Being Old Doesn't Mean Acting Old: How Older Users Interact with Spoken Dialogue System.

Most studies on adapting voice interfaces to older users work top-down by comparing the interaction behavior of older and younger users. In contrast, we present a bottom-up approach. A statistical cluster analysis of 447 appointment scheduling dialogs between 50 older and younger users and 9 simulated spoken dialog systems revealed two main user groups, a “social” group and a “factual” group. “Factual” users adapted quickly to the systems and interacted efficiently with them. “Social” users, on the other hand, were more likely to treat the system like a human, and did not adapt their interaction style. While almost all “social” users were older, over a third of all older users belonged in the “factual” group. Cognitive abilities and gender did not predict group membership. We conclude that spoken dialog systems should adapt to users based on observed behavior, not on age

The MATCH Corpus: A Corpus of Older and Younger Users' Interactions With Spoken Dialogue Systems.

We present the MATCH corpus, a unique data set of 447 dialogues in which 26 older and 24 younger adults interact with nine different spoken dialogue systems. The systems varied in the number of options presented and the confirmation strategy used. The corpus also contains information about the users’ cognitive abilities and detailed usability assessments of each dialogue system. The corpus, which was collected using a Wizard-of-Oz methodology, has been fully transcribed and annotated with dialogue acts and ‘‘Information State Update’’ (ISU) representations of dialogue context. Dialogue act and ISU annotations were performed semi-automatically. In addition to describing the corpus collection and annotation, we present a quantitative analysis of the interaction behaviour of older and younger users and discuss further applications of the corpus. We expect that the corpus will provide a key resource for modelling older people’s interaction with spoken dialogue systems

Reducing working memory load in spoken dialogue systems

We evaluated two strategies for alleviating working memory load for users of voice interfaces: presenting fewer options per turn and providing confirmations. Forty-eight users booked appointments using nine different dialogue systems, which varied in the number of options presented and the confirmation strategy used. Participants also performed four cognitive tests and rated the usability of each dialogue system on a standardised questionnaire. When systems presented more options per turn and avoided explicit confirmation subdialogues, both older and younger users booked appointments more quickly without compromising task success. Users with lower information processing speed were less likely to remember all relevant aspects of the appointment. Working memory span did not affect appointment recall. Older users were slightly less satisfied with the dialogue systems than younger users. We conclude that the number of options is less important than an accurate assessment of the actual cognitive demands of the task at hand

Occupational physical activity in relation with prostate cancer and benign prostatic hyperplasia

Using data from two case-control studies undertaken in Athens, Greece from 1994 to 1997, we have examined the association of occupational physical activity with the risk of prostate cancer and benign prostatic hyperplasia (BPH). Cases consisted of 320 patients with histologically confirmed incident prostate cancer and 184 patients with surgically treated BPH. Controls were 246 patients hospitalized for minor conditions. Occupations before retirement were classified, independently and blindly as to case-control status, into high, medium, and low physical activity levels. After fine controlling for years of schooling, there was a suggestive inverse association of physical activity with prostate cancer (P for trend 0.12) and a significant one with BPH (P for trend 0.04). The odds ratio (95% confidence interval) for high versus low activity was 0.69 (0.40-1.22) for prostate cancer and 0.59 (0.31-1.11) for BPH. The association of physical activity with both conditions tended to be more pronounced among men 65 years old or younger. Given the high frequency of occurrence of the examined conditions in the male population and our limited knowledge about other modifiable risk factors, preventive measures may have to focus on increasing physical activity. European Journal of Cancer Prevention 17:336-339 © 2008 Wolters Kluwer Health | Lippincott Williams and Wilkins

Diet and Expression of Estrogen Alpha and Progesterone Receptors in Malignant Mammary Tissue

Estrogen receptor (ER) and/or progesterone receptor (PR) expression has been associated with more favorable breast cancer prognosis. Results on the differential association of diet with ER and/or PR positive and negative tumors have been inconclusive. In a large case-control study conducted in Athens, Greece, we investigated whether diet is associated with the expression of ERalpha or PR in mammary tumors of 421 women with histologically confirmed breast cancer. Diet was assessed through an extensive food frequency questionnaire and results were analyzed using multiple logistic regression. After controlling for non-nutritional variables and mutually adjusting for energy-generating nutrients and ethanol, carbohydrate intake was inversely associated with ER-alpha (P = 0.04) and PR (P = 0.10) expression. The odds ratios (OR) per one standard deviation increment were 0.69 with 95% confidence interval (95% CI) 0.48-0.98 for ER-alpha and 0.72 (95% CI 0.49-1.07) for PR expression. No consistent or statistically significant associations were noted for any of the other energy-generating nutrients or food groups examined. Although in these data no strong relations of qualitative aspects of diet with hormone receptor expression in breast cancer tumors were evident, the inverse association of carbohydrate intake with ERalpha, and perhaps PR, expression merits further study in future investigations

Expression of estrogen receptors in non-malignant mammary tissue modifies the association between insulin-like growth factor 1 and breast cancer risk

Background: Several studies have reported that the insulin-like growth factor 1 (IGF-1) is positively associated with estrogen receptor-positive [ER(+)] breast cancer risk, whereas there is little or no association with respect to ER(-) breast cancer. All comparisons of ER(+) breast cancer cases, however, have been made versus healthy controls, for whom there is no information about the ER expression in their mammary gland. Patients and methods: In the context of a case-control investigation conducted in Athens, Greece, we studied 102 women with incident ER alpha(+) breast cancer and compared their IGF-1 blood levels with those of 178 ER alpha(+) and 83 ER alpha(-) women with benign breast disease (BBD) who underwent biopsies in the context of their standard medical care. Data were analysed using multiple logistic regression and controlling for potential confounding variables. Results: ER alpha(+) breast cancer patients had higher IGF-1 levels compared with women with BBD [odds ratio (OR) 1.36, 95% confidence interval (CI): 0.95-1.94, per 1 standard deviation (SD) increase in IGF-1 levels]. When ER alpha status of women with BBD was taken into account, the difference in IGF-1 levels between ER alpha(+) breast cancer patients and women with BBD was clearly driven by the comparison with BBD women who were ER alpha(+) (OR = 1.95, 95% CI: 1.31-2.89 per 1 SD increase in IGF-1 levels), whereas there was essentially no association with IGF-1 levels when ER alpha(+) breast cancer patients were compared with ER alpha(-) BBD women. These contrasts were particularly evident among post/peri-menopausal women. Conclusion(s): We found evidence in support of an interaction of IGF-1 with the expression of ER alpha in the non-malignant mammary tissue in the context of breast cancer pathogenesis. This is in line with previous evidence suggesting that IGF-1 increases the risk of ER(+) breast cancer

The hormonal profile of benign breast disease

Background: Limited information exists about the endocrine milieu of benign breast disease (BBD), a documented breast cancer risk factor. We compared blood levels of estrogens, testosterone and insulin-like growth factor-1 (IGF-1) between BBD patients by histological type and women without breast pathology. Methods: We studied 578 BBD patients and 178 healthy women in Athens, Greece, who provided blood samples, and completed interviewer-administered questionnaires. Results: Of the BBD patients, 254 had non-proliferative disease, 268 proliferative disease without atypia and 56 atypical hyperplasia. Comparing BBD patients with healthy women, the per cent differences (and 95% confidence intervals) for blood hormones, among pre-menopausal and peri/post-menopausal women, respectively, were: 22.4% (-4.0%, 56.1%) and 32.0% (5.6%, 65.1%) for estradiol; 26.2% (10.1%, 44.8%) and 30.9% (16.8%, 46.6%) for estrone; 19.5% (3.1%, 38.4%) and 16.5% (-5.0%, 42.9%) for testosterone; and -5.2% (-13.8%, 4.4%) and -12.1% (-19.8%, -3.6%) for IGF-1. Steroid hormones tended to be higher in proliferative compared with non-proliferative BBD. Conclusions: Circulating steroid hormones tend to be higher among women with BBD than women with no breast pathology and higher in proliferative than non-proliferative disease; these patterns are more evident among peri/post-menopausal women. In peri/post-menopausal women IGF-1 was lower among women with BBD compared with healthy women

A comparison of hormonal profiles between breast cancer and benign breast disease: a case-control study

Benign breast disease (BBD), particularly proliferative BBD, is an established breast cancer risk factor. However, there has been no systematic attempt to compare the hormonal profiles of the two conditions. In a case-control investigation in Athens, Greece, we compared levels of estrogens, testosterone and insulin-like growth factor-1 (IGF-1), as well as their principal binding proteins, between breast cancer patients, women with BBD by histological type (proliferative and nonproliferative) and women with no breast pathology. We studied 466 women with incident breast cancer, 704 women with BBD and 244 healthy women. We used multiple regression to compare log-transformed serum hormone levels of breast cancer patients with those of healthy women and women with BBD by histological type (proliferative and nonproliferative BBD). The hormonal profile of breast cancer in our study was in line with the generally accepted hormonal profile of this disease, as reported from large cohort studies. Compared with healthy women, breast cancer patients tended to have higher levels of steroid hormones. The evidence was strong for estrone (difference 21.5%, P < 0.001), weaker for testosterone (difference 15.8%, P = 0.07) and weaker still for estradiol (difference 12.0%, P = 0.18). Also compared with healthy women, breast cancer patients had barely higher levels of IGF-1 (difference 2.0%, P = 0.51), but had significantly lower levels of IGF binding protein 3 (IGFBP-3) (difference -6.7%, P = 0.001). Compared with women with BBD, breast cancer patients had nonstatistically significantly lower levels of steroid hormones, but they had higher levels of IGF-1 [difference 5.5%, 95% confidence interval (CI) 0.7% to 10.6%] and lower levels of IGFBP-3 (difference -3.7%, 95% CI -6.7% to -0.7%). Differences were more pronounced when breast cancer patients were contrasted to women with proliferative BBD. Our findings suggest that high levels of IGF-1 may be an important factor toward the evolution of BBD to breast cancer