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Saturday, February 16, 2019
Predicting climate change
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Gas Shortages Give New York an Early Taste of the Green New Deal
From The GWPF Date: 2/16/19 The state is dependent on imports even though it sits atop the abundant Marcellus Shale. The combination of hydraulic fracturing and horizontal drilling—sometimes known as the "shale revolution"—has enabled Texas, Pennsylvania and other states to produce record quantities of natural gas, some of which is being frozen, loaded onto giant…
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It’s The Oceans, Stupid!
By Paul Homewood
https://www.ospo.noaa.gov/Products/ocean/sst/anomaly/index.html
Climate experts tell us that the oceans are warning rapidly, as a result of GHGs.
Perhaps they might explain how their little theory accounts for the large areas of ocean which show long term cooling.
If there is one thing we know about oceans, it is that they store such enormous amounts of energy that their temperatures cannot change at the flick of a switch.
Whatever forces are going on in the oceans, they are dwarfing any microscopic effects from atmospheric warming.
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Hard Core Linux / Tech Vids
Some technical videos from the Linuxconf.au folks in New Zealand Continue reading →
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UK Thought Crime Wave!
It would seem that in the UK, it is against the law to offend someone. Like that's gonna work out well. Continue reading →
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Legal Experts Accuse New York Climate Crusaders Of Overstepping The Law
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THE GREEN NEW DEAL ISN’T JUST ABOUT ENERGY, IT’S ALSO ABOUT CONTROLLING WHAT AMERICANS EAT
http://bit.ly/2IrXKRs By MICHAEL BASTASCH he Green New Deal seems to embrace the anti-beef and dairy industry sentiment of the environmental left. Green New Dealers want to remake American society, including how produce and eat food. "I think it's pretty clear they want to change people's consumption habits," said one economist. The Green New Deal isn't just [...]
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Minnesota’s Solar Pathway
By Paul Homewood
A reader sent me this recent study, claiming to show how a high level of wind and solar generation could be integrated into Minnesota's grid.
http://mnsolarpathways.org/spa/#finding1
Its main finding was that solar and wind could supply 70% of Minnesota's electricity by 2050, and at a cost comparable to natural gas:
I was expecting some technically sophisticated solutions, but there is actually very little new in it.
Having said that though, the authors have developed a clever toolkit for analysing hourly generation and demand patterns, to test out various scenarios.
But to put the above numbers into perspective, we need to look at Minnesota's current demand load:
Below is Figure 8 from the report. Ignore the red line for the moment, it is the black line which denotes demand:
What we see is that for most of the year, demand hovers around 10 GW, except for summer, presumably when air con kicks in. Even in summer, it only occasionally gets anywhere near 15 GW.
This raises an interesting question right away – what do Minnesotans do for heating in winter? I presume most must use gas or oil. If Minnesota wants to do away with fossil fuels, how will they replace these from the electrical grid, particularly when solar generation peaks in summer?
Now let's look again at that earlier chart:
Relying on so much wind and solar only works by retaining enough standby capacity from reliable sources to cover virtually all of the demand profile.
The summer time peaks can be catered for, because of the higher solar generation then. Night time demand in summer is partly met battery storage.
There is however another aspect to note. To get to the 70% solar/wind target, the plan calls for massive overengineering of solar and wind capacity, so that even on calm, winter days there is still a reasonable amount of generation. The plan calls this "Additional Capacity"
This however causes a fresh set of problems. For much of the time, solar and wind generation will be much more than total demand. So what do you do with the surplus?
The answer is to throw it away, or as the plan calls it "curtail".
Of course, if you don't use all of the generation from wind and solar, the unit cost of what you do use rises considerably. Optimistically, the plan says this is still economical, because wind and solar will be so cheap by then.
I remember hearing similarly optimistic claims about nuclear power in the 1950s!
In fact, the plan assumes massive cost reductions from current costs, down to a level of $20/MWh. And it is on these cost assumptions that they claim solar and wind can match the cost of new gas generation. Without such reductions, the whole plan falls apart.
Whether such reductions are feasible in the long run, I have no idea. But the whole question is immaterial anyway.
If the costs come down sufficiently by 2050, the market will take over. Generators will quickly react by building solar and wind farms, if it is economic for them to do so.
What you most definitely don't do is start working towards a new power mix on the basis that costs might fall in the future.
In summary then, Minnesota can only run on a high level of wind and solar power if it retains on standby enough dispatchable power to supply demand at all but peak periods.
And it can only run the system economically as long as the cost of wind and solar power falls drastically from current levels.
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FRACK’S LACKING BACKING
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FAZ Commentary: Germany Caught Up In Climate Protection Zeal… “Illusion It Can Rescue Planet”
German flagship daily Frankfurter Allgemeine Zeitung (FAZ) publisher Holger Steltzner wrote in an online commentary that the rescue of the global climate" has turned into a religious movement for "a large portion of German society".
In his commentary, Steltzner remarks that even questioning the hundreds of billions spent thus far with hardly any progress in CO2 reductions to show is enough to get yourself branded as a heretic.
Freedom of dissent under attack
The FAZ publisher also questions the branding skeptics of manmade global warming as "climate deniers", thus comparing them to Holocaust-deniers. He wonders: "Is this just the thoughtless use of language that abuses the historical break with civilization of the Shoah through banalization?"
Dissent over climate science in Germany is harshly scorned and the media and science community do not tolerate it.
In his commentary Steltzner reminds that man is in fact just one component in the complex climate system where huge natural factors are at play, and that the vast majority of skeptics do not even deny the climatic changes taking place today and how they are just as concerned about the environment as anyone else is.
Communist central planning
The trained business finance specialist and FAZ publisher writes that the German Energiewende (transition to renewable energies) has led to "price distortions, threatened grid stability and the writing off of modern power plants" and is accurately characterized as "eco-central planning".
Causing more environmental harm than good
And what is even worse is that the Energiewende is likely causing more environmental harm than good. For example forests are being cleared to make way for the industrialization of the country's once idyllic landscape, destroying biotopes with it. Stelzner adds that many Germans are filling up their cars with fuel that is 10% bio-fuel – which in turn leads to orangutans being shot dead so hat palm oil plantations can operate in places like Indonesia.
And according to Steltzer: "One fifth of Germany's agricultural land is used for growing bio fuels."
Another example of Germans trying to ease their conscience is the consumption of tofu in place of meat. He writes: "But weren't there rainforests in Brazil, where today one soy plantation follows the next?"
Other examples Steltzner cites are avocado plantations in Mexico or the lithium-ion battery "which is supposed to save the climate, and whose raw material extraction in Africa, Russia or South America is devastating entire regions."
"Illusion, religious zeal"
Steltzner also comments that it seems that environmental organizations have taken a page from the Vatican playbook, where in the past "believers could even acquire letters of indulgence for deceased people in order to wipe out sin penalties in purgatory."
"Today the purchase of carbon dioxide certificates protects you from being plagued by a bad conscience while shopping in London," Steltzner comments.
Though he perceives climate change as a real challenge, Steltzner summarizes by calling on Germany to "abandon the illusion that it can rescue the planet" and that "climate protection must not be driven with religious zeal".
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Weekend Unthreaded
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‘Climate swamp’: ‘Green New Deal’ accepts ‘climate junk science’ & seeks decarbonization as national policy
http://bit.ly/2T19uih Why the Green New Deal Uses a Particularly Expensive Approach to Not Achieving Its Environmental Objectives By Alan Carlin | February 15, 2019 The Democratic Party continues to rush ever further into the climate swamp. The left wing of the party accepts climate junk science and now wants to implement rapid decarbonization as [...]
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House Democrat counters Trump with resolution declaring climate change a national emergency
https://washex.am/2X9bCTZ by Josh Siegel Democratic Rep. Earl Blumenauer of Oregon said Friday he intends to introduce a resolution declaring climate change a national emergency. Blumenauer, who has endorsed the progressive Green New Deal resolution and is active on environmental and renewable energy issues, circulated a letter to colleagues Friday seeking support for a resolution that [...]
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Australian Met Office Accused Of Man-Made Climate Change
By Paul Homewood
Graham Lloyd has picked up on the story that the Australian BOM have rewritten Australia's temperature records for the second time in six years, and once again the rate of warming has conveniently increased.
One of the most aspects is that the BOM quietly introduced these changes last October , without announcing them:
Rather than the nation's temperature having increased by 1C over the past century, the bureau's updated homogenised data set, known as ACORN-SAT, now shows mean temperatures have risen by 1.23C.
Bureau data shows the rate of mean warming since 1960 has risen to 0.2C a decade, putting the more ambitious IPCC target of limiting future warming to 1.5C close to being broken.
Homogenisation of temperature records is considered necessary to account for changes in instrumentation, changes in site locations and changes in the time at which temperatures were taken. But the bureau's treatment of historical data has been controversial. In recent years there have been claims that the organisation was treating temperature records in such a way that left it exposed to accusations that ideological pursuits had trumped good scientific practice.
Former prime minister Tony Abbott unsuccessfully pushed for a forensic investigation into the bureau's methods.
A number of reviews of the bureau's network equipment and its temperature data handling have been carried out. A technical panel found the homogenisation methods used were largely sound.
But a key recommendation, to include confidence levels or error margins in the data, remains unfulfilled. A BoM spokesman said work was under way on a number of scientific papers looking at uncertainty and confidence intervals for temperature data observations, adjustments and national averages.
"This work will be made available to the public following thorough peer review," the spokesman said.
The bureau had fiercely defended the accuracy of its original ACORN-SAT data. But more recent analysis, including the removal of rounding errors, has effectively increased the rate of warming by 23 per cent, compared with the earlier homogenised ACORN version-one data.
Detailed technical information on the ACORN-SAT update was published late last year, but there has been no public announcement of the revised data, which is now considered the official national average temperature record. A bureau review of the homogenised data said the new version had "increased robustness and greater spatial coherence".
The updating of the ACORN-SAT data coincided with the release last October of a new version of US weather agency NOAA's global land temperature data set.
A bureau spokesman said ACORN-SAT version two was the bureau's "improved official homogeneous temperature data set". The new data set benefited from "the numerous scientific and technological advances which have occurred over the past six years, as well as the insights and recommendations from an independent ACORN-SAT technical advisory forum".
"It also contains new data which was not previously available when the bureau developed the first data set," he said.
The bureau said the updates had been independently peer-reviewed, and the findings were that the methodology was "rigorous and reliable".
Scientist Jennifer Marohasy said that while version two of the data had used the same set of 112 stations as had been used in version one, the data had been remodelled relative to the raw data and also relative to the remodelled version one.
The bureau said the data in version two was subjected to two rounds of homogenisation, as had been the case with version one. "In total, 22 of the 966 adjustments applied in version two of the ACORN-SAT data set arose from this second-round procedure," the bureau said.
A technical analysis of ACORN-SAT 2 by the bureau said 1910-2016 trends in Australian temperature were about 0.02C a decade higher than those found in version one. It said rounding errors in version one accounted for much of the new trend.
Dr Marohasy said the bureau had not explained how it could have generated a 23 per cent increase in the rate of warming, just through updating the official ACORN-SAT record.
The maximum-temperature trend from 1910 to 2016 at the 112 ACORN-SAT weather stations is now an increase of 0.116C a decade. It was 0.09C a decade in the earlier homogenised data.
The minimum-temperature trend is now an increase of 0.13C a decade, compared with 0.109C in ACORN-SAT 1.
The bureau said improved accounting for the widespread relocation of sites out of towns during the 1990s and 2000s, and the incorporation of recent data from new sites, were also substantial contributors.
Dr Marohasy said movement of sites was meant to be part of the adjustments made in the first version of the data.
"The incorporation of data from new sites may account for some of the 23 per cent increase," Dr Marohasy said, "because the bureau have opened new sites in hotter western NSW, while closing higher-altitude weather stations, including Charlotte Pass in the Snowy Mountains."
https://www.thegwpf.com/australian-met-office-accused-of-man-made-climate-change-again/
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This Week In Doom — Opioid Marketing Edition
Item Accused NY Murderer Gets Charge Dropped Thanks To New Infanticide Law
But part of the new infanticide law that Governor Andrew Cuomo just signed "removes abortion from the state's criminal code and puts it into public health law." This was the stated reason the District Attorney gave for dropping the second charge.
Demons exist, and the matriarchy must be taken down.
Key Points
Question To what extent is pharmaceutical industry marketing of opioids to physicians associated with subsequent mortality from prescription opioid overdoses?
Findings In this population-based, cross-sectional study, $39.7 million in opioid marketing was targeted to 67?507 physicians across 2208 US counties between August 1, 2013, and December 31, 2015. Increased county-level opioid marketing was associated with elevated overdose mortality 1 year later, an association mediated by opioid prescribing rates; per capita, the number of marketing interactions with physicians demonstrated a stronger association with mortality than the dollar value of marketing.
Now I don't buy their analysis, which is the result of an over-complex unnecessary statistical model ("adjustment for county-level sociodemographic factors…" etc.) which relies on wee p-values for confirmation.
We don't need the model, because it is obvious the ads work. If the ads pushing docs to prescribe certain meds didn't work, they'd stop running the ads. As the study says, they're expensive (the ads).
What's more important is that this paper is almost admitting the ask-your-doctor-if-this-drug-is-right-for-you advertising works, too.
I was at an Internal Medicine conference once and this was the subject of some eminent speaker. I asked about these kinds of ads and the possibility of over-prescribing and he dismissed the idea completely. Apparently (some) doctors don't like admitting patient desire can sway their treatment decisions at this level.
Here, this looks like a paper lawyers who are suing over an opiod-caused death will use to ask docs "Did you ever see this ad? Did it influence you?"
Item Harvard's Clear Identity: How Kristina Olson's TransYouth Project is overturning expectations about gender
In the United States, the importance of a child'; sex seems a given. Parents-to-be consider whether or not to find out if their baby is a boy or a girl, and often the first words spoken after the birth are "It's a girl!" or "It's a boy!" Children who identify differently are thought to be confused or oppositional. Olson has found that the reverse is true.
Olson is satanic. As is Harvard, a place of evil. Do not let your children go there.
A man is planning to sue his parents in India for giving birth to him 'without his consent'.
Raphael Samuel said he had a 'great relationship' with his parents but has compared having children to 'kidnapping and slavery'.
The 27-year-old from Mumbai is an 'anti-natalist' who believes it is wrong to put an unwilling child through the 'rigmarole' of life for the pleasure of its parents.
The anti-natalist movement is gaining traction in India as younger people resist social pressure to have children.
You have to hand it to this guy. Inventing a new form of insanity in such a crowded field is no small achievement.
Item State bill would outlaw Confederate displays on public [and private?] property
New legislation in Georgia would outlaw any symbols, monuments, memorials or other dedications to the Confederacy on public property.
Under HB 175, the only exception to the ban would be at museums, Civil War battlefields, 11Alive reported.
Even flying a Confederate battle flag on private property might be outlawed.
The bill would also make it illegal to display symbols of the Confederacy at a residence, store, place of business, public building or school. That law includes inside or outside those buildings.
It will be like the Confederacy never even existed. The past must become the future!
There are already denial laws , why not acknowledgement laws?
One of Oxford University's oldest degrees is to be overhauled in bid to boost number of female students getting top grades.
Classics dons who marked last year's exam papers said the gender gap is "very troubling", adding that it must be addressed as a matter of "urgency".
More than double the number of men were awarded first class honours in their Finals last year than women, with 46.8 per cent of men achieving the top grade compared to 12.5 per cent of their female peers.
Academics noted that the gender gap in Finals – which was "already very noticeable" – had "dramatically increased" in the most recent cohort of students due to an a record number of men taking Firsts.
Meanwhile, in second…
As we have discovered multitudinous times, Diversity and Equality always lead to a lowering of standings. Absolutely always.
We may now suspect the women being given degrees are not as good as the men, whereas before mandatory quotas, we could not make that assumption.
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Australian Met Office accused of man-made climate change (again)
This approach to data seems par for the course in climatology, as they strive ever more to make the world look warmer than before, in order to prop up the failing theory of human-caused trace gases ruining the world.
Source: The Global Warming Policy Forum (GWPF)
The Bureau of Meteorology has rewritten Australia's temperature records for the second time in six years, greatly increasing the rate of warming since 1910 in its controversial homogenised data set, writes Graham Lloyd in The Australian.
Rather than the nation's temperature having increased by 1C over the past century, the bureau's updated homogenised data set, known as ACORN-SAT, now shows mean temperatures have risen by 1.23C.
Bureau data shows the rate of mean warming since 1960 has risen to 0.2C a decade, putting the more ambitious IPCC target of limiting future warming to 1.5C close to being broken.
Homogenisation of temperature records is considered necessary to account for changes in instrumentation, changes in site locations and changes in the time at which temperatures were taken.
But the bureau's treatment of historical data has been controversial. In recent years there have been claims that the organisation was treating temperature records in such a way that left it exposed to accusations that ideological pursuits had trumped good scientific practice.
Continued here.
Related: Jennifer Marohasy – Bureau Rewrites History – Again, at Albany
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Study: how the Little Ice Age impacted parts of Australia
Queensland, Australia
The cause(s) of the Little Ice Age is (are) uncertain, but Wikipedia puts forward some ideas with varying degrees of plausibility, including 'inherent variability in global climate' (indeed), and 'decreases in the human population' (what?). Now some interesting evidence of it has been found in Australia.
A study by University of Adelaide researchers and Queensland Government scientists has revealed what south-east Queensland's rainfall was like over the last 7000 years – including several severe droughts worse and longer lasting than the 12-year Millennium Drought, reports Phys.org.
The study – published in Scientific Reports—used preserved paper-bark tea tree leaves from North Stradbroke Island's Swallow Lagoon that have been collecting in the sediment for the past 7700 years.
The leaves – analysed for chemical variation—provided a wealth of information on the El Niño-Southern Oscillation (ENSO) and how it was impacted by major climate changes over the millennia, including the Little Ice Age from about 1450 to 1850.
Researchers found a generally wet period about 5000 to 6000 years ago – indicating a more consistent La Niña-like climate.
"This changed to a more variable and increasingly drier climate about 3000 years ago – highlighting a strengthened El Niño phase," says Associate Professor John Tibby from the University of Adelaide's Geography Department.
"There were substantial droughts during this phase, drier than the Millennium Drought which south-east Australia experienced from 1997-2009. In fact, from what we can ascertain, the probability of a drought worse than the Millennium Drought is much higher than the current prediction of one in 10,000 years.
"Our rainfall reconstruction suggests that it may be as much as 10 times more likely."
Associate Professor Tibby said the Little Ice Age, which ended about the time south-east Queensland was settled, was unusually wet.
The study was possible because Swallow Lagoon contains a continuous sequence of leaves from a single species of tree. Variations in the chemistry of these leaves allowed scientists to reconstruct past rainfall.
Full report here.
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In Search of the Standard Day
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Neuro-Oncology Diet and risk of glioma
| Estimating survival for renal cell carcinoma patients with brain metastases: an update of the Renal Graded Prognostic Assessment tool Abstract Background Brain metastases are a common complication of renal cell carcinoma (RCC). Our group previously published the Renal Graded Prognostic Assessment (GPA) tool. In our prior RCC study (n = 286, 1985–2005), we found marked heterogeneity and variation in outcomes. In our recent update in a larger, more contemporary cohort, we identified additional significant prognostic factors. The purpose of this study is to update the original Renal-GPA based on the newly identified prognostic factors.Methods A multi-institutional retrospective institutional review board–approved database of 711 RCC patients with new brain metastases diagnosed from January 1, 2006 to December 31, 2015 was created. Clinical parameters and treatment were correlated with survival. A revised Renal GPA index was designed by weighting the most significant factors in proportion to their hazard ratios and assigning scores such that the patients with the best and worst prognoses would have a GPA of 4.0 and 0.0, respectively.Results The 4 most significant factors were Karnofsky performance status, number of brain metastases, extracranial metastases, and hemoglobin. The overall median survival was 12 months. Median survival for GPA groups 0–1.0, 1.5–2.0, 2.5–3, and 3.5–4.0 (% n = 25, 27, 30 and 17) was 4, 12, 17, and 35 months, respectively.Conclusion The updated Renal GPA is a user-friendly tool that will help clinicians and patients better understand prognosis, individualize clinical decision making and treatment selection, provide a means to compare retrospective literature, and provide more robust stratification of future clinical trials in this heterogeneous population. To simplify use of this tool in daily practice, a free online application is available at brainmetgpa.com.
|
| Highlights from the Literature |
| Forthcoming Meetings Edited by Albert H. Kim and Jennie W. Taylor |
| Glioblastoma: a prognostic value of AMT-PET? See the article by John et al, pp. 264–273. |
| Old meet new—the path to combination treatments in pediatric low-grade gliomas See the article by Poore et al, pp. 252–263. |
| Disparities along the glioblastoma clinical trials landscape We read with interest the recent work by Vanderbeek et al1 regarding the current clinical trials landscape for glioblastoma (GBM) patients. An unexplored dimension of their analysis centers on disparities and demographic discrepancies between clinical trial participants and the broader GBM population. We therefore examined clinical trials with published results as highlighted by the authors, totaling 51 trials.1 While most of these trials reported details regarding patient age (48/51, 94%) and gender (47/51, 92%), only 14 trials (27%) provided information regarding ethnicity and/or race in either peer-reviewed publications or ClinicalTrials.gov. The rate of reporting ethnicity/race was particularly low among phase I/II studies (9/43, 21%) compared with phase III trials (5/8, 63%, chi-squared test P = 0.02). |
| Multimodal imaging-defined subregions in newly diagnosed glioblastoma: impact on overall survival Abstract Background Although glioblastomas are heterogeneous brain-infiltrating tumors, their treatment is mostly focused on the contrast-enhancing tumor mass. In this study, we combined conventional MRI, diffusion-weighted imaging (DWI), and amino acid PET to explore imaging-defined glioblastoma subregions and evaluate their potential prognostic value.Methods Contrast-enhanced T1, T2/fluid attenuated inversion recovery (FLAIR) MR images, apparent diffusion coefficient (ADC) maps from DWI, and alpha-[11C]-methyl-L-tryptophan (AMT)-PET images were analyzed in 30 patients with newly diagnosed glioblastoma. Five tumor subregions were identified based on a combination of MRI contrast enhancement, T2/FLAIR signal abnormalities, and AMT uptake on PET. ADC and AMT uptake tumor/contralateral normal cortex (T/N) ratios in these tumor subregions were correlated, and their prognostic value was determined.Results A total of 115 MRI/PET-defined subregions were analyzed. Most tumors showed not only a high-AMT uptake (T/N ratio > 1.65, N = 27) but also a low-uptake subregion (N = 21) within the contrast-enhancing tumor mass. High AMT uptake extending beyond contrast enhancement was also common (N = 25) and was associated with low ADC (r = −0.40, P = 0.05). Higher AMT uptake in the contrast-enhancing tumor subregions was strongly prognostic for overall survival (hazard ratio: 7.83; 95% CI: 1.98–31.02, P = 0.003), independent of clinical and molecular genetic prognostic variables. Nonresected high-AMT uptake subregions predicted the sites of tumor progression on posttreatment PET performed in 10 patients.Conclusions Glioblastomas show heterogeneous amino acid uptake with high-uptake regions often extending into non-enhancing brain with high cellularity; nonresection of these predict the site of posttreatment progression. High tryptophan uptake values in MRI contrast-enhancing tumor subregions are a strong, independent imaging marker for longer overall survival. |
| Supratotal resection in glioma: a systematic review Abstract Background Emerging evidence suggests survival benefit from resection beyond all MRI abnormalities present on T1-enhanced and T2‒fluid attenuated inversion recovery (FLAIR) modalities in glioma (supratotal resection); however, the quality of evidence is unclear. We addressed this question via systematic review of the literature.Methods EMBASE, MEDLINE, Scopus, and Web of Science databases were queried. Case studies, reviews or editorials, non-English, abstract-only, brain metastases, and descriptive works were excluded. All others were included.Results Three hundred and nine unique references yielded 41 studies for full-text review, with 7 included in the final analysis. Studies were mostly of Oxford Center for Evidence-Based Medicine Level 4 quality. A total of 88 patients underwent supratotal resection in a combined cohort of 492 patients (214 males and 278 females, age 18 to 82 years). Fifty-one supratotal resections were conducted on high-grade gliomas, and 37 on low-grade gliomas. Karnofsky performance status, overall survival, progression-free survival, neurological deficits postoperatively, and anaplastic transformation were the main measured outcomes. No randomized controlled trials were identified. Preliminary low-quality support was found for supratotal resection in increasing overall survival and progression-free survival for both low-grade and high-grade glioma.Conclusion The literature suggests insufficient evidence for carte blanche application of supratotal resection, particularly in lower-grade gliomas where neurological deficits can result in long-term disability. While the preliminary studies discussed here, containing data from only a few centers, have reported increased progression-free and overall survival, these claims require validation in prospective research studies involving larger patient populations with clearly defined appropriate outcome metrics in order to reduce potential bias. |
| Uncommon low-grade brain tumors Abstract The 2016 World Health Organization (WHO) classification of primary central nervous system (CNS) tumors includes numerous uncommon (representing ≤1% of tumors) low-grade (grades I–II) brain neoplasms with varying clinical behaviors and outcomes. Generally, gross tumor or maximal safe resection is the primary treatment. Adjuvant treatments, though their exact role is unknown, may be considered individually based on pathological subtypes and a proper assessment of risks and benefits. Targetable mutations such as BRAF (proto-oncogene B-Raf), TRAIL (tumor necrosis factor apoptosis inducing ligand), and PDGFR (platelet derived growth factor receptor) have promising roles in future management. |
| Outcomes following stereotactic radiosurgery for small to medium-sized brain metastases are exceptionally dependent upon tumor size and prescribed dose Abstract Background At our institution, we have historically treated brain metastasis (BM) ≤2 cm in eloquent brain with a radiosurgery (SRS) lower prescription dose (PD) to reduce the risk of radionecrosis (RN). We sought to evaluate the impact of this practice on outcomes.Methods We analyzed a prospective registry of BM patients treated with SRS between 2008 and 2017. Incidences of local failure (LF) and RN were determined and Cox regression was performed for univariate and multivariate analyses (MVAs).Results We evaluated 1533 BM ≤2 cm. Median radiographic follow-up post SRS was 12.7 months (1.4–100). Overall, the 2-year incidence of LF was lower for BM treated with PD ≥21 Gy (9.3%) compared with PD ≤15 Gy (19.5%) (sub–hazard ratio, 2.3; 95% CI: 1.4–3.7; P = 0.0006). The 2-year incidence of RN was not significantly higher for the group treated with PD ≥21 Gy (9.5%) compared with the PD ≤15 Gy group (7.5%) (P = 0.16). MVA demonstrated that PD (≤15 Gy) and tumor size (>1 cm) were significantly correlated (P < 0.05) with higher rates of LF and RN, respectively. For tumors ≤1 cm, when comparing PD ≤15 Gy with ≥21 Gy, the risks of LF and RN are equivalent. However, for lesions >1 cm, PD ≥21 Gy is associated with a lower incidence of LF without significantly increasing the risk of RN.Conclusion Our results indicate that rates of LF or RN following SRS for BM are strongly correlated with size and PD. Based on our results, we now, depending upon the clinical context, consider increasing PD to 21 Gy for BM in eloquent brain, excluding the brainstem. |
| Sex difference of mutation clonality in diffuse glioma evolution Abstract Background Sex differences in glioma incidence and outcome have been previously reported but remain poorly understood. Many sex differences that affect the cancer risk were thought to be associated with cancer evolution.Methods In this study, we used an integrated framework to infer the timing and clonal status of mutations in ~600 diffuse gliomas from The Cancer Genome Atlas (TCGA) including glioblastomas (GBMs) and low-grade gliomas (LGGs), and investigated the sex difference of mutation clonality.Results We observed higher overall and subclonal mutation burden in female patients with different grades of gliomas, which could be largely explained by the mutations of the X chromosome. Some well-established drivers were identified showing sex-biased clonality, such as CDH18 and ATRX. Focusing on glioma subtypes, we further found a higher subclonal mutation burden in females than males in the majority of glioma subtypes, and observed opposite clonal tendency of several drivers between male and female patients in a specific subtype. Moreover, analysis of clinically actionable genes revealed that mutations in genes of the mitogen-activated protein kinase (MAPK) signaling pathway were more likely to be clonal in female patients with GBM, whereas mutations in genes involved in the receptor tyrosine kinase signaling pathway were more likely to be clonal in male patients with LGG.Conclusions The patients with diffuse glioma showed sex-biased mutation clonality (eg, different subclonal mutation number and different clonal tendency of cancer genes), highlighting the need to consider sex as an important variable for improving glioma therapy and clinical care. |
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This is the fourth in a series of posts based upon Jordan Peterson's book Maps of Meaning, published in 1999 after 17 years of researc...
