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Background Patients with celiac disease (CeD) reported increased COVID-19 vaccine hesitancy due to a fear of adverse events (AEs). However, the risk of AEs post-COVID-19 vaccination in patients with CeD is unknown. Purpose To assess whether the rate of common side effects (SEs) and AEs due to COVID vaccines are higher in patients with CeD compared to a non-CeD population. Method We conducted a collaborative international cross-sectional study in 16 countries between April 2022 and July 2022. An online survey was distributed to patients with CeD through patients' local societies, and to non-CeD from the general population in each country through social media posts, word-of-mouth, and through academic institutions. We collected data on participant demographics, medical conditions, CeD diagnosis, GFD adherence, history of COVID-19 vaccinations (type and doses) and self-reported SEs and AEs post-COVID-19 vaccine. SEs included pain/swelling at the site, fatigue, fever, chills, nausea and/or headaches. AEs included thrombosis, myocarditis, anaphylactic reaction, and hospitalization related to the vaccine. Logistic regression models were used to assess predictors such as CeD diagnosis, age, gender, vaccine type and comorbidities on the likelihood of reporting SEs and AEs post-vaccine. Result(s) : A total of 17,795 participants completed the survey, 13,638 with CeD (median age of 45[27]) and 4,157 non-CeD controls (median age of 43[20]). There were no significant differences in sex between CeD and controls. Overall, CeD patients had similar odds of SEs compared with non-CeD individuals (aOR=1.02;95% CI=0.92-1.14). SEs were slightly increased only in the second dose of the vaccine in the CeD population compared to non-CeD individuals (aOR= 1.35;95% CI=1.19-1.53). The most common reported SEs in CeD and controls were pain/swelling at the injection site (29% vs 23 %, p< 0.0001) and fatigue (29% vs 24%, p<0.0001). The odds of SEs were higher with Moderna Spikevax, AstraZeneca/Oxford and Johnson and Johnson vaccines than after the Pfizer vaccine (p< 0.0001). The overall rate of AEs post-vaccine was similar between patients with CeD and non-CeD individuals (aOR= 1.29;95% CI= 0.89-1.87). Overall, female gender, older age, GFD adherence, respiratory conditions, obesity and receiving immunosuppressive medications increased the odds of SEs, while only age and a history of allergies increased the odds of AEs. Conclusion(s) In this large international study, patients with CeD reported similar rates of SEs and AEs post-COVID vaccine compared to non-CeD individuals. This information is highly relevant as it addresses the main concern leading to COVID-19 vaccine hesitancy in CeD patients. Disclosure of Interest None Declared
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In this paper, we provide an overview of the upcoming ImageCLEF campaign. ImageCLEF is part of the CLEF Conference and Labs of the Evaluation Forum since 2003. ImageCLEF, the Multimedia Retrieval task in CLEF, is an ongoing evaluation initiative that promotes the evaluation of technologies for annotation, indexing, and retrieval of multimodal data with the aim of providing information access to large collections of data in various usage scenarios and domains. In its 21st edition, ImageCLEF 2023 will have four main tasks: (i) a Medical task addressing automatic image captioning, synthetic medical images created with GANs, Visual Question Answering for colonoscopy images, and medical dialogue summarization;(ii) an Aware task addressing the prediction of real-life consequences of online photo sharing;(iii) a Fusion task addressing late fusion techniques based on the expertise of a pool of classifiers;and (iv) a Recommending task addressing cultural heritage content-recommendation. In 2022, ImageCLEF received the participation of over 25 groups submitting more than 258 runs. These numbers show the impact of the campaign. With the COVID-19 pandemic now over, we expect that the interest in participating, especially at the physical CLEF sessions, will increase significantly in 2023. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The example of Cuba in the aspect of prevention, organization of services, control and constant monitoring (with daily public information) of the evolution of the COVID-19 pandemic at the population level is described as outstanding during all the months of battle. Despite the efforts made by the Ministry of Public Health, and the dignified and heroic work of health professionals in coordination with other sectors, as has happened at different times in most countries of the world, in Cuba The most complex period in the fight against the pandemic was experienced in the months of July and August 2021, with a high incidence of the Delta variant, when, in a context marked by insufficient financing and the increase in the international market of the cost of supplies, the country felt the shortage of medicines and other materials necessary for patient care. Describing the experience of Primary Health Care doctors around the tense situation of those moments is the objective of this work.
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Objective: identify the behavior of the demand for services of the unified health system during the COVID-19 pandemic, based on the racial profile of women in Bage. Method: cross-sectional, population-based study with four serial surveys fortnightly, in which a representative sample of individuals in the city of Bage was interviewed. Held from April to June 2020. Results: There were 984 female interviewees. It has been shown that skin color can determine the health profile. As for the search for a health service in the two weeks prior to the interview, brown women differ from white women, with a higher demand for health care. Primary care units represented the most prevalent health service in all skin color groups. Conclusion: In the context studied, primary care services were available and were used by a group that often encounters barriers to access to health.
ABSTRACT
INTRODUCTION: Ketamine is an NMDA receptor antagonist which has had a resurgence in sedation for critically ill patients. During the COVID-19 pandemic, there was an increase in acute respiratory distress syndrome (ARDS) where deep sedation was required. Ketamine has a lenient hemodynamic profile, opioid sparing properties, bronchodilating and anti-inflammatory effects. These characteristics make it a desirable agent for sedation in COVID-19 ARDS. METHOD(S): This is a single-center retrospective study where time-to-event data of 144 patients admitted to the ICU was analyzed. Kaplan-Meier curves were applied to summarize time from ICU admission to death. Competing risks regression analysis was performed to test the association between ketamine use and ICU-to-floor time, time-to-transfer or discharge to LTAC. RESULT(S): 58 of 144 patients who received ketamine were younger, had higher BMI, and lower APACHE II (median age 59 years, BMI 34.4, APACHE II Score 14) compared to 86 patients who did not receive ketamine. A higher percentage of patients receiving ketamine were on extracorporeal membrane oxygenation (ECMO) (25.9% vs 5.8%). There was no significant difference in time-to-death between the two groups (p=0.124). Patients on ketamine had a lower incidence of being transferred to acute care floors (SHR:0.45, 95% CI) and had prolonged intubation (SHR 0.24, 95% CI). Ketamine was not associated with increased incidence of reintubation. CONCLUSION(S): Among COVID-19 ARDS patients requiring sedation, there was no significant change in time to death in those sedated with ketamine when compared to those without. Patients who required Ketamine had a more prolonged course of invasive mechanical ventilation and required ECMO. It is likely that they had been already on high amounts of sedation at the previous institution leading to higher tolerance to ketamine. However, patients sedated with ketamine in our sample had a higher predicted mortality since admission. Ketamine might still have role in sedation for ARDS COVID-19, but the effects are still unknown and further trials are needed to elucidate its role and possible benefits.
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The guidelines for the approach of patients with COVID-19 at the beginning of the pandemic were carried out by trial since the pathophysiology of this new disease was unknown among the medical actions the use of antibiotic therapies indiscriminately was described also the urged to carry out deep disinfection many times with chemical substances with a negative impact on environmental health both at the level of the microbiota responsible for the ecological balance and in environmental pollution mainly of water. In addition to this due to the health emergency it was required to use more single-use personal protective equipment and as a consequence the increase in hazardous solid waste whose composition is delayed degradation. Therefore, the health response to the pandemic was probably the setting to accentuate antimicrobial resistance and the risk of environmental damage. In this article a systematic review of the scientific literature on these topics was carried out the evidence demostrated the increase in resistance mechanisms of bacteria mainly pathogens of the respiratory tract. Anyways the negative impact due to the irrational use of chemical disinfectants translated into resistant bacteria especially to quaternary ammonium compounds. The bioaccumulation and biomagnification of these substances has caused toxicity mutations propagation of resistance genes. Therefore it is suggested that strategies be prioritized that mitigate the trail that has been spreading as the pandemic passed by SAR-CoV-2.
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Background: The 21st century has been characterized from the beginning by a health problem that has affected the world and Cuba, ranging from an increase in microbial resistance to the appearance of new infectious diseases, such as COVID-19. Objective: To describe the transmission of COVID-19 in the Abreus municipality, Cienfuegos province, between weeks 29 and 41 of the year 2021. Methods: An observational, descriptive, retrospective cross-sectional study was carried out from week 29-41. The universe consisted of 3,421 patients diagnosed with COVID-19, confirmed by a real-time polymerase chain reaction (RT-PCR) diagnostic test. Results: A high magnitude of transmission was observed with 3,421 cases, 122 on average in week 33. Trend of increased case reporting and transmission speed from statistical week 29 to 35 (385 to 3,421 cases). The maximum peak was observed at statistical week 33, with a decrease from that week;In addition, there was a dispersion in all the popular councils, with a greater concentration in the Abreus (1035) and Horquita (725) popular councils. Viral circulation was above 20% in all weeks and the highest occurred in statistical week 37. Conclusions: COVID-19 in the Abreus municipality had a great impact in the period studied. Useful information was provided for decision-making during the development of the disease and a basis for the evolutionary understanding of future analogous events.
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Context: Unpaid carers are the backbone of long-term care (LTC) systems around the world. The COVID-19 pandemic has further increased the pressure many unpaid carers experience;however, their experience has been largely absent from public reporting. Objective: We aim to map the available evidence of the impacts of COVID-19 on unpaid carers of adults (>18 years) with LTC needs as well as of measures implemented to mitigate these effects and how well they have worked. Method: We conducted a rapid review of the academic and grey literature on unpaid carers of adults with LTC needs during the COVID-19 pandemic, covering the period until November 2020. Findings: We identified six key themes that highlight the impacts of COVID-19 on unpaid carers of people living in the community. These are: care commitment, concerns related to COVID-19, availability of formal and informal support, financial implications, carer health and well-being, and carers’ adaptability. In addition, we captured aspects identified by unpaid carers supporting people in residential care settings under the theme ‘carers of people in residential settings’. Finally, we reported evidence of measures implemented to mitigate the impacts on carers. This included the use of technology and the receipt of financial assistance and support for working carers. Limitations: The evidence reported in this review is based largely on cross-sectional data and some of the data reported relies on convenience samples. Implications: We highlight the financial and health impacts that many unpaid carers experience. Given the vital support carers provide to adults with LTC needs, policy makers should consider supporting unpaid carers to mitigate the negative impacts on their lives. © 2021 The Author(s).
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Background and Aims: Background: The care of pediatric patients with new-onset type 1 diabetes in remote areas of Patagonia presents multiple challenges. The current pandemic has presented additional difficulties. We describe the follow-up through telemedicine by an interdisciplinary team of pediatric patients living in rural areas after two years from the start of the SARS COV2 pandemic. Aims: Report on the follow-up of 20 new-onset type 1 diabetes cases in children. The cases were diagnosed in different areas of Patagonia Argentina located more than 200 km from the referral center and were treated through a mixed method : face-to-face and virtual. Methods: Telemedicine was used from the first day to contact the specialist. The management included diabetes education for the patient and family. The patients used multiple daily insulin injections and used software to generate ambulatory glucose profiles. Subsequently, the follow-up was carried out in a mixed modality. Results: The patients achieved adequate glycemic control and reached the diabetes education goals;the management of the cases did not require transfers to the referral center during the first year. Conclusions: These cases show the usefulness of telemedicine to guarantee accessibility to the health systems when the patient's attendance at the referral centers it's not possible. Telemedicine can be used to achieve glycemic control of the patient, for diabetes education in a safe, efficient way and with the satisfaction of the users.The mixed method allows to strengthen the relationship between the team and the patient and the meeting of families in educational workshops.
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Selective mutism (SM) is a relatively rare, but highly interfering, child anxiety disorder characterized by a consistent failure to speak in certain situations, despite demonstrating fluent speech in other contexts. Exposure-based cognitive behavioral therapy and Parent-Child Interaction Therapy adapted for SM can be effective, but the broad availability and accessibility of such specialty care options remains limited. Stay-at-home guidelines to mitigate the spread of COVID-19 further limited the accessibility of office-based specialty care for SM. Building on separate lines of research supporting intensive treatments and telehealth service delivery models, this paper is the first to describe the development, preliminary feasibility, acceptability, and efficacy of a Remote Intensive Group Behavioral Treatment (IGBT) for families of young children with SM (N=9). Treatment leveraged videoconferencing technology to deliver caregiver training sessions, lead-in sessions, 5 consecutive daily IGBT sessions, and an individualized caregiver coaching session. Remote IGBT was found to be both feasible and acceptable. All families (100%) completed diagnostic assessments and caregiver-report questionnaires at four major study timepoints (i.e., intake, pre-treatment, post-treatment, 4-month follow-up) and participated in all treatment components. Caregivers reported high treatment satisfaction at post-treatment and 4-month follow-up and low levels of burden associated with treatment participation at post-treatment. Approximately half of participating children were classified as treatment responders by independent evaluators at post-treatment and 4-month follow-up. Although these pilot results should be interpreted with caution, the present work underscores the potential utility of using videoconferencing to remotely deliver IGBT to families in their natural environments.
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ImageCLEF s part of the Conference and Labs of the Evaluation Forum (CLEF) since 2003. CLEF 2022 will take place in Bologna, Italy. ImageCLEF is an ongoing evaluation initiative which promotes the evaluation of technologies for annotation, indexing, and retrieval of visual data with the aim of providing information access to large collections of images in various usage scenarios and domains. In its 20th edition, ImageCLEF will have four main tasks: (i) a Medical task addressing concept annotation, caption prediction, and tuberculosis detection;(ii) a Coral task addressing the annotation and localisation of substrates in coral reef images;(iii) an Aware task addressing the prediction of real-life consequences of online photo sharing;and (iv) a new Fusion task addressing late fusion techniques based on the expertise of the pool of classifiers. In 2021, over 100 research groups registered at ImageCLEF with 42 groups submitting more than 250 runs. These numbers show that, despite the COVID-19 pandemic, there is strong interest in the evaluation campaign.
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Introduction: Peripheral T-cell lymphomas (PTCL) are a heterogeneous group of lymphomas associated with poor outcomes following anthracycline-based chemotherapy, even when consolidative autologous stem cell transplantation (ASCT) is used. CD30 expression is universal in anaplastic large cell lymphoma (ALCL) and is frequently expressed in other PTCL subtypes. Brentuximab vedotin (BV) is a CD30-directed antibody drug conjugate that prolongs progression-free survival (PFS) and overall survival (OS) when combined with cyclophosphamide, doxorubicin, and prednisone (CHP) as compared to CHOP chemotherapy (Horwitz, 2020). Although a majority of pts treated with BV-CHP remained in durable remission (5y PFS 51%), there is room for improvement. Based on retrospective studies that demonstrated improved outcomes in younger pts, the addition of etoposide to CHOP (CHOEP) is commonly used as initial therapy for PTCL. We performed a multicenter phase 2 trial to evaluate the safety and efficacy of adding etoposide to BV-CHP (CHEP-BV) followed by BV consolidation in pts with newly diagnosed CD30-expressing PTCL. Methods: Adults with newly diagnosed CD30+ (≥ 1% of tumor cells by local pathology) PTCL were eligible, including pts with ALK+ ALCL and IPI score ≥ 2, ALK-negative ALCL, PTCL not otherwise specified (NOS), angioimmunoblastic T-cell lymphoma (AITL), adult Tcell leukemia/lymphoma (ATLL), among others. After accrual of 28 pts, the protocol was amended to allow enrollment of 20 additional pts with CD30+ non-ALCL PTCL (with ALCL allowed in Canada). Pts could receive prephase steroids and/or 1 cycle of CHOPequivalent chemotherapy prior to study entry. 6 pts were treated in a safety lead-in cohort and all pts received CHEP-BV at the recommended phase 2 dose: 6 x 21-day cycles of CHP+BV (1.8mg/kg) on d1 and etoposide 100mg/m2 on d1-3. G-CSF prophylaxis was mandatory. Pts in response after CHEP-BV could receive BV consolidation (1.8mg/kg q3w) for up to 10 additional cycles (16 total BV cycles) either after ASCT or CHEP-BV if no ASCT was performed. The co-primary endpoints were safety and the CR rate (Deauville score 1-3) by PET-CT after CHEP-BV assessed by investigators according to the 2014 Lugano classification. Secondary endpoints were PFS and OS. Results: Accrual has completed and 48 pts were enrolled;all were evaluable for toxicity, 46 were evaluable for efficacy. 16 pts had ALCL (13 ALK+, 3 ALK-) and 32 had non-ALCL PTCL subtypes, including 18 with AITL, 11 with PTCL NOS, 2 with T-follicular helper PTCL, and 1 with ATLL. Baseline characteristics are shown in Table. 43 pts completed CHEP-BV, 2 had progressive disease (PD) prior to completion, 1 pt discontinued CHEP-BV early (MD discretion), 1 pt died due to COVID-19, and 1 remains on CHEP-BV. Of 43 pts who completed CHEP-BV, 24 proceeded to ASCT and 19 did not. 33 (74%) pts received BV consolidation (20 after ASCT, 13 directly after CHEP-BV) and completed a median 8 of the planned 10 cycles (range, 1-10). 13 pts completed all cycles of consolidation;19 pts discontinued early-12 due to adverse events (AE), 5 due to PD, and 2 due to patient/physician choice. The most frequent CHEP-BV related AEs (all grades, G) include fatigue (73%), peripheral sensory neuropathy (67%), anemia (62.5%), nausea (56%), neutropenia (50%), lymphopenia (44%), leukopenia (42%), thrombocytopenia (40%), elevated transaminases (33%). The most common G3+ AEs were neutropenia (37.5%), febrile neutropenia (23%), lymphopenia (21%), anemia (19%), thrombocytopenia (19%). There were 5 deaths, 4 due to PD and 1 due to COVID-19 infection during C3 of CHEP-BV. The interim (n=46) ORR and CR rates (after 3 CHEP-BV cycles, except 1 pt after 2) were 96% and 59% (27 CR, 17 PR), respectively. At completion of CHEP-BV (n=46), the ORR was 91% with 80% CR (37 CR, 5 PR, 4 PD). The ORR/CR rates in ALCL (n=16) vs non-ALCL (n=30) pts were 94%/94% vs 90%/73%, respectively. The ORR/CR rates in pts with CD30 expression 1-9% (n=15) vs 10+% (n=31) were 93%/67% and 90%/87%, respectively. The median follow-up in surviving pts is 1 .1 months (range, 0.9-32.5). The overall 18mo PFS and OS were 61% and 89%;18mo PFS by subgroup: ALCL 81%, non-ALCL 49%, CD30 1-9% 48%, CD30 10+% 67%. Landmark 1y PFS from end of CHEP-BV in responding pts (n=41) was 82% in pts who underwent ASCT vs 48% in pts who did not Conclusions: In a cohort of pts with mostly non-ALCL CD30-expressing PTCL, CHEP-BV (+/-ASCT) followed by BV consolidation was tolerable and effective.
ABSTRACT
Background: High-risk LBCL is associated with poor prognosis after first-line anti-CD20 mAb-containing regimens, highlighting the need for novel treatments. Axi-cel, an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, is approved for treatment of relapsed/refractory (R/R) LBCL after ≥2 lines of systemic therapy. Here we report the primary analysis of ZUMA-12, a Phase 2, multicenter, single-arm study of axi-cel as part of first-line therapy in patients with high-risk LBCL. Methods: Eligible adults had high-risk LBCL, defined by histology (double- or triple-hit status [MYC and BCL2 and/or BCL6 translocations] per investigator) or an IPI score ≥3, plus a positive interim PET per Lugano Classification (Deauville score [DS] 4/5) after 2 cycles of an anti-CD20 mAb and anthracycline-containing regimen. Patients underwent leukapheresis and received conditioning chemotherapy (cyclophosphamide and fludarabine) followed by a single axi-cel infusion at 2×10 6 CAR T cells/kg. Non-chemotherapy bridging could be administered before conditioning per investigator discretion. The primary endpoint was investigator-assessed complete response (CR) rate per Lugano. Secondary endpoints included objective response rate (ORR;CR + partial response), duration of response (DOR), event-free survival (EFS), progression-free survival (PFS), overall survival (OS), incidence of adverse events (AEs), and levels of CAR T cells in blood and cytokines in serum. The primary analysis occurred after all treated patients had ≥6 months of follow-up. Results: As of May 17, 2021, 42 patients were enrolled and 40 were treated with axi-cel. Median age was 61 years (range, 23-86);68% of patients were male, 63% had ECOG 1, 95% had stage III/IV disease, 48% had DS4, 53% had DS5, 25% had double- or triple-hit status per central assessment, and 78% had IPI score ≥3. A total of 37 patients had centrally confirmed double- or triple-hit histology or an IPI score ≥3 and were evaluable for response, with 15.9 months of median follow-up (range, 6.0-26.7). The CR rate was 78% (n=29;95% CI, 62-90);89% of patients had an objective response, and median time to initial response was 1 month. Among all 40 treated patients, 90% had an objective response (80% CR rate). At data cutoff, 73% of response-evaluable patients had ongoing responses. Medians for DOR, EFS, and PFS were not reached;12-month estimates were 81%, 73%, and 75%, respectively. The estimated OS at 12 months was 91%. All 40 treated patients had AEs of any grade;85% of patients had Grade ≥3 AEs, most commonly cytopenias (68%). Grade ≥3 cytokine release syndrome (CRS) and neurologic events (NEs) occurred in 3 patients (8%) and 9 patients (23%), respectively. Median times to onset of CRS and NEs were 4 days (range, 1-10) and 9 days (range, 2-44), with median durations of 6 days and 7 days, respectively. All CRS and most NEs (28/29) of any grade resolved by data cutoff (1 ongoing Grade 1 tremor);39/40 CRS events resolved by 14 days post-infusion and 19/29 NEs resolved by 21 days post-infusion. Tocilizumab was administered to 63% and 3% of patients for management of CRS or NEs, respectively;corticosteroids were administered to 35% and 33% of patients for CRS and NE management. One Grade 5 event of COVID-19 occurred (Day 350). Median peak CAR T-cell level in all treated patients was 36 cells/µL (range, 7-560), and median expansion by AUC 0-28 was 495 cells/µL × days (range, 74-4288). CAR T-cell levels peaked at a median of 8 days post-infusion (range, 8-37). Higher frequency of CCR7+CD45RA+ T cells in axi-cel product, previously associated with greater expansion of CAR T cells (Locke et al. Blood Adv. 2020), was observed in ZUMA-12, compared with the ZUMA-1 study in R/R LBCL (Neelapu et al. New Engl J Med. 2017). Conclusion: In the primary analysis of ZUMA-12, axi-cel demonstrated a high rate of rapid and complete responses in patients with high-risk LBCL, a population with high unmet need. With 15.9 months of median follow-up, responses were durable as medians for DOR, EFS, nd PFS were not yet reached and over 70% of patients remained in response at data cutoff. No new safety signals were reported with axi-cel in an earlier line. Overall, axi-cel may benefit patients exposed to fewer prior therapies, and further trials in first-line high-risk LBCL are warranted to assess axi-cel in this setting. [Formula presented] Disclosures: Neelapu: Kite, a Gilead Company, Merck, Bristol Myers Squibb, Novartis, Celgene, Pfizer, Allogene, Kuur, Incyte, Precision BioSciences, Legend, Adicet Bio, Calibr, and Unum Therapeutics: Other: personal fees;Kite, a Gilead Company, Bristol Myers Squibb, Merck, Poseida, Cellectis, Celgene, Karus Therapeutics, Unum Therapeutics (Cogent Biosciences), Allogene, Precision BioSciences, Acerta and Adicet Bio: Research Funding;Takeda Pharmaceuticals and related to cell therapy: Patents & Royalties;Kite, a Gilead Company, Merck, Bristol Myers Squibb, Novartis, Celgene, Pfizer, Allogene Therapeutics, Cell Medica/Kuur, Incyte, Precision Biosciences, Legend Biotech, Adicet Bio, Calibr, Unum Therapeutics and Bluebird Bio: Honoraria. Dickinson: Janssen: Consultancy, Honoraria;Takeda: Research Funding;Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau;Amgen: Honoraria;Celgene: Research Funding;Bristol-Myers Squibb: Consultancy, Honoraria;MSD: Consultancy, Honoraria, Research Funding, Speakers Bureau;Roche: Consultancy, Honoraria, Other: travel, accommodation, expenses, Research Funding, Speakers Bureau;Gilead Sciences: Consultancy, Honoraria, Speakers Bureau. Munoz: Kite, a Gilead Company, Kyowa, Bayer, Pharmacyclics/Janssen, Seagen, Acrotech/Aurobindo, Beigene, Verastem, AstraZeneca, Celgene/BMS, Genentech/Roche.: Speakers Bureau;Bayer, Gilead/Kite Pharma, Celgene, Merck, Portola, Incyte, Genentech, Pharmacyclics, Seattle Genetics, Janssen, and Millennium: Research Funding;Pharmacyclics/Abbvie, Bayer, Kite, a Gilead Company, Pfizer, Janssen, Juno/Celgene, Bristol Myers Squibb, Kyowa Kirin, Alexion, Fosun Kite, Innovent, Seagen, BeiGene, Debiopharm, Epizyme, Karyopharm, ADC Therapeutics, Servier, and Genmab: Consultancy, Other: advisory role;Alexion, AstraZeneca Rare Disease: Other: Study investigator;Targeted Oncology, OncView, Kyowa Kirin, Physicians' Education Resource, and Seagen: Honoraria. Thieblemont: Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses;Gilead Sciences: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses;Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees;Kyte: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses;Bristol Myers Squibb/Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses;Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees;Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses, Research Funding;Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees;Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses;Cellectis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses;Hospira: Research Funding;Bayer: Honoraria;Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses. Oluwole: Pfizer: Consultancy;Curio Science: Consultancy;Janssen: Consultancy;Kite, a Gilead Company: Consultancy, Research Funding. Herrera: Takeda: Consultancy;Genentech: Consultancy, Research Funding;Merck: Consultancy, Research Funding;Seagen: Consultancy, Research Fundi g;AstraZeneca: Consultancy, Research Funding;Kite, a Gilead Company: Research Funding;Gilead Sciences: Research Funding;Tubulis: Consultancy;ADC Therapeutics: Consultancy, Research Funding;Bristol Myers Squibb: Consultancy, Research Funding;Karyopharm: Consultancy. Ujjani: Loxo: Research Funding;AstraZeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding;Epizyme: Consultancy, Membership on an entity's Board of Directors or advisory committees;Janssen: Consultancy;TG Therapeutics: Honoraria;Gilead: Honoraria;ACDT: Honoraria;Kite, a Gilead Company: Honoraria;Adaptive Biotechnologies: Research Funding;Atara Bio: Consultancy;AbbVie: Consultancy, Research Funding;Pharmacyclics: Consultancy, Research Funding. Lin: Sorrento: Consultancy;Legend: Consultancy;Novartis: Consultancy;Bluebird Bio: Consultancy, Research Funding;Gamida Cell: Consultancy;Janssen: Consultancy, Research Funding;Celgene: Consultancy, Research Funding;Juno: Consultancy;Vineti: Consultancy;Takeda: Research Funding;Merck: Research Funding;Kite, a Gilead Company: Consultancy, Research Funding. Riedell: Bayer: Honoraria;Karyopharm Therapeutics: Consultancy, Honoraria;Morphosys: Research Funding;Celgene/Bristol-Myers Squibb Company: Consultancy, Honoraria, Research Funding;Verastem Oncology: Honoraria;Kite, a Gilead Company: Honoraria, Research Funding, Speakers Bureau;Novartis: Consultancy, Honoraria, Research Funding;Takeda: Consultancy;BeiGene: Consultancy;Calibr: Research Funding;Xencor: Research Funding;Tessa Therapeutics: Research Funding. Kekre: Gilead: Consultancy, Honoraria;Novartis: Consultancy, Honoraria;Celgene: Consultancy, Honoraria. Lui: Gilead Sciences: Other: stock or other ownership;Kite, a Gilead Company: Current Employment, Other: travel support. Milletti: Kite, aGilead company: Current Employment;Gilead Sciences: Other: stock or other ownership. Dong: Kite, a Gilead Company: Current Employment;Gilead Sciences: Other: stock or other ownership;GliaCure/Tufts: Consultancy, Other: advisory role, Patents & Royalties. Xu: Kite, A Gilead Company: Current Employment;Gilead Sciences: Other: stock or other ownership. Chavez: MorphoSys, Bayer, Karyopharm, Kite, a Gilead Company, Novartis, Janssen, AbbVie, TeneoBio, and Pfizer: Consultancy;ADC Therapeutics: Consultancy, Research Funding;Merk: Research Funding;AstraZeneca: Research Funding;MorphoSys, AstraZeneca, BeiGene, Genentech, Kite, a Gilead Company, and Epizyme: Speakers Bureau;BMS: Speakers Bureau.
ABSTRACT
This document analyzes tourism companies' operations-related data by focusing on the use of dimensionality reduction as well as clustering techniques. To do this, a case study has been defined which examines the most relevant variables of small and medium-sized companies' common operations in the tourism sector in Ecuador. Data selected for said study corresponds to the year 2015, being the latest official information available. Principal Component Analysis (PCA) is applied as a method of dimensionality reduction to simplify the complexity of spaces with multiple dimensions. The data set is also analyzed with the k-means clustering technique, defining different groups based on similar characteristics. The study provides information on tourism companies' operation in Ecuador before the pandemic due to COVID-19 as support in 'strategy making', in order to reactivate said industry via data-based decisions.