BACKGROUND: Fake health-related news has spread rapidly through the internet, causing harm to individuals and society. Despite interventions, a fenbendazole scandal recently spread among patients with lung cancer in South Korea. It is crucial to intervene appropriately to prevent the spread of fake news.
OBJECTIVE: This study investigated the appropriate timing of interventions to minimize the side effects of fake news.
METHODS: A simulation was conducted using the susceptible-infected-recovered (SIR) model, which is a representative model of the virus spread mechanism. We applied this model to the fake news spread mechanism. The parameters were set similarly to those in the digital environment, where the fenbendazole scandal occurred. NetLogo, an agent-based model, was used as the analytical tool.
RESULTS: Fake news lasted 278 days in the absence of interventions. As a result of adjusting and analyzing the timing of the intervention in response to the fenbendazole scandal, we found that faster intervention leads to a shorter duration of fake news (intervention at 54 days = fake news that lasted for 210 days; intervention at 16 days = fake news that lasted for 187 days; and intervention at 10 days = fake news that lasted for 157 days). However, no significant differences were observed when the intervention was performed within 10 days.
CONCLUSIONS: Interventions implemented within 10 days were effective in reducing the duration of the spread of fake news. Our findings suggest that timely intervention is critical for preventing the spread of fake news in the digital environment. Additionally, a monitoring system that can detect fake news should be developed for a rapid response.

We develop a simulation framework for studying misinformation spread within online social networks that blends agent-based modeling and natural language processing techniques. While many other agent-based simulations exist in this space, questions over their fidelity and generalization to existing networks in part hinder their ability to drive policy-relevant decision making. To partially address these concerns, we create a \'digital clone\' of a known misinformation sharing network by downloading social media histories for over ten thousand of its users. We parse these histories to both extract the structure of the network and model the nuanced ways in which information is shared and spread among its members. Unlike many other agent-based methods in this space, information sharing between users in our framework is sensitive to topic of discussion, user preferences, and online community dynamics. To evaluate the fidelity of our method, we seed our cloned network with a set of posts recorded in the base network and compare propagation dynamics between the two, observing reasonable agreement across the twin networks over a variety of metrics. Lastly, we explore how the cloned network may serve as a flexible, low-cost testbed for misinformation countermeasure evaluation and red teaming analysis. We hope the tools explored here augment existing efforts in the space and unlock new opportunities for misinformation countermeasure evaluation, a field that may become increasingly important to consider with the anticipated rise of misinformation campaigns fueled by generative artificial intelligence.

People tend to befriend others similar to themselves, generating a pattern called homophily. However, existing studies on friendship patterns often rely on surveys that assess the perspective of relatively few participants on their friendships but do not measure actualized friendship patterns. Here, we used data from a large Slovakian online social network to assess the role of gender, age, and body mass index (BMI) in same-gender online connections among more than 400,000 users. We found that age and BMI homophily occurred in both men\'s and women\'s same-gender connections, but somewhat more strongly among men\'s. Yet, as women diverged in BMI, their connections were less likely to be reciprocated. We discuss how the evolutionary legacy of men\'s coalitional competition (e.g., warfare) and women\'s mating competition or recruitment of allocare providers might contribute to these patterns in modern same-gender relationships. For example, men\'s engagement in physical activities may lead to similar formidability levels among their same-gender peers. Altogether, our findings highlight the importance of trait similarity to same-gender friendship patterns.

BACKGROUND: Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation.
OBJECTIVE: This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users.
METHODS: We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff.
RESULTS: Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users\' perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety.
CONCLUSIONS: This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability.
BACKGROUND: PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528.

Social media has established its place in our daily lives, especially with the advent of the COVID-19 pandemic. It has become the leading source of information for dermatological literacy on various topics, ranging from skin diseases to everyday skincare and cosmetic purposes in the present digital era. Accumulated evidence indicates that accurate medical content constitutes only a tiny fraction of the exponentially growing dermatological information on digital platforms, highlighting an unmet patient need for access to evidence-based information on social media. However, there have been no recent local publications from Turkey analyzing and assessing the key elements in raising dermatological literacy and awareness in digital communication for patients. To the best of our knowledge, this study is the first collaborative work between health care professionals and a social media specialist in the medical literature. Furthermore, it represents the first author-initiated implementation science attempt focusing on the use of social media in addressing dermatological problems, with the primary end point of increasing health literacy and patient benefits. The multidisciplinary expert panel was formed by 4 dermatologists with academic credentials and significant influence in public health and among patients on digital platforms. A social media specialist, who serves as a guest lecturer on \"How social media works\" at Istanbul Technical University, Turkey, was invited to the panel as an expert on digital communication. The panel members had a kickoff meeting to establish the context for the discussion points. The context of the advisory board meeting was outlined under 5 headlines. Two weeks later, the panel members presented their social media account statistics, defined the main characteristics of dermatology patients on social media, and discussed their experiences with patients on digital platforms. These discussions were organized under the predefined headlines and in line with the current literature. We aimed to collect expert opinions on identifying the main characteristics of individuals interested in dermatological topics and to provide recommendations to help dermatologists increase evidence-based dermatological content on social media. Additionally, experts discussed paradigms for dermatological outreach and the role of dermatologists in reducing misleading information on digital platforms in Turkey. The main concluding remark of this study is that dermatologists should enhance their social media presence to increase evidence-based knowledge by applying the principles of patient-physician communication on digital platforms while maintaining a professional stance. To achieve this goal, dermatologists should share targeted scientific content after increasing their knowledge about the operational rules of digital channels. This includes correctly identifying the needs of those seeking information on social media and preparing a sustainable social media communication plan. This viewpoint reflects Turkish dermatologists\' experiences with individuals searching for dermatological information on local digital platforms; therefore, the applicability of recommendations may be limited and should be carefully considered.

BACKGROUND: Previous studies have associated videogame playing and social media use with suicidal behaviors together with lower stress coping or poor emotion regulation strategies. Due to the inconclusive evidence regarding the factors associated with suicidal behavior, the present study aimed to overcome the limitations of previous research and explored the relationship between adolescent stress, problematic internet use (PIU), gaming disorder (GD), and emotional regulation (ER) in a cross-section design. It was hypothesized that stress would have a direct effect on suicide risk (SR) as well as being mediated by PIU, GD, and ER.
METHODS: The participants comprised 430 adolescents (58.4% male) aged between 16 and 19 years. They completed an online survey including the Mobile-Related Experiences Questionnaire, Internet Gaming Disorder Scale-Short Form, Meta-Mood Trait Repair Scale, and Spanish version of the Suicidal Behaviors Questionnaire.
RESULTS: A total of 34.2% of the adolescents (N = 147) were at risk for SR. Results also indicated that 30,7% had experienced suicidal ideation at some point in their life, 12.1% had at least one plan to die by suicide, and 5.1% had attempted suicide. Results of path analysis confirmed that stress appeared to be a risk factor for suicide, but that its effects were not mediated by PIU. However, ER and GD mediated the effect of stress on SR. The results suggest that stress is a main risk factor for suicide, especially among adolescents with poor emotional regulation or problematic gaming.
CONCLUSIONS: Considering the prevalence of suicide among adolescents, the results of the present study suggest that suicide prevention programs should include emotional regulation strategies, stress coping, and videogaming management skills in the early stages of high school. Providing these protective resources to adolescents will help them face the stressful and changing situations typical of adolescence and will help them to attain greater well-being and satisfaction with life.
CONCLUSIONS: 34.2% of the adolescents in the sample were at risk for suicidal behavior. Of the many factors affecting suicide risk among adolescents, problematic use of internet, gaming disorder and difficulties in emotion regulation may play an important role.Stress is a key factor for suicide risk, especially among adolescents with poor emotion regulation and gaming disorder.Suicide prevention programs should include stress coping strategies, as well as emotional and videogaming management skills in early stages of high school.

UNASSIGNED: Social networking site use and social network-based health information seeking behavior have proliferated to the point that the lines between seeking health information from credible social network-based sources and the decision to seek medical care or attempt to treat oneself have become blurred.
UNASSIGNED: We contribute to emerging research on health information seeking behavior by investigating demographic factors, social media use for health information seeking purposes, and the relationship between health information seeking and occurrences of self-treatment.
UNASSIGNED: Data were collected from an online survey in which participants were asked to describe sociodemographic factors about themselves, social media use patterns, perceptions about their motivations for health information seeking on social media platforms, and whether or not they attempted self-treatment after their social media-related health information seeking. We conducted a binomial logistic regression with self-treatment as a dichotomous categorical dependent variable.
UNASSIGNED: Results indicate that significant predictors of self-treatment based on information obtained from social networking sites include race, exercise frequency, and degree of trust in the health-related information received.
UNASSIGNED: With an understanding of how sociodemographic factors might influence the decision to self-treat based on information obtained from social networking sites, health care providers can assist patients by educating them on credible social network-based sources of health information and discussing the importance of seeking medical advice from a health care provider.

Considerable scholarly attention has been paid to understanding belief in online misinformation1,2, with a particular focus on social networks. However, the dominant role of search engines in the information environment remains underexplored, even though the use of online search to evaluate the veracity of information is a central component of media literacy interventions3-5. Although conventional wisdom suggests that searching online when evaluating misinformation would reduce belief in it, there is little empirical evidence to evaluate this claim. Here, across five experiments, we present consistent evidence that online search to evaluate the truthfulness of false news articles actually increases the probability of believing them. To shed light on this relationship, we combine survey data with digital trace data collected using a custom browser extension. We find that the search effect is concentrated among individuals for whom search engines return lower-quality information. Our results indicate that those who search online to evaluate misinformation risk falling into data voids, or informational spaces in which there is corroborating evidence from low-quality sources. We also find consistent evidence that searching online to evaluate news increases belief in true news from low-quality sources, but inconsistent evidence that it increases belief in true news from mainstream sources. Our findings highlight the need for media literacy programmes to ground their recommendations in empirically tested strategies and for search engines to invest in solutions to the challenges identified here.

Users increasingly use social networking services (SNSs) to share their feelings and emotions. For those with mental disorders, SNSs can also be used to seek advice on mental health issues. One available SNS is Reddit, in which users can freely discuss such matters on relevant health diagnostic subreddits.
In this study, we analyzed the distinctive linguistic characteristics in users\' posts on specific mental disorder subreddits (depression, anxiety, bipolar disorder, borderline personality disorder, schizophrenia, autism, and mental health) and further validated their distinctiveness externally by comparing them with posts of subreddits not related to mental illness. We also confirmed that these differences in linguistic formulations can be learned through a machine learning process.
Reddit posts uploaded by users were collected for our research. We used various statistical analysis methods in Linguistic Inquiry and Word Count (LIWC) software, including 1-way ANOVA and subsequent post hoc tests, to see sentiment differences in various lexical features within mental health-related subreddits and against unrelated ones. We also applied 3 supervised and unsupervised clustering methods for both cases after extracting textual features from posts on each subreddit using bidirectional encoder representations from transformers (BERT) to ensure that our data set is suitable for further machine learning or deep learning tasks.
We collected 3,133,509 posts of 919,722 Reddit users. The results using the data indicated that there are notable linguistic differences among the subreddits, consistent with the findings of prior research. The findings from LIWC analyses revealed that patients with each mental health issue show significantly different lexical and semantic patterns, such as word count or emotion, throughout their online social networking activities, with P<.001 for all cases. Furthermore, distinctive features of each subreddit group were successfully identified through supervised and unsupervised clustering methods, using the BERT embeddings extracted from textual posts. This distinctiveness was reflected in the Davies-Bouldin scores ranging from 0.222 to 0.397 and the silhouette scores ranging from 0.639 to 0.803 in the former case, with scores of 1.638 and 0.729, respectively, in the latter case.
By taking a multifaceted approach, analyzing textual posts related to mental health issues using statistical, natural language processing, and machine learning techniques, our approach provides insights into aspects of recent lexical usage and information about the linguistic characteristics of patients with specific mental health issues, which can inform clinicians about patients\' mental health in diagnostic terms to aid online intervention. Our findings can further promote research areas involving linguistic analysis and machine learning approaches for patients with mental health issues by identifying and detecting mentally vulnerable groups of people online.

In China, condomless sex among men who have sex with men (MSM) is the primary route of HIV infection in young people. Chengdu is a hotspot for reported HIV cases among young people nationwide. Extensive use of geosocial networking (GSN) smartphone apps has dramatically changed the pattern of sexual behavior among young MSM (YMSM). However, data on HIV incidence and the risk behavior of YMSM using the GSN app are still obscure.
This study aims to analyze and understand the HIV incidence and its risk factors among YMSM using GSN apps in Chengdu, China.
An open cohort study was conducted among YMSM aged 18-24 years through a gay GSN smartphone app in Chengdu, China, from July 2018 to December 2020. Every participant completed a web-based questionnaire on sociodemographic characteristics, sexual behaviors, and other related statuses; made a reservation for a web-based HIV testing; and then voluntarily got tested at the designated testing site. At least one additional HIV test was taken via the app during the study period, and participants were evaluated at the end of the study or at the time of HIV seroconversion. By dividing the sum of the observed HIV seroconversions by the observed person-years, HIV incidence was calculated and compared between the student and nonstudent MSM. Univariate and multivariate (Cox proportional hazards regression) analyses were used to discuss the risk factors for new HIV infections.
In the study cohort, 24 seroconversions occurred among 625 YMSM who took at least two HIV tests through the app during the study period, contributing to 505 observed person-years. The HIV incidence rate per 100 person-years was 4.75 (95% CI 2.89-6.61) among all MSM, 3.60 (95% CI 1.27-5.93) among student MSM, and 5.88 (95% CI 2.97-8.79) among nonstudent MSM. In addition, the HIV incidence per 100 person-years was 11.11 (95% CI 4.49-17.73) among those who had resided in the area for 6 months or less and 7.14 (95% CI 1.52-12.77) among those with senior high school or less education. Two or more sexual partners (adjusted hazards ratio [HR] 3.63, 95% CI 1.08-12.23) in the preceding 6 months was a risk factor for new HIV infections. Consistent condom use for anal sex (adjusted HR 0.38, 95% CI 0.16-0.88) and insertive anal sex only (adjusted HR 0.10, 95% CI 0.01-0.75) in the preceding 6 months were protective factors for new HIV infections.
The rate of new HIV infections among YMSM who actively used GSN smartphone apps was high, especially among migrant nonstudent MSM. Targeted interventions on GSN smartphone apps should be implemented to provide demand-adapted prevention and services to reduce the threat of HIV.