This study explores the trends of chatbots in education studies by conducting a literature review to analyze relevant papers published in the Social Science Citation Index (SSCI) journals by ...searching the Web of Science (WoS) database. From the analysis results, it was found that the United States, Taiwan and Hong Kong are the top three contributing countries or regions. In addition, most studies adopted quantitative methods in their research design, such as ANOVA (Analysis of variance), descriptive statistics, t test, and correlation analysis. ANCOVA (Analysis of covariance) was the most frequently adopted approach for comparing the performances or perceptions of different groups of students. From the analysis results, the greatest proportion of studies adopted guided learning, followed by no learning activities. It was determined that the studies related to chatbots in education are still in an early stage since there are few empirical studies investigating the use of effective learning designs or learning strategies with chatbots. This implies much room for conducting relevant research to drive innovative teaching in terms of improving the learning process and learning outcomes. Finally, we highlight the research gaps and suggest several directions for future research based on the findings in the present study.
Hypercholesterolemia and dyslipidemia are associated with an increased risk for many cancer types and with poor outcomes in patients with established disease. Whereas the mechanisms by which this ...occurs are multifactorial we determine that chronic exposure of cells to 27-hydroxycholesterol (27HC), an abundant circulating cholesterol metabolite, selects for cells that exhibit increased cellular uptake and/or lipid biosynthesis. These cells exhibit substantially increased tumorigenic and metastatic capacity. Notably, the metabolic stress imposed upon cells by the accumulated lipids requires sustained expression of GPX4, a negative regulator of ferroptotic cell death. We show that resistance to ferroptosis is a feature of metastatic cells and further demonstrate that GPX4 knockdown attenuates the enhanced tumorigenic and metastatic activity of 27HC resistant cells. These findings highlight the general importance of ferroptosis in tumor growth and metastasis and suggest that dyslipidemia/hypercholesterolemia impacts cancer pathogenesis by selecting for cells that are resistant to ferroptotic cell death.
The aims of nursing training include not only mastering skills but also fostering the competence to make decisions for problem solving. In prenatal education, cultivating nurses' knowledge and ...competence of vaccine administration is a crucial issue for protecting pregnant women and newborns from infection. Therefore, obstetric vaccination knowledge has become a basic and essential training program for nursing students. However, most of these training programs are given via the lecture‐based teaching approach with skills practice, providing students with few opportunities to think deeply about the relevant issues owing to the lack of interaction and context. This could have a negative impact on their learning effectiveness and clinical judgment. To address this problem, a mobile chatbot‐based learning approach is proposed in this study to enable students to learn and think deeply in the contexts of handling obstetric vaccine cases via interacting with the chatbot. In order to verify the effectiveness of the proposed approach, an experiment was implemented. Two classes of 36 students from a university in northern Taiwan were recruited as participants. One class was the experimental group learning with the proposed approach, while the other class was the control group learning with the conventional approach (ie, giving lectures to explain the instructional content and training cases). The results indicate that applying a mobile chatbot for learning can enhance nursing students' learning achievement and self‐efficacy. In addition, based on the analysis of the interview results, students generally believed that learning through the mobile chatbot was able to promote their self‐efficacy as well as their learning engagement and performance.
Practitioner notes
What is already known about this topic
Issues relevant to AI technology in education have been extensively discussed and explored around the world.
Among the various AI systems, the potential of chatbots has been highlighted by researchers owing to the user‐friendly interface developed using the natural language processing (NLP) technology.
Few studies using AI chatbots in professional training have been conducted.
What this paper adds
In this study, a mobile chatbot was used in a nursing training program to enhance students' learning achievement and self‐efficacy for handling vaccine cases.
The mobile chatbot significantly improved the students' learning achievement and self‐efficacy in comparison with the conventional learning approach in the vaccine training program.
From the interview results, it was found that the students generally believed that the mobile chatbot was able to promote their self‐efficacy as well as learning engagement and performances in the vaccine training program.
Implications for practice and/or policy
Mobile chatbots have great potential for professional training owing to their convenient and user‐friendly features.
It would be worth applying mobile chatbots as well as other NLP‐based applications to other professional training programs in the future.
Abstract
The immune system functions in a sexually dimorphic manner, with females exhibiting more robust immune responses than males. However, how female sex hormones affect immune function in normal ...homeostasis and in autoimmunity is poorly understood. In this review, we discuss how estrogens affect innate and adaptive immune cell activity and how dysregulation of estrogen signaling underlies the pathobiology of some autoimmune diseases and cancers. The potential roles of the major circulating estrogens, and each of the 3 estrogen receptors (ERα, ERβ, and G-protein coupled receptor) in the regulation of the activity of different immune cells are considered. This provides the framework for a discussion of the impact of ER modulators (aromatase inhibitors, selective estrogen receptor modulators, and selective estrogen receptor downregulators) on immunity. Synthesis of this information is timely given the considerable interest of late in defining the mechanistic basis of sex-biased responses/outcomes in patients with different cancers treated with immune checkpoint blockade. It will also be instructive with respect to the further development of ER modulators that modulate immunity in a therapeutically useful manner.
Graphical Abstract
Graphical Abstract
Artificial intelligence (AI) has been widely explored across the world over the past decades. A particularly emerging topic is the application of AI in e-learning (AIeL) to improve the effectiveness ...of teaching and learning in precision education. This study aims to systematically review publication patterns for AIeL research with a focus on leading journals, countries, disciplines, and applications. In addition, a co-citation network analysis was conducted to explore the invisible relationships among the core papers of AIeL to reveal directions for future research. The analysis is based on a total of 86 core AIeL papers accompanied by 1149 citations in follow-up studies obtained from the Web of Science. It was found that a majority of AIeL studies focused on the development and applications of intelligent tutoring systems, followed by using AI to facilitate assessment and evaluation in e-learning contexts. For field researchers, the visualized network diagram serves as a map to explore the invisible relationships among the core AIeL research, providing a structural understanding of AI-supported research in e-learning contexts. A further investigation of the follow-up studies behind the highly co-cited links revealed the extended research directions from the AIeL mainstreams, such as adaptive learning-based evaluation environments. Implications are discussed.
In language education, the development of writing capability is an important and challenging teaching objective. Writing performance is related not only with students’ comprehension and expression of ...texts, but also their experience and perceptions of the contexts. Descriptive article writing is a basic writing activity; the content includes concrete understanding and perceptions of space, time, and contexts. However, in the traditional language teaching activities, there is usually no chance for students to have in‐depth feelings about the contexts of a topic. This usually results in low learning motivation and limited expression during the writing process. Therefore, the present study attempted to adopt spherical video‐based virtual reality (SVVR) to enable students to have in‐depth experience and perceptions and to facilitate their learning effectiveness. Based on this approach, a Chinese writing SVVR learning system was developed and a quasi‐experiment was conducted to compare the effects of the proposed approach and the conventional technology‐supported learning approach in a senior high school writing class. The findings show that the proposed SVVR writing approach could improve students' writing performance in terms of content and appearance as well as their creativity tendency and writing self‐efficacy, while also reducing their cognitive load.
ABSTRACT
Adequate physical activity is associated with improved sleep in adults. Such associations, however, vary greatly across studies in pediatric populations, with no studies involving infants ...found in the literature. This prospective observational study was designed, therefore, to examine the association between physical activity and sleep patterns in infants. A total of 183 healthy infants aged 6 months wore an actigraph for 7 days to measure physical activity and sleep. Parents and caregivers completed a sleep‐activity diary over the same period documenting the different types of infant activities. Daily mean time spent in screen‐time‐or‐limited physical activity, including screen‐based (e.g., watching television or other electronic devices) and non‐screen based activity (e.g., quiet play or restricted infant movement when carried by caregivers or seated in high chairs, swings, or bouncer seats), was 6.68 hr (SD = 1.99), which represented 47.50% of daytime waking hours (SD = 13.73). We found that 65 (35.5%) infants engaged in some screen time during the study, with 10 (5.5%) infants having an average daily screen time >30 min. In our multivariate linear regression model, more hours of screen‐time‐or‐limited physical activity per day were significantly associated with a decrease in total daily 24 hr sleep duration (p < 0.01). Findings from our study suggest that reducing screen‐time‐or‐limited physical activity might be an approach for promoting adequate sleep and lengthening infant daily sleep duration.
Obesity and elevated circulating cholesterol are risk factors for breast cancer recurrence, while the use of statins, cholesterol biosynthesis inhibitors widely used for treating ...hypercholesterolemia, is associated with improved disease-free survival. Here, we show that cholesterol mediates the metastatic effects of a high-fat diet via its oxysterol metabolite, 27-hydroxycholesterol. Ablation or inhibition of CYP27A1, the enzyme responsible for the rate-limiting step in 27-hydroxycholesterol biosynthesis, significantly reduces metastasis in relevant animal models of cancer. The robust effects of 27-hydroxycholesterol on metastasis requires myeloid immune cell function, and it was found that this oxysterol increases the number of polymorphonuclear-neutrophils and γδ-T cells at distal metastatic sites. The pro-metastatic actions of 27-hydroxycholesterol requires both polymorphonuclear-neutrophils and γδ-T cells, and 27-hydroxycholesterol treatment results in a decreased number of cytotoxic CD8
T lymphocytes. Therefore, through its actions on γδ-T cells and polymorphonuclear-neutrophils, 27-hydroxycholesterol functions as a biochemical mediator of the metastatic effects of hypercholesterolemia.High cholesterol is a risk factor for breast cancer recurrence. Here the authors show that cholesterol promotes breast cancer metastasis via its metabolite 27-hydroxycholesterol (27HC) that acts on immune myeloid cells residing at the distal metastatic sites, thus promoting an immune suppressive environment.
Training nursing students to make correct decisions when facing various nursing cases is an important and challenging objective. In the Objective Structured Clinical Examination (OSCE) program for ...nursing students, the educational aim is not only nursing skills, but also critical thinking for making correct decisions and treatments. In this study, a contextual game-based flipped learning approach (GBFL) is implemented to improve nursing students' learning performances and promoting their positive perceptions in an intravenous injection course. Moreover, a quasi-experiment was implemented to assess the effectiveness of the proposed approach. The subjects were 56 students from two classes of a nursing school. One class was assigned to the experimental group learning with the GBFL approach, while the other class was the control group learning with conventional flipped learning. From the experimental results, it was found that the students learning with the proposed approach showed better intravenous injection comprehension as well as higher learning achievement, learning motivation, learning attitudes, flow experience and critical thinking tendency than those learning with conventional flipped learning.
Background and Purpose
Increasing evidence suggests systemic inflammation‐caused skeletal muscle atrophy as a major clinical feature of cachexia. Triptolide obtained from Tripterygium wilfordii Hook ...F possesses potent anti‐inflammatory and immunosuppressive effects. The present study aims to evaluate the protective effects and molecular mechanisms of triptolide on inflammation‐induced skeletal muscle atrophy.
Experimental Approach
The effects of triptolide on skeletal muscle atrophy were investigated in LPS‐treated C2C12 myotubes and C57BL/6 mice. Protein expressions and mRNA levels were analysed by western blot and qPCR, respectively. Skeletal muscle mass, volume and strength were measured by histological analysis, micro‐CT and grip strength, respectively. Locomotor activity was measured using the open field test.
KEY RESULTS
Triptolide (10–100 fM) up‐regulated protein synthesis signals (IGF‐1/p‐IGF‐1R/IRS‐1/p‐Akt/p‐mTOR) and down‐regulated protein degradation signal atrogin‐1 in C2C12 myotubes. In LPS (100 ng·ml−1)‐treated C2C12 myotubes, triptolide up‐regulated MyHC, IGF‐1, p‐IGF‐1R, IRS‐1 and p‐Akt. Triptolide also down‐regulated ubiquitin‐proteasome molecules (n‐FoxO3a/atrogin‐1/MuRF1), proteasome activity, autophagy‐lysosomal molecules (LC3‐II/LC3‐I and Bnip3) and inflammatory mediators (NF‐κB, Cox‐2, NLRP3, IL‐1β and TNF‐α). However, AG1024, an IGF‐1R inhibitor, suppressed triptolide‐mediated effects on MyHC, myotube diameter, MuRF1 and p62 in LPS‐treated C2C12 myotubes. In LPS (1 mg·kg−1, i.p.)‐challenged mice, triptolide (5 and 20 μg·kg−1·day−1, i.p.) decreased plasma TNF‐α levels and it increased skeletal muscle volume, cross‐sectional area of myofibers, weights of the gastrocnemius and tibialis anterior muscles, forelimb grip strength and locomotion.
Conclusions and Implications
These findings reveal that triptolide prevented LPS‐induced inflammation and skeletal muscle atrophy and have implications for the discovery of novel agents for preventing muscle wasting.
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