NRG Oncology-Radiation Therapy Oncology Group Study 1014: 1-Year Toxicity Report From a Phase 2 Study of Repeat Breast-Preserving Surgery and 3-Dimensional Conformal Partial-Breast Reirradiation for In-Breast Recurrence.

PURPOSE: To determine the associated toxicity, tolerance, and safety of partial-breast reirradiation. METHODS AND MATERIALS: Eligibility criteria included in-breast recurrence occurring \u3e1 year after whole-breast irradiation, \u3c3 \u3ecm, unifocal, and resected with negative margins. Partial-breast reirradiation was targeted to the surgical cavity plus 1.5 cm; a prescription dose of 45 Gy in 1.5 Gy twice daily for 30 treatments was used. The primary objective was to evaluate the rate of grade ≥3 treatment-related skin, fibrosis, and/or breast pain adverse events (AEs), occurring ≤1 year from re-treatment completion. A rate of ≥13% for these AEs in a cohort of 55 patients was determined to be unacceptable (86% power, 1-sided α = 0.07). RESULTS: Between 2010 and 2013, 65 patients were accrued, and the first 55 eligible and with 1 year follow-up were analyzed. Median age was 68 years. Twenty-two patients had ductal carcinoma in situ, and 33 had invasive disease: 19 ≤1 cm, 13 \u3e1 to ≤2 cm, and 1 \u3e2 cm. All patients were clinically node negative. Systemic therapy was delivered in 51%. All treatment plans underwent quality review for contouring accuracy and dosimetric compliance. All treatment plans scored acceptable for tumor volume contouring and tumor volume dose-volume analysis. Only 4 (7%) scored unacceptable for organs at risk contouring and organs at risk dose-volume analysis. Treatment-related skin, fibrosis, and/or breast pain AEs were recorded as grade 1 in 64% and grade 2 in 7%, with only 1 ( CONCLUSION: Partial-breast reirradiation with 3-dimensional conformal radiation therapy after second lumpectomy for patients experiencing in-breast failures after whole-breast irradiation is safe and feasible, with acceptable treatment quality achieved. Skin, fibrosis, and breast pain toxicity was acceptable, and grade 3 toxicity was rare

Hydro‐isostatic deflection and tectonic tilting in the central Andes: Initial results of a GPS survey of Lake Minchin shorelines

Sufficiently large lake loads provide a means of probing rheological stratification of the crust and upper mantle. Lake Minchin was the largest of the late Pleistocene pluvial lakes in the central Andes. Prominent shorelines, which formed during temporary still‐stands in the climatically driven lake level history, preserve records of lateral variations in subsequent net vertical motions. At its maximum extent the lake was 140 m deep and spanned 400 km N‐S and 200 km E‐W. The load of surficial water contained in Lake Minchin was sufficient to depress the crust and underlying mantle by 20–40 m, depending on the subjacent rheology. Any other differential vertical motions will also be recorded as departures from horizontality of the shorelines. We recently conducted a survey of shoreline elevations of Lake Minchin with the express intent of monitoring the hydro‐isostatic deflection and tectonic tilting. Using real‐time differential GPS, we measured topographic profiles across suites of shorelines at 15 widely separated locations throughout the basin. Horizontal and vertical accuracies attained are roughly 30 and 70 cm, respectively. Geomorphic evidence suggests that the highest shoreline was occupied only briefly (probably less than 200 years) and radiocarbon dates on gastropod shells found in association with the shore deposits constrain the age to roughly 17 kyr. The basin‐wide pattern of elevations of the highest shoreline is composed of two distinct signals: (27±1) m of hydro‐isostatic deflection due to the lake load, and a planar tilt with east and north components of (6.8±0.4) 10⁻⁵ and (−5.3±0.3) 10⁻⁵. This rate of tilting is too high to be plausibly attributed to steady tectonism, and presumably reflects some unresolved combination of tectonism plus the effects of oceanic and lacustrine loads on a laterally heterogeneous substrate. The history of lake level fluctuations is still inadequately known to allow detailed inferences of crust and mantle rheology. However, it is already clear that the effective elastic plate thickness is closer to 40 km than the 60–70 km crustal thickness in the central Andes and the effective viscosity is less than 5 10²⁰ Pa s

Adapting the Marine Stewardship Council risk-based framework to estimate impacts on seabirds, marine mammals, marine turtles and sea snakes

Information available on impacts of fisheries on target or bycatch species varies greatly, requiring development of risk assessment tools to determine potentially unacceptable levels. Seabirds, marine mammals, marine turtles and sea snakes are particularly vulnerable given their extreme life histories, and data are often lacking on their populations or bycatch rates with which to quantify fisheries impacts. The Marine Stewardship Council (MSC) use a semi-quantitative Productivity Susceptibility Analysis (PSA) that is applicable to all species, target and non-target, to calculate risk of impact and to provide a score for relevant Performance Indicators for fisheries undertaking certification. The most recent MSC Fisheries Standard Review provided an opportunity to test the appropriateness of using this tool and whether it was sufficiently precautionary for seabirds, marine mammals and reptiles . The existing PSA was tested on a range of species and fisheries and reviewed in relation to literature on these species groups. New taxa-specific PSAs were produced and then reviewed by taxa-specific experts and other relevant stakeholders (e.g., assessors, fisheries managers, non-governmental conservation organizations). The conclusions of the Fishery Standard Review process were that the new taxa-specific PSAs were more appropriate than the existing PSA for assessing fisheries risk for seabirds, marine mammals and reptiles, and that, as intended, they resulted in precautionary outcomes. The taxa-specific PSAs provide useful tools for true data-deficient fisheries to assess relative risk of impact. Where some data are available, the MSC could consider developing or adapting other approaches to support robust and relevant risk assessments

Reading and Ownership

First paragraph: ‘It is as easy to make sweeping statements about reading tastes as to indict a nation, and as pointless.’ This jocular remark by a librarian made in the Times in 1952 sums up the dangers and difficulties of writing the history of reading. As a field of study in the humanities it is still in its infancy and encompasses a range of different methodologies and theoretical approaches. Historians of reading are not solely interested in what people read, but also turn their attention to the why, where and how of the reading experience. Reading can be solitary, silent, secret, surreptitious; it can be oral, educative, enforced, or assertive of a collective identity. For what purposes are individuals reading? How do they actually use books and other textual material? What are the physical environments and spaces of reading? What social, educational, technological, commercial, legal, or ideological contexts underpin reading practices? Finding answers to these questions is compounded by the difficulty of locating and interpreting evidence. As Mary Hammond points out, ‘most reading acts in history remain unrecorded, unmarked or forgotten’. Available sources are wide but inchoate: diaries, letters and autobiographies; personal and oral testimonies; marginalia; and records of societies and reading groups all lend themselves more to the case-study approach than the historical survey. Statistics offer analysable data but have the effect of producing identikits rather than actual human beings. The twenty-first century affords further possibilities, and challenges, with its traces of digital reader activity, but the map is ever-changing

Schoolbooks and textbook publishing.

In this chapter the author looks at the history of schoolbooks and textbook publishing. The nineteenth century saw a rise in the school book market in Britain due to the rise of formal schooling and public examinations. Although the 1870 Education and 1872 (Scotland) Education Acts made elementary education compulsory for childern between 5-13 years old, it was not until the end of the First World War that some sort form of secondary education became compulsory for all children

Bangladesh : Areas Liable to Famine

Scale 1:500,000. 1 map : color ; 119 x 96.5 cm, on sheet 127 x 102 cm. Includes 11 inset maps, notes and diagram. Inset: "Some remedial policies for the components of famine liability." "A project for the Ministry of Relief and Rehabilitation, Government of Bangladesh; supported by the United States of America, Agency for International Development; implemented by the Johns Hopkins University, International Center for Medical Research. Presently: Consultant, Food Systems Group, Resource Systems Institute, East-West Center, Honolulu, Hawaii.

Strategic Directions for Vulnerability Analysis and Mapping in the 21st Century: Examples from Bangladesh

The beginning of the 21st century provides a suitable milestone to review lessons from the past and set a new course for the future of Vulnerability Analysis and Mapping(VAM) for the World Food Programme (WFP) and its Partners. The new strategy outlined below maximises the opportunities provided by the WFP Policy Document, 'Enabling Development' (119) and WFP’s emphasis on 'Intergenerational Hunger' in 'The Hunger Trap'(110). This new strategy seeks to 'leapfrog' the new VAM Unit in WFP Bangladesh from its early lead in vulnerability analysis and mapping a quarter century ago, to a new analytical level in support of WFP’s Bangladesh Country Strategy Outline 2001-2005 (117). In so doing it seeks to lay out some strategic directions for new VAM units in other WFP country programs. In the past WFP VAM in Rome and other Country Offices have borrowed from, and then gone beyond, the Bangladesh experience. As this document seeks to support a ten year development plan for the ultra poor, this VAM strategy should enable other VAM units internationally to support country strategies beyond 2005. This strategy document is developed upon: (i) the experience of vulnerable women living in high risk marginal areas; (ii) the institutional analysis of VAM Bangladesh, from the progressive staff of the WFP Bangladesh Country Office, and (iii) the author's 25 years of experience of vulnerability analysis and mapping in Asia and Africa. The SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis of WFP-VAM Bangladesh forming Part II of this strategy document revealed the need for a radical rethinking of the road ahead. Incrementalism from the progress at the end of the 20th Century will not be sufficient to meet the challenges of VAM with accelerated globalisation in the 21st century.bangladesh