐Basque Centre for Climate ChangeLeioaSpain
| | - Catherine Leigh
- Australian Rivers InstituteGriffith UniversityNathanQldAustralia
- ARC Centre of Excellence for Mathematical & Statistical Frontiers (ACEMS) and Institute for Future EnvironmentsSchool of Mathematical SciencesQueensland University of TechnologyBrisbaneQldAustralia
| | - Chelsea J. Little
- Department of Evolutionary Biology and Environmental StudiesUniversity of ZurichZürichSwitzerland
- Department of Aquatic Ecology, EawagThe Swiss Federal Institute of Aquatic Science and TechnologyDübendorfSwitzerland
| | - Stefan Lorenz
- Institute for Ecological ChemistryPlant Analysis and Stored Product ProtectionJulius‐Kuehn‐InstituteBerlinGermany
| | - Jonathan Marshall
- Department of Environment and ScienceQueensland GovernmentBrisbaneQldAustralia
- Australian Rivers InstituteGriffith UniversityNathanQldAustralia
| | - Angus McIntosh
- School of Biological SciencesUniversity of CanterburyChristchurchNew Zealand
| | - Clara Mendoza‐Lera
- IRSTEAUR RIVERLYCentre de Lyon‐VilleurbanneVilleurbanne CedexFrance
- Department of Freshwater ConservationBTU Cottbus‐SenftenbergBad SaarowGermany
| | | | - Marko Miliša
- Department of BiologyFaculty of ScienceUniversity of ZagrebZagrebCroatia
| | - Musa C. Mlambo
- Department of Freshwater InvertebratesAlbany MuseumAffiliated Research Institute of Rhodes UniversityGrahamstownSouth Africa
| | - Marcos Moleón
- Department of ZoologyUniversity of GranadaGranadaSpain
| | - Peter Negus
- Department of Environment and ScienceQueensland GovernmentBrisbaneQldAustralia
| | - Dev Niyogi
- Missouri University of Science and TechnologyRollaMissouri
| | | | - Isabel Pardo
- Departamento de Ecología y Biología AnimalUniversidad de VigoVigoSpain
| | - Petr Paril
- Department of Botany and ZoologyFaculty of ScienceMasaryk UniversityBrnoCzech Republic
| | - Vladimir Pešić
- Department of BiologyUniversity of MontenegroPodgoricaMontenegro
| | - Pablo Rodriguez‐Lozano
- Department of Environmental Science, Policy, and ManagementUniversity of CaliforniaBerkeleyCalifornia
| | - Robert J. Rolls
- School of Environmental and Rural ScienceUniversity of New EnglandArmidaleNSWAustralia
| | - Maria Mar Sanchez‐Montoya
- Department of Ecology and HydrologyRegional Campus of International Excellence ‘Campus Mare Nostrum’ – University of MurciaMurciaSpain
| | - Ana Savić
- Department of Biology and EcologyFaculty of Sciences and MathematicsUniversity of NišNišSerbia
| | - Alisha Steward
- Department of Environment and ScienceQueensland GovernmentBrisbaneQldAustralia
- Australian Rivers InstituteGriffith UniversityNathanQldAustralia
| | | | - Amina Taleb
- Laboratoire d’Écologie et Gestion des Ecosystèmes Naturels (LECGEN)University of TlemcenTlemcenAlgeria
| | - Ross Vander Vorste
- Department of Environmental Science, Policy, and ManagementUniversity of CaliforniaBerkeleyCalifornia
| | - Nathan Waltham
- TropWATER (Centre for Tropical Water and Aquatic Ecosystem Research)College of Science and EngineeringJames Cook UniversityTownsvilleQldAustralia
| | - Annamaria Zoppini
- Water Research Institute – National Research Council (IRSA‐CNR)Montelibretti (Rome)Italy
| | - Christiane Zarfl
- Center for Applied GeosciencesEberhard Karls Universität TübingenTübingenGermany
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Beller E, McClenachan L, Trant A, Sanderson EW, Rhemtulla J, Guerrini A, Grossinger R, Higgs E. Toward principles of historical ecology. Am J Bot 2017; 104:645-648. [PMID: 28515077 DOI: 10.3732/ajb.1700070] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 04/07/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Erin Beller
- Resilient Landscapes Program, San Francisco Estuary Institute, 4911 Central Avenue, Richmond, California 94804 USA
- Department of Geography, University of California Berkeley, 565 McCone Hall, Berkeley, California 94720 USA
| | - Loren McClenachan
- Environmental Studies, Colby College, 5351 Mayflower Hill, Waterville, Maine 04901 USA
| | - Andrew Trant
- School of Environment, Resources and Sustainability, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G
| | - Eric W Sanderson
- Wildlife Conservation Society Global Conservation Programs, 2300 Southern Blvd, Bronx, New York 10460 USA
| | - Jeanine Rhemtulla
- Forest and Conservation Sciences, University of British Columbia, 3609-2424 Main Mall, Vancouver, British Columbia, Canada V6T 1Z4
| | - Anita Guerrini
- School of History, Philosophy, and Religion, Oregon State University, 322 Milam Hall, Corvallis, Oregon 97331 USA
| | - Robin Grossinger
- Resilient Landscapes Program, San Francisco Estuary Institute, 4911 Central Avenue, Richmond, California 94804 USA
| | - Eric Higgs
- School of Environmental Studies, University of Victoria, Room 205, House 4, Victoria, British Columbia, Canada V8P 5C2
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Abstract
PURPOSE To review records of 371 patients who underwent total hip or knee arthroplasty (THA or TKA) with intra-operative blood salvage to determine the allogeneic blood transfusion rate and the predictors for allogeneic blood transfusion. METHODS Records of 155 male and 216 female consecutive patients aged 17 to 95 (mean, 70) years who underwent primary THA or TKA by a single surgeon with the use of intra-operative blood salvage were reviewed. RESULTS The preoperative haemoglobin level was <120 g/dl in 15% of THA patients and 5% of TKA patients; the allogeneic transfusion rate was 24% in THA patients and 12% in TKA patients. Despite routine use of intra-operative blood salvage, only 59% of THA patients and 63% of TKA patients actually received salvaged blood, as a minimum of 200 ml blood loss was required to activate blood salvage. In multivariable analysis, predictors for allogeneic blood transfusion were female gender (adjusted odds ratio [OR]=2.8, p=0.02), age >75 years (adjusted OR=5.9, p<0.001), and preoperative haemoglobin level <120 g/l (adjusted OR=30.1, p<0.001), despite the use of intra-operative blood salvage. Patients who received allogeneic blood transfusion had a longer hospital stay and greater complication rate. CONCLUSION Intra-operative blood salvage is not effective in preventing allogeneic blood transfusion in patients with a preoperative haemoglobin level <120 g/l. It should be combined with preoperative optimisation of the haemoglobin level or use of tranexamic acid.
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Affiliation(s)
- M Dan
- John Hunter Hospital, NSW, Australia & Department of Medicine, Bond University, Gold Coast, Queensland Australia
| | - D Liu
- Gold Coast Centre for Bone and Joint Surgery, Gold Coast, Australia
| | - S M Martos
- Gold Coast Centre for Bone and Joint Surgery, Gold Coast, Australia
| | - E Beller
- Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Queensland, Australia
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Jull G, Sterling M, Kenardy J, Beller E. Does the presence of sensory hypersensitivity influence outcomes of physical rehabilitation for chronic whiplash? – A preliminary RCT. Pain 2007; 129:28-34. [PMID: 17218057 DOI: 10.1016/j.pain.2006.09.030] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2006] [Revised: 09/11/2006] [Accepted: 09/18/2006] [Indexed: 11/22/2022]
Abstract
Patients with chronic whiplash associated disorders present with varied sensory, motor and psychological features. In this first instance it was questioned whether a multimodal program of physical therapies was an appropriate management to be broadly prescribed for these patients when it was known that some would have sensory features suggestive of a notable pain syndrome. A randomised controlled trial was conducted with 71 participants with persistent neck pain following a motor vehicle crash to explore this question. Participants were randomly allocated to receive either a multimodal physiotherapy program (MPT) or a self-management program (SMP) (advice and exercise). In the randomisation process, participants were stratified according to the presence or not of widespread mechanical or cold hyperalgesia. The intervention period was 10 weeks and outcomes were assessed immediately following treatment. Even with the presence of sensory hypersensitivity in 72.5% of subjects, both groups reported some relief of neck pain and disability (Neck Disability Index) and it was superior in the group receiving multimodal physiotherapy (p=0.04). Post-hoc observations however suggested that relief was marginal in the subgroup with both widespread mechanical and cold hyperalgesia. Further research is required to test the validity of this sub-group observation and to test the effect of the intervention in the long term.
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Affiliation(s)
- G Jull
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Australia.
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Hordern M, Smith L, Beller E, Prins J, Marwick T, Coombes J. Effects of a short-term exercise intervention on insulin sensitivity in Type II Diabetes. J Sci Med Sport 2006. [DOI: 10.1016/j.jsams.2006.12.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bisset L, Paungmali A, Vicenzino B, Beller E. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med 2005; 39:411-22; discussion 411-22. [PMID: 15976161 PMCID: PMC1725258 DOI: 10.1136/bjsm.2004.016170] [Citation(s) in RCA: 210] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A systematic review of the literature on the effectiveness of physical interventions for lateral epicondylalgia (tennis elbow) was carried out. Seventy six randomised controlled trials were identified, 28 of which satisfied the minimum criteria for meta-analysis. The evidence suggests that extracorporeal shock wave therapy is not beneficial in the treatment of tennis elbow. There is a lack of evidence for the long term benefit of physical interventions in general. However, further research with long term follow up into manipulation and exercise as treatments is indicated.
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Affiliation(s)
- L Bisset
- Division of Physiotherapy, University of Queensland, St Lucia, QLD 4072, Australia
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Feng C, Beller E, Boyce J. Prostaglandin E2 inhibits cytokine production by human mast cells through EP2 and EP4 receptors. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Harvey JA, Bessell JR, Beller E, Thomas J, Gotley DC, Burmeister BH, Walpole ET, Thomson DB, Martin I, Doyle L, Burmeister E, Smithers BM. Chemoradiation therapy is effective for the palliative treatment of malignant dysphagia. Dis Esophagus 2004; 17:260-5. [PMID: 15361102 DOI: 10.1111/j.1442-2050.2004.00420.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Between 1993 and 2001, 106 patients with esophageal cancer were reviewed at a multidisciplinary clinic and treated with palliative intent by chemoradiation therapy. This study assesses the palliative benefit on dysphagia and documents the toxicity of this treatment. The study population comprised 72 men and 34 women with a median age of 69 years. Patients were treated with a median radiation dose of 35 Gy in 15 fractions with a concurrent single course of 5 FU-based chemotherapy. Dysphagia was measured at the beginning and completion of treatment and at monthly intervals until death, using a modified DeMeester (4-point) score. Treatment was well tolerated, with only 5% of patients failing to complete therapy. The treatment-related mortality was 6%. The median survival for the study population was 7 months. The median baseline score at presentation was 2 (difficulty with soft food). Following treatment, 49% of patients were assessed as having a dysphagia score of 0 (no dysphagia). Seventy-eight per cent had an improvement of at least one grade in their dysphagia score after treatment. Only 14% of patients showed no improvement with treatment. Fifty-one per cent maintained improved swallowing until the time of last follow-up or death. This single-institution study shows that chemoradiation therapy administered for the palliation of malignant dysphagia is well tolerated and produces a sustainable normalization in swallowing for almost half of all patients.
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Affiliation(s)
- J A Harvey
- Combined Upper Gastrointestinal Oncology Clinic, Princess Alexandra Hospital, Woolloongabba, Australia.
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Limpus A, Chaboyer WP, Purcell C, Schluter PJ, Gibbs H, Beller E, Hetherington R. Effect of body position and graduated compression stocking length on femoral venous blood flow velocity. Phlebology 2003. [DOI: 10.1258/026835503322598027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives: To measure the effect of graduated compression stocking (GCS) length and body position on peak femoral venous blood flow velocity (PVV) and vessel diameter (VD). Methods: Twenty healthy adult volunteers had PVV and VD measured, using colour Doppler ultrasound, at baseline in three body positions. Knee- or thigh-length GCS were assigned randomly.Arandom sequence of the three positions was used to measure PVV and VD. The procedure was repeated, after a two-hour washout period, using the other length GCS. Results: There was no significant difference in the mean change of PVV ( P =0.74) or VD ( P =0.54) measurements from the baseline between thigh- and knee-length GCS. However, significant mean changes in PVV ( P =0.02) and VD ( P <0.001) measurements were observed for the three body positions, after adjusting for baseline values. Conclusions: In healthy volunteers, thigh- and knee-length GCS do not have an effect on PVV or VD, and body position affects PVV significantly, with or without GCS.
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Miller O, Fong T, Keech A, Pigott N, Beller E, Celermajer D. Inhaled nitric oxide in the prevention of pulmonary hypertension after congenital heart surgery. Heart Lung Circ 2000. [DOI: 10.1046/j.1443-9506.2000.06152.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Miller OI, Tang SF, Keech A, Pigott NB, Beller E, Celermajer DS. Inhaled nitric oxide and prevention of pulmonary hypertension after congenital heart surgery: a randomised double-blind study. Lancet 2000; 356:1464-9. [PMID: 11081528 DOI: 10.1016/s0140-6736(00)02869-5] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pulmonary hypertensive crises (PHTC) are a major cause of morbidity and mortality after congenital heart surgery. Inhaled nitric oxide is frequently used as rescue therapy. We did a randomised double-blind study to investigate the role of routinely administered inhaled nitric oxide to prevent pulmonary hypertension in infants at high risk. METHODS We enrolled 124 infants (64 male, 60 female; median age 3 months [IQR 1-5]), 76% with large ventricular or atrioventricular septal defects, who had high pulmonary flow, pressure, or both, and were undergoing corrective surgery for congenital heart disease. They were randomly assigned continuous low-dose inhaled nitric oxide (n=63) or placebo (n=61) from surgery until just before extubation. We measured the numbers of PHTC, time on study gas, and hours spent in intensive care. Analysis was done by intention to treat. FINDINGS Compared with placebo, infants receiving inhaled nitric oxide had fewer PHTC (median four [IQR 0-12] vs seven [1-19]; relative risk, unadjusted 0.66, p<0.001, adjusted for dispersion 0.65, p=0.045) and shorter times until criteria for extubation were met (80 [38-121] vs 112 h [63-164], p=0.019). Time taken to wean infants off study gas was 35% longer in the nitric oxide group than in the placebo group (p=0.19), but the total time on the study gas was still 30 h shorter for the nitric oxide group (87 [43-125] vs 117 h [67-168], p=0.023). No important toxic effects arose. INTERPRETATION In infants at high risk of pulmonary hypertension, routine use of inhaled nitric oxide after congenital heart surgery can lessen the risk of pulmonary hypertensive crises and shorten the postoperative course, with no toxic effects.
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Affiliation(s)
- O I Miller
- Paediatric Intensive Care Unit, Royal Alexandra Hospital for Children, Sydney, Australia
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Dew J, Eden J, Beller E, Magarey C, Schwartz P, Crea P, Wren B. A cohort study of hormone replacement therapy given to women previously treated for breast cancer. Climacteric 1998; 1:137-42. [PMID: 11907916 DOI: 10.3109/13697139809085529] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED Women who have been previously treated for breast cancer are usually advised to avoid hormone therapy for fear of increasing their risk of tumor recurrence. However, for some women, menopausal symptoms are so severe that their quality of life is poor. Because ethic committees are reticent to permit a double-blind randomized trial, we performed a cohort study of hormone therapy after breast cancer. METHODS The study group comprised 1472 women with breast cancer. A total of 167 subjects had used an oral or transdermal estrogen after their treatment for breast cancer. Amongst these estrogen users, 152 (91%) had also used a progestin. In total, 106 other women had used a progestin alone as a treatment for menopausal flushes and not as a treatment for breast cancer. Cox regression analysis was performed using estrogen as a time-dependent covariate with disease-free interval as the outcome. RESULTS The uncorrected hazard ratio for the estrogen-progestin users was 0.67 (95% confidence interval (CI) 0.38-1.16) and for the progestin alone users was 0.85 (95% CI 0.44-1.65). CONCLUSIONS This study was unable to demonstrate a significant increase in risk of breast cancer recurrence for women who used HRT and suggests that the time is now appropriate for a randomized prospective trial of hormone therapy after breast cancer.
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Affiliation(s)
- J Dew
- Women's Health Institute, Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia
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Beller E, Tattersall M, Lumley T, Levi J, Dalley D, Olver I, Page J, Abdi E, Wynne C, Friedlander M, Boadle D, Wheeler H, Margrie S, Simes RJ. Improved quality of life with megestrol acetate in patients with endocrine-insensitive advanced cancer: a randomised placebo-controlled trial. Australasian Megestrol Acetate Cooperative Study Group. Ann Oncol 1997; 8:277-83. [PMID: 9137798 DOI: 10.1023/a:1008291825695] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To investigate the effect of two doses of megestrol acetate (MA) compared with placebo on quality of life (QoL) and nutritional status (NS) in patients with advanced endocrine-insensitive cancer. PATIENTS AND METHODS Two hundred forty patients were randomised to double-blind MA 480 mg/day, MA 160 mg/day, or matching placebo for 12 weeks. Nutritional status (including weight, skinfold thickness and midarm circumference) and QoL (using 6 linear analogue self-assessment (LASA) scales) were assessed at randomisation and after four, eight and 12 weeks. A QoL ranking incorporating QoL and death was also used ranging from 1 = dead to 5 = much better QoL. RESULTS One hundred seventy-four patients were assessable at week four, 136 at week eight and 103 patients at week 12. Patients receiving MA reported substantially better appetite (P = 0.001), mood (P = 0.001) and overall quality of life (P < 0.001), and possibly less nausea and vomiting (P = 0.08) than patients receiving placebo, based on a test for trend. A larger benefit was seen with the higher dose which (unlike the lower dose) was significantly better in pairwise comparisons with placebo for appetite, mood and overall QoL (each P < or = 0.001). Despite some missing data on QoL scores, QoL ranking was available on 227 (95%) of patients with significantly higher QoL ranking associated with MA (P = 0.002). Improvements in QoL occurred early within four weeks and were sustained. No statistically significant differences were observed in NS measurements, including weight (P = 0.29). Side effects of therapy were minor and did not differ significantly across treatments. CONCLUSION Megestrol acetate given at 480 mg/day is useful palliation in patients with endocrine-insensitive advanced cancer. It improves appetite, mood and overall quality of life in these patients, although not through a direct effect on nutritional status.
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Affiliation(s)
- E Beller
- NHMRC Clinical Trials Centre, University of Sydney, Australia
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15
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Qazi QH, Markouizos D, Rao C, Sheikh T, Beller E, Kula R. A syndrome of hypotonia, psychomotor retardation, seizures, delayed and dysharmonic skeletal maturation, and congenital fibre type disproportion. J Med Genet 1994; 31:405-9. [PMID: 8064821 PMCID: PMC1049875 DOI: 10.1136/jmg.31.5.405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Three unrelated Puerto Rican boys, ranging in age from 3 to 4 years, had marked, central, non-progressive hypotonia, chronic constipation, severe psychomotor retardation, seizures or abnormal electroencephalograph or both, abnormal dermatoglyphics, delayed bone age, dysharmonic skeletal maturation, and preponderance and larger size of type 2 muscle fibres. Additional findings included narrow, high arched palate, prominent nasal root, long philtrum, distended abdomen, and drooling from open mouth. Two of the three patients also had undescended testes, hypertelorism, and tapered fingers. Birth weight, postnatal physical growth, and head size were average. Family and gestational histories and laboratory evaluations were normal. The combination of features observed in the three boys appears to be distinct and to represent a new syndrome.
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Affiliation(s)
- Q H Qazi
- Department of Pediatrics, State University of New York Health Science Center at Brooklyn 11203
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Abstract
Common methods of treatment allocation for multi-centre and/or stratified randomized clinical trials can result in substantial differences between the number of patients allocated to each treatment arm. This can occur in the overall trial for a permuted block design or within individual institutions/strata when using a minimization scheme. This may lead to a bias in the result. Also, these procedures can be predictable, with the possibility of an investigator-introduced selection bias. An easily implemented method of randomization is proposed which attempts to overcome these problems by balancing treatment allocations both within strata and across the trial as a whole. The method keeps a running tally on total treatment allocation numbers at all stratification levels. When a patient accrues a hierarchical decision rule is applied, and the allocation is deterministic if certain pre-defined limits are exceeded, and random otherwise. The method is an extension of the big stick design of Soares and Wu, and is related to both Zelen's key number randomization methods and the schemes of Nordle and Brantmark. Simulation studies are used to demonstrate that major imbalances possible with other schemes do not occur using this method, and that the potential for selection bias is much reduced.
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Affiliation(s)
- D F Signorini
- NHMRC Clinical Trials Centre, University of Sydney, NSW, Australia
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Schwarzer AC, Arnold MH, Kelly D, Jones M, Beller E, McNaught PJ, Schrieber L, Brooks PM. The cycling of combination antirheumatic drug therapy in rheumatoid arthritis. Br J Rheumatol 1990; 29:445-50. [PMID: 2257452 DOI: 10.1093/rheumatology/29.6.445] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In this open pilot study a combination of hydroxychloroquine, prednisolone and alternating months of treatment with sulphasalazine or oral weekly pulse methotrexate has been investigated in 16 patients with rheumatoid arthritis (RA) refractory to a total of 67 disease suppressive medications. Results at 3 months indicated significant improvements in visual analogue score for pain, joint count, Ritchie index, scale of disability related to activities of daily living, ESR, rheumatoid factor and C-reactive protein. This degree of improvement, however, was not maintained 6 and 12 months after commencement of treatment. Pain score, Ritchie index and ESR were the only parameters demonstrating significant improvement at 12 months. Therapy was terminated in eight patients, half due to lack of efficacy and half because of side effects.
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Affiliation(s)
- A C Schwarzer
- Sydney University Department of Rheumatology, NSW, Australia
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Verma RS, Agarwal AK, Madahar CJ, Qazi QH, Mathews T, Rodriguez JG, Markouizos D, Beller E. Tandemly repeated DNA sequences of the centromere resulting in 18p+. Prenat Diagn 1989; 9:863-5. [PMID: 2626412 DOI: 10.1002/pd.1970091207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Holman S, Berthaud M, Sunderland A, Moroso G, Cancellieri F, Mendez H, Beller E, Marcel A. Women infected with human immunodeficiency virus: counseling and testing during pregnancy. Semin Perinatol 1989; 13:7-15. [PMID: 2919292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- S Holman
- Infectious Diseases, SUNY-Health Science Center, Brooklyn 11203
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Qazi QH, Mariano E, Milman DH, Beller E, Crombleholme W. Abnormalities in offspring associated with prenatal marihuana exposure. Dev Pharmacol Ther 1985; 8:141-8. [PMID: 3873327 DOI: 10.1159/000457031] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
5 newborn infants, whose mothers acknowledged steady use of marihuana prior to and during pregnancies, displayed symptoms of intrauterine growth retardation, neurological problems, and abnormal morphogenesis. These findings fit in with the experimental studies and surveys of pregnant human populations which have indicated that cannabis products have teratogenic potential, though rigorous proof must await further information.
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Collipp PJ, Gupta KK, Beller E. Achondroplasia: parental age. N Y State J Med 1976; 76:1810-1. [PMID: 1068354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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