A comprehensive call center supporting safe, efficient operations during a pandemic

Research has shown that a comprehensive call center can support a safe, efficient, and quality experience for patients and their families. When a patient receives a cancer diagnosis, the stakes are already high. Add a pandemic to an immunocompromised patient population and fear escalates. In order to accommodate the ever-changing information and ease patients’ anxieties surrounding their cancer diagnoses, it is necessary that an institution be available 24/7 to inform, help navigate systems, and manage symptoms because the emergency room, and many times the clinics, have too many inherent risks. MD Anderson expanded the hours of operation for askMDAnderson, a comprehensive call center staffed by operators, health information specialists, registered nurses, and advance practice providers, to cater to all the needs, and to support safe and efficient operations during the pandemic. This highly skilled team serves as a critical information link to patients and their loved ones for all transitions in care needs, such as guidance on food delivery, parking, medication renewals and side effect management. The askMDAnderson staff educates our stakeholders about MD Anderson services, programs, treatments and clinical trials during and after the pandemic until we return to the new normal. Our employees are available for all levels of “hand holding” and provide a constant flow of timely, factual information. In this case study, you will learn how MD Anderson expanded this newly evolving system and how our team’s efforts led to a safer, more efficient, less expensive, and more satisfying care experiences for patients and their families. Experience Framework This article is associated with the Infrastructure & Governance lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Kinematic Evidence of Minor Mergers in Normal Sa Galaxies: NGC3626, NGC3900, NGC4772 and NGC5854

BVRI and H-alpha imaging and long-slit optical spectroscopic data are presented for four morphologically normal and relatively isolated Sa galaxies, NGC3626, NGC3900, NGC4772 and NGC5854. VLA HI synthesis imaging is presented for the first 3 objects. In all 4 galaxies, evidence of kinematic decoupling of ionized gas components is found; the degree and circumstances of the distinct kinematics vary from complete counterrotation of all of the gas from all of the stars (NGC3626) to nuclear gas disks decoupled from the stars (NGC5854) to anomalous velocity central gas components (NGC3900 and NGC4772). In the 3 objects mapped in HI, the neutral gas extends far beyond the optical radius, R_HI/R_25 > 2. In general, the HI surface density is very low and the outer HI is patchy and asymmetric or found in a distinct ring, exterior to the optical edge. While the overall HI velocity fields are dominated by circular motions, strong warps are suggested in the outer regions. Optical imaging is also presented for NGC 4138 previously reported by Jore et al. (1996) to show counterrotating stellar components. The multiwavelength evidence is interpreted in terms of the kinematic "memory" of past minor mergers in objects that otherwise exhibit no morphological signs of interaction.Comment: 26 pages, 15 figures, accepted for publication in Astron. J., postscript figures available at ftp://culebra.tn.cornell.edu/pub/haynes/figures.tar.g

Threats to seabirds: A global assessment

We present the first objective quantitative assessment of the threats to all 359 species of seabirds, identify the main challenges facing them, and outline priority actions for their conservation. We applied the standardised Threats Classification Scheme developed for the IUCN Red List to objectively assess threats to each species and analysed the data according to global IUCN threat status, taxonomic group, and primary foraging habitat (coastal or pelagic). The top three threats to seabirds in terms of number of species affected and average impact are: invasive alien species, affecting 165 species across all the most threatened groups; bycatch in fisheries, affecting fewer species (100) but with the greatest average impact; and climate change/severe weather, affecting 96 species. Overfishing, hunting/trapping and disturbance were also identified as major threats to seabirds. Reversing the top three threats alone would benefit two-thirds of all species and c. 380 million individual seabirds (c. 45% of the total global seabird population). Most seabirds (c. 70%), especially globally threatened species, face multiple threats. For albatrosses, petrels and penguins in particular (the three most threatened groups of seabirds), it is essential to tackle both terrestrial and marine threats to reverse declines. As the negative effects of climate change are harder to mitigate, it is vital to compensate by addressing other major threats that often affect the same species, such as invasive alien species, bycatch and overfishing, for which proven solutions exist

Satellite galaxies in groups in the CIELO Project I: Gas removal from galaxies and its re-distribution in the intragroup medium

We study the impact of the environment on galaxies as they fall in and orbit in the potential well of a Local Group (LG) analogue, following them with high cadence. The analysis is performed on eight disc satellite galaxies from the CIELO suite of hydrodynamical simulations. All galaxies have stellar masses within the range [10 8.1 -109.56 ] M⊙h-1. We measure tidal torques, ram pressure, and specific star formation rates (sSFRs) as a function of time, and correlate them with the amount of gas lost by satellites along their orbits. Stronger removal episodes occur when the disc plane is oriented perpendicular to the direction of motion. More than one peripassage is required to significantly modify the orientations of the discs with respect to the orbital plane. The gas removed during the interaction with the central galaxies may also be found opposite to the direction of motion, depending on the orbital configuration. Satellites are not totally quenched when the galaxies reach their first peripassage and continue forming about 10 per cent of the final stellar mass after this event. The fraction of removed gas is found to be the product of the joint action of tidal torque and ram pressure, which can also trigger new star formation activity and subsequent supernova feedback.Fil: Rodríguez Moncada, Silvio Ribamar. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; ArgentinaFil: Garcia Lambas, Diego Rodolfo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; Argentina. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba; ArgentinaFil: Padilla, Nelson David. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Astronomía Teórica y Experimental. Universidad Nacional de Córdoba. Observatorio Astronómico de Córdoba. Instituto de Astronomía Teórica y Experimental; ArgentinaFil: Tissera, P.. Pontificia Universidad Católica de Chile; ChileFil: Bignone, Lucas Axel. Consejo Nacional de Investigaciónes Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Astronomía y Física del Espacio. - Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Astronomía y Física del Espacio; ArgentinaFil: Dominguez Tenreiro, Rosa. Pontificia Universidad Católica de Chile; ChileFil: Gonzalez, R.. Pontificia Universidad Católica de Chile; ChileFil: Pedrosa, Susana Elizabeth. Consejo Nacional de Investigaciónes Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Astronomía y Física del Espacio. - Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Astronomía y Física del Espacio; Argentin

Spectroscopic Classification of 42 LMC OB Stars: Selection of Probes for the Hot Gaseous Halo of the LMC

Interstellar C IV absorption line studies of the hot gaseous halo of the Large Magellanic Cloud (LMC) have been hindered by non-ideal selections of early-type probe stars in regions where C+3 can be produced locally via photoionization, fast stellar winds, or supernovae. To observe stars outside such regions, precise spectral classifications of OB stars in the field are needed. Therefore, we have obtained medium-dispersion spectra of 42 early-type stars in the LMC that are distributed outside superbubbles or supergiant shells. The spectral classification of these stars is presented in this paper. Nineteen of these program stars have spectral types between B1 and O7, and are thus suitable probes for interstellar C IV absorption line studies of the hot gaseous halo of the LMC.Comment: To be published in PASP, 11 pages, 6 figures, and 3 table

Central GIP signaling stimulates peripheral GIP release and promotes insulin and pancreatic polypeptide secretion in nonhuman primates

Glucose-dependent insulinotropic polypeptide (GIP) has important actions on whole body metabolic function. GIP and its receptor are also present in the central nervous system and have been linked to neurotrophic actions. Metabolic effects of central nervous system GIP signaling have not been reported. We investigated whether centrally administered GIP could increase peripheral plasma GIP concentrations and influence the metabolic response to a mixed macronutrient meal in nonhuman primates. An infusion and sampling system was developed to enable continuous intracerebroventricular (ICV) infusions with serial venous sampling in conscious nonhuman primates. Male baboons (Papio sp.) that were healthy and had normal body weights (28.9 ± 2.1 kg) were studied (n = 3). Animals were randomized to receive continuous ICV infusions of GIP (20 pmol·kg−1·h−1) or vehicle before and over the course of a 300-min mixed meal test (15 kcal/kg, 1.5g glucose/kg) on two occasions. A significant increase in plasma GIP concentration was observed under ICV GIP infusion (66.5 ± 8.0 vs. 680.6 ± 412.8 pg/ml, P = 0.04) before administration of the mixed meal. Increases in postprandial, but not fasted, insulin (P = 0.01) and pancreatic polypeptide (P = 0.04) were also observed under ICV GIP. Effects of ICV GIP on fasted or postprandial glucagon, glucose, triglyceride, and free fatty acids were not observed. Our data demonstrate that central GIP signaling can promote increased plasma GIP concentrations independent of nutrient stimulation and increase insulin and pancreatic polypeptide responses to a mixed meal

Unified Topological Inference for Brain Networks in Temporal Lobe Epilepsy Using the Wasserstein Distance

Persistent homology can extract hidden topological signals present in brain networks. Persistent homology summarizes the changes of topological structures over multiple different scales called filtrations. Doing so detect hidden topological signals that persist over multiple scales. However, a key obstacle of applying persistent homology to brain network studies has always been the lack of coherent statistical inference framework. To address this problem, we present a unified topological inference framework based on the Wasserstein distance. Our approach has no explicit models and distributional assumptions. The inference is performed in a completely data driven fashion. The method is applied to the resting-state functional magnetic resonance images (rs-fMRI) of the temporal lobe epilepsy patients collected at two different sites: University of Wisconsin-Madison and the Medical College of Wisconsin. However, the topological method is robust to variations due to sex and acquisition, and thus there is no need to account for sex and site as categorical nuisance covariates. We are able to localize brain regions that contribute the most to topological differences. We made MATLAB package available at https://github.com/laplcebeltrami/dynamicTDA that was used to perform all the analysis in this study

Potential ecological and socio-economic effects of a novel megaherbivore introduction: the hippopotamus in Colombia

Introduced species can have strong ecological, social and economic effects on their non-native environment. Introductions of megafaunal species are rare and may contribute to rewilding efforts, but they may also have pronounced socio-ecological effects because of their scale of influence. A recent introduction of the hippopotamus Hippopotamus amphibius into Colombia is a novel introduction of a megaherbivore onto a new continent, and raises questions about the future dynamics of the socio-ecological system into which it has been introduced. Here we synthesize current knowledge about the Colombian hippopotamus population, review the literature on the species to predict potential ecological and socio-economic effects of this introduction, and make recommendations for future study. Hippopotamuses can have high population growth rates (7–11%) and, on the current trajectory, we predict there could be 400–800 individuals in Colombia by 2050. The hippopotamus is an ecosystem engineer that can have profound effects on terrestrial and aquatic environments and could therefore affect the native biodiversity of the Magdalena River basin. Hippopotamuses are also aggressive and may pose a threat to the many inhabitants of the region who rely upon the Magdalena River for their livelihoods, although the species could provide economic benefits through tourism. Further research is needed to quantify the current and future size and distribution of this hippopotamus population and to predict the likely ecological, social and economic effects. This knowledge must be balanced with consideration of social and cultural concerns to develop appropriate management strategies for this novel introduction

Transplantation of canine olfactory ensheathing cells producing chondroitinase ABC promotes chondroitin sulphate proteoglycan digestion and axonal sprouting following spinal cord injury

Olfactory ensheathing cell (OEC) transplantation is a promising strategy for treating spinal cord injury (SCI), as has been demonstrated in experimental SCI models and naturally occurring SCI in dogs. However, the presence of chondroitin sulphate proteoglycans within the extracellular matrix of the glial scar can inhibit efficient axonal repair and limit the therapeutic potential of OECs. Here we have used lentiviral vectors to genetically modify canine OECs to continuously deliver mammalian chondroitinase ABC at the lesion site in order to degrade the inhibitory chondroitin sulphate proteoglycans in a rodent model of spinal cord injury. We demonstrate that these chondroitinase producing canine OECs survived at 4 weeks following transplantation into the spinal cord lesion and effectively digested chondroitin sulphate proteoglycans at the site of injury. There was evidence of sprouting within the corticospinal tract rostral to the lesion and an increase in the number of corticospinal axons caudal to the lesion, suggestive of axonal regeneration. Our results indicate that delivery of the chondroitinase enzyme can be achieved with the genetically modified OECs to increase axon growth following SCI. The combination of these two promising approaches is a potential strategy for promoting neural regeneration following SCI in veterinary practice and human patients

Integral analysis of environmental and economic performance of combined agricultural intensification & bioenergy production in the Orinoquia region

Agricultural intensification is a key strategy to help meet increasing demand for food and bioenergy. It has the potential to reduce direct and indirect land use change (LUC) and associated environmental impacts while contributing to a favorable economic performance of the agriculture sector. We conduct an integral analysis of environmental and economic impacts of LUC from projected agricultural intensification and bioenergy production in the Orinoquia region in 2030. We compare three agricultural intensification scenarios (low, medium, high) and a reference scenario, which assumes a business-as-usual development of agricultural production. The results show that with current inefficient management or with only very little intensification between 26% and 93% of the existing natural vegetation areas will be converted to agricultural land to meet increasing food demand. This results in the loss of biodiversity by 53% and increased water consumption by 111%. In the medium and high scenarios, the intensification allows meeting increased food demand within current agricultural lands and even generating surplus land which can be used to produce bioenergy crops. This results in the reduction of biodiversity loss by 8-13% with medium and high levels of intensification compared to the situation in 2018. Also, a positive economic performance is observed, stemming primarily from intensification of cattle production and additional energy crop production. Despite increasing irrigation efficiency in more intensive production systems, the water demand for perennial crops and cattle production over the dry season increases significantly, thus sustainable management practices that target efficient water use are needed. Agricultural productivity improvements, particularly for cattle production, are crucial for reducing the pressure on natural areas from increasing demand for both food products and bioenergy. This implies targeted investments in the agricultural sector and integrated planning of land use. Our results showed that production intensification in the Orinoquia region is a mechanism that could reduce the pressure on natural land and its associated environmental and economic impacts