Exploring the impact of VoiceBots on multimedia programming education among Ghanaian university students

Conversational user interfaces (CUI), including voice interfaces, which allow users to converse with computers via voice, are gaining wide popularity. VoiceBots allow users to receive a response in real-time, regardless of the communication device. VoiceBots have been explored in fields such as customer service to automate repetitive queries and help reduce redundant tasks; however, they have not been widely applied in the classroom. This study aimed to explore the effects of VoiceBot implementation on student learning. A pre-test–post-test design was implemented with 65 participating undergraduate students in multimedia programming who were randomly allocated to scenarios representing a 2 × 2 design (experimental and control cohorts). Data were collected using an academic achievement test and semi-structured interviews, which allowed for a more in-depth analysis of the students' experiences with the VoiceBot. The results showed that how the VoiceBot was applied positively influenced student learning in the experimental cohort. Moreover, the focus group data demonstrated that the VoiceBot can be a valuable assistant for students and could be easily replicated in other courses. To the best of our knowledge, this study was the first to use VoiceBot to engage undergraduate students in Ghana, thus contributing to the growing literature stream on the development of VoiceBots to improve student learning experiences. This study elucidates the design process using a zero-coding technique, which is considered a suitable approach for educational institutions with limited resources. Practitioner notes What is already known about this topic Conversational user interfaces (CUIs), including voice interfaces, have gained popularity and are used to interact with computers through natural language. VoiceBots have been utilised in various fields such as customer service to automate tasks and reduce redundancy. Instant messaging systems such as WhatsApp and Telegram have been used for communication in educational contexts. Advances in artificial intelligence (AI) and natural language processing (NLP) have led to significant improvements in voice-enabled CUIs (VoiceBots). Existing studies indicate that chatbots affect students' motivation, learning experiences, and achievements; however, research on using VoiceBots for learning improvement is limited. What this paper adds A VoiceBot was introduced as an assistant to facilitate learning in a multimedia programming course. The study used an experimental design with an experimental cohort using a WhatsApp group platform equipped with a zero-coding VoiceBot and a control cohort without the bot. The study found that students interacting with VoiceBot demonstrated better learning achievement than the control group. The study also provides clear suggestions on integrating VoiceBots into educational institutions. Implications for practice and/or policy The study's findings suggest that VoiceBots can play a significant role in improving student learning achievements, especially in subjects such as multimedia programming. Educational institutions could establish learning design and technology centres with subject matter experts to integrate VoiceBots effectively into the learning process. Instructors must possess adequate technological proficiency to engage students with VoiceBots and targeted in-service training may be necessary. Future research can explore VoiceBot use across various academic domains and levels of education, analyse the impact of usage patterns on learning outcomes, and assess its long-term effects on student engagement and motivation.</p

Metabolic syndrome across Europe: Different clusters of risk factors

BACKGROUND: Metabolic syndrome (MetS) remains a controversial entity. Specific clusters of MetS components - rather than MetS per se - are associated with accelerated arterial ageing and with cardiovascular (CV) events. To investigate whether the distribution of clusters of MetS components differed cross-culturally, we studied 34,821 subjects from 12 cohorts from 10 European countries and one cohort from the USA in the MARE (Metabolic syndrome and Arteries REsearch) Consortium. METHODS: In accordance with the ATP III criteria, MetS was defined as an alteration three or more of the following five components: elevated glucose (G), fasting glucose ≥110 mg/dl; low HDL cholesterol, &lt; 40mg/dl for men or &lt;50 mg/dl for women; high triglycerides (T), ≥150 mg/dl; elevated blood pressure (B), ≥130/≥85 mmHg; abdominal obesity (W), waist circumference &gt;102 cm for men or &gt;88 cm for women. RESULTS: MetS had a 24.3% prevalence (8468 subjects: 23.9% in men vs. 24.6% in women, p &lt; 0.001) with an age-associated increase in its prevalence in all the cohorts. The age-adjusted prevalence of the clusters of MetS components previously associated with greater arterial and CV burden differed across countries (p &lt; 0.0001) and in men and women (p &lt; 0.0001). In details, the cluster TBW was observed in 12% of the subjects with MetS, but was far more common in the cohorts from the UK (32.3%), Sardinia in Italy (19.6%), and Germany (18.5%) and less prevalent in the cohorts from Sweden (1.2%), Spain (2.6%), and the USA (2.5%). The cluster GBW accounted for 12.7% of subjects with MetS with higher occurrence in Southern Europe (Italy, Spain, and Portugal: 31.4, 18.4, and 17.1% respectively) and in Belgium (20.4%), than in Northern Europe (Germany, Sweden, and Lithuania: 7.6, 9.4, and 9.6% respectively). CONCLUSIONS: The analysis of the distribution of MetS suggested that what follows under the common definition of MetS is not a unique entity rather a constellation of cluster of MetS components, likely selectively risky for CV disease, whose occurrence differs across countries

Non-coronary atherosclerosis

During the last decades, the clinical and research interest in atherosclerosis has been mostly focused on coronary arteries. After the publications of the European Society Guidelines and AHA/ACC Guidelines on Peripheral artery diseases, and of the Registry REduction in Atherothrombosis for Continued Health Registry, there has been an increased interest in atherosclerosis of the lower extremity arteries and its presence in multifocal disease. However, awareness in the general population and the medical community of non-coronary artery diseases, and of its major prognostic implications remain relatively low. The aim of this general review stemming out of an ESC Working Group on Peripheral Circulation meeting in 2011 is to enhance awareness of this complex disease highlighting the importance of the involvement of atherosclerosis at different levels with respect to clinical presentation, diagnosis, and co-existence of the disease in the distinct arterial territories. We also emphasize the need of an interdisciplinary approach to face the broad and complex spectrum of multifocal disease, and try to propose a series of tentative recommendations and measures to be implemented in non-coronary atherosclerosi

Acute effects of electronic and tobacco cigarettes on vascular and respiratory function in healthy volunteers:a cross-over study

Objectives: To assess the acute effects of nicotine-containing electronic cigarettes versus tobacco smoking on vascular and respiratory function and circulating microparticles, particularly platelet microparticles (PMPs, biomarker of haemostasis/thrombosis) and endothelial microparticles (EMPs, biomarker of endothelial function). Methods: Heart rate (HR), blood pressure, reactive hyperaemia index (RHI, microvascular reactivity), augmentation index (arterial stiffness) and respiratory function were assessed in 20 smokers immediately before and after electronic cigarettes use and tobacco smoking. The number of microparticles was determined by flow cytometry using counting beads as a reference. Labelling with Annexin-V was used to detect the total microparticle fraction. EMPs were characterized as CD31+CD42− and PMPs as CD31+CD42+. Results: HR increased after electronic cigarettes use and tobacco smoking (P &#60; 0.001), whereas blood pressure remained unchanged (P &#62; 0.05). RHI (P = 0.006), augmentation index (P = 0.010) but not augmentation index standardized to HR 75 bpm (P &#62; 0.05) increased with electronic cigarettes use but not with tobacco smoking. Following tobacco smoking, there was a significant increase in total microparticles (P &#60; 0.001), EMPs (P &#60; 0.001) and PMPs (P &#60; 0.001). In contrast, electronic cigarettes were only associated with an increase in PMPs (P &#60; 0.001), with no significant changes in the total microparticle fraction or EMPs (all P &#62; 0.05). Peak expiratory flow significantly decreased following electronic cigarettes use (P = 0.019). Conclusion: Our results demonstrate that acute exposure to tobacco smoking as well as electronic cigarettes influences vascular and respiratory function. Where tobacco smoking significantly increased microparticle formation, indicative of possible endothelial injury, electronic cigarettes use induced vasoreactivity and decreased peak expiratory flow. These findings suggest that both electronic cigarettes and tobacco smoking negatively impact vascular function

The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation

n/

The assessment of vascular risk in men with erectile dysfunction: the role of the cardiologist and general physician.

Erectile dysfunction (ED) and cardiovascular disease (CVD) share risk factors and frequently coexist, with endothelial dysfunction believed to be the pathophysiologic link. ED is common, affecting more than 70% of men with known CVD. In addition, clinical studies have demonstrated that ED in men with no known CVD often precedes a CVD event by 2-5 years. ED severity has been correlated with increasing plaque burden in patients with coronary artery disease. ED is an independent marker of increased CVD risk including all-cause and especially CVD mortality, particularly in men aged 30-60 years. Thus, ED identifies a window of opportunity for CVD risk mitigation. We recommend that a thorough history, physical exam (including visceral adiposity), assessment of ED severity and duration and evaluation including fasting plasma glucose, lipids, resting electrocardiogram, family history, lifestyle factors, serum creatinine (estimated glomerular filtration rate) and albumin:creatinine ratio, and determination of the presence or absence of the metabolic syndrome be performed to characterise cardiovascular risk in all men with ED. Assessment of testosterone levels should also be considered and biomarkers may help to further quantify risk, even though their roles in development of CVD have not been firmly established. Finally, we recommend that a question about ED be included in assessment of CVD risk in all men and be added to CVD risk assessment guidelines

Clusters of risk factors in metabolic syndrome and their influence on central blood pressure in a global study

The effect of metabolic syndrome (MetS) and clusters of its components on central blood pressure (CBP) has not been well characterized. We aimed to describe the effect of MetS and clusters of its components on CBP in a large population and to identify whether this effect differs in men and women. We studied 15,609 volunteers (43% women) from 10 cohorts worldwide who participated in the Metabolic syndrome and Artery REsearch Consortium. MetS was defined according to the NCEP-ATP III criteria (GHTBW, glucose, high-density lipoprotein cholesterol, triglyceride, blood pressure, waist circumference). CBP was measured noninvasively and acquired from pulse wave analysis by applanation tonometry. MetS was associated with a 50% greater odds of having higher CSBP. After controlling for age, male sex, non HDL cholesterol, diabetes mellitus, and mean arterial pressure, only specific clusters of MetS components were associated with a higher CSBP; and some of them were significant in women but not in men. We identified "risky clusters" of MetS variables associated with high CSBP. Future studies are needed to confirm they identify subjects at high risk of accelerated arterial aging and, thus, need more intensive clinical management

Assessment of aortic stiffness by cardiovascular magnetic resonance following the treatment of severe aortic stenosis by TAVI and surgical AVR

Aortic stiffness is increasingly used as an independent predictor of adverse cardiovascular outcomes. We sought to compare the impact of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) upon aortic vascular function using cardiovascular magnetic resonance (CMR) measurements of aortic distensibility and pulse wave velocity (PWV).A 1.5 T CMR scan was performed pre-operatively and at 6 m post-intervention in 72 patients (32 TAVI, 40 SAVR; age 76 ± 8 years) with high-risk symptomatic severe aortic stenosis. Distensibility of the ascending and descending thoracic aorta and aortic pulse wave velocity were determined at both time points. TAVI and SAVR patients were comparable for gender, blood pressure and left ventricular ejection fraction. The TAVI group were older (81 ± 6.3 vs. 72.8 ± 7.0 years, p < 0.05) with a higher EuroSCORE II (5.7 ± 5.6 vs. 1.5 ± 1.0 %, p < 0.05). At 6 m, SAVR was associated with a significant decrease in distensibility of the ascending aorta (1.95 ± 1.15 vs. 1.57 ± 0.68 × 10(-3)mmHg(-1), p = 0.044) and of the descending thoracic aorta (3.05 ± 1.12 vs. 2.66 ± 1.00 × 10(-3)mmHg(-1), p = 0.018), with a significant increase in PWV (6.38 ± 4.47 vs. 11.01 ± 5.75 ms(-1), p = 0.001). Following TAVI, there was no change in distensibility of the ascending aorta (1.96 ± 1.51 vs. 1.72 ± 0.78 × 10(-3)mmHg(-1), p = 0.380), descending thoracic aorta (2.69 ± 1.79 vs. 2.21 ± 0.79 × 10(-3)mmHg(-1), p = 0.181) nor in PWV (8.69 ± 6.76 vs. 10.23 ± 7.88 ms(-1), p = 0.301) at 6 m.Treatment of symptomatic severe aortic stenosis by SAVR but not TAVI was associated with an increase in aortic stiffness at 6 months. Future work should focus on the prognostic implication of these findings to determine whether improved patient selection and outcomes can be achieved

Influence of the central-to-peripheral arterial stiffness gradient on the timing and amplitude of wave reflections

In individuals with compliant aortas, peripheral muscular artery stiffness exceeds central elastic artery stiffness. With ageing, central stiffness increases, with little change in peripheral stiffness, resulting in a reversal of the normal stiffness gradient. This reversal may reduce wave reflection amplitude, due to movement of the major “effective” reflection site further from the heart. To test this, we investigated the relationship among arterial stiffness gradients (normal and reversed), wave reflection amplitude and reflection site distance. Subjects aged ≥50years were recruited from the Anglo-Cardiff Collaborative Trial. Central stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). In study 1, peripheral PWV was also measured in the arm (carotid-radial, crPWV), and in study 2 in the leg (femoral- dorsalis pedis, fpPWV). Reflection site distance was calculated from cfPWV and reflected wave travel time. Subjects were dichotomized into those with a normal stiffness gradient (peripheral>central PWV), or a reversed gradient (peripheral<central PWV). In study 1, reflection site distance was greater in subjects with a reversed gradient (P<0.01), whereas time to reflection was lower (P<0.001). Both augmentation pressure (P<0.001) and augmentation index (P<0.05) were greater in subjects with a reversed gradient. In study 2, augmentation pressure, augmentation index and reflection site distance were greater in subjects with a reversed stiffness gradient (P<0.01, P<0.05 and P<0.01, respectively), and time to reflection was not different between groups. A reversed arterial stiffness gradient is associated with increased reflection site distance and a paradoxical increase in reflected wave amplitude, and augmentation index

Measuring psychological need states in sport: Theoretical considerations and a new measure

© 2019 Elsevier Ltd Objectives: Research guided by Self-determination Theory (Deci & Ryan, 1985; Ryan & Deci, 2017) has repeatedly demonstrated the importance of focusing on both the bright (satisfaction) and dark (frustration) sides of the three basic psychological needs. Recently, researchers have also argued for the utility of assessing a third need state, that of “unfulfillment”. In this paper, we outline an effort to develop and provide initial validity evidence for scores of a new multidimensional and sport-specific measure, the Psychological Need States in Sport-Scale (PNSS-S), to assess the satisfaction, frustration, and unfulfillment of all three needs. Method: In Study 1, we developed 46 candidate items, and tested evidence for the factorial structure of the responses to the newly developed items, internal consistency and discriminant validity of the subscale scores. Following refinement, the replication of the favored model was tested using an independent sample of athletes in Study 2. Evidence for the nomological network of the subscales of the new measure was also demonstrated in Study 2. Results: Factor models incorporating all three need states showed poor fit with the data. However, following post-hoc modifications, a six-factor model assessing the need states of satisfaction and frustration, separately for autonomy, competence, and relatedness, was found to have good fit to the data. After refinement, the 29-item six-factor model was found to demonstrate good fit, good standardized factor loadings, factor correlations in the expected directions, and acceptable estimates of internal consistency in Study 2. Tests of nomological networks showed that the six need states were significantly predicted by contextual autonomy, competence, and relatedness support/thwarts as expected. Autonomy and competence need satisfaction were significantly associated with engagement; and competence and relatedness need satisfaction were significantly associated with positive affect. In addition, autonomy and competence need frustration were significantly associated with exhaustion and all three need frustration states significantly predicted negative affect. Conclusions: A tripartite conceptualization of the need states was not empirically supported. Nevertheless, the PNSS-S makes a unique contribution to the sport literature, as it represents the first sport-specific measure of six distinct, yet, correlated states of the satisfaction and frustration of autonomy, competence, and relatedness needs