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To compare the characteristics of two commercially available compression systems, a dual-compression bandage system (DCS) and a traditional two-layer bandage (TLB), using a laboratory bench test.The compression systems were evaluated in a computer-controlled tensile test to generate force-deflection curves for each sample. The compressive work and the theoretical pressure applied to the limb by the respective compression bandages were calculated at the maximum stretch and a stretch instructed by the manufacturers. The manufacturer of the DCS provides reference points on how much the bandage should be stretched to provide the desired pressure, and the TLB stretch was calculated from the product's datasheet.The combined results of layers 1 and 2 for the DCS showed greater load and work than the TLB at both the maximum and recommended stretch. The recommended stretch for DCS and TLB was less than 50% of the deflection up to the breaking point.The high work provided by the two layers of the DCS suggests a wider range of performance than the TLB when applied to the lower limb, especially after the limb volume is initially reduced by compression. Moreover, using the tensile test and the guide of the reference points on layers 1 and 2 from DCS, the calculated pressure achieved the expected values stated by the manufacturer. Human studies should be conducted to determine whether the reference points provided by DCS are beneficial for obtaining repeatable values.

Idelalisib is a highly selective oral inhibitor of PI3Kδ indicated for the treatment of patients with relapsed chronic lymphocytic leukemia in combination with rituximab. Despite additive clinical effects, previous studies have paradoxically demonstrated that targeted therapies potentially negatively affect anti-CD20 mAb effector mechanisms. To address these potential effects, we investigated the impact of PI3Kδ inhibition by idelalisib on the effector mechanisms of rituximab and obinutuzumab. At clinically relevant concentrations, idelalisib minimally influenced rituximab- and obinutuzumab-mediated Ab-dependent cellular cytotoxicity and phagocytosis on human lymphoma cell lines, while maintaining the superiority of obinutuzumab-mediated Ab-dependent cellular cytotoxicity. Consistent with this, idelalisib did not influence obinutuzumab-mediated B cell depletion in whole-blood B cell–depletion assays. Further, idelalisib significantly enhanced obinutuzumab-mediated direct cell death of chronic lymphocytic leukemia cells. In murine systems, in vivo inhibition of PI3Kδ minimally interfered with maximal rituximab- or obinutuzumab-mediated depletion of leukemic targets. In addition, the duration of rituximab- and obinutuzumab-mediated depletion of leukemia cells was extended by combination with PI3Kδ inhibition. Collectively, these data demonstrate that PI3Kδ inhibition does not significantly affect the effector mechanisms induced by rituximab or obinutuzumab and provides an effective in vivo therapeutic combination. Therefore, combinations of obinutuzumab and idelalisib are currently being assessed in clinical studies.

Background Testing for Clostridioides difficile infection has been the subject of recent debate. Guidelines from the Infectious Diseases Society of America now support the addition of a stool toxin test to a positive nucleic acid amplification test (NAAT) as part of a multi-step testing algorithm. In November 2017, the University of Kentucky HealthCare system added stool toxin testing to any specimen positive for C. difficile by NAAT. This change was accompanied by face to face education with provider groups and clinical decision support in the form of interpretive verbiage added to the results that are reported into the electronic record. The objective of this study was to assess whether this diagnostic stewardship intervention made an impact on C. difficile treatment Methods We performed a retrospective review of adult patients admitted to UK HealthCare from November 1, 2017 through October 31, 2018 who tested positive by NAAT but negative by stool toxin test to determine whether or not they were treated. We also assessed treatment by service line to see whether there were treatment differences among these groups. A cost analysis was also performed. Results A total of 300 adult inpatients were positive for C. difficile by NAAT during the study period with 71% (213 patients) having a negative stool toxin test. Of those, 58% (123) were never started on C. difficile therapy and an additional 14% (30) had their therapy stopped after 48 hours. Only 28% (60) of these patients received a full course of therapy. Hospital medicine had the highest rate of non-treatment at 82%. Conversely, our solid-organ and bone marrow transplant services had the lowest rate of non-treatment at 31%. Overall, this approach was associated with an estimated 1470 oral vancomycin days avoided (5,880 doses) and a cost savings of $6,278. Conclusion The addition of stool toxin testing to NAAT combined with education and clinical decision support lead to a dramatic reduction of treatment for NAAT positive but toxin-negative patients. This form of diagnostic stewardship had a significant impact on therapy decisions and can be a powerful antimicrobial stewardship approach to decrease unnecessary treatment of C. difficile colonization. Disclosures All authors: No reported disclosures.

55 “Visual music” is a term used to refer to a broad range of artistic practices, far-flung temporally and geographically yet united by a common idea: that visual art can aspire to the dynamic and nonobjective qualities of music (Mattis 2005). From paintings to films—and now to computer programs—the manifestations of visual music have evolved along with the technology available to artists. Today’s interactive, computer-based tools offer a variety of possibilities for relating the worlds of sound and image; as such, they demand new conceptual approaches as well as a new level of technical competence on the part of the artist. Jitter, a software package first made available in 2002 by Cycling ’74, enables the manipulation of multidimensional data in the context of the Max programming environment. An image can be conveniently represented by a multidimensional data matrix, and indeed Jitter has seen widespread adoption as a format for manipulating video, both in nonreal-time production and improvisational contexts. However, the general nature of the Jitter architecture is well-suited to specifying interrelationships among different types of media data including audio, particle systems, and the geometrical representations of three-dimensional scenes. This article is intended to serve as a starting point and tutorial for the computer musician interested in exploring the world of visual music with Jitter. To understand what follows, no prior experience with Jitter is necessary, but we do assume a familiarity with the Max/MSP environment. We begin by briefly discussing strategies for the mapping of sound to image; influences here include culturally learned and physiologically inherent cross-modal associations, different domains of association, and musical style. We then introduce Jitter, the format of image matrices, and the software’s capabilities for drawing hardware-accelerated graphics using the OpenGL standard. This is followed by a survey of techniques for acquiring event and signal data from musical processes. Finally, a thorough treatment of Jitter’s variable frame-rate architecture and the Max/MSP/Jitter threading implementation is presented, because a good understanding of these mechanisms is critical when designing a visualization and/or sonification network.

This paper addresses the relationship between temperature or relative humidity and the number of patients seen and how often the treating physician deemed it necessary to transport the patient to the hospital. A retrospective review was performed on 251 patients seen at the Dayton airshow during the 2‐day period of 21‐22 July 2001. The air show has an attendance of approximately 50,000 people spread out through this 3‐day event. The first aid tents that provide the medical care at the air show are staffed by either senior emergency medicine residents or emergency medicine attendings. Results showed that the relationship between the number of patients transported and the temperature reveals a pattern of more patients being transported as the temperature increases.

Evaporation rates and total energy loads from an unoccupied, heated, outdoor pool in Fort Collins, Colorado were investigated. Pool and air temperatures, humidity, thermal radiation, wind speed, and water loss due to evaporation were measured over 21 test periods ranging from 1.1 to 16.2 hours during August and September, 1992. Data were analyzed and compared to commonly used evaporation rate equations, most notably that used in the ASHRAE Applications Handbook. Measured evaporation was 72% of the ASHRAE calculated value with near-zero wind velocity, and 82% of the ASHRAE value at 2.2 m/s wind velocity. A modified version of the ASHRAE equation was developed. Two overnight tests showed energy loss of 56% by evaporation, 26% by radiation, and 18% by convection. A correlation between radiation loss and temperatures was also found for the range of test conditions.

We present spectra of depleted uranium metal from laser plasmas generated by nanosecond Nd:YAG (1064 nm) and femtosecond Ti:sapphire (800 nm) laser pulses. The latter pulses produce short-lived and relatively cool plasmas in comparison to the longer pulses, and the spectra of neutral uranium atoms appear immediately after excitation. Evidence for nonequilibrium excitation with femtosecond pulses is found in the dependence of spectral line intensities on the pulse chirp.

A fully automated rain exclusion canopy system has been designed and constructed to study the impact of simulated acid rain on the growth and yield of agricultural crops. The system consists of three, mobile greenhouse shelters which exclude ambient rainfall and apply simulated acid rain (SAR) treatments to crops established in field plots. All aspects of the field system are controlled by a microcomputer and data acquisition system. In addition, elevated ambient levels of gaseous pollutants (e.g. O3, SO2, NOx) are reduced in field plots via an air exclusion system consisting of large blowers, potassium permanganate-treated alumina filters and perforated polyethylene tubes. Gaseous pollutants can be injected into the treatment plots via the blowers.