ABSTRACT
Background: Acute kidney injury (AKI) is a common complication of patients hospitalized with coronavirus disease 2019 (COVID-19), however, the epidemiological studies are limited by single or few centers and short duration. How the incidence of COVID-19-associated AKI has changed over the last 18 months since start of the pandemic is not known. Methods: We used the N3C enclave to collect data from 42 centers from all geographical regions of the United States of patients hospitalized with COVID-19 from December 2019 to May 2021. Unique patient visit occurrence ID data across various hospitalizations for each center was harmonized to uniformly collect information on serum creatinine (SCr), acute dialysis, end-stage kidney disease (ESKD) and transplantation. From a total of 127,223 patients hospitalized with COVID-19, 3,662 patients with preexisting ESKD and 20,090 with < 2 measures of SCr were excluded. AKI and AKI stages were defined by KDIGO criteria. Baseline SCr was defined from the outpatient values before hospitalization when available or lowest inpatient value if not available. We analyzed how the incidence of in-hospital AKI changed over time (every 4-month period). Mann-Kendall Test was used to test for monotonic trends of the AKI incidence. Results: Of the 103,471 patients hospitalized with COVID-19, 31,634 (30.6%) were diagnosed with AKI (mean age 63.3 years, 43.7% female, 32.4% non-white, and 19.5% Hispanic). 14,129 (13.7%) patients were diagnosed with AKI-1, 7,996 (7.7%) had AKI-2 and 9,509 (9.2%) patients had AKI-3 (6,285 [6.1%] without dialysis and 3,224 [3.1%] with dialysis). The incidence of 'all AKI' decreased from 38.8% in Dec 2019-March 2020 to 26.2% in March-May 2021 (p-value for trend = 0.086) and the incidence of AKI-3 declined from 15.5% to 6.5% (p = 0.086). Conclusions: This is the largest and most nationally representative cohort of patients hospitalized with COVID-19 with the highest number of cases of AKI and of AKI-3 reported thus far. The incidence of COVID-19-associated AKI has shown a nonstatistically significant decline during the past 18 months of the pandemic.
ABSTRACT
This paper describes how the Mars Science Laboratory (MSL) project prepared for and successfully began Curiosity rover Mars operations from their homes in response to the COVID-19 work-from-home orders. In a very short period, the team developed procedures and executed a remote operations readiness test in parallel with the team's support for nominal operations. Continuing regular rover operations with an entirely remote team had not previously been considered feasible due to a variety of factors. These included both the human factors, such as multiple concurrent person-to-person interactions of the uplink planning team, as well as technical factors, such as reliance on powerful workstations dedicated to graphically intensive software tools used for planning. The test was conducted on March 12, 2020, with both the downlink and uplink teams successfully simulating a near full planning day. The JPL administration announced the transition to mandatory telework on Monday, March 16. MSL stood down the uplink planning originally scheduled for the next day while downlink continued monitoring the rover. Full operations then resumed per schedule with nearly the entire operations team teleworking on Friday, March 20, during which the team planned rover activities for three Martian days (sols). These activities included the successful drilling of the "Edinburgh" rock target, a highly complex robotic arm contact science activity. As of October 1, 2020, the Mars Science Laboratory mission operations team has conducted 88 remote tactical uplink shifts for a total of 190 sols of planned rover activity, which accounts for more than 6% of the mission to date. In this period the rover has completed four drilling campaigns and driven over 1160 meters towards its next major science target - a sulfate bearing geologic unit at the foot of Mount Sharp. Success has not been without its challenges. Many of these have been addressed while others will remain in some form until the team can safely return to JPL, which in turn is the largest challenge for the future.
ABSTRACT
This paper describes how the Mars Science Laboratory (MSL) project prepared for and successfully began Curiosity rover Mars operations from their homes in response to the COVID-19 work-from-home orders. In a very short period, the team developed procedures and executed a remote operations readiness test in parallel with the team's support for nominal operations. Continuing regular rover operations with an entirely remote team had not previously been considered feasible due to a variety of factors. These included both the human factors, such as multiple concurrent person-to-person interactions of the uplink planning team, as well as technical factors, such as reliance on powerful workstations dedicated to graphically intensive software tools used for planning. The test was conducted on March 12, 2020, with both the downlink and uplink teams successfully simulating a near full planning day. The JPL administration announced the transition to mandatory telework on Monday, March 16. MSL stood down the uplink planning originally scheduled for the next day while downlink continued monitoring the rover. Full operations then resumed per schedule with nearly the entire operations team teleworking on Friday, March 20, during which the team planned rover activities for three Martian days (sols). These activities included the successful drilling of the 'Edinburgh' rock target, a highly complex robotic arm contact science activity. As of October 1, 2020, the Mars Science Laboratory mission operations team has conducted 88 remote tactical uplink shifts for a total of 190 sols of planned rover activity, which accounts for more than 6% of the mission to date. In this period the rover has completed four drilling campaigns and driven over 1160 meters towards its next major science target - a sulfate bearing geologic unit at the foot of Mount Sharp. Success has not been without its challenges. Many of these have been addressed while others will remain in some form until the team can safely return to JPL, which in turn is the largest challenge for the future. © 2021 IEEE.