On proton beam therapy – notes from NCRI Conference

Was saving these notes in my files but the story was entertaining enough that it reminded me I have a public notebook I should use for more of my notes. (And then I put some effort into making my notes comprehensible to others and it reminded that I shouldn’t waste time making my notes public.)

Anthony Zietman (British clinician sci @ Harvard) v fun on proton beam therapy.

Anthony Zietman now at #ncri2017 on #ProtonTheray – starting with why it's so brilliant… on paper. Tissue sparing and very targeted. pic.twitter.com/WMGM80VcZX

— Science and Innovation at Cancer Research UK (@CRUKresearch) November 7, 2017

A brief overview of why it’s exciting — much more targeted and tissue sparing than traditional RT cos it dumps most energy at a specific depth instead of dumping energy wherever it hits tissue. Why it’s especially good for brain, eye, childhood cancers (cue slide of child survivor with deformed spine caused by RT collateral damage).

But while the physics is better, the biology isn’t entirely settled.

But the fun bit was comparing different countries’ approaches to implementing proton beam. Especially so given that in the UK it’s mainly known for the Ashya King case, where the UK was portrayed as being behind in implementing the technology that was portrayed as revolutionary.

While still none are complete in the UK, the US rushed into building 26 (very very expensive) facilities.

But most of the capacity isn’t being used for kids cancers, or hard to treat cancers, or cancers that need the innovation — it’s being used for prostate cancer!

Zeitman #ncri2017: Rapid growth in very expensive #ProtonTherapy centres in the US, most of them treating prostate cancer... pic.twitter.com/hheLUV3B59

— Science and Innovation at Cancer Research UK (@CRUKresearch) November 7, 2017

And as we know, PC is/was frequently overtreated anyway.

Zeitman #ncri2017: given the ProtecT trial, we often don't need to treat these at all, beyond monitoring, let alone with #ProtonTherapy pic.twitter.com/tXPPeibhF3

— Science and Innovation at Cancer Research UK (@CRUKresearch) November 7, 2017

It was just a fun illustration of how their private healthcare market can rush into crazy things — building very expensive treatment facilities for a patient population who don’t need treatment at all — because that population of patients includes those who are most likely to be in a position to demand/buy expensive treatments when expensive treatments are marketed to them.

And then the bubble started bursting and facilities are now going bankrupt.

The NHS is building 2 PBT facilities for the nation — plenty enough for all the patients we can expect to be able to benefit from it. It remains to be seen what purpose the 3 private facilities being constructed in the UK will serve.

Disclaimer: these are my hastily scribbled notes, don’t count on them, pls don’t blame Zietman for anything I might have (mis)attributed to him, don’t take them as representative of my own views let alone my employer’s or anybody or anything else oh god now I remember why I stopped using a public notebook.

Nobody lives in remote places

In Cycling in Middle England, Mark mentioned that the transport minister responded to a question about policy outside of major cities by waffling about remote places where distances are impractical for cycling. If we’re not living in big cities, apparently we’re living in remote places.

Except of course, by definition, nobody lives there.

Mark points out that most people in West Sussex live in the many sizeable towns. But even those who don’t aren’t remote. Yes there are some properly rural and remote places in Britain but by definition very few Britons live in properly rural and remote places. There is a reason why they’re so often overlooked by policy. They are a small number of weird outliers (literally).

I once saw this image used on twitter as an argument for why government’s focus should be on making driving easier and cheaper, rather than catering for the metropolitan elite with commuter trains and cycleways:

Because look: London is such a small area compared to rural Britain.

But even leaving aside the fact that 440 times as many people are in that small area, even most of the people in the rural north are not in remote areas. Some parts of that school catchment area are extremely remote.

But people by definition don’t live in those remote areas. They live in the more clustered collection of towns and villages where, surprisingly enough, the school and the transport infrastructure is. Their everyday journeys to school and to the shops aren’t covering heroic distances.

So please stop citing the existence of remote undeveloped places against the transport policies we need. Yes, not everybody lives in London. But almost nobody lives in Kielder Forest.

Have any sense of just how rural northern England is? For most of its rural population, it looks something like this:

Dense clusters of villages never all that far from the towns. Places where there should be no excuse for condemning people to a life of car dependence.

Update: for the avoidance of any doubt, and for the one or two people who seem to be having trouble, statements like “nobody lives there” and “people don’t live there” are rhetorical exaggeration. Yes, a few people live in Kielder Forest. Yes, a few people live on isolated crofts in the Highlands. No, 99.99% of the population don’t live in isolated places like that. No, the existence of those isolated dwellings isn’t an excuse to throw out transport policy for the rest of us.

Waterloo to Greenwich Quietways

I’ve not been keeping up with the consultations so much, but I found 5 minutes over lunch to glance at this https://consultations.tfl.gov.uk/cycling/tower-rothsay-webb and scribble the first things that came to mind…

Andrew Gilligan said that things would be "done properly, or not at all." Unfortunately, while some aspects of this scheme look very good, the plans do not yet appear to be done properly.

Specifically, the expected routes for Quietway users at the corner of Webb Street and TBR look unclear and unintuitive — another example of the "fiddly things" that the mayor criticised.

This looks particularly problematic for the route from Rothsay Street to Webb Street, where the crossing appears to feed Quietway users onto the widened footway, at which point the route becomes entirely unclear and could be mistaken for the contraflow cycle lane. This looks like it has the potential to create conflict with pedestrians, oncoming Quietway users, and with road users turning from TBR into Webb Street, as well as placing a large array of pedestrian tactile paving — a known cause of problems for bicycle users — exactly where Quietway users will be making turns, evading conflicts, and attempting to make sense of the intended route.

All of these needless problems and conflicts could be very easily avoided by providing a clear route into Webb Street which could be instantly and intuitively understood by all road users.

The most obvious resolution to this problem which comes to mind would be to move the stop line for southbound TBR traffic back to before Webb Street so that the junction works as a simple, recognisable, easy to understand crossroads, with an intuitive route for Quietway users, no needless conflict with pedestrians, and no chance of conflict with southbound traffic turning from TBR.

Stockwell Cross gyratory removal consultation

In case they are any use to anybody else responding to TfL’s Stockwell Cross consultation: some hastily bashed out and poorly edited down thoughts I gave them. There are lots and lots of problems you could pull out of the details — positioning of lanes on bends, dangerous lane merges, up to 4-stage pedestrian crossings, etc — but I figured there was no point getting into those when the whole thing is such a mess it needs doing from scratch.

While I agree very strongly with the principle of providing dedicated safe space for cycling here, these designs are not nearly good enough. It is a shame, when TfL have produced some good designs nearby at Oval, we are still being presented with substandard designs like these. In the absence of a consistent high quality standard we risk failing to maximise the value of these schemes, because chains are only as strong as their weakest links and because road users will be confused by inconsistent and unintuitive styles. The use of “superhighway” to describe splashes of blue paint on the introduction of CS7 was mocked; nearly five years on, the term still looks laughable applied to these designs.

I have selected “agree” with separated routes through the junction, but in these proposals the routes are not nearly comprehensive enough, and the designs still appear to be compromised by their having been squeezed in around motor traffic. With a better understanding of cycling as a separate mode of transport, and more willingness to imagine provision truly independent of the carriageway, much more comfortable, convenient and comprehensive routes through this junction could be achieved. It is particularly distressing to see designs which, where the very brief separation ends, sends cycle users jostling with buses entering bus lanes and stops.

I have answered “no” to questions 2 to 7, not because I disagree with providing for bicycle transport but because the provision is totally inadequate. Roads that are this busy (including with many fast and large vehicles) require properly designed separate infrastructure. If the infrastructure were properly designed there would be no need for any of the items in questions 2 to 7. Bus lanes are not cycling infrastructure and using them as such is bad for people travelling by either mode of transport: they will continue to act as a barrier to making journeys by bicycle on this route. Properly designed separate infrastructure has no need for advance stop lines. Properly designed separate infrastructure has properly designed separate signal timings.

I have selected “don’t know” to removing the gyratory and simplifying the junctions. I do not believe that there is anything intrinsically good or bad about gyratories. Most are badly designed — and the currently gyratory here is certainly extremely bad. But removing the gyratory does not automatically make for an improvement, and it is possible to imagine designs which retain a gyratory system for motor traffic while making much better routes and places for people on foot and bicycle than the current proposals do. Gyratory removal might be the means to an end, but it should not be treated as an end in itself.

I have selected “don’t know” to the public space improvements around the Memorial Garden. The reason this area is currently an unpleasant public space is its domination and severance by noisy and polluting motor traffic. The proposed designs do nothing to address the volume and dominance of motor traffic, and the area will continue to be filled with many lanes of waiting and speeding traffic. The public space improvements therefore risk becoming another “place faking” exercise.

Why are you still using URL shorteners?

Part of my job includes looking after social media. That means I can’t hide from the torrent of advice from Social Media Experts.

It seems one of the standard lines is still “use bitly on twitter”. I’ve developed an excessive perhaps slightly irrational rage with that one.* It came up again at the Science Online** conference and I was asked to explain. So here’s a hastily scrawled listicle to get the ridiculous rage out my system. See if you can spot which of the reasons is the one I actually feel preposterously strongly about.

6 reasons you shouldn’t be using link shorteners

It’s another site tracking and profiling you

I find it difficult to get all that worried about the whole tracking and profiling thing, but I get why people don’t like it. From the social media management point of view, it’s another tracking and profiling system that you’re exposing your users to.

They’ll break

I guess it’s not really a big deal if all of your old links in throwaway tweets break one day when a URL shortener shuts down, but still…

You don’t know what they’re paying for

Large tech companies whose brand and entire business activity is 100% reliant on domain names registered from dictator-led and war-torn countries? I wonder how you deal with the frictions that might come up in those kinds of relationships…

I can’t see when you’re linking to something nasty

Some of them make some attempt to filter out scams and viruses. But the ones you’re using don’t filter out the Daily Mail.

Yes, I could go to the provider’s site and run a lookup to resolve the target URL. No, that’s not gonna happen.

I won’t click your links anyway

I also can’t see when you’re linking to something that I just don’t want to read. If you’ve done a really good job of making it clear what you’re linking to in the post itself, I might, if I’m really interested, still decide to click. But if neither your text nor the URL make it clear what your link is for and why I should, I’m not clicking it.

Perhaps it’s just me who still looks at link tooltips and decides whether to click. But I think that if there’s one good thing that has come of the SEO arms race, it’s URLs that help me decide whether or not to click on them. Sometimes I won’t click on your URL, because I can see that it’s something I’m not interested in or it’s a story I’ve already heard. But just as often it will be the words in your URL, attached to the brand in the domain name, that tempts me to click — even when the rest of the tweet or post didn’t tempt me.

Of course, if your content is rubbish that I don’t want to read, you might think that disguising that fact is a clever trick. Whatever. If you hide what you’re linking to, I won’t click.

Maybe it’s just me. Maybe somebody should do some actual research into the effect link shortening has on click and engagement rates before endorsing them? Maybe the research has been done but nobody can find it under the avalanche of search engine optimised rubbish telling us to use URL shorteners.

This is satire, right? http://t.co/IJHjgcu3j1

— Car bonbon (@LeithMotive) November 17, 2014

I never found out the punchline.

All of the reasons for using them have been obsolete for years

Link shortening: once upon a time URLs filled up twitter’s character limit. It’s many years since twitter made all links count for an equal number of characters.

Click tracking: another one twitter rolled into the built-in functionality: twitter analytics gives you far more useful info about engagement than link shorteners do.

Beautifying links: beauty’s in the eye of the beholder, of course, but link shorteners make really ugly links. Twitter’s UI and most apps have this covered.

* I removed several swear words from this, not out of self-censorship but because the hyperbole just looked a bit too ridiculous for the topic

** nope, still not going to call it “spoton”.

A quick public service announcement regarding “Sutton PR”

Artists, agents and galleries in New York and Hong Kong: looking to pay some PR agency lots of money to promote your next event? Perhaps piss away your money on some clowns who will spray spam at random irrelevant email addresses, harvested off the internet, of people who live thousands of miles away, who have never even been to your city, and haven’t the slightest interest your art. These clowns even carry on doing that after being asked to stop.

———- Forwarded message ———-

From: Sutton PR USA <newyork@suttonpr.com>
Date: Thu, Apr 10, 2014 at 6:57 PM
Subject: RE: Mnuchin Gallery Announces | Casting Modernity Bronze in the XXth Century | On View April 24 – June 7, 2014
To: Joe

Hello Joe,

This is to confirm that you will be removed from our mailing list.

Best regards,

Karina House

Account Coordinator

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New York, New York 10014

T: +1 212 202 3402

C: +1 512 745 0021

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On Thu, Apr 10, 2014 at 1:06 PM, Sutton PR USA <newyork@suttonpr.com> wrote:

MNUCHIN GALLERY ANNOUNCES CASTING MODERNITY: BRONZE IN THE XXTH CENTURYCo-Curated by Dr. David Ekserdjian On View April 24 – June 7, 2014 Opening Reception: Wednesday, April 23, 5:30 – 7:30 p.m. New York—Mnuchin Gallery, together with Dr. David Ekserdjian, is proud to present Casting Modernity: Bronze in the XXth Century. This exhibition will present a survey of masterworks in bronze by the leading artists of the twentieth century, featuring more than 30 sculptures by Arp, Bourgeois, Brancusi, Calder, Chadwick, de Kooning, Ernst, Giacometti, Johns, Koons, Laurens, Lichtenstein, Marini, Matisse, Miro, Moore, Nauman, Noguchi, Picasso, Richier, Rodin, Smith, and Twombly.  On view from April 24 through June 7, the exhibition will open with a public reception on Wednesday, April 23 from 5:30 to 7:30 p.m. Casting Modernity: Bronze in the XXth Century will be accompanied by a fully-illustrated catalogue authored by Dr. Ekserdjian, Professor of Art History, University of Leicester. The gallery’s presentation is inspired by Bronze, an exhibition curated by Dr. Ekserdjian and Cecilia Treves at the Royal Academy in London in 2012.  While Bronze chronicled works from antiquities to the present and was shown only in the UK, Mnuchin Gallery’s New York exhibition tightens and deepens the focus of works from a 100-year span during which the medium went through some of its most profound and dramatic changes. The new exhibition will include loans from Glenstone, the Hirshhorn Museum and Sculpture Garden, the Nasher Sculpture Center and the Noguchi Museum, as well as numerous private collections, in addition to select works previously on view in the Royal Academy’s Bronze. “When we saw the show Bronze at the Royal Academy in London two years ago, we were struck by the breadth of inventiveness and the range of visual effects at play in the five centuries of bronze objects that the show brought together. When we learned the exhibition would not be traveling outside London, we decided that the experience of Bronze was one that New York audiences simply should not miss,” states Owner Robert Mnuchin. “From the outset, we decided to deepen our investigation into the twentieth century, when bronze was subject to tremendous transformation,” states Partner Sukanya Rajaratnam. “And in the process we made discoveries that suggested how time and time again, this most traditional medium was used in the advancement of modernity.” One of the oldest and most enduring forms of artistic creation, bronze casting has been employed by cultures around the globe for more than 5,000 years.  In an age of seemingly infinite media characterized by a driving impulse towards the new, the leading figures of the last century consistently revisited this traditional material.  Beginning with Rodin, the masters of the modern and postwar periods probed the medium’s historical connotations and techniques while using it to explore new levels of abstraction and contemporary subject matter. In Rodin’s studio, bronze was transformed from a tool of staid portraiture and slick idealization into a vehicle for the artist’s deeply personal vision, its tactile surfaces revealing the mark of the artist’s hand while its forms expressed highly-charged moments of drama and movement.  From then on, bronze was freed from its previous constraints.  Brancusi and Arp placed their gleaming sculptures on stone and wood bases of their own creation, while Bourgeois hung her Rabbit on the wall and Nauman suspended his Untitled (Hand Circle) from the ceiling. Picasso, Giacometti and de Kooning reveled in the deep grooves, angles and folds of their expressive surfaces. Moore, Noguchi and Lichtenstein placed as much importance on the negative spaces in their compositions as on their physical volumes.  Miro and Ernst depicted fantastical beasts directly from their dreams and imaginations.  Johns and Koons created meticulous life casts of functional objects just as they found them.  As with these examples, all of the works on view illustrate the diverse and ever-evolving ways in which these artists used bronze to break new ground in the advancement of modernity and re-envision the possibilities of sculpture. “…it is the twists and turns—the absence of a linear history—that make the panorama of bronze sculpture in the twentieth century so boundlessly fascinating. As a result, no anthology—even when it brings together so many stunning pieces—can hope to be entirely representative, but it can instead encourage us to see both the familiar and the unexpected in a new light. For each of us, which bronzes fall into which of those categories will be very different, but even the best informed will be bound to learn from the experience,” comments Dr. David Ekserdjian, Professor of Art History, University of Leicester. Mnuchin Gallery’s exhibition will focus on American and European artists with work spanning from Rodin’s The Thinker (1880) to Bruce Nauman’s Untitled (Hand Circle) (1996). About Mnuchin Gallery  Mnuchin Gallery is located in the historic townhouse at 45 East 78th Street on Manhattan’s Upper East Side and is dedicated to presenting museum-quality exhibitions of postwar and contemporary art. Owner and founder Robert Mnuchin, whose passion for the arts developed through his childhood and his longstanding career in the financial sector as head of trading at Goldman Sachs, began a successful second career as a dealer in 1992, forming reputable partnerships with Los Angeles dealer James Corcoran, C&M Arts (1992) and Dominique Lévy, L&M Arts (2005). In 2012, Mnuchin and Lévy parted ways and the gallery was reborn as Mnuchin Gallery in January 2013. Mnuchin Gallery carries on the tradition of presenting thoughtfully curated, carefully researched exhibitions, documented with scholarly publications. Its first year of programming included solo shows by some of the most influential artists of the 20th century, including Ellsworth Kelly and Alexander Calder, as well as thematic exhibitions that re-contextualize masterworks from the modern and postwar periods. For more information on Mnuchin Gallery, please visit www.mnuchingallery.com. Media Contact: Concetta Duncan, Sutton PR, +1 212.202.3402 / concetta@suttonpr.com. Image: Pablo Picasso, Head of a Woman (Fernande), 1909, bronze, 16 1/4 x 9 3/4 x 10 1/2 inches (41.3 x 24.8 x 26.7 cm), The Leonard A. Lauder Cubist Trust, New York, Image  © The Metropolitan Museum of Art

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Alarming facts

A year ago I flagged something in feedly for a brief sarcastic comment, and never got around to it. Now that I’m having a clear out…

“It is alarming that a fifth of people killed or seriously injured on our roads in 2011 were involved in a collision where at least one driver was aged 17-24.″

-Patrick McLoughlin, Transport Secretary, 25th March 2013

Isn’t it alarming how easily you can make something mediocre or meaningless sound alarming by prefixing it with “it is alarming that”? I mean, if you think about it for a moment, 17-24 is quite a large block of people — a fifth of the people aged 17-57 (though something less than a fifth of qualified drivers I guess) — and, though I don’t know off the top of my head the average number of drivers per collision, as the quote itself hints out, it’s larger than one. The quoted statistic tells you nothing about whether 17-24 year old drivers are over-represented in collisions (maybe they are, maybe there are proper stats on the subject, I don’t actually really care), and in fact when you think about it provides reason to believe they’re probably not. But it is alarming that a cabinet minister finds it alarming.

On Bill Hamilton

Flicking through a 10 year old notebook, one of those ones made from paper and everything, deciding whether to keep these things cluttering up the place or not. Friday 16 January 2004:

Martin Birch reports that he met Bill one day in the department of zoology, and apologised for forgetting to go to Bill’s research seminar the day before. “That’s alright,” said Bill. “As a matter of fact, I forgot it myself.”

On following rules

After suggesting to twitter that somebody who hangs out on a forum called “Bicycle Driving” might be beyond parody, I stumbled upon John Forester’s recent speech given to a Dutch conference — written up as a pseudo-academic “paper” and posted as a PDF (if ever you needed proof that this is a man who won’t be taking to twitter…).

As usual, the paper provides quite an insight. I particularly enjoyed this insight into the vehicular cycling belief system:

My discussion takes it as proved that if all roadway users obey the same rules, they can all use one set of facilities, while if there are two groups of users who obey conflicting rules, they must each have their own facilities.

Leaving aside the exuberance of ways in which this is obviously bollocks, the bit that tickled me most: if users obey rules. That’s quite some if.

Again, amazing how people have this bizarre idea that, unlike big and expensive and difficult engineering solutions, human behaviour is simple and easy to control and change.

Ten baby names to watch out for in 2014

Way back when I worked in academic publishing, assessing newly submitted papers and finding suitable people to peer review them, I encountered hundreds of weird and wonderful names every day. And kept a list of which most amused. Which never got published because, well, it would be mean. But… the work of Dr Armbuster came up on twitter, and… I’m so sorry, all of you, I just couldn’t keep it in.

10. Sadly the legends are not true: Flaccid Trunk Paralysis in Free-ranging Elephants was not written by the legendary veterinary scientist, Everard Koch.

9. Scott H Long. S.H. Long. Heh. Anyone? Hehe. No? Oh well. Next.

8. This paper was written by Jolly & Rogers. Arrr.

7. I love the name Quackenbush. Better even than Hackenbush. I named a fictional character Quackenbush.

6. Professor Richard Titball. Heh. Sorry Prof, but… Heheh. Dick. Tit. Ball.

5. Sadly, Google Translate is now too clever to try to translate Ferdinando di Cunto‘s name. It used to give exactly what you’d expect di Cunto to translate to.

4. It’s Wei Ning Chen. Hallelujah.

3. Rabuesak Khumthong.

2. Riccardo Wanke. Heheh. Dick Wanke. Heh.

1. Post coital aortic dissection: a case report. By Morris-Stiff, Coxon, Ball, and most hilariously of all, Lewis.