williamaveryhudson

Just got back from a week-long visit to University of Toronto and environs. A good city.

One caution - these are not pure vegan eateries, so purists will need to search onward. I’m not even a vegetarian yet!

Fresh
326 Bloor Street West (and other locations)
freshrestaurants.ca
Sampled: Blue Thrill, Deluxe Burger w/Sweet Fries, Thai Burger, Ayurvedic Bowl, Middle Eastern Plate, Bean Burrito, Fudge Cake, Blueberry Pie

fressen
478 Queen Street West
www.fressen.com
Sampled: Tabouli, Beet Salad, Jicima Salad, Skinny Linguine, Chocolate Terrine

Magic Oven
6 Wellesley Street West (and other locations)
www.magicoven.com

Rice Bar
319 Augusta Avenue
www.ricebar.ca
Sampled: Surfer’s Supper w/Tofu

Siddhartha Pure Vegetarian Cuisine
1411 Gerrard Street East
Toronto Life listing
Sampled: Bhel Poori, Masala Dosa

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

vegan-friendly restaurants toronto

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Vickers AJ, Scardino PT. The clinically-integrated randomized trial: proposed novel method for conducting large trials at low cost. Trials. 2009 Mar 5;10:14. PMID: 19265515.

Andrew Vickers and Peter Scardino, of Memorial Sloan-Kettering Cancer Center, propose a new method of conducting large clinical trials - the clinically integrated clinical trial.

What is a clinically integrated clinical trial? An extended quote from the discussion gives a general idea:

“We propose to integrate randomized trials and routine clinical practice, a design we term the “clinically-integrated randomized trial”. The key principle is that the clinical experience of the patient and doctor is virtually indistinguishable whether or not the patient is randomized. Trial patients go through informed consent procedures, and certain aspects of care, such as modifications to the surgical technique used, are determined by randomization rather than being at the discretion of the doctor. Otherwise, there are no obvious differences between the clinical care, follow-up, payment and documentation requirements between patients who do and do not participate in the trial. Integration of a randomized trial into routine clinical practice also implies that randomization itself is routine, in other words, there should be an attempt to randomize every patient. A corollary is that eligibility criteria need to be minimized. The only eligibility criterion should be that the doctor is uncertain about which of the treatments in the trial would be best for the patient, the ‘uncertainty principle.’”

Scardino is a surgical oncologist specializing in prostate cancer, and the article offers a detailed hypothetical example of a clinically integrated clinical trial in surgery for prostate cancer. Briefer examples involve “me-too drugs,” rare diseases, and lifestyle interventions.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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The UN Global Compact has set a date for its 2010 summit.

24-25 June 2010
New York, USA

“A triennial gathering of the top executives of all Global Compact participants and other stakeholders. The Leaders Summit represents a unique opportunity for Global Compact participants to discuss the Global Compact and corporate citizenship at the highest level, and to produce strategic recommendations and action imperatives related to the future evolution of the initiative.”

More information on agenda and registration to follow.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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Long C, Li S, Long B, Shi Y, Liu B. Medicinal plants used by the Yi ethnic group: a case study in central Yunnan. J Ethnobiol Ethnomed. 2009 Apr 23;5:13. PMID: 19389251

Researchers at Chinese Academy of Sciences, Minzu University of China, Yunnan Agricultural University, and Chuxiong Research Institute of Yi Medicine and Pharmacology inventoried traditional Yi medicinal plants in Chuxiong, central Yunnan Province, Southwest China. From the results:

“One hundred sixteen medicinal plant species were found to be useful by the local people in the treatment of various diseases or disorders, especially those relating to trauma, gastrointestinal disorders and the common cold. Among these 116 species, 25 species (21.55%) were found to have new curative effects and 40 species (34.48%) were recorded for their new preparation methods; 55 different species were used in treating wounds and fractures, and 47 were used to treat gastrointestinal disorders. Traditional Yi herbal medicines are characterized by their numerous quantities of herbaceous plants and their common preparation with alcohol.”

Speaking of alcohol:

“Traditional Yi medicine is especially characterized by its use of alcohol. The Yi people adore alcohol, and it has come to symbolically represent this cultural minority due to its significance in their lives. Home-made alcohol is the most important beverage for the Yi: it is used daily, for ceremonies and holidays, served to respected guests and friends, and is the most common method of administering plant medicines. The practice of combining plants and alcohol has a long history in Yi medicine.”

The authors are motivated by a desire to preserve “indigenous knowledge, and folk knowledge in particular,” which “continues to be impacted by mainstream culture and decreasing biodiversity; traditional practices using specific medicinal plants decreases more quickly than that of the general biodiversity. It is thus urgent and necessary to prevent the further loss of the specialized knowledge of minority peoples.”

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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Idowu OE, Idowu MA. Environmental causes of childhood brain tumours. Afr Health Sci. 2008 Mar;8(1):1-4. PubMed PMID: 19357723

Something new in the world, and not welcome. From the summary:

“Brain tumours hitherto said to be rare in Africans are now known to be common. They cause considerable concern due to their relatively high morbidity, mortality and enormous cost of care, especially in the developing world.”

No likely causes are verified. Investigation most warranted.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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This year I’m focusing on Tumor Biology and Human Genetics, with close attention to molecular diagnostics.

Lots of abstracts look promising, including these:

CANCER GENETICS
Comen EA, Lautenberger J, McGee K et al. (Memorial Sloan-Kettering Cancer Center, National Cancer Institute.)
Use of genome-wide scan in women with breast cancer to identify common germline variants that may be associated with recurrence.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11049).
Conclusions: “Genome-wide SNP genotyping of women with breast cancer identified two novel loci that may be associated with disease recurrence. Further studies in larger cohorts will be performed to replicate these findings.”
Read the ASCO abstract.

Geier LJ, Sheehan M, Elia M et al. (Kansas City Cancer Center.)
The oncologist as genetic consultant: Two-year results in a large community-based practice.
J Clin Oncol 27, 2009 (suppl; abstr e22140)
Conclusions: “This oncologist-centered model proved to be very effective in identifying mutation carriers, particularly among cancer survivors in whom the hereditary syndrome had been previously overlooked. Acceptance of this approach by pts, physicians, and payers has been extremely high. This model should be considered by oncology practices wanting to add GCRA to their service lines.”
Read the ASCO abstract.

EPIDEMIOLOGY/MOLECULAR EPIDEMIOLOGY
Cheung WY, Zhai R, Kulke M et al. (University of Toronto, Harvard School of Public Health, Dana-Farber Cancer Institute, Massachusetts General Hospital, Princess Margaret Hospital.)
Epidermal growth factor (EGF) gene polymorphism, gastroesophageal reflux disease (GERD), and esophageal adenocarcinoma (EAC) risk.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11029)
Conclusions: “EGF A61G polymorphism exerts its effect on EAC susceptibility through an interaction with GERD. Performing EGF genotyping for patients with severe or longstanding GERD can help to identify individuals at the greatest risk of EAC.”
Read the ASCO abstract.

IMMUNOBIOLOGY
Busse A, Asemissen A, Schmittel A et al. (Charité-CBF, Charité-CBF/CCM.)
Immune self-tuning in renal cell carcinoma patients.
J Clin Oncol 27, 2009 (suppl; abstr e22069)
Conclusions: “RCC caused an immune-suppressive phenotype in PBMC characterized by increased mRNA expression levels of IL10 and TGFβ. Surprisingly, in contrast to IL10, a high TGFβ mRNA expression level was an independent good prognostic factor. Whether this observation can be attributed to recently described immune promoting functions of TGFβ needs to be determined.”
Read the ASCO abstract.

MOLECULAR DIAGNOSTICS & STAGING
Tobin D, Bårdsen K, Kauczynska M et al. (Bhagawan Mahavir Jain Hospital; Shrey Hospital Private Ltd; SP Medical College; Dr. Kamakshi Memorial Hospital; Department of Genetics, Radium-Riskhospitalet; Mercy Health Center.
Performance of a blood-based gene-expression test, BCtect, for early breast cancer detection.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11012)
Conclusions: “The blood based gene expression test showed similar diagnostic performance between women with early and late stage BC, and the test was independent of the subject’s BMI and menopausal status suggesting broad applicability of the test and indicating its clinical potential in younger women where mammography is of less value due to dense breast tissue. No correlation with lesion size was seen suggesting the lower limit of detection is below 8mm.”
Read the ASCO abstract.

Müller BM, Kronenwett R, Hennig G et al. (Charité Hospital; Siemens Healthcare Diagnostics; University Hospital.)
Quantitative determination of predictive cancer biomarkers in formalin-fixed, paraffin-embedded tissue using a new, fully automated method for RNA isolation.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11032)
Conclusions: “This novel RNA extraction method is a major technical improvement for implementation of reproducible, high-throughput and cost-efficient testing of cancer biomarkers in the clinical routine and in gene-expression research studies using archived FFPE material in molecular labs.”
Read the ASCO abstract.

Rosenwald S, Gibori H, Gilad S et al. (Rosetta Genomics; Sheba Medical Center; NYU School of Medicine; Rabin Medical Center.)
Identification of tumor tissue origin by a microRNA-based molecular assay.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11036)
Conclusions: “Previous studies highlighted the tissue-specificity of microRNA expression. We developed this potential into a diagnostic assay that identifies tumor origins with high accuracy. This assay provides an important new tool for diagnosing tumor tissue origin.”
Read the ASCO abstract.

Lebanony D, Benjamin H, Gilad S et al. (Rosetta Genomics; NYU School of Medicine; Rabin Medical Center.)
MicroRNA-based assay for differential diagnosis of squamous from non-squamous non-small cell lung carcinoma.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11069)
Conclusions: “MicroRNAs are becoming an important tool for classification of cancers. A diagnostic assay based on the specificity of a single microRNA accurately identifies squamous from non-squamous NSCLC. This assay provides an important new tool for the classification of NSCLC.”
Read the ASCO abstract.

Greco FA, Spigel DR, Yardley DA et al. (Sarah Cannon Research Institute; bioTheranostics.)
Unknown primary cancer (UPC): Accuracy of tissue of origin prediction by molecular profiling.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11070)
Conclusions: “RT-PCR performed on FFPE initial diagnostic tissue was accurate in predicting the primary site of origin in 11 of 16 pts with UPC who eventually had their primary site identified clinically. These data provide a direct validation of the reliability of this RT-PCR assay in predicting the primary site in pts with UPC. When used in concert with clinical features and IHC stains, molecular profiling may provide the basis for more successful site-directed therapy for many of these pts. Prospective studies of RT-PCR in UPC are ongoing.”
Read the ASCO abstract.

PROGNOSTIC FACTORS
Pachmann K, Camara O, Runnebaum IB et al. (Clinic for Internal Medicine II; University Hospital Friedrich Schiller University.)
Gauging the response of circulating epithelial tumor cells (CETC) and tumor stem cell subpopulations to therapy of early-stage cancer in the individual patient.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11026).
Conclusions: “CETC and subpopulation monitoring provides an invaluable tool for prompt gauging of systemic therapy in early stage solid tumors as a tool for therapy guidance and optimal personalized therapies to improve therapy results and spare unnecessary treatments.”
Read the ASCO abstract.

Mook S, Schmidt MK, van de Velde AO et al. (Netherlands Cancer Institute; Comprehensive Cancer Center Amsterdam (IKA); University of Texas.)
Validation of the web-based tool Adjuvant! in 5,381 Dutch breast cancer patients.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11090)
Conclusions: “Adjuvant! accurately predicts 10-year OS for common tumor types in this first large scale European validation study and is of use for adjuvant treatment-decision making.”
Read the ASCO abstract.

TUMOR & CELL BIOLOGY
Kalinsky K, Jacks LM, Hedvat C et al. (Memorial Sloan-Kettering Cancer Center).
Use of multiplex mutation genotyping to identify novel and protective mutations in breast cancer.
J Clin Oncol 27:15s, 2009 (suppl; abstr 11004)
Conclusions: “We have recently defined the positive prognostic significance of PIK3CA mutations in breast cancer. RAS mutations are confirmed to occur rarely in breast cancer. The finding of RET mutations in breast cancer is novel. Future tumor biomarker identification directed towards predictive measurement will assist in tailoring therapy to appropriate patient populations.”
Read the ASCO abstract.

Tsai C, Chen T, Chang K, Hsiao S. (Taipei Veterans General Hospital; Taipei-Veterans General Hospital.)
Combination effects of gefitinib plus cisplatin in non-small cell lung cancer (NSCLC): Why have phase III trials failed?
J Clin Oncol 27:15s, 2009 (suppl; abstr 11022)
Conclusions: “In NSCLC cells, combination of GC showed antagonistic interaction likely because gefitinib interfered with cisplatin cell entry. Three-drug combination PCG was not better than two-drug combination PC or PG in either EGFR wild type or mutant cells. Clinically, simultaneously combined EGFR TKI with platinum in NSCLC should be avoided regardless of EGFR mutation status.”
Read the ASCO abstract.

Kaiser T, Klein G, Solomayer E et al. (Department of Obstetrics and Gynecology; Center for Medical Research.)
Interactions of breast cancer cells with the microenvironment of the human bone marrow.
J Clin Oncol 27, 2009 (suppl; abstr e22097)
Conclusions: “These data indicate that the crosstalk with osteoblasts affects both the adhesive and the migratory ability of BrCa cells favoring the bone colonization process. Furthermore, the presented experimental conditions may provide useful tools to study effects of antiresorptive drugs like bisphosphonates to improve therapeutic strategies for treatment metastatic bone disease.”
Read the ASCO abstract.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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oncology molecular diagnostics

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Pietropaolo V. In the face of cancer. CMAJ. 2009 Mar 17;180(6):645-6. PMID: 19289813

Photosensitive, a collective of photographers using photography as a vehicle for social change, and the Canadian Cancer Society cosponsored this online gallery and traveling exhibition of more than 400 photographs (and growing) of people with cancer.

From the review by Vincenzo Pietropaolo:

“The photographs are mostly portraits of people who look just like you and me, except that that they have physical and/or psychological scars from the experience of having lived with, through and in spite of myriad forms of cancer. The people portrayed are patients, survivors, health care workers, friends — in short, what can be loosely called the “cancer community.” A short and often poignant descriptive caption, usually identifying the subjects, accompanies each picture."

View the online gallery.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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Bowles J, Kotkin J, Giles D. Reviving the City of Aspiration: A Study of the Challenges Facing New York City’s Middle Class. New York: City Futures, Inc., 2009. [Full text available for download.]

The Center for an Urban Future has published a timely and thorough report on the tenuous state of New York City’s endangered middle class. In just fifty pages, this creatively researched, thoughtfully written, and well-edited monograph surveys a shrinking base of opportunity from its origins in 17th century Holland to our present economic crisis.

Jonathan Bowles and his co-authors cannily describe a grim landscape, in which New York is ranked “the worst urban area in the nation for the average citizen to build wealth,” while finding real glimmers of hope, not least in the attitudes of the hardy souls who continue to strive for a better life in the megacity.

Perhaps most important, their report makes the case for why a middle class matters:

“The middle class are the backbone of the city’s workforce—the book editors, web designers, lab technicians, architects, nurses, paralegals, actors, university professors, carpenters and bus drivers that provide the foundation for so many key industries….”

“The middle class contributes significantly to the city’s vitality and vibrancy. They are far more diverse than the wealthy, not only ethnically but also in terms of their backgrounds, shopping habits and entertainment choices. While they may not regularly frequent boutiques on Madison Avenue or the city’s four-star restaurants, the middle class provides the customer base for a wide mix of businesses across the city, including many of the independent stores, cafés, shops and cultural venues that help give New York its unique identity. They also add to New York’s street life simply by being in the city; while many wealthy residents leave the city on the weekends for second and third homes in Aspen, the Hamptons and other hot spots, the middle class are more likely to stay put and spend their weekends in the city.”

Reviving the City of Aspiration is essential reading for people who care about the future of cities and the people who live in them.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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Ma dai fu de zhen suo / Doctor Ma’s Country Clinic (Cong Feng, People’s Republic of China) (European Premiere)
Wednesday, February 11
Read the Forum synopsis

The Berlinale Journal offers a consummate précis:

“Dr Ma Bingcheng runs a popular clinic for traditional Chinese medicine in the barren Province of Gansu in northeastern China. The arduous work in the rough fields has left its mark on his patients. The physician takes their pulse, mixes the appropriate medicine from roots, herbs and tree bark, and gently asks questions to try to discover the source of the illness. Documentary filmmaker Cong Feng patiently listens to the conversations. The healing that Ma Dai Fu De Zhen Suo (Doctor Ma’s Country Clinic) offers does not just treat the diseases, but also the emotional ailments of those left behind by the economic boom in China.”

What can I add. We learn Dr. Ma’s hardscrabble path to medicine, studying and practicing at the same time, his practice growing with his increasing competence. His clinic, scarcely larger than a dormitory room, combines a waiting room, pharmacy, consulting room, and a bed for transfusions and other severe cases. Consultations are necessarily a community affair, as patients gain medical knowledge from their neighbors’ stories.

Dr. Ma’s patients talk openly to the camera, sharing family troubles and age-old farmer complaints of 13-hour days in the fields with little gain to themselves, as they are exploited by their bosses.

“It’s hopeless here in the village.” “We are too ragged and dirty to be filmed.”

Life is so hard here that young people run away, and wives are bought. The film challenges our conceptions about human trafficking while confirming the cruelty of the practice.

The film ends in an elevated, isolated place where a brightly decorated coffin is carried by a horse-drawn cart and buried in a mound marked only by a stick. A little drunk, Doctor Ma talks about the graves and their tenants, all of them known to him in this harsh land.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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Seishin / Mental (Soda Kazuhiro, Japan) (European Premiere)
Monday, February 9
Read the Forum synopsis

The patients who visit Chorale Okayama have profound illnesses - schizophrenia, severe depression - many are self-abusive, some are suicidal. Through several deftly filmed consultations and other encounters, we learn Dr. Yamamoto Masatomo’s original, thoroughly humanistic, and highly social therapeutic method.

Dr. Yamamoto suggests practical tools patients can use to share their perspective with others and guides them to make incremental steps toward self-determined goals. His skillful and caring staff provide practical support and education toward meeting essential tasks of daily life - creating, working, paying bills, preparing food, cleaning house, planning an evening out. Focused on “rebuilding the whole person,” doctor, staff, and ultimately the patients create a uniquely functional community.

During the course of the film, we see how several patients develop remarkable insight and critical acuity, both about their illness and about the relationship of the individual to society. Even while realizing their vulnerability to pathological processes, they accept responsibility for their actions. And in pulling the curtain back on this taboo subject - taboo not only in Japan - each one begins to realize that “I’m mentally ill, but no one is perfect.”

Visit the film website.

Posts for peace, sound environmental stewardship, humane economic policy and promotion of human health and creativity. About the blogger.

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film festivals berlin film festival

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