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Cureus Apr 2024Introduction In this article, we describe our creation of a machine-learning model that uses a combination of rule-based and natural language processing (NLP)...
Introduction In this article, we describe our creation of a machine-learning model that uses a combination of rule-based and natural language processing (NLP) algorithms. We show how this "Empathy Algorithm" was developed and how its results compare to three datasets of professional counseling and peer-led conversations. Methods These conversation datasets were rated by people with varying degrees of empathetic expertise (from counselors to student volunteers) and labeled as either low- or high-quality empathy. Our methodology involved running both these "low-empathy" and "high-empathy" conversations through our algorithm and then looking for a correlation between conversations labeled "high empathy" and an increased presence of six empathy skills flagged by our algorithm. Results We found positive correlations between four of the six skills that our algorithm measures (i.e., four empathizing skills showed up the same or more in each of the "high-empathy" conversations within the three datasets). This suggests that certain empathizing skills are not only consistently present in effective conversations but also quantifiable enough to be measured by today's machine-learning models. Conclusion While limitations of language, binary classifications, and non-verbal cues remain as opportunities for further development, using algorithms to objectively assess empathic skills represents an important step to improve client outcomes and refine communication practices for today's healthcare professionals.
PubMed: 38711721
DOI: 10.7759/cureus.57719 -
Journal of Education & Teaching in... Apr 2024The target audiences for this team-based learning (TBL) activity are resident physicians and medical students.
AUDIENCE
The target audiences for this team-based learning (TBL) activity are resident physicians and medical students.
INTRODUCTION
According to the Centers for Disease Control and Prevention (CDC), nearly half of the adults in the United States have hypertension,1 which is a leading cause of cardiovascular disease and premature death.2 In extreme cases, patients may present in hypertensive emergencies, defined as an acute, marked elevation of systolic blood pressure >180mmHg or diastolic blood pressure >120mmHg with evidence of organ dysfunction.3,4 Patients presenting to the emergency department (ED) with symptoms of hypertensive emergencies must be promptly diagnosed and treated to prevent further morbidity and mortality. This TBL utilizes four clinical cases to educate resident physicians and medical students not only on the recognition of hypertensive emergencies, but also on the workup, management, and disposition of patients who present to the ED with hypertension.
EDUCATIONAL OBJECTIVES
By the end of this TBL session, learners should be able to: 1) define features of asymptomatic hypertension versus hypertensive emergency, 2) discuss which patients with elevated blood pressure may require further diagnostic workup and intervention, 3) identify a differential diagnosis for patients presenting with elevated blood pressures, 4) recognize the features of different types of end-organ damage, 5) review an algorithm for the pharmacologic management of hypertensive emergencies, 6) indicate dosing and routes of various anti-hypertensive medications, 7) choose the appropriate treatment for a patient who is hypertensive and presenting with flash pulmonary edema, 8) identify an aortic dissection on computed tomography (CT), 9) choose the appropriate treatment for a patient who is hypertensive and presenting with an aortic dissection, 10) identify intracranial hemorrhage on CT, 11) choose the appropriate treatment for a patient who is hypertensive and presenting with an intracranial hemorrhage, and 12) describe the intervention for warfarin reversal.
EDUCATIONAL METHODS
This is a classic TBL that includes an individual readiness assessment test (iRAT), a multiple-choice group readiness assessment test (gRAT), and a group application exercise (GAE).
RESEARCH METHODS
Learners and instructors were given the opportunity to provide verbal feedback after completion of the TBL. Learners included senior medical students and first-, second-, and third-year emergency-medicine residents. Learners were specifically asked if they felt the cases were educational, relevant, and useful to their training.
RESULTS
Six resident physicians and three medical students volunteered their verbal feedback, and agreed when they were specifically asked if the cases were educational, relevant, and useful to their training. The same learners also agreed when asked if they felt the TBL was a more enjoyable activity than a direct lecture to refresh their knowledge and skills. One instructor observed that interns and medical students were generally able to reach a correct diagnosis; however, they seemed to struggle more with describing appropriate pharmacologic interventions when compared to more senior learners.
DISCUSSION
Hypertension is a common complaint and incidental finding in patients presenting to the ED. Given its non-specific value, it can be a difficult topic for the novice healthcare provider to master. The differential diagnosis for a patient presenting with hypertension is vast, ranging from benign to emergent, and can sometimes necessitate minimal to substantial workups. Thus, this TBL is a useful, relevant, and effective exercise for residents-in-training to review and understand the management of hypertension.
TOPICS
Hypertension, hypertensive emergency, asymptomatic hypertension, flash pulmonary edema, aortic dissection, intracranial hemorrhage, warfarin reversal, team-based learning.
PubMed: 38707946
DOI: 10.21980/J8BP90 -
Brain Communications 2024Stroke is the leading cause of long-term disability worldwide. Incurred brain damage can disrupt cognition, often with persisting deficits in language and executive...
Stroke is the leading cause of long-term disability worldwide. Incurred brain damage can disrupt cognition, often with persisting deficits in language and executive capacities. Yet, despite their clinical relevance, the commonalities and differences between language versus executive control impairments remain under-specified. To fill this gap, we tailored a Bayesian hierarchical modelling solution in a largest-of-its-kind cohort (1080 patients with stroke) to deconvolve language and executive control with respect to the stroke topology. Cognitive function was assessed with a rich neuropsychological test battery including global cognitive function (tested with the Mini-Mental State Exam), language (assessed with a picture naming task), executive speech function (tested with verbal fluency tasks), executive control functions (Trail Making Test and Digit Symbol Coding Task), visuospatial functioning (Rey Complex Figure), as well as verbal learning and memory function (Soul Verbal Learning). Bayesian modelling predicted interindividual differences in eight cognitive outcome scores three months after stroke based on specific tissue lesion topologies. A multivariate factor analysis extracted four distinct cognitive factors that distinguish left- and right-hemispheric contributions to ischaemic tissue lesions. These factors were labelled according to the neuropsychological tests that had the strongest factor loadings: One factor delineated language and general cognitive performance and was mainly associated with damage to left-hemispheric brain regions in the frontal and temporal cortex. A factor for executive control summarized mental flexibility, task switching and visual-constructional abilities. This factor was strongly related to right-hemispheric brain damage of posterior regions in the occipital cortex. The interplay of language and executive control was reflected in two distinct factors that were labelled as executive speech functions and verbal memory. Impairments on both factors were mainly linked to left-hemispheric lesions. These findings shed light onto the causal implications of hemispheric specialization for cognition; and make steps towards subgroup-specific treatment protocols after stroke.
PubMed: 38707712
DOI: 10.1093/braincomms/fcae129 -
Scientific Reports May 2024Phonological awareness (PA) is at the foundation of reading development: PA is introduced before formal reading instruction, predicts reading development, is a target...
Phonological awareness (PA) is at the foundation of reading development: PA is introduced before formal reading instruction, predicts reading development, is a target for early intervention, and is a core mechanism in dyslexia. Conventional approaches to assessing PA are time-consuming and resource intensive: assessments are individually administered and scoring verbal responses is challenging and subjective. Therefore, we introduce a rapid, automated, online measure of PA-The Rapid Online Assessment of Reading-Phonological Awareness-that can be implemented at scale without a test administrator. We explored whether this gamified, online task is an accurate and reliable measure of PA and predicts reading development. We found high correlations with standardized measures of PA (CTOPP-2, r = .80) for children from Pre-K through fourth grade and exceptional reliability (α = .96). Validation in 50 first and second grade classrooms showed reliable implementation in a public school setting with predictive value of future reading development.
Topics: Humans; Reading; Child; Female; Male; Phonetics; Dyslexia; Reproducibility of Results; Awareness; Child, Preschool
PubMed: 38704429
DOI: 10.1038/s41598-024-60834-9 -
Consciousness and Cognition May 2024A serial reaction time task was used to test whether the representations of a probabilistic second-order sequence structure are (i) stored in an effector-dependent,...
A serial reaction time task was used to test whether the representations of a probabilistic second-order sequence structure are (i) stored in an effector-dependent, effector-independent intrinsic or effector-independent visuospatial code and (ii) are inter-manually accessible. Participants were trained either with the dominant or non-dominant hand. Tests were performed with both hands in the practice sequence, a random sequence, and a mirror sequence. Learning did not differ significantly between left and right-hand practice, suggesting symmetric intermanual transfer from the dominant to the non-dominant hand and vice versa. In the posttest, RTs were shorter for the practice sequence than for the random sequence, and longest for the mirror sequence. Participants were unable to freely generate or recognize the practice sequence, indicating implicit knowledge of the probabilistic sequence structure. Because sequence-specific learning did not differ significantly between hands, we conclude that representations of the probabilistic sequence structure are stored in an effector-independent visuospatial code.
Topics: Humans; Male; Female; Adult; Reaction Time; Young Adult; Space Perception; Transfer, Psychology; Psychomotor Performance; Visual Perception; Functional Laterality; Serial Learning; Practice, Psychological; Hand
PubMed: 38703539
DOI: 10.1016/j.concog.2024.103696 -
Human Brain Mapping May 2024Verbal memory decline is a significant concern following temporal lobe surgeries in patients with epilepsy, emphasizing the need for precision presurgical verbal memory...
Verbal memory decline is a significant concern following temporal lobe surgeries in patients with epilepsy, emphasizing the need for precision presurgical verbal memory mapping to optimize functional outcomes. However, the inter-individual variability in functional networks and brain function-structural dissociations pose challenges when relying solely on group-level atlases or anatomical landmarks for surgical guidance. Here, we aimed to develop and validate a personalized functional mapping technique for verbal memory using precision resting-state functional MRI (rs-fMRI) and neurosurgery. A total of 38 patients with refractory epilepsy scheduled for surgical interventions were enrolled and 28 patients were analyzed in the study. Baseline 30-min rs-fMRI scanning, verbal memory and language assessments were collected for each patient before surgery. Personalized verbal memory networks (PVMN) were delineated based on preoperative rs-fMRI data for each patient. The accuracy of PVMN was assessed by comparing post-operative functional impairments and the overlapping extent between PVMN and surgical lesions. A total of 14 out of 28 patients experienced clinically meaningful declines in verbal memory after surgery. The personalized network and the group-level atlas exhibited 100% and 75.0% accuracy in predicting postoperative verbal memory declines, respectively. Moreover, six patients with extra-temporal lesions that overlapped with PVMN showed selective impairments in verbal memory. Furthermore, the lesioned ratio of the personalized network rather than the group-level atlas was significantly correlated with postoperative declines in verbal memory (personalized networks: r = -0.39, p = .038; group-level atlas: r = -0.19, p = .332). In conclusion, our personalized functional mapping technique, using precision rs-fMRI, offers valuable insights into individual variability in the verbal memory network and holds promise in precision verbal memory network mapping in individuals.
Topics: Humans; Female; Male; Magnetic Resonance Imaging; Adult; Young Adult; Brain Mapping; Memory Disorders; Middle Aged; Drug Resistant Epilepsy; Adolescent; Nerve Net; Postoperative Complications; Neurosurgical Procedures; Verbal Learning; Epilepsy, Temporal Lobe
PubMed: 38703114
DOI: 10.1002/hbm.26691 -
Behavioral and Brain Functions : BBF May 2024Episodic memory (EM) deteriorates as a result of normal aging as well as Alzheimer's disease. The neural underpinnings of such age-related memory impairments in older...
BACKGROUND
Episodic memory (EM) deteriorates as a result of normal aging as well as Alzheimer's disease. The neural underpinnings of such age-related memory impairments in older individuals are not well-understood. Although previous research has unveiled the association between gray matter volume (GMV) and EM in the elderly population, such findings exhibit variances across distinct age cohorts. Consequently, an investigation into the dynamic evolution of this relationship with advancing age is imperative.
RESULT
The present study utilized a sliding window approach to examine how the correlation between EM and GMV varied with age in a cross-sectional sample of 926 Chinese older adults. We found that both verbal EM (VEM) and spatial EM (SEM) exhibited positive correlations with GMV in extensive areas primarily in the temporal and frontal lobes and that these correlations typically became stronger with older age. Moreover, there were variations in the strength of the correlation between EM and GMV with age, which differed based on sex and the specific type of EM. Specifically, the association between VEM and GMVs in the insula and parietal regions became stronger with age for females but not for males, whereas the association between SEM and GMVs in the parietal and occipital regions became stronger for males but not for females. At the brain system level, there is a significant age-related increase in the correlations between both types of EM and the GMV of both the anterior temporal (AT) system and the posterior medial (PM) system in male group. In females, both types of EM show stronger age-related correlations with the GMV of the AT system compared to males.
CONCLUSIONS
Our study revealed a significant positive correlation between GMV in most regions associated with EM and age, particularly in the frontal and temporal lobes. This discovery offers new insights into the connection between brain structure and the diminishing episodic memory function among older individuals.
Topics: Humans; Male; Female; Memory, Episodic; Aged; Gray Matter; Frontal Lobe; Aging; Temporal Lobe; Middle Aged; Magnetic Resonance Imaging; Cross-Sectional Studies; Aged, 80 and over; Organ Size
PubMed: 38702688
DOI: 10.1186/s12993-024-00237-y -
Proceedings of the 2023 7th... May 2023Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized in part by difficulties in verbal and nonverbal social communication. Evidence indicates...
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized in part by difficulties in verbal and nonverbal social communication. Evidence indicates that autistic people, compared to neurotypical peers, exhibit differences in head movements, a key form of nonverbal communication. Despite the crucial role of head movements in social communication, research on this nonverbal cue is relatively scarce compared to other forms of nonverbal communication, such as facial expressions and gestures. There is a need for scalable, reliable, and accurate instruments for measuring head movements directly within the context of social interactions. In this study, we used computer vision and machine learning to examine the head movement patterns of neurotypical and autistic individuals during naturalistic, face-to-face conversations, at both the individual () and interpersonal () levels. Our model predicts diagnostic status using dyadic head movement data with an accuracy of 80%, highlighting the value of head movement as a marker of social communication. The monadic data pipeline had lower accuracy (69.2%) compared to the dyadic approach, emphasizing the importance of studying back-and-forth social communication cues within a true social context. The proposed classifier is not intended for diagnostic purposes, and future research should replicate our findings in larger, more representative samples.
PubMed: 38699395
DOI: 10.1145/3608298.3608309 -
Heliyon May 2024Non-native English-speaking law students and international legal practitioners who speak English as an additional language face significant challenges while pursuing...
Non-native English-speaking law students and international legal practitioners who speak English as an additional language face significant challenges while pursuing legal studies at English-only institutions, participating in professional training or catering to the legal needs of an increasingly diverse clientele. One of the most difficult challenges is sustaining adequate lexical knowledge to initiate and maintain communication regarding legal subject matter. This study aims to address this issue by presenting two short lists of lexical bundles and keywords (KWs) of the . Through a combination of corpus analysis and linguistics methodology, these lists are designed to provide a pedagogically useful and subject-focused source for learning academic vocabulary. Bundles are functionally classified into referentials, discourse organisers and stance markers, and their structural forms are filtered into distinct nominal, prepositional and verbal categories. KWs are POS-tagged to allow for direct instructional intervention. This research discusses the pedagogical implications of the research for teaching English for legal purposes.
PubMed: 38699014
DOI: 10.1016/j.heliyon.2024.e29944 -
Frontiers in Medicine 2024Effective doctor-patient relationships hinge on robust communication skills, with non-verbal communication techniques (NVC) often overlooked, particularly in online...
BACKGROUND
Effective doctor-patient relationships hinge on robust communication skills, with non-verbal communication techniques (NVC) often overlooked, particularly in online synchronous interactions. This study delves into the exploration of NVC types during online feedback sessions for communication skill activities in a medical education module.
METHODS
A cohort of 100 first-year medical students and 10 lecturers at the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), engaged in communication skills activities via Microsoft Teams. Sessions were recorded, and lecturer NVC, encompassing body position, facial expressions, voice intonation, body movements, eye contact, and paralinguistics, were meticulously observed. Following these sessions, students provided reflective writings highlighting their perceptions of the feedback, specifically focusing on observed NVC.
RESULTS
The study identified consistent non-verbal communication patterns during feedback sessions. Lecturers predominantly leaned forward and toward the camera, maintained direct eye contact, and exhibited dynamic voice intonation. They frequently engaged in tactile gestures and paused to formulate thoughts, often accompanied by filler sounds like "um" and "okay." This consistency suggests proficient use of NVC in providing synchronous online feedback. Less observed NVC included body touching and certain paralinguistic cues like long sighs. Initial student apprehension, rooted in feelings of poor performance during activities, transformed positively upon observing the lecturer's facial expressions and cheerful intonation. This transformation fostered an open reception of feedback, motivating students to address communication skill deficiencies. Additionally, students expressed a preference for comfortable learning environments to alleviate uncertainties during feedback reception. Potential contrivances in non-verbal communication (NVC) due to lecturer awareness of being recorded, a small sample size of 10 lecturers limiting generalizability, a focus solely on preclinical lecturers, and the need for future research to address these constraints and explore diverse educational contexts.
CONCLUSION
Medical schools globally should prioritize integrating NVC training into their curricula to equip students with essential communication skills for diverse healthcare settings. The study's findings serve as a valuable reference for lecturers, emphasizing the importance of employing effective NVC during online feedback sessions. This is crucial as NVC, though occurring online synchronously, remains pivotal in conveying nuanced information. Additionally, educators require ongoing professional development to enhance proficiency in utilizing NVC techniques in virtual learning environments. Potential research directions stemming from the study's findings include longitudinal investigations into the evolution of NVC patterns, comparative analyses across disciplines, cross-cultural examinations, interventions to improve NVC skills, exploration of technology's role in NVC enhancement, qualitative studies on student perceptions, and interdisciplinary collaborations to deepen understanding of NVC in virtual learning environments.
PubMed: 38698786
DOI: 10.3389/fmed.2024.1375982