Thursday, January 3, 2013

YouTube sucks on French ISP Free, and French regulators want to ...

The French telecoms regulator, ARCEP is investigating whether or not Google?s YouTube service is being inappropriately and intentionally blocked by popular French ISP Free, and will make a decision early this year. ARCEP is looking into the financial and technical conditions of traffic delivery between ISPs and online content providers, intending to discover whether either side is degrading infrastructure quality.

As part of its investigation, the regulator is also probing three other unnamed companies. The perception is that ISPs in France are either under-investing in infrastructure or violating the spirit of network neutrality, the idea that ISPs should not discriminate on traffic traveling over their pipes. Yet, in France, it seems that at least some in the government are willing to make Google pay for the ability to guarantee that ISP customers can receive its bits, turning the Internet into Gulliver in the land of the Lilliputians, with ISPs and governments tying it down. The question is, will what happens in France happen elsewhere?

The ARCEP investigation and user complaints

Early this year, communications regulator ARCEP will rule on an investigation it opened on November 22 following complaints that video streaming services including YouTube are often too slow to watch. Now three French senators are also calling on the country?s digital economy minister to take action.

ARCEP stepped up when a survey of over 16,000 ISP customers by French consumer group UFC Que Chosir?found 83 percent of Free customers, 47 percent of Orange customers and 46 percent of SFR customers were unable to use YouTube properly.

Since the investigation began, many users have reportedly noted an improvement in connection quality, but connections remain patchy.

1098164_downloading_barAnd this issue is not limited to Google. ?The quality of connection is inadequate in almost all operators,? said?UFC Que Chosir?s survey, which found that France?s native Dailymotion, ironically, is slowest to access through France Telecom?s own Orange ISP, which owns almost half of the YouTube rival. And 25 percent of consumers reported slow-downs whilst watching broadcaster TF1?s MyTF1 catchup service.

Is it under-investment or a desire to make content companies pay?

UFC Que Chosir says these symptoms may be caused by under-investment in infrastructure as well as commercial tensions between ISPs, which deliver web services to the end user but which don?t pay for the infrastructure. It has called on the government to define quality-of-access rules, in part by allowing the competition regulator ARCEP to build a quality-of-service observatory. Similarly, in the U.S., the Federal Communications Commission is also trying to figure out how to measure the quality of a broadband connection beyond just looking at speeds.

Inter-company tensions do appear to be at play. A case before another public agency ? France?s competition regulator,?the?Autorit? De La Concurrence ? in September illustrates how ISPs eager for revenue from web content companies can hold the user experience hostage.

Cogent, which handles YouTube?s peering interconnections, had?complained?to the competition authority that Orange had refused its connections, wanting more money to add ports to connect Cogent traffic to its networks. Much of the interconnections between large ISPs, CDNs and web content companies are negotiated by private deals, so it?s rare to see the government get involved, or even to hear much about them publicly. In the U.S., when Level 3 and Comcast became embroiled in a public peering fight after Level 3 started sending Netflix traffic over its connections with Comcast, the FCC refused to get involved, and both parties settled the disagreement.

But in this case, the competition regulator said one ISP was within its rights to charge more money from services hoping to reach its subscribers. This so-called double-sided business model has been sought by ISPs who argue that companies such as Google are freeloaders making huge profits off the pipes of owned by the ISPs. In contract, Google and other content companies argue that their services are the reason customers upgrade to higher speeds and continue paying ISPs money.

And in France the ISP argument has gained at least one supporter in the Autorit? De La Concurrence. The authority says France Telecom is offering interconnection prices significantly below market value, and it has accepted the telco?s undertakings to ensure transparency.

French policymakers generally are generally in the mood to extract more money from Google. They have already set such wheels in motion around taxation and copyright fees. Now infrastructure could be the next arena. But its unclear how far France will go.

It?s one thing to try to ensure that consumers have an acceptable connection to support online video, through implementing some kind of standards. It?s another to get between participants in peering disputes, and to possibly start setting rates.

The U.S. fight is bigger than France?s

handshake_buddawiggiBut such fights are becoming more common as the stakes over the internet and web video get higher. ISPs are worried about the cost of delivering video traffic over their networks, while also losing out on the ability to charge users for pay TV packages that significantly boost their revenue. Meanwhile, consumers are demanding more video online because they can choose what to watch, when they want to watch it, on any device.

The French competition authority?s earlier investigation referred only to two individual companies at loggerheads in a specific peering fight. But the new inquiry by the communications regulator is much wider, looking at industry-wide practices around infrastructure and interconnection. And it comes following consumer outcry ? identified in UFC Que Chosir?s survey ? to which politicians may be keen to respond.

The outcome will be important because Google is already facing having to pay to re-use news content in some parts of Europe through both commercial agreements and possible new legislation that suggest excerpting is chargeable. That could set new precedents for the online content economy.

The French broadband outcome will be important because it will set up a precedent for other telecom regulators who are struggling with similar issues. Creating standards to ensure that customers have a quality online video experience is no simple task and may well require investment by ISPs, especially those on older technologies or oversubscribed networks.

As for the peering issues, if the government decides to step into the fray there, it could be setting the internet up for regulations that put governments in the role of determining who can connect to whom and how much they can charge. The OECD recently made a convincing argument that such regulations and government involvement would hurt the web and the economic development of companies dependent on the web. So what France does here might have influence far beyond its borders.


GigaOM

Source: http://msoftnews.com/google/youtube-sucks-on-french-isp-free-and-french-regulators-want-to-know-why/

grammy winners obama budget woolly mammoth belize resorts nikki minaj grammy performance shel silverstein niki minaj grammy performance

Wednesday, January 2, 2013

Senate passes massive tax cut which raised ... - Legal Insurrection

There are too many metaphors here applicable to the Senate?s 89-8 passage of a ?fiscal cliff? bill in the middle of the night (around 2 a.m. this morning).

The bill raised taxes by over $600 billion, in addition to Obamacare taxes already coming on line, yet the Senators can claim it was a massive tax cut because the vote took place after midnight, so technically the Bush tax cuts already had expired.

The basic details are in last night?s post.? The index to the bill is here, and the full bill here.

Via WaPo:

Senate leaders had been waiting to schedule the vote until they had received an official score from the Congressional Budget Office, which provides estimates for the budgetary impact of legislation.

But even though that score was released before the measure was voted upon, it?s unlikely that many senators had the chance to read the entire 157-page bill before casting their votes early Tuesday morning.

Support for ? as well as opposition to ? the compromise spanned the ideological spectrum. The eight senators voting ?no? were Democratic Sens. Tom Harkin (Iowa), Tom Carper (Del.), Michael Bennet (Colo.) and Republican Sens. Mike Lee (Utah), Richard Shelby (Ala.), Rand Paul (Ky.), Chuck Grassley (Iowa) and potential 2016 White House hopeful Marco Rubio (Fla.).

The Republican Senators voting against the bill were Rubio, Paul, Grassley, Lee, Shelby, and the Democrats were Harkin, Bennet and Carper.? Not voting were DeMint, Lautenberg, and Kirk.

For historical analogy, CBS News points out:

The measure is the first significant bipartisan tax increase since 1990, when former President George H.W. Bush violated his ?read my lips? promise on taxes. It would raise an additional $620 billion over the coming decade when compared with revenues after tax cuts passed in 2001 and 2003, during the Bush administration. But because those policies expired at midnight Monday, the measure is officially scored as a whopping $3.9 trillion tax cut over the next decade.

Now it goes over to the House.

The most intereting part of the bill that we know of so far is that the automatic sequester cuts are delayed for two months, so there will be another big fight combining the sequester cuts and debt ceiling.? This delay is one of the selling points the Republican leadership is using to sell the bill.

The theory is?that the spending cuts and entitlement reforms have not been surrendered, they will be fought over soon in a context in which the ?rich? already have seen their taxes go up so spending and entitlements, not taxes, will be the only things on the table.

Obama already signalled in his offensive press appearance yesterday that he was not buying into that narrative, and that more ?revenue? would be on the table again.

Update:? Via Twitchy -

Twitter Break Tax Pledge

?

?

?

Source: http://legalinsurrection.com/2013/01/senate-passes-massive-tax-cut-which-raised-taxes-over-600-billion-in-middle-of-night-without-reading-the-bill/

beverly hilton roland martin whitney houston dead at 48 whitney houston dead 2012 whitney houston passed away heartbreak hotel don cornelius

Westridge real estate searches by Specific Communities in the ...

If you are selling, buying or just plain interested in Westridge ? you may know that Westridge is located in the City of Valencia CA. ?Valencia CA is located in the Santa Clarita Valley. ?It is one of the 6 Santa Clarita cities, which include, Castaic, Canyon Country, Newhall, Saugus, and Stevenson Ranch.

We just concluded this ?screen share? video by The Paris911 Team at REMAX. It will give you some great search resources for Westridge. ?You can also take a few notes or follow along with the audio within another browser window. ?That way you can use our MacBoX to it?s fullest extent.

  • We put a listings map on our home page
  • Only active and back up listings are showing ? ONLY
  • When you search other real estate portals ? you are going to find listings that are not available
  • MacBoX ? it is a keyword tool ? with instructions on how to do it
  • Westridge is located on the west side of the Santa Clarita Valley ? north of Stevenson Ranch
  • Valencia Blvd. Crosses over the 5 freeway
  • The homes that are currently for sale will be shown for Westridge when you zoom in
  • The squares with the small red square in the upper left hand corner are distressed real estate
  • The property showing up is a NOD ? short sale
  • Share on your social media by clicking on the property
  • Westridge ? if you want to see the foreclosures ? type in Westridge foreclosures into the MacBoX
  • ZERO currently, as of the date of this post, in the way of Foreclosures and Bank Owned
  • One Stop shop for any area which you are wanting to view with regard to real estate
  • Shoot us an email about homes that are not on the market for sale yet in Westridge
  • You can make determinations with the right intelligence related to real estate
  • One Party show into the macBoX will give you the latest intel about how we assist our buyers
  • We are REMAX?s Paris911 Team at Paris911 dot com

Have a watch and appreciate you very much.

Connor and Paris MacIvor are Realtors in Santa Clarita CA with the REMAX of Valencia CA Brokerage.? They realized at the beginning of their real estate career the importance of being able to be there for their clients - 100% of the time. This blog is about Seller Representation and constant real estate market updates by Factual Numbers provided by the independent Research Firm we hired for our Real Estate sellers and buyers.? Enjoy the Data by The Paris911 Team at REMAX of Valencia CA.

Source: http://realtor.paris911.com/2013/01/02/westridge-real-estate-searches-by-specific-communities-in-the-santa-clarita-valley/

Stand Up to Cancer Azarenka NFL fantasy football Chris Kluwe Jennifer Granholm Tulane player injured frank ocean

Measuring Learning Outcomes in Higher Education: Motivation ...

bored student

The educational legislation known as No Child Left Behind was initially embraced by the education and the public policy sectors, but since its inception criticisms have grown as to such effectiveness of policies that advocate for standardized testing versus more traditional assessment methods. Nevertheless, standardized testing has grown to include higher education, spurred in part by a 2005 Department of Education commission report lamenting the lack of transparency in higher ed practices. In response, many U.S. colleges and universities have adopted standardized student outcomes assessments and partnered with organizations such as Voluntary System of Accountability to better meet accreditation requirements, evaluate teaching effectiveness and, on the national stage, provide the foundation for educational policy recommendations.

These tests may prove useful to higher education institutions, but observers say that their accuracy may be suspect, as the tests typically don?t effect a student?s grade and they are less inclined to try to do their best. Attempts to incentivize test takers with better course grades and/or financial incentives have proved successful in the past, but are not always possible to implement on a wide scale.

A 2012 study from the Educational Testing Service in Princeton, NJ, published in Educational Researcher, ?Measuring Learning Outcomes in Higher Education: Motivation Matters,? investigates the links between student motivation, motivational instruction and test format on standardized test scores. More than 750 participants representing a mix of race, gender and academic aptitude with at least one year of college experience were offered $50 to complete a 36-item multiple-choice test and essay question online, followed by a survey that measured student motivation. Students signed one version of three possible consent forms: 1) individual test results could be shared with faculty and potential employers (the ?personal? condition); 2) individual test results would be private, but scores would be averaged from all participants from that college and could be shared with faculty and employers (the ?institutional? condition); or, 3) test results were for research purposes only and would not be shared (the ?control? condition).

Key study findings included:

  • ?Students do not exert their best effort in taking low-stakes outcomes assessments ? [C]onclusions about value-added learning changed dramatically depending on the test of choice and the motivation levels.? There was no difference in overall performance outcomes across the three participating higher educational institutions involved in the study:? a research institution, a master?s institution and a community college.
  • Student motivation and performance were both consistently higher for the multiple choice component of the test. The researchers suggest that essay tests require more effort and motivation.
  • Motivated sophomores performed as well as the typical senior regardless of condition: with respect to test performance, ?the motivational effect for sophomores was as large as 2 years of college education.?
  • Students assigned to the ?personal? condition group performed on average 41% better than those in the control group; those assigned to the ?institutional? condition group performed on average 23% better than control group participants. Students in the ?personal? group also scored significantly higher on the personal essay component of the test.
  • The researchers suggest that many factors may influence student motivation levels, and that while linking a bonus to student performance may encourage performance, there are ways to motivate students that do not incur financial costs.
  • Seniors in the institutional condition did not excel at the essay-writing component of the test: ?it may take a stronger reason than caring about one?s institutional reputation for seniors to be serious about writing an essay.?

The researchers suggest that low student motivation on standardized tests has likely resulted in underperformance; this could influence an institution?s reputation for good or ill: ?Institutions doing a good job of motivating students could achieve significantly higher rankings than institutions doing a poor job of motivating students, even though their students may have comparable academic abilities.?

Past research has also found that motivation and test performance are linked. A 2007 study shows that ?some individuals do not try their best when no performance based incentives are provided, though these individuals are not the less able ones.?

?Tags: youth, higher education

By Margaret Weigel | January 2, 2013

Citation: Liu, Ou Lynda; Bridgemen, Brent; Adler, Rachel M. "Measuring Learning Outcomes in Higher Education: Motivation Matters." Educational Researcher, Vol. 41, No. 9, 352-362. doi: 10.3102/0013189X12459679.

Analysis assignments

Read the issue-related Edmondson.comarticle titled "Time for a $10,000 Bachelor's Degree in Oklahoma?"

  1. What key insights from the news article and the study in this lesson should reporters be aware of as they cover these issues?

Read the full study titled ?Measuring Learning Outcomes in Higher Education: Motivation Matters.?

  1. What are the study's key technical terms? Which ones need to be put into language a lay audience can understand?
  2. Do the study?s authors put the research into context and show how they are advancing the state of knowledge about the subject? If so, what did the previous research indicate?
  3. What is the study?s research method? If there are statistical results, how did the scholars arrive at them?
  4. Evaluate the study's limitations. (For example, are there weaknesses in the study's data or research design?)
  5. How could the findings be misreported or misinterpreted by a reporter? In other words, what are the difficulties in conveying the data accurately? Give an example of a faulty headline or story lead.

Newswriting and digital reporting assignments

  1. Write a lead, headline or nut graph based on the study.
  2. Spend 60 minutes exploring the issue by accessing sources of information other than the study. Write a lead (or headline or nut graph) based on the study but informed by the new information. Does the new information significantly change what one would write based on the study alone?
  3. Compose two Twitter messages of 140 characters or fewer accurately conveying the study?s findings to a general audience. Make sure to use appropriate hashtags.
  4. Choose several key quotations from the study and show how they would be set up and used in a brief blog post.
  5. Map out the structure for a 60-second video segment about the study. What combination of study findings and visual aids could be used?
  6. Find pictures and graphics that might run with a story about the study. If appropriate, also find two related videos to embed in an online posting. Be sure to evaluate the credibility and appropriateness of any materials you would aggregate and repurpose.

Class discussion questions

  1. What is the study?s most important finding?
  2. Would members of the public intuitively understand the study?s findings? If not, what would be the most effective way to relate them?
  3. What kinds of knowledgeable sources you would interview to report the study in context?
  4. How could the study be ?localized? and shown to have community implications?
  5. How might the study be explained through the stories of representative individuals? What kinds of people might a reporter feature to make such a story about the study come alive?
  6. What sorts of stories might be generated out of secondary information or ideas discussed in the study?

?

Source: http://journalistsresource.org/studies/society/education/measuring-learning-outcomes-higher-education-motivation-matters?utm_source=rss&utm_medium=rss&utm_campaign=measuring-learning-outcomes-higher-education-motivation-matters

Pumpkin Pie Jack Taylor Apple Pie Recipe black friday How long to cook a turkey green bean casserole green bean casserole recipe

Tuesday, January 1, 2013

Colleges helping students scrub online footprints

BUFFALO, N.Y. (AP) ? Samantha Grossman wasn't always thrilled with the impression that emerged when people Googled her name.

"It wasn't anything too horrible," she said. "I just have a common name. There would be pictures, college partying pictures, that weren't of me, things I wouldn't want associated with me."

So before she graduated from Syracuse University last spring, the school provided her with a tool that allowed her to put her best Web foot forward. Now when people Google her, they go straight to a positive image ? professional photo, cum laude degree and credentials ? that she credits with helping her land a digital advertising job in New York.

"I wanted to make sure people would find the actual me and not these other people," she said.

Syracuse, Rochester and Johns Hopkins in Baltimore are among the universities that offer such online tools to their students free of charge, realizing ill-considered Web profiles of drunken frat parties, prank videos and worse can doom graduates to a lifetime of unemployment ? even if the pages are somebody else's with the same name.

It's a growing trend based on studies showing that most employers Google prospective hires and nearly all of them won't bother to go past the first page of results. The online tools don't eliminate the embarrassing material; they just put the graduate's most flattering, professional profile front and center.

"These students have been comfortable with the intimate details of their lives on display since birth," said Lisa Severy, president-elect of the National Career Development Association and director of career services at the University of Colorado-Boulder, which does not offer the service.

"The first item on our 'five things to do before you graduate' list is 'clean up your online profile,'" she said. "We call it the grandma test ? if you don't want her to see it, you probably don't want an employer to, either."

After initially supplying BrandYourself accounts to graduating seniors, Syracuse University this year struck a deal with the company ? begun by a trio of alumni ? to offer accounts to all of its undergraduate and graduate students and alumni at no additional charge. About 25,000 people have access to it so far.

"It's becoming more and more important for students to be aware of and able to manage their online presence, to be able to have strong, positive things come up on the Internet when someone seeks them out," said Mike Cahill, Syracuse's career services director.

Online reputation repair companies have been around for at least a couple of years, often charging hundreds or thousands of dollars a year to arrange for good results on search engine result pages. BrandYourself, which normally charges $10 a month for an account, launched two years ago as a less expensive, do-it-yourself alternative after co-founder Pete Kistler ran into a problem with his own name.

"He couldn't get an internship because he was getting mistaken for a drug dealer with the same name," said co-founder Patrick Ambron. "He couldn't even get calls back and found out that was the problem."

An April survey of 2,000 hiring managers from CareerBuilder found nearly two in five companies use social networking sites to research job candidates, and 11 percent said they planned to start. A third of the hiring managers who said they research candidates reported finding something like a provocative photo or evidence of drinking or drug use that cost the candidate a job.

"We want our students and alumni actively involved in shaping their online presence," said Johns Hopkins Career Center Director Mark Presnell. Students are encouraged to promote positive, professional content that's easily found by employers, he said.

BrandYourself works by analyzing search terms in a user's online profile to determine, for example, that a LinkedIn account might rank 25th on Google searches of the user's name. The program then suggests ways to boost that ranking. The software also provides alerts when an unidentified result appears on a user's first page or if any links rise or fall significantly in rank.

Nati Katz, a public relations strategist, views his presence online as a kind of virtual storefront that he began carefully tending while in graduate school at Syracuse.

Google his name and up pops his LinkedIn page with a listing of the jobs he's held in digital media and the "500+ connections" badge of honor. His Facebook account is adorned with Katz smiling over an elegant Thanksgiving dinner table. There are a couple of professional profiles and his Tumblr link, one after another on the first page of results and all highlighting his professional experience.

Before his 2011 graduation, he took the university up on its offer of the BrandYourself account and said it gave him a leg up with potential employers and internship supervisors.

"Fortunately, I didn't have to deal with anything negative under my profile," said Katz, who used the reputation website BrandYourself.com while pursuing dual degrees in public relations and international affairs. "What I was trying to form was really a nice, clean, neat page, very professional."

Source: http://news.yahoo.com/colleges-help-students-scrub-online-footprints-184052483.html

best buy black friday deals breaking dawn part 2 breaking dawn part 2 Jennifer Lacy Honey Baked Ham hostess israel

Loose The Weight You want And Get Your Figure Back | Ovarian ...

Weight-loss really isn?t as hard as men and women make out. Having said that, it does take determination and perseverance. The work is very considerably worth it.Weight loss really isn?t as hard as people make out. However, it does take determination and perseverance. The effort is very much worth it.

how to lose belly fat for men It?s a well known reality that drinking water may help you shed pounds. Nonetheless, the reality that drinking cold water will boost your metabolism is less nicely known. Any time you drink cold water, the body works to stabilize its internal temperature, and that increases your metabolism.

Make an effort to have your meals close to the same time every day. By carrying out this, you understand when it is time for the next meal, so you will not be considering as significantly about snacking in case you know it?s just about mealtime. Try and schedule your snacks. Possessing a schedule will help cut down on mindless consuming.

Consciously slow your food intake so that the stomach can approach issues appropriately. Chew every single bite a minimum of 20 instances. Smaller sized bites and dinner conversation can assist with this. You may discover a sense of fullness more rapidly and also you will consume just enough to be satiated, not stuffed.

An excellent technique to preserve a healthy lifestyle and shed weight in the procedure will be to employ a dietician. They can help the dieter make healthier food alternatives. Maintaining a healthful and nutritious diet regime is a essential component in any weight-loss plan.

Maintain pressure out of your life. There?s too substantially temptation to eat the incorrect sorts of foods after you are stressed out. It becomes simple to focus on future ambitions and sustain your focus once you are healthy, totally free of stress and living a satisfied life.

Consuming on a schedule daily can help you shed weight. Dieters are unlikely to overeat after they have an eating schedule. Endeavor to produce a time-frame when you are in a position to eat and stick to it.

Dispose of your unhealthy food in your refrigerator and pantry. When you continually frequent fast food establishments, bakeries and candy outlets, you?re sure to be tempted. Nevertheless, if you visit health food shops and fresh outdoor markets, your temptations will probably be much healthier.

click here Try to help keep your portions under control to ensure sustained weight reduction. Study indicates that smaller food portions are beneficial in each attaining and sustaining your encouraged body weight. You might feel awesome, and also you may also look fantastic. You can get pleasure from greater power levels and increase health issues too.

When trying to shed undesirable pounds it really is greatest to grow to be educated on the topic. The much more expertise you?ve, the simpler it becomes to generate the most beneficial choices relating to your wellness. In actual fact, concentrating on your all round wellness might be a big step to you shedding weight. Apply what you have just learned and start to appreciate your good results. best fat burning exercises

?

?

?

Source: http://ovariancervicaluterinecancer.hostingsiteforfree.com/2013/01/01/loose-the-weight-you-want-and-get-your-figure-back/

richard cordray shannon de lima joe torre west virginia university tim howard west virginia rob roy

Paired CT scans catch chemo-killing of liver tumors in real time

Dec. 31, 2012 ? Using two successive pairs of specialized CT scans, a team of Johns Hopkins and Dutch radiologists has produced real-time images of liver tumors dying from direct injection of anticancer drugs into the tumors and their surrounding blood vessels. Within a minute, the images showed whether the targeted chemotherapy did or did not choke off the tumors' blood supply and saved patients a month of worry about whether the treatment, known as chemoembolization, was working or not, and whether repeat or more powerful treatments were needed.

The Johns Hopkins team's report about this novel use of dual-phase cone-bean computed tomography, or DPCBCT, an imaging technique developed at Johns Hopkins, is set to appear in the January 2013 edition of the journal Radiology. The diagnostic scans were performed on 27 men and women with inoperable liver cancer.

"This new scanning method is giving us almost instant feedback about the value of injecting antitumor drugs directly into large liver tumors and their surrounding blood vessels in an effort to quickly kill them, and to prevent the cancer from spreading," says senior study investigator and interventional radiologist Jean-Francois Geschwind, M.D.

Geschwind says if further testing proves equally successful, the paired use of cone-beam CT scans, which are already approved for single-scan use by the U.S. Food and Drug Administration, could supplant the current practice of MRI scanning a month after chemoembolization to check its effects.

"Patients should not have to endure the uncertainty of waiting weeks or more to find out if their chemoembolization was successful in fighting their liver cancer," says Geschwind, a professor in the Russell H. Morgan Department of Radiology at the Johns Hopkins University School of Medicine and its Kimmel Cancer Center.

"Dual-phase cone-beam CT avoids such delays, which also could allow the cancer to grow and spread and, ultimately, compromise chances of remission," he says.

Avoiding delays is particularly important, he says, for people with moderate to advanced stages of the disease, when liver tumors are too large or too numerous to surgically remove, and for whom chemoembolization is the main treatment option. Half of such liver cancer patients succumb within nine months, and liver transplantation is only an option for a quarter of those whose tumors have not spread outside the liver.

The newer DPCBCT scans, in which X-rays are detected by a device the size of a large laptop that can be placed directly below or above the operating room table, have the added advantage of being performed in the same room, or interventional radiology suite, as patients getting chemoembolization.

In their new study, Geschwind and his colleagues found that the initial shrinkage seen with DPCBCT scans taken before and after chemoembolization matched up almost perfectly with MRI scans taken a month later. Tumor death was 95 percent, the same as that seen by MRI. A total of 47 tumors were closely monitored in the study to assess how well DPCBCT tracked tumor death after chemoembolization.
All study participants were treated at The Johns Hopkins Hospital between March and December 2009.

In DPCBCT scanning, a chemical contrast dye is injected into the artery that supplies blood flow to the liver and tumor right before the chemotherapy drug is injected, to enhance the X-ray image. The first set of scans highlights key blood vessels feeding the tumor, as dye flows in and out of the tumor. The second set of scans is performed immediately after chemoembolization, to gauge tumor and key blood vessel death. Computer software is used to sharpen and analyze differences between the images.

The entire DPCBCT scanning time, researchers say, is between 20 seconds and 30 seconds, and the total amount of radiation exposure from the dual scanning averages 3.08 milliseiverts, which is less than half the amount of radiation involved in a modern abdominal 64-CT scan. Cone-beam CT scanners also emit an X-ray, but unlike other CT scanners, the cone-beam type of X-ray is projected onto one large, rectangular detector, roughly a foot and a half long -- and produces a telltale conical shape. The size of the cone-beam CT detector allows for single scans that can capture images the size of most people's entire liver. More powerful 64-CT and 320-CT scanners involve multiple detector rows.

Chemoembolization entails the use of tiny beads containing the chemotherapy drug doxorubicin injected directly into liver tumors.

Ultrathin catheters, about the width of a human hair, are threaded through blood vessels to deliver the drugs, which seep from the beads for several weeks.

Geschwind is leading clinical trials under way at Johns Hopkins and other centers to assess whether the combination drug treatment works for liver cancer patients. Early results have shown promise, with patients with advanced disease living 10 months to 15 months longer.

Geschwind says they plan improvements in image quality in DPCBCT scans, hoping further refinements will encourage physicians to adopt the technique. They also plan updates to the navigational software that, like GPS, can track blood vessels feeding each tumor, and provide more precise and greater numbers of targets.

Liver cancer kills nearly 20,000 Americans each year, and is much more prevalent outside the United States, where it is among the top three causes of cancer death in the world. Experts cite the rising numbers of hepatitis C infections, which cause chronic liver inflammation and are a leading risk factor for liver cancer.

Funding support for this study was provided by the French Society of Radiology and Philips Research North America in Briarcliff Manor, N.Y. Philips, whose parent company is based in the Netherlands, manufactures the CBCT device used in the study. Additional funding support was provided by the U.S. National Cancer Institute, a member of the National Institutes of Health. The corresponding grant numbers are NCI R01-CA160771 and UL1 RR-025005.

The study lead investigators were Romaric Loffroy, M.D., a radiology fellow at Johns Hopkins, and MingDe Lin, Ph.D., a Philips biomedical engineer based at Johns Hopkins who has been collaborating with Geschwind for the past five years to perfect the DPCBCT technique.

In addition to Geschwind, Loffroy and Lin, other Johns Hopkins researchers involved in this research were Gayane Yenokyan, Ph.D., at the university's Bloomberg School of Public Health; and Pramod Rao, M.D.; Nikhil Bhagat, M.D.; and Eleni Liapi, M.D., all at the School of Medicine. Philips investigators involved were Niels Noordhoek, Ph.D.; Alessandro Radaelli, Ph.D.; and Jarl Blijd, M.Sc.

The chemoembolization research study was funded by Bayer HealthCare and Onyx Pharmaceuticals, manufacturer of sorafenib, and Biocompatibles, makers of the microbeads. Geschwind is a consultant to Bayer HealthCare Pharmaceuticals, and to Biocompatibles. The terms of these arrangements are being managed by The Johns Hopkins University in accordance with its conflict-of-interest policies.

Share this story on Facebook, Twitter, and Google:

Other social bookmarking and sharing tools:


Story Source:

The above story is reprinted from materials provided by Johns Hopkins Medicine, via Newswise.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Journal Reference:

  1. R. Loffroy, M. Lin, G. Yenokyan, P. P. Rao, N. Bhagat, N. Noordhoek, A. Radaelli, J. Blijd, E. Liapi, J.-F. Geschwind. Intraprocedural C-Arm Dual-Phase Cone-Beam CT: Can It Be Used to Predict Short-term Response to TACE with Drug-eluting Beads in Patients with Hepatocellular Carcinoma? Radiology, 2012; DOI: 10.1148/radiol.12112316

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/top_news/top_health/~3/BxsY8Gnb_98/121231110516.htm

China abc glock earthquake abc news msnbc meteor shower