Face Mask detection using Mask R-CNN to control the spread of Covid-19

Business executives are developing cutting-edge digital solutions as the virus outbreak spreads. A face mask detection system is one of them, and it can be used to spot people wearing them. Face mask identification software and applications have already been released by a few businesses, and others have promised to do the same for the service. The proposed work examines face mask detection accuracy using CNN networks. Mask wear is now required in many developed and developing countries worldwide when leaving the house or entering public spaces. It will be difficult to maintain touchless access control in buildings while recognising faces wearing masks on any surveillance systems. Masks covering faces has made face detection algorithms and performance difficult. The proposed work detect face mask labeled no mask or mask with detection accuracy. The work train the system to click images of a face and provide labeled data. The work is classified using Convolution Neural Network (CNN), a Deep learning technique, to classify the input image with the help of the classification algorithm MobileNetV2. The trained system shows whether a person in the video frame is wearing a mask or not. © 2023 IEEE.

eCOVID-19: Development of ontology-based clinical decision support system for COVID-19

Introduction: Humankind is passing through a period of significant instability and a worldwide health catastrophe that has never been seen before. COVID-19 spread over the world at an unprecedented rate. In this context, we undertook a rapid research project in the Sultanate of Oman. We developed ecovid19 application, an ontology-based clinical decision support system (CDSS) with teleconference capability for easy, fast diagnosis and treatment for primary health centers/Satellite Clinics of the Royal Oman Police (ROP) of Sultanate of Oman. Material and Methods: The domain knowledge and clinical guidelines are represented using ontology. Ontology is one of the most powerful methods for formally encoding medical knowledge. The primary data was from the ROP hospital's medical team, while the secondary data came from articles published in reputable journals. The application includes a COVID-19 Symptom checker for the public users with a text interface and an AI-based voice interface and is available in English and Arabic. Based on the given information, the symptom checker provides recommendations to the user. The suspected cases will be directed to the nearby clinic if the risk of infection is high. Based on the patient's current medical condition in the clinic, the CDSS will make suitable suggestions to triage staff, doctors, radiologists, and lab technicians on procedures and medicines. We used Teachable Machine to create a TensorFlow model for the analysis of X-rays. Our CDSS also has a WebRTC (Web Real-Time Communication system) based teleconferencing option for communicating with expert clinicians if the patient develops difficulties or if expert opinion is requested. Results: The ROP hospital's specialized doctors tested our CDSS, and the user interfaces were changed based on their suggestions and recommendations. The team put numerous types of test cases to assess the clinical efficacy. Precision, sensitivity (recall), specificity, and accuracy were adequate in predicting the various categories of patient instances. Conclusion: The proposed CDSS has the potential to significantly improve the quality of care provided to Oman's citizens. It can also be tailored to fit other terrifying pandemics. © 2022, Published by Frontiers in Health Informatics.

Immunity Modulators, Repurposed Drugs and Candidate Vaccines for COVID-19: A Review

COVID-19, a pandemic has led the whole globe through unprecedented times and unpre-dictability that has adversely affected the humanity as a whole. Although the severe acute respiratory syndrome was reported in the year 2002-2004 of zoonotic origin caused by SARS-CoV-1 strain. Now recently, in December 2019, SARS-CoV-2 virus has emerged and swiftly spread to the whole world, taking a heavy toll on life. Studies are being conducted worldwide to find antiviral drugs act-ing specifically on the virus and to develop the vaccine for the disease. The present review article summarizes the currently undergoing clinical trials of Indian Ayurvedic herbs and their role in promoting immunity. It also includes studies focused on repurposing the existing drugs and finding alternative treatment methods that can be opted for potential treatment/management of COVID-19. Last but not the least, this paper provides a background on the development of preventive vaccines and the various bioinformatic tools utilized in order to help accelerate the research on coronavirus. The manuscript gives a brief outline of all the possible strategies and therapeutics underway in India and at the global level to fight against the microscopic adversary and lead to an affordable and speedy remedy for COVID-19.Copyright © 2021 Bentham Science Publishers.

THE SOUND OF SILENCE, THE FACE OF FACELESS: THE ORDEAL OF MIGRANT WORKERS IN INDIA DURING THE FIRST WAVE OF COVID-19

In May 2020, when the spread of the COVID-19 pandemic was galloping at a high rate and the entire world's economy was brought almost to a standstill, there was fear and confusion all over. During the ongoing lockdown in India, a newspaper report published in the Hindustan Times shook the hearts of Indians. A small toddler tried in vain to shake up his mother who died on a railway platform in Muzaffarpur Bihar, India. She was a migrant worker, trying to return to her hometown due to the lockdown. (Singh, 2020). Such migrant crises and tragic stories were reported daily. The report posed a big question mark on the law and administration. The present study tried to capture the disaster and migrant crisis that unfolded since the implementation of the first nationwide lockdown in India with effect from March 24, 2020. The study also investigated the role of government agencies to curb the Exodus and provide relief to the millions and millions of interstate migrant workers. It aimed to figure out the reasons for the inefficacy of the government schemes and to understand the role of NGOs and locals who contributed to the relief measures. It also reveals that the worst-hit people due to the lockdown were the undocumented workers of the informal sector. It highlights the short-sightedness of the administration and the apathy shown towards the migrant crisis. The study also brings forward the commendable role of the NGOs and the locals who provided relief to the underprivileged section of the Indian economy. It demonstrates how at times even small efforts can go on to bring huge relief and encourages the participation of common citizens in times of crisis. It also foregrounds the fact that in India, among these migrants the fear of uncertainty and starvation was greater than the fear of the COVID-19 pandemic. © 2022, Supporting Academic Initiatives Foundation. All rights reserved.

Colorectal cancer screen-up-to-date: 10-year prevalence in a regional safety-net health system

Introduction: Colorectal cancer (CRC) screening is an effective secondary prevention method with an increased probability of diagnosing CRC at an earlier stage, and a consequent improvement in survival post-treatment. This is especially true for individuals who undergo guideline recommended screening at appropriate intervals. Studies have reported a consistent rise in long-term trends of guideline-adherent screen-up-to-date (SUTD) rates among predominantly White and insured individuals. Here we use longitudinal data from 2011-2020 and report 10-year prevalence and correlates of CRC SUTD among patients in a safety-net health system. Method(s): All patients aged 50-74 years who had a primary care encounter in any of the 12 community clinics in a large county safety-net health system were included. An individual was considered to be SUTD if he/she had a stool test during the calendar year, flexible sigmoidoscopy in the past 5 years, or colonoscopy in the past 10 years. To obtain a population health estimate (and not only examine frequencies), we included in the denominator patients with a primary care visit in the past 3 years. Multivariable generalized estimating equations (GEE) model was used to examine the association of SUTD status with time-varying demographic and clinical characteristics over the 10-year period. Result(s): Our analytical cohort had 50,647 patients in 2011, of which 40.9% (20,708) patients were SUTD. Annual rates of SUTD were largely unchanged until 2019, when the prevalence increased to 46.8% after initiation of a population health outreach mailed FIT program. The SUTD rate fell to the baseline level of 40.8% in 2020 after the pandemic-induced suspension of the mailed FIT program. Multivariable GEE model demonstrated that older patients, females, and Hispanics had higher odds of being SUTD compared to younger patients, males, and non-Hispanics, respectively. Additionally, patients who had prior interaction with the healthcare system (had prior stool tests or prior primary care encounters) had higher odds of being SUTD than those with no prior experience with the healthcare system (no prior stool tests or no prior primary care encounters). Conclusion(s): This study establishes contemporary evidence about the 10-year prevalence and correlates of CRC SUTD status among patients in a safety-net health system. Prevalence remained constant for most of the decade, except in 2019, when a population-based mailed FIT outreach program was implemented to complement usual visit-based screening. Despite the disruptions caused by the COVID-19 pandemic, screening rates in 2020 did not drop below pre-2019 levels (~40%), though the prior increases due to the mailed FIT program were lost. We believe that effective implementation of broad population-based, screening outreach efforts are instrumental in improving and sustaining CRC SUTD rates in safety-net health systems, and can consequently help to decrease CRC incidence and related mortality.

Real-World Effectiveness of Dupilumab in Asthma: Findings from the Us Advantage Study

Introduction: Real-world evidence on patients with moderate-to-severe asthma treated with dupilumab is limited. Patients included in clinical trials may differ from the ones seen on a clinical office setting. The objective of our study was to characterize real-world effectiveness of dupilumab in US, as an add-on treatment in patients with moderate to severe asthma. Method(s): We retrospectively included patients (>=12 years of age) diagnosed with asthma, initiating dupilumab (index) between November 2018 to September 2020, with 12 months pre- and post-index information. The study employed a pre-post self-control design (TriNetX Dataworks, USA). Asthma exacerbation rates before vs. after dupilumab initiation were analyzed using Generalized Estimating Equations models with Poisson probabilistic link to estimate incidence rate ratios (IRRs). Sensitivity analyses on asthma exacerbations adjusted for COVID-19 confounding effects were performed using natural cubic splines to allow for time-varying effect estimates during pre- and post-pandemic time periods. Result(s): A total of 2400 patients initiating dupilumab met all study criteria and 75.3% were biologic naive. Dupilumab reduced risk of asthma exacerbations by 38% (IRR: 0.62 [95% confidence interval: 0.58-0.65], P=<.0001). Significant reductions in asthma exacerbations were observed in patients with at least 1 or 2, pre-index, asthma exacerbations, by eosinophil count categories, and when adjusted for impact of COVID-19 (Table-1) Conclusion(s): The US ADVANTAGE study demonstrated real-world effectiveness of dupilumab in reducing asthma exacerbation among patients 12 years and older in US clinical practice. These findings are generally consistent with data from previous pivotal clinical trials with dupilumab. Copyright © 2022

POINT-OF-CARE ULTRASOUND FOR DIAGNOSIS AND EFFECT ON CLINICAL DECISION-MAKING DURING EVALUATION OF RESPIRATORY SYMPTOMS IN AN AMBULATORY PULMONARY CLINIC

SESSION TITLE: Technological Innovations in Imaging SESSION TYPE: Original Investigations PRESENTED ON: 10/17/22 1:30 PM - 2:30 PM PURPOSE: Point-of-Care Ultrasound (POCUS) has become an indispensable tool for clinicians evaluating patients with acute illness in hospital settings. Trained clinicians can rapidly detect cardiopulmonary disease with high sensitivity, guiding diagnosis and therapeutic management based on real-time findings. Despite this revolution to bedside care, POCUS has rarely been employed in the ambulatory setting. We aimed to evaluate the role of POCUS in the diagnosis and effect on clinical-decision-making in patients presenting to a pulmonary clinic with respiratory complaints. METHODS: This is a prospective case series of adult patients presenting to a pulmonary clinic in an urban medical center between January and February 2022. POCUS was performed by trained pulmonary faculty and triggered at the discretion of the clinician. Studies triggered by POCUS were followed-up, and a diagnosis if made was recorded. RESULTS: Between January-February 2022, the clinic saw N=53 patients for whom POCUS was triggered for N=10. Reasons included: no prior imaging on record (N=4), physical exam findings (N=5) and/or unclear clinical picture (N=4) after review of history, exam, and the medical record. Average age was 59.5±12.7 years. The chief complaint was dyspnea for all patients. In 4 patients, POCUS revealed diffuse B-lines with irregular pleural line suggestive of ILD. The work-up eventually diagnosed UIP-pattern ILD related to rheumatoid arthritis (N=1), non-specific interstitial pneumonitis (N=1), and sarcoidosis (N=1). Work-up remains pending for 1 patient. POCUS revealed new left ventricular dysfunction in 2 patients: one subclinical post-viral cardiomyopathy following COVID-19 and one ischemic cardiomyopathy from coronary artery disease. POCUS revealed new biventricular failure in one patient, for whom cardiac sarcoidosis is currently being worked-up given a history of anterior uveitis. In 1 patient, POCUS revealed a massive echogenic mass within the right hemithorax, prompting urgent chest x-ray and referral to ER. With a personal history of leiomyosarcoma, this mass was eventually diagnosed as recurrence of cancer. In 1 patient, POCUS diagnosed new pleural effusion, prompting referral for thoracentesis revealing an exudate of unclear etiology. One patient presented with COPD exacerbation, for whom POCUS found a basilar consolidation suggestive of pneumonia, prompting antibiotic therapy. CONCLUSIONS: POCUS can detect in real-time cardiopulmonary disease, and thus may serve as a powerful tool in the diagnosis and clinical-decision-making by trained clinicians encountering patients with respiratory complaints in an ambulatory setting. CLINICAL IMPLICATIONS: Our case series demonstrates the potential utility of POCUS, when triggered appropriately, can allow additional diagnostic studies to be considered earlier, and potentially narrow the time interval between patient presentation and a made diagnosis. DISCLOSURES: No relevant relationships by Gerardo Eman No relevant relationships by Marjan Islam No relevant relationships by Rahul Nair No relevant relationships by Abhishek Sharma No relevant relationships by Shwe Synn No relevant relationships by Tito Zerpa

An empirical study on the effect of repeated online/offline transitions on student satisfaction

The disruption due to COVID has been two-fold due the uncertainty of the pandemic. Once the first wave had subsided the academic activities resumed in offline mode. But due to the rise of the second wave of COVID the classes had to be again shifted to online mode. Such drastic changes in the teaching-learning process will definitely have an impact on the student satisfaction. Hence an empirical study was carried out to understand the mindset of the students and how these transitions have distracted the teaching-learning process from a student point of view. Student satisfaction analysis was conducted with the major scales namely ‘Faculty support’, ‘Peer support’, ‘Student learning’ and ‘Assessment’. Each of these scales were further divided into subscales and the influence of each of these subscales on ‘Student Satisfaction’ is also discussed in detail. Analysis is carried out through stepwise regression analysis, analysis of variance and correlation. Apart from these a brief analysis on the impact of parent support on the student’s learning process is also compiled for better understanding. The results and conclusions from this analysis give us an understanding of how the teachers could better understand the teaching-learning process and adapt themselves accordingly for better results. © 2022, Rajarambapu Institute Of Technology. All rights reserved.

Response Adapted Ultra Low Dose Radiation Therapy for the Definitive Management of Orbital Indolent B-Cell Lymphoma

Radiation therapy (RT) to doses of 24-30 Gy is used for the treatment of indolent B-cell lymphoma (BCL);however, significant acute and late ocular effects are common. We aimed to develop a response adapted (RA) strategy that maintains excellent disease outcomes but reduces orbital morbidity. We performed a phase II prospective study of a RA strategy in 50 patients (pts) with stage I-IV orbital indolent BCL. Pts were treated with ultra-low dose (ULD) RT to 4 Gy in 2 fractions and assessed in 3-month intervals for response. Pts with persistent orbital lymphoma were offered an additional 20 Gy in 10 fractions. Pts that had a complete response (CR) to ULD RT were observed. We also evaluated this treatment strategy in a separate 55 pt retrospective cohort. From July 2015-January 2021 51 pts were enrolled. Fifty evaluable pts had follow-up for study inclusion. The median age was 63 years (29-88);62% were female (n=31). Pts had MALT lymphoma (n=32, 64%), follicular lymphoma (FL, n=16, 32%) and low grade BCL (n=6, 12%). Most pts (62%, n=31) had stage I disease limited to one (n=28) or both (n=3) orbits. Pts had newly diagnosed (n=36, 72%);relapsed (n=9, 18%) and refractory lymphoma (n=5, 10%). At a median follow up of 35 months [95% CI 22.2 – 37.4], 90% of pts (n=45) experienced a CR to RA RT, including 44 pts that had a CR to ULD RT (median time to CR 3.4 months) and 1 pt that had a CR after an additional 20 Gy. No local recurrences were observed. Treatment was well tolerated with no grade ≥3 toxicity. Five pts did not have a CR to planned RA therapy including 1 pt that refused additional RT, one pt treated with rituximab, one pt that had a PR on initial evaluation but has not returned for subsequent in person evaluations due to COVID, one pt being observed with stable disease and a final pt that received an additional 20 Gy to the orbit that has a persistent stable mass after the 20 Gy. In a planned subset analysis of 26 pts with newly diagnosed stage 1 disease (MALT, n=22;FL, n=3;low grade BCL, n=1);92.3% (n=24) had a CR to RA RT, with one pt requiring an additional 20 Gy. For all 26 pts with newly diagnosed stage 1 disease, the 3-year freedom from distant relapse rate was 90.4% with 3 distant relapses (contralateral orbit, n=2;paratracheal nodes, n=1). The median follow-up among the 55 pts (MALT, n=38;FL, n=13;low grade B-cell lymphoma, n=4) treated in the retrospective cohort between March 2013 and October 2021 was 28.7 months (95% CI 21.2 - 36.1);98% (n=54) of pts had a CR with RA RT, including 2 pts with a CR after an additional 20 Gy. The remaining pt went on to receive systemic therapy in lieu of additional RT for persistent disease. Among the 54 pts that had a CR with RA RT there was one local relapse in a pt with conjunctival FL 27.8 months after experiencing a CR to ULD RT. This pt received 20 Gy with resolution of the locally relapsed disease. We observed excellent disease control with negligible toxicity in the first prospective study assessing this novel approach of RA ULD RT for pts with indolent B-cell lymphoma. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Stem cell transplantation for COVID-19 management: Translational possibilities and future

COVID-19 is an unforeseen pandemic engendered by novel SARS COV-II virus, which shattered the lives of people globally from 2019. Although several vaccines have been developed in recent past, the detailed study of the effect of the same is still on advancement. The miserable fact is that there is no complete medication against the virus;however, the palliative treatment is being given on the basis of associated symptoms like pneumonia, pulmonary fibrosis, ARDS, difficulty in breathing, and so on. Several antiviral, antimalarial drugs and antibiotics have been attempted to minimize the peril, but the use of these drugs could negatively affect the patients’ health. Scientists were eagerly looking for an alternative therapy to lessen the symptoms and started thinking of regenerative therapy with stem cells. As the therapy has a potential history of treating several pulmonary disorders, it was a possible aspiration toward the treatment of COVID-19. In this regard, several clinical trials were carried out using different types of stem cells, while in particular MSCs have been specialized in amending the cytokine storm occurred on account of the pandemic. Considering the fact that the regenerative therapy is a long-run process and there is way to go forward with it, more advanced therapies may proceed in the future to halt the adverse effect of COVID-19 pandemic. © 2022 Elsevier Inc. All rights reserved.

Hematopoietic Stem/Progenitor Cells and Engineering: HALF-TRUTH: GRAFT CRYOPRESERVATION DOES NOT IMPACT ENGRAFTMENT AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT (ALLO-HCT)-A SINGLE CENTER EXPERIENCE FROM INDIA

Background & Aim: Background: Traditionally, ‘fresh’ Hematopoietic progenitors cell (HPC) infusions have been preferred over cryopreserved HPC in Allo-HCT because cryopreservation and thawing leads to cell loss, besides DMSO-related adverse reactions in patients. Emergence of COVID-19 pandemic has severely affected fresh HPC infusions and most professional bodies recommend cryopreservation of HPC products before initiating conditioning chemotherapy. Although some western studies suggest no significant impact of graft manipulation on patient outcome, there is no available data from the developing world.Aim: We compare neutrophil and platelet engraftment in patients undergoing Allo-HCT with fresh and cryopreserved HPC products. Methods, Results & Conclusion: Material and Method: Allo-HCT data from October 2018 to October 2021 were analyzed. Cryopreservation was performed by controlled-rate freezing using 10% DMSO, plasmalyte- A and human albumin ( 1:2:1) as cryoprotectant. Cryopreserved products were stored in vapour-phase of Liquid nitrogen tank. CD34+ enumeration and viablity( by 7-AAD) was done on Flow-cytometry on fresh and post-thaw HPC samples. Neutrophil engraftment was defined as absolute neutrophil count >0.5 ×109/L for 3 days. Platelet engraftment was defined as independence from platelet transfusion for at least 7 days with a platelet count >20 × 109/L. Statistical analysis using Wilcoxon Rank Sum test. Results: Ninety-six patients underwent allo-HCT (46 received fresh and 50 received cryopreserved HPC products) (Table 1). There was no significant difference in neutrophil engraftment with fresh and cryopreserved grafts (p>0.05) in different types of transplants( Matched related/unrelated and haploidentical). 22% (11/50) of cryopreserved graft infusions were associated with Grade-1 DMSO-related adverse reactions, which were managed with symptomatic treatment. Cryopreservation increased the cost of related allogeneic transplants by USD1100. No cryopreserved HPC product was culture positive on microbiological assessment. Conclusion: In our experience, the engraftment kinetics were similar with fresh and cryopreserved HPC products as CD34+cell dose administered was almost the same. Cryopreserved grafts had a median 7% CD34+cell loss, associated with mild DMSO-related adverse reactions and cost increment. Even though, graft cryopreservation is a feasible alternative during the pandemic, it is crucial to ensure graft quality and promptly manage DMSO-related adverse reactions.(Table Presented) Table 1 Comparison of Fresh and cryopreserved HPC products in Allo-HCT

ICONIC: Impact of Covid-19 on Outcomes iN muscle Invasive bladder Cancer - preliminary Results from a prospective IBUS (International British Urological Society) led multicentre collaborative study

Introduction: The Covid-19 pandemic in the UK led to much un-certainty about the delivery of cancer services. A shift from established therapy (and its timing) in patients with Muscle invasive Bladder Cancer (MIBC) has potential deleterious consequences. To understand outcomes, we formed a collaborative to measure overall and diseasefree survival at 3-years in patients with non-metastatic MIBC (Figure 1) treated during the UK's first wave of Covid-19. Secondary aims included comparison between treatment modalities and pre-Covid controls. Patients and Methods: The collaborative included clinicians from 13 major centres, representing 3 UK nations. A prospective clinical audit, endorsed by the National Cancer Research Institute, was started to collect comprehensive data. MIBC patients discussed at the multidisciplinary meeting (MDM) between 1/3/2020-30/06/2020 were included. Results: At submission, data were available from 12 centres for 299 patients. The mean age was 69.3 years (27- 90), and there were 72 female and 227 male patients. Mean Charlson Co-morbidity Index was 5 (1-12). Preliminary analysis of available data indicate the following: MDM recommendations for (at least) 1 in 4 patients were deemed as being modified from standard practice. Twenty six patients received neoadjuvant chemotherapy. In total (from available data), 99 received radical radiotherapy and 146 underwent radical cystectomy (65 and 74 specified as open and robotic assisted, respectively). Preliminary analysis suggests that 1 in 3 patients had died within 1 year. Conclusions: Preliminary Results indicate that recommendations for MIBC patients were significantly altered consequent to the pandemic and mortality was high. Analyses towards endpoints are awaited.

Predicting the Death Rate Around the World Due to COVID-19 Using Regression Analysis

Nowadays, COVID-19 is considered to be the biggest disaster that the world is facing. It has created a lot of destruction in the whole world. Due to this COVID-19, analysis has been done to predict the death rate and infected rate from the total population. To perform the analysis on COVID-19, regression analysis has been implemented by applying the differential equation and ordinary differential equation (ODE) on the parameters. The parameters taken for analysis are the number of susceptible individuals, the number of infected individuals, and the number of recovered individuals. This work will predict the total cases, death cases, and infected cases in the near future based on different reproductive rate values. This work has shown the comparison based on four different productive rates (i.e., 2.45, 2.55, 2.65, and 2.75). The analysis is done on two different datasets;the first dataset is related to China, and the second dataset is associated with the world's data. The work has predicted that by 2020-08-12 there will be 59,450,123 new cases, 432,499,003 total cases, and 10,928,383 deaths.

COVID-19 AND MULTIPLE SCLEROSIS: AN UPDATED REPORT OF THE COMMUNITY-BASED LONGITUDINAL UK MS REGISTER STUDY

COVID-19 is a concern in people with multiple sclerosis (MS), mostly because of their long-term physical disabilities and immunomodulatory disease-modifying therapies (DMTs). In this community-based pro-spective longitudinal study, we have been monitoring a cohort of people with MS via the web-based platform of the UK MS Register since the start of the COVID-19 outbreak. We report our findings from 17/03/2020 to 15/01/ 2021. Out of 7344 participants, 883 (12%) have reported a selfdiagnosis of COVID-19 of whom 211 had a confirmed clinical or laboratory-based (n=114) diagnosis. No individual DMT increased the likelihood of contracting COVID-19 (with any of the diagnoses as the outcome). Gender (male: female, adjusted OR: 95% CI [0.94: 0.68'1.3]), web-based Expanded Disability Status Scale score (webEDSS;one-point increase, 0.92: 0.84'1.01), and MS duration (one-year increase, 1: 0.98'1.02) were not associated with contracting COVID-19. Younger age (one-year decrease, 1.04: 1.03'1.06), ethnicities other than white (1.95: 1.13'3.34), and relapsing-remitting MS (versus progressive, 1.72: 2.56'1.16) increased the likelihood of contracting COVID-19. Within a median (interquartile range) of 26 (0'72) days follow-up of participants with COVID-19 (n=532), 69% reported full recovery. A higher webEDSS (one-point increase, 0.84: 0.74'0.96) lowered the likelihood of full recovery. Overall, MS-specific factors do not predispose people with MS to contracting COVID-19, but physical disability can delay recovery.

Analyzing the Sentiments by Classifying the Tweets Based on COVID-19 Using Machine Learning Classifiers

In the current scenario, almost all the countries face one of the biggest disasters in COVID-19. This paper has to analyze the tweets related to COVID 19 and discuss the various machine learning algorithms and their performance analysis on the tweets associated with COVID-19. The implemented classification algorithms are applied to classify the sentiments to predict whether they relate to COVID-19 or non-COVID-19. Ten most popular classification algorithms implemented. The Linear Support Vector Machine (LSVM) achieved the highest test accuracy in these algorithms with 90.3%. Logistic regression has performed better in recall with 96.06%, F1 score of 90.46%, ROC_AUC with 90.48%. Random forest classifier has achieved the better specificity and precision of 99.16% and 96.3%, respectively. Out of all, stochastic gradient descent (SGD) has attained better results in all the computational parameters. © 2021 IEEE.

Continuity of cancer care: The surgical experience of two large Cancer Hubs in London and Milan

Introduction: A better understanding of the reality for cancer patients during COVID-19 will help us readapt current predication models. To further inform future clinical guidelines, we need a deep dive into rich data sources from apex Cancer Centres. We report on the outcomes of cancer patients receiving radical surgery between March-September 2020 (as well as 2019) in the European Institute of Oncology (EIO) in Milan and the South East London Cancer Alliance (SELCA). Methods: IEO is one of the largest cancer hospitals in Italy. SELCA includes 3 major hospital trust, treating about 8,000 new cancer patients per annum. Both institutions implemented a COVID-19 minimal pathway, whereby patients were required to shield for 14 days prior to admission and were swabbed for COVID-19 within 3 days of surgery. Positive patients had surgery deferred until a negative swab. Surgical outcomes assessed were: ASA grade, surgery time, theatre time, ICU stay>24h, pneumonia, length of stay (LOS), and admissions. For COVID-19, we focused on infection rate and mortality. Results: At IEO the number of radical surgeries (270 for gynaecological, 339 for head and neck, 377 for thoracic, and 491 for urological cancers) declined by 6% as compared to the same period in 2019 (n=1477 vs 1560). The main decline was observed for thoracic surgery (377 vs 460, i.e. -18%). Age, sex, SES, ethnicity, comorbidities, and performance status were all comparable between both periods (e.g. 58% male, 38% aged 70+, 48% high SES, 15% with existing cardiovascular diseases). Readmissions were required for 39%, and <1% (n=9) developed COVID-19, of which only 1 had severe disease and died. 11 died of other causes during follow-up (1%). At SELCA, the number of radical surgeries (321 for breast, 129 for colorectal, 114 for gynaecological, 152 for head and neck, 92 for liver, 56 for plastics/skin, 305 for thoracic, 72 for upper gastrointestinal, and 312 for urology) declined by 29% (n=1553 vs 2182). Even though a different geographical setting, characteristics were fairly comparable with the IEO: 58% males, 30% aged 70+, 34% high SES, 16% with existing cardiovascular diseases. Readmissions were required for 22%, <1% (n=7) developed COVID-19, and none died from it. 19 died of other causes within 30 days (1%). Conclusion: Milan and London were both at the epicentre of the first COVID-19 wave. Whilst a decline in number of surgeries was observed, the implemented COVID-19 minimal pathways have shown to be safe for cancer patients requiring radical treatment, with limited complications and almost no COVID-19 infections.

Ibrutinib plus rituximab and venetoclax (IRV) followed by risk-stratified observation or short course R-hyper CVAD/MTX in young patients with previously untreated mantle cell lymphoma-phase-II WINDOW-2 clinical trial

Background - The WINDOW-1 regimen introduced first-line ibrutinib with rituximab (IR) followed by 4 cycles of R-HCVAD for younger mantle cell lymphoma (MCL) patients (pts) demonstrating 90% CR on IR alone and we aimed to improve the CR rate with the addition of venetoclax. We therefore investigated the efficacy and safety of IR and venetoclax (IRV) followed by risk-stratified observation or short course R-HCVAD/MTX-ARA-C as consolidation in previously untreated young patients with mantle cell lymphoma (MCL). Our aim was to use a triplet chemotherapy-free induction to reduce the toxicity, complications and minimize chemotherapy exposure in MCL pts. Methods - We enrolled 50 previously untreated pts in this single institution, single arm, phase II clinical trial - NCT03710772. Pts received IR induction (Part-1) for initial 4 cycles. Pts were restaged at cycle 4 and received IRV for up to eight cycles (Cycle 5 to Cycle 12) starting with ramp up venetoclax dosing in Cycle 5. All pts who achieved CR prior to cycle 12 continued to receive IRV for 4 cycles (maximum 12 cycles) and then moved to part 2. Pts were stratified into three disease risk groups: high, moderate and low risk categories from the baseline data for assignment to R-HCVAD/MTX-ARA-C as consolidation in part 2 (4 cycles, 2 cycles, or no chemotherapy for high, medium and low risk pts respectively). Briefly, low risk pts were those with Ki-67 ≤30%, largest tumor mass <3 cm, low MIPI score and no features of high risk disease (Ki-67 ≥50%, mutations in the TP53, NSD2 or in NOTCH genes, complex karyotype or del17p, MYC positive, or largest tumor diameter >5 cm or blastoid/pleomorphic histology or if they remain in PR after 12 cycles of part 1. Medium risk are pts which did not belong to low or high-risk category. Those who experienced progression on part 1 went to part 2 and get 4 cycles of part 2. Patient were taken off protocol but not off study, if they remained in PR after 4 cycles of chemotherapy, these patients were followed up for time to next treatment and progression free survival on subsequent therapies. After part 2 consolidation, all pts received 2 years of IRV maintenance. The primary objective was to assess CR rates after IRV induction. Adverse events were coded as per CTCAE version 4. Molecular studies are being performed. Results - Among the 50 pts, the median age was 57 years (range - 35-65). There were 20 pts in high-risk group, 20 pts in intermediate-risk group and 10 pts in low-risk group. High Ki-67 (≥30%) in 18/50 (36%) pts. Eighteen (36%) had high and intermediate risk simplified MIPI scores. Six (12%) pts had aggressive MCL (blastoid/pleomorphic). Among the 24 TP53 evaluable pts, eight pts (33%) had TP53 aberrations (mutated and/or TP53 deletion by FISH). Forty-eight pts received IRV. Best response to IRV was 96% and CR of 92%. After part 2, the best ORR remained unaltered, 96% (92% CR and 4% PR). The median number of cycles of triplet IRV to reach best response was 8 cycles (range 2-12). Fifteen pts (30%) did not receive part 2 chemotherapy, two pts (4%) received 1 cycle, 16 pts (32%) 2 cycles and 13 pts (26%) got 4 cycles of chemotherapy. With a median follow up of 24 months, the median PFS and OS were not reached (2 year 92% and 90% respectively). The median PFS and OS was not reached and not significantly different in pts with high and low Ki-67% or with/without TP53 aberrations or among pts with low, medium or high-risk categories. The median PFS and OS was inferior in blastoid/pleomorphic MCL pts compared to classic MCL pts (p=0.01 and 0.03 respectively). Thirteen pts (26%) came off study - 5 for adverse events, 3 for on study deaths, and 2 for patient choice, 2 patients lost to follow up and one for disease progression. Overall, 5 pts died (3 on trial and 2 pts died off study, one due to progressive disease and another due to COVID pneumonia). Grade 3-4 toxicities on part 1 were 10% myelosuppression and 10% each with fatigue, myalgia and rashes and 3% mucositis. One pt developed grade 3 atrial flutter on part 1. None had grade 3-4 bleeding/bruising. Conclusions - Chemotherapy-free induction with IRV induced durable and deep responses in young MCL pts in the frontline setting. WINDOW-2 approach suggests that pts with low risk MCL do not need chemotherapy but further follow up is warranted. This combined modality treatment approach significantly improves outcomes of young MCL pts across all risk groups. Detailed molecular analyses will be reported. (Figure Presented).