Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Customer purchase behavior prediction in E-commerce: a conceptual framework and research agenda

Digital retailers are experiencing an increasing number of transactions coming from their consumers online, a consequence of the convenience in buying goods via E-commerce platforms. Such interactions compose complex behavioral patterns which can be analyzed through predictive analytics to enable businesses to understand consumer needs. In this abundance of big data and possible tools to analyze them, a systematic review of the literature is missing. Therefore, this paper presents a systematic literature review of recent research dealing with customer purchase prediction in the E-commerce context. The main contributions are a novel analytical framework and a research agenda in the field. The framework reveals three main tasks in this review, namely, the prediction of customer intents, buying sessions, and purchase decisions. Those are followed by their employed predictive methodologies and are analyzed from three perspectives. Finally, the research agenda provides major existing issues for further research in the field of purchase behavior prediction online

A learning strategy for developing neural networks using repetitive observations

Neural networks can model system behaviors by learning past system observations. As system observations are usually collected by human judgments, physical experiments or sensor measures, they can be inherently imprecise and inconsistent over time. System behaviors can be learned more completely from repetitive observations. However, repetitive observations can be very different due to system or measurement uncertainty. If abnormal observations are used for developing neural networks, spurious behaviors can be learnt and the neural networks are likely to generate spurious prediction. If abnormal observations are excluded, important system behaviors can partially be ignored. In this paper, a novel strategy is proposed to develop neural networks by learning repetitive observations. Numerous neural networks are developed individually based on either abnormal or normal observations. The predictions generated based on the individual neural networks are integrated to a single prediction. Analytical proof indicates that the overall observation uncertainty involved on the proposed learning strategy is less than the uncertainty involved on the general ones. As less uncertainty is involved, more effective learning can be performed on the proposed strategy. Two case studies are conducted in order to evaluate the effectiveness of the proposed learning strategy, where the two case studies are involved data collection from either sensor measures or human evaluations. Numerical results indicate that the proposed strategy can generate better neural networks which have higher fitting capability to captured observations and higher generalization capability to uncaptured samples