New Non-Invasive Technique Could Revolutionize the Imaging of Metastatic Cancer

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Newswise Bioluminescence, nanoparticles, gene manipulation these sound like the ideas of a science fiction writer, but, in fact, they are components of an exciting new approach to imaging local and metastatic tumors. In preclinical animal models of metastatic prostate cancer, scientists at Virginia Commonwealth University Massey Cancer Center, VCU Institute of Molecular Medicine and Johns Hopkins Medical Institutions have provided proof-of-principle of a new molecular imaging approach that could revolutionize doctors ability to see tumors that have metastasized to other sites in the body, including the bones.

Recently published in the OnlineFirst edition of the journal Cancer Research, a journal of the American Association for Cancer Research, this multiple institution study is the first to develop in vivo (in animal models) a systemically administered, non-invasive, molecular-genetic technique to image bone metastases resulting from prostate cancer. The new method relies on the detection of a gene known as AEG-1, which was originally discovered by the study's co-lead investigator Paul B. Fisher, M.Ph., Ph.D., and has been shown to be expressed in the majority of cancers but not in normal, healthy cells. In preclinical studies, the researchers were able to image bone metastases with greater accuracy than any clinically approved imaging method.

Currently, we do not have a sensitive and specific non-invasive technique to detect bone metastases, so we are very encouraged by the results of this study says Fisher, Thelma Newmeyer Corman Endowed Chair in Cancer Research and co-leader of the Cancer Molecular Genetics research program at VCU Massey Cancer Center, chairman of the Department of Human and Molecular Genetics at the VCU School of Medicine and director of the VCU Institute of Molecular Medicine. Additionally, because AEG-1 is expressed in the majority of cancers, this research could potentially lead to earlier detection and treatment of metastases originating from a variety of cancer types.

Imaging the expression of a gene in real time is not an easy task. To do it, the scientists used a promoter called AEG-Prom. A promoter is a set of chemical instructions coded in DNA that initiates activity in a gene. The team combined AEG-Prom with imaging agents consisting of a gene that produces firefly luciferase, the bioluminescent substance that makes fireflies glow, and a gene called HSV1tk, which initiates a chemical reaction when specific radioactive compounds are administered. The team then inserted the combination into tiny nanoparticles that are injected intravenously. When exposed to specific proteins that activate the AEG-Prom, including the c-MYC protein that is elevated in many cancer cells, the AEG-Prom initiates activity in the imaging agent, and the location of cancer cells expressing the imaging agent are made visible using sensitive imaging devices.

"The imaging agents and nanoparticle used in this study have already been tested in unrelated clinical trials. Moving this concept into the clinic to image metastasis in patients is the next logical step in the evolution of this research," says co-lead author Martin G. Pomper, M.D., Ph.D., William R. Brody Professor of Radiology at Johns Hopkins Medical Institutions. "My colleagues and I are working toward this goal, and we look forward to opening a study to deploy this technology as soon as possible."

Fisher and Pomper are pioneering the use of cancer-specific and cancer-selective gene promoters to image cancer. Previous studies in melanoma and breast cancer leveraged another gene originally discovered by Fisher called progression elevated gene-3 (PEG-3) using a promoter known as PEG-Prom. In addition to imaging, this approach could also be used to deliver therapeutic agents, such as targeted therapies, directly to local and distant tumors sites and allow physicians to monitor drug delivery in real time. Separate studies are currently under way to examine the therapeutic potential of this strategy.

Fisher and Pomper collaborated on this research with Siddik Sarkar, Ph.D., postdoctoral research scientist in the Department of Human and Molecular Genetics at the VCU School of Medicine, as well as Akrita Bhatnagar, Ph.D., Yuchuan Wang, Ph.D., Ronnie C. Mease, Ph.D., Matthew Gabrielson, M.D., Polina Sysa, M.D., lL Minn, Ph.D., Gilbert Green, Brian Simmons, Ph.D., and Kathleen Gabrielson, D.V.M., Ph.D., all from Johns Hopkins Medical Institutions.

This study was supported by National Cancer Institute grant CA151838, the Prostate Cancer Foundation, the Patrick C. Walsh Foundation, the National Foundation for Cancer Research and, in part, by VCU Massey Cancer Centers NIH-NCI Cancer Center Support Grant P30 CA016059.

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New Non-Invasive Technique Could Revolutionize the Imaging of Metastatic Cancer

U2 album: epic fail on a global scale

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Apple CEO Tim Cook and U2 singer Bono. Photo: Getty Images

Maybe it's a case of unlucky 13th? U2's now infamous 13th studio album Songs of Innocence was released only six days ago - via a guerilla-style auto upload into more than 500 million iTunes accounts to coincide with the launch of Apple's iPhone 6.

Many have decried the faux outraged reactions at the method of delivery, like Sharon Osbourne's: "Shame on you ..." and "This is an invasion of my private ... entertainment space".

Talk about first world problems. Just go ahead and delete it.

Unlucky 13? Songs of Innocence, an 11-song album by U2. Photo: AP

But nearly a week later, the dust has not settled, in fact it's getting more and more stirred up. Musically it wasn't a bad album but as a marketing move the verdict is in: an epic fail, on a global scale, even though 33 million people have reportedly listened to it. The Irish band's little free album could become costly to their future if the mud currently being flung sticks.

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Criticism has gone way beyond Osbourne's rant and Tyler the Creator's more amusing comment, "It's like waking up with a pimple or a herpes [d--k]".

Our own Urthboy summed up the way criticism was headed on Wednesday afternoon: "Nothing thatU2do is within a zillion miles of relevance for up and coming acts I reckon."

Wired magazine called the album "horrid" and said the "devious ... giveaway should be remembered as a monumental blunder by the tech industry".

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U2 album: epic fail on a global scale

Ex-con launches startup aimed at inmates

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NEW YORK (CNNMoney)

He filled his days with business planning, even hand-drawing spreadsheets on plain paper from the law library. Upon release, he'd sketched out what would become Pigeon.ly, a venture that connects inmates with their loved ones through phone calls and photos.

Hutson believed he saw a billion dollar opportunity. There are 2.3 million Americans in prison; and millions more with a loved one behind bars. Hutson intimately knew the extreme isolation experienced by inmates. He also noticed was that once his fellow inmates were released, many returned. According to one Bureau of Justice study, three-quarters of prisoners were rearrested within five years.

Those who maintained close ties on the outside fared better. Forty years of research has found that inmates who stayed in contact with their families have lower recidivism rates.

With all this in mind, Hutson developed Pigeon.ly's photo-sharing platform, FotoPigeon, which gives family and friends a way to search all federal prisons for an inmate's current location (which changes frequently). For fifty cents apiece, customers upload photos and Pigeon.ly prints and ships them in plain envelopes that make it through prison mail check.

But despite a well-drawn business plan, Hutson had obvious hurdles launching his start-up: He was released in 2012 to a halfway house without Internet. His business partner and old friend Alfonzo Brooks had to "hire" Hutson so that he could leave for work each day. Not to mention the fact that traditional investors didn't understand the potential market of inmates and their families. His first round of investment came from peers: "Guys we knew from the streets," Hutson explained. "They were close to the problem ... it was a very easy sell." But contributions were small, averaging $500 or $1,000.

The site had to be easy to use -- much of Pigeon.ly's customer base only has mobile access to the Internet. Still others don't have email addresses. They did a lot of testing on grandmothers, because as Hutson puts it, "You can't just make the typical assumptions a tech company would make."

Hutson acquired customers through direct mail, tucking advertisements for FotoPigion into newsletters that included content inmates would find valuable -- like details on new sentencing guidelines.

Using this method, Hutson had attracted 2,000 paying customers by 2013, when Pigeon.ly was accepted to NewME, a San Francisco tech accelerator aimed at supporting underrepresented communities. Hutson raised $1 million in seed money from investors and venture capitalists. In the past year, he's raised another $1 million and is about to close on what will be the company's largest investment round to date, although he declined to give an exact amount.

The company launched TelePigeon in December 2013, which works with Internet phone-service providers to give families phone numbers that are local to where their loved ones are incarcerated. That way, inmates can call home at local rates no matter where they're serving time, which is an alternative to the expensive long-distance collect calls. Families who can't afford the nominal fee get 20 minutes free each month. Hutson said it's saved families over $646,000 since January 2014.

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Ex-con launches startup aimed at inmates

Epic fail could cost dearly

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Apple CEO Tim Cook and U2 singer Bono. Photo: Getty Images

Maybe it's a case of unlucky 13th? U2's now infamous 13th studio album Songs of Innocence was released only six days ago - via a guerilla-style auto upload into more than 500 million iTunes accounts to coincide with the launch of Apple's iPhone 6.

Many have decried the faux outraged reactions at the method of delivery, like Sharon Osbourne's: "Shame on you ..." and "This is an invasion of my private ... entertainment space".

Talk about first world problems. Just go ahead and delete it.

Unlucky 13? Songs of Innocence, an 11-song album by U2. Photo: AP

But nearly a week later, the dust has not settled, in fact it's getting more and more stirred up. Musically it wasn't a bad album but as a marketing move the verdict is in: an epic fail, on a global scale, even though 33 million people have reportedly listened to it. The Irish band's little free album could become costly to their future if the mud currently being flung sticks.

Advertisement

Criticism has gone way beyond Osbourne's rant and Tyler the Creator's more amusing comment, "It's like waking up with a pimple or a herpes [d--k]".

Our own Urthboy summed up the way criticism was headed on Wednesday afternoon: "Nothing thatU2do is within a zillion miles of relevance for up and coming acts I reckon."

Wired magazine called the album "horrid" and said the "devious ... giveaway should be remembered as a monumental blunder by the tech industry".

Read more here:

Epic fail could cost dearly

Balanced Life Family Medicine Ooltewah Perfect Five Star Review by Barbara S… – Video

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Institute of Medicine urges reforms to improve care for dying people

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By Lisa M. Krieger lkrieger@mercurynews.com

An influential national institute has prescribed a powerful cure for America's approach to dying, saying that today's health care system is ill-equipped to provide the comfort and care so cherished in our final days.

The long-awaited report released Wednesday by the Institute of Medicine recommends that regular end-of-life conversations become part of patients' primary care, starting at age 18 and that doctors should be paid for time spent on these discussions -- a controversial initiative eliminated from President Barack Obama's health care law.

The report reflects the growing concern over the dizzying array of high-tech interventions to emerge in recent years that prolong futile suffering, often at great emotional, physical and financial cost. Those interventions were the subject of this newspaper's yearlong series "Cost of Dying." To correct the current, misguided course, Medicare should boost coverage for home health services, not just high-tech hospital care, the report urges. And more doctors must be trained and licensed in end-of-life care, through changes in universities, state medical boards and accrediting agencies, it adds.

"Even though death is very much part of the cycle of life, thinking and talking about one's own death usually remains in the background," said Dr. Philip Pizzo, former dean of Stanford University's School of Medicine and a co-chairman of the report.

"It is our hope,'' said Pizzo, "that this report will lead to improvements in end-of-life care and the experience of dying for all."

The 21-member committee, which included experts in law and medicine, devoted two years to studying federal policy, financing and hospital practices. Recommendations of the institute, a private, nonprofit arm of the National Academy of Sciences in Washington, D.C., often make their way into U.S. laws and federal agency policies.

The "Dying in America" report recommends that federal and state governments and private insurers create financial incentives for patients and clinicians to discuss end-of-life matters, document patient preferences, and provide appropriate services and care.

The report authors also suggest having initial conversations about end-of-life values, guided by a physician, at milestones of life, such as getting a driver's license, turning 18, leaving home or marrying. Additional planning should occur for those in high-risk occupations, at the onset of chronic illness and when applying for Medicare.

"There is unnecessary and gratuitous suffering all over the place," said Dr. BJ Miller, executive director at San Francisco's Zen Hospice, who was not involved in the report. "But when the Institute of Medicine says something, people listen -- at all levels," said Miller, an assistant clinical professor of medicine at UCSF.

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Institute of Medicine urges reforms to improve care for dying people

Guest: Why a WSU medical school would not address doctor shortage in rural areas

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Originally published September 16, 2014 at 5:12 PM | Page modified September 17, 2014 at 11:16 AM

THE University of Washington School of Medicine created the WAMI program with the federal Washington-Alaska Regional Medical Program in 1971. One of its purposes was to address the physician shortage and distribution of doctors in four states.

Now called WWAMI for the five states it works in, the UW medical program trains physicians in Washington, Wyoming, Alaska, Montana and Idaho in conjunction with other educational institutions and rural medical groups.

Washington State University, a participating school, is now considering building a new medical school in Spokane to address the shortage of doctors in rural areas.

The question that has not been addressed is why the WWAMI program has not been successful and how an expensive new medical school in Spokane would solve the physician-distribution issue.

There are frustrations in rural practice associated with the lack of modern technologies readily available to practitioners and their patients, compared with doctors in more populated environments. Coverage for attendance at medical conferences, vacations and the 24/7 demands of medical practice are major issues.

The business management confrontations with insurance companies, litigators and bureaucratic government regulators are an increasingly time-consuming, major frustration that will worsen with the Affordable Care Act.

Not addressed is the spousal factor. Even though WWAMI students are exposed to small rural communities and might enjoy benefits practicing there, spouses find employment opportunities difficult and cultural living options limited.

In Whatcom and Skagit counties, some of the frustrations of rural practice are being addressed by the Family Care Network. The networks chief executive, Marcy Hipskind, is a WSU graduate. She, one of her sisters and I are graduates of the private Washington University School of Medicine in St. Louis, at great savings to Washington state taxpayers.

The networks members total more than 75 family physicians. Billings, contractual agreements with insurance carriers and regulators are conducted for the members by the network. All are on electronic medical records. For members who are retiring, Family Care Network recruits replacements and provides coverage for conferences, vacations and on-call care.

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Guest: Why a WSU medical school would not address doctor shortage in rural areas

UW calls WSU medical school study flawed – Mon, 15 Sep 2014 PST

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The University of Washington on Monday criticized as seriously flawed a feasibility study supporting a second public medical school that would be established in Spokane by Washington State University. WSU commissioned the study, released last week, that concluded WSU could educate medical students at a lower cost than UW. That conclusion is based on the UW School of Medicine receiving about $94.6 million in state funding in 2011. The WSU consultants preparing the study simply divided that $94.6 million figure by 440 medical students to arrive at a per-student cost to the state of $215,000. UW regent

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The University of Washington on Monday criticized as seriously flawed a feasibility study supporting a second public medical school that would be established in Spokane by Washington State University.

WSU commissioned the study, released last week, that concluded WSU could educate medical students at a lower cost than UW.

That conclusion is based on the UW School of Medicine receiving about $94.6 million in state funding in 2011. The WSU consultants preparing the study simply divided that $94.6 million figure by 440 medical students to arrive at a per-student cost to the state of $215,000.

UW regent Orin Smith called those findings an unfortunate and extremely misleading error in the report intended to guide state lawmakers who will be asked to weigh the merits of a second state-funded medical school

In a sharply worded letter to WSU Regent Mike Worthy regarding the report, Smith noted that the $94.6 million includes federal research funds and student tuition, not just state funds. Furthermore, the blend of state, federal and private money funds the work of some 4,500 people throughout the UW medical school system not just the 440 medical students.

Smith said a more realistic figure is $70,000 per student in state support plus tuition.

Using that formula, the WSU study estimated it would cost the state about $60,000 per student at a WSU-run medical school in Spokane after a 10-year phase-in to enrollment of 120 students per class, said WSU Spokane Chancellor Lisa Brown. She noted medical schools use different funding models to arrive at state cost per student estimates.

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UW calls WSU medical school study flawed - Mon, 15 Sep 2014 PST