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This 2013 Woodrow Wilson Presidential $1 Coin 500-Coin Box is comprised of 500 coins – 20 rolls of 25 circulating quality coins minted at the United States Mint at Philadelphia that have never been placed into circulation.
These coins' designs display large, dramatic artwork and edge-incused inscriptions of the year, E PLURIBUS UNUM and the mint mark. Each coin features a likeness of Roosevelt and has a common reverse design featuring a striking rendition of the Statue of Liberty.
The design inscriptions on the obverse (heads) of the 2013 Woodrow Wilson Presidential $1 Coin are:
- 28th PRESIDENT
- 1913-1921
Woodrow Wilson was born in Staunton, Virginia, in 1856. He became a professor of political science and was appointed president of Princeton University in 1902. He was elected Governor of New Jersey in 1910 and President of the United States just two years later. While he was President, the Federal Reserve Act was passed, which provided the country with a more elastic money supply. He suffered a stroke while trying to rally support for the Versailles Treaty, which was defeated by the Senate.
Please Note: United States Mint coins are rolled by an automated machine process and not by hand; thus, we cannot guarantee that the obverse (heads) or reverse (tails) of a coin will be at either end of a coin roll.
In 2005, President Bush signed the Presidential $1 Coin Act of 2005 authorizing the United States Mint to strike $1 coins honoring America's Presidents in the order in which they served. This coin, the 28th in the Presidential $1 Coin Program, honors President Woodrow Wilson.
|Specification Name
|Specification Value
|Coin Specifications
|6% Zinc,
3.5% Manganese,
2% Nickel,
Balance Copper
|8.100 grams
|1.043 inches
26.49 mm
|Mint and Mint Mark
|Philadelphia - P
In addition to the standard shipping and handling fee of $4.95 added to all domestic orders, there is an additional shipping charge of $7.95 per box of 500 coins because of its weight.
On-Sale Date: To ensure that all members of the public have fair and equal access to United States Mint products, any order placed prior to the official on-sale date and time of October 17, 2013, at 12 noon (ET) shall not be deemed accepted by the United States Mint and will not be honored. This product will be available until June 30, 2014, or until inventory is depleted.
Credit Card: If paying by credit card, please be sure your credit card information remains current to avoid any delays in processing your order. If your credit card has expired by the time of shipment, your order will be cancelled. To update credit card information after an order has been placed, you must call 1-800-USA-MINT (872-6468).
Shipping: Please allow one to two (1-2) weeks for shipping of in-stock products.


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Land Rover Freelander 2 review
The compact Land Rover Freelander 2 has a comfortable drive, a strong diesel engine and excellent off-road ability
With the arrival of the excellent Range Rover Evoque, it's easy to forget about the other compact Land Rover in the range – the Freelander 2. But you shouldn't because it offers a comfortable driving experience, brilliant off-road ability and is very well made. It's not as sporty to drive as a BMW X3 and it's expensive to buy, too. But the Freelander is well worth a look, especially as it was revised at the end of 2012, with stylish new lights and a neater interior.
Our choice: Frelander 2 188bhp 2.2 SD4 GS
Video: watch CarBuyer's video review of the Freelander
The Land Rover Freelander has a chunky shape that borrows design cues from larger models such as the Range Rover, yet has a look all of its own. The front end is imposing but it's quite car-like in the flesh, rather than an aggressive SUV. The latest versions have updated headlights, grilles and new bumpers along with some shinier chrome accents. All models come with alloy wheels as standard. Inside, the dashboard is a quality affair with upmarket soft-touch materials along with wood and metal trim. The updates late in 2012 have removed the 'Terrain Response' dial in favour of two small buttons, and the centre console has been tidied up substantially. Nevertheless, the Range Rover Evoque does make it look rather dated both inside and out.
Gone are the days when Land Rover offered a petrol engine in the Freelander - now the range is diesel only. Choose from a 148bhp or 188bhp 2.2-litre turbocharged unit; we'd go for the latter as it never feels underpowered, has lots more low-end torque for easy overtaking and is swift with 0-60mph taking 8.7 seconds and a top speed of 118mph. It's a bit noisy at start-up, but quiet on the move, and gets a six-speed automatic gearbox as standard, while other units have a six-speed manual. The auto is smooth and suits the Freelander well. Around corners, the Freelander isn't as precise or involving as a BMW X3 or an Audi Q5 – or its sister car, the Range Rover Evoque. It has too much body roll and steering that is a little vague. The upside is that it is extremely comfortable, and excels at cushioning occupants from bumpy roads. Sadly, while the Freelander is quiet around town, its boxy shape generates a lot of wind noise on the motorway. Still should the going get tough than the Freelander will tackle rough terrain much more easily than any of its rivals.
You get a host of airbags as standard on the Land Rover Freelander – including front, side and curtain 'bags – while it also features traction and stability control to enhance the car's already excellent levels of grip. Reliability is a different matter – the first generation Freelander was one of the most troublesome cars on UK roads, with owners constantly visiting their dealer. This latest version is a vast improvement, but we would still advise caution, despite the improved build quality and new engines. However, it is worth noting that the current Freelander was awarded a full five-star rating in the Euro NCAP crash tests, putting it at the top of its class.
The Freelander is well suited to the rough and tumble of family life with a big boot that has 755 litres of load space with the rear seats in place and a massive 1,670 litres with them down. That beats the BMW X3 by a long way – plus it features heavy duty, wipe clean materials on the boot floor and lots of cubby holes throughout the cabin. Front seat space is very good but knee room in the back could be better. You sit up high and enjoy a commanding view of the road ahead, thanks to a wide windscreen and relatively narrow A-pillars. Large glass areas behind the driver make it easier than most SUVs to reverse park, too. Off-road, the Freelander beats more on-road focused rivals like the Audi Q5 and BMW X3 hands down thanks to its excellent Terrain Response system, which features a number of modes to tackle different surfaces and limited grip levels. Although be aware that entry-level versions and the eD4 do miss out on this impressive electronic system.
Running Costs
The cheapest way to run a Land Rover Freelander is to go for the entry-level front-wheel drive 148bhp eD4 model which gets stop-start and returns 47.1mpg while emitting 158g/km of CO2. By comparison, the 188bhp 4x4 version posts 40mpg and 185g/km – not bad but not great when you consider a 184bhp 2.0d BMW X3 beats both models, returning 50.4mpg and emitting just 149g/km of CO2. The Freelander is expensive to buy, especially when you consider top-spec models are within reach of the cheapest Range Rover Evoques. However, residuals are strong due to strong brand image. Servicing costs are likely to be average for the class and equipment levels are good. Even entry-level S models get air-con, while GS versions add cruise control, climate control, Terrain Response and parking sensors. Further up the range XS models have electric seats and sat-nav, while flagship HSE models boast leather trim and a CD changer. HSE Lux and Dynamic models were added late in 2012, focusing on providing the ultimate in luxury and sportiness respectively - with subtle visual changes to differentiate them from the rest of the range.
Disqus - noscript
I have had a freelander2 for 9 months and wished I had never bothered had nothing but problems with it .I have had Toyota & Nissan also shogun no problems and will be getting Japanese again.
I would like to buy British but till they get the reliability right I will not buy them.
Took delivery mid March of a new Freelander 2 2013 model. The Sd4 HSE. Our second Freelander 2, having test driven the Evoque. The Evoque is a nice car, but space is limited and felt cramped compared to Freelander 2. The updates for the 2013 model Freelander raise the in cabin comfort and information into the same bracket as the Evoque. The engine for the Freelander 2 is the same as for the Evoque so the Sd4 gives much more power than the previous Td4 Freelander. Quite simply the Freelander represented better value than the Evoque. We had no problems at all in 3.5 years and 36k miles in our past Freelander 2. Why change?
For an alternative review of the latest Land Rover Freelander 2 4x4 visit our sister site carbuyer.co.uk
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subset: commoncrawl


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As asthma rates continue to rise in the U.S. — proportionally affecting more children than adults — experts at UCSF and across the nation continue to search for the best medicines for pediatric patients.
Latest News
September 17, 2012
A new study by a UCSF-led research team has found a way to help asthma sufferers by impeding the two most significant biological responses that lead to an asthma attack.
September 11, 2012
For two decades, asthma treatment for millions of people with a milder form of the disease has consisted of daily inhaled steroid medicine to reduce inflammation. Now, a new study has found that asthmatics who take the low-dose medication as a daily routine do no better than those who turn to their inhalers only when they have symptoms.
May 31, 2012
African-American and Latino children whose mothers smoked during pregnancy are more likely to suffer from acute asthma symptoms in their teens than asthma sufferers whose mothers did not smoke, according to a new study led by a research team at UCSF.
October 03, 2011
Asthma patients could clearly benefit from personalized medicine, a new study suggests. However, the new discovery of a key gene, while exciting, does not mean that day is here quite yet.
August 26, 2011
A common antibiotic can help reduce the severe wheezing and other acute symptoms of chronic obstructive pulmonary disease, according to a large, multicenter clinical trial sponsored by the National Institutes of Health and conducted at the University of California, San Francisco (UCSF).
August 22, 2011
Children with severe asthma are 3.6 times more likely to have been exposed to tobacco smoking before birth – even without later exposure – than children with a mild form of the disease, according to a multicenter study led by researchers at University of California, San Francisco (UCSF).
February 17, 2011
Asthma may have a surprising relationship with the composition of the species of bacteria that inhabit bronchial airways, a finding that could suggest new treatment or even potential cures for the common inflammatory disease, according to a new UCSF-led study.
September 21, 2010
An inexpensive, hundred-year-old therapy for pain – aspirin – is effective in high doses for the treatment of severe headache and migraine caused by drug withdrawal, according to a new study by researchers with the UCSF Headache Center.


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Software Map
Tag cloud | Project Tree | Project List
Project tree
Now limiting view to projects in the following categories:
Intended Audience :: Database Designers [Remove This Filter]
Topic > PostgreSQL Enhancements > Data Types
Browse By:
16 projects in result set.
|0. pgSphere - pgSphere is a server side module for PostgreSQL. It contains methods for working with spherical coordinates and objects. It also supports indexing of spherical objects.
Registered: 2006-11-12 17:25
|1. Indexable IPv4 range / CIDR type - ip4 and ip4r are types that contain a single IPv4 address and a range of IPv4 addresses
respectively. They can be used as a more flexible, indexable version of the cidr type.
|Activity Percentile: 94.44
Activity Ranking: 8.00
Registered: 2005-03-09 18:37
|2. textsearch-ja - Integrated Full-Text-Search for Japanese language using morphological analyze.
|Activity Percentile: 84.92
Activity Ranking: 20.00
Registered: 2007-09-06 11:12
|3. PostgreSQL Multiple Precision Arithmetic - This extension adds support in PostgreSQL for the data types and
functions avaliable in the GMP library for arbitrary precision
|Activity Percentile: 68.25
Activity Ranking: 41.00
Registered: 2011-03-09 10:46
|4. BioPostgres - BioPostgres is a collection of modules that extend PostgreSQL for Computational Biology. It implements new datatypes (graph, range, location, etc) with query operators, index and related tools for large-scale analysis. See also http://biopostgres.org
|Activity Percentile: 42.86
Activity Ranking: 73.00
Registered: 2006-01-09 01:55
|5. pgrpm - pgrpm provides functions and operators to mimic rpm behaviour. This is espacialy useful if you want to sort row by version-release and take care of numeric values.
|Activity Percentile: 42.06
Activity Ranking: 74.00
Registered: 2005-03-23 20:29
|6. GTIN Data Type - The GTIN data type is a full-featured, indexable data type implemented in C that allows values to be stored for all GTIN-compatible bar codes, including UPC, EAN 8, EAN 13, EAN 14, and SSCC.
|Activity Percentile: 16.67
Activity Ranking: 106.00
Registered: 2006-09-15 18:24
|7. Case-Insensitive text - Case-Insensitive text data type named citext for PostgreSQL
|Activity Percentile: 14.29
Activity Ranking: 109.00
Registered: 2008-02-05 15:32
|8. e-mail data type - email data type
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2004-05-10 23:24
|9. Field Level Multilingual Support for PG - With combination of plpg, array suppurt and types one can define mulitilingual support at field level, the main goal is to explore what this sulotion is best for, like porting old db model to multilingual model as well as model design for light dbs.
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2006-02-12 21:51
|10. MS-SQL Migration helper - The definitive one stop information center for MS-SQL -> PostgreSQL migration.
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2004-06-07 16:03
|11. New hstore functionality - Standalone package version of new hstore functionality, for use with versions that do not yet incorporate the new features into contrib/hstore.
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2009-03-22 15:19
|12. Tree structure manipulation functions - A functions library to manipulate trees
and hierarchical structures under PL/pgSQL.
Some Features: add/remove Nodes, tree traversal, tree level traversal, xml/html tree conversion, get path from root to node, get anchestor of 2 nodes
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2007-10-01 18:38
|13. PostgreSQL GUID data type module - PostgreSQL GUID data type
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2005-12-15 11:46
|14. Graph data type for PostgreSQL. - Adds notion of graphs to PostgreSQL extending SQL with graph type.
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2005-09-12 20:27
|15. Arbitrary size integer type - An arbitrary-precision integer datatype for PostgreSQL
|Activity Percentile: 0.00
Activity Ranking: 0.00
Registered: 2008-08-28 07:13


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So sorry and sad for your friend, Bridget. I hope your DBF begins to feel at peace with the whole thing soon.
Christina, wow, you're so young (in my mind) and your *little* bro has been in and out of your family's lives for a couple years? He must be a baby! I hope this means he learned his lesson while still young and can bounce back easily.
L, I hope you have wonderful weather up in Tahoe and your family with you enjoys it. DH will be up there too until early Saturday.


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Funeral services for Arthur E. St. Claire will be held Saturday, Jan. 12, 2013 at 2 p.m. at Rose-Neath Funeral Home Chapel in Minden. Interment will follow at Pine Grove Cemetery in Minden with full military rites.
The family will receive friends from 5 until 7 p.m. today (Friday, Jan. 11, 2013) at Rose-Neath Funeral Home in Minden.
Arthur was born Dec. 12, 1934 in Plain Dealing and entered into rest Jan. 9, 2013 in Shreveport. He served in the United States Marine Corp.
He is survived by his wife, Melba Davis St. Claire of Minden; daughter, Bonnie P. Davis and husband, Rodney of Minden; granddaughter, Jessica P. Smith and husband, Don Smith, Jr.; grandsons, Keith and Derrick Pennington of Minden; great-grandsons, Gabriel and Noah Pennington of Minden, Caden Thornton of Minden, Zakary Smith of Sarepta; and numerous nieces and nephews.


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Rated 3.7 out of 5Â by 6 reviewers.
Men's adidas Running Accessories
Adizero Visor
White/Black (Q31073)
+ Save To Wishlist
Rated 5 out of 5Â by mac4track SUPER!!! LOVE LOVE LOVE this Visor! Not only is it stylish enough to simply wear out and about, but it is also extremely light weight and adjustable, so you dont feel light you have a bag of rocks on your head when you go for a run! The adjustable strap on the back makes it available for any sized head... I'm planning on buying another one so I can have one to wear around town, and one to wear while running! January 29, 2013
Rated 5 out of 5Â by BillTheRunner Comfortable and Extra Absorbent I just tried this visor on a 10-mile run. I like the extra width of the band, and the thickness of the absorbing layer. It runs a bit large, but not a big deal for me, however, it might not be a good fit for others with smaller heads. It is made with high quality, and I'm very satisfied with this purchase. February 2, 2014
Rated 2 out of 5Â by Susan in Phoenix I'm looking for an old adias visor I have with a wide rim, this was not it. March 8, 2013
Rated 5 out of 5Â by BuckeyeSouth Comfy I know....it's just a visor. But it is so comfortable and light. Love it. November 13, 2013
Rated 4 out of 5Â by Bradzo6 Good Technical visor--does the job good fit and function; you won't be disappointed. April 17, 2014
Rated 1 out of 5Â by Greatyankee Not what I expected for visor July 17, 2014
1-6 of 6


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Canine Cancer Blogs
Finding support in first-person-with-dog stories
Photo: Jasper thumbnail image photographed by Hannah Lynch.
Please note comments are moderated. After being approved your comment will appear below.
Submitted by Margarat Nee | June 24 2010 | Permalink
My blog, "La Vida Fresca," didn't start out as a blog about cancer. It started out simply as a blog about "life with a raw fed dog." When my dog was diagnosed, though, cancer inevitably became the focus. I hope that what I write about Vida and her journey through care helps others, and can give people some traction against fear.
Submitted by Paul | September 8 2011 | Permalink
My wife and I have been using a treatment called Neurofascial Process to treat our golden retriever who has cancer (tumors in her spleen, kidney, and liver) along with some holistic medications. The process involves connecting points in the body by touch to release toxins. My wife writes a blog about it at www.greendogmarket.com/dogblog
Submitted by Anonymous | October 24 2011 | Permalink
My father's rottie was just diagnosed with bone cancer at only five years old. They were told she has no chance of survival. As a last hope, she is undergoing a new treatment known as the Navy Protocol. My Dad is keeping a blog online to help track her progress and raise awareness. Please pray for Princess! She is the most wonderful dog!
Submitted by Karen C. | March 1 2012 | Permalink
Our Golden, Duke was diagnosed in January (2012) with non epithelial cutaneous lymphoma, T-cell. We were told that it is rare & usually fatal. Duke has had 3 chemo treatments, & the vet wants to stop since she has seen no decrease in size of his lesions. Duke was only four at diagnosis. He is still very happy and active and has a great appetite. I have him on an immunity boost ultra product from Aloha Medicinals. I don't want to just give up, take him home & wait for him to die! The vet has been consulting with an oncologist from the U of Illinois. Duke is a rescue who we've had since puppyhood -- we have 4 other large rescue dogs as well. I was recently laid off from my occupation, so money is a factor.
Submitted by Amy | March 29 2012 | Permalink
So sorry to hear about Duke. Unfortunately, I can relate - our 5 yr old Lab, Dempsey, was just diagnosed with the same thing. In fact, she began chemo just yesterday. The oncologist told us that out of a couple of thousand cases of lymphoma, this is only the third of this type she's seen. But,the other two had very good outcomes with chemo. One was treated at 18 months, and died at 10 yrs of an unrelated cause; the other was treated at 3 and is still okay a couple of years later. Of course, 2 cases doesn't indicate much, but she sounded guardedly optimistic. At this point, the plan is to have 16 treatments of a type of chemo called the Madison-WI Protocol.
A few years ago we lost another Lab - at 13 y.o. - from Mast Cell cancer. She had a long happy life (the beloved dog my kids grew up with) but it was still awful to see. I have that sinking feeling of 'here we go again...' Money is also a very difficult factor here - between the economy and a child still in college, this couldn't happen at a worse time financially. But, as you said, how do you not treat it? Dempsey is pure love, just the greatest dog.
Submitted by Jane Hughes | June 22 2012 | Permalink
I've been through a lot with my dog. We have been in and out of the hospital for treatments this week. She is a trooper though, sometimes I wonder if I am as strong as she is because she is sooo strong. I have been struggling with paying for the medications and I know a lot of other people do to. I thought I would share this contest I came across to win some free supplements. I entered and all I did was write, Me and my dog like to cook to stay healthy, on their Facebook wall. You could win $60 of free supplements... http://www.facebook.com/ElimaySupplements
Submitted by jeans1234 | February 24 2013 | Permalink
It has gotten to be pretty common, especially in older dogs. Fifty percent of dogs over the age of 10 develop cancer at some point. We see malignant lymphoma, which is a tumor of the lymph nodes. We see mast cell tumors, which is a form of skin cancer. There are mammary gland tumors, or breast cancer, and soft tissue sarcomas. We also see a fair amount of bone cancer in dogs.More info
Submitted by siena | March 27 2013 | Permalink
My beautiful 15 year old sheltie was diagnosed with a fast growing type of oral cancer 2 months ago. It is a devastating shock and like many of us who have commentated here I have set up a blog detailing the experience. Sharing the grief is really helping me cope.
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With over 22,000 square feet of function space at the Skamania Lodge, meetings and events are our specialty. Knowing the importance that audiovisual services play in the overall success of your event, the Skamania Lodge has formed a partnership with PSAV.
Since 1937 PSAV has been setting the stage in meeting, convention and special event production, offering the expertise to accommodate everything from intimate gatherings to large conventions. PSAV is a key element of any meeting services team, and always maintains a "going the extra mile" attitude to earn the customer's loyalty. With their in-depth knowledge and understanding of the venue and an integrated approach with the hotel staff, you are ensured a seamless, worry-free environment. When you are looking for creativity, comfort and confidence, PSAV has the resources to transform your vision into reality. They will deliver the spectacular on every event, every time.
By selecting the Skamania Lodge as your destination of choice to produce your conference, meeting or event, you will gain the expertise and knowledge of PSAV's on-site team of creative professionals with the experience and talent to stage the most dazzling events. From set-up to breakdown, PSAV serves your high-end production needs with a core group of highly skilled professionals utilizing an extensive in-house inventory of the very latest production technology. You will not find a more innovative group of audiovisual specialists at any venue. Their team is with you every step of the way with assistance in theming, budgeting, pre-production, 3D CAD set design, staging and event direction.
PSAV's innovative Web-based event app, Mobile Meeting Manager™ (M3), makes accessing itineraries and agendas fun, while also saving you time and money. With M3, attendees can use their smartphones and tablets to access meeting times, speaker biographies, information about other attendees, exhibitor lists and maps, and more, as well as using M3 to build a personal schedule.
The appearance and content of M3 are completely customizable, and our experienced, dedicated customer service team will take your content in any format and develop the app for you, saving you valuable time. Enjoy the "green" benefits of M3 and reduce printing and shipping costs, while eliminating reprints. You can even generate revenue by selling Banner Ads to sponsors and exhibitors. M3 works on most smartphones and tablets, and no downloading is required. Development of the app usually takes about a week, and revisions are easily made during the event and are automatically updated on attendees' devices. Click here to learn more about M3, and experience the modern alternative to paper agendas!
With PSAV, you can be assured that every aspect of your event will instill a creative energy for your attendees, build a sense of confidence for your presenters and supply a comfortable feeling that all your audiovisual needs have been anticipated by an experienced team.
From the moment you book your event at the Skamania Lodge, PSAV is there for you. During each phase of your event, from pre-planning to production, they will consult with you on how best to accomplish your goals.
PSAV's mission is to create the perfect event. Their team members are empowered to do whatever it takes to make this happen. They will exceed your expectations and maintain exacting standards of professional practice to earn your loyalty.
Simply put, PSAV is committed to you and to your event. Your success and achieving your goals are paramount to them. Their team of highly trained specialists looks forward to meeting with you.
... is PSAV's ultimate goal!
National Headquarters 639E Gravois Bluffs St. Louis, Missouri 63026 Phone: 1.877.792.6528© 2012 Swank Audio Visuals. All rights reserved.


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Shop for St. Louis Rams Merchandise at the Official St. Louis Rams Store where you can find the best selection of St. Louis Rams Clothes for Men, Women and Kids. The Official St. Louis Rams Shop features St. Louis Rams Apparel for Fans in the most popular brands of sports attire, such as Nike. Shop for everyone on your list today and find the hottest styles of St. Louis Clothing and Fan Gear on our site. Our huge assortment of St. Louis Gear includes a wide variety of quality merchandise that's perfect for cheering on your St. Louis Rams during football games. Support St. Louis and buy your brand new Rams Attire from the Official Shop of the St. Louis Rams today! We also have the popular Rams iPhone cases! St. Louis Gifts are the perfect way to show fellow fans you care!
© 2014 Fanatics Retail Group, All Rights Reserved. No portion of this site may be reproduced or duplicated without the express permission of Fanatics Retail Group. | Sitemap


text: Briken glass in my oven door Tom C. • Mt. Sterling, KY • March 21, 2014 My Repair & Advice First I went on the web site and watched the video on how to repair the oven door. The video was great. it showed every step on what to take apart and what not to take apart. After the part came in, I watched the video again to refresh myself. I then turn my attention to the oven door and fixed it without a single problem. Thanks so much for the video. Was this review helpful to you?


text: Get verified Get yourself verified before any of your flights as we want you to have a great and smooth journey! Why? We need to confirm your identity with your travel documents (e.g: I.D, Passport, Driving license, etc) as a security measure for you. What? You will need the following documents for:- Domestic flights Identification Card/ Passport/ Driving license. Note: Driving license is not applicable in Malaysia Birth certificate for infant and children International flights Passport with 6 months validity Return/Onward ticket (if required) Visa (if required) Soft copies of any form of IDs are not acceptable. If you do not have the necessary documents, we have the rights to refuse boarding to ensure the security of the other guests. Who? Everyone that is flying on any AirAsia or AirAsia X flights When? Document check needs to be done at the Document Check Counter 45 minutes before departure. How? AirAsia flights You can head to the Baggage Drop/Document Check Counter at the departure hall or boarding gate. AirAsia X (D7) flights Due to visa/passport and immigration requirements; guest(s) are required to head to the Baggage Drop/Document Check Counter before proceeding to the boarding gate. Document verification WITHOUT checked baggage Document verification WITH checked baggage Proceed to Document Check Counter Proceed to Baggage Drop Counter AirAsia Between 3 hours - 45 minutes before departure AirAsia X Between 3 hours - 1 hour before departure Note: Please proceed to Baggage Drop Counter at the stations which do not have dedicated Document Check Counter. I've been verified, now what? Then you're all set! Enjoy your flight and thank you for choosing AirAsia.


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Distressed cotton tee has rips and tears in all the right places. Extra soft, slightly slinky, with "Kalifornia" screened across the chest. A super chill look when you throw it on with the Kendall & Kylie Printed Pants.
- 24" length.
- 6" sleeve length.
- Measured from a size small.
- Machine washable.
- 100% cotton.


text: "The Big Lebowski" is one of the greatest cinematic accomplishments of our generation. And I know that's, just like, my opinion man- but the folks at CineFix agree with me, as they have paid homage by creating a classic 8 bit video game following the adventures of Jeff Lebowski. Okay, it's just a video of the 8-bit game...for now. But you all know that somewhere in your basement sits an NES console, and with enough blowing, you'd TOTALLY pick up a copy of this badboy and play it.


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Recordings and podcasts of the 2012 workshops (as well as workshops from previous years) are available online:
Using New Approach, Scientists Find Evidence for Cancer Stem Cells
With the help of genetic tools, researchers have identified subsets of cells that appear to drive the growth of tumors in mice. The findings, from three independent studies, provide new support for the cancer stem cell hypothesis—the idea that some tumors are sustained by self-renewing cells that give rise to all types of tumor cells. Two of the studies appeared August 1 in Nature, and the third was published on the same day in Science. Read more > >
Trial Suggests New Treatment Option for Some Women with Metastatic Breast CancerMore research needed before use in the clinic, some scientists caution
U.S. Prostate Cancer Incidence Falls after Change in Screening RecommendationsFindings suggest that recommendations against PSA screening for older men has had an impact
Single HPV Test Predicts the Risk of Cervical Cancer for 18 YearsHPV test predicted risk more accurately than Pap test
Discovery of Fused Genes in Brain Cancer Points to Possible TreatmentsDrugs that target the resulting aberrant proteins might help affected patients
A Conversation with Dr. Walter Willett about Diet and Cancer
The chair of the department of nutrition at the Harvard School of Public Health talks about how research has changed views of diet and cancer over the last 40 years.
NCI Cancer Bulletin Publication Break
The NCI Cancer Bulletin will not be published on August 21. Our next issue will be released on September 4, when we resume our usual biweekly publication schedule. If you are not yet a subscriber, please submit your e-mail address in the toolbox at the top right-hand corner to begin your free subscription.
Featured Clinical Trial: Genetically Engineered Immunotherapy for Advanced CancerWill genetically modified immune cells be safe and effective in patients with mesothelin-expressing cancers?
Bringing Science to Cancer Survivors: Workshop Series Reaches a MilestoneFor 10 years, survivorship workshops have provided practical information
FDA Update
- New Drug Approved for Metastatic Colorectal Cancer
- Everolimus Approved for Treating Some Breast Cancers
- Carfilzomib Approved for Advanced Multiple Myeloma
CDC Update
- Drop in Cigarette Smoking Offset by Rise in Use of Other Forms of Smoked Tobacco
Cancer.gov Update
- New Research Tool Estimates Risk of Radiation-Related Cancers
- Fraumeni Steps Down as Director of NCI's Division of Cancer Epidemiology and Genetics
- NCI Releases New Guidelines for National Clinical Trials Network
- Procedures for Collecting Human Biospecimens Released
Selected articles from past issues of the NCI Cancer Bulletin are available in Spanish.
The NCI Cancer Bulletin is produced by the National Cancer Institute (NCI), which was established in 1937. Through basic, clinical, and population-based biomedical research and training, NCI conducts and supports research that will lead to a future in which we can identify the environmental and genetic causes of cancer, prevent cancer before it starts, identify cancers that do develop at the earliest stage, eliminate cancers through innovative treatment interventions, and biologically control those cancers that we cannot eliminate so they become manageable, chronic diseases.
For more information about cancer, call 1-800-4-CANCER or visit http://www.cancer.gov.
NCI Cancer Bulletin staff can be reached at email@example.com.
Featured Article
Using New Approach, Scientists Find Evidence for Cancer Stem Cells
With the help of genetic tools, researchers have identified subsets of cells that appear to drive the growth of tumors in mice. The findings, from three independent studies, provide new support for the cancer stem cell hypothesis—the idea that some tumors are sustained by self-renewing cells that give rise to all types of tumor cells. Two of the studies appeared August 1 in Nature, and the third was published on the same day in Science.
Each research group used the genetic tools to "label" tumor cells and track their ancestry in a different mouse model. The results of each study suggested that at least some tumors contain certain populations of cells that drive the growth and survival of the tumor. These would be the cancer stem cells, also known as tumor-initiating cells.
"The three studies provide nice additional support for the cancer stem cell hypothesis," said Dr. Max Wicha, director of the University of Michigan Comprehensive Cancer Center and a cancer stem cell researcher who was not involved in the three studies. "They are technically challenging and very well done."
Resisting Chemotherapy
The authors of one of the Nature reports identified a population of brain tumor cells that appeared to allow brain tumors to grow back after treatment with the drug temozolomide. The drug initially depleted proliferating cancer cells, slowing tumor growth. But it did not harm a population of less active cells—the cancer stem cells. As a result, the tumors recurred.
"We think this is a clear and rigorous demonstration that the cancer stem cell hypothesis is alive and well in at least one solid tumor," said lead researcher Dr. Luis F. Parada of the University of Texas Southwestern Medical Center in Dallas. "Time will show how frequently this type of tumor mechanism holds true for other solid tumors."
A second study in Nature identified distinct populations of cancer cells in a mouse model used to investigate the development of skin tumors. Consistent with the cancer stem cell hypothesis, a relatively small population of long-lived tumor cells ultimately gave rise, during tumor growth, to progeny cells that made up a substantial part of the tumor.
"The new method of tracking the fates of tumor cells in situ has demonstrated the existence of cancer stem cells that fuel the growth of tumors in vivo," lead investigator Dr. Cedric Blanpain of the Université libre de Bruxelles wrote in an e-mail message.
The third study, in Science, found evidence of cancer stem cells in precancerous intestinal lesions in mice. Although all three studies point to the existence of cancer stem cells, the relevance of the mouse findings to human cancers is not yet known.
Moving the Field Forward
First discovered in leukemia, cancer stem cells have since been reported in solid tumors such as brain, breast, and colon cancers. Evidence for their existence has come primarily from experiments in which only a small proportion of human tumor cells are able to proliferate extensively and to form new tumors when transplanted into mice.
But factors other than cancer stem cells could explain the formation of new tumors from only certain transplanted cells, researchers have argued. Whether tumors form in mice may depend on how the transplantation was done and the type of mouse model used in the experiment.
There are too many variables to be able to draw firm conclusions about cancer stem cells from these transplantation experiments, noted Dr. Parada. The emergence of genetic tools used to tag tumor cells offered a chance to study potential cancer stem cells in their natural environments.
"The new studies put to rest the idea that you see cancer stem cells only if you perturb the human tumor and transplant it into an animal," said Dr. Wicha. "[These new findings] will move the field forward."
The results also suggest that the same pathways used in normal tissue development may be active in tumor development. "The cellular hierarchy found in early tumor progression is a corruption of the cellular hierarchy found in normal tissue," Dr. Blanpain noted.
Clinical Implications
The concept of cancer stem cells has potential implications for treatment. If these cells exist in human tumors, they would need to be eradicated to achieve long-term survival. The new studies suggest that "to cure a cancer you have to be able to identify and target the cancer stem cells," said Dr. Parada.
Several dozen clinical trials are already testing approaches to target cells with stem-cell-like properties in patients, according to Dr. Wicha. Yet, even with the new findings, cancer stem cells are likely to remain controversial. As Dr. Wicha noted, however, this is not necessarily a problem.
"Controversy is healthy, and questions about cancer stem cells are good for science," he said, adding, "There will always be controversies in the field."
The study led by Dr. Parada was funded in part by the National Institutes of Health (R01 CA131313).
Further reading: "The Evolving Science of Cancer Stem Cells" and "Tweaking and Testing Cancer Stem Cell Models"
Cancer Research Highlights
Trial Suggests New Treatment Option for Some Women with Metastatic Breast Cancer
Results from a phase III clinical trial suggest that, for some women with metastatic breast cancer, combining two drugs that work in different ways to disrupt estrogen's ability to fuel cancer growth may delay disease progression and death. The results were published August 2 in the New England Journal of Medicine.
Several breast cancer specialists cautioned, however, that the trial results are not enough to change clinical practice and need to be confirmed.
In the trial, women with metastatic breast cancer treated with the aromatase inhibitor anastrozole (Arimidex) and the antiestrogen fulvestrant (Faslodex) had better progression-free and overall survival than women who were treated with anastrozole alone. Both drugs are already approved to treat metastatic breast cancer.
About 700 women took part in the NCI-funded trial, which was led by SWOG, formerly the Southwest Oncology Group. All of the women in the trial were postmenopausal, had hormone receptor-positive metastatic breast cancer, and had not been previously treated for metastatic cancer. Women in the combination group were given the standard dose of fulvestrant (500 mg) the first time they received it, followed by a lower dose (250 mg) for the remaining treatments. About 40 percent of the women in the anastrozole-only arm began to receive low-dose fulvestrant after their disease began to progress.
Median progression-free survival—the trial's primary endpoint—was 15.0 months in women who received both drugs and 13.5 months in women who received only anastrozole. Overall survival was 47.7 months in the combination therapy arm and 41.3 months in the anastrozole-only arm.
In general, toxic effects were relatively mild and did not differ greatly between the two groups. Nevertheless, 42 patients who received anastrozole alone, and 51 who received both drugs, experienced severe toxic effects, including musculoskeletal pain, flu-like symptoms, and difficulty breathing.
But the results are convincing, said lead investigator Dr. Rita Mehta of the University of California, Irvine, in an interview. "Fulvestrant and anastrozole should be standard for women who would qualify for the study," she said.
But Dr. Jung-Min Lee, of NCI's Medical Oncology Branch, stressed that overall survival was a secondary endpoint of the study and said that several questions need to be answered before the combination therapy is used in clinical practice. "We first have to define the population who might benefit most from the combination therapy," Dr. Lee said. "And we need more data to confirm the overall survival benefit."
The results also conflict with those from a similar international trial, called FACT, which found no difference in overall survival between women who received anastrozole and fulvestrant and women who received anastrozole alone. The trials had several major differences that likely explain the discrepant findings, Dr. Mehta said.
The FACT trial was smaller, she explained, included more women who had received prior tamoxifen (70 percent versus 40 percent), enrolled patients who had completed chemotherapy for earlier-stage disease within the previous 12 months, and was restricted to patients who had suffered a relapse. These differences in the study populations likely "enriched [the trial] for patients with relatively endocrine-resistant disease," she said.
This research was supported by grants from the National Institutes of Health (CA32102, CA38926, CA35431, CA35281, CA20319, CA04919, CA67575, CA58861, CA37981, CA46368, CA86780, CA46282, CA63848, CA12644, CA27057, CA95860, CA35119, CA46441, CA11083, CA45450, CA35178, CA13612, CA58882, CA45377, CA45807, CA58723, C14028, CA128567, CA22433, CA52654, CA45560, CA35261, CA073590, CA45808, CA35192, CA42777, CA16385, CA35176, CA63845, CA35128, CA35090, CA63844, CA76447, CA58416, CA63850, CA76462, CA35262, CA77202, and CCSRI155469).
U.S. Prostate Cancer Incidence Falls after Change in Screening Recommendations
Soon after an independent task force recommended against routine screening of men aged 75 and older for prostate cancer with the prostate-specific antigen (PSA) test, the incidence of early-stage prostate tumors in that population declined, a new analysis shows. The findings suggest that the revised recommendations led to a reduction in prostate cancer screening rates in older men.
The U.S. Preventive Services Task Force (USPSTF) conducted a systematic review of the medical literature and issued the recommendations in August 2008.
"There's a lot of skepticism that these types of recommendations will have an impact on practice patterns, but at least in this case it looks like there has been some [impact]," said study author Dr. David Howard of Emory University in an interview posted online.
For his analysis, published July 23 in Archives of Internal Medicine, Dr. Howard used data from more than 254,000 men with prostate cancer from NCI's Surveillance, Epidemiology, and End Results registry.
He hypothesized that if screening rates in men aged 75 and older fell, the incidence of early-stage prostate tumors, which are detected primarily by PSA-based screening, would also fall relative to the incidence of late-stage tumors and of early-stage tumors in younger men. "And that's exactly what I found," he said in the online interview.
Between 2007 and 2009, the incidence rate for early- and late-stage prostate tumors fell 25.4 percent and 14.3 percent, respectively, among men aged 75 and older. By contrast, the incidence rate for early-stage tumors dropped 15.2 percent among men aged 65 to 74, and 11 percent among men aged 30 to 64, over the same period.
Dr. Howard's conclusions differ from those of an earlier report that found that self-reported PSA screening rates in men aged 75 and older did not change between 2005 and 2010. Several factors may explain the discrepancy. For instance, "patients do not [always] accurately report receipt of PSA testing," he explained via e-mail, noting that physicians who stopped screening older men may not have discussed this decision with their patients.
Over time, a clearer picture should emerge of physicians' responses to revised screening recommendations. "Dr. Howard's data are interesting and relevant," commented Dr. Scott Eggener of the University of Chicago, senior author of the earlier study. "As with all self-reported or population-based data, it's important to replicate using multiple sources."
In a study that is still under review for publication, Dr. Howard also examined PSA testing rates directly using Medicare claims, which he noted are more reliable than patient self reports. He expects the findings from that study to be published soon.
Further reading: "U.S. Preventive Services Task Force Advises against PSA Screening"
Single HPV Test Predicts the Risk of Cervical Cancer for 18 Years
In a group of more than 20,000 women, the human papillomavirus (HPV) DNA test more accurately predicted the risk of developing cervical cancer over an 18-year follow-up period than the Pap test. Although both tests could identify women who were most likely to develop high-grade precancerous cervical lesions or squamous cervical cancers within 2 years of testing, only the HPV test result predicted the risk for women up to 18 years later.
Dr. Philip Castle of the American Society for Clinical Pathology and his colleagues reported their findings July 30 in the Journal of Clinical Oncology.
The authors, including researchers from NCI's Division of Cancer Epidemiology and Genetics (DCEG), used data from a study initiated by NCI and Kaiser Permanente of women who, in 1989 and 1990, underwent routine Pap testing in Portland, OR. Samples collected at the start of this study were used for Pap and HPV testing.
Recently reported research from this group also showed that HPV testing could predict risk for 18 years, but those results were based on HPV tests that are used only in research settings. These new results are based on the type of HPV tests that are used in current clinical practice.
The researchers found that the HPV test more accurately stratified women by their risk of developing cervical cancer than the Pap test. Over the 18-year follow-up period, 199 women were diagnosed with cervical intraepithelial neoplasias grade 3 or cervical cancer (CIN 3+); more of these cases developed in those with a positive HPV test (112 women) than in women who had an abnormal Pap test (65 women). Conversely, fewer cases of CIN 3+ developed over the follow-up period in women with a negative HPV test at the start of the study than in women with a normal Pap test taken at the same time (87 women versus 134 women).
Current screening guidelines recommend that most women aged 30 to 65 be tested for high-risk HPV types in conjunction with a Pap test every 5 years.
DCEG's Dr. Sholom Wacholder, senior author on the study, said that data from the study showed that, for women aged 30 or older, the 3- and 5-year risks for precancer or cancer after a negative HPV test and negative Pap test were very low, consistent with the guidelines.
Risk of Developing Precancer or Cancer
after Negative HPV and Pap Tests in Women Older than 30
|3-year risk
|0.23 percent
|0.08 percent
|5-year risk
|0.36 percent
|0.16 percent
Recent reports have suggested that some doctors worry that if they offer HPV and Pap co-testing every 5 years in accordance with the new guidelines, women might go several more years between screenings.
"HPV testing is a powerful predictor of cervical cancer risk. This work provides evidence to support extended screening intervals after negative HPV and Pap tests," said Dr. Wacholder. "The very low risk over 10 years in women with a single negative HPV test provides a reassuringly large margin of safety."
This research was supported in part by NCI's Intramural Research Program.
Discovery of Fused Genes in Brain Cancer Points to Possible Treatments
Researchers have found that a small percentage of glioblastoma brain tumors, one of the most lethal forms of cancer, harbors mutations in which portions of two genes are spliced together. The researchers also showed that although the aberrant proteins produced by these fusion genes can transform normal cells into cancer cells, the actions of these fusion genes can be blocked by two experimental drugs being tested for other cancers.
Their findings, published July 26 in Science, raise the possibility that a small subset of people with glioblastoma could be treated with drugs that specifically target the fusion proteins produced by the newly identified fusion genes.
A team led by Drs. Antonio Iavarone, Raul Rabadan, and Anna Lasorella of Columbia University Medical Center found that about 3 percent of the glioblastoma tumors they examined contain FGFR-TACC fusion genes. The fusion activates a tyrosine kinase enzyme whose altered activity has been found to promote tumor growth and survival in several cancer types.
The FGFR-TACC fusion proteins "have a potent pro-tumorigenic effect," Dr. Iavarone said. "That means that when we introduce this fusion [protein] into the brain, we can transform the normal brain cells into cancer cells," he explained. When the researchers put FGFR-TACC into brain cells of healthy mice, 7 of 8 mice died of malignant brain tumors that resembled human glioblastoma.
Additional experiments showed that the FGFR-TACC fusion protein disrupts the process that apportions chromosomes between two daughter cells during cell division. This results in a condition known as aneuploidy, in which cells have an abnormal number of chromosomes. Aneuploidy is a hallmark of cancer, Dr. Iavarone noted.
Finally, the researchers showed that compounds that block the kinase activity of the fusion protein can correct aneuploidy and stop the growth of glioma cells containing FGFR-TACC. These compounds also slowed tumor growth and prolonged survival of mice with malignant brain tumors caused by FGFR-TACC. Two of the compounds, AZD4547 and BGJ398, are being tested in early-stage clinical trials for other cancers, including lung cancer.
Based on these results, "we believe that there is a strong rationale to do a clinical trial where we would target tumors that harbor these gene fusions with these drugs," Dr. Iavarone said. He and his colleagues in the United States and Europe have formed a cooperative research group and begun talks with the drug manufacturers in hopes of moving forward with such a trial.
Further reading: "Common Cancers May Involve Fused Genes"
This research was supported by grants from the National Institutes of Health (R01CA101644, R01CA131126, R01CA085628, R01CA127643, U54 CA121852-05,1R01LM010140-01, R01NS061776).
A Conversation With
A Conversation with Dr. Walter Willett about Diet and Cancer
Dr. Walter Willett, chair of the department of nutrition at the Harvard School of Public Health, recently delivered a lecture titled "Diet & Cancer: The Fourth Paradigm" on the NIH campus in Bethesda, MD. An archived videocast of the lecture, sponsored by NCI's Cancer Prevention Fellowship Program, is available online. During his visit, Dr. Willett spoke with the NCI Cancer Bulletin.
How have views on diet and cancer evolved over the last 40 years?
When I started in this area in the 1960s, the thinking revolved around carcinogens in food. These were chemicals produced by high temperatures, such as with barbecuing, that had been shown to cause DNA mutations in animal models and test systems. In fact, this topic has not been totally resolved, but if carcinogens in food were a major problem for humans, we probably would have seen more evidence than we have. This was the first paradigm.
What were the second and third paradigms?
The second paradigm was the idea that fat in the diet is a major cause of cancer. There was never any strong evidence for this idea, but it was repeated so often that it became dogma in the 1980s and 1990s. For conditions such as heart disease and diabetes, the type of fat in the diet is quite important. But the hypothesis that the percentage of calories from fat in the diet is an important determinant of cancer risk, at least during midlife and later, is not supported by the data.
The third paradigm was that fruits and vegetables dramatically reduce risks of cancer. But, as the prospective data came in, the results just did not support this idea either. That's not to say there's no benefit from fruits and vegetables, but [the benefit is] probably very small and limited to certain foods and certain cancers. Overall, we just don't see a relationship.
That brings us to the fourth paradigm.
The fourth paradigm is that a major cause of cancer is excessive adiposity [obesity]. This paradigm, also referred to as positive energy balance, is here to stay, because the evidence is overwhelming from all types of studies. These findings have coalesced from research over the last 10 to 15 years, but the evidence to support this idea actually goes back to animal studies in the 1930s. In a sense, it was right there in front of us all the time.
Can you put the role of obesity and cancer risk in context?
On a population level, the number of cases of cancer attributable to people being overweight and obese is about equal to the number attributable to current smoking. This is in part because smoking is going down and obesity is going up; in terms of importance within a population, they are in the same ballpark. However, on an individual basis, the cancer risk due to smoking remains substantially higher than that due to obesity.
Are you looking for clues to obesity and cancer in younger people?
Yes, this is one of the new frontiers in cancer research. Until now, we've been looking at a pretty narrow period of life—essentially around the time people are getting cancer. But we have lots of epidemiologic hints that many factors operate earlier in life and maybe even across generations.
What are you learning?
For the first time, we are getting a pretty good look at the diets of adolescents and cancer incidence. In the Nurses' Health Study 3, we have retrospectively collected details about high school diets from participants, who were 25 to 42 years old at the time of enrollment. They weren't so far beyond their high school diets, so we have some data that is recalled pretty well.
In addition, we collected data from their mothers about their mothers' experiences with the pregnancy resulting in our participant and the participant's infant feeding patterns and diet and activity before age 5. We're just starting to get follow-up from that information. This approach can piece together the lifespan, which I think will be necessary for a thorough look at diet and cancer.
If money weren't a factor, what kind of study would you launch?
The most critical missing elements in the research right now are the dimensions of time—the time when we start the studies, and the length of follow up. The ideal study would start during pregnancy (perhaps even before) and would collect data about maternal diets and then continue to collect data and follow participants—in other words, a birth cohort.
Are these studies under way?
There have been some attempts in this country to develop a birth cohort that was big enough to look at cancer, but the studies sank under the weight of huge budgets. On the other hand, there are more than 300,000 participants in birth cohorts in Scandinavian countries. The next generations of scientists will be the ones to analyze the results in terms of cancer. I've been involved in this work and am hoping to see some of the results myself.
—Interviewed by Edward R. Winstead
Further reading: "Energy Balance: Weight and Obesity, Physical Activity, Diet" and "Fact Sheets: Diet and Nutrition"
Featured Clinical Trial
Genetically Engineered Immunotherapy for Advanced Cancer
Name of the Trial
Phase I/II Study of Metastatic Cancer Using Lymphodepleting Conditioning Followed by Infusion of Anti-Mesothelin Gene Engineered Lymphocytes (NCI-12-C-0111). See the protocol summary.
Principal Investigator
Dr. Steven Rosenberg, NCI Center for Cancer Research
Why This Trial Is Important
NCI researchers have been at the forefront of efforts to develop a type of immunotherapy called adoptive cell transfer (ACT). This kind of therapy involves collecting immune system cells from a patient, growing them in the laboratory to many times their original number, and then infusing the cells into the patient to fight his or her cancer. To ensure the survival and optimal functioning of the infused cells, the number of immune cells in the patient's body must be substantially reduced before the cell infusion. This type of preparatory treatment is called lymphodepletion or conditioning.
In one type of ACT, doctors obtain T lymphocytes from the patient's blood and then genetically engineer the cells to recognize and bind to a protein, or antigen, found on the surface of the patient's cancer cells, which will help activate the immune system against these cells. The genetically modified lymphocytes are then multiplied in the laboratory and infused into the patient, where, if the treatment works, they will kill cells that express the targeted antigen.
One potential antigen target is mesothelin, a protein found on normal cells (mesothelial cells) that make up the membranes that line the lungs, heart, and abdominal organs, as well as some other parts of the body. The amounts of this protein are often increased in malignant tumors, including almost all mesotheliomas and pancreatic adenocarcinomas and some types of lung, ovarian, esophageal, and head and neck cancers, making it an attractive target for immunotherapy.
Led by Dr. Steven Rosenberg, researchers in NCI's Center for Cancer Research are exploring the potential of genetically engineering peripheral blood T lymphocytes to recognize and attack cancer cells that express mesothelin.
In this phase I/II clinical trial, doctors will collect T lymphocytes from the blood of patients with metastatic or unresectable cancer that expresses mesothelin and has not responded to previous systemic therapy and genetically engineer these T lymphocytes to recognize mesothelin. The genetically modified cells will then be grown in culture to expand the number of cells, which will be infused into the patients after they have undergone lymphodepleting conditioning. The patients will also receive low-dose aldesleukin, which is a cytokine that will help keep the infused cells alive.
In the phase I part of this trial, groups of patients, called cohorts, will be treated with differing doses of infused lymphocytes to establish a maximum tolerated dose. The phase II part of the trial will involve treating patients with mesothelioma or other mesothelin-expressing cancers at the maximum tolerated dose. All patients will undergo treatment at the NIH Clinical Center in Bethesda, MD, where doctors will assess the safety and effectiveness of this therapy.
For More Information
See the lists of eligibility criteria and trial contact information or call the NCI Clinical Trials Referral Office at 1-888-NCI-1937. The call is toll free and confidential.
Further reading: "Complex Immune-Based Cancer Treatment Shows Signs of Progress"
Community Update
Bringing Science to Cancer Survivors: Workshop Series Reaches a Milestone
The Cancer Survivorship Series, "Living With, Through, and Beyond Cancer," recently concluded its 10th year, with record numbers of attendees participating in the teleconferences. For the past decade, the free workshop series has offered cancer survivors, their friends and families, and health care professionals practical information to help them cope with concerns and issues that arise after treatment ends.
More than 10,000 people participated in this year's series of four workshops, reported workshop co-moderator Dr. Carolyn Messner, director of Education and Training at CancerCare. Each hour-long session drew more than 3,000 callers.
"I love listening to the calls," wrote one survivor in a workshop evaluation. "I feel as though the expert presenters—and the other survivors asking them questions—are speaking directly to me about issues that affect my life."
Another participant, who took part in a previous year's workshop on fatigue and methods for addressing sleep problems, commented, "I finally tried some of those mind-body techniques and they worked! They help me sleep better!"
NCI, along with the Lance Armstrong Foundation (now LIVESTRONG), originally joined CancerCare in establishing the survivorship series because "it allows us to feature some more cutting-edge science on a platform that has enormous reach," explained Dr. Julia Rowland, director of NCI's Office of Cancer Survivorship. "What it does brilliantly is not only features the science but also allows the scientific community to interpret their findings for a lay audience and thereby make them much more accessible to the public."
The teleconference workshops have drawn participants from more than two dozen countries. "I think the global reach of this program is really impressive and reflects the growing demand for this type of information around the world," Dr. Rowland continued.
The current planning committee is drawn from the three founding organizations, as well as from the other partner organizations: the American Cancer Society, the Intercultural Cancer Council, Living Beyond Breast Cancer, and the National Coalition for Cancer Survivorship.
Each workshop kicks off with a 30-minute presentation, starting with the perspective of a cancer survivor or caregiver, Dr. Messner said. For example, in this year's workshop on "Recapturing Joy and Finding Meaning," Dr. Keith Bellizzi, a 15-year cancer survivor who is also a researcher in survivorship studies at the University of Connecticut, contributed the survivor's perspective. "I shared my experience with cancer and discussed how understanding the meaning of the cancer experience was an important part of the healing process for me," he said.
The survivor perspective is followed by brief presentations by two content experts who provide the latest evidence-based findings related to the workshop topic.
Discussions sparked by questions from workshop participants make up the remainder of each session. "We can't take everyone's questions, but we do take a fair number," Dr. Messner said. "We don't prescreen the questions, which is another thing that is really exciting about the program. We have to be prepared and think ahead of time what questions might be coming in and how we want to handle them."
For the rare questions that cannot be answered quickly by one of the workshop experts, callers are referred to the toll-free number for CancerCare (1-800-813-4673) or to the NCI Cancer Information Service (1-800-4-CANCER).
Suggestions and evaluations provided by attendees help guide the topics chosen for the next year's workshops, Dr. Messner noted. A few years ago, the series added a workshop to allow one workshop each year to be devoted to issues faced by caregivers.
Topics and speakers for the 2013 Cancer Survivorship Series will be announced in December.
FDA Update
New Drug Approved for Metastatic Colorectal Cancer
The Food and Drug Administration approved ziv-aflibercept (Zaltrap) for use in combination with the FOLFIRI (leucovorin, fluorouracil, and irinotecan) chemotherapy regimen to treat some adults with colorectal cancer.
The drug is an angiogenesis inhibitor, which means it may prevent the development of tumor blood vessels. It is intended for patients with metastatic colorectal cancer whose tumors are resistant to or have progressed after an oxaliplatin-containing chemotherapy regimen.
"This approval demonstrates the benefits of adding a biological agent, Zaltrap, to a commonly used chemotherapy drug regimen, FOLFIRI," said Dr. Richard Pazdur of the FDA's Center for Drug Evaluation and Research in an August 3 news release. "An improvement in median survival time was noted with the addition of Zaltrap to FOLFIRI, accompanied by an improvement in response rate and a delay in tumor progression and growth."
Ziv-aflibercept was evaluated in a randomized clinical trial of 1,226 patients with metastatic colorectal cancer whose cancers had progressed while they were receiving oxaliplatin-based combination chemotherapy. Participants who had relapsed within 6 months of completing oxaliplatin-based chemotherapy after surgery were also eligible, as were patients who had been treated with bevacizumab. Participants received treatment until their cancer progressed or side effects became unacceptable.
Half of the patients in the trial, called the VELOUR study, were randomly assigned to receive the ziv-aflibercept plus FOLFIRI combination, and the other half to receive FOLFIRI plus placebo. The study was designed to evaluate whether ziv-aflibercept improved overall survival. Patients who received ziv-aflibercept lived an average of 13.5 months, compared with an average of 12 months for those receiving the placebo.
Patients who received aflibercept also had better tumor responses: Tumors shrank in 20 percent of patients in the ziv-aflibercept group versus 11 percent of those in the placebo group.
Ziv-aflibercept also improved progression-free survival. Patients receiving the ziv-aflibercept combination lived without their cancer progressing for an average of 6.9 months, versus 4.7 months for those receiving the placebo.
Ziv-aflibercept was approved with a boxed warning that the drug can cause severe and sometimes fatal bleeding, including gastrointestinal bleeding, and holes in the gastrointestinal tract. The warning also states that the drug can compromise wound healing.
The most common side effects observed in patients receiving ziv-aflibercept plus FOLFIRI were decreased white blood cell count, diarrhea, mouth ulcers, fatigue, high blood pressure, increased amount of protein in the urine, weight loss, decreased appetite, abdominal pain, and headache.
Everolimus Approved for Treating Some Breast Cancers
The Food and Drug Administration (FDA) has approved the drug everolimus (Afinitor) in combination with exemestane (Aromasin) to treat certain postmenopausal women with advanced hormone receptor-positive, HER2-negative breast cancer.
The treatment is intended for women whose disease has progressed after treatment with letrozole (Femara) or anastrozole (Arimidex), according to a July 20 FDA news release.
Everolimus is also approved for treating some patients with advanced renal cell carcinoma, progressive advanced pancreatic neuroendocrine tumors, or the benign brain tumor called subependymal giant cell astrocytoma.
The new approval was based on a clinical trial that showed a 4.6-month improvement in median time to disease progression or death in women who received everolimus and exemestane compared with women who received exemestane and a placebo.
Everolimus prevents cell proliferation and the formation of tumor blood vessels by inhibiting the mammalian target of rapamycin (mTOR) signaling pathway.
The most common side effects in patients receiving everolimus for breast cancer were mouth ulcers, infections, rash, fatigue, diarrhea, and decreased appetite. The FDA cautioned that patients who are aged 65 and older should be monitored closely because they are more likely to have more serious side effects than younger patients.
Carfilzomib Approved for Advanced Multiple Myeloma
The Food and Drug Administration (FDA) has approved carfilzomib (Kyprolis) to treat patients with multiple myeloma whose disease has progressed after at least two prior therapies, including bortezomib (Velcade) and an agent that modulates the immune system such as thalidomide.
Carfilzomib binds to and inhibits enzymes called proteasomes, which degrade cellular proteins. Inhibiting this process leads to cell death and blocks tumor growth.
The July 20 approval was based on the response rate observed in a single-arm study of 266 patients with multiple myeloma who had received at least two prior therapies. One patient taking carfilzomib had all signs of cancer disappear (complete response) and 60 others saw their tumors shrink (partial response), resulting in an overall response rate of 22.9 percent. The median length of time patients responded to carfilzomib was 7.8 months.
Common side effects (observed in more than 30 percent of patients) included fatigue, nausea, anemia, lower-than-normal numbers of red blood cells or platelets, shortness of breath, diarrhea, and fever. Serious adverse reactions were reported in 45 percent of patients. The most common of these were pneumonia, acute kidney failure, fever, and congestive heart failure. The risk of peripheral neuropathy is less with carfilzomib than with similar drugs already on the market, such as bortezomib.
Carfilzomib was approved through the FDA's accelerated approval program, which allows the agency to approve a drug based on clinical data demonstrating a drug's effect on a surrogate endpoint, such as response rate, that is likely to predict its benefit to patients. The manufacturer, Onyx Pharmaceuticals, must submit additional data that confirm the drug's clinical benefit.
CDC Update
Drop in Cigarette Smoking Offset by Rise in Use of Other Forms of Smoked Tobacco
Consumption of all smoked tobacco products in the United States fell by more than one-quarter between 2000 and 2011. But the drop in cigarette smoking was partly offset by a rise in consumption of other smoked tobacco products. These findings appeared August 3 in Morbidity and Mortality Weekly Report.
Researchers from the Centers for Disease Control and Prevention (CDC) analyzed data from the U.S. Department of the Treasury's Alcohol and Tobacco Tax and Trade Bureau to calculate consumption of cigarettes, loose tobacco, and cigars. Although cigarette smoking declined by 32.8 percent from 2000 to 2011, the use of certain other smoked tobacco products more than doubled during that time. The largest increases were in pipe tobacco (482 percent) and large cigars (233 percent).
Last year alone, total consumption of non-cigarette smoked tobacco products rose more than 17 percent. That jump offset much of the decline in cigarette smoking. As a result, total smoked tobacco consumption fell a mere 0.8 percent in 2011, compared with 3.8 percent in 2010.
U.S. Consumption of Cigarettes and Other Combustible Tobacco Products, 2001–2011
The CDC report cited two explanations for the increases in consumption of non-cigarette smoked tobacco products. Such products are taxed at substantially lower rates, making them a cheaper alternative to manufactured cigarettes.
In addition, the products are subject to fewer manufacturing and marketing restrictions than cigarettes. For example, the Food and Drug Administration prohibits the use of flavoring or misleading descriptors such as "light" or "low tar" in cigarettes, but cigars and loose tobacco are not subject to these restrictions.
"The availability of low-priced and less-regulated alternative products to smokers who might have otherwise quit smoking has diminished the public health impact that excise tax increases and uniform regulation might otherwise have had on preventing youth initiation, reducing consumption, and prompting quit attempts," the CDC authors wrote.
"The smoke from non-cigarette combustibles contains the same toxic and cancer-causing chemicals as cigarette smoke," added Dr. Yvonne Hunt of NCI's Tobacco Control Research Branch. "The increase in consumption of these tobacco products is concerning. There is no safe level of exposure to tobacco smoke in any form."
Cancer.gov Update
New Research Tool Estimates Risk of Radiation-Related Cancers
NCI has released the first online radiation risk assessment tool, RadRAT, for use by researchers. The tool can be used for estimating an individual's lifetime risk of radiation-related cancers. A description of the tool and how it was developed appeared July 19 in the Journal of Radiological Protection.
RadRAT uses risk models based largely on those for low-dose radiation exposures developed by the National Academy of Sciences' Biological Effects of Ionizing Radiation (BEIR VII) committee.
The BEIR VII models estimate risk for 11 cancers: stomach, colon, liver, lung, breast, uterus, ovary, prostate, bladder, thyroid, and leukemia. RadRAT estimates risk for these cancers and seven more: oral, esophagus, gallbladder, pancreas, rectum, kidney, and brain/central nervous system. The risk estimates for the seven additional cancers are based on data from Japanese atomic bomb survivors.
The tool is most appropriate for research related to radiation doses of less than 1 gray (Gy; a unit of estimated absorbed dose of ionizing radiation) and for individuals with life-expectancy and cancer rates similar to those in the U.S. population, according to Dr. Amy Berrington de Gonzalez of NCI's Division of Cancer Epidemiology and Genetics, who led the team that developed RadRAT.
"This is a valuable tool for researchers, as it can provide risk estimates with uncertainty intervals for complex exposure histories from sources such as CT scans and dental x-rays to environmental radiation and nuclear accidents," said Dr. Berrington de Gonzalez. "It covers any external low-dose radiation exposure."
Fraumeni Steps Down as Director of NCI's Division of Cancer Epidemiology and Genetics
Dr. Joseph F. Fraumeni, Jr., the founding director of NCI's Division of Cancer Epidemiology and Genetics (DCEG), stepped down from the position last month, after marking 50 years at NCI. He will remain at NCI as a senior investigator and advisor.
Dr. Fraumeni received his undergraduate degree from Harvard College, an M.D. from Duke University, and an M.Sc. in epidemiology from the Harvard School of Public Health. After completing a medical residency at Johns Hopkins Hospital and the Memorial Sloan-Kettering Cancer Center, he joined NCI in 1962 as a commissioned officer in the U.S. Public Health Service.
Through his years of leadership at NCI, Dr. Fraumeni developed an epidemiologic and interdisciplinary research program to identify the environmental and genetic determinants of cancer and the means of cancer prevention. Among his many research accomplishments was the discovery with Dr. Frederick P. Li of a familial constellation of multiple cancers, now known as Li-Fraumeni syndrome, which led to collaborative studies that uncovered inherited mutations in the p53 tumor suppressor gene.
Another seminal contribution was his creation of maps depicting geographic variation in cancer mortality at the county level. This allowed Dr. Fraumeni and his colleagues to develop a way to identify several environmental and lifestyle exposures driving the distinctive patterns of certain malignancies.
While building the intramural research and fellowship programs in epidemiology at NCI, Dr. Fraumeni emphasized collaborative research that incorporates new and emerging molecular technologies into population and family-based studies. These studies are helping to dissect the genetic and environmental components of cancer, along with their effects on the origins and progression of cancer.
Dr. Fraumeni has authored more than 850 scientific publications, including the textbook Cancer Epidemiology and Prevention, co-edited by Dr. David Schottenfeld. Dr. Fraumeni has received numerous honors, including membership in the National Academy of Sciences, the Institute of Medicine, the Association of American Physicians, and the American Academy of Arts and Sciences.
Dr. Margaret A. Tucker, director of the Human Genetics Program in DCEG, is serving as acting director until a permanent director is selected.
NCI Releases New Guidelines for National Clinical Trials Network
In a continuing effort to improve the efficacy and efficiency of NCI's clinical trials program, the institute has released new guidelines for its restructured National Clinical Trials Network (NCTN). The guidelines are intended to encourage a consistently excellent clinical trials program executed by an integrated network of groups that conduct treatment and imaging trials across a broad range of diseases and diverse patient populations. (Read more about the NCTN here.)
The guidelines describe the NCTN program and its policies and procedures, including the terms and conditions of awards; the application format and peer review processes for new funding applications; and the application format for noncompeting continuation applications.
To help investigators understand the new guidelines, NCI is holding several Q&A sessions in August. For information on registering for a session, go online.
- For Operations Center, Statistics/Data Management Center, Integrated Translational Science Center, and Canadian Collaborating Clinical Trials Funding Opportunity Announcements (FOA):
Friday, August 10, 1:00–2:30 p.m. ET
Friday, August 17, 1:00–2:30 p.m. ET
- For Network Lead Academic Participating Site FOA:
Friday, August 10, 3:00–4:30 p.m. ET
Friday, August 17, 3:00–4:30 p.m. ET
- For Network Radiotherapy and Imaging Core Services Centers FOA:
Thursday, August 9, 3:00–4:00 p.m. ET
Thursday, August 16, 3:00–4:00 p.m. ET
Procedures for Collecting Human Biospecimens Released
NCI's Office of Biorepositories and Biospecimen Research's (OBBR) cancer Human Biobank (caHUB) program has released a collection of standard operating procedures (SOPs) that guide the successful collection of postmortem normal human biospecimens for the NIH Genotype-Tissue Expression (GTEx) project.
Successful collection of normal human biospecimens from organ and tissue donors requires complex operations and stringent quality assurance and control processes. For this reason, caHUB has created SOPs to govern the following areas:
- Ethical and regulatory procedures
- Biospecimen collecting and tracking
- Data collection, validation, and management
- Logistics management
- Pathology review
Although these SOPs apply specifically to GTEx, they can serve as a model for other scientists wishing to collect high-quality biospecimens for experimental purposes from postmortem donors.
For questions or comments about these SOPs, please contact: firstname.lastname@example.com


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Detroit Police made an arrest Thursday afternoon. Detroit Free Press photographer Mandi Wright saw the action and started shooting it with her iPhone when suddenly a man was in her face.The stranger did not identify himself as an officer, but snatched her phone. Wright, a veteran photojournalist, struggled briefly to get it back."She still at that point doesn't even know that this is a police officer. She found out a few seconds later and apologized," said Free Press attorney Herschel Fink.He took her camera and took her into custody, but her attorney said she did nothing wrong, and it was a clear violation of her civil rights both as a journalist and as a citizen."Any citizen has a right to photograph police conducting activities in public," Fink said. "This thing just spiraled out of control."Wright was left with the man police arrested, a guy they cuffed for being a felon in possession of a firearm."She was placed in a room with him, and if you thought it couldn't get any worse, the officers left the room and left her alone with this individual," Fink said. "That had to violate every rule in the book."When Wright finally got her phone back late Thursday night, the SIM card had been removed. Fortunately, the video she had been shooting was saved on the internal memory."Someone in the department had attempted to destroy some evidence that might and I think have turned out to be embarrassing to the department," Fink said.Internal Affairs is investigating. Detroit Police are only saying it is an ongoing investigation. Fink told us Wright did nothing wrong, and the only wrongdoing was on the part of DPD.
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Hello and welcome to our site. We're the broadband, phone, TV and mobile phone experts and our mission is to help our customers find the best broadband, phone, TV and mobile deals for them.
Unlike some comparison sites out there, we're totally impartial and we put you, the customer, at the heart of what we do. But you don't have to take our word for it, our sophisticated yet simple-to-use price comparison calculator is one of only a few approved by Ofcom, the UK's communication regulator.
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If you've had the same broadband package for a few years there's a good chance you're paying over the odds. And, if you're doing more and more online, it may no longer be able to keep up with you. Or perhaps you want to upgrade a package that includes phone calls, TV or something else.
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Place your order online and that's it - the provider will take care of the switch from there. We've also got loads of guides and videos put together by our experts to help you choose the right package and get the most out of it, as well as a speed tester so you can work out if you need to switch broadband.
It allows us to find broadband, phone and TV deals in your area, as what's available depends on where you live. However, we take your privacy very seriously, which means we won't pass it on to any other companies or organisations. For more on this, please take a look at our privacy policy.
This means you can put your postcode into our comparison calculator and look for a package that's both better and cheaper than the one you've got safe in their knowledge that you won't be bombarded with junk mail in the near future.
It's a technique - also known as traffic prioritisation or traffic shaping - used by broadband providers to rank, ration and even restrict how networks or individual connections are used. This is done to ensure all everyone gets a decent service, no matter what they're doing online.
If you think of broadband as a motorway, traffic management is like a priority lane for certain types of traffic. The traffic that's prioritised varies from provider to provider, but in general it'll be things like watching TV and films online, and video calls, to stop them from buffering or cutting out.
Every provider does traffic management differently. Some traffic manage their entire network, which means you could see your connection slowed down or restricted if you're constantly downloading really big files, such as high-definition (HD) films, at peak times.
Others only prioritise traffic on individual connections. This means, if you're downloading a lot of music, but then start playing a game online, the former may be slowed down so you can do the latter properly. However, you won't be slowed down to provide room on the network for others.
Traffic management is used to protect the quality of your internet connection rather than punish you for what you do online, but if you're a very heavy downloader and think it'll affect you, a number of providers now offer 'truly unlimited' broadband, which isn't traffic managed in any way.
Every broadband provider has a traffic management policy, which tells you how they use traffic management, the packages it applies to and when they use it. You can find links to the traffic management policies of each of the big broadband providers in the UK below:
The cost of the average broadband and phone package has dropped by over 50% over the last four years, and more than a third of people in the UK haven't switched their broadband in four years or longer. If you're one of them, you could be paying way over the odds by now.
So, by switching you're very likely to save money - providers save their best deals for new customers, so you could get an extra discount. Not only that, but if your current package no longer does what you want then switching to a more suitable one will mean you're getting more for your money.
We can't say for sure, because most providers don't have an official policy on it, but the chances are you'll lose your email address if you switch. BT will let you keep your email address for a small monthly charge, but most providers will close your account after a set number of days.
If your email address is all that's tying you to your current package, you could use a specialist email service like Gmail or Outlook - formerly Hotmail - instead; you should be able to move all your contacts from one to the other in one go.
Do that and the ball's in your court - you'll never have to worry about switching email address again, meaning you can switch broadband providers and get a better deal each time your current contract is up.
Yup. Bundling broadband with phone and TV can save you more than £400 a year when compared to getting all three separately - not a saving to turn your nose up at, eh? Not only that, but it's more convenient as you only have to deal with one provider.
However, don't go for a bundle full of stuff you won't use just because it seems like a bargain - paying for TV channels you don't watch or anytime calls you don't use is a waste of money even if you did get a good deal on them. So, have a think about what you need and then bundle accordingly.
It depends on where you live. Unlike the other big broadband providers in the UK, which use the national phone network to connect you to the internet, Virgin Media has its own fibre optic cable network. This means you can get broadband from Virgin Media without needing a phone line.
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We don't list every single package from each of the providers we list either, but those we do are among the most competitive you'll find and we regularly have deals that are exclusive to us, which offer even better value for money.
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Our calculator lets you compare costs against other providers, check for hidden costs and fair usage policies so you can make sure you are choosing the right deal for you. We rank broadband packages on our site by total first year cost and you can also select other ways to rank the results including monthly cost, download limits or speed.
Our 'Featured deals' table contains sponsored listings chosen by broadbandchoices. For the wider list of packages, sorted according to your chosen criteria, you can enter your postcode in the postcode box.
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