Understanding older people’s voice interactions with smart voice assistants: a new modified rule-based natural language processing model with human input

The COVID-19 pandemic has expedited the integration of Smart Voice Assistants (SVA) among older people. The qualitative data derived from user commands on SVA is pivotal for elucidating the engagement patterns of older individuals with such systems. However, the sheer volume of user-generated voice interaction data presents a formidable challenge for manual coding. Compounding this issue, age-related cognitive decline and alterations in speech patterns further complicate the interpretation of older users’ SVA voice interactions. Conventional dictionary-based textual analysis tools, which count word frequencies, are inadequate in capturing the evolving and communicative essence of these interactions that unfold over a series of dialogues and modify with time. To address these challenges, our study introduces a novel, modified rule-based Natural Language Processing (MR-NLP) model augmented with human input. This reproducible approach capitalizes on human-derived insights to establish a lexicon of critical keywords and to formulate rules for the iterative refinement of the NLP model. English speakers, aged 50 or older and residing alone, were enlisted to engage with Amazon AlexaTM via predefined daily routines for a minimum of 30 min daily spanning three months (N = 35, mean age = 77). We amassed time-stamped, textual data comprising participants’ user commands and responses from AlexaTM. Initially, a subset constituting 20% of the data (1,020 instances) underwent manual coding by human coder, predicated on keywords and commands. Separately, a rule-based Natural Language Processing (NLP) methodology was employed to code the identical subset. Discrepancies arising between human coder and the NLP model programmer were deliberated upon and reconciled to refine the rule-based NLP coding framework for the entire dataset. The modified rule-based NLP approach demonstrated notable enhancements in efficiency and scalability and reduced susceptibility to inadvertent errors in comparison to manual coding. Furthermore, human input was instrumental in augmenting the NLP model, yielding insights germane to the aging adult demographic, such as recurring speech patterns or ambiguities. By disseminating this innovative software solution to the scientific community, we endeavor to advance research and innovation in NLP model formulation, subsequently contributing to the understanding of older people’s interactions with SVA and other AIpowered systems

Tourism‑supported working lands sustain a growing jaguar population in the Colombian Llanos

Understanding large carnivore demography on human-dominated lands is a priority to inform conservation strategies, yet few studies examine long-term trends. Jaguars (Panthera onca) are one such species whose population trends and survival rates remain unknown across working lands. We integrated nine years of camera trap data and tourist photos to estimate jaguar density, survival, abundance, and probability of tourist sightings on a working ranch and tourism destination in Colombia. We found that abundance increased from five individuals in 2014 to 28 in 2022, and density increased from 1.88 ± 0.87 per 100 km2 in 2014 to 3.80 ± 1.08 jaguars per 100 km2 in 2022. The probability of a tourist viewing a jaguar increased from 0% in 2014 to 40% in 2020 before the Covid-19 pandemic. Our results are the first robust estimates of jaguar survival and abundance on working lands. Our findings highlight the importance of productive lands for jaguar conservation and suggest that a tourism destination and working ranch can host an abundant population of jaguars when accompanied by conservation agreements and conflict interventions. Our analytical model that combines conventional data collection with tourist sightings can be applied to other species that are observed during tourism activities. Entender los patrones demográficos de los grandes carnívoros al interior de paisajes antrópicos es fundamental para el diseño de estrategias de conservación efectivas. En el Neotrópico, el jaguar (Panthera onca) es una de estas especies cuyas tendencias poblacionales y tasas de supervivencia en paisajes productivos son desconocidas. Para entender mejor estas dinámicas, integramos nueve años de fototrampeo junto a fotos de turistas para estimar la densidad, supervivencia, abundancia y probabilidad de avistamiento de esta especie en una finca ganadera y destino turístico en Colombia. Entre 2014 y 2022 encontramos que la abundancia incrementó de cinco a 28 individuos y la densidad de 1.88 ± 0.87 jaguares/ 100 km2 a 3.80 ± 1.08 jaguares/ 100 km2. La probabilidad de avistamiento por turistas aumentó de 0% en 2014 a 40% en 2020 antes de la pandemia del Covid-19. Nuestros resultados presentan las primeras estimaciones robustas de abundancia y supervivencia de este felino en paisajes antrópicos dónde el manejo de sistemas productivos combinados con turismo e intervenciones para la mitigación del conflicto puede albergar poblaciones abundantes de jaguares, demostrando su importancia para la conservación de esta especie. Nuestro modelo, al combinar datos convencionales con avistamientos, podría ser aplicado a otras especies observadas durante actividades turísticas. Supplemental files attached below

Venetoclax with decitabine or azacitidine in the first‐line treatment of acute myeloid leukemia

Abstract Treatment paradigms for acute myeloid leukemia (AML) have evolved at a rapid pace in recent years. The combination of venetoclax with a hypomethylating agent prolonged survival in clinical trials when compared to hypomethylating agent monotherapy. However, little is known about the performance of venetoclax‐based regimens outside of clinical trials, given conflicting safety and efficacy data. Even less is known about the impact of the hypomethylating agent backbone. In this study, we demonstrate that decitabine‐venetoclax is associated with a significantly higher rate of grade three or higher thrombocytopenia, but lower rates of lymphocytopenia compared to azacitidine‐venetoclax. There was no difference in response or survival across ELN 2017 cytogenetic risk categories in the overall cohort. Significantly more patients succumb to relapsed or refractory disease than death from any other cause. We demonstrated that a Charlson comorbidity index score threshold of seven identifies exceptionally high‐risk patients, providing evidence for clinical use to reduce the risk of early treatment‐related mortality. Lastly, we provide evidence that measurable residual disease negativity and an IDH mutation predict a significant survival benefit outside clinical trials. Taken together, these data illuminate the real‐world performance of venetoclax and decitabine or azacitidine in the treatment of AML

Importance of Baseline Prognostic Factors With Increasing Time Since Initiation of Highly Active Antiretroviral Therapy: Collaborative Analysis of Cohorts of HIV-1-Infected Patients

Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count 350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART