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

Knowledge and perceptiion of physiotherapy by final year medical students of a Nigerian university

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CBFISKD: A Combinatorial-Based Fuzzy Inference System for Keylogger Detection

A keylogger is a type of spyware that records keystrokes from the user’s keyboard to steal confidential information. The problems with most keylogger methods are the lack of simulated keylogger patterns, the failure to maintain a database of current keylogger attack signatures, and the selection of an appropriate threshold value for keylogger detection. In this study, a combinatorial-based fuzzy inference system for keylogger detection (CaFISKLD) was developed. CaFISKLD adopted back-to-back combinatorial algorithms to identify anomaly-based systems (ABS) and signature-based systems (SBS). The first combinatorial algorithm used a keylogger signature database to match incoming applications for keylogger detection. In contrast, the second combinatorial algorithm used a normal database to detect keyloggers that were not detected by the first combinatorial algorithm. As simulated patterns, randomly generated ASCII codes were utilized for training and testing the newly designed CaFISKLD. The results showed that the developed CaFISKLD improved the F1 score and accuracy of keylogger detection by 95.5% and 96.543%, respectively. The results also showed a decrease in the false alarm rate based on a threshold value of 12. The novelty of the developed CaFISKLD is based on using a two-level combinatorial algorithm for keylogger detection, using fuzzy logic for keylogger classification, and providing color codes for keylogger detection