Hospitals are planning and designing new environments to accommodate a greater concentration of critically ill patients and to permit the installation of sophisticated technology required for the care of this high-acuity population. A serious nursing shortage, customer demands for privacy and personal amenities, and cost constraints pose numerous problems in planning and design processes. The flexible, acuity-adaptable room concept has been introduced as a platform for changing care processes to achieve a cost-effective care model that fosters nursing efficiency and increased customer satisfaction.

This report is divided into five main sections that detail issues and make recommendations related to biological evidence storage, tracking, preservation, and disposition. A glossary, which provides standard definitions of the technical terms used in this report, follows these sections. RETAINING BIOLOGICAL EVIDENCE While most states have established their own statutes and/or policies for biological evidence retention, some have not. It is imperative that high-level guidance be given to biological evidence handlers regarding the circumstances under which evidence must be kept. This section defines recommended best practices for retaining biological evidence, including the length of time such evidence should be kept. It also provides guidance on identifying what biological evidence should be retained. BIOLOGICAL EVIDENCE HAZARDS AND HANDLING Contact with bodily fluids can spread disease such as those caused by bloodborne pathogens, and individuals handling biological evidence should treat it as hazardous to ensure safety. This section offers recommendations on various aspects of biological evidence handling, including the use of personal THE BIOLOGICAL EVIDENCE PRESERVATION HANDBOOK v v protective equipment (PPE), Federal standards, the management of spills or accidents, and biological waste disposal. PACKAGING AND STORING BIOLOGICAL EVIDENCE The use of well-defined procedures for packaging, storing, and tracking can maintain biological evidence integrity for testing. Personnel involved in managing biological evidence often face challenges because of the size and location of the storage facility, supplies available for packaging, adequacy of tracking systems and resources, and other issues. This section identifies current best practices to maintain evidence integrity from initial packaging to final disposition. CHAIN OF CUSTODY AND EVIDENCE TRACKING Providing an accurate and complete chain of custody record ensures that the evidence that arrives in court is what was collected at the crime scene. An accurate chain of custody identifies and tracks the evidence from the time it was collected-including the method by which it was obtained-through final disposition for each individual who had possession and responsibility. This section discusses various evidence tracking systems and recommends procedures to improve all aspects of chain-of-custody recordkeeping. EVIDENCE DISPOSITION Jurisdictions face limitations because of storage space and preservation requirements and must make choices about when to keep or how to dispose of certain evidence. This section makes recommendations for best practices, policies, and procedures to decide what evidence needs to be retained and the length of time it needs to be retained in accordance with applicable statutes. Technical Working Group on Biological Evidence Preservation vi vi just one consideration, albeit a critical one, in a larger system of evidence storage; therefore, the group has put forward some recommendations that can also be applied to other forms of evidence preservat...

Cancerous cells emerge within the body following accumulation of deleterious genetic mutations. These mutations alter the phenotype of a cancer cell marking it as distinct from the surrounding host; an immunological state termed “altered self”. These cells, like other non-self entities such as viruses and bacteria, are recognised by the immune system and marked for destruction, a process known as “immune surveillance”. B7-H1 expression by tumour cells is believed to aid tumours in evading detection and elimination by the immune system. B7-H1 functions in this respect via several alternative mechanisms including driving exhaustion and anergy of tumour infiltrating T lymphocytes, stimulating secretion of immune repressive cytokines into the tumour micro-environment, stimulating repressive regulatory T cell function and protecting B7-H1 expressing tumour cells from lysis by tumour cell specific cytotoxic T cells. Using hybridoma technology and high throughput screening MedImmune has identified a series of fully human antibodies specific for human B7-H1. Further characterisation of these antibodies led to the identification of a single high affinity antibody, MEDI 4736, with the ability to relieve B7-H1 mediated suppression of T cell activation in vitro and to enhance sub-optimal T cell activation in a mixed lymphocyte reaction. In vitro testing shows that MEDI 4736 does not trigger non-specific cytokine release in whole blood, and is only able to activate T cells in the context of an active T cell receptor signal. A surrogate anti-mouse B7-H1 antibody shows significant anti-tumour activity in a syngeneic model when dosed in combination with chemotherapy. Similarly MEDI 4736 is able to inhibit tumour growth in a novel in vivo xenograft model, via a mechanism that is dependent on the presence of tumour specific human T cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-158. doi:10.1158/1538-7445.AM2011-LB-158

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