Identifying False Human Papillomavirus (HPV) Vaccine Information and Corresponding Risk Perceptions From Twitter: Advanced Predictive Models.

BACKGROUND: The vaccination uptake rates of the human papillomavirus (HPV) vaccine remain low despite the fact that the effectiveness of HPV vaccines has been established for more than a decade. Vaccine hesitancy is in part due to false information about HPV vaccines on social media. Combating false HPV vaccine information is a reasonable step to addressing vaccine hesitancy. OBJECTIVE: Given the substantial harm of false HPV vaccine information, there is an urgent need to identify false social media messages before it goes viral. The goal of the study is to develop a systematic and generalizable approach to identifying false HPV vaccine information on social media. METHODS: This study used machine learning and natural language processing to develop a series of classification models and causality mining methods to identify and examine true and false HPV vaccine-related information on Twitter. RESULTS: We found that the convolutional neural network model outperformed all other models in identifying tweets containing false HPV vaccine-related information (F score=91.95). We also developed completely unsupervised causality mining models to identify HPV vaccine candidate effects for capturing risk perceptions of HPV vaccines. Furthermore, we found that false information contained mostly loss-framed messages focusing on the potential risk of vaccines covering a variety of topics using more diverse vocabulary, while true information contained both gain- and loss-framed messages focusing on the effectiveness of vaccines covering fewer topics using relatively limited vocabulary. CONCLUSIONS: Our research demonstrated the feasibility and effectiveness of using predictive models to identify false HPV vaccine information and its risk perceptions on social media.

Estimating the influence of Twitter on pre-exposure prophylaxis use and HIV testing as a function of rates of men who have sex with men in the United States.

OBJECTIVES: Acceptance of pre-exposure prophylaxis (PrEP) and testing for HIV is likely to vary as a function of the norms and communications within a geographic area. This study examined associations involving county tweets, in person communications, and HIV prevention and testing in regions with higher (vs. lower) estimated rates of men who have sex with men (MSM). DESIGN AND METHODS: Ecological analyses examined (a) tweets about HIV (i.e. tweet rates per 100 000 county population and topic probabilities in 1959 US counties); (b) individual-level survey data about HIV prevention and testing and communications about PrEP and HIV (N = 30 675 participants); and (c) estimated county-level MSM rates (per 1 000 adult men). RESULTS: In counties with higher rates of MSM, tweet rates were directly associated with PrEP use and HIV testing (rs = .06, BF10 > 10). Topics correlated with PrEP use (rs = -0.06 to 0.07, BF10 > 10) and HIV testing (rs = -0.05 to 0.05, BF10 > 10). Mediation analyses showed that hearing about and discussing PrEP mediated the relations between tweet rates and PrEP use (bi∗ = 0.01-0.05, BF10 > 100) and between topics and PrEP use (bi∗ = -0.04- 0.05, BF10 > 10). Moreover, hearing about PrEP was associated with PrEP use, which was in turn associated with tweet rates (bi∗ = 0.01, BF10 > 100) and topics (bi∗ = -0.03 - 0.01, BF10 > 10). CONCLUSIONS: Rates of MSM appear to lead to HIV tweets in a region, in person communications about PrEP, and, ultimately, actual PrEP use. Also, as more men hear about PrEP, they may use PrEP more and may tweet about HIV.

Niacinamide May Be Associated with Improved Outcomes in COVID-19-Related Acute Kidney Injury: An Observational Study.

Background: AKI is a significant complication of coronavirus disease 2019 (COVID-19), with no effective therapy. Niacinamide, a vitamin B3 analogue, has some evidence of efficacy in non-COVID-19-related AKI. The objective of this study is to evaluate the association between niacinamide therapy and outcomes in patients with COVID-19-related AKI. Methods: We implemented a quasi-experimental design with nonrandom, prospective allocation of niacinamide in 201 hospitalized adult patients, excluding those with baseline eGFR <15 ml/min per 1.73 m2 on or off dialysis, with COVID-19-related AKI by Kidney Disease Improving Global Outcomes (KDIGO) criteria, in two hospitals with identical COVID-19 care algorithms, one of which additionally implemented treatment with niacinamide for COVID-19-related AKI. Patients on the niacinamide protocol (B3 patients) were compared against patients at the same institution before protocol commencement and contemporaneous patients at the non-niacinamide hospital (collectively, non-B3 patients). The primary outcome was a composite of death or RRT. Results: A total of 38 out of 90 B3 patients and 62 out of 111 non-B3 patients died or received RRT. Using multivariable Cox proportional hazard modeling, niacinamide was associated with a lower risk of RRT or death (HR, 0.64; 95% CI, 0.40 to 1.00; P=0.05), an association driven by patients with KDIGO stage-2/3 AKI (HR, 0.29; 95% CI, 0.13 to 0.65; P=0.03; P interaction with KDIGO stage=0.03). Total mortality also followed this pattern (HR, 0.17; 95% CI, 0.05 to 0.52; in patients with KDIGO stage-2/3 AKI, P=0.002). Serum creatinine after AKI increased by 0.20 (SEM, 0.08) mg/dl per day among non-B3 patients with KDIGO stage-2/3 AKI, but was stable among comparable B3 patients (+0.01 [SEM, 0.06] mg/dl per day; P interaction=0.03). Conclusions: Niacinamide was associated with lower risk of RRT/death and improved creatinine trajectory among patients with severe COVID-19-related AKI. Larger randomized studies are necessary to establish a causal relationship.

HIV messaging on Twitter: an analysis of current practice and data-driven recommendations.

OBJECTIVES: Social media messages have been increasingly used in health campaigns about prevention, testing, and treatment of HIV. We identified factors leading to the retransmission of messages from expert social media accounts to create data-driven recommendations for online HIV messaging. DESIGN AND METHODS: We sampled 20 201 HIV-related tweets (posted between 2010 and 2017) from 37 HIV experts. Potential predictors of retransmission were identified based on prior literature and machine learning methods, and were subsequently analyzed using multilevel negative binomial models. RESULTS: Fear-related language, longer messages, and including images (e.g. photos, gif, or videos) were the strongest predictors of retweet counts. These findings were similar for messages authored by HIV experts, and also messages retransmitted by experts, but created by nonexperts (e.g. celebrities or politicians). CONCLUSIONS: Fear appeals affect how much HIV messages spread on Twitter, as do structural characteristics, like the length of the tweet and inclusion of images. A set of five data-driven recommendations for increasing message spread is derived and discussed in the context of current centers for disease control and prevention social media guidelines.

An Online Risk Index for the Cross-Sectional Prediction of New HIV Chlamydia, and Gonorrhea Diagnoses Across U.S. Counties and Across Years.

The present study evaluated the potential use of Twitter data for providing risk indices of STIs. We developed online risk indices (ORIs) based on tweets to predict new HIV, gonorrhea, and chlamydia diagnoses, across U.S. counties and across 5 years. We analyzed over one hundred million tweets from 2009 to 2013 using open-vocabulary techniques and estimated the ORIs for a particular year by entering tweets from the same year into multiple semantic models (one for each year). The ORIs were moderately to strongly associated with the actual rates (.35 < rs < .68 for 93% of models), both nationwide and when applied to single states (California, Florida, and New York). Later models were slightly better than older ones at predicting gonorrhea and chlamydia, but not at predicting HIV. The proposed technique using free social media data provides signals of community health at a high temporal and spatial resolution.

Proyecto Girona Territori Cardioprotegit: evaluación del funcionamiento de los desfibriladores públicos / The Girona Territori Cardioprotegit project: performance evaluation of public defibrillators

Introducción y objetivos: La desfibrilación pública ha potenciado la difusión y el uso de los desfibriladores externos automáticos (DEA) de manera exponencial, pero se carece de datos recientes sobre su uso en nuestro medio. Se realizó un análisis descriptivo del funcionamiento de los DEA desde el despliegue de un programa de desfibrilación pública. Métodos: Análisis retrospectivo de los trazados electrocardiográficos registrados y del funcionamiento de los desfibriladores, en el marco de un programa de desfibrilación pública en la provincia de Girona, desde su inicio en junio de 2011 hasta junio de 2015. Resultados: De 231 activaciones, se dispuso de información completa en 188, entre dispositivos móviles (82%) y fijos (18%). La asistolia fue el ritmo más prevalente (42%), mientras que un 23% de los ritmos fueron fibrilación ventricular. La especificidad de los dispositivos identificando ritmos desfibrilables fue del 100%, pero hubo 8 falsos negativos (sensibilidad del 83%). En el caso de los 47 ritmos desfibrilables, la tasa de recuperación de la circulación espontánea fue del 49% (23 casos). No hubo ningún accidente relacionado con el uso del dispositivo. Conclusiones: Casi la mitad de los ritmos registrados fueron asistolias. Los DEA analizados presentaron excelentes seguridad y especificidad, con una sensibilidad moderada. El DEA trató con éxito a la mitad de los pacientes que presentaron ritmo desfibrilable (AU)

Introduction and objectives: In recent years, public access defibrillation programs have exponentially increased the availability of automatic external defibrillators (AED) in public spaces but there are no data on their performance in our setting. We conducted a descriptive analysis of the performance of AED since the launch of a public defibrillation program in our region. Methods: A retrospective analysis was conducted of electrocardiographic tracings and the performance of AED in a public defibrillation program from June 2011 to June 2015 in the province of Girona, Spain. Results: There were 231 AED activations. Full information was available on 188 activations, of which 82% corresponded to mobile devices and 18% to permanent devices. Asystole was the most prevalent rhythm (42%), while ventricular fibrillation accounted for 23%. The specificity of the device in identifying a shockable rhythm was 100%, but there were 8 false negatives (sensitivity 83%). There were 47 shockable rhythms, with a spontaneous circulation recovery rate of 49% (23 cases). There were no accidents related to the use of the device (AU)

The Girona Territori Cardioprotegit Project: Performance Evaluation of Public Defibrillators.

INTRODUCTION AND OBJECTIVES: In recent years, public access defibrillation programs have exponentially increased the availability of automatic external defibrillators (AED) in public spaces but there are no data on their performance in our setting. We conducted a descriptive analysis of the performance of AED since the launch of a public defibrillation program in our region. METHODS: A retrospective analysis was conducted of electrocardiographic tracings and the performance of AED in a public defibrillation program from June 2011 to June 2015 in the province of Girona, Spain. RESULTS: There were 231 AED activations. Full information was available on 188 activations, of which 82% corresponded to mobile devices and 18% to permanent devices. Asystole was the most prevalent rhythm (42%), while ventricular fibrillation accounted for 23%. The specificity of the device in identifying a shockable rhythm was 100%, but there were 8 false negatives (sensitivity 83%). There were 47 shockable rhythms, with a spontaneous circulation recovery rate of 49% (23 cases). There were no accidents related to the use of the device. CONCLUSIONS: Nearly half of the recorded rhythms were asystole. The AED analyzed showed excellent safety and specificity, with moderate sensitivity. Half the patients with a shockable rhythm were successfully treated by the AED.

Innovative cross-system and community approaches for the prevention of child maltreatment.

Because of the complexity and depth of problems facing children and families today, child protection can be best accomplished through a community effort--not simply through the efforts of the traditional child welfare system and other child- and family-serving agencies. Community-based initiatives supporting families and individuals are promising mechanisms through which to efficiently reach a wide range of community members consistent with a public health model. This conceptual paper describes the principles of community-based approaches for the prevention of child maltreatment and briefly describes four initiatives that are providing comprehensive, community-based prevention.

Análisis de 50 casos de tumores hipofisiarios operados / Analisys of 55 cases in operated pituitary tumors

Se presenta el análisis de 50 casos de tumores hipofisiarios operados en el Servicio de Neurocirugía de Valdivia, tanto por vía subfrontal, como por vía transesfenoidal, sus características clínicas, radiológicas, complicaciones, evolución y resultados. Se hace hincapié en las dificultades y facilidades que ofrecen ambas vías, acentuadas con los problemas que presenta la Neurocirugía en provincias.