ABSTRACT IMPACT: The integration of patient-reported outcome measures into clinical care is feasible and can facilitate patient-centered care for individuals with systemic lupus erythematosus. OBJECTIVES/GOALS: Patient-reported outcome measures (PROMs) are powerful tools which can facilitate patient-centered care by highlighting individuals’ experience of illness. The aim of this study was to assess the feasibility and impact of implementing web-based PROMs in the routine clinical care of outpatients with systemic lupus erythematosus (SLE). METHODS/STUDY POPULATION: Outpatients with SLE were enrolled in this longitudinal cohort study at two academic medical centers. Participants completed PROMIS computerized adaptive tests assessing multiple quality of life domains at enrollment and prior to two consecutive routinely scheduled rheumatology visits using the ArthritisPower research registry mobile or web-based application. Score reports were shared with patients and providers before the visits. Patients and rheumatologists completed post-visit surveys evaluating the utility of PROMs in the clinical encounters. Proportions with confidence intervals were calculated to evaluate survey completion rates and responses. RESULTS/ANTICIPATED RESULTS: A total of 105 SLE patients and 16 rheumatologists participated in the study. Subjects completed PROMs in 159 of 184 eligible encounters (86%, 95% CI 81 - 91), including 90% of visit 1’s (95% CI 82 - 95) and 82% of visit 2’s (95% CI 72 - 90. Patients and rheumatologists found that PROMs were useful (91% and 83% of encounters respectively) and improved communication (86% and 72%). Rheumatologists reported that PROMs impacted patient management in 51% of visits, primarily by guiding conversations (84%), but also by influencing medication changes (15%) and prompting referrals (10%). There was no statistically significant difference in visit length before (mean=19.5 min) and after (mean=20.4 min) implementation of PROMs (p=0.52). DISCUSSION/SIGNIFICANCE OF FINDINGS: The remote capture and integration of web-based PROMs into clinical care was feasible in a diverse cohort of SLE outpatients. PROMs were useful to SLE patients and rheumatologists and promoted patient-centered care by facilitating communication.

Many historians usually interpret the Spanish Civil War as a confrontation of great collective movements. Looking back into the trenches of the Iberian Peninsula, they see the organized forces of nationalism, communism, anarcho-syndicalism, and socialism clashing along battle lines as much ideological as military. In these standard accounts, such movements, whatever their sharp political differences, commanded popular support based on an ethos of heroism, sacrifice and devotion to a larger cause.

A cationic Schistosoma mansoni cercarial antigen was shown to be a serine protease as it was capable of hydrolysing N-acetyl-dl-phenylalanine β-naphthyl ester (NAPBNE) after precipitation by immunoelectrophoresis, and this reaction was modulated by the serine protease inhibitors phenylmethanesulfonyl fluoride (PMSF) and diisopropylfluorophosphate (DFP). The antigen in the immunoprecipitin arcs could also be radio-isotope labelled with tritiated DFP. The peptidolytic enzyme identified in immunoelectrophoresis with polyspecific sera and radio-isotope labelled with tritiated DFP had a relative molecular size of approximately 27 kDa in sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS–PAGE), and evidence obtained after partial purification, SDS–PAGE and immunoblotting supported this size estimate for the enzyme. A rabbit antiserum raised against the peptidolytic antigen reacted against a doublet of antigens at 27/28 kDa in immunoelectrophoresis arcs and against an antigen of 60 kDa in Western immunoblots of crude cercarial homogenate. However, the latter serum precipitated the cationic antigen in immunoelectrophoresed cercarial homogenates only after pre-incubation of the homogenates with PMSF. Fractions containing the partially purified protease also degraded radio-isotope labelled human IgG. The reactivity of a range of polyspecific and monospecific rabbit antisera in Western blots with larval extracts indicated that antibody responses against the 27/28 kDa doublet may be modulated. When immunized with material which contained the 27 kDa enzyme as a major constituent, and which was secreted by S. mansoni cercariae during transformation, only 5 of 16 mice produced antibody to this antigen that was detectable in Western blots. The 5 antibody ‘responder’ mice were significantly (P<0·001) protected against challenge with a percutaneous infection of S. mansoni cercariae compared with a group of mice also immunized with CTF, but which had not produced antibodies against the 27/28 kDa doublet. The results indicate that the 27 kDa serine protease of S. mansoni larvae is a target that is sensitive to immunological attack.

A manuscript of late seventeenth-century English harpsichord music was sold to an anonymous private collector at Sotheby's in London on 26 May 1994 for £276,500, a record price paid for any British music manuscript. The 85-page oblong quarto, in its original covers, includes 21 pieces in the hand of Henry Purcell (1659–95), five of which were previously unknown, and a further 17 works by Giovanni Battista Draghi (c.1640–1708), also probably autograph, four of which were previously unknown. The manuscript is important because of the rarity of Purcell autographs: this is the first to be sold at public auction since the great collection of fantazias and sonatas (now British Library, Add. MS 30,930) was offered in 1826, and the only major source to surface this century.

The Pantheon Opera remains among the least known of the major theatrical ventures in eighteenth-century London. It came into being amidst the conspiracies that flourished after the King's Theatre, Haymarket, was destroyed by fire in June 1789. Conceived as a kind of English Court Opera, the Pantheon was backed at enormous expense by the Duke of Bedford and the Marquis of Salisbury. It struggled through the 1790–91 season, accumulating ruinous debts, and then on 14 January 1792 it too burned to the ground, just four nights into its second season.

The King's Theatre, Haymarket, was destroyed by fire in June 1789. Shortly thereafter some wealthy and powerful patrons – notably the Prince of Wales (the future George IV), the Duke of Bedford and the Marquis of Salisbury – launched an ambitious scheme to build a fabulously expensive Royal Opera House in Leicester Square. The venture was designed to re-establish London as a major centre for Italian opera and ballet, to reform the wayward financial and artistic management of the King's Theatre and to give the capital city a grand opera house of modern design that would rival any in Europe. Because the royal patent promised for Leicester Square was blocked, the scheme had to be dropped, and the sponsors wound up establishing the ill-fated and short-lived Pantheon Opera instead – but that is another story. Our concern here is with the Leicester Square project which, though never realised, did set in motion many of the changes desired by its backers and helped to return London to the mainstream of opera.

In 1700 the London theatrical world was in crisis. The quality of English plays had deteriorated during the 40 years of restored Stuart rule. Playwrights, believing themselves to be working in the tradition of the finest Elizabethan and Jacobean dramatic poets, were churning out ranting tragedies, stripped of the subtle heroes and comic relief of Shakespeare, and amoral comedies, rarely showing the sparkling wit of Jonson. The two London theatre companies were locked in bitter competition for the small, mostly aristocratic audience, and managers compromised the poets and actors by introducing into their plays music-hall entertainments, from ventriloquists to tumblers. At the center of the crisis, however, was not the lack of playwrights of genius nor a fickle, world-weary audience; rather British drama was seriously weakened by a tradition that had since 1660 allowed the play to become the vehicle not only for spoken drama, but for large quantities of music and dance as well.