text:
Virtual Colonoscopy Identifies Large Polyps
Results from the American College of Radiology Imaging Network (ACRIN) National CT Colonography Trial, published in the September 18 New England Journal of Medicine, show that computed tomography (CT) colonography - also known as virtual colonoscopy - can detect 90 percent of adenomas (noncancerous tumors that can progress to cancer) or colorectal cancers measuring 1 centimeter or more in diameter.
These results compare favorably with standard optical colonoscopy, "which misses roughly 8 to 10 percent" of lesions of this size, says Dr. Carl Jaffe, chief of the NCI Cancer Imaging Program's Diagnostic Imaging Branch.
Extra Copies of Chromosome Affects HER2 Test Results
Women with invasive breast cancer whose tumor cells have extra copies of chromosome 17, where the HER2 gene resides, are more likely to have borderline or "equivocal" results on HER2 testing, a team of Belgian researchers reports. In a study released September 15 in the Journal of Clinical Oncology (JCO), the researchers found that tumors with extra copies of chromosome 17 (a condition called polysomy 17) but not HER2 amplification - that is, extra copies of the HER2 gene - behaved like HER2-negative tumors.
The results of HER2 tests have significant implications for breast cancer patients, including whether they are candidates for the drug trastuzumab (Herceptin), which was specifically developed to treat HER2-positive disease.
Virtual Colonoscopy Identifies Large Polyps
Results from the American College of Radiology Imaging Network (ACRIN) National CT Colonography Trial, published in the September 18 New England Journal of Medicine, show that computed tomography (CT) colonography - also known as virtual colonoscopy - can detect 90 percent of adenomas (noncancerous tumors that can progress to cancer) or colorectal cancers measuring 1 centimeter or more in diameter.
These results compare favorably with standard optical colonoscopy, "which misses roughly 8 to 10 percent" of lesions of this size, says Dr. Carl Jaffe, chief of the NCI Cancer Imaging Program's Diagnostic Imaging Branch.
Both CT colonography and colonoscopy can be employed to screen for precancerous polyps, the removal of which helps prevent the development of colorectal cancer. While colonoscopy uses a thin, tube-like instrument to physically examine the inside of the colon and rectum, CT colonography takes 2- or 3-dimentional pictures of the colon and rectum using a high-powered x-ray machine linked to a computer. The computed tomography technology required for CT colonography is already found in almost all hospitals, explains Dr. Jaffe.
Investigators at 15 hospitals participated in the ACRIN trial and enrolled more than 2,500 participants aged 50 or older who were scheduled for a screening colonoscopy. Participants first underwent CT colonography followed by standard colonoscopy, which was performed on the same day for 99 percent of participants.
The investigators compared results from the CT colonography exam to colonoscopy results for each patient, for the detection of lesions 5 millimeters or more in diameter, and calculated the false negative and false positive rates for CT colonography - the likelihood of missing a lesion (false negative) or falsely identifying a lesion that could not be found on follow-up colonoscopy (false positive).
While CT colonography could correctly identify 90 percent of people who had at least one polyp 10 millimeters in diameter or greater, the ability to correctly identify people who had smaller polyps was lower - down to 65 percent for polyps 5 millimeters in diameter.
Some additional questions about CT colonography remain to be answered, explains Dr. Robert Fletcher, professor emeritus from Harvard Medical School, in an accompanying editorial; in particular, whether CT colongraphy may miss some flat or depressed adenomas and what cumulative radiation dose may result from exposure to regular CT scans for screening.
The difficulty with flat and depressed adenomas, says Dr. Kramer, is that "we don't really yet know their natural history. We don't know how important it is to catch every last one," he explains. Both CT colonography and colonoscopy techniques need to be refined to better detect this type of adenoma.
Dr. Jaffe does not think that the radiation exposure, which is less than a standard CT scan, will be a large concern in this population. "For people over 50, the risk becomes diminutive, and if you use newer CT techniques, you can keep the exposure relatively low," he says.
For him, the most exciting thing about CT colonography is the ability to potentially reserve colonoscopy - which is more expensive and invasive, and currently requires specialists who are in short supply in the United States - for patients who have identified polyps, "so that [gastroenterologists] can concentrate on cases that merit polyp removal," he concludes.
—Sharon Reynolds
The current U.S. Preventive Services Task Force guidelines on colorectal cancer screening are available online at http://www.ahrq.gov/clinic/uspstf/uspscolo.htm.
Extra Copies of Chromosome Affects HER2 Test Results
Women with invasive breast cancer whose tumor cells have extra copies of chromosome 17, where the HER2 gene resides, are more likely to have borderline or "equivocal" results on HER2 testing, a team of Belgian researchers reports. In a study released September 15 in the Journal of Clinical Oncology (JCO), the researchers found that tumors with extra copies of chromosome 17 (a condition called polysomy 17) but not HER2 amplification - that is, extra copies of the HER2 gene - behaved like HER2-negative tumors.
The results of HER2 tests have significant implications for breast cancer patients, including whether they are candidates for the drug trastuzumab (Herceptin), which was specifically developed to treat HER2-positive disease.
"Because polysomy 17 on its own is not associated with HER2 overexpression and because it does not have the same clinicopathologic significance as true HER2 gene amplification, one may wonder whether polysomy 17 tumors benefit from HER2-targeted therapy such as trastuzumab," wrote Dr. Isabelle Vanden Bempt and colleagues from the University Hospital Gasthuisberg in Leuven, Belgium.
The researchers tested tumor samples from 226 patients using the two most common techniques for detecting HER2 - FISH and IHC. They also tested the samples for polysomy 17, finding that it was present in every patient with an equivocal HER2 result (47 of 226 patients), and that it was not associated with characteristics of HER2-positive cancers, such as hormone-receptor negativity or lower disease-free survival.
The authors called for clinical trials to help determine whether women with polysomy 17 tumors can benefit from trastuzumab treatment. In a related editorial in JCO, Dr. Carol Rosenberg from Boston University Medical Center, who lauded the current study, argued that new trials might be premature.
"This finding should influence the interpretation of HER2 test results and could eventually improve selection of patients for HER2-targeted treatment," she wrote. However, "New trials to directly test this question may not be the most efficient approach," she added, noting that review or reanalysis of data from existing trials could determine whether polysomy 17 tumors that lack HER2 are responsive to trastuzumab or lapatinib.
Vaccine Prevents HER2 Tumors in Mice
Researchers at the Karmanos Cancer Institute in Michigan have tested a vaccine that they found to be 100 percent effective at preventing tumors in mice injected with breast cancer cells. The results of their study appeared September 15 in Cancer Research.
The researchers used breast cancer cells that mimic the HER2-positive tumors found in women, which account for 20 to 30 percent of breast cancer cases. Women with HER2-positive tumors can be treated with drugs that target the HER2 receptor, such as trastuzumab (Herceptin) and lapatinib, but in some women these drugs eventually stop working.
The researchers used a panel of four cell types that overexpress HER2 and represent the various prognoses for women with HER2-positive breast cancer: two types that were completely sensitive to targeted drugs, one with initial sensitivity to targeted drugs but eventual resistance, and one with complete resistance to HER2-targeted drugs.
Mice were vaccinated with bacterial DNA engineered to include the gene sequence for a large portion of the HER2 receptor. The researchers used "electrovaccination," where an electric pulse encourages cells to absorb DNA and produce the related protein for presentation to immune cells.
After electrovaccination, the mice were injected with one of the four HER2 breast cancer lines. None of them developed tumors. However, control mice that had been electrovaccinated with a plasmid missing the HER2 DNA sequence developed tumors in every case. After 1 year of follow up, there were no adverse effects from vaccination.
In explaining the mechanisms of resistance to HER2-targeted drugs, the researchers noted that the various cell types they used in the study could co-exist in a single breast tumor, and that selective pressure after eliminating the drug-sensitive cells could cause increased growth of the drug-resistant cells. This would explain the relapse seen in some women.
Other tests in this study revealed aspects of how treatment-resistant cells in the mice were able to abandon HER2 and modify their cell-signaling strategy, employing an "escape mechanism" from HER2-targeted treatment.
"In patients whose tumors are refractory to drug and antibody therapy," the authors stated, "induction of comprehensive immunity by active vaccination will be critical to their long term protection."
Genetic Factors Tied to Blood Cancer Risk
It is still largely unknown what causes the group of diseases called myeloproliferative neoplasms (MPNs), including some rare forms of leukemia, where stem cells that replenish the blood supply begin to grow or differentiate out of control. But, a recent study shows their incidence is five to seven times higher among first-degree relatives of individuals who have been diagnosed with such a disease, providing strong evidence for a genetic link. This analysis, led by researchers from NCI's Division of Cancer Epidemiology and Genetics and collaborators in Sweden, appeared September 15 in Blood.
Using population-based data from Sweden, which has a universal health care system, the researchers identified all patients who had been diagnosed with an MPN between 1958 and 2005. For each patient, four population-based controls matched by sex, year of birth, and county of residence were chosen randomly from the Swedish Population database. From the Swedish Multigenerational Registry, which includes information on parent-offspring relations for all Swedish citizens who were born in 1932 or later, the researchers obtained information on all first-degree relatives (parents, siblings, and offspring) of both patients and controls and linked them to the Swedish Cancer Registry to collect information on incident cancer cases. The study included a total of 11,039 patients with an MPN, 43,550 controls, 24,577 first-degree relatives of patients, and 99,542 first-degree relatives of controls.
The researchers found that the relative risk of developing an MPN among first-degree relatives of patients (versus first-degree relatives of controls) was increased 5.6-fold. The relative risk for specific diseases including polycythemia vera (PV), essential thrombocythemia (ET), and myeloproliferative neoplasm unclassifiable (NOS) was 5.7, 7.4, and 7.5, respectively. Only myelofibrosis (MF) - a disease in which the bone marrow is replaced by fibrous scar tissue - showed no increased risk among first-degree relatives of patients, though the overall incidence of this disease was very rare. Compared to first-degree relatives of controls, first-degree relatives of patients with MPNs had a borderline-significant 1.9-fold increased risk of chronic myeloid leukemia.
"Our results support the theory that there are common, strong, shared susceptibility genes that predispose to PV, ET, MF, and possibly chronic myeloid leukemia," the researchers conclude, noting that this is the largest population-based, case-control study of its kind, and that it "supports the application of gene mapping and candidate gene approaches in high-risk families and case-control studies."
In a related comment in the journal, Dr. Jerry Spivak of Johns Hopkins University concludes that the present study serves to remind us that in MPNs, disease characteristics are "driven as much and possibly more by as-yet-undefined genetic influences as it is by those that have been defined."
Most Cancer Clinical Trials Go Unpublished
Findings from fewer than one in five registered cancer clinical trials are published in peer-reviewed journals, according to a study that appeared September 15 in The Oncologist. This finding, the authors state, raises the concern of publication bias in cancer clinical trials.
Drs. Scott Ramsey and John Scoggins of the Fred Hutchinson Cancer Research Center and the University of Washington found that between 1999 and 2007, only 17.6 percent of cancer-related trials registered with ClinicalTrials.gov (the federal registry for clinical trials of interventions for serious or life-threatening conditions) went on to be published in widely accessible journals listed in the PubMed.gov online database.
The researchers also found evidence of a selection bias on the part of investigators, who are less likely to publish results of a trial that did not meet its endpoints. Though more than 94 percent of the registered, industry-sponsored trials were never published, three-fourths of those in PubMed.gov reported positive results. By comparison, 59 percent of NCI-supported trials were published, half of which reported negative results.
In a related commentary, Dr. James H. Doroshow, director of NCI's Division of Cancer Treatment and Diagnosis, wrote that "the apparent lack of access to the final efficacy and toxicity data…poses multiple scientific and ethical questions." He described an NCI clinical trials database project expected to launch in 2009 that will address this problem by requiring administrative and outcome data for all intervention studies that receive NCI support.
The Oncologist is also considering creating a peer-reviewed, searchable venue for "well-executed trials that fail to meet positive endpoints," wrote Editor-in-Chief Dr. Bruce A. Chabner and Senior Editor Dr. Gregory A. Curt, for trials that are "'negative' in a sense, but valuable nonetheless."
Guest Update by Dr. Robert Croyle
Understanding the Media's Power to Influence Tobacco Use and Control
Despite progress made in reducing tobacco use, today fully one-third of the nation's cancer deaths are caused by cigarette smoking. Approximately 20 percent of American adults still smoke and more than 4,000 adolescents smoke their first cigarette each day.
Why are these rates still so high? Part of the answer is explained in the recently released 19th volume of the NCI Tobacco Control Monograph Series, The Role of the Media in Promoting and Reducing Tobacco Use, which was highlighted at a press conference sponsored by the American Legacy Foundation, the Campaign for Tobacco-Free Kids, the American Public Health Association, and the American Medical Association.
The monograph, which took more than 5 years to complete, involved 5 scientific editors, 23 authors, and 62 expert reviewers, who analyzed more than 1,000 scientific studies on the role of media in encouraging and discouraging tobacco use. Research included in the monograph comes from the disciplines of marketing, psychology, communication, statistics, epidemiology, and public health - all vital to understanding how exposure to the media influences tobacco use.
And the evidence from that research is clear and convincing. The editors concluded, for example, that mass media campaigns to discourage tobacco use can change youth attitudes about tobacco, reduce the chances children will smoke, and encourage adult cessation. The effect on initiation appears greater in controlled field experiments when mass media campaigns are combined with school- and community-based programming. Many population studies document reductions in smoking prevalence when mass media campaigns are combined with other strategies in multi-component tobacco control programs.
Tobacco use still accounts for more than 400,000 premature deaths in the United States each year. Understanding the role of media in reducing or promoting tobacco use is of critical importance in fighting the tobacco epidemic. It is our hope that this new monograph will inform tobacco prevention and control research, practice, and policy for years to come in the United States and around the world. If it is successful in that regard, we know many lives will be saved.
Dr. Robert T. Croyle
NCI Expert Testifies on Biospecimen Policies
At a September 9 hearing chaired by Representative Brad Miller (D-NC), Dr. Jim Vaught, deputy director of NCI's Office of Biorepositories and Biospecimen Research (OBBR), testified before the U.S. House of Representatives Committee on Science and Technology, recommending best practices and policies for biospecimen storage and tracking.
Federal scientific collections are often subject to highly variable and substandard quality management practices, frequently without long-term plans for custodianship, Dr. Vaught stated. He also indicated that many of these collections are priceless and irreplaceable, and adopting practices such as those developed by NCI and other groups will be critical to preserving these collections in the condition necessary to make scientific discoveries and medical advances.
"We are mindful that when patients and other study participants agree to provide blood and other samples for research, they do so with an expectation that their tissue will be used to provide insight into the causes and cures of their disease, or to advance medical research in general," said Dr. Vaught.
To read Dr. Vaught's full testimony or learn more about NCI's initiatives to standardize biospecimen procedures to ensure the availability of high-quality human specimens for cancer research, visit http://biospecimens.cancer.gov.
FDA Approves Anti-nausea Patch, Expands Indication of HPV Vaccine
A skin patch developed to prevent the nausea and vomiting often induced by chemotherapy was approved by the Food and Drug Administration (FDA) earlier this month. The patch, called Sancuso, is expected to be available to patients later this year.
Sancuso delivers granisetron, an established inhibitor of nausea and vomiting that is currently available in oral and intravenous forms. The patch was designed to release granisetron slowly into the patient's bloodstream for up to 5 consecutive days.
According to ProStrakan, the Scottish company that developed the patch, Sancuso was generally well-tolerated by patients in clinical trials. The most common drug-related adverse reaction was constipation. Skin reactions at the application site were reported but were mild and did not lead to discontinuation of use.
Earlier this month, the FDA also expanded its approval of the HPV vaccine Gardasil for the prevention of vaginal and vulvar cancers.
Manufactured by Merck & Co., Gardasil was first approved for women and girls aged 9 to 26 by the FDA in 2006 to prevent infection by HPV types 16, 18, 6, and 11. These four HPV types together cause 70 percent of cervical cancers, 90 percent of genital warts, and an unspecified percentage of vulvar and vaginal cancers.
After following 15,000 participants from the original studies for 2 additional years, researchers found that Gardasil was highly effective in preventing the types of precancerous vulvar and vaginal lesions caused by HPV. Among women who had not received the vaccine, 9 developed precancerous vaginal lesions and 10 developed precancerous vulvar lesions, whereas no such cases were found in the Gardasil group.This is "strong evidence," said Dr. Jesse L. Goodman, director of the FDA's Center for Biologics Evaluation and Research. "While vulvar and vaginal cancers are rare, the opportunity to help prevent them is potentially an important additional benefit from immunization against HPV."
Cell Phones and Brain Cancer: What We Know (and Don't Know)
Concerns about the potential health effects of using cellular telephones were back in the news this summer. But these concerns - and specifically the suggestion that using a cell phone may increase a person's risk of developing brain cancer - are not supported by a growing body of research on the subject.
More than a dozen studies have explored the relationship between the use of cell phones and malignant or benign brain tumors. The majority of these have found little or no overall increased risk of brain tumors within the first 10 years of use. Studies now in the pipeline will yield information on longer-term use, as well as the first results involving children.
"We now have studies covering up to 10 years of cell phone usage, and we're still not seeing any convincing evidence of an increased brain cancer risk," said Dr. Peter Inskip of NCI's Division of Cancer Epidemiology and Genetics, who led one of the first studies on the subject. He recently briefed NCI's National Cancer Advisory Board on what is known and not known about cell phones and cancer.
A major unanswered question is how cell phones might contribute to cancer. Cell phones emit radiofrequency energy, which is a form of electromagnetic radiation. While exposure to high levels of radio frequency energy can heat body tissues, the amount of radiofrequency energy produced by cell phones is too low to cause significant heating of tissue.
"The biological mechanism by which radiofrequency radiation might cause cancers is unknown and entirely a matter of speculation," said Dr. Inskip.
The controversy over cell phones and cancer started on national television in 1993, when Larry King interviewed a man who said that his wife's fatal brain tumor had been caused by her cell phone. The issue received considerable attention in the media, and cell phone stocks plummeted temporarily. Within a week, Congress had asked NCI and other agencies to investigate.
Dr. Inskip was at the time preparing a study to attempt to identify causes of brain cancer, and he added a component to assess cell phone usage. The results, reported in the New England Journal of Medicine in 2001, showed no evidence of an association between recent cell phone use and brain cancer. The conclusion was supported by two other reports published at about the same time.
Since then, most studies have not found a link between cell phones and cancer. The studies have been launched largely in response to people's concerns that any negative health effects from this new technology would be a major public health issue. In the United States alone, there were more than 255 million cell phone subscribers last year, up from 110 million users in 2000 and 208 million in 2005.
Given this dramatic growth, researchers have looked for increases in the incidence of brain cancer in the U.S. population and found none. There was no upturn in the incidence of brain or other nervous system cancers between 1987 and 2005, according to data from NCI's Surveillance, Epidemiology, and End Results program.
Another avenue of research has focused on people who were exposed to increased levels of radiofrequency energy in the workplace. Two such studies - one of employees in a factory manufacturing cell phones and the other of veteran Navy radar technicians exposed during the Korean War - showed no evidence of increased cancer risk.
Because cell phone technology is so new and has changed over time, larger studies are needed to answer questions about longer-term use. Answers may come from a series of multinational studies collectively known as the INTERPHONE study. While the combined analysis is not yet complete, some of the 13 participating countries have pooled their data and reported little or no effect on the risk of brain tumors.
Several European countries are also examining cell phone use in children and adolescents diagnosed with brain cancer. Children may be at greater risk of health effects than adults because their nervous systems are still developing at the time of exposure. In addition, young people may accumulate many years of exposure during their lifetimes.
For the future, it will be important to look for the consistency of results both within and across studies, said Dr. Inskip. "With more data and the ability to look at data in many different ways, some positive results are likely to occur simply by chance," he added.
Of all the potential health risks associated with cell phones that have been examined so far, the most convincing evidence concerns the risk of motor vehicle accidents among people distracted by using their cell phone while driving, Dr. Inskip noted.
—Edward R. Winstead
For a list of published studies and more information see NCI's fact sheet on Cellular Telephone Use and Cancer Risk.
Following are newly released NCI research funding opportunities:
Small Business Innovation Research Program Contract Solicitation
Proposal Receipt Date: Nov. 3, 2008
This funding opportunity will use a contract mechanism. For more information see http://researchportfolio.cancer.gov/initiativedetail.jsp?InitiativeID=3929.
Roadmap Transformative R01 Program
Letter of Intent Receipt Date: Dec. 29, 2008
This funding opportunity will use the R01 award mechanism. For more information see http://researchportfolio.cancer.gov/initiativedetail.jsp?InitiativeID=3941.
Translating Basic Behavioral and Social Science Discoveries into Interventions to Reduce Obesity: Centers for Behavioral Intervention Development
Letter of Intent Receipt Date: Dec. 16, 2008
This funding opportunity will use the U01 award mechanism. For more information see http://researchportfolio.cancer.gov/initiativedetail.jsp?InitiativeID=3942.
New Drug for Patients with Metastatic or Inoperable Kidney Cancer
Name of the Trial
Dr. W. Marston Linehan and Dr. Ramaprasad Srinivasan (Lead Investigator), NCI Center for Cancer Research
Why This Trial Is Important
A new drug called vandetanib (Zactima) also inhibits angiogenesis by interfering with a protein involved in the process: vascular endothelial growth factor receptor 2 (VEGFR2). In addition, vandetanib also inhibits epidermal growth factor receptor (EGFR), a protein that mediates several functions essential for tumor cell growth. Clear cell RCC "is characterized by mutations in a gene we identified that is called the VHL gene," explained Dr. Linehan. "VHL regulates a number of things, including angiogenesis. Vandetanib targets two important parts of the VHL gene pathway - VEGFR2 and EGFR."
In this randomized trial, patients who have RCC that cannot be surgically removed (unresectable) or that has spread (metastatic) and who have previously received sorafenib or sunitinib will take vandetanib daily until their disease progresses or they develop unacceptable side effects.
In addition to monitoring the patients' tumors, the researchers will perform magnetic resonance imaging scans to visualize how vandetanib affects the blood supply to the tumors. The researchers will also collect blood samples from all participants to see if vandetanib is affecting the targeted proteins in the VHL gene pathway.
"We spent 10 years identifying this gene here at NCI, so we're thrilled to be conducting this trial targeting the VHL pathway," said Dr. Linehan.
For More Information
An archive of "Featured Clinical Trial" columns is available at http://www.cancer.gov/clinicaltrials/ft-all-featured-trials.
Patricia Steeg Receives 2008 Brinker Award
Dr. Steeg is being recognized for her work in tumor metastasis, identifying the first metastasis suppressor gene and bringing this research to clinical trial, as well as pioneering work on brain metastasis of breast cancer.
The Komen Brinker Award was established in 1992 to recognize leading scientists for their significant work in advancing research concepts or clinical application in the fields of breast cancer research, screening, or treatment. The recipients will receive their awards at a dinner presentation on December 11, and they are also invited to present their work in a lecture at the annual San Antonio Breast Cancer Symposium.
NCI Patient Education Materials Receive Awards
NCI's "Toolkit to Improve Health Literacy for Radiation Therapy Patients" (in English and Spanish) received a gold award; the Radiation Therapy Fact Sheet Series received a silver award; "La radioterapia y usted: Apoyo par alas personas con cancer" received a bronze award; and merit awards were given to "What You Need To Know About Thyroid Cancer," "You Can Manage Radiation Therapy Side Effects," and "Chemotherapy and You: Support for People with Cancer."
SBIR to Showcase Products and Research
Additional details about the event and the SBIR program can be found at: http://cancercontrol.cancer.gov/hcirb/sbir/research/2008_showcase.html.
New Clinical Trial Reporting Requirements Coming in 2009
These new requirements will provide NCI with a more global view of emerging knowledge to identify important patterns in a timely way in order to assure patient safety and an optimal return on investment in cancer clinical trials. The data provided will allow NCI to better coordinate research efforts and ensure patient safety to optimize the investment in cancer research.
For more information and updates about these changes, go to www.cancer.gov/ncictrp.
Disparities Summit Report Available
Dr. Ana Maria Lopez
Associate Professor of Clinical Medicine and Pathology, University of Arizona College of Medicine
Walnut trees grow on hillsides and old Spanish missions dot the landscape around the Mariposa Community Health Center in Nogales, AZ. In this town of 24,000, 88 percent of the residents are Hispanic and many of them are underserved and poor, including Marietta, a 45-year-old woman who has cervical cancer. She is unable to travel to Tucson to see an oncologist because the family's pickup truck won't survive the trip, and her family simply cannot afford it.
But 65 miles away in Tucson, Dr. Ana Maria Lopez, an oncologist and medical director of the University of Arizona's Telemedicine Program, will see that Marietta receives state-of-the-art care without leaving Nogales. While Marietta's physician examines her cervix, Dr. Lopez will receive digital images of the procedure and work with cervical cancer specialists to determine Marietta's next treatment steps. This study, funded by NCI, is assessing the clinical- and cost-efficacy of telecolposcopy.
Under Dr. Lopez's leadership, the University of Arizona Telemedicine Program performs consults for as many as 2,000 patients a year, including members of Arizona's 28 Native American tribes. She is also the principal investigator of a 4-year American Cancer Society grant on "Examining Barriers to Minority Participation in Cancer Clinical Trials" to determine whether the beliefs of ethnically distinct populations affect the accrual of Latino/Hispanic participants to clinical trials. And, she has been funded on a number of NIH grants dealing with disparities and underserved populations.
"Dr. Lopez has brought the leading cancer center in Arizona to us," says Dr. Eladio Pereira, chief internist and medical director at the Mariposa Community Health Center. Currently, Dr. Lopez is using telemedicine to treat 50 of Dr. Pereira's patients and has set up a telemedicine program to treat and provide follow-up care to breast cancer survivors in Nogales.
Born in Bolivia, Dr. Lopez was only 6 years old when her physician parents immigrated to Chicago to complete their residency training in pathology. She studied philosophy, political science, and chemistry as an undergraduate, and it was during this time that her beliefs regarding equality and compassion in medicine began to take form.
She graduated from Jefferson Medical College and completed her residency and fellowship training in internal medicine, hematology, and oncology, at the University of Arizona in Tucson. Ten years later, she completed her master's degree in public health from the same institution and in 1995 she completed a post-doctoral NIH fellowship in cancer prevention and etiology. Dr. Lopez's interest in medical oncology emerged from her passion for clinical care.
"With the rapid developments in oncology," she says, "working with cancer patients allows me to practice state-of-the-art clinical care that addresses the patient's physical and emotional needs, while integrating the latest developments in translational medicine.
"To care for people is an incredible privilege," she added. "The secret is simply to care for your patient…if you keep that as your focus, you'll do the right thing. In medicine you are always learning and that is what keeps things exciting."
Her latest project is called Ultra Clinic. Normally, patients in rural towns like Nogales have to wait months for the results of a mammogram before knowing whether a biopsy should be performed. "We have integrated the process so the patient can get the results the same day via telemammography readings," Dr. Lopez says.
In July, she demonstrated the use of telemedicine and new Web-based technologies at the White House. The meeting was attended by medical directors from the White House, the U.S. State Department, the Central Intelligence Agency, the Federal Bureau of Investigation, and other federal agencies. In June, she made the cover of the magazine Tucson Lifestyle after being named one of the city's top doctors, as selected by her peers - an honor she has received for several years in a row.
—Francis X. Mahaney, Jr.


text:
Moderators: Jenise, David M. Bueker, Robin Garr
Jenise wrote:And then there's Tater Tots.
Jenise wrote:That's the theme of our next Supper Club, "trailer trash". My first reaction was, "COOL!" and my second was, "What in the heck IS trailer trash food?" I need to adhere to the concept while elevating the food at the same time--after all, it must be edible.
Dale Williams wrote:I'm not really the most PC guy, but I find the idea of people certainly in the top 10 percentile (if not the "1%") making fun of people in the bottom 10 percentile of income rather "tasteless"=obviously others disagree.
Dale Williams wrote:I'm not really the most PC guy, but I find the idea of people certainly in the top 10 percentile (if not the "1%") making fun of people in the bottom 10 percentile of income rather "tasteless"=obviously others disagree.
Mike Filigenzi wrote:Some sort of riff on Jell-O?
Tom NJ wrote:Jenise wrote:And then there's Tater Tots.
TATER TOTS! How the heck did that one not immediately spring to keyboard? Just set out a pile next to a pitcher of Tang or grape soda, and you're golden, baby!
Jenise wrote:Mike Filigenzi wrote:Some sort of riff on Jell-O?
I think I'd have to like Jello more than I do in order to give that "my all". I'm better off at the Tater Tot end of things. But hey, feast your eyes on this recipe: it was the hit dish of a luncheon I was invited to but couldn't attend a few weeks ago, and a clamor for the recipe caused it to land in my inbox. To someone with a white and creamy aversion like me, it doesn't get any scarier.
Subject: Recipe
1 1/3 cups (8 oz.) Ronzoni Acini di Pepe, uncooked
1 can (20 oz.) pineapple chunks, drained (reserve 1/4 cup juice)
1 3/4 cups milk
1/4 cup sugar
1 pkg. (3.4 oz.) vanilla instant pudding
1 can (8 oz.) crushed pineapple, drained
2 cans (11 oz. each) mandarin orange segments, drained
2 cups frozen non-dairy whipped topping, thawed
3 cups miniature marshmallows
1/2 cup flaked coconut
Cook pasta 11 minutes. Rinse with cold water, drain well. In large bowl, beat reserved pineapple juice, milk, sugar and pudding two minutes. Gently stir in pasta and remaining ingredients; cover. Refrigerate at least five hours. 12 servings
Karen/NoCA wrote:
My guess is that this is really good and would go over at your party. Sounds yummy to me!
Karen/NoCA wrote:Hum...I never thought of it in reference to a class of people but rather, a type of food that is easily and quickly thrown together, from cans, boxes, inexpensive ingredients , that type of thing.
Then why not say 'elevated junk food'. It seems to me that the word 'trailer trash' pretty unambiguously refers to a specific class of people.
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subset: commoncrawl


text:
"You Can Hear Me Cry...
See My Dreams All Die
From Where Your Standing, On Your Own"
"This House No Longer Feels Like Home."
Veronica Elena Ruby is the first person to ever live longer than the Volturi. She had a spell casted on her when she was a baby to make her be reborn everytime she grew old and died, she was born again. She knew Edward when they were little kids but had lost him when he caught the Spanish Influenza and when she was a Vampire she started to search for him. Now that she has him back she realizes that he's married to Bella and has a daughter, Renesmee. Her and her Coven are heartbroken as they start falling for the wrong people. They're frozen hearts beat for a second then break into a million pieces. And Veronica's famous quote, "It's so quiet in here, and I feel so cold. This house no longer, feels like home..."
-Boy Or Girl doesn't matter..just an even amount of people
-Long and Detailed replies please! :)
-Up to 2-4 characters you can make
-No OOC drama
-Looooooooooots Of Drama in the rp only!! I love me some drama!!! ;D
-You can make look alikes in this rp..it makes it more awesome
-GIFS, GIFS AND MORE GIFS!!! BTW Gifs are moving pictures. I Loooooooooooove when people use gifs in the rp. I ALWAYS use them. So use them as long as it gows with your comment. I LOVE YOU IF YOU DO!!!! :D
-Add me as a friend so that I can tell you when we start and if your not on for a while I can just remind you about this RP.
-Tell me when you're getting off
-Tell me how long you'll be gone...I understand..I can't go on the computer on school days...sometimes. So I won't take off your character until after 3 weeks.
-If you read the rules put "Love? Who Needs That?? I Have Chocolate!"
Alice~P/B;; With You x
Rosalie~P/B;; Me
Jasper~P/B;; Me
Emmett~P/B;; Me
Edward Anthony Masen Cullen | 111 Years Old/Turned At 17 | Married to Isabella Cullen/In Love With Veronica Ruby | One Kid;; Renesmee Cullen | P/B;; Renesmee Carlie Cullen
Isabella "Bella" Marie Swan-Cullen | 36 Years Old/Turned at 18 | Married To Edward Cullen/In Love With Jacob Black/Crushing On Every Guy In The Ruby Coven | One Kid;; Renesmee Cullen | P/B;; With You x
Renesmee Carlie Cullen | 17 Years Young/Stopped Growing | In Love With Jacob Black/Crushing On Christian Ruby | No Kids | P/B;; ƨℓσω ∂σωи♡ (Me)
Jacob William Black | 33 Years Old/Stopped Aging at 16 Because He Keeps Phasing | In Love With Isabella Cullen And Renesmee Cullen | No Kids | P/B;; With You x
Two gifs
Full Name | Real Age/Turned Age | Personality | Relationship | Enemy(ies)
Veronica Elena Ruby | Over 1 Zillion/Turned At 18 | Loving, Caring, Fighter, Overprotective, Hurting, Broken, Alone... | In Love With Edward Cullen | Enemy Is Isabella Cullen
Veronica Elena Ruby born Ranesana Petreas is a very unique girl. She was born in the B.C. era, when she was a baby they had put a spell on her that they thought was a myth, but it was real. Everytime she grew old and died she would be reborn in a different family. She remembered all of her families and was very scared the first time it happened. She had known Edward when they were little kids but had lost him when he caught the Spanish Influenza. She died and was reborn...again but she was in a car crash and her brain was bleeding, a vampire came in claiming to be her brother and turned her into a vampire. The spell wore off and she was immortal...forever. When she found Edward and his family she was excited until she found out that he was married...and had a daughter. It was the worse phase of her life...the Death & Tear Phase.
"It's so quiet in here, and I feel so cold. This house no longer, feels like home..."
ƨℓσω ∂σωи♡ (ME)
Brianna Allison Ruby | 50/turned at 17| shy around new people,once she gets to know you she is outgoing,can be stubborn| In Love With Jacob Black | Enemies are Renesmee Cullen and Isabella Cullen
Brianna Allison James was born Alexis Katherine Harper. Her mother died when she was 10. When she was 15 her father had a gambling problem. He gave her to a guy he owed money to. The guy made her become an exotic dancer and she was given the name Blondie.When she turned 17 she was turned by a man that she had seen often at the club she worked at. When she woke up three days later she left the house he had taken her to as fast as she could with her throat burning. She found Veronica and has been in her coven ever since.Veronica helped her get over the things in her past.
"What's with all the fighting? And tears???....What happened to romance?"
Played by: Renesmee Carlie Cullen
Christian Alexander Ruby | 122/turned at 19| caring,fun,protective and enjoys being with friends| In love with Renesmee Cullen | Enemies are Jacob Black
Christian Alexander Ruby born Laraoi Renasia is the closest to Veronica other than Edward. He was also the only one that Veronica ever turned into a vampire. He had been beat up by a gang and left in the street to die...it was almost like Rosalie a little just not as horrible as her. When he thought he was dead, Veronica had bitten him. He had woken up with Veronica staring at him sadly and he was in a house..Veronica's house. And she had to explain everything to him and after they got along pretty well which created a strong friendship between them, he can tell her anything and she would always do her best to help him...
"WHY WOULD YOU...?!.....Why would you love someone......that has hurt you sooo many times?? And completely ignore the person who's NEVER hurt you and is DEEPLY IN LOVE WITH YOU!!! That's not how it's supposed to work!!!!!!!"
P/B;; Renesmee Carlie Cullen
Katherine Von Swartzschild | 613/ turned at 17 | Manipulative, Selfish, Childish, Flirty, Cunning, Temperamental, Liar, Strong | Is Felix Volturi's true Mate, But has flings with many people/In Love Edward | Enemies are Veronica, And pretty much everyone in town
Katerina Von Swartzschild Is a descendant of Veronica, And a Doppelganger of hers. A Spell was put on her families blood line that every few thousand years a doppelganger was born, and that could be used to break Veronicas curse. Unlike the one other doppelganger before her, who lived and died as a sweet and caring human, Katerina was Different. She was born to a wealthy family in Germany, and grew up privileged and admired. Felix Volturi and a few other vampires came into town and Katherine fell hard for felix and he told her his secret, then left a month later. She was furious that he left her, even though he promised to return, And she became wild, disobeying the rules and putting herself in danger. Another Vampire came into town, a tracker, and became obsessed with Katherines blood, as she was his singer,and made it into a game. He slaughtered he whole family, all her friends, and her animals. Katherine Fled germany, And at the age of 18, finally met another vampire. She, being very manipulative and sly, convinced him to turn her. She killed him after she woke up, and has been on the run from the tracker ever since, sometimes narrowly escaping him. She ran into Felix during the 1800's, but expressed no interest in him, since she holds grudges.
"I want what I want. And I don't care what I have to do to get it. My list of victims is a long one, and I have no problem adding one more name to that list." and also "Better you die then I"
|Played by;; Faith Lehane
Sophie Minda Ruby | 8,356/16 | Cute, adorable and very protective over her older sister Veronica | In love with Chris | Enemies are Katherine and Renesmee
Sophie is Veronica's half sister but act like they have the same mother. Sophie's mom died when she gave birth to her so was taken in by their father. Her and Veronica have been very close since.Veronica's mom had taken Sophie to be her own blood and never told her that she was not. When she was 16 Sophie was kidnapped by the Volturi and was turn later after, her father was gutted about that and so was Veronica's mom. All the truth spilled out and she was so upset that she ran away, her family tried their all to find her but couldn't. Sophie later on became very successful in England she owned her own theatre and wrote her own plays and in the 1700's opened a school for talented children. She was the most successful women in Britain. In the present time, Sophie desided to come back home, to see what her home looks like now but she couldn't find it but found her sister and some new friends.
"I lost everything, and now that I am back. I intend to repair everything not with my money but with my love"
P/B: With You x
Views: 4263
Renesmee felt tears in her eyes as she ran upstairs. "Mom..please don't leave..stay..stay with me and dad..please..."
Veronica looked around the room, seeing all The Cullens(And Jacob xD) look super depressed. "I'm not going to replace Bella." She said angrily, running out of the house and slamming the door behind her. She ran to the little cave she had been in when she found the note from Aro.
Veronica slid down the hole and walked into the cave, kicking a rock. "Why does this always happen to me?!" She threw a huge rock at the wall but it did nothing. She sat on another huge rock and covered her face. "Brianna was right..we shouldn't have com here..." She felt tears slide down her face.
Edward goes to ronnie and hugs her."Im sorry Ronnie you are my best friend I don't like seeing you upset.I missed you all these years I thought you were dead and now your back into my life I can't let you go now.."
Veronica looked at him. "What about Bella? You don't care that she's gonna leave you and your daughter?" She asked him.
Renesmee hugged Bella tightly then tears came out of her eyes when she left. "I'm gonna miss you..." She whispered, trying to hold back the tears.
Edward-"I care but maybe her going away for a bit would be for the best.She has hurt people we cared about and our family,a break would be good"
Chris-Watching Renesmee he walked over to her and gave her a hug.He knew what she was feeling.His own father left him and his mother.he was hurt and got into some trouble that's how he ended up with a gang related stuff in his human life.
Veronica nodded then looked down and saw their hands intertwined. She looked at Edward and saw him go closer to her. She leaned in closer too and smiled a little, when there lips touched.
Reesmee hugged Chris back hen cuddled into Jacob. "I hope she comes back soon."
Veronica smiled and pulled away slowly, putting her forehead against his and staring into his eyes. "I love you, Edward."
Renesmee frowned and looked at Alice. "What?" She asked sadly.
Chris-looking at Alice"The future can always change,one decision can alter the whole future.Its not set in stone Bella may not leave"
© 2014 Created by Hachette Book Group.
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Five UCSF scientists — bioengineers Tejal Desai and Shuvo Roy, MD/PhD candidate Mozziyar Etemadi, microbiologist Joe DeRisi, and physician/surgeon Michael Harrison — trace their path toward five inventions that are changing the face of medicine in a story featured in the new UCSF Magazine.
Latest News
November 26, 2012
June 14, 2012
A new approach to drug design, pioneered by a group of researchers at UCSF and Mt. Sinai, New York, promises to help identify future drugs to fight cancer and other diseases that will be more effective and have fewer side effects.
May 04, 2012
Academic medical centers can play a larger role in drug development and testing, according to an FDA official, who says there is a need for better strategies to identify winners, minimize costs and reduce failures during drug development.


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When it comes to ladies and their legs, more women are turning to laser and light treatments for smooth, healthy skin. But when it comes to selecting the right spa for the treatment, no one wants to be burned or injured.
On the FOX 29 News at 10 p.m. Tuesday, FOX 29's Joyce Evans introduced you to a woman who was burned after getting treatment at an area spa.
We're not naming the spa where the woman received her treatment because according to current laws, and as far as we can see, no rules have been broken.
Still, whether you're getting a good deal or not, doctors recommend you do your homework before committing to any treatments.
Below, we've put together several recommended links to help you get started.
Better Business Bureau
Find out whether a salon in your neighborhood or city is accredited or not with the BBB. The BBB website allows you to type in key words and search by zip code.
Pennsylvania State Board of Medicine
On the Pennsylvania State Board of Medicine website, you can learn more about medical board credentials, consumer and licensure information and other resources.
New Jersey State Board of Medical Examiners (Division of Consumer Affairs)
Consumers can learn more about their current doctors or search for a physician on the state's Board of Medical Examiners website. The website also offers licensing information and disciplinary action information.
Delaware Board of Medical Licensure and Discipline
Learn more about licensing, disciplinary actions and other reports on the Delaware Board of Medical Licensure and Discipline website.
Websites with consumer recommendations:
There are several websites that offer recommendations, opinions and experiences from fellow consumers. We've listed a few that you might try below.
Yelp allows users to search a business, keyword or service and see other customer reviews and information.
healthgardes.com is a website that allows consumers to search information about physicians and hospitals.


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- Can I just tell you about my weekend in sports? My alma mater lost Homecoming, the Cowboys played an almost perfect game only to lose to the Broncos, the Braves lost in the NLDS, AND I lost BOTH Fantasy Football match-ups. The reason I lost one of them? Alshon Jeffery yet again on my bench with a HUGE game. Ugh.
Alright, let's get this started. Here's some of the best players you should be trying to get off of the waiver wire for this week's games:
1. Pierre Thomas, RB Saints
He's on the waivers in my league but probably not for long. He's a dual threat but so far he's only seen the ball the majority of the time in the passing game and is on pace to have 76 catches on the season. Thomas had a stellar game against the Bears last week and the Saints play the Patriots this week. He'll be good for a flex play.
2. Austin Pettis, WR Rams
He had two touchdowns on Sunday. Yes I know it was against Jacksonville but his previous three games have all been stellar. He could be a steal for you as a possible #2 WR or even for a Flex play.
3. Terrell Pryor, QB Raiders
Before you try to kill me through the computer, just look at his stats. He only missed a start because of a concussion and he's having good games with his only turnover coming in Week 1 vs Indianapolis. If your QB is on a bye this week you could look to Pryor to fill the gap for this week. Be leery though as the Raiders take on the undefeated Chiefs.
4. Terrance Williams, WR Cowboys
Tony Romo had the game of his life on Sunday and Williams, who has been prone to drops in his rookie season, was a big part of that. He had seven catches for 151 yards, 83 yards of that coming on his lone touchdown. With Mile Austin still bothered by a hamstring injury that has hindered him for most of his career it could be Williams lining up the opposite side of Dez Bryant this Sunday night vs Washington.
I'll be back Thursday with this week's "Start 'Em/Sit 'Em". Scout those waiver wires and don't give up on this young season yet, you can still turn things around (I'm mainly saying that to help myself in my 0-5 league).


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Jurors in the Kilpatrick corruption trial piped up for the first time in nearly a week Tuesday, luring the lawyers back to court to discuss how to answer their request for clarification on the racketeering charge and an extortion count.
"Pretty technical, dry stuff, and all you can really take from it is they're paying attention," said attorney John Shea.
Judge Nancy Edmunds told jurors that both counts discuss the same alleged crime, but they must consider them separately.
Bernard Kilpatrick's lawyer said the question provides no clue how the jury will rule.
"There isn't anything about it one way or the other. Again, they're being attentive, and they're being careful. That's all I can really take from it," Shea said.
He had this advice for all you tea leaf readers out there in TV land.
"Throw the leaves say seven or eight times and see if you get the same answer any two times, and I think the answer is no. So don't read the tea leaves," he said.
As we approach day seven of deliberations, Shea also had some advice for all you clock watchers out there.
"The length of time is meaningless. The length of time is directly related to the amount of material that they have to go through in order to process the case," he said.
One thing may have come out in court -- the gender of the jury's foreperson. Then again, maybe it didn't. The judge said the jury's note came from "him," then added "or her." So the foreperson may be one of the four men on the jury. Then again, it may be one of the eight women, which brings us back to the problem with looking for signs.
Meanwhile, we're still waiting for a verdict outside federal court in downtown Detroit.
WJZY FOX 463501 Performance Rd.Charlotte, NC 28214Main Number: (704) 398-0046


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As we prepare to celebrate Father's Day this weekend, a local group is celebrating their success in helping to change lives.The Mission of New Young Fathers is to help teach young fathers the importance and responsibility that comes with being a dad. Why? The statistics are painful.According to the U.S. Census Bureau, one out of three children live without a father at home. These children have the highest odds of ending up behind bars and are more likely to get into drugs and alcohol."A lot of children I come across, they come from single-parent homes and they don't have a relationship with their father," said Steven Dandridge, founder of the group. "And that's horrible because they didn't ask to be here."The group launched their web site in 2008 and has since helped thousands of young dads across the state.
Plus, on Sunday, another group helping young fathers will host an event on Belle Isle. Join Young Fathers Standing United on June 16 from noon - 7 p.m. at Shelter #8.
Fall is here, so it's time to spice up that old mac & cheese with some tastes of the season.
WTTG FOX 5 & myfoxdc5151 Wisconsin Ave. NWWashington, DC 20016Main Number: (202) 244-5151Newsroom: (202) firstname.lastname@example.com


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I wrote specifically earlier about how I thought Larry Drew was a bad idea. I thought someone like a Van Gundy would fit this team perfectly and show the fans that they are committed to winning. FFFFFFFTTTTT what do I know? Nothing I guess. Because the Senator signed the deal to give the head coaching job of the Milwaukee Bucks to Larry Drew. Is this guy a winner, I guess if you want to make the first round and get bounced. Oh wait where have I heard that one before? SCOTT SKILES, that's where. Larry Drew will make the players better because of his message and the way the delivers it. Great so we got a guy who will stroke the best players on the team and ignore the ones who are just busting their rear-ends just to make the team. Sounds like I could have done that.
Let's see where did him being a great leader get Joe Johnson...Brooklyn. The best player on the team gets traded from the Hawks and Larry Drew for Jay-Z...but then again, after I think about it who wouldn't? I have said this a couple of times and I will continue to say it until it happens. Make real moves so the fans get excited and they will come. I will take a line from a very famous movie....If you build it he will come. Herb, if you build it we will come should be the slogan for the Milwaukee Bucks fans.
Joke I am telling you. However, if I am wrong which does happens, I will apologize and maybe even call to see if I can get an interview with the coach and let him know of skepticism. Let him know that I think they need to worry more about the little things rather than the big things. You can't become World Champs without getting to the tournament. Do I want them to make the Eastern Conference finals every year...No, but I do want the a first round win and a second round and maybe Conference finals every now and then. Right now I get NONE OF THAT!
Larry Drew, please, please, please, worry about the small things before you start worrying about the big things.
Whew, that was a great session, next time....Brewers bashing.


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Evening ReadingOn Monday a bombing at Moscow's busiest airport took 35 lives and injured 110 more sending shockwaves through the international community. Listening to BBC World Services on the ride to work this morning I heard Russian President Dmitry Medvedev blasting security at the airport as "chaos" and blaming the tragedy on that.
But as proof I guess of how westernized Russia has become, the government financed Russia Today has pointed the finger at video games (seen on The New York Times). If you played Call of Duty: Modern Warfare 2 you probably know where this is headed. In it, the infamous 'No Russian' level depicted terrorists walking through an airport terminal wantonly gunning down everyone in sight.
Forget the fact that it's fiction and the implication blaming this particular sort of fiction would create for the six seasons of 24 alone. The part that disturbs me the most is how these tragic, gut-wrenching events get sensationalized like this for the sake of generating news. It essentially turns the awful events into entertainment as if they were nothing more than the plot of a TV show, movie, or game. But they aren't. Real people lost their lives; real families were torn apart.
We're long past the grace period for pulling this sort of nonsense. Stop exploiting these situations to create news drama. Much as we might want to rationalize things and have them fit into our perceptions of what makes sense, the raw truth of it has to be faced. Bad people did bad things. And they didn't train with video games. They trained with real guns and bombs.
And now, highlights from today's video game news on the Shack:
- Bulletstorm and Crysis 2 Demos Out
- Mass Layoffs Rumored at Disney Interactive
- New CoD: Black Ops 'First Strike' DLC Trailer
- Video Games of 2011 We Can't Wait to Play: Jeff
- First Three Blizzard-designed StarCraft 2 Custom Games Go Live
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The 2012 football regular season is down to the final weeks. The LHSAA schools have only two weeks left in their regular season, while Glenbrook (MAIS) ends their regular season this week.
There aren't a number of playoff spots on the line this week, but all the schools will be looking for wins, as they look to close out their seasons on the up swing.


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Mississippi Flood (2011)
Associated Press
News about Mississippi Flood (2011), including commentary and archival articles published in The New York Times.
Chronology of Coverage
Jun. 25, 2014
Flooding spans vast regions of Minnesota as result of an unusually heavy snowpack from winter, combined with torrential rain this spring and early summer that has filled lakes and wetlands; swelling Mississippi River is expected to crest at 20.5 feet. MORE
Apr. 23, 2013
Mississippi River begins its slow decline, but threats from flooding still remain; Mississippi and other Midwestern rivers are still significantly above flood stage, spurred by heavy rain. MORE
Apr. 18, 2013
National Weather Service says Mississippi River, so low for much of winter that barge traffic was nearly halted, could reach up to 10 feet above flood stage soon in parts of Iowa, Illinois and Missouri due to rain and storm forecasts. MORE
Jan. 30, 2013
Coast Guard announces that about 7,000 gallons of crude oil remain unaccounted for after barge crash near Vicksburg, Miss, on the Mississippi River, 16 miles of which remain closed. MORE
Jan. 29, 2013
Cleanup crews are skimming oil on Mississippi River near Vicksburg after barge struck bridge, rupturing compartment holding 80,000 gallons of oil. MORE
Jan. 18, 2013
Mississippi River remains open to shipping following remarkable action by Army Corps of Engineers that effectively lowered channel bottom by two feet; record-low water levels following drought had threatened to shut down waterway. MORE
Jan. 5, 2013
Army Corps of Engineers and Coast Guard officials say efforts to keep crucial stretch of drought-starved Mississippi River open to barge traffic should be sufficient enough to avert a shipping shutdown. MORE
Dec. 24, 2012
Midwestern drought has brought Mississippi River to water levels so low that they threaten to shut down shipping; Army Corps of Engineers begins to destroy rock formations in river that hinder navigation, but rejects requests to release more water from reservoirs along Missouri River. MORE
Dec. 8, 2012
Army Corps of Engineers turns back requests by federal lawmakers and barge industry to release more water from Missouri River, believing that drought-starved Mississippi River it feeds will remain open to shipping despite mounting concerns about water levels. MORE
Nov. 27, 2012
Drought of 2012 is causing restrictions on barge traffic on Mississippi River; situation could worsen as Army Corp of Engineers, as part of annual process that will reduce amount of water flowing from upper Missouri River into Mississippi, may affect shipment of $7 billion in agricultural and other projects. MORE
Sep. 20, 2012
Crews scramble to make repairs near Mississippi River's busiest Lock 27, which has snarled hundreds of barges and tugboats in a growing backlog since being shut down Sept 15. MORE
Aug. 21, 2012
Stretch of the lower Mississippi River has been closed periodically since mid August because falling water levels have endangered shipping traffic; river, shrunk by the summer's drought, has fallen to levels near the records set in 1988. MORE
Aug. 20, 2012
More than a dozen dredging vessels are working to make sure that, as a severe Midwestern drought continues, the Mississippi River remains deep enough to allow for water traffic; river's water level is approaching record lows experienced in 1988. MORE
Jun. 3, 2012
American Queen steamboat returns to cruising along the Mississippi River from New Orleans to Vicksburg, Miss, after a four-year-long hiatus; inaugural cruise carries more than 420 people on a six-night trip. MORE
Feb. 5, 2012
Officials and residents in the Mississippi River flood plain near St Louis, Ill, are accusing the Army Corps of Engineers of raising safety standards for levees to unreasonable levels, heaping millions of dollars of unnecessarily expensive repair and insurance costs on their communities; Corps, flush with stimulus money from the federal government, has indeed raised the frequency and standards of their levee inspections, but contend they have done so only to avoid potentially catastrophic damages from flooding. MORE
Jan. 28, 2012
Op-Ed article by author Randy Fertel argues that to halt the erosion of the Mississippi River Delta wetlands, Congress must turn over to the Gulf states the billions in penalties expected from the BP oil spill. MORE
Jan. 12, 2012
Signs of recovery are mounting In southeastern Missouri, where the Army Corps of Engineers blasted a levee last spring in order to flood the Birds Point-New Madrid floodway and relieve the surrounding area; nearly three miles of gaps have been filled in following eight month effort; some citizens of Birds Point continue to assert that move was unnecessarily extreme. MORE
Dec. 21, 2011
Officials in the Great Lakes states remain divided on how to deal with increasing threat from the Asian carp, an invasive species with the potential to upend the lakes' ecosystem; some states, led by Michigan, have filed legal actions aimed at ending access from the tributaries of the Mississippi River to the Great Lakes, while others argue that the plan will interfere with flood control and commercial waterway traffic. MORE
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Vast Stretches of Minnesota Are Flooded as Swollen Rivers Overflow
After heavy winter snows and torrential spring rains, floods spread throughout the state, from Canada to Iowa.
June 25, 2014, Wednesday
MORE ON THE MISSISSIPPI RIVER AND: Rain , Transportation Department (US) , Floods , National Weather Service , Mississippi River , Minnesota , Dayton, Mark B , Rivers
New Orleans by Streetlight
Frank Relle captured the spirit of New Orleans through color-drenched nighttime images of homes grand, modest or even gone.
March 19, 2014, Wednesday
MORE ON THE MISSISSIPPI RIVER AND: Relle, Frank , New Orleans (La) , Mississippi River , Louisiana , Photography , Hurricane Katrina (2005) , Historic Buildings and Sites
Recalling a Disaster Without Uttering a Word
"The Great Flood" uses music and stark images to tell about the destruction and aftermath of the 1927 Mississippi River flood.
January 8, 2014, Wednesday
MORE ON THE MISSISSIPPI RIVER AND: Movies , The Great Flood (Movie) , Morrison, Bill , Mississippi River
New Cruises for Rollin' on the River
New big wheels will start turning on the Mississippi, Snake and Columbia rivers.
December 26, 2013, Thursday
MORE ON THE MISSISSIPPI RIVER AND: Clark, William , Lewis, Meriwether , St Paul (Minn) , New Orleans (La) , Mississippi River , Travel and Vacations , Restoration and Renovation , Cruises
A Historic Vessel, Stuck in Place
Not allowed by law to steam away for overnight cruises and no longer entirely welcome at its dock downtown, the Delta Queen is now an issue before Congress and a sensitive matter for Chattanooga's new mayor.
December 18, 2013, Wednesday
MORE ON THE MISSISSIPPI RIVER AND: Hotels and Travel Lodgings , Mississippi River , Tennessee , Historic Buildings and Sites , Law and Legislation , Berke, Andy , Boats and Boating , Chattanooga (Tenn) , Ships and Shipping
Rashomon at Vicksburg
Did Grant win the siege, or did Pemberton lose it?
July 8, 2013, Monday
MORE ON THE MISSISSIPPI RIVER AND: Grant, Ulysses S , Vicksburg (Miss) , Mississippi River , Civil War (US) (1861-65)
Missouri: Towns Brace for Flooding
Mississippi River communities scrambling Tuesday to fend off the rain-engorged waterway got discouraging news.
June 5, 2013, Wednesday
MORE ON THE MISSISSIPPI RIVER AND: Floods , Mississippi River , Missouri
River Falls, but Flood Threats Remain
The Mississippi River began its slow decline, but it was still significantly above flood stage, spurred by heavy rain last week.
April 23, 2013, Tuesday
MORE ON THE MISSISSIPPI RIVER AND: Mississippi River , Floods , Levees and Dams , Rain
Missouri: Floods Predicted Along the Mississippi
The Mississippi River could reach up to 10 feet above flood stage by the middle of next week in parts of Iowa, Illinois and Missouri, National Weather Service hydrologists said Wednesday.
April 18, 2013, Thursday
MORE ON THE MISSISSIPPI RIVER AND: Floods , Mississippi River , National Weather Service , Missouri
Mississippi: River Remains Closed as Oil Cleanup Continues
The Coast Guard said Tuesday that about 7,000 gallons of crude oil was unaccounted for after a barge crash on Sunday near Vicksburg on the Mississippi River.
January 30, 2013, Wednesday
MORE ON THE MISSISSIPPI RIVER AND: Vicksburg (Miss) , Mississippi River , Oil (Petroleum) and Gasoline , Accidents and Safety , United States Coast Guard , Maritime Accidents and Safety , Oil Spills
Q & A: Unlearned Lessons of 1993
Has the nation forgotten what was learned after the Great Flood of 1993? Experts weigh in.
A Divided City
Murders have declined substantially in St. Louis, but violence remains persistent in the city's majority-black areas.
Helping a River Flow
Actions taken to keep the Mississippi River open.
Popular Anger Against Morsi
TimesCast: In Egypt, anger grows despite retreat over president's authority. | Learning to accept a prosthetic arm. | Rebuilding on the Jersey Shore. | Drought's effects squeeze the Mississippi River.
How New Orleans's New Defenses May Be Tested
New Orleans is expected to get 9 to 10 inches of rainfall in 24 hours. This map shows the rainfall forecast and expected storm surge.
Hurricane Isaac Makes Landfall
As Hurricane Isaac lumbered ashore, water breached a levee, causing extensive flooding near the mouth of the Mississippi River about 95 miles from New Orleans.
Rss Feeds On Mississippi Flood (2011)
Subscribe to an RSS feed on this topic. What is RSS?
Get Alerts On Mississippi Flood (2011)
Receive My Alerts e-mails on topics covered on this page.More Alerts >>


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Narrow your search
Hear the Athan (Azan) automatically five times a day at each prayer time in your computer.
If you would like to go back to your early days of learning math using pencil and paper, this app lets you relive those moments, writing math expressions naturally while delivering solutions immediately.
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Superman's solar power actually contravenes the laws of physics, according to a team of students at the University of Leicester.
Stephen Hawking gets together with betting chain Paddy Power to offer his brain power in predicting likely winners.
Microsoft's free Joulemeter utility gives you a rough estimate of a Windows system's power consumption. Plus: tips for reducing your electronics energy bill.
Finally, you won't have to worry or guess how much tip to leave after a meal. Google has the answer!
Today Honeywell announced that it is providing a service on its Web site that gives an idea of the savings customers could potentially achieve by using a programmable thermostat.
The Tweetulator Twitter time calculator offers a compelling case for keeping your Twitter following activities down to a reasonable size.
A Fermilab theoretical physicist suggests that qualities of the "God particle" show an "alternate" universe could easily "spread out and destroy us."
If needed you can quickly view calculator or address book information from a distance.
Give your brain a rest after a long semester of classes. Instead of manually trying to figure out your GPA, use GPA calculators.


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Tuesday, May 31, 2011 - Dmitry and Pavel
Latest Updates at WilliamHiggins.com
Pavel Modelon and Dmitry Vorobev are two fabulous models. In this scene Pavel encounters Dmitry in the park, and has a chat to him, which ends up with them deciding they want some fun. What a lot of fun it was too as, firstly, Pavel works on Dmitry, feeling him up in his football shorts, and then pulling the dick out and making him hard. Then Dmitry lays on the bed and Pavel plays with his ass, fingering the hole as he sucks Dmitry's dick. Having opened him up sufficiently Pavel slides his rock hard dick into Dmitry's gaping hole. Dmitry has certainly learned how to take it, in the short while he has been with us and does it very well in this scene, changing positions, ending up by riding Pavel's dick. Then Dmitry decides to get Pavel off by sucking him and, at the last minute Pavel pulls out of Dmitry's mouth and squirts over his face. Dmitry then returns the favor, and Pavel, loving it, has a string of cum hanging from his chin as he sucks on Dmitry's dick again.
Fanda Modry is aged 23 and lives in Brno, where he works in security. He enjoys football and hockey. Fanda is a very good looking guy. In this erotic video he gives us a great look at himself as he gets naked and works on his dick, before exposing his ass. As he is lying there, wanking himself a helping hand starts to oil his body and then takes hold of his dick and works on that too. Before long the hands move to his ass and a couple of fingers open it up before using a vibrator and finally a nice thick dildo slides in there to make sure that Fanda is opened up really well.
Albert Mikan and Petr Kristen are the stars of this Raunchy Duo. Albert had already done a shoot and I was very keen to try him in a duo. When we chatted to him about it he was quite keen to try something unusual so we set this Raunchy Duo up, with Petr Kristen. It seems that Albert is game for anything, and enjoyed the setting up, as we chained him up and blindfolded him. He was almost hard as we did it, and then Petr arrived and started to torment Albert, sucking his cock and slapping him, and then sitting on his face until Albert decided to lick Petr's hole. Then, after feeding him some cock, and having a chow down himself Petr slipped his dick into Albert's waiting hole and fucked him deep and hard. Then changing positions, so that Albert was upright we can see Petr continuing the action, while Albert's dick is rock hard. Finally Albert jacks himself, while he sucks on Petr again, until he shoots his load, and Petr rewards him with a very nice facial. What a good scene this is, one that I will savor for a long time.
Ondrej Gulaska is 21 years old and lives in Odolena Voda. He is a student who like winter sports, particularly snowboarding. I like Ondrej very much indeed. He has a great look, such a lovely face and a very nice body. He does very well in this stills session. He clothes suit his look, and then when he is naked we see it all, including some quite low hangers and a well developed dickey doo, as well as a very nice pucker. I enjoyed this shoot immensely and am sure his video shoot will be even better.


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By Lindsey DiMattina, Hollywood.com Staff
Music royalty took the stage on Saturday. Not only did fans get to experience hip hop king Jay-Z performing at the Barclays Center in Brooklyn, N.Y., but the king was also joined by his queen, Beyoncé, for a few special serenades. First, Beyoncé did a rendition of her 2008 single, ""Diva,"" then they performed their song ""Crazy in Love"" together.
But the fun didn't end there. Beyoncé also helped Jay-Z finish up by taking the stage again for a duet of ""Forever Young."" And it's a good thing she was there to help him out because he missed his cue to actually take the stage, so she started his section for him, the Huffington Post reports. ""I should probably rap here,"" Jay-Z said as he finally got on the stage. He then thanked her by giving her a love pat on her famous rear as she exited the stage.
If you weren't able to make the concert, catch the videos of Jay-Z and Beyoncé performing together below.
""Diva"" and ""Crazy in Love"" Performances
""Forever Young"" Performance
Follow Lindsey on Twitter @LDiMat.
[Photo Credit: YouTube]
Jay-Z Talks Baby Number 2
Kanye West and Jay-Z Duet 'No Church in the Wild' VIDEO
The 2012 BET Awards: Kanye, Interrupted
From Our Partners:Kate Upton Poses Topless for Cosmopolitan's November Issue PHOTOS(Celebuzz)
Jack Osbourne and Lisa Stelly to Marry This Weekend in Hawaii EXCLUSIVE(Celebuzz)


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Konami reveals Metal Gear Solid, Zone of the Enders and Silent Hill 'HD' Collections
Konami's Hideo Kojima has revealed HD collections for three of its most beloved franchises: Metal Gear Solid, Zone of the Enders, and Silent Hill.
The Metal Gear Solid HD Collection will come to both the Xbox 360 and PS3 and include Metal Gear Solid 2, Metal Gear Solid 3: Snake Eater, and Metal Gear Solid: Peace Walker. Strangely, the original Metal Gear Solid is absent from the collection. The game had previously been revamped for release on the GameCube by developer Silicon Knights in Metal Gear Solid: Twin Snakes. The Metal Gear Solid Collection is scheduled to arrive this November.
As expected, the Zone of the Enders HD Collection packs the original Zone of the Enders and ZOE 2: The 2nd Runner on the Xbox 360 and PS3. ZOE Collection will arrive sometime in 2012.
On the PlayStation 3, the MGS and ZOE collections will include a "Transfarring" feature. In MGS, the feature allows users to transfer Peace Walker saves from the PSP to the collection. The new technology will also allow players to transfer file saves between the platforms to allow for play on the PSP at one moment and then "transfarring" the save to the PS3 to play the same save file on the television.
Details on the ZOE feature were not revealed; however, deductive reasoning tells us that the collection will allow save files from the classic games to be imported in the collection (provided you own a backwards compatible system or a memory card transfer kit), at the very least. Konami notes it will detail ZOE's "Transfarring" feature soon.
Lastly, the Silent Hill Collection will bundle Silent Hill 2 and Silent Hill 3 along with a fresh coat of HD paint. No platforms were revealed.
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Cheer on the Boston Celtics from a Fan Box seat at upcoming games at TD Garden. With this exclusive deal, individual tickets are $99 (reg. $110-$140) for a variety of upcoming games.
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Explore the waters of Cape Cod on kayak with ECOtourz, which earns a 2013 TripAdvisor Certificate of Excellence. Save up to 60% this spring and summer.
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From http://inauguration.dc.gov/
The average temperature in Washington in January is 36 degrees Fahrenheit. Exposure to cold temperatures can cause serious or life-threatening health problems. Infants and the elderly are particularly at risk, but anyone can be affected. Visitors from warm climates may be more sensitive to the cold and should factor in any sensitivity in deciding how to dress for outdoor inaugural events.
Attendees of all ages are likely to need hats, water-resistant coats, scarves or knit masks to cover the face and mouth, and gloves or mittens. Mittens are warmer than gloves.
Inaugural events may require walking long distances and standing for long periods of time, so attendees are advised to wear warm, comfortable shoes. As people walk around the city it is important to remain hydrated by drinking water and other non-caffeinated beverages. Cold weather can put an extra strain on the heart, so attendees with heart disease or high blood pressure should follow their doctors' advice about exerting themselves in the cold.
The Department of Health and Human Services Centers for Disease Control and Prevention advises that wool, silk or polypropylene inner layers of clothing will hold in more body heat than cotton. Perspiration can increase heat loss, and wet clothing can chill the body rapidly.
To prevent cold-related health problems, dress in layers of loose-fitting clothes, including extra socks, which can be removed as they become damp.
Eating well-balanced meals will help attendees stay warmer, although alcoholic or caffeinated beverages can cause the body to lose heat more rapidly. Warm, sweet beverages or broth can help maintain body temperature.
In the event of wet weather, water-resistant or waterproof outerwear is advisable to reduce the risk of hypothermia (abnormally low body temperature). Hypothermia can occur in chilly weather, and if a person becomes chilled by rain.
As a rule, to avoid illness people should wash their hands frequently with soap and water or use antibacterial products. People who are on medications should bring enough medication for the duration of the visit, and people with medical conditions should bring their medical records with them. Visitors are likely to be away from their hotels and accommodations for many hours and should carry with them any necessary medications.
For more information on cold weather and avoiding hypothermia and frostbite, visit: http://emergency.cdc.gov/disasters/winter/.
For more information on the 57th presidential inaugural, visit www.inauguration.dc.gov.
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How will we receive our free templates? Just wondering! This is my first time doing something on this site. Thanks!
I will be sending out the free bonus today over private message here at GDS. :)
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Dignitaries, family, friends and fans of former Mayor Ed Koch gathered to remember the feisty, three-term leader during a funeral service at Temple Emanu-El on Manhattan's Upper East Side on Monday.
The wooden casket carrying Koch's body arrived at the temple draped in the flag of the City of New York. It was brought out of the synagogue at the conclusion of the service to the sounds of "New York, New York" playing in the background.
The service included remarks from his family and friends as well as President Bill Clinton, Mayor Mike Bloomberg and the Consul General of Israel.
Three of the former mayor's grand-nephews eulogized their beloved uncle.
"He was like a doting grandfather" who only saw "perfection" in his family, said Noah Thayer.
"No mayor, I think, has ever embodied the spirit of New York City like he did," Bloomberg said. "And I don't think anyone ever will."
He also recalled a conversation he had with Koch had before taking office: "I'll act like a one-term mayor and I'll be a three term mayor."
"We're better off because you served," said Clinton, who served as a representative for President Barack Obama at the funeral.
In his weekly radio address Sunday, Bloomberg called Koch "our most tireless, fearless, and guileless civic crusader."
The mayor said his predecessor's "tough, determined leadership and responsible fiscal stewardship -- helped lift the city out of its darkest days and set it on course for an incredible comeback."
NYPD helicopters conducted a flyover of 5th Ave and East 65th St in honor of Koch's funeral service.
Temple Emanu-El is one of the nation's most prominent synagogues, a Reform Jewish congregation on Fifth Avenue. Mayor Bloomberg is a member, as are comedian Joan Rivers and former New York Gov. Eliot Spitzer.
The flags of the United States, Israel and New York City were displayed at the funeral.
The consulate general of Israel called Koch's death a loss for that nation, the Jewish people and all of humanity.
Its statement calls the former New York mayor a "dear friend," a great leader and a symbol of "everything we love about the world's greatest city."
Koch will be buried in Trinity Cemetery in Washington Heights in a plot he brought a few years ago. His former chief of staff said Koch wanted a cemetery located near a subway stop so that New Yorkers could come and visit his grave.
The Associated Press contributed to this report.
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his first puppy pic wasn't so pretty but he matured into a very beautiful dog - he is so handsome!
so pretty!
Thanks. He's the biggest sook. He's so loving he always gives you kisses and loves to snuggle.
very cute I loved seeing how his nose has turned black
Wow, an adorable little pup grown into a handsome little fella, lovely photos
Jasper tri 21/Dec/05, Gabby ruby girl 8/Nov/07, and Felix the cat 4/April/10
Thanks everyone. I love them to bits!
He's adorable. He really has turned into a handsome little guy!
I think his first puppy picture is sweet.
Rosie-06/06 - Ebony-01/07 Harley-08/08
" My sunshine doesn't come from the skies, it comes from the love in my dogs eyes "


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By Maurielle LueFox 2 NewsDETROIT (WJBK) -- A bold ATM robbery unfolded in less than a minute. Only two employees were inside the Hollywood Coney Island on the 9000 block of Gratiot around 4:00 a.m. Christmas Day when surveillance video shows two men wearing black masks walked in and began rocking an ATM back and forth trying to rip it from its post.One of the masked men can be seen violently slamming his back into the trash cans, eventually ripping them out of the wall and pushing them out of the way."That was petty to come in here and steal the ATM machine. How about get a job?" said Tyeisha Bell. "I feel not even safe coming to work here in this neighborhood."Once the ATM was knocked over, video shows the machine being dragged out the door, but we're told there was no payoff."There was no money in there. That's what I heard," Bell said.Then early Thursday morning there was another ATM incident. We're told three guys went to a BP gas station on Van Dyke near the Hollywood Coney Island and took a sledge hammer to the ATM trying to crack it open. The ATM is a little busted up, but still standing. The three masked men made a run for it when the BP employee they were holding at gunpoint called 911.The manager said they were hammering away at the ATM for seven minutes before they gave up.
WTTG FOX 5 & myfoxdc5151 Wisconsin Ave. NWWashington, DC 20016Main Number: (202) 244-5151Newsroom: (202) email@example.com


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Each set contains three super soft unique bamboo muslin swaddling blankets. In Australia, mothers have swaddled and cared for their babies with natural muslin. Aden and Anais brings this tradition to the United States. Breathable which helps prevent overheating and the generous size makes swaddling easy. Use them for the stroller, nursing or as a changing table cover, burping or tummy time.
Three blankets, each 47 inches x 47 inches.
Three blankets, each 47 inches x 47 inches.
Color: Print, Pink, White
Brand: Aden & Anais