Acceptability of artificial intelligence (AI)-enabled chatbots, video consultations and live webchats as online platforms for sexual health advice

Objectives Sexual and reproductive health (SRH) services are undergoing a digital transformation. This study explored the acceptability of three digital services, (i) video consultations via Skype, (ii) live webchats with a health advisor and (iii) artificial intelligence (AI)-enabled chatbots, as potential platforms for SRH advice. Methods A pencil-and-paper 33-item survey was distributed in three clinics in Hampshire, UK for patients attending SRH services. Logistic regressions were performed to identify the correlates of acceptability. Results In total, 257 patients (57% women, 50% aged <25 years) completed the survey. As the first point of contact, 70% preferred face-to-face consultations, 17% telephone consultation, 10% webchats and 3% video consultations. Most would be willing to use video consultations (58%) and webchat facilities (73%) for ongoing care, but only 40% found AI chatbots acceptable. Younger age (<25 years) (OR 2.43, 95% CI 1.35 to 4.38), White ethnicity (OR 2.87, 95% CI 1.30 to 6.34), past sexually transmitted infection (STI) diagnosis (OR 2.05, 95% CI 1.07 to 3.95), self-reported STI symptoms (OR 0.58, 95% CI 0.34 to 0.97), smartphone ownership (OR 16.0, 95% CI 3.64 to 70.5) and the preference for a SRH smartphone application (OR 1.95, 95% CI 1.13 to 3.35) were associated with video consultations, webchats or chatbots acceptability. Conclusions Although video consultations and webchat services appear acceptable, there is currently little support for SRH chatbots. The findings demonstrate a preference for human interaction in SRH services. Policymakers and intervention developers need to ensure that digital transformation is not only cost-effective but also acceptable to users, easily accessible and equitable to all populations using SRH services

Chagas disease reactivation in a heart transplant patient infected by domestic Trypanosoma cruzi discrete typing unit I (TcIDOM)

Background Trypanosoma cruzi, causative agent of Chagas disease, displays high intraspecific genetic diversity: six genetic lineages or discrete typing units (DTUs) are currently recognized, termed TcI through TcVI. Each DTU presents a particular distribution pattern across the Americas, and is loosely associated with different transmission cycles and hosts. Several DTUs are known to circulate in Central America. It has been previously suggested that TcI infection is benign and does not lead to chronic chagasic cardiomyopathy (CCC). Findings In this study, we genotyped T. cruzi parasites circulating in the blood and from explanted cardiac tissue of an El Salvadorian patient who developed reactivation Chagas disease while on immunosuppressive medications after undergoing heart transplant in the U.S. as treatment for end-stage CCC. Parasite typing was performed through molecular methods (restriction fragment length polymorphism of polymerase reaction chain amplified products, microsatellite typing, maxicircle sequence typing and low-stringency single primer PCR, [LSSP-PCR]) as well as lineage-specific serology. We show that the parasites infecting the patient belong to the TcI DTU exclusively. Our data indicate that the parasites isolated from the patient belong to a genotype frequently associated with human infection throughout the Americas (TcI DOM ). Conclusions Our results constitute compelling evidence in support of TcI DTU’s ability to cause end-stage CCC and help dispel any residual bias that infection with this lineage is benign, pointing to the need for increased surveillance for dissemination of this genotype in endemic regions, the USA and globally

Kinetic and Spectroscopic Characterisation of Highly Reactive Methanesulfonates. Leaving Group Effects for Solvolyses and Comments on Geminal Electronic Effects Influencing SN_N1 Reactivity

Highly reactive methanesulfonates (mesylates, ROMs) have been prepared from 1-phenylethanol. cyclohex-2-en-1-ol, diphenylmethanol and p-methoxybenzyl alcohol by treatment with methanesulfonyl chloride and triethylamine in dichloro- or trichloro-methane at - 20 to 0 °C. The mesylates. characterised in solution by $^1$H and $^{13}$C NMR at -20 °C, were obtained in satisfactory purity (ca. 95%) in cold solutions but they decomposed by reaction with chloride, triethylamine or the parent alcohol. Rate constants for solvolyses in aqueous acetone and aqueous ethanol have been determined by a fast response conductimetric method. Product selectivities for solvolyses of pmethoxybenzyl mesylate in aqueous ethanol and methanol at 0 °C have been determined by HPLC. From additional new or Iiterature kinetic data for solvolyses of corresponding bromides. chlorides and p-nitrobenzoates (OPNB). Br/CI. OMs/Br and OMs/OPNB rate ratios were calculated; the results are consistent with electronic effects stabilising the carbocationic transition states and increasing OMs/Br rate ratios for these SN 1 solvolyses; none of the evidence supports a geminal electronic effect on Br/CI rate ratios (e.g. caused by stabilisation of the initial state in pmethoxybenzyl chloride). Steric effects on ester /halide rate ratios for solvolyses of tertiary substrates are confirmed. Relative rates over a 10$^{16}$ range for ester and halide leaving groups are evaluated for solvolyses of 1-phenylethyl substrates in 80% ethanol-water. updating previous work by Noyce et al. (1972)

A Bethe-Salpeter model for light mesons: spectra and decays

The spectra and electroweak decay properties of light mesons are analyzed within the framework of the instantaneous Bethe-Salpeter equation. The interaction kernel comprises alternative spin-structures for a parameterization of confinement and a residual quark-antiquark interaction based on instanton effects. It is shown that only with a vector confinement the parameters can be chosen such as to yield an excellent description of the light pseudoscalar and vector mesons including weak and two photon decays. However it is found that it is not possible to reconcile this with the Regge behavior of higher lying meson states with the same parameter set.Comment: 12 pages, RevTeX, TK-93-1

Ground-state Spectrum of Light-quark Mesons

A confining, Goldstone theorem preserving, separable Ansatz for the ladder kernel of the two-body Bethe-Salpeter equation is constructed from phenomenologically efficacious $u$, $d$ and $s$ dressed-quark propagators. The simplicity of the approach is its merit. It provides a good description of the ground-state isovector-pseudoscalar, vector and axial-vector meson spectrum; facilitates an exploration of the relative importance of various components of the two-body Bethe-Salpeter amplitudes, showing that sub-leading Dirac components are quantitatively important in the isovector-pseudoscalar meson channels; and allows a scrutiny of the domain of applicability of ladder truncation studies. A colour-antitriplet diquark spectrum is obtained. Shortcomings of separable Ans\"atze and the ladder kernel are highlighted.Comment: 30 pages, LaTeX/REVTEX 3.0, no figure

A Dilatometric Study of Graphite Electrodes during Cycling with X-ray Computed Tomography

Graphite is the most commonly used anode material in commercial lithium-ion batteries (LiBs). Understanding the mechanisms driving the dimensional changes of graphite can pave the way to methods for inhibiting degradation pathways and possibly predict electrochemical performance loss. In this study, correlative microscopy tools were used alongside electrochemical dilatometry (ECD) to provide new insights into the dimensional changes during galvanostatic cycling. X-ray computed tomography (CT) provided a morphological perspective of the cycled electrode so that the effects of dilation and contraction on effective diffusivity and electrode pore phase volume fraction could be examined. During the first cycle, the graphite electrode underwent thickness changes close to 9% after lithiation and, moreover, it did not return to its initial thickness after subsequent delithiation. The irreversible dilation increased over subsequent cycles. It is suggested the primary reason for this dilation is electrode delamination. This is supported by the finding that the electrode porosity remained mostly unchanged during cycling, as revealed by X-ray CT

On the validity of the reduced Salpeter equation

We adapt a general method to solve both the full and reduced Salpeter equations and systematically explore the conditions under which these two equations give equivalent results in meson dynamics. The effects of constituent mass, angular momentum state, type of interaction, and the nature of confinement are all considered in an effort to clearly delineate the range of validity of the reduced Salpeter approximations. We find that for $J\not{\hspace*{-1.0mm}=}0$ the solutions are strikingly similar for all constituent masses. For zero angular momentum states the full and reduced Salpeter equations give different results for small quark mass especially with a large additive constant coordinate space potential. We also show that $\frac{1}{m}$ corrections to heavy-light energy levels can be accurately computed with the reduced equation.Comment: Latex (uses epsf macro), 24 pages of text, 12 postscript figures included. Slightly revised version, to appear in Phys. Rev.

Using guided individualised feedback to review self-reported quality of life in health and its importance

© 2014 Taylor & Francis. This pilot study investigated the effects of providing guided, individualised feedback on subjective quality of life (QoL), using results from the multidimensional WHOQOL-BREF profile. Participants (n=129; 85 chronically ill) were recruited in the community, and primary care. They were randomised to receive written or verbal guidance on interpreting a new graphical summary profile, which simultaneously presented (a) their individual self-ratings of QoL and (b) the importance attributed to each QoL dimension. Before and after feedback, participants completed health status, subjective QoL, QoL Importance, goal-oriented QoL and mood measures. Receiving individualised feedback was associated with increased psychological QoL, with modest effect size. No effects were found for physical, social or environmental QoL or QoL importance, health status, mood or goal-oriented QoL. There were no differences between modes of delivering guidance, indicating equal effectiveness. Chronic illness participants reported poorer QoL, moved more slowly towards their QoL goals, and had larger differences between core QoL and QoL Importance than healthy participants. Guided individualised empirical feedback about QoL judgements could be used to promote psychological well-being. Although professional interpretation of feedback is unnecessary, if shared, patients’ profiled WHOQOL information could support self-monitoring, self-management and clinical decision-making

On the instantaneous Bethe-Salpeter equation

We present a systematic algebraic and numerical investigation of the instantaneous Bethe-Salpeter equation. Emphasis is placed on confining interaction kernels of the Lorentz scalar, time component vector, and full vector types. We explore stability of the solutions and Regge behavior for each of these interactions, and conclude that only time component vector confinement leads to normal Regge structure and stable solutions.Comment: Latex (uses epsf macro), 26 pages of text, 12 postscript figures included