When Negativity Is the Fuel. Bots and Political Polarization in the COVID-19 Debate

The contexts of social and political polarization are generating new forms of communication that affect the digital public sphere. In these environments, different social and political actors contribute to extreme their positions, using bots to create spaces for social distancing where hate speech and incivility have a place, a phenomenon that worries scientists and experts. The main objective of this research is to analyze the role that these automated agents played in the debate on social networks about the Spanish Government's management of the global COVID-19 pandemic. For this, "Social Big Data Analysis" techniques were applied: machine learning algorithms to know the positioning of users, bot detection algorithms, "topic modeling" techniques to learn about the topics of the debate on the web, and sentiment analysis. We used a database comprised of Twitter messages published during the confinement, as a result of the Spanish state of alarm. The main conclusion is that the bots could have served to design a political propaganda campaign initiated by traditional actors with the aim of increasing tension in an environment of social emergency. It is argued that, although these agents are not the only actors that increase polarization, they do contribute to deepening the debate on certain key issues, increasing negativity.

The Impact of the COVID-19 Pandemic on Post-Great Recession Entrants: Evidence from Mexico

I study the impact of the COVID-19 pandemic on the formal employment of entrants from each post-Great Recession year. Using longitudinal Mexican social security records and an individual fixed effects difference-in-differences design, I find that the pandemic caused entrants from each post-Great Recession year to lose formal employment at higher rates than individuals who joined the formal sector before them. This gap is narrowing as the economy recovers. My results are explained by differences in firm-specific tenure and pre-pandemic wages, not by geographical variations in hysteresis from the Great Recession.

Factorial Validity, Reliability, Measurement Invariance and the Graded Response Model for the COVID-19 Anxiety Scale in a Sample of Ecuadorians.

The aims of the research are to evaluate the factorial validity, internal consistency, measurement invariance, discrimination, and difficulty of the Covid-19 Anxiety Scale (CAS) applied to a sample of Ecuadorian adults (N = 451). The study is based on an instrumental design with Classical Test Theory (CTT) and Item Response Theory (IRT) technics. The results confirmed the validity of the CAS single-factor structure, with measurement invariance across gender and high internal consistency. Additionally, all CAS items displayed adequate discrimination indexes and proper ordering of the difficulty thresholds. In a conclusion, the CAS is a valid measurement scale for Ecuadorian adults.

Cuando la negatividad es el combustible. Bots y polarización política en el debate sobre el COVID-19

Para ello, se han aplicado técnicas de «Social Big Data Analysis»: algoritmos de «machine learning» para conocer el posicionamiento de los usuarios;algoritmos de detección de «bots»;técnicas de «topic modeling» para conocer los temas del debate en la red, y análisis de sentimiento. The main objective of this research is to analyze the role that these automated agents played in the debate on social networks about the Spanish Government's management of the global COVID-19 pandemic. For this, Social Big Data Analysis techniques were applied: machine learning algorithms to know the positioning of users;bot detection algorithms;topic modeling techniques to learn about the topics of the debate on the web, and sentiment analysis. COVID-19, political bots, political polarization, digital propaganda, public opinion, social networks analysis.

Postoperative Radiotherapy for Locally Advanced NSCLC: Implications for Shifting to Conformal, High-Risk Fields.

BACKGROUND: To examine the effect of radiotherapy field size on survival outcomes and patterns of recurrence in patients treated with postoperative radiotherapy (PORT) for non-small-cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the records of 216 patients with T1-4 N1-2 NSCLC following surgery and PORT using whole mediastinum (WM) or high-risk (HR) nodal fields from 1998 to 2015. Survival rates were calculated using the Kaplan-Meier method. Univariate and multivariable analyses were conducted using Cox proportional hazards modeling for outcomes and logistic regression analysis for treatment toxicities. RESULTS: Median follow-up was 28 months (interquartile range [IQR] 13-75 months) and 38 months (IQR 19-73 months) for WM (n = 131) and HR (n = 84) groups, respectively. Overall survival (OS) was not significantly different between groups (median OS: HR 49 vs. WM 32 months; P = .08). There was no difference in progression-free survival (PFS), freedom from locoregional recurrence (LRR), or freedom from distant metastasis (P > .2 for all). Field size was not associated with OS, PFS, or LRR (P > .40 for all). LRR rates were 20% for HR and 26% for WM groups (P = .30). There was no significant difference in patterns of initial site of LRR between groups (P > .1). WM fields (OR 3.73, P = .001) and concurrent chemotherapy (odds ratio 3.62, P = .001) were associated with grade ≥2 toxicity. CONCLUSIONS: Locoregional control and survival rates were similar between PORT groups; an improved toxicity profile was observed in the HR group. Results from an ongoing prospective randomized clinical trial will provide further insight into the consequences of HR PORT fields.

Why Re-Invent the Wheel? Social Network Approaches Can Be Used to Mitigate SARS-CoV-2 Related Disparities in Latinx Seasonal Farmworkers.

Latinx seasonal farmworkers are essential workers and are at elevated risk for SARS-CoV-2 in the United States. Risk factors for SARS-CoV-2 are unique to this population and include crowded living conditions, isolated social networks, and exploitative working environments. The circumstances and cultural values of Latinx seasonal farmworkers pose a unique challenge to public health authorities working to contain the spread of SARS-CoV-2. This community is in dire need of urgent public health research to identify opportunities to prevent SARS-CoV-2 transmission: social network methods could be the solution. Using previously collected and new information provided by a team of experts, this commentary provides a brief description of Latinx seasonal farmworker disparities that affect tracking and treating SARS-CoV-2 in this important group, the challenges introduced by SARS-CoV-2, and how social network approaches learned from other infectious disease prevention strategies can address these disparities.

Acute mesenteric arterial thrombosis in severe SARS-Co-2 patient: A case report and literature review.

INTRODUCTION: CoV-2 infection generates a pro-inflammatory state, which conditions the formation of thrombi that can affect any system. Multi-organ dysfunction is a cause of death, mesenteric ischemia in COVID 2019 patients reported is 1.9-4%. DESCRIPTION OF THE CASE: We present the case of a 73-year-old male patient who started with severe SARS-CoV-2 and arterial-type intestinal ischemia, necrosis of 3 m of the small intestine, based on SCARE 2020 guide. DISCUSSION: Complications secondary to thrombosis are as follows; myocardial infarction 1.1%, ischemic cerebral events, 2.5-3.7%, microvascular thrombosis including mesenteric ischemia in less than 1% of cases. In patients with mesenteric ischemia the reported postoperative mortality is 23.8% of patients especially during the first 30 days. CONCLUSION: Intestinal thrombosis in patients with SARS-CoV-2 increases mortality.

Community Detection Problem Based on Polarization Measures: An Application to Twitter: The COVID-19 Case in Spain

In this paper, we address one of the most important topics in the field of Social Networks Analysis: the community detection problem with additional information. That additional information is modeled by a fuzzy measure that represents the risk of polarization. Particularly, we are interested in dealing with the problem of taking into account the polarization of nodes in the community detection problem. Adding this type of information to the community detection problem makes it more realistic, as a community is more likely to be defined if the corresponding elements are willing to maintain a peaceful dialogue. The polarization capacity is modeled by a fuzzy measure based on the JDJpol measure of polarization related to two poles. We also present an efficient algorithm for finding groups whose elements are no polarized. Hereafter, we work in a real case. It is a network obtained from Twitter, concerning the political position against the Spanish government taken by several influential users. We analyze how the partitions obtained change when some additional information related to how polarized that society is, is added to the problem.

Impact of Telemedicine on Patient Satisfaction and Perceptions of Care Quality in Radiation Oncology.

BACKGROUND: The COVID-19 pandemic has transformed cancer care with the rapid expansion of telemedicine, but given the limited use of telemedicine in oncology, concerns have been raised about the quality of care being delivered. We assessed the patient experience with telemedicine in routine radiation oncology practice to determine satisfaction, quality of care, and opportunities for optimization. PATIENTS AND METHODS: Patients seen within a multistate comprehensive cancer center for prepandemic office visits and intrapandemic telemedicine visits in December 2019 through June 2020 who completed patient experience questionnaires were evaluated. Patient satisfaction between office and telemedicine consultations were compared, patient visit-type preferences were assessed, and factors associated with an office visit preference were determined. RESULTS: In total, 1,077 patients were assessed (office visit, n=726; telemedicine, n=351). The telemedicine-consult survey response rate was 40%. No significant differences were seen in satisfaction scores between office and telemedicine consultations, including the appointment experience versus expectation, quality of physician's explanation, and level of physician concern and friendliness. Among telemedicine survey respondents, 45% and 34% preferred telemedicine and office visits, respectively, and 21% had no preference for their visit type. Most respondents found their confidence in their physician (90%), understanding of the treatment plan (88%), and confidence in their treatment (87%) to be better or no different than with an office visit. Patients with better performance status and who were married/partnered were more likely to prefer in-person office visit consultations (odds ratio [OR], 1.04 [95% CI, 1.00-1.08]; P=.047, and 2.41 [95% CI, 1.14-5.47]; P=.009, respectively). Patients with telephone-only encounters were more likely to report better treatment plan understanding with an office visit (OR, 2.25; 95% CI, 1.00-4.77; P=.04). CONCLUSIONS: This study is the first to assess telemedicine in routine radiation oncology practice, and found high patient satisfaction and confidence in their care. Optimization of telemedicine in oncology should be a priority, specifically access to audiovisual capabilities that can improve patient-oncologist communication.

Radiation Oncologist Perceptions of Telemedicine from Consultation to Treatment Planning: A Mixed-Methods Study.

PURPOSE: Telemedicine was rapidly implemented for initial consultations and radiation treatment planning in the wake of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we explore utilization of and physician perspectives on this approach in an attempt to identify patient populations that may benefit most from virtual care. METHODS AND MATERIALS: This is a mixed-methods study with a convergent design. Approximately 6 to 8 weeks after implementation of telemedicine, all radiation oncologists in a single academic radiation oncology department were invited to participate in either semistructured interviews with embedded survey questions or a concurrently administered survey only. Rapid qualitative analysis was used to identify common themes, and quantitative data was assessed using descriptive statistics and univariable analyses. RESULTS: At the apex of the pandemic, 92% of radiation oncology visits were conducted via telemedicine. In total, 51 of 61 radiation oncologists participated in the study (response rate 84%). Most (71%) reported no difference in ability to treat cancer appropriately via telemedicine, which was more common among specialized physicians (P = .01) but not those with higher visit volume or years of experience. Over half (55%) perceived no difference or even improvement in overall visit quality with telemedicine. Virtual visits were deemed acceptable for a median of 70% to 96% of patients, which varied by disease site. Need for physical examination, and availability of an acceptable proxy, factored into telemedicine acceptability. Most (88%) found telemedicine better than expected, but opinions were split on how telemedicine would affect physician burnout. Almost all (96%) foresaw a role for telemedicine beyond the pandemic and would opt for a median of 50% (interquartile range 20%-66%) of visits conducted via telemedicine. CONCLUSIONS: Among radiation oncologists in an academic setting, telemedicine was perceived to be highly appropriate and acceptable for most patients. Future studies should focus on identifying the 5% to 30% of patients whose care may be optimized with in-person visits, and if there is alignment with patient preferences.

Need for Caution in the Diagnosis of Radiation Pneumonitis During the COVID-19 Pandemic.

PURPOSE: Patients with cancer are at high risk for mortality from coronavirus disease 2019 (COVID-19). Radiation pneumonitis (RP) is a common toxicity of thoracic radiation therapy with clinical and imaging features that overlap with those of COVID-19; however, RP is treated with high-dose corticosteroids, which may exacerbate COVID-19-associated lung injury. We reviewed patients who presented with symptoms of RP during the intensification of a regional COVID-19 epidemic to report on their clinical course and COVID-19 testing results. METHODS AND MATERIALS: The clinical course and chest computed tomography (CT) imaging findings of consecutive patients who presented with symptoms of RP in March 2020 were reviewed. The first regional COVID-19 case was diagnosed on March 1, 2020. All patients underwent COVID-19 qualitative RNA testing. RESULTS: Four patients with clinical suspicion for RP were assessed. Three out of 4 patients tested positive for COVID-19. All patients presented with symptoms of cough and dyspnea. Two patients had a fever, of whom only 1 tested positive for COVID-19. Two patients started on an empirical high-dose corticosteroid taper for presumed RP, but both had clinical deterioration and ultimately tested positive for COVID-19 and required hospitalization. Chest CT findings in patients suspected of RP but ultimately diagnosed with COVID-19 showed ground-glass opacities mostly pronounced outside the radiation field. CONCLUSIONS: As this pandemic continues, patients with symptoms of RP require diagnostic attention. We recommend that patients suspected of RP be tested for COVID-19 before starting empirical corticosteroids and for careful attention to be paid to chest CT imaging to prevent potential exacerbation of COVID-19 in these high-risk patients.

Palliative Radiation Therapy for Oncologic Emergencies in the Setting of COVID-19: Approaches to Balancing Risks and Benefits.

Palliation of metastatic disease compromises a significant portion of radiation treatments in the United States. These patients present a unique challenge in resource-limited settings, as expeditious treatment is often required to prevent serious morbidity. In order to reduce the risk of infection with severe acute respiratory syndrome coronavirus-2 and maximize the benefit to patients, we present evidence-based recommendations for radiation in patients with oncologic emergencies. Radiation oncologists with expertise in the treatment of metastatic disease at a high-volume comprehensive cancer center reviewed the available evidence and recommended best practices for the treatment of common oncologic emergencies, with attention to balancing the risk of infection with severe acute respiratory syndrome coronavirus-2 and the potential morbidity of delaying treatment. Many prospective trials and national guidelines support the use of abbreviated courses of radiotherapy for patients with oncologic emergencies. As such, in the setting of the current coronavirus disease 2019 pandemic, the use of hypofractionated radiation therapy for patients requiring palliation for oncologic emergencies achieves desirable functional outcomes without compromising care.

Thoracic Radiation Therapy During Coronavirus Disease 2019: Provisional Guidelines from a Comprehensive Cancer Center within a Pandemic Epicenter.

Coronavirus disease 2019 is an unprecedented pandemic with significant and evolving impact on the practice of radiation oncology. Radiation oncology departments must anticipate and account for coronavirus disease 2019 exposure risk for both patients and staff. The potential for severe radiation therapy resource constraints, particularly due to staff illness, must also be considered. Here we present provisional guidelines for thoracic radiation therapy adopted at our facility, a high-volume cancer center located in a United States pandemic epicenter. Generally, these guidelines reflect the principle that where evidence-supported hypofractionated schedules with comparable efficacy and toxicity exist, the shortest such schedules should be employed. In addition, we discuss potential adaptations in the prioritization and timing of radiation therapy for thoracic malignancies under these circumstances.