Merging public health and automated approaches to address online hate speech

The COVID-19 pandemic sparked a rise in misinformation from various media sources, which contributed to the heightened severity of hate speech. The upsurgence of hate speech online has devastatingly translated to real-life hate crimes, which saw an increase of 32% in 2020 in the United States alone (U.S. Department of Justice 2022). In this paper, I explore the current effects of hate speech and why hate speech should be widely recognized as a public health issue. I also discuss current artificial intelligence (AI) and machine learning (ML) strategies to mitigate hate speech along with the ethical concerns with using these technologies. Future considerations to improve AI/ML are also examined. Through analyzing these two contrasting methodologies (public health versus AI/ML), I argue that these two approaches applied by themselves are not efficient or sustainable. Therefore, I propose a third approach that combines both AI/ML and public health. With this proposed approach, the reactive side of AI/ML and the preventative nature of public health measures are united to develop an effective manner of addressing hate speech.

Spike-specific T cells are enriched in breastmilk following SARS-CoV-2 mRNA vaccination.

Human breastmilk is rich in T cells; however, their specificity and function are largely unknown. We compared the phenotype, diversity, and antigen specificity of T cells in breastmilk and peripheral blood of lactating individuals who received SARS-CoV-2 messenger RNA (mRNA) vaccination. Relative to blood, breastmilk contained higher frequencies of T effector and central memory populations that expressed mucosal-homing markers. T cell receptor sequence overlap was limited between blood and breastmilk. Overabundant breastmilk clones were observed in all individuals, were diverse, and contained complementarity-determining regions in three sequences with known epitope specificity, including to SARS-CoV-2 spike. SARS-CoV-2 spike-specific T cell receptors were more frequent in breastmilk compared to blood and expanded in breastmilk following a 3rd mRNA vaccine dose. Our observations indicate that the lactating breast contains a distinct T cell population that can be modulated by maternal vaccination with potential implications for passive infant protection.

Low rate of SARS-CoV-2 incident infection identified by weekly screening PCR in a prospective year-long cohort study.

BACKGROUND: Asymptomatic and pre-symptomatic SARS-CoV-2 infections may contribute to ongoing community transmission, however, the benefit of routine screening of asymptomatic individuals in low-risk populations is unclear. METHODS: To identify SARS-CoV-2 infections 553 seronegative individuals were prospectively followed for 52 weeks. From 4/2020-7/2021, participants submitted weekly self-collected nasal swabs for rtPCR and completed symptom and exposure surveys. RESULTS: Incident SARS2-CoV-2 infections were identified in 9/553 (1.6%) participants. Comparisons of SARS2-CoV-2(+) to SARS2-CoV-2(-) participants revealed significantly more close contacts outside the household (median: 5 versus 3; p = 0.005). The incidence of infection was higher among unvaccinated/partially vaccinated than among fully vaccinated participants (9/7,679 versus 0/6,845 person-weeks; p = 0.004). At notification of positive test result, eight cases were symptomatic and one pre-symptomatic. CONCLUSIONS: These data suggest that weekly SARS2-CoV2 surveillance by rtPCR did not efficiently detect pre-symptomatic infections in unvaccinated participants.

Protein S: function, regulation, and clinical perspectives.

PURPOSE OF REVIEW: Protein S (PS) is an essential natural anticoagulant. PS deficiency is a major contributor to acquired hypercoagulability. Acquired hypercoagulability causes myocardial infarction, stroke, and deep vein thrombosis in millions of individuals. Yet, despite its importance in hemostasis, PS is the least understood anticoagulant. Even after 40 years since PS was first described, we are still uncovering information about how PS functions. The purpose of this review is to highlight recent findings that advance our understanding of the functions of PS and explain hypercoagulability caused by severe PS deficiency. RECENT FINDINGS: PS has long been described as a cofactor for Activated Protein C (APC) and Tissue Factor Pathway Inhibitor (TFPI). However, a recent report describes direct inhibition of Factor IXa (FIXa) by PS, an activity of PS that had been completely overlooked. Thrombophilia is becoming a more frequently reported disorder. Hereditary PS deficiency is an anticoagulant deficiency that results eventually in thrombophilia. In addition, PS deficiency is a predisposing factor for venous thromboembolism (VTE), but an effect of PS deficiency in arterial thrombosis, such as arterial ischemic stroke, is uncertain. Plasma PS concentration decreases in pregnant women. Inherited thrombophilias are important etiologies for recurrent pregnancy loss, and anticoagulation therapy is of benefit to women with recurrent pregnancy loss who had documented only PS deficiency.Hypoxia is a risk factor for VTE, and hypoxia downregulates plasma PS level. Importantly, COVID-19 can lead to hypoxemia because of lung damage from IL6-driven inflammatory responses to the viral infection. Because hypoxia decreases the abundance of the key anticoagulant PS, we surmise that the IL6-induced cytokine explosion combined with hypoxemia causes a drop in PS level that exacerbates the thrombotic risk in COVID-19 patients. SUMMARY: This review is intended to advance understanding of the anticoagulant function of an important plasma protein, PS. Despite 40+ years of research, we have not had a complete description of PS biology as it pertains to control of blood coagulation. However, the picture of PS function has become sharper with the recent discovery of FIXa inhibition by PS. Hemostasis mediated by PS now includes regulation of FIXa activity alongside the cofactor activities of PS in the TFPI/APC pathways. In addition, the direct inhibition of FIXa by PS suggests that PS, particularly a small derivative of PS, could be used to treat individuals with PS deficiencies or abnormalities that cause thrombotic complications.

Women's and Nurses' Perceptions of Visitor Restrictions After Childbirth During the COVID-19 Pandemic.

OBJECTIVE: To examine the perceptions of labor and delivery (L&D) nurses and childbearing women in the postpartum period regarding a restricted visitor policy during the COVID-19 pandemic. DESIGN: Descriptive mixed-methods survey and open-ended questions. SETTING/LOCAL PROBLEM: One hospital in the southwestern United States. There is limited evidence regarding recently imposed visitor restrictions related to COVID-19. PARTICIPANTS: Individuals who were pregnant and self-identified as women who gave birth during October 2020 through March 2021 (n = 674) and L&D nurses (n = 47). INTERVENTION/MEASUREMENTS: Participants who had given birth with visitor restrictions completed an online survey, and L&D nurses completed a paper survey. RESULTS: Childbearing women had positive and negative views; they valued a more intimate familial bonding and recovery without visitors and appreciated decreased pressure to accommodate family/friends. They were also disappointed with sibling restrictions and were sad and frustrated with visitor limitations, especially in special circumstances (e.g., NICU admission or extended stays). Nurses expressed that visitor restrictions allowed more time for higher-quality nursing care/patient teaching and decreased distractions in emergencies, leading to safer care. Women and nurses reported that visitor restrictions allowed women more rest and relaxation as well as less worry and strain from juggling family and friends who wanted to visit, but they also identified that there was decreased family support when it was needed. CONCLUSION: Women's responses were mixed, with some preferring support from many visitors, while others appreciated the intimate focus of just their partner. Most nurses preferred fewer visitors but could empathize with women.

Global Sex Disparity of COVID-19: A Descriptive Review of Sex Hormones and Consideration for the Potential Therapeutic Use of Hormone Replacement Therapy in Older Adults.

The 2019-2020 SARS-related coronavirus-2 (SARS-CoV-2) pandemic has brought unprecedented challenges to healthcare sectors around the world. As of November 2020, there have been over 64 million confirmed cases and approaching 2 million deaths globally. Despite the large number of positive cases, there are very limited established standards of care and therapeutic options available. To date, there is still no Food and Drug Administration (FDA) approved vaccine for COVID-19, although there are several options in various clinical trial stages. Herein, we have performed a global review evaluating the roles of age and sex on COVID-19 hospitalizations, ICU admissions, deaths in hospitals, and deaths in nursing homes. We have identified a trend in which elderly and male patients are significantly affected by adverse outcomes. There is evidence suggesting that sex hormone levels can influence immune system function against SARS-CoV-2 infection, thus reducing the adverse effects of COVID-19. Since older adults have lower levels of these sex hormones, we therefore speculate, within rational scientific context, that sex steroids, such as estrogen and progesterone, needs further consideration for use as alternative therapeutic option for treating COVID-19 elderly patients. To our knowledge, this is the first comprehensive article evaluating the significance of sex hormones in COVID-19 outcomes in older adults.