Instagram for audience engagement: an evaluation of CERC framework in the GCC nations for digital public health during the Covid-19 pandemic.

BACKGROUND: In this study, we investigate the utilization of Instagram by public health ministries across the Gulf Cooperation Council (GCC) nations to disseminate health-related information during the COVID-19 pandemic. With Instagram's visual-centric approach and high user engagement, the research aims to investigate its critical yet complex role in information dissemination amid a health crisis. METHODS: To examine how Instagram communication strategies align with the CDC's Crisis and Emergency Risk Communication (CERC) framework, we employ the content analysis method. This approach helps to evaluate the effectiveness and challenges of employing Instagram for health communication within a region known for its significant social media usage. RESULTS: Findings indicate that Instagram serves as a vital platform for the rapid dissemination of health information in the GCC, leveraging its visual capabilities and wide reach. The GCC ministries of health utilized Instagram to demonstrate a consistent and strategic approach to communicate essential COVID-19 related information. Kuwait and Bahrain were the most active of all the assessed ministries with respect to the number of engagement metrics (likes and comments). Most of the posts, as per the CERC framework, were informational and related to vaccine infection and death cases. The second most salient theme in line with the CERC framework was about promoting actions, followed by Instagram posts about activities, events, and campaigns. CONCLUSIONS: The research underscores Instagram's potential as a powerful tool in enhancing public health resilience and responsiveness during health emergencies in the GCC. It suggests that leveraging social media, with careful consideration of its affordances, can contribute significantly to effective health communication strategies in times of crisis.

A randomized, double-blind, placebo-controlled study of the kappa opioid receptor antagonist, CERC-501, in a human laboratory model of smoking behavior.

Preclinical data indicate that selective kappa opioid receptor antagonists reduce nicotine self-administration and withdrawal symptoms. The aim of the current study was to determine whether treatment with CERC-501, an orally available, potent, and selective kappa opioid receptor antagonist, could alleviate nicotine withdrawal and craving and mitigate mood alterations associated with nicotine withdrawal in humans. Healthy, adult cigarette smokers were enrolled into this randomized, multisite, double-blind, placebo-controlled, crossover study. Participants completed two 8-day treatment phases during which they received either CERC-501 (15 mg, p.o., once daily) or placebo. On the seventh day of each dosing phase, participants were admitted as inpatients for an 18-hour cigarette abstinence period followed by experimental testing. The primary outcome measures were (a) performance on the McKee Smoking Lapse test (ie, latency to smoke in exchange for money) and (b) number of cigarettes self-administered during a 60-minute ad lib smoking period. Other outcomes included measures of craving, mood, anxiety, nicotine withdrawal, and subjective effects of cigarette smoking. A total of 71 participants who smoked an average of approximately 23 cigarettes per day were enrolled, and 56 subjects completed the study. CERC-501 was well tolerated, but it did not significantly alter the latency to start smoking (CERC-501: 16.5 min vs placebo: 17.7 min) or the number of cigarettes smoked (CERC-501: 3.3 cigarettes vs placebo: 3.1 cigarettes). Compared with placebo, CERC-501 also did not affect cigarette craving, mood, anxiety, nicotine withdrawal, or subjective effects of smoking. These findings do not support a role for CERC-501 in the treatment of nicotine use disorder.

COVID-19: Impact analysis and recommendations for power sector operation.

The demand of electricity has been reduced significantly due to the recent COVID-19 pandemic. Governments around the world were compelled to reduce the business activity in response to minimize the threat of coronavirus. This on-going situation due to COVID-19 has changed the lifestyle globally as people are mostly staying home and working from home if possible. Hence, there is a significant increase in residential load demand while there is a substantial decrease in commercial and industrial loads. This devastating situation creates new challenges in the technical and financial activities of the power sector and hence most of the utilities around the world initiated a disaster management plan to tackle this ongoing challenges/threats. Therefore, this study aims to investigate the global scenarios of power systems during COVID-19 along with the socio-economic and technical issues faced by the utilities. Then, this study further scrutinized the Indian power system as a case study and explored scenarios, issues and challenges currently being faced to manage the consumer load demand, including the actions taken by the utilities/power sector for the smooth operation of the power system. Finally, a set of recommendations are presented to support the government/policymakers/utilities around the world not only to overcome the current crisis but also to overcome future unforeseeable pandemic alike scenario.

Viability of power distribution in India - Challenges and Way Forward.

Energy is a key component for economic growth as well as for human development. India is the third-ranking electricity generator in the world but ranks 106th in terms of per capita consumption. Specifically, the distribution of power is the most important link in the value chain of the power sector since it is the cash register for the entire sector. In India, electricity is a concurrent subject shared between the Central and State Governments. While the generation of power has been deregulated since 2003, the supply of power to the consumers is generally carried out by Government-owned power Distribution Companies (DISCOMs). In this paper, the authors analyze the financial distress of DISCOMs in India, and explain how the supply-demand mismatch due to over-ambitious demand projections, the fixed and energy charges of thermal power plants, and the excess procurement of "must-run" renewable sources together contribute to the high cost of power procurement that drives the financial stress faced by DISCOMs. The authors support their assertion with a study of nine DISCOMs supplying electricity to 155 million people in three States and propose policy recommendations for a turnaround of such DISCOMs which can be rolled out with suitable modifications across India.

NMDA Antagonists for Treatment-Resistant Depression.

Fifteen to thirty percent of patients with major depressive disorder do not respond to antidepressants that target the monoaminergic systems. NMDA antagonists are currently being actively investigated as a treatment for these patients. Ketamine is the most widely studied of the compounds. A brief infusion of a low dose of this agent produces rapid improvement in depressive symptoms that lasts for several days. The improvement occurs after the agent has produced its well characterized psychotomimetic and cognitive side effects. Multiple infusions of the agent (e.g., 2-3× per week for several weeks) provide relief from depressive symptoms, but the symptoms reoccur once the treatment has been stopped. A 96-h infusion of a higher dose using add-on clonidine to mitigate the psychotomimetic effects appears to also provide relief and resulted in about 40% of the subjects still having a good response 8 weeks after the infusion. As this was a pilot study, additional work is needed to confirm and extend this finding. Nitrous oxide also has had positive results. Of the other investigational agents, CERC-301 and rapastinel remain in clinical development. When careful monitoring of neuropsychiatric symptoms has been conducted, these agents all produce similar side effects in the same dose range, indicating that NMDA receptor blockade produces both the wanted and unwanted effects. Research is still needed to determine the appropriate dose, schedule, and ways to mitigate against unwanted side effects of NMDA receptor blockade. These hurdles need to be overcome before ketamine and similar agents can be prescribed routinely to patients.

Reversal of Stress-Induced Social Interaction Deficits by Buprenorphine.

Background: Patients with post-traumatic stress disorder frequently report persistent problems with social interactions, emerging after a traumatic experience. Chronic social defeat stress is a widely used rodent model of stress that produces robust and sustained social avoidance behavior. The avoidance of other rodents can be reversed by 28 days of treatment with selective serotonin reuptake inhibitors, the only pharmaceutical class approved by the U.S. Food and Drug Administration for treating post-traumatic stress disorder. In this study, the sensitivity of social interaction deficits evoked by 10 days of chronic social defeat stress to prospective treatments for post-traumatic stress disorder was examined. Methods: The effects of acute and repeated treatment with a low dose of buprenorphine (0.25 mg/kg/d) on social interaction deficits in male C57BL/6 mice by chronic social defeat stress were studied. Another cohort of mice was used to determine the effects of the selective serotonin reuptake inhibitor fluoxetine (10 mg/kg/d), the NMDA antagonist ketamine (10 mg/kg/d), and the selective kappa opioid receptor antagonist CERC-501 (1 mg/kg/d). Changes in mRNA expression of Oprm1 and Oprk1 were assessed in a separate cohort. Results: Buprenorphine significantly reversed social interaction deficits produced by chronic social defeat stress following 7 days of administration, but not after acute injection. Treatment with fluoxetine for 7 days, but not 24 hours, also reinstated social interaction behavior in mice that were susceptible to chronic social defeat. In contrast, CERC-501 and ketamine failed to reverse social avoidance. Gene expression analysis found: (1) Oprm1 mRNA expression was reduced in the hippocampus and increased in the frontal cortex of susceptible mice and (2) Oprk1 mRNA expression was reduced in the amygdala and increased in the frontal cortex of susceptible mice compared to non-stressed controls and stress-resilient mice. Conclusions: Short-term treatment with buprenorphine and fluoxetine normalized social interaction after chronic social defeat stress. In concert with the changes in opioid receptor expression produced by chronic social defeat stress, we speculate that buprenorphine's efficacy in this model of post-traumatic stress disorder may be associated with the ability of this compound to engage multiple opioid receptors.

Serum Levels of N- and C-ERC/Mesothelin and Clinicopathological Factors in Mesothelioma Patients and Those without Mesothelioma.

Objectives: ERC/mesothelin is a glycosylphosphatidylinositol (GPI)-anchor protein expressed in mesothelioma. A precursor protein is cleaved by proteases and an N-terminal fragment (N-ERC) is extracellularly secreted. A remaining C-terminal fragment (C-ERC) is tethered on cellular membranes by the GPI-anchor, but C-ERC is also released after cleavage by proteases. We and other groups reported that serum N-/C-ERC levels are associated with stages of mesothelioma and suggested the possibility of their usefulness as diagnostic markers. However, the N-ERC level is also influenced by renal functions that are not directly associated with conditions of mesothelioma. It is not known whether other clinical factors influence serum N-/C-ERC values. Furthermore, their relationship to the amount of ERC/Mesothelin in mesothelioma is not yet validated. The objective of this study is to clarify the relationship of serum N-/C-ERC levels and the status of mesothelioma and several clinical factors. Materials and Methods: We analyzed relations of serum N-/C-ERC levels and ages, gender and other clinical factors in 522 patients without mesothelioma and examined their relation to the amount of ERC/Mesothelin in mesothelioma tissues in 13 mesothelioma cases. Results: Serum N-ERC levels were influenced by renal functions. On the contrary, those of C-ERC were not influenced by any clinical factors examined in this study and were significantly correlated with the amount of ERC/Mesothelin in mesothelioma. Conclusion: Although both markers are good indicators of treatment-responses in individual patients with mesothelioma, only C-ERC reflected the amount of ERC/Mesothelin in mesothelioma among multiple patients, possibly because N-ERC was influenced by renal functions.

Public health agencies outreach through Instagram during the COVID-19 pandemic: Crisis and Emergency Risk Communication perspective.

Background: Governmental and non-governmental institutions increasingly use social media as a strategic tool for public outreach. Global spread, promptness, and dialogic potentials make these platforms ideal for public health monitoring and emergency communication in crises such as COVID-19. Objective: Drawing on the Crisis and Emergency Risk Communication framework, we sought to examine how leading health organizations use Instagram for communicating and engaging during the COVID-19 pandemic. Methods: We manually retrieved Instagram posts together with relevant metadata of four health organizations (WHO, CDC, IFRC, and NHS) shared between January 1, 2020, and April 30, 2020. Two coders manually coded the analytical sample of 269 posts related to COVID-19 on dimensions including content theme, gender depiction, person portrayal, and image type. We further analyzed engagement indices associated with the coded dimensions. Results: The CDC and WHO were the most active of all the assessed organizations with respect to the number of posts, reach, and engagement indices. Most of the posts were about personal preventive measures and mitigation, general advisory and vigilance, and showing gratitude and resilience. An overwhelming level of engagement was observed for posts representing celebrity, clarification, and infographics. Conclusions: Instagram can be an effective tool for health organizations to convey their messages during crisis communication, notably through celebrity involvement, clarification posts, and the use of infographics. There is much opportunity to strengthen the role of health organizations in countering misinformation on social media by providing accurate information, directing users to credible sources, and serving as a fact-check for false information.

Analysis of crisis communication by the Prime Minister of Australia during the COVID-19 pandemic.

Leadership and communication capabilities of federal leaders during crises are imperative to support and guide citizens' behaviors and emotions. The following content analysis examines crisis communication delivered by the Australian Prime Minister (PM), Scott Morrison during the COVID-19 pandemic. Communication delivered over seven months starting from the first reported case of COVID-19 in Australia, was analyzed through a process of coding to identify central organizing crisis communication frames and themes and measured against eleven main themes based on principles of Crisis and Emergency Risk Communication (CERC) recommended by the WHO and US Centers for Disease Control and Prevention. Transcripts were sourced from the PM's official website and 91 communiques were analyzed. Key epidemiological indicators and public health measures were reviewed over timeframe to examine changes in communication over the pandemic. Findings indicated that PM Morrison included many features of CERC within his official messaging. Our analysis revealed that the original framework was limited in its scope to encompass certain messages and thus the allocation of new frames,'public health and medical advice' and 'assuring and commending the public and institutions', allowed for a more thorough analysis of communication during a novel global health pandemic. The temporal analysis demonstrated that the government's policy and communication temporally followed case numbers and relative threat of the virus. This study has provided an in-depth review of CERC during the first phase of the COVID-19 pandemic. New frames and themes for the current CERC framework are suggested which can be transferable to other crises in Australia and other countries.

Strategic Uses of Facebook in Zika Outbreak Communication: Implications for the Crisis and Emergency Risk Communication Model.

While social media has been increasingly used for communication of infectious disease outbreaks, little is known about how social media can improve strategic communication across various stages of the health crisis. The Crisis and Emergency Risk Communication Model (Reynolds & Seeger, 2005; CERC) outlines strategies across different crisis phases and can guide crisis communication on social media. This research therefore investigates how social media can be utilized to implement and adapt the CERC model, by examining the strategic uses of Facebook in communicating the recent Zika epidemic by health authorities in Singapore. Zika-related Facebook posts of three main Singapore health agencies published within the one year period from January 2016 to December 2016 were thematically analysed. Results suggest that Facebook was used to communicate the crisis strategically, which supported and added to the CERC model. Novel uses of Facebook for outbreak communication were demonstrated, including promoting public common responsibility for disease prevention and expressing regards to the public for cooperation. Results also suggested that preparedness messages might be the most effective, as they produced a great level of public engagement. The adaptability of the CERC model in social media contexts to improve crisis communication is discussed.

How Do the First Days Count? A Case Study of Qatar Experience in Emergency Risk Communication during the MERS-CoV Outbreak.

This case study is the first to be developed in the Middle East region to document what happened during the response to the 2013 MERS outbreak in Qatar. It provides a description of key epidemiologic events and news released from a prime daily newspaper and main Emergency Risk Communication (ERC) actions that were undertaken by public health authorities. Using the Crisis and Emergency Risk Communication (CERC) theoretical framework, the study analyzes how the performed ERC strategies during the first days of the outbreak might have contributed to the outbreak management. METHODS: MERS-CoV related events were chronologically tracked, together with the relevant stories that were published in a major newspaper over the course of three distinct phases of the epidemic. The collected media stories were then assessed against the practiced emergency risk communication (ERC) activities during the same time frame. RESULTS: The Crisis & Emergency Risk Communication (CERC) framework was partially followed during the early days of the MERS-CoV epidemic, which were characterized by overwhelming uncertainty. The SCH's commitment to a proactive and open risk communication strategy since day one, contributed to creating the SCH's image as a credible source of information and allowed for the quick initiation of the overall response efforts. Yet, conflicting messages and over reassurance were among the observed pitfalls of the implemented ERC strategy. CONCLUSION: The adoption of CERC principles can help restore and maintain the credibility of responding agencies. Further work is needed to develop more rigorous and comprehensive research strategies that address sharing of information by mainstream as well as social media for a more accurate assessment of the impact of the ERC strategy.

Targeted Blockade of TARP-γ8-Associated AMPA Receptors: Anticonvulsant Activity with the Selective Antagonist LY3130481 (CERC-611).

BACKGROUND & OBJECTIVE: 6-[(1S)-1-[1-[5-(2-hydroxyethoxy)-2-pyridyl]pyrazol-3-yl]ethyl]- 3H-1,3-benzothiazol-2-one (LY3130481 or CERC-611) is a selective antagonist of AMPA receptors containing transmembrane AMPA receptor regulatory protein (TARP) γ-8 that is under development for epilepsy. The present study provided a broad inquiry into its anticonvulsant properties. LY3130481 was anticonvulsant in multiple acute seizure provocation models in mice and rats. In addition, LY3130481 was effective against absence seizures in the GAERS genetic model and in the Frings mouse model. Likewise, LY3130481 attenuated convulsions in mice and rats with long-term induction of seizures (e.g., corneal, pentylenetetrazole, hippocampal, and amygdala kindled seizures). In slices of epileptic human cortex, LY3130481 significantly decreased neuronal firing frequencies. LY3130481 displaced from rat brain a radioligand specific for AMPA receptors associated with TARP γ-8 whereas non-TARP-selective molecules did not. Binding was also observed in hippocampus freshly transected from a patient. RESULTS & CONCLUSION: Taken as a whole, the findings reported here establish the broad anticonvulsant efficacy of LY3130481 indicating that blockade of AMPA receptors associated with TARP γ-8 is sufficient for these protective effects.