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Sea level dynamics in the coastal zone can differ significantly from that in the open ocean. The presence of the continental slope, shallow waters and the coastlines give rise to a variety of processes that mediate the response of coastal sea level to open-ocean changes and produce distinct spatiotemporal sea level patterns. Yet how exactly this interplay occurs and, more importantly, the extent to what coastal sea level variations differ from open-ocean variability remain poorly understood. In this work, we use coastal altimetry observations in combination with tide gauge data to determine patterns of coherent coastal sea level variations and the degree of decoupling between such variations and open-ocean changes.In a first step, we apply Bayesian mixture models to identify clusters of correlated tide gauge observations that explain a significant fraction of the coastal sea level variability. Using altimetry data, we find high regional coherency of along-shore coastal sea level variations, indicating common underlying mechanisms that cause these correlations.In light of previous research, we confirm that the correlation structures of these coherent patterns are often confined to the continental slopes, particularly in extratropical regions. In regions like the northeastern US continental shelf, correlations decrease with increasing water depth, indicating a decoupling of shelf sea and open-ocean variability. We investigate how these differences between coastal and open ocean sea level variations change as a function of time scale, i.e., from monthly or interannual variations to long-term trends, and validate these results against tide gauge observations. We derive across-shore correlation length scales that provide insights into the space scales of coastal sea level dynamics and are useful to understand how well gridded products can resolve such processes.We discuss possible causes of the coherent sea level fluctuations, such as wind forcing, coastally trapped waves, and large scale climate modes. The results motivate further research to better understand the driving mechanisms behind these coherent sea level variations, as well as the pathways linking remote forcing to coastal changes.

I express some reservations about Hart and Hill's attempt to show that certain Scriptural passages show that God sometimes intends that sins occur, though I express sympathy for the view that God sometimes intends that sins occur.

The deployment of proteomic analysis in clinical studies represents a significant opportunity to detect and validate biomarkers in translational medicine, improve disease understanding, and provide baseline information on population health. However, comprehensive proteome studies usually employ nanoscale chromatography and often require several hours of analysis/sample. Here, we describe a high-throughput liquid chromatography tandem mass spectrometry (LC/MS/MS) methodology using 1 mm scale chromatography requiring only 15 min/sample, coupled to ion mobility-enabled mass spectrometry. The short run time effected a 6-fold increase in productivity compared with nanoscale LC/MS. The method demonstrated excellent reproducibility with retention time coefficient of variations of less than 0.05% and peak area reproducibility ranging from 5 to 15%. The 1 mm system produced similar chromatographic peak capacity values to the nanoscale miniaturized system, detecting 90% of the Escherichia coli proteins identified by the 75 μm LC/MS system (albeit based on only 75% of the peptides found by the latter). Application to the analysis of serum samples from a human prostate cancer study group resulted in the identification of a total of 533 proteins revealing the differential expression of proteins linked to patients receiving hormone-radiotherapy or undergoing surgery.

Next generation aircraft engine efficiency goals will be met through high bypass ratio engines. To achieve these goals, a combination of small core and low pressure ratio fan technologies will be necessary. Additionally, advanced propulsion airframe integration concepts, such as boundary layer propulsion, and distributed electrically driven fans with short inlets or wing integration strategies, are beginning to be investigated for their potential fuel burn savings. In order to realize the potential fuel savings from these technologies, it is necessary to have testing capabilities for the components. The NASA Glenn Research Center (GRC) Single Stage Axial Fan and Compressor Facility (also called the GRC W-8 Facility) has recently undergone several significant upgrades in order to effectively test low pressure ratio fans and various inlet distortions. This paper will outline various challenges to testing low pressure ratio fans and the methods implemented to ensure that the W-8 facility is capable of performing these tests and acquiring high quality data. The upgrades include significant piping upgrades to reduce pressure loss and turbulence, capability for inlet total pressure and swirl distortion, increased test section length including a longer shaft, a two component balance, an upgraded rotating data system, and a new temperature characterization to reduce uncertainties in thermocouple measurements.

Subtitle production is an increasingly creative accessibility service. New technologies allow for placing subtitles at any location of the screen in a variety of formats, shapes, typography, font size, and colour. The screen now affords accessible creativity, with subtitles able to provide novel experiences beyond those offered by traditional language translation. Immersive environments multiply 2D subtitles features to new creative viewing modalities. Testing subtitles in eXtended Reality (XR) has pushed existing methods to address user need and enjoyment of audiovisual content in 360º viewing displays. After an overview of existing subtitle features in XR, the article describes the challenges of generating subtitle stimuli to test meaningful user viewing behaviours, based on eye-tracking technology. The approach for the first experimental setup for implementing creative subtitles in XR using eye-tracking is given, in line with novel research questions. The choices made regarding sound, duration and storyboard are described. Conclusions show that testing subtitles in immersive media environments is both a linguistic and an artistic endeavour, which requires an agile framework fostering contrast and comparison of different functionalities. Results of the present, preliminary study shed light on future experimental setups with eye-tracking. Lay summary Subtitling is an increasingly creative accessibility service. Subtitlers use new technologies to place subtitles at any location on the screen. They can also change shape, typography, font size, and colour of the subtitles. This personalisation opens the door for creative solutions and allows novel experiences beyond traditional 2D subtitles. An immersive environment is an illusionary experience that surrounds you and transports you to another place. The challenges when testing subtitles in these new environments are different from those when testing in 2D media, as the user is no longer a passive spectator but an active part of the story. In this article, we give an overview of existing subtitle features in immersive environments. Then we describe the challenges of generating stimuli suitable for testing subtitles in immersive environments using eye tracking technology. We explain the experimental setup used during our experiment as well as the research questions. We describe the choices we made to design our stimuli, such as the sound, the duration, and the storyboard. We conclude that testing subtitles in immersive media environments present linguistics and artistic challenges and that we need to use a framework that allows for rapid contrast of different solutions. Results of the present, preliminary study clear up how to use eye-tracking technology to test subtitles in immersive environments.

The SARS-CoV-2 pandemic has differentially impacted populations across race and ethnicity. A multi-omic approach represents a powerful tool to examine risk across multi-ancestry genomes. We leverage a pandemic tracking strategy in which we sequence viral and host genomes and transcriptomes from nasopharyngeal swabs of 1049 individuals (736 SARS-CoV-2 positive and 313 SARS-CoV-2 negative) and integrate them with digital phenotypes from electronic health records from a diverse catchment area in Northern California. Genome-wide association disaggregated by admixture mapping reveals novel COVID-19-severity-associated regions containing previously reported markers of neurologic, pulmonary and viral disease susceptibility. Phylodynamic tracking of consensus viral genomes reveals no association with disease severity or inferred ancestry. Summary data from multiomic investigation reveals metagenomic and HLA associations with severe COVID-19. The wealth of data available from residual nasopharyngeal swabs in combination with clinical data abstracted automatically at scale highlights a powerful strategy for pandemic tracking, and reveals distinct epidemiologic, genetic, and biological associations for those at the highest risk.

While anti-angiogenic therapies for wet age-related macular degeneration (AMD) are effective for many patients, they require multiple injections and are expensive and prone to complications. Gene therapy could be an elegant solution for this problem by providing a long-term source of anti-angiogenic proteins after a single administration. Another potential issue with current therapeutic proteins containing a fragment crystallizable (Fc) domain (such as whole antibodies like bevacizumab) is the induction of an unwanted immune response. In wet AMD, a low level of inflammation is already present, so to avoid exacerbation of disease by the therapeutic protein, we propose single-chain fragment variable (scFv) antibodies, which lack the Fc domain, as a safer alternative. To investigate the feasibility of this, anti-vascular endothelial growth factor (VEGF)-blocking antibodies in two formats were produced and tested in vitro and in vivo. The scFv transgene was then cloned into an adeno-associated virus (AAV) vector. A therapeutic effect in a mouse model of choroidal neovascularization (CNV) was demonstrated with antibodies in both scFv and immunoglobulin G1 (IgG1) formats (p < 0.04). Importantly, the scFv anti-VEGF antibody expressed from an AAV vector also had a significant beneficial effect (p = 0.02), providing valuable preclinical data for future translation to the clinic. Keywords: AAV, vector, gene therapy, AMD, CNV mouse model, anti-VEGF scFv antibodies, single-chain, angiogenesis

This research examined the relationship between different measures of narcissism and a range of consumption behaviors. Measures of individual, communal, and collective narcissism were correlated with three sets of consumption behaviors termed vanity, self-improvement, and prosocial consumption behavior. Based on a sample of 552 MTurk users, it was found that all narcissism measures were positively associated with vanity behaviors. However, differences amongst narcissism measures emerged for self-improvement behaviors and prosocial behaviors. The admiration scale of the NARQ was positively associated with self-improvement and prosocial behaviors, whereas the rivalry scale of the NARQ was negatively associated with prosocial behaviors. The communal and collective narcissism scales were also positively associated with prosocial consumption behaviors. The results contribute to the narcissism literature by showing (1) which narcissism measures are most strongly related to consumption behaviors (2) that certain measures of narcissism are positively associated with some prosocial consumption behaviors, and (3) that individual, communal and collective narcissism are not strongly correlated with each other.

ObjectivesAutologous blood transfusion (ABT) enhances athlete’s performance, is banned as doping by the World Anti-Doping Agency (WADA). Currently, there is no implemented detection method for ABT. Transfusion of one’s own, long-term cryopreserved red blood cells (cryo-RBC) immediately increases circulating RBC count, hemoglobin mass, blood volume and oxygen carrying capacity, resulting in enhanced physical performance. Functional viablity of cryo-RBC are maintained for decades, but storage lesions lead to removal of damaged RBC from circulation days after transfusion, with remaining circulating cryo-RBC displaying normal half-life.MethodsThe cytosolic RBC peptidome from 22 human subjects (12 men and 10 women) was analyzed by UHPLC-MS/MS before and after ABT with cryo-RBC. As a control group and for investigation of confounders, 14 elite athletes and 5 recreational subjects were sampled multiple times, also at high altitude.ResultsHere we report alteration in the cytosolic peptidome of circulating RBC weeks after ABT, discriminating doped from non-doped human subjects. A valid discriminating multivariate model (OPLS-DA) based on 2/Q2 = 0.88/0.59, P CV-ANOVA < 0.0001, ROC AUC = 0.97). Models did not show bias for sex, high altitude or elite endurance training and racing.ConclusionIdentified peptides with low intra- and inter-individual variation, and high multivariate model weight and probability scores, create a direct method for the detection of autologous blood doping.

A novel data-independent acquisition (DIA) method incorporating a scanning quadrupole in front of a collision cell and orthogonal acceleration time-of-flight mass analyzer is described. The method has been characterized for the qualitative and quantitative label-free proteomic analysis of complex biological samples. The principle of the scanning quadrupole DIA method is discussed, and analytical instrument characteristics, such as the quadrupole transmission width, scan/integration time, and chromatographic separation, have been optimized in relation to sample complexity for a number of different model proteomes of varying complexity and dynamic range including human plasma, cell lines, and bacteria. In addition, the technological merits over existing DIA approaches are described and contrasted. The qualitative and semiquantitative performance of the method is illustrated for the analysis of relatively simple protein digest mixtures and a well-characterized human cell line sample using untargeted and targeted search strategies. Finally, the results from a human cell line were compared against publicly available data that used similar chromatographic conditions but were acquired with DDA technology and alternative mass analyzer systems. Qualitative comparison showed excellent concordance of results with90% overlap of the detected proteins.

This paper is a critical exercise in haptic aesthetics. The subject matter of such an inquiry is a rather simple one, namely, me in a canoe with a paddle and nowhere in particular to go, in essence, a form of leisure travel explained phenomenologically. Such humble beginnings are interspersed with arguments that illustrate haptic aesthetics along epistemological lines. Further still, it will be shown that paddling as a sensuous leisure activity is deeply haptic but also acoustic and the theory of ‘soundscape ecology’ will be used here to help further describe the sound and feeling of paddling a canoe in a natural environment. It is in this theoretical and sensory connection that readers should notice some ethical connotations and it is also such a connection that illustrates what could be called a ‘practical’ or ‘everyday’ aesthetics of leisure.

As researchers interested in social aspects of sport, we enmesh ourselves in the work of memory, (re)membering and forms of ‘capturing’ sport and sport experiences. While nostalgia is at play in these social constructions of sport, for researchers we contend that the concept of nostalgia can prove devious. In this paper, we illustrate the social significance afforded to nostalgic experiences or events, and consider their representation in social sciences sport research. We develop and apply arguments concerning the senses, nostalgia, and language in line with the ‘abilities’ view of concepts. The consequences of nostalgia can, we contend, be underplayed, taken for granted and/or ignored by sport researchers in ways that curtail more critical readings of sport phenomena. Our purpose is to interrogate the construction and a/effects of nostalgia as hidden/implicit/latent and heuristic. We advocate methodological critique that addresses the elusive, apparent, ‘capturable’ and confusing nature of nostalgia within sport research.

Sonification is the use of non-speech audio to convey information. In this article, sonifications are representations of plots aimed at improving the accessibility of teaching materials. The electronic nature of sonifications means that they can be deployed to students via teaching interfaces such as virtual learning environments. We describe a two-phase study that explores sonifications of plots as a teaching tool in the context of distance learning in STEM. The overall objective of these two phases was to begin to assess the suitability of audio versions of graphs as a teaching tool for non-sighted and sighted students. In the first phase the effectiveness of sonifications within a small group of participants who took part in activities like those encountered in a distance learning setting was explored. We found that even though sonifications were new to them, participants were able to use them to gain impressions of the corresponding plots. The second phase deployed sonifications to all students on an Open University (OU) module. Although many of the students who chose to respond did so negatively, some found the sonifications an interesting augmentation of the plot. Overall, we demonstrate that for a subset of students, information in a plot can be communicated using sonifications.

The application of unit resolution tandem quadrupole and high-resolution orthogonal acceleration ToF mass spectrometers for the quantitation and translational analysis of proteolytic peptides is described. The MS platforms were contrasted in terms of sensitivity and linear response. Moreover, the selectivity of the platforms was investigated and the effect on quantitative precision studied. Chromatographic LC conditions, including gradient length and configuration, were investigated with respect to speed/throughput, while minimizing isobaric interferences, thereby providing information with regard to practical sample cohort size limitations of LC-MS for large cohort experiments. In addition to these fundamental analytical performance metrics, precision and linear dynamic ranges were also studied. An LC-MS configuration that encompasses the best combination of throughput and analytical accuracy for translational studies was chosen, despite the MS platforms giving similar quantitative performance, and instances were identified where alternative combinations were found to be beneficial. This configuration was utilized to demonstrate that proteolytically digested nondepleted samples from heart failure patients could be classified with good discriminative power using a subset of proteins previously suggested as candidate biomarkers for cardiovascular diseases.

Introduction: The advent of biologic drugs like infliximab, Etanercept, rituximab and tocilizumab has greatly improved the treatment of rheumatoid arthritis, however, increased risk of infection and high cost still remain unmet needs. A new generation of targeted therapeutics is being developed to target payload drug specifically to arthritic tissue; to concentrate the drug in the disease area and limit the off target systemic exposure. This might also reduce total effective dose.Areas covered: This article summarizes the properties and progress of targeted therapies that have been published on PubMed, and addresses their clinical potential.Expert commentary: Incredible progress with targeted therapies has already been made in the short time since the principle was first proven in animal models in 2007 when targeting payload drug to overexpressed oncofetal domain of fibronectin in inflamed arthritic joints.

Many STEM subjects are strongly hierarchical: learning and progression depends upon threshold concepts and retained knowledge from previous study. To help progress learning, support can be offered during regular study periods, but what happens during breaks between studies? The requirement to provide continuity during study breaks is recognised as vital in assisting students to bridge the knowledge gap and have the best chance of success.At the Open University, we have found that over 64% of students studying one of our second level mathematics modules completed the prerequisite module over a year before starting the module. During this gap, their use of techniques required to study effectively may have become “rusty”. Even students who progress immediately find there are study holes where some of the retained knowledge has been lost.We describe the creation of a ‘Revise and Refresh’ support program that helped our students revise and refresh the knowledge required to study our level two module successfully.

Calcineurin is a critical cell-signaling protein that orchestrates growth, stress response, virulence, and antifungal drug resistance in several fungal pathogens. Blocking calcineurin signaling increases the efficacy of several currently available antifungals and suppresses drug resistance. We demonstrate the application of a novel scanning quadrupole DIA method for the analysis of changes in the proteins coimmunoprecipitated with calcineurin during therapeutic antifungal drug treatments of the deadly human fungal pathogen Aspergillus fumigatus. Our experimental design afforded an assessment of the precision of the method as demonstrated by peptide- and protein-centric analysis from eight replicates of the study pool QC samples. Two distinct classes of clinically relevant antifungal drugs that are guideline recommended for the treatment of invasive “aspergillosis” caused by Aspergillus fumigatus, the azoles (voriconazole) and the echinocandins (caspofungin and micafungin), which specifically target the fungal plasma membrane and the fungal cell wall, respectively, were chosen to distinguish variations occurring in the proteins coimmunoprecipitated with calcineurin. Novel potential interactors were identified in response to the different drug treatments that are indicative of the possible role for calcineurin in regulating these effectors. Notably, treatment with voriconazole showed increased immunoprecipitation of key proteins involved in membrane ergosterol biosynthesis with calcineurin. In contrast, echinocandin (caspofungin or micafungin) treatments caused increased immunoprecipitation of proteins involved in cell-wall biosynthesis and septation. Furthermore, abundant coimmunoprecipitation of ribosomal proteins with calcineurin occurred exclusively in echinocandins treatment, indicating reprogramming of cellular growth mechanisms during different antifungal drug treatments. While variations in the observed calcineurin immunoprecipitated proteins may also be due to changes in their expression levels under different drug treatments, this study suggests an important role for calcineurin-dependent cellular mechanisms in response to antifungal treatment of A. fumigatus that warrants future studies.

The efficient receptor-mediated targeting of soluble lysosomal proteins to lysosomes requires the modification with mannose 6-phosphate (M6P) residues. Although the absence of M6P results in misrouting and hypersecretion of lysosomal enzymes in many cells, normal levels of lysosomal enzymes have been reported in liver of patients lacking the M6P-generating phosphotransferase (PT). The identity of lysosomal proteins depending on M6P has not yet been comprehensively analyzed. In this study we purified lysosomes from liver of PT-defective mice and 67 known soluble lysosomal proteins were identified that illustrated quantitative changes using an ion mobility-assisted data-independent label-free LC-MS approach. After validation of various differentially expressed lysosomal components by Western blotting and enzyme activity assays, the data revealed a small number of lysosomal proteins depending on M6P, including neuraminidase 1, cathepsin F, Npc2, and cathepsin L, whereas the majority reach lysosomes by alternative pathways. These data were compared with findings on cultured hepatocytes and liver sinusoid endothelial cells isolated from the liver of wild-type and PT-defective mice. Our findings show that the relative expression, targeting efficiency and lysosomal localization of lysosomal proteins tested in cultured hepatic cells resemble their proportion in isolated liver lysosomes. Hypersecretion of newly synthesized nonphosphorylated lysosomal proteins suggest that secretion-recapture mechanisms contribute to maintain major lysosomal functions in liver.

Background Systemic treatment with disease modifying anti-rheumatic drugs (DMARDs) is associated with side effects, since such treatment does not deliver pharmacologically active molecules solely to the site of disease activity in the joints We demonstrated that posttranslational modification of type II collagen (CII) by reactive oxygen species (ROS), which are known to be present in inflamed arthritic joints, can give rise to epitopes specific to damaged cartilage in rheumatoid arthritis (RA) and osteoarthritis (OA). Our goal is to establish that antibodies specific to ROS-modified CII can be used to target therapeutics specifically to arthritic joints. Methods We raised antibodies specific to ROS-modified CII by phage display and validated the specificity by ELISA and immunostaining of articular cartilage from RA and OA patients. The in vivo targeting potential was tested by imaging using mice model with inflammatory arthritis and. The therapeutic effect of anti–ROS-CII was tested by fusing it to soluble murine tumour necrosis factor receptor II–Fc fusion protein (mTNFRII-Fc) and viral IL-10 (vIL-10). Results Anti-ROS-CII: i) binds specifically to arthritic cartilage from patients with RA and OA; ii) stains cartilage in murine models of inflammatory arthritis and OA; and iii) localises in the inflamed joint in vivo in a mouse model of antigen induced arthritis (AIA) following systemic administration of labelled anti-ROS-CII. Targeting mTNFR2-Fc or viral IL-10 significantly enhanced therapeutic effect on inflamed knee swelling in mouse model of inflammatory arthritis compared to un-targeted mTNFR2-Fc or viral IL-10 when they were fused to non-relevant antibody. We next developed a novel imaging platform whereby anti-ROS-CII labelled with Cy5.5 (a near-infrared (NIR) fluorescent probe) allowed us to successfully visualise development and progression of murine OA induced by destabilising of medial meniscus (DMM). Specific retention of Cy5.5-anti-ROS-CII scFv in the DMM joint was noted as early as 4 weeks post-surgery and before any evident cartilage damage. Conclusion The anti-ROS-CII antibodies have the potencial to become a very early diagnostic biomarker for OA as well as for targeting payload drug specifically to arthritic joints whether RA or OA.

Extracellular vesicles have created great interest as possible source of biomarkers for different biological processes and diseases. Although the biological function of these vesicles is not fully understood, it is clear that they participate in the removal of unnecessary cellular material and act as carriers of various macromolecules and signals between the cells. In this report, we analyzed the proteome of extracellular vesicles secreted by primary hepatocytes. We used one- and two-dimensional liquid chromatography combined with data-independent mass spectrometry. Employing label-free quantitative proteomics, we detected significant changes in vesicle protein expression levels in this in vitro model after exposure to well-known liver toxins (galactosamine and Escherichia coli-derived lipopolysaccharide). The results allowed us to identify candidate markers for liver injury. We validated a number of these markers in vivo, providing the basis for the development of novel methods to evaluate drug toxicity. This report strongly supports the application of proteomics in the study of extracellular vesicles released by well-controlled in vitro cellular systems. Analysis of such systems should help to identify specific markers for various biological processes and pathological conditions. Biological significance Identification of low invasive candidate marker for hepatotoxicity. Support to apply proteomics in the study of extracellular vesicles released by well-controlled in vitro cellular systems to identify low invasive markers for diseases.

Context This paper explores how structured feedback and other features of workplace-based assessment (WBA) impact on medical students' learning in the context of an evaluation of a workplace-based performance assessment: the teamwork mini-clinical evaluation exercise (T-MEX). The T-MEX enables observation-based measurement of and feedback on the behaviours required to collaborate effectively as a junior doctor within the health care team. The instrument is based on the mini-clinical evaluation exercise (mini-CEX) format and focuses on clinical encounters such as consultations with medical and allied health professionals, discharge plan preparation, handovers and team meetings. Methods The assessment was implemented during a 6-week period in 2010 with 25 medical students during their final clinical rotation. Content analysis was conducted on the written feedback provided by 23 assessors and the written reflections and action plans proposed by the 25 student participants (in 88 T-MEX forms). Semi-structured interviews with seven assessors and three focus groups with 14 student participants were conducted and the educational impact was explored through thematic analysis. Results The study enabled the identification of features of WBA that promote the development of collaborative competencies. The focus of the assessment on clinical encounters and behaviours important for collaboration provided opportunities for students to engage with the health care team and highlighted the role of teamwork in these encounters. The focus on specific behaviours and a stage-appropriate response scale helped students identify learning goals and facilitated the provision of focused feedback. Incorporating these features within an established format helped students and supervisors to engage with the instrument. Extending the format to include structured reflection enabled students to self-evaluate and develop plans for improvement. Conclusions The findings illuminate the mechanisms by which WBA facilitates learning. The educational features highlighted include effectively structured feedback processes, support for situated learning, a positive backwash (facilitation of learning through preparation for the assessment), and facilitation of informed self-assessment.

Catheter-associated urinary tract infections (CAUTI) have been associated with increases in morbidity and mortality as well as increased costs of hospitalization. At our institution, we implemented a protocol for indwelling catheter use, maintenance, and removal based on Center for Medicare and Medicaid Services (CMS) guidelines, in efforts to reduce CAUTI rates.A hospital committee of quality stewards focused on several measures which included staff education, modification of existing systems to ensure compliance, and auditing of patient care areas for catheter utilization before implementation of the protocol. Pre- and postintervention postoperative cohorts were then identified through American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) for prevalence of CAUTI. Data were collected through chart review and postdischarge patient interviews.A total of 3873 patients were identified between September 2007 and December 2010. Thirty-six patients (2.6%) were diagnosed with a CAUTI in the preintervention group (N = 1404) compared to 38 (1.5%) patients who were diagnosed with a CAUTI in the postintervention group (N = 2469). There was a 1.1% decrease in CAUTI rate after protocol implementation (P.028). This reduction in rates resulted in annual estimated savings of $81,840 to $320,540 annually.A simple, multifaceted approach consisting of staff education and changing existing processes to reflect best care practices has the potential to significantly reduce the incidence of postoperative CAUTI.