Explore the vast range of titles available.

The natural beauty and diversity of birds have fascinated us for centuries. Since their first appearance in the art of ancient Egypt, birds have proved to be a popular and enduring subject for artists who have sought to capture the majesty of these wondrous creatures. Bringing together a collection of artworks depicting birds from the Renaissance to the present, this book reveals how and why birds continue to captivate. Showcasing the forms, movement and colour of a variety of species, and exploring cultural symbolism as well as concerns around climate change and biodiversity loss, it is not only a delightful visual journey but also a pertinent reminder of our impact on the natural world.

When social animals engage in inter-group contests, the outcome is determined by group sizes and individual masses, which together determine group resource-holding potential (‘group RHP’). Individuals that perceive themselves as being in a group with high RHP may receive a motivational increase and increase their aggression levels. Alternatively, individuals in lower RHP groups may increase their aggression levels in an attempt to overcome the RHP deficit. We investigate how ‘group RHP’ influences agonistic tactics in red wood ants Formica rufa. Larger groups had higher total agonistic indices, but per capita agonistic indices were highest in the smallest groups, indicating that individuals in smaller groups fought harder. Agonistic indices were influenced by relative mean mass, focal group size, opponent group size and opponent group agonistic index. Focal group attrition rates decreased as focal group relative agonistic indices increased and there was a strong negative influence of relative mean mass. The highest focal attrition rates were received when opponent groups were numerically large and composed of large individuals. Thus, fight tactics in F. rufa seem to vary with both aspects of group RHP, group size and the individual attributes of group members, indicating that information on these are available to fighting ants.

IntroductionLung cancer is the most common cause of cancer death worldwide and most patients present with extensive disease. One-year survival is improving but remains low (37%) despite novel systemic anti-cancer treatments forming the current standard of care. Although new therapies improve survival, most patients have residual disease after treatment, and little is known on how best to manage it. Therefore, residual disease management varies across the UK, with some patients receiving only maintenance systemic anti-cancer treatment while others receive local consolidative treatment (LCT), alongside maintenance systemic anti-cancer treatment. LCT can be a combination of surgery, radiotherapy and/or ablation to remove all remaining cancer within the lung and throughout the body. This is intensive, expensive and impacts quality of life, but we do not know if it results in better survival, nor the extent of impact on quality of life and what the cost might be for healthcare providers. The RAMON study (RAdical Management Of Advanced Non-small cell lung cancer) will evaluate the acceptability, effectiveness and cost-effectiveness of LCT versus no LCT after first-line systemic treatment for advanced lung cancer.Methods and analysisRAMON is a pragmatic open multicentre, parallel group, superiority randomised controlled trial. We aim to recruit 244 patients aged 18 years and over with advanced non-small-cell lung cancer from 40 UK NHS hospitals. Participants will be randomised in a 1:1 ratio to receive LCT alongside maintenance treatment, or maintenance treatment alone. LCT will be tailored to each patient’s specific disease sites. Participants will be followed up for a minimum of 2 years. The primary outcome is overall survival from randomisation.Ethics and disseminationThe West of Scotland Research Ethics Committee (22/WS/0121) gave ethical approval in August 2022 and the Health Research Authority in September 2022. Participants will provide written informed consent before participating in the study. Findings will be presented at international meetings, in peer-reviewed publications, through patient organisations and notifications to patients.Trial registration numberISRCTN11613852.

Animal interactions often involve chemical exchange but simultaneous evaluation of chemistry and behaviour has been problematical. Here we report findings from a novel method, atmospheric pressure chemical ionization-mass spectrometry (APCI-MS) coupled with manipulation of molecular-mass achieved by rearing organisms on deuterium-enhanced nutrients. This allows real-time monitoring of the occurrence and quantity of volatile chemicals released by each of two interacting individuals, in tandem with behavioural observations. We apply these methods to female-female contests in the parasitoid wasp Goniozus legneri. We show that this species emits the spiroacetal 2-methyl-1,7-dioxaspiro[5.5]undecane. Chemical release is most common in more behaviourally aggressive contests, which occur when prior resource owners successfully resist take-over by similar-sized intruder females. Volatiles released during contests are always emitted by the loser. Aggression in contests is reduced after spiroacetal release. We suggest that the spiroacetal functions as a weapon of rearguard action. We anticipate that APCI-MS, which is rapid, non-intrusive and relatively inexpensive to operate, will be widely applied in studies linking chemistry and behaviour.

British Thoracic Society and Society for Cardiothoracic Surgery in Great Britain and Ireland guidelines on the radical management of patients with lung cancer (2010) This guideline describes potentially resectable N2 NSCLC as non-fixed, non-bulky and single-zone N2 nodal disease where the primary tumour is likely to be completely excised with clear pathological margins.1 In this setting, the guideline recommends that surgery is considered as part of multimodality therapy and this recommendation is graded as evidence level B (based on high-quality case–control and cohort studies with low risk of cofounding or bias). [...]adjuvant chemotherapy was recommended (stage IB >4 cm, II and III) whereas preoperative chemotherapy was not. European Society of Medical Oncology: locally advanced stage III non-small cell lung cancer guidelines (2015 and 2017) This guideline defines potentially resectable N2 NSCLC as minimal, non-bulky N2 disease and single-station N2 disease.3 The authors raise concerns that the evidence base for resectable N2 originates from an era prior to the widespread use of PET staging, widely available endoscopic nodal staging techniques and outdated surgical and radiotherapy practices. [...]the applicability of the results to modern-day practice is questionable. Against some of the guideline recommendations, we believe there is no clear evidence to suggest that single-station or single-zone versus multistation or multizone nodal disease should be used to define different treatment strategies. [...]we would propose all forms of multimodality treatment with or without surgery can be considered for all levels of resectable N2 NSCLC.

Bronchogenic cysts are rare congenital lesions found primarily in the mediastinum. Most patients are asymptomatic and can be treated with minimally invasive resection. We present a case of a middle-aged patient who presented to a district general hospital with palpitations and shortness of breath. She underwent a computerised tomographic pulmonary angiogram that showed a likely bronchogenic cyst and was subsequently transferred to our hospital. She developed atrial fibrillation during admission requiring therapy with beta-blockers and digoxin. Cardiac MRI revealed a large cyst posterior to the left atrium, a moderate circumferential pericardial effusion and bilateral pleural effusions. There was significant left atrial compression. The patient underwent surgical removal of the cyst and was discharged. She returned to the hospital within a week with palpitations and was treated with intravenous antibiotics for sepsis. She was discharged a week later and remained clinically stable.

[...]patients undergoing SABR have a worse OS even when adjusting for identifiable confounders and restricting analysis to those aged under 80 years and with PS of 0–1. [...]the median difference between the date of diagnosis and the date of treatment for surgery was 17 days, while that for SABR was 73 days. [...]in order to match patients, these large cohorts are reduced to a subset of those initially analysed for the final comparison. [...]it is likely that the patient population eligible for surgery will expand, giving frailer patients more treatment options.

This is the first multicenter randomized controlled trial to evaluate the effectiveness and safety of Zephyr Endobronchial Valve (EBV) in patients with little to no collateral ventilation out to 12 months. To evaluate the effectiveness and safety of Zephyr EBV in heterogeneous emphysema with little to no collateral ventilation in the treated lobe. Subjects were enrolled with a 2:1 randomization (EBV/standard of care [SoC]) at 24 sites. Primary outcome at 12 months was the ΔEBV-SoC of subjects with a post-bronchodilator FEV improvement from baseline of greater than or equal to 15%. Secondary endpoints included absolute changes in post-bronchodilator FEV , 6-minute-walk distance, and St. George's Respiratory Questionnaire scores. A total of 190 subjects (128 EBV and 62 SoC) were randomized. At 12 months, 47.7% EBV and 16.8% SoC subjects had a ΔFEV greater than or equal to 15% (P < 0.001). ΔEBV-SoC at 12 months was statistically and clinically significant: for FEV , 0.106 L (P < 0.001); 6-minute-walk distance, +39.31 m (P = 0.002); and St. George's Respiratory Questionnaire, -7.05 points (P = 0.004). Significant ΔEBV-SoC were also observed in hyperinflation (residual volume, -522 ml; P < 0.001), modified Medical Research Council Dyspnea Scale (-0.8 points; P < 0.001), and the BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index (-1.2 points). Pneumothorax was the most common serious adverse event in the treatment period (procedure to 45 d), in 34/128 (26.6%) of EBV subjects. Four deaths occurred in the EBV group during this phase, and one each in the EBV and SoC groups between 46 days and 12 months. Zephyr EBV provides clinically meaningful benefits in lung function, exercise tolerance, dyspnea, and quality of life out to at least 12 months, with an acceptable safety profile in patients with little or no collateral ventilation in the target lobe. Clinical trial registered with www.clinicaltrials.gov (NCT 01796392).

Background Lung metastasectomy in the treatment of advanced colorectal cancer has been widely adopted without good evidence of survival or palliative benefit. We aimed to test its effectiveness in a randomised controlled trial (RCT). Methods Multidisciplinary teams in 13 hospitals recruited participants with potentially resectable lung metastases to a multicentre, two-arm RCT comparing active monitoring with or without metastasectomy. Other local or systemic treatments were decided by the local team. Randomisation was remote and stratified by site with minimisation for age, sex, primary cancer stage, interval since primary resection, prior liver involvement, the number of metastases, and carcinoembryonic antigen level. The central Trial Management Group were blind to patient allocation until completion of the analysis. Analysis was on intention to treat with a margin for non-inferiority of 10%. Results Between December 2010 and December 2016, 65 participants were randomised. Characteristics were well-matched in the two arms and similar to those in reported studies: age 35 to 86 years (interquartile range (IQR) 60 to 74); primary resection IQR 16 to 35 months previously; stage at resection T1, 2 or 3 in 3, 8 and 46; N1 or N2 in 31 and 26; unknown in 8. Lung metastases 1 to 5 (median 2); 16/65 had previous liver metastases; carcinoembryonic antigen normal in 55/65. There were no other interventions in the first 6 months, no crossovers from control to treatment, and no treatment-related deaths or major adverse events. The Hazard ratio for death within 5 years, comparing metastasectomy with control, was 0.82 (95%CI 0.43, 1.56). Conclusions Because of poor and worsening recruitment, the study was stopped. The small number of participants in the trial ( N  = 65) precludes a conclusive answer to the research question given the large overlap in the confidence intervals in the proportions still alive at all time points. A widely held belief is that the 5-year absolute survival benefit with metastasectomy is about 35%: 40% after metastasectomy compared to < 5% in controls. The estimated survival in this study was 38% (23–62%) for metastasectomy patients and 29% (16–52%) in the well-matched controls. That is the new and important finding of this RCT. Trial registration ClinicalTrials.gov, ID: NCT01106261 . Registered on 19 April 2010

Pulmonary metastasectomy for sarcoma is surgery without proven benefit, and in the light of a randomized controlled trial examining pulmonary metastasectomy in colorectal cancer, it should be questioned.