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.

Drag produced by trapped lee waves and propagating mountain waves in a two-layer atmosphere

The surface drag force produced by trapped lee waves and upward propagating waves in non-hydrostatic stratified flow over a mountain ridge is explicitly calculated using linear theory for a two-layer atmosphere with piecewise-constant static stability and wind speed profiles. The behaviour of the drag normalized by its hydrostatic single-layer reference value is investigated as a function of the ratio of the Scorer parameters in the two layers l_2/l_1 and of the corresponding dimensionless interface height l_1 H, for selected values of the dimensionless ridge width l_1 a and ratio of wind speeds in the two layers. When l_2/l_1 → 1, the propagating wave drag approaches 1 in approximately hydrostatic conditions, and the trapped lee wave drag vanishes. As l_2/l_1 decreases, the propagating wave drag progressively displays an oscillatory behaviour with l_1 H, with maxima of increasing magnitude due to constructive interference of reflected waves in the lower layer. The trapped lee wave drag shows localized maxima associated with each resonant trapped lee wave mode, occurring for small l_2/l_1 and slightly higher values of l_1 H than the propagating wave drag maxima. As l1a decreases, i.e. the flow becomes more non-hydrostatic, the propagating wave drag decreases and the regions of non-zero trapped lee wave drag extend to higher l_2/l_1. These results are confirmed by numerical simulations for l_2/l_1 = 0.2. In parameter ranges of meteorological relevance, the trapped lee wave drag may have a magnitude comparable to that of propagating wave drag, and be larger than the reference single-layer drag. This may have implications for drag parametrization in global climate and weather-prediction models.

Diviser, choisir et condenser: rubriques et illustrations du règne d'Uter et Pandragon dans le Merlin de Robert de Boron

La sélection opérée par les rubriques et les enluminures, formes contraintes qui échappent dans une certaine mesure à la linéarité du développement textuel, détermine la réception de l'œuvre. Les manuscrits comprenant des miniatures synthétiques (comme celles qui représentent l'enfance de Merlin) ou des séries iconographiques (comme celles qui rendent compte des amours d'Uterpandragon et Ygerne et de leurs conséquences) présentent donc un caractère exceptionnel, orientant la lecture du texte et son interprétation.

Construction impossible et défense improbable : la tour du roi Vertigier dans l'Historia Brittonum de Nennius, l'Historia Regum Britanniae de Geoffroy de Monmouth, le Brut de Wace et le Merlin de Robert de Boron

La question architecturale de l'impossibilité de l'usurpateur Vertigier à construire sa tour se double d'une réflexion politique et morale déterminante. La tour branlante est en effet à l'image du royaume déchiré de Grande Bretagne : elle emblématise l'instabilité politique et les affrontements militaires qui déterminent l'ascension illégitime puis la chute de ce mauvais roi.

Mixed copper, silver, and gold cyanides, (MxM′1–x)CN: tailoring chain structures to influence physical properties

Binary mixed-metal variants of the one-dimensional MCN compounds (M = Cu, Ag, and Au) have been prepared and characterized using powder X-ray diffraction, vibrational spectroscopy, and total neutron diffraction. A solid solution with the AgCN structure exists in the (CuxAg1–x)CN system over the range (0 ≤ x ≤ 1). Line phases with compositions (Cu1/2Au1/2)CN, (Cu7/12Au5/12)CN, (Cu2/3Au1/3)CN, and (Ag1/2Au1/2)CN, all of which have the AuCN structure, are found in the gold-containing systems. Infrared and Raman spectroscopies show that complete ordering of the type [M–C≡N–M′–N≡C−]n occurs only in (Cu1/2Au1/2)CN and (Ag1/2Au1/2)CN. The sense of the cyanide bonding was determined by total neutron diffraction to be [Ag–NC–Au–CN−]n in (Ag1/2Au1/2)CN and [Cu–NC–Au–CN−]n in (Cu1/2Au1/2)CN. In contrast, in (Cu0.50Ag0.50)CN, metal ordering is incomplete, and strict alternation of metals does not occur. However, there is a distinct preference (85%) for the N end of the cyanide ligand to be bonded to copper and for Ag–CN–Cu links to predominate. Contrary to expectation, aurophilic bonding does not appear to be the controlling factor which leads to (Cu1/2Au1/2)CN and (Ag1/2Au1/2)CN adopting the AuCN structure. The diffuse reflectance, photoluminescence, and 1-D negative thermal expansion (NTE) behaviors of all three systems are reported and compared with those of the parent cyanide compounds. The photophysical properties are strongly influenced both by the composition of the individual chains and by how such chains pack together. The NTE behavior is also controlled by structure type: the gold-containing mixed-metal cyanides with the AuCN structure show the smallest contraction along the chain length on heating.

Concentrations of free amino acids and sugars in nine potato varieties: effects of storage and relationship with acrylamide formation

Acrylamide forms during cooking and processing predominately from the reaction of free asparagine and reducing sugars in the Maillard reaction. The identification of low free asparagine and reducing sugar varieties of crops is therefore an important target. In this study, nine varieties of potato (French fry varieties Maris Piper (from two suppliers), Pentland Dell, King Edward, Daisy, and Markies; and chipping varieties Lady Claire, Lady Rosetta, Saturna, and Hermes) grown in the United Kingdom in 2009 were analyzed at monthly intervals through storage from November 2009 to July 2010. Acrylamide formation was measured in heated flour and chips fried in oil. Analysis of variance revealed significant interactions between varieties nested within type (French fry and chipping) and storage time for most free amino acids, glucose, fructose, and acrylamide formation. Acrylamide formed in chips correlated significantly with acrylamide formed in flour and with chip color. There were significant correlations between glucose or total reducing sugar concentration and acrylamide formation in both variety types, but with fructose the correlation was much stronger for chipping than for French fry varieties. Conversely, there were significant correlations with acrylamide formation for both total free amino acid and free asparagine concentration in the French fry but not chipping varieties. The study showed the potential of variety selection for preventing unacceptable levels of acrylamide formation in potato products and the variety-dependent effect of long-term storage on acrylamide risk. It also highlighted the complex relationship between precursor concentration and acrylamide risk in potatoes.

'A theatre of ruins'. Edward Bond & Samuel Beckett: theatrical antagonists

The playwright Edward Bond has long made known his antagonism to dramatists allied to Martin Esslin’s Theatre of the Absurd. The work of Samuel Beckett has come in for particular criticism by Bond. Using published writings (and unpublished correspondence between myself and Bond), I hope to trace the development of this antagonism between ‘Bondian’ and ‘Beckettian’ views of theatre. However, this article will also set out to argue that both early work such as The Pope’s Wedding (1962), and more recent work such as Coffee (1995), make use of motifs, characters and ideas from Beckett’s theatre. The article will set out provisional reasons why Bond, despite his misgivings, is not averse to incorporating elements from Beckett’s ‘theatre of ruins’, as he terms it, into his own work.

Edward Bond & the celebrity of exile

A shibboleth has grown up around the work of Edward Bond. The tag ‘controversial dramatist’ has continued to dog both the man and his work. This article will hope to explore some of the contradictory, and sometimes frustrating manifestations that such ‘celebrity’ has produced. Since the reception of The War Plays [1985] by the Royal Shakespeare Company at the National Theatre Bond has largely withdrawn his work from mainstream British theatre. Since the late 1990s he has looked to a new home – La Colline Theatre – in France, to premiere new work and run retrospective seasons of older plays. Here, Bond's celebrity is of a different kind, and has allowed him to enhance and develop his work as a playwright, director and writer about theatre. While this article draws on secondary sources it also uses material based on personal correspondence with Edward Bond.

Detecting insect pollinator declines on regional and global scales.

Recently there has been considerable concern about declines in bee communities in agricultural and natural habitats. The value of pollination to agriculture, provided primarily by bees, is >$200 billion/year worldwide, and in natural ecosystems it is thought to be even greater. However, no monitoring program exists to accurately detect declines in abundance of insect pollinators; thus, it is difficult to quantify the status of bee communities or estimate the extent of declines. We used data from 11 multiyear studies of bee communities to devise a program to monitor pollinators at regional, national, or international scales. In these studies, 7 different methods for sampling bees were used and bees were sampled on 3 different continents. We estimated that a monitoring program with 200–250 sampling locations each sampled twice over 5 years would provide sufficient power to detect small (2–5%) annual declines in the number of species and in total abundance and would cost U.S.$2,000,000. To detect declines as small as 1% annually over the same period would require >300 sampling locations. Given the role of pollinators in food security and ecosystem function, we recommend establishment of integrated regional and international monitoring programs to detect changes in pollinator communities.

Orographic drag associated with lee waves trapped at an inversion

The drag produced by 2D orographic gravity waves trapped at a temperature inversion and waves propagating in the stably stratified layer existing above are explicitly calculated using linear theory, for a two-layer atmosphere with neutral static stability near the surface, mimicking a well-mixed boundary layer. For realistic values of the flow parameters, trapped lee wave drag, which is given by a closed analytical expression, is comparable to propagating wave drag, especially in moderately to strongly non-hydrostatic conditions. In resonant flow, both drag components substantially exceed the single-layer hydrostatic drag estimate used in most parametrization schemes. Both drag components are optimally amplified for a relatively low-level inversion and Froude numbers Fr ≈ 1. While propagating wave drag is maximized for approximately hydrostatic flow, trapped lee wave drag is maximized for l_2 a = O(1) (where l_2 is the Scorer parameter in the stable layer and a is the mountain width). This roughly happens when the horizontal scale of trapped lee waves matches that of the mountain slope. The drag behavior as a function of Fr for l_2 H = 0.5 (where H is the inversion height) and different values of l2a shows good agreement with numerical simulations. Regions of parameter space with high trapped lee wave drag correlate reasonably well with those where lee wave rotors were found to occur in previous nonlinear numerical simulations including frictional effects. This suggests that trapped lee wave drag, besides giving a relevant contribution to low-level drag exerted on the atmosphere, may also be useful to diagnose lee rotor formation.

Toward vicarious calibration of microwave remote-sensing satellites in arid environments

The Soil Moisture and Ocean Salinity (SMOS) satellite marks the commencement of dedicated global surface soil moisture missions, and the first mission to make passive microwave observations at L-band. On-orbit calibration is an essential part of the instrument calibration strategy, but on-board beam-filling targets are not practical for such large apertures. Therefore, areas to serve as vicarious calibration targets need to be identified. Such sites can only be identified through field experiments including both in situ and airborne measurements. For this purpose, two field experiments were performed in central Australia. Three areas are studied as follows: 1) Lake Eyre, a typically dry salt lake; 2) Wirrangula Hill, with sparse vegetation and a dense cover of surface rock; and 3) Simpson Desert, characterized by dry sand dunes. Of those sites, only Wirrangula Hill and the Simpson Desert are found to be potentially suitable targets, as they have a spatial variation in brightness temperatures of <4 K under normal conditions. However, some limitations are observed for the Simpson Desert, where a bias of 15 K in vertical and 20 K in horizontal polarization exists between model predictions and observations, suggesting a lack of understanding of the underlying physics in this environment. Subsequent comparison with model predictions indicates a SMOS bias of 5 K in vertical and 11 K in horizontal polarization, and an unbiased root mean square difference of 10 K in both polarizations for Wirrangula Hill. Most importantly, the SMOS observations show that the brightness temperature evolution is dominated by regular seasonal patterns and that precipitation events have only little impact.

On the lack of stratospheric dynamical variability in low-top versions of the CMIP5 models

We describe the main differences in simulations of stratospheric climate and variability by models within the fifth Coupled Model Intercomparison Project (CMIP5) that have a model top above the stratopause and relatively fine stratospheric vertical resolution (high-top), and those that have a model top below the stratopause (low-top). Although the simulation of mean stratospheric climate by the two model ensembles is similar, the low-top model ensemble has very weak stratospheric variability on daily and interannual time scales. The frequency of major sudden stratospheric warming events is strongly underestimated by the low-top models with less than half the frequency of events observed in the reanalysis data and high-top models. The lack of stratospheric variability in the low-top models affects their stratosphere-troposphere coupling, resulting in short-lived anomalies in the Northern Annular Mode, which do not produce long-lasting tropospheric impacts, as seen in observations. The lack of stratospheric variability, however, does not appear to have any impact on the ability of the low-top models to reproduce past stratospheric temperature trends. We find little improvement in the simulation of decadal variability for the high-top models compared to the low-top, which is likely related to the fact that neither ensemble produces a realistic dynamical response to volcanic eruptions.