Health and Science Twitter & Blog Top 50 and 100 Lists. How to Separate the Wheat from the Chaff.

24 04 2012

Recently a Top 100 scientists-Twitter list got viral on Twitter. It was published at accreditedonlinecolleges.com/blog.*

Most people just tweeted “Top 100 Scientists on Twitter”, others were excited to be on the list, a few mentioned the lack of scientist X or discipline Y  in the top 100.

Two scientist noticed something peculiar about the list: @seanmcarroll noticed two fake (!) accounts under “physics” (as later explained these were: @NIMAARKANIHAMED and @Prof_S_Hawking). And @nutsci (having read two posts of mine about spam top 50 or 100 lists [12]) recognized this Twitter list as spam:

It is surprising how easy it (still) is for such spammy Top 50 or 100 Lists to get viral, whereas they only have been published to generate more traffic to the website and/or to earn revenue through click-throughs.

It makes me wonder why well-educated people like scientists and doctors swallow the bait. Don’t they recognize the spam? Do they feel flattered to be on the list, or do they take offence when they (or another person who “deserves” it) aren’t chosen? Or perhaps they just find the list useful and want to share it, without taking a close look?

To help you to recognize and avoid such spammy lists, here are some tips to separate the wheat from the chaff:

  1. Check WHO made the list. Is it from an expert in the field, someone you trust? (and/or someone you like to follow?)
  2. If you don’t know the author in person, check the site which publishes the list (often a “blog”):
    1. Beware if there is no (or little info in the) ABOUT-section.
    2. Beware if the site mainly (only) has these kind of lists or short -very general-blogposts (like 10 ways to….) except when the author is somebody like Darren Rowse aka @ProBlogger [3].
    3. Beware if it is a very general site producing a diversity of very specialised lists (who can be expert in all fields?)
    4. Beware if the website has any of the following (not mutually exclusive) characteristics:
      1. Web addresses like accreditedonlinecolleges.com, onlinecolleges.com, onlinecollegesusa.org,  onlinedegrees.com (watch out com sites anyway)
      2. Websites with a Quick-degree, nursing degree, technician school etc finder
      3. Prominent links at the homepage to Kaplan University, University of Phoenix, Grand Canyon University etc
    5. Reputable sites less likely produce nonsense lists. See for instance this “Women in science blogging”-list published in the Guardian [4].
  3. When the site itself seems ok, check whether the names on the list seem trustworthy and worth a follow. Clearly, lists with fake accounts (other then lists with “top 50 fake accounts” ;)) aren’t worth the bother: apparently the creator didn’t make the effort to verify the accounts and/or hasn’t the capacity to understand the tweets/topic.
  4. Ideally the list should have added value. Meaning that it should be more than a summary of names and copy pasting of the bio or “about” section.
    For instance I have recently been put on a list of onlinecollegesusa.org [b], but the author had just copied the subtitle of my blog: …. a medical librarian and her blog explores the web 2.0 world as it relates to library science and beyond.
    However, sometimes, the added value may just be that the author is a highly recognized expert or opinion leader. For instance this Top Health & Medical Bloggers (& Their Twitter Names) List [5] by the well known health blogger Dean Giustini.
  5. In what way do these lists represent *top* Blogs or Twitter accounts? Are their blogs worth reading and/or their Twitter accounts worth following? A nobel price winner may be a top scientist, but may not necessarily be a good blogger and/or may not have interesting tweets. (personally I know various examples of uninteresting accounts of *celebrities* in health, science and politics)
  6. Beware if you are actively approached and kindly requested to spread the list to your audience. (for this is what they want).It goes like this (watch the impersonal tone):

    Your Blog is being featured!

    Hi There,

    I recently compiled a list of the best librarian blogs, and I wanted to let you know that you made the list! You can find your site linked here: [...]

    If you have any feedback please let me know, or if you think your audience would find any of this information useful, please feel free to share the link. We always appreciate a Facebook Like, a Google +1, a Stumble Upon or even a regular old link back, as we’re trying to increase our readership.

    Thanks again, and have a great day!

While some of the list may be worthwhile in itself, it is best NOT TO LINK TO DOUBTFUL LISTS, thus not  mention them on Twitter, not retweet the lists and not blog about it. For this is what they only want to achieve.

But what if you really find this list interesting?

Here are some tips to find alternatives to these spammy lists (often opposite to above-mentioned words of caution) 

  1. Find posts/lists produced by experts in the field and/or people you trust or like to follow. Their choice of blogs or twitter-accounts (albeit subjective and incomplete) will probably suit you the best. For isn’t this what it is all about?
  2. Especially useful are posts that give you more information about the people on the list. Like this top-10 librarian list by Phil Bradley [6] and the excellent “100+ women healthcare academics” compiled by @amcunningham and @trishgreenhalgh [7].
    Strikingly the reason to create the latter list was that a spammy list not recognized as such (“50 Medical School Professors You Should Be Following On Twitter”  [c])  seemed short on women….
  3. In case of Twitter-accounts:
    1. Check existing Twitter lists of people you find interesting to follow. You can follow the entire lists or just those people you find most interesting.
      Examples: I created a list with people from the EBM-cochrane people & sceptics [8]. Nutritional science grad student @Nutsci has a nutrition-health-science list [9]. The more followers, the more popular the list.
    2. Check interesting conversation partners of people you follow.
    3. Check accounts of people who are often retweeted in the field.
    4. Keep an eye on #FF (#FollowFriday) mentions, where people worth following are highlighted
    5. Check a topic on Listorious. For instance @hrana made a list of Twitter-doctors[10]. There are also scientists-lists (then again, check who made the list and who is on the list. Some health/nutrition lists are really bad if you’re interested in science and not junk)
    6. Worth mentioning are shared lists that are open for edit (so there are many contributors besides the curator). Lists [4] and [7] are examples of crowd sourced lists. Other examples are truly open-to-edit lists using public spreadsheets, like the Top Twitter Doctors[11], created by Dr Ves and  lists for science and bio(medical) journals [12], created by me.
  4. Finally, if you find the spam top 100 list truly helpful, and don’t know too many people in the field, just check out some of the names without linking to the list or spreading the word.

*For obvious reasons I will not hyperlink to these sites, but if you would like to check them, these are the links

[a] accreditedonlinecolleges.com/blog/2012/top-100-scientists-on-twitter

[b] onlinecollegesusa.org/librarian-resources-online

[c] thedegree360.onlinedegrees.com/50-must-follow-medical-school-professors-on-twitter

  1. Beware of Top 50 “Great Tools to Double Check your Doctor” or whatever Lists. (laikaspoetnik.wordpress.com)
  2. Vanity is the Quicksand of Reasoning: Beware of Top 100 and 50 lists! ((laikaspoetnik.wordpress.com)
  3. Google+ Tactics of the Blogging Pros (problogger.net)
  4. “Women in science blogging” by  ( http://www.guardian.co.uk/science)
  5. Top Health & Medical Bloggers (& Their Twitter Names) List (blog.openmedicine.ca)
  6. Top-10 librarian list by Phil Bradley (www.blogs.com/topten)
  7. 100+ women healthcare academics by Annemarie Cunningham/ Trisha Greenhalgh (wishfulthinkinginmedicaleducation.blogspot.com)
  8. Twitter-doctors by @hrana (listorious.com)
  9. EBM-cochrane people & sceptics (Twitter list by @laikas)
  10. Nutrition-health-science (Twitter list by @nutsci)
  11. Open for edit: Top Twitter Doctors arranged by specialty in alphabetical order (Google Spreadsheet by @drves)
  12. TWITTER BIOMEDICAL AND OTHER SCIENTIFIC JOURNALS & MAGAZINES (Google Spreadsheet by @laikas)






Grand Rounds: Evolving from Link-♥♥ to ♬♫-Links?

9 01 2012

Grand Rounds is “the weekly summary of the best healthcare writing online”. I’ve hosted this medical blog carnival twice and considered it a great honor to do so.

I have submitted a lot of posts to the Grand Rounds. Often I even wrote a special blog post to fit the theme if there was one. Almost all my submissions have been accepted. I really enjoyed the compilations. There was a lot of outstanding creativity and originality in how the links to the blogs were “aggregated” and highlighted.

Usually I only read those posts that seemed the most interesting to me (the summary thus works as a filter). But through the Grand Rounds I read posts that I would never have read and I learned about bloggers I never heard of.

Why am I talking in the past tense? The Grand Round is still there, isn’t it?!

Yes, it is still there (luckily), but the organizers are thinking of a “rejuvenation of  this old dinosaur”. As the previous host, Margaret Polaneczky explained

“… Grand Rounds has dropped a bit off all of our radars. Many, if not most of us have abandoned the old RSS feed to hang out on Twitter, where our online community has grown from a few dozen bloggers to feeds and followers in the hundreds and even thousands.”

One of the measures is that the Grand Rounds editions should be more concise and only include the “best posts”.

I too go for quality, and think one should carefully select contributors (and hosts), but is the 7-year-old dinosaur to be saved by chopping him in pieces? Should we only refer to 10 posts at the max and put the message in a tweet-format like Margaret did in an experiment?
I was glad that Margaret gave a good old fashioned long introduction in the Dinosaur’s style, for that was what I read, NOT the tweets. Sorry tweets are NOT a nice compilation. They are difficult to read.
It also isn’t a solution to tweet the individual links, because a lot of those individual tweets will be missed by most of the potential readers. It is not coherent either. The strength of the Grand Rounds is in the compilation, in the way the host makes the posts digestible. I would say: let the host present the posts in an attractive way and let the reader do the selection and digestion.

Also important: how many of us will write blog posts specially for the Grand Rounds if there is a chance of 2 in 3 that it will be rejected?

It is true that the Grand Rounds is less popular than a few years ago and it is harder to get hosts. But that may partly have to do with advertising. My first Grand Rounds got far more hits than the second one, mainly because we sent a notice to great blogs that linked to us, like Instapundit (853 hits alone) and there was an interview with the host announcing the Grand Rounds at MEDSCAPE. In this way the main intended audience (non-blogging lay people) were also reached. The second time my post was just found by a handful of people checking the edition plus this blog own readers.
(I have to admit that this last Grand Rounds Edition might have been better if it had been more concise, but at least one person (Pranab of Scepticemia) spend  2 hours in reading almost all the posts of the round-up. So it wasn’t for nothing)

If some busy clinicians can be persuaded to host The Grand Rounds using a shorter format, that is fine. And it is good to be more concise and leave out what isn’t of high quality. But why make it a rule to include just 10 or 12? Even more important, don’t change blog posts for tweets. For I don’t think, as Margaret passed on, that the concept of the individual blog has been sometimes “overshadowed by Twitter and Facebook, whose continual unending stream demands our constant attention, lest we miss something important that someone said or re-said…” Even I have given up to constantly follow all streams, and I suppose the same is true for most clinicians, nurses etc. Lets not replace posts by tweets but lets use Twitter and Facebook to promote the Grand Rounds and augment its radius.

The main reason for writing this post is that I disliked the description by Bryan Vartebedian (host of the next round) rather off-putting, perhaps even arrogant:

Grand Rounds is evolving as a more focused, curated publication.  Rather than a 4,000 word chain-o-links, Nick Genes, Val Jones and others felt that a focused collection of recommendations would be more manageable for both readers and hosts.  This is Grand Rounds for quality rather than link love.

Bryan loves the word link-love. Two posts back he wrote:

It isn’t contacts, followers, friends, subscriptions, readers, link love, mentions, or people’s attention.  It’s time.  With time I can have all of these things.  

“Link love” and “chain-o-links” undervalue what blog carnivals are about. Perhaps some bloggers just want to be linked to, but most want to be read, and that is the entire idea behind the blog carnival. I can’t imagine that the blog hosts aim to include as many links as possible. At the most it is love for particular posts not “link love” perse.

Changing the format to tweets (♬♫) will only increase the link/text ratio. Links will become more prominent.

I would rather go for the ♥♥-links*, because I  to blog and I  to read good stuff.

——–

* Note that ♥♥-links is not the same as link-♥

——–

Here is a short Twitter Discussion about the new approach. I fully agree with Ves Dimov viewpoint, especially the last tweet.





Friday Foolery # 47 WTF, the True Spirit of Christmas

30 12 2011

The true spirit of Christmas is in “loving” and to “do good for others”, ” thinking of” and “helping the less fortunate”.

However, many of today’s children,  weaned on luxury goods and gadgets, consider themselves as the “less fortunates” and thus are on the  “receiving” rather than the “giving” site. And are easily disappointed… and crossed if they don’t get the expected $$$ gift.

Am I exaggerating? I truly hope so.

But if you had searched Twitter for popular expensive gits “car”, “i-pad” or “i-phone” like comedy writer Jon Hendren (@fart) did, you had seen numerous dissatisfied tweets of extremely spoiled kids and adolescents:

http://twitter.com/SeanMcmaster1/status/151044946164584448

———–

The tweets have even been compiled in a song by Jonathan Mann, the “Song a Day Man“. After seeing the tweets it should be no surprise that it is called “WTF?! I wanted an iPhone!”

———–

It makes me kind a sad. It is quite an anti-Christmas attitude.

The kids in this video below have every right to be disappointed though. (via Mashable)

———–

Sources





Medical Black Humor, that is Neither Funny nor Appropriate.

19 09 2011

Last week, I happened to see this Facebook post of the The Medical Registrar where she offends a GP, Anne Marie Cunningham*, who wrote a critical post about black medical humor at her blog “Wishful Thinking in Medical Education”. I couldn’t resist placing a likewise “funny” comment in this hostile environment where everyone seemed to agree (till then) and try to beat each other in levels of wittiness (“most naive child like GP ever” – “literally the most boring blog I have ever read”,  “someone hasn’t met many midwives in that ivory tower there.”, ~ insulting for a trout etc.):

“Makes no comment, other than anyone who uses terms like “humourless old trout” for a GP who raises a relevant point at her blog is an arrogant jerk and an unempathetic bastard, until proven otherwise…  No, seriously, from a patient’s viewpoint terms like “labia ward” are indeed derogatory and should be avoided on open social media platforms.”

I was angered, because it is so easy to attack someone personally instead of discussing the issues raised.

Perhaps you first want to read the post of Anne Marie yourself (and please pay attention to the comments too).

Social media, black humour and professionals…

Anne Marie mainly discusses her feelings after she came across a discussion between several male doctors on Twitter using slang like ‘labia ward’ and ‘birthing sheds’ for birth wards, “cabbage patch” to refer to the intensive care and madwives for midwives (midwitches is another one). She discussed it with the doctors in question, but only one of them admitted he had perhaps misjudged sending the tweet. After consulting other professionals privately, she writes a post on her blog without revealing the identity of the doctors involved. She also puts it in a wider context by referring to  the medical literature on professionalism and black humour quoting Berk (and others):

“Simply put, derogatory and cynical humour as displayed by medical personnel are forms of verbal abuse, disrespect and the dehumanisation of their patients and themselves. Those individuals who are the most vulnerable and powerless in the clinical environment – students, patients and patients’ families – have become the targets of the abuse. Such humour is indefensible, whether the target is within hearing range or not; it cannot be justified as a socially acceptable release valve or as a coping mechanism for stress and exhaustion.”

The doctors involved do not make any effort to explain what motivated them. But two female anesthetic registrars frankly comment to the post of Anne Marie (one of them having created the term “labia ward”, thereby disproving that this term is misogynic per se). Both explain that using such slang terms isn’t about insulting anyone and that they are still professionals caring for patients:

 It is about coping, and still caring, without either going insane or crying at work (try to avoid that – wait until I’m at home). Because we can’t fall apart. We have to be able to come out of resus, where we’ve just been unable to save a baby from cotdeath, and cope with being shouted and sworn at be someone cross at being kept waiting to be seen about a cut finger. To our patients we must be cool, calm professionals. But to our friends, and colleagues, we will joke about things that others would recoil from in horror. Because it beats rocking backwards and forwards in the country.

[Just a detail, but “Labia ward” is a simple play on words to portray that not all women in the "Labor Ward" are involved in labor. However, this too is misnomer.  Labia have little to do with severe pre-eclampsia, intra-uterine death or a late termination of pregnancy]

To a certain extent medical slang is understandable, but it should stay behind the doors of the ward or at least not be said in a context that could offend colleagues and patients or their carers. And that is the entire issue. The discussion here was on Twitter, which is an open platform. Tweets are not private and can be read by other doctors, midwives, the NHS and patients. Or as e-Patient Dave expresses so eloquently:

I say, one is responsible for one’s public statements. Cussing to one’s buddies on a tram is not the same as cussing in a corner booth at the pub. If you want to use venting vocabulary in a circle, use email with CC’s, or a Google+ Circle.
One may claim – ONCE – ignorance, as in, “Oh, others could see that??” It must, I say, then be accompanied by an earnest “Oh crap!!” Beyond that, it’s as rude as cussing in a streetcorner crowd.

Furthermore, it seemed the tweet served no other goal as to be satirical, sardonic, sarcastic and subversive (words in the bio of the anesthetist concerned). And sarcasm isn’t limited to this one or two tweets. Just the other day he was insulting to a medical student saying among other things:“I haven’t got anything against you. I don’t even know you. I can’t decide whether it’s paranoia, or narcissism, you have”. 

We are not talking about restriction of “free speech” here. Doctors just have to think twice before they say something, anything on Twitter and Facebook, especially when they are presenting themselves as MD.  Not only because it can be offensive to colleagues and patients, but also because they have a role model function for younger doctors and medical students.

Isolated tweets of one or two doctors using slang is not the biggest problem, in my opinion. What I found far more worrying, was the arrogant and insulting comment at Facebook and the massive support it got from other doctors and medical students. Apparently there are many “I-like-to-exhibit-my-dark-humor-skills-and-don’t-give-a-shit-what-you think-doctors” at Facebook (and Twitter) and they have a large like-minded medical audience: the “medical registrar page alone has 19,000 (!) “fans”.

Sadly there is a total lack of reflection and reason in many of the comments. What to think of:

“wow, really. The quasi-academic language and touchy-feely social social science bullshit aside, this woman makes very few points, valid or otherwise. Much like these pages, if you’re offended, fuck off and don’t follow them on Twitter, and cabbage patch to refer to ITU is probably one of the kinder phrases I’ve heard…”

and

“Oh my god. Didnt realise there were so many easily offended, left winging, fun sponging, life sucking, anti- fun, humourless people out there. Get a grip people. Are you telling me you never laughed at the revue’s at your medical schools?”

and

“It may be my view and my view alone but the people who complain about such exchanges, on the whole, tend to be the most insincere, narcissistic and odious little fuckers around with almost NO genuine empathy for the patient and the sole desire to make themselves look like the good guy rather than to serve anyone else.”

It seems these doctors and their fans don’t seem to possess the communicative and emphatic skills one would hope them to have.

One might object that it is *just* Facebook or that “#twitter is supposed to be fun, people!” (dr Fiona) 

I wouldn’t agree for 3 reasons:

  • Doctors are not teenagers anymore and need to act as grown-ups (or better: as professionals)
  • There is no reason to believe that people who make it their habit to offend others online behave very differently IRL
  • Seeing Twitter as “just for fun” is an underestimation of the real power of Twitter

Note: *It is purely coincidental that the previous post also involved Anne Marie.





#FollowFriday #FF @DrJenGunter: EBM Sex Health Expert Wielding the Lasso of Truth

19 08 2011

If you’re on Twitter you probably seen the #FF or #FollowFriday phenomenon. FollowFriday is a way to recommend people on Twitter to others. For at least 2 reasons: to acknowledge your favorite tweople and to make it easier for your followers to find new interesting people.

However, some #FollowFriday tweet-series are more like a weekly spam. Almost 2 years ago I blogged about the misuse of FF-recommendations and I gave some suggestions to do #FollowFriday the right way: not by sheer mentioning many people in numerous  tweets, but by recommending one or a few people a time, and explaining why this person is so awesome to follow.

Twitter Lists are also useful tools for recommending people (see post). You could construct lists of your favorite Twitter people for others to follow. I have created a general FollowFridays list, where I list all the people I have recommended in a #FF-tweet and/or post.

In this post I would like to take up the tradition of highlighting the #FF favs at my blog. .

This FollowFriday I recommend:  

Jennifer Gunter

Jennifer Gunter (@DrJenGunter at Twitter), is a beautiful lady, but she shouldn’t be tackled without gloves, for she is a true defender of evidence-based medicine and wields the lasso of truth.

Her specialty is OB/GYN. She is a sex health expert. No surprise, many tweets are related to this topic, some very serious, some with a humorous undertone. And there can be just fun (re)tweets, like:

LOL -> “@BackpackingDad: New Word: Fungry. Full-hungry. “I just ate a ton of nachos, but hot damn am I fungry for those Buffalo wings!””

Dr Jen Gunter has a blog Dr. Jen Gunther (wielding the lasso of truth). 

Again we find the same spectrum of posts, mostly in the field of ob/gyn. You need not be an ob/gyn nor an EBM expert to enjoy them. Jen’s posts are written in plain language, suitable for anyone to understand (including patients).

Some titles:

In addition, There are also hilarious posts like “Cosmo’s sex position of the day proves they know nothing about good sex or women“,where she criticizes Cosmo for tweeting impossible sex positions (“If you’re over 40, I dare you to even GET into that position! “), which she thinks were created by one of the following:

A) a computer who has never had sex and is not programmed to understand how the female body bends.
B) a computer programmer who has never has sex and has no understanding of how the female body bends.
C) a Yogi master/Olympic athlete.

Sometimes the topic is blogging. Jen is a fierce proponent of medical blogging. She sees it as a way to “promote” yourself as a doctor, to learn from your readers and to “contribute credible content drowns out garbage medical information” (true) and as an ideal platform to deliver content to your patients and like-minded medical professionals. (great idea)

Read more at:

You can follow Jen at her Twitter-account (http://twitter.com/#!/DrJenGunter) and/or you can follow my lists. She is on:  ebm-cochrane-sceptics and the followfridays list.

Of course you can also take a subscription to her blog http://drjengunter.wordpress.com/

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The Second #TwitJC Twitter Journal Club

14 06 2011

In the previous post I wrote about  a new initiative on Twitter, the Twitter Journal Club (hashtag #TwitJC). Here, I shared some constructive criticism. The Twitter Journal Club is clearly an original and admirable initiative, that gained a lot of interest. But there is some room for improvement.

I raised two issues: 1. discussions with 100 people are not easy to follow on Twitter, and 2. walking through a checklist for critical appraisals is not the most interesting to do (particularly because it had already been done).

But as one of the organizers explained, the first session was just meant for promoting #twitjc. Instead of the expected 6 people, 100 tweople showed up.

In the second session, last Sunday evening, the organizers followed a different structure.

Thus, I thought it would only be fair, to share my experiences with the second session as well. This time I managed to follow it from start to finish.

Don’t worry. Discussing the journal club won’t be a regular item. I will leave the organization up to the organizers. The sessions might inspire me, though, to write a blog post on the topic now and then. But that may only work synergistic. (at least for me, because it forces me to rethink it all)

This time the discussion was about Rose’s Prevention Paradox (PDF), a 30 year old paper that is still relevant. The paper is more of an opinion piece, therefore the discussion focused on the implications of the Prevention Paradox theory. It was really helpful that Fi wrote an introduction to the paper, and a Points of Discussion beforehand. There were 5 questions (and many sub-questions).

I still found it very hard to follow it all at Twitter, as illustrated by the following tweet:

  • laikas I think I lost track. Which question are we? #twitjc Sun Jun 12 20:07:03
  • laikas @MsPhelps ik werd wel helemaal duizelig van al die tweets. Er zijn toch wel veel mensen die steeds een andere vraag stellen voor de 1e is beantwoord -9:47 PM Jun 12th, 2011 (about instant nausea when seeing tweets rolling by and people already posing a new question before the first one is answered)

I followed the tweets at http://tweetchat.com/room/twitjc. Imagine tweets rolling by and you try to pick up those tweets you want to respond to (either bc they are very relevant, or because you disagree). By the time you have finished your tweet, already 20 -possibly very interesting tweets- passed by, including the next question by the organizers (unfortunately they didn’t use the official @twitjournalclub account for this).

Well, I suppose I am not very good at this. Partly because I’m Dutch (thus it takes longer to compose my tweets), partly because I’m not a fast thinker. I’m better at thorough analyses, at my blog for instance.

But this is Twitter.  To speak with Johan Cruyff, a legendary soccer-player from Holland, “Every disadvantage has its advantage”.

Twitter may not favor organized discussions, but on the other hand it is very engaging, thought-provoking and easy accessible. Where else do you meet 100 experts/doctors willing  to exchange thoughts about an interesting medical topic?

The tweets below are in line with/reflect my opinion on this second Twitter Journal Club (RT means retweeting/repeating the tweet):

  • laikas RT @themattmak@fidouglas @silv24 Congratulations again on a great #twitjc. Definitely more controversial and debate generating than last week’s! -9:18 PM Jun 12th, 2011
  • laikas @silv24 well i think it went well (it is probably me, I’m 2 slow). This paper is broad, evokes much discussion & many examples can B given -9:45 PM Jun 12th, 2011
  • DrDLittle Less structure to #twitJC last night but much wider debate 7:41 AM Jun 13th, 2011
  • amitns @DrDLittle It’s obviously a very complex topic, more structure would have stifled the debate. A lot of food for thought.#twitJC -7:45 AM Jun 13th, 2011

Again, the Twitter Journal Club gained a lot of interest. Scientist and teachers consider to borrow the concept. Astronomers are already preparing their first meeting on Thursday… And Nature seems to be on top of it as well, as it will interview the organizers of the medical and the astronomy journal club for an interview.

Emergency Physician Tom Young with experience in critically appraisal just summarized it nicely: (still hot from the press):

The two meetings of the journal club so far have not focussed in on this particular system; the first used a standard appraisal tool for randomised controlled trials, the second was more laissez-faire in its approach. This particular journal club is finding its feet in a new setting (that of Twitter) and will find its strongest format through trial and error. indeed, to try to manage such a phenomenon might be likened to ‘herding cats’ that often used description of trying to manage doctors, and I think, we would all agree would be highly inadvisable. Indeed, one of its strengths is that participants, or followers, will take from it what they wish, and this will be something, rather than nothing, whatever paper is discussed, even if it is only contact with another Tweeter, with similar or divergent views. 

Indeed, what I gained from these two meetings is that I met various nice and interesting people (including the organizers, @fidouglas and @silv24). Furthermore, I enjoyed the discussions, and picked up some ideas and examples that I would otherwise wouldn’t know about. The last online meeting sparked my interest in the prevention paradox. Before the meeting, I only read the paper at a glance. After the session I decided to read it again, and in more detail. As a matter of fact I feel inspired to write a blog post about this theory. Originally I planned to write a summary here, but probably the post is getting too long. Thus I will await the summary by the organizers and see if I have time to discuss it as well.

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The #TwitJC Twitter Journal Club, a New Initiative on Twitter. Some Initial Thoughts.

10 06 2011

There is a new initiative on Twitter: The Twitter Journal Club. It is initiated by Fi Douglas (@fidouglas) a medical student at Cambridge,  and Natalie Silvey (@silv24)  a junior doctor in the West Midlands.

Fi and Natalie have set up a blog for this event: http://twitjc.wordpress.com/

A Twitter Journal Club operates in the same way as any other journal club, except that the forum is Twitter.

The organizers choose a paper, which they announce at their website (you can make suggestions here or via a tweet). Ideally, people should read the entire paper before the Twitter session. A short summary with key points (i.e. see here) is posted on the website.

The first topic was:  Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock [PDF]

It started last Sunday 8 pm (Dutch time) and took almost 2 hours to complete.

@twitjournalclub (the twitter account of the organizers) started with a short introduction. People introduced themselves as they entered the discussion. Each tweet in the discussion was tagged with #TwitJC (a so called hashtag), otherwise it won’t get picked up by people following the hashtag. (Tweetchat automatically provides the hashtag you type in).

Although it was the first session, many people (perhaps almost 100?!) joined the Journal Club, both actively and more passively. That is a terrific achievement. Afterwards it got a very positive Twitter “press”. If you know to engage people like @nothern_doctor, @doctorblogs, @amcunningham and @drgrumble and people like @bengoldacre, @cebmblog and @david_colquhoun find it a terrific concept, then you know that it is a great idea that meets a need. As such, enough reason to continue.

There were also not purely positive voices. @DrVes sees it as a great effort, but added that “we need to go beyond this 1950s model rather than adapt it to social media.” Apparently this tweet was not well received, but I think he made a very sensible statement.

We can (and should) asks ourselves if Twitter is the right medium for such an event.

@DrVes has experience with Twitter Journal Clubs. He participated in the first medical journal club on Twitter at the Allergy and Immunology program of Creighton University back in 2008 and presented a poster at an allergy meeting in 2009.

BUT, as far as I can tell, that Twitter Journal Club was both much more small-scale (7 fellows?) and different in design. It seems that Tweets summarized what was being said at a real journal club teaching session. Ves Dimov:

“The updates were followed in real time by the Allergy and Immunology fellows at the Louisiana State University (Shreveport) and some interested residents at Cleveland Clinic, along with the 309 subscribers of my Twitter account named AllergyNotes“.

So that is the same as tweeting during a conference or a lecture to inform others about the most interesting facts/statements. It is one-way-tweeting (overall there were just 24 updates with links).

I think the present  Twitter Journal Club was more like a medical Twitter chat (also the words of Ves).

Is chatting on Twitter effective?

Well that depends on what one wants to achieve.

Apparently for all people participating, it was fun to do and educative.

I joined too late to tell, thus I awaited the transcript. But boy, who wants to read 31 pages of “chaotic tweets”? Because that is what a Twitter chat is if many people join.  All tweets are ordered chronologically. Good for the archive, but if the intention is to make the transcribed chat available to people who couldn’t attend, it needs deleting, cutting, pasting and sorting. But that is a lot of work if done manually.

I tried it for part of the transcript. Compare the original transcript here with this Google Doc.

The “remix of tweets” also illustrates that people have their own “mini-chats”, and “off-topic” (but often very relevant) questions.

In addition, the audience is very mixed. Some people seem to have little experience with critical appraisal or concepts like “intention to treat” (ITT) and would perhaps benefit from supplementary information beforehand (i.e. documents at the TwitJC website). Others are experienced doctors with a lot of clinical expertise, who always put theoretical things in perspective. Very valuable, but often they are far ahead in the discussion.

The name of the event is Twitter  Journal Club. Journal Club is a somewhat ambiguous term. According to Wikipedia “A journal club is a group of individuals who meet regularly to critically evaluate recent articles in scientific literature”. It can deal with any piece which looks interesting to share, including hypotheses and preclinical papers about mechanisms of actions.

Thus, to me Journal club is not per definition EBM (Evidence Based Medicine).

Other initiatives are a critical appraisal of a study and a CAT,  a critical appraisal of a topic (sometimes wrongly called PICO, PICO is only part of it).

The structure of the present journal club was more that of a critical appraisal. It followed the normal checklist for an RCT: What is being studied? Is the paper valid (appropriately allocated, blinded etc ), what are the results (NNT etc) and are the results valid outside of the context of the paper?

Imo, official critical appraisal of the paper costs a lot of time and is not the most interesting. Looking at my edited transcript you see that half of the people are answering the question and they all say the same: “Clearly focused question” is answer to first question (but even in the edited transcript this takes 3 pages), “clear interventions (helpful flowcharts) is the answer to the second question.

Half of the people have their own questions. Very legitimate and good questions, but not in line with the questions of @twitjournalclub. Talking about the NNT and about whether the results are really revolutionary, is VERY relevant, but should be left till the end.

A twitter chat with appr. 100 people needs a tight structure.

However, I wonder whether this  approach of critical appraisal is the most interesting. Even more so, because this part didn’t evoke much discussion.

Plus it has already been done!!

I searched the TRIP database and with the title of the paper, to find critical appraisals or synopses of the paper. I found 3 synopses, 2 of which follow more or less the structure of this journal club here, here (and this older one). They answer all the questions about validity.

Wouldn’t it have better with this older key paper (2001) to just use the existing critical appraisals as background information and discuss the implications? Or discuss new supporting or contradictory findings?

The very limited search in TRIP (title of paper only) showed some new interesting papers on the topic (external validation, cost effectiveness, implementation, antibiotics) and I am sure there are many more.

A CAT may also be more interesting than a synopsis, because “other pieces of evidence” are also taken into consideration and one discusses a topic not one single paper. But perhaps this is too difficult to do, because one has to do a thorough search as well and has too much to discuss. Alternatively one could choose a recent systematic review, which summarizes the existing RCT’s.

Anyway, I think the journal club could improve by not following the entire checklist (boring! done!), but use this as a background. Furthermore I think there should be 3-5 questions that are very relevant to discuss. Like in the #HSCMEU discussions, people could pose those questions beforehand. In this way it is easier to adhere to the structure.

As to the medium Twitter for this journal club. I am not fond of  long Twitter chats, because it tends to be chaotic, there is a lot of reiteration, people tend to tweet not to “listen” and there is a constriction of 140 characters. Personally I would prefer a webinar, where people discuss the topic and you can pose questions via Twitter or otherwise.
Other alternatives wouldn’t work for me either. A Facebook journal club (described by of Neil Mehta) looks more static (commenting to a short summary of a paper), and Skyping is difficult with more than 10 people and not easy to transcribe.

But as said there is a lot of enthusiasm for this Twitter Journal Club. Even outside the medical world. This “convincing effort” inspired others to start a Astronomy Twitter Journal Club.

Perhaps a little modification of goals and structure could make it even more interesting. I will try to attend the next event, which is about Geoffrey Rose’s ‘Prevention Paradox’ paper, officially titled ”Strategy of prevention: lessons from cardiovascular disease”, available here.

Notes added:

[1] A summary of the first Twitter journal club is just posted. This is really valuable and takes away the disadvantages of reading an entire transcript (but one misses a lot of interesting aspects too)!

[2] This is the immediate response of one of the organizers at Twitter. I’m very pleased to notice that they will put more emphasis on implications of the Journal. That would take away much of my critic.

(Read tweets from bottom to top).

References

  1. Welcome (twitjc.wordpress.com)
  2. An important topic for the first Twitter Journal Club (twitjc.wordpress.com)
  3. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M; Early Goal-Directed Therapy Collaborative Group. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001 Nov 8;345(19):1368-77. PubMed PMID: 11794169. (PDF).
  4. The First Journal Club on Twitter – Then and Now (casesblog.blogspot.com)
  5. Allergy and Immunologyclub on Twitter (allergynotes.blogspot.com)
  6. The Utility of a Real-time Microblogging Service for Journal Club in Allergy and Immunology. Dimov, V.; Randhawa, S.; Auron, M.; Casale, T. American College of Allergy, Asthma & Immunology (ACAAI) 2009 Annual Meeting. Ann Allergy Asthma Immunol., Vol 103:5, Suppl. 3, A126, Nov 2009.
  7. https://docs.google.com/document/pub?id=1qzk1WzjNO5fbWd0PAax6cIDdUGGg1sDn86FPT1li-sQ (short remix of the transcript)
  8. Model for a Journal Club using Google Reader and Facebook OR if the prophet does not go to the Mountain…. bring the journal club to FB! (blogedutech.blogspot.com)
  9. Astronomy Twitter Journal Club/ (sarahaskew.net)
  10. A summary of week one: Rivers et al (twitjc.wordpress.com)




Lanyrd, the Social Conference Directory

24 11 2010

I’m a blogger who usually needs quite some time to write blog posts. However, I just learned about a new tool that I need not describe in detail. Firstly, because Heidi Allen just described the tool in a blog post here. Secondly, because the tool is so intuitive and easy.

I’m talking about Lanyrd, a directory of geeky events, technical conferences and social meetings.

It is really so simple and effective. Please follow me.

You go to http://lanyrd.com/, connect via OAuth to Twitter and before you can count to 3, Lanyrd shows you the conferences your friends on Twitter are going to as a speaker (blue border) or an attendee. You can also see friends who keep track of the conference (vague).

Unfortunately purely scientific or medical conferences are not included, but who knows what Lanyrd is up to.

You can track the conferences by subscribing in iCal / Outlook. It is also easy to add conferences.

I might go to Medicine 2.0, but I didn’t make up my mind yet. If I click on the link I see the following page:

You can click on “Attend” or on “Track” if this applies. Furthermore you get an overview of the conference: the location, the link to the website, the Twitter account, the hashtag used in tweets (#med2) and of the speakers.

Oh …. there are none yet, so I added a few.

It is easy to do, people who have never logged into the site can also be added. However, if helps to know the exact twitter name, if many people on Twitter share the same name (else you have to check all the profiles generated with Twitter search).

Lanyrd is the baby of the recently married couple Simon Willison and Natalie Downe. And as it goes with babies, they grow up.

What can we expect the next few years?

Simon in the Guardian:

“We have lots of exciting plans for Lanyrd’s future. One of the things we’re very keen on is gathering information on past conferences – speaker slides, videos, audio recordings and write-ups. In five years’ time, we hope we’ll have the best collection of conference coverage possible.”

Credits to Heidi Allen (@dreamingspires) and Anne Marie Cunningham (@amcunningham) who discussed Lanyrd on Twitter. As said, Heidi wrote a post on Lanyrd, and Anne Marie wrote a short blogpost at Wishful Thinking in Medical Education on the need to find list of upcoming medical or health conferences- and the hashtags that would be used to cover them on twitter. The Solution as it appeared was Lanyrd (at least for some of the conferences).





Implementing Twitter in a Health Sciences Library

23 11 2010

Twitter describes itself as “a service for friends, family, and co-workers to communicate and stay connected through the exchange of quick, frequent answers to one simple question: What are you doing?” [2].

The “answers” are equally simple, because the tweet (that what is being “said”) must fit in 140 characters. The tweet does not only contain plain text, but can contain short-URL’s which link to webpages, figures and videos.

However, tweets have evolved to more than everyday experiences, and take the shape of shared links to interesting content on the web, conversations around hot topics (using hashtags (#), like #cochrane OR #ev2010 (conference evidence2010)), photos, videos, music, and real-time accounts of a newsworthy event [2]. Furthermore, Twitter is now also used by institutions and companies  for branding, marketing and costumer service. This also applies to libraries, with public libraries leading the way. Health science libraries started twittering  in 2009 and as of 2010 there were (only) 24 of them. In addition, the National Library of Medicine (NLM) and most of the regional National Network of Libraries of Medicine (NN/LMs) have a Twitter presence.  I follow @NLM_LHC and @NLM newsroom, for instance.

The NYU Health Sciences Libraries (NYUHSL) began using Twitter in June 2009. The team, consisting of the Director, the Emerging Technologies Librarian and the Web Services Librarian of the NYUHSL, described their experience with the implementation of Twitter in the latest Medical Reference Services Quarterly [1]

The main aim of their Twitter account was to disseminate topics similar to what was posted on their Web site: news about facilities, resources, handy tidbits, services offered, downtime, events, and staff, as well as breaking news.

What was their approach and what were their main experiences?

  • Claim your name, as soon as you vaguely consider using Twitter!
    In the case of  NYUHSL, their usual library acronym was already taken, so they took a similar name: @NYU_HSL (because of the 140-character limit, it is advisable to use as few characters as possible: this will leave more room when somebody replies to you).
  • They added the library logo as a profile picture and included a link to the library website plus a short “bio”.
  • First the team shared responsibility for posting on Twitter (by logging in into the NYU_HSL account and posting), but this posed coordination problems (like double postings, irregular postings). Therefore it was decided that team members would post according to a schedule. Furthermore there was a 2-week rotation. Any important news was tweeted promptly and interesting news from other Twitter users was occasionally retweeted .
  • Later CoTweet was used. This is a free tool, which -as its name suggests- allows multiple people to communicate through corporate Twitter accounts and stay in sync while doing so. One person is the account owner, who creates and maintains the account and gives other people access to it. The individual members can post to Twitter via the Co_tweet account.  CoTweet uses bit.ly as an URL-shortener, displays some (rudimentary) stats, allows scheduling and archiving of tweets and has some other slick features for corporate Twitter use. (See  this post at News CNET for a comparison between CoTweet and the better known Hootsuite)
  • What I most liked about the paper – besides the description of CoTweet – is the content flow diagram the authors used (adapted below). Posts from their library blog were automatically cross-posted via RSS to Twitter using Twitterfeed, whereas tweets were in their turn automatically posted on Facebook. To this end a Twitter Tab was added to the NYUHSL Facebook fan page. In addition it remained possible to post manually to the different social networking tools and to respond to followers or retweet messages of other users.

  • The team also had to find the right tone for Twitter: the style of tweets is more informal than the style of blog posts. They emphasize the importance of keeping the nuances of different social networking sites in mind when establishing an institutional presence.
  • They promoted Twitter in many ways:
    • A large Twitter mascot (blue bird) with the text: “Follow NYU_HSL on Twitter” was placed on the prominent Web’s site feature bar (see Fig. below). Unfortunately the twitter message only appears when you press “next”. Most users will not do this.
    • Creation of a small poster about Twitter.
    • A word of mouth campaign (in orientation presentations, and a tag line with Twitter account information in e-mail correspondence to students: according to Pew Internet [3] college graduates are among the biggest users of Twitter.
    • description and promotion of the Twitter account in the library’s e-mail newsletter and in blog posts.

And finally, we have to come up with the Key Question: was it all worth the effort?

At the time of writing the NYU-HSL had 66 followers, 27 of which were affiliated with the NYU (others being other libraries and librarians for instance). This is not a very big (target) audience, but I agree with the authors that the definition of success in social media is relative.  There were clear (subjective) benefits, like the low cost, ease of use, low effort to maintain the service on the one hand and the possibility to engage the audience, get user opinions and the opportunity to fix problems quickly on the other hand. Furthermore it’s presence on Twitter enhances the library’s reputation, as the library is making an effort to extend beyond its walls and confirms the role of librarians as technology leaders.

I also agree with the library’s basic principle “to give users as many options as possible to keep current with library news, resources, and services.” In this regard Twitter is a simple and effective method for promotion.

Thus health, medical and other libraries. I would say, if you are not twittering, give it a try and read the reviewed paper [1] for more tips. One of these tips is to connect with other libraries on Twitter as to learn from their experiences.

Credits:  @DrShock dm-ed (direct messaged) me on Twitter to alert me to the paper. Thanks Walter!

References (all assessed 2010-11-23)

  1. Cuddy, C., Graham, J., & Morton-Owens, E. (2010). Implementing Twitter in a Health Sciences Library Medical Reference Services Quarterly, 29 (4), 320-330 DOI: 10.1080/02763869.2010.518915
  2. Mashable http://mashable.com/guidebook/twitter/
  3. Lenhart, A., and Fox, S. ‘‘Twitter and Status Updating.’’ Report: Web 2.0, Social Networking. Pew Internet & American Life Project (February 12, 2009). Pew Internet: http://www.pewinternet.org/Reports/2009/Twitter-and-status-updating.aspx




Expert Curators, WisdomCards & The True Wisdom of @organizedwisdom

9 11 2010

Note added 2010-11-12:  Anyone who wishes to can now email info@organizedwisdom.com to let his/her profile as expert curator removed from the site of Organized Wisdom (see comments by Unity Stoakes, Co-founder OrganizedWisdom)

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Twitter and other Social Media can be full of random rubbish, but can also contain useful information. Personally, I use Twitter for work-related tweets about 95 percent of the time, and I choose the people I follow carefully so that I’m not overwhelmed by a flood of tweets. As I’ve said before: people who I follow are my human filter to the Twitter Noise. And I hope that is vice versa.

Organized Wisdom (http://organizedwisdom.com and @organizedwisdom on Twitter) is a 3-4 year old company that uses a similar approach to filter useful health information out of the daily junk.

Or as Steve Krein, CEO of Organized Wisdom tells Matthew Holt of the Health Care Blog in an interview (video below)

Organized Wisdom has created a new way for people to use the internet to solve their health problems by using experts. We think experts are the missing gap between two worlds: heavily simplified health encyclopedias & dictionaries and complex stuff on the internet (where you are quickly overwhelmed by all the health stuff).

OrganizedWisdom® uses WisdomCards™ , a unique service which helps people easily discover great links, curated by experts and organized by topic.

In principle this is an excellent idea, and that is why I originally joined Organized Wisdom.

I have a badge on my blog and I’m a so-called expert curator and contributor for Medical Education and Medical Librarian (topics)

Profile now removed from Organized Wisdom (2010-11-11)

Profile now removed from Organized Wisdom (2010-11-11)

So far so good. Besides being a creator of content (which is nothing more than being a source for automatically created links present in my health-care related tweets), I’m also a “consumer”. Because I’m interested in Endocrinology I follow @EndocrinologyOW on Twitter. There are many other OW topics on Twitter, that you can follow.

Recently Organized Wisdom launched a new account @ActivityDigest, which -it won’t surprise you- gives an activity digest of the curators. Apparently to stimulate “engagement” (Oh wonderful CEO-terminologies).

This is why I got this tweet in my twitter stream (I don’t follow @ActivityDigest, but I see its tweets once it mentions me).

I felt flattered: “recommended as an expert curator for Organized Wisdom“…. That sounds like any scientists could only dream of.

And before I realised it, I retweeted the message (repeated the message to my twitter stream).

Immediately I felt a bit uncomfortable. And this feeling grew as I saw almost everybody in my Twitter stream being labeled as an “Expert Curator”. … and everybody retweeting his/her “pat on the back” and congratulating each other….

I don’t have the original retweets, but a search for “Expert Curator” shows that last weeks “expert-curator”-retweets still continue

  1. American Heart Assoc
    American_Heart Thanks! RT @ActivityDigest @American_Heart was recommended as an Expert Curator for quality links, expertise. Congrats!…
  2. Rudi'sGlutenFree
    rudisglutenfree Cool! RT @ActivityDigest: @rudisglutenfree recommended as Expert Curator 4 quality links, expertise. http://bit.ly/9IOHME @OrganizedWisdom
  3. EndlessBeauty.com
    _EndlessBeauty Oh wow thank you @ActivityDigest!! We appreciate the recommendation for an Expert Curator :) @organizedwisdom
  4. Michael Bermant, MD
    DrBermant Michael Bermant, MD – OrganizedWisdom Contributor Profile http://bit.ly/99hDES Learn why he is an Expert Curator, see links he has shared.
  5. shade gardener
    shadegardener @ActivityDigest Wow, I never heard of Expert Curator for quality links before, thanks for letting me know I was awarded! :-)
  6. Bamboo Inspiration
    bambooinspired @ActivityDigest Hi and thanks for the Expert Curator for quality links mention! That’s really appreciated
  7. BMJ Group
    BMJ_Group Thanks :o) RT @ActivityDigest: @BMJ_Group was recommended as an Expert Curator for quality links, expertise. Congrats! http://bit.ly/an2Vio
  8. Imagine Nursing
    ImagineNursing Nursing Tweets: BMJ_Group: Thanks :o) RT @ActivityDigest: @BMJ_Group was recommended as an Expert Curator for qu… http://bit.ly/954uDQ

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Note (1) the real surprise of some people (Wow, I never heard of Expert Curator for quality links before) and (2) the chaff (endless beauty) between the wheat ((BMJ_GroupAmerican_Heart). I mean: if some of these accounts would start following me, I would probably block them and report them for spam! Really!

Activity Digest  continues its activities. Now everybody knows he or she is a curator,  it tweets what the curators have achieved this week. Probably OW is hoping curators retweet their achievements and spread the word for them. We are not only used as living filters, but even more so as “living ads”!

It made me frown, but the worst thing that struck me today is that the twittered information isn’t really filtered for quality. About a quarter is what I would call SCAM or at least CRAP.

Look on which WisdomCardI land on when I follow a tweet “Tired Of Fake Anti-aging Creams? (Try HGH Energizer”): rubbish by natural healers etc (spread by @EndocrinologyOW)
Similar cards are antiaging medicine that gets at the hormone causessupplements for diabetes support and what about the Type  2 Diabetes Natural Treatment-card. Cinnamon as treatment? Anyone? And of course there are also chiropractor WisdomCard™ cards where “expert curators share great links about chiropractor”.

Part of the problem may be that Organized Wisdom doesn’t only share links from “Health Centers”, but also from Wellness Centers (AgingDietExercise & Fitness etc) and Living Centers (BeautyCookingEnvironment). Apparently one card can have information for 2 or 3 centers (diabetes and multivitamins for example)

I feel used.

Organized Wisdom uses the credibility of me and other curators, including so-called “top expert curators” as Dr Pho (Kevin MD – blog), to cover up the incredibility of others, with the intention to lure users in.

Who doesn’t believe top curators like the ones below? Who doesn’t want to be considered one?

Going through the “expert curator” Twitter search, I saw (only) one very sensible man, EdBennett, who manages web sites for a large academic medical center and creates overviews of social media usage by hospitals. Friendly, he asked to be removed from the Expert Curator list.

I think I will try the same, although (considering the answer of dr Ves), that may not be a sinecure.

Perhaps we can try a concerted action. You know, the power of the crowd….

  1. Ed Bennett
    EdBennett Dear @OrganizedWisdom – please remove me as an “Expert Curator” from your site. Thank you.
  2. Ves Dimov, M.D.
    DrVes @EdBennett I tried this several times but I don’t think it worked… :)
  3. Ed Bennett
    EdBennett @DrVes I like to start by asking nicely.

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Added 2010-11-12: For more striking examples, please read the comments. (anti-quack people “recommending” homeopathy treatment of cancer; dr ves -true expert on asthma beaten by the author of slim-fit-health.info/newsletters/fat-loss-now/…..

Added 2010-11-12: I found a 2 year old post from TechCrunch called OrganizedWisdom, the “Mahalo For Health”, Raises $2.3 Million. Some of the commenters came to the same conclusions (why didn’t anybody pick this up? Vanity? Trust? Ignorance? -this also applies to me I must admit):

Like this one from @Holly (emphasis mine)

I am glad you brought up the “written by people who do not have a clue, let alone ANY medical training [of any kind] at all.” I have no experience with any kind of medical education, knowledge or even the slightest clue of a tenth of the topics covered on OW, yet for some reason they tried to recruit me to review cards there!?! That was my first impression of the company, if they have a bunch of people like me as the final word on their cards, the info will be so off base the site will give the big fail so quick. In my opinion, medical knowledge or advice is not something I would trust from any random joe, so why would I trust anything from random people who work there, considering they have absolutely no experience or knowledge? They advertise that a doctor reviews every card, personally I think that is a bunch of BS, considering neither me nor others that I know work higher up there have any training whatsoever, guess anyone can be a doctor now…

And Josh,

You are correct about some health sites’ contents written by people with limited or non-existent medical knowledge or training; the public at large do not know this. In fact, one of my neighbors, a “MA” or “Medical Assistant,” writes for OrganizedWisdom.com.





Silly Sunday #29 World Cup 2010-Twitter Reports of England’s Loss.

27 06 2010

The World Cup Soccer 2010 started 2 weeks ago. For now I only follow the Dutch team live. But indirectly I follow many other matches via Twitter. It is very entertaining, especially if things go awry, like the way the English were crushed by the Germans today (1:4). This was partly due to the referee who ruled out a legitimate goal by Frank Lampard when it was still 1 : 1.

Below are some of the tweets in my timeline. I especially like @precordialthump’s comparison of the English knock-out with apoptosis.

@Precordialthump opens with the best Faulty Tower fragment: “Don’t mention the War”. I can’t resist to show the fragment here.

And don’t miss the pic: “It wasn’t a goal” (via nutrigenomics)

  1. Maria Wolters
    mariawolters PHEW! #ger AND #gha are through! Go Ghana, go Africa! Now on to #ger / #eng. Mwahahaha …. #fb
  2. precordialthump
  3. precordialthump
    precordialthump Oh my god!!!! Come on England – 1966 in reverse!!!
  4. Sally Church
    MaverickNY @SallyWalker exactly kind of gobsmacked. If they ditch all the bad refs there won’t be any left for the final tho
  5. Maria Wolters
    mariawolters at least #eng will be spared the excruciating penalty shootout this time #brightside #schlaaaaand #fb
  6. Richard Herring
    Herring1967 I blame our 12th invisible player. Everyone keeps passing to him and then he fucks it up.
  7. Theodor Adorno
    TW_Adorno Your team qualified with ease under a Labour Govt and have struggled in every game under the Conservatives. How could this be?
  8. Stephanie Merritt
    thestephmerritt Is this happening because they’ve cut the defence budget? #ididafootballjoke
  9. precordialthump
    precordialthump The England team’s performance turned out to be the World Cup football equivalent of apoptosis… well done, Germany.
  10. Sally Church
    MaverickNY @whydotpharma not sure which was worse: refereeing, #eng or american tv commentary. Probably the last one was most clueless.
  11. jdc 325
    jdc325 Watched the England game with my Dad. My summary: what a shit waste of time. I could have gone for a walk or read a book.
  12. Nutrigenomics
    nutrigenomics Ha RT @biomatushiq: [pretty fast] ROFL RT @sotak: It wasn’t a goal! [pic] http://bit.ly/aHon2g #worldcup #eng #ger
  13. Daft-bint
    TheMarydoll Just been announced that the england team are flying back to glasgow airport so they can get a hero’s welcome.
  14. Laika (Jacqueline)
    laikas RT @BrettAwesome: Breaking News: England have a new coach. It takes them to the airport in 15 minutes.
  15. Maria Wolters

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Will Nano-Publications & Triplets Replace The Classic Journal Articles?

23 06 2010

ResearchBlogging.org“Libraries and journals articles as we know them will cease to exists” said Barend Mons at the symposium in honor of our Library 25th Anniversary (June 3rd). “Possibly we will have another kind of party in another 25 years”…. he continued, grinning.

What he had to say the next half hour intrigued me. And although I had no pen with me (it was our party, remember), I thought it was interesting enough to devote a post to it.

I’m basing this post not only on my memory (we had a lot of Italian wine at the buffet), but on an article Mons referred to [1], a Dutch newspaper article [2]), other articles [3-6] and Powerpoints [7-9] on the topic.

This is a field I know little about, so I will try to keep it simple (also for my sake).

Mons started by touching on a problem that is very familiar to doctors, scientists and librarians: information overload by a growing web of linked data.  He showed a picture that looked like the one at the right (though I’m sure those are Twitter Networks).

As he said elsewhere [3]:

(..) the feeling that we are drowning in information is widespread (..) we often feel that we have no satisfactory mechanisms in place to make sense of the data generated at such a daunting speed. Some pharmaceutical companies are apparently seriously considering refraining from performing any further genome-wide association studies (… whole genome association –…) as the world is likely to produce many more data than these companies will ever be able to analyze with currently available methods .

With the current search engines we have to do a lot of digging to get the answers [8]. Computers are central to this digging, because there is no way people can stay updated, even in their own field.

However,  computers can’t deal with the current web and the scientific  information as produced in the classic articles (even the electronic versions), because of the following reasons:

  1. Homonyms. Words that sound or are the same but have a different meaning. Acronyms are notorious in this respect. Barend gave PSA as an example, but, without realizing it, he used a better example: PPI. This means Protein Pump Inhibitor to me, but apparently Protein Protein Interactions to him.
  2. Redundancy. To keep journal articles readable we often use different words to denote the same. These do not add to the real new findings in a paper. In fact the majority of digital information is duplicated repeatedly. For example “Mosquitoes transfer malaria”, is a factual statement repeated in many consecutive papers on the subject.
  3. The connection between words is not immediately clear (for a computer). For instance, anti-TNF inhibitors can be used to treat skin disorders, but the same drugs can also cause it.
  4. Data are not structured beforehand.
  5. Weight: some “facts” are “harder” than others.
  6. Not all data are available or accessible. Many data are either not published (e.g. negative studies), not freely available or not easy to find.  Some portals (GoPubmed, NCBI) provide structural information (fields, including keywords), but do not enable searching full text.
  7. Data are spread. Data are kept in “data silos” not meant for sharing [8](ppt2). One would like to simultaneously query 1000 databases, but this would require semantic web standards for publishing, sharing and querying knowledge from diverse sources…..

In a nutshell, the problem is as Barend put it: “Why bury data first and then mine it again?” [9]

Homonyms, redundancy and connection can be tackled, at least in the field Barend is working in (bioinformatics).

Different terms denoting the same concept (i.e. synonyms) can be mapped to a single concept identifier (i.e. a list of synonyms), whereas identical terms used to indicate different concepts (i.e. homonyms) can be resolved by a disambiguation algorithm.

The shortest meaningful sentence is a triplet: a combination of subject, predicate and object. A triplet indicates the connection and direction.  “Mosquitoes cause/transfer malaria”  is such a triplet, where mosquitoes and malaria are concepts. In the field of proteins: “UNIPROT 05067 is a protein” is a triplet (where UNIPROT 05067 and protein are concepts), as are: “UNIprotein 05067 is located in the membrane” and “UNIprotein 0506 interacts with UNIprotein 0506″[8].  Since these triplets  (statements)  derive from different databases, consistent naming and availability of  information is crucial to find them. Barend and colleagues are the people behind Wikiproteins, an open, collaborative wiki  focusing on proteins and their role in biology and medicine [4-6].

Concepts and triplets are widely accepted in the world of bio-informatics. To have an idea what this means for searching, see the search engine Quertle, which allows semantic search of PubMed & full-text biomedical literature, automatic extraction of key concepts; Searching for ESR1 $BiologicalProcess will search abstracts mentioning all kind of processes where ESR1 (aka ERα, ERalpha, EStrogen Receptor 1) are involved. The search can be refined by choosing ‘narrower terms’ like “proliferation” or “transcription”.

The new aspects is that Mons wants to turn those triplets into (what he calls) nano-publications. Because not every statement is as ‘hard’, nano-publications are weighted by assigning numbers from 0 (uncertain) to 1 (very certain). The nano-publication “mosquitoes transfer malaria” will get a number approaching 1.

Such nano-publications offer little shading and possibility for interpretation and discussion. Mons does not propose to entirely replace traditional articles by nano-publications. Quote [3]:

While arguing that research results should be available in the form of nano-publications, are emphatically not saying that traditional, classical papers should not be published any longer. But their role is now chiefly for the official record, the “minutes of science” , and not so much as the principle medium for the exchange of scientific results. That exchange, which increasingly needs the assistance of computers to be done properly and comprehensively, is best done with machine-readable, semantically consistent nano-publications.

According to Mons, authors and their funders should start requesting and expecting the papers that they have written and funded to be semantically coded when published, preferably by the publisher and otherwise by libraries: the technology exists to provide Web browsers with the functionality for users to identify nano-publications, and annotate them.

Like the wikiprotein-wiki, nano-publications will be entirely open access. It will suffice to properly cite the original finding/publication.

In addition there is a new kind of “peer review”. An expert network is set up to immediately assess a twittered nano-publication when it comes out, so that  the publication is assessed by perhaps 1000 experts instead of 2 or 3 reviewers.

On a small-scale, this is already happening. Nano-publications are send as tweets to people like Gert Jan van Ommen (past president of HUGO and co-author of 5 of my publications (or v.v.)) who then gives a red (don’t believe) or a green light (believe) via one click on his blackberry.

As  Mons put it, it looks like a subjective event, quite similar to “dislike” and “like” in social media platforms like Facebook.

Barend often referred to a PLOS ONE paper by van Haagen et al [1], showing the superiority of the concept-profile based approach not only in detecting explicitly described PPI’s, but also in inferring new PPI’s.

[You can skip the part below if you're not interested in details of this paper]

Van Haagen et al first established a set of a set of 61,807 known human PPIs and of many more probable Non-Interacting Protein Pairs (NIPPs) from online human-curated databases (and NIPPs also from the IntAct database).

For the concept-based approach they used the concept-recognition software Peregrine, which includes synonyms and spelling variations  of concepts and uses simple heuristics to resolve homonyms.

This concept-profile based approach was compared with several other approaches, all depending on co-occurrence (of words or concepts):

  • Word-based direct relation. This approach uses direct PubMed queries (words) to detect if proteins co-occur in the same abstract (thus the names of two proteins are combined with the boolean ‘AND’). This is the simplest approach and represents how biologists might use PubMed to search for information.
  • Concept-based direct relation (CDR). This approach uses concept-recognition software to find PPIs, taking synonyms into account, and resolving homonyms. Here two concepts (h.l. two proteins) are detected if they co-occur in the same abstract.
  • STRING. The STRING database contains a text mining score which is based on direct co-occurrences in literature.

The results show that, using concept profiles, 43% of the known PPIs were detected, with a specificity of 99%, and 66% of all known PPIs with a specificity of 95%. In contrast, the direct relations methods and STRING show much lower scores:

Word-based CDR Concept profiles STRING
Sensitivity at spec = 99% 28% 37% 43% 39%
Sensitivity at spec = 95% 33% 41% 66% 41%
Area under Curve 0.62 0.69 0.90 0.69

These findings suggested that not all proteins with high similarity scores are known to interact but may be related in another way, e.g.they could be involved in the same pathway or be part of the same protein complex, but do not physically interact. Indeed concept-based profiling was superior in predicting relationships between proteins potentially present in the same complex or pathway (thus A-C inferred from concurrence protein pairs A-B and B-C).

Since there is often a substantial time lag between the first publication of a finding, and the time the PPI is entered in a database, a retrospective study was performed to examine how many of the PPIs that would have been predicted by the different methods in 2005 were confirmed in 2007. Indeed, using concept profiles, PPIs could be efficiently predicted before they enter PPI databases and before their interaction was explicitly described in the literature.

The practical value of the method for discovery of novel PPIs is illustrated by the experimental confirmation of the inferred physical interaction between CAPN3 and PARVB, which was based on frequent co-occurrence of both proteins with concepts like Z-disc, dysferlin, and alpha-actinin. The relationships between proteins predicted are broader than PPIs, and include proteins in the same complex or pathway. Dependent on the type of relationships deemed useful, the precision of the method can be as high as 90%.

In line with their open access policy, they have made the full set of predicted interactions available in a downloadable matrix and through the webtool Nermal, which lists the most likely interaction partners for a given protein.

According to Mons, this framework will be a very rich source for new discoveries, as it will enable scientists to prioritize potential interaction partners for further testing.

Barend Mons started with the statement that nano-publications will replace the classic articles (and the need for libraries). However, things are never as black as they seem.
Mons showed that a nano-publication is basically a “peer-reviewed, openly available” triplet. Triplets can be effectively retrieved ànd inferred from available databases/papers using a
concept-based approach.
Nevertheless, effectivity needs to be enhanced by semantically coding triplets when published.

What will this mean for clinical medicine? Bioinformatics is quite another discipline, with better structured and more straightforward data (interaction, identity, place). Interestingly, Mons and van Haage plan to do further studies, in which they will evaluate whether the use of concept profiles can also be applied in the prediction of other types of relations, for instance between drugs or genes and diseases. The future will tell whether the above-mentioned approach is also useful in clinical medicine.

Implementation of the following (implicit) recommendations would be advisable, independent of the possible success of nano-publications:

  • Less emphasis on “publish or perish” (thus more on the data themselves, whether positive, negative, trendy or not)
  • Better structured data, partly by structuring articles. This has already improved over the years by introducing structured abstracts, availability of extra material (appendices, data) online and by guidelines, such as STARD (The Standards for Reporting of Diagnostic Accuracy)
  • Open Access
  • Availability of full text
  • Availability of raw data

One might argue that disclosing data is unlikely when pharma is involved. It is very hopeful therefore, that a group of major pharmaceutical companies have announced that they will share pooled data from failed clinical trials in an attempt to figure out what is going wrong in the studies and what can be done to improve drug development (10).

Unfortunately I don’t dispose of Mons presentation. Therefore two other presentations about triplets, concepts and the semantic web.

&

References

  1. van Haagen HH, ‘t Hoen PA, Botelho Bovo A, de Morrée A, van Mulligen EM, Chichester C, Kors JA, den Dunnen JT, van Ommen GJ, van der Maarel SM, Kern VM, Mons B, & Schuemie MJ (2009). Novel protein-protein interactions inferred from literature context. PloS one, 4 (11) PMID: 19924298
  2. Twitteren voor de wetenschap, Maartje Bakker, Volskrant (2010-06-05) (Twittering for Science)
  3. Barend Mons and Jan Velterop (?) Nano-Publication in the e-science era (Concept Web Alliance, Netherlands BioInformatics Centre, Leiden University Medical Center.) http://www.nbic.nl/uploads/media/Nano-Publication_BarendMons-JanVelterop.pdf, assessed June 20th, 2010.
  4. Mons, B., Ashburner, M., Chichester, C., van Mulligen, E., Weeber, M., den Dunnen, J., van Ommen, G., Musen, M., Cockerill, M., Hermjakob, H., Mons, A., Packer, A., Pacheco, R., Lewis, S., Berkeley, A., Melton, W., Barris, N., Wales, J., Meijssen, G., Moeller, E., Roes, P., Borner, K., & Bairoch, A. (2008). Calling on a million minds for community annotation in WikiProteins Genome Biology, 9 (5) DOI: 10.1186/gb-2008-9-5-r89
  5. Science Daily (2008/05/08) Large-Scale Community Protein Annotation — WikiProteins
  6. Boing Boing: (2008/05/28) WikiProteins: a collaborative space for biologists to annotate proteins
  7. (ppt1) SWAT4LS 2009Semantic Web Applications and Tools for Life Sciences http://www.swat4ls.org/
    Amsterdam, Science Park, Friday, 20th of November 2009
  8. (ppt2) Michel Dumontier: triples for the people scientists liberating biological knowledge with the semantic web
  9. (ppt3, only slide shown): Bibliography 2.0: A citeulike case study from the Wellcome Trust Genome Campus – by Duncan Hill (EMBL-EBI)
  10. WSJ (2010/06/11) Drug Makers Will Share Data From Failed Alzheimer’s Trials




Friday Foolery [27] Twitter Parade

11 06 2010

There are many Twitter-apps that show “how you are doing” on Twitter.  They show your ranking, your interaction with others, the words you tweet the most, etc. (see this post)

Twitter Parade (http://isparade.jp/#) is more of a fun tool. If you fill in a name, i.e. laikas you see all your followers literally following you in a parade. Some are tweeting.
The first time I saw it I really had to laugh. It is fun to see a very serious doctor applauding or to see Dr. Shock barking as a dog.

You also realize that >1500 followers is really a lot. There is no end to the row.

Instead of  a name you can also fill in a keyword.

Since WordPress.com doesn’t allow scripts I embedded a YouTube video instead.

But it is more fun to try the Twitter parade yourself here (the page takes some time to load).
Perhaps you can find me walking, jumping, clapping there… for you.

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When #Twitter Gets Creepy: People Who Force you to #Autofollow

18 05 2010

The third Twitter post in a row. But this one ain’t positive.

It is about privacy and spam.

Let’s first explain some basic things about Twitter.

People can follow you without your approval, at least if you  have a public account. You can follow them back if you like.

You just have to click on the follow button, that is all!
Everyone with a Twitter account can follow Barack Obama, for instance.

If Barack Obama followed me (whether I followed him or not), I could dm (direct message) him. He (or rather his staff) will receive a private message from me in his inbox.

Only people you follow, are able to dm you. This is to protect you against dm’s from whichever fool, Spam and Bots.

Barack Obama has many followers:  3,964,789. This is no surprise, because he is the president of the United States and everyone wants to know what he has to say.

Some people especially in the marketing sector find the numbers of followers that important that they will do anything to assure a lot of followers. They are even willing to pay for it.

There are several companies who specialize in it. Here is a list of paid Twitter services and their rates (from http://zacjohnson.com/buy-twitter-followers/).

  • BuyTwitterFriends.com = 10,000 Followers for $49.99 (0.0049 each)
  • TweetSourcer.com = 10,000 Followers for $60.00 (0.006 each)
  • UnlimitedTwitterFollowers.com = 10,000 Followers for $74.95 (0.0074 each)
  • Twitter1k.com = 5,000 Followers for $104.97 (0.0209 each)
  • SocialKik.com = 10,000 Followers for $150.00 (0.015 each)
  • USocial.net = 10,000 Followers for $447.30 (0.044 each)
  • Tweetcha.com = 10,000 Followers for $474.99 (0.047 each)
  • PurchaseTwitterFollowers.com = 5,000 Followers for $249.99 (0.049 each)

Buying followers….. that is rather shortsighted. My mother always used to say: “You can’t buy friends” (no real friends anyway).

What are followers worth who don’t follow you because you’re tweets are so interesting, or the stuff you sell is so good, etc… Do these followers really ‘follow’ you, in the sense that they follow what you say? And do they keep following you?

Moreover how are those followers recruited? Are they asked to do so? Are they offered money?

Well I don’t think so. There must be easier money strategies.

But how can you make people follow without asking?

Well there may be a sneaky way to force people to do so, without them being aware of it.

At least I think that has happened to me.

Saturday I got this dm:

I was alarmed.

  • First, somebody sends me a dm with a link to a marketing gift. I never click such links, you never know where they lead to. Even if it comes from someone I trust, it may be that his/her account has been hacked, so I have learned…
  • Second,  I’m not following this guy, at least not any longer….
  • Third I have blocked him before, after a similar dm.

The first time I got a dm of @jonathanvolk I thought I made the mistake by accidentally following him. But now (having blocked him before) I was sure that that wasn’t the case.

Out of curiosity (and to block him) I checked his Twitter account. Here I found several people complaining to him about the very same thing (the first tweet appeared later in response to my tweets).

@SorbetDigital appeared to have similar problems, not only with @jonathanvolk, but also with @JohnChow (see her post).

@JohnChow did ring a bell. Didn’t I block him in the past and didn’t I see his tweets rolling by lately?

I quickly checked Friend or Follow, a fantastic program, that shows you the people you follow and don’t follow you in return (following), your fans (who only follow you) and your friends (reciprocal relationship).

And who did I see there? John Chow, plus another guy that I presumably didn’t follow voluntarily: @MrGatherSuccess.
[The 2nd robot to the upper left also isn't kosher, as I found out today.]

Their Twitter pages ((below in blue and pink) have texts according to expectations.
Their follower/following ratio is absolutely skewed (557:1 and 1090:1 respectively)  so apparently their approach works in the sense that they got more followers, probably recruited in much the same way as they “recruited” me.

Strikingly@jonathanvolk and @Shoemoney are among the 100 people John Chow has chosen to follow. @Shoemoney (follower/-following ratio of 1355:1) and @Chow are also almost the only people followed by @MrGatherSuccess. By the way there is also “College Pages”, that links to Online Colleges, you know the site I warned you about on several occasions (Beware of Top 50 “Great Tools to Double Check your Doctor” or whatever Lists and “Vanity is the Quicksand of Reasoning: Beware of Top 100 and 50 lists!”)

Oh and “the robot” tweeted this today

Common features of these people:

  • they are  all Internet marketers,
  • All have let me follow them, (without following me back)
  • Some have sent me dm’s
  • they have many followers, some having skewed follower/following ratios
  • they “know” each other and may refer to each other

Strikingly @jonathanvolk has a post in which he explains how to get 25,000 Twitter followers with “Twitter Followers for Sale”. Juicy detail: Shoemoney gave him the tip. Vice versa at shoemoney.com, Shoemoney advocates to download the affiliate marketing guide of Jonathan.

Are these the guys behind the link services?

Not necessarily. In a recent post (Something Fishy Goin’ On Here… Paid Twitter Followers) @Jonathanvolk seems sincerely surprised about the pissed of reaction of his forced followers. Quote:

The other week I made a post about Paid twitter followers.

In the post I outline a few methods I have used to essentially pay for twitter followers and how much it has cost me per follower. With the methods like paying twittercounter.com, for example, you know exactly where your twitter followers are coming from.

Recently my follower count has been increasing steadily (and fairly rapidly) without me paying for any more services.

I’ve received a few @ messages before saying the person didn’t follow me and they were unsure how they did. I usually brushed it off as a… how can I put it lightly… computer illiterate person.(emphasis mine)

I think however that one of the services I used is using some sort of application access to automatically make users follow those who pay for the service.

The only problem is, I’m not sure which service is doing it… or if it’s just someone trying to get my account banned.

Since I have no way of know knowing… I have no way of stopping it.

Kinda crazy. Either way, be careful buying followers unless you know explicitly where the users are coming from!

——————

Kinda bullshitSince I have no way of know knowing… I have no way of stopping it.” …. Booh!

Let me give you one tip, guys (assuming that you are honest about this): go sit around the table and see which follower-robbering service you share, and do something about it!!

How people can force you to follow is a technical issue, I know little about. Jonathan refers to a follow bug in Twitter that they have found but should have been fixed.

Indeed @librarianbe told me the same in response to my “tweets for help”. He referred to an article in Gizmodo explaining how to force anyone to follow you on Twitter. Apparently the bug was not fixed (yet?), or there is another leak still to be discovered.

Twitter handled the p @  r  n-spam well. I hope it will find a solution to these problems too.

For such forced following and marketing dm’s are not only annoying, and an intrusion on our privacy, they are also bad for the credibility of a tool like Twitter.

So I’m going to block these guys (of course) and report them to Twitter using the ticket file @mrgunn advised me.

Similar problems? Here is the link to file a ticket with Twitter: http://help.twitter.com/requests/new

Meanwhile I advise you marketer guys to reassess the value of your followers. Do you only care about the size of the flock? Is it just the number of sheep? Do you want to impress by numbers? Or do you care about by whom you are being followed? And if what you’re tweeting does matter to them? Because only then you will have value as a twitterer and deserve to be followed. Otherwise, how can I put it lightly…you’re  a bit sheepish.

Added 18-05-2010

According to Twitter Status the bug that permitted a user to “force” other users to follow them was resolved & cleaned up May 10th. However Jonathan send the dm May 15th (although he might have forced me to follow him longer ago).

If you are still seeing folks you are following who you didn’t choose to follow, Twitter advises to use the block or unfollow tools as a remedy.

However, these buttons do not work effectively as @jonathanvolk and @johnchow keep resurrecting again after a total block.

@jonathanvolk reappeared in the Following Tab of Friend or Follow this very night, about 3 days after blocking (see comment).

Twitter, I hope you listen…








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