Switzerland County, In. — Indiana Department of Transportation officials say work on a $1,710,218 small structure project impacting four sites along State Road 156 in Switzerland County will begin in early 2019.Sunesis Construction Company of West Chester, Ohio, has been contracted to replace a concrete box culvert north of Patriot, install a pipe structure south of Patriot and fit two drainage pipes with liners—one at Markland, the other south of Rising Sun. The culvert and pipe replacements will require closures of S.R. 156 for a total of 45 days. The highway at both locations will not be closed at the same time.S.R. 156 culvert removal and replacement—6 miles east of S.R. 250 at Forty Wink Creek and a tributary to the Ohio River. The new installation will be a 12- X 8-foot reinforced concrete box structure measuring 94 feet in length. Traffic count at the site is 1,130 vehicles per day.S.R. 156 pipe replacement—8.7 miles east of S.R. 101 at a tributary to the Ohio River. The new installation is a 60-inch drainage pipe measuring 73 feet in length. Traffic count at the site is 880 vehicles per day.S.R. 156 pipe lining—4.8 miles east of S.R. 56 at a tributary to Log Lick Creek. An existing 72-inch pipe measuring 105 feet in length will be lined to maintain structure integrity and extend service life. Traffic count at the Markland site is 4,835 vehicles per day. Traffic impact will be minimal.S.R. 156 pipe lining—5.2 miles east of S.R. 250 at a tributary to the Ohio River. An existing 72-inch pipe measuring 97 feet in length will be lined to maintain structure integrity and extend service life. Traffic count at the site south of Rising Sun is 1,130 vehicles per day. Traffic impact will be minimal.All four project locations are in Posey Township.The contractor plans to be onsite for pipe lining operations during February and March. Culvert and pipe replacements are scheduled to be done in April and May. Construction signs will be put in place on January 7.
Shoretire was sprung from the bench in the 74th minute, making history as both the UEFA Youth League and United’s youngest-ever player at this level, aged just 14 years and 314 days.A diminutive winger, Shoretire is eligible to play for Nigeria and has already been invited to train with England’s youth sides after impressing above his age over the past two years.He is highly regarded at Old Trafford, and was part of this summer’s U18 and U23 pre-season training camp in Austria.The winger, just 14 years, 10 months and 10 days old, made his debut in the 2-1 win over Valencia – and is also believed to be the youngest player the Reds have fielded in an official youth team league or cup match.He beat the previous UEFA Youth League mark of Benfica goalkeeper Mile Svilar, who in turn succeeded Real Madrid Iker Casillas as the youngest to appear in the Champions League.The youngster, who is eligible to play for Nigeria but has caught the eye of England youth team selectors, got a pat on the back from team-mate Angel Gomes, who has already made his senior United debut.The forward tweeted: “2-1 win to finish the group unbeaten. Great result! Also a massive shout out to all the debutants and 14 yr old Shola making his debut.”The prodigious Shoretire travelled with Manchester United youngsters to their training camp in Austria.Shoretire is only 14 but United coaches have recognised his outstanding potential by including him in a squad mostly made up of Under-18 and Under-23 players in Obertraun.Academy head Nicky Butt is in Austria with the youngsters as the club considers possible replacements for U18 coach Kieran McKenna along with U23 coach Ricky Sbragia.Shoretire, who featured at the Milk Cup two years above his age group last year, will likely play for the U15s in the upcoming season but his latest recognition could convince United coaches to hand him an early academy debut.The diminutive Shoretire can play on the wing or up front and is described as an ‘exceptional’ talent. The teenager is eligible to represent Nigeria but Shoretire has already been invited to train with England’s juniors.Manchester United Under 19s completed a convincing comeback against Valencia to round off their UEFA Youth League group stage undefeated and Shola Shoretire made a little bit of history as well.The Red Devils went into the game against Group H’s bottom side at Estadio Antonio Puchade with four wins and a draw behind them.It was the hosts, however, who came flying out of the blocks and enjoyed the lion’s share of both possession and chances in the opening exchanges.That pressure led to the opening goal after United failed to clear a cross into the box and were punished by Jordi Escobar, who slotted home to put the hosts one up.Nicky Butt’s side then survived a few close shaves including a goal-line clearance from Dio McGhee as Valencia piled the pressure on.But the visitors found their feet and began to look more assured as the half wore on.Then, Tahith Chong — last year’s winner of the Jimmy Murphy Award burst clear before his attempt on goal was saved, the deflection, however, fell kindly to Nishan Burkart, who chested down and finished well to restore parity.Almost immediately after United found themselves in front.Aidan Barlow collected Largie Ramazani’s cross before ghosting past the Valencia defender and converting his one-on-one chance.Phil Neville’s son, Harvey, was brought on in the second half to try to see out the gameButt then called on his former team-mate’s son as he introduced Harvey Neville, son of United legend Phil who used to be on the books at Valencia when his father and uncle Gary were coaches there, in the second half.Shoretire was then introduced in the 74th minute and, in doing so, made history as the UEFA Youth League’s youngest ever player at just 14 years and 314 days and also United’s youngest ever player at this age level.The diminutive midfielder helped United see out the rest of the game as they finished eventual 2-1 victors in Spain to top the group.Share this:FacebookRedditTwitterPrintPinterestEmailWhatsAppSkypeLinkedInTumblrPocketTelegram Blazing the TrailEngland-born Nigeria’s Shola Shoretire came off the bench on Wednesday afternoon as Nicky Butt’s side beat Valencia to become youngest-ever UEFA Youth League playerNicky Butt’s United came from behind in Spain to top their group and continue their unbeaten run in the competition with goals from Nishan Burkart and Aidan Barlow cancelling out Jordi Escobar’s opener for the hosts.
Jul 13 2018First-line Treatment With Checkpoint Inhibitors Associated With Improved Overall Survival For Patients With Melanoma Brain MetastasesBottom Line: Among patients with cutaneous melanoma who had brain metastases (MBM), first-line treatment with a checkpoint inhibitor was associated with a 1.4-fold increase in median overall survival, according to results from a national cohort.Journal in Which the Study was Published: Cancer Immunology Research, a journal of the American Association for Cancer Research.Authors: First author J. Bryan Iorgulescu, MD, postdoctoral fellow in the Department of Pathology at Brigham and Women’s Hospital/Harvard Medical School and Department of Medical Oncology at the Dana-Farber Cancer Institute; senior author Timothy Smith, MD, PhD, MPH, director of the Computational Neuroscience Outcomes Center at the Department of Neurosurgery at Brigham and Women’s Hospital/Harvard Medical School; and mentor to Iorgulescu David A. Reardon, MD, clinical director of the Center for Neuro-Oncology at the Dana-Farber Cancer Institute and professor of medicine at Harvard Medical SchoolBackground: “Checkpoint blockade immunotherapies have revolutionized how we care for patients with advanced melanoma, leading to long-lasting treatment responses in many patients,” said Iorgulescu. “However, many of the early clinical trials of checkpoint blockade immunotherapies included few melanoma patients with brain metastases – despite their high incidence – and so the survival benefits of these exciting therapies remained unclear for this substantial subset of patients.”How the Study Was Conducted: Iorgulescu and colleagues evaluated data collected from the National Cancer Database (NCDB), which includes information for approximately 70 percent of newly diagnosed patients with cancer in the United States. They analyzed the characteristics, treatments, and overall survival of 2,753 stage 4 melanoma patients who presented with MBMs between 2010 and 2015. The population was further divided into those who had MBM-only disease (patients with brain metastases but no metastases in any other part of the body; 39.7 percent of patients) and those who had MBM with metastatic disease detected in another part of the body (60.3 percent of patients).Results: Overall, following the U.S. Food and Drug Administration (FDA) approvals of checkpoint blockade immunotherapies, the percentage of patients with MBMs that received these therapies increased from 10.5 percent in 2011 to 34 percent in 2015. Following multivariable analysis, the researchers found that first-line treatment of MBM patients with checkpoint blockade immunotherapy was associated with an increase in median overall survival from 5.2 months to 12.4 months, corresponding to a 1.4-fold improvement. Furthermore, the treatment was associated with an increase in the four-year overall survival rate for this group of patients from 11.1 percent to 28.1 percent, corresponding to a 1.5-fold improvement.Related StoriesWearing a hearing aid may mitigate dementia riskNeural pathways explain the relationship between imagination and willingness to helpAn active brain and body associated with reduced risk of dementiaMBM-only patients had more pronounced results; first-line treatment with checkpoint blockade immunotherapy was associated with an increase in the median overall survival from 7.7 months to 56.4 months and an increase in the four-year overall survival rate from 16.9 percent to 51.5 percent.Iorgulescu and colleagues also found that MBM patients were more likely to receive checkpoint blockade immunotherapy if they were younger, had fewer comorbidities, or were insured privately or through Medicare (versus uninsured), among other reasons.Author’s Comments: “Historically, most approaches to treating CNS [central nervous system] metastases from melanoma as well as other solid tumor types have provided minimal benefit for patients,” said Reardon. “The results of our analyses indicate that immune checkpoint inhibitors can achieve a meaningful therapeutic benefit for metastatic melanoma including spread to the CNS. At the same time, not all patients benefit, indicating that much research is still required to optimize the potential of anti-tumor immune responses for CNS metastatic disease.””Through the use of nationwide cancer data, for the first time we can evaluate the impacts on survival that these exciting new therapies have for patients with melanoma brain metastases, highlighting the power of population data to help answer critical, but previously unanswerable, questions that we face every day in clinical practice,” said Smith.Study Limitations: Iorgulescu explained that limitations of the NCDB include a lack of data beyond patients’ initial diagnosis. Thus, the results reported here may not apply to the majority of MBMs that develop following initial presentation. He also noted that the NCDB lacks detailed information about specific immunotherapeutic agents, and while biochemotherapeutics would be also be encoded as immunotherapy, the majority of NCDB-coded immunotherapy following FDA approval in 2011 should represent checkpoint blockade immunotherapy in this study. Source:https://www.aacr.org/Newsroom/Pages/News-Release-Detail.aspx?ItemID=1205#.W0haCNUzbIU