Some may not need breast cancer chemo

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first_imgDoctors who treat women with breast cancer are glimpsing the possibility of a vastly different future. After years of adding more and more to the regimen – more drugs, shorter intervals between chemotherapy sessions, higher doses, longer periods of taking of harsh drugs – they are now wondering whether many women could skip chemotherapy altogether. If the new ideas are validated by large studies, like two that are just beginning, the treatment of breast cancer would markedly change. Today, national guidelines call for giving chemotherapy to nearly every one of the nearly 200,000 women whose illness is diagnosed as breast cancer each year. In the new approach, chemotherapy would be mostly for the 30 percent of women whose cancers are not fueled by estrogen. So far, the data are tantalizing but the evidence is very new and still in flux. And no one can yet say for sure which women with hormone-dependent tumors can skip chemotherapy – the advice a woman gets often depends on which doctor she sees. It could be a decade before the new studies, one American, one European, will provide any answers. “We finally tell people at the end of the day, `You’re going to get a lot of information. Trust your gut; nobody has the answers,”‘ Brenner said. Doctors are also concerned. It took two years before the National Cancer Institute and its researchers could even agree on a study design to test the idea that many women might safely forgo chemotherapy. The study, which will start enrolling patients at the end of this month, will involve women whose cancers are fueled by the hormone estrogen and have not spread beyond the breast. They will be randomly assigned to have the standard treatment, chemotherapy followed by a drug like tamoxifen that starves tumors of estrogen, or to skip chemotherapy and only have treatment with a drug like tamoxifen. In Europe, researchers are planning a similar study. But, unlike the American one, it also will include women whose cancer has spread beyond their breasts into nearby lymph nodes. The American study may eventually add such women too, said Sheila Taube, who directs the cancer diagnosis program at the National Cancer Institute. It is a time, Taube says, that reminds her of a debate a few decades ago, when the question was whether all women with cancer needed mastectomies or whether many could have a lumpectomy instead. “To me, the situations are analogous,” Taube says.160Want local news?Sign up for the Localist and stay informed Something went wrong. Please try again.subscribeCongratulations! You’re all set! AD Quality Auto 360p 720p 1080p Top articles1/5READ MOREBasketball roundup: Sierra Canyon, Birmingham set to face off in tournament quarterfinals“It’s a slightly uncomfortable time,” said Dr. Eric P. Winer, who directs the breast oncology center at the Dana-Farber Cancer Center, which is affiliated with Harvard. “Some of us feel like we have enough information to start backing off on chemotherapy in selected patients, and others are less convinced.” The latter characterization describes Dr. John Glick, director of the Abramson Cancer Center of the University of Pennsylvania. He tells his patients about the new data but he does not suggest they skip chemotherapy. After all, he notes, the national treatment guidelines were based on results from large randomized clinical trials. And the recent studies indicating that some women can skip chemotherapy are based on an after-the-fact analysis of selected clinical trials. “We’re in an era where evidence-based medicine should govern practice,” Glick said. For women with breast cancer, of course, the uncertainty is excruciating. Faced with a disease that already causes uncertainty and anxiety, they are now confronted with incomplete data, different opinions from different doctors and choices that can seem almost impossible: Can they – or should they – give up a treatment when all the answers are not in and they have what may be a fatal disease? “If the medical profession is not even close to being of one mind, how is the woman to know?” said Donald Berry, a statistician at M.D. Anderson Cancer Center and the lead author of a recent paper questioning chemotherapy’s benefits in many women. “There’s a real problem,” said Barbara Brenner, who has had breast cancer and is the executive director of Breast Cancer Action, an advocacy group. last_img

South African rugby in 2011

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first_img20 December 2011In 2011, the Springboks’ defence of their Rugby World Cup crown came up short, but they bowed out of the event with great credit after a somewhat bizarre quarterfinal loss to Australia in which the only statistic they trailed in was the final score.However, the tendency to focus heavily on the four-yearly event cost the Boks in the Tri-Nations tournament once again.After employing a big mix of players, who for the most part looked underprepared, the Springboks won just one of their four Tri-Nations tests, defeating New Zealand 18-5 in a memorable encounter in Port Elizabeth.Prior to that, an underdone team went down 14-9 to Australia in Durban, while second-string line-ups, supposedly forced because of injuries, suffered away defeats of 40-7 to New Zealand and 39-20 to Australia. Such unnecessarily big losses left a bitter taste in the mouths of Springbok supporters.World CupSouth Africa was much improved at the World Cup. Wales, who went on to finish fourth, provided a very tough challenge in the Boks’ first outing, but the men in green and gold managed a 17-16 victory.Improving with every game, they then romped to a 49-3 victory over Fiji, thrashed Namibia 87-0, and held off a fiery Samoan side 13-5.Those wins put the Springboks into the quarterfinals, but that’s where their tournament ended after an 11-9 defeat at the hands of Australia.While the Springboks failed to make the final, South Africa’s Craig Joubert asserted his status as the best referee in the game when he was appointed to take charge of the World Cup final.RetirementsAfter the World Cup, two of the greats of South African rugby retired from the international game: John Smit, after 111 test caps, and Victor Matfield, after 110 tests, which made them number one and two all-time for South Africa.They left, not only as senior players, but also as captain and vice-captain. Their retirement, along with the completion of coach Peter de Villiers’ contract, means that a new era of Springbok rugby is likely to begin in 2012.Super RugbyThe Super Rugby competition was broken up into three conferences in 2011 – Australia, New Zealand, and South Africa – with the top three sides from each conference, plus the three next best teams, qualifying for the playoffs. As it worked out, each conference provided two playoff teams, with the defending champion Bulls just missing out on a place.The Stormers finished on top of the South African conference with 12 wins in 16 matches, while the Sharks finished second after 10 wins and one draw. The Bulls won 10 of their 16 games, while the Cheetahs scored five wins, and the Lions three wins and one draw, which was a considerable improvement on their winless 2010 season.In the playoffs, the Crusaders were handy 36-8 victors over the Sharks in New Zealand. The following week, at Newlands in Cape Town, they ousted the Stormers 29-10. The title, however, went Australia’s way as the Reds downed the Crusaders 18-13 to claim the title.Currie CupFor most of the Currie Cup season, the teams played without their Springboks, who were involved in World Cup preparations and in the World Cup itself.The Golden Lions, who had few Springboks in their ranks, started strongly and surged into an early lead at the top of the table. They held onto it until the end, finishing on 50 points to the Sharks’ 48, the Cheetahs’ 47 and Western Province’s 41. The Blue Bulls just missed out on the semi-finals after finishing a point behind Province.In the semi-finals, the Sharks beat the Cheetahs 20-13 and the Lions shocked a Western Province team with its Springboks 29-20. That set up a rematch of the game between the Lions and the Sharks that had been played two weeks earlier in Durban, with the defending champion Sharks triumphing 53-9. This time, however, the match would take place in Johannesburg.In a fairy tale finish, the Lions outplayed their Springbok-stacked opponents, scoring a lopsided 42-16 victory to claim their first Currie Cup title since 1999. It was also their first at home since 1950!Player of the YearAt the South African Rugby Awards in November, Schalk Burger was named South African Rugby Player of the Year for a second time, while the Golden Lions were named Team of the Year.Bismarck du Plessis, widely regarded as the best hooker in the game, was named the Players’ Player of the Year.SevensThe South African Sevens team enjoyed a good year, winning three tournaments, in Las Vegas, and then back-to-back in London and Edinburgh to end the World Series on a high.They finished second to New Zealand in the final standings and were the only team besides the Kiwis to win more than one tournament.Playmaker Cecil Afrika finished the HSBC Sevens World Series as the top try scorer and points’ scorer. He was deservedly named the International Rugby Board’s Player of the Year.On the women’s front, the South African women’s team achieved a historic victory in August when they beat the USA 26-23. It marked the first time that South Africa had beaten one of the game’s top ranked teams.Would you like to use this article in your publication or on your website? See: Using SAinfo materiallast_img read more

H2Ohio strategies and farm practices outlined by Gov. DeWine

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first_imgShare Facebook Twitter Google + LinkedIn Pinterest By Dusty Sonnenberg, CCA, Ohio Field LeaderOhio Governor Mike DeWine unveiled an overview of his new H2Ohio plan for water quality Thursday afternoon in Toledo. Backdropped by the National Museum of the Great Lakes, Governor DeWine presented basic details of the plan to an invited audience of over 100 farmers and legislators, as well as collaborators from farm associations, conservation groups, universities and research centers, agribusinesses, and public and government entities.Gov. Mike DeWine spoke in Toledo where he outlined the strategy for H2Ohio.“H2Ohio is a dedicated, holistic water quality plan that has long lasting solutions,” said Governor DeWine. “It addresses the causes of the problems and not just the symptoms.”H2Ohio will invest in targeted solutions to help reduce harmful algal blooms, ensure clean water in disadvantaged communities, and prevent lead contamination in daycare centers and schools. In July, the Ohio General Assembly invested $172 million in the plan.“This is one of the most comprehensive data-driven planning processes in our state’s history. The plan is based on science and on economics,” DeWine said. “It focuses on directing the resources that we have on practices that have been studied and that we know will make a difference because they have already been proven to work. This plan is different because we have put together a broad coalition of agriculture, research, conservation, and environmental interest groups that believe this is the right approach to tackle this problem. It has tangible, measurable changes that will have lasting impacts. It is a comprehensive approach to our statewide water quality problems.”The largest portion of the H2Ohio plan is aimed at phosphorus reduction best practices for farmers.“Not all phosphorus comes from farms, but most does. Studies show that nutrient runoff accounts for most of the phosphorus load in the Maumee River watershed,” DeWine said. “Ten key practices have been identified as having the best potential to reduce the most phosphorus at the lowest cost. They will give us the most bang for our buck.”Through a certification process, H2Ohio will provide economic incentives to farmers who develop a nutrient management plan that includes a combination of the best practices. These practices include: 1. Soil Testing, 2. Variable-rate fertilization, 3. Subsurface nutrient application, 4. Manure incorporation, 5. Conservation crop rotation, 6. Cover crops, 7. Drainage water management. 8. Edge-of-field buffers, 10. Wetlands.“H2Ohio will provide an economic incentive to farmers to follow these best practices. It will be done through a certification process whereby farmers will only be eligible for this money if they follow a nutrient management plan,” DeWine said.The governor said H2Ohio would first be targeted at the Maumee River Watershed in northwest Ohio. Ultimately it will be taken to the rest of the state of Ohio. Farmers in the Maumee River Watershed will be able to enroll in H2Ohio programs for funding incentives in time for spring 2020 planting.“Wetlands will be a large part of the H2Ohio plan. These will not just be in the Maumee River Watershed, but also other key areas of Ohio. We have several successful wetland programs now. Adding more wetlands in Ohio will reduce excess phosphorus and nitrogen levels in our water, and store carbon. They will add critical habitat that promotes a diverse array of wildlife. They will help manage periodic flooding. They will also offer additional recreation opportunities from hunting and fishing to hiking and simply wildlife viewing. I am very excited about these possibilities,” DeWine said. “Wetlands will provide multiple benefits. The ODNR will announce specific projects in the coming months.”The Ohio Environmental Protection Agency will be monitoring the phosphorus loading in Lake Erie and the Ohio River along with evaluating new technologies that can contribute to these efforts. EPA activities will be focused primarily outside the Maumee River Watershed under H2Ohio. They will be working to protect Ohio’s drinking water and, under the direction of the EPA, H2Ohio will be funding wastewater infrastructure projects in disadvantaged communities. H2Ohio funds will also help to replace hundreds of failing home septic systems for low income households, and H2Ohio will be assessing lead exposure in schools and day care facilities from lead pipes as well.At the same time, the Ohio Agriculture Conservation Initiative (OACI) will establish a baseline understanding of current conservation and nutrient management efforts on farm fields and build farmer participation in a new certification program in partnership with the DeWine Administration. OACI is an innovative collaboration of agricultural, conservation, environmental and research communities formed in early 2019 to strategically address Ohio’s water quality issues.“Ohio’s farmers have long demonstrated their commitment to doing what is right for Ohio’s waterways, and OACI is acutely aware that some farmers need support in implementing water quality best practices. OACI recognizes this is best done through baseline establishment of practices and increased promotion and education within the farm community,” said 
Scott Higgins, co-chair of OACI and CEO of the Ohio Dairy Producers Association.
“There are approximately 75,000 farmers in the state of Ohio, with about 17,000 farmers located in the Western Lake Erie Basin. We thank the DeWine Administration for bringing resources to the table. OACI looks forward to continued public-private partnership with the DeWine Administration that will ensure that each farm is assessed fairly and uniquely.”OACI has been working diligently throughout 2019 to develop a benchmark of agricultural best practices and create a framework for voluntary certification of Ohio’s farms, all to support healthy waterways in the state.Adam Sharp, Ohio Farm Bureau Audio Playerhttps://www.ocj.com/wp-content/uploads/2019/11/Adam-Sharp-H2Ohio.mp300:0000:0000:00Use Up/Down Arrow keys to increase or decrease volume.Chris Henney, Ohio Agribusines Association Audio Playerhttps://www.ocj.com/wp-content/uploads/2019/11/Chris-Henney-H2Ohio.mp300:0000:0000:00Use Up/Down Arrow keys to increase or decrease volume.Tadd Nicholson, Ohio Corn & Wheat Audio Playerhttps://www.ocj.com/wp-content/uploads/2019/11/Tadd-Nicholson-H2Ohio.mp300:0000:0000:00Use Up/Down Arrow keys to increase or decrease volume.Bob Short, Ohio Soil and Water Conservation Districts Audio Playerhttps://www.ocj.com/wp-content/uploads/2019/11/Bob-Short-H2Ohio.mp300:0000:0000:00Use Up/Down Arrow keys to increase or decrease volume.Ohio Field Leader is a project of the Ohio Soybean Council. For more, visit ohiofieldleader.com.last_img read more

Powell offers coaching tips to aspiring long jumpers

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first_imgKolkata, Dec 16 (PTI) Long jump legend Mike Powell today gave coaching tips to aspiring local athletes here, asking them not to think much about foul jumps.Powell had an hour-long session with 25 athletes at the Sports Authority of India centre here. He was here in a three-day visit as part of 25K run tomorrow.”Be an aeroplane. Run as fast as you can and then take of lightly like a plane does, with the eye on the horizon. Never look down. Look up and beyond the horizon. This is the best way to jump,” Powell, whose 1991 World Championship record of 8.95m is still to be bettered, said.”Dont give a damn about foul jumps, take your leap of faith,” he added.Powell spent almost sixty minutes with 25 odd aspiring long jumpers giving them tips after their jumps.Powell was seen going up to the take-off board and showed the position in which the upper body and knee should be while taking off.He also showed them how to run in the lead up to the jump and how to spread the body to create the perfect aerodynamics to remain in air longer as it mesmerised the aspiring Bengal jumpers.Bhairavi Das and Ramdev Tigga were praised by the legend for their fluid movements and take offs, but they were given tips to further hone their skills.”It was a great moment to be coached by Powell. He is our idol. He taught us simple things. Things we tend to ignore and that is great. I wish I had a coach like him,” Tigga said.advertisement”I am truly mesmerised. He is such a great man with so much knowledge. He has changed the way I used to think about the jump.” PTI TAP PDS PDSlast_img read more

Barcelona could join PL in case of Spain split

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first_imgBarcelona Barcelona could join Premier League if Catalan independence happens, claims sport minister Ignasi Oliva Gispert Additional reporting by Chris Burton Last updated 2 years ago 19:04 29/9/2017 FacebookTwitterRedditcopy Comments(97) Lionel Messi Premier League GFX Getty composite Barcelona Premier League Primera División If Catalunya were to break free of Spain then the Camp Nou giants, along with Espanyol and Girona, would have to explore options away from La Liga Barcelona could look at joining the Premier League, Ligue 1 or Serie A if Catalan independence is secured, according to the region’s sports minister.A controversial referendum is due to be staged on Sunday , with Catalunya seeking to become recognised as a nation in its own right,The Spanish government has deemed the process illegal, with ballot boxes being seized and prime minister Mariano declaring that the vote “won’t happen”. Article continues below Editors’ Picks Why Barcelona god Messi will never be worshipped in the same way in Argentina Lyon treble & England heartbreak: The full story behind Lucy Bronze’s dramatic 2019 Liverpool v Man City is now the league’s biggest rivalry and the bitterness is growing Megan Rapinoe: Born & brilliant in the U.S.A. Barca 13/2 to win CLCatalan natives are pressing ahead with their proposal, though, and that includes a plan of action for sporting clubs should a new country be formed.Barcelona, Espanyol and Girona would all face an uncertain future on the back of independence, but Gerard Figueras believes that there are plenty of intriguing options to explore.”Elite clubs would choose between challenging in a Catalan league or in a foreign league,” Figueras told Goal.In a separate interview, he said: “In the case of independence, Catalan teams in La Liga – Barcelona, Espanyol and Girona – will have to decide where they want to play: in the Spanish league or a neighbouring country like Italy, France or the Premier League.“Now in Spain there teams from other countries who play in national leagues: clubs from Andorra in football and basketball. Monaco play in France, in England Welsh clubs. I don’t think that UEFA has anything against seeing another club play in a different league from their country.”While suggesting that Barca could remain part of the La Liga set-up, those in charge of the Spanish top flight have warned that any exiles will be excluded.Lionel Messi Barcelona Catalan flags 2017Liga president Javier Tebas said: “In sport, it isn’t a la carte and things must be clearly stated. It isn’t easy to have an agreement and study Spanish legislation but if they [the Catalan clubs] do get that, then they will not be able to play in Spain’s La Liga, but I hope it doesn’t come to that.”José Ramon Lete, president of Spanish Consejo Superior de Deportes, refused to be drawn on the matter, with the head of the sports council suggesting that he could not envision La Liga without Barcelona.”We don’t assume it can happen so we don’t give any opinion about it because we consider this scenario of an independence is not going to happen,” Lete told Goal. “I don’t understand Spanish sports without Catalan sportsmen and Catalan clubs.”Barcelona have yet to address the potential ramifications of independence in public, with the club waiting on the will of the people before putting any plans in place.A statement from the club regarding the current state of affairs read: “FC Barcelona, in holding the utmost respect for its diverse body of members, will continue to support the will of the majority of Catalan people, and will do so in a civil, peaceful, and exemplary way.”While events away from the field continue to dominate the headlines in Catalunya, Barca have avoided any distractions to reassert domestic dominance on it.Ernesto Valverde’s side have secured eight successive victories in all competitions this season, with faultless openings being made to their La Liga and Champions League campaigns. Check out Goal’s Premier League 2019-20 fantasy football podcast for game tips, debate and rivalries.last_img read more