Notes

Correction: Antimalarial drug level of resistance molecular marker pens associated with Plasmodium falciparum isolates through Sudan throughout 2015-2017.
10/19 (53%) participants adhered to guidelines of performing a CT chest within 24h of surgery. 10/26 (38%) participants believe their patients are experiencing longer hospital admissions in the COVID-19 setting.

This snap shot survey highlights the dramatic variations in CR cancer surgery practice within the UK and inconsistent adherence to protocols. Guidelines will no doubt change as our knowledge of COVID-19 increases both nationally and internationally. It is essential CR surgeons keep up to date with changes in guidance, so uniformity in practice can be maintained.
This snap shot survey highlights the dramatic variations in CR cancer surgery practice within the UK and inconsistent adherence to protocols. Guidelines will no doubt change as our knowledge of COVID-19 increases both nationally and internationally. It is essential CR surgeons keep up to date with changes in guidance, so uniformity in practice can be maintained.The SARS-CoV-2 virus was first registered in Brazil by the end of February 2020. Since then, the country counts over 150000 deaths due to COVID-19 and faces a profound social and economic crisis; there is also an ongoing health catastrophe, with the majority of hospital beds in many Brazilian cities currently occupied with COVID-19 patients. Thus, a Nonlinear Model Predictive Control (NMPC) scheme used to plan appropriate social distancing measures (and relaxations) in order to mitigate the effects of this pandemic is formulated in this paper. The strategy is designed upon an adapted data-driven Susceptible-Infected-Recovered-Deceased (SIRD) model, which includes time-varying auto-regressive immunological parameters. A novel identification procedure is proposed, composed of analytical regressions, Least-Squares optimization and auto-regressive model fits. The adapted SIRD model is validated with real data and able to adequately represent the contagion curves over large forecast horizons. The NMPC strategy is designed to generate piecewise constant quarantine guidelines, which can be reassessed (relaxed/strengthened) each week. Simulation results show that the proposed NMPC technique is able to mitigate the number of infections and progressively loosen social distancing measures. With respect to a "no-control" condition, the number of deaths could be reduced in up to 30% if the proposed NMPC coordinated health policy measures are enacted.Three novel methods, named α, ζ and ϵ, are suggested in this paper to recover the performance loss during switching in the gas turbine control systems. The Minimum Command Selection (MCS) in the gas turbine control systems prompts this performance loss. Any step towards more productivity with less aging factors have a great impact on the gas turbine's lifetime profit and vice versa. Although many hardware upgrades have been studied and applied to accomplish this, in many cases a low-risk manipulation in the software may yield equivalent achievement. State of the art gas turbine control systems are supposed to handle various forms of disturbances, several operation modes and relatively high transients of the gas turbines. The proposed methods dynamically limit the inactive control loop command and utilize the corresponding loop error to optimally switch the loops. The optimality infers a fuzzy choice based on the designated performance criteria. They demonstrate enhanced performance in comparison with conventional techniques such as static or dynamic saturation proportion to active command, integrator fast rewind, and PI tracking mode. An identified model of W251-B2 gas turbine with robust controllers is exploited to evaluate the empirical authenticity. They exhibit superior performance in comparison with traditional MCS and decrease the over-temperature around 9oC[2%], as the load control switches to the temperature control. The proposed methods provide pragmatic and promising tools in the designer's hands to adapt the methods based on the application requirements.
To investigate the feasibility of using CD4 + T cells genetically modified to express an allo-HLA directed CAR and FOXP3 to suppress T cell proliferation and cytokine secretion in GvHD.

Human CD4+ T cells from A*0201 negative donors were transduced to express A*02 CAR and FOXP3 and co-cultured in mixed lymphocyte reaction assays to demonstrate T cell suppression. A*02- CAR/FOXP CD4+ T cells were then injected into mice engrafted with allogeneic T cells in a GvHD mouse model.

CD4+ T cells genetically modified to express allo-HLA-directed CAR and FOXP3 proliferate rapidly, downregulate CD127 and interferon-γ, express high CD25 and Helios and convert to a stable antigen-dependent suppressive phenotype. In mixed lymphocyte reaction assays, these cells potently suppressed T-cell proliferation and secreted IL-10. In a graft-versus-host disease model, A*02-CAR/FOXP3 CD4+ T cells outperformed polyclonal Tregs by reducing liver and lung inflammation, inhibiting pro-inflammatory cytokine production and limiting grafted CD3+ T-cell expansion.

CD4 + T cells expressing allo-antigen directed HLA-specific CAR and FOXP3 act as potent, specific and stable suppressors of inflammation that out-perform their Treg counterparts both in vitro and in vivo.
CD4 + T cells expressing allo-antigen directed HLA-specific CAR and FOXP3 act as potent, specific and stable suppressors of inflammation that out-perform their Treg counterparts both in vitro and in vivo.
This study examined the impact of geographic distance on survival outcomes for patients receiving treatment for ovarian cancer at the only NCI-designated cancer center (NCI-CC) in Kansas.

We identified ovarian cancer patients treated at the University of Kansas Cancer Center between 2010 and 2015. Demographic factors and clinical characteristics were abstracted. The main outcome measure was overall survival according to geographic distance from the institution. Kaplan Meier survival curves and Cox proportional hazard models were generated using SAS v9.4.

220 patients were identified. Survival analysis based on distance from the institution demonstrated that patients who lived ≤10 miles from the institution had worse overall survival (p=0.0207) and were more likely to have suboptimal cytoreductive surgery (p=0.0276). Lower estimated median income was also associated with a 1.54 increased risk of death, 95% CI (1.031-2.292), p=0.0347.

We determined that ovarian cancer survival disparities exist in our patient population. Lower rates of optimal cytoreductive surgery has been identified as a possible driver of poor prognosis for patients who lived in proximity to our institution.
We determined that ovarian cancer survival disparities exist in our patient population. Lower rates of optimal cytoreductive surgery has been identified as a possible driver of poor prognosis for patients who lived in proximity to our institution.
Racial disparities in surgical outcomes exist for Black patients with IBD compared to White patients. However, previous studies fail to include other racial/ethnic populations. We hypothesized these disparities exist for Hispanic and Asian patients.

This is a retrospective cohort study of patients undergoing surgery for IBD using the American College of Surgeons National Surgical Quality Improvement Program (ACS- NSQIP) database (2005-2017). Bivariate comparisons and adjusted multivariable regressions were performed to evaluate associations between race and outcomes.

Of 23,901 patients with IBD, the racial/ethnic makeup were 88.7% White, 7.6% Black, 2.4% Hispanic and 1.4% Asian. Overall mean LOS was 8 days (SD 8.2) and significantly varied between groups (8d for White, 10d for Black, 8.5d for Hispanic, and 11.1d for Asian; p<0.001). Hispanic patients had the highest odds of readmission (OR 1.4; 95% CI 1.1-1.8). Black patients had increased odds of renal insufficiency (OR 1.8; 95% CI 1.1-2.9), bleeding requiring transfusions (OR 1.7; 95% CI 1.4-1.9), and sepsis (OR 1.7; 95% CI 1.4-2.02) compared to White patients.

Racial disparities exist among IBD patients undergoing surgery. Black, Hispanic and Asian IBD patients experience major disparities in post-operative complications, readmissions and LOS, respectively, when compared to White patients with IBD. Future research is needed to better understand the mechanisms of these disparities including evaluation of social determinants of health.
Racial disparities exist among IBD patients undergoing surgery. Black, Hispanic and Asian IBD patients experience major disparities in post-operative complications, readmissions and LOS, respectively, when compared to White patients with IBD. Future research is needed to better understand the mechanisms of these disparities including evaluation of social determinants of health.
Travel distance to surgical cancer care is increasing. The relationship between increased travel distance and receipt of surgical cancer care in the United States is not well characterized.

A systematic review of studies examining travel distance and receipt of surgery for adult patients in the United States was performed. Literature searches were conducted using PubMed and EMBASE.

Seven studies were included. Only one found lower likelihood of surgery with increasing travel distance. Three studies, all based on hospital-based data, found that increased travel distance was associated with a higher likelihood of receiving surgery. Two studies found no association and one study had mixed findings.

We were unable to identify a consistent relationship between travel distance and receipt of surgery. Our results highlight the need for additional research examining how increasing travel distance impacts receipt of surgical cancer care.
We were unable to identify a consistent relationship between travel distance and receipt of surgery. Our results highlight the need for additional research examining how increasing travel distance impacts receipt of surgical cancer care.
Self-assessment is critical to professional self-regulation yet many trainees may not reliably self-evaluate. We examine the gap between resident and faculty perceptions of trainee operative performance and contributing factors.

Surgery resident and faculty evaluations of trainee performance were collected from 14 academic institutions using smartphone-based performance assessments. Differences in resident/faculty ratings evaluating the same procedure were analyzed using descriptive statistics and Bayesian mixed models.

Of 7382 evaluations, 46% trainees and faculty performance ratings were discrepant (r=0.47), with 80% residents rating themselves lower than faculty in those cases. This gap existed regardless of case complexity and widened as trainees gained experience. Trainees who overrated themselves had the lowest mean performance scores from faculty.

Half of residents perceived their performance differently from faculty, and this difference widened for senior residents. Future focus should be to provide opportunity for trainees to improve skills to reliably assess themselves before graduation.
Half of residents perceived their performance differently from faculty, and this difference widened for senior residents. Future focus should be to provide opportunity for trainees to improve skills to reliably assess themselves before graduation.
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