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Although the trend toward eliminating the most egregious provisions continued this year, our research shows that golden parachute arrangements remain a staple of the pay package for over two-thirds of [...]

Among young men between the ages of 15 and 40 years, germ cell cancer is the most common solid tumor [1]. The worldwide incidence of germ cell cancer is 70 000 cases. Compared to all solid tumors of men, germ cell cancer accounts for 1% of all male tumors. Nevertheless, the mortality of this rare tumor entity is about 13% since 9507 patients died worldwide of germ cell cancer. The improvement in survival of germ cell cancer patients is due to a multimodal treatment of germ cell cancer including cisplatin-based chemotherapy and surgery leading to higher cure-rates even in advanced stages [1], whereas the increasing incidence of germ cell cancers cannot be thoroughly explained. In this article we review the current indications for surgery in metastatic germ cell cancers, highlight the strength and weaknesses of techniques and indications and raise the question how to improve surgical treatment in metastatic germ cell cancer.

Germ cell cancers are the most common solid tumors among men between 15 and 40 years. Non-seminomatous germ cell tumors (NSGCTs) represent a unique and exclusive cohort of germ cell tumor patients. Non-seminoma can harbor different histologic components. The most commonly found histologies are embryonal cell cancer, teratoma, yolk sack tumor and choriocarcinoma, as well as teratocarcinoma and seminoma, in combination with non-seminomatous germ cell tumors histologic types. The clinical definition of stage I non-seminoma is the absence of metastatic lesions on imaging and normal tumor markers. The cure rate for clinical stage I NSGCT is 99% and this can be achieved by three therapeutic strategies: Active surveillance with treatment at the time of relapse, retroperitoneal lymph node dissection or adjuvant chemotherapy. The balancing of these various strategies should always be based on an individual risk profile of NGSCG patient depending on the lymphovascular invasion of the tumor.

Each year, southeastern Virginia comes to life with a vibrant blast of music, theatre, and dance. For the past 20 years, the Virginia Arts Festival (VAF) has made this historic [...]

Polymers are ubiquitous and essential to modern society, which is why the American Chemical Society has mandated inclusion of polymer chemistry in the undergraduate curriculum. To meet this requirement, we have chosen to weave a polymeric theme through multiple laboratory courses beginning with organic chemistry, where students use aspartic acid to synthesize poly(aspartic acid), an ecofriendly alternative to nonbiodegradable poly(carboxylates). Subsequently, these student-synthesized polymers serve as substrates for the enzyme poly(aspartic acid) hydrolase-1 in our biochemistry course. This experiment introduces the concept of biodegradation through a gel assay that allows students to visualize enzyme-mediated polymer degradation. Students learn the difference between mono- and polydisperse polymers, how biodegradation affects the size of a polymer through analysis of mobility shifts in an agarose gel, and how to use densitometry software to calculate enzyme activity. Finally, keeping the same polymeric theme provides a source of continuity in our curriculum while expanding students’ understanding of polymer chemistry from the viewpoint of different chemistry disciplines.

Growing teratoma syndrome (GTS) is a rare clinical phenomenon in patients with nonseminomatous germ cell cancer defined by growing metastatic mass during ongoing or directly after completed chemotherapy with timely decreasing tumor markers and postpubertal teratoma exclusively after resection. GTS was first described in 1982, and few reports have been published. The limited number of studies and the resulting lack of exact knowledge about development, differentiation, and treatment of GTS leaves several clinical problems regarding treatment and follow-up unsolved. This review provides an overview of clinical diagnosis and disease management and an approach to explain the molecular development of GTS.

The repertoire and abundance of proteins displayed on the surface of neuronal dendrites are tuned by regulated fusion of recycling endosomes (REs) with the dendritic plasma membrane. While this process is critical for neuronal function and plasticity, how synaptic activity drives RE fusion remains unexplored. We demonstrate a multistep fusion mechanism that requires Ca2+from distinct sources. NMDA receptor Ca2+initiates RE fusion with the plasma membrane, while L-type voltage-gated Ca2+channels (L-VGCCs) regulate whether fused REs collapse into the membrane or reform without transferring their cargo to the cell surface. Accordingly, NMDA receptor activation triggered AMPA-type glutamate receptor trafficking to the dendritic surface in an L-VGCC-dependent manner. Conversely, potentiating L-VGCCs enhanced AMPA receptor surface expression only when NMDA receptors were also active. Thus L-VGCCs play a role in tuning activity-triggered surface expression of key synaptic proteins by gating the mode of RE fusion.

In an effort to more fully employ underutilized satellite observations in ocean modeling, this work demonstrates a method for quantifying the agreement between time-evolving spatial features evident in fields of differing, but functionally related, variables that are more commonly compared qualitatively via visual inspection. This is achieved through application of the Modified Hausdorff Distance metric to the evaluation of ocean model simulations of surface salinity near riverine sources using satellite ocean color data. The Modified Hausdorff Distance is a metric from the field of topology designed to compare shapes and the methodology provides quantitative assessment of similarity of spatial fields. The Modified Hausdorff Distance can be applied for comparison of many geophysical and ecological fields that vary spatially and temporally. Here, the utility of the metric is demonstrated by applying it to evaluate numerical simulations of the time-evolving spatial structure of the surface salinity fields from three ocean models in the vicinity of large riverine sources in the northeast Gulf of Mexico. Using the Modified Hausdorff Distance, quantitative comparison of modeled sea surface salinity contours to contours of a gridded satellite-derived ocean color product is made under the assumption that the modeled fields are related to optically significant quantities that indicate the spatial extent of riverine influenced water. Three different ocean models are evaluated and are compared individually to the satellite data. The sea surface salinity values and ocean color index values that most closely match (lowest Modified Hausdorff Distance score) are identified for each model. The Modified Hausdorff Distance scores for these best pairings are used to both determine the degree to which surface salinity fields from the models match the satellite observations and obtain an empirical relationship between the two variables for each model. Furthermore, the best pairings are compared between models allowing key differences in the simulated riverine water distributions to be distinguished. The Modified Hausdorff Distance proves a robust and useful diagnostic tool that has the potential to be utilized in many geophysical applications and facilitates the use of satellite ocean color data for quantitative evaluation of hydrodynamic ocean models.

Satellite laser altimetry reveals short timescale changes in Antarctic ice sheet surface elevation that are suggested to be driven by subglacial water transport and storage. Here details of the interaction between the dynamics of ice stream flow, subglacial water system, and bed elevation relief are examined in the context of idealized, heterogeneous bed geometries. Using a two-way coupled model of ice and subglacial water flow, we show that basal topography controls the temporal and spatial variability of the sub–ice stream hydraulic system. The orientation and characteristic dimensions of the topographic undulations determine the morphology (connected subglacial ponds or channel-like subglacial water features) and timescales of the sub–ice stream drainage system. The short-term (several years to decades) variability of the simulated coupled ice stream/subglacial water system suggests that the short-term surface variations detected in remote sensing observations may be indicative of a rapidly evolving subglacial water system. Our simulations also show that interaction between ice flow and the highly dynamic subglacial water system has a strong effect on effective stress in the ice. Large effective stress magnitudes arise over areas where the basal traction is characterized by strong spatial gradients, that is, transitions from high to low basal traction or vise versa. These transitions migrate on multiyear timescales and thus cause large effective stress variability on the same temporal scales. Bed topography determines morphology of subglacial drainage systemThe coupled ice stream/subglacial water system evolves on short timescalesCoupling between ice stream and subglacial water flow results in high effective stresses in ice

As a child I dreamed of being a ballet dancer. When my mother asked me what I wanted for my 12th birthday, I requested dance lessons. Each lesson cost $2, [...]

After a move from the East Coast to the West Coast, my husband, Pat. McMenamin, and I settled in Utah. Taking a walk one day to check out the surrounding [...]

In a survey of 271 undergraduates conducted during the 2nd and 11th week of their 1st semester of college, the authors found that self‐esteem mediated relations between social anxiety and academic, social, and institutional adjustment. Implications for 1st‐year college students with social anxiety are discussed, with an emphasis on early identification and recommendations for counselors to adapt cognitive behavior therapy interventions for use with college populations.

For the enhanced removal of anthropogenic contaminations from the subsurface, thermal enhancement has proven to be efficient. For soils of low permeability and/or contaminants of low volatility, thermal wells are used. Experimental work on the small scale to identify the chief processes and to yield parameter sets for the numerical simulation of remediation by thermal wells is presented. The numerical model is used for the systematic simulation of heat and contaminant mass transport in different porous media under changing conditions. A general overview of the remediation performance of thermal wells for different soils, contaminants and operational parameters based on the numerical investigations is given.

Patients with sepsis and acute lung injury have increased interleukin (IL)‐18 levels systemically. We hypothesize that IL‐18 stimulates neutrophils (PMNs) at physiologic concentrations. IL‐18 primed the oxidase at 15 min (10–100 ng/ml), 30 min (0.1–100 ng/ml), and 60 min (100 ng/ml; P<0.05) and caused translocation of p47phoxto the membrane similar to lipopolysaccharides. CD11b surface expression was increased by IL‐18 in a time‐ and concentration‐dependent manner. IL‐18 caused up‐regulation of the formyl‐Met‐Leu‐Phe receptor, changes in PMN size, and elastase release. Investigation of signaling demonstrated IL‐18‐mediated activation of p38 mitogen‐activated protein (MAP) kinase in a concentration (0.1–100 ng/ml)‐, time (5–15 min)‐, and Ca2+‐dependent manner. IL‐18 directly increased cytosolic Ca2+concentration. IL‐18 activation of PMNs was blocked by inhibition of p38 MAP kinase activity (SB203580) or by inhibition of p38 MAP kinase activation by chelation of cytosolic Ca2+. We conclude that IL‐18, at physiologic concentrations, is an effective PMN priming agent that requires p38 MAP kinase activity.

High-throughput methods for assaying DNA variation require two important steps: (i) discriminating the variation and (ii) de-tecting the signal. In this report, we describe a novel SNP genotyping method that we refer to as melting curve analysis of SNPs (McSNP®). McSNP combines a classic approach for discriminating alleles, restriction enzyme digestion, with a more recent method for detecting DNA fragments, melting curve analysis. Melting curve analysis is performed by slowly heating DNA fragments in the presence of the dsDNA-specific fluorescent dye SYBR®Green I. As the sample is heated, fluorescence rapidly decreases when the melting temperature of a particular fragment is reached. We show that it is possible to determine the composition of simple mixtures of DNA fragments, such as those that result from restriction enzyme digestions of short PCR products. McSNP is well suited for high-throughput genotyping because 96 samples can be analyzed and automatically scored in 20 min. Our results clearly demonstrate that McSNP is a simple, inexpensive, and accurate means of genotyping SNP variation.

We have studied the effects of granulocyte colony-stimulating factor (G-CSF) administration to normal individuals on a variety of functional and biochemical neutrophil characteristics that relate to host defense. G-CSF adversely affected neutrophil (polymorphonuclear leukocyte [PMN]) chemotaxis. While this could be partially explained by reduced assembly of neutrophil F-actin, we also recognized an elevated cytosolic calcium mobilization and a normal upregulation of neutrophil CD11b. G-CSF resulted in reduced PMN killing of Staphylococcus aureus with a 10:1 (bacteria:neutrophil) ratio and normal killing with a 1:1 ratio. In association with this, we demonstrated divergent effects on the respiratory burst of intact cells and divergent effects on the content of marker proteins for neutrophil granules. While G-CSF may have resulted in increased content of cytochrome b558 in the cell membrane, it did not alter the amounts of cytosolic oxidase components. After therapy, there was normal content of the azurophilic granule marker, myeloperoxidase, decreased content of the specific granule marker, lactoferrin, and normal content of lysozyme (found in both granules classes). Finally, G-CSF therapy markedly reduced the apoptotic rate of the isolated neutrophil. Therefore, considering disparate functional and biochemical activities, the real benefit of G-CSF therapy may lie in enhanced number and survival of neutrophils.

The importance of reactive oxygen species (ROS) in neutrophil (PMN)‐mediated injury to host tissues has been strongly implicated in a number of animal models. Peculiarities of the laboratory rat PMN, including an apparent paucity of superoxide release, prompted us to examine disparities in the respiratory burst between human and rat PMNs. Using isolated PMNs, we examined oxygen consumption, superoxide release, nitrate/nitrite release, and dihydrorhodamine (DHR) oxidation in response to an array of soluble stimuli. Our findings confirm that intact rat PMNs release little superoxide in comparison to human PMNs when primed and activated by soluble stimuli. For example, PMA‐activated human PMNs released superoxide at 10.1 ± 2.7 times the rate of rat PMNs (P< 0.01). However, measurements of oxygen consumption, cell‐associated oxidant production (by DHR oxidation) and release of superoxide from electroporated cells suggests that rat PMNs generate oxidants at rates equivalent to human PMNs but preferentially release them in an intracellular compartment. Implications for the study of PMN‐ mediated oxidant injury in animal models are discussed. J. Leukoc. Biol.65: 211–216; 1999.

Abstract: The planar fibrous connective tissues of the body are composed of a dense extracellular network of collagen and elastin fibers embedded in a ground matrix, and thus can be thought of as biocomposites. Thus, the quantification of fiber architecture is an important step in developing an understanding of the mechanics of planar tissues in health and disease. We have used small angle light scattering (SALS) to map the gross fiber orientation of several soft membrane connective tissues. However, the device and analysis methods used in these studies required extensive manual intervention and were unsuitable for largescale fiber architectural mapping studies. We have developed an improved SALS device that allows for rapid data acquisition, automated high spatial resolution specimen positioning, and new analysis methods suitable for large-scale mapping studies. Extensive validation experiments revealed that the SALS device can accurately measure fiber orientation for up to a tissue thickness of at least 500 μm to an angular resolution of∼1o and a spatial resolution of±254 μm. To demonstrate the new device’s capabilities, structural measurements from porcine aortic valve leaflets are presented. Results indicate that the new SALS device provides an accurate method for rapid quantification of the gross fiber structure of planar connective tissues.

We describe the changes exhibited by astrocytes in areas of Wallerian degeneration after spinal cord injury in humans using glial fibrillary acidic protein immunohistochemistry correlated to standard histology at time points ranging from 8 days to 23 years after injury. Astrocytes were slow to react; a slight increase in immunoreactivity was observed at 4 months. Over time they began to lose immunoreactivity in both the somata and the processes as the debris from the degenerative process was cleared. By 1 year after injury the staining intensity had decreased to levels which were lower than in normal areas of the cord. This hypointense staining persisted for at least 23 years after injury. These findings are significantly different from those observed in animal studies and emphasize the need for additional pathological studies of human spinal cord injury.

AbstractSurge tanks for flow smoothing can represent a significant cost of a chemical plant. Several studies have addressed improved level control algorithms to optimize the use of an already specified surge volume. However, little attention has been given to optimally sizing and locating surge tankage in continuous processes. This research addresses this question. The strategy developed is applied to a multiple unit operation process and identifies one of several alternative control schemes as superior in terms of required surge tankage.

We undertook this study to establish a more quantitative understanding of the microstructural response of the aortic valve cusp to pressure loading. Fresh porcine aortic valves were fixed at transvalvular pressures ranging from 0 mmHg to 90 mmHg, and small-angle light scattering (SALS) was used to quantify the gross fiber structure of the valve cusps. At all pressures the fiber-preferred directions coursed along the circumferential direction. Increasing transvalvular pressure induced the greatest changes in fiber alignment between 0 and 1 mmHg, with no detectable change past 4 mmHg. When the fibrosa and ventricularis layers of the cusps were re-scanned separately, the fibrosa layer revealed a higher degree of orientation while the ventricularis was more randomly oriented. The degree of fiber orientation for both layers became more similar once the transvalvular pressure exceeded 4 mmHg, and the layers were almost indistinguishable by 60 mmHg. It is possible that, in addition to retracting the aortic cusp during systole, the ventricularis mechanically may contribute to the diastolic cuspal stiffness at high transvalvular pressures, which may help to prevent over distention of the cusp. Our results suggest a complex, highly heterogeneous structural response to transvalvular pressure on a fiber level that will have to be duplicated in future bioprosthetic heart valve designs. © 1998 John Wiley & Sons, Inc. J Biomed Mater Res, 41, 131–141, 1998.

In Part I of this work we used small-angle light scattering (SALS) to quantify the fiber architecture of 20 bovine pericardial sacs, along with corresponding tissue-thickness measurements, to determine optimal material selection sites. In order to determine the anatomic consistency of these sites, the fiber architecture and thickness data from all 20 sacs were averaged together using a cartographic analysis method that took advantage of the geometry of the prolate spheroid mold used to process the sacs. Optimal selection sites were determined based on a local criteria where all fiber preferred directions within a 2.54-cm circular area were within ±10°. The largest contiguous area (LCA) for the entire BP sac was 20.54 cm,2located in the vicinity of the left ventricle of the heart. The LCA tissue thicknesses were also relatively uniform, further supporting the use of these areas. However, even within these optimal areas there was a ±20° standard deviation in local fiber preferred directions, resulting in at best a 40° spread in local preferred directions. The observed structural variability may be due to regionally heterogeneous physiologic loadings induced by the ligamentous attachments. These attachments may alter the regional fiber preferred orientation to support local mechanical loadings. Overall, given the inherent structural variability of the BP sac, we conclude that use of anatomic location alone will not consistently guarantee the selection of tissue specimens with a highly homogeneous and predictable fibrous structure. It is thus suggested that a direct fiber measurement presorting method be employed when selecting BP specimens for bioprosthetic applications where tissue structural homogeneity and uniformity is critical. © 1998 John Wiley & Sons, Inc. J Biomed Mater Res, 39, 215–221, 1998.

Use of bovine pericardium as an engineered biomaterial in the fabrication of bioprosthetic heart valves is limited, in part, by substantial intra- and intersac variations in its fibrous structure. To quantitatively assess this variability, we determined the fiber architecture of 20 whole BP sacs. Each sac was mounted on a prolate spheroidal mold, cleared and preserved in 100% glycerol, then sectioned into four equisized quadrants. This preparation method allowed for accurate intersac comparisons and minimized tissue distortions. The fiber architecture was evaluated by small-angle light scattering (SALS) using a 2.54-mm rectilinear grid resulting in ~1200 SALS measurements per quadrant, along with tissue thickness measured at 55 locations per quadrant. The fiber architecture was described in terms of fiber preferred directions, degree of orientation, and asymmetry of the fiber angular distribution. The BP sac fiber architecture demonstrated substantial intra- and intersac variability, with local fiber preferred directions changing by as much as 90° within ~5 mm. Overall, most sacs revealed potential selection areas in the apex region characterized by a high degree of orientation, high uniformity in fiber preferred directions, and uniform tissue thickness. However, the size, location, and fiber orientation of these potential selection areas varied sufficiently from sac-to-sac to question whether anatomic location alone is sufficient for consistent localization of regions of high structural uniformity suitable for improved BHV design. © 1998 John Wiley & Sons, Inc. J Biomed Mater Res, 39, 207–214, 1998.

Growth and Change in the Future City Region. T. Hancock, ed. Leonard Hill, 1976, pp. 262, £6.95.Efficiency in the Social Services. Alan Williams and Robert Anderson, Basil Blackwell, 1975 pp. 147, £4.50.Housing Policy and the Housing System. Alan Murie, Pat Niner and Christopher Watson, Allen & Unwin, 1976, pp. 282, £6.95.The Sale of Council Houses (A Study in Social Policy). Alan Murie, University of Birmingham, Centre for Urban and Regional Studies, Occasional Paper No. 35, 1976, pp. 166, £4.00.The Power of the Purse: The Role of European Parliaments in Budgetary Decisions. David Coombes et al. (PEP), George Allen & Unwin, 1976, pp. 393, £8.95 (hardback).Government and the Planning Process P. H. Levin, George Allen & Unwin Ltd., 1975, pp. 337, £6.50.On Management. Harvard Business Review, Heinemann, 1975, pp. 751, £7.50.Toward a Critical Administrative Theory. William H. Dunn and Bahman Fozouni, Sage Professional Paper in Administrative and Policy Studies, 1976, pp. 76, £1.50.The Urban Criminal. J. Baldwin and A. E. Bottoms in collaboration with Monica A. Walker, Tavistock, 1976, pp. 262 £6.50, Social Science Paperback, £3.40.

Competition in the chemical/petrochemical industry has increased the emphasis on product quality. The importance of product quality has put low process variability in a place of prominence among the process design criteria, along with the traditional goals of capital cost and utility consumption minimization. Although control strategy analysis occasionally drives the design toward reduced capital cost, there is usually a tradeoff between control and design issues. This paper identifies three key issues, provides examples that illustrate design/control tradeoffs, and demonstrates the use of simulation tools and early interaction between design and control engineers to resolve the tradeoffs.

Summary A pentapeptide originally isolated by Abiko and coworkers from the ultrafiltrate of a uremic patient was synthesized and studied for its in vitro effects on normal human peripheral blood mononuclear cells. The SRBC-rosette forming capacity of T cells was significantly reduced after preincubation of the cells with the peptide, whereas the viability and the percentage of SRBC-receptor positive cells as determined with a monoclonal antibody remained unchanged. The PHA and ConA induced proliferation of T cells as well as the induction of suppressor cells by ConA were decreased, while the proliferative responses to PWM and specific antigens were enhanced. MLC experiments with separated and reconstituted lymphocyte populations pointed to the T cell as the main target. The data presented demonstrate that at least some of the effects described for so-called middle molecules are reproducible with this peptide at concentrations eventually occurring in patients with chronic renal failure.

Research of the past 5 years with the adult Wechsler scales is critically reviewed. Most investigators used the Wechsler Adult Intelligence Scale. Topical coverage includes: comparative validity; short forms; special populations and applications; refinements and critiques; personality correlates; investigations of diagnostic value; special diagnostic groups; and scatter, patterns, and diagnosis. The 260 articles reviewed show that there is no diminution in the number of researches in the area. While the quality of the research has improved, too many investigators repeat the errors contained in earlier studies, despite the periodic publication of these critical reviews.

In the focal plan of a parabolic concentrator, the assumption of a sun's disk of uniform flux intensity leads to a sharply defined image. However, in planes parallel and adjacent to the focal plane, the heat flux distribution is much less uniform. Further away from the focal planes, the heat flux distribution is again more uniform, but is reduced in intensity. For these cases, the effect of a nonuniform flux intensity across the sun's disk, as well as a uniform sun disk, is considered. Typical flux distribution curves are presented.

The theoretical and practical factors which affect the specific performance characteristics and costs of solar furnaces are reviewed in detail. Technical and economic considerations indicate that the best design for a large solar furnace should incorporate the following features: 1.(1) a parabolic concentrator consisting of adjustable curved-mirror segments,2.(2) a stationary concentrator with its axis horizontal, using an auxiliary movable mirror to follow the sun,3.(3) an angle between the image area and the rim of the concentrator of between 50° to 70°,4.(4) a reflecting surface consisting of back-silvered glass. The actual heat flux available at the target is expressed as p=46.1×103EP0sin2θwhere Eis the over-all efficiency factor of the solar furnace, p0is the solar constant, and θ is the rim angle. Eis defined as = eta;aηrηsγwhere ηaaccounts for loss of radiant energy due to the atmosphere, ηris the combined reflectivity coefficient of the reflecting surfaces of the concentrator and auxiliary mirrors, η8accounts for the nonreflecting portions of the concentrator because of shadowing and open areas between mirror segments, and γ is an index which represents the degree of geometrical perfection of the parabolic concentrator. A tabulation of calculated Eand γ values for a number of actual solar furnaces is presented.

Presents letters to the editor referencing articles and topics discussed in previous homes. Protest against the hysterical red-baiting resolution, adopted at the conference of the American Labor Party; Discussion on the literary style of John T. Flynn; Emphasis on word "dog latin"; Information on the National Labor Relations Act or the wages-and-hours law; Behavior of Ieaders of the Communist Party.

Presents letters to the editor referencing articles and topics discussed in previous issues of the journal. Criticism of a letter related to Stalinism and American liberalism; Reference to the incompatibility of Stalinism and American liberalism; Acceptance of the assumptions of the official Communists that a critic of their policies is a rival Communist; Accusation against this journal for wrongly asserting that its policies are not Stalinist; Comments on an article which accuses this journal of being rank apologists for Stalinism in the U.S.; Demand of reopening the lawsuit of Charles H. Fisher vs. the Board of Trustees of Western Washington College; Correction to the review of the book "Finnegans Wake," by James Joyce; Criticism of the article "Interpretation of Dreams"; Information on the Writers' Congress in which writer James T. Farrell participated; Protest of Estolo K. Ward, executive secretary of the Harry Bridges Defense Committee, to deport the San Francisco organizer.

The optimal definition and prognostic significance of persistently elevated prostate-specific antigen (PSA) after salvage lymph node dissection (sLND) for node-only recurrent prostate cancer (PCa) remain unknown.

Background:Infection preventionists (IPs) are the backbone of the quality and safety matrix of their organizations. Tools to help locate potential gaps can provide unique viewpoints from frontline staff. The CDC provides a Targeted Assessment for Prevention (TAP) strategy that identifies vulnerabilities in the prevention of healthcare-associated infection (HAIs). Methods:A statewide quality improvement organization, partnering with the CDC TAP team, administered TAP facility assessments for catheter-associated urinary tract infection (CAUTI), central-line–associated bloodstream infection (CLABSI), and Clostridioides difficileinfection (CDI) to a collaborative of 15 acute-care and 2 long-term acute hospitals. More than 800 respondents filled out surveys based on their individualized perceptions of infection prevention practices. Results:The survey results yielded the following lagging indicators: lack of awareness of nursing and physician champions, need for competency-based training of clinical equipment, and feedback on device utilization. At the hospital system level, one improvement team focused on CDI, uncovered leading and lagging areas in general infrastructure, antibiotic stewardship, early detection and appropriate testing, contact precautions, and environmental cleaning. To culminate the TAP collaborative, the cohort of organizations, supported by interdisciplinary teams, participated in a full-day TAP workshop in which they reviewed detailed analyses of their HAI data and assessment results, shared best practices for infection prevention and planned for specific improvement projects using the plan-do-study-act model. Conclusions:Results of a statewide analysis of HAI prevention data and opportunities at a local level were reviewed. The TAP strategy can be used to target opportunities for improvement, to assess gaps in practice, and to develop and implement interventions for improving outcomes. Healthcare facilities and quality improvement organizations can drive infection prevention actions.Funding:NoneDisclosures:None

Artwall PREHISTORIC PAINTINGS FOUND on the walls of caves in Lascaux and Altamira continue to convey a sense of the hunt with their overlapping forms, bodies elongated in flight, and [...]

The effect of receptor mediated calcium entry (RMCE) on platelet activating factor (PAF) stimulated human neutrophils (PMNs) was investigated using SKF 96365, a selective inhibitor of RMCE. Changes in cytosolic calcium concentration were determined by the fluorometric dye indo-1, AM, superoxide generation by cytochrome c reduction, and CD11b surface expression by flow cytometry. SKF 96365 pre-treatment diminished the cytosolic calcium rise in PAF primed PMNs. SKF 96365 treatment significantly (p<0.05) decreased superoxide generation in PAF primed PMNs, but did not affect activation of the PMN oxidase by fMLP or PMA. Chelation of extracellular calcium by EGTA, intracellular calcium by BAPTA, AM, and RMCE blockade by SKF 96365 all statistically inhibited the PAF induced increase in surface expression of CD11b (p<0.05); moreover, SKF 96365 inhibited to a greater extent than EGTA or BAPTA, AM treatment. These results suggest that RMCE is required for maximal effects of PAF on PMN function.

How to take good screen shots I would like to compliment you on the superb special supplement on graphic arts that accompanied your May 17 edition. I must take exception, […]