There is an internal server error on Cloudflare's network
By Philip Craft
November 10, 2011
Elon Law's Leadership Fellows hosted a forum for more than 30 undergraduate Leadership Fellows from Elon University to discuss social justice issues
The theme of the forum was,"Think Globally
The day long event involved identifying social problems in local communities and developing action plans to address these problems
as well as looking to examples in history of those who made a difference globally by acting locally
“Using the first-year winter term leadership course as model
the fellows created a program that would allow undergraduates working with law students to think about and discuss social justice and the means to achieving large scale change on a local level,” said Jason Senges
a member of the Class of 2013 and a Leadership Fellow at Elon Law
The event began with an introduction by law school dean George R
“Dean Johnson spoke about the importance of identifying and addressing social issues in our society,” said Senges
“He emphasized the impact individuals can have on social justice through local action.”
“Dean Johnson’s greeting and welcome of the undergraduate fellows set the tone for the long-term ambitions of this event
which was to establish a connection with and to the Elon family at large,” said Karima Grady
also a member of the Class of 2013 and a Leadership Fellow at the law school
Clinical Practitioner in Residence at Elon Law
gave a keynote speech in the afternoon about the Humanitarian Immigration Law Clinic at the law school
She described the clinic’s creation and the needs of the people it assists
the forum consisted of breakout groups identifying local means to address global issues
All breakout groups created an action plan addressing the issue they identified and how to affect change in their community
These action plans were then presented to all participants in the forum for feedback and discussion
“We chose this program because we wanted to open the door to consistent and content-rich collaboration with our counterparts at the undergraduate level,” said law school Leadership Fellow Chantelle Lytle L’13
“The forum was my first exposure to undergraduate Leadership Fellows
I was able to interact with young rising leaders
we were all able to learn something valuable from each other.”
Senges said that the law school’s Leadership Fellows are hoping to bring undergraduate Leadership Fellows to the school every fall for similar events
Click here for information on the Leadership Fellows program at Elon Law
Click here for information on the Leadership Fellows program at Elon University
Tagged: Leadership School of Law
As the newly appointed president of Limelight Records
Spencer hopes to give back to the organization that drew her to Elon University
Brandstetter will deliver the “Message of Appreciation” during Elon University’s 135th commencement exercises on May 23
Stephanie Marken '08 arrived at Elon unsure of her path
but thanks to hands-on experiences and the guidance of dedicated professors
she discovered a passion for public opinion polling that shaped her future
Two Elon alumni have been selected for the National Science Foundation’s Graduate Research Fellowship Program
and one senior has been named an honorable mention
Get more Elon news delivered to your inbox
© 2025 Elon University | All Rights Reserved
Sign In
Subscribe Now
Last September marked an important milestone for Miriam Senges
Her lung cancer hadn’t come back: “Everything looked okay.”
she had completed treatments for her latest cancer – her fourth cancer
she couldn’t make it through spring without a new cancer diagnosis – before the lung cancer was bladder cancer
She was told she had breast cancer in 2010
That first diagnosis was followed by two years of surgery
She doesn’t want you to understand what she’s been going through – because she believes you can’t really understand without going through it yourself
“And I wouldn’t wish it on anybody,” she said
That’s why she accepted a request to speak at the Langley Relay for Life
Lynne Robinson of the Relay committee recently contacted her
telling her that the Relay always starts with a speaker who tells their story of surviving cancer
Usually the speaker shares having survived one cancer
Relay has done a lot for her and for many others
“A lot of headway” has been gained against cancer because of money raised for the Canadian Cancer Society through Langley’s and other communities’ Relay events
she’ll take a victory lap around the track
along with many others who already do understand what she’s been going through
They’ll all be wearing yellow shirts – cancer survivor shirts
This will be her fifth time on the Relay track
Joining the relay was initially her daughter-in-law Alison’s idea
Alison felt it would be a good idea for Miriam to get out and join other cancer survivors and experience the public support for the fight against cancer
months after her treatments for breast cancer were completed
But after signing up for the Relay as a breast cancer survivor
she learned that she was “going through it” again
She had gone to Emergency with blood in her urine
Doctors decided the best course of action was to take out the diseased organ
She actually walked the track with her cancerous kidney
Removal of the kidney was expected to be the end of it… but the following year it was discovered that the cancer had gone to her bladder
She was in surgery for seven hours for a hysterectomy and removal of her bladder
Adjusting to life without a bladder – learning to deal with a stoma and an ostomy bag – “isn’t fun,” she understated
doctors discovered a nodule on Miriam’s lung
The nodule turned out to be a secondary cancer related to the kidney that had been removed two years previous
Her suspicion that there’s a genetic component to her cancers is supported by the fact her father died of kidney
Spring has become a difficult time of year for her
“Every spring I’d been finding these wonderful things,” she said
“Once you’re in the cancer club any aches and pains make you wonder.”
But the Relay for Life has been “a kind of therapy for me.”
“In 2010 no one walked alongside me to say
and this is what’s going to happen to you.’”
Now she wants to walk alongside those who are going through some of what she has dealt with
I sometimes break down when I talk about it…”
she stopped and took a moment to recompose herself before continuing
She also finds some therapy in a blog that she started writing after her fourth cancer diagnosis
Initially it was a way to keep family and friends updated
chronicling her thoughts and experiences dealing with cancer in a compelling and soul-stirring discourse
She tries to be as positive as she can – “a glass half full kind of person – but admits
And then: “I’m here,” she proclaimed triumphantly
has been with her “every step of the way.”
She and Randy just celebrated their 35th wedding anniversary
“We’ve been together since I was 15,” she said
“I couldn’t have got through this without him
beside me… through sickness and in health.”
She also attributes her survival to “my great kids and friends
“My kids have been amazing,” said the 54-year-old mother of three
She noted that hard times tend either to bring families together or push them apart
pointing out that “everybody deals with this in a different way.”
were already living on their own when Miriam was first diagnosed with breast cancer – in fact
she was helping Stephanie plan her wedding while undergoing that first round of treatments
18 years old and in high school at the time
“This has brought us all closer,” she said
but it’s really your little family unit that is most affected.”
She sees people around her – people her age – worried about “so many things… like having enough money for retirement
“You’re just a changed person when you go through this,” she said
You can’t understand it without going through it
“Sometimes I feel like an old soul,” she mused
“You have to enjoy every day just living.”
Miriam Senges will talk about her journey at the opening of Relay
She’s scheduled to take the podium at 6:30 p.m.
about 15 minutes before she joins all the other yellow-shirted survivors for another victory lap
And then Team Senges will take part in the Langley Relay for Life until it finishes up at midnight
Dialogue and debate are integral to a free society and we welcome and encourage you to share your views on the issues of the day. We ask that you be respectful of others and their points of view, refrain from personal attacks and stay on topic. To learn about our commenting policies and how our community-based moderation works, please read our Community Guidelines
College of Art and Design faculty review prospective students' artwork at a National Portfolio Day event on Nov
Several months after attending a two-week portfolio development workshop at RIT
Peighton Senges experienced the benefit of it.
Senges said that experience in July 2019 bolstered her portfolio and got it ready for RIT’s NPD.
“It was a long day but it was so worth it,” Senges said of the Nov
3 event that took place in RIT’s Gordon Field House
“It was really nice to be able to see different schools because every college has different things that they are looking for
So to get different perspectives was beneficial.”
Senges was one of more than 200 high school and college transfer students from around the country who made their way to RIT’s National Portfolio Day — one of 45 such events held around the globe this academic year in support of a critical step in the college admission process.
21 faculty from RIT’s College of Art and Design
as well as reps from 25-plus other top art and design colleges
reviewed prospective students’ artwork and offered constructive feedback
It was an opportunity for students to meet one-on-one with colleges of their choice
They could ask questions about college admission and improving their work
gain a better understanding of what schools look for in a portfolio and even submit their portfolio as part of the application process.
“My experience was great because I got to look at different career paths and majors at RIT that I didn’t consider before,” said Maison Lamanna
“The portfolio reviews were really helpful.”
Senges' portfolio was accepted by RIT as part of the visual portion of her application
Senges said her figure drawing made during RIT’s summer portfolio prep course caught the attention of reviewers at RIT’s NPD
intensive workshop — like a sophisticated charcoal self-portrait — were also shown to college reps
“It was really high quality,” Senges said of the summer preparatory experience taught by RIT School of Art faculty
“I attended to build my skills and get a better portfolio
We pushed our limits and the faculty pushed you out of your comfort zone
graphic design teacher at West Genesee High School
brought 11 of his students and three from nearby Liverpool High School to RIT’s National Portfolio Day on a bus chartered by the College of Art and Design
The group also participated in morning tours of the College of Art and Design that were offered before the portfolio reviews.
“The students were blown away by how professional and unique RIT is,” Haining said.
“The schools were amazing,” he added about the review portion of the day
“They were all so great at helping students find what they were missing in their portfolios and pointing out what was really good and what they should continue doing
It’s rare that you can have this many amazing schools in one place at one time
taking their work outside the bubble of high school and having colleges say
Marissa Tirone, senior lecturer in the School of Design
was one of RIT’s 21 faculty reviewers
She said she finds the face-to-face interaction important because it offers the chance to ask students questions about their work and process
“The portfolios I saw were fantastic,” Tirone said
“It was anything from ceramics to logo design
figure drawing and drawings from direct observation — a huge range of work
They were all really good and well-rounded
The students are producing work at a high level.”
National Portfolio Day events are held annually around the world to help further the development of young artists. As a National Portfolio Day Association member, acclaimed faculty from RIT’s College of Art and Design travel to U.S. cities every September through January for NPD events
Photography grad has her eyes set on unique career
The Creative Development podcast series serves as IFC’s thought leadership outlet on how finance and economic development influence―and are influenced by―creative industries around the world
With a lineup of guests that includes Idris Elba and Youssou N’Dour
Creative Development helped IFC provide answers to the biggest question of all: how people
By shining light on the untapped potentials of the creative economy
this podcast further promotes IFC's agenda of advancing economic development through the creation of new markets and investment opportunities in developing countries
Each episode brings together the Managing Director of the International Finance Corporation
and guests from a range of creative industries - including the visual arts
the host and guest discuss the value of the creative arts and how these industries contribute to job creation and development in emerging markets
Our guests offer revealing perspectives on how they engage with pressing global challenges such as climate change
Ultimately each episode attempts to bridge the gaps between the creative world and the finance world
to reveal pathways of co-operation towards sustainable development
These episodes are then promoted on social and digital channels of the IFC and the World Bank (3.4+ million followers on Twitter and 1.5+ million on LinkedIn)
Creative Development with IFC has attracted over 9,200 downloads globally
in addition to more than 38,000 views on YouTube. Episodes released in 2022 featured actors Idris Alba
Vidya Balan and Dia Mirza; musicians Youssou N’Dour
We have recorded episodes in both English and French
the selection of our guests and the multilingual nature of our podcast has allowed us to reach audiences around the world
Each episode is promoted widely across our IFC and World Bank social media channels (3.4+ million followers on Twitter and 1.5+ million on LinkedIn) targeting young people interested in the creative industries
and our 20,000 World Bank Group staff located in 170 countries
Our audience engagement continues to grow as we reach listeners in the US
Indonesia and many other parts of the world
BOARDMAN — Grocery Outlet Bargain Market
the California-based extreme-value grocery retailer that’s beginning to establish its brand along the East Coast
opened its first store in Ohio on Thursday in Boardman
“We’re honored to open the first store in Ohio … three weeks ago
so we have been a little busy,” said Eric Senges
independently own / operate the two new stores
and we look forward to partnering with schools and other organizations within Boardman and the surrounding community.”
when the couple cut a ribbon to mark the moment
the store was a beehive of activity and the checkout lines were full
Each time a shopper saved at least $100 on a purchase
an associate announced it across the store’s loudspeaker
That was followed by the ringing of a cowbell; the cowbell rang often
Bob Soles of Boardman was among the shoppers
The Senges relocated from California to open and run the Boardman store and another in New Castle
Eric Senges said they operated a store in California and the company approached them with the opportunity for the two area stores
Construction on the 16,000-square-foot store at 317 Boardman-Poland Road — the plaza where Toys R’ Us previously was housed — started in March
The Senges moved from the West Coast in August
we’re individually owned and we’re also
our culture is that you bond with the community and you give back
and that is really what we want to accomplish here is to offer great prices
but also do more and give back to the community,” Eric Senges said
“We’re very passionate about giving back and to bring low prices to our customers
especially during this time when everything is crazy high.”
the store donated $1,000 to the Rescue Mission of the Mahoning Valley
the store is hosting a food drive for the mission through Christmas
That type of support means a lot to the mission
its Chief Development Officer Lynn Wyant said
“We were just comparing our prices for food shopping
and comparing last October to this October
“That is in part because of inflation and increased price of groceries that we all are feeling
and also the number of people we are serving has increased.”
a city north of Oakland in the northern part of the state
The stores are owned by independent operators
AUSTINTOWN — The drizzle and overcast skies over the Mahoning Valley set the mood as members of the Youngstown ..
Copyright © 2025 Eastern Ohio Newspapers, Inc. | https://www.vindy.com | 240 Franklin Street SE, Warren, OH 44482 | 330-841-1600 | Terms of Service
Mukwege works with equal fervor to reintegrate them into society
As part of our profile of news makers, we caught up with Dr
Mukwege while he was visiting the World Bank to speak at a seminar on the sexual violence in Kivu Province
“The Man Who Repairs Women,” the title of Mukwege’s biography by journalist Colette Braeckman
Thank you for choosing to be part of the Nasikiliza community
The latest blog posts and blog-related announcements will be delivered directly to your email inbox
Online web and social media editor for Francophone Africa
Marian has more than 20 years of experience as an Editor covering various industries in B2B publishing
She’s spent the last 10-plus years specifically working in the food industry
including at John Wiley & Sons’ food quality and safety title
Marian's publications have gained recognition in such editorial awards as ASBPE’S Azbee Awards
the SIPAwards and Tabbies International Editorial Awards
Marian lent her professional expertise in the editorial SIPAwards competition by serving as an editorial judge
She joined the Progressive Grocer team as the Digital Editor in November 2020. Marian oversees the publication’s daily online editorial operations
newsletter creation and social media platforms
Marian earned a bachelor's degree in English/journalism from Montclair State University.
Follow her on LinkedIn.
(Please refer to Progressive Grocer's Contributing Guidelines to submit content for consideration.)
has officially entered its ninth state with the Nov
16 grand opening of its first store in Ohio.
Located at 317 Boardman Poland Road in Boardman, the store shares independent operators Eric and Sarah Senges with a second location in New Castle
Both Eric and Sarah share a combined background of more than 30 years in retail
including previously operating a Grocery Outlet location in Lake Elsinore
“We are thrilled to be expanding Grocery Outlet’s footprint and opening a store in Ohio,” said Grocery Outlet CEO and President RJ Sheedy
“Our partnership with the Senges family has proven successful across the country
and I look forward to helping them make high-quality affordable groceries more accessible to the community.”
The company’s presence in Ohio is representative of Grocery Outlet’s long-term strategic geographic expansion
With 455 stores currently open across the country
Grocery Outlet is constantly evaluating growth opportunities
Grocery Outlet is also celebrating three other store openings on Nov
Meanwhile, Grocery Outlet recently reported its third-quarter financial earnings for the period ended Sept
The retailer’s net income soared 55.1% to $27.1 million during the period
while net sales rose by 9.3% to $1 billion
primarily due to comparable-store sales growth of 6.4% and the impact of new stores.
partly offset by a 1.9% decrease in average transaction size
outside the Lamar Dodd School of Art at the University of Georgia in Athens
looks up while sitting outside the Lamar Dodd School of Art at the University of Georgia in Athens
dogs with yellow vests can be seen walking with handlers or sitting in on classes
They are being taught by students to become guide animals for people with visual impairments around the United States
Some students found out about the “Dawgs Raising Dogs” program through word of mouth or by seeing the dogs around campus — both were the case for sophomore graphic design major Peighton Senges
“I heard about it during [sorority] rush … a girl I talked to had done it and I started seeing them all around campus,” Senges said
I just found their Instagram and applied and now I have my own dog.”
The “Dawgs Raising Dogs” program is affiliated with the Athens Area Guide Dog Foundation
Guide Dog Foundation New York and America’s VetDogs
students go through a six-month application process where they are taught commands and positive reinforcement methods before they are given a dog to train
students must attend basic training courses with them
helps teach students the basics before moving on to more advanced techniques
“When you first get your baby from eight weeks old until 4 months old
“Things [are taught] like general socialization
troubleshooting … house breaking and obedience and general manners.”
More advanced skills such as loose leash walking and distraction control aren’t learned until the dogs are 16 to 18 months old
“It is focused specifically on polishing skills
getting the dogs ready to go in for training and learn all of those final skills that they will need to become guide dogs and service dogs,” Bryan said
Most students will train the dogs for around a year before they are sent to the Guide Dog Foundation headquarters in upstate New York
This is where the dogs will be paired with a person with visual impairments and trained even more
“We're the first step on their process and then they go through a lot of other checkpoints to get paired up with someone,” Senges said
Bringing the dogs with them in public is crucial to the training
Bryan suggests that students bring the dogs everywhere from class to movie theaters
“On these outings they are focusing on all of the skills they're practicing in their group classes and applying them in real world scenarios,” Bryan said
“The more that we expose them and get them out in public
the better we are able to identify any potential distractions
fears or any areas that we might need to spend a little more time training.”
Senges has found that some of the training is different than she would have assumed — it is often very different than training a non-service animal
“There's a lot of little things that [you train] for people with visual impairments that you wouldn't think of
like [the dog] always has to be on the left side of you and they always have to make sure they're behind your foot so people don't trip,” Senges said
Senges said her daily routine has changed — she has to wake up earlier to feed the dog and take him on walks
she enjoys it and especially likes having the dog in class with her
“It also makes my day a lot more fun because if I'm stressed out during a class
he's right there and I can pet him … it's another responsibility but it makes you a better person for it,” Senges said
The Athens Area Humane Society held a special adoption event on Monday in celebration of actress
comedian and lifelong animal activist Betty White’s 100th birthday
A few University of Georgia students speak about having emotional support animals to support their mental health
a student-run organization dedicated to helping local homeless animals
organized a fall festival event on Tuesday to bring awareness and assistance to animals in need
a running club started by a University of Georgia student
has inspired students at over 20 other colleges to begin their own
The West Broad Farmers Market opened for the first time this year on Saturday
29 at the Athens Housing Authority parking lot
a unit of the University of Georgia’s Public Service and Outreach
is hosting its annual Valentine’s Day dinner
a romantic meal surrounded by bountiful flora
A small group of people gathered outside of the North Oconee Water Reclamation Facility on Sunday afternoon for a free Valentine’s Day-themed tour of the facility
The Red & Black serves the Athens and University of Georgia communities with reliable
while training the future of the free press
Your browser is out of date and potentially vulnerable to security risks.We recommend switching to one of the following browsers:
January 26, 2011
Seven members of the Class of 2013 have been selected as Leadership Fellows at Elon University School of Law
The Leadership Fellows program was established in 2009 as part of Elon University School of Law’s mission to infuse legal education with an emphasis on leadership development
The faculty and administration of Elon University School of Law welcome the following new Leadership Fellows to the law school:
and globalization have resulted in a world that is more connected and intertwined than ever before
we must understand that this increased connectedness with other cultures both allows and requires us to accept increased responsibility for the betterment of our own society and for the entire global community as well.”
Boeka earned a Bachelor of Science from the United States Military Academy at West Point
with fields of study in psychology and environmental engineering
she served as Postal Platoon Leader and Company Executive Officer
and as Aid-de-Camp for a Commanding General
Boeka served as the leader of a 30-soldier platoon
the executive officer of a 60-soldier company
and the personnel officer in charge of a five-soldier team responsible for the financial and administrative needs of more than 800 soldiers
While at the United States Military Academy
Boeka was a member of NCAA Division I tennis team
qualifying for the NCAA national tournament twice
A former member of the West Point Spanish Club
Her volunteer experience includes involvement with the Orange County Special Olympics
“I realize without the courage of my convictions and the initiative to improve my community
I cannot honestly consider myself to be a leader.”
Burnett earned a Bachelor of Arts in political science from the University of North Carolina at Chapel Hill
with a secondary major in African and Afro-American studies and a minor in social and economic justice
Burnett has contributed to a wide-range of community service projects including her service as a volunteer with Duke HomeCare & Hospice and with the Durham Food Bank
she has participated in the UNC Summer Bridge Program
a program that assists minority students in transitioning from high school into higher education
She also facilitated workshops as part of a Congo Teach-In at UNC Chapel Hill
raising awareness about violence against women in the Democratic Republic of Congo
Burnett’s professional experience includes employment with Laboratory Corporation of America
the Institute of African American Research
She has been honored with membership in the Phi Alpha Delta Pre-Law fraternity and the Society of Janus – UNC Chapel Hill’s National Residence Hall Honorary Society
Leadership is a method of positively influencing a group.”
Dillon earned a Bachelor of Science in political science and a Bachelor of Arts in Spanish from Appalachian State University
helped to plan the “Free to Breathe Lung Cancer 5K” fundraiser
and began coaching the Watauga County Parks & Recreation Little League basketball team
Dillon served as president of the Chi Omega Fraternity
receiving that organization’s first scholarship awarded for academic achievement and leadership
She also served as director of academic affairs for the Appalachian State Student Government Association
Dillon has been recognized as a member of Order of Omega
Her senior honors thesis explored language access in North Carolina courts
“Many young people are going out of their way to serve their communities and are developing an understanding of the underlying issues that vulnerable and under-served populations face
I believe this exposure has the possibility of producing a generation of leaders that will be more attuned to societal needs than previous generations.”
Fried earned a Bachelor of Arts in economics and Spanish from the University of North Carolina at Asheville
she studied abroad at the University of Valencia in Spain
Fried became an AmeriCorps VISTA Volunteer
she helped to build and to sustain a new literacy program for a nonprofit organization in Massachusetts
planning and implementing seminars for state volunteers
Fried served as a teaching assistant for a freshman class on global poverty and received a summer research grant to study property rights in the Brazilian Amazon region
she was a research assistant for a USDA-funded project on farmland valuation in Western North Carolina
she was the captain of the Division I varsity soccer team
“In bridging my career to my community work
I would like to place effort in advocating for programs and policies that build up the family institution and reform urban schools
With success in these two areas we will see drastic improvements in juvenile delinquency.”
Imediegwu earned a Bachelor of Arts from the University of Michigan
Her studies focused on public policy and education
she earned the University of Michigan Distinguished Academic Scholar award
she won the NAACP & Ford Motor Company Oratorical Contest
Imediegwu is the founder of Destiny Investment Initiatives
a nonprofit organization offering professional and personal development programs for girls in school grades five through ten
she served as program director of Destiny Investment Initiatives
Imediegwu has taught pre-school children and served as an after-school program facilitator for third through fifth grade programs aimed at drug prevention
she served as a research assistant at the University of Michigan
focusing her research on the effectiveness and availability of youth summer programs in Ann Arbor
“Strong leaders need to be role models – they must align their actions with shared values.”
Jones earned a Bachelor of Arts in political science at Davidson College
During a semester in the nation’s capital as part of the Davidson in Washington program
Jones served as a research and public affairs intern for the American Legislative Exchange Council
Jones served as president of the Davidson Pre-Law Society
Head Building Manager in the Residence Life Office
and participant in the Leadership Davidson Program
His leadership experience includes ownership and operation of a part-time pressure washing business along with service as a lifeguard for the Wilmington Family YMCA and as a lead teen camp counselor at Camp Kirkwood
Jones served four years as a coordinator and mentor in Big Brothers Big Sisters of Greater Charlotte
has received numerous scholarships including the Ellis Tinsley Eagle Scout Scholarship
the Military Officers Association-Cape Canaveral Chapter Scholarship
and the Washington Crossing Foundation National Scholarship
“Global leaders are forced to deal with statistics; local leaders deal with people
Citizens of the world must first give to their communities
and through this experience will better understand how to care for individuals when they are presented with caring for greater numbers of people.”
Senges earned a Bachelor of Arts from Elon University
majoring in philosophy with minors in political science and history
Senges served as vice delegate chairperson for the North Carolina Student Legislature
co-founder and vice president of a college political society
He also participated in the National Campaign for Political and Civic Engagement
a non-partisan group that fosters political awareness and civic engagement among students
His leadership experience includes service as an assistant campaign manager for a United States congressional election and managerial roles with True Solutions
The products might include agents with pharmaceutical potential
The bacterium Streptomyces chartreusis is an antibiotic-producing bacterium that releases more metabolites into the surrounding medium than scientists assumed based on the analysis of the genome
Many of the substances are likely released to mediate interactions with its environment
They might also include molecules that are of interest as potential pharmaceutical agents
A team headed by Prof Dr Julia Bandow and Christoph Senges from the research group Applied Microbiology at Ruhr-Universität Bochum analysed a broad spectrum of the bacterium’s metabolic products under various culture conditions
Together with colleagues from Bielefeld and Charlottetown
the researchers from Bochum describe the results of their study in the journal “Proceedings of the National Academy of Sciences”
Bacteria of the species Streptomyces produce approximately 70 per cent of all antibiotics of natural origin used in clinical applications
The genome of Streptomyces chartreusis contains 128 gene clusters
predicted to be relevant for the synthesis of natural products
but the number of secreted molecules that we detected exceeded our expectations,” says Julia Bandow
Using three culture media with different composition to grow the bacteria
the team identified 1,044 different substances
Streptomyces synthesised different natural products – some for example were produced only in the absence of iron
The researchers used high end mass spectrometry
to compare the composition of the complex mixtures of natural products secreted into the media and to detect individual components some of which are present only at low quantities
The same method was employed to predict chemical structures of new compounds
compounds were prioritised for structure elucidation by nuclear magnetic resonance spectroscopy
The study was funded by: the German Research Foundation (BA 4193/6-1
the Federal Ministry of Education and Research under the umbrella of the project “Bielefeld-Gießen Center for Microbial Bioinformatics” (031A533)
Natural Sciences and Engineering Council of Canada
Atlantic Canada Opportunities Agency and Jeanne and Jean-Louis Levesque Foundation
Christoph H. R. Senges, Arwa Al-Dilaimi, Douglas H. Marchbank, Daniel Wibberg, Anika Winkler, Brad Haltli, Minou Nowrousian, Jörn Kalinowski, Russell G. Kerr, Julia E. Bandow: The secreted metabolome of Streptomyces chartreusis and implications for bacterial chemistry, in: Proceedings of the National Academy of Sciences USA, 2018, DOI: 10.1073/pnas.1715713115
We studied guideline adherence with respect to overtreatment or undertreatment with OACs in the Rhine-Neckar area
The ARENA project is a campaign to improve treatment of AF in the metropolitan region Rhine-Neckar. One component is a registry in which patients with AF were prospectively registered and followed up (3)
The present analysis includes all persons for whom we were able to calculate a CHA2DS2VASc score
Since in patients without an indication for treatment with OACs
anticoagulation is recommended for at least four weeks after cardioversion or pulmonary vein isolation
these were excluded from our analysis regarding overtreatment
To determine independent predictors for treatment with OACs
we calculated one logistic regression model each for patients with class I indication and without indication
The Figure shows the classification into persons with class I indication (CHA2DS2VASc score > 1 men and > 2 women)
class IIa indication (CHA2DS2VASc score 1 men and 2 women) and without indication for oral anticoagulants (CHA2DS2VASc score 0 men and 1 women)
treatment with oral anticoagulants was done�with vitamin K antagonists (VKAs) in 23.7% and with non-VKA oral anticoagulants (NOACs) in 76.3%
Predictors for OAC treatment were known AF
persistent or permanent AF and valve diseases)
whereas increased bleeding risk was associated less often with treatment with OACs (Table)
Of the 264 patients with a class IIa indication
217 (82.2%) were treated with OACs (VKA 19.4%
9 (3.4%) were treated with thrombocyte inhibitors
and 38 (14.4%) did not receive antithrombotic treatment
Only 80 patients had no indication for OACs treatment; of these
Predictors for overtreatment were persistent or permanent AF
1861 (91.6%) or 2026 persons for whom an unequivocal recommendation existed received the treatment recommended by the guideline
The 1-year Kaplan Meier estimates for the combined endpoint death
and severe bleeding in the three groups indicated that for class I (9.7% versus 13.3%
95% confidence interval: [0.42; 1.14]) and class IIa indication (1.9% versus 4.3%
OAC treatment was associated with a trend towards fewer events
By contrast in those persons in whom no indication existed
numerically more events were seen when OACs were administered (3.2% versus 2.1%
This analysis of patients with AF in the Rhine-Neckar area showed a high degree of adherence to treatment with OACs
More than 90% of patients with an unequivocal recommendation were treated in a guideline-conform manner
Only 7% of persons with a class I indication were not treated with OACs�against the recommendation of the guidelines�and therefore formally undertreated
The crucial factor of influence against OACs is an increased risk of bleeding
Patients with a class IIa indication were treated with anticoagulants in more than 80% of cases
In our study only 7% of patients with a clear indication were not treated with anticoagulants, a rate that is very low in the international comparison. One explanation may be selection bias as persons who agree to participate in a registry represent a positive selection. As in previous studies (5)
ARENA showed for guideline-conform treatment a numerically smaller rate of clinical events
For OAC therapy in patients without any indication the trend went in the opposite direction
our data show good guideline adherence regarding OAC treatment in AF
and a lower event rate for guideline-adherent treatment
The ARENA project was funded by the German Cardiac Society�s center for cardiological health services research
Frankfurt; the Institute for Myocardial Infarction Research
DT received consultancy fees from Bristol-Myers Squibb
He received lecture honoraria from Bayer Vital
He is a member of the steering committee of the AFNET reg
and the speaker of the Basic Science Cluster of the German Cardiac Society
UZ received lecture honoraria from Bayer-Vital
The remaining authors declare that no conflict of interest exists
revised version accepted on 12 January 2023
Translated from the original German by Birte Twisselmann
Senges J: The management of atrial fibrillation with oral anticoagulant drugs�an analysis of guideline adherence in the setting of the ARENA project
entwickelt von L.N. Schaffrath DigitalMedien GmbH