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Abstract With the approval of the first two substances for the treatment of geographic atrophy (GA) secondary to age-related macular degeneration (AMD), a standardized monitoring of patients treated with complement inhibitors in clinical practice is needed. Optical coherence tomography (OCT) provides high-resolution access to the retinal pigment epithelium (RPE) and neurosensory layers, such as the ellipsoid zone (EZ), which further enhances the understanding of disease progression and therapeutic effects in GA compared to conventional fundus autofluorescence (FAF). In addition, artificial intelligence-based methodology allows the identification and quantification of GA-related pathology on OCT in an objective and standardized manner. The purpose of this study was to comprehensively evaluate automated OCT monitoring for GA compared to reading center-based manual FAF measurements in the largest successful phase 3 clinical trial data of complement inhibitor therapy to date. Automated OCT analysis of RPE loss showed a high and consistent correlation to manual GA measurements on conventional FAF. EZ loss on OCT was generally larger than areas of RPE loss, supporting the hypothesis that EZ loss exceeds underlying RPE loss as a fundamental pathophysiology in GA progression. Automated OCT analysis is well suited to monitor disease progression in GA patients treated in clinical practice and clinical trials.

The advent of serial crystallography has rejuvenated and popularized room-temperature X-ray crystal structure determination. Structures determined at physiological temperature reveal protein flexibility and dynamics. In addition, challenging samples (e.g. large complexes, membrane proteins and viruses) form fragile crystals that are often difficult to harvest for cryo-crystallography. Moreover, a typical serial crystallography experiment requires a large number of microcrystals, mainly achievable through batch crystallization. Many medically relevant samples are expressed in mammalian cell lines, producing a meager quantity of protein that is incompatible with batch crystallization. This can limit the scope of serial crystallography approaches. Direct in situ data collection from a 96-well crystallization plate enables not only the identification of the best diffracting crystallization condition but also the possibility for structure determination under ambient conditions. Here, we describe an in situ serial crystallography (iSX) approach, facilitating direct measurement from crystallization plates mounted on a rapidly exchangeable universal plate holder deployed at a microfocus beamline, ID23-2, at the European Synchrotron Radiation Facility. We applied our iSX approach on a challenging project, autotaxin, a therapeutic target expressed in a stable human cell line, to determine the structure in the lowest-symmetry P1 space group at 3.0 Å resolution. Our in situ data collection strategy provided a complete dataset for structure determination while screening various crystallization conditions. Our data analysis reveals that the iSX approach is highly efficient at a microfocus beamline, improving throughput and demonstrating how crystallization plates can be routinely used as an alternative method of presenting samples for serial crystallography experiments at synchrotrons.

Purpose: This paper aims to investigate how narrative is constructed to create connections with fat readers, how books function to envision spaces of fat liberation for young readers and to highlight the incredible importance of providing bigger mirrors (Bishop, 1990) for fat representation in children's literature. Design/methodology/approach: This paper analyzes and reflects on two texts that contain counternarratives of fatness: The (Other) F Word: A celebration of the fat and fierce edited by Angie Manfredi (2019) and Big by Vashti Harrison (2023) to interrogate how these two narratives intentionally disrupt anti-fat bias. Findings: Body size and fatness are identities that need to be included in diversity efforts within education. Books like The (Other) F Word: A celebration of the fat and fierce (Manfredi, 2019) and Big (Harrison, 2023) offer positive representations of fatness, disrupt biases around body size and provide spaces that allow fat students to find joy, hope, connection and, more than anything, imagine a way toward liberation. Research limitations/implications: This paper highlights the need to include more narratives of positive fat representation within children's literature and calls for educators to interrogate their own anti-fat biases and practices. Originality/value: There is a lack of research on fat representation specifically within children and young adult literature. This paper provides an analysis of two pieces of literature with fat representation that brings attention to the need for this type of future research.

BACKGROUND: The Cancer Epitope Database and Analysis Resource (CEDAR) is a newly developed repository of cancer epitope data from peer-reviewed publications, which includes epitope-specific T cell, antibody, and MHC ligand assays. Here we focus on prostate cancer as our first cancer category to demonstrate the capabilities of CEDAR, and to shed light on the advances of epitope-related prostate cancer research. RESULTS: The meta-analysis focused on a subset of data describing epitopes from 8 prostate-specific (PS) antigens. A total of 460 epitopes were associated with these proteins, 187 T cell, 109B cell, and 271 MHC ligand epitopes. The number of epitopes was not correlated with the length of the protein; however, we found a significant positive correlation between the number of references per specific PS antigen and the number of reported epitopes. Forty-four different class I and 27 class II restrictions were found, with the most epitopes described for HLA-A*02:01 and HLA-DRB1*01:01. Cytokine assays were mostly limited to IFNg assays and a very limited number of tetramer assays were performed. Monoclonal and polyclonal B cell responses were balanced, with the highest number of epitopes studied in ELISA/Western blot assays. Additionally, epitopes were generically described as associated with prostate cancer, with little granularity specifying diseases state. We found that in vivo and tumor recognition assays were sparse, and the number of epitopes with annotated B/T cell receptor information were limited. Potential immunodominant regions were identified by the use of the ImmunomeBrowser tool. CONCLUSION: CEDAR provides a comprehensive repository of epitopes related to prostate-specific antigens. This inventory of epitope data with its wealth of searchable T cell, B cell and MHC ligand information provides a useful tool for the scientific community. At the same time, we identify significant knowledge gaps that could be addressed by experimental analysis.

Summary: Chimeric antigen receptor (CAR) T cell therapy has achieved unprecedented clinical outcomes in patients with relapsed/refractory B cell leukemias; however, response rates in patients with large B cell lymphoma (LBCL) are less impressive. Expression of PD-1 on activated T cells and PD-L1 on malignant, stromal, and immune cells within the tumor microenvironment (TME) contribute to CAR-T exhaustion, hypofunction, and treatment failures. Here, a comparative approach is taken to develop a chimeric switch receptor (CSR) with potential to augment CAR-T persistence, function, and clinical efficacy in immune competent, pet dogs with spontaneous B cell lymphoma (BCL). We show that similar to human CAR-T cells, expression of a PD-1/CD28 CSR in canine CAR-T cells results in enhanced function against PD-L1+ targets and preserves central memory phenotype. We also demonstrate that these effects depend upon active CSR signaling. This work paves the way for in vivo studies in canine BCL patients to inform human trial design.

Implementing supported and customized employment in all their components is essential for supporting job seekers with disabilities to achieve their career goals. We asked 42 employment consultants in nine employment programs to respond daily to three quick questions about their employment support activities, for 6 months. Through monthly coaching, we helped the managers of these organizations engage their teams of employment consultants to interpret the data, reflect, set goals, and take action for quality improvement. Based on the positive results of this pilot, we recommend that employment consultants be provided with data-enabled feedback that supports decision making and helps them fully implement supported and customized employment as a necessary step toward improving job seekers' employment outcomes.

This paper details an experiential influencer marketing project in which students acted as micro-influencers to develop and promote their personal brands using social media accounts and blogs. Students reflected on their strategic decisions and performance in six weekly Slack posts. The pre-launch preparation, along with students' successes, challenges, and overall feedback are presented. Considerations for professors teaching Generation Z students social media marketing are described. The project empowered students to experiment with social media marketing strategies and tactics in a real, hands-on environment. They considered the assignment a powerful, valuable, relevant, and applicable learning experience.

Relevance. Real time hardware and software systems are operated in power system operation centers. In these systems the state estimation block is one of the key one, since in accordance with the regime parameters results, derived from this block, the more comprehensive parameters can be calculated. These parameters are reckoned for system stability and reliability. Today telemetry and synchronized phasor measurements are used for parameters estimation. Therefore, the state estimation methods development is a relevant task. Aim. Development and practical evaluation of the regime parameters estimation synthesized method for using in real time hardware and software systems. The synthesized method permits to improve estimation accuracy and decision quality of focal points coming from system stability and reliability stabilization. Methods. Proposed method is based on mathematical frameworks of Gauss–Newton method and extended Kalman filter when telemetry and synchronized phasor measurements arrays are simultaneously utilized. Results. The synthesized method of power systems regime parameters estimation at steady-state and post accident conditions is developed and evaluated. Conclusions. It is confirmed, that presented synthesized method increases accuracy of the voltage and active power flow estimation at steady-state and post accident regimes, thereby enabling the improved accuracy of maximum allowed active power flows and control action volumes in contrast to the standard state estimation method. Developed software provides an opportunity to implement this method into the state estimation block of real time hardware and software systems. The upcoming trends for state estimation methods development in the event of dynamic processes in power system areas are also formed.

Civic organisations and progressive campaigns regard digital advertising as an essential method to register to vote low-participation groups, such as ethnic minorities, young voters and frequent home movers like private-sector tenants. Digital strategies appear to be promising in countries like the UK, where the registration process can be completed online, usually in less than 5 minutes, using a web link in the advert. But are typical digital campaigns effective in registering voters? To find out, we provide evidence from three randomised controlled trials: two conducted with advocacy organisations and the third run by the research team, carried out in two types of UK elections (general and local) and assigned either at the aggregate (Study 1 and Study 2) or individual (Study 3) level. Despite wide reach and relatively high rates of engagement, we find that the digital ad campaigns trialed across three studies did not affect under-registered groups’ voter registrations. These null findings raise questions about commonly-used digital advertising strategies to register marginalised groups. They are consistent with other studies that report either null or minimal effects of digital ads on other types of political behaviour.

Transfer of autologous tumor infiltrating lymphocytes (TIL) to patients with refractory melanoma has shown clinical efficacy in a number of trials. However, extending the clinical benefit to patients with other cancers poses a challenge. Inefficient costimulation in the tumor microenvironment can lead to T cell anergy and exhaustion resulting in poor anti-tumor activity. Here, we describe a chimeric costimulatory antigen receptor (CoStAR) comprised of FRα-specific scFv linked to CD28 and CD40 intracellular signaling domains. CoStAR signaling alone does not activate T cells, while the combination of TCR and CoStAR signaling enhances T cell activity resulting in less differentiated T cells, and augmentation of T cell effector functions, including cytokine secretion and cytotoxicity. CoStAR activity resulted in superior T cell proliferation, even in the absence of exogenous IL-2. Using an in vivo transplantable tumor model, CoStAR was shown to improve T cell survival after transfer, enhanced control of tumor growth, and improved host survival. CoStAR could be reliably engineered into TIL from multiple tumor indications and augmented TIL activity against autologous tumor targets both in vitro and in vivo. CoStAR thus represents a general approach to improving TIL therapy with synthetic costimulation.

Summary: Background: Compared with normal cells, tumour cells contain elevated levels of reactive oxygen species (ROS). Increased levels of the antioxidant protein NAD(P)H:quinone oxidoreductase 1 (NQO1) and phosphorylated signal transducer and activator of transcription 3 (pSTAT3) correlate negatively with the survival of patients with pancreatic cancer. Napabucasin is an investigational, orally administered ROS generator bioactivated by NQO1. Methods: In the open-label, phase 3 CanStem111P study (NCT02993731), adults with previously untreated metastatic pancreatic adenocarcinoma (mPDAC) were randomised (1:1) to napabucasin plus nab-paclitaxel with gemcitabine or nab-paclitaxel with gemcitabine alone. The primary endpoint was overall survival (OS). In exploratory analyses, OS was evaluated in the subgroup of patients with tumours positive for pSTAT3 (biomarker-positive). Findings: Between 30 January 2017 and 20 February 2019, a total of 1779 patients were screened across 165 study sites in Austria, Australia, Belgium, Canada, China, Czech Republic, France, Germany, Italy, Japan, Korea, Netherlands, Poland, Portugal, Russia, Singapore, Spain, Taiwan, Ukraine, and the US. Of the 565 and 569 patients randomised to the napabucasin and control treatment arms, respectively, 206 and 176 were biomarker-positive. Median (95% confidence interval [CI]) OS in the napabucasin and control treatment arms was 11.4 (10.5–12.2) and 11.7 (10.7–12.7) months, respectively (hazard ratio, 1.07; 95% CI, 0.93–1.23). Due to the lack of OS improvement in the napabucasin arm, CanStem111P was terminated due to futility. In the biomarker-positive subgroup, no difference between treatment arms was found for OS. Grade ≥3 adverse events were reported in 85.4% and 83.9% of napabucasin-treated and control-treated patients, respectively. The incidence of gastrointestinal-related grade ≥3 events was higher with napabucasin (diarrhoea: 11.6% vs 4.9%; abdominal pain: 10.0% vs 4.8%). Interpretation: Our findings suggested that although the addition of napabucasin to nab-paclitaxel with gemcitabine did not improve efficacy in patients with previously untreated mPDAC, the safety profile of napabucasin was consistent with previous reports. CanStem111P represents the largest cohort of patients with mPDAC administered nab-paclitaxel with gemcitabine in the clinical trial setting. Our data reinforce the value of nab-paclitaxel plus gemcitabine as a platform for novel therapeutics approaches in mPDAC. Funding: The Sumitomo Pharma Oncology, Inc.

ID23-2 is a fixed-energy (14.2 keV) microfocus beamline at the European Synchrotron Radiation Facility (ESRF) dedicated to macromolecular crystallography. The optics and sample environment have recently been redesigned and rebuilt to take full advantage of the upgrade of the ESRF to the fourth generation Extremely Brilliant Source (ESRF-EBS). The upgraded beamline now makes use of two sets of compound refractive lenses and multilayer mirrors to obtain a highly intense (>1013 photons s−1) focused microbeam (minimum size 1.5 µm × 3 µm full width at half-maximum). The sample environment now includes a FLEX-HCD sample changer/storage system, as well as a state-of-the-art MD3Up high-precision multi-axis diffractometer. Automatic data reduction and analysis are also provided for more advanced protocols such as synchrotron serial crystallographic experiments.

Abstract Objective The common risk factors for oral squamous cell carcinoma (OSCC) are smoking and alcohol abuse. A small percentage of patients, mostly women, are demonstrating oral cancer without the common risk behavior. This study investigates how gender and different patterns of lifestyle factors influence the clinical presentation of OSCC. Patients and Methods From this retrospective study, demographical and tumor‐specific data and lifestyle factors were analyzed. Statistical analyses were performed using the χ2 test or Fisher's exact test for categorical analysis and the t test, ANOVA test, or Kruskal–Wallis test for continuous variables. The influence of the respective lifestyle factors together with their interactions with the gender on tumor characteristics has been tested using logistic and ordinal cumulative link regression models. Results Among a total of 308 patients, men represented the majority of smokers (87.2%) and the female cohort were largely non‐smokers and non‐drinkers (64.9%). For age, tumor site and N‐stage it looks like that differences of men and women are driven by the different risk behavior. But if the lifestyle factors are taken into account, we observe contrary effects between men and women for T‐, N‐, and UICC‐stage. For different cancer locations we saw opposite effects with gender and risk profile. These effects are not dose‐dependent explainable for gender. Conclusion Some but not all differences in the development of OSCC for men and women are explainable by the respective difference in lifestyle behavior. Some further investigations are necessary to find explanations for the obvious differences between men and women in developing OSCC.

Triple-negative breast cancer (TNBC) occurs in 10-15% of all breast cancer patients, yet it accounts for about half of all breast cancer deaths. There is an urgent need to identify new antitumor targets to provide additional treatment options for patients afflicted with this aggressive disease. Preclinical evidence suggests a critical role for insulin-like growth factor-2 (IGF2) and androgen receptor (AR) in regulating TNBC progression. To advance this work, a panel of TNBC cell lines was investigated with all cell lines showing significant expression of IGF2. Treatment with IGF2 stimulated cell proliferation in vitro (p < 0.05). Importantly, combination treatments with IGF1R inhibitors BMS-754807 and NVP-AEW541 elicited significant inhibition of TNBC cell proliferation (p < 0.001). Based on Annexin-V binding assays, BMS-754807, NVP-AEW541 and enzalutamide induced TNBC cell death (p < 0.005). Additionally, combination of enzalutamide with BMS-754807 or NVP-AEW541 exerted significant reductions in TNBC proliferation even in cells with low AR expression (p < 0.001). Notably, NVP-AEW541 and BMS-754807 reduced AR levels in BT549 TNBC cells. These results provide evidence that IGF2 promotes TNBC cell viability and proliferation, while inhibition of IGF1R/IR and AR pathways contribute to blockade of TNBC proliferation and promotion of apoptosis in vitro.

Background. Non-unions of distal femur fractures are difficult to treat and occur in about 6% of cases. Multifactorial causes of fractures non-unions require individual treatment for each patient in accordance with the “diamond” concept. The standard protocol for patients with atrophic non-unions treatment involves bone autografts using, but there are limitations of size, shape, quality and quantity of autografts. Osteoplastic materials with osteoinductive (angiogenic) and osteoconductive activity can be used as bioresorbable implants in combination with autogenous spongy bone in the treatment of extremities long bones non-unions. Clinical case description. A 63-year-old patient was admitted to the clinic for non-union of distal third of the femur with bone defect, fragments were fixed with a plate. The examination revealed plate fracture, screws migration (group III according to the Non-Union Scoring System). The volume of supposed bone defect was about 8.5 cm3. The surgery was performed: plate removal, debridement of the non-union zone, femur defect replacement with a bone autograft in combination with the gene-activated osteoplastic material “Histograft” in a ratio of 1:1, osteosynthesis of the femur with two plates. After 6 months. during the control computed tomography, consolidation was determined (4 points on the REBORNE scale). Pain was practically absent (NRS-2). The range of motion in the knee joint: flexion — 80o, extension — 180o. According to the Knee Society Score (KSS) — 68 points. Conclusion. In this case report the complete fracture fusion was achieved in patient within 6 months — 4 points on the REBORNE scale. No adverse events were observed. It confirms the safety and efficacy of described method and allows to continue the clinical trials.

This study aimed to explore the prognostic value of electrodiagnostic studies (EDS) to clarify their utility in clinical practice prior to cubital tunnel release surgery and to identify patient factors associated with patient-reported functional improvement after surgery. Our hypothesis was that patients with severe preoperative findings on EDS will tend to experience less functional improvement after surgery given the extent of ulnar nerve compressive injury. Patients with cubital tunnel syndrome and preoperative electrodiagnostic data treated from 2012 to 2022 with cubital tunnel release were assessed regarding demographic information, preoperative physical examination findings, EDS findings, postoperative complications, and patient-reported outcomes. Short- to midterm quick Disabilities of the Arm, Shoulder, and Hand questionnaire (qDASH) scores were collected for all patients for further evaluation of preoperative EDS data. Patients were grouped into those who had met the minimal clinically important difference (MCID) in delta qDASH at short- to midterm follow-up and those who did not. EDS data included sensory nerve onset latency, peak latency, amplitude, conduction velocity, as well as motor nerve latency, velocity, and amplitude. Electromyographic (EMG) studies were also reviewed, which included data pertaining to fibrillations, presence of abnormal fasciculation, positive sharp waves, variation in insertional activity, motor unit activity, duration of activity, and presence of increasing polymorphisms. Of the 257 patients included, 160 (62.0%) were found to meet the MCID for short- to midterm qDASH scores. There were no significant differences between patients who did or did not meet the MCID regarding baseline demographics, comorbidities, preoperative examination findings, and operative technique. Patients who met MCID tended to have lower complication (3.80% vs. 7.20%, P =.248) and revision (0.60% vs. 4.10%, P =.069) rates, but these findings were not statistically significant. The cubital tunnel severity as determined by the EDS was similar between cohorts (14.1% vs. 14.3%, P =.498). Analysis of EMG testing showed there were no significant differences in preoperative, short- to midterm qDASH, or delta short- to midterm qDASH scores for patients with or without abnormal EMG findings. Multivariate regression suggested that only age (P =.003) was associated with larger delta qDASH scores. Patient-reported preoperative disease severity may predict the expected postoperative change in ulnar nerve functional improvement, and EDS may not have prognostic value for patients undergoing cubital tunnel decompression. Therefore, physicians may suggest surgical treatment without positive EDS findings and still expect postoperative improvement in functional outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate how narrative is constructed to create connections with fat readers, how books function to envision spaces of fat liberation for young readers and to highlight the incredible importance of providing bigger mirrors (Bishop, 1990) for fat representation in children's literature. Design/methodology/approach: This paper analyzes and reflects on two texts that contain counternarratives of fatness: The (Other) F Word: A celebration of the fat and fierce edited by Angie Manfredi (2019) and Big by Vashti Harrison (2023) to interrogate how these two narratives intentionally disrupt anti-fat bias. Findings: Body size and fatness are identities that need to be included in diversity efforts within education. Books like The (Other) F Word: A celebration of the fat and fierce (Manfredi, 2019) and Big (Harrison, 2023) offer positive representations of fatness, disrupt biases around body size and provide spaces that allow fat students to find joy, hope, connection and, more than anything, imagine a way toward liberation. Research limitations/implications: This paper highlights the need to include more narratives of positive fat representation within children's literature and calls for educators to interrogate their own anti-fat biases and practices. Originality/value: There is a lack of research on fat representation specifically within children and young adult literature. This paper provides an analysis of two pieces of literature with fat representation that brings attention to the need for this type of future research. [ABSTRACT FROM AUTHOR]

Post-translational modification (PTM) serves as a regulatory mechanism for protein function, influencing their stability, interactions, activity and localization, and is critical in many signaling pathways. The best characterized PTM is phosphorylation, whereby a phosphate is added to an acceptor residue, most commonly serine, threonine and tyrosine in metazoans. As proteins are often phosphorylated at multiple sites, identifying those sites that are important for function is a challenging problem. Considering that any given phosphorylation site might be non-functional, prioritizing evolutionarily conserved phosphosites provides a general strategy to identify the putative functional sites. To facilitate the identification of conserved phosphosites, we generated a large-scale phosphoproteomics dataset from Drosophila embryos collected from six closely-related species. We built iProteinDB (https://www.flyrnai.org/tools/iproteindb/), a resource integrating these data with other high-throughput PTM datasets, including vertebrates, and manually curated information for Drosophila. At iProteinDB, scientists can view the PTM landscape for any Drosophila protein and identify predicted functional phosphosites based on a comparative analysis of data from closely-related Drosophila species. Further, iProteinDB enables comparison of PTM data from Drosophila to that of orthologous proteins from other model organisms, including human, mouse, rat, Xenopus tropicalis, Danio rerio, and Caenorhabditis elegans.

In the context of higher education, this study examines the extent to which affective evaluations of the student experience are influenced by the point at which they are made (i.e. before the experience begins, whilst it is happening and after it has ended). It adopts a between-groups quantitative analysis of the affective evaluations made by 360 future, current and past postgraduate students of a UK business school. The study validates the proposition that affective forecasts and memories of the student experience are considerably inflated in prospect and retrospect; a finding that implies a significant impact bias. It is concluded that the impact bias may have important implications for influencing the effectiveness of student decision-making, the timing and comparability of student course evaluations, and understanding the nature and effects of word-of-mouth communication regarding the student experience.

Microglia are central nervous system (CNS) resident immune cells that have been implicated in neuroinflammatory pathogenesis of a variety of neurological conditions. Their manifold context-dependent contributions to neuroinflammation are only beginning to be elucidated, which can be attributed in part to the challenges of studying microglia in vivo and the lack of tractable in vitro systems to study microglia function. Organotypic brain slice cultures offer a tissue-relevant context that enables the study of CNS resident cells and the analysis of brain slice microglial phenotypes has provided important insights, in particular into neuroprotective functions. Here we use RNA sequencing, direct digital quantification of gene expression with nCounter® technology and targeted analysis of individual microglial signature genes, to characterize brain slice microglia relative to acutely-isolated counterparts and 2-dimensional (2D) primary microglia cultures, a widely used in vitro surrogate. Analysis using single cell and population-based methods found brain slice microglia exhibited better preservation of canonical microglia markers and overall gene expression with stronger fidelity to acutely-isolated adult microglia, relative to in vitro cells. We characterized the dynamic phenotypic changes of brain slice microglia over time, after plating in culture. Mechanical damage associated with slice preparation prompted an initial period of inflammation, which resolved over time. Based on flow cytometry and gene expression profiling we identified the 2-week timepoint as optimal for investigation of microglia responses to exogenously-applied stimuli as exemplified by treatment-induced neuroinflammatory changes observed in microglia following LPS, TNF and GM-CSF addition to the culture medium. Altogether these findings indicate that brain slice cultures provide an experimental system superior to in vitro culture of microglia as a surrogate to investigate microglia functions, and the impact of soluble factors and cellular context on their physiology.

This study examined adult age differences on five tests of divergent thinking: associational fluency, expressional fluency, ideational fluency, word fluency, and consequences. Our hypothesis was that young adults ( M = 20.53, n = 60) would score higher than old adults (M = 72.10, n = 60) under standard timed test conditions, but old adults would perform as well as young adults when time limits were removed. The hypothesis was confirmed. Old adults can think as divergently as young adults, but they do so at a much slower rate. (Contains 1 table.)

Younger and older African American and Caucasian American adults, who were matched by age ("M" age = 40.63 years), completed a survey on perceptions of aging and subjective age. The 2 groups did not differ in the age they considered someone to be old ("M" age = 74.5 years). However, when asked which age was the happiest age, African Americans chose a significantly younger age ("M" age = 18.26 years) than did Caucasian Americans ("M" age = 31.32 years), and this racial group difference interacted with age differences such that older Caucasian Americans named an older age than did younger Caucasian Americans. The authors found no such age difference for African Americans. When asked if old age was a happy time, 60% of Caucasian Americans answered "yes", whereas only 2% of African Americans answered "yes". These and other differences in images and concerns of old age and subjective age suggest a far more negative view of aging for African Americans and a need for changes in the provision of positive information about aging for this group. (Contains 3 tables.)

At the authors' school, as in many places, she struggles with making science a meaningful part of her students' lives. The teachers are working under state mandates to prepare students for reading and mathematics tests in third, fourth, and fifth grades. Often, this relegates science and social studies to a distant back burner. In an effort to bring science into everyday lives, the science team decided to bring in real people with science-related jobs or hobbies to the school to show students science is more than a textbook subject or an occasional entertaining experiment. What began five years ago has grown into a marvelous experience of learning by doing, having new experiences, and seeing how components come together to form the whole and how science is part of real life. Though it occurs only one day a year, Science Alive! has truly brought science alive for the authors' school community! This program is briefly described in this article.

Today’s dairies are growing rapidly, with increasing dependence on Latino immigrant workers. This requires new educational strategies for improving milk quality and introduction to state-of-the-art dairy farming practices. It also creates knowledge gaps pertaining to the health of animals and workers, mainly due to lack of time and language barriers. Owners, managers and herdsmen assign training duties to more experienced employees, which may not promote ‘best practices’ and may perpetuate bad habits. A comprehensive and periodic training program administered by qualified personnel is currently needed and will enhance the sustainability of the dairy industry. Strategic management and employee satisfaction will be achieved through proper training in the employee’s language, typically Spanish. The training needs to address not only current industry standards but also social and cultural differences. An innovative training course was developed following the same structure used by the engineering and construction industries, giving farm workers basic understanding of animal care and handling, cow comfort and personal safety. The Dairy Tool Box Talks program was conducted over a ten week period with nine 30-minute sessions according to farm’s various employee work shifts. Bulk milk bacterial counts and somatic cell count were used to evaluate milk quality on the three dairy farms participating in the program.Dairy Tool Box Talks resulted in a general sense of employee satisfaction, significant learning outcomes, and enthusiasm about the topics covered. We conclude this article by highlighting the importance of educational programs aimed at improving overall cross-cultural training.

Groups of 40 older and 40 younger adults were tested using cue sets of 25 U.S. states and 25 movie stars. No overall differences in total recall appeared. Those who did not study cues had better recall of noncued items. Younger adults performed better on noncued sets, older adults on the cued condition for movie stars. (SK)

Relates Carol Gilligan's two perspectives on moral reasoning (care and justice) to discussions in service learning circles concerning the relationship between charity and social change as orientations of service and service-learning and to the nature of "self." The discussion informs the questions of what constitutes "mature" service and of how to structure service-learning experiences to move students toward mature service. (Author/MSE)

Objective: To determine if implementation of a simplified ERP across multiple surgical specialties in different hospitals is associated with improved short and long-term mortality. Secondary aims were to examine ERP effect on length of stay, 30-day readmission, discharge disposition, and complications. Summary Background Data: Enhanced recovery after surgery and various derivative ERPs have been successfully implemented. These protocols typically include elaborate sets of multimodal and multidisciplinary approaches, which can make implementation challenging or are variable across different specialties. Few studies have shown if a simplified version of ERP implemented across multiple surgical specialties can improve clinical outcomes. Methods: A simplified ERP with 7 key domains (minimally invasive surgical approach when feasible, pre-/intra-operative multimodal analgesia, postoperative multimodal analgesia, postoperative nausea and vomiting prophylaxis, early diet advancement, early ambulation, and early removal of urinary catheter) was implemented in 5 academic and community hospitals within a single health system. Patients who underwent nonemergent, major orthopedic or abdominal surgery including hip/knee replacement, hepatobiliary, colorectal, gynecology oncology, bariatric, general, and urological surgery were included. Propensity-matched, retrospective case-control analysis was performed on all eligible surgical patients between 2014 and 2017 after ERP implementation or in the 12 months preceding ERP implementation (control population). Results: A total of 9492 patients (5185 ERP and 4307 controls) underwent ERP eligible surgery during the study period. Three thousand three hundred sixty-seven ERP patients were matched by surgical specialty and hospital site to control non-ERP patients. Short and long-term mortality was improved in ERP patients: 30 day: ERP 0.2% versus control 0.6% (P = 0.002); 1-year: ERP 3.9% versus control 5.1% (P < 0.0001); 2-year: ERP 6.2% versus control 9.0% (P < 0.0001). Length of stay was significantly lower in ERP patients (ERP: 3.9 ± 3.8 days; control: 4.8 ± 5.0 days, P < 0.0001). ERP patients were also less likely to be discharged to a facility (ERP: 11.3%; control: 14.8%, P < 0.0001). There was no significant difference for 30-day readmission. All complications except venous thromboembolism were significantly reduced in the ERP population (P < 0.02). Conclusions: A simplified ERP can uniformly be implemented across multiple surgical specialties and hospital types. ERPs improve short and long-term mortality, clinical outcomes, length of stay, and discharge disposition to home. [ABSTRACT FROM AUTHOR]