ResearchSpace@Auckland
University of Auckland Research Repository - ResearchSpace
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Can AI Deliver Empathetic Medical Consultations? A Randomized Controlled Trial Comparing Ratings of a Digital Human and a Human Physician in High and Low Empathy Consultations
(ResearchSpace@Auckland, 2024) Verma, Ruby; Broadbent, Elizabeth
Background: Clinical empathy in medical consultations can improve patient outcomes.
However, individual and system-level barriers in healthcare systems limit equitable access to empathic care. Digital humans (DHs) are being used to address these challenges, but no RCT has investigated their ability to deliver empathic consultations compared to human physicians.
Aim: The study’s primary aim was to investigate the effects of empathy skills (high or low) and source (DH or human physician) on participants’ perceptions of a brief medical consultation.
Method: A factorial RCT with a 2x2 between-groups design was conducted. 124 adults aged 18 years or over were recruited through social media and randomly allocated to one of four conditions: high-empathy human physician, low-empathy human physician, high-empathy DH, or low-empathy DH. Participants completed the experiment online using the Qualtrics platform, where they watched a 4.5 minute video of a consultation with an actor for the common cold before completing the study questionnaire. Differences in clinical empathy, trust, competence, warmth and adherence intention ratings were compared between groups.
Results: There was a significant main effect of empathy skills. On average, high-empathy consultations were rated higher on clinical empathy, warmth, trust, competence and adherence intention (all p <.0.5) than low-empathy consultations. A significant interaction between empathy skills and source was found for clinical empathy ratings (p = .001), with the high empathy human physician receiving the highest scores. Source significantly affected participants’ perceived adherence intention for the actor (p = .010). No significant differences between the human and DH consultations were found for the other outcomes.
Conclusion: Overall, findings support the integration of DHs into strained healthcare systems. These agents can use high-empathy skills to perform comparably to human physicians in routine consultations. DHs can utilize clinical empathy to build warm, trusting and competent relationships, that improve the potential for compliance. The study extends empathy-related findings with human physicians to DHs and provides insights into the development of effective agents. A closer inspection of the ethics of using AI in patient care is encouraged. Future research using Large Language Models could investigate whether these results apply to dynamic and real-world patient settings.
Synthetic Studies Towards the Spirocyclic Imine Moiety of Cyclic Imine Marine Toxins
(ResearchSpace@Auckland, 2024-07-31) Ma, Chao; Brimble, Margaret; Li, Freda
Dinoflagellate-produced marine toxins, a class of cyclic imines, form the core of various
pharmaceutically relevant natural products featuring a spirocyclic imine motif. These toxins are classified into three subgroups based on their imine ring sizes: 5,6-spirocyclic imines (e.g., portimine A (7a)), 6,6-spirocyclic imines (e.g., kabirimine (6)), and 7,6-spirocyclic imines (e.g., pinnatoxin G (2g)). The spirocyclic imine moiety is the key pharmacophore driving their diverse bioactivities, and
synthesising this moiety is crucial for structure-activity relationship studies and the eventual total
synthesis of these natural products.
This study provides a convergent exo-selective Diels-Alder approach to access various spirolactams
bearing the desired anti relative stereochemistry present in the cyclic imine marine toxins. It was
revealed that the reactivity and diastereoselectivity of the Diels-Alder cycloadditions were significantly
influenced by the protecting groups incorporated on the dienophile/diene (P and R), the ring size of
the α-exo-methylene lactam dienophiles (n = 0-2), the side chain length of the substituent on dienes (m
= 1-3), and the types of dienes (X).
The 6,6-spirocyclic core 428 of kabirimine (6) was prepared from the Diels-Alder cycloaddition between
α-exo-methylene lactam 139h and silyloxydiene 410d followed by the regioselective vinyl group
installation. Alternatively, a tandem Diels-Alder/Stille coupling reaction sequence was employed,
requiring the use of bromodiene 91g to effect a Diels-Alder cycloaddition with α-exo-methylene lactam
139g. The use of chiral methyl α-exo-methylene lactams 139h and 139g in Diels-Alder cycloadditions
proceeded with a complete diastereocontrol to afford (6S,7R)-spirolactams 352a and 342a as the only
isomer albeit bearing the opposite stereochemistry to kabirimine (6).
This study established a robust platform for constructing the spirocyclic core of portimine A (7a) and
kabirimine (6), paving the way for stereoselective synthesis of the more functionalised spirocyclic core
of other cyclic imine natural products (e.g. pinnatoxin G (2g)).
Objects Detection and Tracking Using mmWave Technologies
(ResearchSpace@Auckland, 2025-04-01) Huang, Xu; Nitish, Patel; Wang, Kevin I-Kai
Smart sensing systems have been a significant focus in the industrial community. With the integration of intelligent sensors, controlling buildings and factories autonomously has become both economical and straightforward. However, the central concern in this field remains to identify effective detecting and tracking mechanisms to make real-time decisions and overcome environmental challenges. Therefore, millimeter-wave radar technology (mmWave) has garnered enormous attention from researchers worldwide. The design of efficient object detection, tracking and classification models based on mmWave technology emerges as a possible solution to the challenges of smart sensing systems. This study presents several strategies for detecting, tracking, and classifying multi-objects. These \linebreak methodologies have been developed to overcome some significant obstacles in smart sensing systems, including accuracy and computing constraints.
In the first phase of this research, we developed a small and fast object detection and tracking system for indoor applications. The system operates on an embedded platform in real time with high accuracy. One of the most common challenges of sensing technology is ensuring portability and scalability due to computing constraints. To overcome this challenge, we propose a system with two efficient clustering algorithms for rapid processing and high accuracy. The Recursive Kalman Filter (RKF) tracking algorithm also helps reduce algorithmic complexity and computation time. We evaluated the proposed method through several real indoor scenarios based on a Raspberry Pi platform, demonstrating its effectiveness.
The subsequent phase of this research proposes a multisensor-based fusion system for indoor object detection and tracking. The system employs two noise reduction stages to distinguish cluster groups and remove noise effectively. The proposed data fusion method effectively estimates the transformation of the data alignment, synchronizes the results, and visualizes object information acquired using one radar on another. The tracking algorithm with data association accurately tracks multiple objects simultaneously. We demonstrated the proposed system's effectiveness and advantages over commonly used methods in scenarios involving occlusions and weak data due to sensors returning weak signals or being lost from the sensor's view by low signal reflections. This fusion system consisting of dual sensors has the potential to improve tracking accuracy significantly.
In the final phase of our research, we proposed an identification and classification system that utilizes mmWave radar and deep learning. The point cloud data undergoes processing using a refined density-based clustering algorithm to accurately extract ground truth in 3D space. We used a bi-directional long short-term memory (BiLSTM) network trained with center loss added to the softmax loss to recognize the identities of objects and address the scattered features issue. A Random Forest layer predicted a binary output identifying intruders or insiders. We evaluated our proposed system through a comparative experiment against existing architectures in the literature.
We extended the sensing technology into a dynamic platform and examined the potential of mmWave radar sensors in robotic navigation for indoor object avoidance and navigation purposes due to the increasing demand for such services.
The performance of the proposed strategies was evaluated and tested within practical operating limits throughout the thesis. Although the proposed object detection and tracking mechanisms offer a promising alternative to the currently established methods, there is still potential for improvement in future work concerning theory and application.
Long-term Quality of Life Outcomes in Head and Neck Cancer Survivors
(ResearchSpace@Auckland, 2024) Thompson-Williams, Elizabeth Isla; Miles, Anna
Aim: Understanding the impact of head and neck cancer on quality of life is crucial for enhancing survivor well-being. This study aims to explore regional-specific outcomes using patient-reported outcome measures (PROMS), which have not been extensively studied locally. It also seeks to provide a current perspective on quality of life amidst the evolving landscape of head and neck cancer.
Head and neck cancer is a diverse disease with evolving etiological factors. As the population ages, age-related cancers will increase, posing challenges alongside comorbidities in cancer care. Unique challenges arise from younger patients with human papillomavirus (HPV)-related oropharyngeal cancer surviving longer with treatment-related toxicities, straining healthcare services.
Method: This mixed-methods observational study includes a retrospective clinical records audit and a prospective cross-sectional online survey. Ethical approval was obtained from Auckland Health Research Ethics Committee (Application No. AH25628).
Findings: In the Greater Wellington Region, the majority were male (72%) and over 50 years old, with 45% aged 51-70 and 42% over 71. New Zealand Europeans comprised 70%, followed by New Zealand Māori (9%). Many patients (44%) travelled over 50 kilometres for treatment, primarily referred by public medical professionals (94%). Predominant cancer sites included skin (36%), oral cavity (32%), and oropharynx (21%), often diagnosed at advanced stages. Treatment often involved multimodal approaches, with a high prevalence of P16+ positive oropharyngeal cancers treated with radiation (91%).
Quality of life assessments revealed a mean score of 102 out of 148 on the FACT-HNC scale, indicating relatively good quality of life. Challenges persisted with voice disorders (mean VHI-10 score 6/40) and depression (HADS mean 18%). Fear related to physical appearance was evident (mean FNAES score 9/30).
Utilisation of supportive services highlighted significant reliance on dental, dietetics, and speech-language therapy, with psychological support identified as the most desired service. Specialist cancer care providers were most frequently perceived as helpful.
Conclusions: This study provides critical insights into challenges faced by head and neck cancer survivors in the Greater Wellington Region, Aotearoa New Zealand. Addressing these and advocating for tailored support services can enhance survivorship experiences and outcomes. Collaborative efforts across healthcare sectors are essential to meet evolving patient needs effectively.
The Involuntary Swindler: Readdressing the Impostor Phenomenon
(ResearchSpace@Auckland, 2025-03-29) Barker, Tessa; Peterson, Elizabeth
In the 1970s, the impostor phenomenon (IP) was coined to describe a self-perpetuating, internal experience of feeling like an intellectual phony, which was reported primarily amongst a select population of white, middle- to upper-class high-achieving women (Clance & Imes, 1978). Since its introduction, the IP has gained significant traction in academic and lay communities, leading to various interpretations of what it actually is within the literature. Recently, concerns have been raised by scholars and laypersons alike regarding the conceptualisation and utility of the IP, alongside a noticeable gap in research addressing these concerns. Accordingly, this thesis aims to contribute to the advancement of IP theory by exploring the conceptualisation of the IP within and across academic and lay domains. To accomplish this, I conducted two primary studies as part of an exploratory mixed-methods research design. The first explores the understanding of the IP within the academic domain, and the second in the lay domain. This thesis then compares and integrates the findings from both studies and, in valuing both domains, considers what may be needed to move the research field forward.
The research shows that academic and lay circles discuss conceptual factors and framing variables related to the IP in different ways. This variation likely contributes to the increasing ambiguity of the IP concept and the expansion of its conceptual boundaries. In addressing this issue, this thesis offers a contemporary conceptual framework that clearly distinguishes the core concepts of the IP from framing variables. This effort aims to refine the concept and help future researchers develop a comprehensive understanding of the topic that resonates with both scholarly and general audiences. It is hoped that this shift could aid in identifying individuals most affected by the IP and inform interventions through more targeted approaches.