[To assess Resilience of Russian cities under international sanctions and the consequences of COVID-19: a sociological study].

The paper presents the results of in-depth interviews and a questionnaire survey of the Russian cites administration representatives about cities resilience under the sanctions pressure and COVID-19. The survey was conducted by the Center for Territorial Changes and Urban Development of IPEI RANEPA in March-May 2023, it was attended by representatives of the administration of more than 50 cities of the Russian Federation. We found overall situation as stable: social programs are being implemented in full, unemployment is decreasing, construction of municipal facilities continues, problems with failures in the supply of spare parts, equipment and components are being solved. At the same time, the sanctions have affected the urban economy in completely different ways: while in some cities show significant negative effect, in others the impact of sanctions is insignificant. Cites face number of new challenges: disruption of supply chains, refusal to supply paid equipment, inability to find analogues of imported equipment with the necessary characteristics, rising prices for spare parts. components and construction materials, the rupture of established sales channels to unfriendly countries, a drop in municipal budget revenues, etc. The heads of the city administration work overtime to solve emerging problems, organize interaction between enterprises, establish and deepen business contacts with friendly countries, put forward proposals to improve the situation at the federal level. New tasks successfully solved, although it requires serious efforts. To respond to new challenges, we need a new, more decentralized and local-oriented style of public administration, a process of well-established feedback.

Participative epidemiology and prevention pathway of health risks associated with artisanal mines in Luhihi area, DR Congo.

BACKGROUND: Health issues are associated with artisanal mining in the DR Congo. The scenario is worst when artisanal mining is done informally or with limited material and technical resources. This paper argues that the adoption of healthy practices by artisanal miners might be limited given that it involves unrealistic socio-economic, and administrative aspects and access to health risk prevention means. Making a conceptual framework on the feasibility of revolutionizing artisanal mining practices linked to health risks in the DR Congo requires trans-disciplinary interventions and researches. This case study aims at co-analyzing with actors in the Luhihi artisanal gold mine, the epidemiology of health issues. It also aims at describing the dynamics of resources that mining actors mobilize or think they can mobilize in order to prevent health risks. METHODS: A "socio-anthropological" qualitative study with "transdisciplinary methods" was carried out the Luhihi artisanal mining. Data collection tools and methods included an exploratory survey, semi-structured interviews. Focus groups (FG) mixed with proportional piling were used to support the open-ended interview discussions. The actors interviewed were selected by "convenience sampling" and the saturation principle indicated the size of the sampling. In total, 67 persons were interviewed and 5 FG each consisting of 5 to 10 mining actors were organized. Data were triangulated among respondents to ensure their veracity and an "inductive thematic data analysis" was applied. RESULTS: Key findings are the role of actors involved the organization system at the Luhihi artisanal mining site; a description of a participative epidemiology and determinants of health issues; presentation of the importance of health risks as perceived by mining actors; the constraints in the common illenesses treatment; and opportunities of collective actions for gathering resources required for the organization of healthcare services. CONCLUSION: The results are translated into a grid of powers and interests in relation to the mobilization of resources for the prevention and treatment of health issues. The dialogue for change regarding the ignorance of the actors to exposure to chemical risks such as to exposure mercury, silica, carbon monoxide, and cyanide also entailed the translation of the results. In addition, an analysis of the ability of artisanal mining actors to implement health risk prevention services was made.

Diagnosis and management of adrenal incidentaloma: use of clinical judgment and evidence in dialog with the patient.

The prevalence of adrenal incidentaloma (AI) in imaging studies, including those of the adrenal glands, is estimated to be 1-5%. Essential factors for the proper management of AI include a correct diagnosis, adequate surgical skills, appropriate perioperative management, and sound dialogue with the patient. Aside from the possibility of overdiagnosis, patients with apparent signs or symptoms attributable to adrenal hormone excess have reasonable indications for surgery. At the same time, milder patients may be candidates for active surveillance without intervention. Even individuals with nonfunctioning AI may benefit from surgery if imaging studies depict the tumor as suggestive of malignancy. However, a differential diagnosis of AI may not be easy for surgeons with little experience in seeing such patients.Furthermore, a patient without a correct diagnosis may miss the window of opportunity for a cure or incur a greater risk of developing complications, such as adrenal insufficiency or cardiovascular events during or after surgery, due to inadequate management. The clinical practice guidelines for AI from around the world may be helpful for shared decision-making; however, Japan lacks established guidelines. In this review article, we propose practical guidelines relevant to management by summarizing the evidence for five key questions that are often asked in dialog with patients with AI.

Diversifying Emotional Dialogue Generation via Selective Adversarial Training.

Emotional perception and expression are very important for building intelligent conversational systems that are human-like and attractive. Although deep neural approaches have made great progress in the field of conversation generation, there is still a lot of room for research on how to guide systems in generating responses with appropriate emotions. Meanwhile, the problem of systems' tendency to generate high-frequency universal responses remains largely unsolved. To solve this problem, we propose a method to generate diverse emotional responses through selective perturbation. Our model includes a selective word perturbation module and a global emotion control module. The former is used to introduce disturbance factors into the generated responses and enhance their expression diversity. The latter maintains the coherence of the response by limiting the emotional distribution of the response and preventing excessive deviation of emotion and meaning. Experiments are designed on two datasets, and corresponding results show that our model outperforms existing baselines in terms of emotional expression and response diversity.

Natural-Language-Driven Multimodal Representation Learning for Audio-Visual Scene-Aware Dialog System.

With the development of multimedia systems in wireless environments, the rising need for artificial intelligence is to design a system that can properly communicate with humans with a comprehensive understanding of various types of information in a human-like manner. Therefore, this paper addresses an audio-visual scene-aware dialog system that can communicate with users about audio-visual scenes. It is essential to understand not only visual and textual information but also audio information in a comprehensive way. Despite the substantial progress in multimodal representation learning with language and visual modalities, there are still two caveats: ineffective use of auditory information and the lack of interpretability of the deep learning systems' reasoning. To address these issues, we propose a novel audio-visual scene-aware dialog system that utilizes a set of explicit information from each modality as a form of natural language, which can be fused into a language model in a natural way. It leverages a transformer-based decoder to generate a coherent and correct response based on multimodal knowledge in a multitask learning setting. In addition, we also address the way of interpreting the model with a response-driven temporal moment localization method to verify how the system generates the response. The system itself provides the user with the evidence referred to in the system response process as a form of the timestamp of the scene. We show the superiority of the proposed model in all quantitative and qualitative measurements compared to the baseline. In particular, the proposed model achieved robust performance even in environments using all three modalities, including audio. We also conducted extensive experiments to investigate the proposed model. In addition, we obtained state-of-the-art performance in the system response reasoning task.

Teaching Conversational English: Techniques for Unconscious Competence Versus Development of Thinking Skills.

The purpose of the article is to determine the role of critical thinking and unconscious competence in the implementation of effective communication during group discussions, debates and dialogues. The necessary conditions for creating an effective educational environment conducive to the development of students' conversational skills are demonstrated. An educational experiment was conducted with the participation of 75 third-year students from the School of [BLINDED], [BLINDED], during which the students practiced both critical thinking and unconscious competence in the process of group discussions. The conducted survey at the beginning and end of training, was determined the degree of use of critical thinking skills and unconscious competence in the process of finding answers to arguments during debates, discussions and disputes. The results of the surveys showed that in the process of speaking, critical thinking skills are used more often (79%) than unconscious competence (21%), but at the same time, students considered that unconscious competence (81%) is more effective in debates and discussions, than critical thinking (19%). It was concluded that critical thinking skills are easier and faster to learn to participate in a constructive discussion than the skills of unconscious competence, the development of which must take place in an authentic learning environment for a longer period. The results of the study confirmed that the participation of students in the conversation class increased their ability to analyze, critically evaluate, argue, unconsciously respond and understand the interlocutor. Therefore, it is important to invest additional efforts and create conditions for open, flexible and comfortable communication of students using modern pedagogical methods aimed at developing students' thinking skills of a higher order. The findings can be useful in the field of language teaching, psychology, and linguistics, as well as become the basis for the development of new curricula using collective discussions.

Person-Centered Psychiatry as Dialogical Psychiatry: The Significance of the Therapeutic Stance.

In this article, we present holistic and person-centered perspectives in psychiatry, with the aim of better understanding what a focus on personhood might really mean and what clinical implications it might have. We first introduce classical and philosophical concepts of personhood, in order to then outline person-centered approaches in psychiatry, which mainly focus on the person of the patient. We then argue that, for it to really be person-centered, psychiatry must necessarily also focus on the person of professionals. We thus explore the notion of stance, as the expression of the therapist's personhood. By unpacking the effects that a professional's stance can have on patients, we finally turn to a consideration of the interpersonal sphere. More specifically, we propose clinical considerations on a therapeutic stance that strives to support and to help the person of the patient unfold. Such a stance must - we argue - necessarily be a dialogical one. Drawing on these considerations, we thus claim that a truly person-centered approach in psychiatry must necessarily and automatically be interperson-centered and dialogical. In the concluding remarks, we finally discuss broader societal implications and outline future research perspectives.

Design and Evaluation Challenges of Conversational Agents in Health Care and Well-being: Selective Review Study.

BACKGROUND: Health care and well-being are 2 main interconnected application areas of conversational agents (CAs). There is a significant increase in research, development, and commercial implementations in this area. In parallel to the increasing interest, new challenges in designing and evaluating CAs have emerged. OBJECTIVE: This study aims to identify key design, development, and evaluation challenges of CAs in health care and well-being research. The focus is on the very recent projects with their emerging challenges. METHODS: A review study was conducted with 17 invited studies, most of which were presented at the ACM (Association for Computing Machinery) CHI 2020 conference workshop on CAs for health and well-being. Eligibility criteria required the studies to involve a CA applied to a health or well-being project (ongoing or recently finished). The participating studies were asked to report on their projects' design and evaluation challenges. We used thematic analysis to review the studies. RESULTS: The findings include a range of topics from primary care to caring for older adults to health coaching. We identified 4 major themes: (1) Domain Information and Integration, (2) User-System Interaction and Partnership, (3) Evaluation, and (4) Conversational Competence. CONCLUSIONS: CAs proved their worth during the pandemic as health screening tools, and are expected to stay to further support various health care domains, especially personal health care. Growth in investment in CAs also shows the value as a personal assistant. Our study shows that while some challenges are shared with other CA application areas, safety and privacy remain the major challenges in the health care and well-being domains. An increased level of collaboration across different institutions and entities may be a promising direction to address some of the major challenges that otherwise would be too complex to be addressed by the projects with their limited scope and budget.

A Chatbot to Support Young People During the COVID-19 Pandemic in New Zealand: Evaluation of the Real-World Rollout of an Open Trial.

BACKGROUND: The number of young people in New Zealand (Aotearoa) who experience mental health challenges is increasing. As those in Aotearoa went into the initial COVID-19 lockdown, an ongoing digital mental health project was adapted and underwent rapid content authoring to create the Aroha chatbot. This dynamic digital support was designed with and for young people to help manage pandemic-related worry. OBJECTIVE: Aroha was developed to provide practical evidence-based tools for anxiety management using cognitive behavioral therapy and positive psychology. The chatbot included practical ideas to maintain social and cultural connection, and to stay active and well. METHODS: Stay-at-home orders under Aotearoa's lockdown commenced on March 20, 2020. By leveraging previously developed chatbot technology and broader existing online trial infrastructure, the Aroha chatbot was launched promptly on April 7, 2020. Dissemination of the chatbot for an open trial was via a URL, and feedback on the experience of the lockdown and the experience of Aroha was gathered via online questionnaires and a focus group, and from community members. RESULTS: In the 2 weeks following the launch of the chatbot, there were 393 registrations, and 238 users logged into the chatbot, of whom 127 were in the target age range (13-24 years). Feedback guided iterative and responsive content authoring to suit the dynamic situation and motivated engineering to dynamically detect and react to a range of conversational intents. CONCLUSIONS: The experience of the implementation of the Aroha chatbot highlights the feasibility of providing timely event-specific digital mental health support and the technology requirements for a flexible and enabling chatbot architectural framework.

Multi-source Seq2seq guided by knowledge for Chinese healthcare consultation.

Online healthcare consultation offers people a convenient way to consult doctors. In this paper, we aim at building a generative dialog system for Chinese healthcare consultation. As the original Seq2seq architecture tends to suffer the issue of generating low-quality responses, the multi-source Seq2seq architecture generating more informative responses is much more preferred in this task. The multi-source Seq2seq architecture takes advantage of retrieval techniques to obtain responses from the database, and then takes these responses alongside the user-issued question as input. However, some of the retrieved responses might be not much related to the user-issued question, resulting in the generation of unsatisfying responses that are not correct in diagnosis or instead provide inappropriate advice on prevention or treatment. Therefore, this paper proposes multi-source Seq2seq guided by knowledge (MSSGK) to handle this problem. MSSGK differs from the multi-source Seq2seq architecture in that domain knowledge, including disease labels and topic labels about prevention and treatment, is introduced into the response generation via a multi-task learning framework. To better exploit the domain knowledge, we propose three attention mechanisms to provide more appropriate guidance for response generation. Experimental results on a dataset of real-world healthcare consultation show the effectiveness of the proposed method.

Acceptability of a technology-supported and solution-focused intervention (DIALOG+) for chronic depression: views of service users and clinicians.

BACKGROUND: Treating chronic depression represents a significant burden for the NHS, yet there is a lack of evidence-based interventions and research specifically focused on this condition. DIALOG+, a technology-assisted and resource-oriented intervention found effective for people with psychosis, may improve care for this service user group. The aim of this study was to explore the acceptability and relevance of DIALOG+ for the treatment of chronic depression in community-based settings. METHODS: A convenience sample of 16 mental health professionals and 29 service users with chronic depression tested the DIALOG+ intervention in routine community care appointments for 3 months across 3 different mental health NHS Trusts in England. Of these, 15 clinicians and 19 service users were individually interviewed about their experiences. Interview transcripts were analysed using thematic analysis by an analytic team which included a service user researcher. RESULTS: Analysis of the combined dataset identified five overarching themes: DIALOG+ Structure; Therapeutic Communication; Reflecting and Monitoring; Empowerment and Powerlessness; and The Impact of Technology. Overall, service users and clinicians were interested in the continued use of DIALOG+ as part of routine care. CONCLUSIONS: DIALOG+ was viewed as acceptable by both service users with chronic depression and their clinicians who work in community care settings, albeit with some caveats. Clinician training required significant improvements to address the issues that were referenced, most notably around support with using technology.

NMN-VD: A Neural Module Network for Visual Dialog.

Visual dialog demonstrates several important aspects of multimodal artificial intelligence; however, it is hindered by visual grounding and visual coreference resolution problems. To overcome these problems, we propose the novel neural module network for visual dialog (NMN-VD). NMN-VD is an efficient question-customized modular network model that combines only the modules required for deciding answers after analyzing input questions. In particular, the model includes a Refer module that effectively finds the visual area indicated by a pronoun using a reference pool to solve a visual coreference resolution problem, which is an important challenge in visual dialog. In addition, the proposed NMN-VD model includes a method for distinguishing and handling impersonal pronouns that do not require visual coreference resolution from general pronouns. Furthermore, a new Compare module that effectively handles comparison questions found in visual dialogs is included in the model, as well as a Find module that applies a triple-attention mechanism to solve visual grounding problems between the question and the image. The results of various experiments conducted using a set of large-scale benchmark data verify the efficacy and high performance of our proposed NMN-VD model.

Prokineticin 1-prokineticin receptor 1 signaling promotes angiogenesis in the porcine endometrium during pregnancy†.

Pregnancy establishment in mammals, including pigs, requires proper communication between embryos and the maternal reproductive tract. Prokineticin 1 (PROK1) has been described as a secretory protein with pleiotropic functions and as a novel tissue-specific angiogenic factor. However, despite the studies performed mainly on human cell lines and in mice, the function of PROK1 in the endometrium during early pregnancy is still not fully elucidated. We hypothesized that PROK1 contributes to pregnancy establishment in pigs. The present study is the first to report that the expression of PROK1 and its receptor (PROKR1) is elevated in the porcine endometrium during the implantation and early placentation period. PROK1 protein was detected mainly in luminal epithelial cells, glandular epithelial cells, and blood vessels in the endometrium. Using the porcine in vivo model of unilateral pregnancy, we revealed that conceptuses induced the endometrial expression of PROK1 and PROKR1. Moreover, the embryonic signal, estradiol-17ß, as well as progesterone, stimulated the endometrial expression of PROK1 and PROKR1. We also evidenced that PROK1-PROKR1 signaling supports endometrial angiogenesis in pigs. The PROK1-stimulated proliferation of primary porcine endometrial endothelial (PEE) cells involved PI3K/AKT/mTOR, MAPK, cAMP, and NFKB signaling pathways. Furthermore, PROK1 via PROKR1 promoted the formation of capillary-like structures by PEE cells. PROK1 also stimulated VEGFA and PGF2α secretion, which in turn may indirectly support angiogenic changes within endometrial tissue. In summary, our study suggests that PROK1 acts as an embryonic signal mediator that regulates endometrial angiogenesis and secretory function during the implantation and early placentation period in pigs.

Routine measurement of satisfaction with life and treatment aspects in mental health patients - the DIALOG scale in East London.

AIMS: The DIALOG scale has been implemented as a routine patient outcome and experience measure (PROM/PREM) in a mental health trust in East London since 2017. The resulting healthcare dataset was used to estimate satisfaction with life and treatment aspects over time and factors associated with it. METHODS: Variables available from the Trust were DIALOG items, service level, clinical and basic demographic data. Data was extracted in February 2019. Data is described using a range of descriptive statistics and looking at the subgroups: treatment stage, diagnosis, service type. Predictors for average DIALOG scores across patients was explored with clustered linear regression models. A fixed effect model was chosen to estimate the impact of clinical and service related variables on patient's average DIALOG scores over time. Sensitivity analyses with the whole data set and complete cases were carried out. RESULTS: Of the original 18,481 DIALOG records 12, 592 were kept after data cleaning (5646 patients). The average DIALOG score was 4.8 (SD 1.0) on the 7-point scale. Average satisfaction with life aspects (PROM) was 4.65 (SD 1.1) and with treatment aspects (PREM) was 5.25 (SD 1.17). Across all 11 items, "job situation" scored lowest (mean 4.05) and "meetings with professionals" highest (mean 5.5). Satisfaction for all items increased over time (average increase 0.47). The largest increase was in "mental health" (0.94) and the smallest in "family relationships" (0.34). CONCLUSIONS: Patients in mental healthcare services were "fairly satisfied" in both life and treatment aspects with improvements seen over time. These results will act as a benchmark for clinical services currently implementing DIALOG across the UK and inform local service developments.

Effectiveness of a chat-bot for the adult population to quit smoking: protocol of a pragmatic clinical trial in primary care (Dejal@).

BACKGROUND: The wide scale and severity of consequences of tobacco use, benefits derived from cessation, low rates of intervention by healthcare professionals, and new opportunities stemming from novel communications technologies are the main factors motivating this project. Thus, the purpose of this study is to assess the effectiveness of an intervention that helps people cease smoking and increase their nicotine abstinence rates in the long term via a chat-bot, compared to usual practice, utilizing a chemical validation at 6 months. METHODS: Design: Randomized, controlled, multicentric, pragmatic clinical trial, with a 6-month follow-up. SETTING: Healthcare centers in the public healthcare system of the Community of Madrid (Madrid Regional Health Service). PARTICIPANTS: Smokers > 18 years of age who attend a healthcare center and accept help to quit smoking in the following month. N = 460 smokers (230 per arm) who will be recruited prior to randomization. Intervention group: use of a chat-bot with evidence-based contents to help quit smoking. CONTROL GROUP: Usual treatment (according to the protocol for tobacco cessation by the Madrid Regional Health Service Main variable: Continuous nicotine withdrawal with chemical validation (carbon monoxide in exhaled air). Intention-to-treat analysis. Difference between groups in continuous abstinence rates at 6 months with their corresponding 95% confidence interval. A logistic regression model will be built to adjust for confounding factors. RESULTS: First expected results in January 2020. DISCUSSION: Providing science-based evidence on the effectiveness of clinical interventions via information technologies, without the physical presence of a professional, is essential. In addition to being more efficient, the characteristics of these interventions can improve effectiveness, accessibility, and adherence to treatment. From an ethics perspective, this new type of intervention must be backed by scientific evidence to circumvent pressures from the market or particular interests, improve patient safety, and follow the standards of correct practices for clinical interventions. TRIAL REGISTRATION: ClinicalTrials.gov, reference number NCT03445507.

Repetition Compulsion Revisited in Relational Family Therapy: The Discovery of Old in Order to Develop Something New.

Psychoanalysis has always been full of diversity and controversy, in the theoretical field and especially in the plasticity and variety of its modalities and approaches. Yet all these theories are based on the premise that individuals compulsively repeat their old psycho-organic content, both in their personal lives and in analysis; the premise of Relational Family Therapy is that old emotional, behavioral and bodily complications must first be repeated before being fully processed so that something new can be created.

An Efficient Framework for Development of Task-Oriented Dialog Systems in a Smart Home Environment.

In recent times, with the increasing interest in conversational agents for smart homes, task-oriented dialog systems are being actively researched. However, most of these studies are focused on the individual modules of such a system, and there is an evident lack of research on a dialog framework that can integrate and manage the entire dialog system. Therefore, in this study, we propose a framework that enables the user to effectively develop an intelligent dialog system. The proposed framework ontologically expresses the knowledge required for the task-oriented dialog system's process and can build a dialog system by editing the dialog knowledge. In addition, the framework provides a module router that can indirectly run externally developed modules. Further, it enables a more intelligent conversation by providing a hierarchical argument structure (HAS) to manage the various argument representations included in natural language sentences. To verify the practicality of the framework, an experiment was conducted in which developers without any previous experience in developing a dialog system developed task-oriented dialog systems using the proposed framework. The experimental results show that even beginner dialog system developers can develop a high-level task-oriented dialog system.

The impact of psychological distance on integrative internal dialogs.

Negotiators more distanced from the negotiated goal more often exhibit integrative behavior, which maximizes both their individual and joint outcomes. Based on the assumption of an analogy between interpersonal negotiations and internal dialogs simulating social relationships, an experiment was carried out. It aimed to verify if psychological distance (proximal vs. distant perspective on the situation enacted in an internal dialog) affects the processes of integration and confrontation and, consequently, increases the frequency of integrative dialogs. Data from 115 participants (56 women) were analyzed. An increase in psychological distance was found to reduce the intensity of the confrontation process and to cause an increase in the number of integrative internal dialogs.

The Care Dialog: the "ethics of care" approach and its importance for clinical ethics consultation.

Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an "ethics of care" approach as well as an empirical pilot project-"Ethics from the bottom up"-which organizes ethics consultation based on this focus. Findings and philosophy of the project will be discussed as far as relevant for ethics consultation in the healthcare system.

Application of Synchronous Text-Based Dialogue Systems in Mental Health Interventions: Systematic Review.

BACKGROUND: Synchronous written conversations (or "chats") are becoming increasingly popular as Web-based mental health interventions. Therefore, it is of utmost importance to evaluate and summarize the quality of these interventions. OBJECTIVE: The aim of this study was to review the current evidence for the feasibility and effectiveness of online one-on-one mental health interventions that use text-based synchronous chat. METHODS: A systematic search was conducted of the databases relevant to this area of research (Medical Literature Analysis and Retrieval System Online [MEDLINE], PsycINFO, Central, Scopus, EMBASE, Web of Science, IEEE, and ACM). There were no specific selection criteria relating to the participant group. Studies were included if they reported interventions with individual text-based synchronous conversations (ie, chat or text messaging) and a psychological outcome measure. RESULTS: A total of 24 articles were included in this review. Interventions included a wide range of mental health targets (eg, anxiety, distress, depression, eating disorders, and addiction) and intervention design. Overall, compared with the waitlist (WL) condition, studies showed significant and sustained improvements in mental health outcomes following synchronous text-based intervention, and post treatment improvement equivalent but not superior to treatment as usual (TAU) (eg, face-to-face and telephone counseling). CONCLUSIONS: Feasibility studies indicate substantial innovation in this area of mental health intervention with studies utilizing trained volunteers and chatbot technologies to deliver interventions. While studies of efficacy show positive post-intervention gains, further research is needed to determine whether time requirements for this mode of intervention are feasible in clinical practice.