Americans look to the Centers for Disease Control and Prevention (CDC) to lead by providing an example of healthy people in healthy environments. Recognizing the synergy between environmental health and personal health and well-being, the CDC formed the Go Green, Get Healthy (GGGH) initiative. The GGGH rolls healthier worksite initiatives, quality-of-work-life programs, and internal environmental protection efforts into a coordinated campaign for widespread cultural change with energy conservation as one of the major goals. The CDC hopes that this success will be a model for other agencies and organizations. The Office of Sustainability at the CDC actively engages the entire agency in environmental stewardship and specifically, energy conservation (in the GGGH initiative) by providing a vision with leadership support, education for every individual, effective communication methods, and a robust tracking system for comprehensive data and feedback. The campaign works effectively by breaking down the task of greening the agency into sectors. Each sector needs support of CDC leadership and work of responsible offices, complimented by the grassroots dedication of individuals in the GGGH workgroups and collaborative external partnerships. Several low/no-cost examples are included to demonstrate progress toward a sustainable CDC and these can be used to help other organizations discover a greener and healthier model for their sustainability and conservation efforts with a minimal outlay of funds. Through physical changes, culture changes, and policy/operational changes, energy and water can be saved. This paper seeks to convey the following main learning points: (1)identify low/no-cost ways to reduce energy and water consumption; (2)describe ways to influence workers to adopt more sustainable behaviors; and (3)discuss ways to integrate energy-management decision-making processes and standard operating procedures.

Monoclonal B cell lymphocytosis (MBL) is now recognized as the B-lymphocyte analogue of a monoclonal gammopathy of unknown significance. MBL can be the precursor of chronic lymphocytic leukemia or associated with non-Hodgkin's lymphoma. It may be associated with an autoimmune abnormality or be related to aging (immunosenescence). The combination of available new fluorochrome-conjugated monoclonal antibody reagents, multilaser instrumentation, and improved software tools have led to a new level of multicolor analysis of MBL. Presently, several centers, including the University of Salamanca (Spain), Duke University (Durham, NC), Mayo Clinic (Rochester, MN), and the National Cancer Institute (Bethesda, MD) in conjunction with the Genetics and Epidemiology of Familial chronic lymphocytic leukemia Consortium, the Food and Drug Administration (Bethesda, MD), and the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (Atlanta, GA) in collaboration with Saint Luke's Hospital (Kansas City, MO), the Universita Vita-Salute San Raffaele in Milan (Italy), and Leeds Teaching Hospital (UK) are all actively conducting studies on MBL. This commentary is an updated summary of the current methods used in these centers. It is important to note the diversity of use in reagents, instruments, and methods of analysis. Despite this diversity, there is a consensus in what constitutes the diagnosis of MBL and its subtypes. There is also an emerging consensus on what the next investigative steps should be.