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Full-coverage pedestrian survey to record cultural features on unexplored archaeological landscapes is costly in terms of time, money, and personnel. Over the past two decades, researchers have implemented remote sensing and landscape data collection techniques using unmanned aerial vehicles (UAVs) to combat some of these burdens, but the initial cost of equipment, software, and processing power has hindered the ubiquitous implementation of UAV technology as an accessible companion tool to traditional archaeological survey. This article presents a free and open-source, technology-independent analytical framework for the collection and processing of UAV images to produce high-resolution digital terrain models limited only by the equipment available to the researcher. Results from the free and open-source protocol are directly compared to those produced using proprietary software to illustrate the capabilities of freely available data processing tools for UAV-collected images. By replicating the methods outlined here, researchers should be able to identify and target areas of interest to increase fieldwork efficiency, decrease costs of implementing this technology, and produce high-resolution digital terrain models to conduct spatial analyses that pursue a deeper understanding of cultural landscapes.

Recruitment of skilled professionals for the infection preventionist (IP) role is an ongoing priority for organizations. The objective of this study was to understand differences in recruitment, hiring and training by facility setting and discuss targeted strategies for diverse organizations.A survey study investigated recruitment, hiring and training practices for IPs and stratified by facility location (multi-location health system (MLHS), urban, suburban and rural), specifically pertaining to job description requirements, background of candidates interviewed and hired and training programs.A Master's in Public Health degree was significantly more frequently listed on MLHS and urban facility job descriptions (37.3%, 43.7%, respectively) than suburban (27.4%) and rural facility job descriptions (17.2%)(P.01). Respondents from MLHS (41.3%), urban facilities (47.0%), suburban facilities (41.7%) were more likely to interview public health professionals than rural facilities (20.3%, P = .003). Respondents from MLHS, (73.3%), urban (68.4%), and suburban (62.2%) facilities were significantly more likely to use local Association for Professionals in Infection Control and Epidemiology chapter for training compared to rural facilities (32.4%)(P.001).Our results identified differences in facility setting with recruitment, hiring and training practices. Optimizing recruitment and training best practices will result in a large and well trained IP workforce and patient safety.

Background Surgical site infection (SSI) prevention bundles have proven successful in decreasing infections. Surgeon and nurse engagement and endorsement are essential for success. The objective of this quality improvement project was to develop, implement and sustain a colon SSI prevention bundle and determine which bundle components are most strongly associated with prevention of SSI. Methods The bundle was developed and implemented in a 525 bed Level I trauma hospital and included pre-, intra- and postoperative components. Bundle adherence and SSI rate were continually tracked and communicated to surgeons and nursing staff throughout project. Univariate and multivariate analyses were performed to determine the components associated with lowest SSI rates. Results There were 280 elective and urgent/emergent colon surgeries between October 2015 and March 2018. Over 60% had preoperative components, 76.5% had intraoperative components and 55.6% had postoperative bundle components with a nonsignificant decreasing trend in SSI rate of −0.5 SSI/100 procedures per quarter. The multivariate analysis suggested that use of 2% chlorhexidine gluconate/70% alcohol skin prep, use of wound protector and change of gloves for fascial closure were associated with fewer SSI. Discussion The implementation of a colon SSI prevention bundle in a Level I trauma hospital with pre-, intra- and postoperative components was described. Future directions include focusing implementation efforts on bundle components that significantly prevent SSI to improve adherence.

This brief report explores why Infection Preventionists (IPs) leave their positions and strategies implemented to retain and professionally develop IPs. National survey data of over 500 APIC members found turnover is due to personal reasons, professional advancement opportunities and work-life balance challenges. In addition, IPs are retiring in great numbers. The creation of career pathways and providing an environment that supports work-life balance are novel strategies that could retain and professionally develop IPs.

Over twenty years ago, Janet Poppendieck published Sweet Charity?: Emergency Food and the End of Entitlement. The book, one that is considered by many to be a foundational contribution to the study...

Background: The U.S. Centers for Disease Control and Prevention recommend bathing prior to surgery, surgical skin antisepsis, peri-operative antibiotic administration, normothermia throughout the p...

Background Pyoderma gangrenosum (PG) is a chronic, ulcerative neutrophilic dermatosis. PG presents a diagnostic challenge, largely due to the many mimicking diseases, the lack of confirmatory laboratory or biological markers, and the absence of widely accepted diagnostic criteria. In particular, PG is often mistaken for necrotizing soft tissue infections (NSTI). Methods We reviewed four major textbooks each in general surgery, plastic surgery, trauma surgery, vascular surgery, emergency medicine, and dermatology. We also performed a search of review articles addressing NSTI and necrotizing fasciitis (NF). Results Ten out of the 20 non-dermatology textbooks did not list PG anywhere, and only two listed a differential diagnosis for PG. None of the non-dermatology textbooks indicated PG in the NSTI differential diagnosis, while three of the dermatology textbooks included PG in the NSTI differential diagnosis. PG was listed in all of the dermatology textbooks. Only one of the NSTI and NF articles mentioned PG in the differential diagnosis. Conclusions There is an underrepresentation in major textbooks of surgery and emergency medicine and in NSTI and NF review articles when it comes to diagnosing PG. This might be leading to trainees and advanced providers in these fields being uninstructed on PG, and likely contributes to PG misdiagnosis and mismanagement. We recommend PG be included in the differential diagnosis of chronic ulcers and NSTI in non-dermatology textbooks. We also suggest adding identification and diagnosis of inflammatory mimickers of NSTI (e.g. PG) in teaching modules in surgical and emergency specialties to address this knowledge gap.

The transient receptor potential (TRP) superfamily of ion channels has garnered significant attention by the pharmaceutical industry. In particular, TRP channels showing high levels of expression in sensory neurons such as TRPV1, TRPA1, and TRPM8, have been considered as targets for indications where sensory neurons play a fundamental role, such as pain, itch, and asthma. Modeling these indications in rodents is challenging, especially in mice. The rat is the preferred species for pharmacological studies in pain, itch, and asthma, but until recently, genetic manipulation of the rat has been technically challenging. Here, using CRISPR technology, we have generated a TRPA1 KO rat to enable more sophisticated modeling of pain, itch, and asthma. We present a detailed phenotyping of the TRPA1 KO rat in models of pain, itch, and asthma that have previously only been investigated in the mouse. With the exception of nociception induced by direct TRPA1 activation, we have found that the TRPA1 KO rat shows apparently normal behavioral responses in multiple models of pain and itch. Immune cell infiltration into the lung in the rat OVA model of asthma, on the other hand, appears to be dependent on TRPA1, similar to was has been observed in TRPA1 KO mice. Our hope is that the TRPA1 KO rat will become a useful tool in further studies of TRPA1 as a drug target.

Background:Depictions of eye images and messages encouraging compliance with social norms have successfully motivated behavioral change in a variety of experimental and applied settings. We studied the effect of these 2 visual cues on hand hygiene adherence in a cohort of hospital-based healthcare providers participating in an electronic monitoring and feedback program.Methods:Prospective, quasi-experimental study utilizing an interrupted time-series design. Intervention placards depicting an image of eyes, a social norms message, or a control placard were placed near soap and alcohol-based hand-rub dispensers on 2 hospital units. Placards were alternated every 10 days. Hand hygiene opportunities and adherence rates were assessed electronically via the CenTrak Hand Hygiene Compliance Solution.Results:A total of 166 nurses and certified nursing assistants (74 on a medical-surgical unit and 92 on a progressive care unit) were monitored electronically over the 4-month study period. In total, 184,172 electronic observations were collected (110,903 on a medical-surgical unit and 73,269 on a progressive care unit). The median daily number of electronic observations was 1,471 (interquartile range, 1,337–1,584). The preintervention baseline hand hygiene adherence rate was 70%. No statistically significant increase in hand hygiene adherence was observed as a result of either intervention.Conclusion:Displaying eye images or a social norms message in the hospital environment did not result in measurable improvements in HH adherence in a cohort of healthcare providers participating in an electronic monitoring and feedback program.

Background When patients with COVID-19 began presenting to hospitals in early 2020, medical professionals were unprepared to handle the severity of disease and the number of severely ill patients. Local Problem In response to critical needs of patients with COVID-19 and the threat of nurse burnout, a special operations team comprising physical and occupational therapists was convened to (1) provide help to intensive care unit nurses, (2) help therapists be productive, and (3) use therapists’ specialties for critical patients. Methods Two therapists teamed up each shift to work with every critical patient with COVID-19, performing numerous nursing and therapy activities. Activity frequency was documented by the therapists daily, and duration was estimated and data were summarized by nursing leadership. Results During the 9-week program, 35 critical patients with COVID-19 were included in the special operations program. During the program, the teams performed 10 activities, including prone positioning, turning, and mobilization, 1937 times with the patients with COVID-19. The partnership saved between 5 and 40 minutes of intensive care nurse time per activity, which resulted in a total of 677.2 hours of nursing time saved. Discussion Implementation of the special operations program had a positive impact on patients, nurses, and therapists. Patients benefited both clinically and socially from additional time with special operations teams. Nurses benefited from having help caring for critical patients, and therapists benefited from increased productivity during redeployment. Conclusion Deployment of nonnursing clinical staff could be an effective strategy to leverage available resources while maintaining clinical standards of care and reducing nursing burden during a pandemic or crisis surge.

Transthoracic echocardiography (TTE) is the primary initial imaging modality in cardiac imaging. Advantages include portability, safety, availability, and ability to assess the morphology and physiology of the heart in a noninvasive manner. Because of this, many patients who undergo advanced imaging with CT or MRI will have undergone prior TTE, particularly when cardiac CT angiography or cardiac MRI is performed. In the modern era, the increasing interconnectivity of picture archiving and communication systems (PACS) has made these images more available for comparison. Therefore, radiologists who interpret chest imaging studies should have a basic understanding of TTE, including its strengths and limitations, to make accurate comparisons and assist in rendering a diagnosis or avoiding a misdiagnosis. The authors present the standard TTE views along with multiplanar reformatted CT images for correlation. This is followed by examples of limitations of TTE, focusing on potential blind spots, which have been placed in seven categories on the basis of the structures involved: (a) pericardium (thickening, calcification, effusions, cysts, masses), (b) aorta (dissection, intramural hematoma, penetrating atherosclerotic ulcer), (c) left ventricular apex (infarcts, aneurysms, thrombus, apical hypertrophic cardiomyopathy), (d) cardiac valves (complications of native and prosthetic valves), (e) left atrial appendage (thrombus), (f) coronary arteries (origins, calcifications, fistulas, aneurysms), and (g) extracardiac structures (primary and metastatic masses). Online supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article. (©)RSNA, 2021

Despite the development of effective therapies, a substantial proportion of asthmatics continue to have uncontrolled symptoms, airflow limitation, and exacerbations. Transient receptor potential cation channel member A1 (TRPA1) agonists are elevated in human asthmatic airways, and in rodents, TRPA1 is involved in the induction of airway inflammation and hyperreactivity. Here, the discovery and early clinical development of GDC-0334, a highly potent, selective, and orally bioavailable TRPA1 antagonist, is described. GDC-0334 inhibited TRPA1 function on airway smooth muscle and sensory neurons, decreasing edema, dermal blood flow (DBF), cough, and allergic airway inflammation in several preclinical species. In a healthy volunteer Phase 1 study, treatment with GDC-0334 reduced TRPA1 agonist-induced DBF, pain, and itch, demonstrating GDC-0334 target engagement in humans. These data provide therapeutic rationale for evaluating TRPA1 inhibition as a clinical therapy for asthma.

Despite a cost of approximately $1 billion to develop a new cancer drug, about 90% of drugs that enter clinical trials fail. A tremendous opportunity exists to streamline the drug selection and testing process, and innovative approaches promise to reduce the burdensome cost of health care for those suffering from cancer. There is great potential for 3D models of human tumors to complement more traditional testing methods; however, the shift from 2D to 3D assays at early stages of the drug discovery and development process is far from widely accepted. 3D platforms range from simple tumor spheroids to more complex microfluidic hydrogels that better mimic the tumor microenvironment. While several companies have developed and patented advanced high-throughput 3D platforms for drug screening, their cost and complexity have limited their adoption as an industry standard. In this review, we will highlight the various tumor platforms that have been developed, emphasizing the approaches that have successfully led to commercial products. We will then consider potential directions toward more relevant tumor models, advantages of the adoption of such platforms within the drug development and screening process, and new opportunities in personalized medicine that such platforms will uniquely enable.

Liquid biopsy tests have become an integral part of the molecular diagnosis of patients with non-small cell lung cancer (NSCLC). We describe a new test panel that uses very low input (20 ng) of cell-free nucleic acids extracted from human plasma, which is designed to yield results in less than 72 h. In this study, we performed novel amplicon-based targeted next-generation sequencing with a semiconductor-based system, the Ion GeneStudio S5 Prime. The analytic performance of the assay was evaluated using contrived and retrospectively collected clinical specimens. The cumulative percent coefficient of variation for the new test process was very precise at 8.4% for inter-day, 4.0% for inter-operator and 3.4% for inter-instrument. We also observed significant agreement (95.7&ndash, 100%) with an orthogonal, high-sensitivity droplet digital&trade, Polymerase Chain Reaction (ddPCR) test. This method offers a valuable supplement to assessing targeted mutations from blood while conserving specimens and maintaining sensitivity, with rapid turn-around times to actionable results.

Objectives Pyoderma gangrenosum (PG) is a chronic ulcerative neutrophilic dermatosis. It presents a diagnostic challenge due to the absence of disease-specific markers or histopathology, lack of universally accepted diagnostic criteria, and many mimicking diseases including necrotizing soft tissue infections (NSTI). PG cases often present first to specialties other than dermatology. We reviewed major educational resources in internal medicine, family medicine, and infectious disease for their coverage of PG. Content For each specialty, we reviewed five major textbooks, five prominent journals, and any commonly used online resources. Twelve of 15 textbooks mentioned PG, only three of which included a differential, with none including NSTI in the differential. Only two of 13 journals included review articles about PG, and none of these including NSTI in their differential. Interestingly, online resources tended to be the most complete; six of nine contained PG articles, nearly all including a differential and three listing NSTI within it. Summary We found an underrepresentation of PG among major textbooks and journals in clinical specialties, especially in differentiating PG from its mimickers. While online resources may help fill this gap in knowledge, texts and journals remain essential. Misdiagnosis and resultant mismanagement of PG can lead to disastrous outcomes. Outlook We recommend that PG be added to the differential diagnoses of chronic ulcers in educational resources. We also suggest the addition of identification and differentiation of PG to learning materials and lectures for providers in specialties who may encounter PG, NSTI, or similarly presenting diseases to address this gap.

Volatile organic compounds (VOCs) are ubiquitous in the environment. In the United States (U.S.), tobacco smoke is the major non-occupational source of exposure to many harmful VOCs. Exposure to VOCs can be assessed by measuring their urinary metabolites (VOCMs). The Population Assessment of Tobacco and Health (PATH) Study is a U.S. national longitudinal study of tobacco use in the adult and youth civilian non-institutionalized population. We measured 20 VOCMs in urine specimens from a subsample of adults in Wave 1 (W1) (2013&ndash, 2014) to characterize VOC exposures among tobacco product users and non-users. We calculated weighted geometric means (GMs) and percentiles of each VOCM for exclusive combustible product users (smokers), exclusive electronic cigarette (e-cigarette) users, exclusive smokeless product users, and tobacco product never users. We produced linear regression models for six VOCMs with sex, age, race, and tobacco user group as predictor variables. Creatinine-ratioed levels of VOCMs from exposure to acrolein, crotonaldehyde, isoprene, acrylonitrile, and 1,3-butadiene were significantly higher in smokers than in never users. Small differences of VOCM levels among exclusive e-cigarette users and smokeless users were observed when compared to never users. Smokers showed higher VOCM concentrations than e-cigarette, smokeless, and never users. Urinary VOC metabolites are useful biomarkers of exposure to harmful VOCs.

Nitromethane is a known toxicant and suspected human carcinogen. Exposure to nitromethane in a representative sample of the civilian, noninstitutionalized population in the United States ≥12 years old was assessed using 2007-2012 National Health and Nutritional Examination Survey (NHANES) data. Nitromethane was detected in all 8000 human blood samples collected, of which 6730 were used for analyses reported here. Sample-weighted median blood nitromethane was higher among exclusive combusted tobacco users (exclusive smokers; 774 ng/L) than nonusers of tobacco products (625 ng/L). In stratified sample-weighted regression analysis, smoking 0.5 pack of cigarettes per day was associated with a statistically significant increase in blood nitromethane by 150 ng/L, and secondhand smoke exposure (serum cotinine0.05 ng/mL and10 ng/mL) was statistically significant with a 31.1 ng/L increase in blood nitromethane. Certain dietary sources were associated with small but statistically significant increases in blood nitromethane. At median consumption levels, blood nitromethane was associated with an increase of 7.55 ng/L (meat/poultry), 9.32 ng/L (grain products), and 14.5 ng/L (vegetables). This is the first assessment of the magnitude and relative source apportionment of nitromethane exposure in the U.S. population.

But the past does not exist independently from the present. Indeed, the past is only past because there is a present, just as I can point to something over there only because I am here.But nothing ...

Background Given the changing nature of infection prevention and control (IPC), appropriate infection preventionist (IP) staffing needs to be established. In this study, we aimed to describe current IP staffing levels and IPC department resources in U.S. acute care hospitals. Methods These data came from the 2015 MegaSurvey conducted by the Association of Professionals in Infection Prevention and Epidemiology. Descriptive statistics and bivariate analyses were conducted to examine differences in respondent, facility, and department characteristics by facility size (average inpatient census ≤100 vs >100). Results Data from 1623 respondents were included. Most (72%) had single-site responsibilities and dedicated 76%-100% of their job to IPC (68%). The overall median IP staffing was 1.25 IPs per 100 inpatient census (interquartile range = 1.81). Almost half (46%) represented facilities with daily inpatient census ≤100; the average number of IPs in these facilities was 1.1 (standard deviation = 0.7). The reported number of IPs increased steadily with higher patient census. Significant differences were observed in IP staffing, responsibilities, and support to the IPC department between smaller and larger hospitals. Conclusions This study represents the current snapshot of IP staffing and IPC resources in acute care hospitals. Findings indicate important differences between large and small facilities in staffing and IPC resources. The field of infection prevention would benefit from a comprehensive assessment of IPC department staffing and resource needs.

This pilot study examined feasibility of an unsupervised, facility-based exercise programme for promoting exercise adherence among depressed adult outpatients. The potential effect of adding physical activity counselling on depressive symptoms and physical activity was also explored. Participants were randomly assigned to a 12-week programme comprising an orientation and access to fitness centre resources (control, n = 18) or that programme plus 6 physical activity counselling sessions (intervention, n = 18). Outcome measures were feasibility (fitness centre attendance over 12 weeks); Beck Depression Inventory (BDI-II) and International Physical Activity Questionnaire (IPAQ) completed at baseline and week 12; and qualitative programme feedback. Fitness centre attendance averaged only 12 days (14% of all possible days) with no differences between study groups. No group differences were found on IPAQ or BDI-II scores at week 12. Increases from baseline in IPAQ moderate/vigorous activity minutes were associated with decreases in BDI-II scores at week 12 (p

Background : Ventilator-associated pneumonia (VAP) results in significant increases in both hospital stay and morbidity. A Level I Trauma Center focused attention on VAP prevention following a notable increase over a two-year period. The goal of this project was to implement a new oral care program for vented patients to decrease VAP rates. Methods : Surveillance for VAP was completed for patients at a Level 1 Trauma Center utilizing National Healthcare Safety Network pneumonia definition for critical care patients admitted from 2017 through September 2020. Infection Prevention performed a comprehensive review of ventilated patient care and VAP bundle prevention through staff interviews and shadowing of critical care nursing staff and respiratory therapists. The VAP rate was calculated by the number of VAP/ventilator days x 1000. Results : A comprehensive review of vented patients determined there was variability with oral care practices, including products, number of times oral care occurred per day and oral care documentation. The oral care bundle included (1) increase from Q6 oral care to Q4 oral care for all vented patients, (2) integration and standardization of new oral care products, (3) addition of twice daily chlorhexidine gluconate oral care for seven days post-extubation, (4) Oral Care Road Show entitled “Brush Pneumonia Away” to educate on the importance of oral care and the changes with the process and (5) ability for respiratory therapy to document on VAP bundle prevention including oral care. A 65% decrease in VAP rate occurred between 2018/2019 (9.69) and 2020 (3.31). Conclusions : Implementation of an oral care bundle in a Level I Trauma Center with a significant daily census of critically ventilated patients improved VAP rate. Oral care interventions have been recognized as an effective method in reducing the risk of VAP in critically ill patients.

Studies of human exposure to petroleum (crude oil and fuel) often involve monitoring volatile monoaromatic compounds because of their toxicity and prevalence. Monoaromatic compounds such as benzene, toluene, ethylbenzene, and xylenes (BTEX) associated with these sources have been well studied and have established reference concentrations (RfC) and reference doses (RfD). However, BTEX exposure levels for the general population are primarily from tobacco smoke, where smokers have blood levels up to 8 times higher on average than nonsmokers. Therefore, in assessing petroleum exposure, it is essential to identify exposure to tobacco smoke as well as other types of smoke exposure (e.g., cannabis, wood) because many smoke volatile organic compounds are also found in petroleum products such as crude oil, and fuel. This work describes a method using partition theory and artificial neural network (ANN) pattern recognition to accurately categorize exposure source based on BTEX and 2,5-dimethylfuran blood levels. For this evaluation three categories were created and include crude oil/fuel, other/nonsmoker, and smoker. A method for using surrogate signatures (i.e., relative VOC levels derived from the source material) to train the ANN was investigated where blood levels among cigarette smokers from the National Health and Nutrition Examination Survey (NHANES) were compared with signatures derived from machine-generated cigarette smoke. Use of surrogate signatures derived from machine-generated cigarette smoke did provide a sufficient means with which to train the ANN. As a result, surrogate signatures were used for assessing crude oil/fuel exposure because there is limited blood level data on individuals exposed to either crude oil or fuel. Classification agreement between using an ANN model trained with relative VOC levels and using the 2,5-dimethylfuran smoking biomarker cutpoint blood level of 0.014 ng/mL was up to 99.8 % for nonsmokers and 100.0% for smokers. For the NHANES 2007–08 data, the ANN model using a probability cutpoint above 0.5 assigned 7 samples out of 1998 (0.35%) to the crude oil/fuel signature category. For the NHANES 2013–14 data, 12 out of 2906 samples (0.41%) were assigned to the crude oil/fuel signature category. This approach using ANN makes it possible to quickly identify individuals with blood levels consistent with a crude oil/fuel surrogate among thousands of results while minimizing confounding from smoke. Use of an ANN fixed algorithm makes it possible to objectively compare across populations eliminating classification inconsistency that can result from relying on visual evaluation.

// Jordan M. Reese 1 , Elizabeth S. Bruinsma 2 , David G. Monroe 2 , Vivian Negron 3 , Vera J. Suman 4 , James N. Ingle 5 , Matthew P. Goetz 1,5 and John R. Hawse 2 1 Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA 2 Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA 3 Department of Pathology, Mayo Clinic, Rochester, MN, USA 4 Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA 5 Department of Oncology, Mayo Clinic, Rochester, MN, USA Correspondence to: John R. Hawse, email: // Keywords : TNBC, ERβ, cell cycle, CDK, estrogen Received : March 21, 2017 Accepted : September 16, 2017 Published : October 11, 2017 Abstract Triple negative breast cancer (TNBC), which comprises approximately 15% of all primary breast cancer diagnoses, lacks estrogen receptor alpha, progesterone receptor and human epidermal growth factor receptor 2 expression. However, we, and others, have demonstrated that approximately 30% of TNBCs express estrogen receptor beta (ERβ), a nuclear hormone receptor and potential drug target. Treatment of ERβ expressing MDA-MB-231 cells with estrogen or the ERβ selective agonist, LY500307, was shown to result in suppression of cell proliferation. This inhibitory effect was due to blockade of cell cycle progression. In vivo , estrogen treatment significantly repressed the growth of ERβ expressing MDA-MB-231 cell line xenografts . Gene expression studies and ingenuity pathway analysis identified a network of ERβ down-regulated genes involved in cell cycle progression including CDK1, cyclin B and cyclin H. siRNA mediated knockdown or drug inhibition of CDK1 and CDK7 in TNBC cells resulted in substantial decreases in proliferation regardless of ERβ expression. These data suggest that the tumor suppressive effects of ERβ in TNBC result from inhibition of cell cycle progression, effects that are in part mediated by suppression of CDK1/7. Furthermore, these data indicate that blockade of CDK1/7 activity in TNBC may be of therapeutic benefit, an area of study that has yet to be explored.

Background Nurses have historically occupied the infection preventionist (IP) role. As the knowledge and skills needed to advance the field expand, professionals from public health and the laboratory sciences have become IPs. Our study describes the characteristics of current IPs and assesses for relationships between background, certification, experience, and type of work performed. Methods The data were drawn from an existing dataset collected in the conduct of the Association for Professionals in Infection Control and Epidemiology (APIC) MegaSurvey. Descriptive statistics were computed. Associations were calculated using χ2 or Cochran-Mantel-Haenszel tests. Characteristics of IPs were stratified by work-related activities to allow for comparisons between groups. Results Of the 13,050 active APIC members, 4,079 participated in the survey (31% response rate). The primary job activity for nurses (97.9%; n = 2,434) was preventing and controlling the transmission of infectious agents or health care–associated infections, for laboratory scientists (97.5%; n = 307) it was the interpretation of surveillance data, and for public health professionals (96.1%; n = 136) it was management and communication: feedback. Conclusions Infection control departments would benefit from hiring IPs with diverse education and training to address the expanding roles and responsibilities of IPs. This may facilitate the implementation of novel and innovative processes that will impact patient care.

There are many models for sharing clinical-trial data. These investigators provide their viewpoint on why an open-data model has value over others.

Objectives While critical value procedures have been adopted in most areas of the clinical laboratory, their use in transfusion medicine has not been reviewed in detail. The results of this study present a comprehensive overview of critical value reporting and communication practices in transfusion medicine in the United States. Methods A web-based survey was developed to collect data on the prevalence of critical value procedures and practices of communicating results. The survey was distributed via email to US hospital-based blood banks. Results Of 123 facilities surveyed, 84 (68.3%) blood banks had a critical value procedure. From a panel of 23 common blood bank results, nine results were selected by more than 70% of facilities as either a critical value or requiring rapid communication as defined by an alternate procedure. Conclusions There was overlap among results communicated by facilities with and without a critical value procedure. The most frequently communicated results, such as incompatible crossmatch for RBC units issued uncrossmatched, delay in finding compatible blood due to a clinically significant antibody, and transfusion reaction evaluation suggestive of a serious adverse event, addressed scenarios associated with the leading reported causes of transfusion-related fatalities.

In the wake of the August 2012 fire at the Chevron refinery in Richmond, California, the United States (US) Chemical Safety Board proposed the safety case regulatory approach as an alternative to the current approach used in the US today. The current regulations known as the Process Safety Management (PSM) regulations were promulgated in 1992. This followed several highly publicized catastrophic incidents (e.g., Phillips 66 Pasadena, Texas polyethylene plant explosion, 1989; Piper Alpha, North Sea, 1988 and Bhopal, India, 1984). The US approach to regulation is best described as a combination of prescriptive and performance-based regulations that address safety considerations in design and operations. A safety case approach, as used in the United Kingdom (UK), Australia and Norway, requires a detailed analysis of hazards and steps taken to address those hazards, and thus minimize or mitigate the risk. Both the safety case and PSM processes address many of the same aspects such as management of change, identification of hazards and assessment of risks, but the process and format for documentation and regulatory review differs. The question then arises as to the effectiveness of these two regulatory regimes in preventing process safety related incidents. Many reputable organizations and research groups have taken positions regarding whether the US should abandon the existing system of safety regulations. Review of several global incidents has shown that while appropriate hazards and risks were identified, operational shortcomings led to incidents. Uniform and consistent process safety data are in the early stages of being collected and published by such organizations as the American Petroleum Institute (API) and The International Association of Oil & Gas Producers (OGP), using API RP 754 defined metrics. For this paper, data have been collected on oil and gas operations in the US, UK, Norway and Australia to compare the performance of the differing regulatory regimes. While the data are not comprehensive, from existing data on major incidents, spills and fatalities, one cannot conclude that one regulatory regime is superior to the other. Consistent reporting of incidents in a database with appropriate metrics is sorely needed. Furthermore, the authors express the need to move beyond regulatory compliance and suggest research on application of a systems approach to process safety by developing a process resilience analysis framework for process design and operations.

We implemented a cleaning process for mobile patient equipment (MPE) and determined its success using adenosine trisphosphate (ATP) monitoring and data feedback. Following education for staff and ATP data feedback, the data suggest that the MPE cleaning program we implemented was successful.

This article introduces artificial neural networks as a computational tool to utilize legacy archaeological data for precisely and accurately estimating dates of residential site occupation. The implementation of this deep learning algorithm can provide high-resolution demographic reconstructions of a study area from non-collection, non-invasive, and non-destructive data collection methods that only record frequencies of artifact types on the contemporary ground surface. The utility of this deep learning algorithm is presented through an example from the central Mesa Verde region in the northern US Southwest. Results show a properly trained artificial neural network predicts annual residential occupation with an average 92.8% accuracy from AD 450–1300. An annual demographic reconstruction of the central Mesa Verde region using occupation predictions from the artificial neural network is also presented.

Background: There is a need for improved tools to detect high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC) in patients with Barrett's esophagus. In previous work, we demonstrated that a 3-tier classifier predicted risk of incident progression in Barrett's esophagus. Our aim was to determine whether this risk classifier could detect a field effect in nondysplastic (ND), indefinite for dysplasia (IND), or low-grade dysplasia (LGD) biopsies from Barrett's esophagus patients with prevalent HGD/EAC. Methods: We performed a multi-institutional case–control study to evaluate a previously developed risk classifier that is based upon quantitative image features derived from 9 biomarkers and morphology, and predicts risk for HGD/EAC in Barrett's esophagus patients. The risk classifier was evaluated in ND, IND, and LGD biopsies from Barrett's esophagus patients diagnosed with HGD/EAC on repeat endoscopy (prevalent cases, n = 30, median time to HGD/EAC diagnosis 140.5 days) and nonprogressors (controls, n = 145, median HGD/EAC-free surveillance time 2,015 days). Results: The risk classifier stratified prevalent cases and non-progressor patients into low-, intermediate-, and high-risk classes [OR, 46.0; 95% confidence interval, 14.86-169 (high-risk vs. low-risk); P < 0.0001]. The classifier also provided independent prognostic information that outperformed the subspecialist and generalist diagnosis. Conclusions: A tissue systems pathology test better predicts prevalent HGD/EAC in Barrett's esophagus patients than pathologic variables. The results indicate that molecular and cellular changes associated with malignant transformation in Barrett's esophagus may be detectable as a field effect using the test. Impact: A tissue systems pathology test may provide an objective method to facilitate earlier identification of Barrett's esophagus patients requiring therapeutic intervention. Cancer Epidemiol Biomarkers Prev; 26(2); 240–8. ©2016 AACR.

Youth in the criminal justice system commonly suffer from multiple medical and psychological health problems. Because they likely live in lower socioeconomic environments, the medical care they receive through the justice system might be their only recent medical care and can result in the discovery of health problems or chronic illnesses that must be managed while in the system and beyond. We describe the case of an adolescent diagnosed with a serious chronic disease during his time in an urban detention center to illustrate how health workers and justice staff must use a team approach in caring for this vulnerable population of children. Barriers to appropriate care, including social and systems-level challenges, are discussed. The lessons learned in this case can be applied more broadly to other vulnerable youth populations, including those in foster care and impoverished communities where the primary care pediatrician (or other assigned pediatric specialist) is both the leader of the medical team and an advocate for quality care.

We developed Behaviorally Anchored Rating Scales (BARS) for measuring teaching practice, and compared them to the well-established Framework for Teaching (FfT; Danielson, 2013). BARS provide behavioral anchors delineating levels of performance via a set of behaviors. Our BARS focused on two dimensions of teaching, leading a classroom discussion and making content and practices explicit. We examined how a) rater agreement for BARS compares to rater agreement using the FfT, and b) how BARS and the FfT compare regarding perceived ease of use, perceived accuracy, and perceived advantages and disadvantages. Nineteen raters, who are users of the FfT and were trained to use BARS, independently evaluated video-taped teacher lessons using both methods. Rater agreement was higher for the FfT, which may, in part, be a factor of the raters' greater experience with that rating system. Nonetheless, raters reported that there are many aspects of BARS that are desirable.

Boundary-layer separation, a critical phenomenon in the operation of aerodynamic surfaces, limits the performance of compressor and turbine blades, fixed and rotary wings, as well as bluff bodies moving through a fluid. Flow separation leads to increased drag, decreased lift, and unpredictable vibrations due to unsteadiness. On these systems, effective control of separation could provide greater maneuverability and performance, and reduced vibration. Separated flow is a macroscale phenomenon governed by complex flow interactions, but it can be controlled by microscale actuation. Recently, the emergence of closed-loop methods has enhanced robustness. Modern processors enable the use of sophisticated adaptive control methods that achieve separation control with adaptive models. This paper considers control of flow separation over a NACA-0025 airfoil using microjet actuators. Experimental results are presented for a novel approach to nonlinear model predictive control, referred to as adaptive sampling-based ...

Background The National Healthcare Safety Network’s (NHSN) catheter-associated urinary tract infection (CAUTI) definition has changed multiple times in the previous decade with substantial changes occurring in 2009, 2013, and 2015. Efforts to improve the clinical relevance of this definition have been made, notably the exclusion of Candida species. This study quantifies the magnitude of discrepancy in CAUTI between the 2014 and 2015 definitions and determines which of these definitions has more clinical relevance. Methods This is a retrospective study at a 500 bed academic hospital. Eligible cases were identified by a query of our facility’s 2014 NHSN CAUTI cases. We reviewed cases to determine whether they met criteria for CAUTI using the 2014 and 2015 NHSN definitions and also to determine the clinical relevance of the CAUTI. Clinical CAUTI was defined as a provider documenting CAUTI in the progress notes or discharge summary. Subcategories of Clinical CAUTI included “Definite CAUTI”, the presence of UTI in clinical documentation without another documented etiology of fever, and “Possible CAUTI”, documentation of both UTI and another cause of fever. A positive urinalysis was defined as The presence of ≥10 WBC, moderate/large leukocyte esterase, or nitrites. Results There were 65 eligible CAUTI in 61 patients reported to NHSN in 2014. All met the 2014 definition, but only 38 (58%) met the 2015 definition. The median age was 57 years (IQR 51–67), and 54% (n = 33) were male. Clinical CAUTI was diagnosed in 44 patients (68%) meeting the 2014 definition and 33 patients (87%) meeting the 2015 definition (P < 0.001). Half of Clinical CAUTI identified by the 2014 definition were considered to be Definite CAUTI; similar results were found using the 2015 definition. Independent predictors of Clinical CAUTI included urine cultures positive for Gram-negative bacilli (OR 5.2, 95% CI 0.9 to 29.2), positive urinalysis (OR 7.1, 1.4 to 36.1), and use of the 2015 definition (OR 4.7, 0.9 to 23.4). Conclusion This data suggests that introduction of the 2015 definition may result in a 42% reduction in CAUTI. The 2015 definition was associated with more Clinical CAUTI. Further refinement of the 2015 CAUTI definition could be attained by excluding those cases attributed to other causes of fever. Disclosures All authors: No reported disclosures.

Blood-based methods for profiling tumor-sourced nucleic acids have become increasingly important in the diagnostic workup for cancer patients, particularly in non-small cell lung cancer (NSCLC). Blood-based assays address several limitations of tissue-based testing approaches such as inaccessible lesions, limited tissue, extended time to results, and invasive specimen collection procedures. Broad-profiling next-generation sequencing (NGS) methods are used to detect rare variants in blood samples. Here we describe the utility of a newly developed 52 gene NGS test, which uses the GeneStudio S5 Prime platform. We report on performance verification of the assay using contrived specimens as well as studies which evaluated clinical specimens at diagnosis and during monitoring. Thirty-eight cell-free nucleic acid (cfNA) specimens were evaluated from donors previously diagnosed with NSCLC. Specimens were collected in blood collection tubes containing preservatives (Streck cfDNA BCT) and shipped at ambient temperature to our central testing Laboratory. cfNA was isolated from plasma and reverse transcribed. The sequencing metrics for these studies included an average of 15 million mapped reads, 94.4% of on target reads, and a mean sequencing depth of 52,000. Additionally, the average molecular coverage was 2400 reads per amplicon with 99.9% uniformity at 500x coverage. Detected variants and their allelic frequencies were compared with reference results from a validated ddPCR method. Eleven variants (6 EGFR and 5 KRAS) were detected in the cohort with allele frequencies ranging from 0.90 - 96.16%. Results were highly concordant between the two methods (R2=0.992) with 90.3% sensitivity and 100% specificity. In addition, we present a case study to further demonstrate clinical utility of NGS for longitudinal monitoring over 540 days for clearance followed by re-emergence of EGFR positive cfNA harboring the EGFR C797S resistance mutation. These studies add to the growing body of knowledge supporting the utility of molecular detection for actionable and emerging biomarkers in liquid biopsy. Citation Format: Jordan Reese, Victoria Maxwell, Leisa Jackson, Gary Pestano, Hestia S. Mellert. Utility of a new targeted next generation sequencing test for liquid biopsy samples from patients with NSCLC [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3101.

Background Foley catheter (FC) insertions in the Emergency Department (ED) create inherit infectious and non-infectious risks to patients due to the chaotic environment. Numerous FCs are placed in the ED due to convenience, lack of patient diagnosis and urgency. The objective of this study was to reduce the amount of FCs that are inserted in the ED, by utilizing a multidisciplinary team to implement practice changes based on real time data. Methods A cross-sectional study was performed from January 2018 – November 2019 in a Level I Trauma hospital. A multidisciplinary team including Infection Prevention (IP), Clinical Data Analytics and ED leadership developed a dashboard to determine FC insertions in the ED/1000 patients and common indications for Foley placement in the ED. Additionally, every FC that was placed in the ED was reviewed by IP and ED leadership for appropriateness. Any FC that were deemed inappropriate were then discussed with physicians and staff. Weekly and monthly reports were reviewed with ED leaders for trends. The number of FC insertions in the ED/1000 patient days in the pre-intervention period (January 2018 – December 2018) was compared to post-intervention (January 2019 – November 2019). A T-test was used to determine statistically significant change. Results A 22% reduction of FC insertions in the ED occurred between the pre- and post-intervention. During the pre-intervention period, the FC insertion rate was 11.62 FC insertions /1000 patients compared to 9.33 during the post intervention period (p Conclusions An engaged ED staff and clinical data analytics team were able to reduce risk to patients by decreasing FC insertions in the ED. Next steps will be to determine non-infectious poor outcomes to further reduce FC insertions in the ED.

Background Hand hygiene (HH) is the number one intervention to prevent hospital-associated infections. Accurate HH data is challenging to collect for multiple reasons including biased data collection, inconsistent training, and the Hawthorne effect. Inaccurate HH data makes it difficult for the Infection Preventionist to enact meaningful change for the facility to increase HH compliance. In a Level I Trauma Center, secret shoppers did not receive standardized HH data collection education and were frequently trained by the trainer. The objective of this study was to evaluate HH compliance before and after standardized education. Methods A pre-post study was utilized in a Level I Trauma Center to evaluate reported HH compliance before and after standardized education of secret shoppers. Infection Prevention trained a leader and at least one HH champion from each unit or ancillary service between March and May 2019. Any champion who continued to report high HH compliance were shadowed to determine the cause of their over-reporting to reduce bias in reporting. The 5 months of HH compliance pre- and post- intervention were compared utilizing a t-test. Results A total of 91 HH champions from 41 departments attended the standardized education. The average HH compliance was 97.5% (n = 1212) in the pre-intervention period compared to 75.9% (n = 2575) in the post-intervention period (p Conclusions Standardized education and bias follow-up significantly reduced over reporting of HH compliance. By moving to a standardized education model, Infection Preventionists collected more accurate HH data to better understand opportunities in their facility. With access to more accurate data, Infection Prevention will start to assess gaps in HH practices to improve compliance.

Prehistoric water management in the northern US Southwest was integral to successful subsistence. On the Mesa Verde cuesta in southwestern Colorado, several types of water management features have been identified in the archaeological record, but research into these features has typically focused on the efficacy of reservoirs—a large-scale, labor-intensive, and community-oriented means of collecting and storing water. This focus on large-scale water management features has largely ignored the productive potential of small-scale and low-cost strategies for water management executed by individual households. There is considerable evidence, for example, that extensive check dam networks were constructed and used on the Mesa Verde cuesta, but their actual utility as a small-scale risk-aversion strategy to resource stress has not systematically been explored. This paper identifies all ephemeral drainages on the Mesa Verde cuesta where check dam construction was possible, then applies a maize growing niche model to estimate total yields from check dam farming plots for each year from AD 890–1285. A demographic reconstruction is then used to estimate the percentage of the total cuesta population that could have been supported using only check dam maize yields through time. Results suggest that check dam farming could have supplied a reliable source of surplus annual maize sufficient for household storage needs even during the most populous time periods across the cuesta landscape.

Triple-negative breast cancer (TNBC) accounts for a disproportionately high number of deaths due to a lack of targeted therapies and an increased likelihood of distant recurrence. Estrogen receptor beta (ERβ), a well-characterized tumor suppressor, is expressed in 30% of TNBCs, and its expression is associated with improved patient outcomes. We demonstrate that therapeutic activation of ERβ elicits potent anticancer effects in TNBC through the induction of a family of secreted proteins known as the cystatins, which function to inhibit canonical TGFβ signaling and suppress metastatic phenotypes both in vitro and in vivo. These data reveal the involvement of cystatins in suppressing breast cancer progression and highlight the value of ERβ-targeted therapies for the treatment of TNBC patients.

Random vibration under preload is important in multiple endeavors, including those involving launch and re-entry. In these days of increasing reliance on predictive simulation, it is important to address this problem in a probabilistic manner – this is the appropriate flavor of quantification of margin and uncertainty in the context of random vibration. One of the quantities of particular interest in design is the probability distribution of von Mises stress. There are some methods in the literature that begin to address this problem, but they generally are extremely restricted and astonishingly, the most common restriction of these techniques is that they assume zero mean loads. The work presented here employs modal tools to suggest an approach for estimating the probability distributions for von Mises stress of a linear structure for the case of multiple independent Gaussian random loadings combined with a nonzero pre-load.

Strong human genetic evidence points to an essential contribution of the voltage-gated sodium channel Nav1.7 to pain sensation: loss of Nav1.7 function leads to congenital insensitivity to pain, whereas gain-of-function mutations in theSCN9Agene that encodes Nav1.7 cause painful neuropathies, such as inherited erythromelalgia, a syndrome characterized by episodic spontaneous pain. Selective Nav1.7 channel blockers thus hold promise as potential painkillers with improved safety and reduced unwanted side effects compared with existing therapeutics. To determine the maximum effect of a theoretically perfectly selective Nav1.7 inhibitor, we generated a tamoxifen-inducible KO mouse model enabling genetic deletion of Nav1.7 from adult mice. Electrophysiological recordings of sensory neurons from these mice following tamoxifen injection demonstrated the loss of Nav1.7 channel current and the resulting decrease in neuronal excitability of small-diameter neurons. We found that behavioral responses to most, but surprisingly not all, modalities of noxious stimulus are abolished following adult deletion of Nav1.7, pointing toward indications where Nav1.7 blockade should be efficacious. Furthermore, we demonstrate that isoform-selective acylsulfonamide Nav1.7 inhibitors show robust analgesic and antinociceptive activity acutely after a single dose in mouse pain models shown to be Nav1.7-dependent. All experiments were done with both male and female mice. Collectively, these data expand the depth of knowledge surrounding Nav1.7 biology as it relates to pain, and provide preclinical proof of efficacy that lays a clear path toward translation for the therapeutic use of Nav1.7-selective inhibitors in humans.SIGNIFICANCE STATEMENTLoss-of-function mutations in the sodium channel Nav1.7 cause congenital insensitivity to pain in humans, making Nav1.7 a top target for novel pain drugs. Targeting Nav1.7 selectively has been challenging, however, in part due to uncertainties in which rodent pain models are dependent on Nav1.7. We have developed and characterized an adult-onset Nav1.7 KO mouse model that allows us to determine the expected effects of a theoretically perfect Nav1.7 blocker. Importantly, many commonly used pain models, such as mechanical allodynia after nerve injury, appear to not be dependent on Nav1.7 in the adult. By defining which models are Nav1.7 dependent, we demonstrate that selective Nav1.7 inhibitors can approximate the effects of genetic loss of function, which previously has not been directly established.

Highlights • We detected an outbreak of nosocomial human rhinovirus C in our neonatal intensive care unit. • Although the outbreak only consisted of 2 cases, it emphasizes the importance of hand hygiene in a neonatal intensive care unit to prevent the spread of infectious diseases to a susceptible population. • Laboratory techniques, such as respiratory panel polymerase chain reaction, improve the efficiency of test results, allowing clinicians the ability to detect outbreaks and detect them earlier., Nosocomial respiratory infections cause significant morbidity and mortality, especially among the extremely susceptible neonatal population. Human rhinovirus C is a common viral respiratory illness that causes significant complications in children

Introduction Sedation and analgesia in the intensive care unit (ICU) for patients with sepsis can be challenging. Opioids and benzodiazepines can lower blood pressure and decrease respiratory drive. Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist that provides both amnesia and analgesia without depressing respiratory drive or blood pressure. The purpose of this pilot study was to assess the effect of ketamine on the vasopressor requirement in adult patients with septic shock requiring mechanical ventilation. Materials and Methods We conducted a two-phase study in a multi-disciplinary adult ICU at a tertiary medical center. The first phase was a retrospective chart review of patients admitted with septic shock between July 2010 and July 2011; 29 patients were identified for a historical control group. The second phase was a prospective, non-randomized, open-label pilot study. Patients were eligible for inclusion if they were 18-89 yr of age with a diagnosis of septic shock, who also required mechanical ventilation for at least 24 h, concomitant sedation, and vasopressor therapy. Pregnant patients, patients in the peri-operative timeframe, and patients with acute coronary syndrome were excluded. Patients enrolled in the phase two pilot study received ketamine as the primary sedative. Ketamine was administered as a 1-2 mg/kg IV bolus, then as a continuous infusion starting at 5 mcg/kg/min, titrated 2 mcg/kg/min every 30 min as needed to obtain a Richmond Agitation Sedation Scale (RASS) goal of -1 to -2. If continuous sedation was still required after 48 h, patients were transitioned off ketamine and sedative strategy reverted to usual ICU sedation protocol. The primary outcome was the dose of vasopressor required at 24, 48, 72 and 96 h after enrollment. Secondary outcomes included cumulative ketamine dose, additional sedative and analgesics used, cumulative sedative and analgesic dosing at all time periods, corticosteroid use, days of mechanical ventilation, ICU LOS, hospital LOS, and mortality. Contiguous data were analyzed with unpaired t-tests and categorical data were analyzed with two-tailed, Fisher's exact test. This study was approved by our Institutional Review Board. Results From January 2012 to April 2015, a total of 17 patients were enrolled. Patient characteristics were similar in the control and study group. Ketamine was discontinued in one patient due to agitation at 36 h. There was a trend towards decreased norepinephrine and vasopressin use in the study group at all time periods. Regarding secondary outcomes, the study group received less additional analgesia with fentanyl at 24 and 48 h (p < 0.001), and less additional sedation with lorazepam, midazolam or dexmedetomidine at 24 h (p = 0.015). Conclusion This pilot study demonstrated a trend towards decreased vasopressor dose, and decreased benzodiazepine and opiate use when ketamine is used as the sole sedative. The limitations to our study include a small sample size and those inherent in using a retrospective control group. Our findings should be further explored in a large, randomized prospective study.

International audience; Particle identification at radioactive ion beam facilities requires Time-of-Flight detectors with an optimal time resolution and high rate capability. Segmented plastic scintillators are a common option for such detectors. A promising approach to cope with the high segmentation of modern devices is the use of silicon photomultipliers (SiPMs) as readout of the Time-of-Flight detectors. A prototype device consisting of strips of plastic scintillator of 4.4 × 100 × 1 mm 3 readout at both ends by SiPMs of two different sizes was tested using a 124 Xe beam at 600 MeV/nucleon. Timing and time-over-threshold information were extracted. The time resolution of the prototype was found to vary with the applied voltage and the SiPM size. After optimizing the voltage, resolutions of 14.3(10) ps and 10.4(1) ps were obtained for SiPMs of 1 × 1 mm 2 and 3 × 3 mm 2 respectively. These results point to SiPMs being suitable as readout of plastic scintillators at radioactive ion beam facilities.

Objectives The research examined the efficacy of regional volumes of thigh ratios assessed by stereovision body imaging (SBI) as a predictor of visceral adipose tissue measured by magnetic resonance imaging (MRI). Body measurements obtained via SBI also were utilized to explore disparities of body size and shape in men and women. Method One hundred twenty-one participants were measured for total/regional body volumes and ratios via SBI and abdominal subcutaneous and visceral adipose tissue areas by MRI. Results Thigh to torso and thigh to abdomen-hip volume ratios were the most reliable parameters to predict the accumulation of visceral adipose tissue depots compared to other body measurements. Thigh volume in relation to torso [odds ratios (OR) 0.44] and abdomen-hip (OR 0.41) volumes were negatively associated with increased risks of greater visceral adipose tissue depots, even after controlling for age, gender, and body mass index (BMI). Irrespective of BMI classification, men exhibited greater total body (80.95L vs. 72.41L), torso (39.26L vs. 34.13L), and abdomen-hip (29.01L vs. 25.85L) volumes than women. Women had higher thigh volumes (4.93L vs. 3.99L) and lower-body volume ratios [thigh to total body (0.07 vs. 0.05), thigh to torso (0.15 vs. 0.11), and thigh to abdomen-hip (0.20 vs. 0.15); P