Diagnostic Laboratory Stewardship in a Growing Integrated Delivery Network.

Background: Many organizations institute laboratory diagnostic stewardship (DS) programs to improve the utilization of laboratory resources.

Methods: In this paper, we describe the road to implementing laboratory DS in a large, not-for-profit integrated delivery network located in the western United States.

Results: Program structure, projects, challenges, and future opportunities are discussed, providing tactics and opportunities that facilities can employ to maximize their initial foray into the DS landscape.

Dengue and Zika virus NS4B proteins differ in topology and in determinants of ER membrane protein complex dependency.

Flaviviruses utilize the cellular endoplasmic reticulum (ER) for all aspects of their lifecycle. Genome replication and other viral activities take place in structures called replication organelles (ROs), which are invaginations induced in the ER membrane. Among the required elements for RO formation is the biogenesis of viral nonstructural proteins NS4A and NS4B.

Managing Friends and Foes: Sanctioning Mutualists in Mixed-Infection Nodules Trades off With Defense Against Antagonists.

Successful plant growth requires plants to minimize harm from antagonists and maximize benefit from mutualists. However, these outcomes may be difficult to achieve simultaneously, since plant defenses activated in response to antagonists can compromise mutualism function, and plant resources allocated to defense may trade off with resources allocated to managing mutualists. Here, we investigate how antagonist attack affects plant ability to manage mutualists with sanctions, in which a plant rewards cooperative mutualists and/or punishes uncooperative mutualists.

Development and evaluation of a quality improvement educational video on joint contractures for care home staff.

Background: Contractures are a debilitating problem for individuals living in long-term care settings. However, there is a lack of education and training among the care staff regarding the identification of risk factors related to contractures and the preventive strategies that can decrease their development or progression. Addressing this knowledge gap has the potential to improve the quality of care provided to residents in care homes.

An Accessory Right Hepatic and Cystic Arteries Derived from the Superior Mesenteric Artery: A Cadaveric Case Report.

BACKGROUND The configuration of the hepatic arteries is known to vary substantially between individuals. Here, we report a rare retroperitoneal configuration of an accessory hepatic artery existing alongside a left and right hepatic artery branching from the proper hepatic artery. During routine dissection, we discovered an anomalous configuration of the hepatic arteries that does not fit the commonly used categorizations for abnormal hepatic vasculature.