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The cows are in the corn
Everyone in the family is upset when the farm animals get into the crops, but Mother remains calm and knows just what to do.
Development and validation of a model for individualized prediction of hospitalization risk in 4,536 patients with COVID-19
Coronavirus Disease 2019 is a pandemic that is straining healthcare resources, mainly hospital beds. Multiple risk factors of disease progression requiring hospitalization have been identified, but medical decision-making remains complex.
To characterize a large cohort of patients hospitalized with COVID-19, their outcomes, develop and validate a statistical model that allows individualized prediction of future hospitalization risk for a patient newly diagnosed with COVID-19.
Retrospective cohort study of patients with COVID-19 applying a least absolute shrinkage and selection operator (LASSO) logistic regression algorithm to retain the most predictive features for hospitalization risk, followed by validation in a temporally distinct patient cohort. The final model was displayed as a nomogram and programmed into an online risk calculator.
One healthcare system in Ohio and Florida.
All patients infected with SARS-CoV-2 between March 8, 2020 and June 5, 2020. Those tested before May 1 were included in the development cohort, while those tested May 1 and later comprised the validation cohort.
Demographic, clinical, social influencers of health, exposure risk, medical co-morbidities, vaccination history, presenting symptoms, medications, and laboratory values were collected on all patients, and considered in our model development.
4,536 patients tested positive for SARS-CoV-2 during the study period. Of those, 958 (21.1%) required hospitalization. By day 3 of hospitalization, 24% of patients were transferred to the intensive care unit, and around half of the remaining patients were discharged home. Ten patients died. Hospitalization risk was increased with older age, black race, male sex, former smoking history, diabetes, hypertension, chronic lung disease, poor socioeconomic status, shortness of breath, diarrhea, and certain medications (NSAIDs, immunosuppressive treatment). Hospitalization risk was reduced with prior flu vaccination. Model discrimination was excellent with an area under the curve of 0.900 (95% confidence interval of 0.886-0.914) in the development cohort, and 0.813 (0.786, 0.839) in the validation cohort. The scaled Brier score was 42.6% (95% CI 37.8%, 47.4%) in the development cohort and 25.6% (19.9%, 31.3%) in the validation cohort. Calibration was very good. The online risk calculator is freely available and found at https://riskcalc.org/COVID19Hospitalization/.
Retrospective cohort design.
Our study crystallizes published risk factors of COVID-19 progression, but also provides new data on the role of social influencers of health, race, and influenza vaccination. In a context of a pandemic and limited healthcare resources, individualized outcome prediction through this nomogram or online risk calculator can facilitate complex medical decision-making.
Journal Article
Integrated halide perovskite photoelectrochemical cells with solar-driven water-splitting efficiency of 20.8
Achieving high solar-to-hydrogen (STH) efficiency concomitant with long-term durability using low-cost, scalable photo-absorbers is a long-standing challenge. Here we report the design and fabrication of a conductive adhesive-barrier (CAB) that translates >99% of photoelectric power to chemical reactions. The CAB enables halide perovskite-based photoelectrochemical cells with two different architectures that exhibit record STH efficiencies. The first, a co-planar photocathode-photoanode architecture, achieved an STH efficiency of 13.4% and 16.3 h to t
60
, solely limited by the hygroscopic hole transport layer in the n-i-p device. The second was formed using a monolithic stacked silicon-perovskite tandem, with a peak STH efficiency of 20.8% and 102 h of continuous operation before t
60
under AM 1.5G illumination. These advances will lead to efficient, durable, and low-cost solar-driven water-splitting technology with multifunctional barriers.
High-efficiency photoelectrodes, which integrate light absorption with catalysis, have been limited to costly materials. Here, the authors develop an anticorrosion barrier that enables low-cost semiconductors for integrated solar fuel devices with 20.8% solar-to-hydrogen energy conversion efficiency.
Journal Article
Alternative mechanisms that mediate graft-versus-host disease in allogeneic hematopoietic cell transplants
Allogeneic hematopoietic cell transplantation (alloHCT) benefits increasing numbers of patients with otherwise lethal diseases. Graft-versus-host disease (GVHD), however, remains one of the most potentially life-threatening complications due to its own comorbidities and the side effects of its treatment. In this issue of the JCI, two groups have turned dogma on its head by providing evidence for alternative mechanisms of acute GVHD (aGVHD) in humans. The principle of donor T cell reactivity elicited by host antigen-presenting cells (APCs) expressing MHC-encoded major HLA disparities or expressing minor histocompatibility antigen (miHA) differences presented by identical HLA molecules remains intact. These reports, however, demonstrate that GVHD can additionally result from peripheral host T cells resident in skin and gut being stimulated against donor APCs in the form of monocyte-derived macrophages. Moreover, these donor monocyte-derived macrophages can themselves mediate cytopathic effects against resident host T cells in skin explants and against a keratinocyte-derived cell line.
Journal Article
Radically rethinking copyright in the arts : a philosophical approach
\"This book radically rethinks the philosophical basis of copyright in the arts. The author reflects on the ontology of arts to argue that current copyright laws cannot be justified. The book begins by identifying two problems that result from current copyright laws: 1) creativity is restricted and 2) they primarily serve the interests of large corporations over the artists and general public. Against this background, the author presents an account of the ontology of artworks and explains what metaphysics can tell us about ownership in the arts. Next, he makes a moral argument that copyright terms should be shorter and that corporations should not own copyrights. The remaining chapters tackle questions regarding the appropriation of tokens of artworks, pattern-types, and artistic elements. The result is a sweeping reinterpretation of copyright in the arts that rests on sound ontological and moral foundations. Radically Rethinking Copyright in the Arts will be of interest to scholars and advanced students working in aesthetics & philosophy of art, metaphysics, philosophy of law, and intellectual property law\"-- Provided by publisher.
BOOK
Water reduction by a p-GaInP2 photoelectrode stabilized by an amorphous TiO2 coating and a molecular cobalt catalyst
Producing hydrogen through solar water splitting requires the coverage of large land areas. Abundant metal-based molecular catalysts offer scalability, but only if they match noble metal activities. We report on a highly active p-GaInP
2
photocathode protected through a 35-nm TiO
2
layer functionalized by a cobaloxime molecular catalyst (GaInP
2
–TiO
2
–cobaloxime). This photoelectrode mediates H
2
production with a current density of ∼9 mA cm
−2
at a potential of 0 V versus RHE under 1-sun illumination at pH 13. The calculated turnover number for the catalyst during a 20-h period is 139,000, with an average turnover frequency of 1.9 s
−1
. Bare GaInP
2
shows a rapid current decay, whereas the GaInP
2
–TiO
2
–cobaloxime electrode shows ≤5% loss over 20 min, comparable to a GaInP
2
–TiO
2
–Pt catalyst particle-modified interface. The activity and corrosion resistance of the GaInP
2
–TiO
2
–cobaloxime photocathode in basic solution is made possible by an atomic layer-deposited TiO
2
and an attached cobaloxime catalyst.
Producing hydrogen via solar water splitting with metal-based molecular catalysts offers scalability. An active p-GaInP
2
photocathode stabilized by a TiO
2
layer functionalized by a cobaloxime molecular catalyst is now reported for water reduction.
Journal Article
Ultralearning : master hard skills, outsmart the competition, and accelerate your career
\"Future-proof your career and maximize your competitive advantage by becoming an Ultralearner--the skill necessary to stay relevant, reinvent yourself, and adapt to whatever the workplace throws your way\"-- Provided by publisher.
Book
Alternative mechanisms that mediate graft-versus-host disease in allogeneic hematopoietic cell transplants
Allogeneic hematopoietic cell transplantation (alloHCT) benefits Increasing numbers of patients with otherwise lethal diseases. Graft-versus-host disease (GVHD), however, remains one of the most potentially life-threatening complications due to its own comorbidities and the side effects of its treatment. In this issue of the JCI, two groups have turned dogma on its head by providing evidence for alternative mechanisms of acute GVHD (aGVHD) in humans. The principle of donor T cell reactivity elicited by host antigen-presenting cells (APCs) expressing MHC-encoded major HLA disparities or expressing minor histocompatibility antigen (miHA) differences presented by identical HLA molecules remains intact. These reports, however, demonstrate that GVHD can additionally result from peripheral host T cells resident in skin and gut being stimulated against donor APCs in the form of monocyte-derived macrophages. Moreover, these donor monocyte-derived macrophages can themselves mediate cytopathic effects against resident host T cells in skin explants and against a keratinocyte-derived cell line.
Journal Article