Curiosities of Medical History: The controversy of using cold as a treatment

 The history of medicine is filled with accounts of strange and often downright dangerous “treatments,” but these have sometimes opened the way for lifesaving discoveries. In this Curiosities of Medical History feature, we look at the unusual practice of exposing the body to cold temperatures for therapeutic purposes: therapeutic hypothermia.

The term “hypothermia” appears to have first emerged in English-language texts in the late 19th century. It comes from the ancient Greek word for “hot” or “warm” — “thermós” — to which the Greek-derived prefix “hypo-,” meaning “under,” is added.

Nowadays, hypothermia is classed as a severe condition in which the body is unable to maintain its normal heat, and body temperature drops dangerously. Severe hypothermia can result in heart failure and death.

This dangerous medical condition has been understood as such for centuries, yet there is also another side to the history of hypothermia.

Therapeutic hypothermia — the cooling of the body for therapeutic purposes — is a medical practice that has been around, in one form or another, since ancient times.

Some of its uses have been controversial at best, but it has also given rise to legitimate modern-day treatments. In this Special Feature, we briefly outline the complex history of therapeutic hypothermia.

To understand more about the curious history of therapeutic hypothermia and the continued appeal of exposure to low temperature for medical purposes, we also spoke to Dr. Phil Jaekl, neuroscientist and science writer, whose upcoming book, Out Cold: A Chilling Descent into the Macabre, Controversial, Lifesaving History of Hypothermia, discusses these topics at length.

The use of cold in ancient medicine

Therapeutic hypothermia seems to have been practiced for over 5,000 years. Its first known mention was in the Edwin Smith Papyrus, a medical treatise outlining treatments for various injuries and ailments, a text that may date back to around 3,500 B.C.E.

“The earliest written records of using cold were discovered in ancient Egyptian texts,” Dr. Jaekl told Medical News Today. “Some experts think these texts are the first recordings of medical teachings from Imhotep, a polymath and advisor to the pharaoh Zoser. They suggest using local cold applications to treat skin irritations, likely for [enslaved people] or in military situations.”

For “an abscess with prominent head on the breast,” the papyrus prescribes “cool applications,” which in this case were ointments with cooling effects, made of ingredients such as fruit, mason’s mortar, and water.

According to Dr. Jaekl, “[t]hese texts are significant because they are some of the first to advocate systematic medical procedures rather than incantations or prayers, which were common at that time.” The Edwin Smith Papyrus is possibly one of the first medical “textbooks” laying out case studies of physical ailments and indicating dedicated treatments.

Some of the better known forefathers of medical science also wrote about cold temperatures and their dangers and therapeutic potential. “The next big advancement for using cold therapeutically didn’t happen until over 1,000 years had passed, when cold was incorporated into the humorist system of medicine,” Dr. Jaekl noted.

This system posited that in the human body, there circulate four “humors,” or liquids, which, when out of balance, would cause any number of diseases. To restore health, a physician would have to diagnose and address the humoral imbalance.

These humors, most often listed as black bile, yellow bile, phlegm, and blood, were either “hot” or “cold,” “wet” or “dry,” thus causing corresponding afflictions. Fever, as a “hot” disease, would have required exposure to an opposite element as a treatment.

Ancient Greek physician HippocratesTrusted Source (c. 460–370 B.C.E.) spoke of the dangers of exposure to cold at some length in his treatises. He pointed out that “cold causes fits, tetanus, gangrene, and feverish shivering fits [and it] is bad for the bones, teeth, nerves, brain, and the spinal cord.”

Yet he also recognized the therapeutic potential of cooling elements, as he prescribed using snow and iceTrusted Source to stop bleeding, and drinking cold water to bring down fever.

Galen (129–c. 210 C.E.), who was significantly influenced by Hippocrates, is credited with the invention of cold cream, which he prescribed not for skin care or the removal of makeup, as it later came to be used, but for cooling purposes in a medicinal context.

His cold cream may have been a mixture of olive oil, water, and beeswax.

The emergence of cold bathing

The method of cooling the body as a therapeutic intervention further expanded in the 17th century, when physicians such as John Floyer (1649–1734) started experimenting more widely with the use of hot and cold water in medicine.

In his treatise, An Enquiry into the Right Use and Abuses of the Hot, Cold, and Temperate Baths in England (1697), Floyer wrote at some length about the hygiene and medicinal benefits of cold water baths.

Source: Medical News Today

'Insufficient evidence' that weight loss supplements work

 

• Researchers have recently presented the results of the first global analysis in 19 years of clinical trials for weight loss supplements.
• Drawing on two literature reviews, they found insufficient evidence to warrant the recommendation of supplements for weight loss.
• The study’s authors drew their conclusions from 121 clinical trials involving nearly 10,000 participants.

According to the World Health Organization (WHO)Trusted Source, obesity worldwide has nearly tripled since 1975. Alongside this trend, there has been an explosion in the sales of lightly regulated, under-researched herbal and dietary weight loss supplements.

About 15%Trusted Source of people in the United States have tried one of these dietary aids, the products of an industry valued at $140 billion in 2020.

The first global review in 19 years regarding the efficacy of herbal and dietary supplements for weight loss was recently presented by researchers from the University of Sydney (USYD) in Australia to the European Congress on Obesity (ECO).

The research, which encompassed two literature reviews including 121 randomized placebo-controlled trials involving over 10,000 participants with overweight or obesity, found insufficient evidence that herbal and dietary supplements produce clinically significant weight loss.

Erica Bessell, lead author of the study, said:

“Our rigorous assessment of the best available evidence finds that there is insufficient evidence to recommend these supplements for weight loss. Even though most supplements appear safe for short-term consumption, they are not going to provide weight loss that is clinically meaningful.”

Not as well regulated as drugs

At issue are a range of pills, powders, and liquids marketed with the promise that they can help people lose weight. The products may include entire plants or products in which a plant is an active ingredient. They may also contain isolates from animal- and plant-based substances, such as fats, fiber, and protein.

“Over-the-counter herbal and dietary supplements promoted for weight loss are increasingly popular, but unlike pharmaceutical drugs, clinical evidence for their safety and effectiveness is not required before they hit the market,” said Bessell.

There is often little in the way of regulation to protect consumers from unproven claims. For instance, while the Food and Drug Administration (FDA) is responsible for the safety of dietary supplements once they become available on the market, prior to that, there is limited scope for FDA involvement.

The FDATrusted Source states that “the law does not require the manufacturer or seller [of an herbal or dietary supplement] to prove to FDA’s satisfaction that the claim is accurate or truthful before it appears on the product.”

Herbal supplement trials

The first study involved a review of 54 trials that compared the effects of herbal supplements with those of placebos. The research involved 4,331 participants aged 16 years or above with overweight or obesity.

A weight loss of at least 5.5 pounds more than that achieved by a placebo was considered clinically meaningful.

The studies tested:

• ephedra, a metabolism stimulant
• garcinia cambogia
• white kidney bean
• licorice root
• yerba maté, the herbal tea derived from the Ilex paraguariensis plant
• African mango
• veld grape
• mangosteen
• East Indian Globe Thistle

Only one of the substances — white kidney bean — produced a statistically significant benefit when tested as a single agent compared with placebo, although it still fell significantly short of the threshold for a clinical benefit.

Other supplements did produce statistically significant benefits when given in combination with other supplements, but, again, these benefits were not clinically significant.

In addition, the last four substances on the list above may have shown some promise for clinically significant weight loss. However, the authors of the study caution that each was tested in three trials at most and that those studies were characterized by substandard methodology and reporting.

Source: Medical News Today

Obesity: New drug turns ‘energy-storing’ fat into ‘energy-burning’ fat

 

• In response to starvation, a nerve signaling molecule called neuropeptide Y (NPY) boosts food intake and reduces energy output.
• A new study in mice suggests that a drug that blocks a receptor for NPY increases heat generation in fat tissue.
• In animals fed a high-fat diet, the drug reduced weight gain by around 40%.
• The drug does not appear to cross the blood-brain barrier, so unlike other weight loss drugs, it is unlikely to adversely affect mood.

According to the World Health Organization (WHO), the prevalence of obesity worldwide has more than tripledTrusted Source since 1975.

In 2016, the WHO estimates, 39% of all adults worldwide were overweight, and 13% had obesity. These conditions are associated with diabetes, cardiovascular disease, and some cancers.

Changing exercise and dietary habits can help people reach and maintain a healthy weight. However, taking these steps effectively can be challenging for many reasons, and some people also look to appetite-suppressing medication.

Over the years, various drugs that suppress the appetite by acting directly on neurotransmitter systems in the brain have been withdrawn from the market due to adverse effects, particularly involving mood and the function of the heart.

“Most current prescribed treatments are aimed at reducing food intake by targeting the central nervous system,” says Dr. Yanchuan Shi, who leads the neuroendocrinology group at the Garvan Institute of Medical Research, in Sydney, Australia.

“However, these can have significant psychiatric or cardiovascular side effects, which have resulted in over 80% of these medications being withdrawn from the market,” she notes.

Dr. Shi and colleagues wanted to test a new way of reducing weight gain without affecting the central nervous system. Their research has been published in Nature CommunicationsTrusted Source.

Conserving energy stores

The team focused on a nerve signaling molecule called NPY. It helps many animals, including mice and humans, survive conditions in which food shortages are commonplace.

NPY increases food intake and conserves energy stores by reducing heat generation in a type of fat tissue called brown adipose tissue.

In an environment where people have ready access to food and do not get sufficient exercise, however, NPY may make it particularly difficult to lose weight.

“NPY is a metabolism regulator that plays a critical role during states of low energy supply, where it helps store fat as a survival mechanism,” says Prof. Herbert Herzog, head of the Eating Disorders Lab at the Garvan Institute.

“Today, however, these advantageous effects can exacerbate existing diet-induced weight gain, leading to obesity and metabolic disease.”

Dr. Shi, Prof. Herzog, and colleagues investigated the effects of a drug called BIBO3304 on mice and human fat cells from people with obesity. The drug blocks a type of cell receptor for NPY called Y1 that is found in fat tissue and other tissues in the body.

Crucially, BIBO3304 cannot cross the blood-brain barrier, so it is unlikely to adversely affect mood.

Increased heat generation

For 7 weeks, the researchers fed mice a high-fat diet, with or without BIBO3304.

They found that the mice given the drug gained 40% less weight. This, the team discovered, resulted from increased heat generation in the animals’ brown adipose tissue and reduced overall fat mass.

Interestingly, the scientists discovered that the fat tissue from both mice and humans with obesity had higher activity of the genes for the Y1 receptor than tissue from individuals with a healthy weight.

This may partly explain why losing weight can be so difficult, given that NPY increases food intake and reduces energy output when it binds to Y1.

When the researchers applied BIBO3304 to fat cells from people with obesity, the cells switched on the same genes involved in heat generation as those that had been activated in the mice.

This suggests that the drug, or similar molecules, could work in the same way in people as it does in mice.

Added benefits

In addition to reducing weight gain in mice, the authors discovered that blocking Y1 has several knock-on effects, including improving glucose metabolism.

As Y1 contracts blood vessels, blocking Y1 with BIBO3304 may widen blood vessels, a process called vasodilation, which lowers blood pressure.

“We predict that blocking this receptor could cause vasodilation that may be beneficial in the context of hypertension, but further study needs to be done to confirm this,” Dr. Shi told Medical News Today.

The researchers had previously shown that BIBO3304 also stimulates bone cell growthTrusted Source, which could help maintain bone density, preventing osteoporosis in older people.

Dr. Shi acknowledged that the study did not directly test whether the drug could promote weight loss in people with obesity. Rather, it demonstrated that BIBO3304 could prevent weight gain in mice.

“While we didn’t test the approach in models of obesity, obesity is, similarly, a condition of energy oversupply due to the accumulation of fat,” she said. “Therefore, our study suggests that a treatment like BIBO3304 could help treat obesity by increasing energy expenditure through the burning of fat, leading to weight loss.”

Source: Medical News Today

Why preclinical research models must reflect diverse populations

 

• In a new report, researchers cite a dire need to increase diversity in preclinical research using human cell lines (HCL). Currently, some 95% of commonly used cell lines come from people of European descent.
• The authors explain that African Americans and other groups are under-represented in preclinical research and are often discriminated against by the medical system.
• To fix this systemic problem, the authors write that researchers must regain the trust of previously marginalized populations to encourage people of more diverse genetic backgrounds to contribute to the development of more diverse cell lines.
• Researchers must also consciously prioritize factors such as sex and genetic ancestry representation over ease of accessibility or the cost of a cell line.

The Black Lives Matter movement has encouraged some researchers in the biomedical community to focus on the under-representation of Black adults and other groups in medical study populations.

This is a significant problem, given that people of certain racial or ethnic backgrounds experience some conditions differently or at different rates. For example, African American men are 2.5 times more likely to die Trusted Source from prostate cancer than white American men. However, 97% Trusted Source of the human prostate cell lines made by major medical research supplies are of white European origin.

These compounding factors, such as someone’s ethnicity, race, sex, or ancestral genetic origin, are widely excluded from most preclinical and clinical research. This means that researchers are often developing treatments that may not work for all groups of people.

This situation underserves large groups of people and leads to a significant waste of time, money, and resources. It can also increase the risk that some people may be harmed by taking medications that have not received sufficient testing in their specific population.

This is why two researchers, Dr. Amanda Capes-Davis with the Children’s Medical Research Institute (CMRI) in Sydney, Australia, and Dr. Sophie Zaaijer, who has affiliations with Cornell Tech, New York, decided to create a report alerting biologists and other stakeholders of the importance of conscious decision-making when selecting cell lines for research.

Cell lines are grown from a single cell taken from living tissue. Scientists grow them outside of the body in a laboratory under controlled conditions and produce a population of cells with the same genetic make-up that can grow over a long period.

The new report, which appears in the journal Cell, also outlines ways to address this systemic issue of under-representation by proposing a simple action plan.

If widely adopted, the authors’ proposed methods could help more researchers consciously consider sex and genetic ancestry factors when choosing cell lines to study. In turn, this could help improve the impact and efficacy of preclinical and clinical research, which could help create treatments and procedures that benefit all populations.

The origins of Black-white disparities in medical research

Historically, the predominantly white medical and research community has ‘earned’ the mistrust of groups they have systematically marginalized and discriminated against, such as African Americans. The famous cases of Henrietta Lacks or the 1930s Tuskegee Institute syphilis trialsTrusted Source are only two of the more prominent examples of such discrimination and abuse.

This distrust, in addition to reduced access to healthcare, discrimination, and other socioeconomic factors, is likely responsible for the under-representation of African Americans and other groups in many areas of medical research.

The authors write that, historically, when scientists first developed cell lines, they were geographically restricted to certain locations, and these geographical disparities were perpetuated and exacerbated over the years. Currently, Africa comprises 54 countries and 1.3 billion people, but scientists only use about 73 human cell lines from African American people and those of African descent. For comparison, Europe consists of 44 countries and 0.7 billion people, but 867 cell lines represent people of European descent.

Furthermore, the authors write that the few cell lines of African origin that we do have were obtained, historically, without consent and do not reflect the rich genetic diversity of African populations. To illustrate this point, Zaaijer and Capes-Davis use the example of African-American Henrietta Lacks, who provided, unbeknown to her, “The first human [cell line], HeLa” in 1951.

“The resulting HeLa [cell line] is responsible for many advances in biomedical research,” the authors write, but “a single [cell line] cannot be used in isolation as a model for the rich genetic diversity in the African community.”

How to make change now

The authors of the new paper praise several projects underway worldwide tackling the issue of ancestral genetic diversity in preclinical research.

The Human Heredity and Health in African Consortium is working to increase genetic information about African populations. The Consortium’s datasetsTrusted Source represent 426 people from 50 ethnolinguistic groups across 13 African countries that have helped discover more than 3 million genetic variants so far; some linked to disease susceptibility and outcomes.

The National Institute of Health (NIH)’s “All of Us” project also aims to monitor genetic info from millions of people from mixed, diverse backgrounds in the United States. The New York Genome Center (NYGC) is also running a large project called Polyethnic-1000 to improve research in cancer risk, treatment response, and tumor biology in ethnically diverse groups, using data from residents of New York City.

Projects such as these can help create new, more genetically diverse cell lines, improving the options available to researchers and the applicability of their findings.

The authors write that researchers must make more genetically conscious decisions throughout the research process.

Currently, the authors write that researchers consider several factors when selecting an appropriate set of HCLs for a study, including:

• tissue type
• presence of a certain phenotype
• how easy it is to culture or access
• whether other researchers use it for similar uses
• how cheap it is
• funding for different cell lines

Source: Medical News Today

Does the weirdness of dreams help keep the brain flexible?

 

• The “overfitted brain” hypothesis centers on the idea that as animals learn repetitive tasks, they run the risk of becoming hidebound, losing the ability to generalize what they have learned.
• This hypothesis, which was inspired by machine learning, proposes that the brain needs a dose of randomness every night in the form of dreams to restore its flexibility and generalization.
• Novels, films, and other art forms may act as “artificial dreams,” performing the same restorative function for the brain.

In the early months of 2020, as millions of people around the world went into isolation due to the burgeoning COVID-19 pandemic, many reported an increase in the vividness and frequency of their dreams.

The hashtag #pandemicdreams began to trend on Twitter as users shared their bizarre dreams.

According to Erik Hoel, Ph.D., a research assistant professor of neuroscience at Tufts University, in Medford, MA, the tedium of our lives under lockdown may have provoked our brains to dose themselves with bursts of random nighttime “noise.”

Dr. Hoel believes that the nervous systems of all kinds of animals, from nematode worms to humans, risk becoming “overfitted” to the information acquired during waking hours.

This means that while animals, including humans, may become very good at performing specific tasks, they fail to generalize what they have learned to other tasks.

To resolve this issue, Dr. Hoel reasons, dreams evolved in higher animals to inject flexibility into their brains’ models of the world.

Psychologists have found that if a person’s tasks during the day are narrow and repetitive, such as playing the game Tetris, they are more likely to have dreams related to these tasks.

This could explain why the unexciting and repetitive experience of life under lockdown has provoked a burst of dreaming in so many people. “Of course, it’s hypothetical, but it does provide an explanation,” Dr. Hoel told Medical News Today.

Machine learning

Dr. Hoel studies machine learning algorithms called deep neural networks, which can be trained to perform tasks such as translating text and recognizing particular features in pictures.

In a paper in the journal Patterns, he writes that all deep neural networks run up against the same problem: They “overfit” to the particular datasets that modelers use to train them.

This means that the networks fail to generalize what they have learned to novel data.

Modelers often use “noise injections” to solve the problem of overfitting. These are random or corrupted datasets that restore flexibility to the network’s operations.

In his paper, Dr. Hoel argues that after a day’s learning experiences, the brain faces a similar problem of overfitting, which it solves in much the same way.

He speculates that dreams are “corrupted sensory inputs” — which the brain concocts from random, or “stochastic,” brain activity — that evolved to increase the generalizability of its internal models of reality.

“It is the very strangeness of dreams in their divergence from waking experience that gives them their biological function,” he writes. “Sleep loss, specifically dream loss, leads to an overfitted brain that can still memorize and learn but fails to generalize appropriately,” he adds.

Dr. Hoel calls his idea the “overfitted brain” hypothesis.

To find out whether his hypothesis is correct, the researcher says, it should be possible for psychologists to design behavioral tests that differentiate between the ability to memorize new things and the ability to generalize that knowledge to other tasks.

They would use repetitive training tasks to induce overfitting in participants then measure the effects of sleep deprivation on their ability to remember and generalize.

Waking dreams

Dreams may be so beneficial for efficient brain function, Dr. Hoel speculates, that humans have found ways to dream while awake.

Contrary to the prominent idea among psychologists that art forms such as novels, painting, and music are evolutionary “cheesecake,” pleasurable but with no value for survival, Dr. Hoel believes that they prevent our brains from overfitting.

“As a novelist, myself,” Dr. Hoel observes, “It is nice to think that fictions, which are in a sense artificial dreams, may have cognitive utility by keeping us from fitting to the daily quotidian events of our lives too well,” he told MNT.

The idea that the brain becomes overfitted to its experiences during waking hours and that dreams help build the process of generalizing knowledge has deep roots in machine learning.

In 1995, computer scientists proposed the idea of a “wake-sleep algorithm” that can learn without human supervision by alternating between waking and sleeping phases.

Nearly a decade later, in 2014, the neuroscientist Prof. Karl Friston, from University College London, in the United Kingdom, and co-authors built on this concept by developing a theory that dreams are the brain’s way of minimizing the complexity of its models.

Prof. Friston views the brain as a machine for generating predictions about the world that make our every perception, thought, and action possible. According to his free energy principleTrusted Source, we dream in order to streamline or simplify the brain’s predictive models.

“This was recently extended to periods of waking reflection and an account of ‘aha!’ moments, when the simplicity of things becomes apparent,” he told MNT in an email. “We have even used complexity minimization to critique deep learning!”

Source: Medical News Today

Could humans breathe through their intestines?

 The world is more than a year into the COVID-19 pandemic, so many people have been living with lockdown restrictions, quarantine periods, and physical distancing for an extended period of time. Hand sanitizer and masks are rife, and the common cold has not felt so common. But what will these lifestyle changes do to our health?

In this article, we look at what effect living physically distanced from other people might have on the immune systems of adults, children, and infants born during the pandemic.

Some people have voiced concerns over whether their immune systems are being challenged, given that the general public is no longer physically mixing.

Might our immune systems consequently “forget” how to fight off disease-causing agents? For adults and older children, there is some good news: This is not how immunity works.

According to MIT Medical, by the time a person reaches adulthood, their immune system has already had exposure to plenty of bacteria and viruses and is able to mount an attack against these invaders.

Because of this, the immune system has already learned how to destroy these microbes and will not forget, even in the wake of long-term lockdowns.

But what about younger children, whose immune systems are still in the learning phase?

Children and the ‘hygiene hypothesis’

Many parents and caregivers will be familiar with the so-called hygiene hypothesis, even if they do not know it by name.

It is essentially the idea that there is a link between the rise in allergic conditions and reduced exposure to microbes during childhood resulting from hygiene measures, such as frequent hand washing, introduced to protect children from infection.

Dr. David Strachan first proposed this link in an article that appeared in the BMJTrusted Source in 1989.

In a paper that appeared in the journal Perspectives in Public Health in 2016, Prof. Sally F. Bloomfield and colleagues examine Dr. Strachan’s original paper.

They write: “The immune system is a learning device, and at birth it resembles a computer with hardware and software but few data. Additional data must be supplied during the first year of life, through contact with microorganisms from other humans and the natural environment.”

Prof. Jonathan Hourihane, from the RCSI University of Medicine and Health Sciences in Dublin, Ireland, adds that the increases in eczema, asthma, hay fever, and food allergies over the past 30 years have likely resulted from decreased exposure to infections.

“We want to see children playing on the floor, getting dirty, and being exposed to lots of people in lots of environments,” he says. “The outcome of this is usually a strong immune system, linked to a healthy population of gut bacteria, called the microbiome.”

With this in mind, should parents of infants or young children be concerned about the effects of physical distancing and lockdowns on their immune systems?

Yes and no.

Some microbes are friends, others are not

Prof. Bloomfield and colleagues write that while “evidence supports the concept of immune regulation driven by microbe-host interactions, the term ‘hygiene hypothesis’ is a misleading misnomer. There is no good evidence that hygiene, as the public understands, is responsible for the clinically relevant changes to microbial exposures.”

Their paper lays out how the idea that we have become “too clean” has remained in the public mind. Writing in 2016, Prof. Bloomfield and team prophetically note that this is also “happening at a time when infectious disease issues mean that hygiene is becoming more, rather than less, important.”

This is particularly relevant for respiratory viruses such as SARS-CoV-2, which causes COVID-19. Because viruses are not treatable with antibiotics, preventing them with hygiene practices such as washing the hands and cleaning surfaces is paramount.

The authors point to the post-hygiene hypothesis theory known as the old friends (OF) mechanismTrusted Source.

Introduced in 2003, it suggests that the important exposures to microbes in early life are not actually colds, measles, or other childhood ailments, but rather those microbes that were already around during the hunter-gatherer period, when the immune system was evolving.

These microbes include species that live in both indoor and outdoor environments, and they come from the skin, gut, and respiratory tracts of other people.

“OF exposures are vital,” say the researchers, “because they interact with the regulatory systems that keep the immune system in balance and prevent overreaction, which is an underlying cause of allergies. Diversity of microbial exposure is key.”

They note that the most important times in life for OF exposure are during pregnancy, delivery, and the first months of infancy. They also add that continuing exposure from the mother and siblings is vital.

Likewise, having pets increases the overall diversity of microbes in the home.

Source: Medical News Today

The Go Viral! game makes a person better at spotting misinformation

 

• “Prebunking” strengthens a person’s awareness of the manipulative tactics that characterize misinformation.
• An online game called “Go Viral!” teaches players how misinformation works, as they try to win by making fake news go viral.
• Researchers find that prebunking games and infographics can help people spot manipulative, untrustworthy information.

“While fact-checking is vital work, it can come too late,” says Professor Sander van der Linden, Director of the Social Decision-Making Lab at Cambridge University in the United Kingdom. “Trying to debunk misinformation after it spreads is often a difficult if not impossible task.”

However, research suggests that individuals can be “vaccinated” against the susceptibility to misinformation, preventing it from taking root in the first place.

“By exposing people to the methods that individuals use to produce fake news, we can help create a general ‘inoculation,’ rather than trying to counter each specific falsehood,” says Cambridge Gates Scholar Melisa Basol.

This is called prebunking, and it is the subject of a new study from the University of Cambridge’s Social Decision-Making Lab. Basol is the study’s lead author, while Professor van der Linden is its senior author.

The lab co-developed a browser-based game called Go Viral! with media agency DROG. In the game, players learn how fake news spreads by trying to get some fake news of their own to go viral.

In learning the tricks of the fake news trade, players develop a skepticism that helps them recognize misinformation.

The study also investigates the effectiveness of infographic images designed to debunk COVID-19 misinformation. The United Nations Educational, Scientific and Cultural Organization (UNESCO) produced the images as part of their #ThinkBeforeSharing program.

The study appears in the journal Big Data and Society.

Playing a nasty game to win

People have played more than 400,000 games of Go Viral!, which is available in several languages. This includes sessions associated with the World Health Organization (WHO), which is using the game as a real intervention in their “Stop the SpreadTrusted Source” campaign.

In the game, players post information on COVID-19 designed to be provocative enough to generate “likes.” They use emotionally charged language, fear, and outrage — techniques employed by real-life conspiracists — to keep their audience clicking and sharing. When a player’s baseless misinformation goes viral, they win the game.

“By preemptively exposing people to a microdose of the methods individuals use to disseminate fake news,” says Professor van der Linden, “we can help them identify and ignore it in the future.”

Basol and co-author Dr. Jon Roozenbeek told Medical News Today that serious games, such as Go Viral! — and others, such as Cranky Uncle, which gamifies climate change — “are really promising because we can apply them as part of educational workshops, school curricula, university courses, as well as standalone interventions that anyone with an internet connection can access.

Active vs. passive debunking, plus Tetris

One of two experiments that researchers undertook for the study was a comparison of the effectiveness of Go Viral! and UNESCO’s prebunking infographics.

The team instructed 1,777 volunteers to rate 18 tweets. Nine tweets contained accurate information, while the rest incorporated one of three types of manipulation that individuals commonly deploy in misinformation campaigns: moral-emotional language, fake expert testimony, and conspiratorial reasoning.

The researchers then asked participants to play a game of Go Viral! or examine the UNESCO infographics. The control group played 5 minutes of Tetris.

When participants returned to the tweets, just 55% of the control group identified misinformation, slightly better than chance. The infographics viewers fared slightly better, with 61% spotting the manipulation.

Of the people who had played Go Viral!, 74% correctly identified tweets containing misinformation.

When the researchers questioned the Go Viral! players about their ability to spot fake news in the future, 67% of them felt more confident of their ability.

Source: Medical News Today