Here Comes the Bad News: Doctor Robot Taking Over

To test in how far the Media Equation and Computers Are Social Actors (CASA) validly explain user responses to social robots, we manipulated how a bad health message was framed and the language that was used. In the wake of Experiment 2 of Burgers et al. (Patient Educ Couns 89(2):267–273, 2012. https://doi.org/10.1016/j.pec.2012.08.008), a human versus robot doctor delivered health messages framed positively or negatively, using affirmations or negations. In using frequentist (robots are different from humans) and Bayesian (robots are the same) analyses, we found that participants liked the robot doctor and the robot’s message better than the human’s. The robot also compelled more compliance to the medical treatment. For the level of expected quality of life, the human and robot doctor tied. The robot was not seen as affectively distant but rather involving, ethical, skilled, and people wanted to consult her again. Note that doctor robot was not a seriously looking physician but a little girl with the voice of a young woman. We conclude that both Media Equation and CASA need to be altered when it comes to robot communication. We argue that if certain negative qualities are filtered out (e.g., strong emotion expression), credibility will increase, which lowers affective distance to the messenger. Robots sometimes outperform humans on emotional tasks, which may relieve physicians from a most demanding duty of disclosing unfavorable information to a patient

Noninvasive Prenatal Diagnosis of Fetal Trisomy 18 and Trisomy 13 by Maternal Plasma DNA Sequencing

Massively parallel sequencing of DNA molecules in the plasma of pregnant women has been shown to allow accurate and noninvasive prenatal detection of fetal trisomy 21. However, whether the sequencing approach is as accurate for the noninvasive prenatal diagnosis of trisomy 13 and 18 is unclear due to the lack of data from a large sample set. We studied 392 pregnancies, among which 25 involved a trisomy 13 fetus and 37 involved a trisomy 18 fetus, by massively parallel sequencing. By using our previously reported standard z-score approach, we demonstrated that this approach could identify 36.0% and 73.0% of trisomy 13 and 18 at specificities of 92.4% and 97.2%, respectively. We aimed to improve the detection of trisomy 13 and 18 by using a non-repeat-masked reference human genome instead of a repeat-masked one to increase the number of aligned sequence reads for each sample. We then applied a bioinformatics approach to correct GC content bias in the sequencing data. With these measures, we detected all (25 out of 25) trisomy 13 fetuses at a specificity of 98.9% (261 out of 264 non-trisomy 13 cases), and 91.9% (34 out of 37) of the trisomy 18 fetuses at 98.0% specificity (247 out of 252 non-trisomy 18 cases). These data indicate that with appropriate bioinformatics analysis, noninvasive prenatal diagnosis of trisomy 13 and trisomy 18 by maternal plasma DNA sequencing is achievable

External validation of the PAGE-B score for HCC risk prediction in people living with HIV/HBV coinfection

Background & Aims: HBV coinfection is common among people living with HIV (PLWH) and is the most important cause of hepatocellular carcinoma (HCC). While risk prediction tools for HCC have been validated in patients with HBV monoinfection, they have not been evaluated in PLWH. Thus, we performed an external validation of PAGE-B in people with HIV/HBV coinfection. Methods: We included data on PLWH from four European cohorts who were positive for HBsAg and did not have HCC before starting tenofovir. We estimated the predictive performance of PAGE-B for HCC occurrence over 15 years in patients receiving tenofovir-containing antiretroviral therapy. Model discrimination was assessed after multiple imputation using Cox regression with the prognostic index as a covariate, and by calculating Harrell's c-index. Calibration was assessed by comparing our cumulative incidence with the PAGE-B derivation study using Kaplan-Meier curves. Results: In total, 2,963 individuals with HIV/HBV coinfection on tenofovir-containing antiretroviral therapy were included. PAGE-B was <10 in 26.5%, 10–17 in 57.7%, and ≥18 in 15.7% of patients. Within a median follow-up of 9.6 years, HCC occurred in 68 individuals (2.58/1,000 patient-years, 95% CI 2.03–3.27). The regression slope of the prognostic index for developing HCC within 15 years was 0.93 (95% CI 0.61–1.25), and the pooled c-index was 0.77 (range 0.73–0.80), both indicating good model discrimination. The cumulative incidence of HCC was lower in our study compared to the derivation study. A PAGE-B cut-off of <10 had a negative predictive value of 99.4% for the development of HCC within 5 years. Restricting efforts to individuals with a PAGE-B of ≥10 would spare unnecessary HCC screening in 27% of individuals. Conclusions: For individuals with HIV/HBV coinfection, PAGE-B is a valid tool to determine the need for HCC screening. Impact and implications: Chronic HBV infection is the most important cause of hepatocellular carcinoma (HCC) among people living with HIV. Valid risk prediction may enable better targeting of HCC screening efforts to high-risk individuals. We aimed to validate PAGE-B, a risk prediction tool that is based on age, sex, and platelets, in 2,963 individuals with HIV/HBV coinfection who received tenofovir-containing antiretroviral therapy. In the present study, PAGE-B showed good discrimination, adequate calibration, and a cut-off of <10 had a negative predictive value of 99.4% for the development of HCC within 5 years. These results indicate that PAGE-B is a simple and valid risk prediction tool to determine the need for HCC screening among people living with HIV and HBV

Pregnancy-related pelvic girdle pain: an update

A large number of scientists from a wide range of medical and surgical disciplines have reported on the existence and characteristics of the clinical syndrome of pelvic girdle pain during or after pregnancy. This syndrome refers to a musculoskeletal type of persistent pain localised at the anterior and/or posterior aspect of the pelvic ring. The pain may radiate across the hip joint and the thigh bones. The symptoms may begin either during the first trimester of pregnancy, at labour or even during the postpartum period. The physiological processes characterising this clinical entity remain obscure. In this review, the definition and epidemiology, as well as a proposed diagnostic algorithm and treatment options, are presented. Ongoing research is desirable to establish clear management strategies that are based on the pathophysiologic mechanisms responsible for the escalation of the syndrome's symptoms to a fraction of the population of pregnant women

The evolutionary psychology of leadership trait perception

Knowles, Kristen K. - ORCID 0000-0001-9664-9055 https://orcid.org/0000-0001-9664-9055Many researchers now approach the understanding of how facial characteristics shape the perception of leadership ability through the lens of human evolution. This approach considers what skills and characteristics would have been valuable for leaders to possess in our evolutionary history, including dominance, masculinity, and trustworthiness. Moreover, it gives an understanding about why rapid categorisation of these social cues from faces is adaptive. In this chapter, I present evolutionary arguments for social inferences based on faces, and discuss how our understanding of this categorisation has shifted away from purely associative phenomena towards evolved, innate processes. I explain how the perception of leadership ability in faces is linked to variance in facial morphology, and how these morphologies tell us something about the individuals who carry them. Specific facial cues relating to leadership-relevant traits are discussed, as well as the underlying biological systems that accompany these traits. I also explain the importance of context and individual differences on the prioritisation of seemingly disparate facial cues to leadership: dominance and trustworthiness. I also discuss recent findings in this area which further extend these concepts to examine cues to leadership in women’s faces, generally overlooked by evolutionary psychologists, and how political ideology can interact with these effects.https://doi.org/10.1007/978-3-319-94535-4_5pubpu

Stroke genetics informs drug discovery and risk prediction across ancestries

Previous genome-wide association studies (GWASs) of stroke — the second leading cause of death worldwide — were conducted predominantly in populations of European ancestry1,2. Here, in cross-ancestry GWAS meta-analyses of 110,182 patients who have had a stroke (five ancestries, 33% non-European) and 1,503,898 control individuals, we identify association signals for stroke and its subtypes at 89 (61 new) independent loci: 60 in primary inverse-variance-weighted analyses and 29 in secondary meta-regression and multitrait analyses. On the basis of internal cross-ancestry validation and an independent follow-up in 89,084 additional cases of stroke (30% non-European) and 1,013,843 control individuals, 87% of the primary stroke risk loci and 60% of the secondary stroke risk loci were replicated (P < 0.05). Effect sizes were highly correlated across ancestries. Cross-ancestry fine-mapping, in silico mutagenesis analysis3, and transcriptome-wide and proteome-wide association analyses revealed putative causal genes (such as SH3PXD2A and FURIN) and variants (such as at GRK5 and NOS3). Using a three-pronged approach4, we provide genetic evidence for putative drug effects, highlighting F11, KLKB1, PROC, GP1BA, LAMC2 and VCAM1 as possible targets, with drugs already under investigation for stroke for F11 and PROC. A polygenic score integrating cross-ancestry and ancestry-specific stroke GWASs with vascular-risk factor GWASs (integrative polygenic scores) strongly predicted ischaemic stroke in populations of European, East Asian and African ancestry5. Stroke genetic risk scores were predictive of ischaemic stroke independent of clinical risk factors in 52,600 clinical-trial participants with cardiometabolic disease. Our results provide insights to inform biology, reveal potential drug targets and derive genetic risk prediction tools across ancestries

From UX to Engagement: Connecting Theory and Practice, Addressing Ethics and Diversity

In the field of Human-Computer Interaction (HCI), engagement bears critical significance, not just for informing a design and implementation of the interface, but also for creating improved and advanced interfaces that can adapt to users. While the idea of user engagement is passively being researched in a range of domains, it has been used to various related but diverse concepts. For instance, engagement is the vital element of an effective HCI design. The primary goal of this paper is to introduce relevant research questions related to the engagement domain. The paper studies engagement from four different perspectives: (i) Theory: identifying key issues that aid in building a pluralism of engagement frameworks, (ii) Practice: developing novel methodologies for user engagement and reliable assessment tools, (iii) Ethics: discussing the ethical aspects of engagement especially for designers and developers of humane technologies, (iv) Diversity: investigating individual differences to develop personalized engaging designs and understanding user diversities to provide equal opportunities for user engagement. The discussion will lead to opportunities for the potential researchers to acquire relevant knowledge, assess the mechanisms of engagement and evaluate the current design frameworks. © 2019, Springer Nature Switzerland AG

Developing a virtual coach for chronic patients:A user study on the impact of similarity, familiarity and realism

Healthcare costs are increasing dramatically due to disproportional consumption of healthcare resources by chronic patients. Automated forms of health coaching can contribute to improved patient self-management while reducing costs due to increased scalability and availability of the use of human health coaches. Embodied Conversational Agents (ECAs) seem to be good candidates to function as automated coaches, as they introduce a social component to human-computer interactions which makes them particularly suitable to influence a user’s attitude or behavior. To date, there is limited knowledge on the impact of appearance-related characteristics of an ECA as a virtual coach among a chronically ill elderly population. The primary aim of this study is to investigate the impact of three appearance cues on user acceptance: (i) similarity; (ii) familiarity; and (iii) realism. Findings demonstrate that patients (a) preferred the realistic-looking ECA over the more stylized one; (b) showed no preference for the familiar over the unfamiliar ECAs (but did evaluate the unfamiliar ECAs as more positive than the familiar one); and (c) evaluated an ECA as virtual coach for self-management support as useful