Disentangling the effects of message content and message sharer on students' views of political misinformation.

A consistent finding in fake news research is that people are more likely to believe content in favor of their political views. Unclear, however, is whether this political bias is moderated by contextual effects, such as politicians sharing content on their social media accounts. The present study investigated how both message content and sharer affect views of political misinformation. Participants (N = 164) evaluated eight news messages. Message content (pro-left/pro-right misinformation) and sharer (left-wing/right-wing/unknown politician) were manipulated within subjects. As expected, participants agreed more with concordant misinformation (aligned with their political orientation) and perceived it as more accurate than discordant misinformation. There was an additional, smaller effect of politician: Participants agreed more with discordant misinformation when shared by a politician representing their political viewpoint than when shared by others. Furthermore, left-oriented participants' agreement with concordant misinformation was hardly affected by message sharer, whereas right-oriented participants' agreement with concordant misinformation was-unexpectedly-positively affected by the left-wing politician. Irrespective of their political orientation, participants perceived misinformation from the left-wing politician as more accurate than misinformation from other politicians. Our findings suggest that both message content and sharer affect views of misinformation and interact in doing so, which is important for designing interventions on recognizing misinformation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Management of severe neonatal respiratory distress due to vertical transmission of severe acute respiratory syndrome coronavirus 2: a case report.

BACKGROUND: Neonates with severe acute respiratory syndrome coronavirus 2 infection are usually asymptomatic or have mild to moderate symptoms. Acute respiratory distress syndrome due to severe acute respiratory syndrome coronavirus 2 with respiratory insufficiency is rare. Therefore, information about the best intensive care strategy for neonates requiring mechanical ventilation is lacking. We report a neonatal case of severe acute respiratory distress syndrome, probably due to vertical transmission of severe acute respiratory syndrome coronavirus 2, complicated by Staphylococcus aureus sepsis. We aim to inform pediatric providers on the clinical course and acute management considerations in coronavirus disease-related neonatal acute respiratory distress syndrome. CASE PRESENTATION: A late preterm (gestational age 36 0/7 weeks) Caucasian girl was born from a severe acute respiratory syndrome coronavirus 2-positive mother and tested positive for severe acute respiratory syndrome coronavirus 2 at 19 hours after birth. She developed acute respiratory distress syndrome requiring intensive care admission and mechanical ventilation. The clinical course was complicated by S. aureus pneumonia and bacteremia. Multimodal management included well-established interventions for respiratory distress syndrome such as surfactant therapy, high-frequency oscillatory ventilation, and inhaled nitric oxide, combined with therapies extrapolated from adult care for severe acute respiratory syndrome coronavirus 2 patients such as dexamethasone, coronavirus disease 2019-specific immunoglobins, and prophylactic low-molecular-weight heparin. The neonate was successfully weaned from the ventilator and improved clinically. CONCLUSION: This case shows a rare but serious neonatal severe acute respiratory syndrome coronavirus 2 infection, leading to severe acute respiratory distress syndrome. Because of limited therapy guidelines for neonates, we suggest multimodal management with awareness of the possibility of S. aureus coinfection, to treat this age group successful.

Prognostic Value of Natriuretic Peptides for All-Cause Mortality, Right Ventricular Failure, Major Adverse Events, and Myocardial Recovery in Advanced Heart Failure Patients Receiving a Left Ventricular Assist Device: A Systematic Review.

Aims: Major adverse event (MAE) rates during left ventricular assist device (LVAD) therapy in advanced heart failure (HF) patients are high, and impair quality of life and survival. Prediction and risk stratification of MAEs in order to improve patient selection and thereby outcome during LVAD therapy is therefore warranted. Circulating natriuretic peptides (NPs) are strong predictors of MAEs and mortality in chronic HF patients. However, whether NPs can identify patients who are at risk of MAEs and mortality or tend toward myocardial recovery after LVAD implantation is unclear. The aim of this systematic review is to analyze the prognostic value of circulating NP levels before LVAD implantation for all-cause mortality, MAEs and myocardial recovery after LVAD implantation. Methods and Results: Electronic databases were searched for studies analyzing circulating NP in adults with advanced HF before LVAD implantation in relation to mortality, MAEs, or myocardial recovery after LVAD implantation. Twenty-four studies published between 2008 and 2021 were included. Follow-up duration ranged from 48 hours to 5 years. Study sample size ranged from 14 to 15,138 patients. Natriuretic peptide levels were not predictive of all-cause mortality. However, NPs were predictive of right ventricular failure (RVF) and MAEs such as ventricular arrhythmias, moderate or severe aortic regurgitation, and all-cause rehospitalization. No relation between NPs and myocardial recovery was found. Conclusion: This systematic review found that NP levels before LVAD implantation are not predictive of all-cause mortality after LVAD implantation. Thus, NP levels may be of limited value in patient selection for LVAD therapy. However, NPs help in risk stratification of MAEs and may be used to identify patients who are at risk for RVF, ventricular arrhythmias, moderate or severe aortic regurgitation, and all-cause rehospitalization after LVAD implantation.

Recognizing biased reasoning: Conflict detection during decision-making and decision-evaluation.

Although it is well established that our thinking can often be biased, the precise cognitive mechanisms underlying these biases are still debated. The present study builds on recent research showing that biased reasoners often seem aware that their reasoning is incorrect; they show signs of conflict detection. One important shortcoming in this research is that the conflict detection effect has only been studied with classic problem-solving tasks, requiring people to make a decision themselves. However, in many reasoning situations people are confronted with decisions already made by others. Therefore, the present study (N = 159) investigated whether conflict detection occurs not only during reasoning on problem-solving tasks (i.e., decision-making), but also on vignette tasks, requiring participants to evaluate decisions made by others. We analyzed participants' conflict detection sensitivity on confidence and response time measures. Results showed that conflict detection occurred during both decision-making and decision-evaluation, as indicated by a decreased confidence. The response time index appeared to be a less reliable measure of conflict detection on the novel tasks. These findings are very relevant for studying reasoning in contexts in which recognizing reasoning errors is important; for instance, in education where teachers have to give feedback on students' reasoning.

"You're wrong!": The impact of accuracy feedback on the bat-and-ball problem.

The popular bat-and-ball problem is a relatively simple math riddle on which people are easily biased by intuitive or heuristic thinking. In two studies we tested the impact of a simple but somewhat neglected manipulation - the impact of minimal accuracy feedback - on bat-and-ball performance. Participants solved a total of 15 standard and 15 control versions of the bat-and-ball problem in three consecutive blocks. Half of the participants received accuracy feedback in the intermediate block. Results of both studies indicated that the feedback had, on average, no significant effect on bat-and-ball accuracy over and above mere repeated presentation. We did observe a consistent improvement for a small number of individual participants. Explorative analyses indicated that this improved group showed a more pronounced conflict detection effect (i.e., latency increase) at the pretest and took more deliberation time after receiving the negative feedback compared to the unimproved group.

Physical activity: the relative associations with cognitive and affective risk beliefs.

Objective: The role of affectively oriented risk beliefs in explaining health behaviors has not been examined in the context of physical activity or in diverse study populations. We evaluated whether affective risk beliefs account for unique variance in physical activity intentions and behavior above and beyond that accounted for by cognitive risk beliefs. Design: A cross-sectional survey of socio-demographically diverse US residents (N = 835; 46.4% no college training; 46.7% minority racial/ethnic ancestry; 42.6% men). Main outcome measures: Physical activity intentions and behavior. Results: Hierarchical linear regressions showed that affective risk beliefs accounted for variance in physical activity intentions beyond that predicted by socio-demographics and cognitive risk beliefs (F-change ps<.001). Specifically, intentions were higher among people with higher anticipated regret (ps<.001) and with higher absolute feelings of risk (ps<.05) or worry (ps<.05). There was an indirect relationship between perceived absolute likelihood and intentions through anticipated regret and feelings of risk. Neither cognitive nor affective risk beliefs accounted for variance in physical activity behavior (F-change ps>.05), but unsurprisingly, behavior was positively associated with physical activity intentions (p<.001). Conclusion: Future interventions could target affective risk beliefs-particularly anticipated regret-to increase intentions, and then add other intervention components to bridge the intention-behavior gap.

Using the Short Graph Literacy Scale to Predict Precursors of Health Behavior Change.

BACKGROUND: Visual displays can facilitate risk communication and promote better health choices. Their effectiveness in improving risk comprehension is influenced by graph literacy. However, the construct of graph literacy is still insufficiently understood, partially because existing objective measures of graph literacy are either too difficult or too long. OBJECTIVES: We constructed a new 4-item Short Graph Literacy (SGL) scale and examined how SGL scores relate to key cognitive, affective, and conative precursors of health behavior change described in common health behavior theories. METHODS: We performed secondary analyses to adapt the SGL scale from an existing 13-item scale. The initial construction was based on data collected in a laboratory setting in Germany ( n = 51). The scale was then validated using data from nationally representative samples in Germany ( n = 495) and the United States ( n = 492). To examine how SGL scores relate to precursors of health behavior change, we performed secondary analyses of a third study involving a nationwide US sample with 47% participants belonging to racial/ethnic minorities and 46% with limited formal education ( n = 835). RESULTS: Graph literacy was significantly associated with cognitive precursors in theoretically expected ways (e.g., positive associations with risk comprehension and response efficacy and a negative association with cognitive risk perception). Patterns for affective precursors generally mirrored those for cognitive precursors, although numeracy was a stronger predictor than graph literacy for some affective factors (e.g., feelings of risk). Graph literacy had predictive value for most cognitive and affective precursors beyond numeracy. In addition, graph literacy (but not numeracy) predicted key conative precursors such as defensive processing. CONCLUSIONS: Our data suggest that the SGL scale is a fast and psychometrically valid method for measuring objective graph literacy. Our findings also highlight the theoretical and practical relevance of graph literacy.

Don't know responses to cognitive and affective risk perception measures: Exploring prevalence and socio-demographic moderators.

OBJECTIVES: Many people report uncertainty when appraising their risk of cancer and other diseases, but prior research about the topic has focused solely on cognitive risk perceptions. We investigated uncertainty related to cognitive and affective risk questions. We also explored whether any differences in uncertainty between cognitive and affective questions varied in magnitude by item-specific or socio-demographic characteristics. DESIGN: Secondary analysis of data collected for a 2 × 2 × 3 full-factorial risk communication experiment (N = 835) that was embedded within an online survey. METHODS: We investigated the frequency of 'don't know' responses (DKR) to eight perceived risk items that varied according to whether they assessed (1) cognitive versus affective perceived risk, (2) absolute versus comparative risk, and (3) colon cancer versus 'any exercise-related diseases'. Socio-demographics were as follows: sex, age, education, family history, and numeracy. We analysed the data using multilevel logistic regression. RESULTS: The odds of DKR were lower for affective than cognitive perceived risk (OR = 0.64, p < .001). This difference occurred for absolute but not comparative risk perceptions (interaction effect, p = .004), but no interactions for disease type or demographic characteristics were found (ps > .05). CONCLUSIONS: Lower uncertainty for affective (vs. cognitive) absolute perceived risk items is consistent with research stating: (1) Risk perceptions are grounded in people's feelings about a hazard, and (2) feelings are easier for people to access than facts. Including affective perceived risk items in health behaviour surveys may reduce missing data and improve data quality. Statement of contribution What is already known on this subject? Many people report that they don't know their risk (i.e., risk uncertainty). Evidence is growing for the importance of feelings of risk in explaining health behaviour. Feelings are easier for people to access than facts. What does this study add? Don't know responding is higher for absolute cognitive than absolute affective risk questions. This difference does not vary in magnitude by demographic characteristics. Affective perceived risk questions in surveys may reduce missing data and improve data quality.

Combining risk communication strategies to simultaneously convey the risks of four diseases associated with physical inactivity to socio-demographically diverse populations.

A single risk factor can increase the risk of developing multiple diseases, but most risk communication research has been conducted in the context of a single disease. We explored which combination of three recommended risk communication strategies is most effective in simultaneously conveying risk estimates of four diseases associated with physical inactivity: colon cancer, stroke, diabetes, and heart disease. Participants (N = 1161, 50% no college experience, 50% racial/ethnic minority) were shown hypothetical risk estimates for each of the four diseases. All four diseases were placed at varying heights on 1 of 12 vertical bar charts (i.e., "risk ladders") to indicate their respective probabilities. The risk ladders varied in a 2 (risk reduction information: present/absent) × 2 (numerical format: words/words and numbers) × 3 (social comparison information: none/somewhat higher than average/much higher than average) full factorial design. Participants were randomly assigned to view one of the risk ladders and then completed a questionnaire assessing message comprehension, message acceptance, physical activity-related risk and efficacy beliefs, and physical activity intentions. Higher message acceptance was found among (1) people who received risk reduction information versus those who did not (p = .01), and (2) people who did not receive social comparison information versus those told that they were at higher than average risk (p = .03). Further, absolute cognitive perceived risk of developing "any of the diseases shown in the picture" was higher among people who did not receive social comparison information (p = .03). No other main effects and only very few interactions with demographic variables were found. Combining recommended risk communication strategies did not improve or impair key cognitive or affective precursors of health behavior change. It might not be necessary to provide people with extensive information when communicating risk estimates of multiple diseases.

Pictorial Cigarette Warning Labels: Effects of Severity and Likelihood of Risk Messages.

INTRODUCTION: Pictorial cigarette warning labels often contain text-messages about severity of health risks and less often about the likelihood of health risks. We aimed to examine the influence of severity of risk versus likelihood of risk text-messages on information-seeking behavior. METHODS: Study 1: An experimental study with a 2 (severity) × 2 (likelihood) between-subjects design (n = 260); Study 2: An experimental study with a 2 (severity) × 2 (likelihood) × 2 (picture) between-subjects design (n = 537). Main outcome measures were information-seeking intention and information-seeking behavior (accepting a brochure about smoking cessation in Study 1; clicking on a link to a smoking cessation webpage in Study 2). RESULTS: In Study 1, exposure to likelihood text-messages was associated with more information-seeking behavior but not with attitudes and intention to quit. In Study 2, exposure to likelihood text-messages was not associated with information-seeking behavior, but was associated with higher warning label ratings and with more positive attitudes towards quitting when it was a pictorial cigarette warning label; exposure to severity text-messages was associated with higher warning label ratings and higher risk perceptions. Presence of a picture with smokers' diseased lungs in Study 2 was associated with higher warning label ratings and with higher risk perceptions, but did not influence attitudes and intention to quit. CONCLUSIONS: We found preliminary indications that pictorial cigarette labels with likelihood of risk text-messages may be effective in influencing behavior. However, results from our two studies were not consistent. Therefore, future studies should examine this further. IMPLICATIONS: Although we can only draw preliminary conclusions from our study that should be replicated in future studies, our findings suggest that it is worthwhile to further explore the addition of likelihood of risk text-messages to pictorial cigarette warning labels, which is not the current practice in most countries.

The Relationship Between Young Adult Smokers' Beliefs About Nicotine Addiction and Smoking-Related Affect and Cognitions.

Risk beliefs and self-efficacy play important roles in explaining smoking-related outcomes and are important to target in tobacco control interventions. However, information is lacking about the underlying beliefs that drive these constructs. The present study investigated the interrelationships among young adult smokers' beliefs about the nature of nicotine addiction and smoking-related affect and cognitions (i.e., feelings of risk, worry about experiencing the harms of smoking, self-efficacy of quitting, and intentions to quit). Smokers (n = 333) were recruited from two large universities. Results showed that quit intentions were associated with feelings of risk, but not with worry or self-efficacy. Furthermore, higher feelings of risk were associated with lower beliefs that addiction is an inevitable consequence of smoking and with lower beliefs that the harms of smoking are delayed. This suggests that it is important for health messages to counter the possible negative effects of messages that strongly emphasize the addictiveness of nicotine, possibly by emphasizing the importance of quitting earlier rather than later. The findings also add to the evidence base that feelings of risk are powerful predictors of behavioral intentions. Furthermore, our results suggest that in some circumstances, feelings of risk predict quit intentions beyond that predicted by worry and self-efficacy. Gaining additional understanding of the tobacco-related beliefs that can increase feelings of risk and incorporating those beliefs into educational campaigns may improve the quality of such campaigns and reduce tobacco use.

Sun protection during snow sports: an analysis of behavior and psychosocial determinants.

This study investigated sun protective behavior during snow sports and its psychosocial determinants. A longitudinal study was conducted among 418 Dutch adults who planned to go on a ski holiday. Participants were asked to fill in a questionnaire before and after their ski trip. In the baseline questionnaire several psychosocial factors were measured (i.e. knowledge, risk perception, worry, attitude, social influence, self-efficacy and intention). At follow-up, sunscreen use and frequency of sunburns were measured. The results showed that, despite their generally high intention, a substantial part of the respondents (40%) did not use sunscreen adequately during their ski holiday. Furthermore, one-fourth of the respondents reported at least one sunburn during their ski holiday. Men and younger respondents used sunscreen less frequently and were sunburnt more often. Sunscreen use was predicted by a positive attitude, high self-efficacy levels, high intention, high knowledge and high perceived risk. The background and psychosocial variables explained 32% of the total variance of sunscreen use. Suggestions for future research and interventions are discussed.

Influencing feelings of cancer risk: direct and moderator effects of affectively laden phrases in risk communication.

Evidence is accumulating for the importance of feelings of risk in explaining cancer preventive behaviors, but best practices for influencing these feelings are limited. This study investigated the direct and moderational influence of affectively laden phrases in cancer risk messages. Two experimental studies were conducted in relation to different cancer-related behaviors--sunbed use (n = 112) and red meat consumption (n = 447)--among student and nonstudent samples. Participants were randomly assigned to one of two conditions: (a) a cognitive message using cognitively laden phrases or (b) an affective message using affectively laden phrases. The results revealed that affective phrases did not directly influence feelings of risk in both studies. Evidence for a moderational influence was found in Study 2, suggesting that affective information strengthened the relation between feelings of risk and intention (i.e., participants relied more on their feelings in the decision-making process after exposure to affective information). These findings suggest that solely using affective phrases in risk communication may not be sufficient to directly influence feelings of risk and other methods need to be explored in future research. Moreover, research is needed to replicate our preliminary indications for a moderational influence of affective phrases to advance theory and practice.

Successful treatment of a congenital extra-truncal vascular malformation by orally administered propranolol.

Abstract The ß-blocker propranolol has become a valuable and effective drug for the treatment of infantile hemangiomas. Its therapeutic action probably results from vasoconstriction, blocking of angiogenesis through effects on vascular endothelial growth factor and induction of apoptosis. It is reasonable to suggest that propranolol can also be used effectively in the treatment of other vascular abnormalities. This case report describes propranolol treatment of vascular malformations such as Klippel-Trénaunay syndrome or Parkes-Weber syndrome in adults.

Altered phenotype and functionality of varicella zoster virus-specific cellular immunity in individuals with active infection.

BACKGROUND: Varicella zoster virus (VZV) establishes lifelong persistence and may reactivate in individuals with impaired immune function. To investigate immunologic correlates of protection and VZV reactivation, we characterized specific immunity in 207 nonsymptomatic immunocompetent and 132 immunocompromised individuals in comparison with patients with acute herpes zoster. METHODS: VZV-specific CD4 T cells were quantified flow cytometrically after stimulation and characterized for expression of interferon-γ, interleukin 2, and tumor necrosis factor α and surface markers for differentiation (CD127) and anergy (cytotoxic T lymphocyte antigen 4 [CTLA-4] and programmed death [PD]-1). Immunoglobulin G and A levels were quantified using an enzyme-linked immunosorbent assay. RESULTS: In healthy individuals, VZV-specific antibody and T-cell levels were age dependent, with the highest median VZV-specific CD4 T-cell frequencies of 0.108% (interquartile range, 0.121%) during adolescence. VZV-specific T-cell profiles were multifunctional with predominant expression of all 3 cytokines, CD127 positivity, and low expression of CTLA-4 and PD-1. Nonsymptomatic immunocompromised patients had similar VZV-specific immunologic properties except for lower T-cell frequencies (P<.001) and restricted cytokine expression. In contrast, significantly elevated antibody- and VZV-specific CD4 T-cell levels were found in patients with zoster. Their specific T cells showed a shift in cytokine expression toward interferon γ single positivity, an increase in CTLA-4 and PD-1, and a decrease in CD127 expression (all P<.001). This phenotype normalized after resolution of symptoms. CONCLUSIONS: VZV-specific CD4-T cells in patients with zoster bear typical features of anergy. This phenotype is reversible and may serve as adjunct tool for monitoring VZV reactivations in high-risk patients.

Effectiveness and tolerability of ipilimumab: experiences from 198 patients included in a named-patient program in various daily-practice settings and multiple institutions.

BACKGROUND: Ipilimumab is an approved anti-cytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody introducing immune responses in melanoma patients. Treatment experiences from named-patient programs support the evaluation of the efficacy and tolerability of new medicines under usual circumstances of health care practice. Here, the largest ever reported cohort treated with ipilimumab 3 mg/kg alone is described. METHODS: This report retrospectively analyzes data of 198 patients who were followed up in 15 hospital centers in Germany between April 2010 and March 2013. Patients had received prior therapy for unresectable stage III or IV melanoma before receiving ipilimumab (4 doses of 3 mg/kg every 21 d). Routine staging and tumor response evaluation procedures were applied. RESULTS: Of the patients, 119 received the planned 4-course therapy schedule; in further 79 patients, the number of doses was reduced mainly because of toxicity or fast progression. In all, 196 patients were eligible for evaluation of the efficacy of ipilimumab under routine care conditions. Median overall survival (OS) was 6.8 months [95% confidence interval, 5.6-10.3] from the start of therapy. OS differed significantly among patients who received 4 doses (n=119) and those receiving <4 doses (n=79) (14.2 vs. 2.0 mo; P<0.0001). The overall response rate (ORR) of 11% was in the same range as reported from previous clinical trials; and stable disease (SD) was observed in 11% resulting in a disease control rate (ORR+SD) of 22%. In 23 of the 79 patients with reduced dosing, dose omission was most probably caused by toxicity, whereas 56 patients had progressive disease before receiving all 4 treatment cycles. Immune-related adverse events (irAE) were reported in 30% of all treated patients, the occurrence of irAE correlated significantly with the probability of response to therapy and prolonged OS. CONCLUSION: In this named-patient program including heavily pretreated patients, the efficacy and tolerability of ipilimumab 3 mg/kg corresponds with findings from the confirmatory clinical trial.

The importance of affectively-laden beliefs about health risks: the case of tobacco use and sun protection.

Affect is gaining prominence in health behavior research. However, little is known about the relative influence on behavior of specific affectively-laden beliefs about health risks (affective likelihood, worry, anticipated regret), particularly in comparison to cognitive likelihood beliefs. We investigated this issue in relation to two very different cancer-related behaviors. In two prospective studies [tobacco use (N = 1,088); sunscreen use (N = 491)], hierarchical linear and logistic regression analyses revealed that affectively-laden risk beliefs predicted intentions and behaviors more strongly than cognitive likelihood beliefs. Cognitive likelihood contributed independently only for sunscreen use intentions. Smoking-related outcomes were most strongly associated with anticipated regret. Sunscreen-related outcomes were most strongly associated with affective likelihood. Affectively-laden beliefs might be stronger predictors of some cancer-related behaviors than traditional cognitive likelihood measures. Including affective aspects of health risk beliefs in health behavior interventions and theoretical models, including investigating their interrelationships in different behavioral contexts, could advance both theory and practice.