اي جلجتا، اي كه از چوب دارو درختت بود

ديدي كه آن مرد مصلوب از جام آخر مست

چون دانه بعد از نهفتن از كام سنگش رُست

چون غنچه بعد از شكفتن از دام تنگش رَست

سیمین بهبهانی

Some New Stuff

I added 4 new albums to my music archive:
Canaan : A Calling To Weakness 2002
Evadne : The 13th Condition 2007
Orestea : Love Lines and Blood Ties 2010
Future of Forrestery : Travel III EP 2010

An Iconic Visit

"Had a tour around The White House. Unfortunately never met The President as he was locked in meetings but a great experience all the same."

Michael Owen on twitter

@Manutd.com

Dilapidation and Death

Trying to separate the outside from the inside
Trying to remain calm, 'though they mix in subtle manner
Chaos inside, losing all hope, basking in pain that seems endless
Alone in this life and its futile signs of malignant forms
Silent hatred for nothing, weakened for everything


Gloom is no more the same, light increases the pain in this suffering
Feelings have shriveled to death, awaiting to die with no idolatry
Believing in nothing at all
These bleeding veins are as indifferent as existence in itself
No sorrow behind these wounds, just hatred and pain
Reaching the end for good


I might as well just sleep and awake no more to watch the dilapidation of all
I might as well just dream there would be a life instead of growing nothingness


"Who told you that I wouldn't come back to you
I am inside and growing, destroying your mind and your worthless dreams
Corrupting your senses, erasing the reason and all that's left of you
You can't escape for I've become you - forevermore!"


The sight is darkening and chaos reigns in here
There's no more explanations for this seems like the end
All your precious memories and wishes are gone
The swirl of damnation furls you to this nightmare
Touching the cosmic horror beyond the space and time
Reaching for inhuman experience, the journey to afar
The limits of mind are gone, hallucinating the death of the universe
Vortex of chaos and hell leaves only ash and dust


There was none to witness the death of a man who saw it all coming
Juhani Palumaki

The Dilemma of Breast Cancer Screening

By : Kevin Pho
The American College of Obstetricians and Gynecologists (ACOG) recently released their recommendations for breast cancer screening.
Previously, they had recommended a mammogram every 1 to 2 years for women between the ages of 40 to 49.
Now, they recommend more intensive screening:
Due to the high incidence of breast cancer in the US and the potential to reduce deaths from it when caught early, The American College of Obstetricians and Gynecologists (The College) today issued new breast cancer screening guidelines that recommend mammography screening be offered annually to women beginning at age 40. Previous College guidelines recommended mammograms every one to two years starting at age 40 and annually beginning at age 50.
This contradicts the 2009 recommendation from the USPSTF, which recommended an individualized approach and against routine screening for women aged 40-49.
No wonder patients are confused.
In our society, which values tests and generally believes that earlier cancer detection is better care, the ACOG recommendations were met with media acclaim.
Gary Schwitzer, for instance, points out the bias in CNN’s reporting the guidelines, and specifically takes senior medical correspondent Elizabeth Cohen’s Tweet on the issue to task:
On many occasions that we’ve written about on this blog in recent years, CNN has demonstrated a bias in favor of screening – touting benefits, minimizing harms. Sanjay Gupta’s badgering of US Preventive Services Task Force member Lucy Marion will always stand out in my mind – and in the minds of many of who saw it – as opinionated “attack” journalism that reflects the polarization we often see in politics now creeping (leaping?) into health care and into health care journalism.
As to which guideline to believe, physicians will be divided. I suspect that physicians who practice more strict evidence-based medicine will go with the USPSTF recommendations, while gynecologists will follow their college’s more aggressive recommendations.
Although I’m a proponent of clinical guidelines, obtaining the needed consensus will be difficult. There are too many proverbial cooks in the pot, with every medical society releasing potentially conflicting recommendations and confusing both doctors and patients.
@KevinMD

Amy Winehouse's Death:Still Mystery

An autopsy on the body of Amy Winehouse revealed no cause of death Monday for the 27-year-old retro-soul singer, leaving fans and family to wait for the results of toxicology tests due in two to four weeks.

A funeral for Winehouse, who was Jewish, was likely to be held Tuesday or Wednesday.
"I can't tell you what this means to us," father Mitch Winehouse told fans gathered Monday outside her home in London's Camden district. "We're devastated and I'm speechless, but thanks for coming."
The singer's mother, Janis Winehouse, was in tears as she examined the flowers, candles, vodka bottles, flags, drawings and handwritten cards left by neighbors, fans and well-wishers. Many of the offerings expressed the same sentiment: "What a waste."
Amy Winehouse, who had last spoken to members of her team around 10 a.m. Saturday, may have been dead for several hours before she was found by security guard Andrew Morris in her home that afternoon.
"She was in her bedroom after saying she wanted to sleep and when (Morris) went to wake her, he found she wasn't breathing," Chris Goodman, her representative in Britain, told the Sun. "He called the emergency services straight away. He was very shocked.
"At this stage, no one knows how she died. She died alone in bed."
The frail singer had been getting regular doctor checkups, the Sun said, most recently the night before her death. Her family said Monday that reports their daughter had bought cocaine, ketamine and ecstasy hours before she died were "nonsense."
Though only in her 20s, Winehouse reportedly suffered from emphysema as a result of smoking cigarettes and crack cocaine.
Winehouse's last public appearance came Wednesday when she briefly joined her goddaughter, singer Dionne Bromfield, on stage at the iTunes Festival near Camden. Winehouse didn't sing, but danced and clapped and encouraged the audience to buy Bromfield's album.
An inquest into the singer's death was opened and adjourned at London's St. Pancras Coroner's Court on Monday. During the two-minute hearing, an official read out the name, birth date and address of Winehouse, described as "a divorced lady living at Camden Square NW1."
Ex-husband Blake Fielder-Civil, currently serving a 32-month jail sentence for burglary and gun possession, was "in total shock" and inconsolable upon hearing about the death, girlfriend Sarah Aspin told the Sun.
The scene at Winehouse's home had been investigated and "determined non-suspicious." In Britain, inquests are held to establish facts when a person dies violently or in unexplained circumstances. Winehouse's inquest will resume Oct. 26.
By Christie D'Zurilla, Los Angeles Times
@Edmonton Journal

یک انتقاد

    ریشه ی این مشکلات کجاست؟ چیست ریشه ی این نخوت ؟ چیست رازاین کلبی مشربی  ؟

اعتقاد من این است که کسی جرات نکرد یک بار ، صریح ، روشن ، مستدل بگوید  حرف هایت یاوه گویی است... ،جرات نکرد بگویداین رفتارها یت زننده و بچگانه است...جرات نکرد بگوید منشا این غرور ،ضعف است. جرات نکرد برملا کند پشت این ژشت دموکراسی خواهانه ،خودکامه ترین اگو نشسته است.جرات نکرد فاش بگوید ،پشت پرده ی عقلانیت معظم تو هزار کتاب نخوانده است

با کمال احترام ، این موضع برتر تو را درک نمی کنم.این تمسخربه اصطلاح فرودست و این تحقیرهمنوع  برایم قابل فهم  نیست. ...رفته رفته به میانسالی نزدیک میشوی...کمبود هایی حس می کنی   

Ramadan

Raven perched on the dusty balcony , staring at me.
Pedram

Gutted by The Bitter News

Wow

Marine researchers in South Africa had a narrow escape after a three-metre-long great white shark breached the surface of the sea and leapt into their boat, becoming trapped on deck for more than an hour.
The incident occurred while the research team was conducting a shark population study off Seal Island, near Mossel Bay, on South Africa's Cape coast.
Using sardines as bait to attract the predators, the seven-strong crew was able to observe four great whites. The animals are renowned locally for bursting through the surface as they prey on seals.
Dorien Schröder, team leader at Oceans Research, based at Mossel Bay, said that last Monday morning, after more than an hour of shark activity around the vessel, the Cheetah, the waters at the stern had been quiet for five minutes. "Next thing I know I hear a splash, and see a white shark breach out of the water from [the] side of the boat hovering, literally, over the crew member who was chumming [throwing food bait] on the port side," she said.
Schröder recounted how she pulled her colleague to safety before the shark, weighing about 500kg (half a ton) landed on top of the bait and fuel containers. At first half of its body was outside the boat but in a panic the shark thrashed its way further on to the vessel, cutting the fuel lines and damaging equipment before becoming trapped between the containers and the stern. The crew found safety at the bow of the boat.
As Schröder poured water over the shark's gills to keep it alive, another boat was sent out to the Cheetah. A rope from the second vessel was secured around the shark's tail, but repeated efforts to tow the fish into the water failed.
The rescue ship then towed Cheetah to the port with the shark still on deck. A hosepipe was placed in the fish's mouth to ventilate its gills, before it was lifted off the boat with a crane, then lowered back into the water.
Though the shark swam away it was unable to navigate its way out of the harbour and soon beached. With Oceans Research's co-director, Enrico Gennari, an expert on great white sharks, the team tried unsuccessfully to "walk" the shark back to sea. Finally they tied ropes to the shark's tail fin and behind its pectoral fin, and attached these ties to the rescue vessel, which towed the shark out through the harbour estuary. The ropes were then removed and the animal swam away.
Gennari said it was the first time he had heard of a great white shark jumping onto a research vessel. He estimated the predator would have had to have leapt about three metres out of the water to be able to land on the boat. A smaller vessel would have capsized, he said.
As for the cause of the shark's behaviour, Gennari said it was almost certainly an accident rather than an attack on the boat. In the low-visibility water the fish could have mistaken the vessel's shadow for prey, or been disturbed by another shark close by, he said.
"It's all speculation," he said. "But sometimes a shark breaches the surface when it feels another shark underneath it. They [move] like a flying fish and end up several metres away."
@Guardian
pic :A great white shark off Seal Island, South Africa. The animal on the Cheetah would have leapt three metres out of the water, scientists said. Photograph: Chris Brunskill Ltd/Rex Features

تکامل را به عروسک بازیمان راهی نیست

همان است ، عینا همان ، همان بازی بچگانه ، همان عروسک بازی.شگفتا ،سال ها،به اصطلاح بلوغ ،به اصطلاح آکادمی ، به اصطلاح تمدن،چیزی را در توتغییر نداده است.میوه ای  که گویا هر زمان بچینی طعم فساد می دهد.مشغول با همان توهمات کودکانه.احساس ابلهانه ی تملک در رگهایت می جوشد. تکامل بر علیه خود بر آشفت، به خودت واگذار کردندو چنین شد...توانستی همه چیز را با قواعد عروسک بازیت سامان بدهی ولی این یک نقطه خلا ،مغفول مانده و تا لب به سخن می گشایی،  اسرار هولناکی آشکار می شود. صادقانه بگویم کمتر رغبتی در وجودم باقی می ماند وقتی به این تقابل نامیمون با تووامثال تومی اندیشم.وقتی بیشتر حس می کنم نباید هم انتظار آسودگی داشته باشم.باید جامه ی رزم بر تن کرد،بر علیه شما قوم همواره بر حق باید جنگید.

کودک میانسال ما :به عروسک بازی خود ادامه بده.صاحب شو:هر آنچه لیاقتش را داری ...و نداری.سخن بگو :راجع هرآن چه درک می کنی ...و نمی کنی.عروسک جان ندارد . حس نمی کند.پاسخی نمی دهد،نفرتش را ابراز نمی کند،بر خلاف انسان. پدرام 28 تیر 1390

Biutiful (2010)

(Courtesy of Adelina)
a dazzling movie. It's become one of my favorites.Javier Bardem's just astonishing.Inarritu surprises again this time with a gritty biutiful ! It will be watched several times.

The Risks and Benefits of 5α-Reductase Inhibitors

Authors : Marc R. Theoret, M.D., Yang-Min Ning, M.D., Ph.D., Jenny J. Zhang, Ph.D., Robert Justice, M.D., Patricia Keegan, M.D., and Richard Pazdur, M.D.
The use of 5α-reductase inhibitors for prevention of prostate cancer continues to be widely discussed within the scientific and medical communities. Much of this discussion has been fueled by the findings of two large randomized, placebo-controlled trials — the Prostate Cancer Prevention Trial (PCPT) with finasteride and the Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial . Together, these trials showed an overall relative reduction of 23 to 25% in prostate-cancer diagnoses, a seemingly significant benefit from drugs aimed at preventing one of the most common cancers in men. However, the observed reduction resulted from a decreased incidence of only low-grade prostate cancer (Gleason score, ≤6). In fact, in both trials, there was an absolute increase in the incidence of high-grade prostate cancers in the chemoprevention group.
Evaluating the potential chemopreventive benefits of 5α-reductase inhibitors and assessing the potential increased risk for high-grade prostate cancers have been central issues for the Food and Drug Administration (FDA). There has been much hope for an FDA-approved chemopreventive agent for prostate cancer, and there is clearly ongoing off-label use of 5α-reductase inhibitors for this indication. The FDA has been actively evaluating the relevant data and held a meeting of its Oncologic Drugs Advisory Committee to address this topic in December 2010.

Both chemoprevention trials were conducted in men who were at risk for prostate cancer but did not have diagnosed prostate cancer at study entry. The FDA’s analysis of the trials confirmed that there was a relative reduction of approximately 25% in the overall incidence of prostate cancer and a significantly increased incidence of high-grade prostate cancers. During the FDA review of the REDUCE trial, we requested that biopsy specimens be reassessed, according to the modified Gleason scale, by an independent pathologist who was unaware of the earlier scores. The central pathologist for PCPT performed this reassessment. The use of modified Gleason scores is consistent with current recommendations for prostate-cancer grading and the grading system used in PCPT; modified Gleason scores were not originally reported in the REDUCE trial.
The reassessment revealed no reduction in the incidence of tumors with modified Gleason scores between 7 and 10 — a finding that was consistent with the published data. However, an absolute increase of 0.5% in the incidence of tumors with modified Gleason scores of 8 to 10 (relative risk, 2.06; 95% confidence interval [CI], 1.13 to 3.75) was observed with dutasteride treatment. This increase is similar to the absolute increase of 0.7% in the incidence of such tumors observed with finasteride treatment (relative risk, 1.70; 95% CI, 1.23 to 2.34) .These results suggest that one additional man would receive a diagnosis of high-grade prostate cancer (modified Gleason score, 8 to 10) for every 150 to 200 men treated long-term with a 5α-reductase inhibitor.

It has been suggested that detection bias, attributable to the fact that 5α-reductase inhibitors reduce serum levels of prostate-specific antigen (PSA) and prostate volume, led to an increase in detection of high-grade prostate cancer in the finasteride group of the PCPT. Indeed, the sensitivity of an elevated PSA level (a PSA level above 4 ng per milliliter in the placebo group or, in the finasteride group, above the adjusted value designed to correct for a finasteride-induced PSA reduction of approximately 50%) for the detection of prostate cancer, including high-grade tumors, was increased in the finasteride group of the PCPT. The observation that the increased risk of high-grade tumors (modified Gleason score, 8 to 10) with finasteride or dutasteride persisted in analyses of scheduled biopsies independent of PSA results argues against PSA-related detection bias as the cause of the observed increase in the incidence of high-grade tumors. Approximately 56% of all prostate cancers in the PCPT and 90% of those in the REDUCE trial were diagnosed by means of scheduled biopsies.
As for detection bias due to 5α-reductase inhibitors’ reduction of prostate volume by approximately 20%, it is possible that core needle biopsies may uncover more cancers, including high-grade tumors, in smaller prostates because of increased sampling density. Proponents of this hypothesis accounted for the intergroup difference in prostate volume either by statistically adjusting for prostate volume at the time of biopsy (using logistic-regression analysis or the Peters–Belson method) or by circumventing any potential for sampling bias by extrapolating from the Gleason scores for a subgroup of patients who had had prostatectomies to patients without prostatectomy data (weighted imputation estimation). These analyses resulted in estimates of the relative risk of high-grade prostate cancer (Gleason score, 7 to 10) in the finasteride group ranging from no increase to a relative decrease of 27%. Since conventional criteria define “high-grade” as a Gleason score of 8 to 10 and 75% of the increase in tumors with modified Gleason scores of 7 to 10 observed in the finasteride group involved tumors with a score between 8 and 10, the FDA repeated the same analyses, statistically adjusting for prostate volume and using a modified Gleason score of 8 to 10 as the definition of a high-grade tumor. The results of those analyses do not support the contention that increased sampling density is responsible for the increased incidence of high-grade tumors in the finasteride group (see table for opposing risk estimations for tumors with a modified Gleason score of 7 to 10 and those with a score of 8 to 10). Although questions concerning detection bias remain, none of the post hoc exploratory analyses provide convincing evidence that the increased incidence of high-grade disease observed in both trials can be dismissed.
Analyses of these trials indicate that the reduction in prostate-cancer risk with both drugs was limited to tumors with a modified Gleason score of 6 or lower. Prospectively collected data in REDUCE showed that 80% of such tumors met the Epstein pathological criteria for “very-low-risk” disease, which indicates that a reduction in their incidence is unlikely to be clinically significant. An analysis of biopsies performed in response to an elevated PSA level or an abnormal digital rectal examination, as would be done in clinical practice, revealed a smaller reduction in the relative risk of prostate cancer (14%; 95% CI, 4 to 23%) than that reported for all cancers in men receiving finasteride. Therefore, the trade-off inherent in using a 5α-reductase inhibitor for prostate-cancer prevention is the acceptance of one additional high-grade cancer in order to avert three to four potentially clinically relevant lower-grade cancers.

The conclusion drawn by the advisory committee in December was that finasteride and dutasteride do not have a favorable risk–benefit profile for the proposed use of chemoprevention of prostate cancer in healthy men. The FDA agrees with this assessment. The effects of finasteride or dutasteride on the incidence of metastatic prostate cancer and prostate-cancer–specific morbidity and mortality have not been evaluated.
Strategies for reducing cancer risk expose people who do not have and may never develop cancer to a drug and its potential adverse effects. In these circumstances, a high level of certainty about benefits and risks of intervention is warranted. The labels of approved 5α-reductase inhibitors, which are currently indicated for the treatment of symptomatic benign prostatic hyperplasia and male-pattern hair loss, have been modified to include the observation of high-grade prostate cancers in the relevant trials. In addition, health care professionals prescribing 5α-reductase inhibitors to men who opt for PSA screening should be aware that these agents reduce PSA values and that any increase in the PSA level above the lowest value obtained may signal the presence of prostate cancer, even if the value remains in the normal range for men not taking such an agent.

Post-Galactico Madrid Era

If there's anyone in the world who could have done with a decent summer holiday and a month-long lie-down it was José Mourinho. In May, the plot-losing Madrid manager was at war with Barcelona, UEFA, his own bosses, the Spanish FA, the Spanish League, referees and probably his own reflection if he gave himself a funny look, as the pressure of having to deliver immediate success at the Santiago Bernabeu took its toll on the Special One's suffering psyche.

That grey-haired, slouching, bleary-eyed rant-bag has been banished and replaced by an infinitely more relaxed figure, who sat in the team hotel in Los Angeles and spoke to the media for the first time since his self-imposed press exile two months ago. There was good reason for the Special One to be looking so sprightly, as Mourinho is now enjoying full control of the sales and signings at the club without having suits standing over him, tutting about marketing values or shirt sales in Singapore.
On Monday, the Real Madrid squad gathered together and headed to the UCLA campus for a second summer in a row for pre-season training and three friendly games. And as in the year before, there were no new shiny Galacticos on board the plane. Instead the new recruits for Real Madrid would barely get 80 people to their presentations, rather than the 80,000 who turned up to see Cristiano Ronaldo in 2009.

This is especially the case with 19-year-old French defender, Raphael Varane, who was signed from Lens for €10m with 'Marca' claiming that the young centre-back was the new Hierro, for lack of any other information on him. Even Michel Platini admitted that he had never heard of him in an interview with the paper.
Midfielder, Nuri Sahin, may have been the Bundesliga player of the year last season, but is hardly a household name in Spain. Free transfer, Hamit Altintop, didn't exactly set the pulses racing and nor did the purchase of former youth team player, José Callejón and his trademark wedge haircut, who joined from Espanyol.
Most money has been spent on speedy left back Fabio Coentrao, but few Madrid fans would admit to knowing that much about the former Benfica defender aside from the fact that he has bleached hair, has cost quite a lot of cash and shares the same agent as Mourinho.
The fairly low profile of the footballers reflects the control that Mourinho now has at the club with former Director General, Jorge Valdano, moved out by Florentino Pérez. Rather than Galacticos coming to the Spanish capital like Kaká, the Portuguese boss has brought in footballers he sees as being pliable team-members rather than superstars, a long way from mohican-sporting, show-boating, five sponsor-possessing Neymar for example. "We have signed players that we felt were important for completing a squad that was already very good."
Mourinho says that there is one more recruit to come over the summer in the form of a striker and the signs are that it won't be Neymar or Sergio Kun Agüero joining for €45m, despite the latter being the obsession of Florentino Pérez, but the less glamourous Emmanuel Adebayor returning for a permanent spell after a decent loan period last season. "Adebayor is better as it is closer," admitted the Madrid boss.
A second sign of the power that Mourinho now has in being able to mould the club to his own desires is the footballers that have been shunted onto the sidelines. These include Pedro León and Sergio Canales - two players brought in by Valdano that Mourinho appears to neither rate as players nor like as people - and Lassana Diarra who refused to travel to Los Angeles and instead chose to sulk in Madrid and wait for a move to the Premier League.

'Cantera' players such as Pablo Sarabia and Juan Carlos have been sold to Getafe and Zaragoza respectively, rather than being moved into the first team as Barcelona might have done. Mourinho still has little sentimentality when it comes to hiring and firing his players and feels no obligation to promote youth teamers no matter how much supporters and the press grumble when comparing Madrid's youth policy to La Masia.
Another former youth-teamer, Dani Parejo - a footballer that Alfredo Stefano thought was one of the best he had ever seen - was allowed to move from Getafe to Valencia after Mourinho decided not to activate the buy-back clause on the U-21 international.
The former Chelsea man appears to have succeeded where so many have failed, in turning Florentino Pérez away from the Galactico policy of 'Zidanes and Pavones' to a much more balanced way of doing business. While Zinedine Zidane has become Madrid's Sporting Director - although the role is not yet clearly defined - it is obvious who is wearing the trousers in this relationship.
Indeed, Real Madrid may even make money this summer if Kun and Neymar are passed over with the resale value of the transferable Diarra, Fernando Gago, Léon, Canales and Royston Drenthe potentially being greater than the current outlay of €55m.
However, this more modest strategy of Mourinho could all change if Barcelona manage the double whammy deal of bringing in Cesc Fabregas and Alexis Sánchez to strengthen for the season ahead. At this point Florentino Pérez may begin to panic and revert to default mode by bringing in a big name, against Mourinho's wishes. But until this moment comes, Real Madrid is becoming a Galactico-free zone as Mourinho begins to take complete control of the club.
By Tim Stannard
@Football365

The Adjustment Bureau(2011)

Written and Directed by George Nolfi
Starring : Matt Damon,Emily Blunt
I liked the concept .

In a Stew

A piece of bread which tastes nonexistence.
Pic : James Nachteway/Magnum:Famine victims received rehydration salts and food from volunteer aid workers

My Album of The Month (June 2011)

If you'd asked , i'd definitely say it was Gavin Hayes' voice , lurking in my ears all these long days.
Two thumbs up Dredg , Two Thumbs up "The Pariah, the Parrot, the Delusion".Their fantastic concept album is a fair mix of Progressive Rock and experimental music .Gavin Hayes' vocal's adorable.

ADT for Prostate Cancer

In the 1990s, reversible androgen suppression with the use of luteinizing hormone–releasing hormone analogues and oral antiandrogen agents was shown to induce apoptotic regression in androgen-responsive cancers, potentially improving the prospects of local control and the duration of survival free of metastatic disease.
Clinical Pearls

How can short-term androgen deprivation be achieved?
In this study, patients assigned to short-term androgen-deprivation therapy (ADT) received flutamide at a dose of 250 mg orally three times a day and either monthly subcutaneous goserelin at a dose of 3.6 mg or intramuscular leuprolide at a dose of 7.5 mg for 4 months.
How more effective was ADT with radiotherapy as compared to radiotherapy alone for patients with localized prostate cancer in this study?
According to the results of this study, the 10-year rate of overall survival was 62% among patients receiving radiotherapy plus short-term ADT (the combined-therapy group) versus 57% among patients receiving radiotherapy alone (hazard ratio for death with radiotherapy alone, 1.17; P=0.03). The addition of short-term ADT was associated with a decrease in the 10-year disease-specific mortality from 8% to 4% (hazard ratio for radiotherapy alone, 1.87; P=0.001).
Morning Report Questions
Q. Which group of patients benefited the most from ADT in this study?
A. The addition of short-term ADT to radiotherapy conferred the greatest clinical benefit in the intermediate-risk subgroup, with an increase in the 10-year rate of overall survival from 54 to 61% and a reduction in the 10-year disease-specific mortality from 10 to 3%.
Q. What are adverse effects of ADT?
A. In prospective studies, short-term ADT caused measurable muscle loss, fat accumulation, decreased insulin sensitivity, and increased cholesterol and triglyceride levels.
@NEJM

This Crazy Summer

Is he coming?

Business and Healthcare;Entrepreneurship Joints?

Part-maverick, part-unconventional, part-smart business owner Sir Richard Branson has business lessons to share in spades. Since I recently read his third autobiographical book Business Stripped Bare: Adventures of a Global Entrepreneur, I wanted to pass on some of what I learned from the book.

Without knowing exactly why, I have long admired his acumen and chutzpah. His story has provided me insights into why I’ve been so drawn to his adventures in business and his larger-than-life personality.
For those of you who don’t know much about him, Branson is the product of a somewhat privileged middle-class upbringing (he descends from a line of barristers and judges) and an English public school (what we in the US call a private school). A self-proclaimed poor student with dyslexia, he failed to complete any college degree, but opted instead to start a business, first as a magazine publisher and then as a mail-order record company owner. He went on to found Virgin Records, and this single venture expanded over the decades to become the Virgin Group, a conglomerate of businesses focused on travel (planes, trains, space travel), entertainment and lifestyle (including humanitarian ventures like fighting HIV, AIDS and climate change).
I came away with many business lessons. Here are a few.
Branson’s business philosophy is crystallized in these words, when asked why he went into business:
I’ve never been interested in being ‘in business’. I’ve been interested in creating things … Business is creative. It’s like painting. You start with a blank canvas. You can paint anything – anything – right there, is your first problem. For every good painting you might turn out, there are a zillion bad paintings just aching to drip off your brush. Scared? You should be. You start. You pick a color. The next color you pick has to work with the first color … People who succeed in business have swallowed their fear and have set out to create something special, something to make a difference to people’s lives …
Lesson: To thrive in business, it really helps to be passionate about creating something worthwhile. As a relative newcomer to entrepreneurship, I have maintained for years now that being an entrepreneur is a radical act of creativity, and it makes an every day “practice” so much more fun once you think of it as an entrepreneurial venture.
His fiercely independent path to success, in the face of rampant naysayers and critics, is both inspirational and hard to imagine duplicating. His gut instincts have won out many times over the analytics and pompous prognostications of others. He’s a master as staying on course with his vision and sense of purpose and ignoring the conventional wisdom.
I’m not good at theory. Almost everything I’ve learned, I’ve learned by doing.
Lesson: While you may draw insight and inspiration from someone else’s success story, you must rely on knowledge about your own marketplace, along with your inner talents and skills, to forge your own path.
Branson has been driven by the desire to innovate, partly I suspect because it’s in his genetic make-up and partly because he has been an astute observer of his own ecosystem’s evolution.
The best, most solid way out of a crisis in a changing market is through experimentation and adaptation.
Lesson: Healthcare is in crisis and the market is changing. It’s vital that we, as providers in an unstable setting, experiment and adapt. New business models? New levels of customer service? New joint ventures, relationships, partnerships?
His two greatest secrets of business success, in my opinion?
1. His relentless focus on the Virgin brand, along with his absolute clarity about what the brand stands for.
2. His dogged insistence on placing the people who work for him first. Wouldn’t that be nice, in healthcare?
by Philippa Kennealy, MD, MPH

Listening To Lovers In Japan !

Lovers, keep on the road your on

Runners, until the race is run

Soldiers, you've got to soldier on

Sometimes even right is wrong

They are turning my head out

To see what I'm all about

Keeping my head down

To see what it feels like now

But I have no doubt

One day, were gonna get out

Tonight, maybe we're gonna run

Dreaming of the Osaka sun

Ohh, ohh, ohhh

Dreaming of when the morning comes

They are turning my head out

To see what I'm all about

Keeping my head down

To see what it feels like now

But I have no doubt

One day, the sun will come out

Truly amazing song ;p.

Pic : Martin Buzora

It's The Month of July

Today was the day of a fierce tete-a-tete.I'm gonna fight till the very end.Pedram,July 11 2011

Off To US

My Author of The Month (June 2011)

How i feel his vigorous presence in my life

With Love

Ghost of perdition deflowered plenty of innocent souls

Pedram

An Engrossing Picture

Fortunately i managed a pretty succinct schedule to watch some underrated and out of the spotlight movies in the last 2 weeks.Special thanks to my friend Amir who earnestly suggests and shares the most matched .
Here is a brief note on one of the most thrilling experiences i had in recent months.
Red,White and Blue 2010
Written and directed by Simon Rumley
First of all i had not heard about Simon Rumley ; that zero expectance made the apporoach more fascinating :)
Movie info according to Rottentomatoes:
"Red, White and Blue is a powerful, visceral and oddly touching thriller/slash movie. It's also very sophisticated storytelling with temporal shifts and three protagonist characters who function as both the killer and the prey.Erica  is a tough, troubled nymphomaniac with wounds across her soul. For Erica, sleeping with multiple men forms the core of her life, until she meets the mysterious Iraq vet Nate .Despite his quiet air of danger, Nate's the only guy who doesn't immediately want to sleep with her, and the two form a hesitant bond. But in a shocking twist, one of Erica's earlier sexual encounters, with wannabe rock star Franki , will have unexpected - and devastating - consequences on both of their lives. Hard-edged and uncompromising, the film has already been compared to the works of such disparate filmmakers as Larry Clark and Sam Peckinpah. "
i believe the movie , a brutal americana is a polished image of violence and its cursed cycle. Three protagonists' unsavory characters are masterfully executed in a 102 min run.
Beware:i have to agree with David Lewis of San Francisco Chronicle: the movie is certainly going to leave some squeamish !
Pedram
pic : Amanda Fuller , Marc Senter , Noah Taylor

Assault on Democracy

Hugo Chávez has long considered Noam Chomsky one of his best friends in the west. He has basked in the renowned scholar's praise for Venezuela's socialist revolution and echoed his denunciations of US imperialism.

Venezuela's president, who hasrevealed that he has had surgery in Cuba to remove a cancerous tumour, turned one of Chomsky's books into an overnight bestseller after brandishing it during a UN speech. He hosted Chomsky in Caracas with smiles and pomp. Earlier this year Chávez even suggested Washington make Chomsky the US ambassador to Venezuela.
The president may be about to have second thoughts about that, because his favourite intellectual has now turned his guns on Chávez.
Speaking to the Observer last week, Chomsky has accused the socialist leader of amassing too much power and of making an "assault" on Venezuela's democracy.
"Concentration of executive power, unless it's very temporary and for specific circumstances, such as fighting world war two, is an assault on democracy. You can debate whether [Venezuela's] circumstances require it: internal circumstances and the external threat of attack, that's a legitimate debate. But my own judgment in that debate is that it does not."
Chomsky, a linguistics professor at Massachusetts Institute of Technology, spoke on the eve of publishing an open letter  that accuses Venezuela's authorities of "cruelty" in the case of a jailed judge.
The self-described libertarian socialist says the plight of María Lourdes Afiuni is a "glaring exception" in a time of worldwide cries for freedom. He urges Chávez to release her in "a gesture of clemency" for the sake of justice and human rights.
Chomsky reveals he has lobbied Venezuela's government behind the scenes since late last year after being approached by the Carr centre for human rights policy at Harvard University. Afiuni earned Chávez's ire in December 2009 by freeing Eligio Cedeño, a prominent banker facing corruption charges. Cedeño promptly fled the country.
In a televised broadcast the president, who had taken a close interest in the case, called the judge a criminal and demanded she be jailed for 30 years. "That judge has to pay for what she has done."
Afiuni, 47, a single mother with cancer, spent just over a year in jail, where she was assaulted by other prisoners. In January, authorities softened her confinement to house arrest pending trial for corruption, which she denies.
"Judge Afiuni has suffered enough," states Chomsky's letter. "She has been subject to acts of violence and humiliations to undermine her human dignity. I am convinced that she must be set free."
Amnesty International and the European parliament, among others, have condemned the judge's treatment but the intervention of a scholar considered a friend of the Bolivarian revolution, which is named after the hero of Venezuelan independence, Simón Bolívar, is likely to sting even more.
Speaking from his home in Boston, Chomsky said Chávez, who has been in power for 12 years, appeared to have intimidated the judicial system. "I'm sceptical that [Afiuni] could receive a fair trial. It's striking that, as far as I understand, other judges have not come out in support of her … that suggests an atmosphere of intimidation."
He also faulted Chávez for adopting enabling powers to circumvent the national assembly. "Anywhere in Latin America there is a potential threat of the pathology of caudillismo [authoritarianism] and it has to be guarded against. Whether it's over too far in that direction in Venezuela I'm not sure, but I think perhaps it is. A trend has developed towards the centralisation of power in the executive which I don't think is a healthy development."
Chomsky expressed concern over Chávez's cancer and wished the president a full and prompt recovery.
Chomsky's book Hegemony or Survival: America's Quest for Global Dominance became a publishing sensation after Chávez waved a copy during a UN address in 2006 famous for his denunciation of President George W Bush as a devil.
Its author remains fiercely critical of the US, which he said had tortured Bradley Manning, alleged source of the diplomatic cables exposed by WikiLeaks, and continued to wage a "vicious, unremitting" campaign against Venezuela.
The Chávez government deserved credit for sharply reducing poverty and for its policies of promoting self-governing communities and Latin American unity, Chomsky said. "It's hard to judge how successful they are, but if they are successful they would be seeds of a better world."
Leonardo Vivas, co-ordinator of Latin American initiatives at the Carr Centre, said that Afiuni's case was the most prominent example of the erosion of justice in several Latin American countries. The centre hoped that Caracas would now heed Chomsky.
"He is one of the most important public intellectuals in the US and is respected by the Venezuelan government."
The decision to lobby publicly was taken because quiet diplomacy had limits, said Vivas.
Chávez, who is convalescing in Cuba, has a reputation for lashing back at criticism, raising the risk that the Afiuni initative could backfire.
"That could happen," said Vivas. "But that would mean recognition of the problem."








Chomsky's letter


Judge María Lourdes Afiuni has suffered enough
With this public letter I want to express my open support of the liberty of judge María Lourdes Afiuni, detained in Venezuela since December 2009. In November of last year I was informed of her situation by the Latin American initiative of the Carr Centre for human rights policy at Harvard University. Ever since, I have been directly involved in mediation efforts with the Venezuelan government, with the purpose of releasing her from prison through a gesture of clemency by President Chávez.
Judge Afiuni had my sympathy and solidarity from the very beginning. The way she was detained, the inadequate conditions of her imprisonment, the degrading treatment she suffered in the Instituto Nacional de Orientación Femenina, the dramatic erosion of her health and the cruelty displayed against her, all duly documented, left me greatly worried about her physical and psychological wellbeing, as well as about her personal safety.
Those reasons motivated me in December 2010 to address, jointly with the Carr Centre, a petition for an official pardon from the president in the context of the yearly presidential amnesties.
In January I received with relief the news that Venezuela's attorney general had suggested house arrest for judge Afiuni given her fragile health condition, which ended up with emergency surgery. Being in her house with her family and with adequate medical attention has been without doubt a significant improvement of her situation.
However, judge Afiuni has suffered enough. She has been subject to acts of violence and humiliations to undermine her human dignity. I am convinced that she must be set free, not only due to her physical and psychological health conditions, but in conformance with the human dignity the Bolivarian revolution presents as a goal. In times of worldwide cries for freedom, the detention of María Lourdes Afiuni stands out as a glaring exception that should be remedied quickly, for the sake of justice and human rights generally and for affirming an honourable role for Venezuela in these struggles.
For the above reasons I want Venezuelans to be aware of my total solidarity with judge Afiuni, while I affirm my unwavering commitment with the efforts advanced by the Carr Centre in Harvard University to release her from imprisonment. At the same time, I shall keep high hopes that President Chávez will consider a humanitarian act that will end the judge's detention.
@Guardian
Pic : Maria Lourdes Afiuni

Sun Day

It's inside of me.

it's what I want to be.

It's inside of me,

and it's clear to see.

You're my heart.

You're my heart.

You're my heart.

You're my heart.

It's inside of me.

It's what I'll always be.

It's inside of me,

and it's clear to see.

You're my heart.

You're my heart.

You're my heart.

You're my heart.

You're my heart.

You're my heart.

You're my heart.

You're my heart.

You're my heart.

my...