Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20–60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov , NCT04384926 . Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include...

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BACKGROUND:The aims of this study were to provide data on the safety of head and neck cancer surgery currently being undertaken during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This international, observational cohort study comprised 1137 consecutive patients with head and neck cancer undergoing primary surgery with curative intent in 26 countries. Factors associated with severe pulmonary complications in COVID-19-positive patients and infections in the surgical team were determined by univariate analysis. RESULTS: Among the 1137 patients, the commonest sites were the oral cavity (38%) and the thyroid (21%). For oropharynx and larynx tumors, nonsurgical therapy was favored in most cases. There was evidence of surgical de-escalation of neck management and reconstruction. Overall 30-day mortality was 1.2%. Twenty-nine patients (3%) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within 30 days of surgery; 13 of these patients (44.8%) developed severe respiratory complications, and 3.51 (10.3%) died. There were significant correlations with an advanced tumor stage and admission to critical care. Members of the surgical team tested positive within 30 days of surgery in 40 cases (3%). There were significant associations with operations in which the patients also tested positive for SARS-CoV-2 within 30 days, with a high community incidence of SARS-CoV-2, with screened patients, with oral tumor sites, and with tracheostomy. CONCLUSIONS: Head and neck cancer surgery in the COVID-19 era appears safe even when surgery is prolonged and complex. The overlap in COVID-19 between patients and members of the surgical team raises the suspicion of failures in cross-infection measures or the use of personal protective equipment. Cancer 2020;0:1-13.

Agriculture is crucial to the economic prosperity and development of India. Plant diseases can have a devastating influence towards food safety and a considerable loss in the production of agricultural products. Disease identification on the plant is essential for long-term agriculture sustainability. Manually monitoring plant diseases is difficult due to time limitations and the diversity of diseases. In the realm of agricultural inputs, automatic characterization of plant diseases is widely required. Based on performance out of all image-processing methods, is better suited for solving this task. This work investigates plant diseases in grapevines. Leaf blight, Black rot, stable, and Black measles are the four types of diseases found in grape plants. Several earlier research proposals using machine learning algorithms were created to detect one or two diseases in grape plant leaves; no one offers a complete detection of all four diseases. The photos are taken from the plant village dataset in order to use transfer learning to retrain the EfficientNet B7 deep architecture. Following the transfer learning, the collected features are down-sampled using a Logistic Regression technique. Finally, the most discriminant traits are identified with the highest constant accuracy of 98.7% using state-of-the-art classifiers after 92 epochs. Based on the simulation findings, an appropriate classifier for this application is also suggested. The proposed technique’s effectiveness is confirmed by a fair comparison to existing procedures.

Providing an identity solution is essential for a reliable blockchain-based land registry system. A secure, privacy-preserving, and efficient identity solution is essential but challenging. This paper examines the current literature and provides a systematic literature review in three stages based on the three research questions (RQ) that show the assessment and interpretation process step by step. Based on the parameters and RQ specified in the research methodology section, a total of 43 primary articles have been selected from the 251 articles extracted from various scientific databases. The majority of these articles are concerned with evaluating the existing self-sovereign identity (SSI) solutions and their role in the blockchain-based land registry system to address the compliance issues in the existing SSI solutions with SSI principles and find the best possible SSI solution to address the identity problems in the land registry. The existing digital identity solutions cannot handle the requirements of the identity principle and are prone to various limitations like centralization and dependency on third parties that further augment the chance of security threats. SSI has been designed to overcome these limitations and provide a secure, reliable, and efficient identity solution that gives complete control to the users over their personal identity information (PII). This paper reviews the existing SSI solutions, evaluates them based on the SSI principles, and comes up with the best possible SSI solution for a blockchain-based land registry system. It further provides a detailed investigation of each SSI solution to present its functionalities and limitations for further improvement.