Explore the vast range of titles available.

'Speaking with Skill' marks a fundamental change in the pedagogy of speech training for actors and speakers. The method employed is already and increasingly being used by instructors on major actor training programs in the United States, Canada, Australia, Ireland and the UK.

BETWEEN THE LARYNX AND THE LIPS, SOUND BECOMES SPEECH

Prominent suspected traffickers who have sought refuge in Venezuela include three Colombian members of the North Valley cartel who are on the FBI's 10 Most Wanted list, three U.S. and Colombian counter-drug officials have told The Miami Herald. They are Wilber Varela, nicknamed Soap; Juan Carlos Ramirez-Abadia, also known as Lollipop; and Diego Montoya, alias Don Diego. The FBI is offering up to $5 million for information leading to the capture of any of the three.

One inmate who didn't identify himself told local television that the guards stopped the initial fight and removed one of the brawlers only to return him to the cellblock later, causing a second fight to ensue. Another inmate who survived the fire told a Dominican journalist that the guards blocked their exit from the cellblock during the fire. The Vietnam cellblock alone housed close to 150 inmates, authorities said. The cellblock got its name from the repeated conflicts that have occurred between inmates there.

Norplant was recently added to Alberta Health's drug benefit list, after the implant received federal approval in March. Alberta is the first province to do so. It is also among drugs funded for welfare recipients. ``The drug in Norplant is also in Triphasil, the most prescribed brand of oral contraception. One in three women in Canada use it,'' he said, adding: ``Norplant is a new system for an old drug.'' While the Alberta Status of Women and the Women's Collective Resource Centre welcomed another choice for contraception, they fear welfare recipients could be forced to get the implant in order to receive funding -- a notion dismissed by Alberta Social Services.

Treatment decision-making can be difficult and complex for patients with low-risk prostate cancer. To the authors' knowledge, there is no consensus regarding an optimal treatment strategy and the choice of therapy involves tradeoffs between differing harms and benefits that are sensitive to patient values. In such situations, patients are often asked to participate actively in the decision-making process, and high-quality decisions require a well-informed patient whose values and preferences have been taken into consideration. Prior studies have indicated that patients have poor knowledge and unrealistic expectations regarding treatment, and physician judgments concerning patient preferences are often inaccurate. Decision aids (DAs) have been developed to help inform patients with low-risk prostate cancer about treatment options and assist in the decision-making process; however, little is currently known regarding the effects of such programs in this population. Thirteen studies of DAs for patients with prostate cancer were reviewed and it was found that the use of DAs can improve knowledge, encourage more active patient involvement in decision-making, and decrease levels of anxiety and distress. The effect of DAs on treatment choice was less clear, although fewer patients chose surgery compared with historical controls, particularly in Europe. Further studies are needed to determine how best to implement DAs into practice, and whether they improve the consistency between patient preferences and treatment choice. [PUBLICATION ABSTRACT]

Abstract Background Despite advances in medical therapy, many children and adults with ileal Crohn’s disease (CD) progress to fibrostenosis requiring surgery. We aimed to identify MRI and circulating biomarkers associated with the need for surgical management. Methods This prospective, multicenter study included pediatric and adult CD cases undergoing ileal resection and CD controls receiving medical therapy. Noncontrast research MRI examinations measured bowel wall 3-dimensional magnetization transfer ratio normalized to skeletal muscle (normalized 3D MTR), modified Look-Locker inversion recovery (MOLLI) T1 relaxation, intravoxel incoherent motion (IVIM) diffusion-weighted imaging metrics, and the simplified magnetic resonance index of activity (sMaRIA). Circulating biomarkers were measured on the same day as the research MRI and included CD64, extracellular matrix protein 1 (ECM1), and granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies (Ab). Associations between MRI and circulating biomarkers and need for ileal resection were tested using univariate and multivariable LASSO regression. Results Our study sample included 50 patients with CD undergoing ileal resection and 83 patients with CD receiving medical therapy; mean participant age was 23.9 ± 13.1 years. Disease duration and treatment exposures did not vary between the groups. Univariate biomarker associations with ileal resection included log GM-CSF Ab (odds ratio [OR], 2.87; P = .0009), normalized 3D MTR (OR, 1.05; P = .002), log MOLLI T1 (OR, 0.01; P = .02), log IVIM perfusion fraction (f; OR, 0.38; P = .04), and IVIM apparent diffusion coefficient (ADC; OR, 0.3; P = .001). The multivariable model for surgery based upon corrected Akaike information criterion included age (OR, 1.03; P = .29), BMI (OR, 0.91; P = .09), log GM-CSF Ab (OR, 3.37; P = .01), normalized 3D MTR (OR, 1.07; P = .007), sMaRIA (OR, 1.14; P = .61), luminal narrowing (OR, 10.19; P = .003), log C-reactive protein (normalized; OR, 2.75; P = .10), and hematocrit (OR, 0.90; P = .13). Conclusion After accounting for clinical and MRI measures of severity, normalized 3D MTR and GM-CSF Ab are associated with the need for surgery in ileal CD. Lay Summary Despite advances in medical therapy, many patients with ileal Crohn’s disease progress to fibrostenosis requiring surgery. Our study has shown that GM-CSF autoantibodies and MRI biomarker sequences are associated with the need for ileal resection and may help guide management decisions.

We previously identified circulating and MRI biomarkers associated with the surgical management of Crohn's disease (CD). Here we tested associations between these biomarkers and ileal resection inflammation and collagen content. Fifty CD patients undergoing ileal resection were prospectively enrolled at 4 centers. Circulating CD64, extracellular matrix protein 1 (ECM1), GM-CSF autoantibodies (GM-CSF Ab), and fecal calprotectin were measured by ELISA. Ileal 3-dimensional magnetization transfer ratio (3D MTR), modified Look-Locker inversion recovery (MOLLI) T1 relaxation, diffusion-weighted intravoxel incoherent motion (IVIM), and the simplified magnetic resonance index of activity (sMaRIA) were measured by MRI. Ileal resection specimen acute inflammation was graded, and collagen content was measured quantitatively using second harmonic imaging microscopy. Associations between biomarkers and ileal collagen content were tested. Median (interquartile range [IQR]) age was 19.5 (16-33) years. We observed an inverse relationship between ileal acute inflammation and collagen content (r = -0.39 [95% confidence interval {CI}: -0.61, -0.10], P = .008). Most patients (33 [66%]) received biologics, with no variation in collagen content with treatment exposures. In the univariate analysis, CD64, GM-CSF Ab, fecal calprotectin, and sMaRIA were positively associated with acute inflammation and negatively associated with collagen content (P < .1). The multivariable model for ileal collagen content (R2 = 0.31 [95% CI: 0.11, 0.52]) included log CD64 (β = -.27; P = .19), log ECM1 (β = .47; P = .06), log GM-CSF Ab (β = -.15; P = .01), IVIM f (β = .29, P = .10), and IVIM D* (β = 1.69, P = .13). Clinically available and exploratory circulating and MRI biomarkers are associated with the degree of inflammation versus fibrosis in CD ileal resections. With further validation, these biomarkers may be used to guide medical and surgical decision-making for refractory CD.

This month NASA learned a little more about the human race's chances on Mars with the successful landing of Spirit, the six- wheeled Mars rover. Giant airbags protected the spacecraft as it hit Mars and then deflated as planned, allowing a clear view for photographs. Spirit's high-gain antenna, a lollipop-shaped gizmo that can send data directly back to Earth, required a little tweaking to get a clear view of the planet, but soon began beaming black-and-white pictures to NASA to furious and relieved applause. \"The biggest showstoppers, I think, for Mars are understanding human physiology and learning to do something about it for long trips,\" says Mike Duke, who had been the chief scientist in NASA's exploration office. People have spent more than 14 months in orbit on space stations. A round trip to Mars would take 18 to 30 months.