Future increase in extreme El Niño supported by past glacial changes.

El Niño events, the warm phase of the El Niño-Southern Oscillation (ENSO) phenomenon, amplify climate variability throughout the world. Uncertain climate model predictions limit our ability to assess whether these climatic events could become more extreme under anthropogenic greenhouse warming. Palaeoclimate records provide estimates of past changes, but it is unclear if they can constrain mechanisms underlying future predictions.

Unraveling forced responses of extreme El Niño variability over the Holocene.

Uncertainty surrounding the future response of El Niño-Southern Oscillation (ENSO) variability to anthropogenic warming necessitates the study of past ENSO sensitivity to substantial climate forcings over geological history. Here, we focus on the Holocene epoch and show that ENSO amplitude and frequency intensified over this period, driven by an increase in extreme El Niño events. Our study combines new climate model simulations, advances in coral proxy system modeling, and coral proxy data from the central tropical Pacific.

Special Considerations in Patients with Early-Stage Breast Cancer and Survivors.

Multidisciplinary care is the standard for the treatment of breast cancer. Even among women with early-stage breast cancer, the multiple subtypes and various treatment pathways involve coordination of care plans among multiple providers. Nuances exist in defining treatment strategies for specific subtypes of cancer and for different subsets of breast cancer.

The Effect of Lumpectomy and Cavity Shave Margin Status on Recurrence and Survival in Breast-Conserving Surgery.

Background/objective: Cavity shave margins (CSMs) decrease rate of positive margins and need for re-excision. Recurrence data following breast-conserving surgery (BCS) are not always available in large cancer registries. We sought to define our recurrence and survival data in BCS with routine excision of CSMs.