text:
Brian Hanson, pianist, composer and comedian, will perform on Friday, September 16 in John White Chapel at 10:10 a.m. Hanson′s concerts feature piano music, audience participation and humor while presenting a unique blend of handpicked traditional favorites from old time hymns and gospel songs, the best of contemporary praise and worship music, and original compositions.
Over the past 30 years Hanson has produced and composed numerous successful recordings including "The Prayer of Jabez," which was number one for a combined 10 weeks on mp3.com′s Christian Easy Listening chart. As a music score composer for film and video, he has written and arranged the original music for the soundtrack of The WatchWORD Bible, the world′s first media Bible, which was recently featured on Living the Life on Fox Family Channel. His music can also be heard on the award-winning film, Prison to Praise.
Hanson produced the nationally televised talk show Worship Live on The Christian Network. He was also the channel′s network image producer, and his music has often been used in numerous television programs and films.
Geneva College is a comprehensive Christian college of the arts, sciences and professional studies. Founded in the tradition of the Reformed Christian faith, Geneva prepares students to serve Christ in all areas of society: work, family and the church. Geneva College′s philosophy of education is based on the Foundational Concepts of Christian Higher Education. Geneva is a founding member of the Council for Christian Colleges & Universities (CCCU).


text:
Dusty Bums Productions Bring ANGELS AND WHISKEY to Hollywood Fringe, Now thru 6/27
When John has a heart attack in a bar he doesn't immediately notice his own death but he does order another whiskey from the reaper. Now, stuck in a heaven that he 'chose' himself, condemned to drink the same glass of whiskey over and over for eternity, his misery attracts the attention of Lucifer who is curious about someone who has successfully created their own Hell in Heaven. And the fun begins.
A dark comedy about free will, Angels and Whiskey is the show to see of you want to know what really happened to Shakespeare, The Marquis de Sade, Ayn Rand and Gandhi once they shuffled off this mortal coil.
ANGELS AND WHISKEY features Joshua Thomas, Daniel J. Parker and Bruce Cervi as John.
JOSHUA THOMAS is an award winning actor and playwright with shows produced in St Louis, New York and now LA. Born in New Zealand, trained in Australia and now performing in the US, his recent performance of Orsino in the Shakespeare Festival of St Louis' production of Twelfth Night won him the Best Actor in a Comedy award for St Louis' 2013 theatre season. The same year also saw Joshua a winner of the inaugural Labute New American Theatre Festival for his play 'Kink'.
BRUCE CERVI most recently appeared as Brabantio in "Othello", for Shakes and Vets. Prior to that, as Aufidius in "Coriolanus", also for Shakes and Vets. As Colonel Gaines, aka "Gump", in "Fit for Society", for the Veterans Center for the Performing Arts. As the Physician in "MacBeth", for the Uprising Theater Company. Recently co-directed the one-man show "Cry Havoc" staged at Shakespeare L.A. and directed Yasmina Reza's award winning "Art" at the Actor's Workout Studio in North Hollywood. Deepest thanks to Joshua Thomas.
DANIEL J. PARKER was born in England and raised in Switzerland, Daniel moved to L.A. to pursue his career in acting as they don't shoot a lot of films in the alps. He's a former DJ who writes, acts, directs and produces in both film and theatre. www.danieljparker.net
The show runs for five shows only at THE ACTORS COMPANY, in 'The Other Space' theatre, 916 A North Formosa Ave, LA, 90046. Tickets: $12.
PREVIEW: Saturday June 7th at 7pm. $1 tickets available using code 'whiskey' at checkout!
Friday June 13th at 11:30pm. Our 'pay what you can' night using code 'postcard at checkout!
Saturday June 21st at 5:30pm
Sunday June 22nd at 4pm
Friday June 27th at 8:30pm
All fringe participants are pwyc can for every performance. Tickets available at www.dustybums.wix.com/angels-and-whiskey and http://www.hollywoodfringe.org/projects/1632.

subset: commoncrawl


text:
Max Jacobson commented on the post, Why You Should Watch… NASCAR 4 years, 7 months ago
Enigma commented on the post, Why You Should Watch… NASCAR 4 years, 7 months ago
@aka_robyn @hays33d I wrote 'no offense' to show it was not my intention to offend anyone, but rather to expess my opinion. I realise some people might take offense from it, but that wasn't my intention.
MagillaGorilla commented on the post, Why You Should Watch… NASCAR 4 years, 7 months ago
@hays33d Finally someone said it, it is irritating especially some people almost borderline xenophobic or anti-america in their comments. I love F1Fanatic, but the people that make these comments don't do a board […]
US_Peter commented on the post, Vijay Mallya facing arrest warrant in India 4 years, 11 months ago
@hays33d I completely agree. The Indycar crew taking over F1 coverage is my biggest fear as well. I hope they have the sense to at least hire Matchett & Buxton. Varsha is apparently a SPEED employee, and […]
Robbie commented on the post, 2012 Monaco Grand Prix result 5 years, 4 months ago
raymondu999 replied to the forum topic What is this pit crew doing? in the group F1 5 years, 6 months ago
@hays33d The explanation by @joao-pedro-cq is absolutely spot on. When the car is lifted on the jacks – it can still rock side to side – and so the position at which the mechanics with the guns have to aim their […]
JPedroCQF1 replied to the forum topic What is this pit crew doing? in the group F1 5 years, 6 months ago
@hays33d I think they are holding the car so that it doesn't shake with all the movement of taking the wheels out and put others in.
Craig Woollard commented on the post, Buemi becomes reserve driver for Red Bull 5 years, 8 months ago
@hays33d and @prisoner-monkeys they brought De La Rosa in on loan from McLaren!! He had to take part in FP2 in his McLaren overalls!
snowman commented on the post, FOTA trouble is good for Bernie Ecclestone 5 years, 9 months ago
@hays33d @Keith Collantine
From auto-und-sport which is a respected magazine not some daily tabloid!
"When the Dutch company Cap Gemini, visited the factories of Red Bull, McLaren, Ferrari, Mercedes, Sauber […]
Prisoner Monkeys replied to the forum topic Mr. Sad Face in the group F1 5 years, 11 months ago
@hays33d – I wouldn't go reading too much into it. Hamilton and Scherzinger have supposedly broken up on at least three previous occasions. And I'm pretty sure one of them was after Monaco-Montreal this year. […]


text:
Jelly Belly Candy Co.'s BeanBoozled jelly beans will get two new products this summer.
Grocer Stop & Shop has joined with Norwalk Hospital FastCare to introduce a new in-store health clinic in Fairfield, Conn.
Military shoppers at Travis Air Force Base near Fairfield, Calif., welcomed the opening of a new Army and Air Force Exchange Service experience as a renovated and rebranded exchange opened earlier this month.
Hy-Vee has opened a new store in Fairfield, Iowa, its fifth since it began operations there 60 years ago, the company said.


text:
Featured Posts
Recent posts
In the UK and Europe, Canaccord Genuity Wealth Management is well-established with a strong track record of meeting our clients' needs. With offices covering multiple jurisdictions in London, Guernsey, Jersey and Isle of Man, we manage and administer more than £15 billion* of assets on behalf of over 12,000 clients.
We offer a broad range of services including discretionary and advisory portfolio management, stockbroking and independent wealth planning.
We also have a range of in-house funds. You can read more about these services here.
*As at 30 June 2017


text:
The Consultative Committee for the Selection of a Dean of the Wharton School was convened by President Amy Gutmann and Provost Ron Daniels on February 1, 2007. During its three and a half months of work, the full Committee met on seven occasions and formally reported its recommendations to the President and Provost on May 10, 2007. The Committee members were:
David Asch (Medicine, Health Care Management, and Economics)
Jay Dearborn (W '01, WG '08)
Michael Gibbons (Finance)
Eduardo Glandt (Engineering)–Chair
John Hershey (Operations and Information Management)
Richard Hillen (W '08) Beth Kaplan (W '80, WG '81)
Daniel Levinthal (Management)
William Mack (W '61)
Olivia Mitchell (Insurance and Risk Management)
Diana Mutz (Political Science and Communications)
G. Richard Shell (Legal Studies and Business Ethics)
The search was supported by Dr. Stephen P. Steinberg of the Office of the President and Kenneth Kring of the executive search firm of Heidrick and Struggles. Jon M. Huntsman, Vice Chair of the University's Board of Trustees and Chair of the Wharton School Board of Overseers, served of counsel to the President during this search.
The Committee and its consultants conducted more than 20 informational interviews and consultative meetings with individuals and groups in the Wharton community, as well as many informal contacts, in order to better understand the scope, expectations, and challenges of the Dean's position and the challenges facing the Wharton School in the years ahead. These consultative activities included full Committee meetings with Dean Patrick Harker, former Dean Thomas Gerrity, and Deputy Dean David Schmittlein; individual conversations with each of the Vice Deans and department chairs; informal discussions with graduate students; and two open meetings for undergraduate students. The Committee also solicited advice and nominations via email from all faculty, staff, students, and alumni of the School and reviewed documents produced by the School's current strategic planning process.
Based on these conversations and materials, the Committee's charge from the President and Provost, and its own discussions, a comprehensive document was prepared outlining the scope of the position and the challenges a new Dean will face, as well as the qualities the Committee sought among the candidates. The vacancy was announced (and input invited from the entire Penn community) in Almanac and advertised in the Chronicle of Higher Education, New York Times, Hispanic Outlook, and Diverse Issues in Higher Education.
The Committee sought a strategic leader with an uncompromising commitment to academic excellence, an experienced administrator, an able and energetic fundraiser, and a collaborator with a global and interdisciplinary outlook, a demonstrated strong commitment to diversity in all its forms, and a special passion for the Wharton School and the preeminent role that it plays in international business education.
The Committee identified and considered some 143 active candidates, prospects, contacts, applicants, and nominees. The Committee selected 43 individuals for closer examination, and then seven finalists for interviews with the entire Committee. Based on voluntary self-identifications and other sources, we believe the initial pool contained 23 women, 120 men, and at least 14 persons of color (4 African-Americans and 10 Asians). There were 16 candidates from abroad and 21 internal nominees.
On June 21, 2007 (see Almanac Between Issues, June 21, 2007, www.upenn.edu/almanac/between/2007/0621-dean.html), President Gutmann announced her selection of one of the candidates recommended by the Consultative Committee—Thomas S. Robertson, the Asa Griggs Candler Professor of Marketing in the Goizueta School of Business at Emory University and Executive Faculty Director of Emory's Institute for Developing Nations—to be the next Dean of the Wharton School. An accomplished academic leader, a seasoned administrator, and a highly successful fundraiser, Dr. Robertson brings a distinctive interdisciplinary and international vision of business education in the 21st century and an enthusiastic commitment to academic excellence and diversity. He also brings significant decanal experience, having served as Dean of the Goizueta School of Business at Emory University from 1998 to 2004, and a deep knowledge of the Wharton School, where he was formerly a faculty member (1971-94), department chair, and associate dean. He took office as Dean on August 1, 2007, and will be presented to the Trustees of the University of Pennsylvania at their October meeting.
—Eduardo Glandt, Chair
Consultative Committee for the Selection of a
Dean of the Wharton School


text:
- Classificar por:
- Data ▼
- Título
- Curtir/Votos
- Comentários
- Visualizações
What System Firmware is recommend for Power 770, 780, 795 and why?
nagger Marcações: systems hmc hypervisor firmware 795 power7 power 780 770 1 Comentário 17.248 Visualizações
As we all know, the advanced PowerVM virtualisation functions of POWER7 based machines are implemented in the hardware (the POWER7 processor itself and the System Firmware, which includes PowerVM Hypervisor) for increased security, high performance and...
do Blog: AIXpert Blog
Local, Near, Far part 11 - Why Local+Far on Lower End machines?
nagger Marcações: 795 xyz 780 near systems aix memory 770 ab far power power7 bus local 8.225 Visualizações
I have been wondering why the lower end POWER7 machines have local and far memory and not local and near. Perhaps you wondered too! Well at the Miami Power Technical University, I got to talk to Dr Joel Tendler (IBMer) and a POWER7 processor guru and put the...
do Blog: AIXpert Blog


text:
My Doctor added cartilage from my ear to build up the bridge, which was too low from a surgery years ago. It's too straight, and much narrower than the rest of my bridge, not natural. Wouldn't ear cartilage always be thin? He didn't want to go back and soften it.
Why Does Ear Cartilage Added to Bridge Look Narrow?
Doctor Answers 3
Ear cartilage isn't nasal cartilage
Which is too bad really. Its inferior to septal cartilage in several ways. One problem is it starts out twisted. This is OK for certain uses, but not great for the bridge of the nose. So often to make it straighter, its 'morcelized' or hit repeatedly with a hammer, just like you tenderize a poor cut of meat. Unfortunately this can damage the cartilage and increase the likelihood of absorption, which is an issue at all times anyway. This is one explanation. Another is the amount that can be harvested.
Its often not enough depending on the size of the nose. Finally the quality of ear cartilage is such that its difficult to sculpt, so feathering the edges is technically a challenge at times. This could make your bridge have defined edges and look narrow. Bottom line- since there are many reasons for your poor result, you need to see an experienced nasal surgeon to sort all this out.
Narrow Bridge after Placement of Ear Cartilage
The appearance of your bridge has nothing to do with the source of the cartilage graft. Over the past 35 years i have seen consults who complained that their bridges were too wide after ear cartilage grafts. See an experienced revision surgeon to determine what should be done at this time. More cartilage or fascia grafts may be necessary.
Ear cartilage to the nose looks narrow and why.
If the graft is made narrow or absorbs slightly, it will look narrow. See a revision rhinoplasty expert who can advise you about what to do after examining your nose.
You might also like...
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


text:
Whlist working on a lot of machines the Pacersdigest machine was left bereft of it's lifesaving juicy electrics.
Unbeknown to me of course, and we left for another job 80 miles down the road.....
Suffice to say I was in no mood to spend 4 hours in traffic, so we waited for staff to arrive on the scene and remotely let them in to our serverroom, instructed them on this highy charged job and watched from afar how Pacersdigest arose from the ashes of starvation.
It's back and I'm sorry for the cockup


text:
Josh Helmuth delivers the top sports stories of the week!
Redemption – NOT met – in Super Bowl 46. The New England Patriots were looking to get back their loss to the New York Giants from the Super Bowl 4 years ago, but fell to the Giants once again on Sunday 21-17. It was dejavu all over again as Giants quarterback Eli Manning took his team on an 88 yard drive within the final minutes that concluded with an Ahmad Bradshaw touchdown. The game ended on a final hail mary heave by Tom Brady, that just missed the finger tips of tight end Rob Gronkowski. Eli Manning was named the game's MVP for the second time. The Giants, who were 7-7 in mid-december now have 4 Super Bowl wins all-time…they are the first Super Bowl winner with a 9-7 regular season record.
Keeping it in the NFL, Aaron Rodgers took home the MVP for the regular season, in a landslide, getting 48 of the 50 votes. Rodgers is the first Packers MVP since a guy named Brett Favre won the award in 1997. Saints Quarterback Drew Brees won Offensive Player of the Year for the second time, after shattering Dan Marino's passing record, while Baltimore linebacker Terrell Suggs took home Defensive Player of the Year.
Hopefully offering some sobering perspective, some tragic events unfolded in Egypt last week, one player stating "it was like a war" when at least 74 people died and hundreds injured in a malay following a soccer game in Port Said. Fans of the home team Al Masry rushed the field while police and military failed to intervene. In fact the police that stood by had reportedly been told by government officials to not take action against fans since political protests had resulted in deaths with such action back in November. It is the worst soccer violence worldwide since 1996. The state prosecutor of Egypt has ordered an immediate investigation while the Egypt Football Association ordered an indefinite suspension of the League matches.
In college basketball, Duke lost another home game at Cameron Indoor, this time, to Miami – first time that has ever happened. And the Kentucky Wildcats are currently the unanimous number 1.
Thanks for watching. Catch us right here again next week, to get your Sports Fix.


text:
Not Everyone Carried Marbles
August 25, 1979
It was hot as hell and Sharon Goldstein knew everyone had to be positively sweltering out back. Her mother was especially intolerant of humidity and boastful that Los Angeles, the paradise that she and her husband had been wrested away from to come here, to Washington, did not make its inhabitants bear such humiliating conditions. (What about earthquakes, Nana? Vanessa had said yesterday, but Helen had waved her away.) It was only six o'clock and already the cicadas were screaming.
As Sharon made her way around the kitchen, she pictured each one piling paper-thin sheets of prosciutto (well, not her father, whose newly kosher regime she refused to acknowledge) on melon wedges, and spreading runny Brie on the baguette she'd baked yesterday. Imagining her family eating in the yard bordered by the lit tiki lights pleased her. More, she had to admit, than actually sitting there with them.
The neighborhood sounds of skateboards scraping asphalt and kids playing kick-the-can drifted in through the open doors, and she could see the Farrell girls across the street waving their thin arms in the air so the gnats would go to the highest point, far away from their tanned, freckled faces. As Sharon diced cucumbers and apples for her gazpacho—what made hers special was a garnish of peeled green apples and long slivers of tender basil—she wondered if her idea of an outdoor dinner had been misguided.
"To see Ben off !" she'd told Dennis last month. They'd been lying in bed watching President Carter talk about the energy crisis, and she'd opened her night-table drawer, taken out an emery board, and begun to saw at her nails. The erosion of our confidence in the future is threatening to destroy the social and the political fabric of America, Carter had said, and Sharon had turned to her husband. "Let's have a family dinner for Ben," she'd said. "We'll have your parents and mine, and we'll eat in the backyard. The night before he goes."
"Shh," Dennis said. "I'm listening to this."
Sharon hadn't been able to focus on the speech, perhaps because her son's impending departure had caused alarm, or was it a symptom of the general malaise of the country that the president was speaking about ? Apathy was not like her; once Sharon had been a woman who had cared about politics deeply. Too deeply, perhaps, and this had led her to flee conservative Los Angeles, her parents' Los Angeles, the one with her father's balding B-movie cronies chewing cigars on the back deck and discussing the HUAC hearings. I don't give one goddamn who goes down, they'd said. Communists? Just ask me. They'd spit names up at the sky, toward the fuzzy line of the San Gabriels. That Los Angeles. Sharon had come east to George Washington University, even though Helen said no one smart went to GW, ever, and at the end of her junior year Sharon had found herself sitting at a Student Nonviolent Coordinating Committee meeting planning the Freedom Riders' trip from Washington to New Orleans, to register voters and fight Jim Crow in each city along the way.
By summer, Sharon and her roommate, Louise Stein, decided they wanted to accompany the hundreds of other kids, black and white, all ready to sit together at luncheonettes across the South. The Klan was rumored to be waiting in Birmingham to beat Riders, but Sharon and Louise ignored these reports, believing that being together and doing what was right would somehow arm them against terrible violence.
The night before they were to get on that Trailways bus to Mississippi, however, Sharon's father forbade it. Don't you so much as set foot on that bus, he'd phoned to tell her. And Sharon had listened. The next day, she stood at the door gathering her robe at her throat and watched Louise go out into the foggy Georgetown morning alone. She returned not a week later, after a night in jail in Jackson, Mississippi. Sharon had been nearly feral with envy as she'd run her hands along the white insides of Louise's wrists, where the handcuffs had been locked too tight, the blue-black bruises flowering where the metal had pinched her skin.
But Sharon had listened to her father, and instead of fighting for civil rights, she'd dated two doctors, a lawyer, and one potter before settling on Dennis, marrying, and having children.
The night of Carter's speech, though, she thought instead of Benjamin throwing his jockstraps and Merriweather Post concert T-shirts into a green duffel bag and heading north.
"Don't you think a dinner will be nice, D?" Sharon had asked.
Our people are losing faith, Carter had said. The phrase had momentarily stopped her menu planning—an elegant barbecue, steak and grilled corn and cold soup and some kind of a summer cobbler. She looked up at the screen and wondered if the president had just read her mind. Lost faith. She had thought then of her father, finding God as if He were a shiny penny he'd come upon along a crowded city street.
It was 1979; only a decade and a half previously, Sharon had been pregnant with Vanessa when Louise had come to D.C. to march for jobs and freedom. As they'd entered the Mall, she handed Sharon a fistful of marbles. So horses will slip and fall and the pigs will be crushed, Louise hissed. Things could get violent, she'd said. Dennis had looked askance as he held Ben high, so he could see just how many people were standing against inequality, and Sharon remembered fingering the marbles, the feel of them pinging against one another along her hips when she moved. They'd given her a sense of reckless power, but she did not let them fall. Sharon was no revolutionary, she knew that now, but she had tried and she had cared profoundly, and she had been so furious at her father that she had fled for the East Coast, but in the end she had not defied him. Yet, she had thought that glorious day, it was not every girl who could say she carried marbles.
Now her faith in the power to make changes in the world felt like a fluid that had been drained from her.
"Okay!" Dennis said. "Please, Sharon." His hand hovered over her wrist to stop her from filing her nails, and Sharon settled back and decided right then: gazpacho.
Now Sharon opened the fridge and lifted the large serving bowl, hugging it to her chest. As she headed out back, she thought that though the outdoor dinner may have been a flawed idea, she had known it would be perfect to have the family sitting together in the backyard, all along the large communal table, the scuffed wood illuminated by lit candles and flickering torches, before Ben became a dot on the horizon and left them all behind.
Benjamin absentmindedly carved at the wooden table with his steak knife until he saw his mother emerge from the porch with a colossal glass bowl of red soup, the screen door slapping behind her. She carried it with the same beaming pride with which she brought out her impeccably browned turkey at Thanksgiving and her tender brisket at Passover, with an air that made it impossible—and unnecessary—to compliment her.
"Borscht!" Tatiana, Dennis's mother, threw her delicate white hands up in delight.
Sharon nudged in between Ben and her father to place the bowl on the table. "Gazpacho," she said. She swished her long hair to one side. "Andalusian gazpacho."
"Well, it looks delicious," Tatti said, nearly wicked, like Natasha on Bullwinkle, her Russian accent so intense it always sounded bogus to Ben. She seemed to him to be the very embodiment of Russia; when she rose from her seat, he'd half expect her ass to leave an imprint of a hammer and sickle.
Sharon looked for a moment at the bowl, then shot up and sprinted back into the house, the porch door smacking again behind her.
"From Andalusia," Helen said, leaning into Vanessa. "Fancy-pants." She giggled, poking her granddaughter in the side with two of the pearly daggers she called fingernails.
Vanessa bristled, holding her stomach.
Sharon returned with a small bowl of cubed apple, and sliding in next to Benjamin, she began ladling out the deep red soup.
"Here, Dad," she said, sprinkling the tiny cubes of apple and cucumber on the smooth surface, then a few strands of basil.
"Looks lovely, sweetheart," Herbert said.
"It sure does," Dennis's father, Sigmund, said. "You won't be eating this well in college, that's for sure, Ben."
Everyone laughed except Vanessa, who looked around the yard as if she were waiting for someone to pop out of the hedges that separated their property from that of Mrs. Krandle, a thick-ankled woman who lived alone and once caught an eight-year-old Vanessa picking her lilies of the valley. She'd stomped over to the house to complain. I'm sure she'll turn into a fine young woman, Mrs. Krandle had said, but right now, she's stealing and I can't say that bodes well for the future. Soon after, her bushes went up, which, Dennis pointed out, didn't bother him one bit, even if he was opposed on principle to folks being portioned off from one another. When they'd moved in, almost twelve years ago now, Sharon had wanted a fence. Dennis had argued against it first for the expense, and then against the concept altogether. We as people should not be closed off from each other, he'd argued. But now that the hedges were there, the privacy was appreciated.
"You'll have plenty of bagels to eat, that's for sure," Vanessa said, taking the bowl from her mother in both hands. The hedges had concealed much over the years: her sunbathing, Ben squirming around on the hammock with some cheerleader or lacrosse player, two bodies caught in a net, and the parties her parents used to have when she and Ben were young and had to come downstairs to say good night to the red-faced, slurring guests. This summer Vanessa was grateful that her awkward first embraces had been obscured. "How much oil is in here, Mom?" she asked, looking into the bowl.
"Hardly any," Sharon said. "It's mostly just vegetables." Vanessa had started a diet in early July, and at first her constant questions about nutrition had cheered Sharon, a champion of any kind of interest in vitamins, minerals, and general nourishment. She believed in the power of wheat germ; she had been thinking for years about how to extract nutrients from one food, say, sardines, and placing them in an altogether different food, say, her famous scones, to see if the nutritional benefits could be transferred. She wondered now if Vanessa's attention to food had not become a bit obsessive. She had lost a good deal of weight, which looked lovely, as if she were hatching from the egg of her adolescence, her features now fully formed, cheekbones high, eyes pronounced in their wide sockets, the muscles in her arms and legs long and defined. But Sharon wanted it to stop now with Vanessa fixed right here in her emergent state of about-to-be-womanhood.
"Now come on," Sigmund said, leaning over his soup. "I'd say Brandeis has a lot to offer besides bagels."
"That's true," Vanessa said. "They probably have chopped liver and kugel too."
"Where does she get this?" Herbert shook his head.
Sharon sent Dennis a sharp look.
"You really shouldn't talk that way," Herbert said to Vanessa, who also looked over at her father for support.
"It's a school with a very strong history," Sigmund said. "Benjamin is going somewhere with a history of protest. This is extremely important."
Avoiding his wife's and his daughter's pointed looks, Dennis put down his spoon. "Thanks, Dad. We're aware." He willed his father not to start up tonight, to stay silent about the Bolsheviks, Joe Hill, and all the dead labor icons, the shit conditions of the workers, the way the corporate pigs were draining them for every goddamn penny. He knew. He knew: the workers' bodies were not machines; they were giving out! Just like John Henry hammering down the railway spikes; industry will beat you or it will beat you. Dennis knew this, but tonight was not the night.
Dennis looked at his father, his home, framed by the hydrangea and the azalea bushes, behind him. Dennis was unable to shake his father's look of disappointment the first time he and Tatiana had come here, when they'd just purchased the place. He'd driven his parents from the train station, Sigmund turning in the passenger seat and clicking his tongue as he watched the District recede in their wake as they headed up Sixteenth Street, toward Military Road, toward the suburbs. His mother had sat up straight in the back, her lime green beauty case in her lap. Didn't his father realize Washington was nothing like Manhattan? Here, there were the rich neighborhoods, hardly urban hubs, on the streets above Dupont, and Foxhill and Georgetown Park—unaffordable all, Dennis worked for the government—and then there was ghetto, and it was black ghetto, not a bunch of Jewish socialists buying chickens and herring and potatoes like his old neighborhood on the Lower East Side. He remembered taking the stairs two at a time, racing his sister up to the third floor and into that railroad apartment. Outside the closed windows of the flat, shut against the cold and then the dust and the stink, Orchard Street screamed. It hollered with rage and it shit and it breathed its halitosis breath and it urinated on its own stones. It would have been one thing if there'd been no choice, but his father had decided to live where the workers lived. They could have gone west into the Village or to Stuyvesant Town like so many of their neighbors had. But not Sigmund Goldstein.
His father seemed oblivious to the way cities had changed. The public pool on Pitt Street turned overnight from Jewish and Italian girls in red lipstick and white bathing suits cutting into protuberant thighs to the lithe bodies of the Puerto Rican and Dominican women. Dennis didn't even know who sat on those lounge chairs now. The Cantonese? Sigmund's friends had gone, but he wouldn't move, insisting he wanted no more—nor less—than what anyone else had.
"Absolutely," Sharon said. "Brandeis has a history to be proud of." She was relieved Ben had not chosen one of those schools so far south, with their emphasis on fraternities and sports.
"The spell of revolution is powerful." Sigmund wiped his mouth with a napkin. "Right, Tatiana?"
"Well, yes, I suppose it is in this family, isn't it?" she said.
Sharon nodded and Dennis bent his head and resumed eating.
"Hmmm," Dennis said. "You didn't seem to think that during Vietnam."
"That's simply not true," Sigmund said. "You know I was as against the war as you were. Our methods of protest were different, absolutely. But what I'm saying here has nothing to do with Vietnam. Nothing at all. Clearly you don't understand."
Dennis nodded. "Well, to my generation, Vietnam defined us. But while we were rioting in the streets, your friends were inside, writing about it. It is a lot more relevant than the Bolsheviks, that's for sure."
"Every movement can be traced back to the Bolsheviks," Sigmund said. "You cannot turn your back on history."
"Well, I think I have a better understanding of Vietnam. And let me tell you something. You can't turn away from the future either, Dad. It's going to happen again. Because we're giving the Soviets their Vietnam now, aren't we? This is what will happen if—or I should say when—there's an invasion in Afghanistan. The country will be ripped to bits. And it will never end! You know we've authorized funding for arming the mujahideen there, don't you?"
"Of course this doesn't surprise me." Sigmund scratched his throat. "Because they are anti-communists. It doesn't surprise me at all."
"Well, it's true," Dennis said. "And I'm telling you, it will be just the same as Vietnam."
"Dennis," Sigmund said, leaning toward his son, "why is it always this way? We are on the same side."
Vanessa groaned. "Enough about politics!" As a child she'd wondered if little kids growing up in other cities were also stuck listening only to discussions about affairs of state or if her unfortunate proximity to the White House was to blame for the constancy of these arguments.
"It's gonna be a problem," Dennis said. "There's going to be a big problem is all I have to say. Carter's going to do something really, really stupid."
"Let's not forget," Herbert said to Ben, returning to the original conversation, "that Brandeis is a Jewish institution. This is important. This is what makes it special."
Sharon closed her eyes. She didn't know what had happened; one day not so long ago she woke up to find her parents no longer ate oysters, and Friday evenings they went to shul instead of the Brown Derby. They were full-fledged Jews now, and tonight her father wore a colorfully embroidered yarmulke pinned to the few strands of hair he had left. It reminded her of her father's fanatical nationalism, the way he'd go nuts when they watched the Olympics together. Goddamn Reds! he'd scream, hitting the television when the Soviets were skating. He cried every time the national anthem played and an American stood with a hand over his chest.
"Yes," Sigmund said. "That historical aspect is interesting as well. But it is not in fact a Jewish institution, Herb. It's not a synagogue; it's a university."
Herbert shrugged. "Well, I'll tell you this, it sure as hell wasn't built by the gentiles."
Sharon hated it when her father spoke this way: of us and of them, especially since he had spent a large part of her youth trying so goddamn hard to be them. There had been a brief period when he'd gone by a different name—Thomas. Herbert Thomas, but then, when it had come to legally changing the entire family's name, he had let it go. Sharon wondered, as she had many times before, exactly why Dennis was so angry at his father. Because Sigmund was so, well, cool. What would it have been like to have had him as a father? She knew Sigmund would have let her go on the Freedom Ride. He would have given her his blessing, and she would have gone down South and seen the disenfranchisement and the segregation and the sadness and the poverty firsthand. She would have had bruises of her own. Sharon looked around the table. Perhaps she wouldn't even be here, she thought. Maybe she'd be a lesbian, as Louise turned out to be.
"Ummm, can I talk here?" Benjamin said. "Because I'm the one leaving tomorrow, right?"
"Yes, Ben," all the adults murmured.
"Of course, darling," Sharon said, touching his wrist.
"We know!" Vanessa said. "Ben's going!" She set her spoon down loudly on the table. It seemed as if there had been talk of little else all month. Everyone deferred to Ben—the college boy!—and her mother must have cooked what he'd wanted for dinner each night for the entire fucking summer. Go already, she thought, just go! But she hadn't yet processed what it would mean to have him actually leave. Because Ben was in nearly every memory she held. So many late nights they had met in this backyard and lain back on the soft grass, letting the night sky shift and twist for hours over their drunken heads. They'd make sure their mother was sound asleep before they tiptoed up the stairs—avoiding the creaking ones—together.
"She's upset," Sharon said.
"I am not!" Vanessa said. "I am not upset, okay?"
Ben looked down at his soup, quiet for a moment, slightly panicked to think of arriving on campus to find that Grandpa Herbert had been correct, and he'd be greeted by several men in long black cloaks, white threads at their waists, and twirls of hair emerging from tall black hats. Or worse, a long line of reform rabbis would pat him on the shoulder—What a good little bar mitzvah boy! they'd tell him—and encourage him to join Hillel, date only girls with lifetime memberships to Hadassah, and exchange some of his bar mitzvah loot for Israeli bonds.
He hadn't thought of it much at all until last spring, when his friends got wind of his decision to go to Brandeis in the fall.
"Brandeis?" His friend and teammate Nick Papadopoulos, left forward to Ben's right, and who was heading to Notre Dame, was most incredulous. And Jon Ratner, the goalie, who got into Columbia, the lucky shit, said, "They don't even have a football team. And the soccer, is it even Division Three?"
"I don't know," Ben said. But he did know. Brandeis was hardly known for its excellence in sports. It was just that his priorities had changed, overnight it seemed, and what he'd valued so much until this point seemed saved for high school, completed. After that day something "Jewish" appeared in Ben's locker each week: a jar of gefilte fish, the large ovals nesting in a gelatinous mass; a box of matzo, Go Brandeis Bagels! written across the label in blue pen; a massive jar of Manischewitz beet borscht that crashed to the floor and splattered along the hallway and all over Ben's new Levi's when he opened the locker door.
"It's a radical place to be," Ben had told his friends that day, and he told his family the same thing now. "The Ten Most Wanted on the FBI list of 1970 all went to Brandeis. Abbie Hoffman, the Yippies, they were all there."
"Yes, they were," Dennis said, pointing his spoon at his father. "Radicals come in every generation, Ben."
"Oh my goodness, we forgot a toast!" Sharon wobbled up from the bench and lifted her glass. "To Benjamin!" she said, leaning awkwardly over the table. "At the beginning of this brand-new adventure!" Sharon choked on the last word.
"Hear, hear," Dennis said, standing, also raising his glass, in part to save his wife from tears. "Ben, may this next chapter of your life be fulfilling and fruitful. We wish you the sweetest happiness and success."
Sharon waited as Dennis clinked glasses with Ben.
"Wait, wait!" Tatti said after all the glasses were lowered, because they had not clinked in every conceivable combination, and she had not yet touched stemware with her son's.
"Pust' sbudutsya vse tvoi mechty!" she said. May all your dreams come true.
"Vashee zda-ró-vye," Dennis said to the table. To your health.
"What?" Sharon said. "Tell us!" She disliked it when Dennis and his mother spoke in Russian together. While Dennis's Russian was useful for his work, and while she understood that it was a gift passed from mother to son, she envied it.
"Don't worry. It was just one of Tatti's many toasts." Sigmund laughed.
"In the old days, every first toast was to Stalin." Tatti shook her head. "Well, at least when we thought the neighbors were listening. But not now."
"I'm not worried," Sharon said, sniffing toward Sigmund. "Though I can't say I've learned the entire collection of them." Sharon sat back. She had sat through countless long and sentimental Russian toasts: to the dead, to the newlyweds, to the soldiers who had died in the war, to those who were still fighting. But she had never heard one to Stalin. "When did you?" She smiled at her father-in-law, thin and wiry in the blue jeans he'd taken to wearing, right around when he'd started getting into disco music, odd choices both, as she had always seen him as a man steeped in the past. Sharon wondered now, if she were to shake Sigmund, would his bones break and only those ridiculous dungarees, perfectly creased and thick with Tatti's starch, keep the rest of him intact?
"I manage in Russian," Sigmund said. "After all these years."
"Oh, go ahead, have some wine." Helen reached over Vanessa for the bottle of Chianti on the table. "It's a special occasion tonight."
Vanessa covered the top of her glass. "I don't drink anymore, Nana."
"Since when?" Helen's ash blond hair, sprayed high, was now wilting like a dying bouquet, and beads of sweat trickled down her brown, spotted chest into the deep opening of her blouse. "You don't eat and you don't drink. What else is there?" Helen said, turning to Sharon.
"I don't think I want to know," Sharon said, laughing, but she had also begun to wonder about her daughter, who seemed to be reducing herself to only the most necessary elements.
"I'm not interested in living numb," Vanessa said. It might have been Jason's lingo, but there was truth in it. And truth was what she was after now. Which was why she had stopped doing the empty, false activities her friends seemed to favor and that she too had once fallen prey to—drinking at country-club bonfires, smoking pot at Rachel's beach house—stuff that led them on an endless search for comfort, for male attention, for beauty. It made them live life unaware of the larger machinery that kept them all down. When she'd met Jason this past June, she'd felt able to cut loose from what she only now realized had been an isolating experience with her friends.
"My lord, sweetie, you're young! Have some fun while you still can!" Helen said. "Right, Herb? Tell the poor girl to have some fun. Do you dance, honey?"
"Sure," he said. "Have a good time. Whatever you want, sweetheart." He smiled at Vanessa.
"Yeah, Nana." Vanessa smirked. "I dance." In a way, though, her grandmother was not wrong. She had stripped herself of frivolity and had begun to go to shows this summer at Fort Reno and d.c. space, entering a world where kids thrashed to hard music and whipped themselves fiercely into one another. And while she couldn't say she felt a natural connection to this world, it was new, and it felt important; the music itself was essential. It seemed to be making a case for art in general, that it was not stupid or tertiary or unnecessary, and it brought her away from her girlfriends and their beach houses and crocheted bikinis and their transistors blasting ELO and Styx.
"Oh my God, the meat!" Sharon said, standing suddenly and beginning to stack everyone's soup bowls, Vanessa's half-filled bowl on top.
"Let me help you," Sigmund said, rising.
"It's okay, Grandpa." Vanessa stood to help her mother clear. Even though Tatti had waited on him for nearly forty years, Sigmund had recently become acquainted with women's liberation. It was a logical extension of workers' rights, and he seemed amazed—and a little ashamed—that he had not thought of this sooner. Now he often made huge efforts to help, getting up from the dining room table at holiday meals and clattering his own dinner plate and flatware toward the kitchen.
Tatiana rose as well. "Not tonight, my dear. Just sit."
Helen lit a cigarette.
"Mom!" Sharon said, climbing over the bench with the enormous serving bowl. "We're eating, for Christ sake!"
"Go on then," Helen said, pointing her Winston, mashed between two brown fingers, at the door. "You won't notice if you're not here, now, will you?"
Dennis looked over at his mother-in-law and shook his head as she threw her head back, cackling with laughter.
"Oh, Dennis, relax. What are you going to do, report me? To your friends."
"Yes," Dennis said, bracing himself.
"Your friends in Moscow?" Helen squinted at Dennis, then at Tatti. "Huh?"
"I'm from St. Petersburg," Tatti said, laughing, the deep red hair at her hairline darkening, wet with sweat. "My brother is the only person I know in Moscow, I'm afraid."
"Yes," Dennis said again, getting up awkwardly off the bench. He thought of his uncle Misha in a badly cut boiled-wool coat, the collar rimmed with fur, the Kremlin rising behind him as they made their way through Red Square. Red for beauty, Misha had told him. Not for communism, he'd said, wagging his finger. Misha was his mother's only living relation, yet only Dennis had met him, when he was on business in the Soviet Union. The old ladies, hair tied in kerchiefs, bending over their wares, always threw out their bright scarves and polished their babushkas when he stepped up to their carts with Misha. "I believe I will have to report you," Dennis said. Helen had been accusing him of being a spy since Vanessa's birth, which he'd missed. He'd been on a business trip to Moscow, traveling for the Department of Agriculture, and Vanessa had been two weeks early! The Cold War had heated and cooled for sixteen years since then, but no matter its temperature, Helen was convinced her son-in-law was not really an undersecretary at Agriculture, but an agent in some complicated espionage ring. "I need to make a call to my superior," he said, "right after I get us another bottle of wine."
Sigmund shook his head. "This gets more and more ridiculous every time I hear it."
"Oh, lighten up, Sigmund," Helen said. "It's just a game I play with your son. Games are good! They don't hurt anyone, now, do they?" She exhaled up into the sky, but the smoke lingered, heavy above the table.
"You really shouldn't," Herbert said across the table to Helen. "It bothers her."
Vanessa wished she could have a cigarette with her grandmother, the way they did behind her house in Beverly Hills, Helen's housecoat pulled tight around her, balled-up tissues and matches bulging from her pockets, as they blew smoke toward the mountains and talked about Helen's past—as a singer, in a nightclub, before I married that son-of-a-bitch grandfather of yours. Helen had taught Vanessa how to blow smoke rings, and she had spent an entire visit jutting out and popping her bottom jaw just so, and then watching the smoke rings rise up and cross one another—which always reminded her of the rings of the Olympics her mother so freakishly adored—before they disappeared. Cigarettes, Vanessa found, were not something that she had to forgo.
Helen shrugged. "Everything bothers her. All I can say is, we gotta live how we gotta live, right, Dennis?"
"As long as everyone is happy," Dennis said, picking up the empty bottle and turning toward the porch.
After the steak—which Sharon had marinated in ginger and soy, and a touch of cream for sweetness, even though she knew Vanessa, who had a few weeks back announced she was a vegetarian, would not touch it—and the corn and the salad were finished, Sharon brought out the cobbler she'd made with blackberries and raspberries from the Haley farm. Dennis opened another bottle of wine, though he wasn't sure if anyone but he and Helen, whom he had never seen refuse a drink of any kind, would partake.
He filled Ben's empty glass.
"College boy," he said. Ben, I hardly knew ya, he wanted to say, thumping him on the back. But it was true; how he had raised a kid whose thigh muscles bulged from the speed and coordination that enabled him to start varsity soccer as a freshman still confounded him. Ben had lettered. Dennis had felt as if he were living in some teen movie about high school when Ben had come home with that big W, for "Wildcats," and handed it to Sharon to sew on the back of his jacket. Only now did Dennis realize he had been waiting for the moment that Benjamin would come home with a passion that was not of the body.
Because that was another thing about Ben. Ben and his body. Sometimes if Dennis arrived home unexpectedly, he would be greeted by the sound of his son schtupping in the bedroom down the hall. Always some different little tart. If it weren't so off-putting, it would be admirable, Dennis supposed, but it was off-putting, terribly so. He tried not to think of the girls. Just last week, Dennis had been unable to sleep and had gone downstairs to the basement, his little spot beneath the house where he did his own brand of yoga. It was also where he stored his living-room-banned artwork from the painting and sculpture classes he'd taken at the Corcoran when the kids were young. As he'd slipped into the sleeping bag he kept rolled behind the couch for just this purpose, his bare legs were met by something cold and wet. He stuck his hand inside and was besieged by the sharp, tinny smell of what he realized, as he brought his fingers to his nose, was semen.
He wouldn't miss being confronted by Ben's semen, that's for sure, Dennis thought, clinking glasses with his son. But he missed the young Benjamin, the one he'd carried around in that little sack strapped to his chest, the Benjamin he'd buckled into swings at Candy Cane City and pushed high in the air to his exhilarated delight, the preverbal Ben, his hot breath on his cheek as he lay in bed with him on Sunday mornings while Sharon baked popovers downstairs. That Ben—the one bobbing to Peter, Paul and Mary, pretending he had a hammer, and a bell, and a song! to! sing!, going at the bongo drums and the xylophone, gifts from a friend at the State Department—he'd been gone for quite a while now.
"Oh, Ben," Dennis said. "We're really going to miss you."
Everyone watched Ben take a sip, and then they saw him smile over the rim of his glass as three blushing young women, followed by Jon Ratner, made their way up the side path to the back of the house.
And that, Sharon thought, stacking the plates in the dishwasher, was that. The torches had been extinguished, the gray twilight had darkened to night, and everyone had moved inside. Her father was talking to Tatiana in the living room about how Brandeis was giving Russian Jews asylum, which was really nice, he was saying, didn't she agree?
Ben was gone for the night. He'd gotten up to greet the girls, his back turned to her, his arms wide, and Sharon had seen the girls' faces—such tan, small-featured, young faces—their eyes shut tight, lips quivering into smiles, their chins hooked over his shoulder. "Hey, Mr. and Mrs. G," Jon had said. "Looks like I missed a good dinner."
"Ben," Sharon had nervously said, just before he shook free of the girls' embrace.
"Let him go," Helen said. "It's his last night home, darling, just let him."
Sharon sighed and sat up straight. "Are you going out, Ben?" she asked stiffly.
He turned back to face the table. "Yeah. Just for a bit, okay?"
"There's a party over at Papadopoulos's," Jon said by way of explanation.
Sharon nodded quickly and, looking down at the table, ran her finger over the scratches in the wood. "Sure."
"Of course!" Dennis grandly stood up. "Have fun, gang."
Vanessa cringed. Gang.
"Thanks." Ben went to kiss his grandparents good-bye. And then his mother. "Dinner was totally great." He waved at Vanessa. "See ya, pal," he said, to which she rolled her eyes and flipped him the bird.
"Bright and early." Dennis leaned lightly on Helen's shoulder for support as he climbed off the bench.
"Yes," Sharon said. "We need to get an early start for Boston."
They all watched Benjamin lope down the hill, following Jon and the girls into an old magenta Pinto. Then they sped off, the tailpipe dragging down the empty street.
© 2010 Jennifer Gilmore
A Novel
Something Red
A Novel
In Washington, D.C., life inside the Goldstein home is as tumultuous as the shifting landscape of the times. It is 1979, and Benjamin is heading off to college and sixteen-year-old Vanessa is in the throes of a rocky adolescence. Sharon, a caterer for the Washington elite, ventures into a cultlike organization. And Dennis, whose government job often takes him to Moscow, tries to live up to his father's legacy as a union organizer and community leader.
The rise of communism and the execution of the Rosenbergs is history. The Cold War is waning, the soldiers who fought in Vietnam have all come home, and Carter is president. The age of protest has come and gone and yet each of the Goldsteins is forced to confront the changes the new decade will bring and explore what it really means to be a radical.
Something Red is at once a poignant story of husbands and wives, parents and children, activists and spies, and a masterfully built novel that unfurls with suspense and humor.
- Scribner |
- 320 pages |
- March 2010
Browse Related Books
Read an Excerpt
Reading Group Guide
It's 1980 in Washington D.C. and the domestic disturbances of the Goldstein family – a son going off to college, a daughter in the throes of adolescence, a mother's mid-life crisis– inevitably collide with the shifting political landscape of Jimmy Carter's presidency, the end of the Cold War and the grain embargo against the U.S.S.R.
Navigating three generations, Jennifer Gilmore deftly intertwines the lives of her indelible characters as their marriages, faith and politics play out against the backdrop of history – the execution of the Rosenbergs, the Olympic boycott and the Iranian hostage crisis. Something Red is at once a poignant story of husbands and wives, parents and children, activists and spies and a brilliant novel crackling with energy, humor, and intelligence.
Questions and Topics for Discussion
1.) Gilmore includes an epigraph selected from Grace Paley's "Faith in the Afterno see more


text:
The Schools offering UG & PG Courses are:
- School of Engineering and Technology
- School of Life Sciences and Basic Sciences
- School of Business and Management
- School of Computer & Systems Sciences
- Seeding Institute of Law and Governance
- School of Pharmaceutical Sciences
- School of Nursing
- School of Social Sciences
- School of Education
- School of Hotel Management & Catering Technology
- School of Languages, Literature and Society
- Seeding Institute of Media Studies
- School of Distance Education and Learning
For Undergraduate:
Candidates should passed 10 + 2 examination in relevant discipline with 50% of marks from a recognized Board of examination.
For Postgraduate:
Candidates should have a Bachelor's degree in relevant discipline with 50% of marks from a recognized university.
Selection Procedure:
Candidates will selected based on entrance test score conducted by the university.
How to apply:
Application form can be downloaded from the official website of Jaipur National University or can be obtained from the admission office of Jaipur National University.
Important Dates:
Last date for the submission of application form is April 16, 2012.
Entrance test will be held on May 27, 2012.
Contact Details:
Jaipur National University,
Jaipur-Agra Bypass,
Near New RTO office,
Jaipur – 302025.
Tel,: 0141 – 2753377.


text:
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI), gefitinib and erlotinib have been tested as maintenance therapy in patients with advanced non-small-cell lung cancer (NSCLC). The studies are quite heterogenous regarding study size and populations, and a synopsis of these data could give some more insight in the role of maintenance therapy with TKI.
In September 2012 we performed a search in the pubmed, EMBASE and Cochrane library databases for randomized phase III trials exploring the role of gefitinib or erlotinib in advanced non-small cell lung cancer. Through a rigorous selection process with specific criteria, five trials (n = 2436 patients) were included for analysis. Standard statistical methods for meta-analysis were applied.
TKIs (gefitinib and erlotinib) significantly increased progression-free survival (PFS) [hazard ratio (HR) 0.63, 95% confidence interval (CI) 0.50–0.76, I2 = 78.1%] and overall survival (HR 0.84, 95% CI 0.76–0.93, I2 = 0.0%) compared with placebo or observation. The PFS benefit was consistent in all subgroups including stage, sex, ethnicity, performance status, smoking status, histology, EGFR mutation status, and previous response to chemotherapy. Patients with clinical features such as female, never smoker, adenocarcinoma, Asian ethnicity and EGFR mutation positive had more pronounced PFS benefit. Overall survival benefit was observed in patients with clinical features such as female, non-smoker, smoker, adenocarcinoma, and previous stable to induction chemotherapy. Severe adverse events were not frequent. Main limitations of this analysis are that it is not based on individual patient data, and not all studies provided detailed subgroups analysis.
The results show that maintenance therapy with erlotinib or gefitinib produces a significant PFS and OS benefit for unselected patients with advanced NSCLC compared with placebo or observation. Given the less toxicity of TKIs than chemotherapy and simple oral administration, this treatment strategy seems to be of important clinical value.
Citation: Chen X, Liu Y, Røe OD, Qian Y, Guo R, Zhu L, et al. (2013) Gefitinib or Erlotinib as Maintenance Therapy in Patients with Advanced Stage Non-Small Cell Lung Cancer: A Systematic Review. PLoS ONE 8(3): e59314. https://doi.org/10.1371/journal.pone.0059314
Editor: William C.S. Cho, Queen Elizabeth Hospital, Hong Kong
Received: December 9, 2012; Accepted: February 13, 2013; Published: March 21, 2013
Copyright: © 2013 Chen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This work is supported by the Program for Development of Innovative Research Team in the First Affiliated Hospital of NJMU (Nanjing Medical University). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Current recommendations for chemotherapy treatment of patients with advanced non-small cell lung cancer (NSCLC) are four to six cycles as more cycles do not provide a survival benefit but a higher risk of toxicity [1]. However, only 50–70% patients will have second line treatment, while a substantial proportion of patients do not get further therapy due to side effects or low performance status [2], [3]. Thus, exploration of a non-chemo maintenance strategy has been a sensible development.
Maintenance therapy refers to the use of systemic therapy, either by continuing the primary drug or switch to a new one, in patients who get objective response or stable disease from the first line chemotherapy. This was primarily tested with cytotoxic agents such as gemcitabine [4], docetaxel [3] and pemetrexed [2]. The outstanding results of the JMEN study proved that maintenance of pemetrexed significantly improved the overall survival (OS) in advanced NSCLC patients was a proof of principle [2]. Subsequently, the results of the SATURN study also showed a significant prolongation of progression-free survival (PFS) and overall survival (OS) with maintenance erlotinib compared with placebo [5]. Zhang L et al [6] and other researchers [7], [8] also demonstrated the positive role of maintenance therapy with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), erlotinib and gefitinib. Due to their low toxicity and good efficacy data, EGFR TKIs have aroused great attention in maintenance therapy. Recently, the updated ASCO guidelines recommended that immediate treatment with an alternative, single-agent chemotherapy (including EGFR TKIs) in patients may be considered [9].
Behera et al [10] carried out a meta-analysis focusing on the role of single agent maintenance therapy in patients with advanced non-small cell lung cancer. They included twelve studies (five meeting abstracts, seven full manuscripts) and showed that single agent maintenance therapy provided superior OS (HR 0.86, 95% CI 0.80–0.92) and PFS (HR 0.62, 95% CI 0.57–0.67). However, only four studies (two meeting abstracts and two full manuscripts) about EGFR TKIs were included. Furthermore, because they emphasized the role of switch and continuation, the outcomes of EGFR TKIs maintenance were not analyzed in detail. Petrelli et al [11] did a pooled analysis of three randomized trials of erlotinib as maintenance therapy and confirmed the addition of maintenance erlotinib significantly improved PFS and OS in patients with advanced non-small cell lung cancer who had not progressed after four cycles of first-line chemotherapy. The benefit seemed to exist across the subgroups. But that analysis did not include any study on gefitinib maintenance.
We thus conducted this meta-analysis of high quality randomized clinical trials on maintenance therapy with gefitinib and erlotinib. Our aim was to determine the role of maintenance EGFR TKIs in patients with advanced NSCLC and to explore which subgroups of patients who will benefit from EGFR TKIs maintenance.
Patients and Methods
Search Method
In September 2012, an electronic search of the Pubmed, the EMBASE and the Cochrane library databases was performed. The search keywords were: "gefitinib and maintenance", or "erlotinib and maintenance", "non-small cell lung cancer (NSCLC)". The list of retrieved studies was then manually searched and reviewed. The published languages and years were not limited. Meeting abstracts from the American society of Clinical Oncology (ASCO) (2007–2012) and World Congress of Lung Cancer (WCLC) (2007–2011) were also hand searched for eligible trials. Reference lists of original articles and review articles were also examined for additional literature.
Selection of Trials
Details on the selection process are shown in the supplementary information file (Protocol S1). The selection of trials were performed by two authors and blinded. Randomized controlled phase III trials reporting the efficacy of gefitinib or erlotinib as maintenance therapy (single or combined with other agents except chemotherapeutics) immediately after the first line chemotherapy in stage IIIB/IV NSCLC were considered eligible. Patients should be pathologically or cytologically diagnosed with NSCLC and randomized just before the maintenance period. Peer-reviewed meeting abstracts fulfilling the criteria were also included. All quality of all eligible studies were also assessed by the Jadad Scale [12]. When a study had updated data, both the original and updated papers or abstracts were included. The references were screened by titles and further selected by reading the abstracts. Papers fulfilling the criteria were reviewed in detail. Articles were also obtained from cross-checking references of publications.
Data Extraction
Two independent reviewers extracted all data from the identified papers using standardized data compilation forms. Disagreements were resolved by discussion. The methodological quality of each paper was scrutinized and data such as the first author, year of publication, number of patients, median age, percentage of adenocarcinoma and data related to the clinical outcomes such as objective response rate (ORR), progression free survival (PFS), overall survival (OS), adverse events (AE) were extracted. The final data were used when updated data were available. Supplementary data of the IFCT-GFPC 0502 and EORTC 08021/ILCP 01/03 study were obtained by contacting the correspondent authors.
The primary outcome of this systematic review is whether the TKIs maintenance will produce OS benefit, the secondary outcomes including PFS benefit, subgroups analysis regarding OS and PFS, response rate and data on harms. First, the outcome data were pooled and reported as hazard ratio (HR) (fixed model or random model). HR <1 represents results in favor of TKI maintenance therapy. The PFS and OS were estimated by collection of HRs with 95% Confidence Intervals (CIs) which were mentioned in the original publications. The pooled risk ratio (RR) for ORR was calculated from the number of events and the number of patients at risk in each group. Prespecified subgroup analysis according to clinical features was also done.
The study heterogeneity was tested and a P<0.1 was defined as heterogenous. A fixed-effect model (Mantel Haenszel) was applied in case of absence of heterogeneity between studies and otherwise a random-effect model was performed. The meta-analysis results were displayed as forest plots. All calculations were performed using Stata (version 11, Stata, USA).
Study Selection Results
Our search in electronic database and meeting abstracts retrieved 463 references. Of these, only five studies [5], [6], [7], [8], [13], [14] met the criteria. The selection steps are summarized in the flow chart shown in Fig. 1. One phase III study (WJTOG0203) [15] comparing 3 cycles of platinum-doublet chemotherapy followed by gefitinib maintenance with continued platinum-doublet chemotherapy in Japanese patients with advanced non-small cell lung cancer was excluded because the randomization was performed before the beginning of chemotherapy rather than before the maintenance period and the continuous use of chemotherapy. Another study, SWOG S0023 study [16], evaluated gefitinib maintenance in inoperable stage III NSCLC patients who had not progressed after chemoradiotherapy (concurrent cisplatin and etoposide with thoracic radiation, then 3 cycles docetaxel consolidation). This study was excluded because the maintenance was not after first line chemotherapy and the patients were not stage IIIB/IV.
The data of the final five studies containing a total of 2436 patients were in 7 publications. The results of the SATURN study was formally published in Lancet Oncology in 2010 by Cappuzzo [5], and the data in Asian patients were separately reported in Lung Cancer most recently by Wu [17]. The ATLAS study was initially reported at the 2009 ASCO annual meeting by Miller [14], with updated OS in 2010 by Kabbinavar [7]. The original and updated publications were all included where the PFS and safety data were obtained from the original publications while the OS data were extracted from the updated abstracts.
Characteristics of the Five Trials in the Review
All of the five trials identified were randomized and controlled phase III trials, and all were of high quality assessed by the Jadad scale (Score4 or more). Two of the studies [6], [8] used gefitinib (250 mg/qd) and the other three used erlotinib (150 mg/qd) maintenance [5], [7], [13]. In all studies maintenance was commenced after 4 cycles' first line chemotherapy in stage IIIB/IV NSCLC. All of the studies enrolled patients with a mixed population (EGFR mutated and non-mutated) and two of the studies (INFORM and SATURN) reported the outcomes of EGFR patients related to EGFR status. Four studies were double blind and placebo controlled, and only one trial (IFCT-GFPC 0502) [13] was open label. This study investigated maintenance gemcitabine or erlotinib versus observation, following induction chemotherapy. Only the data of erlotinib and observation arms were extracted for the present analysis. A total of 2436 patients were included where the majority were of Caucasian, second largest group were Asian (n = 521) and one study included patients of Arabic decent (n = 54). There were 2391(98%) patients with ECOG performance status 0–1, and 1512(62%) had adenocarcinoma. A summary of the trial characteristics and clinical outcomes is provided in Table 1.
Response Rate
Data on response rate was available only in three of the trials, two with gefitinib and one with erlotinib and where the control arms were placebo. The gefitinib studies INFORM and the EORTC showed a higher response rate than the SATURN study [5], [6], [8]. However, the overall response rate was 14.50% (n = 671) in EGFR TKI maintenance and 3.8% (n = 682) in the control arm respectively. The pooled RR was 3.80 (95% CI 2.49–5.79), indicating that EGFR TKIs have a significant tumor shrinking effect after induction with chemotherapy.
Progression Free Survival
TKI maintenance therapy provided significant improvement in PFS (HR 0.63, 95% CI 0.50–0.76; I2 = 78.1%; Random model; Fig. 2). The significance is consistent between gefitinib (HR 0.50, 95% CI 0.32–0.68) and erlotinib subgroups (HR 0.71, 95% CI 0.63–0.78). The INFORM study provided a much lower HR (0.42, 95% CI 0.33–0.55) and this may lead to the heterogeneity between the trials. When excluded the INFORM study, the results turned out to be homogenous with a similar favorable HR (0.70, 95% CI 0.63–0.76; I2 = 0.0). We also did a cross-study subgroup analysis by pooling the HRs of the common subgroups reported in these studies. The results showed that the maintenance treatment of EGFR-TKIs provided consistent PFS benefits in all subgroups, including stage, sex, ethnicity, PS, smoking status, histology, EGFR mutation status and previous response to chemotherapy (Table 2). Notably, more impressive benefit was found in patients with EGFR mutation (HR 0.12, 95% CI 0.03–0.21) according to SATUN and INFORM study (Fig. 3).
(A) EGFR mutation positive. (B) EGFR wild type.
Overall Survival
The heterogeneity between these trials regarding OS was not significant (I2 = 0.0%, p = 0.95) and thus we used a fixed model to pool the HRs. A significant improvement of OS was found in the maintenance group (HR 0.84, 95% CI 0.76–0.93; Fig. 4). This was also shown in the erlotinib subgroup (HR 0.85, 95% CI 0.75–0.94) but not in gefitinib subgroup (HR 0.84, 95% CI 0.65–1.02). To determine whether this result was heavily influenced by SATURN study, the only trial that showed significant OS benefit in TKI maintenance group., a pooled HR without SATURN study was also calculated. A significant improvement of OS was still detected in the maintenance group (HR 0.87, 95% CI 0.76–0.98), but not in the erlotinib (HR 0.84, 95% CI 0.65–1.02) or gefitinib subgroup (HR 0.89, 95% CI 0.75–1.03). Subgroups analysis according to clinical features as female sex, adonocarcinoma, non-smoker, smoker and stable disease to previous induction chemotherapy conferred OS benefit by EGFR TKIs maintenance, while patients who were male, non-adenocarcinoma, and responded to chemotherapy did not (Fig. 5–8). Subgroup analysis regarding ethnicity and EGFR mutation status were available only in SATURN and ATLAS study. We thus did not pool the HRs for these subgroups.
(A) Female. (B) Male.
(A) adenocarcinoma. (B) non-adenocarcinoma.
(A) Objective response after induction. (B) Stable disease after induction.
(A) Non-smoker. (B) Smoker.
Data on Harms and Quality of Life
As the adverse events (AEs) were generally less frequent and reported differently, we were unable to carry out a pooled analysis. The most frequent AEs≥grade 3 were rash and diarrhea, which were more frequent in clinical trials on erlotinib. The incidence of ≥grade 3 rash was 9% in the SATURN study, and 10.4% in the ATLAS. The incidence of ≥ grade 3 diarrhea was 2% in the SATURN study and 9.3% in the ATLAS. Assessment of quality of life (QoL, by Functional Assessment of Cancer Therapy-Lung instrument) was obtained from two studies (INFORM and SATURN). In the INFORM study, a significantly higher percentage of patients had a sustained clinically relevant improvement in lung cancer symptoms with gefitinib than with placebo. No significant difference in QoL was found for patients receiving erlotinib compared with those receiving placebo in SATURN study.
The studies on maintenance therapy in advanced NSCLC are heterogenous regarding to study design and compounds, but in general the results are promising for this group of patients. Importantly, the discussion on the trade-off between a gain in PFS or OS versus the toxicity has called for less toxic substances [18], [19]. Recently the TKIs have shown activity in phase III studies of unselected populations with advanced NSCLC with the combined advantage of less toxicity and hospital admittance and the ease of oral administration. Here we performed a meta-analysis on all phase III studies on maintenance TKI treatment where patients were included after the induction chemotherapy, thus the data will more correctly refect the benefit or harm from maintenance therapy. The results of our meta-analysis confirmed that EGFR TKIs (gefitinib or erlotinib) maintenance therapy could provide both PFS and OS benefit in patients with advanced NSCLC who had not progressed after first line chemotherapy. According to the pooled results, EGFR TKIs produced a reduction of 37% and 16% in the risk of progression and death, respectively. Notably, though maintenance arms in all of the studies showed significant benefit in PFS, a significant OS benefit was only found in the SATURN study. Among the five included studies, four were aimed to detect the PFS benefit in maintenance groups and thus the study samples were probably not large enough to detect the difference in OS. Also, the widespread use of second and third line treatment at progression makes the value of OS as end-point more obscure. The EORTC 08021/ILCP 01/03 [8] study, which planed to enroll 598 randomized patients and observe 514 deaths, was designed to test the OS difference, but was prematurely closed due to low accrual after inclusion of 173 patients. This meta-analysis, by pooling the similar randomized control studies, showed strong evidence of OS benefit in EGFR TKI maintenance therapy, both in the erlotinib subgroup and in total.
Clinical and biomarker guided therapy has convincingly been demonstrated in the use of EGFR TKIs as both second line [20], [21], [22] and first line [23] treatment. But this has not been fully defined in maintenance therapy. We thus carried out a subgroup analysis to explore the sub-populations who may benefit or benefit more from maintenance therapy. Interestingly, the PFS benefit existed in all the subgroups including stage, sex and ethnicity, PS, smoking status, histology, EGFR mutation status and previous response to chemotherapy. Patients with stage IIIB or IV, PS 0 or 1, objective response or stable to previous chemotherapy had similar benefit with regard to PFS. Consistent with previous studies in first line, patients who were Asian (HR 0.40, 95% CI 0.21–0.58), female (HR 0.61, 95% CI 0.46–0.75), non-smoker (HR 0.53, 95% CI 0.31–0.75), those who had adenocarcinoma (HR 0.59, 95% CI 0.38–0.79) and most impressively, EGFR mutant (HR 0.12, 95% CI 0.03–0.21) may benefit more from EGFR TKIs. Moreover, a significant OS benefit was also found in patients who were female (HR 0.73, 95% CI 0.58–0.89), nonsmoker (HR 0.68, 95% CI 0.48–0.88), and smoker (HR 0.88, 95% CI 0.78–0.98) or had adenocarcinoma (HR 0.83, 95% CI 0.71–0.95), according to subgroup analysis on OS. In the EORTC study 54/173 patients were recruited in Cairo, Egypt, and potentially this could affect the result if ethnic Egyptians had a higher rate of EGFR mutated tumors. To our knowledge, there are no available data on this. A large study on EGFR mutation status in African-Americans showed no difference in frequency of mutational status, but there is still very little known about other ethnicities than Asian and Caucasian [24].
Although only 27% of patients in INFORM and 59% in SATURN were available for the EGFR mutation analysis, the impressive HR in EGFR mutant positive patients reinforce the notion that EGFR mutation is a predictive biomarker for EGFR TKIs. In the EORTC study, there were not enough cases tested for EGFR to validate these findings. A series of studies [23], [25], [26], [27] have clearly proved the rationale of first line EGFR TKIs in advanced NSCLC patients harboring EGFR active mutation. Since EGFR TKIs can prolong the PFS and OS as maintenance after first line chemotherapy in the same population, then, which strategy will lead to better outcome? As the available data in EGFR TKIs maintenance are still limited, especially the data with EGFR mutation status, future studies should address this question.
Nevertheless, the pooled analysis showed that patients with EGFR wild type also benefit from TKI maintenance (this mainly due to the effect of erlotinib in SATURN). As SATURN is the only trial that showed significant PFS benefit (HR 0.77, 95% CI 0.61–0.97, p = 0.0243) in patients with EGFR wild type, the role of EGFR TKIs in this population should be verified by more studies. An ongoing study conducted by Roche (NCT01328951) may contribute to this issue. This double-blind, placebo-controlled study will evaluate the benefit of first-line maintenance erlotinib versus erlotinib at the time of disease progression in patients with advanced non-small cell lung cancer (NSCLC) who have not progressed following four cycles of platinum based-chemotherapy. Importantly, this study enrolls patients whose tumor does not harbor an EGFR activating mutation.
Another controversial issue is whether we can select suitable patients for maintenance treatment according to the response to first-line treatment. The results are conflicting. In SATURN trial, patients who had stable disease after chemotherapy had a higher OS from maintenance treatment (HR 0.72, 95% CI 0.59–0.89), compared to those who responded to chemotherapy (HR 0.94, 0.74–1.20). Although no similar statistically significant difference in the OS benefit was observed in other studies, this tendency was also found in EORTC 08021/ILCP 01/03 and ATLAS study. The pooled results of the three trials showed that patients who experienced stable disease after first line treatment had a more pronounced OS benefit (HR 0.76, 95% CI 0.64–0.88) than those who gained objective response (HR 0.91, 95% CI 0.74–1.07). However, both categories of patients can achieve similar PFS benefit from EGFR TKIs maintenance (HR 0.66, 95% CI 0.49–0.83 for SD patients and HR 0.65, 95% CI 0.48–0.82 for patients who respond to chemotherapy).
A great advantage of EGFR TKIs is the less toxicity and easy administration, which reinforce the feasibility of EGFR TKIs as maintenance treatment. The summary of the adverse events indicated the incidence of grade 3 or more AEs were generally very low and most patients did not require dose reductions or interruptions.
To strengthen the results of the present meta-analysis, the inclusion criteria were strictly set. Phase II randomized studies were excluded and the randomization had to be done only before the beginning of maintenance so that the effect of the maintenance therapy could be clearly evaluated. The included studies were quite similar in design. Except in ATLAS study, the control groups were placebo (four studies) or observation (IFCT-GFPC 0502). Bevacizumab was previously recommended to use continuously after combination with chemotherapy in advanced NSCLC [28], [29]. In the ATLAS study, bevacizumab was added to the first line chemotherapy, and continued in both maintenance and control groups. The only difference was the maintenance use of erlotinib. Thus, this study was regarded as eligible and was also included in the erlotinib maintenance meta-analysis [10], [11]. The similarity in designs of included studies was important to confer this meta-analysis greater reliability. However, there are some limitations of the present meta-analysis that should be noted. First, the analysis is not based on individual patient data which could have provided further insight into the efficacy of the maintenance strategy. Then, although the included studies are very similar in structure, mechanisms of effect and clinical efficacy, differences on safety profile and clinical effects are also observed between gefitinib and erlotinib. Ideally, only studies published as full manuscripts in peer-reviewed journals should be included, but due to the lack of eligible studies, and after scrutiny of the quality, data from the ATLAS study published in peer-reviewed meeting abstracts was included. Not all studies provided detailed subgroups analysis, and the sample sizes in subgroups were inevitably underpowered. Finally, one should keep in mind that these trials were all partly funded by pharmaceutical industry, with the inherent conflict of interest and possible bias, but these studies were all of high quality and were the only eligible studies to examine the relevant question. The results of this meta-analysis should therefore be carefully interpreted when used in clinical practice.
In conclusion, we demonstrate that maintenance therapy with EGFR TKIs (gefitinib and erlotinib) produces a significant PFS and OS benefit for patients with advanced NSCLC compared with placebo or observation. The PFS benefit is also significant in all subgroups including stage, sex, ethnicity, PS, smoking status, histology, EGFR mutation status and previous response to chemotherapy. The toxicity associated with EGFR TKIs maintenance was generally low and well tolerated. These data suggest that maintenance with EGFR TKIs after first line chemotherapy is a good treatment strategy in unselected patients with advanced NSCLC, and an excellent option for patients with EGFR mutation.
Supporting Information
Table S1.
PRISMA 2009 Checklist for this Meta-analysis.
Protocol S1.
Protocol for this systematic review.
We thank professor Maurice Perol and professor Rabab M. Gaafar for providing us supplementary data of the IFCT-GFPC 0502 and EORTC 08021/ILCP 01/03 study. We thank professor Jia He (Department of Health Statistics of the Second Military Medical University, Shanghai, China) for her kind help in statistics.
Author Contributions
Conceived and designed the experiments: XFC YMY YYQ YS. Performed the experiments: XFC YQL YYQ. Analyzed the data: XFC ODR LJZ RHG YMY YQS. Contributed reagents/materials/analysis tools: XFC YQL YQS. Wrote the paper: XFC YQL ODR YYQ.
- 1. Azzoli CG, Baker S Jr, Temin S, Pao W, Aliff T, et al. (2009) American Society of Clinical Oncology Clinical Practice Guideline update on chemotherapy for stage IV non-small-cell lung cancer. J Clin Oncol 27: 6251–6266.
- 2. Ciuleanu T, Brodowicz T, Zielinski C, Kim JH, Krzakowski M, et al. (2009) Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomised, double-blind, phase 3 study. Lancet 374: 1432–1440.
- 3. Fidias PM, Dakhil SR, Lyss AP, Loesch DM, Waterhouse DM, et al. (2009) Phase III study of immediate compared with delayed docetaxel after front-line therapy with gemcitabine plus carboplatin in advanced non-small-cell lung cancer. J Clin Oncol 27: 591–598.
- 4. Brodowicz T, Krzakowski M, Zwitter M, Tzekova V, Ramlau R, et al. (2006) Cisplatin and gemcitabine first-line chemotherapy followed by maintenance gemcitabine or best supportive care in advanced non-small cell lung cancer: a phase III trial. Lung Cancer 52: 155–163.
- 5. Cappuzzo F, Ciuleanu T, Stelmakh L, Cicenas S, Szczesna A, et al. (2010) Erlotinib as maintenance treatment in advanced non-small-cell lung cancer: a multicentre, randomised, placebo-controlled phase 3 study. Lancet Oncol 11: 521–529.
- 6. Zhang L, Ma S, Song X, Han B, Cheng Y, et al. (2012) Gefitinib versus placebo as maintenance therapy in patients with locally advanced or metastatic non-small-cell lung cancer (INFORM; C-TONG 0804): a multicentre, double-blind randomised phase 3 trial. Lancet Oncol 13: 466–475.
- 7.
Kabbinavar VAM, Johnson BE, O'Connor PG, Soh C, ATLAS Investigators (2010) Overall survival (OS) in ATLAS, a phase IIIb trial comparing bevacizumab (B) therapy with or without erlotinib (E) after completion of chemotherapy (chemo) with B for first-line treatment of locally advanced, recurrent, or metastatic non-small cell lung cancer (NSCLC). J Clin Oncol 28(15s): (abstr 7526).
- 8. Gaafar RM, Surmont VF, Scagliotti GV, Van Klaveren RJ, Papamichael D, et al. (2011) A double-blind, randomised, placebo-controlled phase III intergroup study of gefitinib in patients with advanced NSCLC, non-progressing after first line platinum-based chemotherapy (EORTC 08021/ILCP 01/03). Eur J Cancer 47: 2331–2340.
- 9. Azzoli CG, Temin S, Aliff T, Baker S Jr, Brahmer J, et al. (2011) 2011 Focused Update of 2009 American Society of Clinical Oncology Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer. J Clin Oncol 29: 3825–3831.
- 10. Behera M, Owonikoko TK, Chen Z, Kono SA, Khuri FR, et al. (2012) Single agent maintenance therapy for advanced stage non-small cell lung cancer: A meta-analysis. Lung Cancer 77: 331–338.
- 11. Petrelli F, Borgonovo K, Cabiddu M, Barni S (2011) Erlotinib as maintenance therapy in patients with advanced non-small cell lung cancer: a pooled analysis of three randomized trials. Anticancer Drugs 22: 1010–1019.
- 12. Olivo SA, Macedo LG, Gadotti IC, Fuentes J, Stanton T, et al. (2008) Scales to assess the quality of randomized controlled trials: a systematic review. Phys Ther 88: 156–175.
- 13. Perol M, Chouaid C, Perol D, Barlesi F, Gervais R, et al. (2012) Randomized, Phase III Study of Gemcitabine or Erlotinib Maintenance Therapy Versus Observation, With Predefined Second-Line Treatment, After Cisplatin-Gemcitabine Induction Chemotherapy in Advanced Non-Small-Cell Lung Cancer. J Clin Oncol 30(28): 3516–3524.
- 14.
Miller POC, Soh C, Kabbinavar F, for the ATLAS Investigators (2009) A randomized, double-blind, placebo-controlled, phase IIIb trial (ATLAS) comparing bevacizumab (B) therapy with or without erlotinib (E) after completion of chemotherapy with B for first-line treatment of locally advanced, recurrent, or metastatic non-small cell lung cancer (NSCLC). J Clin Oncol 27(18s): (abstr LBA8002).
- 15. Takeda K, Hida T, Sato T, Ando M, Seto T, et al. (2010) Randomized phase III trial of platinum-doublet chemotherapy followed by gefitinib compared with continued platinum-doublet chemotherapy in Japanese patients with advanced non-small-cell lung cancer: results of a west Japan thoracic oncology group trial (WJTOG0203). J Clin Oncol 28: 753–760.
- 16. Kelly K, Chansky K, Gaspar LE, Albain KS, Jett J, et al. (2008) Phase III trial of maintenance gefitinib or placebo after concurrent chemoradiotherapy and docetaxel consolidation in inoperable stage III non-small-cell lung cancer: SWOG S0023. J Clin Oncol 26: 2450–2456.
- 17. Wu YL, Kim JH, Park K, Zaatar A, Klingelschmitt G, et al. (2012) Efficacy and safety of maintenance erlotinib in Asian patients with advanced non-small-cell lung cancer: A subanalysis of the phase III, randomized SATURN study. Lung Cancer 77: 339–345.
- 18. Soon YY, Stockler MR, Askie LM, Boyer MJ (2009) Duration of chemotherapy for advanced non-small-cell lung cancer: a systematic review and meta-analysis of randomized trials. J Clin Oncol 27: 3277–3283.
- 19. Belani CP, Brodowicz T, Ciuleanu TE, Krzakowski M, Yang SH, et al. (2012) Quality of life in patients with advanced non-small-cell lung cancer given maintenance treatment with pemetrexed versus placebo (H3E-MC-JMEN): results from a randomised, double-blind, phase 3 study. Lancet Oncol 13: 292–299.
- 20. Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan EH, Hirsh V, et al. (2005) Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 353: 123–132.
- 21. Chang A, Parikh P, Thongprasert S, Tan EH, Perng RP, et al. (2006) Gefitinib (IRESSA) in patients of Asian origin with refractory advanced non-small cell lung cancer: subset analysis from the ISEL study. J Thorac Oncol 1: 847–855.
- 22. Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, et al. (2003) Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer (The IDEAL 1 Trial) [corrected]. J Clin Oncol 21: 2237–2246.
- 23. Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, et al. (2009) Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med 361: 947–957.
- 24. Reinersman JM, Johnson ML, Riely GJ, Chitale DA, Nicastri AD, et al. (2011) Frequency of EGFR and KRAS mutations in lung adenocarcinomas in African Americans. J Thorac Oncol 6: 28–31.
- 25. Zhou C, Wu YL, Chen G, Feng J, Liu XQ, et al. (2011) Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 12: 735–742.
- 26. Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, et al. (2012) Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 13: 239–246.
- 27. Gaughan EM, Costa DB (2011) Genotype-driven therapies for non-small cell lung cancer: focus on EGFR, KRAS and ALK gene abnormalities. Ther Adv Med Oncol 3: 113–125.
- 28. Reck M, von Pawel J, Zatloukal P, Ramlau R, Gorbounova V, et al. (2009) Phase III trial of cisplatin plus gemcitabine with either placebo or bevacizumab as first-line therapy for nonsquamous non-small-cell lung cancer: AVAil. J Clin Oncol 27: 1227–1234.
- 29. Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, et al. (2006) Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 355: 2542–2550.


text:
Review by Bill Wood
"Not much to do with lasers, but awesome nonetheless."
LaserCat is an Xbox Live indie game featuring a cat, who -- despite the awesome title -- has no lasers at his disposal. This cat is on a mission to rescue his owl friend, who has been captured by some cranky old wizard dude and transported to an unknown location in outer space. If you're still with me after those last two sentences, please read on. It gets better.
The best way I can describe LaserCat is a Metroidvania game on the Atari 2600. I'm sure there are more accurate descriptions but they fail me at the moment. As the titular feline hero(ine?), you'll be exploring various rooms on a huge map in search of the 30 keys that will secure the release of your avian companion. Most rooms are a combination of traps and enemies, and although there is no way to attack your enemies, they are usually quite easy to avoid. The focus is light on contact and heavy on exploration, which is a nice refreshing of pace from the "punishment platformer" archetype that permeates many Xbox Live indie games. Checkpoints are numerous, which means you're never far away from a game save. And since all checkpoints also double as warp zones, you can teleport to any previously explored area in the blink of an eye. Convenience is the key word here.
The minimalist approach to graphic design is a suitable compliment to the minimalist approach to game design. Character sprites are limited in detail and animations are sparse. In fact, if not for the giveaway in the title, you could have told me the protagonist was a dog or a rabbit or a chupacabra and I've have probably believed you. The game's artistic stylings are very reminiscent of the Atari 2600 era -- or perhaps Intellivision as it was a slightly more advanced piece of technology -- with modern flourishes added. Objects glow vibrantly and colors shift randomly, creating a soothing effect that blends perfectly with the methodical pace of the game. It's easy on the eyes, which helps to create a game that you'll want to keep playing.
Like many one-dollar indie games, LaserCat isn't going to take you very long to complete. I believe my first playthrough lasted roughly an hour and a half, which included exploring every single room on the map and backtracking quite a bit. Some of the areas need to be accessed in a non-linear fashion, which adds a bit of time and challenge to an otherwise easy game. Despite the short length (or perhaps because of it), I found myself looking forward to future playthroughs.
If you can't tell by reading this review thus far, I really enjoyed my time with LaserCat. It definitely won't leave you scratching your head or chucking your controller against the nearest wall, instead it is a well-paced and simple little video game to relax with, a nice of way of unwinding in front of the TV set after a long day. And who doesn't need that every now and then?
Reviewer's Rating: 4.0 - Great
Originally Posted: 01/19/12, Updated 01/23/12
Game Release: LaserCat (US, 04/28/11)
Got Your Own Opinion?
Submit a review and let your voice be heard.


text:
Occupations Women T-Shirts are an Idakoos specialtiy! Idakoos has many things to offer. Whether you want to get a Occupations Women T-Shirt for a special occasion, give a Printed Occupations Women T-Shirt as a present or need to represent with a funny Occupations Tee during Holidays or Family and Friends get-togethers, Idakoos is sure to have the right Occupations Women T-Shirt for you! Even if it turns out you can't find the right Occupations Tshirt with the perfect design for your mother, father or children; Idakoos offers all of its men's women's and children's Occupations Tshirts as Custom Occupations Women T-Shirts. Personalize any Occupations Women T-Shirt the way you want to ensure the perfect gift.
Showing 1 - 24 of 235702 Women T-Shirts


text:
Sorry, but specific product you requested is not currently available. Hopefully you can find another option below.
Vogue Knitting Magazine. Typically contains 30+ patterns for women, men, home, and children.
Knit Simple - 2015 Spring/Summer and Knit Simple - 2014 Fall are both similar books: magazines and periodicals category book by vogue.
We provide endless possibilities for you including yarn, knitting gifts, needles, kits, sale yarn, free knitting patterns, and more! Jimmy Beans Wool is Your Local Yarn Store... Online!


text:
Record Store Day a big celebration for independent shops
Saturday, April 16, is Record Store Day, the biggest celebration of the year for independent record stores and, more importantly, their customers.
One of the highlights of Record Store Day (recordstoreday.com) is the exclusive music releases that are available to independent stores that participate in the day.
Many of these releases are limited to 2,000 copies or less, worldwide, which makes most of them instant collector's items. This also means that no single store or customer is likely going to receive everything that they want.
At Triple Play we registered, signed a pledge and sent in money to become an official Record Store Day participant. What that all means is that we agreed to follow the rules of protocol for record store day and not sell items on e-Bay before the actual day, as some stores and people have done in the past.
For our participation, we received a very large number of promotional items to give away Saturday. These items include various sampler CDs from record labels such as New West, Capitol, Labrador, Select-O-Hits and Sub Pop. There is even a sampler from France called "Le Disquare Day."
There are two specific "Record Store Day" samplers that mostly contain songs that are yet to be released.
Triple Play also has received several booklets, such as Utne and Decibel, with download codes for loads of music, and one booklet with a CD of artists from the Coachella music festival in California.
The coolest promotional items, however, are four different samplers from Sub Pop Records with each artist/song on the disc represented by a postcard in the package.
Triple Play received a little more than half of the items we asked for, which isn't too bad. We may have a few more that find their way into the store by Friday, April 15, but for the most part this is what we are going to have available Saturday:
There will be special 7-inch records from Jimi Hendrix, ZZ Top and Mastadon and the White Stripes.
Bruce Springsteen and the Kings of Leon each have a special two song 12-inch record available.
We mostly went after full length LPs for our choices, and we will be receiving special full-length vinyl from Flaming Lips, Country Joe and the Fish, Bob Dylan, Foo Fighters, Gorillaz, Grateful Dead, Ray LaMontagne, Mississippi John Hurt, Mumford and Sons, Nickel Creek, Ozzy Osbourne, Pink Floyd, Pearl Jam, Robbie Robertson, Skip James, Syd Barrett and Tom Petty and the Heartbreakers.
We will also be receiving CDs from the Decemberists and Crowded House.
Besides making sure that everyone who comes into Triple Play on Saturday will leave with some free schwag, we are going to discount all of our vinyl that day, excluding Record Store Day items, and there will be other specials.
As the Main Street reconstruction has progressed we have reconstructed our vinyl records at Triple Play to make it easier for you.
Come down to Triple Play tomorrow and celebrate Record Store Day 2011 with us and all the independent record stores across the country.
# # #