Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children

NSF Fellows' perceptions about incentives, research misconduct, and scientific integrity in STEM academia

There is increased concern about perverse incentives, quantitative performance metrics, and hyper-competition for funding and faculty positions in US academia. Recipients of the prestigious National Science Foundation Graduate Research Fellowships (n = 244) from Civil and Environmental Engineering (45.5%) and Computer Science and Engineering (54.5%) were anonymously surveyed to create a baseline snapshot of their perceptions, behaviors and experiences. NSF Fellows ranked scientific advancement as the top metric for evaluating academics followed by publishing in high-impact journals, social impact of research, and publication/citation counts. The self-reported rate of academic cheating was 16.7% and of research misconduct was 3.7%. Thirty-one percent of fellows reported direct knowledge of graduate peers cheating, and 11.9% had knowledge of research misconduct by colleagues. Only 30.7% said they would report suspected misconduct. A majority of fellows (55.3%) felt that mandatory ethics trainings left them unprepared for dealing with ethical issues. Fellows stated academic freedom, flexible schedules and opportunity to mentor students were the most positive aspects of academia, whereas pressures for funding, publication, and tenure were cited as the most negative aspects. These data may be useful in considering how to better prepare STEM graduate trainees for academic careers.

Modulating the Microbiome for Crohn's Disease Treatment

The central role of the gut microbiota in the regulation of health and disease has been convincingly demonstrated. Polymicrobial interkingdom interactions between bacterial (the bacteriome) and fungal (the mycobiome) communities of the gut have become a prominent focus for development of potential therapeutic approaches. In addition to polymicrobial interactions, the complex gut ecosystem also mediates interactions between the host and the microbiota. These interactions are complex and bidirectional; microbiota composition can be influenced by host immune response, disease-specific therapeutics, antimicrobial drugs, and overall ecosystems. However, the gut microbiota also influences host immune response to a drug or therapy by potentially transforming the drug's structure and altering bioavailability, activity, or toxicity. This is especially true in cases where the gut microbiota has produced a biofilm. The negative ramifications of biofilm formation include alteration of gut permeability, enhanced antimicrobial resistance, and alteration of host immune response effectiveness. Natural modulation of the gut microbiota, using probiotic and prebiotic approaches, may also be used to affect the host microbiome, a type of "natural" modulation of the host microbiota composition. In this review, we discuss potential bidirectional interactions between microbes and host, and we describe the changes in gut microbiota induced by probiotic and prebiotic approaches as well as their potential clinical consequences, including biofilm formation. We outline a systematic approach to designing probiotics capable of altering the host microbiota in disease states, using Crohn's disease as a model chronic disease. Understanding how the effective changes in the microbiome may enhance treatment efficacy may unlock the possibility of modulating the gut microbiome to improve treatment using a natural approach.

Health misinformation and freedom of expression: considerations for policymakers

Health misinformation, most visibly following the COVID-19 infodemic, is an urgent threat that hinders the success of public health policies. It likely contributed, and will continue to contribute, to avoidable deaths. Policymakers around the world are being pushed to tackle this problem. Legislative acts have been rolled out or announced in many countries and at the European Union level. The goal of this paper is not to review particular legislative initiatives, or to assess the impact and efficacy of measures implemented by digital intermediaries, but to reflect on the high constitutional and ethical stakes involved in tackling health misinformation through speech regulation. Our findings suggest that solutions focused on regulating speech are likely to encounter significant constraints, as policymakers grasp with the limitations imposed by freedom of expression and ethical considerations. Solutions focused on empowering individuals - such as media literacy initiatives, fact-checking or credibility labels - are one way to avoid such hurdles.

Resistance to Change

Advances in medical technology do not follow a smooth process and are highly variable. Implementation can occasionally be rapid, but often faces varying degrees of resistance resulting at the very least in delayed implementation. Using qualitative comparative analysis, we have evaluated numerous technological advances from the perspective of how they were introduced, implemented, and opposed. Resistance varies from benign - often happening because of inertia or lack of resources to more active forms, including outright opposition using both appropriate and inappropriate methods to resist/delay changes in care. Today, even public health has become politicized, having nothing to do with the underlying science, but having catastrophic results. Two other corroding influences are marketing pressure from the private sector and vested interests in favor of one outcome or another. This also applies to governmental agencies. There are a number of ways in which papers have been buried including putting the thumb on the scale where reviewers can sabotage new ideas. Unless we learn to harness new technologies earlier in their life course and understand how to maneuver around the pillars of obstruction to their implementation, we will not be able to provide medical care at the forefront of technological capabilities.

Spatial and temporal distribution of emerging airborne viral infectious diseases outbreaks on a global scale

Aim

This study aimed to explore the spatial and temporal characteristics of emerging airborne viral infectious diseases outbreaks worldwide.

Subject and methods

We conducted a systematic literature review on outbreaks of emerging airborne viral infectious diseases and calculated outbreak number and intensity at the country level. Fisher's exact test was used to compare the viral infectious diseases outbreaks in different income-level regions. To identify the major airborne viral infectious diseases outbreaks, we ranked and extracted the leading viral infectious diseases in outbreak number and intensity in each country by year.

Results

A total of 2505 outbreaks were reported from 1873 to 2021 across 2010 studies. There were 47 countries (47/130, 36.15%) with more frequent emerging airborne viral infectious disease outbreaks (more than nine outbreaks), and these countries mainly distributed in high-income regions (22/47 countries, 46.81%, p < 0.05), especially in Western Europe (14/47 countries, 29.79%, p < 0.05). The number of overall outbreaks was more in the United States and China than in other countries in different years. Outbreaks of measles and influenza are always frequent and intense. Highly pathogenic human coronaviruses infection caused short-term pandemics during which their outbreak number and intensity exceeded other viruses. Rift valley fever outbreaks in the human population are spreading outside of Africa through the flow of goods and travelers.

Conclusion

Countries in high-income regions reported more emerging airborne viral infectious diseases outbreaks, especially in the Western European region, the United States, and China. It is urgent to strengthen collaborative surveillance of emerging airborne viruses, cross-border flow of goods and travelers, and ecological environment to avoid the spread of viral infectious diseases outbreaks worldwide.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-023-01850-3.

Turkish middle school students' evaluation of fallacious claims about vaccination

In today's world, there is too much information pollution and people circulate it without questioning, and the claims on controversial issues often contain fallacies and conspiracy theories. Considering this point of view, it is necessary to create citizens who critically evaluate information. In order to achieve this goal, science educators need to address students' evaluation of fallacies on controversial issues. The aim of the present study, thus, is to explore eighth graders' evaluation of fallacies about vaccination. We used case study in the study in which 29 eighth grade students participated. We adapted a rubric that was developed by Lombardi et al. (Int J Sci Educ 38(8):1393-1414, 2016. https://doi.org/10.1080/09500693.2016.1193912) to assess students' evaluation levels between claims and evidence and used it to analyze students' evaluations of each fallacy in groups and individually. The findings of this study indicate that students were mostly unable to evaluate claims and evidence critically. We advocate that attempts should be made so that students cope with misinformation and disinformation, ensuring that they establish a consistent relationship between claim and the evidence, and the social and cultural factors that affect their evaluation of false claims should be identified. The implications of this study suggest to make deliberate attempts in order to enable middle school students to evaluate claims and evidence critically in various science topics, particularly in health issues, due to the COVID-19 pandemic. Implications of the present research include suggestion of a method including discussions of fallacies about controversial issues and utilizing additional data sources such as interviews to reveal student ideas in-depth and analyze students' decision-making skills.

How to Respond to Misinformation From the Anti-Vaccine Movement

Vaccines are doubtlessly one of the most crucial life-saving medical interventions to date. However, perplexingly, they court more public controversy than their objectively excellent safety profile warrants. While doubts about the safety of vaccines, as well as opposition to vaccine policies, can be traced back at least to the mid-19th century, the modern anti-vaccine movement has come in 3 distinct waves, or generations, each precipitating around distinct key events. Here, we describe the first 2 generations and trace the origins of an emerging third generation anti-vaccine movement. Currently, this third generation is an integral part of the larger anti-COVID movement and in this more libertarian environment propagates the idea of individualism superseding the responsibility for community health. We highlight the need for a better science education of the young, as well as the general public to further enhance overall science literacy and suggests strategies to achieve these goals.

Exploring nurses' experiences of a tailored intervention to increase MMR vaccine acceptance in a Somali community in Stockholm, Sweden: a qualitative interview study

OBJECTIVES

To explore nurses' experiences of a tailored intervention that supported them with knowledge and tools to use during encounters and dialogue with parents with low vaccine acceptance.

DESIGN

A qualitative study with in-depth interviews conducted in 2017. Data were analysed using thematic analysis.

SETTING

This study was part of a multicomponent intervention targeting Somali parents and the nurses at child health centres in the Rinkeby and Tensta neighbourhoods of Stockholm. An area with documented low measles, mumps and rubella (MMR) vaccination coverage. Previous research has revealed that Somali parents in the community delayed MMR vaccination due to fear of autism despite lack of scientific evidence. The interventions were implemented in 2015-2017.

PARTICIPANTS

Eleven nurses employed at the child health centres involved in the intervention participated in interviews. The tailored intervention targeting nurses included a series of seminars, a narrative film and an information card with key messages for distribution to parents.

RESULTS

The qualitative analysis revealed an overarching theme: perception of improved communication with parents. Two underlying themes were identified: (1) feeling more confident to address parents' MMR vaccine concerns and (2) diverse tools as useful support to dispel myth and reduce language barriers.

CONCLUSION

From the nurses' perspective, the tailored intervention was useful to improve communication with parents having vaccine concerns. Nurses have a crucial role in vaccine uptake and acceptance. Interventions aiming to strengthen their communication with parents are therefore essential, especially in areas with lower vaccine acceptance.

Co-VAN study: COVID-19 vaccine associated neurological diseases- an experience from an apex neurosciences centre and review of the literature

BACKGROUND

Recent studies have shown various neurological adverse events associated with COVID-19 vaccine.

OBJECTIVE

We aimed to retrospectively review and report the neurological diseases temporally associated with COVID-19 vaccine.

METHODS

We performed a retrospective chart review of admitted patients from 1st February 2021 to 30th June 2022. A total of 4672 medical records were reviewed of which 51 cases were identified to have neurological illness temporally associated with COVID-19 vaccination.

RESULTS

Out of 51 cases, 48 had probable association with COVID-19 vaccination while three had possible association. Neurological spectrum included CNS demyelination (n = 39, 76.5 %), Guillain-Barré-syndrome (n = 3, 5.9 %), stroke (n = 6, 11.8 %), encephalitis (n = 2, 3.9 %) and myositis (n = 1, 2.0 %). Female gender had a greater predisposition (F:M, 1.13:1). Neurological events were more commonly encountered after the first-dose (n = 37, 72.5%). The mean latency to onset of symptoms was 13.2 ± 10.7 days after the last dose of vaccination. COVIShield (ChAdOx1) was the most commonly administered vaccine (n = 43, 84.3 %). Majority of the cases with demyelination were seronegative (n = 23, 59.0 %) which was followed by anti-Myelin oligodendrocyte-glycoprotein associated demyelination (MOGAD) (n = 11, 28.2 %) and Neuromyelitis optica (NMOSD) (n = 5, 12.8 %). Out of 6 Stroke cases, 2 cases (33.3 %) had thrombocytopenia and coagulopathy. At discharge, 25/51 (49.0 %) of the cases had favourable outcome (mRS 0 to 1). Among six patients of stroke, only one of them had favourable outcome.

CONCLUSION

In this series, we describe the wide variety of neurological syndromes temporally associated with COVID-19 vaccination. Further studies with larger sample size and longer duration of follow-up are needed to prove or disprove causality association of these syndromes with COVID-19 vaccination.

Cohort-guided insights into gene-environment interactions in autism spectrum disorders

Prospective birth cohorts offer unprecedented opportunities to investigate the pathogenesis of complex disorders such as autism, in which gene-environment interactions must be appreciated in a temporal context. This Perspective article considers the history of autism research, including missteps that reflected an incomplete understanding of the epidemiology of autistic spectrum disorders, the effects of advocacy and philanthropy on the trajectory of scientific inquiry, and the current and future roles of prospective birth cohort research in illuminating the pathology of these and other complex disorders wherein exposures during gestation might not manifest until later in life.

Injecting fun? Humour, conspiracy theory and (anti)vaccination discourse in popular media

Conspiracy theories have accompanied vaccination since its mass introduction, circulating, among other forms, in humour - such as cartoons, and now, memes. Importantly, humour has targeted both vaccination and anti-vaccination stances. In this study, we discuss the peculiarities of humorous content within the vaccination debate and uncover the most popular thematic categories, forms and logical mechanisms of humour. We show that humorous and serious discussions on vaccination go hand-in-hand, but playfulness and ambiguity of humour complicate public understanding of the vaccination debate. Our analysis shows that vaccination humour often simplifies the complex issue of vaccination and makes it more understandable and more tangible for a broad audience.

Mitigating Vaccine Hesitancy and Building Trust to Prevent Future Measles Outbreaks in England

Measles, a highly infectious respiratory viral infection associated with severe morbidity and mortality, is preventable when coverage with the highly effective measles, mumps and rubella vaccine (MMR) is ≥95%. Vaccine hesitancy is responsible for measles outbreaks in countries where measles had previously been eliminated, including in England, and is one of the ten threats to global public health identified by the World Health Organization (WHO). Official administrative 2012-2021 data on measles incidence and MMR coverage in England were reviewed alongside a scoping literature review on factors associated with MMR uptake in England. Whilst measles incidence has reduced significantly since 2012, sporadic measles outbreaks in England have occurred with geographic disparities and variations in MMR coverage. Over the last decade, MMR uptake has fallen across all regions with no area currently reaching the WHO target of 95% coverage of both doses of MMR necessary for herd immunity. Factors associated with MMR coverage overlap with the 3C (convenience, complacency and confidence) model of vaccine hesitancy. The COVID-19 pandemic has reinforced pre-existing vaccine hesitancy. Increasing MMR uptake by reducing vaccine hesitancy requires allocated funding for area-based and targeted domiciliary and community-specific immunisation services and interventions, public health catch-up campaigns and web-based decision aid tools.

Searching for the 'Trigger': An ethnographic analysis of parental beliefs regarding autism causation and vaccination in Puerto Rico

This study examines the personal beliefs held by parents of autistic children in Puerto Rico regarding the cause of their child's autism and how these beliefs may influence parental vaccination decision-making. This study seeks to contribute towards diversifying the autism literature by focusing on an autism community living in a relatively lower income, resource-deficit context. These findings expand our understandings of how parents of autistic children may perceive vaccines and how these perceptions are informed by various sources of knowledge. This ethnographic research study was conducted between May 2017 and August 2019. Methods included 350+ hours of participant-observation and semi-structured interviewing of 35 Puerto Rican parents of autistic children. 32 of these 35 parents interviewed believed autism to be the result of genetic risks that are 'triggered' by an unknown environmental factor. Suggested 'triggers' included various environmental contaminants and vaccinations. The subject of vaccination came up in every interview; 18 interviewed parents did not believe vaccines 'triggered' autism, 3 parents attributed their child's autism entirely to vaccines, while 14 considered vaccines to be one of several possible 'triggers'. It is important to note that no parents interviewed perceived vaccinations to be inherently or universally harmful. Rather, they perceived vaccinations to be one of many possible 'triggers' for a child predisposed to develop autism. In some cases, this perception prompted parents to oppose mandatory vaccination policies on the island. Parents shared nuanced, complex understandings of autism causation that may carry implications for COVID-19 vaccine uptake within the Puerto Rican autistic community.

Assessment of Understandability and Actionability of YouTube Videos on Hemolytic Disease of the Newborn

Introduction With revolutions in Information Technology, information and misinformation are easier to be found online. YouTube is the largest and most commonly searched video content website in the world. It is assumed that, due to the coronavirus pandemic, most patients try to know about diseases through the internet and reduce the number of hospital exposures unless otherwise. In order to assess the understandability and actionability of such YouTube videos available freely online about the disease, Hemolytic disease of the newborn (HDN), this study was planned. Methods This is a cross-sectional study conducted with the first 160 videos available on May 14, 2021, with the search keyword "HDN" with a relevance filter and a duration of 4 to 20 minutes. The videos were further screened regarding the information content and language. These videos were assessed by three independent assessors using the patient educational materials assessment tool for audio-visual content. Results Out of the first 160 videos selected for screening, 58 videos were excluded due to a lack of content about the searched disease "HDN". Another 63 videos were excluded due to the language of instruction not being in English. Finally, 39 videos were assessed by three assessors. The understandability and actionability responses were checked for reliability and a Cronbach's alpha of 93.6% was found, indicating good data reliability. To reduce subjectivity, average scores of understandability and actionability were taken based on the scores of these three assessors. There were eight and 34 videos with average understandability and actionability scores of <70% respectively. The median average understandability and actionability scores were 84.4% and 50% respectively. There was a statistically significant difference between understandability and actionability scores with considerably lower actionability scores of YouTube videos on the disease, HDN (p<0.001). Conclusion There is a great need to include actionable information by content developers in videos. Most information available has adequate understandable content making it easier for the general public to know about the diseases. YouTube and similar social sites thus possibly are helping in the dissemination of information promoting awareness among the public in general and patients in particular.

The silent shot: An analysis of the origin, sustenance and implications of the MMR vaccine - autism rumour in the Somali diaspora in Sweden and beyond

This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the Somali diaspora in a number of countries across the globe. The rumour stipulates that the MMR vaccine - the silent shot - causes autism spectrum disorder (ASD). Although the association between MMR and ASD is non-causal, and various public health initiatives have promoted health information campaigns, the rumour continues to circulate in the Somali diaspora in many countries, including Sweden. This paper shows that there are valid reasons for this. The findings from this paper draw on a systematic scoping review and qualitative interview data from Sweden. The results show that the Somali community experiences higher than average rates of ASD compared to the general population. Moreover, ASD does not exist in the Somali language or their home country, is considered a Western disease that only affects Somali children in the diaspora, and is a highly stigmatised disease. Also, the Somali diaspora has had negative experiences with ASD diagnosis and care. The rumour has been sustained by the absence of an answer to their ASD fear and through active diaspora networks on social media. The network that surrounds the rumour has arguably further helped to create an epistemic community for a community whose concerns have been silenced.

Loss of Acquired Skills: Regression in Young Children With Autism Spectrum Disorders

Objectives

Regression, while not a core symptom of autism spectrum disorder (ASD), has been suggested to be a distinct subtype by previous studies. Therefore, this study aimed to explore the prevalence and clinical differences between those with and without regression in children with ASD.

Methods

This study includes data from toddlers and young children aged 2-7 years acquired from other projects at Seoul National University Bundang Hospital. The presence and characteristics of regression were explored using question items #11-28 from the Autism Diagnostic Interview-Revised. Chi-square and independent t-tests were used to compare various clinical measurements such as autistic symptoms, adaptative behavior, intelligence, and perinatal factors.

Results

Data from 1438 young children (1020 with ASD) were analyzed. The overall prevalence rate of regression, which was mainly related to language-related skills, was 10.2% in the ASD group, with an onset age of 24 months. Regarding clinical characteristics, patients with ASD and regression experienced ASD symptoms, especially restricted and repetitive interests and behaviors, with greater severity than those without regression. Furthermore, there were significant associations between regression and hypertension/placenta previa.

Conclusion

In-depth surveillance and proactive interventions targeted at young children with ASD and regression should focus on autistic symptoms and other areas of functioning.

Systemic Obstacles to Addressing Research Misconduct in Higher Education: A Case Study

Several widely publicized incidents of academic research misconduct, combined with the politicization of the role of science in public health and policy discourse (e.g., COVID, immunizations) threaten to undermine faith in the integrity of empirical research. Researchers often maintain that peer-review and study replication allow the field to self-police and self-correct; however, stark disparities between official reports of academic research misconduct and self-reports of academic researchers, specifically with regard to data fabrication, belie this argument. Further, systemic imperatives in academic settings often incentivize institutional responses that focus on minimizing reputational harm rather than the impact of fabricated data on the integrity of extant and future research.

Parents' and Health Professionals' Attitudes to Advancing Primary MMR Vaccine Administration from Fifteen to Six Months of Age-A Qualitative Thematic Analysis Embedded in a Randomized Trial

Declining levels and duration of passively acquired maternal antibodies prompted a Danish trial to test the feasibility of advancing administration of the first measles, mumps, and rubella vaccine (MMR1) from 15 to 6 months of age. A trial-embedded qualitative study aimed to understand parents' (N = 24) and health professionals' (N = 11) attitudes about the measles, mumps, and rubella vaccine (MMR) in general and about advancing MMR1 administration. Overly positive parent attitudes were contrasted by members of a vaccine-skeptical organization including parents considering that their child was seriously vaccine-injured long ago. Parents' attitudes to advancing MMR1 mirrored their attitudes about the MMR vaccine in general, with four positions along a continuum of trust in the healthcare system: unquestioning trust, acceptance after careful consideration, challenging indecisiveness, and defensive rejection. Low tolerance was identified between vaccine supporters and vaccine opponents. Parents of children with perceived serious vaccine-related injuries described lifelong unresolved feelings of guilt. Supporters of advanced MMR1 saw it as a timely and convenient administration of a well-known vaccine, whereas opponents feared it would disturb the children's immature immune systems and emphasized difficulties in recognizing side effects so early in life. Health professionals were supportive of advancing the MMR1 vaccine and they carefully challenged the parents. Current MMR vaccine supporters show readiness to advance MMR1 administration.

Self-correction in science: The effect of retraction on the frequency of citations

We investigate the citation frequency of retracted scientific papers in science. For the period of five years before and after retraction, we counted the citations to papers in a sample of over 3,000 retracted, and a matched sample of another 3,000 non-retracted papers. Retraction led to a decrease in average annual citation frequency from about 5 before, to 2 citations after retraction. In contrast, for non-retracted control papers the citation counts were 4, and 5, respectively. Put differently, we found only a limited effect of retraction: retraction decreased citation frequency only by about 60%, as compared to non-retracted papers. Thus, retracted papers often live on. For effective self-correction the scientific enterprise needs to be more effective in removing retracted papers from the scientific record. We discuss recent proposals to do so.

Does searching online for vaccination information affect vaccination coverage? Evidence from Sub-Saharan African countries

The Internet is reshaping the way people access health information. Over the past decades, an increasing number of people have been using the Internet to access vaccine-related information. Many studies suggest that the Internet can help improve people's understanding of health issues but at the same time facilitate the rapid spread of misinformation. This study explores the impact that searching the Internet for immunization information has on vaccination coverage. Using Google trends data, we found that access to online vaccination information has impacted vaccine uptake from 2004 to 2017, in Sub-Saharan African countries. The results indicate an overall positive impact on vaccine uptake. We also found that the effects are heterogeneous among vaccines. The effect is statistically significant for the vaccine related to high-risk disease, but not significant for the controversial vaccine and the vaccine related to low-risk disease.

Progressive and degenerative journals: on the growth and appraisal of knowledge in scholarly publishing

Despite continued attention, finding adequate criteria for distinguishing "good" from "bad" scholarly journals remains an elusive goal. In this essay, I propose a solution informed by the work of Imre Lakatos and his methodology of scientific research programmes (MSRP). I begin by reviewing several notable attempts at appraising journal quality - focusing primarily on the impact factor and development of journal blacklists and whitelists. In doing so, I note their limitations and link their overarching goals to those found within the philosophy of science. I argue that Lakatos's MSRP and specifically his classifications of "progressive" and "degenerative" research programmes can be analogized and repurposed for the evaluation of scholarly journals. I argue that this alternative framework resolves some of the limitations discussed above and offers a more considered evaluation of journal quality - one that helps account for the historical evolution of journal-level publication practices and attendant contributions to the growth (or stunting) of scholarly knowledge. By doing so, the seeming problem of journal demarcation is diminished. In the process I utilize two novel tools (the mistake index and scite index) to further illustrate and operationalize aspects of the MSRP.

Epistemic neighbors: trespassing and the range of expert authority

The world is abuzz with experts who can help us in domains where we understand too little to help ourselves. But sometimes experts in one domain carry their privileged status into domains outside their specialization, where they give advice or otherwise presume to speak authoritatively. Ballantyne (in: Knowing our limits. Oxford University Press, New York, 2019) calls these boundary crossings "epistemic trespassing" and argues that they often violate epistemic norms. In the few cases where traveling in other domains is permissible, Ballantyne suggests there should be regulative checks ("easements") for the experts who are crossing domain boundaries. I argue that boundary crossing is warranted more often than Ballantyne allows. And while Ballantyne argues that boundary crossing is prima facie epistemically problematic, I contend that many cases of boundary crossing are not properly instances of "trespassing," and, therefore, raise no prima facie epistemic concerns. I further argue that identifying cases of what I call "epistemic neighborliness" bolsters Ballantyne's project, making it easier for novices and other experts to identify epistemic trespassing along with its epistemic problems.

Vaccine Hesitancy: Contemporary Issues and Historical Background

Vaccination, despite being recognized as one of the most effective primary public health measures, is viewed as unsafe and unnecessary by an increasing number of individuals. Anxiety about vaccines and vaccination programs leading to vaccine hesitancy results from a complex mix of social and political influences, cultural and religious beliefs, the availability of and ability to interpret health and scientific information, and personal and population experiences of health systems and government policies. Vaccine hesitancy is becoming a serious threat to vaccination programs, and was identified as one of the World Health Organization’s top ten global health threats in 2019. The negative impact of anti-vaccination movements is frequently cited as one of the major reasons for rising vaccine hesitancy amongst the general public world-wide. This review discusses the various issues surrounding vaccine hesitancy and the anti-vaccine movement, starting with the definitions of vaccine hesitancy and the anti-vaccine movement in their early history and in the modern era, before discussing the key drivers of vaccine hesitancy, particularly across different regions of the world, with a focus on various countries with low-, middle-, or high-income economies with different socio-economic populations. The review concludes with the impact of vaccine hesitancy on herd immunity and social, psychological, and public health measures to counter vaccine hesitancy.

Hemostatic system and COVID-19 crosstalk: A review of the available evidence

Since the discovery of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its resultant coronavirus disease 2019 (COVID-19) pandemic, respiratory manifestations have been the mainstay of clinical diagnosis, laboratory evaluations, and radiological investigations. As time passed, other pathological aspects of SARS-CoV-2 have been revealed. Various hemostatic abnormalities have been reported since the rise of the pandemic, which was sometimes superficial, transient, or fatal. Mild thrombocytopenia, thrombocytosis, venous, arterial thromboembolism, and disseminated intravascular coagulation are among the many hemostatic events associated with COVID-19. Venous thromboembolism necessitating therapeutic doses of anticoagulants is more frequently seen in severe cases of COVID-19, especially in patients admitted to intensive care units. Hemorrhagic complications rarely arise in COVID-19 patients either due to a hemostatic imbalance resulting from severe disease or as a complication of over anticoagulation. Although the pathogenesis of coagulation disturbance in SARS-CoV-2 infection is not yet understood, professional societies recommend prophylactic antithrombotic therapy in severe cases, especially in the presence of abnormal coagulation indices. The review article discusses the various available evidence on coagulation disorders, management strategies, outcomes, and prognosis associated with COVID-19 coagulopathy, which raises awareness about the importance of anticoagulation therapy for COVID-19 patients to guard against possible thromboembolic events.

[Autism Spectrum Disorders: What the COVID-19 Pandemic Has Taught Us]

The article is devoted to the consequences of the pandemic caused by SARS-CoV-2 and more particularly, of the preventive measures adopted during this period on people with autism spectrum disorders (ASD). These people are more at risk (especially in cases of comorbidity with intellectual disability) of being infected and hospitalized longer. This increased risk is explained by the presence of biological risk factors (increased cytokines, decreased melatonin) and by psychological factors related to the clinical picture of ASD. Hesitancy concerning COVID vaccinations is discussed in relation to the erroneously purported link between vaccination and the onset of autism. As expected, the pandemic has had negative effects on the clinical picture of children, adolescents, and adults with ASD: sleep disorders, increased behavioural disorders, more stereotypies, parental distress. Unexpectedly, researchers and clinicians have also highlighted the positive effects of the pandemic, described as the "paradoxical‿ effects (improved communication and relationships, decreased anxiety, being happier because of being more in control over their schedule). The explanation for these effects was related to non-attendance at school and, thus, no bullying, decreased sensory and social overload, increased time spent at home, and solidarity with the autistic community and with the entire community. Finally, the question of the transfer of certain conditions that contributed to the above-mentioned improvements to the post-pandemic period is addressed.

A Comprehensive Investigation of the Current Subacute Sclerosing Panencephalitis (SSPE) Treatment Options to Improve Patient Quality of Life

Subacute sclerosing panencephalitis (SSPE) is a progressive, disabling, and deadly neurological disorder related to measles (rubeola) infection occurring primarily in children. The slow but persistent viral infection occurs in children or young adults and affects their central nervous system (CNS). There have been plenty of reports on SSPE throughout the world, but it is considered a rare disease in developed countries. This research focuses on comparing the current treatments available to prolong the life of patients for over three years after the onset of SSPE. The goal was to identify possible patterns or trends among the treatments in order to find the best possible method to lengthen a patient's life. The results indicated that interferon alpha, inosine pranobex, and ribavirin display the most effective treatment plan and indicate the most potential in discovering a more effective therapeutic for SSPE.

Does Vaccination Increase the Risk of Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a developmental disorder that can cause significant social, communicative, and behavioral difficulties. With autism rates rising dramatically in recent years, researchers and concerned parents have theorized the causes of autism, and the subject has received much attention. Is the high rate of autism now due to increased diagnosis and reporting, changing autism definitions, or a rise in the number of people with ASD? People started to blame vaccines as a cause of the increased number of people with ASD. Vaccines and their connection to autism have been the subject of continuous debate. Some parents are concerned that vaccines, particularly the measles-mumps-rubella (MMR) vaccine and preservatives used in other childhood vaccines, may play a role in developing autism in their children. This systemic review explores the link between vaccination and autism in children. We conducted a literature search using PubMed and Google Scholar. We included papers written in the English language from 1998 to 2022, conducting human research that examines the relationship between vaccination and the development of autism using appropriate quality assessment tools. Two reviewers independently reviewed the content of the included studies. In total, 21 studies were deemed eligible.

Vaccine Hesitancy in Pediatrics

Vaccine hesitancy is a growing complex and multifaceted phenomenon. It encompasses a wide spectrum of context-dependent attitudes and beliefs. Multiple factors influence parental decision-making including knowledge, sources of information, risk perception, trust, and individual experiences among others. This review focuses on describing the most common reasons that contribute to vaccine hesitancy among parents. Social media and the Internet have been described as major elements that can negatively influence parental decision-making regarding vaccines. The next focus is describing effective interventions that clinical providers can apply. Nonconfrontational and open discussions along with trusting and strong relationships between parents and providers seem to create a solid foundation toward vaccine acceptance. In addition, motivational interviewing is a helpful tool that has proven to be effective during these discussions. Ultimately, an individualized approach tailored to a specific community will likely be most effective in addressing vaccine hesitancy.

Perceptions of Parents towards COVID-19 Vaccination in Children, Aseer Region, Southwestern Saudi Arabia

Vaccines are an important part of the COVID-19 pandemic response plan. This cross-sectional study aims to assess the attitude and perception levels of parents toward COVID-19 vaccines for children aged 0–18 years in the Aseer region of Saudi Arabia. Data were analyzed using SPSS version 16.0. Out of a total of 1463 parents, 30.6% assumed that COVID-19 vaccination may be more dangerous for children than adults. Nearly 36.5% parents don’t have any concern about children’s vaccination. About 12.8% of children have not received the vaccination, 55% of parents have some sort of hesitation and 32.2% of parents did not hesitate before vaccinating their children against COVID-19. Only 15.4% of parents expect that the COVID-19 vaccine affects their child’s genes. About 23.4% parents strongly agreed and 35.1% agreed about the importance of getting their children vaccinated. About 22.1% of parents strongly agreed and 33.3% agreed regarding their willingness to get their children vaccinated to prevent Coronavirus disease. More than 80% of parents recommended rushing to receive the COVID-19 vaccine. Health professionals and policymakers should implement and support strategies to ensure children are vaccinated for COVID-19. They also need to educate parents and families regarding childhood vaccination.

A protocol to gather, characterize and analyze incoming citations of retracted articles

In this article, we present a methodology which takes as input a collection of retracted articles, gathers the entities citing them, characterizes such entities according to multiple dimensions (disciplines, year of publication, sentiment, etc.), and applies a quantitative and qualitative analysis on the collected values. The methodology is composed of four phases: (1) identifying, retrieving, and extracting basic metadata of the entities which have cited a retracted article, (2) extracting and labeling additional features based on the textual content of the citing entities, (3) building a descriptive statistical summary based on the collected data, and finally (4) running a topic modeling analysis. The goal of the methodology is to generate data and visualizations that help understanding possible behaviors related to retraction cases. We present the methodology in a structured step-by-step form following its four phases, discuss its limits and possible workarounds, and list the planned future improvements.

Impact of COVID-19 Vaccine Misinformation on Social Media Virality: Content Analysis of Message Themes and Writing Strategies

BACKGROUND

Vaccines serve an integral role in containing pandemics, yet vaccine hesitancy is prevalent globally. One key reason for this hesitancy is the pervasiveness of misinformation on social media. Although considerable research attention has been drawn to how exposure to misinformation is closely associated with vaccine hesitancy, little scholarly attention has been given to the investigation or robust theorizing of the various content themes pertaining to antivaccine misinformation about COVID-19 and the writing strategies in which these content themes are manifested. Virality of such content on social media exhibited in the form of comments, shares, and reactions has practical implications for COVID-19 vaccine hesitancy.

OBJECTIVE

We investigated whether there were differences in the content themes and writing strategies used to disseminate antivaccine misinformation about COVID-19 and their impact on virality on social media.

METHODS

We constructed an antivaccine misinformation database from major social media platforms during September 2019-August 2021 to examine how misinformation exhibited in the form of content themes and how these themes manifested in writing were associated with virality in terms of likes, comments, and shares. Antivaccine misinformation was retrieved from two globally leading and widely cited fake news databases, COVID Global Misinformation Dashboard and International Fact-Checking Network Corona Virus Facts Alliance Database, which aim to track and debunk COVID-19 misinformation. We primarily focused on 140 Facebook posts, since most antivaccine misinformation posts on COVID-19 were found on Facebook. We then employed quantitative content analysis to examine the content themes (ie, safety concerns, conspiracy theories, efficacy concerns) and manifestation strategies of misinformation (ie, mimicking of news and scientific reports in terms of the format and language features, use of a conversational style, use of amplification) in these posts and their association with virality of misinformation in the form of likes, comments, and shares.

RESULTS

Our study revealed that safety concern was the most prominent content theme and a negative predictor of likes and shares. Regarding the writing strategies manifested in content themes, a conversational style and mimicking of news and scientific reports via the format and language features were frequently employed in COVID-19 antivaccine misinformation, with the latter being a positive predictor of likes.

CONCLUSIONS

This study contributes to a richer research-informed understanding of which concerns about content theme and manifestation strategy need to be countered on antivaccine misinformation circulating on social media so that accurate information on COVID-19 vaccines can be disseminated to the public, ultimately reducing vaccine hesitancy. The liking of COVID-19 antivaccine posts that employ language features to mimic news or scientific reports is perturbing since a large audience can be reached on social media, potentially exacerbating the spread of misinformation and hampering global efforts to combat the virus.

[Conflicts of Interest in Research and Clinical Practice]

Recently, doctors and researchers are establishing relationships with interested parties from companies, research institutes, health care institutions, and academic journals, instead of conducting independent medical care or research work. They may have multiple interests as an advisor or a shareholder in the relevant company. Such a situation can foster a conflict of interest when their interests influence one's decision or judgment. Conflict of interest is an extremely important issue because it can infringe the integrity of research, endanger subjects or patients, pose a risk to the public, and deteriorate public perception of science. This brief review explores the definition, examples, and solutions to conflict of interest.

Vaccines and the social amplification of risk

In 2019, the World Health Organization (WHO) named "Vaccine Hesitancy" one of the top 10 threats to global health. Shortly afterward, the COVID-19 pandemic emerged as the world's predominant health concern. COVID-19 vaccines of several types have been developed, tested, and partially deployed with remarkable speed; vaccines are now the primary control measure and hope for a return to normalcy. However, hesitancy concerning these vaccines, along with resistance to masking and other control measures, remains a substantial obstacle. The previous waves of vaccine hesitancy that led to the WHO threat designation, together with recent COVID-19 experience, provide a window for viewing new forms of social amplification of risk (SAR). Not surprisingly, vaccines provide fertile ground for questions, anxieties, concerns, and rumors. These appear in new globalized hyperconnected communications landscapes and in the context of complex human (social, economic, and political) systems that exhibit evolving concerns about vaccines and authorities. We look at drivers, impacts, and implications for vaccine initiatives in several recent historical examples and in the current efforts with COVID-19 vaccination. Findings and insights were drawn from the Vaccine Confidence Project's decade long monitoring of media and social media and its related research efforts. The trends in vaccine confidence and resistance have implications for updating the social amplification of risk framework (SARF); in turn, SARF has practical implications for guiding efforts to alleviate vaccine hesitancy and to mitigate harms from intentional and unintentional vaccine scares.

Analyzing the vaccination debate in social media data Pre- and Post-COVID-19 pandemic

The COVID-19 virus has caused and continues to cause unprecedented impacts on the life trajectories of millions of people globally. Recently, to combat the transmission of the virus, vaccination campaigns around the world have become prevalent. However, while many see such campaigns as positive (e.g., protecting lives), others see them as negative (e.g., the side effects that are not fully understood scientifically), resulting in diverse sentiments towards vaccination campaigns. In addition, the diverse sentiments have seldom been systematically quantified let alone their dynamic changes over space and time. To shed light on this issue, we propose an approach to analyze vaccine sentiments in space and time by using supervised machine learning combined with word embedding techniques. Taking the United States as a test case, we utilize a Twitter dataset (approximately 11.7 million tweets) from January 2015 to July 2021 and measure and map vaccine sentiments (Pro-vaccine, Anti-vaccine, and Neutral) across the nation. In doing so, we can capture the heterogeneous public opinions within social media discussions regarding vaccination among states. Results show how positive sentiment in social media has a strong correlation with the actual vaccinated population. Furthermore, we introduce a simple ratio between Anti and Pro-vaccine as a proxy to quantify vaccine hesitancy and show how our results align with other traditional survey approaches. The proposed approach illustrates the potential to monitor the dynamics of vaccine opinion distribution online, which we hope, can be helpful to explain vaccination rates for the ongoing COVID-19 pandemic.

Misinformation and Disinformation: The Potential Disadvantages of Social Media in Infectious Disease and How to Combat Them

Although the use of social media to spread misinformation and disinformation is not a new concept, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has further highlighted the dangers that misinformation can pose to public health. More than two-thirds of Americans receive their news from at least 1 social media outlet, most of which do not undergo the same review process as academic journals and some professional news organizations. Unfortunately, this can lead to inaccurate health information being conveyed as truth. The purpose of this article is to inform the infectious diseases community of the history and dangers of health misinformation and disinformation in social media, present tools for identifying and responding to misinformation, and propose other ethical considerations for social media.

Vulnerability of African Neurosurgery to Predatory Journals: An Electronic Survey of Aspiring Neurosurgeons, Residents, and Consultants

BACKGROUND

Predatory journals (PJs) publish research with little to no rigorous peer review in exchange for money. It is unclear what proportion of researchers is vulnerable to PJs and which factors are associated with vulnerability. The aim of this study was to evaluate the vulnerability of African neurosurgery researchers to PJs and identify their correlates.

METHODS

A 3-part electronic survey in English and French versions was distributed via social media to African consultants and trainees from November 1 to December 1, 2021. Bivariable relationships were evaluated with χ² test, Mann-Whitney U test, Spearman ρ correlation, odds ratios, and 95% confidence intervals. A P value < 0.05 was considered statistically significant.

RESULTS

There were 101 respondents to the survey (response rate 56.1%). Respondents had mean age of 34.9 years, 82.2% were male (n = 83), 38.6% were consultant neurosurgeons (n = 39), and 33.7% were from Central Africa (n = 34). Of respondents, 66 had published ≥ 1 articles in the past, and 13 had published at least 1 article in a PJ. A PJ had contacted 34 respondents via e-mail, and 8 respondents had reviewed articles for a PJ. The Think. Check. Submit initiative and Beall's list were familiar to 19 and 13 respondents, respectively. Publication in PJs was correlated with the respondent's age (R = 0.23, P = 0.02) and total scholarly output (R = 0.38, P < 0.01).

CONCLUSIONS

Young African neurosurgery researchers are vulnerable to PJs primarily because they are not familiar with the concept of PJs or how to identify them.

Mis-Dis Information in COVID-19 Health Crisis: A Narrative Review

BACKGROUND

In this narrative review, we address the COVID-19 pandemic mis-dis information crisis in which healthcare systems have been pushed to their limits, with collapses occurring worldwide. The context of uncertainty has resulted in skepticism, confusion, and general malaise among the population. Informing the public has been one of the major challenges during this pandemic. Misinformation is defined as false information shared by people who have no intention of misleading others. Disinformation is defined as false information deliberately created and disseminated with malicious intentions.

OBJECTIVE

To reach a consensus and critical review about mis-dis information in COVID-19 crisis.

METHODS

A database search was conducted in PsychINFO, MedLine (Pubmed), Cochrane (Wiley), Embase and CinAhl. Databases used the MeSH-compliant keywords of COVID-19, 2019-nCoV, Coronavirus 2019, SARS-CoV-2, misinformation, disinformation, information, vaccines, vaccination, origin, target, spread, communication.

RESULTS

Both misinformation and disinformation can affect the population's confidence in vaccines (development, safety, and efficacy of vaccines, as well as denial of the severity of SARS-CoV infection). Institutions should take into account that a great part of the success of the intervention to combat a pandemic has a relationship with the power to stop the misinformation and disinformation processes. The response should be well-structured and addressed from different key points: central level and community level, with official and centralized communication channels. The approach should be multifactorial and enhanced by the collaboration of social media companies to stop misleading information, and trustworthy people both working or not working in the health care systems to boost the power of the message.

CONCLUSIONS

The response should be well-structured and addressed from different key points: central level and community level, with official and clearly centralized communication channels. The approach should be multifactorial and enhanced from the collaboration of social media companies to stop misleading information, and trustworthy people both working and not working in the health care systems to boost the power of a message based on scientific evidence.

A Framework for Online Public Health Debates: Some Design Elements for Visual Analytics Systems

Nowadays, many people are deeply concerned about their physical well-being; as a result, they invest much time and effort investigating health-related topics. In response to this, many online websites and social media profiles have been created, resulting in a plethora of information on such topics. In a given topic, oftentimes, much of the information is conflicting, resulting in online camps that have different positions and arguments. We refer to the collection of all such positionings and entrenched camps on a topic such as an online public health debate. The information people encounter regarding such debates can ultimately influence how they make decisions, what they believe, and how they act. Therefore, there is a need for public health stakeholders (i.e., people with a vested interest in public health issues) to be able to make sense of online debates quickly and accurately. In this paper, we present a framework-based approach for investigating online public health debates—a preliminary work that can be expanded upon. We first introduce the concept of online debate entities (ODEs), which is a generalization for those who participate in online debates (e.g., websites and Twitter profiles). We then present the framework ODIN (Online Debate entIty aNalyzer), in which we identify, define, and justify ODE attributes that we consider important for making sense of online debates. Next, we provide an overview of four online public health debates (vaccines, statins, cannabis, and dieting plans) using ODIN. Finally, we showcase four prototype visual analytics systems whose design elements are informed by the ODIN framework.