Effect of patient age on management decisions in breast cancer: consensus from a national consultation

This qualitative study investigated the attitudes, perceptions, and practices of breast cancer specialists with reference to the effect of patient age on management decisions in breast cancer, and attempted to identify national consensus on this issue. One hundred thirty-three relevant specialists, including 75 surgeons and 43 oncologists, participated in a virtual consultation using e-mailed questionnaires and open-ended discussion documents, culminating in the development of proposed consensus statements sent to participants for validation. A strong consensus was seen in favor of incorporating minimum standards of diagnostic services, treatment, and care for older patients with breast cancer into relevant national guidance, endorsed by professional bodies. Similarly, an overwhelming majority of participants agreed that simple, evidence-based protocols or guidelines on standardizing assessment of biological and chronological age should be produced by the National Institute for Health and Clinical Excellence and the Scottish Medicines Consortium, developed in collaboration with specialist oncogeriatricians, and endorsed by professional bodies. A further recommendation that all breast cancer patient treatment and diagnostic procedures be undertaken in light of up-to-date, relevant scientific data met with majority support. This study was successful in gauging national specialist opinion regarding the effect of patient age on management decisions in breast cancer in the U.K.

Management of elderly patients with breast cancer: updated recommendations of the International Society of Geriatric Oncology (SIOG) and European Society of Breast Cancer Specialists (EUSOMA)

As the mean age of the global population increases, breast cancer in older individuals will be increasingly encountered in clinical practice. Management decisions should not be based on age alone. Establishing recommendations for management of older individuals with breast cancer is challenging because of very limited level 1 evidence in this heterogeneous population. In 2007, the International Society of Geriatric Oncology (SIOG) created a task force to provide evidence-based recommendations for the management of breast cancer in elderly individuals. In 2010, a multidisciplinary SIOG and European Society of Breast Cancer Specialists (EUSOMA) task force gathered to expand and update the 2007 recommendations. The recommendations were expanded to include geriatric assessment, competing causes of mortality, ductal carcinoma in situ, drug safety and compliance, patient preferences, barriers to treatment, and male breast cancer. Recommendations were updated for screening, primary endocrine therapy, surgery, radiotherapy, neoadjuvant and adjuvant systemic therapy, and metastatic breast cancer.

Immunoassays, methods for carrying out immunoassays, immunoassay kits and method for manufacturing immunoassay kits

The invention relates to immunoassays, methods for carrying out immunoassays, immunoassay kits and methods for manufacturing immunoassay kits. In particular, the invention has relevance to capillary (especially microcapillary) immunoassay technology.

The role of the international cocoa germplasm database and the international cocoa quarantine centre in information management and distribution of cocoa genetic resources

A range of physiological parameters (canopy light transmission, canopy shape, leaf size, flowering and flushing intensity) were measured from the International Clone Trial, typically over the course of two years. Data were collected from six locations, these being: Brazil, Ecuador, Trinidad, Venezuela, Côte d’Ivoire and Ghana. Canopy shape varied significantly between clones, although it showed little variation between locations. Genotypic variation in leaf size was differentially affected by the growth location; such differences appeared to underlie a genotype by environment interaction in relation to canopy light transmission. Flushing data were recorded at monthly intervals over the course of a year. Within each location, a significant interaction was observed between genotype and time of year, suggesting that some genotypes respond to a greater extent than others to environmental stimuli. A similar interaction was observed for flowering data, where significant correlations were found between flowering intensity and temperature in Brazil and flowering intensity and rainfall in Côte d’Ivoire. The results demonstrate the need for local evaluation of cocoa clones and also suggest that the management practices for particular planting material may need to be fine-tuned to the location in which they are cultivated.

Investigating global tropical cyclone activity with a hierarchy of AGCMs: the role of model resolution

The ability to run General Circulation Models (GCMs) at ever-higher horizontal resolutions has meant that tropical cyclone simulations are increasingly credible. A hierarchy of atmosphere-only GCMs, based on the Hadley Centre Global Environmental Model (HadGEM1), with horizontal resolution increasing from approximately 270km to 60km (at 50N), is used to systematically investigate the impact of spatial resolution on the simulation of global tropical cyclone activity, independent of model formulation. Tropical cyclones are extracted from ensemble simulations and reanalyses of comparable resolutions using a feature-tracking algorithm. Resolution is critical for simulating storm intensity and convergence to observed storm intensities is not achieved with the model hierarchy. Resolution is less critical for simulating the annual number of tropical cyclones and their geographical distribution, which are well captured at resolutions of 135km or higher, particularly for Northern Hemisphere basins. Simulating the interannual variability of storm occurrence requires resolutions of 100km or higher; however, the level of skill is basin dependent. Higher resolution GCMs are increasingly able to capture the interannual variability of the large-scale environmental conditions that contribute to tropical cyclogenesis. Different environmental factors contribute to the interannual variability of tropical cyclones in the different basins: in the North Atlantic basin the vertical wind shear, potential intensity and low-level absolute vorticity are dominant, while in the North Pacific basins mid-level relative humidity and low-level absolute vorticity are dominant. Model resolution is crucial for a realistic simulation of tropical cyclone behaviour, and high-resolution GCMs are found to be valuable tools for investigating the global location and frequency of tropical cyclones.

Importance of oceanic resolution and mean state on the extra-tropical response to El Niño in a matrix of coupled models

The extra-tropical response to El Niño in configurations of a coupled model with increased horizontal resolution in the oceanic component is shown to be more realistic than in configurations with a low resolution oceanic component. This general conclusion is independent of the atmospheric resolution. Resolving small-scale processes in the ocean produces a more realistic oceanic mean state, with a reduced cold tongue bias, which in turn allows the atmospheric model component to be forced more realistically. A realistic atmospheric basic state is critical in order to represent Rossby wave propagation in response to El Niño, and hence the extra-tropical response to El Niño. Through the use of high and low resolution configurations of the forced atmospheric-only model component we show that, in isolation, atmospheric resolution does not significantly affect the simulation of the extra-tropical response to El Niño. It is demonstrated, through perturbations to the SST forcing of the atmospheric model component, that biases in the climatological SST field typical of coupled model configurations with low oceanic resolution can account for the erroneous atmospheric basic state seen in these coupled model configurations. These results highlight the importance of resolving small-scale oceanic processes in producing a realistic large-scale mean climate in coupled models, and suggest that it might may be possible to “squeeze out” valuable extra performance from coupled models through increases to oceanic resolution alone.

The short- and long-term fitness consequences of natal dispersal in a wild bird population

Dispersal is a key process in population and evolutionary ecology. Individual decisions are affected by fitness consequences of dispersal, but these are difficult to measure in wild populations. A long-term dataset on a geographically closed bird population, the Mauritius kestrel, offers a rare opportunity to explore fitness consequences. Females dispersed further when the availability of local breeding sites was limited, whereas male dispersal correlated with phenotypic traits. Female but not male fitness was lower when they dispersed longer distances compared to settling close to home. These results suggest a cost of dispersal in females. We found evidence of both short- and long-term fitness consequences of natal dispersal in females, including reduced fecundity in early life and more rapid aging in later life. Taken together, our results indicate that dispersal in early life might shape life history strategies in wild populations.

Realism of rainfall in a very high-resolution regional climate model

The realistic representation of rainfall on the local scale in climate models remains a key challenge. Realism encompasses the full spatial and temporal structure of rainfall, and is a key indicator of model skill in representing the underlying processes. In particular, if rainfall is more realistic in a climate model, there is greater confidence in its projections of future change. In this study, the realism of rainfall in a very high-resolution (1.5 km) regional climate model (RCM) is compared to a coarser-resolution 12-km RCM. This is the first time a convection-permitting model has been run for an extended period (1989–2008) over a region of the United Kingdom, allowing the characteristics of rainfall to be evaluated in a climatological sense. In particular, the duration and spatial extent of hourly rainfall across the southern United Kingdom is examined, with a key focus on heavy rainfall. Rainfall in the 1.5-km RCM is found to be much more realistic than in the 12-km RCM. In the 12-km RCM, heavy rain events are not heavy enough, and tend to be too persistent and widespread. While the 1.5-km model does have a tendency for heavy rain to be too intense, it still gives a much better representation of its duration and spatial extent. Long-standing problems in climate models, such as the tendency for too much persistent light rain and errors in the diurnal cycle, are also considerably reduced in the 1.5-km RCM. Biases in the 12-km RCM appear to be linked to deficiencies in the representation of convection.

Briefing: re-engineering the city 2020–2050 – urban foresight and transition management

Cities may be responsible for up to 70% of global carbon emissions and 75% of global energy consumption and by 2050 it is estimated that 70% of the world's population could live in cities. The critical challenge for contemporary urbanism, therefore, is to understand how to develop the knowledge, capacity and capability for public agencies, the private sector and multiple users in city regions systemically to re-engineer their built environment and urban infrastructure in response to climate change and resource constraints. Re-Engineering the City 2020–2050: Urban Foresight and Transition Management (Retrofit 2050) is a major new interdisciplinary project funded under the Engineering and Physical Science Research Council's (EPSRC) Sustainable Urban Environments Programme which seeks to address this challenge. This briefing describes the background and conceptual framing of Retrofit 2050 project, its aims and objectives and research approach.

Genome-wide association mapping to candidate polymorphism resolution in the unsequenced barley genome

Although commonplace in human disease genetics, genome-wide association (GWA) studies have only relatively recently been applied to plants. Using 32 phenotypes in the inbreeding crop barley, we report GWA mapping of 15 morphological traits across ∼500 cultivars genotyped with 1,536 SNPs. In contrast to the majority of human GWA studies, we observe high levels of linkage disequilibrium within and between chromosomes. Despite this, GWA analysis readily detected common alleles of high penetrance. To investigate the potential of combining GWA mapping with comparative analysis to resolve traits to candidate polymorphism level in unsequenced genomes, we fine-mapped a selected phenotype (anthocyanin pigmentation) within a 140-kb interval containing three genes. Of these, resequencing the putative anthocyanin pathway gene HvbHLH1 identified a deletion resulting in a premature stop codon upstream of the basic helix-loop-helix domain, which was diagnostic for lack of anthocyanin in our association and biparental mapping populations. The methodology described here is transferable to species with limited genomic resources, providing a paradigm for reducing the threshold of map-based cloning in unsequenced crops.

Volatile isoprenoid emissions from plastid to planet

Approximately 1–2% of net primary production by land plants is re-emitted to the atmosphere as isoprene and monoterpenes. These emissions play major roles in atmospheric chemistry and air pollution–climate interactions. Phenomenological models have been developed to predict their emission rates, but limited understanding of the function and regulation of these emissions has led to large uncertainties in model projections of air quality and greenhouse gas concentrations. We synthesize recent advances in diverse fields, from cell physiology to atmospheric remote sensing, and use this information to propose a simple conceptual model of volatile isoprenoid emission based on regulation of metabolism in the chloroplast. This may provide a robust foundation for scaling up emissions from the cellular to the global scale.