Social media is an important means of communication for political agencies, which makes it possible to engage with large sectors of the public. For institutions which are not directly elected by voters, such as the European Commission (EC), social media can be a strategic tool for increasing perceived legitimacy and citizen engagement, especially in contexts of high politicization. In this paper, we use natural language processing techniques to provide a comprehensive overview of how EC communication on Twitter has evolved between 2010 and 2022, with respect to both its topics and its style. Our analyses show that, over time, the focus of EC communication has shifted substantially from economy-, finance- and governance-related topics, towards social policy, digital and environmental policy, and identity. These changes have progressively differentiated the EC’s profile from that of other institutions (especially more technocratic ones) and contributed to better alignment with engagement patterns of its social media audience. In addition, EC communication has become less neutral (in favor of more positive sentiment), simpler, and more readable, all features which are associated with more accessible and engaging messaging. Yet, while the EC currently scores better than most other reference agencies on several descriptors of accessibility, its style is still lexically more complex, less concrete and less action-oriented than that of other institutions. Alongside providing novel insights on how the EC’s online communication and projected political identity have changed over time, this study lays the foundations for future experimental and hypothesis-driven work combining social media data with external data sources.
Importance Sepsis is a leading cause of death among children worldwide. Current pediatric-specific criteria for sepsis were published in 2005 based on expert opinion. In 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, but it excluded children.
Objective To update and evaluate criteria for sepsis and septic shock in children.
Evidence Review The Society of Critical Care Medicine (SCCM) convened a task force of 35 pediatric experts in critical care, emergency medicine, infectious diseases, general pediatrics, nursing, public health, and neonatology from 6 continents. Using evidence from an international survey, systematic review and meta-analysis, and a new organ dysfunction score developed based on more than 3 million electronic health record encounters from 10 sites on 4 continents, a modified Delphi consensus process was employed to develop criteria.
Findings Based on survey data, most pediatric clinicians used sepsis to refer to infection with life-threatening organ dysfunction, which differed from prior pediatric sepsis criteria that used systemic inflammatory response syndrome (SIRS) criteria, which have poor predictive properties, and included the redundant term, severe sepsis. The SCCM task force recommends that sepsis in children be identified by a Phoenix Sepsis Score of at least 2 points in children with suspected infection, which indicates potentially life-threatening dysfunction of the respiratory, cardiovascular, coagulation, and/or neurological systems. Children with a Phoenix Sepsis Score of at least 2 points had in-hospital mortality of 7.1% in higher-resource settings and 28.5% in lower-resource settings, more than 8 times that of children with suspected infection not meeting these criteria. Mortality was higher in children who had organ dysfunction in at least 1 of 4—respiratory, cardiovascular, coagulation, and/or neurological—organ systems that was not the primary site of infection. Septic shock was defined as children with sepsis who had cardiovascular dysfunction, indicated by at least 1 cardiovascular point in the Phoenix Sepsis Score, which included severe hypotension for age, blood lactate exceeding 5 mmol/L, or need for vasoactive medication. Children with septic shock had an in-hospital mortality rate of 10.8% and 33.5% in higher- and lower-resource settings, respectively.
Conclusions and Relevance The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force using a large international database and survey, systematic review and meta-analysis, and modified Delphi consensus approach. A Phoenix Sepsis Score of at least 2 identified potentially life-threatening organ dysfunction in children younger than 18 years with infection, and its use has the potential to improve clinical care, epidemiological assessment, and research in pediatric sepsis and septic shock around the world.
