ABSTRACT
Background: The SARS-CoV-2 pandemic has had an unprecedented impact on healthcare systems, and cancer patients were amongst the most vulnerable. CONTACT is a national multidisciplinary study assessing the impact of the SARS-CoV-2 pandemic upon diagnostic and treatment pathways among patients with pancreatic ductal adenocarcinoma (PDAC). Method(s): A novel, mixed prospective and retrospective design, with retrospective case identification of both cohorts, and trainee-performed data collection. The treatment of consecutive patients with newly diagnosed PDAC from a pre-COVID cohort (07/01/ 2019-03/03/2019) were compared to a cohort diagnosed during the first wave of SARS-CoV-2 in the UK ('COVID' cohort, 16/03/2020-10/05/ 2020), with 12-month follow-up. Result(s): Among 984 patients (pre-COVID: N=483, COVID: N=501), across 96 hospitals, the COVID cohort were less likely to receive staging investigations other than CT scan (148/501, 29.5% vs 180/486, 37.2%;p=0.01). Among patients treated with curative intent, there was a reduction in the proportion of patients recommended surgery (42/77, 54.5% vs 72/94, 76.6%, p=0.001) and increase in the proportion recommended neoadjuvant therapy (35/77, 45.5% vs 22/94, 23.4%, p=0.002). Among patients within a non-curative pathway, fewer patients were recommended (201/424, 47.4% vs 223/389, 57.3%, p=0.004) or received palliative therapy (87/424, 20.5% vs 103/389, 26.5%, p=0.045). Ultimately, fewer patients in the COVID cohort underwent resection surgery (29/501, 6.4% vs 45/483, 9.3%, OR 0.64, 95%CI: 0.37- 0.97, p=0.036), whilst more patients received no treatment whatsoever (347/ 501, 69.3% vs 286/483, 59.2% p=0.009). There was no difference in median survival between the COVID and pre-COVID cohorts, (105 days, IQR: 86-124 vs 130 days, IQR: 108-157, p=0.093). Conclusion(s): The CONTACT study confirms alarming reduction in the staging and treatment provided to patients with PDAC diagnosed during the SARS-CoV-2 pandemic. Restoration of cancer services to pre-pandemic standards must be urgently addressed.
ABSTRACT
Many medical decisions during the pandemic were made without the support of causal evidence obtained in clinical trials. We study the case of nebulized ibuprofen (NaIHS), a drug that was extensively used on COVID-19 patients in Argentina amidst wild claims about its effectiveness and without regulatory approval. We study data on 5,146 patients hospitalized in 11 health centers spread over 4 provinces, of which a total of 1,019 (19.8%) received the treatment. We find a large, negative and statistically significant correlation between NaIHS treatment and mortality using inverse probability weighting estimators. We consider several threats to identification, including the selection of "low" risks into NaIHS, spillovers affecting patients in the control group, and differences in the quality of care in centers that use NaIHS. While the negative correlation appears to be, broadly, robust, our results are best interpreted as emphasizing the benefits of running a randomized controlled trial and the challenges of incorporating information produced in other, less rigorous circumstances.
ABSTRACT
A graph analysis on the tweets and users networks from a set of curated news was done to study the existing difference in communication patterns between legitimate and misinformation news. Our findings suggest there is no difference in the influence of misinformation and legitimate news but misinformation news tend to be more shared and present than legitimate news, meaning that while misinformation tweets do not have more influence, their authors are more prolific. Misinformation reach wider audience even if the tweets, individually, are not more influential. A subsequent qualitative analysis on the users reveal that there is also influence of misinformation spreading in Spain from other Spanish speaking countries. © 2021, Springer Nature Switzerland AG.
ABSTRACT
The severe pandemic caused by the respiratory coronavirus SARS-CoV-2 (COVID-19) is currently a major problem in all elective surgery clinics, including those that perform refractive surgery, which has been rescheduling most of their procedures for a long time due to high morbidity and mortality. Currently, due to changes in the knowledge of the disease, as well as protective measures with barriers, many refractive surgery clinics have restarted their procedures without yet having a consensus about protection for doctors and patients. This work aims to adapt the international information of the existing guidelines, as well as to provide recommendations that can be applied and be useful for the practice of these procedures in Mexico.
ABSTRACT
The European Union is pushing forward its European Green Deal where sustainable mobility is one of the main areas of interest, especially after the COVID-19 crisis. The role of battery electric buses (BEBs) in public transit is key to achieve sustainable mobility and to reduce city pollution and greenhouse gas emissions and, therefore, global warming. Standardization plays a key role to ensure the deployment of a safe, cost effective, energy efficient, sustainable BEBs fleet. Standardization of components, interoperability, generalized recharge possibility, and even the possibility of using the BEBs as controllable loads, with energy storage that can be returned to the grid, must be done. This paper presents the most relevant legislation at European level, the International and European standardization outline in the field of BEBs, and the most important standardization activities going on. It gives references to deal with the very high number of standards relevant for the BEBs and the related activities that are in constant update, from different standardization entities. © 2020 IEEE.