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.

(Non)differentiability and asymptotics for potential densities of subordinators

For subordinators with positive drift we extend recent results on the structure of the potential measures and the renewal densities. Applying Fourier analysis a new representation of the potential densities is derived from which we deduce asymptotic results and show how the atoms of the Lévy measure translate into points of (non)differentiability of the potential densities.

Botanising women : transmission, translation and European exchange

This issue of the Journal of Literature and Science is a special issue entitled ‘Women and Botany’ edited by Sam George and Alison E. Martin.

‘European strategists and European identity in the nuclear age’

European writers on strategy (in French: strategistes, as opposed to practitioners, stratèges) developed their thoughts on the best strategies and postures of nuclear deterrence against their own beliefs in the identities of their own countries - were they seen as "Europesn" or as "nation-states" who must under no condition surrender their sovereignty?

Soils and food security: challenges and opportunities

Soils most obviously contribute to food security in their essential role in crop and fodder production, so affecting the local availability of particular foods. They also have a direct influence on the ability to distribute food, the nutritional value of some foods and, in some societies, the access to certain foods through local processes of allocation and preferences. The inherent fertility of some soils is greater than that of others, so that crop yields vary greatly under semi-natural conditions. Husbandry practices, including the use of manures and fertilisers, have evolved to improve biological, chemical and physical components of soil fertility and thereby increase crop production. The challenge for the future is to sustain soil fertility in ways that increase the yield per unit area while simultaneously avoiding other detrimental environmental consequences. This will require increased effort to develop practices that use inputs such as nutrients, water and energy more efficiently. Opportunities to achieve this include adopting more effective ways to apply water and nutrients, adopting tillage practices that promote water infiltration and increase of organic matter, and breeding to improve the effectiveness of root systems in utilising soil-based resources.

Contribution of non-volatile and volatile compounds to the umami taste and overall flavour of shiitake mushroom extracts and their application as flavour enhancers in cooked minced meat

Aqueous extracts of dried shiitake mushrooms (Lentinus edodes) were prepared as taste and flavour enhancers for meat formulations. Effects of time and temperature on the chemical and sensory properties of the extracts were examined. Extracts prepared at 70 °C had significantly higher concentrations (p<0.001) of the savoury tasting 5’-ribonucleotides than those prepared at 22 °C but increasing the extraction time from 30 to 360 mins only increased their recovery slightly (p=0.053). In contrast, higher temperature extracts had considerably smaller concentrations of the major volatile compounds, such as lenthionine, 1-octen-3-ol, 1,3-dithiethane and dimethyl disulfide, because of loss through volatilisation. A sensory discrimination test showed that the lower temperature extract was perceived to have less umami taste than the higher temperature extract (p=0.048). Incorporating the 70 °C shiitake extract into minced meat formulations led to significantly higher levels of savoury tasting 5’-ribonucleotides in the cooked meat but no significant difference in umami perception.

Implications of climate change for diseases, crop yields and food security

Accelerated climate change affects components of complex biological interactions differentially, often causing changes that are difficult to predict. Crop yield and quality are affected by climate change directly, and indirectly, through diseases that themselves will change but remain important. These effects are difficult to dissect and model as their mechanistic bases are generally poorly understood. Nevertheless, a combination of integrated modelling from different disciplines and multi-factorial experimentation will advance our understanding and prioritisation of the challenges. Food security brings in additional socio-economic, geographical and political factors. Enhancing resilience to the effects of climate change is important for all these systems and functional diversity is one of the most effective targets for improved sustainability.

Developmental changes in the balance of disparity, blur and looming/proximity cues to drive ocular alignment and focus

Accurate co-ordination of accommodation and convergence is necessary to view near objects and develop fine motor co-ordination. We used a remote haploscopic videorefraction paradigm to measure longitudinal changes in simultaneous ocular accommodation and vergence to targets at different depths, and to all combinations of blur, binocular disparity, and change-in-size (“proximity”) cues. Infants were followed longitudinally and compared to older children and young adults, with the prediction that sensitivity to different cues would change during development. Mean infant responses to the most naturalistic condition were similar to those of adults from 6-7 weeks (accommodation) and 8-9 weeks (vergence). Proximity cues influenced responses most in infants less than 14 weeks of age, but sensitivity declined thereafter. Between 12-28 weeks of age infants were equally responsive to all three cues, while in older children and adults manipulation of disparity resulted in the greatest changes in response. Despite rapid development of visual acuity (thus increasing availability of blur cues), responses to blur were stable throughout development. Our results suggest that during much of infancy, vergence and accommodation responses are not dependent on the development of specific depth cues, but make use of any cues available to drive appropriate changes in response.

Diurnal warm-layer events in the western Mediterranean and European shelf seas

We characterize near-surface ocean diurnal warm-layer events, using satellite observations and fields from numerical weather forecasting. The study covers April to September, 2006, over the area 11°W to 17°E and 35°N to 57°N, with 0.1° cells. We use hourly satellite SSTs from which peak amplitudes of diurnal cycles in SST (dSSTs) can be estimated with error ∼0.3 K. The diurnal excursions of SST observed are spatially and temporally coherent. The largest dSSTs exceed 6 K, affect 0.01% of the surface, and are seen in the Mediterranean, North and Irish Seas. There is an anti-correlation between the magnitude and the horizontal length scale of dSST events. Events wherein dSST exceeds 4 K have length scales of ≤40 km. From the frequency distribution of different measures of wind-speed minima, we infer that extreme dSST maxima arise where conditions of low wind speed are sustained from early morning to mid afternoon.

A multimodel assessment of future projections of North Atlantic and European extratropical cyclones in the CMIP5 climate models

The response of North Atlantic and European extratropical cyclones to climate change is investigated in the climate models participating in phase 5 of the Coupled Model Intercomparison Project (CMIP5). In contrast to previous multimodel studies, a feature-tracking algorithm is here applied to separately quantify the re- sponses in the number, the wind intensity, and the precipitation intensity of extratropical cyclones. Moreover, a statistical framework is employed to formally assess the uncertainties in the multimodel projections. Under the midrange representative concentration pathway (RCP4.5) emission scenario, the December–February (DJF) response is characterized by a tripolar pattern over Europe, with an increase in the number of cyclones in central Europe and a decreased number in the Norwegian and Mediterranean Seas. The June–August (JJA) response is characterized by a reduction in the number of North Atlantic cyclones along the southern flank of the storm track. The total number of cyclones decreases in both DJF (24%) and JJA (22%). Classifying cyclones according to their intensity indicates a slight basinwide reduction in the number of cy- clones associated with strong winds, but an increase in those associated with strong precipitation. However, in DJF, a slight increase in the number and intensity of cyclones associated with strong wind speeds is found over the United Kingdom and central Europe. The results are confirmed under the high-emission RCP8.5 scenario, where the signals tend to be larger. The sources of uncertainty in these projections are discussed.

On SETAR non-linearity and forecasting

We compare linear autoregressive (AR) models and self-exciting threshold autoregressive (SETAR) models in terms of their point forecast performance, and their ability to characterize the uncertainty surrounding those forecasts, i.e. interval or density forecasts. A two-regime SETAR process is used as the data-generating process in an extensive set of Monte Carlo simulations, and we consider the discriminatory power of recently developed methods of forecast evaluation for different degrees of non-linearity. We find that the interval and density evaluation methods are unlikely to show the linear model to be deficient on samples of the size typical for macroeconomic data