Do CMIP5 models reproduce observed low-frequency North Atlantic jet variability?

The magnitude of observed multi‐decadal variations in the North Atlantic Oscillation (NAO) is at the upper end of the range simulated by climate models and a clear explanation for this remains elusive. Recent research shows that observed multi‐decadal NAO variability is more strongly associated with North Atlantic (NA) jet strength than latitude, thus motivating a comprehensive comparison of NA jet and NAO variability across the CMIP5 models. Our results show that the observed peak in multi‐decadal jet strength variability is even more unusual than NAO variability when compared to the model‐simulated range across 133 historical CMIP5 simulations. Some CMIP5 models appear capable of reproducing the observed low‐frequency peak in jet strength, but there are too few simulations of each model to clearly identify which. It is also found that an observed strong multi‐decadal correlation between jet strength and NAO since the mid‐19th century may be specific to this period

Advanced Renal Cell Cancer and Low-Dose Palliative Radiation Treatment: A Case of a Substantial and Sustained Treatment Response

Clear cell carcinoma is the most common form of renal cell carcinoma (RCC). Metastatic RCC is poorly responsive to treatment and has a bleak prognosis. Newer systemic agents have improved outcomes. Furthermore, their interaction with radiation treatment (RT) may provide further therapeutic options. RCC is considered to be radioresistant, however we report the case of a patient with progression on targeted therapy and immunotherapy who achieved a substantial and sustained local, and possibly abscopal, response to low dose palliative radiation therapy

Individual learning and building organisational capacity for development

Building capacities and capabilities for international development is an ongoing subject for debate, further fuelled by recent interest in learning and knowledge. This article focuses on how, and the extent to which, individual learners in education and training programmes for development policy and management interact with their organisations to build capacities and capabilities. It demonstrates some of the ways that individual learning and organisational capacity are linked by examining case studies from Uganda, Zimbabwe and South Africa. The article reflects on the complex nature of this interaction and on the broader challenges of linking learning to development. Copyright © 2006 John Wiley & Sons, Ltd

Evaluating the utility of knowledge-based planning for clinical trials using the TROG 08.03 post prostatectomy radiation therapy planning data

Background and purpose: Poor quality radiotherapy can detrimentally affect outcomes in clinical trials. Our purpose was to explore the potential of knowledge-based planning (KBP) for quality assurance (QA) in clinical trials. Materials and methods: Using 30 in-house post-prostatectomy radiation treatment (PPRT) plans, an iterative KBP model was created according to the multicentre clinical trial protocol, delivering 64 Gy in 32 fractions. KBP was used to replan 137 plans. The KB (knowledge based) plans were evaluated for their ability to fulfil the trial constraints and were compared against their corresponding original treatment plans (OTP). A second analysis between only the 72 inversely planned OTPs (IP-OTPs) and their corresponding KB plans was performed. Results: All dose constraints were met in 100% of KB plans versus 69% of OTPs. KB plans demonstrated significantly less variation in PTV coverage (Mean dose range: KB plans 64.1 Gy-65.1 Gy vs OTP 63.1 Gy-67.3 Gy, p \u3c 0.01). KBP resulted in significantly lower doses to OARs. Rectal V60Gy and V40Gy were 17.7% vs 27.7% (p \u3c 0.01) and 40.5% vs 53.9% (p \u3c 0.01) for KB plans and OTP respectively. Left femoral head (FH) V45Gy and V35Gy were 0.4% vs 7.4% (p \u3c 0.01) and 7.9% vs 34.9% (p \u3c 0.01) respectively. In the second analysis plan improvements were maintained. Conclusions: KBP created high quality PPRT plans using the data from a multicentre clinical trial in a single optimisation. It is a powerful tool for utilisation in clinical trials for patient specific QA, to reduce dose to surrounding OARs and variations in plan quality which could impact on clinical trial outcomes

Multimodality Treatment Improves Locoregional Control, Progression-Free and Overall Survival in Patients with Anaplastic Thyroid Cancer:A Retrospective Cohort Study Comparing Oncological Outcomes and Morbidity between Multimodality Treatment and Limited Treatment (May, 10.1245/s10434-021-10146-3, 2021)

Background: Patients with anaplastic thyroid cancer (ATC) have poor overall survival, and the optimal management approach remains unclear. The aim of this study is to evaluate our experience with multimodality (MMT) versus limited treatment (LT) for ATC. Patients and Methods: A cohort study of patients with ATC managed in a tertiary referral center was undertaken. The outcomes of MMT were compared with those of LT. The primary outcome measures were locoregional control and progression-free and overall survival. Secondary outcome measures were treatment-related complications and factors associated with improved survival. Results: In total, 59 patients (35 females) with a median age of 73 years (range 39-99 years) and ATC stage IVA (n = 2), IVB (n = 28), or IVC (n = 29) were included. LT was utilized in 25 patients (42%), and 34 cases had MMT. MMT patients had a longer time of locoregional control (18.5 versus 1.9 months; p < 0.001), progression-free survival (3.5 versus 1.2 months; p < 0.001), and overall survival (6.9 versus 2.0 months; p < 0.001) when compared with LT. For patients with stage IVC ATC, locoregional control (p = 0.03), progression-free survival (p < 0.001), and overall survival (p < 0.001) were superior in the MMT cohort compared with LT. MMT had more treatment-related complications than LT (p < 0.001). An Eastern Cooperative Oncology Group performance status < 2 (HR 0.30; p = 0.001) and MMT (HR 0.35; p = 0.008) were associated with improved overall survival. Conclusion: MMT is likely to improve locoregional control, progression-free survival, and overall survival in selected ATC patients including stage IVC tumors but comes with a greater complication risk

Multimodality Treatment Improves Locoregional Control, Progression-Free and Overall Survival in Patients with Anaplastic Thyroid Cancer:A Retrospective Cohort Study Comparing Oncological Outcomes and Morbidity between Multimodality Treatment and Limited Treatment

Background: Patients with anaplastic thyroid cancer (ATC) have poor overall survival, and the optimal management approach remains unclear. The aim of this study is to evaluate our experience with multimodality (MMT) versus limited treatment (LT) for ATC. Patients and Methods: A cohort study of patients with ATC managed in a tertiary referral center was undertaken. The outcomes of MMT were compared with those of LT. The primary outcome measures were locoregional control and progression-free and overall survival. Secondary outcome measures were treatment-related complications and factors associated with improved survival. Results: In total, 59 patients (35 females) with a median age of 73 years (range 39-99 years) and ATC stage IVA (n = 2), IVB (n = 28), or IVC (n = 29) were included. LT was utilized in 25 patients (42%), and 34 cases had MMT. MMT patients had a longer time of locoregional control (18.5 versus 1.9 months; p < 0.001), progression-free survival (3.5 versus 1.2 months; p < 0.001), and overall survival (6.9 versus 2.0 months; p < 0.001) when compared with LT. For patients with stage IVC ATC, locoregional control (p = 0.03), progression-free survival (p < 0.001), and overall survival (p < 0.001) were superior in the MMT cohort compared with LT. MMT had more treatment-related complications than LT (p < 0.001). An Eastern Cooperative Oncology Group performance status < 2 (HR 0.30; p = 0.001) and MMT (HR 0.35; p = 0.008) were associated with improved overall survival. Conclusion: MMT is likely to improve locoregional control, progression-free survival, and overall survival in selected ATC patients including stage IVC tumors but comes with a greater complication risk

Race at the margins: A Critical Race Theory perspective on race equality in UK planning.

Despite evidence of the growing ethnic diversity of British cities and its impact on urban governance, the issue of racial equality in UK planning remains marginal, at best, to mainstream planning activity. This paper uses Critical Race Theory (CRT) to consider the reasons why the ‘race’ and planning agenda continues to stall. CRT, it is argued, offers a compelling account of why changes in practice over time have been patchy at best, and have sometimes gone into reverse

Consistency and discrepancy in the atmospheric response to Arctic sea-ice loss across climate models

This is the author accepted manuscript. The final version is available from Springer Nature via the DOI in this recordThe decline of Arctic sea ice is an integral part of anthropogenic climate change. Sea-ice loss is already having a significant impact on Arctic communities and ecosystems. Its role as a cause of climate changes outside of the Arctic has also attracted much scientific interest. Evidence is mounting that Arctic sea-ice loss can affect weather and climate throughout the Northern Hemisphere. The remote impacts of Arctic sea-ice loss can only be properly represented using models that simulate interactions among the ocean, sea ice, land and atmosphere. A synthesis of six such experiments with different models shows consistent hemispheric-wide atmospheric warming, strongest in the mid-to-high-latitude lower troposphere; an intensification of the wintertime Aleutian Low and, in most cases, the Siberian High; a weakening of the Icelandic Low; and a reduction in strength and southward shift of the mid-latitude westerly winds in winter. The atmospheric circulation response seems to be sensitive to the magnitude and geographic pattern of sea-ice loss and, in some cases, to the background climate state. However, it is unclear whether current-generation climate models respond too weakly to sea-ice change. We advocate for coordinated experiments that use different models and observational constraints to quantify the climate response to Arctic sea-ice loss.J.A.S. and R.B. were funded by the Natural Environment Research Council (NE/P006760/1). C.D. acknowledges the National Science Foundation (NSF), which sponsors the National Center for Atmospheric Research. D.M.S. was supported by the Met Office Hadley Centre Climate Programme (GA01101) and the APPLICATE project, which is funded by the European Union’s Horizon 2020 programme. X.Z. was supported by the NSF (ARC#1023592). P.J.K. and K.E.M. were supported by the Canadian Sea Ice and Snow Evolution Network, which is funded by the Natural Science and Engineering Research Council of Canada. T.O. was funded by Environment and Climate Change Canada (GCXE17S038). L.S. was supported by the National Oceanic and Atmospheric Administration’s Climate Program Office