KRAS and BRAF mutation screening in metastatic colorectal cancer costly in relation to benefits
Thursday, November 29, 2012
Researchers report that screening for KRAS and BRAF mutations can reduce the cost of anti-EGFR treatment for metastatic colorectal cancer but with a very small reduction in overall survival according to a new study published on November 28 in the Journal of the National Cancer Institute.
Metastatic colorectal cancer patients whose tumors harbor mutations in KRAS (and to a lesser extent, in BRAF) are unlikely to respond to costly anti-EGFR therapies. Screening of patients who are candidates for these therapies for mutations in one of these genes (KRAS) has been recommended, with the goal of providing treatment to those who are likely to benefit from it while avoiding unnecessary costs and harm to those who are not likely to benefit. However, the real-world impact of mutation screening for both KRAS and BRAF is unclear.
To better understand the impact of mutation screening with regard to health outcomes, costs, and value, Ajay S. Behl, Ph.D., M.B.A., of the HealthPartners Research Foundation in Bloomington, Minnesota, and colleagues, performed a cost-effectiveness analysis that took into account the treatments, resection of metastases, and survival for the different types of metastases. They conducted patient-level decision analytic simulation modeling comparing four strategies involving KRAS and BRAF mutation testing to select treatments for metastatic colorectal cancer patients: no anti-EGFR therapy (best supportive care); anti-EGFR therapy without screening; screening for KRAS mutations only (before providing anti-EGFR therapy); and screening for KRAS and BRAF mutations (before providing anti-EGFR therapy).
The researchers found that compared with no anti-EGFR therapy, screening for both KRAS and BRAF mutations showed a very high (ie, unfavorable) incremental cost-effectiveness ratio, meaning it was very costly in relation to its benefits. Compared with anti-EGFR therapy without screening, screening for KRAS mutations saved approximately $7,500 per patient; adding BRAF mutation screening saved another $1023, with little reduction in expected survival.
The authors write, "In general, our results are less supportive of the use of anti-EGFR therapy than previous analyses, and they indicate lower cost savings from KRAS testing than previously reported. Although we cannot confirm that anti-EGFR therapy is a cost-effective use of health care resources, we can affirm that KRAS testing is cost-saving. BRAF testing may offer additional savings."
In an accompanying editorial, Josh J. Carlson, M.P.H., Ph.D., of the Department of Pharmacy, University of Washington, and Scott D. Ramsey, MD, PhD, of the Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, both in Seattle, note two practical points highlighted by the study: that molecular testing is as much about generating cost savings by identifying nonresponders as it is about improving survival by identifying responders, and that good modeling must account for the fact that community practice (as opposed to clinical trials) "is messy." They write, "most importantly, this study of an unusually accurate test raises important issues that should be considered for other molecular tests in other settings."
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Journal of the National Cancer Institute: http://jncicancerspectrum.oupjournals.org
Thanks to Journal of the National Cancer Institute for this article.
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Several confounding questions surround yet another alarming situation at a private school owned by a man whose financial track record can only be described as wanting at best. The Prep Academy is now the fourth school owned by Hendrik Lamprecht to fall into deep trouble, though its exact status remains hazy.
Prep's former principal, Theresa Kern, exposed the dire situation in a detailed article by Herald education reporter Katy Bergen last week. Incredibly, Kern often had to produce copies of textbook pages because classrooms lacked books.
Yet parents paid a $250 book fee, never saw textbooks in classroom, and their children never came home with any.
Kern and other teachers did not receive paychecks for months -- just like employees at other Lamprecht schools.
In the latest lawsuit against Lamprecht, the property owner of the building that housed The Prep Academy is seeking more than $57,000 in back rent and damages. Lamprecht has not paid rent since March, the civil action states, and the building owner wants the school evicted.
This case follows several other lawsuits against Lamprecht. A dozen former teachers claim he owes them more than $200,000 in unpaid salaries.
In the past two years, Lamprecht operated three other private schools in Manatee County, and all closed over foreclosure, insufficient funds or other misfortunes. The Bradenton Prep, The Prep Learning Academy and New Path Academy all disappeared.
Now The Prep Academy is distressed. The school opened in July 2011 with state approval to receive taxpayer money in the form of McKay Scholarships for Students with Disabilities. That's easy money since state monitoring is almost nonexistent and private schools enjoy most control by simply filing compliance forms.
The Prep Academy accepted the first quarterly payments of at least one student's $14,000 scholarship and another's $11,000 scholarship. Fewer than 10 of the school's 50 students receive McKay money. Statewide, the program paid out an average of about $6,850 per scholarship this school year.
This leads to those disconcerting questions:
n Why does the state of Florida impose exacting regulations on public schools but allows private ones to rake in McKay Scholarships and operate fairly free of oversight or accountability?
n Why would parents place their children in a school without thoroughly checking the owner's background and educational expertise?
n Why would educators take employment at a place where the owner has a history of not cutting paychecks and quickly closing schools?
Gov. Rick Scott, state education leaders and top legislators all promote charter and private schools as a panacea for parental choice, contending that competition with public schools will raise learning standards and student achievement. While that's a laudable goal, the reality is far different in many cases -- with numerous charter schools failing.
Private schools are another matter, being free of the state rules that govern charter and public schools. Florida law doesn't require private schools to certify that teachers are qualified to instruct students with special needs before receiving McKay funds, nor do statutes mandate oversight on how a school spends McKay money. Once parents endorse a scholarship check over to a school, they have little influence.
Amazingly, the state does not ask private schools about curriculum. On its website until early October, The Prep Academy claimed to hold accreditation from the Southern Association of Colleges and Schools and from an organization that ceased to exist after merging with another accreditation group in 2008.
Once informed of the misrepresentation, the school deleted the erroneous reference.
Lamprecht's private academies rank as the poster children for mismanagement.
The state of Florida cannot claim to be working toward improving an education system with teacher merit pay and new standardized tests and then allow private schools to hold a free pass on accountability.
The Legislature and governor should address this failure and set standards for any school that receives taxpayer money.
REVIEW:?A juicy, bloody, grimy and profane crime drama that amply satisfies as a deep-dish genre piece, "Killing Them Softly" rather insistently also wants to be something more.
Writer-director Andrew Dominik, whose extraordinary Western "The Assassination of Jesse James by the Coward Robert Ford" proved too long and arty for the masses, repositions George V. Higgins? 1974 Boston mob-world novel as a metaphor for the ills of American capitalism circa 2008, a neatly provocative tactic. But he also shamelessly shows off his directorial acumen; unlike the leading character, who?s all business, Dominik makes sure you notice all his moves. Tight, absorbing and entertainingly performed by a virtually all-male cast topped by Brad Pitt, this Weinstein Co. release should generate solid mid-level business this fall.
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A lawyer, professor and assistant U.S. Attorney who long investigated organized crime in addition to writing 27 novels, Higgins knew well of what he wrote. His first novel, "The Friends of Eddie Coyle," was made into a fine film and his third, "Cogan?s Trade," ?the basis of this one, consists of torrents of exceptionally vivid Beantown wiseguy dialogue with bits of plot tucked almost incidentally into the chatter.
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Moving the action to decimated post-Katrina New Orleans without a tourist in sight, Dominik has done a keen, disciplined job of coaxing the plot out of the shadows while retaining the flavor of underclass lingo and attitude. With the background dominated by then-presidential candidate Barack Obama?s optimistic speeches stressing the availability of ?the American promise? to all, some bottom-feeding criminals plot what looks like a no-risk scheme: Old-timer Johnny Amato (Vincent Curatola, the great Johnny Sack of "The Sopranos") hires unwashed kids Frankie (Scoot McNairy) and Russell (Ben Mendelsohn) to raid the regular card night run by Markie Trattman (Ray Liotta), who once robbed his own game and got away with it.
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While allowing these low-enders to emerge in all their miserable glory, Dominik also adds his own flourishes right from the outset, from striking lateral camera moves to amusingly supplying one of the young hoods with a pathetic little dog. Despite their general ineptitude, the boys pull off the job, but this is bad news for Markie, as it?s going to be assumed he?s run the same scam a second time.
At least this is what is suspected by the unnamed and unseen corporate mob, which has cog-in-the-system ?Driver? (Richard Jenkins) engage shrewd hit man Jackie Cogan (Pitt) to deal with this disruption of business as usual. Needlessly, Markie gets horribly beat up, Cogan brings in another hired killer, Mickey (James Gandolfini) to help him with a double-killing, and plenty more blood gets spilled before order is, after a fashion, restored.
Although the plot bases are dutifully, if briefly, covered, this is a crime story like so many others in which it doesn?t really matter if you can follow who everyone is and why awful things are happening to them; it?s basically a given that everyone on view is guilty of something, so you can?t feel too badly when they come to grisly ends.
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What matter more are style and attitude, which Dominik ladles on like sauce on ribs. Russell?s drug-addled disorientation is represented by multiple distortions of time, visual perception and sound; the pursuit of one victim is imaginatively covered entirely from the outside of the building in which the chase is consummated; Cogan arrives on the scene to the accompaniment of Johnny Cash?s ?The Man Comes Around?; the just-scraping-by 21st century hoods drive late-?60s/early-?70s cars like a Riviera and Toronado; and one man?s execution is rendered from many angles in a slow-motion explosion of breaking glass and penetrating bullets so elaborate and prolonged that it resembles a self-standing art installation.
In a related way, some of the dialogue scenes, especially a couple of near-monologues superbly delivered by Gandolfini as a booze-guzzling, sex-obsessed, past-his-prime hit man, almost have the feel of brilliant, free-standing acting class scenes; they serve the film?s purposes, to be sure, but there?s a self-consciously showy aspect to them that makes you easily imagine students using them as audition pieces.
The film is terribly smart in every respect, with ne?er-a-false note performances and superb craft work from top to bottom, but it never lets you forget it, from Pitt?s pithy excoriation of Thomas Jefferson?s hypocrisy right down to his ?Crime is the business of America? final line that is bound to be widely quoted.?
The film noir crime dramas of the late 1940s and early 1950s were about a palpable unease in the country, but this remained a subtext rather than the overt subject of the films. Here, Dominik explicitly articulates his intended meanings, which have to do with money, institutional rot and what happens when you don?t keep your economic house in order. Either approach is valid but, perhaps in this day and age, audiences need their messages to be quick and direct. "Killing Them Softly" delivers them that way.
Steven Tyler isn't going to take Nicki Minaj's claims that he's a racist lying down. Though the Aerosmith rocker inserted his foot firmly in his mouth during a recent interview, he has come forth to say that the American Idol judge had taken his quotes out of context.
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With December just around the corner, it?s time to start thinking about how you?re going to invite the holiday spirit into your home. Putting up decorations is lovely, and the smell of Christmas cookies baking in the oven is deeply comforting, but without the laughter of friends or family, your holiday house isn?t quite a home for the holidays. So make a plan to host a simple party that draws the kind of warmth you can?t get by adding another log to the fire. The key to pulling off a celebration of any kind within the month of December is keeping it simple. Everyone has a lot going on, so a clear, focused theme keeps the planning in check for both the host and guests. No need to go crazy, just follow three easy steps to host any of these five classic gatherings.
Holiday Tree Trimming 1. Pick a date, customize this card, and send it to your ten favorite people. 2. The day before your tree-trimming party, set up your tree so the boughs have time to relax. Make sure enough space is cleared that guests can easily move around the tree. Pre-test light strands, set out boxes of decorations, and cue up Christmas music on the stereo. 3. On the day of your party, put out a crockpot or an urn filled with hot cocoa, and set out a few plates of Christmas cookies. For an additional activity for kids, set up a station for making garlands ? popcorn and cranberries for the older kids, looped construction paper for the younger kids.
Holiday Open House
1. Pick a date, customize this card, and send it to local friends and family members. 2. The great thing about a holiday open house is that you can keep things super casual. Simply choose a wide-open window of time one weekend afternoon/evening, then plan to have snackable items available for friends and family members who swing by within that time. 3. On the day of your party, simply cue up some holiday music and enjoy your company as they come and go.
Cookie Exchange
1. Pick a date, customize this card, and send it to anyone who loves to bake ? invite between five and seven guests. 2. Make sure you make the terms of the cookie exchange clear. Instruct guests to make a minimum of one dozen cookies for each guest in attendance, and to bring a copy of the recipe. 3. On the day of your party, all you have to supply is a beverage ? coffee or hot cocoa ? to accompany the cookie sampling, plus boxes, tissue paper and ribbons for packing up cookies to go.
Ornament Exchange
1. Pick a date, customize this card, and send it to your favorite girlfriends or a handful of friends and family members. 2. You can either choose names from a hat ahead of time, instructing guests to bring the perfect ornament for that person, or you can ask guests to bring an ornament anyone would love. 3. To keep the party casual, request that guests bring their favorite holiday treat too. All you have to do is provide a few choices of beverages, and set a cozy scene for a festive celebration.
Christmas Cocktails 1. Pick a date, customize?this card, and send it to all the people you?ve been dying to have a fancy drink with. 2. Choose two killer cocktails to be at the center of the evening?s toasts ? one that?s light and refreshing like a candy cane martini?and one that?s warming like a Kentucky Christmas bourbon cocktail. Set up a station where guests can mix their own using a preprinted recipe card, plus all the right tools and ingredients. 3. Serve simple snacks that pair well with the cocktails you choose. Warm dips with fresh bread or a classic spread of cheese and crackers is plenty.
If you really want to make a statement, print recipe cards for everything from cookies to cocktails that match your original invitations, then send them home with guests as mini party favors. (Check out our previous post on how to create your own recipe cards here). But the most important thing is to NOT get caught up in the need to be perceived as Martha Stewart. It?s far more valuable to keep the celebrations simple so they actually happen!
There's not a lot to see here -- that's the Blue Skies live wallpaper I've been using for some time now. What's new is that it's been updated to serve as a sort of screen save as part of the Android 4.2 full-screen "Daydreams" feature. So when you plug in your phone, you can enjoy the same beautiful sky as when it's sitting in your hand.
Expect to see more live wallpapers do this, we reckon, and don't forget to check to see if your favorite widgets have been updated to work on the Android 4.2 lock screen.
A 425-pound woman died last month in Hungary after three airlines allegedly told her she was too fat to fly back to America.
Janos?Soltesz plans to sue Delta, KLM, and Lufthansa next month, claiming the airlines are responsible for his wife Vilma Soltesz's death after all three refused to fly her back to America ? even though Delta and KLM flew her to Hungary without complaint, the New York Post reported Tuesday.
The Solteszs spent three weeks in their native Hungary before Vilma needed to come back for treatment for diabetes and renal disease.
?Very rarely do you have discrimination causing much more than humiliation and psychological damages, but in this instance, the discriminatory actions of the airlines led to something much more serious ? Vilma?s death,? Soltesz's lawyer Holly Ronai told the Post.
Soltesz?is seeking a total of $6 million from the three airlines.
The U.S. Department of Transportation is investigating Vilma's death, according to the Post.
But Lufthansa is telling a much different story.
"Of course nobody said she was too fat to fly home," spokesman Nils Haupt told Business Insider.
The airline says it actually reserved three seats for Vilma, who had to be brought onboard the plane by a special lift. But once she was on the aircraft, Haupt says, it was impossible to move her from her wheelchair to her plane seats.
"There was not the slightest idea how to move her out of the wheelchair without hurting her," Haupt said.
Crews tried to move Vilma for about 30 minutes before she was taken off the plane, according to Haupt.
In a statement sent to Business Insider, KLM said it was "deeply saddended" by Vilma's death but that when she tried to fly home it appeared "it was not physically possible for her to board the aircraft, despite every effort made by KLM to this end. A seat or belt extender did not offer a solution either."
In a statement emailed to Business Insider, Delta spokesman Russell Cason said the airline was "physically unable to board" Vilma on a flight.
However, both Delta and KLM "did everything possible to assist the family."
This isn't the first time airlines have come under fire for allegedly refusing passage to customers they deem overweight.
Filmmaker Kevin Smith lambasted Southwest Airlines in 2010, claiming a pilot ejected him from a flight because he was too fat to fly, ABC News reported at the time.
Smith went on Twitter tirade against the airline, Mashable reported at the time:
Dear @SouthwestAir ? I know I?m fat, but was Captain Leysath really justified in throwing me off a flight for which I was already seated?
Wanna tell me I?m too wide for the sky? Totally cool. But fair warning, folks: IF YOU LOOK LIKE ME, YOU MAY BE EJECTED FROM @SOUTHWESTAIR.
Dear @SouthwestAir, I?m on another one of your planes, safely seated & buckled-in again, waiting to be dragged off in front of the normies.
Southwest ultimately tweeted an apology to Smith.
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Given all of the information resources at the homeowner?s fingertips today, choosing the best home improvement advice can be tough. Without the right information, your projects can turn into a disaster. The article below can help you get started with a number of home improvement tasks the right way.
Tie or snip extra cord length on your window blinds. It is easy for a child or pet to get caught and strangled in these cords. Make sure you do leave enough cord to maneuver the blinds, but make sure that the cord that does hang down serves no purpose. You may prevent a tragedy by removing the excess cord.
Install a pergola to give your house some character. This garden fixture will add both romance and tranquility to the aesthetics. A pergola can be installed in as little as one weekend when you enlist the help of your friends.
Many people use CFL bulbs, but few know how to deal with them when they break. Bulbs contain mercury, which is poisonous to living beings. Therefore, when one breaks, you should immediately clear out any person or pet so that the room can air out. Then clean up the glass fragments, using duct tape to carefully pick up the smallest pieces. Dispose of the shattered bulb in a double bag, and thoroughly vacuum the entire area, emptying the canister or bag immediately after.
As you plan on making home improvement projects, try to find out how to do certain things by yourself. The pros charge as much as $50 per hour, so tackling those projects on your own can save tons of money. Plus, you will have the satisfaction of knowing you did it yourself.
Improvement Projects
Research ideas for your home improvement projects before you begin. When you stay on the lookout for projects that you think could work in your home, you give yourself many options from which to choose when it comes time to decide on which home improvement projects you want to undertake. Don?t rush into picking color schemes; you don?t want to stress yourself out.
Consider how long you plan on living in the house. If you plan to move in less than five years, it makes no sense to spend a lot of money on huge changes. You should however not overlook maintenance, but any major improvements can be left to a long time owner.
Always carefully review any home improvement contract prior to signing it. As silly as it may seem, you want to make sure everything you are agreeing to is to your approval. If you sign without realizing what the contract contains, you can lose a lot of time and money. Whether you trust him or not, read the details.
Clean with an old toothbrush you no longer use. Whether you?re cleaning the grout in your bath tub area or scrubbing engine parts, you will find that old toothbrushes do an outstanding job. What?s more is that they are free! Why get a new brush when you still have something with a lot of life in it! Save the money for later.
To save money, refinish dreary cabinets in lieu of replacing them. Repaint the cabinet base and replace the doors and fixtures to get an updated new look. It is a more affordable way to improve the look of the kitchen.
In rooms that are most used, installing ceiling fans will help circulate your home?s air. You will not need to turn your air conditioner up as high and you will get warm air moving in the winter. Fans typically can be switched so that they either draw or push air as needed.
Any decent home improvement project will include laying brick and purchasing as many as necessary beforehand would make things flow much quicker. If you should need to repair or add to brickwork, you may have a difficult time trying to match the bricks you already have. Styles of brick change often. If you have extras on hand, you will be well prepared for the future.
Improvement Project
Remember that is easy to make a home improvement project a lot more complicated than it should be. With the tips provided in this article, you will be able to obtain legitimate information about home improvement. By incorporating the tips and techniques found in the above article, you will be well on your way to completing any home improvement project.
Waves are seen on Nov. 16 breaking around a roller coaster destroyed during Superstorm Sandy in Seaside Heights, N.J.
By Elizabeth Chuck, NBC News
A crumpled roller coaster partially submerged in the Atlantic Ocean off of New Jersey's boardwalk won't stay there as a "tourist attraction," despite the town's mayor advocating for that a week ago.
The iconic Star Jet roller coaster in Seaside Heights was destroyed when Sandy crashed ashore Oct. 29, wrecking parts of Casino Pier and tearing the coaster from the boardwalk.
On Monday, Seaside Heights Mayor Bill Akers said that borough officials and Casino Pier owners have been in talks to remove the coaster from the ocean, where it has sat since the storm, reported The Asbury Park Press.
Akers got criticized when he told NBC New York last week that he was working with the Coast Guard to see if the ride was stable enough to just leave as-is.?
If it was, he said, it would make "a great tourist attraction."
Mario Tama / Getty Images
The destroyed roller coaster is seen in Seaside Heights, N.J., on Oct. 31.
His comments came after demolition crews finished removing the rest of the damage in the area in preparation for businesses to rebuild on the boardwalk, the town's financial and communal beating heart.
?Everyone all over on Facebook was commenting on it and took a shot at me,?? Akers said, according to The Asbury Park Press.?
On Monday, Akers tried to clarify his "tourist attraction" remark.
"I told them [NBC New York], that I did not have an issue with it [staying], it?s not my decision since its private property,?? Akers said to The Asbury Park Press. ?That was the extent of my comment, and then all of this firestorm. It was not the brightest comment.??
He added, ?If it was going to stay, there are issues...??Does it have to be anchored down properly? And the Coast Guard would need to approve it. The whole situation is unfortunate.??
According to Akers, tourism makes up 75 percent of Seaside Heights' budget, with the remaining 25 percent coming from property owners.?
?Our biggest concern is returning the boardwalk to where it was before the storm,?? he told The Asbury Park Press.??Tourism is the lifeblood of this town."
Construction of a new boardwalk is scheduled to begin in January and be ready by Memorial Day, according to NBC New York. Casino Pier officials are still assessing the cost of the damage.
Courtesy Joel A. Rogers of CoasterGallery.com
An archival image of the Star Jet is seen at the Casino Pier, N.J., in 2007.
The now-defunct Star Jet roller coaster was built in 2002?by Portland, Ore.-based E&F Miler Industries. It replaced a decades-old roller coaster that had been in its spot and was demolished to make room for the new steel one, Fred Miler, principal of E&F Miler, told NBC News on Tuesday.
The ride had a maximum height of 52 feet, according to coastergallery.com.
Its name, Miler said, has caused some confusion.
"It's called the Star Jet," he said. "There was another coaster there that it replaced -- it was called the Jet Star. Sometimes they still use that name."
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Nomura's Paul Louie is out with a huge report examining the Hong Kong real estate market for 2013. It highlights another way the economy is changing in one of the world's fastest growing and dynamic city's
The country's condos have always been famously expensive, but as Louie notes, Hong Kong is in a particularly precarious situation, because growth is slowing, while residences are more expensive than ever before.
By at least one metric, home prices/income, housing is as expensive as it has ever been.
Nomura
However, the really interesting thing is the theory that the apartment bubble is causing a "reverse baby boom" so to speak.
We are not seeing the usual boom in Dragon babies ? Even on the demographic front, we are witnessing something very unusual. In the first eight months of 2012, there were only 60,103 births in Hong Kong. Compared to the same period in 2011, this is down 5.2% y-y. In the past two Years of the Dragon (2000 and 1988), the number of births rose by 6% and 4% even as the marriage numbers declined by 1% and 7%. Thus, the current condition of a 5% drop in births while marriages are up by 5% is highly unusual. Considering that this is the Year of the Dragon and private hospitals? zero quota on mainland babies does not come into effect until 1 January 2013, the decline in the birth rate may suggest that Hong Kong may have become so unaffordable that local fundamental demand is now being curtailed.
The connection seems hard to prove, but that is quite a drop in a year that was expected to see a baby boom. If there's a sense of a real estate bubble, and people are feeling less secure about their incomes, it seems plausible.
SEE ALSO: The world's #1 housing bubble has gotten crazy again >
Despite the low consumer price index in November, investors still stood on the sidelines last week as the VN-Index and average daily trade on the southern bourse were lower than the previous week.
With four falling and one rising session, the VN-Index lost a combined 4.01 points last week and hit 381.7 on Friday. A familiar scenario of moving in a narrow range of the VN-Index expanded last week as the index did not change over 0.5% a day.
Moreover, trade on the bourse nearly declined day by day. The whole week saw an average 21 million securities changing hands a day with an average value of VND300 billion. The trading value last week was the lowest of the year.
Last Friday saw 84 stocks increasing and 97 others falling. Most of high-cap stocks declined as only six of the 30 biggest stocks on the bourse rose while 14 others fell. That made the VN30 index lose 2.51 points at 449.73.
Foreigners were net buyers on Friday with a net buying value of VND5.56 billion. In general, they still focus on large-cap stocks like KDC, DPM, PNJ, HSG, and BVH. Kinh Do Corp. (KDC) led the buying list of foreign investors as their buying of the stock was worth VND29 billion last week.
Given the recent poor performance of the stock market, securities companies haven?t given any optimistic comments. Viet Capital Securities said in a report last Friday that there was no clear market trend, so disbursing money at the moment was seen as unwise.
Viet Dragon Securities Co. said that the recovery prospect of the stock market in short and middle terms were very low. If the VN-Index falls below 380 points this week, it will help to improve market liquidity, but the firm?s analysts don?t expect that more investors will jump into the market to catch low-price opportunities given the current situation.
The Hanoi index fell 0.7% to 51.2 points on Friday and lost a total of 0.61 point last week. Investors traded 21.3 million shares on the northern bourse on Friday at a total value of VND125 billion, rising 15% and 36% from the session earlier.
Retirement homes are where seniors can live freely and independently and families can worry less about their aging loved ones in Chicago. Some retirement homes have an age minimum. This keeps the atmosphere consistent amongst the residents. Transportation issues will be a thing of the past for most seniors and their families when one of the Chicago retirement homes is chosen as a senior living option.
It is hard to convince a senior aged loved one that he or she needs to change their living arrangement. When the car has become dangerous and driving has been restricted or prohibited by a physician or law enforcement, a senior will need to make arrangements for transportation. In many cases, seniors who live as home have a primary caregiver and someone who is essentially at their disposal for assistance for most of the day. Some seniors and their families do not have the luxury of being able to provide senior care in the home and cater to the needs of a senior. For this reason, changing the living situation or finding senior housing like that of retirement homes can be the best option for a senior and his or her family.
Without the worry of maintenance on a home or how a senior aged loved one will be able to live an independent lifestyle without a lot of help from a caregiver or family member?s assistance.
Most retirement homes in Chicago are able to offer one fixed cost for scheduled transportation services, interior and exterior home maintenance, trash removal or pick-up and snow removal or landscaping. Seniors who live in retirement homes in Chicago will be responsible for other ?unfixed? or variable personal expenses like utilities such as electric, cable and telephone, unscheduled transportation to personal doctor?s visits or appointments and the cost of health related expenses.
Some retirement homes in Chicago offer home health, hospice, and pastoral care, in home companionship and graceful aging services. Some Chicago retirement homes may also have small convenience-type stores, hair salons, on-site dining and on-site gym facilities or physical therapy offices. Many senior aged residents never have a need to leave the worry-free environment of the retirement homes. In Chicago, there are many options available with regard to retirement homes and senior living. Research the available options and make a decision based on the needs and desires of your senior aged loved one.
Many retirement homes offer community or cultural areas to preserve the sense of community or cultural integrity of a community or area. Seniors are able to interact with other residents of the retirement home and maintain a sense of community in Chicago. Arts and activities are shared amongst residents of many senior living and retirement homes in Chicago, and many also offer live music and other events, which are scheduled and planned for their residents.
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My friend Dr. Silvia Hodges recently asked me to contribute to a book she was compiling and editing, Buying Legal: Procurement Insights and Practice, published by the Ark Group in association with Managing Partner.? The book is a collection of articles from 32 leading authorities discussing the increasing partnership between the corporate legal department and the corporate procurement function to select and manage legal expenses, including outside counsel.? The book is divided into two parts, Section A is designed to benefit outside counsel and Section B is for in-house counsel and procurement professionals.? However, I recommend that anyone involved in the buying or selling of legal services would do well to read the entire book.
The involvement of procurement in the purchasing of legal services is swiftly becoming the ?new normal.? And not just for sourcing low-end, routine or commoditized legal services ? but increasingly for higher-stakes legal work too!?This critical new report will equip law firms and in-house legal and procurement teams with the necessary tools to make these new relationships successful.
It?s packed with original research, case studies, opinion pieces, practical approaches, and checklists that address the key challenges and opportunities that buying and selling legal services creates ? from relationship building and management, to financial and strategic decision-making. Industry leaders, Riverview Law, Wragge & Co LLP, PwC, Dechert LLP, Kennedys Law LLP, Corporate Executive Board, Institute for Supply Management, Akin Gump Strauss Hauer & Feld LLP, Validatum, Vantage Partners LLC, Trusted Advisor Associates and many more provide insightful case studies and advice on key topics, including:
Benchmarking the procurement of legal services
Pricing and negotiation strategies
Bulk buying of legal services
Understanding the requirements of the procurement department
Successful complex tendering
Current trends in the procurement of international legal services
Procurement departments? sourcing strategies
Building relationships with the CPO
The role of procurement in purchasing legal services
The positive and negative effects of discounts
Top tips for successfully procuring legal services
Trusted tactics to get the most from spending on outside services
Demonstrating law department value through analytics
Using technology to source legal services; and much more
The chapter I submitted is titled ?Why CEOs Love Procurement? and discusses how corporations continually seek a competitive cost advantage.? This is particularly critical in challenging economies or markets when revenues are flat or declining.? A modern CEO doesn?t just look at growing revenue or decreasing overhead, but looks to lower the cost of goods sold and service delivery.? For law firm leaders faced with declining demand, increasing price pressure and competition from above and below, it?s critical to understand the role of procurement in managing a corporation?s expenses.? Lawyers who believe procurement is a euphemism for ?selecting the lowest cost provider? are misguided.? Differentiation on factors other than price are critical, yet most lawyers and most law firms market in ways that are indistinguishable from the competition.? As I wrote a few years ago when I first tackled the role of procurement:? ?A law firm that can demonstrate its prowess in managing to a budget through effective project management, that keeps the client fully informed of any changes to expectations, that staffs appropriately and doesn?t ?overwork? matters or expect clients to subsidize young associate training, is in a better position to present clear, quantifiable evidence of its higher rates.?
Prostate Cancer Awareness Project (http://www.carsforprostatecancer.org) is a charity involved in spreading awareness about prostate cancer. Our mission is to spread awareness about the disease and in particular the need for early detection through regular screening. Prostate cancer hasn?t received as much publicity as it deserves given that annually about 200,000 men are diagnosed with it and close to 30,000 men die from it.
?To pursue our mission we accept vehicle donations from well-wishers and which we sell so as to secure funding. We accept all kinds of vehicles so you can donate motorcycle, donate motor home, and donate RV, and pretty much any kind of vehicle you have gathering dust in your garage. Whatever vehicle you donate, whether you donate motor home or donate RV, we will collect it from you and do all the paperwork required. When you donate motorcycle or a car we don?t sell it until some sprucing up work is done on it to make it fetch a better price. By making a donation to us you will definitely be putting your old vehicles to very good use.
David Rosenberg is throwing his support behind the Canadian dollar being included as a reserve currency at the IMF.
The chief economist and strategist at Gluskin Sheff + Associates noted that the loonie has already become a de facto global currency as central banks continue to add Canadian dollars to their reserve portfolios.
He said this reflects Canada?s growing importance in the global economy, its prudent monetary policy, a truly AAA sovereign rating and a pro-business majority government.
?However, this move will go beyond symbolism as it will make official the Canadian dollar as international reserves, and the status upgrade from the IMF will certainly boost more global asset diversification into Canada, which will further strengthen the CAD value in our view,? Mr. Rosenberg said in Wednesday?s Breakfast with Dave.
He expects this will be particularly evident if the IMF includes the Canadian and Australian dollars to its SDR (Special Drawing Rights) basket in its next review.
In a Nov. 14 report, it said the two currencies will be considered separately for Composition of Foreign Exchange Reserves (COFER) data, which currently includes only the U.S. dollar, euro, British pound, Japanese yen and Swiss franc.
The Canadian and Australian currencies are currently included in the IMF?s ?other currencies? category, which rose to 5.3% of global foreign exchange reserves in the second quarter, up from 2% in 2007.
Novel mechanism through which normal stromal cells become cancer-promoting cells identifiedPublic release date: 21-Nov-2012 [ | E-mail | Share ]
Contact: Jeremy Moore jeremy.moore@aacr.org 215-446-7109 American Association for Cancer Research
PHILADELPHIA New understanding of molecular changes that convert harmless cells surrounding ovarian cancer cells into cells that promote tumor growth and metastasis provides potential new therapeutic targets for this deadly disease, according to data published in Cancer Discovery, a journal of the American Association for Cancer Research.
"New approaches for treating patients with ovarian cancer are desperately needed," said Ernst Lengyel, M.D., Ph.D., professor in the department of obstetrics and gynecology at the University of Chicago. "There have been no new approaches introduced into the clinic for quite some time, and we have seen no major improvements in patient survival over the years."
According to Lengyel, greater understanding of the biology of ovarian cancer should provide new therapeutic targets. He and his colleagues set out to learn how normal stromal cells are transformed into cancer-associated fibroblasts, which are found in the tissue immediately surrounding the ovarian cancer cells. Intimate cross talk between cancer-associated fibroblasts and cancer cells boosts tumor growth and metastasis.
"The strength of our study lies in the fact that we used cells from patients, rather than cell lines," said Lengyel. "This means that our model system reflects as closely as possible the clinical situation in patients."
Initial analysis indicated that cancer-associated fibroblasts from patients with ovarian cancer had altered patterns of expression of small molecules called microRNAs compared with normal and tumor-adjacent fibroblasts.
MicroRNAs are important regulators of gene expression because they help direct that cell's function. Thus, modified patterns of microRNA expression change cell function.
Lengyel and colleagues further studied the microRNA most upregulated in cancer-associated fibroblasts and the two microRNAs most significantly downregulated. When they changed the pattern of expression of these three microRNAs in normal fibroblasts to mimic the pattern they had seen in cancer-associated fibroblasts, they found that the normal fibroblasts were converted into cells with in-vitro characteristics of cancer-associated fibroblasts. Moreover, the cells reprogrammed to become cancer-associated fibroblasts by altering microRNA expression enhanced the growth of tumor cells in a mouse model of ovarian cancer.
Conversely, restoring the pattern of expression of the three microRNAs to normal in cancer-associated fibroblasts reduced their cancer-promoting characteristics.
"Therapeutic approaches targeting microRNAs in cancer cells are under development," said Lengyel. "Our work suggests that it might be possible to modify microRNA expression in cancer-associated fibroblasts for therapeutic benefit."
Lengyel added that treatments targeting microRNAs in cancer-associated fibroblasts may be particularly effective because these cells are genetically stable, unlike cancer cells, therefore, the risk that cancers will become unresponsive to these treatments is less than for treatments targeting cancer cells.
###
Follow the AACR on Twitter: @aacr #aacr
Follow the AACR on Facebook: http://www.facebook.com/aacr.org
About the American Association for Cancer Research
Founded in 1907, the American Association for Cancer Research (AACR) is the world's first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 17,000 attendees. In addition, the AACR publishes seven peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the scientific partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of team science and individual grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer.
For more information about the AACR, visit www.AACR.org.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Novel mechanism through which normal stromal cells become cancer-promoting cells identifiedPublic release date: 21-Nov-2012 [ | E-mail | Share ]
Contact: Jeremy Moore jeremy.moore@aacr.org 215-446-7109 American Association for Cancer Research
PHILADELPHIA New understanding of molecular changes that convert harmless cells surrounding ovarian cancer cells into cells that promote tumor growth and metastasis provides potential new therapeutic targets for this deadly disease, according to data published in Cancer Discovery, a journal of the American Association for Cancer Research.
"New approaches for treating patients with ovarian cancer are desperately needed," said Ernst Lengyel, M.D., Ph.D., professor in the department of obstetrics and gynecology at the University of Chicago. "There have been no new approaches introduced into the clinic for quite some time, and we have seen no major improvements in patient survival over the years."
According to Lengyel, greater understanding of the biology of ovarian cancer should provide new therapeutic targets. He and his colleagues set out to learn how normal stromal cells are transformed into cancer-associated fibroblasts, which are found in the tissue immediately surrounding the ovarian cancer cells. Intimate cross talk between cancer-associated fibroblasts and cancer cells boosts tumor growth and metastasis.
"The strength of our study lies in the fact that we used cells from patients, rather than cell lines," said Lengyel. "This means that our model system reflects as closely as possible the clinical situation in patients."
Initial analysis indicated that cancer-associated fibroblasts from patients with ovarian cancer had altered patterns of expression of small molecules called microRNAs compared with normal and tumor-adjacent fibroblasts.
MicroRNAs are important regulators of gene expression because they help direct that cell's function. Thus, modified patterns of microRNA expression change cell function.
Lengyel and colleagues further studied the microRNA most upregulated in cancer-associated fibroblasts and the two microRNAs most significantly downregulated. When they changed the pattern of expression of these three microRNAs in normal fibroblasts to mimic the pattern they had seen in cancer-associated fibroblasts, they found that the normal fibroblasts were converted into cells with in-vitro characteristics of cancer-associated fibroblasts. Moreover, the cells reprogrammed to become cancer-associated fibroblasts by altering microRNA expression enhanced the growth of tumor cells in a mouse model of ovarian cancer.
Conversely, restoring the pattern of expression of the three microRNAs to normal in cancer-associated fibroblasts reduced their cancer-promoting characteristics.
"Therapeutic approaches targeting microRNAs in cancer cells are under development," said Lengyel. "Our work suggests that it might be possible to modify microRNA expression in cancer-associated fibroblasts for therapeutic benefit."
Lengyel added that treatments targeting microRNAs in cancer-associated fibroblasts may be particularly effective because these cells are genetically stable, unlike cancer cells, therefore, the risk that cancers will become unresponsive to these treatments is less than for treatments targeting cancer cells.
###
Follow the AACR on Twitter: @aacr #aacr
Follow the AACR on Facebook: http://www.facebook.com/aacr.org
About the American Association for Cancer Research
Founded in 1907, the American Association for Cancer Research (AACR) is the world's first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than 34,000 laboratory, translational and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 17,000 attendees. In addition, the AACR publishes seven peer-reviewed scientific journals and a magazine for cancer survivors, patients and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the scientific partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration and scientific oversight of team science and individual grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer.
For more information about the AACR, visit www.AACR.org.
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
It's "back to basics" week here at Eurocast Towers, with the rest of the team ill, undergoing surgery or continent hopping, it's left to Dan and Jamie to hash out the week's biggest technology stories. Unfortunately, that's mostly centered around EE, charitable giving and that beautiful moment where Sony sees where it's been going wrong all this time.
ScienceDaily (Nov. 21, 2012) ? For the first time, researchers tracking the behavior of emperor penguins near the sea have identified the importance of sea ice for the penguins' feeding habits. The research, published November 21 in the open access journal PLOS ONE by Shinichi Watanabe from Fukuyama University, Japan and colleagues, Japan describes emperor penguin foraging behavior through the birds' chick-rearing season.
Unlike other species like Adelie penguins, emperor penguins spent much more time diving for food, and only used about 30% of their time at sea to take short breaks to rest on sea ice. The birds did not travel for long distances on the ice, or use it for other activities. The study also suggests that these short rest periods on sea ice may help the penguins avoid predators such as leopard seals.
Though sea ice conditions are known to affect penguin populations, the relationship between ice levels and penguins' foraging has been unclear because of the difficulties of tracking the birds at sea. Watanabe says, "The monitoring technique developed in this study will help to understand the relationship."
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Journal Reference:
Shinichi Watanabe, Katsufumi Sato, Paul J. Ponganis. Activity Time Budget during Foraging Trips of Emperor Penguins. PLoS ONE, 2012; 7 (11): e50357 DOI: 10.1371/journal.pone.0050357
Note: If no author is given, the source is cited instead.
Disclaimer: Views expressed in this article do not necessarily reflect those of ScienceDaily or its staff.
Motorola Atrix HD users enrolled in the Motorola Feedback Network are getting a message about an upcoming soak test that should commence soon. There's no news about what version being tested, so we can't say this is the promised Jelly Bean update, but we certainly can hope. Officially, the communication is pretty generic, and pretty standard as far as soak test invites go.
We are inviting owners of the Motorola ATRIX HD on AT&T to participate in an early preview of a new software release, and provide feedback. If you are not currently using a Motorola ATRIX HD, please excuse and ignore this email.
The Atrix HD is one of the handful of phones that Motorola says they will continue to support past ICS, so any mention of a software update gets us interested. When the push goes out to testers, I imagine we'll know a little more.
With numerous individuals logging onto the Internet coming from across the globe daily, there are many chances for businesses that took their own undertakings online to build contacts with potential customers and nurture their partnership with current ones. It?s no longer enough for a company to have a physical store or office where people may visit to do business; now, if you wish to be on top of your game and be prosperous in your field, then maintaining your presence online with a top-quality website is essential in securing your spot being a major model in your market.
Companies need to push traffic towards their official sites; when they get to the site, they have the opportunity to view all of the available products, buy product or service, and talk about the info to other consumers online. The challenge, however, is based on effectively directing Internet users to their site, and among the most effective ways to accomplish this is via a Web marketing model known as pay per click (PPC). Businesses can employ this kind of marketing tactic to produce quality traffic while keeping a certain financial budget.
Through pay-per-click, a business proprietor like you may put an ad on some other website or a search engine with the intention of leading clients from that website to your own. You?d simply need to pay the publisher whenever a web user ticks on your advertisement; it doesn?t matter whether the web user proceeds to buy an item from your site or not. The model offers a great opportunity for your business to get in touch with numerous Web users and gain an advantage above your competitors.
In case setting up such an online advertising campaign is totally new to you, you can hire experts in PPC campaign management to handle the task and help you be successful. These experts can help you with all elements of creating the marketing campaign: creating a Google Adwords account, developing a Google Adwords technique, exploring key terms and competitors, selecting key terms, as well as making designs, adgroups, and commercials.
When your campaign is well on its way, a PPC management company could also guide you through different important elements of the advertising process. They could help your business with writing and assessing multiple advertisements, monitoring your Google Analytics account and your conversions, handling search term optimisation and bids, maximising clicks, and planning standard marketing reviews.
With seasoned marketers at the head of your PPC promotion, you can anticipate to see positive results in just a few months. The key to an effective marketing plan like this would be to continuously check, monitor, and adjust your promotion to adjust your results and then observe significant increase in customer response. Producing quality traffic for your site is a continuous task that successful entrepreneurs must regularly manage and modify to create great effects.
You can find a lot of causes why you will want expert assistance in PPC. In Dubai, experts can direct you towards your prosperity.
ER MAH GERD BLERCK FRERDER! We've been avoiding Black Friday deals thus far because a) it's free advertising for retailers and b) you'll have to shoot me with adrenaline and a taser to get me out of bed before 9 a.m. on Friday morning. That said, I'm more than happy to give a shot out to Nest. The Nest first generation (everyone's favorite smart thermostat that makes your wall look like the set of Star Trek) is $198 at Lowe's this week, down $30 from the original price.
1. Pick a date, customize this card, and send it to your ten favorite people.
1. Pick a date, customize this card, and send it to your favorite girlfriends or a handful of friends and family members.
1. Pick a date, customize?this card, and send it to all the people you?ve been dying to have a fancy drink with.
Retirement homes are where seniors can live freely and independently and families can worry less about their aging loved ones in Chicago. Some retirement homes have an age minimum. This keeps the atmosphere consistent amongst the residents. Transportation issues will be a thing of the past for most seniors and their families when one of the Chicago retirement homes is chosen as a senior living option.
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Public release date: 21-Nov-2012
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ER MAH GERD BLERCK FRERDER! We've been avoiding Black Friday deals thus far because a) it's free advertising for retailers and b) you'll have to shoot me with adrenaline and a taser to get me out of bed before 9 a.m. on Friday morning. That said, I'm more than happy to give a shot out to