iL Dottore

ION Sad news on the move to the new apartment, I have just been informed by Mrs iD that the move will require "half-sizing" (like "downsizing" but more radical: at least 50% of our "stuff" Must Go!). This means that ALL my 4mm rolling stock, kits, accessories, etc., Will Have To Go, as will the majority of my Railway Books (prototype and modelling). Plus I will need to find new homes for The Brunel Pub, The Georgian Terrace Houses and other buildings. This weekend I'll be cataloging what I actually have (PM me if you're interested in getting some "good sh*t" 😁). I think I can sell most of the 4mm stuff in one batch . It's mostly GWR stuff, so if you're looking for something specifically GWR PM me and I may be able to help! On the upside Mrs iD has to "half-size" her shoe and bric-a-brac collections. So, not ALL gloom and doom!

Not only that, it's the type and amount of training they. I read that the average amount of time a US cop spends in training is 833 hours, a hair-stylist in Austin Tx requires a minimum of 1000 hrs training and cosmetologist training varies between 4 and 5 years! At least you can be reassured that in Austin Tx your hair is safe!

Re. dirty & muddy dogs: both Schotty and Lucy love rolling around on the ground. With Schotty, his preference is for snow (preferably fresh powder snow); Lucy's preference is for cow poo! Fair enough, you might say, they're dogs enjoying being dogs - something we encourage (NOT the poo rolling though, however Lucy just ignores our instructions NOT to roll in cow pats) and a quick towel down (Schotty) or quick shower (Lucy) resolves things EXCEPT.... except Lucy takes great personal affront at being made to shower and makes her feelings very clear about it. She does aristocratic disdain like no other dog I"ve ever known. Dame Maggie Smith (Downton Abbey) in full Dowager Duchess mode has nothing on a post-shower Lucy!

She may just be being polite (y"know, keeping the Guv"nor happy). When she starts to insist her dinner is served in a LMS/GWR/SR/LNER/BR liveried dog bowl, you'll know you have trained her right.

Indeed. But reading through the BBC article it does seem that this was yet another one of the recurring and seemingly never ending NHS medical scandals. Tony's brief description of the situation his mother faced sounds a lot like a NHS scandal waiting to erupt. Nowadays, IRBs, regulatory agencies and the Pharma Companies themselves are incredibly strict - as today the consequences for malfeasance are significant involving loss of reputation and careers, significant legal penalties and significant financial damage. Apart from GCP (Good Clinical Practice) being the right thing to do (as everyone in clinical development will tell you), a reputable, ethical Pharma Company is not going to risk millions of pounds by overlooking investigator malfeasance

I did NOT say that, Tony and I resent you implying that I did. I only said "No clinical trial withholds essential treatment from a patient. To do so would be unethical, immoral and counterproductive (not to mention that the regulatory agencies would descend like a ton of bricks on any clever clogs trying to do so)". Whomever the physician was, what they were doing - if the situation was not misunderstood by your mother - would get them a nice cosy chat with their IRB, if not the BMA and the GMC. And the pharma company sponsoring that trial (if it wasn't an investigator sponsored trial - where standards are much looser) would soon ensure that he/she did no more clinical trials on their watch (and in serious situations, investigator malfeasance would be brought to the attention of the regulatory agencies - with severe penalties a very distinct possibility).

Poor lass. I hope she makes a full and uneventful recovery.

Not necessarily, if a certain adverse event is seen in a large percentage of a patient population it doesn’t mean that you will experience that adverse event, just that you have a high probability of experiencing that AE. In one oncology study I worked on significant hypotension was a common AE seen immediately after treatment and although most patients experienced hypotension, a number did not. Depends upon the study design and the disease being treated. In life threatening disease, studies are designed so that patients get either <standard of care + new drug> or <standard of care + placebo>. Unfortunately, in some countries and/or some diseases <standard of care> means no treatment at all beyond managed decline. It is a sad commentary on the state of many health services across the world that sometimes the only way to access state of the art care is to sign up to a clinical trial. Nope, the physicians don’t get paid, the hospitals/clinics/institutions where the study is placed get paid per patient - but this is to pay for the blood work/scans/assessments/specialised pharmacy, nursing and study staff needed by a clinical trial (some institutions are notorious for charging eye gouging mark-ups on the otherwise routine tests required by a clinical trial). The average per-patient cost in an oncology trial (which excludes things like data management or production of study drug) is about £50,000 (and can go much higher). No clinical trial withholds essential treatment from a patient (see my earlier comment). To do so would be unethical, immoral and counterproductive (not to mention that the regulatory agencies would descend like a ton of bricks on any clever clogs trying to do so). This might have happened in the 50s and 60s, but not today. EVERY clinical study - both observational and interventional - has to be approved by the local IRB (institutional review board)/ethics committee before being allowed to proceed. Having had to - in person - justify to a German IRB why it was necessary to perform more CT scans than local standard of care, I can tell you they are NO pushover (definitely one of the toughest meetings I’ve ever been in. Even tougher than getting an extra $20 million out of senior management). As for the second highlighted point - just because to a layman they seem similar, doesn’t mean they are. Different patient populations, different regimens, different drug mode-of-actions - all relevant differences (and given the cost of a clinical trial no-one does one “just for the hell of it”). As for results being published: that doesn’t mean everything is “done and dusted”. Every single drug (or surgical intervention or other patient intervention) gets continuously studied and monitored during its effective lifespan - frequently leading to new therapeutic interventions and ALWAYS to new safety data.

I’m glad that you added that qualifier JJB. Although it is true that my knowledge of SE Asian food is not as extensive as I’d like it to be. I wonder what Shi En would makes of PB’s culinary world (standards, efforts, menus etc.). I wouldn’t worry too much about being “on the list”. The list being, I am reliably assured, scrawled in green crayon on lined paper. To be honest, I quite like “being on the list”, after all being on The List means that you have ANNOYED THE BEAR, which is a noble and fine endeavour. Unfortunately, moving will mean that I will have to trade my underground, “nuclear shelter” type shed for a “bastelraum” in the flat and TWO parking spaces (with associated storage) in the secure underground, garage. Still in return in addition to the usual rooms I’ll get a small loggia with a Japanese garden in it and a decent kitchen that can be, with some equipment changes, as professional a kitchen as you can get away with in a private dwelling.

Do you know the price of methylated spirits in Switzerland, if you can find it?(some sort of umweltschutz thingy). Now, whilst my circle of acquaintances is both broad and eclectic I have yet to encounter any toper who preferred tipple is meths (I do have a few acquaintances who drink lager, but you do need to make some allowances for your chums’ foibles). Obstwasser is cheaper and tastes better than meths (AND you can use Obstwasser to fire your live steam locos….)

Oh, I know the English alright, I was being diplomatic. And that’s a very English bit of understatement…. Not only wine, many in the UK think that paying more than £5 for anything comestible is extortionate…. Very sad. Napoleon had the right idea about Champagne: “in defeat you need it, in victory you deserve it”. Sparkling wine should be enjoyed at any time…. “Of almost any description” is - I suppose - a charitable way of describing the fizzy, alcoholic, lemonades that are the most sold (ahem) “beers” in the UK (according to Londonlovesbusiness.com) Thank goodness for microbreweries say I, otherwise you’d all be drinking the modern equivalent of Watney’s Red Barrell - were the brewing conglomerates to get their own way.

Regarding Champagne vs prosecco: it depends - I’ve drunk both Dom Perignon and Veuve Clicquot La Grande Dame, both were excellent (as you’d expect from a Champagne costing more that £170 a bottle); but most of the time “bog standard” Champagnes aren’t worth the price (although I find that the Heidsieck & C° Monopole Blue Top is a pretty decent “every day” Champagne). The Prosecco exported to the UK is pretty much undrinkable, as is most of the Prosecco exported from Italy (the Italians keeping the best stuff for themselves). Export Prosecco tends to be far too sweet, presumably to cater to local (UK, DACH) tastes (remember Blue Nun anyone?). Hunt around and you can get some really good Prosecco - but the price of the really, really good stuff is heading towards Champagne territory. Our current “go-to” fizzy is from Switzerland and is the Mauler Cuvée Tradition Rosé Brut (see https://www.mauler.ch/fr/catalogue-mauler-cuvees-classiques-cuvee-tradition-rose-75cl-c1-t2-p21.php) at SFr 25 or so a bottle (about £22) it’s worth every penny as it’s easily as good as any Rosé Champagne at three times the price.

Don’t blame the Wing Commander. He was - as they say - following medical advice. Having recently had surgery, our <boy in blue> is still recuperating, both physically and psychologically (any major surgery has a degree of psychological impact*). Therefore I advised him that the sight of pachydermal and ursine freeloaders wallowing in, and stuffing themselves with, CAKE would set his recovery back a couple of weeks. Being a sensible chap, he heeded my advice and thus had an enjoyable and stress free birthday. * this is actually true.

It depends upon the cake. The cheap ones from the supermarket not only use the cheapest ingredients (e.g. synthetic vanilla flavour vs real vanilla extract) but are also full of all kinds of interesting (ahem) “stuff” to facilitate transportation and extend shelf-life*. Furthermore, far too many are (unnecessarily) sickly sweet. These are definitely Not Good For You. At the other end of the scale are those cakes (homemade or from a patisserie) that are made from best quality ingredients and are sweet but not sickly so. These tend to have a very short shelf-life - in terms of edibility as well as availability (as in they get scoffed quickly). These aren’t terribly good for you, although a slice or two as part of a balanced diet will not go amiss. I can’t remember the last time I ate a shop bought “industrial quality“ cake. The last slice of cake I had was from a variation on a boiled fruitcake that I made last weekend, where – instead of boiling the fruit– the raisins were left to soak overnight in an Irish whiskey liqueur. The result was more than scrumptious (as was the rhubarb crumble cake I made the weekend before that). * an interesting bit of trivia: Mrs iD loves “sliced white” for her toast (we all have our little foibles), so one week I bought a loaf of “sliced white” for her and made my usual wholewheat loaf (just flour, water, salt, fresh yeast [and a little bit of sugar to keep the yeast happy]), as Mrs iD only ever eats a slice or two of toast, the “sliced white” hung around for a bit. By the end of the week the homemade bread had gone hard as a rock (but still edible and used for croutons) whilst the commercially made bread - full of preservatives - had gone mouldy!

Is that a secret RAF code for naughty indoor shenanigans? Like ‘Allo, ‘Allo’s “flying helmet and stick of celery”?