Comparing the effectiveness of robot-based to human-based intervention in improving joint attention in autistic children.

Background: Children with autism have impairments in initiation of joint attention (IJA) and response to joint attention (RJA). Aims: The present study compared the learning effectiveness of robot-based intervention (RBI) with that of content-matched human-based intervention (HBI) in improving joint attention (JA). We examined whether RBI would enhance RJA, in comparison to HBI. We also examined whether RBI would increase IJA, in comparison to HBI. Methods and procedures: Thirty-eight Chinese-speaking children with autism aged 6 to 9 years were randomly assigned to RBI and HBI groups. Before intervention, their autism severity, cognitive abilities, and language skills were assessed. Each child received six 30-min training sessions over 3 weeks. During training, he/she watched one or two robot/human dramas twice where two robot/human actors demonstrated eye contact and RJA. Outcomes and results: Children in the RBI (but not HBI) group produced more RJA and IJA behaviors in the delayed post-test than in the pre-test. Parents of the RBI children rated the program more positively than those of the HBI children. Conclusions and implications: RBI may be more effective than HBI in promoting JA in autistic children with high support needs. Our findings shed light on the application of robot dramas in enhancing social communication skills.

Phenotyping empyema by pleural fluid culture results and macroscopic appearance: an 8-year retrospective study.

Background: The clinical impact of phenotyping empyema is poorly described. This study was designed to evaluate clinical characteristics and outcomes based on the two readily available parameters, pleural fluid culture status and macroscopic fluid appearance. Methods: A retrospective study was conducted on patients with empyema hospitalised between 2013 and 2020. Empyema was classified into culture-positive empyema (CPE) or culture-negative empyema (CNE) and pus-appearing empyema (PAE) or non-pus-appearing empyema (non-PAE) based on the pleural fluid culture status and macroscopic fluid appearance, respectively. Results: Altogether, 212 patients had confirmed empyema (CPE: n=188, CNE: n=24; PAE: n=118, non-PAE: n=94). The cohort was predominantly male (n=163, 76.9%) with a mean age of 65.0±13.6 years. Most patients (n=180, 84.9%) had at least one comorbidity. Patients with CPE had higher rates of in-hospital mortality (19.1% versus 0.0%, p=0.017) and 90-day mortality (18.6% versus 0.0%, p=0.017) and more extrapulmonary sources of infection (29.8% versus 8.3%, p=0.026) when compared with patients with CNE. No significant difference in mortality rate was found between PAE and non-PAE during the in-hospital stay and at 30 days and 90 days. Patients with PAE had less extrapulmonary sources of infection (20.3% versus 36.2%, p=0.010) and more anaerobic infection (40.9% versus 24.5%, p=0.017) than those with non-PAE. The median RAPID (renal, age, purulence, infection source, and dietary factors) scores were higher in the CPE and non-PAE groups. After adjusting for covariates, culture positivity was not independently associated with mortality on multivariable analysis. Conclusion: Empyema is a heterogeneous disease with different clinical characteristics. Phenotyping empyema into different subclasses based on pleural fluid microbiological results and macroscopic fluid appearance provides insight into the underlying bacteriology, source of infection and subsequent clinical outcomes.

High-pressure leakage of pleural fluid through the healed entry site of the indwelling pleural catheter from undrained locules.

The indwelling pleural catheter (IPC) is an established treatment for recurrent pleural effusion. Fluid leakage through the IPC insertion tract has been reported, but its occurrence is only limited to a short period after the procedure. Besides, the drainage efficacy of IPC may be limited by the presence of loculation in the pleural space, especially when intrapleural fibrinolytic is contraindicated. We report a case of fluid leakage through the healed entry site of IPC due to high pressure built from undrained pleural fluid locules, which was successfully treated with an additional drain targeting the largest undrained locule.

A Robot-Based Play-Drama Intervention May Improve the Joint Attention and Functional Play Behaviors of Chinese-Speaking Preschoolers with Autism Spectrum Disorder: A Pilot Study.

Children with autism spectrum disorder (ASD) have deficits in joint attention and play behaviors. We examined whether a robot-based play-drama intervention would promote these skills. Chinese-speaking preschool children were randomly assigned to an intervention group (N = 12) and a waitlist control group (N = 11). Children in the intervention group watched three robot dramas and engaged in role-plays with both robots and human experimenters over the course of 9 weeks. There were significant improvements in joint attention initiations and functional play behaviors in the intervention group. Parents of this group of children also reported less severe social impairments. It was therefore concluded that a robot-based play-drama intervention can enhance the joint attention and play behaviors of children with ASD.

Robot-based play-drama intervention may improve the narrative abilities of Chinese-speaking preschoolers with autism spectrum disorder.

BACKGROUND: Children with autism spectrum disorder (ASD) have deficits in their narrative skills and gestural communication. Very few intervention studies have been conducted with the aim of improving these skills. AIMS: We examined whether children with ASD who received the robot-based drama intervention had better narrative abilities and gestured more often than their peers who did not receive the intervention. METHODS AND PROCEDURES: Preschool children were randomly assigned to the intervention group (N = 13) and waitlist control group (N = 13). Children in the intervention group watched three robot dramas and engaged in roleplays with both robots and human experimenters. Children in both groups took the pre-tests, immediate post-tests, and, two week later, delayed post-tests, in which they narrated three stories. OUTCOMES AND RESULTS: There were significant improvements in various narrative measures, including narrative length, syntactic complexity, narrative structure, and cognitive inferences, in the intervention group. There was also an improvement in the average number of overall gestures per clause in this condition. These learning outcomes were maintained in the delayed post-test. These patterns were not found in the waitlist control group. CONCLUSIONS AND IMPLICATIONS: A robot-based play-drama intervention can enhance the narrative abilities and gestural communication of children with ASD.