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In the 1966 article “Word, Dialogue, and Novel,” Julia Kristeva introduces the concept of intertextuality through her study of Mikhail Bakhtin’s tracing of multivalent voices in Dostoevsky’s polyph...

Sarah Ruden provides the best translation of Aristophanes’s Lysistrata. She effectively addresses feminism (as demonstrated by theories of Sheila Jeffreys and Naomi Wolf) through transgressive writing for a contemporary audience. Ruden allows her characters to establish a speech community through their language. The argument that Ruden’s translation is superior is supported by a comparison of several passages of Ruden’s Lysistrata to other translations, an examination of selected criticism of Ruden’s Lysistrata, and a look at Ruden’s own commentary about her play.

BACKGROUND Resection (R) followed by single- or multi-fraction stereotactic radiosurgery (SRT) of brain metastases (BMs) lowers resection bed recurrence compared to R alone. Nevertheless, for larger BMs, 12-month recurrence rates after R+SRT can exceed 20–30%. Aiming to improve outcomes, a permanently implanted collagen tile brachytherapy device (GammaTile, GT Medical Technologies, Tempe, AZ) utilizing Cs-131 seeds embedded within a bioresorbable collagen tile was developed and is described as Surgically Targeted Radiation Therapy (STaRT) to distinguish it from external beam radiotherapy. STaRT allows rapid, intense localized radiation dose delivery directly to the tumor bed with predictable dosimetry immediately at the time of R, which may confer reduced risk for radiation necrosis compared to other therapies. It is hypothesized that R+ STaRT will increase surgical bed recurrence-free survival (SB-RFS), while reducing impact on functional and neurocognitive status compared to R+SRT. METHODS Multicenter, randomized, comparison trial of patients with resectable, previously untreated “index” BMs (≥ 2.5–5cm), and 0–3 other tumors, will be preoperatively randomized 1:1 to undergo R+SRT or R+STaRT to the index lesion; unresected tumors in both groups will receive SRT. Planned sample size is 180 from 14 sites. Enrollment opened 03/31/2021. First subject was enrolled 04/07/2021. Primary endpoint is SB-RFS. Secondary endpoints include overall survival, quality of life, neurocognition, functional status, imaging findings and adverse events. Follow-up will be through 24 months. This will be the first randomized trial comparing R+SRT versus R+STaRT delivered by Cs-131 sources in permanently implanted resorbable collagen tile carriers. Primary and secondary outcome measures captured will elucidate the potential risks and benefits of these two RT delivery methods in the setting of newly diagnosed BMs. We will present trial accrual progress, available data, experience and lessons learned.

BACKGROUND For patients with operable intracranial neoplasms, there are opportunities to augment local control beyond traditional methods, such as external beam radiation therapy. Brachytherapy, the implantation of radioactive sources into the resection cavity, can be useful in this setting by providing immediate initiation of radiation and limiting the exposure of surrounding normal tissue to radiation. Traditional intracranial brachytherapy has been limited by uneven dose distributions, complicated workflows, extended procedural times, cost of dedicated equipment, and frequent adverse events. To address these issues, a permanently implanted device with Cs-131 radiation seeds embedded in a bioresorbable collagen carrier tile (GammaTile, GT Medical Technologies, Tempe, AZ USA) was developed. Described as surgically targeted radiation therapy (STaRT), it is FDA-cleared for use in newly-diagnosed malignant intracranial neoplasms and recurrent intracranial tumors, and has demonstrated excellent safety and efficacy in early commercial use. The primary objectives of this multicenter, prospective, observational (phase IV) registry study are to evaluate “real-world” clinical outcomes and patient-reported outcomes that measure the safety and efficacy of STaRT using the GammaTile. METHODS Patients undergoing resection (R) of brain tumors with intra-operative GammaTile placement are eligible for enrollment. Planned sample size is 600 at up to 50 enrolling sites. First subject was enrolled 10/14/2020. Tumor pathology, overall survival, radiation- and surgery-related adverse events, patient- and provider-reported quality of life, serial MRIs, and timing of surgical bed and/or distant recurrence are collected. Powered primary endpoints for recurrent brain metastases, recurrent glioblastoma, and recurrent meningioma (surgical bed-progression free survival (PFS), overall survival, and PFS, respectively), compare STaRT to standard-of-care benchmarks. Results will be used to improve awareness and access to this treatment, benchmark clinical outcomes in the real-world setting, allow for comparisons to existing treatments, facilitate the design of future clinical trials, and contribute to the optimal sequencing of treatments for intracranial neoplasms.

In the tradition of the bildungsroman, the two volumes of John Cleland’s Fanny Hill, or Memoirs of a Woman of Pleasure (1748–49) conveniently divide the main character’s sexual initiation into peri...

A 52 year old, never smoker presented to hospital with progressive shortness of breath and significant stridor over a five month period. He also described the feeling of needing to cough but being unable to expectorate. CT Thorax demonstrated a mass lesion in the trachea just distal to the larynx which was then confirmed on rigid bronchoscopy. Subsequent histology confirmed an epithelial-myoepithelial carcinoma. Only a few case reports document these rare salivary gland tumours occurring in other locations such as the respiratory tract. After staging showed only local disease, the patient was managed with rigid bronchoscopy and laser ablation therapy. We present the first documented case to be treated with endobronchial laser ablation therapy with discussion of the incidence, presentation and characteristics of these tumours including the treatment options, as well as the use of laser ablation in the management of benign and malignant endobronchial lesions.

Objective To describe nontraditional roles for Certified Pharmacy Technicians (CPhTs) within pharmaceutical industry. Setting Drug information department within a large biotechnology/pharmaceutical organization. Practice Description The Medical Communications department within Genentech uses a skills-mix staffing model in which employees with varying educational and training backgrounds work as a team on meeting the informational needs of consumers and health professionals who contact the company. One position within the department is that of Medical Communications Associate, responsible primarily for managing product inquiries. Practice Innovation Medical Communications Associates have degrees in life sciences or an equivalent combination of education and experience, including a minimum of 2 years of related experience in the health care industry. Currently, four of the seven Medical Communications Associates in the department are CPhTs. Interventions Not applicable. Main Outcome Measure Ability to recruit CPhTs for Medical Communications Associate positions, and job satisfaction of those hired into these positions. Results Critical basic skills needed for the Medical Communications Associate position include strong computer literacy, ability to multitask, and ability to work in an environment with frequent interruptions. Strong oral and written communications skills, customer service skills, ability to deal with stressful situations, product–specific knowledge, ability to work on a daily basis with Medical Communications Pharmacists, and knowledge of medical terminology are also important. The skills set of CPhTs matches these requirements, as evidenced by the experiences of the four staff members who have worked in the department for a total of 17 person–years. Conclusion This nontraditional role for CPhTs can be rewarding and beneficial to all, affording an unique opportunity within the pharmaceutical industry. The skill set and experience of CPhTs can be used in the nontraditional pharmacy practice setting of drug information.

Global education has been defined as a process that provides students and individuals with the knowledge, skills, and attitudes necessary for them to meet their responsibilities as citizens of their community, state, and nation in an increasingly interdependent and complex global society (Florida Task Force, 1982). The development of agricultural industry in any country is inextricably linked to changes in global economy and educational advancement. The mission of agricultural education in the United States is to foster the development of knowledge and skills related to the industry of agriculture (National Task Force, 1987). To compete effectively in the ever changing, complex international labor force, agriculturally educated individuals must understand the global nature of agricultural industry and its effects on United States domestic food production, distribution, and consumption. In 1988, the National Research Council recommended that the dominance of local production agriculture in the curriculum must be broadened to include global concepts on utilization of agricultural commodities, distribution, and management. The implementation of this recommendation requires a major change in the agricultural curriculum. This curriculum change will require teachers who are committed to internationalizing their agricultural programs.

Intradermal injections of MER-BCG 0.1 mg or 0.2 mg at each of 10 multiple sites, led to local granuloma formation. The nodules reached approximately 10 mm in diameter, ulcerated and were accompanied by granulomatous changes in the regional lymph nodes. Six or twelve successive treatments (each including 10 injections) at 4 week intervals produced the same histopathological lesions but no changes in hematological and blood chemical parameters or general morphology and no changes in general condition with exception of occasional weight loss in a few animals. Injection with 0.01 or 0.001 mg/site produced similar, though less severe, skin lesions but no changes in the draining lymph nodes. The immunogenicity of MER-BCG was characterized by granuloma formation, a positive skin response to old tuberculin, and a positive lymphocyte transformation to PPD tuberculin, thus indicating stimulation of cell-mediated immune responses. However, there was a decreased responsiveness to PHA and PPD with continuing treatment with MER-BCG. The decreased responsiveness and accumulation of numerous depots of antigen would suggest an "immunologic paralysis" contraindicating the administration of excessive amounts of MER-BCG during immunotherapy. A specific humoral response to the administration of MER-BCG was not detected, but an MER-BCG dose independent decrease in albumin associated with a non-specific, dose related elevation in serum IgG was observed.

Acknowledgments Introduction Part I. History One. The Making of Modern Consumption Two. "Ever Dearer in Our Thoughts": Patina and the Representation of Status before and after the Eighteenth Century Three. Lois Roget: Curatorial Consumer in a Modern World Part II. Theory Four. Clothing as Language: An Object Lesson in the Study of the Expressive Properties of Material Culture Five. Meaning Manufacture and Movement in the World of Goods Part III. Practice Six. Consumer Goods, Gender Construction, and a Rehabilitated Trickle-down Theory Seven. The Evocative Power of Things: Consumer Goods and the Preservation of Hopes and Ideals Eight. Diderot Unitites and the Diderot Effect: Neglected Cultural Aspects of Consumption Nine. Consumption, Change, and Continuity Notes References Index