Conversion of a Skilled Nursing and Rehabilitation Facility into a Satellite Hospital in Response to a COVID-19 Surge.

BACKGROUND: New York City was among the earliest and hardest hit areas during the COVID-19 pandemic. Prior to the peak of the surge in April 2020, a makeshift hospital was opened to address the growing need of overflow beds in Brooklyn, New York. A rehabilitation center was converted into a satellite hospital with a capacity of up to 425 patient beds in 10 days. DESIGN-BUILD APPROACH: Our institution worked in coordination with larger hospital systems and state and local governments, which allowed for a rapid lease of an underutilized structure, influx of supplies, and personnel. Hospital staff were voluntarily redeployed from their assigned services based on reduced need. OUTCOMES: A total of 204 COVID-19 patients were accepted for transfer to the facility between April 6, 2020, and May 11, 2020. There were no major adverse outcomes and no deaths at the facility. LESSONS LEARNED: When a surge of patients is projected to outnumber the available beds in a hospital, such as during a pandemic, it may become necessary to establish a satellite facility. Creativity with existing spaces, health care infrastructure, and reallocation of available resources, as well as having all stakeholders on board, is imperative. Providing mandatory emergency planning and response trainings to hospital staff and leadership can improve preparedness. By leaning on revised protocols established at the satellite facility during the initial surge, the hospital was able to lease and convert another nursing facility and make it patient-ready in less than one week during the second surge of COVID-19 patients.

Influence of a Socially Assistive Robot on Physical Activity, Social Play Behavior, and Toy-Use Behaviors of Children in a Free Play Environment: A Within-Subjects Study.

Background: Play is critical for children's physical, cognitive, and social development. Technology-based toys like robots are especially of interest to children. This pilot study explores the affordances of the play area provided by developmentally appropriate toys and a mobile socially assistive robot (SAR). The objective of this study is to assess the role of the SAR on physical activity, play behavior, and toy-use behavior of children during free play. Methods: Six children (5 females, Mage = 3.6 ± 1.9 years) participated in the majority of our pilot study's seven 30-minute-long weekly play sessions (4 baseline and 3 intervention). During baseline sessions, the SAR was powered off. During intervention sessions, the SAR was teleoperated to move in the play area and offered rewards of lights, sounds, and bubbles to children. Thirty-minute videos of the play sessions were annotated using a momentary time sampling observation system. Mean percentage of time spent in behaviors of interest in baseline and intervention sessions were calculated. Paired-Wilcoxon signed rank tests were conducted to assess differences between baseline and intervention sessions. Results: There was a significant increase in children's standing (∼15%; Z = -2.09; p = 0.037) and a tendency for less time sitting (∼19%; Z = -1.89; p = 0.059) in the intervention phase as compared to the baseline phase. There was also a significant decrease (∼4.5%, Z = -2.70; p = 0.007) in peer interaction play and a tendency for greater (∼4.5%, Z = -1.89; p = 0.059) interaction with adults in the intervention phase as compared to the baseline phase. There was a significant increase in children's interaction with the robot (∼11.5%, Z = -2.52; p = 0.012) in the intervention phase as compared to the baseline phase. Conclusion: These results may indicate that a mobile SAR provides affordances through rewards that elicit children's interaction with the SAR and more time standing in free play. This pilot study lays a foundation for exploring the role of SARs in inclusive play environments for children with and without mobility disabilities in real-world settings like day-care centers and preschools.

Interconversion between Tumorigenic and Differentiated States in Acute Myeloid Leukemia.

Tumors are composed of phenotypically heterogeneous cancer cells that often resemble various differentiation states of their lineage of origin. Within this hierarchy, it is thought that an immature subpopulation of tumor-propagating cancer stem cells (CSCs) differentiates into non-tumorigenic progeny, providing a rationale for therapeutic strategies that specifically eradicate CSCs or induce their differentiation. The clinical success of these approaches depends on CSC differentiation being unidirectional rather than reversible, yet this question remains unresolved even in prototypically hierarchical malignancies, such as acute myeloid leukemia (AML). Here, we show in murine and human models of AML that, upon perturbation of endogenous expression of the lineage-determining transcription factor PU.1 or withdrawal of established differentiation therapies, some mature leukemia cells can de-differentiate and reacquire clonogenic and leukemogenic properties. Our results reveal plasticity of CSC maturation in AML, highlighting the need to therapeutically eradicate cancer cells across a range of differentiation states.

Relationship between visual-motor integration and spatial organization of written language and math.

PURPOSE: The relationship between visual-motor integration and academic achievement is not clearly understood. The purpose of this study was to assess the type and frequency of errors made by children with poor visual-motor integration during a written language and math task. METHODS: Eighteen children with normal visual-motor integration (> or =36%) and 19 children with low visual-motor integration (< or =16%) participated in the study. The two groups had similar ages, gender profiles, and cognitive and reading levels. Each group copied and solved math problems and copied a written passage. The errors for the math and writing task were combined into a total error score, and the time taken to complete each task was combined into a total time score. RESULTS: The low visual-motor integration group made more errors than the normal visual-motor integration group. However, the time taken to copy both tasks was not different between the two groups. A secondary analysis of the errors revealed that alignment of numbers (p = 0.02), organization of math problems (p = 0.05), and spacing errors of letters and words (p = 0.01) were more common in the low visual-motor integration group. CONCLUSIONS: The results suggest that reduced visual-motor integration may contribute to poor spatial organization of written work.