Twitter: Towards a slow spiral of death

Twitter is getting desperate after an increased focus and scrutiny of its actual number of users. While they use metrics like users who were online in the past month, Twitter knows that it is a sinking ship.

There was a lot of hoopla about Twitter making its first profit after consecutive losses. However, it seemed like a flash in the pan. It is yanking off the API’s (third party services which connect via desktop applications). It wants web-only services so that it can serve up “personalised” advertisements. The daily engagement with the service is declining.

It is a worrying trend. While the BTSM practitioners have linked and bonded over this microblogging service, it is easier to get lost in the din of rapid tweets which makes it impossible for any coherent discourse. I have seen posts from institutions- pictures shot from the OT about the cases that they have done. Why this kind of marketing?

The impact of social media ought to be real- like reaching out to potential donors, for example. However, that individual tweet is decidedly less likely to be seen by a specific person. Re-Tweets or Symplur impressions hardly have any bearing on the impact of “tweet”. It only states how many people could have possibly seen. Were they the correct target audience?

A vast majority of the population isn’t aware of nuances of Twitter which can be overwhelming. Mobile interface, like Telegram, needs to be explored in earnest. It should be linked to all the Telegram links (like URL’s). That is also a safe, secure service which doesn’t track you, unlike Twitter.

Social Media: Falsehoods

I was alarmed to read about falsehoods about health spreading through WhatsApp. It is a Facebook-owned application which has millions of users worldwide. It is impossible to get the actual numbers but suffice to say that it is prevalent in emerging economies.

The alarm went off with an excellent article from The Wired which has chronicled the rise in Yellow Fever epidemic in Brazil and the falsehoods surrounding the vaccination. I reproduce some essential bits here.

In recent weeks, rumours of fatal vaccine reactions, mercury preservatives, and government conspiracies have surfaced with alarming speed on the Facebook-owned encrypted messaging service, which is used by 120 million of Brazil’s roughly 200 million residents. The platform has long incubated and proliferated fake news, in Brazil in particular.

The phenomenon of fake news isn’t peculiar to Brazil, but these spread rapidly through the social networks.

“These videos are very sophisticated, with good editing, testimonials from experts, and personal experiences,” Sacramento says. It’s the same journalistic format people see on TV, so it bears the shape of truth. And when people share these videos or news stories within their social networks as personal messages, it changes the calculus of trust.

If you wish to have a scientific basis to why this happens, Science published a great resource.

We classified news as true or false using information from six independent fact-checking organisations that exhibited 95 to 98% agreement on the classifications. Falsehood diffused significantly farther, faster, deeper, and more broadly than the truth in all categories of information, and the effects were more pronounced for false political news than for false news about terrorism, natural disasters, science, urban legends, or financial information. We found that false news was more novel than true news, which suggests that people were more likely to share novel information.

This is an example of a rumour cascade:

The purpose of this post is that physicians should step up their game and have an active social media presence. A lot of sane voices will go a long way to dispel myths and fears about public health initiatives.

That is the reason why I set up Telegram channel to have physician vetted information and a one-stop solution for brain tumour affected patients. We owe people more!

Why blogging is essential

When you face an empty sheet, the hardest part is to define the direction you want to give to your words.

This post was in response to a brilliant blog post on 33charts, which is peddled by an influential paediatrician. I love the way he wraps up his ideas which is both a joy and a delight to read.

I have flirted and experimented with blogging consistently over the past few years (a decade or more). I am aware of how the blogging landscape evolved.

This neuroblog was set up later in response to many recommendations by those who had been there. Blogging is the best way to be able to get your ideas out. It showcases what is on your mind.

If you are clear in your mind, you can set out to do what you wish to achieve. Hence, this blogging platform is essential to categorise as well as firm up the opinion.

Twitter is sorely limited to express both the nuance as well as context. A blogging platform only explains the background, but spoken word or personal interactions best explain nuance.

Each one of these leads to a more vibrant diversity of opinion.

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Can we have a Spotify like model for academic publishing?

I have always disliked the idea of paywalls. If I have to borrow the cliche from silicon valley rags, it amounts to having “friction” in accessing the resources. It is a huge pain, especially, if you don’t have the resources.

Much has been written about the advent of scientific publishing in the internet era. And despite the monopolistic tendencies of publishers in erecting huge barriers, likes of Sci-Hub are winning. A few “pirate” websites have extended its support and currently houses the bulk of published scientific literature. Interestingly, the majority of access happens from university campuses where they have already paid for the access! It is a natural human tendency to look for the most comfortable way out!

This post is not about accessing Sci-Hub, but it reminds me of a bitter battle between pirates and Hollywood executives who had similar issues in 90’s with torrents. They are losing profits, as per their claims (despite mansions/big cars/lavish lifestyles) and are locked in pitched battles with telecom service providers to identify those who “pirate”. Paywalls and digital rights management system did not deter those who were determined to access content. Telegram, for example, has emerged as one of the largest piracy hubs for movie distribution on mobile because of its generous file limits.

This post is not to discuss these nuances, but it set me thinking. Why can’t we have a Spotify/Netflix like model for academic papers? At a monthly cost of around 10 USD with all publishers pooling in their resources, it can be a formidable challenge to a tendency to pirate. Technology has made DRM easier. Do we see pirated Netflix original content? Yes, true. But Netflix/Spotify offers a superior UI. The ratio of people paying up versus those who pirate is larger; hence these companies are profitable.

Publishing houses should accept the writing on the wall. I would be all for a Spotify like model for papers. Every stakeholder stands to gain.

Why a Telegram channel for brain tumours was created?

The idea behind setting up a Telegram channel and a group was inspired by holding a Twitter-based discussion with a colleague. I am placing this on record here.

The central premise is a straightforward thing. If I were to face a similar situation, what would have been my state of mind? What is the ideal way to go about this? So, I decided to set up something in a way which I would have wanted. The first and foremost is the platform wherein I could access psychological support. These issues hit from nowhere, and it is essential to know that I am not vulnerable nor alone. While a lot of emphases has been placed on breaking bad news by the oncologists, handling the aftermath of emotional distress by a patient is an unaddressed issue. Having access to psychological resources or a support group becomes imperative at that moment.

How do I choose a support group? Ideally, one that has an active involvement of a clinician in some capacity. Most patients hit Google with a furious pace to know more about the disease. It is essential to guide them efficiently to informed sources about what we are dealing with, the likely side effects and estimated financial impact. Like a multi-disciplinary set up in a hospital, it should reflect some of it’s moving parts in a chat group as well. Patients should reasonably be expected to be guided through a simple workflow; a place where their queries are answered.

That, in simple terms, is the purpose of having a dedicated Telegram group. It is envisaged that patients would find others who have gone through similar experiences, interact with rehabilitation specialists (the medium should allow exchanging large files like videos or multimedia content) and access all old messages about the same thread (through a global search or use of hashtags). These are the broad contours to get the project off the ground and fine tune it as we go along.

Besides, regular updates and events about brain tumours need to be disseminated. A stream of messages in the proper group would become too overwhelming for every participant. Telegram offers a mechanism to copy the link of a particular message in the channel and share it anywhere (each exchanged message has a unique link available for the administrators). This would make it more efficient to share content across the application.

As with any application, users would need time to get used to the user interface. Twitter isn’t intuitive but is most widely used (along with Facebook). Twitter is meant for the immediacy of events, as they unravel. Hence, it becomes difficult (or even overwhelming) for a vast majority of users to get used to it. Like for example, no one subscribes to public lists of patient advocates that I have curated and collected, because most users aren’t aware of how to use Twitter effectively. As a result, their timelines are cluttered forcing them to spend more time. Due to process improvements, I usually skip over my timeline (using Mac desktop version) in less than 15 minutes because everything I need to focus on is there.

I hope that users find Telegram a vital addition to their daily lives.

5 ways how Twitter helps: How I embraced Twitter (and learned to stop worrying)

I had been social media averse because of privacy concerns. I am much happier to pay for a service than have a company muck around with my personal data. I had been on Twitter way before “fake news” became a phenomenon and much before presidential tweets became the new normal.

As an individual, its easier to get lost in the stream of work, cynicism and unmet goals. This plays out in professional domain as well since its impossible to keep personal life segregated completely. However, those seeking care from us require more emergent solutions that requires us to “divorce” our personal problems, cast them aside and have a smiling face. Social awkwardness has its own set of limitations though; it becomes difficult to open up to a colleague , at times, to discuss issues like marriage or issues with boss etc (problems which are universal).

As a result, we wear a thick coat of cynicism. We look at the issues (as they are happening) through a narrow perspective. While we are attending to patients, it appears as if we are merely going through the motions of it; almost like a robot. This needed a change.

Much has changed over the past few years (ever since I quit Twitter in the first instance). I have matured, become more patient and accommodating. However, I couldn’t feel the inner connect with my drive; I knew I am capable of far better output!

Twitter, as a platform, has become better than previous iteration. I discovered a whole community of very interesting people and indeed a revelation! In no specific order, Twitter interactions with them definitely helped me both personally and professionally (and I have just started!) by helping me to see what people are doing; what they have achieved and what I can aim at.

  1. First and foremost is the patient advocacy. This is extremely important because patients need a voice of their own and they need to look up to their clinicians. I have always been empathic to this cause and realised early on that their individual voices need to be channelised. Many organisations are now harnessing the power of social media and its important to amplify this good cause. Once I got used to the interface, I made a specific twitter list for various patient advocates. There’s a whole community out there which touches the lives of individuals in a profound way; makes them one of their own. This is important aspect in their recovery and coping up mechanisms.

2.Overcoming my “writers block”. I have always been blogging and writing about everything else except my own profession! This step was important and I owe it to some individuals who are prolific writers in their own right! The breath of ideas and thoughts has deeply impacted me and motivated me to get on with my own writing.

3. I have always been interested about technology and how deeply it impacts our day to day lives. I am more keen for the privacy aspect; especially the deluge of data being analysed by unknown entities. Big data has entered our lexicon that brings forth new set of challenges for professionals. “Shape up or ship out” is the new mantra; healthcare professionals are being tasked with administrative issues which requires this domain expertise. The inter-connectedness of diverse health care streams and cross pollination of ideas is bound to affect the rich heterogeneity of radiation oncology community. I was very happy to find people with similar interests there!

4. I was extremely happy to learn about other disciplines; especially Pathology! It was something that I dread during med school days but it is only because I couldn’t appreciate or go beyond the routine “stains”. However, much water has flowed since then! Molecular diagnostics has made a roaring presence and “clinico-radio-pathological” diagnosis (as part of the comprehensive joint neuro-oncology meet ups) is the new norm. Nothing beats the thrill of a diagnosis and a debate between diverse fields! I have a renewed respect for my colleagues pursuing it! (Bonus tip: I love the #pathart so much!)

5. Last but not the least. Its an amazing community to be with. Ignore the “politics” and you’ll find more meaning in it. I did some things to automate tweets, use RSS feeds to push new updates (which in turn have been sliced and diced using complex rules), follow timeline with muted words and hashtags (to improve signal from the noise) and created multiple private lists to avoid being overwhelmed with information. Its worthwhile intellectually fulfilling exercise!

More importantly, it has become a go-to place to see whats being discussed and I get more ideas to write about; blogging is actively being shaped by my Twitter experience in order to get my voice out. I owe to each one of them!

Thats how I embraced Twitter and stopped worrying about it!