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

Perioperative management and prognosis in over aged patients undergoing non-cardiac surgery： experience with 828 cases in a single center

Objective To investigate perioperative management and prognosis in patients aged≥80 years old undergoing non-cardiac surgery. Methods Clinical data of 828 patients aged≥80 years old undergoing non-cardiac surgery were retrospectively analyzed. Intraoperative hypotension， accumulated time of hypotension， operation time， intraoperative blood loss， postoperative ICU admission， length of ICU stay， length of hospital stay， cost of care， perioperative complications need to be treated， and perioperative death were recorded and analyzed. Results The mean age of 828 patients was （84±4） years old. All cases were classified as American Society of Anesthesiologist （ASA） gradeⅡ-Ⅴ. Postoperative complications occurred in 111 patients （13.4%）， and postoperative death occurred in 24 patients （2.9%）. The incidence of postoperative complications and death in thoracic， neuro-，and vascular surgery was 29% and 17%， the highest among various types of operations （all P < 0.05）. Among patients with different ASA grades， the incidence of postoperative complications and death in patients with ASA gradeⅣand V was significantly higher than that in their counterparts with ASA gradeⅡ（both P < 0.001）. The selection of anesthesia approach did not affect the incidence of postoperative complications and death in different operations except thoracic， neuro-， and vascular surgery under general anesthesia （P > 0.05）. Compared with patients with intraoperative systolic pressure of <120 mmHg， the incidence of postoperative complications was significantly higher in those with systolic pressure of < 90 mmHg（P < 0.05）. The proportion of ICU admission， length of hospital stay， and incidence of postoperative complications were significantly increased over age （all P < 0.01）， whereas postoperative death rate did not differ among patients of different ages （P > 0.05）. Conclusions Patients aged≥80 years old have high incidence of postoperative complications and death rates， which is probably associated with high-risk operation and intraoperative hypotension， especially systolic hypotension of < 90 mmHg enduring for≥10 min

Effect of Ascorbic Acid on Mineral and Bone Disorders in Hemodialysis Patients: a Systematic Review and Meta-Analysis

Background/Aims: Hemodialysis (HD) patients often have inadequate nutrition, especially with respect to ascorbic acid (AA). It is reported that every HD session may cause a 50%– 75% decrease in plasma AA levels. Some studies have shown that supplementation of AA can change the outcome of chronic kidney disease-mineral bone disorders (CKD-MBD), but the effect of AA on HD patients with CKD-MBD remains controversial. Consequently, we decided to perform a meta-analysis to evaluate the efficacy of AA supplementation in CKD-MBD patients requiring dialysis. Methods: A search was conducted using Pubmed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure (CNKI), Wanfang database and VIP information database up to April 2018 for all English and Chinese language publications. The main indicators of our study were changes in serum phosphate (P), calcium (Ca) and parathyroid hormone (PTH) levels after AA treatment. The efficacy of AA was evaluated by weighted mean difference (WMD) and confidence intervals (CI). Cardiovascular events, mortality and adverse events reported during the experiment were also noted. Results: In total, 371 patients in six studies were involved in this meta-analysis. Compared to placebo, AA treatment had no positive effect on serum P (353 patients; WMD = -0.05; 95% CI, -0.3 to 0.2; I2 = 28%) or PTH levels (275 patients; WMD = -17.04; 95%CI, -63.79 to 29.72; I2 = 75%). The pooled mean difference of the change of Ca levels from baseline was higher in the AA therapy group versus placebo (353 patients; WMD = 0.15; 95% CI, 0.01 to 0.3; I2 = 0%). No side effects were observed. Conclusion: Our systematic review and meta-analysis does not support prescription of AA to HD patients with CKD-MBD. AA had no positive effect on CKD-MBD patients as it couldn’t influence the serum P or PTH levels but did raise serum Ca levels in the short-term

Applying Address Encryption and Timing Noise to Enhance the Security of Caches

Encrypting the mapping relationship between physical and cache addresses has been a promising technique to prevent conflict-based cache side-channel attacks. However, this method is not foolproof and the attackers can still build a side-channel despite the increased difficulty of finding the minimal eviction set. To address this issue, we propose a new protection method that integrates both address encryption and timing noise extension mechanisms. By adding the timing noise extension mechanism to the address encryption method, we can randomly generate cache misses that prevent the attackers from pruning the eviction set. Our analysis shows that the timing noise extension mechanism can cause the attackers to fail in obtaining accurate timing information for accessing memory. Furthermore, our proposal reduces the timing noise generating rate, minimizing performance overhead. Our experiments on SPEC CPU 2017 show that the integrated mechanism only resulted in a tiny performance overhead of 2.9%

Aging Mechanism of a Diatomite-Modified Asphalt Binder Using Fourier-Transform Infrared (FTIR) Spectroscopy Analysis

In this paper, Fourier-transform infrared (FTIR) spectroscopy was used to evaluate the effects of diatomite on aging properties of an asphalt binder. The modified asphalts included 5%, 10%, and 15% diatomite, and were prepared in the laboratory. The changes in functional groups of asphalt were employed to investigate the aging mechanisms of the modified and control asphalts. Effects of diatomite on the anti-aging properties of asphalt were analyzed via the changes in intensity of the absorption peaks. Results showed that there were no new functional groups generated after diatomite mixing with asphalt. This indicated that the process of diatomite modification was just physical mixing. Furthermore, parts of saturates and aromatics were volatilized in the aging process of modified asphalt. Polar molecules reacted with oxygen in aging. Meanwhile, carbonyl (C=O) and sulfoxide (S=O) were also generated. The aging resistance of modified asphalt was the best when the diatomite content was 10%. The work of this paper may provide a new perspective to evaluate asphalt aging