Kinect Engineering with Learning (KEWL)

According to a Nielsen survey at the time of this reporting, 41% of all households have a game console. This is one market in which NASA has been absent from education and outreach efforts. Kinect Engineering with Learning (KEWL) is made to enter into that market and bring NASA education and outreach to a very familiar venue. KEWL creates an education and outreach experience that is more participatory, both in a school and museum environment. KEWL is a set of applications that runs on an Xbox 360 using the Kinect controller used for education and outreach. These applications currently include: Train R2, a visual simulation of Robonaut 2 that allows students to control a virtual R2 in a game environment; Drive R2, an interface using the Xbox 360 and Kinect controller that allows students to control the real R2 using the methods they learned playing Train R2; ISS experience, a visual tour of the interior of the International Space Station where students use their body to fly through the virtual ISS; Gravity Ball, a simulation of throwing balls in the gravity of different planets; Solar Array repair, a simulation of the simplified STS-121 solar array repair mission; and PlaySpace, a Mars/Moon application that allows students to experience different aspects of Mars/Moon. Users can "fly through" the ISS using their body, allowing an experience similar to what an astronaut would have on orbit. In PlaySpace, users can fly over the surface of Mars and view surface data obtained by Mars rovers. Users of Train R2 and Drive R2 can experience what it is like to control a robot over a distance with a time delay, simulating the time delay that would occur between ground control and an on-orbit robot. The initial ISS experiences were built using parts of code from the NASA Enigma software. The models used in these experiences were also from the Integrated Graphics Operations and Analysis Lab model database. The PlaySpace experience incorporates surface data obtained from NASA rovers and satellites and was built by NASA JPL

Transport in three-dimensional topological insulators: theory and experiment

This article reviews recent theoretical and experimental work on transport due to the surface states of three-dimensional topological insulators. The theoretical focus is on longitudinal transport in the presence of an electric field, including Boltzmann transport, quantum corrections and weak localization, as well as longitudinal and Hall transport in the presence of both electric and magnetic fields and/or magnetizations. Special attention is paid to transport at finite doping, to the $\pi$-Berry phase, which leads to the absence of backscattering, Klein tunneling and half-quantized Hall response. Signatures of surface states in ordinary transport and magnetotransport are clearly identified. The review also covers transport experiments of the past years, reviewing the initial obscuring of surface transport by bulk transport, and the way transport due to the surface states has increasingly been identified experimentally. Current and likely future experimental challenges are given prominence and the current status of the field is assessed.Comment: Review article to appear in Physica

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Colorectal cancer in young Cambodians

Aim: Colorectal cancer (CRC) is a common disease in the older population, but it has become increasingly evident that it is also not infrequent in the young. The aim of this study was to describe the epidemiological, clinical and pathological characteristics of CRC in young Cambodians. Methods: We examined clinical and pathological data from all CRC cases registered in the two reference centres for gastrointestinal tumours in Cambodia between 2005-2010. Age-specific CRC incidence rates were computed using the national population census 2008 data from the National Institute of Statistics. We compared differences in distribution of tumour location, histology, differentiation and UICC/TNM stage in two age groups, namely = 40. Results: During this period, there were 356 new CRC cases, of which 29.8% affected patients younger than 40. This proportion is the second highest in the world, with a higher proportion only reported in Egyptian population. The crude incidence was 2.82 and 2.36 per 100,000 in females and males, respectively. Adenocarcinoma was the most common histologic type, and >50% of all tumours occurred in the colon, with no appreciable variation between the two age groups. Mucin-producing and advanced-grade tumours were twice more frequent in the young. Conclusion: The unusually high CRC proportion in the young in our study could be due to referral bias. Nevertheless, together with the continuous exposure to hazardous environmental agents and the prevalent consanguinity in Cambodia, this question warrants further research to advance our understanding of CRC risk factors and perhaps genetic-environmental interactions in CRC epidemiology in young adults

Determinants of exposure to Aedes mosquitoes: A comprehensive geospatial analysis in peri-urban Cambodia

Aedes mosquitoes are some of the most important and globally expansive vectors of disease. Public health efforts are largely focused on prevention of human-vector contact. A range of entomological indices are used to measure risk of disease, though with conflicting results (i.e. larval or adult abundance does not always predict risk of disease). There is a growing interest in the development and use of biomarkers for exposure to mosquito saliva, including for Aedes spp, as a proxy for disease risk. In this study, we conduct a comprehensive geostatistical analysis of exposure to Aedes mosquito bites among a pediatric cohort in a peri‑urban setting endemic to dengue, Zika, and chikungunya viruses. We use demographic, household, and environmental variables (the flooding index (NFI), land type, and proximity to a river) in a Bayesian geostatistical model to predict areas of exposure to Aedes aegypti bites. We found that hotspots of exposure to Ae. aegypti salivary gland extract (SGE) were relatively small (< 500 m and sometimes < 250 m) and stable across the two-year study period. Age was negatively associated with antibody responses to Ae. aegypti SGE. Those living in agricultural settings had lower antibody responses than those living in urban settings, whereas those living near recent surface water accumulation were more likely to have higher antibody responses. Finally, we incorporated measures of larval and adult density in our geostatistical models and found that they did not show associations with antibody responses to Ae. aegypti SGE after controlling for other covariates in the model. Our results indicate that targeted house- or neighborhood-focused interventions may be appropriate for vector control in this setting. Further, demographic and environmental factors more capably predicted exposure to Ae. aegypti mosquitoes than commonly used entomological indices

Development of Inapparent Dengue Associated With Increased Antibody Levels to Aedes aegypti Salivary Proteins: A Longitudinal Dengue Cohort in Cambodia.

BackgroundWe established the first prospective cohort to understand how infection with dengue virus is influenced by vector-specific determinants such as humoral immunity to Aedes aegypti salivary proteins.MethodsChildren aged 2-9 years were enrolled in the PAGODAS (Pediatric Assessment Group of Dengue and Aedes Saliva) cohort with informed consent by their guardians. Children were followed semi-annually for antibodies to dengue and to proteins in Ae. aegypti salivary gland homogenate using enzyme-linked immunosorbent assays and dengue-specific neutralization titers. Children presented with fever at any time for dengue testing.ResultsFrom 13 July to 30 August 2018, we enrolled 771 children. At baseline, 22% (173/770) had evidence of neutralizing antibodies to 1 or more dengue serotypes. By April 2020, 51 children had symptomatic dengue while 148 dengue-naive children had inapparent dengue defined by neutralization assays. In a multivariate model, individuals with higher antibodies to Ae. aegypti salivary proteins were 1.5 times more likely to have dengue infection (hazard ratio [HR], 1.47 [95% confidence interval {CI}, 1.05-2.06]; P = .02), particularly individuals with inapparent dengue (HR, 1.64 [95% CI, 1.12-2.41]; P = .01).ConclusionsHigh levels of seropositivity to Ae. aegypti salivary proteins are associated with future development of dengue infection, primarily inapparent, in dengue-naive Cambodian children.Clinical trials registrationNCT03534245

The PAGODAS protocol: pediatric assessment group of dengue and Aedes saliva protocol to investigate vector-borne determinants of Aedes-transmitted arboviral infections in Cambodia

Abstract Background Mosquito-borne arboviruses, like dengue virus, continue to cause significant global morbidity and mortality, particularly in Southeast Asia. When the infectious mosquitoes probe into human skin for a blood meal, they deposit saliva containing a myriad of pharmacologically active compounds, some of which alter the immune response and influence host receptivity to infection, and consequently, the establishment of the virus. Previous reports have highlighted the complexity of mosquito vector-derived factors and immunity in the success of infection. Cumulative evidence from animal models and limited data from humans have identified various vector-derived components, including salivary components, that are co-delivered with the pathogen and play an important role in the dissemination of infection. Much about the roles and effects of these vector-derived factors remain to be discovered. Methods/Design We describe a longitudinal, pagoda (community)-based pediatric cohort study to evaluate the burden of dengue virus infection and document the immune responses to salivary proteins of Aedes aegypti, the mosquito vector of dengue, Zika, and chikungunya viruses. The study includes community-based seroprevalence assessments in the peri-urban town of Chbar Mon in Kampong Speu Province, Cambodia. The study aims to recruit 771 children between the ages of 2 and 9 years for a three year period of longitudinal follow-up, including twice per year (rainy and dry season) serosurveillance for dengue seroconversion and Ae. aegypti salivary gland homogenate antibody intensity determinations by ELISA assays. Diagnostic tests for acute dengue, Zika and chikungunya viral infections will be performed by RT-PCR. Discussion This study will serve as a foundation for further understanding of mosquito saliva immunity and its impact on Aedes-transmitted arboviral diseases endemic to Cambodia. Trial registration NCT03534245 registered on 23 May 2018