Tracking Program Research Articles

The University of Chicago Clinical Excellence Scholars Track: Aligning Dynamic Students With Innovative Programming in Early Medical Education at the Undergraduate Level.

The Clinical Excellence Scholars Track was developed in 2012 as a shared initiative between the Bucksbaum Institute for Clinical Excellence, the University of Chicago (UChicago) Careers in Healthcare office, and the UChicago Medicine Office of Community and External Affairs. The goal of the Clinical Excellence Scholars Track is to foster an understanding of the physician career and the doctor-patient relationship for a select group of undergraduate students. The Clinical Excellence Scholars Track achieves this goal through carefully tailored curricular requirements and direct mentoring experiences between Bucksbaum Institute Faculty Scholars and the student scholars. After participating in the Clinical Excellence Scholars Track program, student scholars report that their career understanding and preparation have benefitted as a result and that they meet with success in the medical school application process as well.

“Zero to Hero”: Creating an Innovative Approach to Track Program Outcomes in Graduate Nursing

“Zero to Hero”: Creating an Innovative Approach to Track Program Outcomes in Graduate Nursing

AnimalTA: A highly flexible and easy‐to‐use program for tracking and analysing animal movement in different environments

Abstract Computer programs for video tracking of animal movement are evolving increasingly efficient, using complex algorithms or artificial intelligence systems. Despite the consequent progress in this field, researchers still face some fundamental problems in the use of such programs. For example, the best‐performing programs are often uneasy to use, and user‐friendly programs require source videos recorded under strict conditions (e.g. homogenous environments, constant lighting and high resolution), which may be difficult to meet in both laboratory and field studies. We present here AnimalTA, a new program that tracks and analyses animal movement in diverse environments. This program aims to be accessible to everyone, including those without knowledge of coding and image analysis. AnimalTA allows to process rapidly a high number of videos and manage multi‐arena tracking. It is adapted to follow the movement of targets in variable conditions, including heterogenous and complex environments, or in low‐quality videos. AnimalTA provides tools for editing videos and correcting problems caused by camera tremors, light changes or perspective deformation. AnimalTA also allows the user to easily correct tracking errors and repeat the tracking in a subsample of the video. The target's identity can be personalized to facilitate video analysis. The tracking results can be analysed in AnimalTA to obtain many different variables related to the trajectory of each target, such as average speed, total distance travelled, latency to reach defined areas, distance to a defined point, distance to other individuals, number of contacts with others, explored surface, among others. Users can set and control different parameters for these analyses and directly view the results.

Practice Pattern Variation in Adoption of New and Evolving Percutaneous Coronary Intervention Procedures.

Assess factors contributing to variation in the use of new and evolving diagnostic and interventional procedures for percutaneous coronary intervention (PCI). Evidence-based practices for PCI have the potential to improve outcomes but are variably adopted. Finding possible drivers of PCI procedure-use variability is key for efforts aimed at establishing more uniform practice. Veterans Affairs Clinical Assessment, Reporting, and Tracking Program data were used to estimate a proportion of variation attributable to hospital-, operator-, and patient-level factors across (a) radial arterial access, (b) intravascular imaging/optical coherence tomography, and (c) atherectomy for PCI. We used random-effects models with hospital, operator, and patient random effects. Overlap between levels generated cumulative variability estimates greater than 100%. A total of 445 operators performed 95,391 PCI procedures across 73 hospitals from 2011 to 2018. The rates of all procedures increased over this time. 24.45% of variability in the use of radial access was attributable to the hospital, 53.04% to the operator, and 57.83% to patient-level characteristics. 9.06% of the variability in intravascular imaging use was attributable to the hospital, 43.92% to the operator, and 21.20% to the patient. Lastly, 20.16% of the variability in use of atherectomy was attributed to the hospital, 34.63% to the operator, and 57.50% to the patient. The use of radial access, intracoronary imaging, and atherectomy is influenced by patient, operator, and hospital factors, but patient and operator-level effects predominate. Efforts to increase the use of evidence-based practices for PCI should consider interventions at these levels.

Fast Track Protocols and Early Rehabilitation after Surgery in Total Hip Arthroplasty: A Narrative Review.

The Enhanced Recovery After Surgery (ERAS) or Fast Track is defined as a multi-disciplinary, peri- and post-operative approach finalized to reduce surgical stress and simplify post-operative recovery. It has been introduced more than 20 years ago by Khelet to improve outcomes in general surgery. Fast Track is adapted to the patient's condition and improves traditional rehabilitation methods using evidence-based practices. Fast Track programs have been introduced into total hip arthroplasty (THA) surgery, with a reduction in post-operative length of stay, shorter convalescence, and rapid functional recovery without increased morbidity and mortality. We have divided Fast Track into three cores: pre-, intra-, and post-operative. For the first, we analyzed the standards of patient selection, for the second the anesthesiologic and intraoperative protocols, for the third the possible complications and the appropriate postoperative management. This narrative review aims to present the current status of THA Fast Track surgery research, implementation, and perspectives for further improvements. By implementing the ERAS protocol in the THA setting, an increase in patient satisfaction can be obtained while retaining safety and improving clinical outcomes.

Timeliness and completeness of weekly surveillance data reporting on epidemic prone diseases in Uganda, 2020–2021

IntroductionDisease surveillance provides vital data for disease prevention and control programs. Incomplete and untimely data are common challenges in planning, monitoring, and evaluation of health sector performance, and health service delivery. Weekly surveillance data are sent from health facilities using mobile tracking (mTRAC) program, and synchronized into the District Health Information Software version 2 (DHIS2). The data are then merged into district, regional, and national level datasets. We described the completeness and timeliness of weekly surveillance data reporting on epidemic prone diseases in Uganda, 2020–2021.MethodsWe abstracted data on completeness and timeliness of weekly reporting of epidemic-prone diseases from 146 districts of Uganda from the DHIS2.Timeliness is the proportion of all expected weekly reports that were submitted to DHIS2 by 12:00pm Monday of the following week. Completeness is the proportion of all expected weekly reports that were completely filled and submitted to DHIS2 by 12:00pm Wednesday of the following week. We determined the proportions and trends of completeness and timeliness of reporting at national level by year, health region, district, health facility level, and facility ownership.ResultsNational average reporting timeliness and completeness was 44% and 70% in 2020, and 49% and 75% in 2021. Eight of the 15 health regions achieved the target for completeness of ≥ 80%; Lango attained the highest (93%) in 2020, and Karamoja attained 96% in 2021. None of the regions achieved the timeliness target of ≥ 80% in either 2020 or 2021. Kampala District had the lowest completeness (38% and 32% in 2020 and 2021, respectively) and the lowest timeliness (19% in both 2020 and 2021). Referral hospitals and private owned health facilities did not attain any of the targets, and had the poorest reporting rates throughout 2020 and 2021.ConclusionWeekly surveillance reporting on epidemic prone diseases improved modestly over time, but timeliness of reporting was poor. Further investigations to identify barriers to reporting timeliness for surveillance data are needed to address the variations in reporting.

MP59-20 ARE ALL FELLOWSHIPS CREATED EQUAL? VARIATION IN PROSTATE ENUCLEATION CASE VOLUMES DURING ENDOUROLOGY FELLOWSHIPS

You have accessJournal of UrologyCME1 Apr 2023MP59-20 ARE ALL FELLOWSHIPS CREATED EQUAL? VARIATION IN PROSTATE ENUCLEATION CASE VOLUMES DURING ENDOUROLOGY FELLOWSHIPS Garrett Ungerer, Reza Roshandel, Aaron Potretzke, MN Rochester, Li-Ming Su, and Kevin Koo Garrett UngererGarrett Ungerer More articles by this author , Reza RoshandelReza Roshandel More articles by this author , Aaron PotretzkeAaron Potretzke More articles by this author , MN RochesterMN Rochester More articles by this author , Li-Ming SuLi-Ming Su More articles by this author , and Kevin KooKevin Koo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003312.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is growing interest in training opportunities that offer proficiency in enucleation procedures for BPH, which offers considerable advantages when treating large volume prostate glands. With an estimated learning curve of 25 cases, many trainees seek out fellowships to become proficient. We aimed to characterize variation in surgical training experience in prostate enucleation during endourology fellowships. METHODS: We analyzed surgical case logs submitted to the Endourological Society for all graduating fellows in 2020-2022. Case logs were cross-referenced with a list of verified fellowship graduates to ensure accuracy. Based on contemporary training literature, we defined the threshold for technical proficiency as 25 enucleation procedures. RESULTS: Case logs for 131 certified endourology fellows were analyzed. 48 (37%) fellows in 29 fellowship programs reported performing at least 1 prostate enucleation case during fellowship (Figure 1). The average number of cases performed was 52 (range 1-334). 8 (17%) of fellows were women, corresponding to 112 of 2503 (4%) enucleation cases. 26 of the 29 (90%) programs offering enucleation training were based in the United States. The average number of cases performed in a 2-year fellowship was 98 cases, compared to 27 cases in 1-year programs. 23 (48%) of fellows met the minimum threshold of 25 cases during fellowship to reach proficiency (dotted line in Figure 1). Among different fellowship tracks, 2-year stone track fellowships offered the largest volume of enucleations, averaging 145 cases per fellow, compared to 38 cases for 1-year stone track programs, 30 cases for 2-year combined stone/robotics track programs, and 7 cases for 1 year robotics track programs. No enucleations were reported at 2-year robotics track programs. CONCLUSIONS: There is substantial variation in enucleation case volumes between fellows and institutions. Roughly half of fellows who performed enucleation cases surpassed the proficiency threshold of 25 cases. Expanding advanced training for BPH including enucleation may help improve access to care for this disease. Source of Funding: None to report © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e816 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Garrett Ungerer More articles by this author Reza Roshandel More articles by this author Aaron Potretzke More articles by this author MN Rochester More articles by this author Li-Ming Su More articles by this author Kevin Koo More articles by this author Expand All Advertisement PDF downloadLoading ...

The ACGME Framework for Medically Underserved Areas and Populations and Graduate Medical Education

The ACGME Framework for Medically Underserved Areas and Populations and Graduate Medical Education

Association Between Magnetic Resonance Imaging Findings and Time to Return to Sport After Muscle Injuries in High-Level Youth Athletes.

To describe the relationship between magnetic resonance imaging (MRI) findings and time to return to sport (RTS) from muscle injuries in youth athletes. Prospective collection of injury surveillance data over 6 seasons (2014-2015 to 2019-2020) and reanalysis of MRIs by a radiologist blinded to RTS time after the data collection period. National sports academy and sports medicine hospital. Male youth (11-19 years) athletes participating in the football (soccer) or athletics (track and field) programs with a muscle injury. Magnetic resonance imaging findings (eg, grade and location) in time-loss muscle injuries. Injury incidence, distributions, and RTS time. In total, 353 time-loss muscle injuries were recorded for 1089 athlete-seasons, of which 85 satisfied our inclusion criteria (MRI within 14 days). Return to sport time was significantly longer for reinjuries compared with index injuries. Associations between MRI findings and RTS time were specific to the muscle group, with significant differences in RTS time observed between categories of structure, location, and grade. The largest number of injuries was to the hamstrings (n = 46), where injuries involving the tendon were more severe than those involving the myotendinous junction and muscle, proximal injuries were more severe than mid-portion and distal, and longer RTS time was observed for higher injury grade ( P < 0.05). Muscle injuries in youth are diverse and cannot be treated as a single injury type. Specific injury durations can be expected depending on injury characteristics such as reinjury, location, structure, and grade.

Dynamic virtual assistance of I/O functionalities

With significant advancements being witnessed in the engineering industry daily, it has become increasingly vital for society to seek out particular new ways of interacting with computer technology and automation as their demand grows in society. Today, every device is developing the use of touch screen technology on its computer systems, although it is not cost-effective to use in all applications. A specialized system, similar to a virtual device, that provides object pursuit (tracking) and Gestures to let us engage; it might be an effective alternative to the standard touch screen and also the solid physical gadgets. The goal is to create an object pursuit (tracking) program that communicates with the computer system. This proposed model is a computer vision-based control system that involves hand movements taken from a digital camera via a hand detection technique implemented with OpenCV libraries. Our project applies gesture recognition as a topic that comes under two computer science fields augmented reality and human-computer interaction and we have created a virtual gesture system to elucidate human gestures through mathematical algorithms. Users can use simple finger or hand gestures to control or interact with the system without physically touching them and also included voice assistance to start and end the gesture controlling system. Gesture recognition can be viewed as a way for computers to begin to recognize human body language and signs, thus stuffing the void between computing systems and humans than the earliest text user interfaces or even graphical user interfaces, which still limit the majority of input to keyboard and mouse are may not be very efficient at all times. The algorithm is focused on deep learning for detecting the gestures. Hence, the proposed system will avoid the pandemic situation of COVID-19 spread by reducing the human interaction with the devices to control the system

Accuracy of the maxillomandibular relationship at centric relation position recorded by using 3 different intraoral scanners with or without an optical jaw tracking system: An in vivo pilot study

PurposeTo measure the accuracy (trueness and precision) of the maxillomandibular relationship at centric relation position recorded by using 3 different intraoral scanners with or without an optical jaw tracking system. Material and methodsA completely dentate volunteer was selected. Seven groups were generated: conventional procedure (control group), 3 IOSs: Trios4 (Trios4 group), Itero Element 5D Plus (Itero group), i700 (i700 group), and 3 groups with a jaw tracking system for each corresponding IOS system (Modjaw-Trios4, Modjaw-iTero, and Modjaw-i700 groups) (n = 10). In the control group, casts were mounted on an articulator (Panadent) using a face bow and a CR record captured with the Kois deprogrammer (KD). The casts were digitized by using a scanner (T710) (control files). In the Trios4 group, intraoral scans were obtained by using the corresponding IOS and duplicated 10 times. The KD was used to obtain a bilateral occlusal record at CR position. These same procedures were followed for the Itero and i700 groups. In the Modjaw-Trios 4 group, the intraoral scans acquired by using the corresponding IOS at MIP were imported into the jaw tracking program. The KD was used to record the CR relationship. For acquiring the specimens in the Modjaw-Itero and Modjaw-i700 groups, the same procedures were followed as in the Modjaw-Trios4 group, with the scans obtained with the Itero and i700 scanners respectively. The articulated virtual casts of each group were exported. Thirty-six inter-landmark linear measurements were used to calculate the discrepancies between the control and experimental scans. The data were analyzed by using 2-way ANOVA followed the pairwise comparison Tukey tests (α=0.05). ResultsSignificant trueness and precision discrepancies were found among the groups tested (P<.001). The Modjaw-i700, Modjaw-iTero, Modjaw-Trios4, and i700 groups obtained the best trueness and precision among the groups tested, and the iTero and Trios4 groups obtained the worst trueness. The iTero group obtained the worst precision among the groups tested (P>.05). ConclusionsThe maxillomandibular relationship recorded was influenced by the technique selected. Except for the i700 IOS system, the optical jaw tracking system tested improved the trueness value of the maxillomandibular relationship recorded at CR position when compared with the corresponding IOS.

Improving State Government's Responsiveness to Family Planning Interventions in Nigeria Using an Innovative Reflection and Action Tool.

The Challenge Initiative (TCI) works with state governments in Nigeria to scale high-impact family planning and reproductive health (FP/RH) interventions rapidly and sustainably. The Reflection and Action to Improve Self-reliance and Effectiveness (RAISE) tool is an innovative responsive feedback (RF) mechanism developed by TCI to periodically monitor governments' readiness to sustain implementation of their FP/RH interventions. The RAISE tool-a facilitated, self-administered tool used quarterly to track program improvements, identify gaps, and provide feedback-contains FP/RH progress indicators across 4 pillars: political and financial commitment, government capacity, institutionalization, and sustained demand. As a maturity matrix that helps state governments to understand the extent of their self-reliance in leadership and program management, the tool measures the stages of capacity: "beginning" (54% and below), "developing" (55-69%), "expanding" (70-84%), and "mature" (85% and above). Participants self-administer the tool with a trained government facilitator, develop a remediation plan with timelines and responsible persons assigned to address identified gaps, and communicate the plan to the broader FP/RH program team. Thirteen supported states have completed 5 rounds of assessments between June 2020 and September 2022. Baseline results revealed that 4 states were at the developing stage, 8 were at the expanding stage, and 1 had a mature program. The most recent assessment revealed mature capacity for 9 states while the 4 others are in the expanding stage. Consequently, all the states demonstrated improved government self-reliance over the course of the year. To ensure objectivity, RAISE participants, who include government policymakers, program managers, and implementers, use available government data sources to complement assessment findings. As an RF mechanism, the RAISE tool contributed to governments' enhanced leadership and management of their FP/RH programs, with current considerations for modifications to serve other primary health care programs.

Effective Techniques for Protecting the Privacy of Web Users

With the rapid growth of web networks, the security and privacy of online users are becoming more compromised. Especially, the use of third-party services to track users’ activities and improve website performance. Therefore, it is unavoidable that using personal information to create unique profiles may violate individuals’ privacy. Recently, several tools have been developed such as anonymity, anti-tracking, and browser plugins to ensure the protection of users from third-party tracking methods by blocking JavaScript programs and other website components. However, the current state lacks an efficient approach that provides a comprehensive solution. In this paper, we conducted a systematic analysis of the most common privacy protection tools based on their accuracy and performance by evaluating their effectiveness in correctly classifying tracking and functional JavaScript programs, then evaluating the estimated time the browser takes to render the pages for each tool. To achieve this, we automatically browsed the most 50 websites determined in 2022 and categorized them according to different fields to get the in-page (as part of HTML script tags), and all external JavaScript programs. Then we collected data and datasets of 1578 JavaScript elements and obtained six diverse Firefox profiles when the tools were enabled. The results found that Ghostery has the highest percentage of allowing most functioning scripts with the lowest average error rate (AER). While at the same time NoScript achieved the highest percentage of blocking most tracking scripts since it is the highest blocker of third-party services. After that, we examined the speed of the browser finding that, Ghostery improved the load time by 36.2% faster than the baseline, while Privacy Badger only reduced the load time by 7.1%. We believe that our findings can help users decide on a privacy tool that meets their needs. Moreover, researchers and developers can use our findings to improve the privacy of internet users by designing more effective privacy protection techniques.

Numerical simulation of two-phase evaporation and condensation

The evaporation and condensation mechanism of two-phase flow is studied. The Euler-Euler pattern is used to express the evaporation and condensation properties of two-phase flow. The research shows that the tracking program can accurately track the interface. The thermal resistance on the confluence of the condensation part and insulation part becomes larger. The working fluids have significant influence of two-phase.

Abstract P139: Behavioral Weight Loss Programs for Cancer Survivors: A Non-Randomized Clinical Trial

Background: Clinical trials for weight loss in cancer survivors have been shown to be safe and effective. Pragmatic approaches are needed to facilitate broader adoption. The ASPIRE study evaluates real-world, lifestyle weight loss programs in Maryland on reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) outcomes. Here we report 6-month data on weight change. Methods: Participants were adults with overweight or obesity, who had a history of solid malignant tumors and completed curative intent treatment. The exclusion criteria were minimized to increase generalizability. Participants self-selected 1 of 3 programs: the Self-Directed (SD) Program provided evidence-based, written materials; the App-Directed (AD) Program additionally provided a commercially available, free smartphone app and weekly diet and exercise tips; and the Coach-Directed (CD) Program additionally included 1-on-1 telephonic coaching. SD and AD had versions with and without weight tracking; CD required weight tracking. Weights were transmitted to the study team using cellular technology with the scales provided and collected at baseline, 3, 6, and 12 months. Results: 5,644 cancer survivors were invited, mostly via electronic health records; 9% expressed interest. Of these, 67% enrolled (total n=340; n=240 in weight tracking programs; 54% black, 74% women.) Participants in CD were younger, more likely to be women, less likely to have bachelor’s degree, and weighed more than those in SD. At 6m, weights were obtained from 97.5% of participants. Within-program weight reduction was most significant in CD. In the adjusted mixed-effects models, compared with SD participants, CD participants achieved significant weight reduction (see Table) Conclusion: Remotely delivered weight loss programs are desirable and can be broad- reach. Intervention with remote coaching was effective. While selected by many participants, app-directed program with weight tracking but without coaching led to small weight reduction.

Clinical Characteristics and Outcomes Among People Living With HIV Undergoing Percutaneous Coronary Intervention: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.

Background Clinical characteristics and outcomes in people living with HIV (PLWH) undergoing percutaneous coronary intervention (PCI) remain poorly described. We sought to compare real-world treatment of coronary artery disease, as well as patient and procedural factors and outcomes after PCI between PLWH and uninfected controls. Methods and Results We utilized procedural registry data from the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program between January 1, 2009 and December 31, 2019 to analyze patients with obstructive coronary artery disease on angiography. In the PCI subgroup, we used inverse probability of treatment weighting and applied Cox proportional hazards to evaluate the association of HIV serostatus with outcomes, including all-cause mortality at 5 years. Among 184 310 patients with obstructive coronary artery disease, treatment strategy was similar between PLWH and controls-35.7% versus 34.2% PCI, 13.6% versus 15% coronary artery bypass grafting, and 50.7% versus 50.8% medical therapy. The PCI cohort consisted of 546 (0.9%) PLWH and 56 811 (99.1%) controls. PLWH undergoing PCI had well-controlled HIV disease, and compared with controls, were younger, more likely to be Black, had fewer traditional risk factors, more acute coronary syndrome, less extensive coronary artery disease, and similar types of stents and P2Y12 therapy. However, PLWH experienced worse survival as early as 6 months post-PCI, which persisted over time and amounted to a 21% increased mortality risk by 5 years (hazard ratio, 1.21 [95% CI, 1.03-1.42; P=0.02]). Conclusions Despite well-controlled HIV disease, a more favorable overall cardiovascular risk profile, and similar PCI procedural metrics, PLWH still have significantly worse long-term survival following PCI than controls.

Implementasi Algoritma Correlation Tracker Untuk Sistem Pencarian Objek Menggunakan Library DLIB

Object tracking is a process to determine and follow the position of a desired moving object using a camera in real time. There are various algorithms in making object tracking systems, one of which is the correlation tracker algorithm in the DLIB library. This object tracking system uses Raspberry Pi 4 which contains a python program for object tracking. Pi Camera is used as a realtime video image input. The results of using the correlation tracker algorithm in the DLIB library, namely the object tracking process can run well. There are 5 objects that are tracked and as a result the tracking box is always around the object, whether the object is moving left, right, forward, and backward. As the object moves back and forth, the scale on the tracking box may change according to the object's size. Performance on the Raspberry Pi can be seen from the video framerate of 10.5 fps.

Rural Internal Medicine Residencies: Models, Facilitators, Barriers, and Equity Considerations.

Rural communities in the USA on average experience higher mortality rates and greater physician shortages than urban communities, especially rural communities that are historically Black, American Indian, and Alaska Native. Graduate medical education resources in the USA are concentrated within teaching hospitals in non-rural settings. The federal government has recently established several pathways to expand rural graduate medical education. In the 2010s, most of the expansion and innovation in rural graduate medical education occurred in family medicine. In the 2020s, internal medicine has also begun to increase its rural graduate medical education footprint. Rural internal medicine residency training models include Rural Track Programs (RTPs), in which training is split between urban and rural training sites. RTPs, though the cornerstone of rural residency expansion in family medicine, raise complex issues in internal medicine. We review the structure of RTPs, alternate rural residency training pathways, and the facilitators and challenges of each pathway with respect to internal medicine training.

Contemporary Management Before Chronic Total Occlusion Percutaneous Coronary Interventions: Insights From the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.

Guidelines recommend maximal antianginal medical therapy before attempted coronary artery chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The degree to which this occurs in contemporary practice is unknown. We aimed to characterize the frequency and variability of preprocedural use of antianginal therapy and stress testing within 3 months before PCI of CTO (CTO PCI) across a nationally integrated health care system. We identified patients who underwent attempted CTO PCI from January 2012 to September 2018 within the Veterans Affairs Healthcare System. Patients were categorized by management before CTO PCI: presence of ≥2 antianginals, stress testing, and ≥2 antianginals and stress testing within 3 months of PCI attempt. Multivariable logistic regression and inverse propensity weighting were used for adjustment before trimming, with median odds ratios calculated for variability estimates. Among 4250 patients undergoing attempted CTO PCI, 40% received ≥2 antianginal medications and 24% underwent preprocedural stress testing. The odds of antianginal therapy with more than one medication before CTO PCI did not change over the years of the study (odds ratio [OR], 1.0 [95% CI, 0.97-1.04]), whereas the odds of undergoing preprocedural stress testing decreased (OR, 0.97 [95% CI, 0.93-0.99]), and the odds of antianginal therapy with ≥2 antianginals and stress testing did not change (OR, 0.98 [95% CI, 0.93-1.04]). Median odds ratios (MOR) showed substantial variability in antianginal therapy across hospital sites (MOR, 1.3 [95% CI, 1.26-1.42]) and operators (MOR, 1.35 [95% CI, 1.26-1.63]). Similarly, preprocedural stress testing varied significantly by site (MOR, 1.68 [95% CI, 1.58-1.81]) and operator (MOR, 1.80 [95% CI, 1.56-2.38]). Just under half of patients received guideline-recommended management before CTO PCI, with significant site and operator variability. These findings suggest an opportunity to reduce variability in management before CTO PCI.

Fully Geant4 compatible package for the simulation of Dark Matter in fixed target experiments

A package for the simulation of Dark Matter (DM) particles is presented. It is intended for fixed target experiments. We chose the Geant4 toolkit framework as a standard in order to be compatible with particle tracking programs used in many High Energy Physics (HEP) experiments. One part of the package is a collection of codes that return the cross sections of DM particles’ production in such processes as electron and muon bremsstrahlung off nuclei, annihilation in flight and Primakoff processes. In most cases they are calculated at runtime. In the case of bremsstrahlung processes the total cross sections are either calculated numerically at exact tree level (ETL) or calculated at runtime using approximations validated by comparing with results of the ETL calculations. Other parts contain codes for the simulation of the above mentioned processes and DM particle classes.