ASTRO and SSO Issue Consensus Guideline on Margins for Breast-Conserving Surgery with Whole-Breast Irradiation

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Newswise Fairfax, Va., February 10, 2014 The American Society for Radiation Oncology (ASTRO) and the Society of Surgical Oncology (SSO) are pleased to announce the publication of the consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. The guideline document represents an intensive collaboration among experts in the radiation oncology and surgical oncology fields, led by Meena S. Moran, MD, associate professor of the Department of Therapeutic Radiology at Yale School of Medicine in New Haven, Conn., on behalf of ASTRO, and Monica Morrow, MD, SSO immediate past president, breast cancer surgeon and Chief of Breast Surgery at Memorial Sloan-Kettering Cancer Center in New York, co-chairs of the Margin Consensus Panel (MCP). In addition to determining the ideal margin width that minimizes the risk of ipsilateral breast tumor recurrence (IBTR), the guideline outlines an evidence-based surgical treatment path that could reduce unnecessary surgery for patients.

Society of Surgical OncologyAmerican Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer uses the results of a meta-analysis of margin width and IBTR from a thorough review of 33 research studies from MEDLINE and evidence-based medicine published from 1965 to January 2013, in the context of outcomes from contemporary trials. The included studies encompassed 28,162 patients with stage I or II invasive breast cancer who were treated with whole-breast irradiation and with a minimum median follow-up time of four years. Patients treated with neoadjuvant chemotherapy or patients with pure ductal carcinoma in situ (DCIS) breast cancer were not included in the research for the guideline.

The consensus guideline was made possible by a research grant from the Susan G. Komen Foundation and underwent extensive peer review prior to approval by the SSO Executive Council and ASTROs Board of Directors in October 2013. In addition, the American Society of Breast Surgeons and the American Society of Clinical Oncology (ASCO) have both endorsed the guideline. It is available open access online as a PDF document at http://www.redjournal.org, http://www.annsugoncol.org and http://jco.ascopubs.org/, and will be published in the March 1, 2014 print issue of the International Journal of Radiation Oncology Biology Physics (Red Journal), the official scientific journal of ASTRO; the March 2014 print issue of Annals of Surgical Oncology, the official journal of SSO; and the March 10, 2014 issue of the Journal of Clinical Oncology, the official journal of ASCO.

The consensus guideline includes eight clinical practice recommendations: 1) positive margins, defined as ink on invasive cancer or DCIS, are associated with at least a two-fold increase in IBTR. This increased risk is not nullified by delivery of a boost, delivery of systemic therapy or favorable biology; 2) negative margins (no ink on tumor) optimize IBTR. Wider margin widths do not significantly lower this risk; 3) the rates of IBTR are reduced with the use of systemic therapy. In the event that a patient does not receive adjuvant systemic therapy, there is no evidence suggesting that margins wider than no ink on tumor are needed; 4) margins wider than no ink on tumor are not indicated based on biologic subtype; 5) the choice of whole-breast irradiation delivery technique, fractionation and boost dose should not be dependent on margin width; 6) wider negative margins than no ink on tumor are not indicated for invasive lobular cancer. Classic lobular carcinoma in situ (LCIS) at the margin is not an indication for re-excision. The significance of pleomorphic LCIS at the margin is uncertain; 7) young age (40 years) is associated with both an increased risk of IBTR after breast-conserving therapy (BCT) and an increased risk of local relapse on the chest wall after mastectomy and is more frequently associated with adverse biologic and pathologic features. There is no evidence that increased margin width nullifies the increased risk of IBTR in young patients; and 8) an extensive intraductal component (EIC) identifies patients who may have a large residual DCIS burden after lumpectomy. There is no evidence of an association between increased risk of IBTR and EIC when margins are negative.

Our hope is that this guideline will ultimately lead to significant reductions in the high re-excision rate for women with early-stage breast cancer undergoing breast-conserving surgery. Based on the consensus panels extensive review of the literature, the vast majority of re-excisions are unnecessary because disease control in the breast is excellent for women with early-stage disease when radiation and hormonal therapy and/or chemotherapy are added to a womens treatment plan, said Dr. Moran.

A significant portion of breast cancer surgeries in the United States are performed by surgical oncologists, and the definition of an adequate margin has been a major controversy. Therefore, it was only natural that we decided to create a definitive guideline that helps to minimize unnecessary surgery while maintaining the excellent outcomes seen with lumpectomy and radiation therapy, said Dr. Morrow. We are proud to provide this pivotal document to the oncology community, which will improve the lives and treatment of patients touched by this disease.

In addition to Drs. Moran and Morrow, members of the MCP and authors of the Society of Surgical OncologyAmerican Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer include Stuart J. Schnitt, MD, of the Department of Pathology at Harvard Medical School, Boston; Armando E. Guiliano, MD, of the Department of Surgery at Cedars-Sinai Medical Center, Los Angeles; Jay R. Harris, MD, FASTRO, of the Department of Radiation Oncology at Harvard Medical School, Boston; Seema A. Khan, MD, of the Department of Surgery at Northwestern University Feinberg School of Medicine, Chicago; Janet Horton, MD, of the Department of Radiation Oncology at Duke University Medical Center, Durham, N.C.; Suzanne Klimberg, MD, of the Department of Surgery at University of Arkansas for Medical Sciences, Fayetteville, Ark.; Mariana Chavez-MacGregor, MD, of the Department of Medical Oncology at the University of Texas MD Anderson Cancer Center, Houston; Gary Freedman, MD, of the Department of Radiation Oncology at University of Pennsylvania School of Medicine, Philadelphia; Nehmat Houssami, MD, PhD, of the School of Public Health at the University of Sydney Medical School, New South Wales, Australia; and Peggy L. Johnson, Advocate in Science, Susan G. Komen, Wichita, Kan.

We appreciate the dedicated efforts of Drs. Moran and Morrow for leading an exemplary team to produce this valuable guideline from both specialty organizations, said Colleen A.F. Lawton, MD, FASTRO, chair of ASTROs Board of Directors. Society of Surgical OncologyAmerican Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer is an essential tool for every practice to provide the necessary context and variables in order to provide high quality, patient-centered care.

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ASTRO and SSO Issue Consensus Guideline on Margins for Breast-Conserving Surgery with Whole-Breast Irradiation

Playing super metroid (pt 2) using human level artificial intelligence – Video

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Playing super metroid (pt 2) using human level artificial intelligence
http://www.humanlevelartificialintelligence.com This video shows a robot playing a SNES game called Super Metroid. There are no sound in the video because I ...

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Playing super metroid (pt 2) using human level artificial intelligence - Video

Debt Advice Software, Offered To Consumers At No Cost, Marks The First Use Of A Newly Patented Artificial Intelligence …

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Chicago, IL (PRWEB) February 11, 2014

A new innovative personal debt analysis system, based on patented artificial intelligence software, became public recently. Partners In Charity, the non-profit sponsor of the site, provides the new program, offering completely free debt advice for all consumers in the United States. Programmed in conjunction with Financial Firebird Corporation, and a former debt and bankruptcy attorney, the system employs powerful analysis to help point people with unsecured debt in the right direction to deal their medical and credit card bills in a proper way.

The new patented artificial intelligence decision making methods stand apart from previous systems in many ways. Most existing artificial intelligence systems merely rank choices in order returning the winner to the user. The new patented method provides additional analysis for better outcomes. First the choices go through a comparative evaluation. For example, rather than reporting solution A ranked highest and stopping there, the program ranks all solutions against each other comparatively with a result that while some choices may look better than another, they stand close enough that the user should also examine them as alternative options. The system also conducts a qualitative analysis to determine the independent value of the selections. This allows the user to understand the importance of the output. In some cases the results from the software might represent the perfect answer. In other cases the program identifies the best outcome, but knows enough to alert the consumer that the choice merely represents the best out of a group of bad options where all rank as unacceptable.

To think of the whole concept in a basic way, which also differentiates it from prior artificial intelligence programs, the new patented method operates as an expert. Some artificial intelligence programs allow the user to make decisions they already know how to make, but faster and in greater volumes, yet only with the expertise that they bring to the table in the first place. This new system acts as the expert, with a purpose of potentially suggesting options that the user never knew existed using methods well beyond their comprehension. Yet, consumers should not think of the program as legal advice or substitute it for legal advice about their debt. Rather they should use it to become informed about solutions and a more educated customer when engaging a debt professional, like a lawyer to complete the debt elimination task.

The system offers suggested solutions without any cost, obligation or further contact, the consumer must pick up the ball from there to take any action including reading articles offering more free debt information. The systems ten potential solutions include credit card debt settlement, non-profit credit counseling, chapter 13 bankruptcy and chapter 7 filing amongst others.

Most people deep in debt trouble dont even know ten solutions exist to deal with their credit card debt or medical debt, let alone which method suits their personal financial situation. With this free system consumers can learn about the next steps to take in the privacy of their own home without any cost, obligation or contact from service providers unless the consumer specifically initiates it.

About Partners In Charity And Financial Firebird Corporation

For 12 yrs now Partners In Charity has helped thousands of American home owners every year. PIC provides hands on home owner counseling, construction, & education. Most services are FREE of Charge, all services to struggling home owners struggling home owners are Free, including crisis budget counseling. We continue our daily mission to build & rehab homes for our veterans & seniors.

Financial Firebird Corporation provides unbiased consumer information, software and marketing services for the mortgage lending, debt, foreclosure, auto lending, personal budgeting, and other financial, travel or real estate related industries as well as basic marketing, financial and website services for all companies. Established 2000 and a proud BBB member.

Radio stations interested in promoting the system may participate in the PSA program by airing the attached spot. Those interested in licensing the patented system or purchasing other rights may contact Financial Firebird Corporation.

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Debt Advice Software, Offered To Consumers At No Cost, Marks The First Use Of A Newly Patented Artificial Intelligence ...

New Live-Cell Printing Technology Works Like Ancient Chinese Woodblocking

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Released: 2/6/2014 12:20 PM EST Embargo expired: 2/10/2014 3:00 PM EST Source Newsroom: Houston Methodist Contact Information

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Newswise HOUSTON -- ( Feb. 6, 2014 ) -- With a nod to 3rd century Chinese woodblock printing and children's rubber stamp toys, researchers in Houston have developed a way to print living cells onto any surface, in virtually any shape. Unlike recent, similar work using inkjet printing approaches, almost all cells survive the process, scientists report in this week's Proceedings of the National Academy of Sciences.

The researchers, led by Houston Methodist Research Institute nanomedicine faculty member Lidong Qin, Ph.D., say their approach produces 2-D cell arrays in as little as half an hour, prints the cells as close together as 5 micrometers (most animal cells are 10 to 30 micrometers wide), and allows the use of many different cell types. They've named the technology Block-Cell-Printing, or BloC-Printing.

"We feel the current technologies are inadequate," Qin said. "Inkjet-based cell printing leaves many of the cells damaged or dead. We wanted to see if we could invent a tool that helps researchers obtain arrays of cells that are alive and still have full activity."

Recent work to print cells in two and three dimensions using electricity-gated inkjet technology have been largely successful, but sometimes only half of the printed cells survive the printing process -- a source of frustration for many laboratory scientists.

"Cell printing is used in so many different ways now -- for drug development and in studies of tissue regeneration, cell function, and cell-cell communication," Qin said. "Such things can only be done when cells are alive and active. A survival rate of 50 to 80 percent is typical as cells exit the inkjet nozzles. By comparison, we are seeing close to 100 percent of cells in BloC-Printing survive the printing process."

BloC-Printing manipulates microfluidic physics to guide living cells into hook-like traps in the silicone mold. Cells flow down a column in the mold, past trapped cells to the next available slot, eventually creating a line of cells (in a grid of such lines). The position and spacing of the traps and the shape of the channel navigated by the cells is fully configurable during the mold's creation. When the mold is lifted away, the living cells remain behind, adhering to the growth medium or other substrate, in prescribed formation.

Qin's group tested BloC-Printing for its utility in studying cancerous cells and primary neurons. By arranging metastatic cancer cells in a grid and examining their growth in comparison with a non-metastatic control, the researchers found they could easily characterize the metastatic potential of cancer cells.

"We looked at cancer cells for their protrusion generation capability, which correlates to their malignancy level," Qin said. "Longer protrusion means more aggressive cancer cells. The measurement may help to diagnose a cancer's stage."

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New Live-Cell Printing Technology Works Like Ancient Chinese Woodblocking

Engineering The Human Genome One Letter At A Time

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Image Caption: Beating-heart cells derived from iPS cells are shown. A single DNA base-pair of the PRKAG2 gene was edited using the method developed by Drs. Miyaoka and Conklin. Credit: Luke Judge/Gladstone Institutes

Anne D. Holden, PhD Gladstone Institutes

Gladstones innovative technique in stem cells to boost scientists ability to study and potentially cure genetic disease

Sometimes biology is cruel. Sometimes simply a one-letter change in the human genetic code is the difference between health and a deadly disease. But even though doctors and scientists have long studied disorders caused by these tiny changes, replicating them to study in human stem cells has proven challenging. But now, scientists at the Gladstone Institutes have found a way to efficiently edit the human genome one letter at a time not only boosting researchers ability to model human disease, but also paving the way for therapies that cure disease by fixing these so-called bugs in a patients genetic code.

Led by Gladstone Investigator Bruce Conklin, MD, the research team describes in the latest issue of Nature Methods how they have solved one of science and medicines most pressing problems: how to efficiently and accurately capture rare genetic mutations that cause disease as well as how to fix them. This pioneering technique highlights the type of out-of-the-box thinking that is often critical for scientific success.

Advances in human genetics have led to the discovery of hundreds of genetic changes linked to disease, but until now weve lacked an efficient means of studying them, explained Dr. Conklin. To meet this challenge, we must have the capability to engineer the human genome, one letter at a time, with tools that are efficient, robust and accurate. And the method that we outline in our study does just that.

One of the major challenges preventing researchers from efficiently generating and studying these genetic diseases is that they can exist at frequencies as low as 1%, making the task of finding and studying them labor-intensive.

For our method to work, we needed to find a way to efficiently identify a single mutation among hundreds of normal, healthy cells, explained Gladstone Research Scientist Yuichiro Miyaoka, PhD, the papers lead author. So we designed a special fluorescent probe that would distinguish the mutated sequence from the original sequences. We were then able to sort through both sets of sequences and detect mutant cellseven when they made up as little one in every thousand cells. This is a level of sensitivity more than one hundred times greater than traditional methods.

The team then applied these new methods to induced pluripotent stem cells, or iPS cells. These cells, derived from the skin cells of human patients, have the same genetic makeup including any potential disease-causing mutations as the patient. In this case, the research team first used a highly advanced gene-editing technique called TALENs to introduce a specific mutation into the genome. Some gene-editing techniques, while effective at modifying the genetic code, involve the use of genetic markers that then leave a scar on the newly edited genome. These scars can then affect subsequent generations of cells, complicating future analysis. Although TALENs, and other similarly advanced tools, are able to make a clean, scarless single letter edits, these edits are very rare, so that new technique from the Conklin lab is needed.

Our method provides a novel way to capture and amplify specific mutations that are normally exceedingly rare, said Dr. Conklin. Our high-efficiency, high-fidelity method could very well be the basis for the next phase of human genetics research.

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Engineering The Human Genome One Letter At A Time

Gameday: Comets at Rockford

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February 9, 2014 - American Hockey League (AHL) Utica Comets UTICA COMETS (18-22-2-4) @ ROCKFORD ICEHOGS (23-21-4-2)

BMO Harris Bank Center, 5 pm

Radio: 94.9 K-Rock

Tonight's Game: The Comets are rolling and have won five of their past six on the road as they travel to Rockford to take on the IceHogs in their final game before the AHL All-Star Break. Tonight's game is Utica's fourth straight away from home and the final match-up of their Midwestern road swing.

When They Last Met: The Comets dropped a nailbiting 2-1 decision against Rockford last Saturday at The AUD. Pascal Pelletier scored Utica's lone goal just 28 seconds into the game and Joacim Eriksson took the loss, despite 28 saves on 30 shots. Kent Simpson was the star of the evening with 34 saves on 35 shots for Rockford, while Pat Mullane and Brandon Mashinter each scored for the IceHogs.

Comets Outlook: Utica moved to 2-1 on their road trip with a 3-0 blanking of the Milwaukee Admirals on Friday evening. Joacim Erikson picked up his fourth shutout of the season with a 21 save effort between the pipes for the Comets. Darren Archibald (2-0-2) and Alex Biega (0-2-2) paced the Comets offensively with two points apiece and Kent Huskins also found the back of the net with his first goal of the season. Marek Mazanec took the loss for Milwaukee with 28 saves on 31 shots.

IceHogs Outlook: Rockford tied a season high with a six goal offensive output as they defeated the Hamilton Bulldogs 6-4 at BMO Harris Bank Center. Mark McNeil paced Rockford with three points (1-2-3), while Brandon Mashinter (2-0-2), Alex Broadhurst (1-1-2), Terry Broadhurst (1-1-2), Adam Clendining (0-2-2) and Klas Dahlback (0-2-2) each contributed multi-point games. Sven Andrighetto led the way for Hamilton with a goal and three assists.

Into Thin Eriksson: Utica netminder Joacim Eriksson vaulted his way to the top of the AHL leaderboards with his fourth shutout of the season on Friday in Milwaukee. Eriksson is now tied with four other goaltenders for the league lead. The Galve, Sweden native is 13-12-1-2 on the season with a .916 save percentage, which ranks eighth in the league amongst goalies with more than 25 games played, and a 2.48 goals against average.

Double Dog Darren: Utica winger Darren Archibald contributed the first two goal game of the season against the Admirals on Friday. Archibald now has five multi-point games this season, a career high. The Newmarket, ON native now has 18 points (9-9-18) as a Comet, fourth most amongst active players and four shy of his single season high set in 2012-13 with the Chicago Wolves.

From Husk Til Dawn: Defenseman Kent Huskins found the back of the net for the first time as a Comet on Friday against Milwaukee. Huskins scored for the first time in the AHL since Feb. 23, 2007 as a member of the Portland Pirates, his final AHL contest before being recalled to Anaheim en route to a Stanley Cup championship. The 6'4" blueliner has collected three points (1-2-3) and has posted a +2 rating over 36 games with Utica this season.

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Gameday: Comets at Rockford

Comets Defeated by Blast

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February 9, 2014 - Major Indoor Soccer League (MISL) Missouri Comets INDEPENDENCE, Missouri (February 9, 2014) - The Missouri Comets fell to the Baltimore Blast 18-4 at the Independence Events Center today. The rematch of last season's championship series was not the thriller many expected. The Comets were missing captain and playmaker Vahid Assadpour with a knee injury and never got in a rhythm on the night. Mike Lookingland led the Blast with a hat trick and seven points for the night while Bryan Perez and Alex Megson scored the Comets' only two goals. Despite the loss, the Comets still clinched their spot in the 2014 MISL Postseason by virtue of a Rochester Lancers loss earlier in the day.

The first quarter started out slow for both teams. It took a penalty to score the first goal of the game. After Lucas Rodriguez stepped onto the field a little early on a Comets substitution, the Blast were awarded a two minute penalty. Lucio Gonzaga took a shot from outside the three-point arc that ricocheted into the net off a Comets defender.

Baltimore's Mike Lookingland scored his first goal of the night shortly after the second quarter began. Then Max Ferdinand added another power play goal to the Blast's tally, giving them a 7-0 lead at the break.

Halftime was dedicated to the men and women who have served our country in the military. U.S. Army Reserve Captain Stephanie Ramos helped swear in new members of the Army after singing a beautiful rendition of God Bless America.

The action started back up on the field with an early goal after Bryan Perez converted on a Comets power play to get Missouri on the board. Lookingland answered with two unassisted goals for Baltimore, one of them on a penalty kick. One more goal from Marco Mangione rounded out the goals in the third quarter.

The Comets' Alex Megson got the Comets within ten early in the final frame. His goal from Rodriguez cut the score to 14-4. However, Baltimore's Lucas Roque and Diego Zuniga took credit for the last two goals of the game and the final 18-4 score.

The Comets are back at the Independence Events Center on Valentine's Day, February 14th at 7:35p.m. CT for Pink Night. The team will be wearing pink jerseys that will be auctioned off following the game. A portion of the proceeds from the auction will benefit The Ali Kemp Educational Foundation. This will be the only trip to Independence this season for the Pennsylvania Roar. For tickets call 855.4KC.GOAL or email tickets@kcproscoccer.com.

Comets Indoor Soccer: The Comets, one of the most storied & iconic sports franchises in Kansas City's history, returned in 2010 to begin a new era at the Independence Events Center in Independence, MO. Picking up right where they left off, they boast three straight MISL Semi-Finals appearances, 11 League Awards, two MISL MVPs and a Championship Finals Appearance in 2013; the Comets are continuously striving for success on and off the field.

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Comets Defeated by Blast

Blast Defeats Comets; Lookingland Has a Hat Trick

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February 9, 2014 - Major Indoor Soccer League (MISL) Baltimore Blast The Blast traveled to Missouri to play the Comets for the second time this season. After beating the Ambush on Thursday night, Baltimore kept their momentum and came out with another victory tonight, 18-4 against the Comets. The Blast are now 13-3 on the season.

Lucio Gonzago got the Blast on the board first when he scored a 3-point power play goal, 6:41 left in the quarter off an assist from Adauto Neto. Gonzaga had the lone goal in the first quarter and the Blast went into the second, 3-0 against the Comets.

Mike Lookingland, who led the Blast with 6 points on Thursday against St. Louis, scored the first goal of the second quarter from an assist by Pat Healey. This was Lookingland's 39th point of the season. Less than 5 minutes later, Tony Donatelli assisted Max Ferdinand's goal with 4:39 left in the second quarter. At the end of the first half, the Blast led the Comets 7-0.

Two minutes into the second half the Comets got their first goal of the night from a power play; John Sosa assisted Bryan Perez. Less than 5 minutes later Mike Lookingland scored his second goal of the night from a penalty kick. With 5 minutes left in the third quarter, Lookingland scored his third goal of the night off a restart. This was also his 3rd 3-point goal of the season. 22 seconds later, Mike Deasel assisted Marco Mangione for the Blast's 5th goal of the night. At the end of the third quarter, the Comets trailed the Blast, 14-2.

Alex Megson from the Comets got his team on the board first in the fourth quarter; Lucas Rodriguez assisted his goal with 10:00 left on the clock. Less than one minute later, Lucas Roque scored off an assist from Tony Donatelli. At 6:31 on the clock, Roque helped the Blast with their 8th goal of the night when he assisted Diego Zuniga's goal. At the final whistle, the Blast beat the Comets 18-4.

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Blast Defeats Comets; Lookingland Has a Hat Trick

Catch indie kids Little Comets at Cambridge Junction

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Monday 10 Feb 2014 2:52 PM

Written byELLA WALKER

Little Comets can be counted on to ply you with dance floor indie stuff you can stretch out your skinny jeans to while chatting with bright eyed boys over Jaeger bombs. You know? Theyre that kind of band: fun, jaunty and singing right at you if youre an all over the place twenty-something.

Hence why Zane Lowe and Huw Stevens both like them.

The angular Tyne and Wear lads are frontman and guitarist Robert Coles, whos joined by brother Michael on lead guitar, Matt Hall on bass and touring drummer David Green.

Their debut album, In Search of Elusive Little Comets, prompted music website Drowned In Sound to say: You could listen to the track like a normal human being, listen to that wonky, stop-start guitar line, do a little wobbly-kneed pogo dance and wonder why Maximo Park stopped writing pop songs as enjoyable as this.

Basically, they dont do the cynical, woe-is us, struggling artists thing. Instead, theyre all about the joy of it. Life Is Elsewhere, their 2012 offering follows suit with charmingly jangly, catchy indie-pop; live they cant be anything less than giddy bundles of energy.

Theyll be supported by Catfish and The Bottlemen at the Cambridge Junction gig go have a listen, and a dance, of course.

:: Little Comets, Cambridge Junction, Saturday, February 15 at 7pm. Tickets 11 from (01223) 511511 / junction.co.uk

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Catch indie kids Little Comets at Cambridge Junction