Source: http://healthy-eating.infotips-canada.com/i-think-i-need-anger-management-advice/
Monday, December 31, 2012
I think I need anger management. Advice?
[unable to retrieve full-text content]Join Date: Oct 2012 Posts: 51 Folks, I've been separated for nearly two months and I'm now working on self-improvement. One area I identified that I need to work on is managing my anger. My husband would bring out th ...
Tuesday, December 18, 2012
Kipling Seoul Laptop Large Backpack True Blue ? Travel & Leisure ...
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Even the smallest stroke can damage brain tissue and impair cognitive function
Dec. 16, 2012 ? Blocking a single tiny blood vessel in the brain can harm neural tissue and even alter behavior, a new study from the University of California, San Diego has shown. But these consequences can be mitigated by a drug already in use, suggesting treatment that could slow the progress of dementia associated with cumulative damage to miniscule blood vessels that feed brain cells. The team reports their results in the December 16 advance online edition of Nature Neuroscience.
"The brain is incredibly dense with vasculature. It was surprising that blocking one small vessel could have a discernable impact on the behavior of a rat," said Andy Y. Shih, lead author of the paper who completed this work as a postdoctoral fellow in physics at UC San Diego. Shih is now an assistant professor at the Medical University of South Carolina.
Working with rats, Shih and colleagues used laser light to clot blood at precise points within small blood vessels that dive from the surface of the brain to penetrate neural tissue. When they looked at the brains up to a week later, they saw tiny holes reminiscent of the widespread damage often seen when the brains of patients with dementia are examined as a part of an autopsy.
These micro-lesions are too small to be detected with conventional MRI scans, which have a resolution of about a millimeter. Nearly two dozen of these small vessels enter the brain from a square millimeter area of the surface of the brain.
"It's controversial whether that sort of damage has consequences, although the tide of evidence has been growing as human diagnostics improve," said David Kleinfeld, professor of physics and neurobiology, who leads the research group.
To see whether such minute damage could change behavior, the scientists trained thirsty rats to leap from one platform to another in the dark to get water.
The rats readily jump if they can reach the second platform with a paw or their snout, or stretch farther to touch it with their whiskers. Many rats can be trained to rely on a single whisker if the others are clipped, but if they can't feel the far platform, they won't budge.
"The whiskers line up in rows and each one is linked to a specific spot in the brain," Shih said. "By training them to use just one whisker, we were able to distill a behavior down to a very small part of the brain."
When Shih blocked single microvessels feeding a column of brain cells that respond to signals from the remaining whisker, the rats still crossed to the far platform when the gap was small. But when it widened beyond the reach of their snouts, they quit.
The FDA-approved drug memantine, prescribed to slow one aspect of memory decline associated with Alzheimer's disease, ameliorated these effects. Rats that received the drug jumped whisker-wide gaps, and their brains showed fewer signs of damage.
"This data shows us, for the first time, that even a tiny stroke can lead to disability," said Patrick D. Lyden, a co-author of the study and chair of the department of neurology at Cedars-Sinai Medical Center in Los Angeles. "I am afraid that tiny strokes in our patients contribute -- over the long term -- to illness such as dementia and Alzheimer's disease," he said, adding that "better tools will be required to tell whether human patients suffer memory effects from the smallest strokes."
"We used powerful tools from biological physics, many developed in Kleinfeld's laboratory at UC San Diego, to link stroke to dementia on the unprecedented small scale of single vessels and cells," Shih said. "At my new position at MUSC, I plan to work on ways to improve the detection of micro-lesions in human patients with MRI. This way clinicians may be able to diagnose and treat dementia earlier."
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The above story is reprinted from materials provided by University of California - San Diego, via EurekAlert!, a service of AAAS. The original article was written by Susan Brown.
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Monday, December 17, 2012
Steve Case On Next Internet Revolution - Business Insider
Fred Wilson, a Union Square Ventures partner and a prominent investor in companies like Zynga and Twitter, recently argued that it's harder for consumer startups to get VC funding because the industry has matured and is moving away from the web to mobile, and that late investors are no longer interested in that field.
While many disagree, the question of whether there's still opportunity for new internet companies and trends is valid.
We asked co-founder of AOL and current CEO of Revolution Ventures, Steve Case at our IGNITION conference, what he thought the next phase of the web was, and if he agreed with Wilson's assertions.
Watch the video below to see why Case thinks there will be a second internet revolution and what it might look like.
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Source: http://www.businessinsider.com/steve-case-on-next-internet-revolution-2012-12
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Hillary Clinton faints, suffers a concussion
U.S. Secretary of State Hillary Clinton reportedly fainted from being dehydrated and suffered an apparent concussion in the incident. NBC's Andrea Mitchell reports.
By NBC News staff
Updated at 6:45 p.m. ET: Secretary of State Hillary Clinton fainted days ago and suffered a concussion after becoming dehydrated because of a stomach virus, the State Department said Saturday.
"She has been recovering at home and will continue to be monitored regularly by her doctors. At their recommendation, she will continue to work from home next week, staying in regular contact with Department and other officials," the State Department said in a statement.
State Department officials said Clinton, 65, fainted earlier this week, although they would not specify when the incident occurred.
Saturday evening, the State Department issued a statement from?Dr. Lisa Bardack of Mount Kisco Medical Group and Dr. Gigi El-Bayoumi of George Washington University:
"Secretary Clinton developed a stomach virus, leading to extreme dehydration, and subsequently fainted. ? Over the course of this week we evaluated her and ultimately determined she had also sustained a concussion. ?We recommended that the Secretary continue to rest and avoid any strenuous activity, and strongly advised her to cancel all work events for the coming week. ?We will continue to monitor her progress as she makes a full recovery."
NBC?s chief medical editor Dr. Nancy Snyderman said Clinton?s exhausting schedule could have made her susceptible to fainting. Clinton is known for her grueling travel schedule and has earned the distinction of being the secretary of state who has traveled the most.
?If a patient has been logging millions of miles a year and is tired and not eating or drinking the right things in a couple of days, a shift in blood volume can cause fainting,? Snyderman said.
This isn?t the first time Clinton passed out after having a stomach bug. As a U.S. senator representing New York, Clinton fainted in 2005 during a speech in Buffalo after complaining of a stomach virus.
A history of fainting could indicate underlying heart problems, Snyderman said, specifically ?that the heart is not pumping correctly.?
?Heart valve or thyroid issues can be more common in older women,? Snyderman explained. ?The standard protocol would be to have a cardiac workout to make sure her heart rhythm and heart valves are normal. You worry about the heart not beating correctly. That?s a very simple thing to check.?
She said that given Clinton?s past fainting episode, her doctors would likely put her through a cardiac stress test.
The concussion will have doctors ?watching her like a hawk,? Snyderman said, particularly if Clinton hit the side of her head. If Clinton hit the back of her head, her brain would be better protected, she said.
Clinton canceled a trip to Morocco earlier in the week because she wasn't feeling well. She was scheduled to be in Morocco to officially recognize the Syrian rebels who have been engaged for nearly two years in an armed battle against Syrian President Bashar al-Assad?s regime.
Kevin Lamarque / Reuters, file
U.S. Secretary of State Hillary Clinton came down with a stomach bug earlier this week and fainted, suffering a concussion. Here she is pictured speaking during a news conference at Stormont Castle in Belfast, in Northern Ireland, on Dec. 7.
Due to her health, Clinton will no longer testify at a?House Foreign Affairs Committee on Thursday?on the attack on a U.S. mission in Libya.
"I am sorry to learn of Secretary Clinton's ill health and I wish her a quick and full recovery. It is, however, unfortunate that Secretary Clinton is unable to testify next week before the House Committee on Foreign Affairs on the investigation into the terrorist attack that killed four Americans and left others injured," committee chairwoman?Rep. Ileana Ros-Lehtinen, R-Fla., said in a statement.
Deputy Secretary William Burns and Deputy Secretary Thomas Nides will provide testimony in Clinton's absence.
"Although I respect Bill and Tom, we still don't have information from the Obama administration on what went so tragically wrong in Benghazi that resulted in the deaths of four patriotic Americans," Ros-Lehtinen said. "We have been combing through classified and unclassified documents and have tough questions about State Department threat assessments and decision-making on Benghazi. This requires a public appearance by the secretary of state herself. Other cabinet secretaries involved should also be held publicly accountable."
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jukkanmukkir: Accredited Institutions for Online Homeschooling High ...
December 16th, 2012
Our house is our very first training ground. With that said, mother and father are the primary lecturers and instructors of their children. You may not remember, but your mother and father are those who taught you the best way to stand up, walk and even dance. You?re in a position to utter your first phrases like ma-ma and da-da because you imitated the sounds your mother and father make whenever they talk. That is why each time a child accomplishes one thing like spelling his name or learning the best way to bike, mother and father are just so proud.
Traditional College Programs Vs Christian Homeschooling Curriculum At present, teaching programs range from tradition classroom curriculum to homeschooling programs. In conventional education setting, students share the identical classroom, teacher and topic matter. Additionally there are school?s rules, the place students are subjected to follow. Homeschooling education, alternatively is extra flexible than conventional setting. It truly permits a child to study at his or her personal pace. As mentioned earlier, mother and father do have a significant role in a child?s education. Actually, since youngsters cannot nonetheless make determination for themselves, their mother and father are ones who determine what?s best for them. Selecting the best teaching programs for their youngsters is without doubt one of the high priorities of parents. Christian Homeschooling Christians imagine that homeschooling is a biblical type of education. Within the bible, God even addresses mother and father as the primary educators of their very own children. Beneath are verses that present God?s instructions to oldsters with reference to homeschooling education. Deuteronomy 6:6-7 ?And these phrases which I command you at this time shall be in your heart. You shall educate them diligently to your youngsters, and shall talk of them when you sit in your own home, when you walk by the best way, when you lie down, and when you rise up.? Proverbs 22:6 ? ?Train up a child in the best way he ought to go, and when he?s outdated he won?t depart from it.? These two verses clearly state the significance of oldsters? guidance and assist as to their youngsters?s education. Homeschooling Excessive College Youngster Below a homeschooling education system, youngsters are taught at home both by their mother and father or home instructors.These days, several institutions are providing homeschooling high school education to youngsters who want to proceed and develop their learning skills but are unable to get to common school. At present, everyone can have access to a standardized and sensible education. The Keystone Excessive College, iQ Academy, Ok 12, Calvert College are among the education institutions that supply on-line homeschooling high school education.
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Tuesday, December 11, 2012
Quantum Wave To Put $100M Into Quantum Tech Behind The Next Computing Wave
Amid the startups, panels and speeches at TechCrunch Moscow today has been some emerging news about the Russian scene. For one, there is the move from Russia's top echelons to address patent law and a robotics investment. But also today has come news of a new fund which takes a very 'Russian' - shall we say - approach to the future of computing. Quantum Wave Fund (Qwave) is a new $100 million fund launched today which aims to commercialize breakthrough technologies from quantum physics - one of which will be the development of new quantum technologies, in addition to computers which will run thousands - perhaps millions - of times faster than today's Silicon-based computers. And they'll be using Russian scientists to do the due diligence.Source: http://feedproxy.google.com/~r/Techcrunch/~3/zA9kANSXe5U/
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Monday, December 10, 2012
Too much religion at military academies? West Point cadet revives charge.
Citing overt religiosity on campus, a West Point Academy cadet publicly quit this week just months before graduation. This is not the first time the military has come under fire for practices that nonreligious students see as aggressively evangelical.
When Blake Page announced this week that he was quitting West Point a few months before graduation, citing the overt religiosity on campus, he raised recurring questions about the pervasiveness and impact of evangelical Christianity within the ranks of the US military.
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?I do not wish to be in any way associated with an institution which willfully disregards the Constitution of the United States of America by enforcing policies which run counter to the same,? Mr. Page wrote in his letter of resignation to the US Military Academy at West Point, in New York. ?
He cites, among other things, routine prayers at mandatory events for cadets and the practice of awarding off-campus passes and credit to students who take part in religious retreats and chapel choirs.?These activities, in turn, foster ?open disrespect of non-religious new cadets,? Page argued, adding that he had been told at West Point that it was not possible for people to have morals without believing in God.
This is not the first time such charges have been leveled within a military training academy. The US Air Force Academy came under similar criticism in 2005 for conferring preferential treatment on cadets who were evangelical Christians and promoting proselytizing in the ranks.
A survey commissioned by the Air Force Academy in 2010 showed some improvements in the climate of religious tolerance on campus, but also found that many cadets still felt pressured to take part in religious activities. Nearly half of the non-Christian cadets surveyed, for example, said their fellow students have a ?low tolerance? for atheists, a 20 percent jump from a similar 2008 survey.
Charges of evangelism went international when the Pentagon came under fire in 2010 for using gun sights engraved with Bible verses, fueling concerns that the war in Afghanistan would be seen as a military crusade. Some Pentagon officials at first dismissed complaints against the gun sights, comparing them to US currency engraved with ?In God We Trust,? but senior officers demanded that the military stop using them.
This came on the heels of reports that Air Force missileers were receiving Bible-centered ethics training, with the aim of helping them shake off lingering doubts about firing nuclear weapons. The training ? which had been in place for almost two decades and was known jokingly among the airmen as ?Jesus loves nukes? ? was halted in 2011.
?God and country is a big part of the military culture,? says Page in a phone interview with the Monitor. ?Anytime we have a ceremony of any type, there?s always prayer.?
During his time at West Point as the head of the Secular Student Alliance, Page helped to establish ?nontheist chapel time,? an alternative for nonreligious cadets. ?Before [that, if you didn't go to chapel] you could either go back to your room or have cleaning detail,? Blake recalls. ?A friend of mine was made to sing and dance and recite knowledge and do all sorts of embarrassing things while everyone else went to church.??
Sunday, December 9, 2012
Feng Shui and Its Importance in Home Dcor ? home improvement
Feng Shui is a Chinese art of placement of things in a house that helps in creating a positive energy. It helps in creating an atmosphere of happiness and harmony within a house. The practitioners of Feng Shui believes that by arranging the furniture and other dcor items in the house as per the Feng Shui principle one can create a feel good environment within the house. Following the
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Butterfly Spa - Chinese Massage
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High School Football: Long Beach Poly beats Clovis North 28-7
High School Football: Long Beach Poly beats Clovis North 28-7
www.ksee24.comLong Beach Poly beats Clovis North 28-7 in the South Division I Regional Bowl Game. The Broncos end their season with a 12-2 overall record. The Jackrabbits will face Granite Bay for the Division I State Title.
Source: http://www.facebook.com/KSEE24/posts/227344017397325
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Saturday, December 8, 2012
Can Roger Goodell Save Football?
Goodell mingles with fans in Jacksonville, Fla. The Senator's son has a politician's touch
On the morning of Dec. 1, NFL commissioner Roger Goodell received an unfathomable phone call from the league's head of security. Jovan Belcher, a fourth-year linebacker for the Kansas City Chiefs, had killed his girlfriend in their home, then driven to the team's practice complex. There, despite the pleadings of his coach and general manager, he shot himself in the parking lot, leaving his 3-month-old daughter an orphan.
(LIST: Top 10 Sports Moments of 2012)
Goodell recalls his disbelief. "My first thoughts weren't about football at all," he told TIME. "This is not a football tragedy. It's...
Source: http://feedproxy.google.com/~r/time/topstories/~3/BYMJGgD7OTA/0,9171,2130975,00.html
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Gaming Everything ? Blog Archive ? Dark Souls II officially ...
December 7th, 2012 Posted in 360, News, PC, PS3
Posted By: Valay
Namco Bandai has officially announced Dark Souls II following its reveal at the 2012 VGAs.
Unsurprisingly, FromSoftware has been confirmed as the game?s developer. The game ?will continue a legacy of goading its passionate fan base with unrelenting challenge and suffering that are considered a hallmark of the series; while presenting new devilishly devised obstacles for players to overcome.?
Dark Souls II is being made for the PlayStation 3, Xbox 360, and PC. Access the teaser site here.
Read on below for the official announcement with a few more details.
SAN JOSE, Calif. ? December 7, 2012 ? Leading video game publisher and developer NAMCO BANDAI Games America Inc. today proudly announces that the critically acclaimed Dark Souls? saga marches forward with Dark Souls? II, currently in development at FromSoftware in Tokyo, Japan. Dark Souls II will continue a legacy of goading its passionate fan base with unrelenting challenge and suffering that are considered a hallmark of the series; while presenting new devilishly devised obstacles for players to overcome. Dark Souls II will be available for the PlayStation?3 computer entertainment system, the Xbox 360? video game and entertainment system from Microsoft, and PCs.Built upon the foundation established by Souls series creator and Dark Souls II Supervisor, Hidetaka Miyazaki with development helmed by FromSoftware Director Tomohiro Shibuya, Dark Souls II will feature a new hero, a new storyline, and an unfamiliar world for players to survive in while delivering its signature brand of unrelenting punishment that players hunger for. Epic battles with gruesome enemies and blood-thirsty bosses await adventurers as they traverse through a devastated world filled with death and despair; only those who are strong willed or cunning can survive this journey to achieve great glory. Players seeking to share their experience will discover a revamped server-based multiplayer mode that will put a distinct Dark Souls II twist on the concept of playing with others.
?Dark Souls II retains the core essence of Dark Souls while evolving to present new twists and challenges that are sure to please longtime fans and attract new comers to the series,? says Carlson Choi, Vice President of Marketing at NAMCO BANDAI Games America Inc. ?FromSoftware is going to take a very dark path with Dark Souls II; players will need to look deep within themselves to see if they have the intestinal fortitude to embark on this journey.?
?This new chapter in the Dark Souls saga presents opportunities for us to drive innovation in gameplay design, develop an entirely new story, and expand the scope of the world in which the player interacts with the game. We have taken these necessary steps with Dark Souls II in order to evolve the overall experience of the Dark Souls series,? says Tomohiro Shibuya, FromSoftware Director on Dark Souls II. ?The entire development team is striving to make Dark Souls II an experience that is fresh while not forsaking its roots in presenting players with challenging gameplay. Our goal is to surprise and delight our fans with new experiences and plot twists while enticing new players to join our dark journey.?
More details surrounding Dark Souls II will become available in the months leading to its release. Begin your Dark Souls II journey at www.DarkSoulsII.com or join the Dark Souls II conversation on Facebook at www.Facebook.com/DARKSOULS or follow us on Twitter at www.Twitter.com/Filthierich
Source: Namco Bandai PR
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Friday, December 7, 2012
Australia's Gillard in spoof: Mayans were right, world is ending
CANBERRA (Reuters) - According to Australian Prime Minister Julia Gillard, the Mayans were right and the apocalypse is near.
In a spoof 50-second video appearance promoting a local radio station's breakfast show, Gillard provided hair-raising details that she said would come when the world ends this month, as the ancient Mayans calendar predicted.
With the straight face she often uses in a normal press conference, and surrounded by Australian national flags, Gillard addressed viewers as "My dear remaining fellow Australians."
"The end of world is coming. It wasn't Y2K, it wasn't even the carbon price," said Gillard firmly. "It turns out that the Mayan calendar is true."
Y2K was the computer glitch feared globally just before the year 2000, while the carbon tax refers to a major controversial policy put forward by her Labour government in 2012.
She went into terrifying details about the end of the world such as "flesh-eating zombies" and "demonic hell beasts", but then wooed her constituents with promises.
"If you know one thing about me it is this: I will always fight for you to the very end," she said, but noted that there is also a bright spot.
"At least this means I won't have to do Q&A again," she said, referring to an Australian TV show where politicians usually have to face tough questions from the audience.
A spokesman for Gillard said the video, which was uploaded by radio station Triple J on Thursday and has already been viewed more than 232,000 times on YouTube, was simply a spoof.
"It's just bit of fun," he told Reuters. "It's just a bit of humour for the end of the year. Nothing else."
The video comes out in the wake of a phone hoax in which two Australian presenters from another local radio station called the hospital which is treating Prince William's wife Kate and posed as Queen Elizabeth and Prince Charles to ask questions about her condition.
(Reporting By Maggie Lu Yueyang, editing by Elaine Lies)
Source: http://news.yahoo.com/australias-gillard-spoof-mayans-were-world-ending-110728105.html
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Rilpivirine for HIV: Added benefit for single agent proven
![[ Back to EurekAlert! ]](http://www.eurekalert.org/images/back2e.gif){kind=small}
Public release date: 7-Dec-2012[ | E-mail |
Share ] Contact: Dr. Anna-Sabine Ernst
presse@iqwig.de
0049-221-356-850
Institute for Quality and Efficiency in Health Care
Contents of the dossier for the fixed combination product incomplete: Existing study data not adequately analysed
Since the start of 2012, a new drug called rilpivirine has been available for adult patients infected with the human immunodeficiency virus type 1 (HIV-1). It is marketed by two different pharmaceutical companies, by one as a single agent (trade name Edurant) and by the other as a fixed combination with other HIV drugs (trade name Eviplera). In two early benefit assessments pursuant to the "Act on the Reform of the Market for Medicinal Products" (AMNOG), the Institute for Quality and Efficiency in Health Care (IQWiG) has investigated whether the two new drugs have advantages over current standard therapies.
According to IQWiG, there is proof that rilpivirine as a single agent offers a considerable added benefit to men infected with HIV-1. For women, the available studies provide corresponding "indications" of considerable added benefit.
On the other hand, no added benefit can be derived from the manufacturer's dossier for the fixed combination - although precisely the same studies were available to the two pharmaceutical companies. This is because, unlike the manufacturer of the single agent, the company making the fixed combination product did not analyse the study data in a suitable way. Hence the contents of its dossier are incomplete.
G-BA specifies efavirenz as the appropriate comparator therapy
Two pharmaceutical companies introduced the new drug onto the market in Germany at the same time; one as a single agent and one in a fixed combination with emtricitabine and tenofovir. Both products are approved for adults who are beginning a treatment directed at stopping the multiplication of the virus for the first time and in whom not more than 100,000 viral components can be detected per millilitre of blood.
The Federal Joint Committee (G-BA) has in each case specified efavirenz-based therapy in combination with other drugs as the appropriate comparator therapy.
Studies on the single agent also relevant for the fixed combination
Results from a total of 3 studies were available. Since, at the time of the assessment, only analyses after 48 weeks were fully available for the two largest studies, IQWiG's assessment is based on these analyses.
In all 3 studies, rilpivirine was tested as a single agent. Nevertheless, the results are also relevant for the assessment of the combination product, because the dosage of rilpivirine, emtricitabine and tenofovir administered in these studies corresponds exactly to the dosage in the fixed combination.
Viral load is a sufficiently valid surrogate parameter
In its dossier, the manufacturer of the single agent did not submit any data on the patient-relevant outcome "AIDS-defining diseases/death", i.e. on the outbreak of AIDS and on survival. Instead, the manufacturer used results of "viral load" in order to prove the added benefit. The viral load denotes the number of components of a virus present in the blood and it shows how active HIV is.
In principle, IQWiG considers this "surrogate parameter" as valid, i.e. meaningful, because patients in whom the number of viruses can be persistently suppressed below the limit of detection have, according to the current state of knowledge, a lower risk of developing AIDS or of dying. However, it is unclear whether a treatment has just as great an effect on the patient-relevant outcome as on the surrogate parameter.
Effect depends on gender
As regards the reduction in viral load, the 3 studies showed a statistically significant difference in favour of rilpivirine. However, as shown by the data on subgroups presented in this dossier [on the single agent], this only applies to male patients. This means that gender is here an "effect modifier". IQWiG therefore determines that there is proof of an added benefit in HIV-1-infected men, but not in women. Because of the described uncertainty concerning the size of the effect on the patient-relevant outcome, the extent of this added benefit cannot be quantified (is "non-quantifiable").
Fewer neurological side effects
Rilpivirine as a single agent also has advantages in terms of side effects: "neurological events" such as headaches or insomnia occurred less frequently. However, the analysis presented by the manufacturer contains a few uncertainties, which is why IQWiG considers there is no proof here, but only an "indication" of a lesser harm with rilpivirine compared to efavirenz.
Based on the overall results on side effects and viral load, the Institute considers that for male patients, there is proof of a considerable added benefit and for female patients a corresponding "indication".
No proof of added benefit of the fixed combination
In contrast to the single agent, there is no proof of an added benefit for the fixed combination of rilpivirine, emtricitabine and tenofovir. In its dossier the manufacturer did not analyse the available data in a suitable way.
Subgroup analyses (age, gender, severity of disease etc.) are routinely required in every dossier. However in this case the manufacturer did not carry these out, despite the fact that its dossier refers to the same studies reported in the dossier submitted by the manufacturer of the rilpivirine single agent, in which gender had been identified as an effect modifier. It is, however, precisely under these circumstances that such subgroup analyses are essential. The necessary data that the manufacturer should have analysed in an appropriate manner were indeed available. The pharmaceutical company also gives no reasons why the subgroup analyses were not provided.
In addition, the company excluded one study although it contained relevant information. The manufacturer of the single agent product accordingly included this study in its dossier.
In view of these deficiencies, IQWiG considers itself compelled to declare the contents of the dossier as "incomplete".
Dossiers are of a widely differing quality
"What is immediately striking in the assessment of rilpivirine, is the widely differing quality of the two dossiers - although the data on which they are based are practically identical", commented Institute Director Jrgen Windeler. "Whereas one manufacturer has used and suitably processed all the available data, the other has completely excluded one relevant study and has also not properly analysed the two other studies". The motives remain obscure.
G-BA decides on the extent of added benefit
The dossier assessment is part of the overall procedure for early benefit assessment conducted by the G-BA. After publication of the manufacturer's dossier and its assessment by IQWiG, the G-BA initiates a formal commenting procedure which provides further information and can result in a change to the benefit assessment. The G-BA then decides on the extent of the added benefit, thus completing the early benefit assessment.
You can also find easily understandable and brief German-language information about rilpivirine and rilpivirine/emtricitabine/tenofovir on the website gesundheitsinformation.de, published by IQWiG.
The G-BA website contains both general English-language information about the procedure of benefit assessment pursuant to 35a Social Code Book V and specific German-language information on the assessment of rilpivirine and of rilpivirine/emtricitabine/tenofovir.
###
[ | 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.
Public release date: 7-Dec-2012[ | E-mail |
Share ] Contact: Dr. Anna-Sabine Ernst
presse@iqwig.de
0049-221-356-850
Institute for Quality and Efficiency in Health Care
Contents of the dossier for the fixed combination product incomplete: Existing study data not adequately analysed
Since the start of 2012, a new drug called rilpivirine has been available for adult patients infected with the human immunodeficiency virus type 1 (HIV-1). It is marketed by two different pharmaceutical companies, by one as a single agent (trade name Edurant) and by the other as a fixed combination with other HIV drugs (trade name Eviplera). In two early benefit assessments pursuant to the "Act on the Reform of the Market for Medicinal Products" (AMNOG), the Institute for Quality and Efficiency in Health Care (IQWiG) has investigated whether the two new drugs have advantages over current standard therapies.
According to IQWiG, there is proof that rilpivirine as a single agent offers a considerable added benefit to men infected with HIV-1. For women, the available studies provide corresponding "indications" of considerable added benefit.
On the other hand, no added benefit can be derived from the manufacturer's dossier for the fixed combination - although precisely the same studies were available to the two pharmaceutical companies. This is because, unlike the manufacturer of the single agent, the company making the fixed combination product did not analyse the study data in a suitable way. Hence the contents of its dossier are incomplete.
G-BA specifies efavirenz as the appropriate comparator therapy
Two pharmaceutical companies introduced the new drug onto the market in Germany at the same time; one as a single agent and one in a fixed combination with emtricitabine and tenofovir. Both products are approved for adults who are beginning a treatment directed at stopping the multiplication of the virus for the first time and in whom not more than 100,000 viral components can be detected per millilitre of blood.
The Federal Joint Committee (G-BA) has in each case specified efavirenz-based therapy in combination with other drugs as the appropriate comparator therapy.
Studies on the single agent also relevant for the fixed combination
Results from a total of 3 studies were available. Since, at the time of the assessment, only analyses after 48 weeks were fully available for the two largest studies, IQWiG's assessment is based on these analyses.
In all 3 studies, rilpivirine was tested as a single agent. Nevertheless, the results are also relevant for the assessment of the combination product, because the dosage of rilpivirine, emtricitabine and tenofovir administered in these studies corresponds exactly to the dosage in the fixed combination.
Viral load is a sufficiently valid surrogate parameter
In its dossier, the manufacturer of the single agent did not submit any data on the patient-relevant outcome "AIDS-defining diseases/death", i.e. on the outbreak of AIDS and on survival. Instead, the manufacturer used results of "viral load" in order to prove the added benefit. The viral load denotes the number of components of a virus present in the blood and it shows how active HIV is.
In principle, IQWiG considers this "surrogate parameter" as valid, i.e. meaningful, because patients in whom the number of viruses can be persistently suppressed below the limit of detection have, according to the current state of knowledge, a lower risk of developing AIDS or of dying. However, it is unclear whether a treatment has just as great an effect on the patient-relevant outcome as on the surrogate parameter.
Effect depends on gender
As regards the reduction in viral load, the 3 studies showed a statistically significant difference in favour of rilpivirine. However, as shown by the data on subgroups presented in this dossier [on the single agent], this only applies to male patients. This means that gender is here an "effect modifier". IQWiG therefore determines that there is proof of an added benefit in HIV-1-infected men, but not in women. Because of the described uncertainty concerning the size of the effect on the patient-relevant outcome, the extent of this added benefit cannot be quantified (is "non-quantifiable").
Fewer neurological side effects
Rilpivirine as a single agent also has advantages in terms of side effects: "neurological events" such as headaches or insomnia occurred less frequently. However, the analysis presented by the manufacturer contains a few uncertainties, which is why IQWiG considers there is no proof here, but only an "indication" of a lesser harm with rilpivirine compared to efavirenz.
Based on the overall results on side effects and viral load, the Institute considers that for male patients, there is proof of a considerable added benefit and for female patients a corresponding "indication".
No proof of added benefit of the fixed combination
In contrast to the single agent, there is no proof of an added benefit for the fixed combination of rilpivirine, emtricitabine and tenofovir. In its dossier the manufacturer did not analyse the available data in a suitable way.
Subgroup analyses (age, gender, severity of disease etc.) are routinely required in every dossier. However in this case the manufacturer did not carry these out, despite the fact that its dossier refers to the same studies reported in the dossier submitted by the manufacturer of the rilpivirine single agent, in which gender had been identified as an effect modifier. It is, however, precisely under these circumstances that such subgroup analyses are essential. The necessary data that the manufacturer should have analysed in an appropriate manner were indeed available. The pharmaceutical company also gives no reasons why the subgroup analyses were not provided.
In addition, the company excluded one study although it contained relevant information. The manufacturer of the single agent product accordingly included this study in its dossier.
In view of these deficiencies, IQWiG considers itself compelled to declare the contents of the dossier as "incomplete".
Dossiers are of a widely differing quality
"What is immediately striking in the assessment of rilpivirine, is the widely differing quality of the two dossiers - although the data on which they are based are practically identical", commented Institute Director Jrgen Windeler. "Whereas one manufacturer has used and suitably processed all the available data, the other has completely excluded one relevant study and has also not properly analysed the two other studies". The motives remain obscure.
G-BA decides on the extent of added benefit
The dossier assessment is part of the overall procedure for early benefit assessment conducted by the G-BA. After publication of the manufacturer's dossier and its assessment by IQWiG, the G-BA initiates a formal commenting procedure which provides further information and can result in a change to the benefit assessment. The G-BA then decides on the extent of the added benefit, thus completing the early benefit assessment.
You can also find easily understandable and brief German-language information about rilpivirine and rilpivirine/emtricitabine/tenofovir on the website gesundheitsinformation.de, published by IQWiG.
The G-BA website contains both general English-language information about the procedure of benefit assessment pursuant to 35a Social Code Book V and specific German-language information on the assessment of rilpivirine and of rilpivirine/emtricitabine/tenofovir.
###
[ | 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.
Source: http://www.eurekalert.org/pub_releases/2012-12/ifqa-rfh120712.php
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Optimism turns to despair as NHL talks break off
NEW YORK (AP) ? Donald Fehr thought he and the hockey players he leads were close to a deal to save the season. The NHL said not so fast, and then took away everything that created all the optimism in the first place.
When the 82nd day of the lockout was over, it was hard not to think the sides were thrown back to the very start of the fight. The problem is this is not the summer or even October. It's December, and there isn't much time left to reach the elusive deal and get back on the ice.
Most of Thursday, NHL negotiators waited for the players' association to wrap up internal discussions and get back to them regarding a proposal the league made Wednesday night. Owners greatly increased the amount of dollars they were willing to pay on the "make-whole" provision to compensate players in transitioning to the new collective bargaining agreement.
But that price came with a cost: Three conditions the NHL required the players to agree to if they wanted the influx of funds. The league wasn't looking to negotiate on those points on Thursday. It wanted a yes or no answer.
When management didn't get it, negotiators got up after only an hour together and left.
Fehr didn't take that as a negative response when he stood in front of a large throng of reporters in a Manhattan hotel and proclaimed that agreements had been all but reached on key issues, and a full deal could be reached in short order.
"If we can get a positive response and conclude this, hopefully it doesn't take long," Fehr said.
Then things took a wild and unprecedented turn.
While players were talking to reporters, they were told to return to the podium where they had flanked Fehr moments before. Word spread that Fehr was coming back to speak again, and when he did, the tone and the news were nowhere near as hopeful.
"There has been a development. It's not a positive one," he said. "We have been advised in a voice mail message that the moves the players made were not acceptable. There was no reason to stay around tonight or tomorrow, that they would be in touch. And that something ? everything is off the table.
"We don't know what that means."
They would soon find out when NHL Commissioner Gary Bettman and deputy commissioner Bill Daly took Fehr's place at the podium and gave their side of the story. Three news conferences in the span of an hour turned the talk from whether there could be a deal in days to conversations questioning whether an agreement could be made at all.
"I find it almost incomprehensible he did that," the visibly angry Bettman said of Fehr's positive spin. "I am disappointed beyond belief that we are where we are. I need to take a deep breath and try to regroup."
Hot-button topics such as the "make-whole" provision on existing contracts not only weren't settled, but are no longer being offered by the league. Forget that owners were willing to pay up to $300 million to cover the costs, now Bettman is saying the entire concept is off the table ? along with everything else the league proposed during the previous two days of marathon talks.
When the NHL agreed to increase its offer of payments from $211 million, it was part of a proposed package that required the union to agree to three nonnegotiable points. The players' association accepted the raise, but then made counterproposals on the issues the league stated had no wiggle room.
"We put 100 million dollars on the table and it was received with silence," Bettman said of the union's response to the offer Wednesday night.
The NHL wants to limit personal player contracts to five years, seven for a club's own player, and has elevated the issue to the highest level of importance.
"It's the hill we will die on," Daly said.
The union countered with an offer of an eight-year maximum length with the variable in salary being no greater than a 25 percent difference between the highest-paid year of the deal and the lowest.
The other NHL demands are a 10-year term on the new agreement, with a mutual opt-out option after eight years, and no compliance buyouts or caps on escrow in the transition phase to the new structure. The union presented an offer of an eight-year deal with a reopener after six.
"The take or give or bottom line on all this is it appears that the union is suggesting because we made substantial movements in certain areas that we're close to a deal," Bettman said. "Those moves were contingent on the union specifically agreeing on other things, which while the union may have moved toward, didn't agree to."
Bettman added that the six owners involved with the negotiations were taken aback by the players' reaction to what the NHL felt was a major concession. As soon as the players wanted to negotiate the corresponding demands, the NHL felt it had nothing left to talk about.
"They knew there was a major gulf between us and yet they came down here and told you we were close," Daly said.
Fehr vehemently disputed that assessment and stuck to his opinion that the sides really aren't far apart, saying they are "clearly very close if not on top of one another."
The sides won't meet again before Saturday at the earliest. While Bettman insisted that a drop-dead date for a deal that would preserve a season with "integrity" hasn't been established ? even internally ? clearly there isn't a lot of time to work out an agreement.
"I'm surprised. We feel like we moved in their direction," Pittsburgh Penguins star Sidney Crosby said.
The 2004-05 season was lost before the players' association accepted a deal that included a salary cap for the first time. While no major philosophical issues such as that exist now, the sides don't appear ready to come to an agreement.
"It looks like this is not going to be resolved in the immediate future," Fehr said.
A 48-game season was played in 1995 after a lockout stretched into January. Bettman said he wouldn't have a season shorter than that.
Union special counsel Steve Fehr was stunned by the NHL's quick rejection of the players' offer. He missed Daly's call that came during Donald Fehr's initial news conference.
"Not only is it unusual, I would be hard-pressed to think of anything comparable in my experience," he said of the instant rejection.
Talks resumed Tuesday night with owners and players in the room, and Bettman and Donald Fehr on the outside. It sparked what seemed to be the most optimistic developments in the lockout. But the tenor began to change Wednesday, and the discourse erupted Thursday.
"The sense of optimism almost inexplicably disappeared Wednesday afternoon after such a good day Tuesday," Bettman said.
When the players suggested Wednesday night that they wanted Donald Fehr to rejoin the negotiations Thursday, the NHL informed them that his inclusion could be a deal-breaker.
"We thought we were getting close. There was definitely movement toward each other," Winnipeg Jets defenseman Ron Hainsey said. "As confident as some of us players are in the issues, we cannot close deals. I'd love to think I could, we cannot."
Donald and Steve Fehr were in Thursday's session, as were Daly and lead league counsel Bob Batterman.
Steve Fehr and a number of players stood in the back of the room with arms folded as Bettman and Daly presented the league's position Thursday.
There were already signs the process was breaking down earlier when the union requested that federal mediators rejoin the discussions. Mediators previously were unsuccessful in creating a breakthrough after two days of discussions last week.
"What we got today, quite frankly and disappointingly, missed the mark," Daly said. "For the union to suggest somehow we are close, is cherry picking and it's unfortunate."
The owners who joined the process this week expressed their disappointment, too.
"Regrettably, we have been unable to close the divide on some critical issues that we feel are essential to the immediate and long-term health of our game," Winnipeg Jets chairman Mark Chipman said in a statement released by the NHL. "While I sense there are some members of the players' association that understand our perspective on these issues, clearly there are many that don't."
The sides are trying to avoid another lost season. The NHL became the first North American professional sports league to cancel a full year because of a labor dispute back in 2005. The deal reached then was in place until this September, and the lockout was enacted when it expired.
"While trust was built and progress was made along the way, unfortunately, our proposal was rejected by the union's leadership," Toronto Maple Leafs minority owner Larry Tanenbaum said in a statement. "My love for the game is only superseded by my commitment to our fans, and I hold out hope we can soon join with our players and return the game back to its rightful place on the ice."
All games through Dec. 14, along with the New Year's Day Winter Classic and the All-Star game, have been wiped off the schedule.
Source: http://news.yahoo.com/optimism-turns-despair-nhl-talks-break-off-090924345--nhl.html
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What do I Need to Watch TV Over the Internet ~ Tech News 24h
Sunday, September 30, 2012
Watching television over the Internet has become increasingly common, from taking in the Olympics on the BBC website, to enjoying television series as part of subscriptions to Netflix and Lovefilm. To watch television in this way, you?ll typically require a fast enough connection, a good image and audio set up, and access to the right services, be they official providers or replay and catchup services. At the same time, its worth being awareness of the law surrounding watching television online, and some of the optional extras that can be used to enjoy the experience.A Fast Enough Connection
Most broadband enabled computers and devices can now easily stream video signals, with many video players optimised to run in low bandwidth versions, as well as high definition. You may occasionally experience some buffering as the result of a connection, but most services are set up to allow you to stream without using a large amount of your bandwidth. For example, the BBC iPlayer recommends that users have a download rate of at least 3.2 mbps a second to stream content, which is below the national average of 4 to 6 mbps for users with broadband. Most smartphones and tablets can now handle this speed through wireless and 3G connections.A Good Image and Audio Set Up
Although not essential, it?s worth having a good image and audio set up in place to watch television online. A flat screen television and decent sound can make a difference to watching content, particularly in high definition. It?s also worth investing in separate speakers if you want a comprehensive sound system.Access to the Right Services
Of the most common services for watching television online in the UK, the BBC iPlayer is among the most used in terms of replaying BBC television and radio, and providing live streams. However, you will still need a TV license for the iPlayer, even if it is only watched on a computer. Other broadcaster related services like the ITV Player, 4OD, and Channel 5 On Demand are available for free viewing, with the expectation that you will have to sit through adverts. These services can typically only be used on a computer in the UK.Other options include subscription only players like Sky GO, which provides live streams and library content from its channels, but requires you to pay for a monthly package. Other services that need a monthly subscription include Netflix and Lovefilm, which have large libraries of film and television content.
Catch up services, representing websites that group together the best recently aired programmes from broadcasters like the BBC and Channel Four are also useful. Free to use, they provide a way of sorting through the week?s content, and can be organised by genre, as well as by channels and favourites. These sites can make it much easier to avoid missing content, and can prevent you from being overwhelmed by the sheer amount of material that appears online every week.
Awareness of the Law
It?s important to be aware of the dangers of watching television online. Always use legal sites and official players if possible, as illegal streaming and downloading sites can damage your computer, and can feature streams that are low quality. It?s best to invest in a small payment for a high quality site, where you will be able to make the most of high quality content on demand.Optional Extras
Another option for watching television online is to synchronise your Internet and television services, meaning that you can stream content from the iPlayer and other sites over your television or games network in high quality. Author Bio:Patrick Hegarty is a technophile?and likes to share his latest findings about?watching TV online?with a growing community of followers.
This post was published by: AppSapp
AppSapp is a professional blogger, entrepreneur and internet visionary. Follow him on Twitter
Source: http://www.technews24h.com/2012/09/what-do-i-need-to-watch-tv-over-internet.html
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Open Source Fear Mongering Is Ridiculous With The Advent Of Open APIs
Open source fear mongering is still a reality. But in today's world, it is nuanced with the belief that an open enterprise means open APIs. They are not the same and should not be confused.Source: http://feedproxy.google.com/~r/Techcrunch/~3/AwwGSQZBH_s/
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D.C. sniper 10 years later: ?I was a monster?
John Lee Malvo is escorted from court, Jan. 14, 2003. (Pablo Martinez Monsivais/AP)
Lee Boyd Malvo, who was convicted along with John Allen Muhammad in the 2002 D.C. sniper shootings that left 10 dead and three wounded, says he remembers the killings vividly but can't explain why he did what he did.
"I was a monster," Malvo told the Washington Post in a recent interview from a Virginia prison where he's serving six consecutive life sentences without the possibility of parole. "If you look up the definition, that's what a monster is. I was a ghoul. I was a thief. I stole people's lives. I did someone else's bidding just because they said so. There is no rhyme or reason or sense."
Malvo, now 27, was a teenager at the time of the shootings. Muhammad was executed in 2009. The shooting spree lasted three weeks before the pair were arrested at a truck stop in Maryland.
"At that point in time, I had been desensitized," Malvo continued. "In the midst of the task, there is no feeling. It got to a point where I'd get in a zone. There was nothing else but whoever is before me, and anything that comes between me and, as you would say, the target, I'm either going to destroy, or if it's too big, find a way around it. Nothing is going to stop me but death to get that done."
Muhammad was a father figure to him, Malvo said.
"I trusted him," he said. "I was unable to distinguish between Muhammad the father I had wanted and Muhammad the nervous wreck that was just falling to pieces. He understood exactly how to motivate me by giving approval or denying approval. It's very subtle. It wasn't violent at all. It's like what a pimp does to a woman."
"He picked me because he knew he could mold me," he said. "He knew I could be what he needed me to be. ... He could not have chosen a better child."
After their arrest, Malvo said, he claimed responsibility for the killings in an attempt to save Muhammad from the death penalty.
"I did everything I thought I could do to save his life," Malvo said. "It was just a mixture of half-truths, details that only I or the killer would know, because I was there. What's crazy is this entire process. I'm concerned for him, and he doesn't give a rat's a-- whether I live or die."
Source: http://news.yahoo.com/blogs/lookout/d-c-sniper-10-years-later-monster-192331103.html
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