Improving Social Bot Detection Through Aid and Training.

OBJECTIVE: We test the effects of three aids on individuals' ability to detect social bots among Twitter personas: a bot indicator score, a training video, and a warning. BACKGROUND: Detecting social bots can prevent online deception. We use a simulated social media task to evaluate three aids. METHOD: Lay participants judged whether each of 60 Twitter personas was a human or social bot in a simulated online environment, using agreement between three machine learning algorithms to estimate the probability of each persona being a bot. Experiment 1 compared a control group and two intervention groups, one provided a bot indicator score for each tweet; the other provided a warning about social bots. Experiment 2 compared a control group and two intervention groups, one receiving the bot indicator scores and the other a training video, focused on heuristics for identifying social bots. RESULTS: The bot indicator score intervention improved predictive performance and reduced overconfidence in both experiments. The training video was also effective, although somewhat less so. The warning had no effect. Participants rarely reported willingness to share content for a persona that they labeled as a bot, even when they agreed with it. CONCLUSIONS: Informative interventions improved social bot detection; warning alone did not. APPLICATION: We offer an experimental testbed and methodology that can be used to evaluate and refine interventions designed to reduce vulnerability to social bots. We show the value of two interventions that could be applied in many settings.

When Do Humans Heed AI Agents' Advice? When Should They?

OBJECTIVE: We manipulate the presence, skill, and display of artificial intelligence (AI) recommendations in a strategy game to measure their effect on users' performance. BACKGROUND: Many applications of AI require humans and AI agents to make decisions collaboratively. Success depends on how appropriately humans rely on the AI agent. We demonstrate an evaluation method for a platform that uses neural network agents of varying skill levels for the simple strategic game of Connect Four. METHODS: We report results from a 2 × 3 between-subjects factorial experiment that varies the format of AI recommendations (categorical or probabilistic) and the AI agent's amount of training (low, medium, or high). On each round of 10 games, participants proposed a move, saw the AI agent's recommendations, and then moved. RESULTS: Participants' performance improved with a highly skilled agent, but quickly plateaued, as they relied uncritically on the agent. Participants relied too little on lower skilled agents. The display format had no effect on users' skill or choices. CONCLUSIONS: The value of these AI agents depended on their skill level and users' ability to extract lessons from their advice. APPLICATION: Organizations employing AI decision support systems must consider behavioral aspects of the human-agent team. We demonstrate an approach to evaluating competing designs and assessing their performance.

Indirect Identification of Perinatal Psychosocial Risks from Natural Language.

During the perinatal period, psychosocial health risks, including depression and intimate partner violence, are associated with serious adverse health outcomes for birth parents and children. To appropriately intervene, healthcare professionals must first identify those at risk, yet stigma often prevents people from directly disclosing the information needed to prompt an assessment. In this research we use short diary entries to indirectly elicit information that could indicate psychosocial risks, then examine patterns that emerge in the language of those at risk. We find that diary entries exhibit consistent themes, extracted using topic modeling, and emotional perspective, drawn from dictionary-informed sentiment features. Using these features, we use regularized regression to predict screening measures for depression and psychological aggression by an intimate partner. Journal text entries quantified through topic models and sentiment features show promise for depression prediction, corresponding with self-reported screening measures almost as well as closed-form questions. Text-based features are less useful in predicting intimate partner violence, but topic models generate themes that align with known risk correlates. The indirect features uncovered in this research could aid in the detection and analysis of stigmatized risks.

An Investigation into the Mechanism Mediating Counterillumination in Myctophid Fishes (Myctophidae).

AbstractCounterillumination is a camouflage strategy employed primarily by mesopelagic fishes, sharks, crustaceans, and squid, which use ventral bioluminescence to obscure their silhouettes when viewed from below. Although certain counterilluminating species have been shown to control the intensity of their ventral emissions to match the background downwelling light, the feedback mechanism mediating this ability is poorly understood. One proposed mechanism involves the presence and use of eye-facing photophores that would allow simultaneous detection and comparison of photophore emissions and downwelling solar light. Eye-facing photophores have been found in at least 34 species of counterilluminating stomiiform fishes and the myctophid Tarletonbeania crenularis. Here, we examined nine phylogenetically spaced myctophid species for eye-facing photophores to assess whether this mechanism is as prevalent in this group as it is in the Stomiiformes. First, microcomputed tomography imaging data were collected for each species, and three-dimensional reconstructions of the fishes were developed to identify potential eye-facing photophores. The fishes were then dissected under a stereomicroscope to confirm the presence of all identified photophores, probe for any photophores missed in the reconstruction analysis, and determine the orientation of the photophores' emissions. Although photophores were identified near the orbits of all species examined, none of the fishes' photophores directed light into their orbits, suggesting that myctophids may regulate bioluminescence through an alternative mechanism.

Electro-Optic Fourier Transform Chronometry of Pulsed Quantum Light.

The power spectrum of an optical field can be acquired without a spectrally resolving detector by means of Fourier-transform spectrometry, based on measuring the temporal autocorrelation of the optical field. Analogously, we here perform temporal envelope measurements of ultrashort optical pulses without time resolved detection. We introduce the technique of Fourier transform chronometry, where the temporal envelope is acquired by measuring the frequency autocorrelation of the optical field in a linear interferometer. We apply our technique, which is the time-frequency conjugate measurement to Fourier-transform spectrometry, to experimentally measure the pulse envelope of classical and single-photon light pulses.

Duped by Bots: Why Some are Better than Others at Detecting Fake Social Media Personas.

OBJECTIVE: We examine individuals' ability to detect social bots among Twitter personas, along with participant and persona features associated with that ability. BACKGROUND: Social media users need to distinguish bots from human users. We develop and demonstrate a methodology for assessing those abilities, with a simulated social media task. METHOD: We analyze performance from a signal detection theory perspective, using a task that asked lay participants whether each of 50 Twitter personas was a human or social bot. We used the agreement of two machine learning models to estimate the probability of each persona being a bot. We estimated the probability of participants indicating that a persona was a bot with a generalized linear mixed-effects model using participant characteristics (social media experience, analytical reasoning, and political views) and stimulus characteristics (bot indicator score and political tone) as regressors. RESULTS: On average, participants had modest sensitivity (d') and a criterion that favored responding "human." Exploratory analyses found greater sensitivity for participants (a) with less self-reported social media experience, (b) greater analytical reasoning ability, and (c) who were evaluating personas with opposing political views. Some patterns varied with participants' political identity. CONCLUSIONS: Individuals have limited ability to detect social bots, with greater aversion to mistaking bots for humans than vice versa. Greater social media experience and myside bias appeared to reduce performance, as did less analytical reasoning ability. APPLICATION: These patterns suggest the need for interventions, especially when users feel most familiar with social media.

Heralding Multiple Photonic Pulsed Bell Pairs via Frequency-Resolved Entanglement Swapping.

Entanglement is a unique property of quantum systems and an essential resource for many quantum technologies. The ability to transfer or swap entanglement between systems is an important protocol in quantum information science. Entanglement swapping between photons forms the basis of distributed quantum networks. Here an experiment demonstrating entanglement swapping from two independent multimode time-frequency entangled sources is presented, resulting in multiple heralded frequency-mode Bell states. Entanglement in the heralded states is verified by measuring conditional anticorrelated joint spectra and quantum beating in two-photon interference. Our experiment heralds up to five orthogonal Bell pairs within the same setup, and this number is ultimately limited only by the entanglement of the initial sources.

In Situ Simulation to Promote Residents as Resuscitation Leaders.

Objectives  Our study sought to assess whether perceptions of residents as resuscitation team leaders could be improved by using emergency department (ED) in situ simulations involving ED staff. Secondarily, we monitored changes indicated in overall resuscitation team dynamics. Methods We conducted a prospective experimental study over the 2018-2019 academic year. Data were collected at a community-based ED with an emergency medicine residency program. Prior to starting the education, all ED staff including residents, attending physicians nurses and techs completed a survey of their perceptions of team performance and leadership during medical resuscitations. Throughout the year, residents and ED staff members were exposed to various in situ simulation scenarios. A follow-up survey was administered to reassess resident and ED staff perceptions of team dynamics and, specifically, residents as patient care team leaders. A relational coordination survey analysis was performed, dichotomized by professional domain. Results A total of 20 participants completed surveys before and after the in situ simulations, covering the professional domains with matched pre-simulation and post-simulation data showing significant improvement in communication and team dynamics for residents (p = 0.029) and other ED staff in medical resuscitations. Using residents as the team leaders for the simulation improved perceived leadership during resuscitation (p = 0.006). Conclusions Our study suggests that in situ simulation within the ED leads to improved team dynamics and defined roles while emphasizing the resident as a resuscitation leader.

A strategy to improve expert technology forecasts.

Forecasts of the future cost and performance of technologies are often used to support decision-making. However, retrospective reviews find that many forecasts made by experts are not very accurate and are often seriously overconfident, with realized values too frequently falling outside of forecasted ranges. Here, we outline a hybrid approach to expert elicitation that we believe might improve forecasts of future technologies. The proposed approach iteratively combines the judgments of technical domain experts with those of experts who are knowledgeable about broader issues of technology adoption and public policy. We motivate the approach with results from a pilot study designed to help forecasters think systematically about factors beyond the technology itself that may shape its future, such as policy, economic, and social factors. Forecasters who received briefings on these topics provided wider forecast intervals than those receiving no assistance.

The influence of social relationships on substance use behaviors among pregnant women with opioid use disorder.

OBJECTIVE: To describe the social network characteristics of pregnant women with opioid use disorder (OUD) and explore how changes in social relationships during pregnancy may influence substance use behaviors. METHODS: Between 2017 and 2018, we conducted an exploratory pilot study among 50 pregnant women with OUD. Participants completed a detailed social network inventory to describe the behaviors (e.g. substance-using), social support characteristics (e.g. financial, emotional, informational) and roles (e.g. family member, friend) of network members. The primary outcome was a self-reported decrease in substance use during pregnancy. Pearson correlations were used to test for associations between covariates reflecting different aspects of participants' social networks and decreased substance use during pregnancy. RESULTS: Most participants (84.0 %) decreased substance use during pregnancy and stated that pregnancy motivated them to engage in treatment (94.0 %). Participants had a median of 8 (IQR: 4-18) network members with differing proportions of those who did and did not use substances. Pregnancy prompted participants to significantly increase contact with (26.4 % vs. 5.0 %), have increased support from (35.7 % vs. 7.5 %), and a have a feeling of increased closeness with (26.1 % vs. 3.3 %) network members who did not use substances. However, decreased substance use during pregnancy was most strongly (negatively) associated with the proportion of network members who used substances and provided informational support (r=-0.25, p = 0.08) and a feeling of closeness (r=-0.26, p = 0.08). CONCLUSIONS: Our findings indicate that pregnancy has a profound influence on women's substance use behaviors and that changes in social relationships due to pregnancy may influence substance use.

A secure procedure for early career scientists to report apparent misconduct.

Early career scientists sometimes observe senior scientists engage in apparent scientific misconduct, but feel powerless to intervene, lest they imperil their careers. We propose a Secure Reporting Procedure that both protects them, when pursuing those concerns, and treats the senior scientists fairly. The proposed procedure is, we argue, consistent with the ethical principles of the scientific community, as expressed in the codes of its professional organizations. However, its implementation will require changes in procedures and regulations. Those efforts will be a small price to pay for protecting the scientific community's integrity and fidelity to its principles. We begin by describing the circumstances motivating the proposal, then sketch its design, and, finally, illustrate next steps in its application in two national settings.

Temporal mode transformations by sequential time and frequency phase modulation for applications in quantum information science.

Controlling the temporal mode shape of quantum light pulses has wide ranging application to quantum information science and technology. Techniques have been developed to control the bandwidth, allow shifting in the time and frequency domains, and perform mode-selective beam-splitter-like transformations. However, there is no present scheme to perform targeted multimode unitary transformations on temporal modes. Here we present a practical approach to realize general transformations for temporal modes. We show theoretically that any unitary transformation on temporal modes can be performed using a series of phase operations in the time and frequency domains. Numerical simulations show that several key transformations on temporal modes can be performed with greater than 95% fidelity using experimentally feasible specifications.

Single-photon characterization by two-photon spectral interferometry.

Single-photon sources are a fundamental resource in quantum optics and quantum information science. Photons with differing spectral and temporal shapes do not interfere well and inhibit the performance of quantum applications such as linear optics quantum computing, boson sampling, and quantum networks. Indistinguishability and purity of photons emitted from different sources are crucial properties for many quantum applications. The ability to determine the state of single-photon sources therefore provides a means to assess their quality, compare different sources, and provide feedback for source tuning. Here, we propose and demonstrate a single-configuration experimental method enabling complete characterization of the spectral-temporal state of a pulsed single-photon source having both pure and mixed states. The method involves interference of the unknown single-photon source with a reference at a balanced beam splitter followed by frequency-resolved coincidence detection at the outputs. Fourier analysis of the joint-spectral two-photon interference pattern reveals the density matrix of the single-photon source in the frequency basis. We present an experimental realization of this method for pure and mixed state pulsed single-photon sources.

An observational study of the securement of central venous access devices with a subcutaneous anchor device in a paediatric population at a tertiary level hospital.

Paediatric central venous access devices are associated with significant complications. Failure rates have been estimated to be as high as 25%, with securement failure a significant contributing factor. In this study, we evaluate the use of a subcutaneous securement device, securAcathTM, in minimising rates of central venous access device dislodgement and unintended early removal within a paediatric population. Data were collected on 52 consecutive paediatric patients, aged less than 18 years old, who required peripherally inserted central catheters and non-cuffed tunnelled centrally inserted central catheters. We found that the rate of securement failure with securAcathTM was 2.01 per 1000 catheter days. This compared to 2.58 in our previous practice without securAcathTM. With the use of securAcathTM, no securement failures were observed in our patients with non-cuffed tunnelled centrally inserted central catheters. There were three instances of securement failure in patients with peripherally inserted central catheters. We conclude that the use of a securAcathTM fixation device in central venous access devices is an effective method of securement, especially in use with non-cuffed tunneled centrally inserted central catheters. However, when significant tension is applied to the central venous access devices migration is still possible.

Doctor, I'm Seeing Two of Everything.

Acute diplopia is a rare chief complaint with a broad differential diagnosis; key historical and physical characteristics aid with emergency management. This case report discusses the important findings, imaging, and multidisciplinary interaction between emergency medicine, ophthalmology, and neurology regarding the approach to addressing acute painless vertical diplopia. A 51-year-old male presented to the emergency department (ED), reporting that he was seeing 'two of everything,' since awakening. Although the patient had a history of ischemic stroke, he had never experienced this sensation of diplopia. His ED workup was essentially unremarkable; he was admitted for evaluation of the possibilities of a fourth cranial nerve (CN IV) palsy, acute Parinaud syndrome, or ischemic stroke. Ultimately the patient was sent home one day after admission with the diagnosis of CN IV neuropathy. Highlighted is an approach to undifferentiated diplopia with an included discussion of the pathophysiology of a CN IV palsy and Parinaud syndrome. Understanding basic pathophysiology and anatomy allows for a proper history, physical exam, and appropriate consultation. With these tools, emergency physicians can improve their approach to patients with acute diplopia when arriving at the ED.

Innovations in Airway Education: 3D Printed Neonatal and Pediatric Needle Cricothyrotomy Trainers.

Audience: Three dimensional printed cricothyrotomy trainers are designed to be used at all levels of training in emergency medicine, both for skill acquisition and to prevent skill atrophy. Introduction: Simulation has long provided a means to train providers on rarely performed procedures.1,2 For example, surgical cricothyrotomy has commonly been practiced in a simulated environment almost exclusively via low-fidelity models.3-6 What seems to be lacking in this training is simulation of needle cricothyrotomy for the pediatric population. Needle cricothyrotomy remains the standard of care for temporary airway management in a "can't intubate, can't oxygenate" scenario for pediatric patients. In order to address this educational deficiency, we designed a 3D printed pediatric needle cricothyrotomy trainer using evidenced-based cadaveric literature demonstrating neonatal cricothyroid membrane dimensions. These trainers will serve as a simulation tool that will help educate emergency medicine residents to perform a rare, high-stakes procedure within a controlled environment. Educational Objectives: By the end of this educational session, participants should be able to:Discuss indications and contraindications for needle cricothyrotomy in the pediatric population.Assemble the equipment needed to complete a needle cricothyrotomy.Describe and perform the steps of neonatal and pediatric needle cricothyrotomy.Discuss post-procedure ventilation options. Educational Methods: Trainers were created to enhance needle cricothyrotomy training in this rarely performed, yet critical procedure. It was felt that this procedure was only discussed in concept. There was no hands-on, procedure-based option available to realistically reproduce the procedure in a controlled training environment, and we felt the creation of a task trainer was ideal to address this deficiency. Once the trainers were created, we curated assigned pre-reading using a flipped classroom approach. The idea was to provide learners with multiple resources including textbook chapters, blogs, and podcasts, so that they could choose one or two resources that matched their learning style. We felt this was the best way to ensure learner retention. Additionally, we created a PowerPoint presentation to illustrate the stepwise procedure, required equipment, indications/contraindications, and ventilation aspect of the procedure, which can be reviewed with learners prior to performing the hands-on portion of the skills station.In order to create such a trainer, we worked in conjunction with the OhioHealth Simulation Department to obtain a 3D printer. Adult cricothyrotomy trainers were previously purchased from The Airway App, a company specializing in airway management education. The company also provides a standard template library (.STL) file that contains code for 3D printing cricothyrotomy trainers. Using this code, we made changes to the scale in order to create a smaller model that would resemble neonatal, school-aged, and adolescent patients (25%, 33%, and 50% of the original adult trainer, respectively). These scale models, particularly the neonatal model, were chosen based on the neonatal cadaveric measurements researched by Navasa, et al.7To prepare the trainer for use, sim skin and sim tape were used to cover and obscure the landmarks. Learners were given the materials previously discussed in preparation of the skills lab. Although all sizes of trainers were used by the learners, particularly attention was paid to the neonatal trainer. Emphasis was placed on the difficulty finding landmarks during this procedure. Instructors were available for the entirety of the skill station in order to answer questions and give direct feedback. Debriefing was performed at the end of the skills session. Research Methods: Post-simulation surveys were completed by PGY 1-4 emergency medicine resident physicians assessing pre- and post-simulation procedural comfortability using a 5-point Likert scale. In this survey, 1 represented "not comfortable at all" while 5 represented "completely comfortable." Two, three, and four showed a gradual increase in comfortability, respectively. Median pre- and post-scores were calculated with interquartile ranges (IQR). A two-tailed Mann-Whitney U test was performed for statistical significance. Realism and future use were also surveyed. Results: Thirty-one emergency medicine resident physicians ranging from PGY1 to PGY4 completed the post-simulation survey. Median pre-simulation score was 2 (IQR 1-2.5) and post-simulation score was 4 (IQR 3-4). The two-tailed Mann-Whitney U test showed statistical significance at p<0.01. Ninety-seven percent of participants felt the trainers were realistic and 100% would recommend them for future simulation use. Discussion: Novel 3D printed needle cricothyrotomy trainers are a much-needed addition to emergency medicine procedural training. Specifically, we focus on the use of low-cost, high-fidelity trainers for educating emergency medicine resident physicians. By using a pre-templated .STL file, we were able to manipulate sizes and dimensions to create several simulation trainers for simulating needle cricothyrotomy. Our results show that these trainers are valuable to emergency medicine procedural training, increasing resident comfortability. Furthermore, participants feel this is realistic and would recommend this for future simulations. Given the relative ease and low-cost nature of these trainers, in addition to their proven benefit with residents, we hope that others will be able to use similar trainers to help develop needle cricothyrotomy skills at all levels of training. Topics: Needle cricothyrotomy, pediatrics, difficult airway, 3D printing, education.

Sex, Drugs, and Seizures: Subarachnoid Hemorrhage in a Young Patient.

A 17-year-old male patient presented to the emergency department (ED) with seizures after sexual intercourse. The patient was found to have an intracerebral hemorrhage (ICH) likely secondary to sexual intercourse and concomitant amphetamine use, an extremely rare finding in this patient population. In this case review, we will discuss the presentation, management, and disposition of subarachnoid hemorrhage (SAH), a well-known emergency diagnosis within the ED, while highlighting a case that is clearly uncommon. In addition, we discuss the etiology of ICH in the setting of intercourse and amphetamine use with the ultimate goal of understanding the interdisciplinary care of a complex subject.

Comparing the predictive ability of a commercial artificial intelligence early warning system with physician judgement for clinical deterioration in hospitalised general internal medicine patients: a prospective observational study.

OBJECTIVE: Our study compares physician judgement with an automated early warning system (EWS) for predicting clinical deterioration of hospitalised general internal medicine patients. DESIGN: Prospective observational study of clinical predictions made at the end of the daytime work-shift for an academic general internal medicine floor team compared with the risk assessment from an automated EWS collected at the same time. SETTING: Internal medicine teaching wards at a single tertiary care academic medical centre in the USA. PARTICIPANTS: Intern physicians working on the internal medicine wards and an automated EWS (Rothman Index by PeraHealth). OUTCOME: Clinical deterioration within 24 hours including cardiac or pulmonary arrest, rapid response team activation or unscheduled intensive care unit transfer. RESULTS: We collected predictions for 1874 patient days and saw 35 clinical deteriorations (1.9%). The area under the receiver operating curve (AUROC) for the EWS was 0.73 vs 0.70 for physicians (p=0.571). A linear regression model combining physician and EWS predictions had an AUROC of 0.75, outperforming physicians (p=0.016) and the EWS (p=0.05). CONCLUSIONS: There is no significant difference in the performance of the EWS and physicians in predicting clinical deterioration at 24 hours on an inpatient general medicine ward. A combined model outperformed either alone. The EWS and physicians identify partially overlapping sets of at-risk patients suggesting they rely on different cues or decision rules for their predictions. TRIAL REGISTRATION NUMBER: NCT02648828.

Using graph learning to understand adverse pregnancy outcomes and stress pathways.

To identify pathways between stress indicators and adverse pregnancy outcomes, we applied a nonparametric graph-learning algorithm, PC-KCI, to data from an observational prospective cohort study. The Measurement of Maternal Stress study (MOMS) followed 744 women with a singleton intrauterine pregnancy recruited between June 2013 and May 2015. Infant adverse pregnancy outcomes were prematurity (<37 weeks' gestation), infant days spent in hospital after birth, and being small for gestational age (percentile gestational weight at birth). Maternal adverse pregnancy outcomes were pre-eclampsia, gestational diabetes, and gestational hypertension. PC-KCI replicated well-established pathways, such as the relationship between gestational weeks and preterm premature rupture of membranes. PC-KCI also identified previously unobserved pathways to adverse pregnancy outcomes, including 1) a link between hair cortisol levels (at 12-21 weeks of pregnancy) and pre-eclampsia; 2) two pathways to preterm birth depending on race, with one linking Hispanic race, pre-gestational diabetes and gestational weeks, and a second pathway linking black race, hair cortisol, preeclampsia, and gestational weeks; and 3) a relationship between maternal childhood trauma, perceived social stress in adulthood, and low weight for gestational age. Our approach confirmed previous findings and identified previously unobserved pathways to adverse pregnancy outcomes. It presents a method for a global assessment of a clinical problem for further study of possible causal pathways.