Embodied Conversational Agents for Chronic Diseases: Scoping Review.

BACKGROUND: Embodied conversational agents (ECAs) are computer-generated animated humanlike characters that interact with users through verbal and nonverbal behavioral cues. They are increasingly used in a range of fields, including health care. OBJECTIVE: This scoping review aims to identify the current practice in the development and evaluation of ECAs for chronic diseases. METHODS: We applied a methodological framework in this review. A total of 6 databases (ie, PubMed, Embase, CINAHL, ACM Digital Library, IEEE Xplore Digital Library, and Web of Science) were searched using a combination of terms related to ECAs and health in October 2023. Two independent reviewers selected the studies and extracted the data. This review followed the PRISMA-ScR (Preferred Reporting Items of Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) statement. RESULTS: The literature search found 6332 papers, of which 36 (0.57%) met the inclusion criteria. Among the 36 studies, 27 (75%) originated from the United States, and 28 (78%) were published from 2020 onward. The reported ECAs covered a wide range of chronic diseases, with a focus on cancers, atrial fibrillation, and type 2 diabetes, primarily to promote screening and self-management. Most ECAs were depicted as middle-aged women based on screenshots and communicated with users through voice and nonverbal behavior. The most frequently reported evaluation outcomes were acceptability and effectiveness. CONCLUSIONS: This scoping review provides valuable insights for technology developers and health care professionals regarding the development and implementation of ECAs. It emphasizes the importance of technological advances in the embodiment, personalized strategy, and communication modality and requires in-depth knowledge of user preferences regarding appearance, animation, and intervention content. Future studies should incorporate measures of cost, efficiency, and productivity to provide a comprehensive evaluation of the benefits of using ECAs in health care.

TROP2-directed nanobody-drug conjugate elicited potent antitumor effect in pancreatic cancer.

BACKGROUND: Pancreatic cancer is a highly aggressive malignancy with limited treatment options and a poor prognosis. Trophoblast cell surface antigen 2 (TROP2), a cell surface antigen overexpressed in the tumors of more than half of pancreatic cancer patients, has been identified as a potential target for antibody-drug conjugates (ADCs). Almost all reported TROP2-targeted ADCs are of the IgG type and have been poorly studied in pancreatic cancer. Here, we aimed to develop a novel nanobody-drug conjugate (NDC) targeting TROP2 for the treatment of pancreatic cancer. RESULTS: In this study, we developed a novel TROP2-targeted NDC, HuNbTROP2-HSA-MMAE, for the treatment of TROP2-positive pancreatic cancer. HuNbTROP2-HSA-MMAE is characterized by the use of nanobodies against TROP2 and human serum albumin (HSA) and has a drug-antibody ratio of 1. HuNbTROP2-HSA-MMAE exhibited specific binding to TROP2 and was internalized into tumor cells with high endocytosis efficiency within 5 h, followed by intracellular translocation to lysosomes and release of MMAE to induce cell apoptosis in TROP2-positive pancreatic cancer cells through the caspase-3/9 pathway. In a xenograft model of pancreatic cancer, doses of 0.2 mg/kg and 1 mg/kg HuNbTROP2-HSA-MMAE demonstrated significant antitumor effects, and a dose of 5 mg/kg even eradicated the tumor. CONCLUSION: HuNbTROP2-HSA-MMAE has desirable affinity, internalization efficiency and antitumor activity. It holds significant promise as a potential therapeutic option for the treatment of TROP2-positive pancreatic cancer.

[Research advances on the duration aftereffect].

Recent sensory history plays a critical role in the perception of event duration. For example, repetitive exposure to a particular duration leads to the distortion of subsequent duration perception. This phenomenon, termed duration adaptation, induces a robust repulsive duration aftereffect. In particular, adaptation to relatively long sensory events shortens the perceived duration of a subsequent event, while adaptation to relatively short sensory events lengthens the perception of subsequent event durations. This phenomenon implies the plasticity of duration perception and offers important clues for revealing the cognitive neural mechanism of duration perception. Duration aftereffect has received more and more attention in recent years. In this review, we introduce recent research advances in our understanding of duration aftereffect, especially with regards to its manifestations, origin, and cognitive neural mechanisms. We also propose possible directions for future research. In sum, we posit that studies on the duration aftereffect phenomenon are helpful in understanding general duration perception, and as such, should receive more attention in future.

The influence of phasic alerting on multisensory temporal precision.

The relationship between attention and multisensory integration has attracted the attention of many researchers but remains a topic of debate. As a mechanism that regulates the intensity of attention, little is known regarding whether and how phasic alerting affects multisensory perception. Three experiments and warning cues were employed to investigate the influence of phasic alerting on multisensory temporal processing. Experiments 1 and 2 used a temporal order judgement task and a simultaneity judgement task with audiovisual target stimuli presented at varying stimulus onset asynchronies. Experiment 3 further adopted a dual task to generate a new estimate of participants' performance. Although these tasks differ in terms of the required cognitive mechanisms, decreased just noticeable difference scores in trials with warning cues consistently indicated that participants under phasic alerting had enhanced multisensory temporal precision. The point of subjective simultaneity values differed among the three tasks, suggesting that the influence of phasic alerting on perceptual deviation might be modulated by specific task demands. Experiment 4 adopted a strict method to verify that the mechanisms by which warning cues facilitate multisensory temporal precision are most likely transient general arousal rather than temporal expectancy. There is a close relationship between multisensory integration and some neurodevelopmental disorders. Considering that phasic alerting may heighten attentional capacity, future research could explore the potential medical interventions for the patients with relatively limited attention resources.

Which types of income matter most for well-being in China: Absolute, relative or income aspirations?

China has experienced remarkable economic growth, but that has not been associated with increases in individual well-being, implying that well-being may not be sensitive to increases in absolute income (AI). Thus, the relationship between well-being and other types of income is worth investigating. This study employed a national sample of 5471 respondents from 31 provinces of China (excluding Hong Kong, Macao and Taiwan) to compare the effects of AI, relative income (RI) and income aspirations (IA) on individual well-being in China. The results of a hierarchical regression analysis found that, compared to AI and RI, IA explained more variation in well-being. These findings highlight the importance of IA for well-being among the Chinese.

Duration adaptation modulates EEG correlates of subsequent temporal encoding.

Repetitive exposure to relatively long or short sensory events has been shown to shorten or lengthen the perceived duration of a subsequent event. However, the neural basis of this phenomenon, called duration adaptation, remains unclear. In this study, we used electroencephalography (EEG) to investigate whether duration adaptation could modulate the subsequent temporal encoding represented by the contingent negative variation (CNV). Participants were asked to reproduce the duration of a test stimulus after adapting duration (Experiment 1) or after anchor duration (Experiment 2). We found that both adapting duration and anchor duration affected the reproduction duration of a subsequently presented test stimulus. The simultaneously recorded event-related potentials (ERPs) revealed that test stimuli evoked clearly identifiable N1, P2 and CNV components in the fronto-central scalp. Further analyses showed that the CNV amplitude was modulated by duration adaptation: adaptation to shorter duration (200ms) increased whereas adaptation to longer duration (800ms) decreased the CNV amplitude. These findings suggest that the neural correlates of temporal encoding represented by the CNV amplitude reflect the duration aftereffect. Additionally, the duration adaptation effect observed on the P2 component also suggests an early expectancy effect on subsequent encoding processes. Finally, no effect of anchor duration was observed on the CNV amplitude, which implies that different mechanisms underlie the duration aftereffect and the anchor effect.

The colour red affects time perception differently in different contexts.

Previous studies have found that psychological and behavioural functions of the colour red vary according to context. In this research, we used the verbal estimation paradigm to determine if the colour red affects individuals' perception of interval duration. In our results, perceived duration was shorter in a red condition than in a blue one; additionally, only in the red condition, perceived duration was shorter in an online dating context than in an online interviewing context. The contribution and limitations of this study and future research directions are discussed.

Crafting a Job among Chinese Employees: The Role of Empowering Leadership and the Links to Work-Related Outcomes.

The present study aims to examine the process through which empowering leadership shapes employees' work engagement and in-role performance by facilitating job-crafting behaviors, specifically seeking resources, seeking challenges, and reducing demands. Based on the extensive data from 733 Chinese employees across various organizations located predominantly in Chongqing and Xi'an, China, we carried out different types of statistical analysis such as confirmatory factor analysis (CFA) and structural equation modeling (SEM) to examine the relationships among empowering leadership, specific job-crafting behaviors, work engagement and in-role performance, test our hypothesis and our conceptual model. The results from structural equation modeling (SEM) suggested that empowering leadership was positively related to employees' work engagement and in-role performance; empowering leadership was positively related to employees' job crafting (seeking resources, seeking challenges and reducing demands); seeking resources, seeking challenges and reducing demands were positively related to in-role performance, and seeking challenges and reducing demands were positively related to work engagement. In the relationship between empowering leadership and in-role performance, seeking resources serves as a mediating factor. Similarly, seeking challenges mediates the association between empowering leadership and both work engagement and in-role performance. Furthermore, reducing demands mediates the links between empowering leadership and both work engagement and in-role performance. The implications of these findings are subsequently discussed.

Bacterial lipase-responsive polydopamine nanoparticles for detection and synergistic therapy of wound biofilms infection.

Wound biofilms represent an elusive conundrum in contemporary treatment and diagnostic options, accredited to their escalating antibiotic resistance and interference in chronic wound healing processes. Here, we developed mesoporous polydopamine (mPDA) nanoparticles, and grafted with rhodamine B (Rb) as biofilm lipase responsive detection probe, followed by π - π stacking mediated ciprofloxacin (CIP) loading to create mP-Rb@CIP nanoparticles. mPDA NPs with a melanin structure could quench fluorescence emissions of Rb. Once encountering biofilm in vivo, the ester bond in Rb and mPDA is hydrolyzed by elevated lipase concentrations, triggering the liberation of Rb and restore fluorescence emissions to achieve real-time imaging of biofilm-infected wounds. Afterwards, the 808 nm near-infrared (NIR) illumination initiates a spatiotemporal controlled antibacterial photothermal therapy (PTT), boosting its effectiveness through photothermal-triggered CIP release for synergistic biofilm eradication. The mP-Rb@CIP platform exhibits dual diagnostic and therapeutic functions, efficaciously treating biofilm-infected wounds in vivo and in vitro. Particularly, the mP-Rb@CIP/NIR procedure expedites wound-healing by alleviating oxidative stress, modulating inflammatory mediators, boosting collagen synthesis, and promoting angiogenesis. Taken together, the theranostic nanosystem strategy holds significant potential for addressing wound biofilm-associated infections.

A potential strategy for bladder cancer treatment: inhibiting autophagy to enhance antitumor effects of Nectin-4-MMAE.

Research and development on Nectin-4 antibody-drug conjugates (ADC) have been greatly accelerated since the approval of enfortumab vedotin to treat uroepithelial cancer. During the course of this study, we identified that autophagy serves as a cytoprotective mechanism during Nectin-4-MMAE treatment and proposed a strategy to enhance the antitumor effects of Nectin-4-MMAE in bladder cancer. Nectin-4-MMAE rapidly internalized into bladder cancer cells in 30 minutes and released MMAE, inducing the onset of caspase-mediated apoptosis and leading to the inhibition of tumor cell growth. Transcriptomics showed significant alterations in autophagy-associated genes in bladder cancer cells treated with Nectin-4-MMAE, which suggested autophagy was activated by Nectin-4-MMAE. Furthermore, autophagy activation was characterized by ultrastructural analysis of autophagosome accumulation, immunofluorescence of autophagic flux, and immunoblotting autophagy marker proteins SQSTM1 and LC3 I/II. Importantly, inhibiting autophagy by LY294002 and chloroquine significantly enhances the cytotoxicity effects of Nectin-4-MMAE in bladder cancer cells. Additionally, we detected the participation of the AKT/mTOR signaling cascade in the induction of autophagy by Nectin-4-MMAE. The combination of Nectin-4-MMAE and an autophagy inhibitor demonstrated enhanced antitumor effects in the HT1376 xenograft tumor model. After receiving a single dose of Nectin-4-MMAE, the group that received the combination treatment showed a significant decrease in tumor size compared to the group that received only one type of treatment. Notably, one mouse in the combination treatment group achieved complete remission of the tumor. The combination group exhibited a notable rise in apoptosis and necrosis, as indicated by H&E staining and immunohistochemistry (cleaved caspase-3, ki67). These findings demonstrated the cytoprotective role of autophagy during Nectin-4-MMAE treatment and highlighted the potential of combining Nectin-4-MMAE with autophagy inhibitors for bladder cancer treatment.

Pain perception in the self and observation of others: an ERP investigation.

The nature of interactions between observing pain in others (other-pain) and subjective pain perception (self-pain) has been debated. To test whether other-pain and self-pain primes increase or decrease responsiveness to complementary self-pain or other-pain targets, two ERP studies were conducted. In Study 1, twenty participants (10 women, 10 men) were exposed to pictures depicting other-pain or other non-painful situations, followed by self-pain or non-nociceptive heat stimulation delivered to the forearm. Significant visual prime×sensory target interactions indicated that compared to other non-painful primes, other-pain visual primes predicted faster reaction times (RTs) and smaller P2 amplitudes in response to self-pain stimuli while responses to self-heat stimuli were not affected by priming images. However, effects of other-pain primes on elevations in intensity ratings were not specific to self-pain and extended to self-heat targets. In Study 2, self-pain and self-heat stimuli were applied to the same participants followed by other-pain and other non-painful visual targets. Similar to the pattern for Study 1, sensory prime×visual target interactions indicated that compared to self-heat primes, self-pain sensory primes predicted marginally faster RTs and smaller P3 amplitudes in response to other-pain targets while responses to other non-painful targets were unaffected by sensory priming stimuli. Again, self-pain primes predicted higher intensity ratings for both target types compared to self-heat primes. Together, findings supported the shared-representation model of pain empathy more strongly than the threat value of pain hypothesis.

The Influence of Personal Harmony Value on Temporal Order Perception.

Empirical studies have demonstrated that self-relevant information affects temporal order perception. Therefore, the question arises of whether personal values-which are the core components of the self-influence temporal order perception. To explore this problem, we chose harmony, one of the most common values in Chinese culture, as the starting point. First, the harmony scale was used to measure the harmony values of the participants, and the participants were divided into high- and low-harmony groups. The validity of the grouping was then verified using an implicit-association test. Furthermore, two temporal order judgment (TOJ) tasks were used to explore the impact of harmony values on temporal order perception. The results revealed that in both TOJ tasks, participants in the high-harmony group tended to perceive harmonious stimuli before non-harmonious stimuli, while the effect was not found in the low-harmony group. We conclude that harmony values affect temporal order perception, and only if the values are important to the individual.

The development of a glossary of contemporary Chinese values and its initial application.

A value is an outward or inward view of what is "worthwhile" and is a belief system that people uses to distinguish between good and bad and to guide their behavior. Values vary from culture to culture and from time to time. In order to develop a vocabulary for measuring the values of contemporary Chinese, an open-ended survey was conducted in Study 1 to collect the value vocabulary of the Chinese public, and a text analysis was conducted in Study 2 to acquire the value vocabulary of the Chinese society. In Study 3, a word list of contemporary Chinese values was developed by integrating the words obtained from the above two studies and combining words from previous studies, and a preliminary application of the word list was conducted. The results revealed that Chinese values include four dimensions: self-fulfillment, self-cultivation, social development, and interpersonal ethics. Chinese values are characterized by diversity, and some of the socially advocated values have been internalized into the value system of individuals.

Neural correlates of aftereffects induced by adaptations to single and average durations.

Duration perception can be heavily distorted owing to repetitive exposure to a relatively long or short sensory event, often causing a duration aftereffect. Here, we used a novel procedure to show that adaptations to both single and average durations produced the duration aftereffect. Participants completed a duration reproduction task (Experiment 1) or a duration category rating task (Experiment 2) after long-term adaptations to a stimulus of medium duration and to stimuli of averagely medium duration. We found that adaptations to both single and average durations resulted in duration aftereffects. The simultaneously recorded functional magnetic resonance imaging (fMRI) data revealed that the reduction in neural activity due to long-term adaptation to single duration was observed in the right supramarginal gyrus (SMG) of the parietal lobe, while adaptation to average duration resulted in fMRI adaptations in the left postcentral gyrus (PCG) and middle cingulate gyrus (MCG). At the individual level, the magnitude of the behavioral aftereffect was positively correlated with the magnitude of fMRI adaptation in the right SMG after adaptation to single duration, while there were no significantly positive correlations between the behavioral aftereffect and fMRI adaptations in the left PCG and MCG. These results suggest that there are different neural mechanisms for aftereffects caused by adaptations to single and average durations.

The Use of Gamification in the Self-Management of Patients With Chronic Diseases: Scoping Review.

BACKGROUND: Chronic disease self-management is a public health issue of worldwide concern, and gamification is an emerging strategy to improve patients' participation in chronic disease self-management. Some studies have summarized designs for the gamification of chronic disease self-management from the perspective of eHealth technology, but they have not mentioned differences in design methods, functions, and evaluation methods of gamified designs for self-management in different chronic diseases. OBJECTIVE: This scoping review aims to synthesize the characteristics of realization forms, functions, and evaluation methods in chronic disease self-management gamification to improve self-management among the chronic disease population. METHODS: We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. As of January 7, 2023, we systematically searched 9 databases for relevant studies from January 2012 to December 2022. Related data were extracted based on the research questions. We calculated the frequencies, charted the quantitative data, and coded the extracted material for qualitative content analysis. RESULTS: We retrieved 16,221 records, of which 70 (0.43%) met the eligibility criteria. In the included research, the target populations for gamified designs for self-management of chronic diseases included patients with stroke, cancer, diabetes, chronic obstructive pulmonary disease, coronary heart disease, obesity, and hypertension. Almost all studies mentioned technical support for gamification (68/70, 97%), mainly in the form of active video games (58/70, 83%); however, less than half of the studies mentioned the theoretical basis for gamification (31/70, 44%). There were 37 concepts or theories relevant to gamification design, most of which were in the field of psychology or were cross-disciplinary (n=33, 89%). Gamification for the self-management of chronic diseases has been widely recognized, including for promoting physical exercise and rehabilitation training (48/99, 48%), increasing initiative for symptom management (18/99, 18%), providing psychological support (14/99, 14%), improving cognitive function (12/99, 12%), and improving medication adherence (7/99, 7%). A total of 39 studies mentioned the gamification effect; however, we did not find a unified evaluation standard. CONCLUSIONS: This scoping review focuses on gamification designs for chronic disease self-management and summarizes the realization forms and functions of gamification in self-management for different patient populations. With practice in a gamified internet-based environment, patients can not only master the knowledge and skills of self-management in fascinating scenarios but also benefit from gaming experience and make better health-related decisions in real life. It is worth noting that a comprehensive evaluation of the users as well as a personalized and targeted intervention should be developed before gamification.

The impact of stereotype threat on endogenous poverty-elimination dynamics in generationally poor individuals.

Introduction: The study examines the impact of stereotype threat on generationally poor individuals and its effect on achievement motivation. It also explores the extent to which self-affirmation has an intervention effect on the negative impact of stereotype threat. Methods and results: In Study 1, statements that contained negative stereotypes were used to elicit stereotype threat in generationally poor individuals; the results show that stereotype threat reduced the performance of generationally poor individuals in a mental-rotation task. Study 2 used a questionnaire to measure the endogenous dynamics of generationally poor individuals attempting to escape poverty after experiencing stereotype threat; participants in the stereotype-threat group showed lower-level endogenous poverty-elimination dynamics than those in the control group. In Study 3, a self-affirmation intervention was administered to the stereotype-threat group after the stereotype threat was induced. Participants in the self-affirmation group were shown to have higher-level endogenous poverty-elimination dynamics than those in the control group. Discussion: These findings confirm the negative effect of stereotype threat on endogenous poverty-elimination dynamics and verify the effectiveness of self-affirmation in mitigating the negative effects of stereotype threat.

Research progress of interleukin-15 in cancer immunotherapy.

Interleukin-15 (IL-15) is a cytokine that belongs to the interleukin-2 (IL-2) family and is essential for the development, proliferation, and activation of immune cells, including natural killer (NK) cells, T cells and B cells. Recent studies have revealed that interleukin-15 also plays a critical role in cancer immunotherapy. Interleukin-15 agonist molecules have shown that interleukin-15 agonists are effective in inhibiting tumor growth and preventing metastasis, and some are undergoing clinical trials. In this review, we will summarize the recent progress in interleukin-15 research over the past 5 years, highlighting its potential applications in cancer immunotherapy and the progress of interleukin-15 agonist development.

A collagen-binding SIRPαFc fusion protein for targeted cancer immunotherapy.

Collagen is abundant but exposed in tumor due to the abnormal tumor blood vessels, thus is considered as a tumor-specific target. The A3 domain of von Willebrand factor (vWF A3) is a kind of collagen-binding domain (CBD) which could bind collagen specifically. Previously we reported a chemosynthetic CBD-SIRPαFc conjugate, which could block CD47 and derived tumor-targeting ability by CBD. CBD-SIRPαFc conjugate represented improved anti-tumor efficacy with increased MHC II+ M1 macrophages, but the uncertain coupling ratio remained a problem. Herein, we produced a vWF A3-SIRPαFc fusion protein through eukaryotic expression system. It was examined at both molecular and cellular levels with its collagen affinity, uninfluenced original affinity to targets and phagocytosis-promoting function compared to unmodified SIRPαFc. Living imaging showed that vWF A3-SIRPαFc fusion protein derived the improved accumulation and retention in tumor than SIRPαFc. In the MC38 allograft model, vWF A3-SIRPαFc demonstrated a superior tumor-suppressing effect, characterized by increased MHC II+ M1 macrophages and T cells (particularly CD4+ T cells). These results revealed that vWF A3-SIRPαFc fusion protein derived tumor-targeting ability, leading to improved anti-tumor immunotherapeutic efficacy compared to SIRPαFc. Altogether, vWF A3 improved the anti-tumor efficacy and immune-activating function of SIRPαFc, supporting targeting tumor collagen as a possible targeted strategy.

Emotional primes modulate the responses to others' pain: an ERP study.

Previous event-related potential (ERP) and brain imaging studies have suggested observer responses to others' pain are modulated by various bottom-up and top-down factors, including emotional primes. However, the temporal dynamics underlying the impact of emotional primes on responses to others' pain remains poorly understood. In the present study, we explored effects of negative, neutral, and positive emotional priming stimuli on behavioral and cortical responses to visual depictions of others in pain. ERPs were recorded from 20 healthy adults, who were presented with painful and non-painful target pictures following observation of negative, neutral, and positive emotional priming pictures. ERP analyses revealed that relative to non-painful pictures, differential P3 amplitudes for painful pictures were larger followed by negative primes than either neutral or positive primes. There were no significant differential P3 amplitudes for painful pictures relative to non-painful pictures were found followed neutral and positive emotional primes. These results suggest that negative emotional primes strengthen observers' attention toward others' pain. These results support the threat value of pain hypothesis.

Color Sensitivity of the Duration Aftereffect Depends on Sub- and Supra-second Durations.

The perception of duration becomes biased after repetitive duration adaptation; this is known as the duration aftereffect. The duration aftereffect exists in both the sub-second and supra-second ranges. However, it is unknown whether the properties and mechanisms of the adaptation aftereffect differ between sub-second and supra-second durations. In the present study, we addressed this question by investigating the color sensitivity of the duration aftereffect in the sub-second (Experiment 1) and supra-second (Experiment 2) ranges separately. We found that the duration aftereffect in the sub-second range could only partly transfer across different visual colors, whereas the duration aftereffect in the supra-second range could completely transfer across different visual colors. That is, the color-sensitivity of the duration aftereffect in the sub-second duration was stronger than that in the supra-second duration. These results imply that the mechanisms underlying the adaptation aftereffects of the sub-second and supra-second ranges are distinct.