Despite hype, costly prostate cancer treatment offers little relief from side effects

Public release date: 13-Dec-2012
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Contact: Karen N. Peart
karen.peart@yale.edu
203-432-1326
Yale University

Prostate cancer patients receiving the costly treatment known as proton radiotherapy experienced minimal relief from side effects such as incontinence and erectile dysfunction, compared to patients undergoing a standard radiation treatment called intensity modulated radiotherapy (IMRT), Yale School of Medicine researchers report in the Journal of the National Cancer Institute.

Standard treatments for men with prostate cancer, such as radical prostatectomy and IMRT, are known for causing adverse side effects such as incontinence and erectile dysfunction. Proponents of proton radiotherapy argue that the physical properties of protons may decrease these common side effects.

"Proton radiotherapy is increasing in popularity and more and more proton centers are being built throughout the country," said the study's lead author James Yu, M.D., assistant professor of therapeutic radiology at Yale Cancer Center and member of the Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center at Yale. "However, there is a surprising lack of information about whether proton radiotherapy is actually superior to IMRT."

To find out, the Yale COPPER team studied a national sample of about 30,000 men with Medicare coverage who received treatment with either IMRT or proton radiotherapy for prostate cancer from 2008 to 2009. During this time, there were six centers offering proton radiotherapy in the United States and the authors found that some men travelled across the country for the treatment.

The team found that the incidence of complications such as problems with urinary function was slightly lower for proton radiotherapy at six months after treatment, but by 12 months after treatment there was no longer any difference. Despite the fact that there was no longer term benefit to the treatment in terms of side effects, Medicare paid over $32,000 per course of treatment, compared to less than $19,000 for a course of IMRT.

"We were surprised by these findings," said Cary Gross, senior author of the study and co-director of the COPPER Center. "Cancer centers are paying up to $100 million to build their own proton centers, and patients are travelling long distances to undergo proton therapy because the conventional wisdom has been that proton radiotherapy is better than IMRT. Our results suggest that this enthusiasm for proton therapy may be premature; it remains to be seen how proton radiotherapy will compare to IMRT at 10 or 15 years post-treatment."

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Other authors on the study include Pamela Soulos, Jeph Herrin, Laura Cramer, Arnold Potosky, and Kenneth Roberts.

The study was funded by a grant from the National Cancer Institute (R01CA149045). Yu is also supported by the National Center for Research Resources (NCRR) and the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for medical research (KL2 RR024138).

Citation: JCNI: 10.1093/jnci/djs463

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Public release date: 13-Dec-2012
[ | E-mail | Share ]

Contact: Karen N. Peart
karen.peart@yale.edu
203-432-1326
Yale University

Prostate cancer patients receiving the costly treatment known as proton radiotherapy experienced minimal relief from side effects such as incontinence and erectile dysfunction, compared to patients undergoing a standard radiation treatment called intensity modulated radiotherapy (IMRT), Yale School of Medicine researchers report in the Journal of the National Cancer Institute.

Standard treatments for men with prostate cancer, such as radical prostatectomy and IMRT, are known for causing adverse side effects such as incontinence and erectile dysfunction. Proponents of proton radiotherapy argue that the physical properties of protons may decrease these common side effects.

"Proton radiotherapy is increasing in popularity and more and more proton centers are being built throughout the country," said the study's lead author James Yu, M.D., assistant professor of therapeutic radiology at Yale Cancer Center and member of the Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center at Yale. "However, there is a surprising lack of information about whether proton radiotherapy is actually superior to IMRT."

To find out, the Yale COPPER team studied a national sample of about 30,000 men with Medicare coverage who received treatment with either IMRT or proton radiotherapy for prostate cancer from 2008 to 2009. During this time, there were six centers offering proton radiotherapy in the United States and the authors found that some men travelled across the country for the treatment.

The team found that the incidence of complications such as problems with urinary function was slightly lower for proton radiotherapy at six months after treatment, but by 12 months after treatment there was no longer any difference. Despite the fact that there was no longer term benefit to the treatment in terms of side effects, Medicare paid over $32,000 per course of treatment, compared to less than $19,000 for a course of IMRT.

"We were surprised by these findings," said Cary Gross, senior author of the study and co-director of the COPPER Center. "Cancer centers are paying up to $100 million to build their own proton centers, and patients are travelling long distances to undergo proton therapy because the conventional wisdom has been that proton radiotherapy is better than IMRT. Our results suggest that this enthusiasm for proton therapy may be premature; it remains to be seen how proton radiotherapy will compare to IMRT at 10 or 15 years post-treatment."

###

Other authors on the study include Pamela Soulos, Jeph Herrin, Laura Cramer, Arnold Potosky, and Kenneth Roberts.

The study was funded by a grant from the National Cancer Institute (R01CA149045). Yu is also supported by the National Center for Research Resources (NCRR) and the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for medical research (KL2 RR024138).

Citation: JCNI: 10.1093/jnci/djs463

---

[ | E-mail | Share ]

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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.

Source: http://www.eurekalert.org/pub_releases/2012-12/yu-dhc121312.php

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Earn More Money With These Forex Tips - Search Forex

Even though there is potentially a good deal of money that can be made from foreign exchange trading, it is imperative for new traders to learn all that they can before investing. You will be able to do this when you are practicing with a demo account. These are some suggestions to get you going and help you learn more.

Fibonacci Levels

Research and learn about why Fibonacci levels are powerful for anyone looking to be a successful trader. Fibonacci levels supply specified calculations and numbers that will teach you whom to trade with and when. They may even be able to provide predictions on the best time to exit.

Don?t fall into the trap of handing your trading over to a software program entirely. However, this can lead to large losses.

TIP! Beware of schemes within the forex trading system. Many people who do Forex trading have past histories of day trading.

Trades involving six percent of available funds or more are not advisable. This way, your exposure to massive loss is lower. Although you might take a big hit from a bad trade, you can still work your way back up. If you frequently watch the market, you may be tempted to trade more money. Try to remain conservative.

Risk management can really save you from taking a major financial loss. You should know how much of a loss you can tolerate. Make sure you place your limits and stops in the right place, and stick to them. Your account could get wiped out before you know it if you ignore loss prevention. You need to always look out for losing positions and know when to get away from them.

Many new traders go all in with trading due to the thrill of something new. The majority of people can only put excellent focus into trading for around a few hours or so. Take breaks when trading, remember that it will still be going on when you return.

Research your broker when using a managed account. For the best chance at success, select a broker who has been working for a minimum of five years and whose performance is at least as good as the market. These qualifications are particularly important if you are a newcomer to currency trading.

TIP! Don?t think that you can come along and change the whole Forex game. The forex market is extremely complex.

Stop Loss Orders

A stop loss is an essential way to avoid losing too much money. Stop loss orders act like a risk mitigator to minimize your downside. Not using a stop order cause you to lose a lot if something unexpected happens. Stop loss orders help you bail out before you lose too much.

When you first start trading it?s important to go slow, no matter how successful you become right away. Panic and fear can also lead to a similar result. Do not do anything based on a ?feeling?, do it because you have the know how and knowledge.

The forex market is not tied down to one specific place. Natural disasters do not have much of an impact on the market as a whole. If something does occur, you don?t have to sell everything in a panic. Major events like these will obviously have an effect in the market, but it probably won?t affect the currency that you?re trading.

TIP! Never let your strong emotions control how you trade. If you let emotions like greed or panic overcome your thoughts, you can fail.

So, you want to make your fortune in foreign exchange? An important part of learning how to trade is understanding of foreign currency markets. Understand why currency markets move and the reasons for the fluctuations. Get acquainted with many of the foreign currencies that use the Forex market. The more you know, the better odds you will have to choose currencies which are more likely to increase in value over time.

While you do need to use advice from seasoned professionals, do not make choices simply because somebody else thought it was a good idea. Traders on the currency exchange markets are no different than other people; they emphasize their successes and try to forget about their failures. Remember, even the most successful trader can make a wrong call at any moment. Do not follow other traders; stick your signals and execute your strategy.

Gain better critical thinking skills so that you can understand all the tables and charts. It?s essential to synthesize information from different sources to succeed in Foreign Exchange trading.

If you are new to Forex trading, you might want to consider opening a mini account. This lets you practice, but with real money. It is one easy way to start making trades with real money, but keeping your risk to a minimum.

TIP! Don?t buy ?closed source? trading systems, as most of them are totally useless. Results about their efficacy are often exaggerated.

Learn what bugs your trading software has. No program is going to be perfect. Be prepared for flaws in any software program by doing your homework. You do not want to find out that it will not accept certain information in the middle of a trade.

Foreign Exchange

You can make a lot of profits when you have taught yourself all you can about foreign exchange. Remember that you need to stay on top of the market, and keep learning as things change. Staying informed can really help you to be successful in foreign exchange trading.

If you work at it, you can make a lot of money. Once you win a trade, request a withdrawal and take some of that hard earned money out to use for something you need. If you are making money with Forex, you deserve to enjoy it!

TIP! Traders limit potential risk through the use of equity stop orders. Also called a stop loss, this will close out a trade if it hits a certain, pre-determined level at which you want to cut your losses on a specific trade.

Source: http://search-forex.com/earn-more-money-with-these-forex-tips/

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Wifi-only Galaxy Note 10.1 gets Jelly Bean, starting in Germany

Hot on the heels of the Wifi and HSPA+ Galaxy Note 10.1, the Wifi-only model (GT-N8010) is today receiving its update to Android 4.1.1 Jelly Bean. The over-the-air update package, which tips the scales at around 300MB, is now rolling out to Wifi-only Note 10.1 tablets in Germany. As is always the case with Samsung updates, other territories are likely to follow in the days and weeks ahead.

The Android 4.1.1 update for the Note 10.1 introduces well-known Jelly Bean features like expandable notifications, Google Now and "Project Butter" performance tweaks, along with "Premium Suite" enhancements from Samsung. These include a re-vamped multi-window feature with support for windowed apps, as well as "easy clip" for capturing areas of the screen, and a redesigned S Note app.

If you're seeing the update notification waiting on your Galaxy Note 10.1 this morning, hit the comments let us know how the upgrade's going for you.

Source: XDA, SamMobile

Source: http://feedproxy.google.com/~r/androidcentral/~3/kOsqcbIDp7U/story01.htm

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BoE's Dale warns of further fall in UK living standards

LONDON (Reuters) - Britons' living standards are likely to fall further, and there is little the Bank of England can do about it, the British central bank's chief economist warned on Wednesday.

Spencer Dale said Britain's economy still had further to go to adjust to the aftermath of the financial crisis, and that a mix of slow wage growth and stubborn inflation is likely while that happens.

"Monetary policy has only a limited role to play as an economy adjusts to these types of real shocks," he said in a speech to economists in London.

"The (BoE) can try to pick the least costly route, but ultimately it can't avoid the journey being long and painful," he said at the event, hosted by MNI Deutsche Boerse.

The BoE stopped buying more government bonds to stimulate Britain's economy last month, and economists polled by Reuters are fairly evenly divided on whether it will ever resume them.

Dale's remarks come after a mixed set of labour market data earlier on Thursday. This showed a record number of Britons in work, but a rate of unemployment that is still high at 7.8 percent, and wage growth slowing to 1.7 percent - well below inflation at 2.7 percent.

Britain has recovered much more slowly than most other big economies since the financial crisis, and government forecasts suggest it will tip back into contraction during the current quarter, just three months after it came out of recession.

But Dale said the amount of slack in Britain's economy was not a reliable guide to inflation pressures.

British inflation has been above its 2 percent target since December 2009, and the BoE does not forecast it will fall below target until the second half of 2014.

"The stickiness of inflation is a by-product of the real adjustment that our economy has been forced to make," Dale said.

"Looking ahead, it seems likely that this adjustment process is not yet complete and so the stickiness in inflation may persist for a while yet."

GILT COUPON CONCERNS

Dale's comments about the limits of monetary policy echo closely those given by Governor Mervyn King in a speech in New York on Monday, but he struck a different note on another issue to have hit the central bank in recent weeks.

Shortly before November's policy decision, the government told the BoE it would take back gilt coupons paid to the central bank as a result of its previous 375 billion pounds of asset purchases - something roughly equivalent to 35 billion pounds of new asset purchases.

King brushed aside public concerns about the deal being a threat to the BoE's independence, but Dale was more sympathetic to this view, even if the transaction had not affected his decision to oppose an increase in asset purchases in November.

"The flows of money between the Bank and Her Majesty's Treasury that are likely to result from this decision are large, very large," Dale said. "We should have our eyes open that large financial flows between the fiscal and monetary authorities may raise understandable concerns."

Particular problems may come at a time when the BoE wants to raise interest rates, which would both increase government borrowing costs and require the government to pay money to the BoE under the terms of the complex deal, Dale added.

(Reporting by David Milliken and Olesya Dmitracova; Editing by Catherine Evans)

Source: http://news.yahoo.com/boes-dale-warns-sticky-uk-inflation-persist-105200008--business.html

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Dispatch From Morocco: ?Excuse Me, Aren?t We About to Start a War Here??

During the five days I?ve spent in Morocco at the Marrakech International Film Festival, not a single person I?ve spoken with knows that a few days after the festivities close, Secretary of State Hilary Clinton arrives here to meet with King Mohammed VI. The next day Clinton will attend the Friends of Syria conference, at the same venue that?s housing the festival.

Even with NBC News citing reports from unnamed U.S. officials that Syria?s President Bashar al-Assad has loaded missiles with sarin nerve gas, everyone in Marrakech was more concerned about attending a dinner hosted by Dior.

A lot of people in the movie business?George Clooney and Angelina Jolie are just two?prove by where they put their money, their mouths and their time that they care about politics and human rights. But those aren?t people I?m running into in Marrakech. Remember the scene in Bruno where Sacha Baron Cohen?s titular character goes to see a charity-advisement public-relations firm?

MORE: Syria: No Warrant Needed (Video)

?Climate change is very hot right now,? the PR hand said.

I may be paraphrasing here, but really: Why is there no market for Save Syria T-shirts?

Mingling among a mix of the international film crowd has shoved me right up against the hard dichotomy between fantasy and reality. I?m seeing red carpets galore, princely dinners, paparazzi, dozens of screenings and hotels nicer than Dubai?s best. But no one?s talking about NATO approving Patriot Missiles being deployed on the Turkish border of Syria.

Yet Morocco is at the center of geo-politics right now. On top of a visit by Secretary Clinton and the Syria conference, the country is chairing the U.N. Security Council this month.

In September, the U.S. announced a ?strategic partnership? with the kingdom. That proffer of partnership seemed to have excited visions of a democratized process back home to Deputy Foreign Minister Yousef Amrani, who told the Washington Post: ?We would like to include new players?civil society [leaders], business leaders. We want a unique . . . mode of cooperation, consultation and understanding. We think we can be a model.?

Now, back to reality. Let?s get this out there: Morocco is a closed society, an authoritarian monarchy. Average Moroccans aren?t even allowed into the nice hotels with Westerners (much like Cuba, another horrible-for-humans system).

A group of young Moroccans, all dressed in amazing tracksuits, stood waiting for stars to arrive and walk the festival red carpet. ?None of those people want us to be free? said one. ?The French would still control us if they could. The West thinks Arabs aren?t worthy of freedom.?

During the Arab Spring, King Mohammed VI acted when protests erupted, promising constitutional changes. The king made good in August 2011: Power over the government council was transferred from the throne to the prime minister.

These reforms are steps in the right direction, but the king still heads the council that approves all judges. He exerts absolute control over the military and religious issues. Secretary Clinton should push for more.

Much of the buzz at the Festival has been about Zero Dark Thirty, Kathryn Bigelow?s film reenacting the killing of Osama bin Laden, a production that the Obama administration cooperated on. If only these people buzzing also cared about the politics behind the movie. At a moment when the Mideast is in throes of war and revolution, Americans are tuning out. We?re back to the oblivious pre-9/11 mindset.

Who cares about Syria, right? Well, if the regime uses chemical weapons, as reports have it, then America will likely be at war. An estimated 75,000 U.S. troops would be needed to secure the chemical weapons.

The other night I spoke with a group of young Moroccans, all dressed in amazing tracksuits. They stood waiting for Bollywood stars to arrive and walk the festival red carpet.

These boys are called Ultras?hardcore soccer fans. In Egypt, they were at the forefront of the revolution and are still protesting now.

?We like our king,? a young Moroccan named Abdul told me. ?But we are ready for democracy.?

Looking at a gaggle of French actors and actresses making their way into the festival, he added, ?None of those people want us to be free. The French would still control us if they could. The West thinks Arabs aren?t worthy of freedom.?

Sadly, my experience here somewhat confirms that. Almost 10 years after Operation Iraqi Freedom, news of NATO upping the ante on Syria and the perils of containing Assad?s WMD have yet to become talking points among average Westerners.

Have the recent allegations that President Assad is preparing sarin gas weapons brought Syria into your conversation? Say how or how not in COMMENTS.

Related Stories on TakePart:

? Photo of the Day: Syrians Leave Home, Stay Alive

? America, Syria and the State of Child Soldiering 2012

? Syria: No Warrant Needed (Video)

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Ray LeMoine was born in Boston and lives in New York. He?s done humanitarian work in Iraq and Pakistan and has written for various media outlets, including the New York Times, New York Magazine and the Awl.

Source: http://news.yahoo.com/dispatch-morocco-excuse-aren-t-start-war-014557147.html

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Syria envoy Brahimi to meet Clinton, Lavrov on Thursday

DUBLIN (Reuters) - Russian Foreign Minister Sergei Lavrov and U.S. Secretary of State Hillary Clinton will meet international Syria mediator Lakhdar Brahimi in Dublin on Thursday to try to put a U.N. peace process for Syria back on track, diplomatic sources said.

The talks come ahead of a meeting of the Western-backed "Friends of Syria" group in Marrakech next week which is expected to boost support for rebels fighting to overthrow Syrian President Bashar al-Assad.

"We have been trying hard to work with Russia to stop the bloodshed in Syria and start a political transition towards a post-Assad Syrian future and very much support what Lakhdar Brahimi is trying to do," Clinton told a news conference ahead of the meeting.

"Events on the ground in Syria are accelerating and we see that in many different ways - the pressure against the regime in and around Damascus seems to be increasing. We've made it clear what our position is with respect to chemical weapons and I think we will discuss that and many other aspects."

Assad's deputy foreign minister said on Thursday that Western powers were whipping up fears of a fateful move to the use of chemical weapons in Syria's civil war as a "pretext for intervention".

In Moscow, a senior Russian lawmaker and ally of Vladimir Putin described Syria's government as being incapable of doing its job properly, in a sign Russia is trying to distance itself from Assad.

Clinton held a bilateral meeting with Lavrov ahead of the talks with Brahimi, which are set to take place after 12:30 p.m. EDT (1730 GMT) on the sidelines of an Organization for Security and Cooperation in Europe (OSCE) gathering.

Brahimi also met separately with Lavrov.

A Western diplomatic source hinted that at least some change may be forthcoming from Russia.

"I don't really know what may come out of the meeting, but I'd expect something based on the Geneva agreement as I cannot imagine Russia now changing completely on Assad. So I am not expecting anything radically new, rather a new version of Geneva maybe," the source said.

The Geneva Declaration, which was agreed when Kofi Annan was international mediator, called for a transitional administration but did not specify what role, if any, Assad would have.

RUSSIAN, CHINESE OPPOSITION

Rebels have made advances across Syria in recent weeks, despite punishing air raids, and have stepped up fighting outside Damascus, where fighting raged on Wednesday in an arc of suburbs on the capital's eastern outskirts.

Assad's family has ruled Syria for 42 years and the Syrian president has vowed to fight to the death in a conflict that has killed an estimated 38,000 people and risks sucking in other countries.

Opposition sources said on Wednesday rebels, riven by deep divisions and rivalries, were trying to restructure their leadership across Syria in an effort to secure foreign funding for their armed revolt.

Brahimi has called for world powers to issue a U.N. Security Council resolution based on a June deal they reached to set up a transitional government in a bid to end the bloodshed in Syria.

The United States and its allies want Assad to step down but are at odds with China and Russia over what role he should have in the process and whether the U.N. Security Council should pass tough measures to punish non-compliance by the Assad government.

Annan's plan also called for Syrians to be allowed to demonstrate freely, the release of political prisoners and an immediate halt to violence. But it did not resolve the question of arms sales to Syria and a host of other issues.

As violence continued in Syria unabated, Western countries proposed a new resolution at the U.N. Security Council in July aimed at putting direct pressure on Assad by threatening more sanctions if his troops did not stop using heavy weapons and withdraw troops from towns and cities within 10 days.

However, Russia and China for the third time vetoed the resolution saying it represented a direct effort to interfere in Syria's internal affairs.

Annan stepped down in August, saying divisions in the Security Council made his plan unworkable.

The United States and its allies said the plan failed because of Assad's refusal to abide by its provisions and Russia and China's refusal to hold Assad accountable at the Security Council.

The United States said it would focus its efforts on rallying support outside the U.N. system for more help for Syria's opposition.

(Additional reporting by Conor Humprhries, Stephen Mangan and Gabriela Baczynska in Moscow; Editing by Michael Roddy)

Source: http://news.yahoo.com/syria-envoy-brahimi-meet-clinton-russias-lavrov-thursday-092339710.html

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In The Rob Gronkowski Jersey Social Media Marketing - i4Giveu.com

Social networking internet sites enable worldwide Rob Gronkowski Jersey communication that is certainly revolutionary, exciting, and fast. If you want to employ this global industry, and use it to boost company, then you need an effective marketing strategy. In this post we shall talk about a number of the do?s and don?ts of social media advertising.

Do not forget that social websites is not about talking like a firm. Whenever you address a potential client, expose your self by the real brand. Tend not to deal with them as being a good friend work as a specialist all the time. You will have to produce a helpful voice and keep the main focus on your own consumers rather than on your own.

Use the questions and respond to function of LinkedIn. LinkedIn?s Q&A performs just like a big dialogue Rob Gronkowski Jersey online community: search for queries associated with your products or market and write valuable techniques to them. You might post the link to each of your posts should you not have time to write some thing.

Possess an expose tab on your Fb web page: only your pals or supporters are able to see it. Persuade folks to ?like? your web page to enable them to have access to this original articles. You might for instance expose an exclusive promotional code for the Facebook customers that have ?liked? your web page.

Keep track of the competitors on social media sites. Commit a little time looking at what your top five rivals are going to do available from the social media entire world. Examine which interpersonal websites these are most energetic on, what type of articles these are publish, the number of supporters Rob Gronkowski Jersey they already have and just how they advertise their internet site and what they need to supply.

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To make best use of social media marketing, answer queries and feedback in a really well-timed method. You do not wish to spend time at your workdesk relaxing your email 24/7, but you do would like to sign in several times daily if you can. Anybody asking questions is either a devoted customer you want to preserve and get much more business from, or an intrigued potential customer who may open up their finances Rob Gronkowski Jersey if you allow them to have some personal focus.

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The realm of social media has increased global advertising and marketing opportunities Rob Gronkowski Jersey for most businesses. On this page, we have discussed some efficient business advertising strategies, and several points to steer clear of too, when contemplating a social networking campaign. Start using these suggestions sensibly as well as your business will view the positive aspects.

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