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The importance of PSA testing to men varied according to the strategy used to identify factors that might influence the decision-making process, a study of values clarification found.
More than half of men valued reducing the odds of prostate cancer death as their priority when asked to rate or rank factors by importance, according to Michael Patrick Pignone, MD, of the University of North Carolina at Chapel Hill, and colleagues. In contrast, about a third of men considered the risk of prostate cancer death as their priority when presented with a balance sheet of potential benefits and harms, or when asked to choose between hypothetical outcomes associated with PSA screening.
Similar variation appeared in responses to other values-clarification exercises, although about three-fourths of the men said they intended to undergo PSA testing, irrespective of their responses, they reported online in JAMA Internal Medicine.
"Different values clarification methods produce different patterns of attribute importance and different preferences for screening when presented with an unlabeled choice," the authors wrote. "Further studies with more distal outcome measures are needed to determine the best method of values clarification, if any, for decisions such as whether to undergo screening with PSA."
A man's decision to undergo PSA testing involves a complex interaction of beliefs, values, and information. High-quality decision processes should inform patients and incorporate their values, the researchers noted in their introduction.
Decision aids can provide patients with information useful for making preference-sensitive decisions. The aids have been shown to improve patient knowledge, reduce uncertainty, and encourage shared decision-making, the authors continued.
Few studies have evaluated the decision aids with explicit values clarification versus those without, or compared different values clarification techniques. To address the lack of information, Pignone and colleagues conducted a randomized trial to compare one implicit method of values clarification and two techniques that involve explicit values clarification methods.
Investigators in the U.S. and Australia recruited men from an online survey panel. Each participant completed a baseline questionnaire and reviewed basic information about PSA testing and associated decision making. The men were randomized to one of the three values clarification techniques and completed a values clarification task. Finally, the participants completed a posttest questionnaire.
Investigators described PSA decision options in terms of four key attributes: the risk of dying of prostate cancer, the risk of biopsy, the risk of a prostate cancer diagnosis, and the risk of becoming impotent or incontinent as a consequence of treatment.
The three values clarification techniques were:
- Balance sheet: Involved implicit values clarification and was based on modeling studies of PSA-related outcomes, randomized clinical trials, and observational evidence. Men allocated to this group chose the most important of the four key attributes.
- Rating and ranking: Participants assigned a value of 0 to 5 to a list of attributes associated with PSA testing, and they were asked to rank the three most important attributes from sets of the key attributes.
- Discrete choice experiment: Participants chose between hypothetical alternatives defined by four key attributes. As an example, participants chose an acceptable 10-year risk for diagnosis of prostate cancer: 60 in 1,000 or 40 in 1,000.
The primary outcome was the highest-valued attribute determined by patients. The final analysis included 911 survey panel participants.
The results showed that 54% of men assigned to rating and ranking chose the likelihood of dying of prostate cancer as the most important attribute, compared with 35.1% of the balance-sheet group, and 32.5% of the men assigned to discrete choice experiment (P<0.001).
A higher proportion of the balance-sheet group (43.7%) preferred a PSA-like screening option over an option similar to no screening, as compared with 34.2% of the rating and ranking group and 20.2% of the discrete choice experiment group.
The balance-sheet group assigned almost equal importance to the risk of prostate cancer death and the risk of prostate cancer diagnosis (35.8%). The diagnosis risk was second in importance for the other two groups. The chance of developing treatment-induced incontinence or impotence was the third most important attribute in all three groups, and the risk of biopsy was the least important of the key attributes across all three study groups.
"The conceptualization of preferences measurement as values clarification has important implications for outcomes," Sara J. Knight, PhD, of the Department of Veterans Affairs, said in an accompanying editorial.
"If the measurement itself is likely to change the preferences, as might be the case in values clarification, the preferences expressed in the initial scores on the measures may represent a preliminary value and not the value that is revealed through the values clarification process."
The study "represents a significant step forward giving physicians and patients the tools they need to transform information-based decision-making to values-informed decision making," Knight added.
The study was supported by the North Carolina Cancer Research Fund and by the National Cancer Institute.
Neither the authors nor Knight had any relevant disclosures.
- Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner


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Car News
Volvo to Discontinue S40 and V50
They were once the most dangerous vehicles on the road, but according to the Insurance Institute for Highway Safety (IIHS), SUVs have changed for the better. The non-profit group recently published its annual study on vehicle mortality rates, noting that SUVs have gone from having some of the highest death rates to some of the lowest.
Of the top ten vehicles with the lowest mortality rates in the IIHS study, seven were SUVs: the Ford Edge, Nissan Armada, Land Rover Range Rover Sport and LR3, each of which tied for the lowest score in the study at zero fatalities per million registered vehicles, and the Honda CR-V, Jeep Grand Cherokee and Acura MDX, which were close behind. That's a huge change compared to just ten years ago, when top-heavy SUVs were frequently involved in rollover crashes.
Why the change? According to the IIHS, it's mostly due to the widespread availability of Electronic Stability Control, a key safety feature common in recent SUVs that helps prevent rollovers. Indeed, each of the top-rated SUVs in the group's study comes standard with ESC.
"The rollover risk in SUVs used to outweigh their size [and] weight advantage, but that's no longer the case, thanks to ESC," said Anne McCartt, the IIHS's senior vice president for research.
Of course, it's not only SUVs that performed well in the mortality study, which looked at model year 2005 through 2008 vehicles. The Toyota Sienna minivan and the Audi A6 and Mercedes E-Class premium sedans also topped the test with zero fatalities per million registered vehicles, and the Kia Sedona minivan and Saab 9-3 sedan also scored well. Among midsize sedans, the Honda Accord was ranked best with just 19 fatalities per million registered vehicles, while the Honda Pilot was top among midsize SUVs.
The test also highlighted one important factor that appears to make a significant difference in vehicle mortality rates: weight. Cars weighing less than 2,500 pounds saw 71 deaths per million registered vehicles, a number which dropped to just 41 deaths for cars between 4,000 and 4,500 pounds. SUVs saw the same trend, with 39 deaths per million between 3,000 and 3,500 pounds, which dropped to 20 per million for SUVs above 5,000 pounds. The lesson: even with all of today's advanced safety features, it's still better to have as much metal around you as possible.
View the full results of the study for more information.

subset: commoncrawl


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Warriors' Thompson seeks extension, ignores trade rumors
Klay Thompson just finished a four-day trip to Istanbul and plans to spend a week fishing in Mexico before reporting to Las Vegas for the U.S. basketball team's training camp next month.
The Warriors' shooting guard hopes that completes his travels for a while.
The focus of a number of trade rumors involving a potential swap for Minnesota's Kevin Love this summer, Thompson brushed off the scuttlebutt during a recent interview with The Chronicle, reiterating his desire to sign a contract extension with the Warriors this offseason.
"First off, it'd be a dream come true if I was able to sign an extension. Whether it happens or not, I know I'm a fortunate man to be in the NBA," said Thompson, who did community service, worked at youth basketball camps and hosted a three-on-three tournament in Turkey. "I'm excited about the Warriors' franchise. I think we're becoming one of the premier franchises in the NBA. It's awesome to be part of it. ... I'm going to try to get better and do everything that I can to keep this organization on an upward trend."
Heading into his fourth season, during which he'll be paid about $4.5 million, one of the game's best two-way guards is due a big payday. Thompson's agent, Bill Duffy, and Warriors general manager Bob Myers may discuss an extension between July and next season's opener in October - a deal that owner Joe Lacob said will "unequivocally" get done.
It was an unpopular decision to fire head coach Mark Jackson, but any ill thoughts seem to have been quieted when the Warriors made the coup of hiring Steve Kerr, who was believed to be headed to New York.
"It was tough seeing Coach Jackson go. It was great playing for him, but I'm excited about Steve," Thompson said. "I feel like he has a brilliant mind for the game. He was a great shooter, so me and Steph (Curry) can really learn from him. He was around winning for his whole career, so that's cool. We got a guy who knows how to win. I'm excited to get to work with him. I think we can build a great relationship together."
Thompson, whose father, Mychal, was the No. 1 overall pick in 1978 and calls Lakers games, met Kerr well before entering the NBA. He said he came away impressed from their first meeting and had those feelings reinforced during a recent phone call.
The two didn't discuss the specifics of Kerr's planned offense, which is expected to include elements of the triangle offense. Thompson, a hoop head who grew up watching the Lakers execute the triangle offense, mocked himself for not knowing much about the scheme, but he would be a standout in the triple-post sets or the two-man game on the backside.
He'd be even better if the Warriors find a way to land Love, who wants out of Minnesota and is said to like Golden State, without having to deal their star-in-the-making. Thompson said Love's versatile offensive game would be a great fit with the Warriors, and the shooting guard is trying to ignore the idea that he could have to be traded in order to get Love.
"It's all speculation, really," Thompson said. "With trade rumors, if you read too far into them, it's not healthy. ...
"I'm a fortunate young man to be playing the NBA, and I'll be fortunate wherever I'm playing. But I love playing with the Warriors. I want to be there for a long time. The Warriors are committed to winning, and they'll do whatever is necessary to do that."
Rusty Simmons is a San Francisco Chronicle staff writer. E-mail: firstname.lastname@example.com Twitter: @Rusty_SFChron


text:
Sale of Boston Globe to Red Sox owner is finalized
John Henry buys paper for $70 million
Sale of Boston Globe to Red Sox owner is finalized
John Henry buys paper for $70 million
The Boston Globe says its sale to principal Boston Red Sox owner John Henry is finalized.
The paper said in August that Henry had agreed to buy it from The New York Times Co. The deal will give Henry the 141-year-old newspaper, its websites and affiliated companies.
The Times announced in February it was putting the Globe up for sale four years after calling off a previous attempt to sell it. The company's CEO said at the time that selling the Globe would help it focus attention on The New York Times brand.
The deal was briefly held up by a restraining order in a lawsuit against the Telegram & Gazette of Worcester, part of the New England Media Group along with the Globe. That order was lifted Thursday.


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European Start-Ups Should List on NASDAQ
Bruce Aust Executive Vice President says companies thinking of floating should care about getting the best value for shareholders and that means listing on Nasdaq.
This transcript has been automatically generated and may not be 100% accurate.
I ... I'm here in uni with Bruce all says the executive vice president of Nasdaq ... um ... why he is a ... big New York exchange what you know not U S exchange here in Europe's leading European companies to go to America to that exchanges here in Europe twice in a given to me that that ... will then there's actually a lot of U S companies years well but we do see a lot or European startups looking to the U S markets the Nasdaq has been known for innovation technology ... were the home of the Vista now is pray Demark brands like Apple's mobile Amazon they're all this in our markets of our Cubbies aspire to not to list on Nasdaq ... they said ... let's take this example innovate European company ... aam thinking that getting Temasek's ... how does the Europeans kamikaze open onto a move that they're ready for a listing on the ... right place of positive by getting the right to buy is around you so much of the investment bankers lawyers ... um you're probably richer cap a list that invests in you have a history of bringing companies public on ... on the Nasdaq and other markets to make sure they're ready to be sure to build good solid board of directors ... and that's a good foundation for is ... you know getting ready to go public ... it's a ... the success of a company that's going to do this on ... are there any particular concerns that they should be having so what you really should care about is were due to this valuation for your shoulders ... Acquity fear shareholders ... aam and you ... what you have the studying from income that you can rely upon ... becoming ever us inside the data were your Cubbies going the best way you look at tapping the U S markets and ... on we think that we are ready ... my last push in one piece of advice if you have a good one piece of advice ... to re unite Europe and entrepreneurs was thinking of of of of of Listing ... Pop Wall Street this asset ... other advice but is one piece of Isaac ... he I would say deftly gaze exchange early aam you know we can help I worked at companies for many years for the go public ... with less service that she help you get ready to go public and I are PR corporate governance ... billable preview ready for that day that you start reading ... to talk to the extent that tax increase thank you very much indeed it did ...


text:
Today's Hours
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Wednesday, Jan 23
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Event box
May Spotlight: Mental Health Awareness Month
This month-long May Spotlight focuses on Mental Health Awareness Month.
According to the National Alliance on Mental Illness:
"Each year, millions of Americans face the reality of living with a mental health condition, as 1 in 5 U.S. adults will experience a mental health condition in their lifetime. However, everyone is affected or impacted by mental illness through friends and family."
Check out some related resources we have on display in the Reference Area.
For more information, visit:
- Date:
- Wednesday, May 30, 2018 Show more dates
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- All Day Event
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- Library Display - Spotlight On
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Rombelli Crowned Portoferraio Winner At 2013 Audi Melges 20 Sailing Series
9 June 2013
Portoferraio, Italy - After five races, Alessandro Rombelli aboard STIG with 2012 Melges 32 World Champion tactician Paul Goodison and fellow Gold Cup Champion crew member Giorgio Tortarolo has won the Portoferraio edition of the 2013 Audi Melges 20 Sailing Series. Giancarlo Capolino on Legionario had a smashing good regatta to finish second overall. Guido Miani on Out of Reach is third.
The second day of racing in Portoferraio commenced with a short postponement due to shifty breeze. Eventually the wind filled in to a sailable 15 knots under overcast skies for the start for Race Three. Marco Francini on Mezza Luna, Andrea Pozzi on Shimmer and Rombelli lead the fleet single file around the top mark. The fleet surfed downwind while the three fought fiercely with Rombelli proving to be too much to hold off for Francini and Pozzi. Rombelli ultimately grabbed the win, placing him in the overall event lead. Capolino pulled up to overtake and place second. Pozzi settled for third.
Race Four delivered more success for Rombelli as he took an immediate lead for the win. Renato Vallivero's Audi Ultra Giacomel finished second and Francini stayed strong to place third.
With Race Five in play, heavy rain settled in for the start with Marco Zaoli on Shadow rounding the top mark in first, then Francini and Pozzi respectively in second and third. Overnight leader Miani hit the mark trying for fourth and Rombelli in fifth. Zaoli stayed strong to pass through the gate holding on for the lead, leaving Pozzi and Rombelli to battle for second and third. Francini found some nice upwind speed to overtake for the lead at the final mark with Rombelli on his heels. Zaoli slipped back to third. Capolino pulled out all the stops in the final run to the finish taking a grand win at the line just ahead of Achille Onorato on Mascalzone Latino Jr., Zaoli placed third.
Post Portoferrio, Miani maintains his Series leadership, with Onorato now in second. Rombelli moves up to third, and Francesco Farnetti on ITA-157 now in fourth. Mirko de Falco on Peccere is fifth.
The 2013 Audi Melges 20 Sailing Series is organized by B-Plan Sport&Events in full collaboration with the International Audi Melges 20 Class Association and Melges Europe. A maximum of six races are scheduled over the next two days.
The remaining Series events are Torbole (6-7 July) and Porto Rotondo (29 August - 1 September) where the very first Audi Melges 20 European Championship will take place.
TOP TEN RESULTS (FINAL - After Five Races)
1.) Alessandro Rombelli/Paul Goodison, STIG; 4-10-1-1-4 = 20
2.) Giancarlo Capolino/Francesco Ivaldi, Legionario; 11-5-2/ZULU-3-1 = 27
3.) Guido Miani/Gabriele Benussi, Out of Reach; 1-3-12-8-7 = 31
4.) Renato Vallivero/Enrico Fonda, Audi Ultra Giacomel; 2-14-6-2-13 = 37
5.) Mirko de Falco/Guglielmo Giordano, Peccere; 8-1-11-6-17 = 43
6.) Francesco Farneti/Alberto Bolzan, ITA-157; 3-8-9-19-5 = 44
7.) Marco Francini/Sandro Montefusco, Mezza Luna; 10-17-3-7-10 = 47
8.) Robert Wilber/Anthony Kotoun, Cinghiale; 9-4-15-12-8 = 48
9.) Manfredi Vianini Tolomei/Lorenzo Bodini, Maolca; 6-2-7-22-12 = 49
10.) Achille Onorato/Lorenzo Bressani, Mascalzone Latino Jr.; 12-13-10-14-2 = 51
View Full Results
View Full Crew/Entry List
View Photo Gallery - Borlenghi Studio
View Photo Gallery - Leonardo Bianchi
View Full 2013 Audi Melges 20 Sailing Series Results (After 12 Races)


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|Hey Mom! Learn more about the Gerber Life Insurance Grow-Up Plan!
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Roommates reaction to 2yos behavior VENT
I have no idea where to post this...so I decided to post it in a few places. I need to both vent and get advice... Please refrain from bashing me (my parenting techniques and all..im still learning) in any way... This situation is really bothering me and starting to get out of hand..This will be long..
Trying to use positive discipline with my kids ..I use ALOT of distracting and redirecting for Ocean... I feel like its still appropriate not only at this age but for how his mind is working...
**HERES THE BIG THING -- it happens often...with our roommate.. Ocean will do something that he doesnt like and he responds SO WRONG dispite how i jump in and model better behavior.. I have explained to him before that NO i wont hit oeans hand or even yell at him for doing something like..say..turning the tv on and off...or getting a lap top off the coffee table.. DONT LEAVE ur stuff down he wont get it.... I baby proof for both ease of mind and so my kids can have a fun safe easy place to play not one where they cant touch things they want to... HOW UN FUN FOR THEM! he will be older one day and things can be left down but he is TWO
*MY REASON TODAY FOR VENT IS... ocean had the maraka this morning before asking me to play he went to roomate and hit him on knee NOT hard! but still hit him... im not saying its okay im saying that the adults reaction is worse.. anyways roomate takes maraka and holds it above oceans head... WHAT? before saying anything I watched bc I thought this is the time ill say something that will make an impact bc nothing has so far...then he gives it back..then ocean goes away 15 min later does it again and roomate throws it accross the room.. Ocean laughs then goes and grabs it and hits roomate again..BC he thinks its a fun game! then rooomate shoves him and thats when I jump in with my ..he wants to play..he thinks its fun.. and why the heck are you bulling a 2yo by holding something outa his reach then throwing it..then shoving him?? roomate responded that he didnt know what to do.."ocean keeps hitting me" DUDE your 25 not 5... and I explain to roomate AGAIN like i did to my kids..why i think ocean is acting that way and that it will pass could take months and how we have to be persistant... AND BIGest thing of all... YOU MUST tell him what you want him to do .not just whine..shove and show him bad behavior.. when he hits the kids they stop what they are doing..find out what it is his wants bc they know he cant talk yet...and they play with him for atleast a full minute I am BIG not not leaving ocean out i dont care how old you are...if he wants attention he gets it... we all do..when i want it... i want it too LOL
If this were you..how would you react? roomate situation is very short term like id say a month more tops prolly less... Im sick and tired of him just thinking I dont discipline my kid and he thinks i just let him get away with stuff NO its not what im doing...im doing fine correct me if im wrong...
Mama to 3 boys (8,6 and 2) and WELCOME Aira Denise born 3/19/12!
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It wasn't pretty — and it vaguely reminded everyone of the Orlando loss — but NBA folk always say the first game back from a road trip is the hardest. Doubly hard if it's an opponent the Clippers are expected to beat handily. And every team, good or bad, is out there to "punk" one of the good teams. That's right, the Clippers walk around with a bullseye on their back.
Buzzer Reaction
Recap | Box score
No Daily Dime tonight. So instead, enjoy the Clippers' power foward run the break and throw a lob to the center.
Tweet of the Game
100 percent honest: #Clippers dance team performs to "Devil with the blue dress on." Joey Crawford mouths all the words.
— Dan Woike (@DanWoikeSports) January 20, 2013
Sadly, Joey Crawford didn't sing along to Kanye West's "Stronger."
— Dan Woike (@DanWoikeSports) January 20, 2013
Eric Bledsoe Per36 Stat o' The Night
|Eric Bledsoe
ClipperBlogLive's Best Moment
For Jordan's de fact Facetime, he explains what all the ruckus was about in the crowd during the third quarter. A WWE heel move!
Check Your Messages
Tactical Adjustments
Trap games are real, and, at least for this year's Clippers team, easy to define: weekend games against middling opposition in front of a lackluster home crowds are trouble. To his credit, Vinny Del Negro – for whom the Orlando loss is doubtless still fresh – was doing everything he could to find a smooth lineup in this choppy game, which included debuting two-never-before-seen groups.
The Clips closed the first half with 6 minutes of Paul, Crawford, Barnes, Hill and Blake. It demonstrates how far Blake has progressed as a defender in Vinny's eyes, because last season Del Negro openly admitted his reluctance to play him at the 5. The Wiz tried to take advantage of the perceived mismatch by forcing the ball in to Nene in the post, but the Clippers collapsed effectively, forcing the ball out of Nene's hands, and recovering quickly to trouble the Wizards' suspect perimeter shooters.
New line-up #2 was Paul, Bledsoe, Barnes, Hill, Lamar Odom, who played together for a few minutes midway through the fourth. Why is this so interesting? Because nine times out of ten, Bledsoe gets pulled for Crawford here. But VDN, realizing that John Wall was the most dynamic player on the court, left Bled in to chase him around, rather than asking a still-bruised CP3 to take the tougher cover. That's right: tactical adjustments, people! As Andrew Han said on CBL, it's enough to give a girl the vapors.
– Jordan Heimer
What Happened to the Choice Cuts?
At the outset of the season and through the early segment of the 17-game winning streak, the Clippers made their money from off-ball movement. While Jamal Crawford's individual brilliance facilitated the scoring on the second-unit and the Paul/Griffin duo carried the offensive load for the starters, the remainder of the Clippers persistently moved to open space in order provide secondary options for the principals. It was this opportunism that enabled the Clippers to dismantle poor and premium opponents alike. But recently, cutting has given way to a sort of drifting. Maybe there's an element of midseason fatigue or maybe the cutters have developed a preference for outside shots. Nonetheless, isolations are more frequent, as are contested shots from the outside. But most significantly for the Clippers offensive strategy, there's a marked decrease of secondary action when the ball goes into the post. Given opposing defense's historic success in slowing down the Clippers by doubling Blake Griffin, getting in the habit of laboriously moving off the ball wil absolutely pay dividends come the playoffs.
– Michael Shagrin
Inbound Sets
One of the things I like to watch are what a team runs out of a timeout, especially in late clock situations. In Houston, the Clippers ran a very simple, but effective, give-and-go between Barnes and Odom that got Matt a wide open look from three. Miss.
Tonight, with about 3 seconds left until halftime, the Clippers picked a play in the timeout and went at it again: Griffin set a high pick for Crawford's man and rolled to the basket. Hill set a backscreen for Barnes, the inbounder, and Barnes broke for the corner. Hill's man had already collapsed to the paint because a diving Griffin is a recipe for a highlight. This left Barnes completely open in the corner.
Now, Wall tipped Paul's dribble and nothing materialized as the play broke down; not even a shot. But there is definitely some reasoned thought going into these designed plays.
– Andrew Han
Latest posts by Andrew Han (see all)
- Redesign the Clippers' logo winner – June 17, 2015
- Redesign the New Clippers Logo – May 31, 2015
- ClipperBlog Live: Los Angeles Clippers 99, New York Knicks 78 – December 31, 2014


text: People do Business with People they Know, and we want to get to know YOUR BUSINESS! The Greater Mount Airy Chamber of Commerce provides you the opportunity to build business relationships and make new business contacts. Chamber partners are the voice of business which shapes and molds our community, keeping the economics of the Greater Mount Airy area healthy and prosperous.


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Dagor Bragollach
|Dagor Bragollach
|Conflict: War of the Jewels
|Date: F.A. 455
|Place: Northern Beleriand/Anfauglith
|Outcome: Victory for Morgoth, breaking of the Siege of Angband, destruction of Dorthonion, loss of key fortresses and passes
The Ñoldor, The Edain (especially the House of Bëor)
Forces besieging Angband, garrisons of several strongholds including Himring, Barad Eithel, Nargothrond and Tol Sirion, Men of the House of Bëor and Dor-lómin
Heavy for both Elves and Men, including the virtual destruction of the House of Bëor
Unknown, but probably heavy
The Dagor Bragollach (Sindarin for "Battle of Sudden Flame") was the fourth battle of the Wars of Beleriand.
The Battle Opens
It began when Morgoth broke the Siege of Angband, which had held for four hundred years. On a winter's night, Morgoth sent out rivers of flame, consuming Ard-galen, which was renamed Anfauglith. Many elves perished as they fled from these flames, from the fire and the smoke. His armies of Balrogs and Orcs, led by Glaurung first of the Urulóki, overran the highlands of Dorthonion, and slew Angrod and Aegnor. Maglor's horsemen were burnt alive on the plain of Lothlann, and Maglor's Gap was taken, giving Morgoth an entry into Beleriand itself. Maglor retreated with heavy losses to Himring, where he helped defend the city of Maedhros.
East Beleriand Overrun
The Pass of Aglon was also breached, and Celegorm and Curufin fled south of Doriath to Nargothrond. Morgoth's Orcs took the mountain forests of Mount Rerir, and defiled Lake Helevorn, scattering south through Thargelion into East Beleriand. Caranthir fled to Amon Ereb, where he and Amrod built defenses. From there they slowly freed East Beleriand of the Orcs, while Maglor and Maedhros held the northern border.
Minas Tirith in the Pass of Sirion in the West under Orodreth held, and Orodreth's brother and Lord Finrod Felagund came north from Nargothrond with a large army. However, they were ambushed by a large army of Morgoth's forces at the Fen of Serech. The Noldor now found themselves trapped, and Finrod would have been killed but for a sortie by Barahir, who descended from Dorthonion and rescued the Elven lord. It was this deed which later earned Barahir the ring of Finrod which would become known as the Ring of Barahir.
Finrod and his folk fled south to Nargothrond, while Barahir continued defending Dorthonion. The mountain forts of the Ered Wethrin around Hithlum also held, although barely.
The Battle Ends: Fingolfin's Duel
Thus the Siege was broken, the Sons of Fëanor scattered, and the forces of Morgoth roamed at will throughout the north.
When Fingolfin, the High King of the Noldor, learned of the losses of so many Noldor, he rode in anger across the dust of Anfauglith and challenged Morgoth to single combat. At the doors of Angband itself, they fought a great duel. Fingolfin's sword, Ringil, wounded Morgoth seven times. Yet, he was felled by Morgoth's hammer, Grond, and slain by Morgoth's mighty foot.
See also
|Wars of Beleriand
|First Battle · Dagor-nuin-Giliath · Dagor Aglareb · Dagor Bragollach · Nirnaeth Arnoediad · War of Wrath