How has the COVID-19 pandemic affected the climate change debate on Twitter?

Climate change and the COVID-19 pandemic share many similarities. However, in the past months, concerns have increased about the fact the health emergency has put on hold during the pandemic many climate adaptation and mitigation policies. We focus our attention on understanding the role of the recent health emergency on the transmission of information related to climate change, jointly with other socio-economic variables, social norms, and cultural dimensions. In doing so, we create a unique dataset containing the number of tweets written with specific climate related keywords per country worldwide, as well as country specific socio-economic characteristics, relevant social norms, and cultural variables. We find that socio-economic variables, such as income, education, and other risk-related variables matter in the transmission of information about climate change and Twitter activity. We also find that the COVID-19 pandemic has significantly decreased the overall number of messages written about climate change, postponing the climate debate worldwide; but particularly in some vulnerable countries. This shows that in spite of the existing climate emergency, the current pandemic has had a detrimental effect over the short-term planning of climate policies in countries where climate action is urgent.

The pregnant female surgical resident.

BACKGROUND: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. METHODS: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. RESULTS: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%). Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents). Seven of the programs (27%) stated that they have had zero residents pregnant. We had 22 residents respond (37%). Over half of the residents (55%) were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE) score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95%) stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work with a child at home was the most difficult part. CONCLUSION: Our preliminary study shows that the programs surveyed were accommodating to the female surgical resident. Nevertheless, despite adequate support from their program and an overall positive experience, many residents indicated that they had a decline in their education and performance.

Impact of initial surgical margins and residual cancer upon re-excision on outcome of patients with localized breast cancer.

BACKGROUND: A significant proportion of patients undergoing breast conservation therapy require additional operations to obtain clear margins. The aim of this study was to assess the impact of initial margins and residual carcinoma found on second surgery on the outcomes of breast cancer patients. METHODS: In this retrospective study, Cox proportional-hazard regression analysis was performed to evaluate data from 437 patients with stage I to IIIA breast cancer who underwent initial breast-conserving surgery between 1994 and 2004. RESULTS: The distant recurrence rate was higher among patients with initial positive margins than among those with initial negative margins (15.5% vs 4.9%; hazard ratio, 3.6; 95% confidence interval 1.5-8.7; P = .003). For patients who had underwent second surgery, the finding of a residual invasive carcinoma was associated with increased risk for distant recurrence (22.8% vs 6.6%; hazard ratio, 3.5; 95% confidence interval, 1.8-7.4; P = .0001). CONCLUSION: Invasive residual carcinoma found during subsequent surgery after initial compromised margins is an important prognostic marker for distant recurrence.

Operating room management: operative suite considerations, infection control.

An operating room's condition is rarely directly implicated in dis-ease transmission. Even so, to prevent such rare transmissions,hospitals must be thoughtful in designing operating rooms as important adjuncts to infection control. Proper ventilation in and near the operating room is the single most important component in establishing an environment that stops the spread of infection. Other considerations include attention to traffic control, equipment maintenance and storage, and construction materials that enhance the ability to maintain clean rooms. Hospitals can avert potential infectious problems through preventive maintenance and the use of infection control risk assessments (ICRAs) for preemptive consideration of infectious risks before renovations, repairs and new construction. Guidelines should be consulted and incorporated into each operating room's policies and procedures.