Modeling Intrapersonal and Interpersonal Influences for Automatic Estimation of Therapist Empathy in Counseling Conversation

Counseling is usually conducted through spoken conversation between a therapist and a client. The empathy level of therapist is a key indicator of outcomes. Presuming that therapist's empathy expression is shaped by their past behavior and their perception of the client's behavior, we propose a model to estimate the therapist empathy by considering both intrapersonal and interpersonal influences. These dynamic influences are captured by applying an attention mechanism to the therapist turn and the historical turns of both therapist and client. Our findings suggest that the integration of dynamic influences enhances empathy level estimation. The influence-derived embedding should constitute a minor portion in the target turn representation for optimal empathy estimation. The client's turns (interpersonal influence) appear to slightly surpass the therapist's own turns (intrapersonal influence) in empathy estimation effectiveness. It is noted that concentrating exclusively on recent historical turns can significantly impact the estimation of therapist empathy

A Study on Prosodic Entrainment in Relation to Therapist Empathy in Counseling Conversation

Counseling is carried out as spoken conversation between a therapist and a client. The empathy level expressed by the therapist is considered an important index of the quality of counseling and often assessed by an observer or the client. This research investigates the entrainment of speech prosody in relation to subjectively rated empathy. Experimental results show that the entrainment of intensity is more influential to empathy observation than that of pitch or speech rate in client-therapist interaction. The observer and the client have different perceptions of therapist empathy with the same entrained phenomena in pitch and intensity. The client's intention to make adjustment on pitch variation and intensity of speech is considered an indicator of the client's perception of counseling quality.Comment: Accepted by INTERSPEECH 202

Hierarchical Attention Network for Evaluating Therapist Empathy in Counseling Session

Counseling typically takes the form of spoken conversation between a therapist and a client. The empathy level expressed by the therapist is considered to be an essential quality factor of counseling outcome. This paper proposes a hierarchical recurrent network combined with two-level attention mechanisms to determine the therapist's empathy level solely from the acoustic features of conversational speech in a counseling session. The experimental results show that the proposed model can achieve an accuracy of 72.1% in classifying the therapist's empathy level as being "high" or "low". It is found that the speech from both the therapist and the client are contributing to predicting the empathy level that is subjectively rated by an expert observer. By analyzing speaker turns assigned with high attention weights, it is observed that 2 to 6 consecutive turns should be considered together to provide useful clues for detecting empathy, and the observer tends to take the whole session into consideration when rating the therapist empathy, instead of relying on a few specific speaker turns.Comment: Submitted to INTERSPEECH 202

Describing bilinguals: A systematic review of labels and descriptions used in the literature between 2005–2015

Recent years have seen a surge in research comparing bilinguals to monolinguals, yet synthesizing this literature is complicated by the diversity of language and social backgrounds behind these dichotomous labels. The current study examines the labels and descriptions reported in 186 studies comparing bilinguals and monolinguals published between 2005-2015 in order to understand how bilingualism has been operationalized and describe the degree to which different facets of bilingual experience are reported. Proficiency and usage were the most frequently reported features (77% and 79%), followed by language history (67%) and the language of schooling (60%). However, less than half of the studies measured proficiency objectively or reported proportional usage, and even less - 30% - described the sociolinguistic context from which the sample was drawn. Given the increase in language contact due to globalization, more transparent and comprehensive reporting of participant characteristics is critical to building our understanding of how bilingualism affects experience

Unravelling the Diversity of the Cyclopiazonic Acid Family of Mycotoxins in Aspergillus flavus by UHPLC Triple-TOF HRMS

Cyclopiazonic acid (α-cyclopiazonic acid, α-CPA) is an indole-hydrindane-tetramic acid neurotoxin produced by various fungal species, including the notorious food and feed contaminant Aspergillus flavus. Despite its discovery in A. flavus cultures approximately 40 years ago, its contribution to the A. flavus mycotoxin burden is consistently minimized by our focus on the more potent carcinogenic aflatoxins also produced by this fungus. Here, we report the screening and identification of several CPA-type alkaloids not previously found in A. flavus cultures. Our identifications of these CPA-type alkaloids are based on a dereplication strategy involving accurate mass high resolution mass spectrometry data and a careful study of the α-CPA fragmentation pattern. In total, 22 CPA-type alkaloids were identified in extracts from the A. flavus strains examined. Of these metabolites, 13 have been previously reported in other fungi, though this is the first report of their existence in A. flavus. Two of our metabolite discoveries, 11,12-dehydro α-CPA and 3-hydroxy-2-oxo CPA, have never been reported for any organism. The conspicuous presence of CPA and its numerous derivatives in A. flavus cultures raises concerns about the long-term and cumulative toxicological effects of these fungal secondary metabolites and their contributions to the entire A. flavus mycotoxin problem.Valdet Uka was financially supported by Project Basileus V (Erasmus Mundus Action 2) funding from the European Commission

Sex differences in the association between socioeconomic status and diabetes prevalence and incidence in China: cross-sectional and prospective studies of 0.5 million adults

Aims/hypothesis China has undergone rapid socioeconomic transition accompanied by lifestyle changes that are expected to have a profound impact on the health of its population. However, there is limited evidence from large nationwide studies about the relevance of socioeconomic status (SES) to risk of diabetes. We describe the associations of two key measures of SES with prevalent and incident diabetes in Chinese men and women. Methods The China Kadoorie Biobank study included 0.5 million adults aged 30–79 years recruited from ten diverse areas in China during 2004–2008. SES was assessed using the highest educational level attained and annual household income. Prevalent diabetes was identified from self-report and plasma glucose measurements. Incident diabetes was identified from linkage to disease and death registries and national health insurance claim databases. We estimated adjusted ORs and HRs for prevalent and incident diabetes associated with SES using logistic and Cox regression models, respectively. Results At baseline, 30,066 (5.9%) participants had previously diagnosed (3.1%) or screen-detected (2.8%) diabetes among 510,219 participants included for cross-sectional analyses. There were 480,153 people without prevalent diabetes at baseline, of whom 9544 (2.0%) had new-onset diabetes during follow-up (median 7 years). Adjusted ORs (95% CIs) for prevalent diabetes, comparing highest vs lowest educational level, were 1.21 (1.09, 1.35) in men and 0.69 (0.63, 0.76) in women; for incident diabetes, the corresponding HRs were 1.27 (1.07, 1.51) and 0.80 (0.67, 0.95), respectively. For household income, the adjusted ORs for prevalent diabetes, comparing highest vs lowest categories, were 1.45 (1.34, 1.56) in men and 1.26 (1.19, 1.34) in women; for incident diabetes, the HRs were 1.36 (1.19, 1.55) and 1.06 (0.95, 1.17), respectively. Conclusions/interpretation Among Chinese adults, the associations between education and diabetes prevalence and incidence differed qualitatively between men and women, whereas higher household income was positively associated with diabetes prevalence and incidence in both sexes, with a stronger relationship in men than in women.</p

CRISPR-enhanced human adipocyte \u27browning\u27 as cell therapy for metabolic disease [preprint]

Obesity and type 2 diabetes (T2D) are associated with poor tissue responses to insulin [1,2], disturbances in glucose and lipid fluxes [3-5] and comorbidities including steatohepatitis [6] and cardiovascular disease [7,8]. Despite extensive efforts at prevention and treatment [9,10], diabetes afflicts over 400 million people worldwide [11]. Whole body metabolism is regulated by adipose tissue depots [12-14], which include both lipid-storing white adipocytes and less abundant \u27brown\u27 and \u27brite/beige\u27 adipocytes that express thermogenic uncoupling protein UCP1 and secrete factors favorable to metabolic health [15-18]. Application of clustered regularly interspaced short palindromic repeats (CRISPR) gene editing [19,20] to enhance \u27browning\u27 of white adipose tissue is an attractive therapeutic approach to T2D. However, the problems of cell-selective delivery, immunogenicity of CRISPR reagents and long term stability of the modified adipocytes are formidable. To overcome these issues, we developed methods that deliver complexes of SpyCas9 protein and sgRNA ex vivo to disrupt the thermogenesis suppressor gene NRIP1 [21,22] with near 100% efficiency in human or mouse adipocytes. NRIP1 gene disruption at discrete loci strongly ablated NRIP1 protein and upregulated expression of UCP1 and beneficial secreted factors, while residual Cas9 protein and sgRNA were rapidly degraded. Implantation of the CRISPR-enhanced human or mouse brown-like adipocytes into high fat diet fed mice decreased adiposity and liver triglycerides while enhancing glucose tolerance compared to mice implanted with unmodified adipocytes. These findings advance a therapeutic strategy to improve metabolic homeostasis through CRISPR-based genetic modification of human adipocytes without exposure of the recipient to immunogenic Cas9 or delivery vectors

Distinct tau prion strains propagate in cells and mice and define different tauopathies

Prion-like propagation of tau aggregation might underlie the stereotyped progression of neurodegenerative tauopathies. True prions stably maintain unique conformations (“strains”) in vivo that link structure to patterns of pathology. We now find that tau meets this criterion. Stably expressed tau repeat domain indefinitely propagates distinct amyloid conformations in a clonal fashion in culture. Reintroduction of tau from these lines into naive cells reestablishes identical clones. We produced two strains in vitro that induce distinct pathologies in vivo as determined by successive inoculations into three generations of transgenic mice. Immunopurified tau from these mice recreates the original strains in culture. We used the cell system to isolate tau strains from 29 patients with 5 different tauopathies, finding that different diseases are associated with different sets of strains. Tau thus demonstrates essential characteristics of a prion. This might explain the phenotypic diversity of tauopathies and could enable more effective diagnosis and therapy

Prognostic Implications for Adolescents With Depression Who Drop Out of Psychological Treatment During a Randomized Controlled Trial

OBJECTIVE: High therapy dropout rates among adolescents have been reported, but little is known about whether dropout is associated with poor outcomes. This study aimed to examine clinical outcomes in adolescents with depression who dropped out of psychological therapy and to determine whether this varied by treatment type. METHOD: Data were drawn from the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) study, a randomized controlled trial, comparing a brief psychosocial intervention, cognitive-behavioral therapy, and short-term psychoanalytic psychotherapy in the treatment of adolescent major depression. The sample comprised 406 adolescents with a diagnosis of major depression, 169 of whom dropped out of treatment before the planned end of therapy. Primary outcome was self-report Mood and Feelings Questionnaire (MFQ); secondary outcomes were Health of the Nation Outcome Scale for Children and Adolescents, Revised Children's Manifest Anxiety Scale, Modified Leyton Obsessional Inventory, and clinical diagnosis. RESULTS: During follow-up, there was a nonsignificant trend for dropouts to report higher depressive symptoms than completers. However, modeling showed insufficient evidence for an association between dropout and outcomes. CONCLUSION: In contrast to studies of adult therapy, there was no strong evidence that adolescent patients who dropped out had poorer clinical outcomes compared with those who completed therapy, when dropout was defined as ending treatment without agreement of the therapist. This challenges us to understand why adolescents stop going to therapy, how dropout should be defined, and whether what is prescribed is what is always needed. CLINICAL TRIAL REGISTRATION INFORMATION: Improving Mood and Preventing Relapse With Psychoanalytic Psychotherapy and Cognitive Behavior Therapy; http://www.isrctn.com/; 83033550