10 Years of Tamoxifen Better Than Five: Are You Kidding Me?












FIRST PERSON | Results from a recent study called ATLAS (adjuvant tamoxifen longer against shorter) show that 10 years of tamoxifen therapy is better than the current treatment of five years. The findings will be presented at the San Antonio Breast Cancer Symposium this week. A major drug manufacturer is one of the study’s sponsors.


Study is suspect












I find it interesting that one of the sponsors of the ATLAS study is drug manufacturer AstraZeneca. The company currently markets and manufactures Nolvadex, a brand-name version of the drug tamoxifen. Current guidelines for tamoxifen recommend that patients take the drug for five years. By doubling the number of years women take tamoxifen, AstraZeneca stands to make a lot more money. This fact makes me question the validity and objectivity of the research.


The ATLAS study suggests that taking tamoxifen for 10 years greatly increases a woman’s survival rate from estrogen-positive breast cancers. However, there was no difference in deaths or recurrences of breast cancer during the second five-year period. The increase in survival rates comes after women stop taking the drug. Trevor J. Powles of the Cancer Center in London told the New York Times that the benefits of tamoxifen far outweigh any side effects — I disagree.


Why I won’t take tamoxifen


Let me explain my situation. I have stage 2, estrogen-positive breast cancer. My oncologist recommended that I take tamoxifen for five years — I refused. This is why a study like ATLAS is so important to me.


I completely disagree with Trevor J. Powles’ statement about benefits outweighing the risks. Tamoxifen comes with some pretty serious side effects, including endometrial cancers, pulmonary embolisms, cataracts, increase in blood cholesterol, and bad interactions with many common drugs, including benedryl. The rate for endometrial cancers doubles in the second five years of taking the drug, to almost 4 percent.


Tamoxifen’s side effects are definitely something to consider before recommending that treatment be extended by an additional five years. In addition to serious side effects, 40 percent of the women taking tamoxifen in the ATLAS study stopped prior to completing the trials because of side effects.


Tamoxifen causes menopausal symptoms like night sweats, hot flashes and vaginal dryness. While not life threatening, these symptoms have a direct impact on quality of life. Bone pain is another side effect.


Tamoxifen does not work for approximately 1/3 of the women who take it. ATLAS does not address this issue.


Is ATLAS a study that truly looks to benefit women battling breast cancer or is it a way for a drug manufacturer to line their pockets? When you look at all the information, it seems like the latter is true. Apparently, AstraZeneca would rather increase their bottom line instead of increasing a breast cancer patient’s quality of life.


Lynda Altman was diagnosed with breast cancer in November 2011. She writes a series for Yahoo! Shine called “My Battle With Breast Cancer.”


Medications/Drugs News Headlines – Yahoo! News


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Asia stocks rise as US employment claims dip












BANGKOK (AP) — Asian stock markets rose Friday after the number of Americans seeking unemployment benefits fell last week, offsetting a somber economic forecast by the European Central Bank for a bleak year ahead in the region.


The U.S. Labor Department said Thursday that applications dropped 25,000 last week to a seasonally adjusted 370,000, a level consistent with modest hiring. The number of people continuing to receive unemployment aid also fell.












Japan’s Nikkei 225 index rose 0.1 percent to 9,554.09. South Korea’s Kospi added 0.4 percent to 1,958.13. Australia’s S&P/ASX 200 rose 1 percent to 4,552.40. Hong Kong’s Hang Seng rose 0.2 percent to 22,299.21.


On Thursday, the European Central Bank said that the economies of 17 countries that use the euro will contract next year. The central bank stopped short of offering new measures to boost growth and left its key interest rate unchanged at a record low.


The combined economy of the euro countries is in a recession after a massive debt crisis followed by government spending cuts and tax hikes that have hurt growth.


“Although the ECB left policy rates unchanged the post ECB meeting press conference effectively opened the door to a rate cut in Q1 next year following sharp downward revisions to growth projections and well below target inflation projected over the medium term,” said analysts at Credit Agricole CIB in Hong Kong.


Benchmark oil for January delivery was up 16 cents to $ 86.42 in electronic trading on the New York Mercantile Exchange. The contract fell $ 1.62, or 1.8 percent, to finish at $ 86.26 per barrel in New York on Thursday.


In currencies, the euro rose to $ 1.2969 from $ 1.2963 late Thursday in New York. The dollar rose to 82.47 yen from 82.36 yen.


___


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Toronto mayor to stay in power pending appeal of ouster












TORONTO (Reuters) – Toronto Mayor Rob Ford can stay in power pending an appeal of a conflict of interest ruling that ordered him out of his job as leader of Canada’s biggest city, a court ruled on Wednesday.


Madam Justice Gladys Pardu of the Ontario Divisional Court suspended a previous court ruling that said Ford should be ousted. Ford’s appeal of that ruling is set to be heard on January 7, but a decision on the appeal could take months.












Justice Pardu stressed that if she had not suspended the ruling, Ford would have been out of office by next week. “Significant uncertainty would result and needless expenses may be incurred if a by-election is called,” she said.


If Ford wins his appeal, he will get to keep his job until his term ends at the end of 2014. If he loses, the city council will either appoint a successor or call a special election, in which Ford is likely to run again.


“I can’t wait for the appeal, and I’m going to carry on doing what the people elected me to do,” Ford told reporters at City Hall following the decision.


Ford, a larger-than-life character who took power on a promise to “stop the gravy train” at City Hall, has argued that he did nothing wrong when he voted to overturn an order that he repay money that lobbyists had given to a charity he runs.


Superior Court Justice Charles Hackland disagreed, ruling last week that Ford acted with “willful blindness” in the case, and must leave office by December 10.


Ford was elected mayor in a landslide in 2010, but slashing costs without cutting services proved harder than he expected, and his popularity has fallen steeply.


He grabbed unwelcome headlines for reading while driving on a city expressway, for calling the police when a comedian tried to film part of a popular TV show outside his home, and after reports that city resources were used to help administer the high-school football team he coaches.


The conflict-of-interest drama began in 2010 when Ford, then a city councillor, used government letterhead to solicit donations for the football charity created in his name for underprivileged children.


Toronto’s integrity commissioner ordered Ford to repay the C$ 3,150 ($ 3,173) the charity received from lobbyists and companies that do business with the city.


Ford refused to repay the money, and in February 2012 he took part in a city council debate on the matter and then voted to remove the sanctions against him – despite being warned by the council speaker that voting would break the rules.


He pleaded not guilty in September, stating that he believed there was no conflict of interest as there was no financial benefit for the city. The judge dismissed that argument.


In a rare apology after last week’s court ruling, he said the matter began “because I love to help kids play football”.


Ford faces separate charges in a C$ 6 million libel case about remarks he made about corruption at City Hall, and is being audited for his campaign finances. The penalty in the audit case could also include removal from office.


(Reporting by Claire Sibonney; Editing by Janet Guttsman, Russ Blinch, Nick Zieminski; and Peter Galloway)


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In brewing rivalry, Instagram trims ties to Twitter












SAN FRANCISCO (Reuters) – Facebook Inc’s recently acquired photo-sharing service Instagram removed a key element of its integration with Twitter, signaling a deepening rift between two of the Web’s dominant social media companies.


Instagram Chief Executive Kevin Systrom said Wednesday his company turned off support for Twitter “cards” in order to drive Twitter users to Instagram’s own website. Twitter “cards” are a feature that allows multimedia content like YouTube videos and Instagram photos to be embedded and viewed directly within a Twitter message.












The move marked the latest clash between Facebook and Twitter since April, when Facebook, the world’s no. 1 social network, outbid Twitter to nab fast-growing Instagram in a cash-and-stock deal valued at the time at $ 1 billion. The acquisition closed in September for roughly $ 715 million, reflecting Facebook’s recent stock drop.


The companies’ ties have been strained since. In July, Twitter blocked Instagram from using its data to help new Instagram users find friends.


Beginning earlier this week, Twitter’s users began to complain in public messages that Instagram photos did not seem to display properly on Twitter’s website.


Systrom confirmed Wednesday that his company had decided its users should view photos on Instagram’s own Web pages and took steps to change its policies.


“We believe the best experience is for us to link back to where the content lives,” Systrom said in a statement, citing recent improvements to Instagram’s website.


“A handful of months ago, we supported Twitter cards because we had a minimal Web presence,” Systrom said, noting that the company has since released new features that allow users to comment about and “like” photos directly on Instagram’s website.


The move escalates a rivalry in the fast-growing social networking sector, where the biggest players have sought to wall off access to content from rival services and to their ranks of users.


“They’re both competing for slices of the same pie, the pie being users’ attention,” said Ray Valdes, an analyst with research firm Gartner.


If Facebook decides to offer advertising on Instagram, it’s important that the users visit Instagram’s own website, said Valdes. “If the eyeballs are elsewhere, you have less to work with in terms of monetization,” he said.


Photos are among the most popular features on both Facebook and Twitter, and Instagram’s meteoric rise in recent years has further proved how picture-sharing has become a key front in the battle for social Internet supremacy.


Instagram, which has 100 million users, allows consumers to tweak the photos they take on their smartphones and share the images with friends, a feature that Twitter has reportedly also begun to develop. Twitter’s executive chairman, Jack Dorsey, was an early investor in Instagram and had hoped to acquire it before Facebook CEO Mark Zuckerberg made a successful bid.


When Zuckerberg announced the acquisition in an April blog post, he highlighted Instagram’s inter-connectivity with other social networks.


“We think the fact that Instagram is connected to other services beyond Facebook is an important part of the experience,” Zuckerberg wrote. “We plan on keeping features like the ability to post to other social networks.”


A Twitter spokesman declined comment Wednesday, but a status message on Twitter’s website confirmed that users are “experiencing issues,” such as “cropped images” when viewing Instagram photos on Twitter.


(Reporting By Alexei Oreskovic and Gerry Shih; Editing by Nick Zieminski and Leslie Adler)


Internet News Headlines – Yahoo! News


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Republicans weigh swallowing tax hike on the wealthy












WASHINGTON (Reuters) – While Republican leaders in the House of Representatives insist that raising tax rates on the rich is an impossibility, some Republican lawmakers now see it as inevitable to avoiding the “fiscal cliff” of severe tax hikes and spending cuts set to start January 1.


Congressional aides, who asked not to be identified, said Republicans are losing the public relations battle over keeping low tax rates for the rich and are getting battered by President Barack Obama and his fellow Democrats in Congress following their November 6 election victories.












On Capitol Hill aides often play an important role of communicating what members are thinking but cannot say themselves. In recent days, increasing numbers are putting out word through news organizations that Republicans now feel they cannot win on tax cuts for the wealthy, at least not now.


Without a deal by December 31, $ 600 billion in across-the-board spending cuts and tax increases, which are so severe that they likely would shove the economy into recession, are scheduled to begin.


Republican Senator Bob Corker of Tennessee told reporters that his fellow Republicans are beginning to see a possible upside to giving in to Obama on tax rates so the party can then try to gain the upper hand in subsequent negotiations – maybe next year – to make savings in expensive “entitlement” programs such as Medicare healthcare for the elderly.


“If the House were to give that to him, where does the discussion then go? It goes to entitlements, which is where it ought to be in the first place,” said Corker, who added, “I’m hearing whispers of a light going off in some people’s minds.”


Conservative Republican Senator Tom Coburn of Oklahoma told MSNBC: “Personally I know we have to raise revenue. I don’t really care which way we do it. Actually, I would rather see the rates go up than do it the other way because it gives us a greater chance to reform the tax code and broaden the base in the future.”


Democrats on Wednesday kept up pressure on Republicans to allow votes on legislation to continue low tax rates on everyone with net incomes below $ 250,000 a year – an estimated 98 percent of taxpayers. Rates for the 2 percent above that threshold would snap back to pre-2001 levels of 35 percent and 39.6 percent under a Senate-approved bill.


“The first step, the most obvious step, is for the Republican House to take the 98 percent both sides agree on and pass our Senate bill and send it to the president for his signature,” Democratic Senator Patty Murray of Washington state said in excerpts to a speech she was to deliver on the Senate floor later on Wednesday.


A Senate Republican aide noted that Republicans “are in a very weak bargaining position” on maintaining low tax rates of 33 percent and 36 percent on the top two income brackets “and we all know we are going to get hell if we go off the cliff.”


The aide saw the possibility of Republicans and Democrats swapping a few more proposals that they know will be rejected, before moving to an end-game by mid-December or so.


One such Republican proposal, according to another Republican aide, would set forth a $ 1.6 trillion deficit-reduction plan, with half the savings coming from higher revenues and the other half from tough entitlement program cuts – meaning benefit reductions for the elderly and poor that Democrats undoubtedly would oppose, at least for now.


THE REAL DEAL?


But the real proposal – one that would be presented to the full House and Senate for passage this month – could involve letting tax rates rise on the highest income earners, although maybe not to as high a level as Obama is demanding, according to aides. It could be coupled with extending low estate taxes and protecting middle-income people from being thrown into a tax level intended for the rich.


The deal also would set up a framework, which has been widely discussed, to work on comprehensive tax and spending reforms next year that ultimately could reduce all tax rates while ending a broad swath of tax breaks.


The Senate Republican aide added that if there is no deal to avert the fiscal cliff by December 31, Republicans would find themselves in an even worse position in the new Congress convening in January.


Senate Democrats will have a larger majority next year, having picked up two more seats as a result of the November 6 elections. The party also has gained seats in the House.


“We know that if we wait until the new Congress, the 98 percent bill will get passed by the Senate and there will be more pressure in the House to do it by discharge,” the Senate Republican aide said.


“Discharge” refers to attempts already underway by House Democrats to get the Democratic bill extending tax cuts for everyone but the rich to the House floor through a “discharge petition” signed by a majority of the chamber’s members.


Even amid all the speculation of a Republican-Democratic deal in coming weeks, it is hard to find anyone who voices complete confidence in such an outcome, leaving open the possibility that the country can still go off the fiscal cliff on January 1.


(Additional reporting by Kim Dixon and Thomas Ferraro; Editing by Fred Barbash and Vicki Allen)


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Asia stocks mixed on Obama remarks












BANGKOK (AP) — Asian stock markets remained in a holding pattern Thursday as investors assessed President Barack Obama‘s comments that reaching a budget deal to prevent the U.S. from a possible recession was “not that tough” and could even be done quickly.


Obama’s remarks follow days of contentious negotiations between the White House and Congress on a deal to avert the so-called “fiscal cliff” of automatic spending cuts and tax increases at the start of next year. Without a deal, the U.S. could fall back into recession and drag much of the world down with it.












Wall Street stocks ended higher Wednesday after Obama was quoted telling business leaders in Washington that, despite a deep divide on critical issues, political leaders “can probably solve this in about a week, it’s not that tough.”


Obama is demanding that Republicans agree to raise tax rates for the richest Americans as part of a deal to rein in future deficits. Republican leaders say they will agree to higher revenue, but they want to close loopholes or reduce tax breaks rather than raise rates.


Chris Weston of IG Markets in Melbourne said in a market commentary that “there are distant signs that both parties should come to at least a short-term agreement. Certainly the market is seeing it that way and giving the situation the benefit of the doubt.”


Japan’s Nikkei 225 index rose 0.8 percent, in part buoyed by a weaker yen, to 9,541.21. South Korea’s Kospi rose 0.3 percent to 1,952.66. Hong Kong’s Hang Seng fell 0.1 percent to 22,245.56. Benchmarks in Indonesia, New Zealand and the Philippines rose while Singapore, Australia and mainland China fell.


Benchmark oil for January delivery was down 15 cents to $ 87.73 per barrel in electronic trading on the New York Mercantile Exchange. The contract fell 62 cents to finish at $ 87.88 per barrel on the Nymex on Wednesday.


In currencies, the euro fell to $ 1.3056 from $ 1.3079 late Wednesday in New York. The dollar rose to 82.52 from 82.35 yen.


___


Follow Pamela Sampson on Twitter at http://twitter.com/pamelasampson


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Death toll from Philippine typhoon nears 300












NEW BATAAN, Philippines (AP) — Stunned parents searching for missing children examined a row of mud-stained bodies covered with banana leaves while survivors dried their soaked belongings on roadsides Wednesday, a day after a powerful typhoon killed nearly 300 people in the southern Philippines.


Officials fear more bodies may be found as rescuers reach hard-hit areas that were isolated by landslides, floods and downed communications.












At least 151 people died in the worst-hit province of Compostela Valley when Typhoon Bopha lashed the region Tuesday, including 78 villagers and soldiers who perished in a flash flood that swamped two emergency shelters and a military camp, provincial spokeswoman Fe Maestre said.


Disaster-response agencies reported 284 dead in the region and 14 fatalities elsewhere from the typhoon, one of the strongest to hit the country this year.


About 80 people survived the deluge in New Bataan with injuries, and Interior Secretary Mar Roxas, who visited the town, said 319 others remained missing.


“These were whole families among the registered missing,” Roxas told the ABS-CBN TV network. “Entire families may have been washed away.”


The farming town of 45,000 people was a muddy wasteland of collapsed houses and coconut and banana trees felled by Bopha’s ferocious winds.


Bodies of victims were laid on the ground for viewing by people searching for missing relatives. Some were badly mangled after being dragged by raging flood waters over rocks and other debris. A man sprayed insecticide on the remains to keep away swarms of flies.


A father wept when he found the body of his child after lifting a plastic cover. A mother, meanwhile, went away in tears, unable to find her missing children. “I have three children,” she said repeatedly, flashing three fingers before a TV cameraman.


Two men carried the mud-caked body of an unidentified girl that was covered with coconut leaves on a makeshift stretcher made from a blanket and wooden poles.


Dionisia Requinto, 43, felt lucky to have survived with her husband and their eight children after swirling flood waters surrounded their home. She said they escaped and made their way up a hill to safety, bracing themselves against boulders and fallen trees as they climbed.


“The water rose so fast,” she told AP. “It was horrible. I thought it was going to be our end.”


In nearby Davao Oriental, the coastal province first struck by the typhoon as it blew from the Pacific Ocean, at least 115 people perished, mostly in three towns that were so battered that it was hard to find any buildings with roofs remaining, provincial officer Freddie Bendulo and other officials said.


“We had a problem where to take the evacuees. All the evacuation centers have lost their roofs,” Davao Oriental Gov. Corazon Malanyaon said.


The International Federation of Red Cross and Red Crescent Societies issued an urgent appeal for $ 4.8 million to help people directly affected by the typhoon.


The sun was shining brightly for most of the day Wednesday, prompting residents to lay their soaked clothes, books and other belongings out on roadsides to dry and revealing the extent of the damage to farmland. Thousands of banana trees in one Compostela Valley plantation were toppled by the wind, the young bananas still wrapped in blue plastic covers.


But as night fell, however, rain started pouring again over New Bataan, triggering panic among some residents who feared a repeat of the previous day’s flash floods. Some carried whatever belongings they could as they hurried to nearby towns or higher ground.


After slamming into Davao Oriental and Compostela Valley, Bopha roared quickly across the southern Mindanao and central regions, knocking out power in two entire provinces, triggering landslides and leaving houses and plantations damaged. More than 170,000 fled to evacuation centers.


As of Wednesday evening, the typhoon was over the South China Sea west of Palawan province. It was blowing northwestward and could be headed to Vietnam or southern China, according to government forecasters.


The deaths came despite efforts by President Benigno Aquino III’s government to force residents out of high-risk communities as the typhoon approached.


Some 20 typhoons and storms lash the northern and central Philippines each year, but they rarely hit the vast southern Mindanao region where sprawling export banana plantations have been planted over the decades because it seldom experiences strong winds that could blow down the trees.


A rare storm in the south last December killed more than 1,200 people and left many more homeless.


The United States extended its condolences and offered to help its Asian ally deal with the typhoon’s devastation. It praised government efforts to minimize the deaths and damage.


___


Associated Press writers Jim Gomez, Teresa Cerojano and Oliver Teves in Manila contributed to this report.


Asia News Headlines – Yahoo! News


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Toshiba’s 10-inch Excite 10 SE tablet sells for $349.99, comes with Jelly Bean












While every other company is busy chasing the 7-inch tablet market, Toshiba (TOSBF) is keeping its eye on people interested in 10-inch tablets. Its new Excite 10 SE Android tablet is fairly similar to its Excite 10 LE, sporting a 10.1-inch 1280 x 800 resolution display, NVIDIA Tegra 3 quad-core processor, 16GB of internal storage, 3-megapixel rear camera, HD front camera, microSD card slot and Android 4.1 Jelly Bean. It doesn’t have the iPad’s eye-popping Retina display or the Samsung (005930) Nexus 10′s crisp 2,560 x 1,600 resolution with 300 pixels per inch, but it’s more than adequate for most basic tablet tasks. And at $ 349.99, it’s not a bad deal for a 10-inch tablet. The Excite 10 SE goes on sale December 6th and will be available from ToshibaDirect.com and select retail stores. Toshiba’s press release follows below.



Toshiba expands excite family of tablets with new 10-inch model












New Excite 10 SE Tablet Powered by Android 4.1 Starting at $ 349.99 MSRP


IRVINE, Calif. — Dec. 4, 2012 — Toshiba’s Digital Products Division (DPD), a division of Toshiba America Information Systems, Inc., today announced the availability of the Excite™ 10 SE tablet, a multimedia-rich tablet with a 10.1-inch touchscreen, powered by Android™ 4.1, Jelly Bean. The Excite 10 SE offers an affordable option for people looking for a powerful and versatile tablet for the home, starting at only $ 349.99 MSRP[i].


“Our Excite family of tablets continues to grow with options to suit a wide range of consumer needs, from portability and gaming to versatility and power,” said Carl Pinto, vice president of marketing of Toshiba America Information Systems, Inc., Digital Products Division. “We designed the Excite 10 SE to be a full featured tablet that offers a pure Android, Jelly Bean experience, while maintaining an attractive price point.”


The Excite 10 SE features Android 4.1, Jelly Bean, which improves on the simplicity and usability of Android 4.0. Moving between customizable home screens and switching between apps is effortless, while the Chrome™ browser and new Google Now intelligent personal assistant and Voice Search apps makes surfing the web fast and fluid.


Slim and light at only 0.4 inches thick and weighing 22.6 ounces[ii], the Excite 10 SE is encased with a textured Fusion Lattice finish, making it comfortable to hold and easy to carry. The tablet offers a vibrant 10.1-inch diagonal AutoBrite™ HD touchscreen display[iii] plus the NVIDIA® Tegra® 3 Super 4-PLUS-1™ quad-core processor[iv] that delivers smooth web browsing and outstanding performance for games, HD movies and more.


Stereo speakers with SRS® Premium Voice Pro create an optimized audio experience for music, video and games, while providing greater clarity for video chatting via the tablet’s HD front-facing camera. The Excite 10 SE also includes a 3 megapixel rear-facing camera with auto-focus and digital zoom for capturing HD video and photos. Featuring a wide range of connectivity, the tablet includes 802.11 b/g/n Wi-Fi®, Bluetooth® 3.0, as well as Micro SD and Micro USB ports for expandability. The tablet also charges conveniently via the Micro USB port.


Availability


The Excite 10 SE will be available starting at $ 349.99 MSRP for the 16GB model at select retailers and direct from Toshiba at ToshibaDirect.com on December 6, 2012.



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‘Dr. Phil”s stolen classic Chevy recovered












BURBANK, Calif. (AP) — Los Angeles police say they’ve recovered a stolen 1957 Chevrolet Bel Air Convertible that belongs to talk-show host Phil McGraw.


Detective Jess Corral said Tuesday that investigators recovered McGraw’s classic car, along with 13 others, after law enforcement began targeting auto theft rings.












McGraw is known as television’s “Dr. Phil. His car was stolen from the RODZ shop in Burbank in August, and was found with minor damage.


The car is worth at least $ 80,000.


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Chelsea’s hypotension drug fails to prove efficacy past week one












(Reuters) – Chelsea Therapeutics Inc said its experimental hypotension drug met the main goal of a study by significantly reducing dizziness in patients at week one, but results beyond that period were not statistically significant.


The U.S. Food and Drug Administration declined to approve the drug, Northera, in March, and asked for data that proved it was effective over two to three months.












The company’s shares, which have lost about two-thirds of its value so far this year, fell 22 percent to $ 1.40 in extended trading after closing at $ 1.79 on Tuesday on the Nasdaq.


Chelsea said in August that it would modify the main goal of the ongoing 306B study, though the FDA had said the study was unlikely to provide sufficient data for a marketing application and had suggested the company conduct an additional trial.


The drugmaker said on Tuesday that preliminary data showed that beyond week one, dizziness/lightheadedness and standing blood pressure predominantly favored Northera-treated patients over placebo, although the results were not statistically significant.


The drug, known generically as droxidopa, is designed to treat symptomatic neurogenic orthostatic hypotension — a chronic and often debilitating drop in blood pressure on standing up that is most often associated with Parkinson’s disease.


(Reporting by Vidya P L Nathan in Bangalore; Editing by Anthony Kurian)


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