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Wireless Body Area Networks (WBANs) are in the spotlight of researchers and engineering industries due to many applications. Remote health monitoring for general as well as military purposes where tiny sensors are attached or implanted inside the skin of the body to sense the required attribute is particularly prominent. To seamlessly accomplish this procedure, there are various challenges, out of which temperature control to reduce thermal effects and optimum power consumption to reduce energy wastage are placed at the highest priority. Regular and consistent operation of a sensor node for a long-time result in a rising of the temperature of respective tissues, where it is attached or implanted. This temperature rise has harmful effects on human tissues, which may lead to the tissue damage. In this paper, a Temperate Aware and Energy Optimized (TAEO) routing protocol is proposed that not only deals with the thermal aspects and hot spot problem, but also extends the stability and lifetime of a network. Analytical simulations are conducted, and the results depict better performance in terms of the network lifetime, throughput, energy preservation, and temperature control with respect to state of the art WBAN protocols.

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Background The Center for Disease Control and Prevention recommends strict contact isolation precautions (CP) that include hand hygiene (HH) and barrier (gloves and gown) precautions upon entering and leaving the rooms of patients diagnosed with multidrug-resistant organism or Clostridium difficile infections. Although this policy has been in place for several years, compliance rate among HCW is rarely studied. The aim of our study was to covertly monitor, analyze, and compare the overall bundle compliance (OBC) and individual (HH, glove and gown) component compliance (ICC) among HCWs during routine patient care. Methods A prospective observational study was done in six Detroit Medical Centers (July 2017 to February 2018). Trained observers audited both inpatient and intensive care units on random days and time. Components audited (1) HH before donning and after doffing (2) gowning and gloving techniques before entering and after existing the patient room. A mobile application (speedy audit) was used to record all data. A pilot targeted education program (TEP) was also conducted in one of the hospitals where education was focused only on strict HH practice before donning. Results A total of 6,274 observations were collected. The OBC was 38%. Common HCWs observed included nurses (registered nurse and nursing student) 47%; physicians (attending’s, residents, fellows) 28%; service workers including Environmental Service, Food service, Patient transporter, Social worker, Pastoral care- 14%; Allied Health Professions including Dietician, Blood Collection, Physiotherapist, Radiology Tech, Respiratory Therapist 4%; The OBC among all HCW were below 50%. For the ICC, HH (49%) was way below the gloving (80%,) and gowning (62%) compliance. HH compliance before donning was strikingly lower (40%) than the compliance after doffing (62%). This trend was similar in all HCW. Within a month of TEP, a drastic increase in both HH [↑ to 75% from 26% (P < 0.001)] and OBC [↑ to 68% from 16% (P < 0.001)] was seen. Conclusion Common misconception that gloves are substitute to HH could explain the low HH rates before donning. Recognition of this gap and focused education on HH before donning has led to improved compliance in all HCW. Disclosures All authors: No reported disclosures.

among travelers returning from tropical countries [2]. In the United States, most cases are found in the southeastern and central regions [2, 3]. Dogs or cats that carry the hookworms deposit the larvae, which are present in their feces, into the sand or soil, where the larvae can survive for several days. On contact with unprotected skin, the larvae penetrate the epidermis but are contained by the basement membrane. Humans are incidental hosts, and the hookworms cannot complete their life cycle in humans. The infection causes erythematous, pruritic papules. In 5-14 days, the characteristic reddened, intensely pruritic skin eruption is visible along the path of larval migration (figure 1) [2]. Cutaneous larva migrans is usually self-limited, with most cases lasting a few weeks or months. The diagnosis is based on clinical appearance and a history of probable exposure. Eosinophilia is not common but has been noted in some cases of infection. In one series, up to 20% of patients had eosinophilia [4]. Biopsy is not indicated because the migrating parasite is usually not identified. Treatment is not required, but it is usually recommended to manage intense cases of pruritus. Topical (2-3 times per day for 5 days) and oral (25 mg/kg 2 times per day for 2 days) thiabendazole are effective. Successful treatment with albendazole or ivermectin