INNV-27. AN INNOVATIVE VIRTUAL MULTI-INSTITUTIONAL, MULTIDISCIPLINARY NEURO-ONCOLOGY TUMOR BOARD: THE NIH-NOB EXPERIENCE DURING THE COVID-19 PANDEMIC

Abstract BACKGROUND The American Academy of Neurology Institute and Society for Neuro-Oncology recommend multidisciplinary tumor board (MTB) meetings as a quality metric in neuro-oncology. With the COVID-19 pandemic resulting in travel restrictions, we expanded our existing MTB by transitioning to a virtual format that maintained our commitment to providing consultation for primary CNS tumor cases. This transition permitted participation by neuro-oncology teams from over 30 Brain Tumor Trials Collaborative (BTTC)/National Cancer Institute-Comprehensive Oncology Network Evaluating Rare CNS Tumors (NCI-CONNECT) centers across the United States. Here, we describe results from opening our MTB remotely to these teams. METHODS We retrospectively reviewed records from remote MTB meetings held between April 2020 and March 2021. To gauge the impact of our MTB on clinical management, we administered a brief survey querying BTTC members. RESULTS Twenty-eight providers presented 41 cases during 24 virtual MTB meetings (range: 1-4 cases per meeting). Two cases (5%) were presented only for educational value. Approximately half (54%) of the cases discussed dealt with diagnosis/management of an NCI-CONNECT rare CNS tumor. During MTB discussions of the 39 cases seeking diagnosis/management recommendations, 32% received clinical trial recommendations, 10% were suggested to enroll in the NCI Neuro-Oncology Branch (NOB) Natural History Study (NCT02851706), 17% received a recommendation to obtain central neuropathology review, and 100% received recommendations for further disease management. Most BTTC survey respondents (83%) found these recommendations impactful in the management/treatment of their presented case or generally useful/informative for their clinical practice. CONCLUSION We describe the feasibility and utility of an innovative virtual multi-institutional MTB. These novel remote meetings allowed for discussion of complex neuro-oncology cases and recommendations from experts, particularly important for those with rare CNS tumors. Our study’s findings during the COVID-19 pandemic of the value of providing remote access to MTBs should apply post-pandemic.

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UNWTO World Tourism Barometer and Statistical Annex, October 2020

UNWTO World Tourism Barometer ◽

10.18111/wtobarometereng.2020.18.1.6 ◽

2020 ◽

Vol 18 (6) ◽

pp. 1-36 ◽

Cited By ~ 3

Keyword(s):

The United States ◽

International Travel ◽

International Tourism ◽

The European Union ◽

International Tourist ◽

The Pacific ◽

Slow Virus ◽

Travel Restrictions ◽

Main Barrier ◽

The Impact

International travel plunges 70% in the first eight months of 2020 International tourist arrivals (overnight visitors) declined 70% in the first eight months of 2020 over the same period of last year, amid global travel restrictions including many borders fully closed, to contain the ongoing COVID-19 pandemic. International arrivals plunged 81% in July and 79% in August, traditionally the two busiest months of the year and the peak of the Northern Hemisphere summer season. Despite such large declines, this represents a relative improvement over the 90% or greater decreases of the previous months, as some destinations started to reopen to international tourism, mostly in the European Union. The decline in January-August 2020 represents 700 million fewer international tourist arrivals compared to the same period in 2019, and translates into a loss of US$ 730 billion in export revenues from international tourism, more than 8 times the loss in 2009 under the impact of the global economic crisis. Asia and the Pacific, the first region to suffer the impact of the pandemic, saw a 79% decrease in arrivals in January-August 2020. Africa and the Middle East both recorded a 69% drop this eight-month period, while Europe saw a 68% decline and the Americas 65%. Data on international tourism expenditure continues to reflect very weak demand for outbound travel, though in several large markets such as the United States, Germany and Italy there is a small uptick in spending in the months of July and August. Based on latest trends, a 75% decrease in international arrivals is estimated for the month of September and a drop of close to 70% for the whole of 2020. While demand for international travel remains subdued, domestic tourism is strengthening recovery in several large markets such as China and Russia. The UNWTO Confidence Index continues at record lows. Most UNWTO Panel Experts expect a rebound in international tourism by the third quarter of 2021 and a return to pre-pandemic 2019 levels not before 2023. Experts consider travel restrictions as the main barrier weighing on the recovery of international tourism, along with slow virus containment and low consumer confidence.

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ЮНВТО Всемирная туристская Барометр, и статистическое приложение Обновленная информация, Декабрь 2020 года

Барометр меҗдународного туризма ЮНВТО ◽

10.18111/wtobarometerrus.2020.18.1.7 ◽

2020 ◽

Vol 18 (7) ◽

pp. 1-36

Keyword(s):

Travel Demand ◽

Economic Loss ◽

The United States ◽

International Travel ◽

International Tourism ◽

Current Trends ◽

International Tourist ◽

The Pacific ◽

Travel Restrictions ◽

The Impact

International tourism expected to decline over 70% in 2020, back to levels of 30 years ago International tourist arrivals (overnight visitors) fell by 72% in January-October 2020 over the same period last year, curbed by slow virus containment, low traveller confidence and important restrictions on travel still in place, due to the COVID-19 pandemic. The decline in the first ten months of the year represents 900 million fewer international tourist arrivals compared to the same period in 2019, and translates into a loss of US$ 935 billion in export revenues from international tourism, more than 10 times the loss in 2009 under the impact of the global economic crisis. Asia and the Pacific saw an 82% decrease in arrivals in January-October 2020. The Middle East recorded a 73% decline, while Africa saw a 69% drop this ten-month period. International arrivals in both Europe and the Americas declined by 68%. Data on international tourism expenditure continues to reflect very weak demand for outbound travel. However, some large markets such as the United States, Germany and France have shown some shy signs of recovery in the recent months. While demand for international travel remains subdued, domestic tourism continues to grow in several large markets such as China and Russia, where domestic air travel demand has mostly returned to pre-COVID levels. Based on current trends, UNWTO expects international arrivals to decline by 70% to 75% for the whole of 2020. This would mean that international tourism could have returned to levels of 30 years ago. The estimated decline in internationals tourism in 2020 is equivalent to a loss of about 1 billion arrivals and US$ 1.1 trillion in international tourism receipts. This plunge in international tourism could result in an estimated economic loss of over US$ 2 trillion in global GDP, more than 2% of the world’s GDP in 2019. Looking ahead, the announcement and the roll-out of a vaccine are expected to gradually increase consumer confidence and contribute to ease travel restrictions. UNWTO’s extended scenarios for 2021-2024 point to a rebound in international tourism by the second half of 2021. Nonetheless, a return to 2019 levels in terms of international arrivals could take 2½ to 4 years.

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Music industry in crisis: The impact of a novel coronavirus on touring metal bands, promoters, and venues

10.31219/osf.io/96ptk ◽

2020 ◽

Author(s):

Kyle J. Messick

Keyword(s):

Qualitative Interviews ◽

Music Industry ◽

The United States ◽

Metal Music ◽

Preventative Measures ◽

Live Music ◽

Travel Restrictions ◽

Novel Coronavirus ◽

The Impact ◽

Financial Losses

In March of 2020 the world began to take widespread preventative measures against the spread of a novel coronavirus through travel restrictions, quarantines, and limitations on group gatherings. These restrictions resulted in the immediate closing of many businesses, including concerts venues, and also put an abrupt end to live music performances across Europe and the United States. This had immediate implications for touring bands, as bands earn most of their income touring, and many found themselves in a situation where they experienced substantial financial losses alongside negative affective ramifications. This article utilized evidence from qualitative interviews and public statements to draw inferences about the impact of COVID-19 on the music industry, with a particular focus on touring musicians and their respective managers, promoters, booking agencies, and record labels. Musicians reported negative affective and financial ramifications as a result of COVID-19, but they also reported overwhelming support from metal music fans that made the fallout from the pandemic less severe.

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Incidence Rates of Pediatric Central Nervous Tumors Display No Geographical Variation

10.1101/2021.09.27.21264205 ◽

2021 ◽

Author(s):

Dayton P Grogan ◽

Vamsi Reddy ◽

Christopher Banerjee ◽

Jennifer Waller ◽

Theodore Johnson ◽

...

Keyword(s):

United States ◽

Statistical Significance ◽

The United States ◽

Fold Change ◽

Cns Tumors ◽

Tumor Type ◽

United States Census Bureau ◽

Cns Tumor ◽

Geographical Regions ◽

Small Effect Size

Background: Central nervous system (CNS) tumors affect over 4,600 children throughout the United States each year. Despite recent trends of increasing incidence of pediatric CNS tumors, the understanding of variations in their incidence between different geographical regions remains incomplete. Methods: Data used in this study was obtained from the Surveillance, Epidemiology, and End Results (SEER) Program. The SEER database and its built-in operation software was used to generate state-specific incidence data for newly diagnosed CNS tumor diagnoses in children ages 0-19 for the years 2001-2014. Results were organized by tumor type and individual states were clustered into nine geographical regions as defined by the United States Census Bureau. Results: Statistically significant differences were found in the regional incidence of astrocytoma, primitive neuroectodermal tumor (PNET), and the category of unspecified intracranial and intraspinal neoplasms. However, the magnitude of the difference in incidence (ΔI) between specific regions was small, on the order of 0.1 to 0.6 per 100,000 population, representing a nominal 0.05-fold to 0.79-fold change in incidence (ΔI/incidence for comparator region) for astrocytoma and for the category of unspecified intracranial and intraspinal neoplasms, and a larger 3.25-fold to 3.75-fold change in incidence for PNET. Conclusions: Differences in incidence between geographical regions for certain CNS tumor types met the bar for statistical significance. However, these differences are unlikely to be clinically meaningful due to the small effect size.

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Medical Capacity Shortages Facilitated the Rapid Dissemination of COVID-19 in Wuhan, New York State, and Italy

10.1101/2020.11.05.20226530 ◽

2020 ◽

Author(s):

Yuehao Xu ◽

Cheng Zhang ◽

Lixian Qian

Keyword(s):

New York ◽

New York State ◽

The United States ◽

Control Measures ◽

York State ◽

Travel Restrictions ◽

Rapid Dissemination ◽

City State ◽

And Control ◽

The Impact

AbstractDuring the coronavirus disease 2019 (COVID-19) outbreak, every public health system faced the potential challenge of medical capacity shortages. Infections without timely diagnosis or treatment may facilitate the stealth transmission and spread of the virus. Using infection and medical capacity information reported in Wuhan in China, New York State in the United States, and Italy, we developed a dynamic susceptible–exposed–infected–recovered (SEIR) model to estimate the impact of medical capacity shortages during the COVID-19 outbreak at the city, state, and country levels. After accounting for the effects of travel restrictions and control measures, we find that the number of infections in Wuhan could have been 39% lower than the actual number if the medical capacity were doubled in this city. Similarly, we find the less shortages in medical capacity in both New York state and Italy, the faster decline in the daily infection numbers and the fewer deaths. This study provides a method for estimating potential shortages and explains how they may dynamically facilitate disease spreading during future pandemics such as COVID-19.

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Identifying individuals with primary central nervous system tumors at risk for hereditary cancer syndromes using the Utah Population Database.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10532 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10532-10532

Author(s):

Nicholas Shawn Whipple ◽

Wendy Kohlmann ◽

Samuel Cheshier ◽

Zhe Yu ◽

Karen Curtin ◽

...

Keyword(s):

At Risk ◽

Hereditary Cancer ◽

Cancer Genetics ◽

Cancer Surveillance ◽

Cns Tumors ◽

Hereditary Cancer Syndrome ◽

Cancer Syndrome ◽

Population Database ◽

Cns Tumor ◽

The Impact

10532 Background: CNS tumors are the most common solid tumors and the deadliest cancers in children. Approximately 10% of children with a CNS tumor harbor a hereditary cancer syndrome (HCS), but many will not be tested for a HCS. The Utah Population Database (UPDB) contains comprehensive cancer registry data for Utah families and can determine multigenerational cancer pedigrees across an archive of 5.8 million individuals. Early identification of HCSs results in improved cancer surveillance and outcomes, reducing the impact of CNS tumors in children. We hypothesize that the UPDB can identify children and families with HCSs not previously identified. Methods: We queried the UPDB for individuals ages 0-39 diagnosed with a primary CNS tumor (malignant and benign) between 1966-2017 and generated cancer pedigrees of 3 generations or more for probands, extending to at least third-degree relatives. Specialized software calculated a familial standardized incidence ratio (FSIR) to determine families with excess clustering of CNS tumors. Clinical cancer genetics experts reviewed pedigrees to confirm patterns of HCS. Results: We identified 4,634 CNS tumors in 4,550 individuals, of whom 2,233 (49%) reside in high-quality pedigrees containing ≥2 grandparents, at least 1 from both maternal and paternal sides. To identify families with excess clustering of CNS tumors, we selected pedigrees with an FSIR P< 0.05 and ≥2 affected patients, resulting in 161 high-risk families with a mean of 170 (median 96) relatives per pedigree of 3-6 generations. Among these 161 families, there were 2,017 unique relatives (first-third degree) of CNS probands with 2,355 tumors (any site), for a per pedigree average of 14.7 tumors in 12.5 relatives. Review of the 10 highest risk pedigrees indicated that 4 meet HCS criteria, including Li-Fraumeni (n = 2), von Hippel-Lindau (n = 1), and rhabdoid tumor predisposition (n = 1). Conclusions: The UPDB can produce multigenerational cancer pedigrees that identify individuals and families at risk of harboring a HCS who warrant germline testing. These findings should encourage clinicians to perform thorough family history screening and to always consider workup for associated HCSs.

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Navigating Through Uncertainty in the Era of COVID-19

Journal of International Students ◽

10.32674/jis.v12i1.3305 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Manca Sustarsic ◽

Jianhui Zhang

Keyword(s):

International Students ◽

International Student ◽

Research University ◽

Student Mobility ◽

The United States ◽

Host Institution ◽

International Graduate ◽

Travel Restrictions ◽

And Coping ◽

The Impact

With the spread of COVID-19 around the world, the lives of international students became affected by a sudden shift to online learning, sheltering in place, and travel restrictions. Drawing upon the stress and coping framework, this study explores the experiences and coping of international graduate students at a large Western research university in the United States. We employed a phenomenological inquiry of in-depth interviews with 20 participants. Findings reveal the increased levels of stress and anxiety among participants as they faced academic challenges, personal challenges, and immigration-related uncertainties. Over time, students developed emotion-focused and problem-focused coping strategies to minimize the impact of the pandemic on their lives. Participants’ concerns about the host country’s treatment of international students raise important questions about the future of international student mobility. Finally, this study demonstrates the need to develop emergency responding mechanisms of the host institution.

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Baromètre OMT du tourisme mondial et annexe statistique, Decembre 2020

Baromètre OMT du tourisme mondial ◽

10.18111/wtobarometerfra.2020.18.1.7 ◽

2020 ◽

Vol 18 (7) ◽

pp. 1-36

Keyword(s):

Travel Demand ◽

Economic Loss ◽

The United States ◽

International Travel ◽

International Tourism ◽

Current Trends ◽

International Tourist ◽

The Pacific ◽

Travel Restrictions ◽

The Impact

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RARE-41. GLIOBLASTOMA MULTIFORME AND OTHER CNS TUMORS IN HEREDITARY MISMATCH REPAIR DEFICIENCIES

Neuro-Oncology ◽

10.1093/neuonc/noz175.964 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi230-vi230

Author(s):

Evan Dishion ◽

Clayton Korson ◽

Darren Groh

Keyword(s):

Brain Tumor ◽

Glioblastoma Multiforme ◽

Literature Review ◽

Mismatch Repair ◽

The United States ◽

Germline Mutations ◽

Lifetime Risk ◽

Cns Tumors ◽

Current Management ◽

Cns Tumor

Abstract BACKGROUND Lynch syndrome (LS) and constitutional mismatch repair deficiency syndrome (CMMRD) are caused by germline mutations in mismatch repair (MMR) genes, namely MLH1, MSH2, MSH6, and PMS2. LS patients have an inherited mono-allelic MMR defect, whereas CMMRD patients have a bi-allelic defect. MMR is critical to maintaining genomic integrity during DNA replication and these germline defects are known to produce microsatellite instability (MSI). Both LS and CMMRD have reported cases of increased primary brain cancer, namely glioblastoma multiforme (GBM). Given the shared pathophysiology of these syndromes, the large number of cases and registry studies published, and recent treatments of CNS tumors in CMMRD, a literature review has been conducted. OBJECTIVES: Review the pathophysiology of germline MMR deficiency and how it relates to brain tumor formation. Review the risk of developing primary CNS tumors with various MMR defects. Review the current management of CNS tumors in LS and CMMRD. METHODS Literature review of the most recent understanding of pathophysiology, all literature on CNS tumors in LS and CMMRD, and the current management of GBM including recent literature on CMMRD. RESULTS The lifetime risk of developing a primary malignant brain tumor or other CNS tumor in the United States has been calculated at 0.62%. Based on registry data, current estimates of the lifetime risk of developing a primary CNS tumor in LS is between 1–8.7%. Of the 146 genetically confirmed cases of CMMRD, 58 cases of high-grade gliomas were identified (including GBM). Most patients with CMMRD carry homozygous germline mutations in PMS2 (approximately 60%). Although primary CNS tumors appears to be a less common extra-colonic manifestation in LS, it is relatively common amongst CMMRD patients. Acknowledgement: Henry Lynch

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Gulf states will boost United Arab Emirates tourism

Emerald Expert Briefings ◽

10.1108/oxan-db219883 ◽

2017 ◽

Keyword(s):

United Arab Emirates ◽

The United States ◽

Subsequent Increase ◽

Content Type ◽

Tourism Sector ◽

New Destination ◽

Travel Restrictions ◽

Gulf States ◽

In Transit ◽

The Impact

Significance Within the UAE, the tourism giant is Dubai, which has long aimed to attract 20 million visitors by 2020 -- an ambitious goal but not impossible. Abu Dhabi is also a significant player. From a low base, Ras al-Khaimah is emerging as a new destination, achieving 10.9% growth in visitor arrivals in 2016. Impacts Growth in the tourism sector will underline the UAE’s reputation as the best managed of the GCC states. Rising tourism and the subsequent increase in services receipts to government revenue will support the balance of payments. The impact on Emirati employment will be negligible, as nationals shun low-paid, low-status jobs in the sector, or have cultural objections. Visitors from the United States (or those stopping in transit on that route) may be deterred by new travel restrictions. In the longer term, the major risks are environmental challenges and security concerns.

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