Which Social Media Platforms Provide the Most Informative Data for Monitoring the Opioid Crisis?

Background and Aims: Social media can provide real-time insight into trends in substance use, addiction, and recovery. Prior studies have leveraged data from platforms such as Reddit and X (formerly Twitter), but evolving policies around data access have threatened their usability in opioid overdose surveillance systems. Here, we evaluate the potential of a broad set of platforms to detect emerging trends in the opioid crisis. Design: We identified 72 online platforms with a substantial global user base or prior citations in opioid-related research. We evaluated each platform's fit with our definition of social media, size of North American user base, and volume of opioid-related discourse. We created a shortlist of 11 platforms that met our criteria. We documented basic characteristics, volume and nature of opioid discussion, official policies regulating drug-related discussion, and data accessibility of shortlisted platforms. Setting: USA and Canada. Measurements: We quantified the volume of opioid discussion by number of platform-specific Google search hits for opioid terms. We captured informal language by including slang generated using a large language model. We report the number of opioid-related hits and proportion of opioid-related hits to hits for common nouns. Findings: We found that TikTok, YouTube, and Facebook have the most potential for use in opioid-related surveillance. TikTok and Facebook have the highest relative amount of drug-related discussions. Language on TikTok was predominantly informal. Many platforms offer data access tools for research, but changing company policies and user norms create instability. The demographics of users varies substantially across platforms. Conclusions: Social media data sources hold promise for detecting trends in opioid use, but researchers must consider the utility, accessibility, and stability of data on each platform. A strategy mixing several platforms may be required to cover all demographics suffering in the epidemic.

Postharvest quality of two orange-fleshed sweet potato [Ipomoea batatas (L) Lam] cultivars as influenced by organic soil amendment treatments.

Two orange-fleshed sweet potato cultivars: Apomuden and "Nane" were grown on cow dung-, chicken manure-, compost-amended soils, and untreated soil. Apomuden is a variety, while "Nane" is being evaluated to be released in Ghana. The storage roots (SRs) were harvested at 3 months, cured by heaping the SRs and covering with the sweet potato foliage for 7 days in the field. The cured SRs were kept in an evaporative cool chamber to study the effect of soil amendment treatments on weight loss, rot, some nutrient composition, and sensory attributes. Boiled SRs were assessed by 70 untrained panelists after 7 weeks of storage based on the following: general appearance, sweetness, finger-feel firmness, and overall acceptability using a 5-point hedonic scale (1 = dislike extremely to 5 = like extremely). Percent rot for "Nane" showed a linear trend, while that of Apomuden was nonlinear. Both cultivars showed similar trends in terms of cumulative weight loss with "Nane" recording lower weight loss compared with Apomuden. A significant (p < 0.001; r = 0.71) strong positive correlation was observed between weight loss and rots. "Nane" had higher dry matter (37.15% vs. 30.19%; p < 0.001, respectively) and starch content (59.16% vs. 51.86%; p < 0.001, respectively) than Apomuden. Stored SRs grown on chicken manure-amended soil recorded the highest protein (6.41%; p < 0.001) and ß-carotene (16.64 mg/100 g; p < 0.001) content than the other treatments. There was a 35% decline in ß-carotene for Apomuden, while "Nane" increased by 24% at the end of the 7-week storage. "Nane," the cultivar with high dry matter content had good storage properties than Apomuden. Stored SRs cultivated on soils amended with chicken manure had higher ß-carotene and protein content. All sensory attributes ranged from 3.35 to 3.68 indicating a good consumer preference for both cultivars irrespective of the soil amendment treatment applied.

Assessing the impact of short-term surgical education on practice: a retrospective study of the introduction of mesh for inguinal hernia repair in sub-Saharan Africa.

PURPOSE: Inguinal hernia repair is the most common general surgery operation performed globally. However, the adoption of tension-free hernia repair with mesh has been limited in low-income settings, largely due to a lack of technical training and resources. The present study evaluates the impact of a 2-day training course instructing use of polypropylene mesh for inguinal hernia repair on the practice patterns of sub-Saharan African physicians. METHODS: A surgical training course on tension-free mesh repair of hernias was provided to 16 physicians working in rural Ghanaian and Liberian hospitals. Three physicians were requested to prospectively record all their inguinal hernia surgeries, performed with or without mesh, during the 14-month period following the training. Demographic variables, diagnoses, and complications were collected by an independent data collector for mesh and non-mesh procedures. RESULTS: Surgery with mesh increased significantly following intervention, from near negligible levels prior to the training to 8.1 % of all inguinal hernia repairs afterwards. Mesh repair accounted for 90.8 % of recurrent hernia repairs and 2.9 % of primary hernia repairs after training. Overall complication rates between mesh and non-mesh procedures were not significantly different (p = 0.20). CONCLUSIONS: Three physicians who participated in an intensive education course were routinely using mesh for inguinal hernia repair 14 months after the training. This represents a significant change in practice pattern. Complication rates between patients who underwent inguinal hernia repairs with and without mesh were comparable. The present study provides evidence that short-term surgical training initiatives can have a substantial impact on local healthcare practice in resource-limited settings.

Outbreak of vancomycin-, ampicillin-, and aminoglycoside-resistant Enterococcus faecium bacteremia in an adult oncology unit.

An outbreak of bacteremia caused by Enterococcus faecium with high-level resistance to vancomycin (MIC of > or = 256 micrograms/ml), ampicillin (MIC of > or = 64 micrograms/ml), and gentamicin or streptomycin (MIC of > or = 2,000 micrograms/ml) occurred in an adult oncology unit from June 1991 to May 1992. Active surveillance for the presence of this organism in stool or perianal cultures was begun in September 1991. Between June 1991 and May 1992, seven patients with bacteremia and 22 noninfected carriers of the organism in stool were identified. The vanA gene, tested for by PCR and gene probe, was present in all isolates evaluated. All bacteremic patients also had resistant E. faecium present in a stool or perianal culture; the stool isolates tested were closely related to the respective blood isolates as determined by pulsed-field gel electrophoresis. Antibiotic regimens using high-dose ampicillin and an aminoglycoside were ineffective with four patients. Five patients (71%) had multiple positive blood cultures; four of these patients died. Following a multiple logistic regression analysis, it was found that bacteremic patients received a significantly greater number of total antibiotic days compared with noninfected stool carriers (P = 0.019). The emergence of E. faecium with high-level resistance to vancomycin, ampicillin, and aminoglycosides underscores the importance of performing susceptibility testing on all clinically significant isolates. In the neutropenic adult oncology patient, bacteremia with this organism is of probable gastrointestinal origin, is often persistent, and is refractory to treatment with ampicillin in combination with an aminoglycoside. Prolonged use of antibiotics may predispose patients with gastrointestinal colonization to develop bacteremia.