Everyday Virtuality: A Multimodal Analysis of Political Participation and Newsworthiness

Due to the COVID-19 pandemic, digital interactions ceased to be "just another form of communication”;indeed, they became the only means of social interaction, mediated and driven by information and communication technologies (ICTs). Consequently, working in a digital context switched from being a phenomenon to be studied to the primary means of socializing and the primary workspace for researchers. This study explores four different methodologies to question how discursive interactions related to power and newsworthiness may be addressed in digital contexts. The multimodal approach was reviewed through the affordances of critical discourse analysis, issue ownership and salience, morphological discourse analysis, and protest event analysis. It starts by theoretically addressing concepts of multimodality and phenomenology by focusing on the implications of both perspectives. It examines publications and interactions in digital contexts in Ecuador from March 2017 to December 2020 within three political phenomena. The results of the analysis of these publications and interactions suggest that when analyzing political participation and newsworthiness, the virtual becomes a subjective space. Moreover, qualitative research is one of the primary ways to combine multimodality with other forms of discourse analysis. This paper concludes that perceptions, practices, and meanings assigned to social online representations can be better analyzed through multimodality, which tackles the intertwined characteristics of virtual discourses. © 2023 by the authors.

Business Interruption Insurance and COVID-19: A Critical Analysis of the Jurisprudence and the Response of the Spanish Insurance Sector

The closure of commercial establishments decided by Spanish authorities on several occasions between 2020 and 2021 as a measure to prevent the spread of the COVID-19 virus resulted in a flood of claims to insurers for damages resulting from business interruption. In Spain, the insurance covering those losses is a guarantee within a multi-risk insurance that also covers material damage to the premises and the right to compensation for loss of profits only arises if there is prior material damage. As a result, the insurers refused to pay and ended up being sued in court. This chapter analyses: (i) the Spanish rulings that have been handed down in relation to these claims (a clear change of trend can be observed here);(ii) whether policyholders who have received government aid due to the temporary closure of their businesses should have their insurance compensation reduced (if they are entitled to receive it);(iii) the measures that insurers are introducing in their contracts and wordings to avoid being exposed to paying compensation for business interruptions resulting from pandemics in the future;and (iv) the position of the insurance companies' association (UNESPA) and the Spanish government in relation to the future coverage of these damages. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Preterm Birth Associated with COVID-19

Introduction: The COVID-19 responsible for the pandemic has not only produced alterations at the pulmonary level but has also affected other types of population such as pregnant women and has brought with it different complications such as premature birth. Objective: To identify the relationship between premature birth and COVID-19. Methods: A narrative review was carried out including all the studies performed between March 2020 and May 2021, which evaluated women during their last trimester of pregnancy, and who were carriers of COVID-19 infection. Information was reviewed in Clinical Key, Cochrane Library, Pubmed, SciELO, and Medline databases. Conclusions: The symptomatology that prevailed in pregnant women with mild SARS-Cov-2 infection was fever and dry cough, while in moderate to severe infection they had hypoxia, dyspnea and tachypnea. There is high prevalence of premature labor when contracting SARS-Cov-2, and it was even found that this prevalence was double compared to uninfected pregnant women. This prevalence was observed in pregnant women who had moderate to severe symptoms of COVID-19 due to the pro-inflammatory state during the third trimester of pregnancy. © 2022, Editorial Ciencias Medicas. All rights reserved.

[Effects of COVID-19 lockdown on the demand for health care of children and adolescents with burns in three specialized outpatient centers in Chile]. / Efectos del confinamiento por COVID-19 en la demanda de atención de niñas, niños y adolescentes con quemaduras en tres centros ambulatorios especializados de Chile.

INTRODUCTION: COVID-19 pandemic has meant adapting to a different reality, with long-term lockdowns that might cause an increase of burns in children at home. OBJECTIVE: To compare the epidemiological situation of patients admitted to the Corporación de Ayuda al Niño Quemado (COANIQUEM) due to out patient burn injuries management at the beginning of COVID-19 lockdown with the same period the year before. PATIENTS AND METHODS: Analytical and cross-sectional study. A population of 2,027 patients under the age of 20, who were admitted to COANIQUEM for the first time with burn inju ries, between April and July of 2019 and 2020 was analyzed. The number of patients admitted each month was registered as well as their demographic, social, and clinical characteristics. The monthly percentage variation was calculated by comparing patient data in both years. RESULTS: During 2020, there was a 48.7% decrease in overall outpatient admissions. There was a relative increase of 10.5% in burns in patients under 5 years old, 18.3% in scalds, 33.1% in the number of burns in 3 or more body locations, and 16.8% in burns occurring at home. These parameters were not influenced by geographic location, sex, or socioeconomic level. CONCLUSIONS: In the first period of the COVID-19 pandemic, with strict lockdown strategies, there was a decrease in the demand for burn care, affecting both outpatients with acute burns and those who were admitted for sequelae rehabilitation, as a result of the effective decrease in the burns incidence and the reduced access to health care.

An Integrated and Digitalized Approach to Reduce the Well Failure Index During Covid-19 Global Pandemic in Shushufindi Field

The Covid-19 pandemic is an unprecedented condition to the global economy including the oil & gas industry. The ability to adapt to the imposed changes, requires creativity, innovation, digitalization of processes, and resilience. This work will show a novel integrated approach around four pillars which had improved operation efficiency and brought monetary value during a challenging 2020 in Shushufindi field, Ecuador. The first pillar is new technology adoption. This aims to extend run life of critical equipment resulting in a higher well productive time. Examples of adopted technology: Chrome-enrich tubulars, downhole microcaps chemical deployment, de-sander and multiphase/extended gas handler. The second pillar is the P3 process (Pre-Pulling-Post) to quickly and effectively find the root cause of well failure that leads to definite remedial action. Digital enabler is the third pillar, its value come from reducing operational downtime and risk by using real-time surveillance capability, remote control, and data intelligence. The final pillar is to re-establish an effective communication with all stakeholders. Various dashboards have been developed in order to provide the big picture of actual field condition in quickly manner as well as implementation of ESP real time surveillance & diagnostics, real time multiphase production test, and chemical treatment automation. Workshops, online technical, and service quality meetings are regularly conducted to ensure that recommendations and opportunities can be executed properly including contractual negotiations to enable new technology implementation. Despite all the restrictions during covid-19 pandemic and some force majeures in 2020, this integrated and digitalized approach has resulted an outstanding outcome: Well failure index reduced from 0.62 in 2019 to 0.41 in 2020;Production deferment related to well failure declined significantly from 2,420 bopd in 2019 to 1,259 bopd in 2020, which translate in savings of $16.8 million dollars. In addition to that, there was a reduction on operational cost from $26.3 million dollars in 2019 to $15.2 million dollars in 2020. This proven initiative has been supported and recognized by all stakeholders. Some new technologies and digitalization projects are in the process to be implemented in Shushufindi field as part of Ecuador digital strategy 2022. This successful integrated and digitalized approach can be adopted in other fields and will generate a huge business impact. © Copyright 2021, Society of Petroleum Engineers

Influence of covid-19 infection in patients with inflamatory bowel disease with biological and no biological therapy

Background: Inflammatory bowel disease (IBD) patients undergoing treatments that act on the inmune system and present an increased risk of infections. For this reason, we could consider that these patients may have an increased risk of severe SARS-CoV-2 infection, however, it remains unclear. We aimed to analyze the cumulative incidence, the severity of the infection and its influence on the natural history of IBD in patients under biological treatment and also evaluating the possible differences with another group without these therapy. Methods: Retrospective observational study about our IBD patients followed from March 2020 to January 2021 divided into two groups: patients on treatment with biological drugs (anti-TNF, vedolizumab, ustekinumab and tofacitinib) and patients without biological drugs (thiopurines or 5-ASA). We evaluated: the cumulative incidence in 10 months for COVID-19 in the 2 cohorts;clinical variables considered risk factors for the infection, the infection severity and influence on the course of IBD employing Harvey-Bradshaw index in Crohn's disease and Mayo partial index in ulcerative colitis before and after infection. Results: It collected 755 IBD patients. 89 were infected by SARSCOV-2, 43 in the biological group and 46 in non biological group. The cumulative incidence in 10 months was 10.85% in the first group (figure 1) and 12.81% in the second group with no significant differences. We verified comparability of the groups discarded the existence of statistical differences in all of the risk factors (sex, age, hypertension, diabetes, dyslipidemia, cardiovascular disease and BMI). In most cases, the infection was mild (94.4%) and the required treatment was symptomatic in 86.4% of the total (Figure 2), without significant differences between groups. Pneumonia was diagnosed in 5 patients, whose required hospital admission (3 belonged to the biological group and 2 to the other). The maximum respiratory support required was FIO2 36%, no patient required admission to ICU and there were no deaths. Additionally, the course of IBD was not affected because of COVID-19, considering no significant differences were observed in clinical scores in each group before and after infection, even taking into account 14 patients discontinued biological therapy temporarily during infection. Conclusion: Our study suggests that IBD patients under biological therapy do not have an increased incidence of SARS-COV-2 infection and also do not have a higher risk of severe disease than IBD patients without this therapy. Furthermore, COVID-19 does not affect the natural history of IBD. These data go in the same direction as those published to date, however, we need multicentre registries with a larger sample size in the future.

Influence of COVID-19 on inflammatory bowel disease patients and biological treatment

Introduction: Inflammatory bowel disease (IBD) patients undergoing treatment with drugs that act on the immune system present an increased risk of infections in general1. For this reason, we could consider that these patients may have an increased risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, however, it remains unclear2. We aimed to analyze the cumulative incidence, the severity of the SARS-COV2 infection and its influence on the natural history of IBD in patients under biological treatment, also evaluating the possible differences with another group without these treatments. Aims & Methods: Retrospective observational study about our IBD patients followed between March 2020 and January 2021 divided into two groups: patients on treatment with biological drugs (anti-TNF, vedolizumab, ustekinumab and tofacitinib) and patients without biological therapy as thiopurines or mesalamine (5-ASA). We evaluated: the cumulative incidence in 10 months for COVID-19 in the 2 cohorts;clinical variables considered risk factors for the infection (sex, age, hypertension, diabetes, dyslipidemia, cardiovascular disease, body mass index)3,4;the infection severity (visits to the emergency room, need for hospital admission, type of treatment received) and influence on the course of IBD (Harvey- Bradshaw index and Mayo partial in Crohn's disease and ulcerative colitis respectively, before and after COVID-19). Results: It collected 755 IBD patients treated in our centre. Of these, a total of 89 patients were infected by SARS-COV-2, 43 belonged to the biologics group and 46 were to 5-ASA and thiopurines group treatment. Only 3 patients out of 89 were being treated with corticosteroids. We verified the groups' comparability discarded the existence of statistical differences in age, sex distribution and the rest of the risk factor's. The cumulative incidence in 10 months was 10.85% in the biologics group and 12.81% in the group without biologics, with no incidence significant differences. In most cases, the infection was mild (94.4%) and the required treatment was symptomatic in 86.4% of the total, without significant differences between groups. Pneumonia was diagnosed in 5 patients, whose required hospital admission (3 belonged to the biological group and 2 to the other). Only 18 patients (20,2%) required one emergency room visit and the rest none. The maximum respiratory support required was FIO2 36%, no patient required admission to the intensive care unit and there were no deaths. Additionally, the course of IBD was not affected as a result of COVID-19, considering no significant differences were observed in clinical scores in each group before and after infection, even though 14 of the patients in the biological group discontinued these medications temporarily during infection (mean 2.87 weeks). None of the patients in the thiopurines and 5-ASA group discontinued the drug Conclusion: Our study suggests that IBD patients under biological treatment do not have an increased incidence of SARS-COV-2 infection and also do not have a higher risk of severe disease than IBD patients with other treatments (5-ASA or thiopurines).

ANALYSIS OF COMPUTER SECURITY IN VIRTUAL ENVIRONMENTS OF THE AUTONOMOUS REGIONAL UNIVERSITY OF THE ANDES EXTENSION QUEVEDO IN TIMES OF COVID-19

This research is conducted in order to obtain the impact of computer security processes in the members of UNIANDES-Quevedo in time of COVID 19, it is known that nationally the pandemic has forced several institutions to change their face-to-face mode by the virtual and so far no studies have been conducted on the effects on the level of computer security in the institution, which is why the study is proposed, the use of the computer technologies in all the aspects of the human daily life, has led to that the computer security is not only a concern of the big companies, with the pandemic that crosses the whole world many companies have been seen in the obligation to implement the telework in their companies remaining vulnerable before the lack of controls that allow them to protect themselves of not wished instructions. With an exploratory research, with descriptive information management, a field research was applied, with techniques such as interview and survey in order to investigate and obtain information of the systems implemented in UNIANDES in times of pandemic;determining the impact of security in the processes offered by UNIANDES.

Prevalence of Depression, Anxiety, and Perceived Stress in Postpartum Mexican Women during the COVID-19 Lockdown

The COVID-19 lockdown represents a new challenge for mental health researchers and clinical practitioners. This cross-sectional study aimed to investigate the prevalence of depression, anxiety, and perceived stress in postpartum Mexican women. The study included 293, 4-12-week postpartum women over the age of 18. The Edinburgh Postpartum Depression Scale (EPDS), Trait-State Trait Anxiety Inventory (T-STAI), and Ten Perceived Stress Scale (PSS-10), which are all questionnaires validated for the Mexican population, were applied using a web-based online survey. Prevalence and 95% confidence intervals (CIs) were calculated. The mean +/- standard deviation (SD) of the maternal age was 29.9 +/- 6.3 years;the EPDS score: 11 +/- 6, T-STAI score: 41.7 +/- 12.3, and PSS-10 score: 17.1 +/- 7. The prevalence (95% CI) of the postpartum depression symptoms was 39.2% (34-45%), trait anxiety symptoms were found among 46.1% (32-43%) of the participants, and moderate and high perceived stress were in 58% (52-64) and 10.9% (7.8-15) of the participants, respectively. The prevalence of depressive symptoms, generalized anxiety, and perceived stress was higher among postpartum Mexican women during the COVID-19 outbreak than before the lockdown. Our findings highlight the importance of monitoring perinatal mental health during pandemics and the need to design effective psychologic interventions for these patients.

Mechanisms of infection by SARS-CoV-2, inflammation and potential links with the microbiome

The pandemic SARS coronavirus 2 utilizes efficient mechanisms to establish infection and evade the immune system. Established infection leads to severe inflammation in susceptible patients, the main hallmark of progression to severe coronavirus disease (COVID-19). Knowledge of the mechanisms of disease has expanded rapidly. As inflammation emerges as the central pathophysiological feature in COVID-19, elucidating how the immune system, lungs and gut communicate and interact with microbial components of the ecological niches that conform the human microbiome will shed light on how inflammation and disease progression are promoted. Studying the microbiome in COVID-19 could allow scientists to identify novel approaches to prevent severe inflammation by targeting components of the human microbiome. Innovation in the aforementioned is needed to combat this pandemic.

CATASTROPHIC STROKE DESPITE ASPIRIN AND THERAPEUTIC ENOXAPARIN IN PATIENT WITH SEVERE COVID-19

SESSION TITLE: Medical Students/Residents' COVID-19 SESSION TYPE: Med Student/Res Case Report PRESENTED ON: October 18-21, 2020 INTRODUCTION: Coagulopathy in COVID-19 has been associated with increased mortality and can result in deep venous thrombosis/pulmonary embolism, ischemic stroke and disseminated intravascular coagulation (DIC). Herein we present a case of a patient with severe COVID-19 complicated by ischemic stroke despite therapeutic enoxaparin. CASE PRESENTATION: Our patient was a 48 year-old-male with past medical history of morbid obesity, hypertension and hyperlipidemia who presented with one week history of progressive cough and dyspnea. He was hypoxemic requiring non-rebreather oxygen at 15 liters/minute to maintain saturation's >92%. Blood work was remarkable for an elevated c-reactive protein to 9.86 mg/dL and and high sensitivity d-dimer to 732 ng/dL. Chest x-ray revealed extensive bilateral airspace opacities (Image 1). The patient was admitted to our intensive care unit and transitioned to high-flow nasal cannula oxygen. Initial arterial blood gas revealed PaO2/FiO2 of 71. He was started on deep venous thrombosis prophylaxis with enoxaparin 40mg every 12 hours and continued on his home aspirin, 81mg daily. On hospital day (HD) 1 patients COVID-19 PCR returned positive. He received 400mg of intravenous tocilizumab and a unit of convalescent plasma. Early HD 3 the patients d-dimer trended up to >1000 ng/mg and he was transitioned to therapeutic enoxaparin at a dose of 1mg/kg twice daily. His platelet count remained stable and within normal limits. Late HD 4 he was found to have paralysis of his left upper and lower extremity. STAT imaging revealed large right middle cerebral artery infarction with mid-line shift (Image 2). He was not a candidate for systemic thrombolytic therapy or mechanical thrombectomy. HD 6 patient required right hemicraniectomy for worsening cerebral vasogenic edema. Brain biopsy revealed acute cerebritis characterized by marked perivascular and parenchymal neutrophilic infiltrates and associated acute hypoxic neurons, marked edema and small vessel thrombi (Image 3). Unfortunately the patient’s condition ultimately deteriorated and he expired on HD 13. DISCUSSION: The case presented is as striking as it is tragic. Despite our patient’s home aspirin dose and therapeutic enoxaparin there was interval development of a devastating cerebral vascular event. The initiation of prophylactic anti-coagulation in patients with COVID-19 is controversial and not currently recommended by the International Society of Thrombosis and Hemostasis. One recent study demonstrated significantly increased inpatient median survival time without a significant change in inpatient mortality in patients with COVID-19 treated with prophylactic anti-coagulation. CONCLUSIONS: Coagulopathy in COVID-19 predisposes patients to potentially devastating thrombotic events. Further studies will need to be conducted to determine an ideal anti-coagulation strategy to minimize risk of these events. Reference #1: Tang, Ning, Dengju Li, Xiong Wang, and Ziyong Sun. 2020. “Abnormal Coagulation Parameters Are Associated with Poor Prognosis in Patients with Novel Coronavirus Pneumonia.” Journal of Thrombosis and Haemostasis: JTH 18 (4): 844–47. Reference #2: Thachil, Jecko, Ning Tang, Satoshi Gando, Anna Falanga, Marco Cattaneo, Marcel Levi, Cary Clark, and Toshiaki Iba. 2020. “ISTH Interim Guidance on Recognition and Management of Coagulopathy in COVID-19.” Journal of Thrombosis and Haemostasis: JTH 18 (5): 1023–26.3. Reference #3: Paranjpe, Ishan, Valentin Fuster, Anuradha Lala, Adam Russak, Benjamin S. Glicksberg, Matthew A. Levin, Alexander W. Charney, et al. 2020. “Association of Treatment Dose Anticoagulation with In-Hospital Survival Among Hospitalized Patients with COVID-19.” Journal of the American College of Cardiology, May. https://doi.org/10.1016/j.jacc.2020.05.001. DISCLOSURES: No relevant relationships by Daniel Condit, source=Web Response No relevant relationships by Rudra Ramanathan, sou ce=Web Response No relevant relationships by M. Camila Trejo-Paredes, source=Web Response Consultant relationship with Boston Scientific Please note: $1001 - $5000 Added 06/01/2020 by Patrick Troy, source=Web Response, value=Consulting fee Advisory Committee Member relationship with Boston Scientific Please note: $1001 - $5000 Added 06/01/2020 by Patrick Troy, source=Web Response, value=Consulting fee