Distrust in scientific expertise
is dangerous. Opposition to vaccination with a future vaccine against SARS-CoV-2, the causal agent of COVID-19, for example, could amplify outbreaks
, as happened for ...measles in 2019
. Homemade remedies
and falsehoods are being shared widely on the Internet, as well as dismissals of expert advice
. There is a lack of understanding about how this distrust evolves at the system level
. Here we provide a map of the contention surrounding vaccines that has emerged from the global pool of around three billion Facebook users. Its core reveals a multi-sided landscape of unprecedented intricacy that involves nearly 100 million individuals partitioned into highly dynamic, interconnected clusters across cities, countries, continents and languages. Although smaller in overall size, anti-vaccination clusters manage to become highly entangled with undecided clusters in the main online network, whereas pro-vaccination clusters are more peripheral. Our theoretical framework reproduces the recent explosive growth in anti-vaccination views, and predicts that these views will dominate in a decade. Insights provided by this framework can inform new policies and approaches to interrupt this shift to negative views. Our results challenge the conventional thinking about undecided individuals in issues of contention surrounding health, shed light on other issues of contention such as climate change
, and highlight the key role of network cluster dynamics in multi-species ecologies
.
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FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This presentation will focus on the following innovative areas in medical treatments for endometriosis. Where were we, say, a decade ago compared to where we are now? What diagnostic techniques ...should we employ to define the population we should treat? Does gold standard surgical treatment help patients avoid unwanted medical treatment - or should it now be the other way round? Do we still believe that medical treatment is not indicated for infertility related to endometriosis? What are the genuinely evidence-based innovative medical treatments for endometriosis? Consensus statements and guidelines represent a clear line in the sand of what may be considered gold standard practice of the time – the World Endometriosis Society’s consensus on current management of endometriosis (2013) 1 provides a good perspective on where we were around a decade ago; the ESHRE Guideline (2022) 2 reflects best practice today. There is growing consensus that a laparoscopic (+/- histological) diagnosis is no longer practical, or indeed needed, in most cases to implement the whole gamut of medical treatment, even though the entire evidence base for treating endometriosis hinges on laparoscopic diagnosis. Hence, “in 2023, there is a strong case for treatment of endometriosis to be based on a clinical diagnosis of ‘likely endometriosis’ supported by imaging findings, when appropriate, in lieu of a traditional diagnosis by laparoscopy +/- histology”. Following laparoscopic surgery, those not intending to conceive should consider the levonorgestrel intrauterine system or combined oral contraceptive pill for at least 18-24 months to reduce the recurrence of endometriosis-related pain symptoms; 2 following surgery for either endometriomas or deep endometriosis, long term hormone therapy should be considered to reduce the chance of recurrence. 2 Given the respective evidence bases, progestin hormone therapy may be preferable to the combined oral contraceptive pill to turn the tide of increasing prevalence of endometriosis. 3 While medical treatment has not been recommended to improve fertility, indeed a delaying effect on fertility through medical treatment has traditionally been highlighted, innovative analysis methods, including network meta-analysis, have raised the question whether some medical treatments (dydrogesterone and GnRH agonists) might benefit fertility – and this is merit-worthy of further investigation. GnRH antagonists and aromatase inhibitors are the innovative medical treatments that have shifted from ‘showing potential’ to ‘recommended’, so we will delve into the data supporting this to discover that, for aromatase inhibitors, this remains far from convincing, but for GnRH antagonists, these present a genuine innovative medical treatment option for those suffering from endometriosis.
Offline events and online hate Lupu, Yonatan; Sear, Richard; Velásquez, Nicolas ...
PloS one,
01/2023, Volume:
18, Issue:
1
Journal Article
Peer reviewed
Open access
Online hate speech is a critical and worsening problem, with extremists using social media platforms to radicalize recruits and coordinate offline violent events. While much progress has been made in ...analyzing online hate speech, no study to date has classified multiple types of hate speech across both mainstream and fringe platforms. We conduct a supervised machine learning analysis of 7 types of online hate speech on 6 interconnected online platforms. We find that offline trigger events, such as protests and elections, are often followed by increases in types of online hate speech that bear seemingly little connection to the underlying event. This occurs on both mainstream and fringe platforms, despite moderation efforts, raising new research questions about the relationship between offline events and online speech, as well as implications for online content moderation.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
STUDY QUESTION
What is the global consensus on the classification of endometriosis that considers the views of women with endometriosis?
SUMMARY ANSWER
We have produced an international ...consensus statement on the classification of endometriosis through systematic appraisal of evidence and a consensus process that included representatives of national and international, medical and non-medical societies, patient organizations, and companies with an interest in endometriosis.
WHAT IS KNOWN ALREADY
Classification systems of endometriosis, developed by several professional organizations, traditionally have been based on lesion appearance, pelvic adhesions, and anatomic location of disease. One system predicts fertility outcome and none predicts pelvic pain, response to medications, disease recurrence, risks for associated disorders, quality of life measures, and other endpoints important to women and health care providers for guiding appropriate therapeutic options and prognosis.
STUDY DESIGN, SIZE, DURATION
A consensus meeting, in conjunction with pre- and post-meeting processes, was undertaken.
PARTICIPANTS/MATERIALS, SETTING, METHODS
A consensus meeting was held on 30 April 2014 in conjunction with the World Endometriosis Society's 12th World Congress on Endometriosis. Rigorous pre- and post-meeting processes, involving 55 representatives of 29 national and international, medical and non-medical organizations from a range of disciplines, led to this consensus statement.
MAIN RESULTS AND THE ROLE OF CHANCE
A total of 28 consensus statements were made. Of all, 10 statements had unanimous consensus, however none of the statements was made without expression of a caveat about the strength of the statement or the statement itself. Two statements did not achieve majority consensus. The statements covered women's priorities, aspects of classification, impact of low resources, as well as all the major classification systems for endometriosis. Until better classification systems are developed, we propose a classification toolbox (that includes the revised American Society for Reproductive Medicine and, where appropriate, the Enzian and Endometriosis Fertility Index staging systems), that may be used by all surgeons in each case of surgery undertaken for women with endometriosis. We also propose wider use of the World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonisation Project surgical and clinical data collection tools for research to improve classification of endometriosis in the future, of particular relevance when surgery is not undertaken.
LIMITATIONS, REASONS FOR CAUTION
This consensus process differed from that of formal guideline development, although based on the same available evidence. A different group of international experts from those participating in this process may have yielded subtly different consensus statements.
WIDER IMPLICATIONS OF THE FINDINGS
This is the first time that a large, global, consortium–representing 29 major stake-holding organizations, from 19 countries – has convened to systematically evaluate the best available evidence on the classification of endometriosis and reach consensus. In addition to 21 international medical organizations and companies, representatives from eight national endometriosis organizations were involved, including lay support groups, thus generating and including input from women who suffer from endometriosis in an endeavour to keep uppermost the goal of optimizing quality of life for women with endometriosis.
STUDY FUNDING/COMPETING INTEREST(S)
The World Endometriosis Society convened and hosted the consensus meeting. Financial support for participants to attend the meeting was provided by the organizations that they represented. There was no other specific funding for this consensus process. Mauricio Abrao is an advisor to Bayer Pharma, and a consultant to AbbVie and AstraZeneca; G David Adamson is the Owner of Advanced Reproductive Care Inc and Ziva and a consultant to Bayer Pharma, Ferring, and AbbVie; Deborah Bush has received travel grants from Fisher & Paykel Healthcare and Bayer Pharmaceuticals; Linda Giudice is a consultant to AbbVie, Juniper Pharmaceutical, and NextGen Jane, holds research grant from the NIH, is site PI on a clinical trial sponsored by Bayer, and is a shareholder in Merck and Pfizer; Lone Hummelshoj is an unpaid consultant to AbbVie; Neil Johnson has received conference expenses from Bayer Pharma, Merck-Serono, and MSD, research funding from AbbVie, and is a consultant to Vifor Pharma and Guerbet; Jörg Keckstein has received a travel grant from AbbVie; Ludwig Kiesel is a consultant to Bayer Pharma, AbbVie, AstraZeneca, Gedeon Richter, and Shionogi, and holds a research grant from Bayer Pharma; Luk Rombauts is an advisor to MSD, Merck Serono, and Ferring, and a shareholder in Monash IVF. The following have declared that they have nothing to disclose: Kathy Sharpe Timms; Rulla Tamimi; Hugh Taylor.
TRIAL REGISTRATION NUMBER
N/A
Background: Role modeling has been highlighted as an important teaching and learning strategy. The aim of this research study was to explore the influences and impact of positive doctor role ...modelling in twenty-first century medical education.
Methods: This study was part of a larger study investigating the process of positive doctor role modeling in medical education. This study used focus group interviews with 52 medical students, semi-structured interviews with 25 consultants and interviews after clinics with five consultants and five medical students. A qualitative methodology using the grounded theory approach of Strauss and Corbin was then used to explore the impact of modeling in medical education.
Results: Three main outcomes of role modeling were identified - the development of professional behaviors, the development of professional identity, and the shaping of career aspirations.
Conclusion: This study illustrates the powerful, often subconscious impact of doctor role modeling in medical education. This research illustrates that role models are critically important in the professional development, character development, and career development of the modelees. In this way, role modeling effectively enhances the transformation of the student to a doctor.
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DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Research into providing effective online education has suggested an important goal for instructors is the creation of an online community of inquiry (CoI) where social, cognitive, and teacher ...presence are all important aspects of successful online learning. With reference to a recent reflective practice case study, this paper describes ways that the research on online communities of inquiry may be enriched through the use of digital ethnography. In the target reflective case study, data analysis tasks were designed and presented in an online VoiceThread site, promoting dialogic and multimodal engagement with data from actual research studies that are central to the module theme in teacher education. Interaction around these tasks is coded using the CoI framework. Ethnographic data from the participants was collected and coded using qualitative research protocols to contextualise the interaction data and provide a clearer understanding of how participants had come together throughout the module. The ethnographic data revealed some interesting concerns with online learning, including the use of technology as a barrier to participation.
Polarization is a ubiquitous phenomenon in social systems. Empirical studies document substantial evidence for opinion polarization across social media, showing a typical bipolarized pattern devising ...individuals into two groups with opposite opinions. While coevolving network models have been proposed to understand polarization, existing works cannot generate a stable bipolarized structure. Moreover, a quantitative and comprehensive theoretical framework capturing generic mechanisms governing polarization remains unaddressed. In this Letter, we discover a universal scaling law for opinion distributions, characterized by a set of scaling exponents. These exponents classify social systems into bipolarized and depolarized phases. We find two generic mechanisms governing the polarization dynamics and propose a coevolving framework that counts for opinion dynamics and network evolution simultaneously. Under a few generic assumptions on social interactions, we find a stable bipolarized community structure emerges naturally from the coevolving dynamics. Our theory analytically predicts two-phase transitions across three different polarization phases in line with the empirical observations for the Facebook and blogosphere data sets. Our theory not only accounts for the empirically observed scaling laws but also allows us to predict scaling exponents quantitatively.
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CMK, CTK, FMFMET, IJS, NUK, PNG, UL, UM
The available toxicity data of benzalkonium chloride (BKC) clearly shows that it is toxic; however, the weight of evidence favors the view that at doses encountered in nasally and orally inhaled ...pharmaceutical preparations it is well tolerated. The adverse toxicological data predominantly come from in vitro and animal studies in which doses and exposure periods employed were excessive in relation to the clinical doses and their posology and, therefore, not directly applicable to the clinic. The conflict between the in vitro and animal data and the clinical experience can be reconciled by understanding some of the physicochemical properties of BKC, the nasal and respiratory tract microenvironments, the doses used, and the posology.
Abstract
Why does online distrust (e.g., of medical expertise) continue to grow despite numerous mitigation efforts? We analyzed changing discourse within a Facebook ecosystem of approximately 100 ...million users who were focused pre-pandemic on vaccine (dis)trust. Post-pandemic, their discourse interconnected multiple non-vaccine topics and geographic scales within and across communities. This interconnection confers a unique, system-level (i.e., at the scale of the full network) resistance to mitigations targeting isolated topics or geographic scales—an approach many schemes take due to constrained funding. For example, focusing on local health issues but not national elections. Backed by numerical simulations, we propose counterintuitive solutions for more effective, scalable mitigation: utilize “glocal” messaging by blending (1) strategic topic combinations (e.g., messaging about specific diseases with climate change) and (2) geographic scales (e.g., combining local and national focuses).
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Influence operations are large-scale efforts to manipulate public opinion. The rapid detection and disruption of these operations is critical for healthy public discourse. Emergent AI technologies ...may enable novel operations that evade detection and influence public discourse on social media with greater scale, reach, and specificity. New methods of detection with inductive learning capacity will be needed to identify novel operations before they indelibly alter public opinion and events. To this end, we develop an inductive learning framework that: (1) determines content- and graph-based indicators that are not specific to any operation; (2) uses graph learning to encode abstract signatures of coordinated manipulation; and (3) evaluates generalization capacity by training and testing models across operations originating from Russia, China, and Iran. We find that this framework enables strong cross-operation generalization while also revealing salient indicators-illustrating a generic approach which directly complements transductive methodologies, thereby enhancing detection coverage.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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