Four decades of NCI-funded NCTN trials: 14.2 million life-years, at $326 per year

Peer-Reviewed Publication

SWOG CANCER RESEARCH NETWORK

Clinical trials in adults conducted within the National Cancer Institute’s (NCI’s) National Clinical Trials Network (NCTN) over the last four decades are estimated to have extended the lives of patients with cancer in the U.S. by at least 14.2 million life-years, according to a new analysis. Importantly, the study estimated that the costs of those gains have been quite modest: roughly $326 in federal investment for each life-year added.

The results are published in the Journal of Clinical Oncology. The analysis was led by researchers from the SWOG Cancer Research Network, one of the NCTN clinical trials groups funded by the NCI, which is part of the National Institutes of Health (NIH).

The research team also quantified some of the enormous clinical and scientific impact the results of NCTN trials have had. Overall, the researchers identified 162 phase III trials conducted since 1980 with positive results. Primary findings of the 162 analyzed studies were cited in the scientific literature more than 165,000 times through the end of 2020, and 87.7 percent of the trials have been referred to as evidence in subsequent cancer care recommendations made in widely used guidelines.

Joseph M. Unger, PhD, a SWOG health services researcher and biostatistician with Fred Hutchinson Cancer Center, is lead author on the work. 

“This work provides a clear statement about the impact of publicly funded cancer research,” Dr. Unger said. “When we discuss investments in infrastructure, it’s important to also consider scientific infrastructure. In the U.S., the NCI-sponsored network groups have been a vital element of the scientific infrastructure of clinical research for decades, and have returned incredible value to cancer patients and to the U.S. taxpayer.”  

To estimate the life-years gained from NCTN research, the team looked at trials conducted by the four adult network groups (or their predecessors): the Alliance for Clinical Trials in Oncology, the ECOG-ACRIN Cancer Research Group, NRG Oncology, and SWOG Cancer Research Network. Together with the Children’s Oncology Group, which performs research into childhood cancers, these groups are the core of a network that, in conjunction with the NCI Community Oncology Research Program (NCORP), runs clinical trials at more than 2,200 academic and community treatment sites across the U.S. and beyond, and they have conducted publicly funded research into effective new cancer treatments for more than half a century.

“First and foremost, we commend the generosity and courage of patients who participate in clinical trials,” said Monica M. Bertagnolli, M.D., director of NCI.  “This work is a clear demonstration that those who do so make a tremendous contribution to society.  We also acknowledge the work of clinical providers and other caregivers who go above and beyond usual care to make clinical trials possible.  This result validates the key role of NCTN and other networks in improving the outlook for patients with cancer and progressing toward our goal to reduce the cancer death rate by half within 25 years.”

For the current analysis of the work of the adult NCTN groups, researchers identified randomized phase 3 studies with primary results published in or after 1980 that reported an improvement in a time-dependent outcome favoring the experimental treatment. The 162 trials they analyzed had enrolled at total of 108,334 patients.

For each trial showing an overall survival benefit on the experimental arm, the researchers mapped the benefit onto the U.S. cancer population using national cancer registry and life table data.

The 14.2 million life-years these trials added through 2020 represents 4.2 percent of the 336.8 million years of life lost in the U.S. due to cancer from 1980 – 2020. The researchers further project that by 2030, this same set of already completed studies will have added 24.1 million life-years for patients. 

Total federal investment to conduct these trials was calculated using public data on estimated funding for the four NCTN groups – a total of $4.63 billion in federal investment over those 40 years. To put this $4.63 billion figure (an average yearly investment of about $116 million) in context, in the year 2015 alone, the U.S. spent $183 billion on cancer care, and the total years of life lost to 2015 adult cancer deaths in the U.S. resulted in an estimated $94.4 billion loss in future earnings.

The impact of the results on clinical care was measured by determining whether a trial’s results were cited as evidence in favor of a recommended treatment in major clinical guidelines or in package inserts for new drug approvals by the U.S. Food and Drug Administration. Overall, the findings from 87.7% of the trials were used to support recommended clinical care. The overall scientific impact of the trial findings was assessed by determining how often the primary report on each study’s results was cited in Google Scholar. In total, the 162 trials were cited 165,336 times through 2020, and nearly all of the trials (90.1 percent) were published in high-impact scientific journals.

The authors acknowledge that the $326 per life-year gained federal investment figure does not encompass all costs, noting that the costs of initial drug discovery and early testing are not included in the analysis, nor are the full costs of conducting these trials, including the costs borne by clinical institutions and the time and effort of research investigators.

On the other hand, the authors also discuss multiple additional benefits patients have derived from these and other NCTN clinical trials that are not accounted for in these statistics. 

“These trials have also made substantial contributions in ways that are harder to measure,” Dr. Unger added. “For instance, negative trials are critical for showing what treatments should not be used, and federally sponsored research groups also provide critical opportunities to mentor new generations of clinical researchers. And for patients, these trials routinely provide access to treatments for underserved patient populations that may not be as accessible in industry-sponsored trials.” 
 

This research was funded by the NIH/NCI through grants CA189974, CA180888, CA180819, CA180820, CA180821, and CA180868.

In addition to Unger, authors on the work include Michael LeBlanc, PhD, SWOG Statistics and Data Management Center and Fred Hutchinson Cancer Research Center; Suzanne George, MD, Office of the Alliance Group Chair andDana-Farber Cancer Institute; Norman Wolmark, MD, NRG Oncology; Walter J. Curran, Jr., MD, Department of Radiation Oncology, Emory University; Peter J. O’Dwyer, MD, Department of Medicine, University of Pennsylvania; Mitchell D. Schnall, MD, PhD, Department of Genetics, Perelman School of Medicine, University of Pennsylvania; Robert S. Mannel, MD, Stephenson Cancer Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma; Sumithra J. Mandrekar, PhD, Department of Health Sciences Research, Alliance Statistics and Data Management Center, Mayo Clinic; Robert J. Gray, PhD, ECOG-ACRIN Biostatistics Center andDana-Farber Cancer Institute; Fengmin Zhao, PhD, Dana-Farber Cancer Institute and ECOG-ACRIN Biostatistics Center; Mariama Bah, SWOG Statistics and Data Management Center and Fred Hutchinson Cancer Research Center; Riha Vaidya, PhD, SWOG Statistics and Data Management Center and Fred Hutchinson Cancer Research Center; Charles D. Blanke, MD, SWOG Cancer Research Group Chair’s Office and Oregon Health and Science University Knight Cancer Institute
 

SWOG Cancer Research Network is part of the National Cancer Institute's National Clinical Trials Network and the NCI Community Oncology Research Program and is part of the oldest and largest publicly funded cancer research network in the nation. SWOG has more than 18,000 members in 45 states and nine foreign countries who design and conduct clinical trials to improve the lives of people with cancer. SWOG trials have led to the approval of 14 cancer drugs, changed more than 100 standards of cancer care, and saved more than 3 million years of human life. Learn more at swog.org, and follow us on Twitter at @SWOG.

 

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JOURNAL

Journal of Clinical Oncology

DOI

10.1200/JCO.22.01826 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Population, Clinical, and Scientific Impact of National Cancer Institute's National Clinical Trials Network Treatment Studies

How a test drive may lead to an electric vehicle purchase

Taking a spin boosts buyer identity as an early technology adopter

Peer-Reviewed Publication

OHIO STATE UNIVERSITY

COLUMBUS, Ohio – There’s something about test driving an electric vehicle that boosts some potential buyers’ personal identity as being early adopters of the latest technologies, a new study has found.

And that strengthened sense of being a timely user of new gadgetry was linked to a higher likelihood that the test-driver would show interest in buying the car, the study suggested.

Though the test drive also increased study participants’ impression that an electric vehicle could function as a status symbol, that expectation did not translate into interest in making a purchase.

The findings help increase understanding of what fuels consumer behavior behind purchases related to sustainability and offers insights that could guide electric vehicle (EV) marketing efforts, said senior author Nicole Sintov, associate professor of behavior, decision making and sustainability at The Ohio State University. 

“An electric vehicle can symbolize different things to different people – it’s not going to be the same across the board. That’s why it’s important to consider the variety of different qualities an EV can reflect,” she said. “What we found is that EV test drives have a lot of potential to change how people think of themselves – and that was linked to increased intention to buy.”

Sintov completed the study with first author Atar Herziger, a former postdoctoral researcher at Ohio State who is now on the faculty of Technion – Israel Institute of Technology.

The research was published recently in the Journal of Environmental Psychology.

Sintov and Herziger set out to determine whether and how a test drive of an electric vehicle affects two kinds of symbolic meaning: private meaning, which supports an individual’s self-perception, or public meaning – influencing how others would view the EV owner. And if those meanings change, does that affect the prospective buyer’s plan to make a purchase?

Two studies were conducted, one a randomized experiment using a virtual test drive and the other a partnership with Smart Columbus to survey people who opted to participate in an EV test-driving experience.

A total of 729 participants over the two studies were asked before and after the test drive to rate how owning an EV would influence their self-perception and how having the car would affect the way others view them. After the test drive, they were asked how likely they were to buy or lease the car or recommend it to a friend. 

The research focused on three types of private symbolic meaning linked to owning an electric car: being pro-environment, an early adopter of new technologies or a car authority. To gauge public meaning, the survey asked participants to report the extent to which they perceived that driving the EV says something about the kind of person they are.

In the case of the virtual test drive, the researchers used an identical video – eliminating all visible branding and sound – of an EV model that wasn’t yet available in the United States. The virtual test drive included examples of how interior features worked and took participants on a short ride from the driver’s point of view – the only difference was that some were told the car was a conventional gas-powered vehicle, and others were told it was an EV.

Statistical analysis showed that from pre- to post-test drive, the virtual experience in the EV strengthened participants’ perception of the EV as an expressive object and increased their self-identity as early adopters of technology.

“We didn’t see that for those who were told they were test-driving a conventional vehicle,” said Sintov, a faculty member in Ohio State’s School of Environment and Natural Resources. “They had the same stimuli, but telling them it was one thing or another obviously changed the perceptions not only of the vehicle, but of themselves.”

But only the reinforced personal identity – the private symbolic meaning – was associated with intention to make a purchase.

The real-life test drive results had similar effects on enhancing public and private symbolic meanings of an EV, this time increasing both early-technology-adopter and car-authority identities – and again, only the reinforced personal identities led to stronger intentions to lease or buy the car.

From a theoretical and practical point of view, the distinctions between public and private meanings and their influence on purchasing intentions is important, Sintov said. And considering the test drive’s influence on those meanings also takes into account the fact that lots of thought usually goes into buying a car – it’s not a decision made at a single point in time, she said.

“We really wanted to parse these things out more concretely than previous studies on EV symbolic meanings have – all in the context of whether a test drive moves things,” she said.

And because the results showed test drives can move consumers toward a purchase, the marketing around such experiences could be particularly important.

“If EV marketing efforts focus on saying, ‘Look at you – you have cool person status,’ that is not the route we identified,” Sintov said. “‘How do I think about myself differently after this test drive, and in particular, how do I see myself differently in terms of being an early adopter of technology?’ That is what makes people want to buy the car.”

#

Contact: Nicole Sintov, Sintov.2@osu.edu

Written by Emily Caldwell, Caldwell.151@osu.edu

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JOURNAL

Journal of Environmental Psychology

DOI

10.1016/j.jenvp.2022.101907 

ARTICLE TITLE

Give it a Try! How electric vehicle test drives influence symbolism perceptions and adoption intent

AKRON RUBBER TIRE CO.

Do polar bear paws hold the secret to better tire traction?

University of Akron researchers review paw prints to find secret to traction in snow and ice

Peer-Reviewed Publication

UNIVERSITY OF AKRON

Traction is important. Humans have been continually interested in discovering how to better move across wet or frozen surfaces safely – whether to improve shoes for walking on sidewalks or tires to maneuver the roadways. But what makes it possible for some arctic animals to walk and run across the ice so effortlessly and gracefully without slipping and falling? Three researchers from The University of Akron (UA) took a deep dive into the paws of polar bears to find out. Their research was published in the November issue of the Journal of the Royal Society Interface.

Why polar bears?

The project team included Ali Dhinojwala, the H.A. Morton Professor of Polymer Science in the School of Polymer Science and Polymer Engineering, Nathaniel Orndorf, a 2022 Ph.D. graduate who is now employed as a senior material scientist at Bridgestone Americas, and Austin Garner, a 2021 Ph.D. graduate who is now an assistant professor of biology at Syracuse University. The project began during the height of the pandemic when things were on lockdown. 

“We had an ongoing project for many years focused on ice; we were looking at the friction of materials and we were interested in this topic because we are in Akron and our national partners need to develop tires with a strong grip on the road in ice and snow conditions,” said Dhinojwala. “Nate had an interest in how nature has adapted to this solution for snow. The example that came to his mind was polar bears – and the research began from there.”

The project was very interdisciplinary, combining approaches and techniques from both biological and materials research. Orndorf and Dhinojwala are polymer scientists who integrate biology into their research, while Garner is an animal biologist who integrates materials science into his research.

The idea was to look at the paw pads of polar bears. Reviewing older literature, the team discovered that previous work studied the microstructures (papillae, the little bumps on the pad of the foot) of polar bear paws and asserted that the papillae were adaptations for improved traction on snow. The previous studies did not include other species of bear so Garner helped identify two species closely related to the polar bear (the brown bear and American black bear) and one distantly related (the sun bear) to include in the study.

“The quietness of the lab during COVID gave me the opportunity to connect with a variety of scientists and environmentalists across the country,” said Orndorf. “I reached out to museums, taxidermists and many others to collect and view actual samples and replicas of bear paw pads.”

Orndorf and Garner then prepared the paw pad samples from the bears and imaged them using a scanning electron microscope. The team also created 3D printouts of the structures to vary diameter and height of features. They were then tested in snow in the lab to see how they reacted to the conditions. 

What the team discovered was that all bears (except sun bears) have papillae on their paw pads, but that the papillae on polar bears were taller – up to 1.5 times. And, that the taller papillae of polar bears help to increase traction on snow relative to shorter ones. Even though polar bears have smaller paw pads compared to the other species (likely because of greater fur coverage for heat conservation), the taller papillae of polar bears compensate for their smaller paw pads, giving them a 30-50% increase in frictional shear stress.

“Papillae are not unique to polar bears. Previous work [in that area] made the implicit assumption that papillae themselves are adaptations for enhanced traction on snow without studying the paw pads of other bears. It was fascinating for us to discover that the other North American bears have them as well and that the physical characteristics of the papillae are what matters for traction on snow,” said Garner.

Impact on traction

Now that the research has been published, other scientists and manufacturers can look at its application to their specific projects.

“If you look at snow tires you will see that they do have some deeper treads, but this research could also show various ways to design them that could have a larger impact,” said Dhinojwala.

But the interest isn’t just for tire manufacturers. “Individuals who do high altitude climbing are interested in this research, companies that specialize in the delivery of goods in bad weather would love to have better grip, etc.” he added.

The same experiments could also be performed on animals such as dogs, wolves, foxes and mountain goats to determine if specific snow/ice induced surface roughness profiles are present in different animals, [TE1] or if nature has evolved different surface roughness profiles in order to increase traction on ice and snow, and which profile has the best performance.

Building on past research

This isn’t the first research conducted in the area of traction or grip at UA. As part of the Biomimicry Research Center (BRIC) at The University of Akron, and in collaboration with faculty members in the BRIC program, Dhinojwala and his team have examined gecko adhesion, spider silk, mussel adhesion, and structural colors inspired by birds and other organisms. His research is supported by National Science Foundation, Air Force Office of Scientific Research and Industries.

His team is continuing to look at ice – how ice formation takes place, ice adhesion, etc. Research that is very helpful for the automotive and aircraft industries. His students have just begun working with NASA on a grant funded project in this area.

“It’s exciting to give our students such interesting research projects to be part of,” said Dhinojwala. “They are an asset to our team, and many go on to continue to be excellent research partners after they leave UA.”

“The Integrated Bioscience Ph.D. Program at UA provided exceptional interdisciplinary research experiences that were formative in my development as a researcher – this collaboration was certainly one of them,” said Garner. “It was a particularly unique experience for me because most of my work before this had focused on how small lizards, like geckos, attach to surfaces. So, it was an exciting and rewarding opportunity to apply my existing skills and expertise to large mammals like bears."

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JOURNAL

Journal of The Royal Society Interface

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

Animals

ARTICLE TITLE

Polar bear paw pad surface roughness and its relevance to contact mechanics on snow

Charging the future with modern aqueous batteries

University of Houston researchers on mission to create better, safer and less expensive batteries

Peer-Reviewed Publication

UNIVERSITY OF HOUSTON

 

IMAGE: UNIVERSITY OF HOUSTON RESEARCHERS YAN YAO AND YANLIANG “LEONARD” LIANG view more 

CREDIT: UNIVERSITY OF HOUSTON

Lithium-ion batteries, which today power everything from the smartphones we carry in our pockets to the electric vehicles we drive, are projected to capture 80% of the rechargeable battery market in the coming years.

There’s good reason for their popularity – lithium-ion batteries offer better battery capacity, efficiency and longevity than others in the current marketplace. However, they are still quite expensive and can catch fire or explode in extreme conditions.

Two top battery experts at the University of Houston contend that the gold-standard lithium-ion battery is about to get some competition. They are betting on humble aqueous batteries – with water-based electrolytes – generally regarded as safe, reliable and affordable.

“The idea is to develop advanced aqueous batteries that can combine better safety and higher voltage,” said Yan Yao, Hugh Roy and Lillie Cranz Cullen Distinguished Professor of Electrical and Computer Engineering and principal investigator at the Texas Center for Superconductivity at the University of Houston. Yao has been leading research on energy storage materials and devices for about a decade now. His team is on a mission to create better, safer and less expensive batteries.

Yao, and Yanliang “Leonard” Liang, research assistant professor of electrical and computer engineering, were recently invited by Nature Reviews Materials, a high-impact academic journal, to review the evolution of rechargeable aqueous batteries. “Designing modern aqueous batteries” highlights key breakthroughs over the last decade and provides guidance and direction for new research.

“Our review is extensive in scope because we wanted to paint a big picture on the landscape of aqueous batteries,” Liang said. “If we don’t understand the overall picture, we can’t know where the next opportunity will be.”

Where are aqueous batteries now and where do they need to be?

The big push toward electrification in almost every aspect of life, the growing demand for consumer electronics and electric vehicles and the need for adequate storage for renewable energy are driving the demand for batteries higher and higher.

Commercial aqueous batteries that exist today lack the energy density and lasting power needed to be seriously considered for large-scale application such as transportation and grid storage.

However, Liang and Yao stress that innovations involving materials and chemistries, coupled with other research advances have created new opportunities for a modern, more advanced form of aqueous batteries.

Rechargeable aqueous batteries offer many advantages - abundant and low-cost raw materials; minimal requirements for manufacturing environments; non-inflammable; simple fabrication and high power, which determines how long it takes to fully charge and accelerate from 0 to 60 mph.

They have their drawbacks, too – narrow thermodynamic electrochemical stability window, faulty operations that could lead to explosions and, of course, low energy density.

According to the authors, there are modern versions made with innovative materials that are in the early stages of commercialization which are key developments in the transition to the next big battery research breakthrough.

The goal is to create an advanced aqueous battery that can deliver the best of both worlds. “This new water-based battery will deliver better safety and higher voltage,” Yao said.

Designing the breakthrough aqueous battery

Designing the new and improved version of the aqueous battery that will revolutionize the battery market is no easy task. It requires knowledge of the most basic intricacies and new technologies to create the ideal version – from mixing and matching ion selective membranes and coatings to lean water electrolytes, to new types of electrode reactions and modular cell design.

According to the researchers, the goal is to widen the window of electrochemical stability, allowing battery chemistry to work across wider voltage ranges and produce more energy, leading to new opportunities.

“How we integrate the different components will have a profound impact in this field,” Liang said. “We must mix and match and try new combinations. Sometimes it will result in improvement in one area but compromises in another. We have to be realistic and keep trying to make it better and better.”

It’s all about coming up with smart combinations that will deliver the twin targets of high energy and high safety.

Liang, whose research interest spans everything from solid state and aqueous batteries to multivalent metal batteries, as well as lithium and sodium batteries, is hopeful that the ideal is achievable thanks to modern tools and new discoveries. “One day, you will have an aqueous battery that has the same voltage as the lithium-ion battery, but it will be safer because it is water-based,” he said.

However, researchers will have to continue pursuing improvements to turn the hope into the reality of an advanced commercially viable aqueous battery. There is excellent incentive to spur researchers on – not only will the aqueous batteries of the future offer more energy and safety, but they will also make battery disposal easier on the environment because of the materials used.

Yao and Liang recently launched a startup called LiBeyond to scale up and further develop innovative battery technologies originally developed at UH. They envision possible applications in electric vehicles and other areas of transportation to help power entire fleets and grid-scale storage.

“This will be especially important when grid reliability is key, such as during situations like hurricanes, winter storms and other emergencies,” Yao said. He added that wearable technologies would also benefit from this development.

“One of the key features of aqueous batteries is safety, which is vital in wearable technologies because you ‘wear’ them directly on the body,” he said. “The possibilities these modern aqueous batteries will offer [once developed] are endless.”

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JOURNAL

Nature Reviews Materials

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Designing Modern Aqueous Batteries

NTU Singapore doctors find mental health chatbots are effective in helping treat symptoms in people with depression

Peer-Reviewed Publication

NANYANG TECHNOLOGICAL UNIVERSITY

 

IMAGE: (L-R) PROFESSOR JOSIP CAR, DIRECTOR OF THE CENTRE FOR POPULATION HEALTH SCIENCES AT NTU’S LKCMEDICINE AND DR LAURA MARTINENGO, A RESEARCH FELLOW FROM LKCMEDICINE. view more 

CREDIT: NTU SINGAPORE

Clinician scientists from Nanyang Technological University, Singapore (NTU Singapore) have found that mental health chatbots are able to effectively engage people with depression in empathetic conversations and assist in the treatment of their symptoms.

 

Chatbots or conversational agents are computer programmes that simulate human conversations.  They are increasingly used in healthcare, for example, to help manage mental health conditions such as depression and anxiety and for general well-being.

 

A 2021 survey[1] by Woebot Health, one of the leading therapeutic chatbot companies in the US, found that 22 per cent of adults have used a mental health chatbot, with nearly half (47 per cent) saying they would be interested in using one if needed.

 

This study by doctors from NTU’s Lee Kong Chian School of Medicine (LKCMedicine) is among the first to analyse user-Chatbot dialogues to evaluate their effectiveness.

 

The researchers analysed nine mental health chatbots from leading app stores, of which five had at least 500,000 downloads, to see whether they offered self-help for people with depression.

 

Nine mental health chatbots were included in the study, four of which, Marvin, Serenity, Woebot, 7 Cups, are free-to-use, while Happify, InnerHour, Wooper, Wysa and Tomo, required a subscription or one-time purchase to be used.  

 

The chatbots were evaluated by the NTU research team through scripted user personas that were created to reflect different cultures, ages, and genders. The personas also presented behaviours that reflect varying degrees of depressive symptoms. 

 

This study published in December in the peer-reviewed Journal of Affective Disorders found that all the chatbots engaged in empathetic and non-judgmental conversations with users and offered support and guidance through psychotherapeutic exercises commonly used by psychologists and counsellors.

 

Through examination of the app interfaces and their privacy policy legal statements, the researchers observed that all the chatbots kept the confidentiality of the user's personal information and did not transfer or store any of it. This information includes chat history, names, or addresses, which they might divulge during chat sessions.

 

Depression affects 264 million people globally and is undiagnosed and untreated in half of all cases, according to the World Health Organisation.[2]  In Singapore, the COVID-19 pandemic has led to an increase in mental health concerns, which include depression.[3]

 

Professor Josip Car, Director of the Centre for Population Health Sciences at NTU’s LKCMedicine, who led the study, said, “There are still a lot of stigmas surrounding mental health disorders and the COVID-19 pandemic has significantly increased the number of people affected by mental health issues. Worldwide, healthcare systems are struggling to cope with the increased demand for mental health services. Digital health tools, including chatbots, could assist in providing timely care to individuals who may be unwilling or unable to consult a healthcare provider. Through this study, we have shown how chatbots are being used and how they engage in therapeutic conversations.”

 

 

Chatting up chatbots to test their effectiveness

 

Although international research has shown that chatbots could help people, previous studies have not evaluated the dialogues between chatbots and users.

 

The NTU team’s content analysis evaluated the quality and effectiveness of the chatbots’ responses and looked at the level of personalisation, appropriateness in supporting self-management in users with depression, and how they conveyed empathy to users.

 

The study also monitored how the chatbots guided users to engage in or complete mood-boosting activities, how they monitored moods and managed suicide risks. 

 

The researchers said that all the chatbots displayed a “coach-like” personality that is encouraging, nurturing, and motivating. However, their analysis showed that while chatbots could engage in empathetic conversations with users they were not able to deliver personalised advice. This in-depth analysis of the conversational flow may be useful to help app developers design future chatbots.

 

First author Dr Laura Martinengo, a research fellow from LKCMedicine said: “Chatbots are not yet able to provide personalised advice and do not ask enough personal questions – possibly to avoid breaching user anonymity.  However, these chatbots could still be a useful alternative for individuals in need especially those who are not able to access medical help. For some people, it’s easier to talk to a machine than a human being.”

 

While chatbots may support the self-management of depression and other mental health disorders, the researchers said that further research is needed to improve chatbots for individuals at risk of suicide and to evaluate the long-term effectiveness of chatbot-led interventions for mental health.

 

The researchers will be conducting further studies to advance the scope, quality and safety of their research looking into the effectiveness of other digital methods for mental well-being.

 

***

Notes to Editor:

 

The research paper titled “Evaluation of chatbot-delivered interventions for self-management of depression: Content analysis” was published in Journal of Affective Disorders in Dec 2022. DOI 10.1016/j.jad.2022.09.028

 

*** END ***

 

Media contact:

Mr Joseph Gan

Manager, Media Relations

Corporate Communications Office

Nanyang Technological University, Singapore

Email: joseph.gan@ntu.edu.sg

 

About Nanyang Technological University, Singapore

 

A research-intensive public university, Nanyang Technological University, Singapore (NTU Singapore) has 33,000 undergraduate and postgraduate students in the Engineering, Business, Science, Medicine, Humanities, Arts, & Social Sciences, and Graduate colleges.

NTU is also home to world-renowned autonomous institutes – the National Institute of Education, S Rajaratnam School of International Studies, Earth Observatory of Singapore, and Singapore Centre for Environmental Life Sciences Engineering – and various leading research centres such as the Nanyang Environment & Water Research Institute (NEWRI) and Energy Research Institute @ NTU (ERI@N).

Under the NTU Smart Campus vision, the University harnesses the power of digital technology and tech-enabled solutions to support better learning and living experiences, the discovery of new knowledge, and the sustainability of resources.

Ranked amongst the world’s top universities, the University’s main campus is also frequently listed among the world’s most beautiful. Known for its sustainability, over 95% of its building projects are certified Green Mark Platinum. Apart from its main campus, NTU also has a medical campus in Novena, Singapore’s healthcare district.

For more information, visit www.ntu.edu.sg

 

 

 

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[1] Woebot Health. Large-Scale Study Finds Mental Health App Forms Bond with Users (2021).

[2] World Health Organisation.  Depression, a fact sheet (2021)

 

[3] Institute of Mental Health, Singapore. Novel Coronavirus, Population Well-being and Resilience Cross-Sectional Study (2021)

 

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JOURNAL

Journal of Affective Disorders

DOI

10.1016/j.jad.2022.09.028 

METHOD OF RESEARCH

Meta-analysis

ARTICLE TITLE

Evaluation of chatbot-delivered interventions for self-management of depression: Content analysis

SOUTH EAST ASIANS

Indian American youth share their experiences with discrimination

Study reveals second-generation Indian American adolescents experience discrimination as early as preschool

Peer-Reviewed Publication

TEXAS A&M UNIVERSITY

Racial and ethnic discrimination is a regular occurrence for many of the more than 3.5 million South Asians living in the United States. A new study from the Texas A&M University School of Public Health reveals that for young Asian Indian Americans, this discrimination can start as early as preschool and influences development of their identities.

Studies have found increasing rates of hate crimes directed at South Asian Americans, including many Indian Americans. Despite facing similar levels of discrimination as Hispanic and Native American people, there have been fewer studies of discrimination and its effects on South Asian Americans. And most previous studies have focused on adult populations, excluding adolescents who are especially vulnerable to discrimination as they explore and form their identities.

A new study published in the journal Frontiers in Public Health takes a new look at ethnic and racial discrimination that a subgroup of South Asian Americans—Indian Americans—face in the United States, focusing on a younger population than in previous studies. The research team led by Jamilia Blake, Ph.D., School of Public Health professor and director of the Center for Health Equity and Evaluation Research (CHEER), surveyed second-generation Indian American adolescents to find out about their experiences with racial and ethnic discrimination and how these experiences affected their identities.

The study relied on data from open-ended surveys of nine Indian American adolescents between the ages of 12 and 17. These adolescents were all classified as second-generation, in this case meaning they were born in the United States and had parents who emigrated from India after the age of 18. The researchers collected data through individual interviews with participants lasting between 30 minutes and one hour. The interviews covered five hypothetical situations involving discrimination and included follow-up questions as needed to gain an understanding of how each participant viewed the scenarios.

The interviews highlighted the ways Indian American adolescents experience discrimination and how those experiences influence their identities. The interviewees reported about hate crimes and their experiences with peers at school who made discriminatory comments about Indian culture, language or religion.

These adolescents also discussed the difficulties they faced balancing their Indian identity with their desire to be seen as American. This balancing act often relies on code switching, where the interviewees spoke and acted differently when with family and at school. In some cases, these adolescents felt they were seen as fitting into neither group. The interviews also showed that Indian American youth begin facing discrimination as early as preschool or elementary school.

These findings highlight some of the challenges that young South Asian Americans may face. However, the researchers caution that the study sample was small, from a single geographical area, and with only one ethnic group among South Asian Americans. Thus, the findings may not reflect the experiences of South Asian American adolescents everywhere in the country. Future research that includes more people from a wider range of locations would provide more knowledge on the experiences of South Asian American youth as a whole.

Despite these limitations, this study gives insight into the experiences of young Indian Americans and how those experiences affect their development. The findings of this work can be used to guide future research into discrimination and its mental health and social effects in this population.

The research team also included recent doctoral graduate Asha K. Unni and colleagues from Texas A&M University and Davidson College.

Racial and ethnic discrimination is a regular occurrence for many of the more than 3.5 million South Asians living in the United States. A new study from the Texas A&M University School of Public Health reveals that for young Asian Indian Americans, this discrimination can start as early as preschool and influences development of their identities.

Studies have found increasing rates of hate crimes directed at South Asian Americans, including many Indian Americans. Despite facing similar levels of discrimination as Hispanic and Native American people, there have been fewer studies of discrimination and its effects on South Asian Americans. And most previous studies have focused on adult populations, excluding adolescents who are especially vulnerable to discrimination as they explore and form their identities.

A new study published in the journal Frontiers in Public Health takes a new look at ethnic and racial discrimination that a subgroup of South Asian Americans—Indian Americans—face in the United States, focusing on a younger population than in previous studies. The research team led by Jamilia Blake, Ph.D., School of Public Health professor and director of the Center for Health Equity and Evaluation Research (CHEER), surveyed second-generation Indian American adolescents to find out about their experiences with racial and ethnic discrimination and how these experiences affected their identities.

The study relied on data from open-ended surveys of nine Indian American adolescents between the ages of 12 and 17. These adolescents were all classified as second-generation, in this case meaning they were born in the United States and had parents who emigrated from India after the age of 18. The researchers collected data through individual interviews with participants lasting between 30 minutes and one hour. The interviews covered five hypothetical situations involving discrimination and included follow-up questions as needed to gain an understanding of how each participant viewed the scenarios.

The interviews highlighted the ways Indian American adolescents experience discrimination and how those experiences influence their identities. The interviewees reported about hate crimes and their experiences with peers at school who made discriminatory comments about Indian culture, language or religion.

These adolescents also discussed the difficulties they faced balancing their Indian identity with their desire to be seen as American. This balancing act often relies on code switching, where the interviewees spoke and acted differently when with family and at school. In some cases, these adolescents felt they were seen as fitting into neither group. The interviews also showed that Indian American youth begin facing discrimination as early as preschool or elementary school.

These findings highlight some of the challenges that young South Asian Americans may face. However, the researchers caution that the study sample was small, from a single geographical area, and with only one ethnic group among South Asian Americans. Thus, the findings may not reflect the experiences of South Asian American adolescents everywhere in the country. Future research that includes more people from a wider range of locations would provide more knowledge on the experiences of South Asian American youth as a whole.

Despite these limitations, this study gives insight into the experiences of young Indian Americans and how those experiences affect their development. The findings of this work can be used to guide future research into discrimination and its mental health and social effects in this population.

The research team also included recent doctoral graduate Asha K. Unni and colleagues from Texas A&M University and Davidson College.

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JOURNAL

Frontiers in Public Health

DOI

10.3389/fpubh.2022.955011 

ARTICLE TITLE

“No, but where are you really from?” Experiences of perceived discrimination and identity development among Asian Indian adolescents

Zoonotic disease in dogs rises in Southern Chile after deworming program cancelled

Reestablishing program could help protect people and animals from hydatid disease

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - DAVIS

 

IMAGE: DOGS AT A SHEEP RANCH LOUNGE BESIDE A VEHICLE IN TIERRA DEL FUEGO IN SOUTHERN CHILE. CANINE ECHINOCOCCOSIS, A PARASITIC DISEASE, HAS INCREASED IN THE PROVINCE AFTER A DEWORMING PROGRAM WAS CANCELLED. view more 

CREDIT: ERIC EISENMAN, UC DAVIS

A parasitic disease, canine echinococcosis, has increased in Chile’s Tierra del Fuego province after a governmental dog deworming program was cancelled in 2004, according to a study from the University of California, Davis’ One Health Institute and School of Veterinary Medicine.

(Lea este artículo en español.)

The study, published in the journal Zoonoses and Public Health, was conducted in collaboration with the Universidad de Chile and the Wildlife Conservation Society-Chile. It notes that this zoonotic disease can significantly impact people. Cystic echinococcosis — also known as hydatid disease — affects more than 1 million people worldwide and is the second most common cause of human deaths from parasitic disease in Chile.

It is caused by the tapeworm Echinococcus granulosus, which is shed by dogs and can infect people. Dogs acquire the disease by consuming viscera of infected animals, such as sheep, making it prevalent in sheep farms and rural communities. 

The deworming program had reduced the prevalence of the disease in dogs in sheep farms from Chile’s Tierra del Fuego province from 68.4 percent in 1978 to 1.2 percent in 2002. The study found that without the intensive program, canine echinococcosis has increased to 6.9 percent, as of 2016.

“This study points to a persistent risk of echinococcosis in domestic dogs at ranches in Tierra del Fuego, where sheep farming is the main economic activity,” said corresponding author Marcela Uhart, director of the Latin America Program within the UC Davis One Health Institute. “It highlights the need to reestablish Chile’s program to prevent this disease’s reemergence as a significant public health concern.”

Sheep, foxes and other factors

For the study, researchers sampled 356 domestic dogs and interviewed owners and workers at 45 sheep ranches across Tierra del Fuego. They conducted dog fecal sample testing to detect the disease at Universidad de Chile’s School of Veterinary Medicine in Santiago.

They found that the prevalence of canine echinococcus was higher on ranches where interviewees reported infrequent deworming. The number of sheep, frequency of sheep slaughter and feeding dogs with sheep viscera and other ranch operational characteristics also influenced the prevalence of tapeworm eggs.

Infection prevalence was also associated with reports of presence of culpeo foxes. All canids present on the island, including the native culpeo and the introduced chilla foxes, are known to be hosts of the disease.

“Considering the increasing presence of feral dogs in Tierra del Fuego, it is important to develop an ethical program to manage them and reduce the potential spread of echinococcus and other pathogens that can affect both human and wildlife health on the island,” said Alejandro Vila, a coauthor of this study and regional program manager for the Southern Cone at Wildlife Conservation Society.

“This study was undertaken through an international collaboration and could not have been possible without the participation of the ranchers of Tierra del Fuego,” said senior author Cristobal Briceño of Universidad de Chile. “The findings highlight the relevance of addressing health threats from a One Health perspective, including human, animal and environmental health.”

The study’s additional authors include Eric Eisenman, Ralph Vanstreels and Jonna Mazet of the UC Davis One Health Institute and School of Veterinary Medicine; and Alejandro Kusch of the Wildlife Conservation Society-Chile.

The study was funded by the Fogarty International Center of the National Institutes of Health and the UC Global Health Institute.

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JOURNAL

Zoonoses and Public Health

DOI

10.1111/zph.13017 

ARTICLE TITLE

Increased prevalence of canine echinococcosis a decade after the discontinuation of a governmental deworming program in Tierra del Fuego, Southern Chile

ARTICLE PUBLICATION DATE

13-Dec-2022