Prognostic Accuracy of Screening Tools for Clinical Deterioration in Adults With Suspected Sepsis in Northeastern Thailand: A Cohort Validation Study.

Background: We sought to assess the performance of commonly used clinical scoring systems to predict imminent clinical deterioration in patients hospitalized with suspected infection in rural Thailand. Methods: Patients with suspected infection were prospectively enrolled within 24 hours of admission to a referral hospital in northeastern Thailand between 2013 and 2017. In patients not requiring intensive medical interventions, multiple enrollment scores were calculated including the National Early Warning Score (NEWS), the Modified Early Warning Score, Between the Flags, and the quick Sequential Organ Failure Assessment score. Scores were tested for predictive accuracy of clinical deterioration, defined as a new requirement of mechanical ventilation, vasoactive medications, intensive care unit admission, and/or death approximately 1 day after enrollment. The association of each score with clinical deterioration was evaluated by means of logistic regression, and discrimination was assessed by generating area under the receiver operating characteristic curve. Results: Of 4989 enrolled patients, 2680 met criteria for secondary analysis, and 100 of 2680 (4%) experienced clinical deterioration within 1 day after enrollment. NEWS had the highest discrimination for predicting clinical deterioration (area under the receiver operating characteristic curve, 0.78 [95% confidence interval, .74-.83]) compared with the Modified Early Warning Score (0.67 [.63-.73]; P < .001), quick Sequential Organ Failure Assessment (0.65 [.60-.70]; P < .001), and Between the Flags (0.69 [.64-.75]; P < .001). NEWS ≥5 yielded optimal sensitivity and specificity for clinical deterioration prediction. Conclusions: In patients hospitalized with suspected infection in a resource-limited setting in Southeast Asia, NEWS can identify patients at risk of imminent clinical deterioration with greater accuracy than other clinical scoring systems.

Dataset for multimodal fake news detection and verification tasks.

The proliferation of online disinformation and fake news, particularly in the context of breaking news events, demands the development of effective detection mechanisms. While textual content remains the predominant medium for disseminating misleading information, the contribution of other modalities is increasingly emerging within online outlets and social media platforms. However, multimodal datasets, which incorporate diverse modalities such as texts and images, are not very common yet, especially in low-resource languages. This study addresses this gap by releasing a dataset tailored for multimodal fake news detection in the Italian language. This dataset was originally employed in a shared task on the Italian language. The dataset is divided into two data subsets, each corresponding to a distinct sub-task. In sub-task 1, the goal is to assess the effectiveness of multimodal fake news detection systems. Sub-task 2 aims to delve into the interplay between text and images, specifically analyzing how these modalities mutually influence the interpretation of content when distinguishing between fake and real news. Both sub-tasks were managed as classification problems. The dataset consists of social media posts and news articles. After collecting it, it was labeled via crowdsourcing. Annotators were provided with external knowledge about the topic of the news to be labeled, enhancing their ability to discriminate between fake and real news. The data subsets for sub-task 1 and sub-task 2 consist of 913 and 1350 items, respectively, encompassing newspaper articles and tweets.

Breaking bad news: A mix methods study reporting the need for improving communication skills among doctors in Pakistan.

BACKGROUND: Effective skills and training for physicians are essential for communicating difficult or distressing information, also known as breaking bad news (BBN). This study aimed to assess both the capacity and the practices of clinicians in Pakistan regarding BBN. METHODS: A cross-sectional study was conducted involving 151 clinicians. Quantitative component used a structured questionnaire, while qualitative data were obtained through in-depth interviews with 13 medical educationists. The responses were analyzed using descriptive statistics and thematic analysis. RESULTS: While most clinicians acknowledged their responsibility of delivering difficult news, only a small percentage had received formal training in BBN. Areas for improvement include time and interruption management, rapport building, and understanding the patients' point of view. Prognosis and treatment options were not consistently discussed. Limited importance is given to BBN in medical education. DISCUSSION: Training in BBN will lead to improved patient and attendants' satisfaction, and empathetic support during difficult times.

Association Between the Time Spent on and Sources of the News of Russo-Ukrainian War and Psychological Distress Among Individuals in Poland and Ukraine: The Mediating Effect of Rumination.

Background: The Russo-Ukrainian War has resulted in massive social, economic, and psychological burdens worldwide. This study aimed to investigate the associations between time spent on the war-related news and psychological distress, including depression, anxiety, and post-traumatic stress disorder (PTSD) and the mediating effects of rumination on the associations in people residing in Poland and Ukraine. Methods: This cross-sectional study recruited 1438 internet users in Poland and Ukraine, and collected data on levels of rumination, psychological distress, and the amount of time spent on and sources of the news of the Russo-Ukrainian War. Structural equation modeling with bootstrapping methods was used to evaluate the mediation effect. Multivariate linear regression was used to identify predictive effect of the source of the war-related news on psychological distress and rumination. Results: The results showed a mediating effect of rumination on the association between the amount of time spent on the war-related news and psychological distress among participants in Poland (ß = 0.16, p < 0.001) and Ukraine (ß = 0.15, p < 0.001). Approaching the news from television was associated with rumination (ß = 0.607, p < 0.001) and PTSD symptoms in Poland (ß = 2.475, p = 0.009), while approaching news from the internet was associated with rumination in Poland (ß = 0.616, p = 0.001). Conclusion: The study identified the mediating effect of rumination and the associations of approaching the war-related news from television and the internet with mental health.

Public health framing of firearm violence on local television news in Philadelphia, PA, USA: a quantitative content analysis.

BACKGROUND: Firearm violence is an intensifying public health problem in the United States. News reports shape the way the public and policy makers understand and respond to health threats, including firearm violence. To better understand how firearm violence is communicated to the public, we aimed to determine the extent to which firearm violence is framed as a public health problem on television news and to measure harmful news content as identified by firearm-injured people. METHODS: This is a quantitative content analysis of Philadelphia local television news stories about firearm violence using a database of 7,497 clips. We compiled a stratified sample of clips aired on two randomly selected days/month from January-June 2021 from the database (n = 192 clips). We created a codebook to measure public health frame elements and to assign a harmful content score for each story and then coded the clips. Characteristics of stories containing episodic frames that focus on single shooting events were compared to clips with thematic frames that include broader social context for violence. RESULTS: Most clips employed episodic frames (79.2%), presented law enforcement officials as primary narrators (50.5%), and included police imagery (79.2%). A total of 433 firearm-injured people were mentioned, with a mean of 2.8 individuals shot included in each story. Most of the firearm-injured people featured in the clips (67.4%) had no personal information presented apart from age and/or gender. The majority of clips (84.4%) contained at least one harmful content element. The mean harmful content score/clip was 2.6. Public health frame elements, including epidemiologic context, root causes, public health narrators and visuals, and solutions were missing from most clips. Thematic stories contained significantly more public health frame elements and less harmful content compared to episodic stories. CONCLUSIONS: Local television news produces limited public health coverage of firearm violence, and harmful content is common. This reporting likely compounds trauma experienced by firearm-injured people and could impede support for effective public health responses to firearm violence. Journalists should work to minimize harmful news content and adopt a public health approach to reporting on firearm violence.

External validation of two clinical prediction models for mortality in COVID-19 patients (4C and NEWS2), in three centers in Medellín, Colombia: Assessing the impact of vaccination over time.

OBJECTIVES: External validation of the 4C and NEWS2 scores for the prediction of in-hospital mortality in COVID-19 patients, and evaluation of its operational performance in two time periods: before and after the start of the vaccination program in Colombia. METHODS: Retrospective cohort in three high complexity hospitals in the city of Medellín, Colombia, between June 2020 and April 2022. RESULTS: The areas under the ROC curve (AUC) for the 4C mortality risk score and the NEWS2 were 0.75 (95% CI 0.73-0.78) and 0.68 (95% CI 0.66-0.71), respectively. For the 4C score, the AUC for the first and second periods was 0.77 (95% CI 0.74-0.80) and 0.75 (95% CI 0.71-0.78); whilst for the NEWS2 score, it was 0.68 (95% CI 0.65-0.71) and 0.69 (95% CI 0.64-0.73). The calibration for both scores was adequate, albeit with reduced performance during the second period. CONCLUSIONS: The 4C mortality risk score proved to be the more adequate predictor of in-hospital mortality in COVID-19 patients in this Latin American population. The operational performance during both time periods remained similar, which shows its utility notwithstanding major changes, including vaccination, as the pandemic evolved.

Improving patient outcomes following vital sign monitoring protocol failure: A retrospective cohort study.

Background and Aims: Vital sign monitoring needs to be timely and correct to recognize deteriorating patients early and trigger the relevant clinical response. The aim of this study is to retrospectively evaluate compliance specifically toward the regional vital sign monitoring protocol the so called early warning score protocol (EWS-protocol) 72 h before a medical emergency team response (MET-response) and thereby illuminate whether poor compliance translates into a worse patient outcome. Methods: It was investigated all eligible patients that underwent MET responses during the calendar year 2019. The inclusion criteria encompassed somatic patients above 18 years of age admitted to the hospital and detailed evaluations of the medical records of the included patients were conducted. Results: Four hundred and twenty-nine MET-responses were included in the final analysis. EWS-protocol failure was observed for more than half the patients within all the time frames assessed. Thirty-day mortality was significantly higher for patients subject to EWS protocol failure in the timeframes 24-16, 16-8, 8-0 h before MET response. Adjusting for admission length, age, and gender, patients subject to EWS-protocol failure had an odds ratio (OR) of 1.9, 2.0, 2.1, 2.3 for mortality in the time frames 72-48, 24-16, 16-8, and 8-0 h before the MET-response, respectively. The adjusted OR for ICU-admission was 1.7, and 1.6 for patients subject to EWS-protocol failure in the time frames 16-8 and 8-0 h before MET-response, respectively. Conclusion: According to all the data analysis in this article, there is evidence that compliance toward the NEWS-protocol is poor. EWS-protocol failure is associated with a significant higher mortality and ICU-admission rate.

Critical Gaps in Medical Research Reporting by Online News Media.

BACKGROUND: The integrity of medical research reporting in online news publications is crucial for informed healthcare decisions and public health discourse. However, omissions, lack of transparency, and the rapid spread of misinformation on digital and social media platforms can lead to an incomplete or inaccurate understanding of research findings. This study aims to analyze the fidelity of online news in reporting medical research findings, focusing on conflicts of interest, study limitations, statistical data, and research conclusions. METHODS: Fifty randomized controlled trials published in major medical journals and their corresponding news reports were evaluated for the inclusion of conflicts of interest, study limitations, and inferential statistics in the news reports. The alignment of conclusions was evaluated. A binomial test with a Bonferroni correction was used to assess the inclusion rate of these variables against a 90% threshold. RESULTS: Conflicts of interest were reported in 10 (20%) of news reports, study limitations in 14 (28%), and inferential statistics in 19 (38%). These rates were significantly lower than the 90% threshold (p<0.001). Research conclusions aligned in 43 (86%) cases, which was not significantly different from 90% (p=0.230). Misaligned conclusions resulted from overstating claims. CONCLUSION: Significant gaps exist in the reporting of critical contextual information in medical news articles. Adopting a structured reporting format could enhance the quality and transparency of medical research communication. Collaboration among journalists, news organizations, and medical researchers is crucial for establishing and promoting best practices, fostering informed public discourse, and better health outcomes.

Viral Transmission? A Longitudinal Study of Media Use and Its Relation to Mental Strain During the First 2 Years of the COVID-19 Pandemic.

BACKGROUND: In light of the dynamic COVID-19 pandemic, the exposure to pandemic-related media coverage may change over time and may be particularly relevant due to associations with psychopathological symptoms. The aims of the present study were to examine changes in media consumption over time and to analyze its prospective associations with psychological strain. METHOD: The study uses a longitudinal observational design with ten periods of online data collection from March 2020 to April 2022 in an adult convenience sample (N = 8337) of the general population in Germany. RESULTS: Our data revealed that the frequency and duration of pandemic-related media exposure as well as their subjective critical evaluation showed the highest levels at the beginning of the pandemic and peaked again in autumn 2020 and spring 2021. The primarily used media formats changed only slightly over time. The amount of media exposure at baseline was associated with more impairing pandemic-related anxiety 1 month, 1 year, and 2 years later. CONCLUSION: Our results hint to potentially problematical and long-lasting associations of pandemic-related media consumption with mental strain. Our findings could serve as an orientation for recommendations, further research, and adequate interventions for a responsible dealing with media coverage. TRIAL REGISTRATION: The authors have pre-registered this research at clinicaltrials.gov without an analysis plan; retrievable at: https://clinicaltrials.gov/ct2/show/NCT04331106 .

Doomscrolling: Prospective associations between daily COVID news exposure, internalizing symptoms, and substance use among sexual and gender minority individuals assigned female at birth.

Cross-sectional studies have demonstrated associations between COVID news exposure, anxiety, and depression. However, longitudinal research examining the directionality of these associations is extremely limited. Further, most studies have focused on the general population and neglected sexual and gender minority individuals (SGM), a population disproportionately impacted by the pandemic. To address these limitations, the current study utilized data from a 30-day diary study of SGM assigned female at birth (N = 429). We examined concurrent and prospective associations between COVID news exposure, depressed and anxious affect, COVID distress, substance use, and motives for use. Further, we examined associations between cumulative COVID news exposure across the diary period and prospective changes in anxiety, depression, and COVID distress. When participants were exposed to more COVID news, they experienced more depressed and anxious affect, more COVID distress, less positive affect, and were more likely to use alcohol and cannabis to cope. Further, when participants were exposed to more COVID news, they experienced subsequent increases in depressed affect, decreases in positive affect, and increases in the likelihood of using cannabis to cope. Findings also provided evidence of bi-directional prospective associations between COVID news exposure and COVID distress and of a cumulative impact of COVID news exposure on anxiety, depression, and COVID distress. Findings suggest that individuals should balance the need to remain informed about the pandemic and their own mental health when considering how much COVID news to consume.

Memory and belief updating following complete and partial reminders of fake news.

Fake news can have enduring effects on memory and beliefs. An ongoing theoretical debate has investigated whether corrections (fact-checks) should include reminders of fake news. The familiarity backfire account proposes that reminders hinder correction (increasing interference), whereas integration-based accounts argue that reminders facilitate correction (promoting memory integration). In three experiments, we examined how different types of corrections influenced memory for and belief in news headlines. In the exposure phase, participants viewed real and fake news headlines. In the correction phase, participants viewed reminders of fake news that either reiterated the false details (complete) or prompted recall of missing false details (partial); reminders were followed by fact-checked headlines correcting the false details. Both reminder types led to proactive interference in memory for corrected details, but complete reminders produced less interference than partial reminders (Experiment 1). However, when participants had fewer initial exposures to fake news and experienced a delay between exposure and correction, this effect was reversed; partial reminders led to proactive facilitation, enhancing correction (Experiment 2). This effect occurred regardless of the delay before correction (Experiment 3), suggesting that the effects of partial reminders depend on the number of prior fake news exposures. In all experiments, memory and perceived accuracy were better when fake news and corrections were recollected, implicating a critical role for integrative encoding. Overall, we show that when memories of fake news are weak or less accessible, partial reminders are more effective for correction; when memories of fake news are stronger or more accessible, complete reminders are preferable.

Intersections in the digital society: cancel culture, fake news, and contemporary public discourse.

This article critically examines the intricate relationship between cancel culture and fake news, shedding light on their collective impact on current societies. The changing social landscape, marked by the transition from the "network society" to the "platform society," has given rise to unprecedented phenomena such as cancel culture. Rooted in social media complaints, cancel culture intersects with the dissemination of intentionally created false information, forming a complex web of dynamics. The study explores the multifaceted nature of cancel culture, its unintended consequences and the nuanced definitions surrounding it. The synthesis of erasure culture and fake news prompts critical reflections on the democratization of information, the protection of fundamental rights, and the potential risks to democracies of an unbridled online narrative. As digital networks continue to play a central role in everyday life, understanding and addressing these challenges is essential to maintaining a balanced discourse that upholds democratic values.

Syndromic testing for respiratory pathogens but not National Early Warning Score can be used to identify viral cause in hospitalised adults with lower respiratory tract infections.

BACKGROUND: Community-acquired lower respiratory tract infection (LRTI) is a common reason for hospitalisation. Antibiotics are frequently used while diagnostic microbiological methods are underutilised in the acute setting. OBJECTIVES: We aimed to investigate the relative proportion of viral and bacterial infections in this patient group and explore methods for proper targeting of antimicrobial therapy. METHODS: We collected nasopharyngeal samples prospectively from adults hospitalised with LRTIs during three consecutive winter seasons (2016-2019). Syndromic nasopharyngeal testing was performed using a multiplex PCR panel including 16 viruses and four bacteria. Medical records were reviewed for clinical data. RESULTS: Out of 220 included patients, a viral pathogen was detected in 74 (34%), a bacterial pathogen in 63 (39%), both viral and bacterial pathogens in 49 (22%), while the aetiology remained unknown in 34 (15%) cases. The proportion of infections with an identified pathogen increased from 38% to 85% when syndromic testing was added to standard-of-care testing. Viral infections were associated with a low CRP level and absence of pulmonary infiltrates. A high National Early Warning Score did not predict bacterial infections. CONCLUSIONS: Syndromic testing by a multiplex PCR panel identified a viral infection or viral/bacterial coinfection in a majority of hospitalised adult patients with community-acquired LRTIs.

A Sesotho news headlines dataset for sentiment analysis.

Sentiment Analysis (SA) is a subset of Natural Language Processing (NLP) which has become a promising research area enabling the provision of language specific services. Although research in high resource languages such as English and Chinese has achieved promising results, research in low resource African languages such as Sesotho is still in its infancy due to limited text and speech datasets. This study contributes in this regard by availing the Sesotho News (SN) dataset, as an annotated dataset for the SA and Aspect Based Sentiment Analysis (ABSA) tasks. This dataset may be used for NLP research to benefit 1.85 million Sesotho speakers in Lesotho and 11.5 million speakers in South Africa. The dataset includes 4651 headlines for the ABSA task and 2401 headlines for the SA task using Lesotho's orthography of Sesotho. The news headlines were collected from Sesotho online newspapers and then annotated for the ABSA and SA tasks. The Spearman's correlation and Cohen's Kappa Index metrics show that there is good correlation between the annotators, implying that the SN dataset is of gold standard.

ANN: adversarial news net for robust fake news classification.

With easy access to social media platforms, spreading fake news has become a growing concern today. Classifying fake news is essential, as it can help prevent its negative impact on individuals and society. In this regard, an end-to-end framework for fake news detection is developed by utilizing the power of adversarial training to make the model more robust and resilient. The framework is named "ANN: Adversarial News Net," emoticons have been extracted from the datasets to understand their meanings concerning fake news. This information is then fed into the model, which helps to improve its performance in classifying fake news. The performance of the ANN framework is evaluated using four publicly available datasets, and it is found to outperform baseline methods and previous studies after adversarial training. Experiments show that Adversarial Training improved the performance by 2.1% over the Random Forest baseline and 2.4% over the BERT baseline method in terms of accuracy. The proposed framework can be used to detect fake news in real-time, thereby mitigating its harmful effects on society.

Exploring stigmatization in digital newspaper coverage of substance use disorder.

Substance use disorder is a global health issue that profoundly affects both individuals and societies. Social stigma acts as a significant barrier to treatment motivation. Mass media plays a substantial role in shaping societal perceptions. This study aims to identify stigmatizing attitudes in news narratives concerning substance use disorder as portrayed in digital newspapers. We examined news articles from the top eight national digital newspapers published during 2022 by using quantitative and retrospective content analysis. Following the review, we collected 1.233 news articles, removed 480 articles which were irrelevant or duplicate, and analyzed the remaining 753 articles using quantitative content analysis methods on SPSS 26.0. The majority of news articles depict substance use disorder in a negative consideration. The analysis revealed that nearly all news sources were news agencies and only 11% of the articles offered potential solutions. Alarmingly, 69.7% of the articles contained stigmatizing content, while 53.1% directly impacted the social lives of individuals with substance use disorder. Furthermore, 44.1% of the articles reinforced a dangerous perception associated with individuals with substance use disorder. To address these issues, we recommend a more empathetic portrayal of substance use disorder, support for help-seeking behavior, and advocacy for effective solutions in news coverage.

Resources Utilized by Otolaryngology Fellowship Directors When Determining Reputations of Residency Programs.

OBJECTIVE: Residency program reputation is consistently reported as an important factor by fellowship directors when considering applicants. This study sets out to determine resources fellowship directors rely on when determining residency program reputation. STUDY DESIGN: Cross-sectional study. SETTING: Using an anonymous online survey of all 2022 Otolaryngology (OHNS) fellowship program directors. METHODS: The 13-question survey sought to assess fellowship director's perspectives and resource utilization when determining residency program reputation. RESULTS: Representing all OHNS fellowship program directors and co-directors (N = 287), 103 responded to our survey, response rate 35.9%. Most participants reported that residency reputation was important for fellowship candidacy. On a Likert scale of 1 to 5, 1 being most important and 5 being not important, personal knowledge of the residency program (2.03 out of 5) and program faculty/mentor reputation (2.09 out of 5) were the most important factors cited. 63% were unfamiliar with the survey methodology of Doximity Residency Navigator (DRN), while 53% contributed to DRN by filling out surveys. Nearly all fellowship directors (N = 100, 97%) reported their rank list was not influenced by DRN. Most fellowship directors reported that US News and World Report (USNWR) and DRN were neither consistent nor inconsistent with their perceptions of residency reputations (38% and 56%, respectively), suggesting ambivalence toward these resources. CONCLUSION: Residency reputation is important for fellowship directors when evaluating fellowship candidates. Directors do not rely on USNWR, National Institute of Health (NIH) ranking, or DRN when gauging residency reputation, but rather personal knowledge of the applicant's residency program or reputation of the otolaryngology faculty.

Illusions of knowledge due to mere repetition.

Repeating information increases people's belief that the repeated information is true. This truth effect has been widely researched and is relevant for topics such as fake news and misinformation. Another effect of repetition, which is also relevant to those topics, has not been extensively studied so far: Do people believe they knew something before it was repeated? We used a standard truth effect paradigm in four pre-registered experiments (total N = 773), including a presentation and judgment phase. However, instead of "true"/"false" judgments, participants indicated whether they knew a given trivia statement before participating in the experiment. Across all experiments, participants judged repeated information as "known" more often than novel information. Participants even judged repeated false information to know it to be false. In addition, participants also generated sources of their knowledge. The inability to distinguish recent information from well-established knowledge in memory adds an explanation for the persistence and strength of repetition effects on truth. The truth effect might be so robust because people believe to know the repeatedly presented information as a matter of fact.