RCIs and regression-based norms are complementary indexes and can be particularly useful in examining the test-retest performance of individual patients who undergo epilepsy surgery as well as in the more general investigation of cognitive outcome after epilepsy surgery.

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Aim:Non-melanoma skin cancer (NMSC) of the lower legs is a challenge to treat. Surgery can be difficult given the challenged blood supply.Radiotherapy (RT) is a controversial treatment modality and some radiation oncologists (ROs) will not offer definitive treatment for lesions below the knee for fear of creating a radiation-induced ulcer. This study is a retrospective audit of a single RO’s treatment of lower leg NMSCs. The aim is to evaluate the efficacy of RT in gaining local control of these lesions. The aim is also to document the development of late side effects following RT, including radiation-induced ulcers and their treatment. Referral growth over time was also investigated. Methods:Electronic medical records were searched for patients with lower leg NMSCs treated by the RO between January 2009 and December 2019 at three locations in Sydney, Australia (St Vincent’s Hospital, Mater Hospital, and Macquarie University Hospital). Patient, tumour, treatment, and outcome factors were collected and analysed.Referrals over time were recorded. Results:111 lesions arising in 56 patients were identified. There was even distribution of sex and the mean age was 82 (range 57–95). There were 78 cutaneous squamous cell carcinomas (cSCCs) and 23 basal cell carcinomas (BCC). Median lesion size was 2 centimetres (range 1–10cm). The most common RT modality used was electrons (91 [82%]), followed by superficial RT (SXRT) (20 [18%]). Median duration of follow-up was 4 months (range 0–117 months). Of the 77 lesions treated with curative intent, cure was achieved in 74 (96%) lesions. 2 cSCCs and 1 BCC recurred, with a median time to recurrence of 24 months. 15 (14%) lesions developed a radiation-induced ulcer following RT. Median duration of therapy required for these ulcers was 5 months (range 1–55 months), with conservative treatment being the most common therapy used. Referrals increased from 8 in the 2008-2011 period to 26 in the 2016-2019 period. Conclusion: This study showed RT treatment of lower leg NMSCs achieves local control of lesions with an acceptably low rate of radiation-induced ulcers, thus supporting the use of this modality for this patient population. Referrals grew over time which may reflect growing referrer knowledge and confidence in definitive RT below the knee.

A standard answer of the Metis people to those curious as to when the Metis originated has been: "Nine months after the first White man set foot in Canada~'2The inhabitants are chiefly of Canadian origin, all more or less imbued with Indian blood. Not being previously aware of the diversity in the character of the inhabitants, the sudden change from an American to a French population, has a surprising, and to say the least, an unpleasant effect; for the first twenty-four hours, the traveler fancies himself in a real Babel. ... The business of a town of this kind differs so materially from that carried on in our cities, that it is almost impossible to fancy ourselves still within the same territorial limits.

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