The FLARE score, circulating neutrophils, and association with COVID-19 outcomes in patients with solid tumors

Background: Inflammation and neutrophils play a central role in severe Covid-19 disease. In previous data, we showed that the FLARE score, combining both tumor and Covid-19-induced proinflammatory status (proinflamstatus), predicts early mortality in cancer patients (pts) with Covid-19 infection. We aimed to assess the impact of this score in a larger cohort and characterize the immunophenotype (IF) of circulating neutrophils. Methods: Multicenter retrospective cohort (RC) of pts with cancer and Covid-19 infection across 14 international centers. Circulating inflammatory markers were collected at two timepoints: baseline (-15 to -45d before Covid-19 diagnosis) and Covid-19 diagnosis. Tumor-induced proinflam-status was defined by high dNLR (neutrophils/(leucocytes-neutrophils)> 3) at baseline. Covid-19-induced proinflam-status was defined by +100% increase of dNLR between both timepoints. We built the FLARE score combining both Tumor and Infection-induced inflammation: T+/I+ (poor), if both proinflam-status;T+/I- (T-only), if inflammation only due to tumor;T-/I+ (I-only), if inflammation only due to Covid;T-/I- (favorable), if no proinflam-status. The IF of circulating neutrophils by flow cytometry was determined in a unicenter prospective cohort (PC) of pts with cancer during Covid-19 infection and in healthy volunteers (HV). Primary endpoint was 30-day mortality. Results: 524 pts were enrolled in the RC with a median follow- up of 84d (95%CI 78-90). Median age was 69 (range 35-98), 52% were male and 78% had baseline PS <1.Thoracic cancers were the most common (26%). 70% had active disease, 51% advanced stage and 57% were under systemic therapy. dNLR was high in 25% at baseline vs 55% at Covid-19 diagnosis. The median dNLR increase between both timepoints was +70% (IQR: 0-349%);42% had +100% increase of dNLR. Pts distribution and mortality across FLARE groups is resumed in the Table. Overall mortality rate was 26%. In multivariate analysis, including gender, stage and PS, the FLARE poor group was independently associated with 30-day mortality [OR 5.27;1.37-20.3]. 44 pts were enrolled in the PC. Median circulating neutrophils were higher in pts with cancer (n=10, 56.7% [IQR: 39-78.4%]) vs HV (n=6, 35.8% [IQR: 25.6-21%]), and particularly higher in pts with cancer and severe Covid-19 infection (n=7, 88.6% [IQR: 80.9-94%] (p=0.003). A more comprehensive characterization of the IF of circulating neutrophils, including Lox1/CD62/CD64, will be presented at ASCO. Conclusions: The FLARE score, combining tumor and Covid-19-induced proinflam-status, can identify the population at higher risk for mortality. A better characterization of circulating neutrophils may help improve the prediction of Covid-19 outcomes in pts with cancer. (Table Presented).

Perspectives, Challenges, and Opportunities: The Pandemic Teaching Experiences in Science Courses

The shift to distance learning has created unique perspectives and challenges to educational stakeholders specifically among teachers who are tasked with keeping teaching and learning on track despite their professional, technical, and personal concerns, and inadequate familiarity to the new learning modality. While these realities have been challenging the capability of teachers, they also open the doors for opportunities of levelling up to a new education landscape and harnessing potentials which may be useful for the furtherance of the teaching practices. The present qualitative study aims to document Science teachers’ perspectives, challenges and opportunities in the teaching of Science courses during the pandemic. It consists of the various insights, initiatives, coping strategies and actions, and opportunities of eight Filipino Science teachers towards securing a responsive and efficient learning management in the midst of the unforeseen challenges in the education sector brought by the impact of the COVID-19 pandemic. © 2022, North American Business Press. All rights reserved.

Cura Personalis: Institutionalizing Compassion during Emergency Remote Teaching

Faced with the fears and anxieties brought on by the COVID-19 crisis, educational institutions had to devise new compassion-based teaching and learning policies and approaches that recognized and provided for the pandemic’s psychological and emotional toll. This paper describes how the Ateneo de Manila University in the Philippines enacted its core value of cura personalis, care for the entire person, in the context of emergency remote teaching. We describe the circumstances that prompted the greater emphasis on compassion and the adjustments to classroom management, course content, class interactions, and assessment. Finally we describe the tradeoffs or costs of this approach. © 2021 29th International Conference on Computers in Education Conference, ICCE 2021 - Proceedings. All rights reserved

Emotional distress in cancer patients during the first wave of the COVID-19 pandemic in Madrid

Background: The COVID-19 pandemic has emerged as the most important international health problem of the last decades. This study explores the psychopathological implications that Covid-19 has caused on cancer patients during the first wave of the pandemic in Spain. Methods: In this prospective study, we included cancer patients in active treatment from March to June 2020. A 24-question semi-structured questionnaire was designed to measure baseline demographic, clinical and Covid-19 exposure characteristics. Mental health was assessed using the validated Hospital Anxiety and Depression Scale. A descriptive and analytical univariate analysis of the variables studied was performed. Results have been compared with baseline emotional distress rates from historical cohorts in cancer patients. Results: 104 cancer patients were included;a 52.8% of emotional distress, 42.3% of anxiety and 58.6% of depression were detected. 51% of patients expressed higher concern about cancer diagnosis vs COVID-19 infection. Tumor type, stage, type of oncologic treatment or rescheduling of cancer therapy were not related with higher levels of psychological symptomatology. Patients with previous consumption of psychotropic drugs and those who adopted additional infection prevention measures because they considered themselves at risk of having a more aggressive COVID-19 disease had higher levels of emotional distress (p=0.008;p=0.003), anxiety (p=0.026;p=0.004) and depression (p=0.013;p=0.008). Emotional distress was higher in patients whose financial status had worsened (p=0.002). Anxiety rates were higher among patients who often used relaxing therapies (p=0.011) and those who were frequently exposed to media (p=0.05). Depression rates were higher among patients with lower educational level (p=0.032), in those whose economic situation had worsened (p=0.003), and those who relied on Religion or Faith (p=0.029). Conclusions: High rates of emotional distress have been detected during the first wave of the Covid-19 pandemic among cancer patients in active treatment, however, not higher than expected in this population. The cancer disease itself continues to be the main factor of concern for cancer patients, above and beyond the distress generated by Covid-19 pandemic. Legal entity responsible for the study: Hospital Universitario De La Princesa, Medical Oncology Department. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

When Language Learning Suddenly Becomes Online: Analyzing English as Second Language Learners’ (ELLs) Attitude and Technological Competence

As COVID-19 pandemic disrupted every aspect of humanity, worldwide lockdown has placed a heavy toll on the education sector that resulted in the shift from the traditional face-to-face activities to online learning modality. Since the massive closure of educational institutions worldwide, a number of studies have explored teachers’ technological competence and attitude towards online learning. Yet, such line of research that focuses on leaners themselves seem lacking. Using the Attitude towards Online Learning Questionnaire (AOLQ) and Javier’s (2020) Technological Competence Tool (TCT), this quantitative study aims to determine the technological competence and attitude towards online learning of 1,408 college students with no prior experience as regards the new mode of teaching and learning. It also explored significant difference on respondents’ technological competence and attitude towards online learning when they are grouped according to gender. Finally, it examines the relationship between technological competence and attitudes to online learning. Results reveal that respondents exhibited ‘somehow positive attitude’ towards online learning, and ‘somehow competent’ level of technological competence. Further, no significant difference has been established on technological competence and attitude towards online learning when respondents were grouped according to gender. Finally, attitude towards online learning has been found to be significantly related with technological competence. © 2021. All Rights Reserved.

Endoscopy in a COVID-19 referral national university hospital: A single-center experience and recommendations

Rationale. COVID-19 pandemic disease, can be transmitted during gastrointestinal procedures, via aerosolized droplets, and via fecal shedding. Both international and local endoscopy societies have issued strategies to alleviate the risk to endoscopy personnel. However, several barriers against the implementation of these recommendations exist thus individual center’s policies are employed whenever applicable. Objectives. This narrative study aims to describe the current experience and set-up in the endoscopy unit of a COVID referral center, discuss the stratification of patients for endoscopy, the operational management of the personnel and endoscopy unit in line with the adapted local and international guidelines and offer endoscopists a quick reference guide to adapt endoscopy practice during the pandemic in a resource-limited setting. Methodology. This paper reviews and consolidates current endoscopy guidelines and describes the single-center experience of Philippine General Hospital. Results. In resource-limited settings, with uncertainties of prolonged COVID-19 impact to healthcare, modification of practice, adherence to strategies and recommendations, empowerment of workforce, establishing the sustainability of resources, training, and service to patients, are essential components to combat current dilemma brought about by this pandemic. Conclusion. Integration of current local and international guidelines encompass all aspects of endoscopy practice during the pandemic. The recommendations cited are aimed to guide other resource-limited endoscopy units for potential changes and guidance in the overall practice. © 2021 University of the Philippines Manila. All rights reserved.

Pandemic humor: Inventory of the humor scripts produced during the COVID-19 outbreak

Humor is no cure for COVID-19, does feed the hungry, nor can pay the bills of the jobless. Many do not approve of humor out of crisis, yet millions of people have come up with COVID-19 related humor scripts on social medial platforms if only to soften grief, lighten mood, and distract people from the struggle in accepting the new normal. Humor is also used as coping mechanism for the bad scenario experienced by many. Everybody tends to laugh at those they love and hate, and many times they joke about the good and bad fortunes of people. The present quantitative-qualitative study documents and categorizes the 214 humor scripts (equal distribution of Tagalog and English humor scripts) that were produced and circulated in social media platforms during the COVID-19 pandemic. The collected humor scripts were coded according to humor types (i.e., aggressive, national/ethnic, positive, self-deprecating, sexual, sexist), humor targets, humor subjects and humor structure (i.e., conversational, narrative, one-liner, question and answer, verse/lyrical). Humor targets and subjects exclusive to Tagalog and English humor scripts were also discussed. © 2020 Asian E F L Journal Press. All rights reserved.