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Aim Precancer identification of women with hereditary breast and ovarian cancer (HBOC) could prevent 20% of these ovarian cancers. The objective was to determine whether standardized Facing Our Risk of Cancer Empowered (FORCE) materials are acceptable, improve knowledge of HBOC and increase disclosure to family members. Methods A prospective cohort of women with breast or ovarian cancer was identified prior to genetic testing. Subjects completed a baseline knowledge survey and were provided three communication aids. Knowledge, acceptability and communication to family members were reassessed at 6 months and compared to a retrospective cohort who had undergone genetic testing for breast or ovarian cancer prior to the intervention. The primary outcome was increase in HBOC knowledge, requiring 20 pre‐ and postknowledge scores to detect a 10% difference. Results Forty women were enrolled. The median age at cancer diagnosis was 50 years and 55% had a family history of breast or ovarian cancer. Though subjects found the resources acceptable, knowledge scores did not improve after their use. Disclosure rates were of no different between cohorts (83% preintervention vs 77% postintervention, P = 0.26) though there was an increase in deleterious mutation carriers, 0% (0/6) preintervention vs 100% (22/22) postintervention. Rates of subsequent testing in relatives were low in both preintervention and postintervention cohorts (0% vs 4.5%). Conclusion Inclusion of standardized communication tools is acceptable to patients. Knowledge did not improve after their use. In deleterious mutation carriers, disclosure rates increased postintervention.

Premise plumbing conditions can contribute to low chlorine or chloramine disinfectant residuals and reactions that encourage opportunistic pathogen growth and create risk of Legionnaires’ Disease outbreaks. This bench-scale study investigated the growth of Legionella spp. and Acanthamoeba in direct contact with premise plumbing materials—glass-only control, cross-linked polyethylene (PEX) pipe, magnesium anode rods, iron pipe, iron oxide, pH 10, or a combination of factors. Simulated glass water heaters (SGWHs) were colonized by Legionella pneumophila and exposed to a sequence of 0, 0.1, 0.25, and 0.5 mg/L chlorine or chloramine, at two levels of total organic carbon (TOC), over 8 weeks. Legionella pneumophila thrived in the presence of the magnesium anode by itself and or combination with other factors. In most cases, 0.5 mg/L Cl2 caused a significant rapid reduction of L. pneumophila, Legionella spp., or total bacteria (16S rRNA) gene copy numbers, but at higher TOC (>1.0 mg C/L), a chlorine residual of 0.5 mg/L Cl2 was not effective. Notably, Acanthamoeba was not significantly reduced by the 0.5 mg/L chlorine dose.

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Introduction: Systemic Arterial Pulsatility Index, (SAPi), [systemic pulse pressure/left ventricular end diastolic pressure (LVEDP)] has emerged as a useful prognostic tool in many cardiac diseases. We aimed to compare this hemodynamically derived index of pulsatility with directly measured pulsatility on gated CT imaging (SAPi-CT) in pre-TAVR patients, as well as with SAPi calculated from pre-TAVR transthoracic echocardiography (SAPi-TTE). We also evaluated the correlation of each of these measurements with the patients’ pre-TAVR 5-meter walk times (5MWT). Methods: The three SAPi were calculated as; SAPi-Cath using invasive hemodynamics, SAPi-TTE using the Nagueh formula (PCWP = 1.24 X (E/e’) +1.9) as surrogate for LVEDP, and SAPi-CT by calculating the difference in aortic cross-sectional area during systole and diastole on gated CT imaging at the level of the ascending aorta (the level of right pulmonary artery). Correlational comparisons of these methods with each other and with pre-TAVR 5MWT were made using R software. Results: Among 110 patients studied (mean age 77.3, 56% female), the mean SAPi-Cath, SAPi-TTE, and cross-sectional area on CT were 3.15, 3.03, and 53.83mm 2 respectively. There was a significant positive correlation between SAPi-Cath and SAPi-CT [(r=0.275, p=0.0073); shown in Figure 1a], but not between SAPi-Cath and SAPi-TTE (r=0.163, p=0.1852). SAPI-Cath was significantly associated 5MWT (r=0.287, p=0.0064); shown in Figure 1b. Using a linear regression, the relationship between SAPi-Cath and the 5MWT is estimated to be: 5MWT=4+SAPI. SAPi-CT did not correlate with 5MWT (r=0.021, p=0.8478). Conclusions: SAPi-Cath and SAPi-CT showed a significant positive correlation. Only SAPi-Cath showed a significant correlation with 5MWT. Given the known prognostic value of SAPi-Cath, future studies utilizing imaging variables should be performed to enhance prognostication with multi-modal data.