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To clarify the definition and evolution of Patient and Public Involvement and Engagement (PPIE) and identify its attributes, antecedents, and consequences in health-related research.
This study follows Rodgers' evolutionary concept analysis with a seven-step framework.
Datasets were searched using terms related to PPIE and key categories (i.e., attributes, antecedents, and consequences). Data were sourced from CINAHL, PsycInfo, Scopus, PubMed, and Web of Science covering publications from inception to October 31, 2024. Document titles, abstracts, and keywords were manually screened to identify relevant studies for full-text review.
A total of 1751 documents were screened, resulting in 38 eligible studies included in the final analysis. PPIE has evolved from a narrow focus on patient inclusion and participation, where patients had minimal influence on research and researchers resisted sharing control of research, to a collaborative model emphasising sustained partnerships, shared contributions, equitable power distribution, and active involvement across research stages. This shift has been driven by research innovation, a growing emphasis on healthcare equity and patient-centred care, technological advances, and stakeholder advocacy (e.g., patients, funders, ethics committees). While PPIE enhances research relevance and impact, barriers, such as resource constraints, power imbalances, patient limited research capabilities and increased researcher workload persist. Facilitators, such as training programmes, standardised guidelines, flexible arrangements and transparent communication can enable meaningful partnerships.
The concept of PPIE is evolving toward greater clarity and consistency in research, positioning patients and the public as active, essential contributors rather than passive participants. Barriers and facilitators were identified to inform its utilisation in research.
This study clarifies the conceptual ambiguities of PPIE, informs theory development, and provides actionable insights. Healthcare and nursing researchers can draw on its findings to utilise PPIE to enhance collaborative and inclusive research practices that align with the needs of patients and the public.
This study adheres to the PRISMA (2020) reporting guidelines for systematic reviews.
One of our co-authors is a patient with lived experience of cancer, who contributed valuable comments and suggestions to enhance this paper.
To evaluate the impact of game-based teaching on undergraduate nursing students' learning satisfaction, clinical thinking, clinical skills, and anxiety.
Systematic review and meta-analysis.
China National Knowledge Infrastructure, Wanfang, Weipu, SinoMed, CINAHL, PubMed, Web of Science, Cochrane Library, and Embase. Our systematic literature search was conducted up to 31 October 2024 and included all studies published before this date, with no restrictions on publication year.
The study quality was appraised using version 1 of the Cochrane risk-of-bias tool and the JBI Critical Appraisal Tools for Quasi-Experimental Studies. A meta-analysis was performed using STATA version 12.
1712 undergraduate nursing students from 19 studies were included. Meta-analysis showed that game-based teaching improved undergraduate nursing students' learning satisfaction, critical thinking, clinical decision-making, and clinical skills. Game-based teaching did not significantly enhance undergraduate nursing students' problem-solving skills.
Our research findings indicated that game-based teaching had more significant potential to enhance undergraduate nursing students' learning satisfaction, critical thinking, clinical decision-making, and clinical skills. However, game-based teaching did not show a substantial advantage in improving problem-solving skills compared to other teaching methods. Limited studies of the effects of game-based teaching on clinical reasoning and anxiety in nursing students cannot be meta-analysed. Future studies could improve how game-based learning is designed to support undergraduate nursing students' development of these competencies.
This study explores the effects of game-based teaching in nursing education and finds that it promotes learning satisfaction, critical thinking, clinical decision-making, and clinical skills in undergraduate nursing students, while having no significant effect on problem-solving skills. Game-based teaching can be a functional pedagogical approach to guide nursing educators to improve learning outcomes for undergraduate nursing students.
Inapplicable.
We aimed to identify the barriers and facilitators to participation in interventions aimed at improving cognitive function among older adults with type 2 diabetes mellitus (T2DM) and mild cognitive impairment (MCI) in rural areas.
This study is the qualitative phase of a larger randomised controlled trial and employs a descriptive approach.
We conducted in-depth, semi-structured face-to-face interviews with older adults diagnosed with T2DM and MCI in rural areas of China in November 2023. The interviews were guided by the Capability, Opportunity, Motivation, and Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). The interview recordings were transcribed and analysed using NVivo V.11 software. Two research assistants independently coded the transcriptions, and the identified barriers and facilitators were mapped to the corresponding domains within the COM-B model and TDF.
A total of 26 older adults, aged 60–87, participated in the interviews. Nine themes were identified, including disease awareness, disease attitude, social interaction, responsibility and health, emotion guidance, organisational management, expertise and benefits, self-perception and role identity crisis. These themes mapped onto the three core components of the COM-B model as well as the nine domains of the TDF, which include: knowledge, environmental context and resources, social influences, intentions, emotions, reinforcement, beliefs about consequences, beliefs about capabilities and social identity.
Addressing barriers and leveraging facilitators can effectively enhance the willingness of elderly patients in rural areas to participate in interventions aimed at improving cognitive function. A multi-layered approach should be adopted, focusing on disease knowledge and attitudes, social interactions, the impact of the disease burden on both family and individuals, emotional state, organisational management, team expertise and timely assessment, individual self-efficacy and role perception.
The study adheres to the COREQ reporting guidelines.
The participants in this study were older adults with T2DM and MCI from rural areas. Participants were involved in the development of the interview guide and were subsequently interviewed regarding the facilitators and barriers to their participation in cognitive function interventions.
To (1) examine the attitudes of community-dwelling adults towards death and their ability to cope with death, as well as (2) understand the influence of advance care planning on community-dwelling adults' death attitudes and coping with death.
A sequential explanatory mixed-methods study was conducted in Singapore.
In Phase I, a case–control study was conducted to examine the differences in death attitudes and coping with death ability between community-dwelling adults who have completed advance care planning and those who have not. A univariate general linear model was used to compute the mean difference in death attitudes and coping with death scores. In Phase II, a descriptive qualitative study was conducted to provide an in-depth understanding of the influence of advance care planning among community-dwelling adults. Thematic analysis was used for qualitative analysis. Mixed-methods analysis was conducted to integrate the quantitative and qualitative data.
In Phase I, 80 community-dwelling adults who had completed advance care planning and 81 community-dwelling adults who did not have advance care planning were included. Adults who had completed advance care planning had significantly higher coping with death scores (t = 4.14, p < 0.01). In Phase II, a purposive sample of 24 adults who had completed advance care planning was selected for individual semi-structured interviews. From the thematic analysis, three themes were developed: (1) Advance care planning enables coping with death, (2) overcoming fear of death with advance care planning and (3) confronting death with advance care planning.
Advance care planning may influence death attitudes and coping with death. Further work on longitudinal designs and among individuals from different age groups should be used to gain further in-depth understanding of the impacts of advance care planning.
Strategies to enhance one's coping abilities with death and death attitudes should be developed to stimulate the uptake of advance care planning.
This paper was reported according to the Good Reporting of A Mixed Methods Study framework.
Community-dwelling adults participated in the survey and interviews.
Near infrared (NIR) therapy is increasingly used to enhance postoperative wound healing, yet clinical trial results remain inconsistent. To evaluate the effectiveness of NIR therapy on postoperative wound healing and identify treatment parameters associated with optimal outcomes: This systematic review and meta-analysis registered at PROSPERO (CRD420251163415) assessed evidence on comparing NIR therapy (630–1100 nm) with standard care or placebo on healing of surgical-induced wounds. A multilevel random-effects meta-analysis of standardised mean differences (SMDs) was conducted. Moderator analyses examined the wavelength, fluence, session number, application technique and anatomical site. Risk of bias was assessed using Cochrane RoB 2.0 and certainty of evidence was rated with GRADE. Fifty-six trials (N = 4920) were included for systematic review and 35 trials contributed 69 outcomes to meta-analysis. NIR significantly improved wound healing (0.78, [0.46–1.09], p < 0.01) and reduced postoperative pain (0.71, [0.24–1.17], p < 0.01), but heterogeneity was high and effects varied across studies. Optimal outcomes were associated with short NIR wavelengths (700–850 nm), 4–10 sessions and non-contact application. Effects on swelling, scarring and inflammatory markers were inconsistent. Overall, certainty of evidence was very low. This first systematic review and meta-analysis indicates that NIR therapy demonstrates promise for enhancing postoperative healing and reducing pain, though effects vary by protocols.
To develop a comprehensive and psychometrically validated scale for evaluating the core competencies of community nurses for public health emergencies.
A study of instrument development and validation was conducted.
A total of 1057 community nurses provided valid responses for this study conducted in Shanghai, China. Building upon previous study findings of the adapted core competency model and integrating the World Health Organisation's Framework for Action, this study was conducted in two phases. First, scale items were developed through systematic review, qualitative research, stakeholder meeting, and Delphi survey, refined with cognitive interviews to establish version 1.0 of the scale. Second, item analysis was performed with item-total correlations, Cronbach's alpha, and exploratory factor analysis, resulting in version 2.0. The final scale was produced after assessing the validity (content validity, confirmatory factor analysis, known-groups validity) and reliability (internal consistency, test–retest reliability).
The final scale consisted of 47 items categorised into four competency factors: prevention, preparation, response, and recovery competency. Factor analysis results indicated adequate factor loadings, excellent model fit, and well-established construct validity. The overall scale and its sub-factors exhibited high internal consistency and good test–retest reliability.
The study presents a theoretically grounded and scientifically validated scale measuring the competencies that community nurses need for public health emergency response.
This study enhances the theoretical framework of community nurses' core competencies in public health emergencies, provides a validated assessment tool, and clarifies their role in enhancing preparedness and effectiveness.
The study addressed the need for a standardised tool for assessing community nurse core competency for public health emergencies and will impact policy initiatives to enhance early prevention, emergency response, and integrated recovery practices in crisis management.
Strengthening the Reporting of Observational studies in Epidemiology checklist.
No Patient or Public Contribution.
The study examines the associations between nursing competence, work environment, and health system resilience. It also analyzes how nursing competence and work environment relate to different patterns of health system resilience.
A multiple center cross-sectional study was conducted between December 2023 and January 2024 across 33 hospitals in eastern China, involving 2435 nurses.
Questionnaires measuring nursing competence, work environment resources, nurse disaster resilience, and organizational commitment to resilience were utilised, along with the collection of additional personal demographic data. Structural equation modelling and cluster analysis were performed to explore the underlying mechanisms within the overall model and across multiple groups. Multivariable regression was conducted to identify variables associated with resilience in different subgroups.
Structural equation modelling demonstrated significant influences of nursing competence and work environment support on system resilience. Cluster analysis identified four resilience patterns: strong, marginal, low, and critical vulnerability. Strong resilience correlated with balanced individual-organizational resources, while vulnerable systems relied heavily on environmental support.
Our findings support policymakers and managers in developing systematic strategies with distinct focal points—targeting nurse workforce investment and optimised work environment—to enhance health system resilience across varying levels of public health emergencies.
This study validated the framework connecting individual and organizational resilience, offering evidence-based insights for nurse training and resource allocation to enhance healthcare systems' adaptability during disasters.
The study addressed how nursing competence and work environment significantly influenced resilience during public health emergencies, identified four resilience patterns, and provided insights to guide policymakers and healthcare managers in developing targeted, effective strategies.
Strengthening the Reporting of Observational studies in Epidemiology checklist.
No patient or public contribution.
Nurse-led interventions have demonstrated effectiveness in managing emergence delirium (ED), but there is a lack of evidence in pediatric studies.
To systematically synthesize the evidence on the effectiveness of the nurse-led interventions on ED in pediatric patients.
A comprehensive literature search was conducted in PubMed, CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, and APA PsycINFO from the inception to January 13, 2025. Risk of bias was assessed by using the revised Cochrane risk-of bias tool (ROB2) and the Cochrane risk of bias in non-randomized studies-of interventions (ROBINS-I). The meta-analysis was performed using Stata16.0. The forest plots showed the overall effect of the included study.
A total of 20 studies were included, involving 2369 children, comprising 17 RCTs, 1 quasi-experimental study and 2 cohort studies. Compared with usual care, nurse-led interventions significantly reduced the incidence of ED (risk ratio [RR]: 0.50, 95% confidence interval [CI]: 0.33 to 0.77, p = 0.002, I 2 = 77.2%), m-YPAS scores (weighted mean difference [WMD]: −7.67, 95% CI: −10.96 to −4.39, p = 0.000, I 2 = 91.7%), PAED scores (WMD: −1.47, 95% CI: −2.35 to −0.60, p = 0.000, I 2 = 91.3%), and FLACC scores (WMD: −0.97, 95% CI: −1.59 to −0.35, p = 0.000, I 2 = 92.9%). However, no significant effect was observed on the length of PACU stay or the anesthesia induction compliance.
Nurse-led interventions can reduce the incidence and severity of ED in children, as well as in alleviating preoperative anxiety and postoperative pain. However, more research is needed on influencing PACU length of stay and induction compliance.
Nurse-led interventions can be integrated into the perioperative management of children to reduce the incidence of ED. However, in clinical practice, these interventions should be flexibly adapted based on the individual differences of pediatric patients.
This study protocol was registered on PROSPERO with the registration number CRD42024601191
This study aims to identify distinct profiles of work engagement among oncology nurses through Latent Profile Analysis and explore how these profiles influence nurse safety behaviour.
A cross-sectional design with latent profile analysis.
A total of 957 oncology nurses from tertiary hospitals across five provinces and municipalities in China participated in this questionnaire-based study. Data were collected on demographic information, the Work Engagement Scale, the General Self-Efficacy Scale and the Nurse Safety Behaviour Scale. The analysis was conducted using SPSS 24.0 and Mplus 8.3, with Latent Profile Analysis, R3STEP and BCH methods employed to uncover underlying patterns and relationships.
The results revealed three distinct profiles of work engagement: ‘Highly Efficient and Focused Type’ (43.7%), ‘Moderately Balanced Type’ (37.4%) and ‘Low Effort and Coping Type’ (18.9%). The distribution of these profiles was closely related to factors such as weekly working hours, adverse event experiences, safety training experiences and self-efficacy. Moreover, these work engagement profiles positively impacted nurse safety behaviour.
The study demonstrates that different work engagement profiles significantly influence the safety behaviour of oncology nurses. Key factors such as weekly working hours, adverse event experiences, safety training experiences and self-efficacy play a crucial role in shaping these work engagement profiles.
The findings provide a new perspective and intervention approach for enhancing work engagement and nurse safety behaviour. It is recommended that hospital management develop personalised training and incentive measures tailored to nurses with different characteristics to improve overall nursing quality and patient safety.
No patient or public involvement.
To investigate the level of humanistic care ability of oncology nurses, its association with empathy and emotional intelligence, and the mediative role of emotional intelligence on empathy and humanistic caring ability.
This was a cross-sectional study conducted in a cancer hospital in China.
We enrolled a total of 1189 oncology nurses from several cancer hospitals from December 2023 to January 2024. All participants completed three general questionnaires: the Caring Ability Inventory, the Jefferson Scale of Empathy-Health Professionals and the Emotional Intelligence Scale.
The overall scores for the three scales were 202.35 ± 23.89, 112.38 ± 18.85 and 137.49 ± 17.81, respectively. A positive correlation was detected between caring ability, empathy and emotional intelligence (r = 0.741, p < 0.001; r = 0.577, p < 0.001). And emotional intelligence mediates the association between empathy and caring ability in oncology nurses (0.233, p < 0.001). The total and direct effect were also significant (0.825, p < 0.001; 0.592, p < 0.001).
The study findings indicated that oncology nurses exhibit a moderate level of caring ability. Emotional intelligence mediates the relationship between empathy and caring ability, at least in part. Therefore, an increase in the level of emotional intelligence in oncology nurses could improve their caring ability.
When designing training to improve humanistic care, we recommend the integration of specific training relating to empathy and emotional intelligence into the training system.
Oncology patients experience multiple forms of distress and require high-quality humanistic care. This study identified a moderate association between empathy and emotional intelligence. Our findings provide further recommendations for nurse leaders in medical institutions relating to how the humanistic care ability of oncology nurses can be improved by specific training in empathy and emotional intelligence.
This study was reported using the STROBE Checklist for cross-sectional studies.
Nurse leaders organised this survey in their own hospital.
by YanYing Zhu, XueYan Li, YueXin Chen, HaiYan Xie, YuKun Liu, XiaoChen Xu, Jing Wang
PurposeAxial elongation is a key factor in myopia progression, yet its genetic basis remains incompletely understood. This study aims to identify pathogenic genetic variants associated with excessively elongated axial length in children.
MethodsThis study included 56 children with axial lengths exceeding the normal range for their age group, and whole-exome sequencing (WES) was performed on their oral mucosal samples. Clinical evaluations included axial length measurement, refraction testing, and fundus photography to assess the degree of myopia and retinal changes. Co-segregation analysis was conducted in selected families (F#1, F#2, F#5) to validate the familial inheritance patterns of the variants.
ResultsFifteen children carried variants in genes including BBS2, OPN1LW, P4HA2, FBN1, LOXL3, FZD4, USH2A, COL2A1, and BFSP2, with five novel variants identified: BBS2 (c.700C > T), P4HA2 (c.1382C > G), FBN1 (c.7130T > C), LOXL3 (c.1580delC), and FZD4 (c.1315G > A). Notably, a rare compound heterozygous BBS2 variant (c.700C > T/c.534 + 1G > T) was found in a non-syndromic child, and the P4HA2 (c.419A > G) variant in family F#5 exhibited a phenotype distinct from previous studies.
ConclusionsThis study identified five novel variants sites and discovered two cases with phenotypes distinct from previous studies, thereby expanding the genetic variant spectrum associated with myopia and providing new targets for genetic screening and intervention.
The best evidence on programmed weaning from mechanical ventilation in neurocritical care patients should be gathered, evaluated, and integrated to provide an evidence basis for determining the optimal weaning program for these patients.
According to the ‘6S’ pyramid model of evidence-based practice resources, Chinese and international guideline websites, websites of relevant professional societies, and Chinese and English databases were systematically searched. The databases were searched from the time of establishment to October 2024. Literature screening was subsequently performed according to the inclusion and exclusion criteria. Two researchers independently evaluated the literature quality and extracted and summarised the evidence.
A total of 21 publications were included, including 3 guidelines, 5 expert consensus papers, 1 evidence summary, and 12 systematic reviews. A total of 29 pieces of best evidence in the following 5 aspects were summarised: preweaning preparation and screening, a weaning protocol, extubation assessment, extubation preparation and procedure, and postextubation management.
This study summarises the best evidence for the programmed weaning of neurocritical care patients from mechanical ventilation and provides a basis for clinical medical personnel to standardise this weaning process. Evidence-based application of these strategies should be implemented to verify their clinical efficacy and safety in practice.
Successful weaning is key in the management of neurocritical care patients receiving mechanical ventilation. The establishment of a localised extubation protocol guided by a multidisciplinary team can significantly reduce the extubation failure rate, the duration of mechanical ventilation and the incidence of related complications. However, evidence-based application is needed to verify the efficacy and safety of these strategies in clinical practice.
This evidence review adhered to the evidence review report guidelines formulated by the Evidence-Based Nursing Center of Fudan University. These guidelines cover aspects such as problem establishment, literature search, literature screening, literature evaluation, evidence summary and classification, as well as the formulation of practical suggestions. This evidence summary followed the evidence summary reporting specifications of the Fudan University Center for Evidence-Based Nursing (http://ebn.nursing.fudan.edu.cn) with registration number ES20244849.
This study was based on the evidence summary reporting specifications of the Fudan University Center for Evidence-based Nursing; the registered name is ‘Summary of the best evidence for weaning from mechanical ventilation in neurocritical care patients’; the registration number is ES20231823
Quarantine during the COVID-19 pandemic resulted in longer-term sedentary behaviours and mental health problems. Our study aimed to evaluate the impact of the Otago exercise programme (OEP) on physical function and mental health among elderly with cognitive frailty during COVID-19.
Lockdowns and restrictions during the COVID-19 pandemic result in longer-term sedentary behaviours related disease and mental problem. Older people with cognitive frailty are more vulnerable to be influenced. Timely intervention may achieve better outcomes, OEP exercise was designed as a balance and muscle-strengthening programme for elderly people.
A parallel-group, assessor-blinded randomised controlled trial was performed according to CONSORT guidelines.
This study was conducted from July 2020 to October 2020 among 62 elderly people with cognitive frailty from a nursing home. Participants were randomly divided into an OEP group (n = 31) or a control group (n = 31). Both groups received sleep- and diet-related health education. The OEP group also received a 12-week group exercise programme. The Five Times Sit to Stand Test (FTSST), Berg Balance Scale (BBS), and Timed Up and Go Test (TUGT) were used to assess physical function. The Geriatric Depression Scale-15 (GDS-15) and the 12-Item Short Form Health Survey Mental Component Summary (SF-12 MCS) were used to assess mental health. Outcomes were measured at 6 and 12 weeks.
Physical function and mental health were similar in the two groups at baseline. At 12 weeks, the OEP group (difference in change from baseline: FTSST, −2.78; TUGT, −3.73; BBS, 2.17; GDS-15, −0.72; SF-12 MCS, 2.58; all p < .001) exhibited significantly greater improvements than the control group (difference in change from baseline: FTSST, 1.55; TUGT, 1.66; BBS, −0.10; GDS-15, 1.07; SF-12 MCS, −5.95; all p < .001).
Our findings showed the OEP group had better physical function and mental health outcomes than the control group. OEP can be used to improve the physical and mental function among elderly people with cognitive frailty during the COVID-19 pandemic.
Relevance to clinical practice: Otago exercise program intervention programmes should be implemented to improve physical function for cognitive frailty elderly to reduce the harm of longer-term sedentary behaviours, and to ruduce depression symptom and improve mental health, particularly during COVID-19 pandemic period.
To assess the effectiveness, process, and economic outcomes of integrated care for community-dwelling frail older adults.
A systematic review and meta-analysis.
We searched nine databases, including PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, CNKI, SinoMed, Wanfang, and VIP, three trial registers, grey literature, and reference lists up to April 2024, with an updated search in March 2025.
Randomised controlled trials and non-randomised studies of interventions involving integrated care for community-dwelling frail older adults were included. Data analysis was conducted using the Comprehensive Meta-Analysis software.
This review included 12 studies involving 6819 community-dwelling frail older adults from high-income regions. The results indicated that integrated care had significantly positive effects on frailty and functional ability, but not on social function, hospitalisation, nursing home admission, quality of life, and mortality. Outcomes of caregivers and professionals were rarely reported. The cost-effectiveness of integrated care has not been confirmed by limited evidence. Few studies have adopted a systematic approach to designing and conducting comprehensive process evaluations guided by scientific frameworks.
Integrated care improves frailty and functional ability in community-dwelling frail older adults but lacks consistent benefits for other outcomes. The lack of evidence on cost-effectiveness and the caregiver and professional outcomes highlight critical gaps in current research. The absence of systematic process evaluations underscores the need for future studies to adopt rigorous frameworks to assess them.
This implicates that more research, particularly in underserved regions that lack a high standard of usual medical services, should emphasise the outcomes of caregivers and healthcare professionals, process evaluation, and health economics. Policymakers and practitioners must consider these gaps when implementing integrated care programmes to ensure equitable and sustainable healthcare solutions.
PRISMA 2020 Checklist.
No patient or public contribution.
CRD42024568811
The characteristics, application, and effectiveness of chatbots in improving the mental health of young people have yet to be confirmed through systematic review and meta-analysis.
This systematic review aims to evaluate the effectiveness of chatbot-delivered interventions for improving mental health among young people, identify factors influencing effectiveness, and examine feasibility and acceptability.
To identify eligible interventional studies, we systematically searched 11 databases and search engines covering a publication period of January 2014 to September 2024. Meta-analyses and subgroup analyses were performed on randomized controlled trials to investigate the effectiveness of chatbot-delivered interventions and potential influencing factors. Narrative syntheses were conducted to summarize the feasibility and acceptability of these interventions in all the included studies.
We identified 29 eligible interventional studies, 13 of which were randomized controlled trials. The meta-analysis indicated that chatbot-delivered interventions significantly reduced distress (Hedge's g = −0.28, 95% CI [−0.46, −0.10]), but did not have a significant effect on psychological well-being (Hedge's g = 0.13, 95% CI [−0.16, 0.41]). The observed treatment effects were influenced by factors including sample type, delivery platform, interaction mode, and response generation approach. Overall, this review demonstrates that chatbot-delivered interventions were feasible and acceptable.
This review demonstrated that chatbot-delivered interventions had positive effects on psychological distress among young people. Chatbot-delivered interventions have the potential to supplement existing mental health services provided by multidisciplinary healthcare professionals. Future recommendations include using instant messenger platforms for delivery, enhancing chatbots with multiple communication methods to improve interaction quality, and refining language processing, accuracy, privacy, and security measures.
FreshRSS 