Published in 2021, EMPEROR-Preserved trial randomized about 6,000 patients with NYHA class II-IV symptoms, LVEF >40% (i.e., HFmrEF and HFpEF), and NT-proBNP >300 pg/mL (no AF) or >900 pg/mL (AF) regardless of diabetes history to the SGLT2i empagliflozin or placebo. With 26.2 months of follow-up, empagliflozin was associated with a lower risk of HF hospitalization or CVD mortality (13.8% vs.17.1%; HR 0.79; 95% CI 0.69-0.90), which was primarily driven by fewer HF hospitalization events. About 1/3rd of the participants had HFmrEF, which appeared to have the greatest benefit in the subgroup analysis. There also appeared to be a benefit among those with traditionally-considered HFpEF. Ultimately, EMPEROR-Preserved provides initial clinical evidence for the use of SGLT2i therapy in HFmrEF and HFpEF. These were later confirmed in DELIVER (2022).
In recent years, DXA has been used as an alternative to standard epidemiological estimation techniques of obesity indices such as BMI and waist-to-hip ratio. However, waist-to-hip ratio addresses abdominal fat, including any muscle mass in the waist region. On the other hand, DXA measures regional adiposity more accurately than conventional anthropometry; in addition, the benefit of DXA is the dissection of fat compartments, including TBF, android fat, gynoid fat, and more recently, VAT.22 37 Therefore, it is advantageous in understanding the possible causes of pre-diabetes concerning the different fat compartments. In addition, compared with waist-to-hip ratio and BMI, studies have shown that DXA demonstrated more accurate cardiovascular risk estimates concerning total and regional adiposity.24 38 39 TBF is highly associated with diabetes and pre-diabetes.40 In our results (figure 1), we observed a more apparent association between TBF and a higher prevalence of pre-diabetes than observed with waist-to-hip ratio but not BMI. Compared with BMI, TBF measures the TBF and does not consider muscle and bone mass in the calculation.41
In comparison with general obesity indices (BMI and TBF), we used the ability of DXA to differentiate between various fat depots to measure android fat, gynoid fat, android-to-gynoid fat ratio, and VAT to assess which fat compartment is a better predictor of pre-diabetes. Android fat, which is measured in the abdominal region and can be described as interabdominal fat VAT,42 is generally accepted as an important risk factor for insulin resistance43; whereas gynoid fat (lower body adiposity) may lower that risk.44 In our study, android fat mass showed strong associations with pre-diabetes prevalence, and the association was similar in males and females. Interestingly, gynoid fat mass was positively associated with pre-diabetes prevalence among males but not females. The android fat PRs showed a similar association with pre-diabetes along with the four quartiles in comparison with TBF. As for gynoid fat, in general, there was a weaker association with and lower prediction (ie, AUC) of pre-diabetes in comparison with android fat, which was corroborated in a study where they found the DXA-measured android fat was highly associated with cardiovascular disease and T2DM, and showed a stronger correlation with impaired fasting glucose than gynoid fat.39 Nonetheless, in males, the gynoid fat showed similar associations with pre-diabetes to android fat, whereas in females, the association was weaker, indicating that gynoid fat is not an important risk factor for pre-diabetes in females.39 45
For third-party libraries to capture the results of another/same application's activity, the Kony Android provides an interface named com.konylabs.ffi.ActivityResultListener. The third-party library class must implement and register this interface with the platform through com.konylabs.android.KonyMain.registerActivityResultListener().
For third-party libraries to fetch the result of a service involving non-UI, the client Class must register an instance of android.content.BroadcastReceiver with the system along with Intent for which it wants to listen. To register a listener, invoke Context.registerReceiver() and then implement its onReceive() method. For more information about BrodcastReceiver, see BroadcastReceiver on the Android developer site.
Our predictions were as follows. Based on theoretical views emphasizing the automaticity of mimicry-related processes, we predicted that the android would elicit spontaneous human mimicry. Furthermore, such mimicry should occur even when participants do not perceive the android as having intentionality, and even when participants experience psychological discomfort with the agent. Based on the idea that mimicry requires a sense of similarity and relatedness between the self and the other [16], [18], we also predicted that mimicry should be magnified by perceptions of human-likeness as well as the physical presence of the robot.
We first tested whether people attribute mental states to the android, which according to some views discussed earlier, is essential for mimicry. We ran this pretest separately so as not to interfere with the measurement of spontaneous mimicry reactions. In this pretest, we used the widely used Individual Differences in Anthropomorphism Questionnaire, or IDAQ [40]. It includes questions regarding the mental states (e.g., intention, free will, and emotion) of technological devices, as well as non-human animals, and natural entities. In addition, we constructed a modified IDAQ with the same questions regarding the android and the human control. During the pretest study, 392 separate UCSD participants (300 female) first filled out the standard IDAQ questionnaire. Next, participants watched happy and angry (matched-intensity) videos of both the android and the control (counterbalanced) and then filled out a modified IDAQ about the android and the human control.
Forty-eight undergraduates from University of California, San Diego (UCSD) participated in this experiment (30 female and 18 male). The research protocol was approved by UCSD Institutional Review Board and all participants provided written informed consent. Twelve subjects were excluded from EMG analyses due to corrupt data, 2 were excluded from the experiment due to their familiarity with the android or human control, and another 5 were excluded from the experiment because they guessed that we were measuring facial expressions or mimicry specifically.
In each condition, there were separate blocks of natural videos, along with matched-intensity expression videos, each with 40 trials. Following the mimicry tasks, participants again rated both agents on various attributes (see above). We gauged participants' mimicry behavior using facial electromyography (EMG), a technique that measures electrical changes in underlying muscle activity, thus allowing for fast and sensitive online assessment of participants' facial reactions to the android's expressions. Our methods follow the official and published standards for EMG recording, collection, analyses and data presentation [41], [42]. Following these standards, electrodes were placed over the cheek muscle (zygomaticus major) and the brow muscle (corrugator supercilii) (for more details, see File S1).
Data were analyzed by comparing happy and angry trials separately for each muscle using a repeated-measures MANOVA over 500 millisecond intervals of a 6 second trial (i.e., 12 time points). Because spontaneous mimicry reactions can occur rapidly [5], [20], we also conducted similar MANOVAs over 200 millisecond intervals of the first second of the trial (i.e., 5 timepoints). Time was included as a factor in all analyses to account for changes in EMG responses over the course of the trial. Gender effects were tested and are reported separately in File S1. Before the main analyses, we collapsed responses to the matched-intensity and natural videos, as preliminary analyses did not reveal any effect of these conditions. Next, we first present our analyses conducted on each agent (android, human) separately, and then discuss an omnibus ANOVA that includes agent type as a factor. In addition, we tested the role of humanlike perception of the android. To do so, we conducted mimicry analyses on participants who responded high or low on the human-like rating, using a median split. Finally, to test whether emotional unease decreases mimicry, we conducted similar analyses on participants who responded high or low on comfort ratings [25].
This pretest assessed people's general beliefs about intentionality and technology, and their perception of the android's mental states after a face-to-face interaction. Participants were a separate group of 203 undergraduates (148 female). The participants first, and in a separate room, completed the general IDAQ questionnaire [40]. Next, they were sat in a chair facing the android where they examined him making two facial expressions: a happy expression and an angry expression. Participants were then asked to answer the same questions used in Study 1 (i.e., how humanlike is the android, how comfortable do they feel, how aroused/excited do they feel, how sad/bad do they feel, how happy/good do they feel, and how creepy/scary is the android), along with additional questions regarding his mental states. Gender differences in these ratings are reported in File S1.
Participants rate the present android as significantly lower in intentionality than his video counterpart, and the human control. Participants feel the least comfortable with the physically present android, yet rate him more humanlike than his likeness in the video. Note: ratings for comfort and humanlike were made on a 1-9 scale, while those on intentionality were made on a 0-10 scale in accordance with the IDAQ [40].
First, participants were explicitly informed that Einstein is a robot. Mimicry was measured using the same paradigm as in Study 1 (see also File S1). Participants watched the android produce a randomized sequence of angry and happy expressions. This occurred under two conditions: spontaneous mimicry (first) and intentional mimicry (second), each containing 30 expressions. Note that this paradigm allows not only detection of spontaneous mimicry but also the comparison of human-android synchronization under spontaneous and intentional conditions [5], [6]. Mimicry was again measured with facial EMG on the zygomaticus major (cheek muscle) and corrugator supercilii (brow muscle), similar to Study 1.
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