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HIPAA Security Reminder – Treat Paper Records & Electronic Data Equally
Protected Health Information (PHI) exists in many forms. The HIPAA Privacy Final Rule concerns itself with permissable and proper use and disclosure of all forms of PHI, including electronic PHI (ePHI). It's important to not lose track of the requirements to safeguard all PHI. Learn more about what you and your company should be doing…to protect yourself and your stakeholders…
Treat Paper Records & Electronic Data Equally
Sensitive information on paper is the same as sensitive information on a computer. Both need to be protected from unauthorized access and should be treated with caution and discretion. In particular, protected health information (PHI) in all forms (e.g., verbal, fax, paper, electronic) is covered by the HIPAA privacy regulations. Electronic PHI (ePHI) is specifically covered by the HIPAA security regulations.
Sometimes, it may be necessary to print out sensitive electronic information on paper and make copies. Do not leave these copies lying around in open areas within your workspace, as this information may be seen or even taken by unauthorized parties. If you would not want someone to read that information on your computer, you probably would not want them to read the same information on paper.
Keep printouts of sensitive information such as medical records in a secure location, such as a locked desk, locked filing cabinet or a safe. Avoid leaving sensitive documents unattended, especially in high traffic areas.
Always shred copies of sensitive information when disposing – do not simply toss them in the trash. Cross-cut shredders are very useful in making printed sensitive information both unreadable and unusable. Remember to shred any printouts containing any information that would be useful to identity thieves, an ever-increasing problem. This includes documents containing any personal, financial or protected health information.
In Guidance Specifying the Technologies and Methodologies That Render Protected Health Information Unusable, Unreadable, or Indecipherable to Unauthorized Individuals, there is a description of the technologies and methodologies that can be used to render PHI unusable, unreadable, or indecipherable to unauthorized individuals. This creates "secured" PHI. Unsecured PHI is PHI that has not been rendered unusable, unreadable, or indecipherable. Under the Breach Notification Interim Final Rule, CEs and BAs must only provide the required notification if the breach involved unsecured protected health information.
While covered entities and business associates are not required to follow the guidance, the specified technologies and methodologies, if used, create the functional equivalent of a safe harbor, and thus, result in covered entities and business associates not being required to provide the notification otherwise required by section 13402 of The HITECH Act in the event of a breach."
The complete HIPAA Privacy, Security and Breach regulations are here.
If you'd like keep up to date on HIPAA Security and Privacy reminders or HIPAA-HITECH in general, please also consider (all optional!):
- Joining our AboutHIPAA LinkedIn Group: http://AboutHIPAALI.org
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- Checking our company web site: http://clearwatercompliance.com/
- Attending a HIPAA HITECH live webinar: http://abouthipaa.com/webinars/upcoming-live-webinars/
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- Viewing a pre-recorded webinar: http://abouthipaa.com/webinars/on-demand-webinars/


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Maybe this is silly, but I have been sick for 2-3 days now and I am SO hungry. For the last month or so I have led a decently strict high protien-low calorie diet. Since im sick is it ok to go away from the diet? Does my body need calories to "fight back". I feel like eating my face off would help, but then again it could just be me being a pansy. Any Help?
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● This comes hardly as a shock, but word has it that Snooki has gone and gotten engaged to her baby dady, Jionni. [People]
● Odd Future's Frank Ocean and the Roc's new girl, Rita Ora, have been tapped to open for Coldplay on the band's stadium tour through Europe this summer. [Rap-Up]
● Kim Kardashian let wedding guests know in a thank you note that she has donated twice the value of what she received in gifts to the Dream Foundation. Who says good things can't come of 72-day weddings? [Us]
● At last, a Hunger Games-inspired fitness plan for all those hoping to be strong like a Career or swift like Katniss. [VF]
● Charlie Sheen is back to work, this time using his mad man rep to shill teeny-tiny but oh-so-expensive Fiats. [Time]
● Is there a posthumous Aaliyah album on the way? [Prefix]
source: http://www.blackbookmag.com/tv/afternoon-links-snooki-gets-engaged-charlie-sheen-gets-back-to-work-1.45597


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Wednesday, September 19, 2012
China Glaze Rare and Radiant
Today's offering from the China Glaze New Bohemian Collection is Rare and Radiant. This is another Chanel Peridot/OPI Just Spotted the Lizard type green, bronze/gold, navy multichrome shifter. Very pretty. Very. Not unique. But if you have been on the lookout for a polish of this kind at a nice, affordable price, China Glaze Rare and Radiant may be the one for you.
This swatch is two coats and Seche Vite. The formula is, as I have already said quite fabulous. I could post a thousand shots of this baby and every one would be different. Since you have all seen a million pictures of this particular type of multichrome many times, I am just posting three, this time around.
Aren't I great?
Is pretty, no?
What do you think of China Glaze Rare and Radiant? Like it? Tired of seeing this kind of multichrome? Are you ready for Fall? Am I the only one craving pancakes, around here? Would you like me to STFU?
Thank you for popping in. Have a loverly day and may your polish never bubble.
8 comments:
wow great..ReplyDelete
Pretty! And I'm always up for pancakes, LOL!ReplyDelete
- erikatheicyoneSeptember 19, 2012 at 3:24 PM
Thank you.ReplyDelete
Pancakes rule. :D
- erikatheicyoneSeptember 19, 2012 at 3:25 PM
Thank you. :)ReplyDelete
I have not tired of this particular multichrome yet. I just think it is the prettiest thing. Every other polish company who doesn't already have one could make a dupe and I'd still drool a little bit.ReplyDelete
- erikatheicyoneSeptember 20, 2012 at 11:20 AM
It is a pretty multichrome and I am not surprised to see it being done by so many lines. :)ReplyDelete
Not sure I am loving this oneReplyDelete
- erikatheicyoneSeptember 21, 2012 at 8:05 AM
There are so many versions of this duochrome out there that one may be the one you love. Or this look may not be your cup of tea. :)ReplyDelete
Thank you so much for reading and commenting. I truly appreciate each and every one of my readers and the time you take out of your busy day to read and share your thoughts with me. <3
Please send blog links to me by e-mail. You can find my e-mail address in my Contact tab at the top of my blog page.
Have a fabulous day! :D


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Left Handed Single Dummy Trim for One Side of Door from the Flair Collection
- Interior screws are exposed
- Flair single dummy trim, used for left handed applications.
- This single dummy trim is for one side of a door
- It can be used as a door pull or as matching inactive trim.
- Only for left handed applications
- Length: 4"
- Rose Diameter: 2 3/4"
- Projection: 2 1/4"
Additional Schlage Links
Our SKU: Schlage F170-FLA-LH
This product is listed under the following manufacturer number(s):
- Schlage F170FLA716LH
Aged Bronze
- Schlage F170FLA609LH
Antique Brass
- Schlage F170FLA620LH
Antique Pewter
- Schlage F170FLA505LH*
Lifetime Polished Brass
- Schlage F170FLA613LH
Oil Rubbed Bronze
- Schlage F170FLA605LH
Polished Brass
- Schlage F170FLA625LH
Polished Chrome
- Schlage F170FLA626LH
Satin Chrome
- Schlage F170FLA619LH
Satin Nickel
*Denotes a finish or option that has been discontinued
Manufacturer Resources
Installation Resource Center
Whether you are installing the product yourself or hiring a professional, our installation Resource Center has everything you need to get your project done. Visit the Installation Resource Center to get started.


text:
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Beilstein Journal of Organic Chemistry - Latest Articles. Faculty.txwes.edu/ppelphrey/course2/documents/Resonance_000.pdf. LIQUID-FUEL ROCKET ENGINES. HOW to DESIGN, BUILD and TEST SMALL LIQUID-FUEL ROCKET ENGINES Reprinted with permission. ROCKETLAB cannot assume responsibility, in any manner whatsoever, for the use readers make of the information presented herein or the device resulting therefrom. MIT, LCS, and the volunteers who have made this information available on the W3 likewise disclaim all responibility for whatever use readers make of this information. 35 Scientific Concepts That Will Help You Understand The World, by Aimee Groth. In order to sharpen our reasoning skills, we must have a good grasp of our own cognitive biases, as well as the basic laws of the universe.
But in a dynamic world, new laws are constantly emerging. The editors over at Edge.org asked some of the most influential thinkers in the world — including neuroscientists, physicists and mathematicians — what they believe are the most important scientific concepts of the modern era. The result is "This Will Make You Smarter: New Scientific Concepts To Improve Your Thinking," a compilation of nearly 200 essays exploring concepts such as the "shifting baseline syndrome" and a scientific view of "randomness. " Gates Puts Feynman Lectures Online. MicrosoftThe new Tuva Web site features annotated videos of Richard Feynman's physics lectures.
Microsoft Chairman Bill Gates believes that if he had been able to watch physicist Richard Feynman lecture on physics in 1964 his life might have played out differently. Mr. Gates, of course, is legendary as a Harvard University dropout who went on to create the world's most successful software firm. He has told associates that if had watched the lectures earlier in his life he might have become a physicist instead of a software entrepreneur. Tongue controller for the paralyzed offers greater independence. 25 Documentaries Everybody Should Watch. Sans Soleil This is not your average documentary.
It is a fleeting memory, a sudden remembrance of times long past, a meditation on time and culture, a touch of an emotional diary. We follow the eyes of a world traveller who makes sharp observations and tries to convey them to his friend. We never learn who they are and where they came from, and this is perhaps a subtle point the documentary wants to make.
The narrator's voice switches from Japanese to German to English to French, thereby embodying the language of the places visited. Must Watch: An Out-of-Character Stephen Colbert Interviews Neil deGrasse Tyson. While I believe in God, I do not ignore the value and contribution that science makes.
People often confuse the two as separate and nothing could be further from the truth. Having said that, the question of morality, and the Tree of Knowledge of Good and Evil are exactly the lesson that God was teaching. Tyson eluded that we need better moral management, while God on the other hand was warning us that we do not have the capacity to do so on our own. This tree did no way mean moral ability and insight! If so, Adam and Eve wouldn´t even KNOW it was wrong to eat, thus God wouldn´t have punished them. Encyclopedia of Life - Animals - Plants - Pictures & Information. Kickstarter. Phonebloks: a utopian world where smartphones are a bit more like Lego.
We hate to open too negatively here, but let's just say that this seems like one of those ideas that's just too good to be true.
But heck, much stranger things have happened in the world of consumer electronics, and certainly the maker and crowdfunding communities have gone a ways toward helping us rethink our devices. What about a smartphone that could score a 10 every time iFixit teared it down? Phonebloks: a utopian world where smartphones are a bit more like Lego. See What Happens When a Squid Listens to Cypress Hill. Ever wonder what a squid listening to Cypress Hill's Insane in the Brain looks like?
Fascinated by the fast color-changing nature of the squid's skin and their ability to quickly control pigmented cells called chromatophores, the folks at Backyard Brains wondered what exactly would happen if they played music to a squid. In order to satisfy their curiosity they attached a suction electrode to the squid's fin nerve and then connected the electrode to an iPod nano as their stimulator. The results are incredible. Scientists engineer suicide bomber bacteria to kill other bacteria. In a lab in Singapore, scientists are designing and breeding suicide bombers.
If their efforts pan out, they will be applauded rather than jailed, for their targets are neither humans nor buildings. They're bacteria. Nazanin Saeidi and Choon Kit Wong have found a new way of killing Pseudomonas aeruginosa, an opportunistic species that thrives wherever humans are weak. The Effects of Marijuana on Consciousness. From: Altered States of Consciousness, edited by Charles T.
Tart, Doubleday & Co., 1972, Chapter 22 A marijuana high usually lasts two or three hours, during which a wide range of effects may occur, varying both in intensity and quality. The usual, most noticeable effect is intensification of sensation and increased clarity of perception. Visually, colors are brighter, scenes have more depth, patterns are more evident, and figure-ground relations both more distinct and more easily reversible. SniffCode.com : Hacking into the Human. Untitled. Learn to Pick Locks for Fun and an Increased Understanding of Security. If your file is that cheap, you need a better file.
As for worrying about your file, I'd worry more about what the bump key will do to the lock you're trying to open.. They can really do some damage in the hands of the wrong person.. Hacksaw blade was already suggested so I'll give it a +1. For car locks, I was at a garage sale in Anchorage many moons ago and everything was on the floor of the garage, dang near walked by a complete lockpick set for cars and truck, including the book. New Model of the Universe Says Past Crystallizes out of the Future.
What's the difference between the past and the future?
Not a great deal, if you take a purely relativistic view of the universe, say George Ellis from the University of Cape Town in South Africa and Tony Rothman from Princeton University in New Jersey. The standard spacetime diagrams used in relativity accord no special status to the past, the present or the future. That's because they assume that everything evolves from time-reversible local physics. Murphy. Murphy's Law Calculator. Murphy's Law Calculator From a formula for * Sod's Law provided by British Gas: ((U+C+I) x (10-S))/20 x A x 1/(1-sin(F/10)) "anything that can go wrong, will go wrong! " Find out in advance whether you will be able to successfully repair your VCR, get to a meeting on time, impress your date, or be a success at any activity whatsoever !
Casebook: Jack the Ripper - Main. Science news and science jobs from New Scientist. How to Forecast Weather. Ever wondered how to forecast the weather without actually using instruments? Check the Clouds: Clouds can tell us a lot about the weather. For example, they can tell us if it's going to be warmer on a particular night by simply being there. That's because they prevent heat radiation from escaping. ScienceWorld. Some paradoxes - an anthology. Greatest Hits of TED Videos. Hack Your Own Super Fridge. How to turn "water" into marbles. Stolen Camera Finder - find your photos, find your camera.
Make your own Airsoft machine gun with a soda bottle. Would you like to own an Airsoft gun, but can't afford to buy one? How about making one instead using a soda bottle? Better yet, how about making a machine gun that only requires 4 cheap and commonly available parts that's capable of firing hundreds Airsoft BBs before a reload is required? The informative video below shows you exactly how to do that for around $15. The parts you'll need include a plastic soda bottle, a quick release air compressor adaptor, an air compressor blowgun, and a 7mm by 6-inch brake line. The other thing you will need is a compressed air supply. Plastic-eating fungus could help deal with landfill. A team from Yale University has discovered a fungus deep in the South American rainforest that can live entirely on plastic - offering hope for new methods of waste disposal.
Pestalotiopsis microspora, found in the jungles of Ecuador, can digest polyurethane - which often currently ends up in landfill and takes generations to decay. Burning polyurethane releases toxins as well as carbon dioxide; and, while it can be recycled, it frequently isn't. The fungus can live entirely on polyurethane. And, most intriguingly, the fungus can break down polyeurethane even without the presence of oxygen, meaning it could do its trick even at the bottom of a landfill site. Fracture Putty can heal a broken bone in days.
Scirus - for scientific information. Psilocybin, the Drug in 'Magic Mushrooms,' Lifts Mood and Increases Compassion Over the Long Term. Professor of Theoretical Physics, CUNY. Most Popular Repurposing Tricks of 2011. Top Sites To Find All The Serials You Need. Forked from: [BetweenAS3]uzumaki. 10 Search Engines to Explore the Invisible Web. 5 Ways To Hack Your Brain Into Awesomeness. #3038363. Kurzweil Accelerating Intelligence.


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Health Information - Med Help
My MedHelp
Burning vagina
Common Questions and Answers about Burning vagina
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Hello, It is clear from your and your boyfriend's symptoms that you had contact dermatitis(allergic or irritant) to the dye.As your boyfriend had An Allergic reaction immediately after using the dye,so after having intercourse your skin had come in contact with the hair or dye in any way and so you also started having burning sensation. Avoid using this hair color in future and pls don't allow hair to touch you skin .
Read More
Just yesterday, the outer parts of my
(around my clitoris and lips) have turned red and began
to touch. It doesn't really itch but is very sore. What could it be?
Read More
I have had
pain in my
over a month now. It was severe that sometimes I can't even wear my underpants. I went to see my gyn., she did not see any lesion or anything that may cause the pain. Since I had history of herpes infection (a year ago), she said that it can be because of that. Thus, she perscribed Valtrex. I just start taking it, but the pain is still there. I'm not sure if that's the cause. Does anyone have any suggession?
Read More
The day after him performing oral sex on me my
and it has not stopped for 5 days. The pain is getting to me and I am scared I have herpes now. I have no bumps or blisters or anything of that sort. My vagina does not look any different at all. It just burns. It even burns in places he did not kiss. Does anyone know what this could be? Please help I am in pain and scared.
Read More
Hi i had a swollen bleeding and
for almost a month what should i do
Read More
Why is my
all of a sudden? What do I do? Me and my boyfriend have been going out for two years now. Just last week my vagina started to hurt during sex. It stopped hurting the next day but we didnt try having sex again till 4-5 days later. I couldnt even bare the pain because it hurt instantly once he tried to go in. I did have a UTI about a month ago. And we dont use lubrication which is kind of a problem sometimes...
Read More
I'm 37 weeks a long and my husband and I had sex tonight and ever since then my
has been
SOOOO bad, it hurts to urinate and even walk. We've had sex before while im this pregnant and it's never happened. Is this normal, and why.
Read More
Are u sexually active? Had unprotected sex? Any itching or
? U could have an STD. Go get checked.
Read More
Hello and hope you are well. In vaginal yeast infections there is
, soreness, pain during intercourse or urination, vaginal discharge which is thick white with cottage cheese appearance. It can also cause local pain in vulvar area called vulvodynia.The treatment includes topical application of antifungals like clotrimazole,miconazole.Oral medications like fluconazole are available and vaginal suppositories are also prescribed by some doctors.
Read More
excessive discharge, changes in discharge color and odor, itching, irritation, soreness or
sensation of
and vulva. If you have an abnormal vaginal discharge then there will be an increase in the amount and thickness of discharge, white and clumpy (like cottage cheese), grayish, greenish, yellowish, or blood-tinged discharge, mucus and pus mixed in with discharge or frothy smell. Does this discharge have a smell to it and/or causing any itching/burning?
Read More
is really itchy inside and out I also had a kidney transplant not long ago and I understand it's common to get UTI's and Vaginal Thrush with the medication, my symptoms include, itchiness, burning, mild fever and pain just before you finish urinating.
Read More
every time I get sexually aroused I get a
and itch in the entrance of my
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Sinds 6 days the right outer lips is swollen 2 days ago i went to Gyn she said it is a infection and I got antibioticts for 7 days.
Read More
i had sex like a week ago and my vagina is slightly sore but its red and itches alot and burns and i dont know what this might be i cant quit scratching at it and im worried that it might be a std i have medicade and i can go to the doctor i was just wonderig if anyone knew what this might be
Read More
For the past couple days its burned when I pee && my vagina has a weird different smell && my vagina has just hurt. My friend said its a possibility that I have a UTI but I'm not sure. What could this be ?
Read More
My whole
burns when i pee its very painful how can i get relief from the pain an burn
Read More
What could be the problem if I have
around the urethra and
areas after having intercourse w/my husband?
Read More
is it right if it burns when i pee and i have a huge rash all over my
and buttoks.
Read More
I have REALLY bad
on my
so bad that i cant move or walk it hurts. Can anyone help me. I dont know if its from shaving or sex? Its bumpy too.
Read More
Utis do that i reccomend a bag of peas and ALOT of cranberry juice
Read More
In my
area it has starting itching and
but i have been with the same person for two years and it has gotten worse. What can i do.
Read More
Last night me and my boyfriend were having sex I was getting this burning feeling in my
. When I got home it was really bad, it kinda felt like a throbbing/
sensation. And it hurt a little when I went to the bathroom. I think I was too dry down there, as I didn't have any foreplay it was just sex. I was dry the other night too, and it hurt a little when he started fingering me, but got better as I got more wetter. Could me being dry cause the burning sensation?
Read More
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text: LG Electronics, Inc. (LG) has decided to discontinue current discussions with Conergy AG (Conergy) regarding the proposed joint venture for solar cell manufacturing due to current worldwide economic uncertainty and changes in strategic direction. LG said that it "will continue to explore opportunities to become a global leader in photovoltaic cell and module manufacturing. In this context, LG will also continue to review other options for cooperation with Conergy, a leading global downstream player."


text:
The 165th meeting of the National Advisory Allergy and Infectious Diseases Council (NAAIDC) convened at 10:30 a.m. on Monday, May 24, 2010, in Conference Rooms E1/E2, Building 45, National Institutes of Health. Dr. Anthony S. Fauci, director, National Institute of Allergy and Infectious Diseases (NIAID) presided as chair.
In accordance with the provisions of Public Law 92-463, the meeting was open to the public from 10:30 a.m. to 11:40 a.m. and from 1:00 p.m. to 4:30 p.m. The meeting was closed to the public from 8:30 a.m. to 10:00 a.m. and from 11:40 a.m. to 12:00 p.m. for review and consideration of individual grant applications. Notice of the meeting was published in the Federal Register.
Council Members Present:
Ex Officio Members Present:
Council Members Absent:
NIAID Senior Staff Present:
Table of Contents
The National Advisory Allergy and Infectious Diseases Council convened in closed session to consider applications in the areas of allergy and immunology, microbiology and infectious diseases, and AIDS.
Funding Actions: The Council reviewed 2,888 research and training applications with primary assignment to NIAID for a requested amount of $1,172,158,331 in first-year direct costs and recommended approval of 672 applications for $445,750,313 in first-year direct costs. Five Method to Extend Research in Time (MERIT) awards were recommended for approval.
Dr. Fauci opened the Council session by welcoming visitors to the meeting and extended a special welcome to new ex officio member Dr. Rima Khabbaz, deputy director for infectious diseases at the Centers for Disease Control and Prevention. Two Council members, Drs. Louis Picker and Connie Celum, were unable to attend the meeting.
Council considered the minutes of the February 1, 2010, meeting and approved them as written.
Dr. Fauci acknowledged several new appointments and retirements at NIH and NIAID since the last Council meeting.
At the NIH level, Dr. Raynard Kington, deputy director of NIH, is leaving to become president of Grinnell College in Grinnell, Iowa. President Obama announced his plan to appoint Dr. Harold Varmus to serve as the director of the National Cancer Institute.
After 40 years at NIH, Dr. Brian Murphy retired as chief of the Respiratory Viruses Section and co-chief of the Laboratory of Infectious Diseases, NIAID. Dr. Murphy is renowned for his expertise in the fields of virology, vaccine research, and respiratory diseases. Dr. Jeffrey Cohen is the new chief of the Laboratory of Infectious Diseases.
Dr. Fauci announced the following appointments: Dr. Suzanne Frisbie as the first deputy director of the NIAID Office of Technology Development; Jean McKay as director of the Office of Program Planning, Operations, and Scientific Information, DAIT; and Diane Randall as the new deputy director of the Office of Research Operations, Office of the Director.
Dr. Fauci congratulated Dr. Gary Nabel, director of the Vaccine Research Center, on being named a 2010 fellow of the American Academy of Arts and Sciences. Dr. Tom Quinn, chief of the International HIV and STD Unit, Laboratory of Immunoregulation, received the 2010 Ed Nowakowski Senior Memorial Clinical Virology Award from the Pan American Society for Clinical Virology. The American Society of Tropical Medicine and Hygiene awarded Dr. Jesus Valenzuela, chief of the Vector Molecular Biology Unit, Laboratory of Malaria and Vector Research, the 2009 Bailey Ashford Medal.
Dr. Richard Whitley, one of NIAID's Council members, received the 2010 Distinguished Physician Award from the Pediatric Infectious Diseases Society.
The overall NIH budget for FY 2010 is $31 billion, a 2.3 percent increase over FY 2009. NIAID received $4.8 billion, an increase of 2.5 percent over FY 2009. Dr. Fauci noted that the appropriation bill includes a provision for a 2 percent inflationary increase for noncompeting grants.
NIAID will support a payline to the 11th percentile for unsolicited investigator-initiated research and the 16th percentile for new and early-stage investigators.
NIAID received $1.11 billion in American Recovery and Reinvestment Act (ARRA) funds. Most of the funds are being used to support research project grants, and a small percentage is supporting solicited initiatives, such as RFAs and PAs and signature projects.
The President's FY 2011 budget for NIH is $32 billion, a 3.2 percent increase over FY 2010. NIAID's allocation is just under $5 billion, a proposed increase of 3.3 percent over FY 2010.
On March 23, President Obama signed into law the Patient Protection and Affordable Care Act, commonly referred to as the Health Care Reform Act. The law contains a provision introduced by Senator Arlen Specter that establishes the Cures Acceleration Network (CAN). CAN will support research for high-priority therapeutics, biologics, or medical devices that have not attracted funding from the private sector.
On April 28, 2010, Dr. Fauci accompanied Dr. Francis Collins, NIH director, who testified before the House Appropriations Subcommittee on the FY 2011 President's Budget request for NIH. On May 5, Dr. Collins testified on the FY 2011 NIH budget before the Senate Appropriations Subcommittee.
Also on April 28, Dr. Fauci and Dr. Tom Frieden, director, Centers of Disease Control and Prevention, testified before the House Energy and Commerce Subcommittee on Health on antibiotic resistance and the threat to public health.
On April 30 at a Congressional briefing sponsored by the Foundation for AIDS Research, or amfAR, and several other HIV-advocacy organizations, Dr. Fauci spoke about the accomplishments and future challenges of AIDS research.
On May 13, Dr. Fauci participated as the keynote speaker at the National Italian American Foundation Public Policy Forum on Capitol Hill. He spoke about emerging and re-emerging infectious diseases, with a particular focus on the recent H1N1 influenza pandemic.
Dr. Fauci began by giving an update on swine flu. He presented current statistics of the estimated number of cases, hospitalizations, and deaths in the U.S. The 2010-2011 seasonal flu vaccine will include the 2009 California H1N1-like virus. The CDC's Advisory Committee on Immunization Practices recommends vaccinating everyone who is able to be vaccinated for seasonal influenza.
Dr. Fauci briefly discussed AIDS, malaria, and tuberculosis. He talked about neglected tropical diseases and how they are emerging as an important issue because of their disease burden measured in disability adjusted life years.
Dr. Gerald Nepom replaced Dr. Jeffrey Bluestone as the director of the Immune Tolerance Network. Dr. Fauci gave an update on the status of the guidelines for the diagnosis and management of food allergies and the Inner City Asthma Program.
Dr. Fauci outlined the White House Medical Countermeasures Initiative that will give the U.S. the capacity to respond faster and more effectively to bioterrorism or sudden outbreaks of an infectious disease. HHS conducted a Medical Countermeasure Review that included an Institute of Medicine workshop, a National Biodefense Science Board workshop, and the Medical Countermeasure Policy Review Team. Dr. Fauci will provide updates on this initiative over the next few Council meetings.
Dr. Francis Collins began by identifying the opportunities for research and NIH where advances could lead to substantial benefits: high-throughput technologies, translational medicine, health care reform, global health, and innovation in the biomedical research community. He then explained how these five themes fit into NIH's mission.
Dr. Collins discussed the pipeline for developing new therapeutics with potential clinical benefits and how NIH might play a more aggressive role in this process. The goal is to provide resources for projects that are unattractive to companies because of the lack of economic incentive. Another benefit of this effort is the possible discovery of new purposes for compounds that are already available.
Dr. Peggy Hamburg, FDA commissioner, and Dr. Collins are putting together a joint leadership council to look at ways to improve the translational pipeline.
The Health Care Reform bill contained a component called the Cures Acceleration Network (CAN). The purpose of CAN is to advance the development of new treatments and get them through the pipeline. Until money is appropriated for this program, NIH will not be funding awards.
The desired outcome is to develop a pipeline where projects could enter and leave at different stages and provide the capacity to find cures that have been very difficult to achieve.
Dr. Collins stressed the importance of supporting innovation and promoting diversity in the scientific workforce.
DAIT Staffing/Organizational Changes: Dr. Rotrosen welcomed the subcommittee members of the National Advisory Allergy and Infectious Diseases Council. Dr. Rotrosen took the opportunity to inform the subcommittee members on a number of strategic issues: 1) the Institute has developed a new methodology for reporting what the Institute spends on immunology. Under this new methodology there should be a greater representation of immunology from all of the divisions within Institute; 2) The Institute last year awarded about half of the $1.1 billion of ARRA funds that were allocated to us on 936 awards. The vast majority of these (86 percent) went to research project grants and very small amounts to training resource-related grants, intramural, and a small amount (4 to 7 percent) for the centers and R&D contracts; 3) There has been a tremendous effort on the part of the Asthma, Allergy and Inflammation branch to develop guidelines for the diagnosis and management of food allergy. In the development of these guidelines, the staff has brought together close to 30 other federal agencies and professional societies and patient advocacy groups with very different perspectives on this issue; and 4) in closing, Dr. Rotrosen mentioned we've had a leadership change in the Immune Tolerance Network, (ITN) one of the main clinical trial networks supported by the division. Dr Jeff Bluestone was recently appointed provost and executive vice chancellor at UCSF and because of that had to step down from the ITN leadership. We are fortunate that Dr. Jerry Nepom at the Benaroya Institute in Seattle has agreed to chair the scientific leadership committee of the ITN.
Dr. Rotrosen next mentioned there would be an update given by Dr. Lynda Chiodetti, Basic Immunology branch on "Adjuvant Discovery and Immunological Research using High Throughput Screening." He also let the members know, that Dr. Christopher Austin, Director, NIH Chemical Genomics Center, would be presenting on "NIH Chemical Genomics Center – Partners in Assay Development and High Throughput Screening."
Following the presentations, Dr. Rotrosen noted there were three concepts for review and approval.
The following concepts were presented for the Subcommittee's consideration:
Infant Immune System: Implications for Vaccines and Response to Infections: This initiative will support research to define the mechanisms for establishing and maintaining immunity in infants (0 to 12 months of age) after infection with or vaccination against emerging/re-emerging infectious diseases, including potential agents of bioterrorism. This program will also establish collaborations among immunologists, neonatologists, and microbiologists to expand our knowledge of the infant immune system. Information obtained through this program can be applied to the design of improved vaccines and immunotherapies to combat infections in this vulnerable population. The subcommittee unanimously approved this initiative.
Systems Approach to Innate Immunity: The primary objective of the program is to use a systems biology approach to develop a comprehensive understanding of innate and adaptive immune responses to microbial infection with a focus on NIAID Category A-C pathogens. The initiative will support quantitative analyses that will identify and measure dynamic networks regulating immune responses. This initiative requires an interdisciplinary team to achieve the goals. The basis of the research program will be genome wide screens of mutant mice for identification of key regulatory immune response genes. Random mutagenesis approaches are preferred, such as ethylnitrosourea (ENU) mutagenesis, although more targeted high throughput methods may be utilized with adequate justification. The studies will be complemented by detailed genomics, proteomics, computational biology, and bioinformatics approaches that focus on transcriptional regulation and signaling mechanisms. Investigators will analyze a subset of the newly discovered immune regulatory genes in human correlation studies. The subcommittee unanimously approved this initiative.
Taconic Mouse Exchange Program: Support distribution of immunology-related, gene-targeted mouse strains to the broader research community. This Division of Intramural Research (DIR) contract supports the breeding and distribution of novel mutant mouse strains containing gene knockout or novel trans-genes of immunological interest. The program is managed by NIAID DIR staff with input from DAIT staff, and partially supported with extramural (DAIT) funds. The mouse strains to be included in this program are based on projected value to the immunology community. The contract partially defrays the cost of mouse production so that investigators pay a reduced rate to receive animals. The subcommittee unanimously approved this initiative.
Following her welcoming remarks, Dr. Heilman introduced Dr. Rima Khabbaz, Deputy Director for Infectious Diseases at the Centers for Disease Control and Prevention (CDC), as the new CDC representative on NIAID's Advisory Council. Dr. Heilman also acknowledged that Subcommittee member Rich Whitley was recently named the 2010 recipient of the Distinguished Physician Award by the Pediatric Infectious Diseases Society, in recognition of his stellar and productive role as a researcher and director of the University of Alabama's Division of Pediatric Infectious Diseases.
She then deferred to the DMID branch chiefs to report on recent staff changes in their respective branches.
Following her introductory remarks, Dr. Heilman noted the Institute's new policies and procedures for investigator-initiated clinical trials, and informed the Subcommittee that Elizabeth Hollomon in DMID's Office of Clinical Research Activities is available to answer any questions regarding these changes (a flyer announcing the policy changes and listing Ms. Hollomon's contact information was distributed).
There were several concepts presented for the Subcommittee's consideration:
International Clinical Studies Support – the objective of this concept is to support clinical research carried out at international sites through assistance with protocol development, design, and implementation, site assessment, and monitoring; relevant training opportunities related are also provided. The Subcommittee was enthusiastic about the International Clinical Studies Support (ICSSC) program and felt it provided critical support for foreign investigators. A Subcommittee member asked if we had any mechanisms in place to measure the impact of this program so that we could determine if it was having its intended effect. Dr. Sager noted that the current contractor routinely solicited feedback from participants receiving training under the program. Dr. Heilman agreed that it would be valuable to secure additional metrics to more broadly assess the benefits of the program. The Subcommittee also asked how this program fits with other international activities. The Subcommittee suggested trying to measure "softer" contributions, such as institutional development and sustainability. The concept was unanimously approved.
NIAID International Research in Infectious Diseases, including AIDS – the objective of this concept is to support clinical research carried out at international sites through assistance with protocol development, design, and implementation, site assessment, and monitoring; relevant training opportunities related are also provided. The Subcommittee noted that the International Research in Infectious Diseases, including AIDS (IRIDA) is an important component of DMID's international portfolio. Subcommittee members suggested several ways to increase awareness of this unique opportunity for foreign investigators. The concept was unanimously approved.
An Integrated Approach in Understanding Host-Pathogen Interactions – the objective of this concept is to better understand, at a molecular level, the interactions of the pathogen and host, and how these interactions influence the presentation, progression and severity of clinical infectious disease. The Subcommittee unanimously and enthusiastically supported the concept, noting that the current availability of high-throughput technologies will facilitate understanding of the dynamics of host-pathogen molecular interactions while taking into account temporal factors. A lot of power was recognized in the proposed use of repetitive samples from hosts with persistent and recurrent infections, but the availability of samples for these studies could also be a challenge. The program should emphasize the generation of analysis tools and experimental protocols to extract meaningful data sets from the huge amount of data this program is expected to generate. Finally, a Subcommittee member noted that the overall benefits of the entire DMID genomic program to the microbiology and infectious disease community include the sharing of resource and data sets generated by initiatives such as this one.
Strategies for the Protection of Pregnant Women and Infants Against Infectious Diseases – the objective of this concept is to improve understanding of the host-pathogen interactions that underlie infectious diseases that are unique to, or occur at elevated incidence or with enhanced/modified pathology in, pregnant women, fetuses and neonates. The Subcommittee unanimously endorsed this concept, and expressed considerable enthusiasm for its goals. There was extensive discussion of the initiative and several recommendations were made. Regarding the initiative's scope, the subcommittee recommended a situational analysis to define critical high-impact scientific questions regarding infectious diseases in pregnancy, and using the results as the basis for focusing the initiative. They recommended against defining the initiative's scope on the basis of a set of microorganisms of interest, and instead focusing on the important questions that must be addressed. They also suggested requesting a letter of interest from prospective applicants as a way of proactively eliminating applications outside the initiative's scope. Dr. Kalt commented that such letters could be requested but would not be binding. Regarding peer review, the subcommittee cautioned that reviewers should be chosen carefully to encompass the breadth of expertise needed to evaluate multidisciplinary projects, and in particular to assess their impact on the field, including clinical practice. Finally, the subcommittee encouraged the participation of other ICs with interests in this area, particularly NICHD.
Finally, Dr. Katrin Eichelberg from NIAID's Division of Extramural Activities presented a concept entitled Administrative Supplements for T32 Global Health Physician Scientist Postdoctoral Training Programs for the Subcommittee's consideration and approval. The purpose of these administrative supplements is to allow existing T32 Institutional Research Training Programs with an overall focus on infectious diseases and a global health research capability, including collaborations with foreign clinical research sites, to add 1-2 clinical postdoctoral trainees over the remaining non-competitive segment of the parent award. The goal is to respond to and support the enthusiasm of clinical fellows eager to help solve global health problems in infectious diseases (including HIV). Additional research training will allow clinical fellows to gain international experience that will enhance their ability to function in foreign settings where many communicable diseases and associated health conditions are endemic. It will also provide research experience where other important infectious disease influences are prevalent, such as multiple co-morbidities, nutritional factors, cultural practices, and health care delivery challenges. The Subcommittee unanimously and enthusiastically supported the concept and it was considered an important addition to the existing T32 portfolio. Concern was raised regarding the distribution of funds based on the number of existing T32 programs with focus on Global Health among NIAID's scientific divisions, and the Subcommittee encouraged equilibrium among the competing infectious diseases.
Carl W. Dieffenbach, Ph.D., Director, DAIDS
Budget Update
Dr. Carl Dieffenbach reported on the FY 2010 and FY 2011 budgets for NIAID. The 2010 appropriation for NIAID is $4.8 billion, a 2.5-percent increase over the 2009 budget. The 2010 figure includes $300 million for the NIH Global Fund. The payline has been set at the 11th percentile for unsolicited investigator-initiated research. For new principal investigators and early stage investigators, the payline was set through the 16th percentile. NIAID has a selective pay pool of $9 million and a Bridge Award pool of $18 million.
The budget will enable NIAID to pursue its research priorities, which include basic research for infectious diseases and immunology, development of AIDS prevention strategies, development of new platform technologies and medical countermeasures for emerging infectious diseases and biodefense, and the study of human immunology and the development of medical interventions for immune-mediated diseases.
The NIH received $1.11 billion in funds from the American Recovery and Reinvestment Act (ARRA), more than 70 percent of which was slated for research project grants (RPGs). About 3–5 percent of that supported solicited projects, and about 11 percent supported 4 "Signature," or high-priority, projects. Carry-over of ARRA funding into a third year will be allowed, using no-cost extensions. For FY 2010 between $58 million and $68 million of ARRA funds were allocated to DAIDS, and to date $28 million has been released. Some of the funds ($7.5M) have been used to study and understand individuals who are exposed to HIV yet remain uninfected. A July workshop will address questions and issues for a research agenda targeting such individuals (exposed and resistant) to define terms, identify needed assays, and solicit new ideas. ARRA funds have also been used to support H1N1 vaccine trials, a prevention study and studies of HIV persistence.
For FY 2011, the President has proposed a $32 billion budget for NIH. The NIAID allocation would be $4.9 billion, a 3.3-percent increase from this year. The proposal includes a 3.4-percent increase for the HIV/AIDS portfolio, a 3.3-percent increase for biodefense and emerging infectious diseases, and a 3.3-percent increase for infectious and immunologic diseases. Congressional subcommittee hearings on the budget have occurred, and subsequent markups are planned.
Strategic Working Group
The next meeting of the Strategic Working Group (October 13–14, 2010) will feature discussions of the AIDS Clinical Trials Group (ACTG) Tuberculosis (TB) research agenda, the START Pilot Study, and restructuring of the HIV/AIDS clinical trials networks.
Clinical Trials Network Restructuring
Dr. Dieffenbach noted that the plan to restructure the clinical trials networks has been developing out of a stated goal of the President's: to address not only HIV/AIDS, but also malaria, TB, polio, and other infectious diseases (e.g., hepatitis), in an integrated health strategy. Today, the United States has fewer people dying or being hospitalized because of classic AIDS-defining opportunistic infections and cancers. However, many cohorts feature growing morbidity and mortality as a result of liver disease, cardiovascular disease, diabetes/metabolic conditions, non-AIDS malignancies, and psychiatric conditions. The epidemic's focus has been shifting from infectious disease issues to issues of internal medicine. The NIH has an important role in integrating care, prevention, and treatment as it supports basic and clinical research.
The leadership groups for the six NIAID HIV/AIDS clinical trials networks will expire by 2013 or 2014, and the Institute is using this as an opportunity to explore whether and how the networks can be used in a multi-disease capacity. The goal would be to capitalize on the infrastructure of the clinical trials network, integrating disease efforts (in particular, TB, malaria, and hepatitis). As of right now, the thinking is that none of the networks would be population specific; all population-specific studies would be incorporated and integrated into the work of each network. Community involvement will remain a key component of the network structure. In restructuring the networks, NIAID wants to ensure that there are mechanisms that enable the best new ideas from inside and outside the network to be brought forward. Other objectives for a new network structure include greater flexibility, or "rental capacity," easier ways to establish and close sites, and more efficient and timely approval for projects in other countries.
A new clinical trials network structure should feature greater coordination at all levels, especially among laboratories and statistical centers. Prevention research priorities should include clinical product development, prevention of acquisition, prevention of transmission, integrated prevention, HIV vaccines, and other highly meritorious ideas. Therapeutics research priorities should include non-infectious co-morbidities and novel interventions, treatment and prevention of TB, malaria, and hepatitis, a cure or functional cure for HIV/AIDS, and high priority questions (including "rental" research possibilities). Successful transition to a new structure will require early and detailed planning.
The timeline for establishing the new networks is as follows:
NIAID will hold a town hall-style meeting in the fall of 2010 to collect input. It will encourage comments to be made on the NIAID Web site, will seek consultations, and will hold meetings with the individual networks.
In discussion, the question was raised as to why prevention research priorities were basically split into prevention of acquisition and prevention of transmission. Dr. Dieffenbach noted that this would ensure that single approaches would be proved before being brought into combination prevention modalities. It was suggested that this be explained in future presentations and that issues such as test and treat, which addresses both acquisition and transmission be raised for people to begin thinking about. It was also suggested that NIAID consider strategies, in consultation with other agencies and organizations, how overseas assets can be utilized to help address multiple disease questions.
Christel H. Uittenbogaart, M.D.
Dr. Uittenbogaart reviewed the March 8, 2010, meeting of the Office of AIDS Research Advisory Council (OARAC). At that meeting, there was a follow up of the November 5, 2009, OARAC meeting when various NIH institutes provided overviews of their AIDS-related research, with a major emphasis on issues of aging. At the March 8, 2010, meeting, investigators from academia and the NIH were invited to present their research on aging and HIV. The agenda included presentations on:
The discussion at the OARAC meeting encompassed various issues, including concern that HIV- infected individuals are 15–21 years older phenotypically than their chronological ages; recognition that HAART does not prevent accelerated aging because of inflammation and immune activation; lower arterial distensibility caused by vascular endothelial changes, and dementia and increased amyloid among HIV-infected individuals.
In discussion, Dr. Birx wondered about the role of the National Institute on Aging (NIA). Dr. Uittenbogaart stated that the NIA takes a lead in aging research while engaging in collaborations with the other Institutes. Dr. Dieffenbach noted that there ongoing efforts to coordinate research between NIA and NIAID, and that the OAR has been helpful in this regard.
James Bradac, Ph.D.
Dr. James Bradac reported on the last meeting of the AIDS Vaccine Research Subcommittee (AVRS), which took place in February, 2010. He noted that Satya Dandekar, Ph.D., will be serving as the AVRS liaison to the ARAC in the future. The next subcommittee meeting will take place following ARAC on May 25, 2010.
The February meeting featured sessions on the Thai Phase III HIV vaccine trial (RV144). In addition, Dr. Johnston, Director of the DAIDS Vaccine Research Program provided a review of the DAIDS HIV vaccine research portfolio, and there were reviews of the portfolio of the Division of Allergy, Immunology, and Transplantation (DAIT) and the portfolio of the Division of Microbiology and Infectious Diseases (DMID).
The session on RV144 featured presentations on the study findings and the newly formed working groups that will help to build on the results. Anthony Fauci, M.D., Director of NIAID, charged the AVRS to help determine how we can best move forward and investigate the results of the study. It was emphasized that RV144 was a collaborative effort between the U.S. Army (Military HIV/AIDS Research Program), NIAID, and the Thai government, and as such, future studies should be done by the field not just the MHRP, for example. Other large networks and organizations, such as the HIV Vaccine Trials Network (HVTN), Bill & Melinda Gates Foundation (BMGF), and Center for HIV/AIDS Vaccine Immunology (CHAVI), among others, will also be utilized. An organizational structure has been set up to study correlates of protection in this trial, and a formal process for review and decision making has been established for access to the clinical specimens from this trial. There is a product development advisory group and a scientific steering committee, which oversees 4 scientific advisory groups; humoral and innate immunity, cellular immunity, host genetics and animal models. Three of these groups will be working with samples that came out of RV144. The final group, the animal models, will come up with studies they can do in non-human primates to try to duplicate what was seen in RV144.
Representatives of a number of organizations were invited to present their planned activities to build on the RV144 results: Lawrence Corey (HVTN), Guiseppe Pantaleo (Poxvirus T-cell Vaccine Discovery Consortium/CAVD), Nelson Michael (MHRP), Wayne Koff (IAVI), Gary Nabel (VRC), Jóse Esparza (BMGF) and Barton Haynes (CHAVI).
The subcommittee made the following recommendations:
Dr. Bradac reported that the May 25–26, 2010, meeting of the subcommittee will include a workshop on the non-human primate challenge model and an update on RV144.
Katharine Kripke, Ph.D.
This concept has the objective of determining which components and strategies of the research education program, called the Biomedical Prevention of HIV Research Education Initiative, or B-PHREI, are most effective. The evaluation project will guide decisions about the continuation, enhancement, and expansion of the B-PHREI and also inform prevention education activities within the DAIDS-funded HIV/AIDS clinical trials networks and other researchers and stakeholders. This is a renewal with expansion using an N01 contract mechanism. The duration is 5 years, with a first year cost of $200,000. There will be one award.
This concept has the objective of determining which components and strategies of B-PHREI, the prevention research education program, are most effective. The evaluation project will guide decisions about the continuation, enhancement, and expansion of the B-PHREI and also inform prevention education activities within the DAIDS-funded HIV/AIDS clinical trials networks as well as other researchers and stakeholders. This is a renewal with expansion using an N01 contract mechanism. The duration is 5 years, with a first year cost of $200,000. There will be one award.
Dr. Kripke explained that the project will conduct an impact study of approaches to educating populations about HIV prevention research. To provide context for this initiative, she described the need prevention research education. The population that is recruited into vaccine trials is uninfected. The lack of obvious direct benefit to the trial participant, coupled with misconceptions about HIV prevention clinical research, and distrust of government and researchers, makes HIV prevention clinical trial recruitment particularly challenging. For example, previous research has shown that among the populations we need to reach for HIV vaccine trials, a majority either didn't know or incorrectly believed that they could get infected from an HIV vaccine. And as we get results from many of our HIV prevention efficacy trials, it will become more complex to talk about participating in vaccine or other prevention trials.
The ARAC reviewers initially expressed some concern that the cost of the evaluation is high compared to the cost of the actual education program, and that it will be important to ensure that the evaluation design is appropriate and rigorous. In response, NIAID reduced first year costs from $400,000 to $200,000, with an option of adding more funds back into the initiative to conduct a household survey if deemed appropriate. This would be determined after NIAID gets results from the household survey that is planned to be conducted this year.
In order to ensure the appropriateness of the design, Dr. Kripke noted that the applications will undergo peer review by a panel of experts specifically set up for this solicitation. Once the contract is implemented, an oversight committee will be established that will include representatives from DAIDS, as well as the NIAID Strategic Planning and Evaluation Branch, National Institute of Mental Health and from the relevant clinical trials networks. The ARAC asked whether information on factors such as age and gender would be collected as part of the evaluative process. While the future evaluation has not yet been designed, it was noted that current evaluation activities for the NIAID HIV Vaccine Research Education Initiative included information about both age and gender.
The reviewers were very satisfied by staff efforts to address their concerns. They recognize the need for ongoing vaccine and biomedical prevention research education and the value of evaluating impact and effectiveness of the approaches being utilized.
The ARAC members expressed support for the concept, made a motion to approve it, and voted in favor.
Scott Proestel, M.D.
This concept has the objective of providing clinical research support services to help DAIDS achieve its scientific goals within specific programs, networks, and non-network studies and sites. As such, the contract supplements the division's ability to ensure compliance with regulations, standards, and good clinical practice guidelines, safety and welfare of study participants, and study quality and integrity. It features research program operations management, clinical and laboratory support, clinical trial support, and support for regulatory compliance, training, quality management, and more. It provides services across the division. This is a renewal and a N01 contract mechanism, with 7 years duration.
The ARAC reviewers expressed support for the concept/program, describing it as essential. They cautioned about overlapping with services that are supplied by other entities and suggested that the new contractor should have experience in supporting all phases of clinical trials research, international research, and vaccine trials, and in advanced clinical development. The importance of capacity building, mentoring capacity in resource-limited settings, and training were emphasized by the committee. It was also noted that there should be clarity about training so that it is not duplicative of other activities. The ARAC members expressed support for the concept, made a motion to approve it, and voted in favor.
Carl W. Dieffenbach, Ph.D.
The objective of this concept is to evaluate the impact of large-scale prevention and treatment programs that target specific health concerns in resource-limited countries and to develop more efficient and effective methodologies for implementing and integrating the programs with primary health care. The concept addresses the gap between our scientific knowledge base and a public health impact, including prevention, treatment, and services. It will seek to design, test, and deliver interventions efficiently and effectively and will support informed choices. While NIAID will take a lead role, other NIH institutes will be involved. This is a new grant competition, using the R01 mechanism. The duration will be up to 3 years, and the first-year cost is $10 million with funds being provided by the State Department.
The ARAC reviewers suggested identifying high priority areas on which the program can focus. They also proposed a 2-tiered funding mechanism, with lower amounts used to fund data analysis projects and higher amounts used to fund in-country, on-site activities. Examples of possible priority areas are optimal interventions, comparative effectiveness evaluation, point-of-care evaluation, and benefits of antiretroviral therapy. Dr. Dieffenbach noted that the program will require collaboration between the PEPFAR sites and other experts in implementation science. In discussion it was pointed out that there will be great interest in the program among many potential partners, which will make focus and coordination with other federal agencies and organizations critical. The ARAC members expressed support for the concept, made a motion to approve it, and voted in favor.
Chris Lambros, Ph.D.
The SBIR program seeks to stimulate technological innovation in the private sector, strengthen the role of small business in meeting federal research and development and increase private-sector commercialization of innovations developed through federal work.
This is a new program using the SBIR contract mechanism (N01). The duration is 6–12 months for Phase I and up to 3 years for Phase II. The first year costs are $250,000 for Phase I and $750,000 for Phase II. Phase I is to determine the feasibility and potential for commercialization of the proposed research, while Phase II is to continue major research and development efforts from Phase I. Phase III involves finding a commercial partner, with non-SBIR funds, to pursue the commercialization of the results of the research and development efforts funded in Phases I and II. The SBIR contract program project officer works with the company to prepare a statement of work, which is milestone driven.
The NIAID proposed three topics for the program: (1) Aminoglycosides: Formulation for Oral Delivery; (2) High Throughput in Vitro Immunization System for Evaluating Human B-Cell Immune Responses to HIV-1 Vaccine Antigens; and (3) In Vitro Immunization System for Evaluating Human T-Cell Immune Responses to HIV-1 Vaccine Antigens. Proposals related to those topics are now in the award phase for Phase I projects. (No proposals for the 3rd topic were submitted.) Three proposals were submitted for topic 1 and all three were found technically acceptable. One proposal was submitted for topic 2 and was found technically unacceptable. No proposals were submitted for topic 3. The three proposals submitted for topic 1 are under consideration for selection for Phase I awards.
Dr. Dieffenbach asked the ARAC members to consider the viability of the program and to suggest topics for next year's awards. Suggestions included studies of new TB and malaria drugs, point-of-contact diagnostics, focus on global health needs, and studies of oral formulations for drug delivery. In response to a question, it was noted that applications are reviewed by a formal study section assembled by the scientific review officer within NIAID. The selection of reviewers is based on the specific scientific topic being addressed and the expertise that's required to evaluate it. During the discussion a suggestion was made to examine the outcomes of the SBIR grants that DAIDS has supported. The ARAC members expressed support for continuing the program/concept, made a motion to approve it, and voted in favor (with one abstention).
Karl Salzwedel
This concept has an objective of facilitating HIV/AIDS research by providing standardized reagents, technology, and other research resources to investigators around the world. It is a renewal and uses the N01 contract mechanism. The duration is 7 years, and the first-year cost is between $2 million and $3.2 million. Begun in 1988, the program has evolved to become a state-of-the-art online resource of reagents for research on HIV and related opportunistic agents. It currently features 8,643 unique reagents that are made available to investigators. The scope is broad, including cell lines, viruses, monoclonal and polyclonal antibodies, recombinant proteins, and more. The program also examines the scientific field, anticipates needed reagents, and verifies new procedures and protocols. More than 3,046 scientists use the materials today, mainly in academic research. About 14,000 reagents were distributed in 2009.
In response to the ARAC reviewers question about international use, it was noted that about one-quarter of the reagents are used in foreign labs. Nonetheless, efforts to broaden the international reach through Web site links and exposure at international conferences will continue.
Reviewers also suggested that the program consider expansion to include reagents related to Hepatitis B and Hepatitis C. In fact, this was done several years ago and that component of the contract was then transferred to another contract. However, to address the need for coordination between these two contracts, a prominent link was added to the front page of the AIDS Reagent Web site and users of either can make requests for additional reagents to be added to that collection of reagents. Another suggestion was that NIAID consider adding reagents that would facilitate the study of latency and persistence of HIV.
The ARAC members expressed a strong degree of support for this program overall based on previous experience and knowledge. They supported the concept for the program's continuation, made a motion to approve it, and voted in favor.
Sandra Bridges, Ph.D.
This concept has the objective of developing functional cure strategies that would allow HIV-infected persons to live free of antiretroviral drugs for extended periods. It will support multi-project applications for the development of innovative therapeutic approaches to improve on current HIV treatment methodologies that require lifetime commitment to combination drug therapy. It is a new initiative, and uses the PO1 mechanism. The duration of grants will be up to 5 years, and the first year cost is $5 million (total). There will be two or three awards, and each application would be required to include a private-sector partner.
The existence of HIV-infected individuals who can effectively suppress virus replication (elite controllers) suggests that a functional mechanism to stop HIV is possible. This concept is designed to support research efforts in gene therapy, therapeutic vaccines, stem cell strategies, antibodies, and more. The ARAC reviewers characterized the concept as important, solid, and timely. It was noted that the program will be open to applications with two or more projects and multiple institutions/organizations, and the inclusion of a private-sector partner will help to translate the research. While the rationale for requiring a private-sector was questioned, DAIDS staff noted that, based on experience, the projects are stronger when a private-sector partner is involved and both partners – academic and private-sector – report benefits from the collaboration. Another question concerned intellectual property issues, and while those are matters between the project partners, it is highly recommended that they be dealt with early on. The ARAC members expressed support for the concept, made a motion to approve it, and voted.
Dr. Dieffenbach asked the ARAC members to consider the agenda for the September ARAC meeting. Two possible topics are:
The meeting of the Council was adjourned at 4:20 p.m., on Monday, May 24, 2010.
We do hereby certify that, to the best of our knowledge, the foregoing minutes are accurate and complete.
Anthony S. Fauci, M.D.
Chair, National Advisory Allergy and Infectious Diseases Council
Director, National Institute of Allergy and Infectious Diseases
Marvin R. Kalt, Ph.D.
Executive Secretary
National Advisory Allergy and Infectious Diseases Council
Director, Division of Extramural Activities
National Institute of Allergy and Infectious Diseases
Anthony S. Fauci, M.D.
Chair, National Advisory Allergy and Infectious Diseases Council
Director, National Institute of Allergy and Infectious Diseases
Marvin R. Kalt, Ph.D.
Executive Secretary
National Advisory Allergy and Infectious Diseases Council
Director, Division of Extramural Activities
National Institute of Allergy and Infectious Diseases
These minutes will be formally considered by the Council at its next meeting; any corrections or notations will be incorporated in the minutes of that meeting.
Last Updated August 05, 2013
Last Reviewed August 05, 2013


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A-Trak announces Tuna Melt EP for Fool's Gold
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published30 Nov 2012
The big-room superstar will drop a new EP on December 4 via his own label.
A-Trak's Tuna Melt features four hip-hop-infused electro tracks: dancefloor and festival anthems crafted with his usual aplomb. Expect block-rocking beats and big slabs of synths throughout. For the EP, A-Trak collaborated with contemporaries Tommy Trash, GTA, Galantis, and Oliver; stream 'Landline' and sample the entire EP below. He might think EDM is a dumb name, but it'd be fine if all mainstream "EDM" sounded like this.
Tuna Melt EP:
01 Tuna Melt (ft. Tommy Trash)
02 Landline (ft. GTA)
03 Jumbo (ft. Galantis)
04 Disco Nap (ft. Oliver)
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Southern rap stars, Chicago's new wave and industrial electronics: the week's best mixtapes and free mixes


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My Simple Harmonica Notation System
The numbering system is really quite simple. Over each word or syllable in the lyrics to a song is a number. If
that number is a 4 then you blow into hole number 4. However, if it is a -4 then you draw into hole number 4. If
the number is preceeded by the < symbol, (which only occurs on the chromatic scale songs) then this means that
you push the lever in on the right side of the instrument to produce a sharp note. This is what enables the
chromatic scale harmonica to be able to play any song, regardless of the number of sharps and flats in the
So What If You Don't Know The Songs?
Only attempt to play familiar tunes. If you can hum it or whistle it, then you can learn to play it fairly soon.
In fact, think of yourself as singing the song through your instrument and the reeds of your instrument as a
substitute for your vocal chords.
Enough of the introduction. Each lesson will include helpful tips on improving your playing. Each lesson will
also include a couple practice songs. (the downloaded version of these lessons includes four practice songs) Learn
each song before moving on to the next lesson.
Play each line at least five times. Start slowly and increase speed with each repetition. Blow into the hole
indicated unless there is a minus sign (-) in front of the number, in which case you draw through that hole.
It is not absolutely necessary that you play clear single notes. When trying to get a blow #4, it is OK if you
include holes #3 and #5. Eventually you will want to learn to play single notes. Work at it and it will come to you
Make sure you practice every day. Your practice does not need to be for long periods of time. It is quite
acceptable to practice for just five to ten minutes. In fact, it is possible to practice for too long. It may be
counter productive. It is more important to practice every day, then it is to practice for a complete hour once a
4 5 6 6 6 -6
-6 6
Kum ba yah, My Lord, Kum ba yah,
Play this on your C harmonica
Purchase Suzuki
Promaster Harmonica
from Coast to Coast Music


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Robert Berend has not received any gifts yet
Hi Robert,
My name is Leslie Wasserman and I'm looking for a tennis partner. I'm about a 2.5, not competitive, just want to hit balls and have fun. I live near Beverly Hills tennis on olympic. Let me know if you have interest. firstname.lastname@example.com Thanks
want to play some tennis? I am a 2.5/3, have not played in a while though.
© 2014 Created by Mark / The Mayor.


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'To build a St. Clair-like LRT line down one of the busiest tractor trailer roads in the country, outside of the highways … it is just not going to work'
We think of Mississauga as car-dependant sprawl. But it's changing. About 30 new condo towers are sprouting around City Hall. Increasingly, citizens ride transit
An industry group is sounding the alarm over the bundling of light rail transit lines into a 'mega-project' they say will exclude smaller Ontario firms and cost taxpayers an extra $500-million
Chris Selley: This is already worse than the St. Clair disaster, not just financially but because City Council created it all by itself
The issue became a turning point in the ongoing subway debate, when Mayor Rob Ford initially suggested the funding could be reallocated Scarborough
The Scarborough subway hangs in the balance amid fresh concerns over whether the project could jeopardize federal funding for the planned Sheppard LRT
When it opened in the mid-1980s, the RT line was the toast of the TTC. Now city councillors argue over how best to replace the rickety six-stop shuttle
This week, Metrolinx, the province's transit agency, announced it would take over operation and maintenance of the lines but the councillors feel Metrolinx isn't cut out for the job
But Transportation Minister Bob Chiarelli says the province won't back the new OneCity transit proposal brought forward from Toronto Transit Commission chairwoman and opposed by Mayor Rob Ford
An advocacy group for TTC riders fears that revised timelines for light rail transit expansion in Toronto will "open the door to more political interference."


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What Is Your Battle Cry?
Lo! Who is that, stalking amidst the terrain! It is RedWingedKiss, hands clutching a mighty sword! And with an ominous cry, her voice cometh:
"I'm going to hump you beyond the end of time, and plunge you into financial ruin!!!"
Find out!Enter username: Are you a girl, or a guy ?
created by beatings : powered by monkeys
Post a comment in response:


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Damen Spaces
The Damen Student Center offers a number of spaces ideal for meetings and events. The following spaces are available for programming:
Meeting Rooms (1st and 2nd Floors)
- Medium Sized Meeting Room (5): 8-12 Capacity
- Large Sized Meeting Rooms (4): 15-25 Capacity
Medium Sized Meeting Rooms come with "set" furniture and DO NOT have built in screens. Large Sized Meeting Rooms come with 4 individual tables allowing for conference style set ups or lecture set ups. These meetings rooms come equipped with A/V.
Laptop computers for meetings and programs MUST be requested when the reservation request is submitted through the Campus Reservations web-viewer.
Sister Jean Dolores Schmidt, BVM Multi-Purpose Room (2nd Floor)
- Divisible into (2) separate rooms
- South Side Capacity: 240 (lecture), 180 (banquet--66" tables), 25 tables (fair--6' tables)
- North Side Capacity: 160 (lecture), 100 (banquet--66" tables), 20 tables (fair--6' tables)
- Total Capacity (both rooms): 400 (lecture), 280-300 (banquet--66" tables), 50 tables (fair---6' tables)
- A/V built in both sides (screens, computers, wireless mic)
- 2 Podiums (south and north)
- Stage: upon request at time of reservation on Campus Reservations web-viewer
- Additional A/V: mics, etc.: upon request at time on Campus Reservations web-viewer
Damen Student Center Cinema
- NOT available for reservation on Campus Reservation web-viewer
- MUST contact Damen Student Center staff for event inquiries (773.508.8770)
- 125 Seat Capacity
- Microphones, etc. available upon request
- Hours of Operation: 8:30AM-12:00AM (Monday-Sunday, academic year)
- Charges apply for technical assistance (Damen Student Center staff required)
Ireland's Sports Lounge:
- NOT available for reservation on Campus Reservation web-viewer
- PIRVATE parties NOT allowed
- All "events" MUST be open to general student body
- Alcohol allowed (must be in addition to food, and ample non-alcoholic beverages)
- MUST contact Damen Student Center staff for all event inquiries (773.508.8770)
- Hours of Operation: 6:00AM-1:00AM (M-F academic year); 8:00AM-1:00AM (Sa-Su academic year)
The following spaces are NOT available for programming:
- Damen Food Court and Atrium Seating Area
- Damen Residential Dining (unless sponsored by Aramark)
- SCB Fireplace Lounge (unless sponsored by Damen Student Center)
- Lobby Areas (unless an approved student organization table event)
For more information, please contact the Damen Student Center Administrative Offices at 773.508.8770


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Via The Minneapolis Institute of Arts Newsletter:
Sunday, August 12
11 a.m. to 5 p.m.
Come inside and play at the MIA, then get outside and enjoy Peace Games in Washburn Fair Oaks Park! Target Family Day is a free monthly event for families, kids, and the young at heart.
Art-Making: Home Sweet Home
11 a.m.–4:30 p.m.
Explore interiors and exteriors, then design your dream home inside and out, in a drop-in studio session.
11:30 a.m., 12:30, 2 & 3 p.m.
Strike poses inspired by artworks found in and around the museum, with instructor Anna Vazquez from River Garden Yoga Center.
Gallery Hunt: At Home in the MIA
11 a.m.–4:30 p.m.
Make yourself at home in the galleries as you explore household objects with unique artistic flair.
Art-Making and Exhibition Showcase: "Game Face | A Summer of Photography"
11 a.m.–4:30 p.m.
Be wowed by works created by local kids with Free Arts Minnesota and photographer Wing Young Huie. Then create a unique photo inspired by the exhibition.
Gallery Walk: Game Face
Chat with local artist Wing Young Huie about the exhibition "Game Face | A Summer of Photography."
Gallery Walk: Fair Oaks
2 p.m.
Step outside with artist Matthew Bakkom for a tour of his colorful installation in Washburn Fair Oaks Park. Bakkom teamed up with the Minneapolis Park & Recreation Board and its Teen Teamworks crews to paint park benches inspired by the MIA's collection.
Special Exhibition: "Rembrandt in America," Presented by U.S. Bank
11 a.m.–4 p.m.
Feast your eyes on the largest selection of paintings by Dutch master Rembrandt van Rijn ever assembled in the United States. Free admission generously provided by Target. Tickets available at the Visitor & Member Services desk in the Third Avenue lobby on a first-come, first-served basis.
Demonstration: Metal Casting
Noon–2 p.m.
Watch a live metal pour with Sara Hanson from Workshop on Wheels.
Art-Making: Pianos on Parade
Noon–4:30 p.m.
Paint a piano in a collaborative art project hosted by Keys 4/4 Kids.
Art-Making: Open Field Trip
Noon–4:30 p.m.
Join educators from the Walker Art Center for Open Field art activities.
Art-Making: Balloon Sunburst
Noon–4:30 p.m.
Work with Art in the Park educators to create a marvelous sculpture, fashioned after the MIA's Sunburst by Dale Chihuly.
Art-Making: Art in the Park Benches
Noon–4:30 p.m.
Craft your own miniature park bench inspired by the Fair Oaks bench project.
Peace Games Community Tent
Noon–5 p.m.
Dig into community-building with info and activities brought to you by the Whittier Alliance and other local organizations.
Peace Games Culture Tent
Noon–5 p.m.
Play games, make crafts, and sample food from local cultural organizations.
2–5 p.m.
Get your groove on as dancers and musicians take the stage for an afternoon of lively performances in the park.
Tags: Free Family Fun, Minneapolis, Minneapolis Institute of Arts, Minnesota, Target Family Day, Twin Cities


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Views Archive
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Building solar and wind projects in the wrong place is wasting billions of dollars in Europe.
84 comments


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January 9-10-11, 2015
January 23-24-25, 2015
Madison Comic Con
February 6-7-8, 2015
Indianapolis Comic Con
February 13-14-15, 2015
Cleveland Comic Con
February 20-21-22, 2015
Bruce Campbells Horror Fest
March 6-7-8, 2015
Raleigh Comic Con
March 13-14-15, 2015
Las Vegas Comic Con
April 24-25-26, 2015
Minneapolis Comic Con
May 1-2-3, 2015
Philadelphia Comic Con
May 7-8-9-10, 2015
St. Louis Comic Con
May 22-23-24, 2015
Greenville Comic Con
May 29-30, 2015
Des Moines Comic Con
June 12-13-14, 2015
Sacramento Comic Con
June 19-20-21, 2015
Richmond Comic Con
July 31 - August 1-2, 2015
Chicago Comic Con
August 20-21-22-23, 2015
San Jose Comic Con
September 4-5-6, 2015
Ohio Comic Con
Sept. 18-19-20, 2015
Nashville Comic Con
September 25-26-27, 2015
Fort Lauderdale Comic Con
October 2-3-4, 2015
Tulsa Comic Con
October 23-24-25, 2015
Austin Comic Con
October 30-31, 2015
Louisville Comic Con
November 6-7-8, 2015
Reno Comic Con
November 20-21-22, 2015
San Antonio Comic Con
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Futurecon is a 3-Day time-travel themed New Year's Eve extravaganza at the Holiday Inn Hotel & Suites Markham. This upscale non-profit event is in support of Epilepsy Toronto, and features some of the biggest TV personalities, authors, comic book artists, and comedians in Canada! Referenced by some as "the Burning Man of Canadian conventions" because of its creative, innovative "organized chaos," Futurecon is best described an "un-convention."
The Futurecon organization also does year-round education and outreach to get people talking about Epilepsy, including participation in Purple Day -- World Epilepsy Awareness day, March 26th. Founded by Canadian TV star Liana K, Futurecon strives to remove the stigma and isolation suffered by the 1 in 100 children and adults living with Epilepsy, including her 7 year-old nephew Iain. For more on Futurecon and Epilepsy Toronto, please visit futurecon.wordpress.com.
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Rad Collector puts us onto David Choe's limited-edition Hammerhead Decks released through Giant Robot. Both "Untitled Portrait" and "Ignored Prayers" are limited to 50 pieces each and are now available here.
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The point when somebody wishes you a blissful new year, you really want to feel as though there is some crisp vigor spilling out through the highest point of your head and washing down the distance to your toes. The expression "New" implies trust and positive updates that achieve expectation and energy.
Entering into the New Year dependably carries on top of it numerous New Year's resolutions. The New Year likewise gives every one of you the explanations or boldness you have to go out of your solace zone to do something you have not done in the recent past.
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Tip: Introduction to the Quad Menu
by a.cangelosi
In this new tip tutorial for 3ds max 2011, we'll talk about the Quad Menu, how to use it, and how it will be possible to access to multiple quad Menu configuration using a combination of keys and mouse button. We'll take a fast look to the customization possibilities too.
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Seriously cool black patent and white genuine leather oxfords featuring a gold plated front and colorblocked design. Genuine leather lining. Looks super cute with a day dress! By Jeffrey Campbell.
*Genuine Leather Upper/Lining, Synthetic Sole
*Shoe Height: 5"/12.75cm
*Heel Height: 2"/5cm
*Platform Height: 0.75"/2cm
Please use these size charts to help determine your size. Because sizing and cut will vary between brands, please use the charts as a general guide to compare the various size scales. If you have a specific sizing question or would like more information, please contact Customer Care.
Sizes listed are US, unless otherwise noted.
If you're not utterly obsessed with your recent purchase, it's now so easy to send it back! All US returns can be completed online using our fast, hassle-free system. Check out the links below for more details.