Moraines in the Austrian Alps record repeated phases of glacier stabilization through the Late Glacial and the Early Holocene.

Climate is currently warming due to anthropogenic impact on the Earth's atmosphere. To better understand the processes and feedbacks within the climate system that underlie this accelerating warming trend, it is useful to examine past periods of abrupt climate change that were driven by natural forcings. Glaciers provide an excellent natural laboratory for reconstructing the climate of the past as they respond sensitively to climate oscillations. Therefore, we study glacier systems and their behavior during the transition from colder to warmer climate phases, focusing on the period between 15 and 10 ka. Using a combination of geomorphological mapping and beryllium-10 surface exposure dating, we reconstruct ice extents in two glaciated valleys of the Silvretta Massif in the Austrian Alps. The mountain glacier record shows that general deglaciation after the Last Glacial Maximum (LGM) was repeatedly interrupted by glacier stabilization or readvance, perhaps during the Oldest Dryas to Bølling transition (landform age: 14.4 ± 1.0 ka) and certainly during the Younger Dryas (YD; 12.9-11.7 ka) and the Early Holocene (EH; 12-10 ka). The oldest landform age indicates a lateral ice margin that postdates the 'Gschnitz' stadial (ca. 17-16 ka) and predates the YD. It shows that local inner-alpine glaciers were more extensive until the onset of the Bølling warm phase (ca. 14.6 ka), or possibly even into the Bølling than during the subsequent YD. The second age group, ca. 80 m below the (pre-)Bølling ice margin, indicates glacier extents during the YD cold phase and captures the spatial and temporal fine structure of glacier retreat during this period. The ice surface lowered approximately 50-60 m through the YD, which is indicative of milder climate conditions at the end of the YD compared to its beginning. Finally, the third age group falls into a period of more substantial warming, the YD-EH transition, and shows discontinuous glacier retreat during the glacial to interglacial transition. The new geochronologies synthesized with pre-existing moraine records from the Silvretta Massif evidence multiple cold phases that punctuated the general post-LGM warming trend and illustrate the sensitive response of Silvretta glaciers to abrupt climate oscillations in the past.

Glacier fluctuations in the northern Patagonian Andes (44°S) imply wind-modulated interhemispheric in-phase climate shifts during Termination 1.

The Last Glacial Termination (T1) featured major changes in global circulation systems that led to a shift from glacial to interglacial climate. While polar ice cores attest to an antiphased thermal pattern at millennial timescales, recent well-dated moraine records from both hemispheres suggest in-phase fluctuations in glaciers through T1, which is inconsistent with the bipolar see-saw paradigm. Here, we present a glacier chronology based on 30 new 10Be surface exposure ages from well-preserved moraines in the Lago Palena/General Vintter basin in northern Patagonia (~ 44°S). We find that the main glacier lobe underwent profound retreat after 19.7 ± 0.7 ka. This recessional trend led to the individualization of the Cerro Riñón glacier by ~ 16.3 ka, which underwent minor readvances at 15.9 ± 0.5 ka during Heinrich Stadial 1, during the Antarctic Cold Reversal with successive maxima at 13.5 ± 0.4, 13.1 ± 0.4, and 13.1 ± 0.5 ka, and a minor culmination at 12.5 ± 0.4 ka during Younger Dryas time. We conclude that fluctuations of Patagonian glaciers during T1 were controlled primarily by climate anomalies brought by shifts in the Southern Westerly Winds (SWW) locus. We posit that the global covariation of mountain glaciers during T1 was linked to variations in atmospheric CO2 (atmCO2) promoted by the interplay of the SWW-Southern Ocean system at millennial timescales.

Long-term demise of sub-Antarctic glaciers modulated by the Southern Hemisphere Westerlies.

The accelerated melting of ice on the Antarctic Peninsula and islands in the sub-Antarctic suggests that the cryosphere is edging towards an irreversible tipping point. How unusual is this trend of ice loss within the frame of natural variability, and to what extent can it be explained by underlying climate dynamics? Here, we present new high-resolution reconstructions of long-term changes in the extents of three glaciers on the island of South Georgia (54°S, 36°W), combining detailed analyses of glacial-derived sediments deposited in distal glacier-fed lakes and cosmogenic exposure dating of moraines. We document that the glaciers of South Georgia have gradually retracted since the Antarctic cold reversal (ACR, 14.5-12.8 ka), culminating in the disappearance of at least one of the reconstructed glaciers. The glacier retreat pattern observed in South Georgia suggests a persistent link to summer insolation at 55°S, which intensified during the period from the ACR to approximately 2 ka. It also reveals multi-decadal to centennial climate shifts superimposed on this long-term trend that have resulted in at least nine glacier readvances during the last 10.5 ka. Accompanying meridional changes in the Southern Hemisphere westerlies and their interconnection with local topography may explain these glacier readvances.

A multimillion-year-old record of Greenland vegetation and glacial history preserved in sediment beneath 1.4 km of ice at Camp Century.

Understanding the history of the Greenland Ice Sheet (GrIS) is critical for determining its sensitivity to warming and contribution to sea level; however, that history is poorly known before the last interglacial. Most knowledge comes from interpretation of marine sediment, an indirect record of past ice-sheet extent and behavior. Subglacial sediment and rock, retrieved at the base of ice cores, provide terrestrial evidence for GrIS behavior during the Pleistocene. Here, we use multiple methods to determine GrIS history from subglacial sediment at the base of the Camp Century ice core collected in 1966. This material contains a stratigraphic record of glaciation and vegetation in northwestern Greenland spanning the Pleistocene. Enriched stable isotopes of pore-ice suggest precipitation at lower elevations implying ice-sheet absence. Plant macrofossils and biomarkers in the sediment indicate that paleo-ecosystems from previous interglacial periods are preserved beneath the GrIS. Cosmogenic 26Al/10Be and luminescence data bracket the burial of the lower-most sediment between <3.2 ± 0.4 Ma and >0.7 to 1.4 Ma. In the upper-most sediment, cosmogenic 26Al/10Be data require exposure within the last 1.0 ± 0.1 My. The unique subglacial sedimentary record from Camp Century documents at least two episodes of ice-free, vegetated conditions, each followed by glaciation. The lower sediment derives from an Early Pleistocene GrIS advance. 26Al/10Be ratios in the upper-most sediment match those in subglacial bedrock from central Greenland, suggesting similar ice-cover histories across the GrIS. We conclude that the GrIS persisted through much of the Pleistocene but melted and reformed at least once since 1.1 Ma.

A first-order flexible ELA model based on geomorphic constraints.

Alpine glaciers, with their valuable combination of highly sensitive response to climate and near-global extent, are powerful tools for investigating previous and present climate changes. They also represent critical water resources for areas around the globe, with the potential for far-reaching effects in a warming world. Advancements to understand and model glacial changes and the variables influencing them are therefore paramount. Many glacier models fall into one of two endmembers: either highly complex transient models requiring careful tuning of multiple parameters to individual glaciers, or basic empirical correlations of glacier area and length with few considerations for local and regional variations in characteristics. Here we detail a physical steady-state model for alpine glaciers relating directly to glacier mass balance (via the equilibrium line altitude) while retaining the simplicity of other morphology methods, and simultaneously including error estimates. We provide custom MATLAB functions as a user-friendly and generally-applicable method to estimate glacier equilibrium line altitudes from only a limited number of glacier bed topography and glacier width measurements. As a test of the model's efficacy, we compare the model results for present-day glaciers in the Swiss Alps with previously published estimates of equilibrium line altitudes and intermediate model outputs.•The method estimates glacier equilibrium line altitudes from a limited set of bed topography measurements and constraints on glacier width.•The method is based on continuity equations, reducing the need for empirical coefficients tuned with measured data.•The method uses Monte Carlo sampling and bootstrapping to generate uncertainty bounds on the equilibrium line altitude estimates.

Rate of mass loss from the Greenland Ice Sheet will exceed Holocene values this century.

The Greenland Ice Sheet (GIS) is losing mass at a high rate1. Given the short-term nature of the observational record, it is difficult to assess the historical importance of this mass-loss trend. Unlike records of greenhouse gas concentrations and global temperature, in which observations have been merged with palaeoclimate datasets, there are no comparably long records for rates of GIS mass change. Here we reveal unprecedented mass loss from the GIS this century, by placing contemporary and future rates of GIS mass loss within the context of the natural variability over the past 12,000 years. We force a high-resolution ice-sheet model with an ensemble of climate histories constrained by ice-core data2. Our simulation domain covers southwestern Greenland, the mass change of which is dominated by surface mass balance. The results agree favourably with an independent chronology of the history of the GIS margin3,4. The largest pre-industrial rates of mass loss (up to 6,000 billion tonnes per century) occurred in the early Holocene, and were similar to the contemporary (AD 2000-2018) rate of around 6,100 billion tonnes per century5. Simulations of future mass loss from southwestern GIS, based on Representative Concentration Pathway (RCP) scenarios corresponding to low (RCP2.6) and high (RCP8.5) greenhouse gas concentration trajectories6, predict mass loss of between 8,800 and 35,900 billion tonnes over the twenty-first century. These rates of GIS mass loss exceed the maximum rates over the past 12,000 years. Because rates of mass loss from the southwestern GIS scale linearly5 with the GIS as a whole, our results indicate, with high confidence, that the rate of mass loss from the GIS will exceed Holocene rates this century.

Quality of Life and Decision Regret After Postoperative Radiation Therapy to the Prostatic Bed Region With or Without Elective Pelvic Nodal Radiation Therapy.

PURPOSE: To evaluate patient-reported health-related quality of life (HRQOL) and decision regret (DR surgery or DR radiation therapy) after radiation therapy to the prostatic bed (PBRT) with or without whole pelvic radiation therapy (WPRT). METHODS AND MATERIALS: Patients received 79.29 Gy (n = 78; R1/detectable tumors) or 71.43 Gy (n = 56; R0/undetectable tumors) equivalent dose in 2-Gy fractions (EQD-2). Out of 134 patients, 51 had received additional WPRT with 44 Gy. Decision regret was reported using a 5-item instrument (best/worst scores: 0-100); European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-PR25 questionnaires were used for HRQOL evaluation. RESULTS: At a median follow-up of 53 months, 134 valid questionnaires were returned. Most patients had locally advanced, node-positive (T3-4/N0 = 54.5%; N1 = 17.2%) or high-risk tumors (27.6%). Mean DR surgery was 17.61 and not associated with positive margins, salvage strategy, or radiation therapy regimen. Mean DR radiation therapy was 18.64 and better in patients who had PBRT compared with WPRT (P = .034; 24.39 vs. 15.24). Patient-reported bowel and urinary symptoms were worse after WPRT compared with PBRT (both P < .05); general HRQOL was numerically but not significantly better after PBRT without WPRT (P = .055). Subset analyses identified increased bowel and urinary symptom scores after WPRT irrespective of higher or lower dose cohorts (all P < .05). CONCLUSIONS: WPRT was associated with increased symptom burden and decision regret compared with PBRT. It is uncertain if the results can be extrapolated to lower-dose (<70 Gy) regimens. Further research is required to evaluate if specific decision support tools or treatment modifications according to the individual risk situation may be beneficial in this setting.

Postoperative elective pelvic nodal irradiation compared to prostate bed irradiation in locally advanced prostate cancer - a retrospective analysis of dose-escalated patients.

BACKGROUND: It is uncertain if whole-pelvic irradiation (WPRT) in addition to dose-escalated prostate bed irradiation (PBRT) improves biochemical progression-free survival (bPFS) after prostatectomy for locally advanced tumors. This study was initiated to analyze if WPRT is associated with bPFS in a patient cohort with dose-escalated (> 70 Gy) PBRT. METHODS: Patients with locally advanced, node-negative prostate carcinoma who had PBRT with or without WPRT after prostatectomy between 2009 and 2017 were retrospectively analyzed. A simultaneous integrated boost with equivalent-doses-in-2-Gy-fractions (EQD-2) of 79.29 Gy or 71.43 Gy to the prostate bed was applied in patients with margin-positive (or detectable) and margin-negative/undetectable tumors, respectively. WPRT (44 Gy) was offered to patients at an increased risk of lymph node metastases. RESULTS: Forty-three patients with PBRT/WPRT and 77 with PBRT-only were identified. Baseline imbalances included shorter surgery-radiotherapy intervals (S-RT-Intervals) and fewer resected lymph nodes in the WPRT group. WPRT was significantly associated with better bPFS in univariate (p = 0.032) and multivariate models (HR = 0.484, p = 0.015). Subgroup analysis indicated a benefit of WPRT (p = 0.029) in patients treated with rising PSA values who mostly had negative margins (74.1%); WPRT was not associated with a longer bPFS in the postoperative setting with almost exclusively positive margins (96.8%). CONCLUSION: We observed a longer bPFS after WPRT compared to PBRT in patients with locally advanced prostate carcinoma who underwent dose-escalated radiotherapy. In subset analyses, the association was only observed in patients with rising PSA values but not in patients with non-salvage postoperative radiotherapy for positive margins.

Quality of life after low-dose rate-brachytherapy for prostate carcinoma - long-term results and literature review on QLQ-C30 and QLQ-PR25 results in published brachytherapy series.

BACKGROUND: Patient-reported health-related quality of life (HRQOL) differs between treatment options for prostate carcinoma. Long-term HRQOL data in brachytherapy series are scarce. Therefore, we analyzed prostate-specific and general HRQOL in patients treated with brachytherapy for prostate carcinoma after long-term follow-up. METHODS: Two hundred ninety-six patients with prostate carcinoma were treated with brachytherapy (01/1998-11/2003). General and prostate-specific HRQOL were measured using EORTC-QLQ-C30 and EORTC-QLQ-PR25, respectively. Patients were asked to complete the questionnaires after a median follow-up of 141 (119-181) months. QLQ-C30 results were compared to the German reference population. QLQ-PR25 results were compared to an earlier follow-up after a median of 51 months (no published QLQ-PR25 reference population for comparison). Additionally, a literature review on HRQOL data in brachytherapy series was performed. RESULTS: One hundred six (35.8%) patients were lost to follow-up, 70 (23.6%) had died. 120 (40.5%) patients were contacted. 80 questionnaires were returned (27% of the original cohort; 91% of alive patients were ≥70 years). Sexual activity declined over time (mean scores: 40.5 vs. 45.5; p = 0.006), hormonal treatment-related symptoms, problems associated with incontinence aids, and burden of obstructive urinary symptoms did not differ significantly compared to the 51-month follow-up. General HRQOL was numerically better in our cohort as compared to the German reference population (> 16% relative difference for both age strata; < 70 and ≥70 years). CONCLUSIONS: Our results indicate that symptom-burden after long-term follow-up and associated prostate-specific HRQOL remains relatively stable from 51 to 141 months. General HRQOL in surviving patients was numerically better compared to the reference population.

Glacier advance during Marine Isotope Stage 11 in the McMurdo Dry Valleys of Antarctica.

We mapped six distinct glacial moraines alongside Stocking Glacier in the McMurdo Dry Valleys, Antarctica. Stocking Glacier is one of several alpine glaciers in the Dry Valleys fringed by multiple cold-based drop moraines. To determine the age of the outermost moraine, we collected 10 boulders of Ferrar Dolerite along the crest of the moraine and analyzed mineral separates of pyroxene for cosmogenic 3He. On the basis of these measurements, the exposure age for the outermost moraine is 391 ± 35 ka. This represents the first documented advance of alpine glacier ice in the Dry Valleys during Marine Isotope Stage (MIS) 11. At this time, Stocking Glacier was ~20-30% larger than today. The cause of ice expansion is uncertain, but most likely it is related to increased atmospheric temperature and precipitation, associated with reduced ice extent in the nearby Ross Embayment. The data suggest complex local environmental response to warm climates in Antarctica and have implications for glacial response to Holocene warming. The study also demonstrates the potential for using alpine glacier chronologies in the Transantarctic Mountains as proxies for retreat of grounded glacier ice in the Ross Embayment.

Greenland was nearly ice-free for extended periods during the Pleistocene.

The Greenland Ice Sheet (GIS) contains the equivalent of 7.4 metres of global sea-level rise. Its stability in our warming climate is therefore a pressing concern. However, the sparse proxy evidence of the palaeo-stability of the GIS means that its history is controversial (compare refs 2 and 3 to ref. 4). Here we show that Greenland was deglaciated for extended periods during the Pleistocene epoch (from 2.6 million years ago to 11,700 years ago), based on new measurements of cosmic-ray-produced beryllium and aluminium isotopes (10Be and 26Al) in a bedrock core from beneath an ice core near the GIS summit. Models indicate that when this bedrock site is ice-free, any remaining ice is concentrated in the eastern Greenland highlands and the GIS is reduced to less than ten per cent of its current volume. Our results narrow the spectrum of possible GIS histories: the longest period of stability of the present ice sheet that is consistent with the measurements is 1.1 million years, assuming that this was preceded by more than 280,000 years of ice-free conditions. Other scenarios, in which Greenland was ice-free during any or all Pleistocene interglacials, may be more realistic. Our observations are incompatible with most existing model simulations that present a continuously existing Pleistocene GIS. Future simulations of the GIS should take into account that Greenland was nearly ice-free for extended periods under Pleistocene climate forcing.

Glacier maxima in Baffin Bay during the Medieval Warm Period coeval with Norse settlement.

The climatic mechanisms driving the shift from the Medieval Warm Period (MWP) to the Little Ice Age (LIA) in the North Atlantic region are debated. We use cosmogenic beryllium-10 dating to develop a moraine chronology with century-scale resolution over the last millennium and show that alpine glaciers in Baffin Island and western Greenland were at or near their maximum LIA configurations during the proposed general timing of the MWP. Complimentary paleoclimate proxy data suggest that the western North Atlantic region remained cool, whereas the eastern North Atlantic region was comparatively warmer during the MWP-a dipole pattern compatible with a persistent positive phase of the North Atlantic Oscillation. These results demonstrate that over the last millennium, glaciers approached their eventual LIA maxima before what is considered the classic LIA in the Northern Hemisphere. Furthermore, a relatively cool western North Atlantic region during the MWP has implications for understanding Norse migration patterns during the MWP. Our results, paired with other regional climate records, point to nonclimatic factors as contributing to the Norse exodus from the western North Atlantic region.

Hazard potential of volcanic flank collapses raised by new megatsunami evidence.

Large-scale gravitational flank collapses of steep volcanic islands are hypothetically capable of triggering megatsunamis with highly catastrophic effects. Yet, evidence for the generation and impact of collapse-triggered megatsunamis and their high run-ups remains scarce or is highly controversial. Therefore, doubts remain on whether island flank failures truly generate enough volume flux to trigger giant tsunamis, leading to diverging opinions concerning the real hazard potential of such collapses. We show that one of the most prominent oceanic volcanoes on Earth-Fogo, in the Cape Verde Islands-catastrophically collapsed and triggered a megatsunami with devastating effects ~73,000 years ago. Our deductions are based on the recent discovery and cosmogenic (3)He dating of tsunamigenic deposits found on nearby Santiago Island, which attest to the impact of this giant tsunami and document wave run-up heights exceeding 270 m. The evidence reported here implies that Fogo's flank failure involved at least one fast and voluminous event that led to a giant tsunami, in contrast to what has been suggested before. Our observations therefore further demonstrate that flank collapses may indeed catastrophically happen and are capable of triggering tsunamis of enormous height and energy, adding to their hazard potential.

Younger Dryas deglaciation of Scotland driven by warming summers.

The Younger Dryas Stadial (YDS; ∼ 12,900-11,600 y ago) in the Northern Hemisphere is classically defined by abrupt cooling and renewed glaciation during the last glacial-interglacial transition. Although this event involved a global reorganization of atmospheric and oceanic circulation [Denton GH, Alley RB, Comer GC, Broecker WS (2005) Quat Sci Rev 24:1159-1182], the magnitude, seasonality, and geographical footprint of YDS cooling remain unresolved and pose a challenge to our understanding of abrupt climate change. Here, we present a deglacial chronology from Scotland, immediately downwind of the North Atlantic Ocean, indicating that the Scottish ice cap disintegrated during the first half of the YDS. We suggest that stratification of the North Atlantic Ocean resulted in amplified seasonality that, paradoxically, stimulated a severe wintertime climate while promoting warming summers through solar heating of the mixed layer. This latter process drove deglaciation of downwind landmasses to completion well before the end of the YDS.

Glacier retreat in New Zealand during the Younger Dryas stadial.

Millennial-scale cold reversals in the high latitudes of both hemispheres interrupted the last transition from full glacial to interglacial climate conditions. The presence of the Younger Dryas stadial (approximately 12.9 to approximately 11.7 kyr ago) is established throughout much of the Northern Hemisphere, but the global timing, nature and extent of the event are not well established. Evidence in mid to low latitudes of the Southern Hemisphere, in particular, has remained perplexing. The debate has in part focused on the behaviour of mountain glaciers in New Zealand, where previous research has found equivocal evidence for the precise timing of increased or reduced ice extent. The interhemispheric behaviour of the climate system during the Younger Dryas thus remains an open question, fundamentally limiting our ability to formulate realistic models of global climate dynamics for this time period. Here we show that New Zealand's glaciers retreated after approximately 13 kyr bp, at the onset of the Younger Dryas, and in general over the subsequent approximately 1.5-kyr period. Our evidence is based on detailed landform mapping, a high-precision (10)Be chronology and reconstruction of former ice extents and snow lines from well-preserved cirque moraines. Our late-glacial glacier chronology matches climatic trends in Antarctica, Southern Ocean behaviour and variations in atmospheric CO(2). The evidence points to a distinct warming of the southern mid-latitude atmosphere during the Younger Dryas and a close coupling between New Zealand's cryosphere and southern high-latitude climate. These findings support the hypothesis that extensive winter sea ice and curtailed meridional ocean overturning in the North Atlantic led to a strong interhemispheric thermal gradient during late-glacial times, in turn leading to increased upwelling and CO(2) release from the Southern Ocean, thereby triggering Southern Hemisphere warming during the northern Younger Dryas.

Holocene glacier fluctuations in the Peruvian Andes indicate northern climate linkages.

The role of the tropics in triggering, transmitting, and amplifying interhemispheric climate signals remains a key debate in paleoclimatology. Tropical glacier fluctuations provide important insight on regional paleoclimatic trends and forcings, but robust chronologies are scarce. Here, we report precise moraine ages from the Cordillera Vilcabamba (13 degrees 20'S) of southern Peru that indicate prominent glacial events and associated climatic shifts in the outer tropics during the early Holocene and late in the "Little Ice Age" period. Our glacier chronologies differ from the New Zealand record but are broadly correlative with well-dated glacial records in Europe, suggesting climate linkages between the tropics and the North Atlantic region.

High-frequency Holocene glacier fluctuations in New Zealand differ from the northern signature.

Understanding the timings of interhemispheric climate changes during the Holocene, along with their causes, remains a major problem of climate science. Here, we present a high-resolution 10Be chronology of glacier fluctuations in New Zealand's Southern Alps over the past 7000 years, including at least five events during the last millennium. The extents of glacier advances decreased from the middle to the late Holocene, in contrast with the Northern Hemisphere pattern. Several glacier advances occurred in New Zealand during classic northern warm periods. These findings point to the importance of regional driving and/or amplifying mechanisms. We suggest that atmospheric circulation changes in the southwest Pacific were one important factor in forcing high-frequency Holocene glacier fluctuations in New Zealand.

Intraoperative radiotherapy (IORT) is an option for patients with localized breast recurrences after previous external-beam radiotherapy.

BACKGROUND: For patients suffering of recurrent breast cancer within the irradiated breast, generally mastectomy is recommended. The normal tissue tolerance does not permit a second full-dose course of radiotherapy to the entire breast after a second breast-conserving surgery (BCS). A novel option is to treat these patients with partial breast irradiation (PBI). This approach is based on the hypothesis that re-irradiation of a limited volume will be effective and result in an acceptable frequency of side effects. The following report presents a single center experience with intraoperative radiotherapy (IORT) during excision of recurrent breast cancer in the previously irradiated breast. METHODS: Between 4/02 and 11/06, 15 patients were treated for in-breast recurrences at a median of 10 years (3-25) after previous EBRT (10 recurrences in the initial tumor bed, 3 elsewhere in-breast failures, 2 invasive recurrences after previous DCIS). Additional 2 patients were selected for IORT with new primary breast cancer after previous partial breast EBRT for treatment of Hodgkin's disease. IORT with a single dose of 14.7 - 20 Gy 50 kV X-rays at the applicator surface was delivered with the Intrabeam-device (Carl Zeiss, Oberkochen, Germany). RESULTS: After a median follow-up of 26 months (1-60), no local recurrence occurred. 14 out of 17 patients are alive and free of disease progression. Two patients are alive with distant metastases. One patient died 26 months after BCS/IORT due to pulmonary metastases diagnosed 19 months after BCS/IORT. Acute toxicity after IORT was mild with no Grade 3/4 toxicities and cosmetic outcome showed excellent/good/fair results in 7/7/3 cases. CONCLUSION: IORT for recurrent breast cancer using low energy X-rays is a valuable option for patients with recurrent breast cancer after previous radiotherapy.

Near-synchronous interhemispheric termination of the last glacial maximum in mid-latitudes.

Isotopic records from polar ice cores imply globally asynchronous warming at the end of the last glaciation. However, 10Be exposure dates show that large-scale retreat of mid-latitude Last Glacial Maximum glaciers commenced at about the same time in both hemispheres. The timing of retreat is consistent with the onset of temperature and atmospheric CO2 increases in Antarctic ice cores. We suggest that a global trend of rising summer temperatures at the end of the Last Glacial Maximum was obscured in North Atlantic regions by hypercold winters associated with unusually extensive winter sea ice.