The scientific method drives improvements in public health, but a strategy of obstructionism has impeded scientists from gathering even a minimal amount of information to address America's gun violence epidemic. We argue that in spite of a lack of federal investment, large amounts of publicly available data offer scientists an opportunity to measure a range of firearm-related behaviors. Given the diversity of available data - including news coverage, social media, web forums, online advertisements, and Internet searches (to name a few) - there are ample opportunities for scientists to study everything from trends in particular types of gun violence to gun-related behaviors (such as purchases and safety practices) to public understanding of and sentiment towards various gun violence reduction measures. Science has been sidelined in the gun violence debate for too long. Scientists must tap the big media data stream and help resolve this crisis.

The accuracy of statistical reporting that informs medical and public health practice has generated extensive debate, but no studies have evaluated the frequency or accuracy of effect size (the magnitude of change in outcome as a function of change in predictor) reporting in prominent health journals. To evaluate effect size reporting practices in prominent health journals using the case study of ORs. Articles published in the American Journal of Public Health (AJPH), Journal of the American Medical Association (JAMA), New England Journal of Medicine (NEJM) and PLOS One from 1 January 2010 through 31 December 2019 mentioning the term 'odds ratio' in all searchable fields were obtained using PubMed. One hundred randomly selected articles that reported original research using ORs were sampled per journal for in-depth analysis. We report prevalence of articles using ORs, reporting effect sizes from ORs (reporting the magnitude of change in outcome as a function of change in predictor) and reporting correct effect sizes. The proportion of articles using ORs in the past decade declined in JAMA and AJPH, remained similar in NEJM and increased in PLOS One, with 6124 articles in total. Twenty-four per cent (95% CI 20% to 28%) of articles reported the at least one effect size arising from an OR. Among articles reporting any effect size, 57% (95% CI 47% to 67%) did so incorrectly. Taken together, 10% (95% CI 7% to 13%) of articles included a correct effect size interpretation of an OR. Articles that used ORs in AJPH more frequently reported the effect size (36%, 95% CI 27% to 45%), when compared with NEJM (26%, 95% CI 17.5% to 34.7%), PLOS One (22%, 95% CI 13.9% to 30.2%) and JAMA (10%, 95% CI 3.9% to 16.0%), but the probability of a correct interpretation did not statistically differ between the four journals (χ2=0.56, p=0.90). Articles that used ORs in prominent journals frequently omitted presenting the effect size of their predictor variables. When reported, the presented effect size was usually incorrect. When used, ORs should be paired with accurate effect size interpretations. New editorial and research reporting standards to improve effect size reporting and its accuracy should be considered.

Background

The death of George Floyd while in police custody has resurfaced serious questions about police conduct that result in the deaths of unarmed persons.

Objective

Data-driven strategies that identify and prioritize the public's needs may engender a public health response to improve policing. We assessed how internet searches indicative of interest in police reform changed after Mr Floyd's death.

Methods

We monitored daily Google searches (per 10 million total searches) that included the terms "police" and "reform(s)" (eg, "reform the police," "best police reforms," etc) originating from the United States between January 1, 2010, through July 5, 2020. We also monitored searches containing the term "police" with "training," "union(s)," "militarization," or "immunity" as markers of interest in the corresponding reform topics.

Results

The 41 days following Mr Floyd's death corresponded with the greatest number of police "reform(s)" searches ever recorded, with 1,350,000 total searches nationally. Searches increased significantly in all 50 states and Washington DC. By reform topic, nationally there were 1,220,000 total searches for "police" and "union(s)"; 820,000 for "training"; 360,000 for "immunity"; and 72,000 for "militarization." In terms of searches for all policy topics by state, 33 states searched the most for "training," 16 for "union(s)," and 2 for "immunity." States typically in the southeast had fewer queries related to any police reform topic than other states. States that had a greater percentage of votes for President Donald Trump during the 2016 election searched more often for police "union(s)" while states favoring Secretary Hillary Clinton searched more for police "training."

Conclusions

The United States is at a historical juncture, with record interest in topics related to police reform with variability in search terms across states. Policy makers can respond to searches by considering the policies their constituencies are searching for online, notably police training and unions. Public health leaders can respond by engaging in the subject of policing and advocating for evidence-based policy reforms.

Introduction

Public perceptions of electronic nicotine delivery systems (ENDS) remain poorly understood because surveys are too costly to regularly implement and, when implemented, there are long delays between data collection and dissemination. Search query surveillance has bridged some of these gaps. Herein, ENDS' popularity in the U.S. is reassessed using Google searches.

Methods

ENDS searches originating in the U.S. from January 2009 through January 2015 were disaggregated by terms focused on e-cigarette (e.g., e-cig) versus vaping (e.g., vapers); their geolocation (e.g., state); the aggregate tobacco control measures corresponding to their geolocation (e.g., clean indoor air laws); and by terms that indicated the searcher's potential interest (e.g., buy e-cigs likely indicates shopping)-all analyzed in 2015.

Results

ENDS searches are rapidly increasing in the U.S., with 8,498,000 searches during 2014 alone. Increasingly, searches are shifting from e-cigarette- to vaping-focused terms, especially in coastal states and states where anti-smoking norms are stronger. For example, nationally, e-cigarette searches declined 9% (95% CI=1%, 16%) during 2014 compared with 2013, whereas vaping searches increased 136% (95% CI=97%, 186%), even surpassing e-cigarette searches. Additionally, the percentage of ENDS searches related to shopping (e.g., vape shop) nearly doubled in 2014, whereas searches related to health concerns (e.g., vaping risks) or cessation (e.g., quit smoking with e-cigs) were rare and declined in 2014.

Conclusions

ENDS popularity is rapidly growing and evolving. These findings could inform survey questionnaire development for follow-up investigation and immediately guide policy debates about how the public perceives the health risks or cessation benefits of ENDS.

This study monitored online posts from readers seeking specific health information on a social media platform to evaluate the volume of information requests, whether readers sought an initial or second opinion for diagnosis, and the amount of response time before a reply answer was sent.

The strategies that experts have used to share information about social causes have historically been top-down, meaning the most influential messages are believed to come from planned events and campaigns. However, more people are independently engaging with social causes today than ever before, in part because online platforms allow them to instantaneously seek, create, and share information. In some cases this "organic advocacy" may rival or even eclipse top-down strategies. Big data analytics make it possible to rapidly detect public engagement with social causes by analyzing the same platforms from which organic advocacy spreads. To demonstrate this claim we evaluated how Leonardo DiCaprio's 2016 Oscar acceptance speech citing climate change motivated global English language news (Bloomberg Terminal news archives), social media (Twitter postings) and information seeking (Google searches) about climate change. Despite an insignificant increase in traditional news coverage (54%; 95%CI: -144 to 247), tweets including the terms "climate change" or "global warming" reached record highs, increasing 636% (95%CI: 573-699) with more than 250,000 tweets the day DiCaprio spoke. In practical terms the "DiCaprio effect" surpassed the daily average effect of the 2015 Conference of the Parties (COP) and the Earth Day effect by a factor of 3.2 and 5.3, respectively. At the same time, Google searches for "climate change" or "global warming" increased 261% (95%CI, 186-335) and 210% (95%CI 149-272) the day DiCaprio spoke and remained higher for 4 more days, representing 104,190 and 216,490 searches. This increase was 3.8 and 4.3 times larger than the increases observed during COP's daily average or on Earth Day. Searches were closely linked to content from Dicaprio's speech (e.g., "hottest year"), as unmentioned content did not have search increases (e.g., "electric car"). Because these data are freely available in real time our analytical strategy provides substantial lead time for experts to detect and participate in organic advocacy while an issue is salient. Our study demonstrates new opportunities to detect and aid agents of change and advances our understanding of communication in the 21st century media landscape.

The reasons for using electronic nicotine delivery systems (ENDS) are poorly understood and are primarily documented by expensive cross-sectional surveys that use preconceived close-ended response options rather than allowing respondents to use their own words. We passively identify the reasons for using ENDS longitudinally from a content analysis of public postings on Twitter. All English language public tweets including several ENDS terms (e.g., "e-cigarette" or "vape") were captured from the Twitter data stream during 2012 and 2015. After excluding spam, advertisements, and retweets, posts indicating a rationale for vaping were retained. The specific reasons for vaping were then inferred based on a supervised content analysis using annotators from Amazon's Mechanical Turk. During 2012 quitting combustibles was the most cited reason for using ENDS with 43% (95%CI 39-48) of all reason-related tweets cited quitting combustibles, e.g., "I couldn't quit till I tried ecigs," eclipsing the second most cited reason by more than double. Other frequently cited reasons in 2012 included ENDS's social image (21%; 95%CI 18-25), use indoors (14%; 95%CI 11-17), flavors (14%; 95%CI 11-17), safety relative to combustibles (9%; 95%CI 7-11), cost (3%; 95%CI 2-5) and favorable odor (2%; 95%CI 1-3). By 2015 the reasons for using ENDS cited on Twitter had shifted. Both quitting combustibles and use indoors significantly declined in mentions to 29% (95%CI 24-33) and 12% (95%CI 9-16), respectively. At the same time, social image increased to 37% (95%CI 32-43) and lack of odor increased to 5% (95%CI 2-5), the former leading all cited reasons in 2015. Our data suggest the reasons people vape are shifting away from cessation and toward social image. The data also show how the ENDS market is responsive to a changing policy landscape. For instance, smoking indoors was less frequently cited in 2015 as indoor smoking restrictions became more common. Because the data and analytic approach are scalable, adoption of our strategies in the field can inform follow-up survey-based surveillance (so the right questions are asked), interventions, and policies for ENDS.

The immune response to dengue virus (DENV) infection is complex and not fully understood. Using longitudinal data from 181 children with dengue in Thailand who were followed for up to 3 years, we describe neutralizing antibody kinetics following symptomatic DENV infection. We observed that antibody titers varied by serotype, homotypic vs heterotypic responses, and primary versus postprimary infections. The rates of change in antibody titers over time varied between primary and postprimary responses. For primary infections, titers increased from convalescence to 6 months. By comparing homotypic and heterotypic antibody titers, we saw an increase in type specificity from convalescence to 6 months for primary DENV3 infections but not primary DENV1 infections. In postprimary cases, there was a decrease in titers from convalescence up until 6 months after infection. Beginning 1 year after both primary and postprimary infections, there was evidence of increasing antibody titers, with greater increases in children with lower titers, suggesting that antibody titers were boosted due to infection and that higher levels of neutralizing antibody may be more likely to confer a sterilizing immune response. These findings may help to model virus transmission dynamics and provide baseline data to support the development of vaccines and therapeutics.

Despite estimates that, each year, as many as 300 million dengue virus (DENV) infections result in either no perceptible symptoms (asymptomatic) or symptoms that are sufficiently mild to go undetected by surveillance systems (inapparent), it has been assumed that these infections contribute little to onward transmission. However, recent blood-feeding experiments with Aedes aegypti mosquitoes showed that people with asymptomatic and pre-symptomatic DENV infections are capable of infecting mosquitoes. To place those findings into context, we used models of within-host viral dynamics and human demographic projections to (1) quantify the net infectiousness of individuals across the spectrum of DENV infection severity and (2) estimate the fraction of transmission attributable to people with different severities of disease. Our results indicate that net infectiousness of people with asymptomatic infections is 80% (median) that of people with apparent or inapparent symptomatic infections (95% credible interval (CI): 0-146%). Due to their numerical prominence in the infectious reservoir, clinically inapparent infections in total could account for 84% (CI: 82-86%) of DENV transmission. Of infections that ultimately result in any level of symptoms, we estimate that 24% (95% CI: 0-79%) of onward transmission results from mosquitoes biting individuals during the pre-symptomatic phase of their infection. Only 1% (95% CI: 0.8-1.1%) of DENV transmission is attributable to people with clinically detected infections after they have developed symptoms. These findings emphasize the need to (1) reorient current practices for outbreak response to adoption of pre-emptive strategies that account for contributions of undetected infections and (2) apply methodologies that account for undetected infections in surveillance programs, when assessing intervention impact, and when modeling mosquito-borne virus transmission.