Renal cell cancer:Nurses' role in prevention and management

In both the UK and throughout Europe, more patients are presenting with renal cell cancer (RCC), also known as renal cell carcinoma or kidney cancer. The overall survival rate varies depending on tumour grade, nodal involvement and metastasis. For those with metastasis survival drops to 10%. This article explores the risk factors associated with RCC diagnosis and staging, treatments including drugs and procedures and the role of the nurse in diagnosis and accurate assessment. Nurses are ideally suited to consider the physical, functional, social, and emotional status of their patients In addition, it is essential that the nurse has an understanding of new pharmaceutical therapies, which have been licensed to treat RCC, and a sound knowledge of the possible side effects and nursing management associated with these drugs.

The Pan-STARRS Moving Object Processing System

We describe the Pan-STARRS Moving Object Processing System (MOPS), a modern software package that produces automatic asteroid discoveries and identifications from catalogs of transient detections from next-generation astronomical survey telescopes. MOPS achieves >99.5% efficiency in producing orbits from a synthetic but realistic population of asteroids whose measurements were simulated for a Pan-STARRS4-class telescope. Additionally, using a nonphysical grid population, we demonstrate that MOPS can detect populations of currently unknown objects such as interstellar asteroids. MOPS has been adapted successfully to the prototype Pan-STARRS1 telescope despite differences in expected false detection rates, fill-factor loss, and relatively sparse observing cadence compared to a hypothetical Pan-STARRS4 telescope and survey. MOPS remains highly efficient at detecting objects but drops to 80% efficiency at producing orbits. This loss is primarily due to configurable MOPS processing limits that are not yet tuned for the Pan-STARRS1 mission. The core MOPS software package is the product of more than 15 person-years of software development and incorporates countless additional years of effort in third-party software to perform lower-level functions such as spatial searching or orbit determination. We describe the high-level design of MOPS and essential subcomponents, the suitability of MOPS for other survey programs, and suggest a road map for future MOPS development.

The chronostratigraphy of the Haua Fteah cave (Cyrenaica, northeast Libya)

The 1950s excavations by Charles McBurney in the Haua Fteah, a large karstic cave on the coast of northeast Libya, revealed a deep sequence of human occupation. Most subsequent research on North African prehistory refers to his discoveries and interpretations, but the chronology of its archaeological and geological sequences has been based on very early age determinations. This paper reports on the initial results of a comprehensive multi-method dating program undertaken as part of new work at the site, involving radiocarbon dating of charcoal, land snails and marine shell, cryptotephra investigations, optically stimulated luminescence (OSL) dating of sediments, and electron spin resonance (ESR) dating of tooth enamel. The dating samples were collected from the newly exposed and cleaned faces of the upper 7.5m of the ~14.0m-deep McBurney trench, which contain six of the seven major cultural phases that he identified. Despite problems of sediment transport and reworking, using a Bayesian statistical model the new dating program establishes a robust framework for the five major lithostratigraphic units identified in the stratigraphic succession, and for the major cultural units. The age of two anatomically modern human mandibles found by McBurney in Layer XXXIII near the base of his Levalloiso-Mousterian phase can now be estimated to between 73 and 65ka (thousands of years ago) at the 95.4% confidence level, within Marine Isotope Stage (MIS) 4. McBurney's Layer XXV, associated with Upper Palaeolithic Dabban blade industries, has a clear stratigraphic relationship with Campanian Ignimbrite tephra. Microlithic Oranian technologies developed following the climax of the Last Glacial Maximum and the more microlithic Capsian in the Younger Dryas. Neolithic pottery and perhaps domestic livestock were used in the cave from the mid Holocene but there is no certain evidence for plant cultivation until the Graeco-Roman period. © 2013 Elsevier Ltd.

Tephrochronology and the extended intimate (integration of ice‐core, marine and terrestrial records) event stratigraphy 8-128kab2k

The comparison of palaeoclimate records on their own independent timescales is central to the work of the INTIMATE (INTegrating Ice core, MArine and TErrestrial records) network. For the North Atlantic region, an event stratigraphy has been established from the high-precision Greenland ice-core records and the integrated GICC05 chronology. This stratotype provides a palaeoclimate signal to which the timing and nature of palaeoenvironmental change recorded in marine and terrestrial archives can be compared. To facilitate this wider comparison, without assuming synchroneity of climatic change/proxy response, INTIMATE has also focussed on the development of tools to achieve this. In particular the use of time-parallel marker horizons e.g. tephra layers (volcanic ash). Coupled with the recent temporal extension of the Greenland stratotype, as part of this special issue, we present an updated INTIMATE event stratigraphy highlighting key tephra horizons used for correlation across Europe and the North Atlantic. We discuss the advantages of such an approach, and the key challenges for the further integration of terrestrial palaeoenvironmental records with those from ice cores and the marine realm.

Impact of composite ply continuity constraints on aerospace stiffened panel design

Considering the development of aerospace composite components, designing for reduced manufacturing layup cost and structural complexity is increasingly important. While the advantage of composite materials is the ability to tailor designs to various structural loads for minimum mass, the challenge is obtaining a design that is manufacturable and minimizes local ply incompatibility. The focus of the presented research is understanding how the relationships between mass, manufacturability and design complexity, under realistic loads and design requirements, can be affected by enforcing ply continuity in the design process. Presented are a series of sizing case studies on an upper wing cover, designed using conventional analyses and the tabular laminate design process. Introducing skin ply continuity constraints can generate skin designs with minimal ply discontinuities, fewer ply drops and larger ply areas than designs not constrained for continuity. However, the reduced design freedom associated with the addition of these constraints results in a weight penalty over the total wing cover. Perhaps more interestingly, when considering manual hand layup the reduced design complexity is not translated into a reduced recurring manufacturing cost. In contrast, heavier wing cover designs appear to take more time to layup regardless of the laminate design complexity. © 2012 AIAA.

Investigating the dynamics of laser induced sparks in atmospheric helium using Rayleigh and Thomson scattering

We have used optical Rayleigh and Thomson scattering to investigate the expansion dynamics of laser induced plasma in atmospheric helium and to map its electron parameters both in time and space. The plasma is created using 9 ns duration, 140 mJ pulses from a Nd:YAG laser operating at 1064 nm, focused with a 10 cm focal length lens, and probed with 7 ns, 80 mJ, and 532 nm Nd:YAG laser pulses. Between 0.4 μs and 22.5 μs after breakdown, the electron density decreases from 3.3 × 1017 cm−3 to 9 × 1013 cm−3, while the temperature drops from 3.2 eV to 0.1 eV. Spatially resolved Thomson scattering data recorded up to 17.5 μs reveal that during this time the laser induced plasma expands at a rate given by R ∼ t0.4 consistent with a non-radiative spherical blast wave. This data also indicate the development of a toroidal structure in the lateral profile of both electron temperature and density. Rayleigh scattering data show that the gas density decreases in the center of the expanding plasma with a central scattering peak reemerging after about 12 μs. We have utilized a zero dimensional kinetic global model to identify the dominant particle species versus delay time and this indicates that metastable helium and the He2 + molecular ion play an important role.

Latanoprost for open-angle glaucoma (UKGTS): a randomised, multicentre, placebo-controlled trial

Background
Treatments for open-angle glaucoma aim to prevent vision loss through lowering of intraocular pressure, but to our knowledge no placebo-controlled trials have assessed visual function preservation, and the observation periods of previous (unmasked) trials have typically been at least 5 years. We assessed vision preservation in patients given latanoprost compared with those given placebo.

Methods
In this randomised, triple-masked, placebo-controlled trial, we enrolled patients with newly diagnosed open-angle glaucoma at ten UK centres (tertiary referral centres, teaching hospitals, and district general hospitals). Eligible patients were randomly allocated (1:1) with a website-generated randomisation schedule, stratified by centre and with a permuted block design, to receive either latanoprost 0·005% (intervention group) or placebo (control group) eye drops. Drops were administered from identical bottles, once a day, to both eyes. The primary outcome was time to visual field deterioration within 24 months. Analyses were done in all individuals with follow-up data. The Data and Safety Monitoring Committee (DSMC) recommended stopping the trial on Jan 6, 2011 (last patient visit July, 2011), after an interim analysis, and suggested a change in primary outcome from the difference in proportions of patients with incident progression between groups to time to visual field deterioration within 24 months. This trial is registered, number ISRCTN96423140.

Findings
We enrolled 516 individuals between Dec 1, 2006, and March 16, 2010. Baseline mean intraocular pressure was 19·6 mm Hg (SD 4·6) in 258 patients in the latanoprost group and 20·1 mm Hg (4·8) in 258 controls. At 24 months, mean reduction in intraocular pressure was 3·8 mm Hg (4·0) in 231 patients assessed in the latanoprost group and 0·9 mm Hg (3·8) in 230 patients assessed in the placebo group. Visual field preservation was significantly longer in the latanoprost group than in the placebo group: adjusted hazard ratio (HR) 0·44 (95% CI 0·28–0·69; p=0·0003). We noted 18 serious adverse events, none attributable to the study drug.

Interpretation
This is the first randomised placebo-controlled trial to show preservation of the visual field with an intraocular-pressure-lowering drug in patients with open-angle glaucoma. The study design enabled significant differences in vision to be assessed in a relatively short observation period

Ultracold, radiative charge transfer in hybrid Yb ion – Rb atom traps

Ultracold hybrid ion–atom traps offer the possibility of microscopic manipulation of quantum coherences in the gas using the ion as a probe. However, inelastic processes, particularly charge transfer can be a significant process of ion loss and has been measured experimentally for the ${\rm Y}{{{\rm b}}^{+}}$ ion immersed in a Rb vapour. We use first-principles quantum chemistry codes to obtain the potential energy curves and dipole moments for the lowest-lying energy states of this complex. Calculations for the radiative decay processes cross sections and rate coefficients are presented for the total decay processes; ${\rm Y}{{{\rm b}}^{+}}(6{\rm s}{{\;}^{2}}{\rm S})+{\rm Rb}(5{\rm s}{{\;}^{2}}{\rm S})\to {\rm Yb}(6{{{\rm s}}^{2}}{{\;}^{1}}{\rm S})+{\rm R}{{{\rm b}}^{+}}(4{{{\rm p}}^{6}}{{\;}^{1}}{\rm S})+h\nu $ and ${\rm Y}{{{\rm b}}^{+}}(6{\rm s}{{\;}^{2}}{\rm S})+{\rm Rb}(5{\rm s}{{\;}^{2}}{\rm S})\to {\rm YbR}{{{\rm b}}^{+}}({{X}^{1}}{{\Sigma }^{+}})+h\nu $. Comparing the semi-classical Langevin approximation with the quantum approach, we find it provides a very good estimate of the background at higher energies. The results demonstrate that radiative decay mechanisms are important over the energy and temperature region considered. In fact, the Langevin process of ion–atom collisions dominates cold ion–atom collisions. For spin-dependent processes [1] the anisotropic magnetic dipole–dipole interaction and the second-order spin–orbit coupling can play important roles, inducing coupling between the spin and the orbital motion. They measured the spin-relaxing collision rate to be approximately five orders of magnitude higher than the charge-exchange collision rate [1]. Regarding the measured radiative charge transfer collision rate, we find that our calculation is in very good agreement with experiment and with previous calculations. Nonetheless, we find no broad resonances features that might underly a strong isotope effect. In conclusion, we find, in agreement with previous theory that the isotope anomaly observed in experiment remains an open question.

The Cyrenaican Prehistory Project 2012: the sixth season of excavations in the Haua Fteah cave

The paper reports on the sixth season of fieldwork of the Cyrenaican Prehistory Project (CPP) undertaken in September 2012. As in the spring 2012 season, work focussed on the Haua Fteah cave and on studies of materials excavated in previous seasons, with no fieldwork undertaken elsewhere in the Gebel Akhdar. An important discovery, in a sounding excavated below the base of McBurney's 1955 Deep Sounding (Trench S), is of a rockfall or roof collapse conceivably dating to the cold climatic regime of Marine Isotope Stage (MIS) 6 (globally dated to c. 190-130 ka) but more likely the result of a seismic event within MIS 5 (globally dated to c. 130-80 ka). The sediments and associated molluscan fauna in Trench S and in Trench D, a trench being cut down the side of the Deep Sounding, indicate that this part of the cave was at least seasonally waterlogged during the accumulation, probably during MIS 5, of the -6.5 rn of sediment cut through by the Deep Sounding. Evidence for human fréquentation of the cave in this period is more or less visible depending on how close the trench area was to standing water as it fluctuated through time. Trench M, the trench being cut down the side of McBurney's Middle Trench, has now reached the depth of the latest Middle Stone Age or Middle Palaeolithic (Levalloiso-Mousterian) industries. The preliminary indications from its excavation are that the transition from the Levalloiso-Mousterian to the blade-based Upper Palaeolithic or Late Stone Age Dabban industry was complex and perhaps protracted, at a time when the climate was oscillating between warmstage stable environmental conditions and colder and more arid environments. The estimated age of the sediments, c. 50-40 ka, places these oscillations within the earlier part of MIS 3 (globally dated to 60-24 ka), when global climates experienced rapid fluctuations as part of an overall trend to increasing aridity and cold.

Oscar Wilde at Home

Oscar, Constance, Speranza (and Bosie) are “at home” in the exquisitely beautiful Florence Court House this Mayday weekend. House guests will include Jack, Algy, Gwendolen and Cecily from the Importance of Being Earnest, (not to mention the redoubtable Lady Bracknell), Lord and Lady Windermere, the impetuous Lord Darlington, and the precocious Dorian Gray. Visitors will be conducted throughout the house where a range of short scenes from Wilde’s most popular works will be performed live by actors in each of the principal rooms. Is it life or is it art? Come and decide for yourself as we welcome you to the witty, complex and contradictory world of Oscar Wilde. Conceived and directed by David Grant.

Dramatis Personae
Oscar Wilde (and Lord Henry Wotton) – Donal Morgan
Constance Wilde (Lady Wotton, and Cecily Cardew) – Julie Lamberton
Lady Speranza Wilde (Lady Bracknell and Mrs Erlynne) – Antoinette Morelli
Lord Alfred Douglas (and Dorian Gray) – Sydney Bull
Lord Darlington and Basil Hallward – Richard Croxford
Lady Windermere and Gwendolen Fairfax – Stephanie Dale
Jack Worthing – Patrick McBrearty
Algernon Moncrieff and Lord Windermere – Stefan Dunbar
Lane and Parker – Curtis Reed and tbc

Production Team
Costume Design – Enda Kenny
Sound Design – Sydney Bull
Sound Operator – Seth Taylor
Stage Manager – Bronagh McFeely
Company Manager – Eamon Quinn
Director – David Grant

A Lightweight Tool for Anomaly Detection in Cloud Data Centres

Cloud data centres are critical business infrastructures and the fastest growing service providers. Detecting anomalies in Cloud data centre operation is vital. Given the vast complexity of the data centre system software stack, applications and workloads, anomaly detection is a challenging endeavour. Current tools for detecting anomalies often use machine learning techniques, application instance behaviours or system metrics distribu- tion, which are complex to implement in Cloud computing environments as they require training, access to application-level data and complex processing. This paper presents LADT, a lightweight anomaly detection tool for Cloud data centres that uses rigorous correlation of system metrics, implemented by an efficient corre- lation algorithm without need for training or complex infrastructure set up. LADT is based on the hypothesis that, in an anomaly-free system, metrics from data centre host nodes and virtual machines (VMs) are strongly correlated. An anomaly is detected whenever correlation drops below a threshold value. We demonstrate and evaluate LADT using a Cloud environment, where it shows that the hosting node I/O operations per second (IOPS) are strongly correlated with the aggregated virtual machine IOPS, but this correlation vanishes when an application stresses the disk, indicating a node-level anomaly.

Topical antihistamines and mast cell stabilisers for treating seasonal and perennial allergic conjunctivitis

BACKGROUND: Seasonal/perennial allergic conjunctivitis is the most common allergic conjunctivitis, usually with acute manifestations when a person is exposed to allergens and with typical signs and symptoms including itching, redness, and tearing. The clinical signs and symptoms of allergic conjunctivitis are mediated by the release of histamine by mast cells. Histamine antagonists (also called antihistamines) inhibit the action of histamine by blocking histamine H1 receptors, antagonising the vasoconstrictor, and to a lesser extent, the vasodilator effects of histamine. Mast cell stabilisers inhibit degranulation and consequently the release of histamine by interrupting the normal chain of intracellular signals. Topical treatments include eye drops with antihistamines, mast cell stabilisers, non-steroidal anti-inflammatory drugs, combinations of the previous treatments, and corticosteroids. Standard treatment is based on topical antihistamines alone or topical mast cell stabilisers alone or a combination of treatments. There is clinical uncertainty about the relative efficacy and safety of topical treatment.

OBJECTIVES: The objective of this review was to assess the effects of topical antihistamines and mast cell stabilisers, alone or in combination, for use in treating seasonal and perennial allergic conjunctivitis.

SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2014, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to July 2014), EMBASE (January 1980 to July 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 17 July 2014. We also searched the reference lists of review articles and relevant trial reports for details of further relevant publications.

SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing topical antihistamine and mast cell stabilisers, alone or in combination, with placebo, no treatment or to any other antihistamine or mast cell stabiliser, or both, that examined people with seasonal or perennial allergic conjunctivitis, or both. The primary outcome was any participant-reported evaluation (by questionnaire) of severity of four main ocular symptoms: itching, irritation, watering eye (tearing), and photophobia (dislike of light), both separately and, if possible, by an overall symptom score. We considered any follow-up time between one week and one year.

DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed risk of bias. Disagreements were resolved by discussion among review authors and the involvement of a third review author. We followed standard methodological approaches used by Cochrane.

MAIN RESULTS: We identified 30 trials with a total of 4344 participants randomised, with 17 different drugs or treatment comparisons. The following antihistamines and mast cell stabilisers were evaluated in at least one RCT: nedocromil sodium or sodium cromoglycate, olopatadine, ketotifen, azelastine, emedastine, levocabastine (or levocabastine), mequitazine, bepotastine besilate, combination of antazoline and tetryzoline, combination of levocabastine and pemirolast potassium. The most common comparison was azelastine versus placebo (nine studies).We observed a large variability in reporting outcomes. The quality of the studies and reporting was variable, but overall the risk of bias was low. Trials evaluated only short-term effects, with a range of treatment of one to eight weeks. Meta-analysis was only possible in one comparison (olopatadine versus ketotifen). There was some evidence to support that topical antihistamines and mast cell stabilisers reduce symptoms and signs of seasonal allergic conjunctivitis when compared with placebo. There were no reported serious adverse events related to the use of topical antihistamine and mast cell stabilisers treatment.

AUTHORS' CONCLUSIONS: It seems that all reported topical antihistamines and mast cell stabilisers reduce symptoms and signs of seasonal allergic conjunctivitis when compared with placebo in the short term. However, there is no long-term data on their efficacy. Direct comparisons of different antihistamines and mast cell stabilisers need to be interpreted with caution. Overall, topical antihistamines and mast cell stabilisers appear to be safe and well tolerated. We observed a large variability in outcomes reported. Poor quality of reporting challenged the synthesis of evidence.

Effect of contact pressure on fretting fatigue behavior of Ti-1023

With a new test facility, we have investigated fretting fatigue properties of Ti-1023 titanium alloy at different contact pressure. Both fatigue fracture and fretting scar were analyzed by scanning electron microscopy (SEM). Moreover, the depth of crack initiation area in fatigue fracture has been analyzed quantitatively, to investigate the relationship between the depth of crack initiation area and the fretting fatigue strength. The changing trends of the depth of crack initiation area and fretting fatigue strength with the increase of contact pressure show obvious opposite correlations. The depth of crack initiation area increases rapidly with the increase of contact pressure at low contact pressure (smaller than 10 MPa), and the fretting fatigue strength drops rapidly. At the contact pressure of 10–45 MPa, both the depth of crack initiation area and the fretting fatigue strength do not vary significantly. Contact pressure influences fatigue strength through influencing the initiation of fatigue crack. The main damage patterns are fatigue flake and plow.

A Gendered Profession

A Gendered Profession, RIBA Publications, Oct 2016

For a profession that claims to be so concerned with the needs of society, the continuing gender imbalance in architectural education and practice is a difficult subject. Difficult, because it’s been stagnant for some thirty years. This book seeks to change that.
Beyond the profession, the emergence of fourth wave feminism has broken a twenty-year drought in the discourse[1]. A new generation of feminist critique is emerging, characterised by a broader civic commitment, one fuelled by the recognition that time and again, women and minorities have been the first casualties of neo-liberalism.
Whereas after World War II the architectural profession rallied around its obligation to fulfil a social need, today architecture has all but capitulated its absolute servitude to capitalism. Recognising that feminist thinking is a meaningful response to the inequalities of capitalism, A Gendered Profession will be a forum for a discussion about the failure of our profession – one that is so explicitly concerned with the design of inclusive environments – to resolve its own inequalities. Contributions have been sought and responses elicited from all corners of the discipline to propose strategies, attitudes and solutions to this crisis in representation.
At stake is more than just the lack of female representation. Male architects suffer from the same ingrained mechanisms of gender stereotyping, obliged to place professional commitments above those to their family and children. And while three quarters of lesbian, gay, bisexual and transsexual architects report being comfortable about being open about their sexuality in the workplace, that number drops to just sixteen per cent when on the building site.
A Gendered Profession will aim to perform a diagnostic check of the architecture profession from one end of the spectrum to the other. Whereas much has been written on feminism and architecture, the majority is produced exclusively by women. A Gendered Profession has worked hard towards gender parity in both its contributions and editorial structure and therefore does not limit its understanding of gender to an either/or analogue. The chapters featured in the book are written by artists, academics, practitioners and students.
Through its diverse authorship, this book will provide the first ever attempt to move the debate beyond the tradition of gender-partitioned diagnostic or merely critical discourse on the gender and wider inclusivity debate towards something more propositional, actionable and transformative.