Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care

The JEM-EUSO mission

JEM-EUSO is a space science mission to explore the extreme energies and physics of the Universe. Its instrument will watch the darkside of the earth and will detect UV photons emitted from the extensive air shower caused by an ultra-high energy cosmic ray (UHECR above 1018 eV), or an extremely high energy cosmic ray (EHECR) particle (e.g. above about 1020 eV). Such a high-rigidity particle as the latter arrives almost in a straight line from its origin through the magnetic fields of our Milky Way Galaxy and is expected to allow us to trace the source location by its arrival direction. This can open the door to new astronomy with charged particles. In its 5 years of operation including the tilted mode, Extreme Universe Space Observatory an Japanese Experiment Module (JEM-EUSO) will detect at least 1000 events with E > 7 × 1019 eV with the Greisen–Zatsepin–Ku’zmin (GZK) suppression spectrum. It can determine the energy spectrum and source locations of GZK to super-GZK regions with a statistical accuracy of several percent. JEM-EUSO is planned to be deployed by H2 transfer vehicle (HTV) and will be attached to the Japanese Experiment Module/Exposure Facility (JEM/EF) of International Space Station. JAXA has selected JEM-EUSO as one of the mission candidates of the second phase utilization of JEM/EF for launch in the early-to-mid 2010 s