Currently, the rationale for selecting and trying out therapeutic regimens for thymomas is the efficacy of these treatments for other cancers. The identification of nonproliferation-associated druggable target genes may enable selection and trials of appropriate therapies, paving a path towards personalized medicine. In conclusion, we have developed and validated a nine-gene prognostic assay that serves as an independent predictor of MFS and appears superior to currently-used prognosticators such as Masaoka stage and histology. The current study provides a useful template for the efficient application of genetic expression data for the patient’s benefit, especially in rare diseases. First, many patients with recently diagnosed CDI are seen in outpatient clinics after discharge from healthcare facilities. Second, patients with CDI often continue to shed spores after their diarrhea resolves. Current guidelines do not recommend that special precautions be taken when caring for CDI patients whose diarrhea has resolved. Finally, environmental disinfection is often suboptimal in inpatient settings, and may be even less ideal in outpatient settings with frequent patient turnover. The goal of this study was to 
test the hypothesis that patients with recent CDI are an underappreciated source of C. difficile transmission in outpatient settings. We prospectively examined the frequency of and risk factors for skin contamination and environmental shedding of spores by CDI patients at the time of outpatient clinic visits. A clinical prediction rule was derived to provide a tool to predict those patients with recent CDI presenting the greatest risk for transmission. To further assess contamination in this setting, we examined the point-prevalence of contamination of high-touch surfaces in multiple outpatient clinics and emergency departments. Finally, we determined the frequency of prior outpatient visits in all patients with community-associated CDI in our facility during a 3-year period. A separate sterile glove was used to contact each culture site. To assess environmental shedding, high-touch surfaces including the examination chair arm rest, examination table, and telephone and computer keyboard in the physician work area were cultured similarly using gloved hand prints both before the provider entered the room but after collection of perirectal and skin cultures and again after completion of the outpatient visit. Patients with positive environmental cultures prior to the provider interaction were excluded from the analysis. Our study provides support for the hypothesis that the outpatient healthcare setting may be an underappreciated source of community-associated CDI cases. First, we found that 81% of CDI patients discharged from the hospital had 1 or more outpatient clinic visits within 12 weeks after discharge. About onethird of these patients presented a risk for transmission based on acquisition of spores on investigators hands.