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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) first reached the United States in January 2020. Located in New York City (NYC), MSK Kids, at Memorial Sloan Kettering Cancer Center services, is one of the largest pediatric cancer centers in the U.S., caring for children, teenagers, and young adults with cancer, immune deficiencies, and blood disorders. Methods: Implementation for infection mitigation and ongoing care of patients included: (1) the creation of a strategic planning team of physicians, advanced practice providers, nurses, and administrators to develop guidance and workflows, (2) continuous reassessment of patients’ needs for hospital services and visit frequency, (3) the use of telemedicine to replace in-person visits, (4) the use of satellite regional centers to manage patients living outside NYC, (5) pre-screening of patients prior to visits for risks and symptoms of coronavirus disease 2019 (COVID-19) infection, (6) day-of-service screening for risks or symptoms of COVID-19 infection, (7) surveillance testing of children and their caregivers, and (8) creation of cohort plans for the management of COVID-19 positive and uninfected patients within the same institution, in both the outpatient and inpatient settings. Results: We describe the timeline for planning mitigation during the first weeks of the pandemic, and detail in a stepwise fashion the rationale and implementation of COVID-19 containment efforts in the context of a large pediatric oncology program. Discussion: Our experience offers a model on which to base strategic planning efforts at other pediatric oncology centers, for continued preparedness to combat the threat posed by SARS-CoV-2 worldwide.

No ano de 2003 formou-se na Amazônia peruana um sistema de Áreas Naturais Protegidas (ANP) constituído pelo Parque Nacional Otishi e as Reservas Comunais Indígenas Asháninka e Matsiguenga. A legalização desse sistema tem por finalidade tanto a conservação da diversidade de espécies de flora e fauna, quanto a conservação do patrimônio cultural presente no âmbito da Cordilheira de Vilcabamba. Selecionou-se para esse estudo a comunidade Camantavishi do grupo Asháninka pertencente à família etnolinguistica Arawak pré-andino, cuja terra localiza-se na parte baixa da Cordilheira, na área de amortecimento das ANP. Conseqüentemente as decisões tomadas nesta parte terão repercussão direta sobre as partes altas de Vilcabamba. Com a formação das ANP as Comunidades Indígenas encontram-se sobe a influência de inúmeros fatores que geram impactos que podem ser considerados positivos ou negativos. O primeiro capítulo descreve o nível de participação dos povos indígenas na gestão das ANP, verificando-se que existe o envolvimento por parte das autoridades representantes das comunidades. Como indicador dos impactos culturais que ocorrem no interior da unidade produtiva fez-se uso da caracterização das variações na produção artesanal decorrentes da inserção ao mercado. No segundo capítulo, aprofunda-se sobre as técnicas de aproveitamento e o manejo tradicional da espécie florestal Trichilia pallida e suas mudanças provenientes do contato com múltiplos fatores exógenos à cultura Asháninka. São apresentadas as principais características da espécie, obtidas através de dados secundários bem como de informações obtidas junto à Comunidade escolhida. Esse capítulo apresenta também resultados advindos do levantamento qualitativo com técnicas de observação participante e entrevistas parcialmente estruturadas realizadas junto a 30 mulheres e 11 homens que moram no núcleo de Camantavishi e 13 mulheres e 13 homens do centro Shima. In the year 2003, a system of Protected Natural Areas was formed in the Peruvian Amazon (ANP) constituted by the National Park Otishi and the Indigenous Communal Reserves of two ethnic groups, Asháninka and Matsiguenga. The beginning of this system had the purpose of conserving the diversity of flora and fauna species, as well as the conservation of the living cultural patrimony in the area of Vilcabamba Mountain. The Asháninka group was selected for this study belonging to the Preandino Arawak etnolinguistic family. The land of this group is situated in the low region of the Mountain forming the buffer zone of ANP; consequently the exploitation of resources in these areas will have direct effect on the high lands of the Mountain. As a result of ANP formation, the Indigenous Communities have now the influence of a variety of factors that generate impacts that can be considered positive or negative. The first chapter describes the participation level of the Indigenous people in the ANP management, trying to check if there is an involvement of the representative authorities of the communities. As an indicator of cultural impacts that occur in the core of the productive unit, it was used the characterization of the variations in the handcrafts from the new processes that come from the contact with the market. In the second chapter describes deeply in the techniques of exploitation and the traditional handling of the forest species, Trichilia pallida and its changes preceding the contact with multiple exogenous factors from Asháninka culture. The main characteristics of the species are presented here, from secondary data as well as information from the Camantavishi Community. This chapter also presents results from the qualitative survey with techniques of participatory observation and partially structured interviews done with 30 women and 11 men who live in the nucleus of Camantavishi Community and 13 women and 13 men of the Shima center.

We find that a five-phase (substrate, mixed native oxide and roughness interface layer, metal oxide thin film layer, surface ligand layer, ambient) model with two-dynamic (metal oxide thin film layer thickness and surface ligand layer void fraction) parameters (dynamic dual box model) is sufficient to explain in-situ spectroscopic ellipsometry data measured within and across multiple cycles during plasma-enhanced atomic layer deposition of metal oxide thin films. We demonstrate our dynamic dual box model for analysis of in-situ spectroscopic ellipsometry data in the photon energy range of 0.7-3.4 eV measured with time resolution of few seconds over large numbers of cycles during the growth of titanium oxide (TiO

Background Transmission of healthcare-associated Clostridium difficile infection (HA-CDI) has been shown to occur directly or indirectly through a contaminated environment. At a tertiary-care cancer center, HA-CDI rates were higher for pediatric units than for other general oncology units. To address the problem, a multidisciplinary team, including Infection Control, Nursing, and Environmental Services (EVS), was convened and identified refusals and room clutter as barriers to proper cleaning of rooms on the unit. Aim: The aim of this study seeks to reduce HA-CDI in the inpatient pediatrics setting through environmental and educational interventions. Methods In the first phase of the study from February to April 2016, a baseline assessment of prevalent environmental disinfection practices was made among Nursing, EVS, Physicians, and Patient Representatives. Based on this feedback, the following were implemented during Phase 2, from June through October 2016: 1) Unit-wide disinfection with bleach twice a day including common and high traffic areas; 2) Initiation of a “preferred time for cleaning” program to engage families; 3) Enhanced visitor and family education on PPE use; 4) Creation of a communication plan in case of refusal to clean rooms; and 5) Dedicated use of diaper scales. Results During the first phase of the study, the following barriers to cleaning were identified: 1) High refusal rate as cleaning was perceived as inconvenient by families due to timing; 2) Common perception among EVS staff that multiple requests for cleaning the room may appear intrusive to the families; 3) Excessive clutter in the room; 4) Lack of education regarding PPE use; and 5) Shared equipment for diapers. To overcome these barriers, several interventions as outlined in methods were implemented. In Phase 2, there were 0 cases of HA-CDI identified in pediatric patients starting in July through October, 2016. Conclusion Control of CDI on pediatric units poses unique challenges. Engagement of key stakeholders is essential to identify and meet these challenges and to devise effective strategies that will ultimately lead to reduced hospital-based transmission of CDI. Disclosures All authors: No reported disclosures.