The need for deeper semantic processing of human language by our natural language processing systems is evidenced by their still-unreliable performance on inferencing tasks, even using deep learning techniques. These tasks require the detection of subtle interactions between participants in events, of sequencing of subevents that are often not explicitly mentioned, and of changes to various participants across an event. Human beings can perform this detection even when sparse lexical items are involved, suggesting that linguistic insights into these abilities could improve NLP performance. In this article, we describe new, hand-crafted semantic representations for the lexical resource VerbNet that draw heavily on the linguistic theories about subevent semantics in the Generative Lexicon (GL). VerbNet defines classes of verbs based on both their semantic and syntactic similarities, paying particular attention to shared diathesis alternations. For each class of verbs, VerbNet provides common semantic roles and typical syntactic patterns. For each syntactic pattern in a class, VerbNet defines a detailed semantic representation that traces the event participants from their initial states, through any changes and into their resulting states. The Generative Lexicon guided the structure of these representations. In GL, event structure has been integrated with dynamic semantic models in order to represent the attribute modified in the course of the event  as a sequence of states related to time points or intervals. We applied that model to VerbNet semantic representations, using a class's semantic roles and a set of predicates defined across classes as components in each subevent. We will describe in detail the structure of these representations, the underlying theory that guides them, and the definition and use of the predicates. We will also evaluate the effectiveness of this resource for NLP by reviewing efforts to use the semantic representations in NLP tasks. The long-awaited time when we can communicate with computers naturally-that is, with subtle, creative human language-has not yet arrived. We've come far from the days when computers could only deal with human language in simple, highly constrained situations, such as leading a speaker through a phone tree or finding documents based on key words. We have bots that can write simple sports articles , which entails putting the Ingestibles in the mouth for delivery to the digestive system. This may include the use of an Instrument.” VerbNet, however, uses first order logic representations with defined predicates to show the relationships between roles and to track any changes to the participants across the timeline of the event, with variations for each syntactic pattern included in the class.Often compared to the lexical resources FrameNet and PropBank, which also provide semantic roles, VerbNet actually differs from these in several key ways, not least of which is its semantic representations. Both FrameNet and VerbNet group verbs semantically, although VerbNet takes into consideration the syntactic regularities of the verbs as well. Both resources define semantic roles for these verb groupings, with VerbNet roles being fewer, more coarse-grained, and restricted to central participants in the events. What we are most concerned with here is the representation of a class's (or frame's) semantics. In FrameNet, this is done with a prose description naming the semantic roles and their contribution to the frame. For example, the Ingestion frame is defined with “An VerbNet is also somewhat similar to PropBank and Abstract Meaning Representations (AMRs). PropBank defines semantic roles for individual verbs and eventive nouns, and these are used as a base for AMRs, which are semantic graphs for individual sentences. These representations show the relationships between arguments in a sentence, including peripheral roles like Time and Location, but do not make explicit any sequence of subevents or changes in participants across the timespan of the event. VerbNet's explicit subevent sequences allow the extraction of preconditions and postconditions for many of the verbs in the resource and the tracking of any changes to participants. In addition, VerbNet allow users to abstract away from individual verbs to more general categories of eventualities. We believe VerbNet is unique in its integration of semantic roles, syntactic patterns, and first-order-logic representations for wide-coverage classes of verbs.VerbNet's semantic representations, however, have suffered from several deficiencies that have made them difficult to use in NLP applications. To unlock the potential in these representations, we have made them more expressive and more consistent across classes of verbs. We have grounded them in the linguistic theory of the Generative Lexicon (GL)  and VerbNet, and explain our method for using GL's theory of subevent structure to improve VerbNet's semantic representations. We show examples of the resulting representations and explain the expressiveness of their components. Finally, we describe some recent studies that made use of the new representations to accomplish tasks in the area of computational semantics.motion or cause. Event participants that have syntactic relevance are identified with various stages of the event evoked by the syntactic frame. The original semantic representations, what we are here calling “Classic VerbNet,” were intended to provide atomic event representations associated with groups of semantically similar language predicates . There are, however, several ways in which the Classic VerbNet semantics were unsatisfactory: (i) the representation was not first-order; (ii) there were no explicitly identified (reified) subevents that could be referenced in discourse models or planning algorithms; and (iii) there was no mention of the actual predicative change, i.e., the opposition structure that is implicated in a change-of-state event, such as close or break.VerbNet is a lexicon of around 5,200 English verbs, organized primarily around Levin 's verb cstart, during, or end. For example, the semantics for one intransitive frame in class Run-51.3.2 is shown in (1)Consider the first issue. Classic VerbNet represented each event with a single event variable E, and predicates were temporally positioned relative to one another within the larger event through the inclusion of a second-order predicate, namely, (1)    Classic Verbnet representationBilly ran into a cafe.          path_rel(start(E), Theme, ?Initial_location, ch_of_loc, prep)          motion(during(E), Theme)          path_rel(during(E), Theme, ?Trajectory, ch_of_loc, prep)          path_rel(end(E), Theme, Destination, ch_of_loc, prep)          start, during, and end, which were included as arguments of the appropriate first-order predicates.Since there was only a single event variable, any ordering or subinterval information needed to be performed as second-order operations. For example, temporal sequencing was indicated with the second-order predicates, end(E) was given but not start(E), and some classes involving change of location of participants  did not include a motion predicate at all. In order to accommodate such inferences, the event itself needs to have substructure, a topic we now turn to in the next section.However, as Zaenen et al.  point ou◦ (Allen's “meet” relation); and strict overlap, ◦ (Allen's “identity” relation).Many of the issues described in Section 2.1 can be resolved by adopting a linguistically motivated subevent representation for verb predication, such as that developed in Generative Lexicon Theory, where different Aktionsarten are distinguished in terms of their inherent subeventual structure     a. state: →   e     b. love, know            process: →   e1…en     c. run, push            transitionach: → statestate     d. open, die            transitionacc: → processstate     e. give, build            Event Structure Lexicon (ESL)               se1: pre-state: not_be_in            se2: process: driving (x)           se3: post-state: be_in esl of the verb arrive, compared with the semantic frame of the verb in classic VerbNet.The goal of this subevent-based VerbNet representation was to facilitate inference and textual entailment tasks. Similarly, encode but dynamically track those object attributes modified in the course of the event  The resulting event structure representation is called a Dynamic Event Structure , that is true in a state, s, in the model. For our purposes, a state is a set of propositions with assignments to individual variables at a specific frame. We can think of atomic programs as input/output relations, i.e., relations from states to states, and hence interpreted over an input/output state-state pairing: e.g., “The glass broke” is interpreted as a program, α:s1 → s2, where at state s1, the proposition, ¬broken(x), is true, and at s2, the proposition, broken(x) is true. The model encodes three kinds of representations: (i) predicative content of a frame; (ii) programs that move from frame to frame; and tests that must be satisfied for a program to apply. These include: pre-tests, while-tests, and result-tests.A dynamic approach to modeling updates makes a distinction between formulae, ϕ, and programs, π  encode either an intrinsic predicate opposition  to dead), or a specified relational opposition  to loc_at). Creation predicates and accomplishments generally also encode predicate oppositions. As we will describe briefly, GL's event structure and its temporal sequencing of subevents solves this problem transparently, while maintaining consistency with the idea that the sentence describes a single matrix event, E.A further step toward a proper subeventual meaning representation is proposed in Brown et al. , 2019, wstart(E), during(E), and end(E), allowing for more nuanced temporal relationships between subevents. The default assumption in this new schema is that e1 precedes e2, which precedes e3, and so on. When appropriate, however, more specific predicates can be used to specify other relationships, such as meets to show that the end of e2 meets the beginning of e3, or co-temporal to show that e2 and e3 occur simultaneously. The latter can be seen in Section 3.1.4 with the example of accompanied motion.With the introduction of GL's event structure, the biggest change to VerbNet is the move from a tripartite division of the temporal span of any event  to a model with explicitly quantified (and indexed) subevents, which can be increased or decreased to accommodate the complexity of the event and are ordered using Allen's relational calculus Allen, . This alcause, as seen in 4.The second significant change is how causation is represented. In Classic VerbNet, the semantic form implied that the entire atomic event is caused by an Agent, i.e., (4)     Classic Verbnet representationThe lion tamer jumped the lions through the hoop.          motion(during(E), Theme)          path_rel(start(E), Theme, ?Initial_location, ch_of_loc, prep)          path_rel(during(E), Theme, Trajectory, ch_of_loc, prep)          path_rel(end(E), Theme, ?Destination, ch_of_loc, prep)          cause          do] causes a state change or another event , which would be indicated with cause. This is seen in (5) below, where In contrast, in revised GL-VerbNet, “events cause events.” Thus, something an agent does [e.g., (5)    GL-Verbnet representationThe lion tamer jumped the lions through the hoop.                    Agent V Theme {PREP} Destinationhas_location          do          motion          ¬has_location          has_location          cause          has_state, emit, or cause, and an event variable, either E or e (see Section 3.2.3 for an explanation of the event variable types). This conjunction of predicates more closely tracks the participants through the various stages of the event evoked by the syntactic frame. For example, an intransitive frame in the class Run-51.3.2 is shown in 6, with the final 4 lines making up the semantic representation, as a conjunction of predicates.As with Classic VerbNet, each GL-VerbNet class is still defined by a set of members, thematic roles for the predicate-argument structure of these members, selectional restrictions on the arguments, and frames consisting of a syntactic description and a corresponding semantic representation. The semantic representations in each GL-VerbNet class are also still compatible with the member verbs and the syntactic frames of the class. This pairing of each syntactic frame in a class with a semantic representation is a unique feature of VerbNet that emphasizes the close interplay of syntax and semantics. The semantic information is still expressed as a conjunction of semantic predicates, such as (6)    GL-Verbnet representationThe horse ran into the barn.                    NP V PP          Theme V Destinationhas_location          motion          ¬has_location          has_location          has_location semantic predicate above includes an unidentified Initial_Location. That role is expressed overtly in other syntactic alternations in the class , but in this frame its absence is indicated with a question mark in front of the role. Temporal sequencing is indicated with subevent numbering on the event variable e.The arguments of each predicate are represented using the thematic roles for the class. These roles provide the link between the syntax and the semantic representation. Each participant mentioned in the syntax, as well as necessary but unmentioned participants, are accounted for in the semantics. For example, the second component of the first as a group. For some classes, such as the Put-9.1 class, the verbs are semantically quite coherent  and the semantic representation is correspondingly precise 7.A class's semantic representations capture generalizations about the semantic behavior of the member verbs (7)    GL-Verbnet representationI put the book on the table.                    NP V NP PP          Agent V Theme {PREP} Destinationhas_location          do          motion          ¬has_location          has_location          cause          dry, gentrify, renew, whiten). The representation must be very general to apply to all the verbs. The following representation captures the change of the Patient from its initial state to its final state but ignores the specific type of state change in the example sentence  in order to be general enough for any verb in the class when used in a basic transitive sentence.Other classes, such as Other Change of State-45.4, contain widely diverse member verbs     GL-Verbnet representationNicholas thawed the meat.                    NP V NP          Agent V Patient¬has_state          do          has_state          cause          Start, During, and End, which limited the granularity of the subevents and their sequencing. No predicates existed to show causal relationships between the subevents, and semantically necessary roles that were never explicit in the syntax of a class could not be referred to. For example, in the Instrument_Communication-37.4.1 class, no mention could be made of the instrument that was incorporated in every verb in the class .Classic VerbNet semantic representations were similar to the new ones in several ways: a class's thematic roles were used as arguments to the semantic predicates, and subevents were situated in a temporal ordering. However, as described in Section 2.1, the representation only allowed for three temporal phases: (9)    Classic Verbnet representationHeather emailed the news to Sarah.                    Agent V Topic Recipienttransfer_info (during(E), Agent, Recipient, Topic)          cause          To achieve the expressiveness we wanted in the revised semantic representations, we identified several desiderata:Participants clearly tracked across an event for changes in location, existence or other states.Flexibility in the number of subevents.Subevents related within a representation for causality, temporal sequence and, where appropriate, aspect.Predicates consistently used across classes and hierarchically related for flexible granularity.Verb-specific features incorporated in the semantic representations where possible.Roles to refer to semantically relevant but syntactically absent participants.Incorporating all these changes consistently across 5,300 verbs posed an enormous challenge, requiring a thoughtful methodology, as discussed in the following section.VerbNet currently has 329 different classes of verbs and over 1,600 semantic representations. A major revision of these required several stages of development. To begin, we identified consistencies in the types of events across VerbNet classes and then grouped all classes by a short list of basic event types:Change of location.Change of state.Change of possession.Transfer of information.States.Processes.Other.By far the most common event types were the first four, all of which involved some sort of change to one or more participants in the event. We developed a basic first-order-logic representation that was consistent with the GL theory of subevent structure and that could be adapted for the various types of change events. We preserved existing semantic predicates where possible, but more fully defined them and their arguments and applied them consistently across classes. In this first stage, we decided on our system of subevent sequencing and developed new predicates to relate them. We also defined our event variable e and the variations that expressed aspect and temporal sequencing. At this point, we only worked with the most prototypical examples of changes of location, state and possession and that involved a minimum of participants, usually Agents, Patients, and Themes.Once our fundamental structure was established, we adapted these basic representations to events that included more event participants, such as Instruments and Beneficiaries. We applied them to all frames in the Change of Location, Change of State, Change of Possession, and Transfer of Information classes, a process that required iterative refinements to our representations as we encountered more complex events and unexpected variations.The next stage involved developing representations for classes that primarily dealt with states and processes. Because our representations for change events necessarily included state subevents and often included process subevents, we had already developed principles for how to represent states and processes.The final category of classes, “Other,” included a wide variety of events that had not appeared to fit neatly into our categories, such as perception events, certain complex social interactions, and explicit expressions of aspect. However, we did find commonalities in smaller groups of these classes and could develop representations consistent with the structure we had established. Many of these classes had used unique predicates that applied to only one class. We attempted to replace these with combinations of predicates we had developed for other classes or to reuse these predicates in related classes we found.In revising these semantic representations, we made changes that touched on every part of VerbNet. Within the representations, we adjusted the subevent structures, number of predicates within a frame, and structuring and identity of predicates. Changes to the semantic representations also cascaded upwards, leading to adjustments in the subclass structuring and the selection of primary thematic roles within a class. In this section we will go through the details of these changes. To give an idea of the scope, as compared to VerbNet version 3.3.2, only seven out of 329—just 2%—of the classes have been left unchanged. We have added 3 new classes and subsumed two others into existing classes. Within existing classes, we have added 25 new subclasses and removed or reorganized 20 others. 88 classes have had their primary class roles adjusted, and 303 classes have undergone changes to their subevent structure or predicates. Our predicate inventory now includes 162 predicates, having removed 38, added 47 more, and made minor name adjustments to 21. All of the rest have been streamlined for definition and argument structure.start(E), during(E), and end(E) into a greater number of subevents if needed. These numbered subevents allow very precise tracking of participants across time and a nuanced representation of causation and action sequencing within a single event. In the general case, e1 occurs before e2, which occurs before e3, and so on. We've further expanded the expressiveness of the temporal structure by introducing predicates that indicate temporal and causal relations between the subevents, such as cause and co-temporal.Using the Generative Lexicon subevent structure to revise the existing VerbNet semantic representations resulted in several new standards in the representations' form. As discussed in Section 2.2, applying the GL Dynamic Event Model to VerbNet temporal sequencing allowed us refine the event sequences by expanding the previous three-way division of n to represent processes. Transitions are en, as are states that hold for only part of a complex event. These can usually be distinguished by the type of predicate-either a predicate that brings about change, such as transfer, or a state predicate like has_location. Our representations of accomplishments and achievements use these components to follow changes to the attributes of participants across discrete phases of the event.Second, we followed GL's principle of using states, processes and transitions, in various combinations, to represent different Aktionsarten. We use E to represent states that hold throughout an event and ëduring(E) phase. This type of structure made it impossible to be explicit about the opposition between an entity's initial state and its final state. It also made the job of tracking participants across subevents much more difficult for NLP applications. Understanding that the statement 'John dried the clothes' entailed that the clothes began in a wet state would require that systems infer the initial state of the clothes from our representation. By including that initial state in the representation explicitly, we eliminate the need for real-world knowledge or inference, an NLU task that is notoriously difficult.Finally, the Dynamic Event Model's emphasis on the opposition inherent in events of change inspired our choice to include pre- and post-conditions of a change in all of the representations of events involving change. Previously in VerbNet, an event like “eat” would often begin the representation at the John died is analyzed as the opposition 〈alive,, ¬alive,〉. In (10), we use the opposition between has_location and ¬has_location to make clear that once the Theme is in motion (in e2), it is no longer at the Initial_location.One way we captured this opposition was by adding this type of initial state predicate in those representations of change that did not already have one. We also greatly expanded the use of negated predicates to make explicit the opposition: e.g., (10)    GL-Verbnet representationThe rabbit hopped across the lawn.                        Theme V Trajectoryhas_location            motion            ¬has_location            has_location            Although people infer that an entity is no longer at its initial location once motion has begun, computers need explicit mention of this fact to accurately track the location of the entity (see Section 3.1.3 for more examples of opposition and participant tracking in events of change).E to indicate a state that holds throughout an event. For this reason, many of the representations for state verbs needed no revision, including the representation from the Long-32.2 class.Like the classic VerbNet representations, we use (11)    Classic and GL-Verbnet representationDanny longed for a sunny day.            desire            During(E) format to represent states, such as Exist-47.1, Intend-61.2, and Contain-15.4. The last, for example, was changed from contain(During(E), Pivot, Theme) to contain. In other cases, the change was in the opposite direction, from state to process. The representation in the Exhale-40.1.3 class included body_process, which has been changed to body_process.Sixteen classes, however, used the During(E) phase of the representation, but that phase was not restricted to processes. With the introduction of ë, we can not only identify simple process frames but also distinguish punctual transitions from one state to another from transitions across a longer span of time; that is, we can distinguish accomplishments from achievements.Process subevents were not distinguished from other types of subevents in previous versions of VerbNet. They often occurred in the sleep; Simple_dressing-41.3.1-1, with the predicate wear; and Work-73.2, with the predicates work and cooperate. Of course, adding temporal or locational information to a sentence expressing a process can transform it into an achievement  VerbNet only includes such phrases in its syntactic frames when they are obligatory  or when they are part of key syntactic alternations that distinguish a class, such as the dative alternation in the Give-13.1 class.Eighteen classes in GL-VerbNet group together simple process verbs. Examples include Snooze-40.4, with the predicate motion as a subevent.Processes are very frequently subevents in more complex representations in GL-VerbNet, as we shall see in the next section. For example, representations pertaining to changes of location usually have Many of the changes inspired by the Generative Lexicon's Dynamic Event Model come together in the 163 VerbNet classes that focus on events of change. These range from change of location classes like Run-51.3.2 (39 classes); to change of possession classes like Give-13.1 (18 classes); to information transfer classes like Lecture-37.11 (25 classes); to changes of state like Become-109.1 (81 classes). We give examples here of the prototypical form used for these events, along with some variations. Further examples can be found in Brown et al. , 2019. Sdepart, arrive and flee. The most basic change of location semantic representation (12) begins with a state predicate has_location, with a subevent argument e1, a Theme argument for the object in motion, and an Initial_location argument. The motion predicate (subevent argument e2) is underspecified as to the manner of motion in order to be applicable to all 40 verbs in the class, although it always indicates translocative motion. Subevent e2 also includes a negated has_location predicate to clarify that the Theme's translocation away from the Initial Location is underway. A final has_location predicate indicates the Destination of the Theme at the end of the event. As mentioned earlier, not all of the thematic roles included in the representation are necessarily instantiated in the sentence.The Escape-51.1 class is a typical change of location class, with member verbs like (12)    GL-Verbnet representationNatasha came to Colorado.            has_location            motion            ¬has_location            has_location            This representation follows the GL model by breaking down the transition into a process and several states that trace the phases of the event.Representations for changes of state take a couple of different, but related, forms. For those state changes that we construe as punctual or for which the verb does not provide a syntactic slot for an Agent or Causer, we use a basic opposition between state predicates, as in the Die-42.4 and Become-109.1 classes. 13 shows a simple version of this format.(13)    GL-Verbnet representationThe belt came undone.            ¬has_state            has_state            State changes with a notable transition or cause take the form we used for changes in location, with multiple temporal phases in the event. The similarity can be seen in 14 from the Tape-22.4 class, as can the predicate we use for Instrument roles.(14)    GL-Verbnet representationLinda stitched the front to the back with green thread.            ¬attached            do            utilize            attached            cause            e1 and non-possession in e3 of the Theme makes clear that once the Agent transfers the Theme, the Agent no longer possesses it. However, in 16, the E variable in the initial has_information predicate shows that the Agent retains knowledge of the Topic even after it is transferred to the Recipient in e2.A final pair of examples of change events illustrates the more subtle entailments we can specify using the new subevent numbering and the variations on the event variable. Changes of possession and transfers of information have very similar representations, with important differences in which entities have possession of the object or information, respectively, at the end of the event. In 15, the opposition between the Agent's possession in (15)    GL-Verbnet representationI gave my dog a treat.            has_possession            ¬has_possession            transfer            has_possession            ¬has_possession            cause            (16)    GL-Verbnet representationCarlos told Stella about his vacation.            has_information            transfer_info            has_information            cause            start, finish, meets, overlaps, co-temporal, repeated_sequence, cause, and in_reaction_to. In the semantic representations, the subevent sequencing indicated by the numbered subevent variables is enough to express the time sequence when subevents follow a simple progression. However, subevents can occur simultaneously or overlap. Predicates that take two or more subevent variables as arguments clarify what would otherwise be misleading subevent numbering. For example, in (17), start clarifies the relationship between the party (e3) and the speech (e2). This predicate has been defined as “One subevent is the beginning portion of another subevent.”We have introduced or revised eight predicates that refine the temporal and causal relations between subevents: (17)    GL-Verbnet representationI began the party with a speech.                        Agent V Eventuality with Subeventuality¬occur            engage_in            occur            start            Another significant change to the semantic representations in GL-VerbNet was overhauling the predicates themselves, including their definitions and argument slots. We added 47 new predicates, two new predicate types, and improved the distribution and consistency of predicates across classes. Improving the preexisting predicates involved streamlining their internal structure, providing each with a clear definition and clear descriptions of the roles played by each argument slot, and creating hierarchies through which the predicates are linked to one another according to shared semantics, aspectual behavior, and valency patterns. Within the representations, new predicate types add much-needed flexibility in depicting relationships between subevents and thematic roles. As we worked toward a better and more consistent distribution of predicates across classes, we found that new predicate additions increased the potential for expressiveness and connectivity between classes. We also replaced many predicates that had only been used in a single class. In this section, we demonstrate how the new predicates are structured and how they combine into a better, more nuanced, and more useful resource. For a complete list of predicates, their arguments, and their definitions see .Start, During, or End of E) and an often inconsistent number of semantic roles. The time stamp pointed to the phase of the overall representation during which the predicate held, and the semantic roles were taken from a list that included thematic roles used across VerbNet as well as constants, which refined the meaning conveyed by the predicate. Some predicates could appear with or without a time stamp, and the order of semantic roles was not fixed. For example, the Battle-36.4 class included the predicate manner, where a constant that describes the manner of the Agent fills in for manner. While manner did not appear with a time stamp in this class, it did in others, such as Bully-59.5 where it was given as manner. In some classes, the order of its two semantic arguments was reversed.Introducing consistency in the predicate structure was a major goal in this aspect of the revisions. In Classic VerbNet, the basic predicate structure consisted of a time stamp     Classic Verbnet representationTwenty couples exchanged rings.            plural〉 V Theme 〈+plural〉            Agent 〈+path_rel(Start(E), Source_I, Theme_I, ch_of_poss, prep)            path_rel(Start(E), Source_J, Theme_J, ch_of_poss, prep)            transfer(During(E), Theme_I)            transfer(During(E), Theme_J)            path_rel(End(E), Goal_J, Theme_I, ch_of_poss, prep)            path_rel(End(E), Goal_I, Theme_J, ch_of_poss, prep)            cause            equals            equals            equals            equals            opposition            path_rel predicate because of the limitation that one argument must be of a Source or Goal type. But in some cases where argument order was not applied consistently and an Agent role was used, it became difficult for both humans and computers to track whether the Agent was initiating the overall event or just the particular subevent containing the predicate.Having an unfixed argument order was not usually a problem for the The new predicates eliminate the inconsistencies and ambiguities of the old and define three separate predicate types. Each predicate now comes with a clear definition and a fixed set of argument slots, each with a clear description of what the argument named in the slot contributes to the overall situation or relation the predicate describes. That the argument slots are fixed indicates that each argument is an essential part of the situation. If a predicate is used in a class for which certain slots are never realized as explicit verb arguments, that predicate argument should still be understood to be an integral part of the semantic representation, and the slot will be filled by an essential role Palmer,  or a con(19)    GL-Verbnet representationTwenty couples exchanged rings.            plural〉 V Theme 〈+plural〉            Agent 〈+has_possession            ¬has_possession            has_possession            ¬has_possession            transfer            transfer            has_possession            ¬has_possession            has_possession            ¬has_possession            cause            cause            path_rel was replaced by a series of more specific predicates depending on what kind of change was underway. Here, it was replaced by has_possession, which is now defined as “A participant has possession of or control over a Theme or Asset.” It has three fixed argument slots of which the first is a time stamp, the second is the possessing entity, and the third is the possessed entity. These slots are invariable across classes and the two participant arguments are now able to take any thematic role that appears in the syntactic representation or is implicitly understood, which makes the equals predicate redundant. It is now much easier to track the progress of a single entity across subevents and to understand who is initiating change in a change predicate, especially in cases where the entity called Agent is not listed first.The first major change to this representation was that has_location. Every semantic representation and every subevent must include at least one situation predicate.The new predicates are divided into three basic structural types: situation predicates, relation predicates, and subevent modifier predicates. Situation predicates make up the majority of the predicate inventory and describe events and states; each has a time stamp as its first argument slot and thematic roles or constants in the remaining slots. A typical situation predicate is cause. Role-role relations describe relationships between thematic roles, for example part_of, which says that the Theme is a constituent part of the Agent.Relation predicates come in two varieties: subevent-subevent relations, and role-role relations. As per Section 3.1.4, subevent-subevent relations take two or more subevent variables as their arguments and describe a causal or temporal relation that holds between them, such as in_reaction_to. Here, as well as in subevent-subevent relation predicates, the subevent variable in the first argument slot is not a time stamp; rather, it is one of the related parties. In_reaction_to should be understood to mean that subevent e1 occurs as a response to a Stimulus. Subevent modifier predicates also include monovalent predicates such as irrealis(e1), which conveys that the subevent described through other predicates with the e1 time stamp may or may not be realized.Sometimes a thematic role in a class refers to an argument of the verb that is an eventuality. Because it is sometimes important to describe relationships between eventualities that are given as subevents and those that are given as thematic roles, we introduce as our third type subevent modifier predicates, for example, en, E, and ë. Here, we showcase the finer points of how these different forms are applied across classes to convey aspectual nuance. As we saw in example 11, E is applied to states that hold throughout the run time of the overall event described by a frame. When E is used, the representation says nothing about the state having beginning or end boundaries other than that they are not within the scope of the representation. This is true whether the representation has one or multiple subevent phases.Section 3.1 introduced the new subevent variables motion example 10) or it can be the only subevent, as in (20) below from Snooze-40.4:Similarly, ë is in and of itself associated with ongoing processes, i.e., the process event variable in Pustejovsky , 2013. I(20)    GL-Verbnet representationGloria snoozed.                        Agent Vbody_process            sleep            e1 with a subevent-modifying duration predicate to differentiate the representation from ones like (20) in which a single subevent process is unbounded.In multi-subevent representations, ë conveys that the subevent it heads is unambiguously a process for all verbs in the class. If some verbs in a class realize a particular phase as a process and others do not, we generalize away from ë and use the underspecified e instead. A process described by ë is ongoing throughout its entire subevent. If a representation needs to show that a process begins or ends during the scope of the event, it does so by way of pre- or post-state subevents bookending the process. The exception to this occurs in cases like the Spend_time-104 class (21) where there is only one subevent. The verb describes a process but bounds it by taking a Duration phrase as a core argument. For this, we use a single subevent (21)    GL-Verbnet representationShe spent five years waiting tables.                        Agent V Duration Eventualityspend_time            duration            Another pair of classes shows how two identical state or process predicates may be placed in sequence to show that the state or process continues past a could-have-been boundary. In example 22 from the Continue-55.3 class, the representation is divided into two phases, each containing the same process predicate. This predicate uses ë because, while the event is divided into two conceptually relevant phases, there is no functional bound between them.(22)    GL-Verbnet representationHe continued to pack.                        Agent V Eventualityengage_in            engage_in            contact) inherit the event variable type of the transition, ë or e.As we will see in Section 3.3.2, each situation predicate is associated with its own typical Aktionsart which informs the type of e it takes as a time stamp. However, since subevent variables often pick out a period of time during which multiple predicates hold, a decision must be made as to which type of e best characterizes the set. Since E can only be used for states that hold through an entire representation, all predicates headed with it must meet this criterion. States that hold while a transition takes place     GL-Verbnet representationLydia pocketed the change.            has_location            do            motion            ¬has_location            has_location            cause            (24)    GL-Verbnet representationWe bottled the cider in one-gallon jugs.            has_location            do            motion            ¬has_location            has_location            cause            In addition to substantially revising the representation of subevents, we increased the informativeness of the semantic predicates themselves and improved their consistency across classes. This effort included defining each predicate and its arguments and, where possible, relating them hierarchically in order for users to chose the appropriate level of meaning granularity for their needs. We also strove to connect classes that shared semantic aspects by reusing predicates wherever possible. In some cases this meant creating new predicates that expressed these shared meanings, and in others, replacing a single predicate with a combination of more primitive predicates.apart in the Separate-23.1, Split-23.2, and Disassemble-23.3 classes, but the predicate attached in the Tape-22.4 class. We eliminated apart and used attached and ¬attached throughout these classes. Similarly, we found three semantically similar classes in different areas of VerbNet that each had only a single predicate used in no other classes: The representation in the Confront-98 class (Lee tackled the problem) was simply confront(During(E), Agent, Theme, Instrument); in Cope-83 (She handled the unruly customers) it was cope, and in Neglect-75.1 (He failed to do the job), it was neglect. We replaced all three with either handle or ¬handle.One obvious way to increase semantic coherence was to choose a single predicate to represent opposing predicates and use negation to show the opposition. For example, Classic VerbNet had the predicate base predicate with more general and more widely-used predicates.In thirty classes, we replaced single predicate frames  with multiple predicate frames that clarified the semantics or traced the event more clearly. For example, (25) and (26) show the replacement of the (25)    Classic Verbnet representationWe based our plans on his information.            cause            base            (26)    GL-Verbnet representationWe based our plans on his information.            support            engage_in            utilize            support predicate links this class to deduce-97.2 and support-15.3 (She supported her argument with facts), while engage_in and utilize are widely used predicates throughout VerbNet.Using the We have organized the predicate inventory into a series of taxonomies and clusters according to shared aspectual behavior and semantics. These structures allow us to demonstrate external relationships between predicates, such as granularity and valency differences, and in turn, we can now demonstrate inter-class relationships that were previously only implicit.https://uvi.colorado.edu/references_page). The perfective category includes all events that include a terminus and has been subdivided into achievements and accomplishments. To connect this back to examples we have already seen, motion (5) is categorized as a process, transfer (15) as a perfective, and has_location (5) as a state.The first taxonomy  groups pemit, which may represent a process or a perfective). This allows the semantic representations to remain appropriately general while laying a foundation for future work in which they may be expanded in a verb-specific manner.Because predicates must apply evenly across all verbs in a class and because some classes contain an aspectually diverse set of verbs or verbs that may be realized according to more than one Aktionsart within the class, we also include subgroups in this taxonomy for predicates that may be associated with more than one aspectual type  places bounds on a process or state, and the repeated_sequence can be considered to turn a sequence of subevents into a process, as seen in the Chit_chat-37.6, Pelt-17.2, and Talk-37.5 classes. Irrealis may be use to make result states optional.Although they are not situation predicates, subevent-subevent or subevent-modifying predicates may alter the Aktionsart of a subevent and are thus included at the end of this taxonomy. For example, the Together is most general, used for co-located items; attached represents adhesion; and mingled indicates that the constituent parts of the items are intermixed to the point that they may not become unmixed. Spend and spend_time mirror one another within sub-domains of money and time, and in fact, this distinction is the critical dividing line between the Consume-66 and Spend_time-104 classes, which contain the same syntactic frames and many of the same verbs. Similar class ramifications hold for inverse predicates like encourage and discourage.A second, non-hierarchical organization  groups tTo get a more comprehensive view of how semantic relatedness and granularity differences between predicates can inform inter-class relationships, consider the organizational-role cluster . This seAuthority_relationship shows a stative relationship dynamic between animate participants, while has_organization_role shows a stative relationship between an animate participant and an organization. Lastly, work allows a task-type role to be incorporated into a representation (he worked on the Kepler project).With the aim of improving the semantic specificity of these classes and capturing inter-class connections, we gathered a set of domain-relevant predicates and applied them across the set. path_rel(ch_of_loc) predicates plus cause, in keeping with the basic change of location format utilized throughout the other -10 classes. This representation was somewhat misleading, since translocation is really only an occasional side effect of the change that actually takes place, which is the ending of an employment relationship. See Fire-10.10 and Resign-10.11 formerly included nothing but two authority_relationship predicate and its negation, leaving it with no visible connection to Fire-10.10.The new representation for the Hire-13.5.3 class mirrors Fire-10.10 now, clearly demonstrating the connection between these classes. In the past, Hire-13.5.3 consisted solely of an opposition between an yield predicate (a predicate not defined and not found anywhere else in VerbNet—a true singleton) while Supervision-95.2.2 and Subordinate-95.2.1 used just authority_relationship. The latter two representations differed only in the ordering of their predicate arguments. To flesh these representations out a bit, we added an authority_relationship predicate to Acquiesce-95.1 and expanded not only the representation but the overall scope of Supervision-95.2.2. First, we defined yield and contextualized it by placing it in the org-role semantic predicate cluster. With the inclusion of authority_relationship, the representation now provides more information about the authority dynamic between the participants within the yielding event and we connect Acquiesce to the rest of the org-role group. Supervision-95.2.2's coverage has expanded considerably with the addition of work and has_role predicates. We found that all verbs in the class support syntactic frames that incorporate a task-type Theme role (Martha led the students in a task), so we added Theme to the class as a primary role along with two new frames exemplifying its use. The class has an additional, previously ignored hallmark: all of the member verbs encode semantics relating to the social role played by the Agent in the event . Since these social roles were not limited to organization-internal positions, we included the coarser-grained has_role predicate with a V_Attribute argument pointing back to the verb. This and the other semantic clusters we created demonstrate that having external predicate structures provide a valuable new layer of semantic refinement within and between classes.Acquiesce-95.1, Supervision-95.2.2, and Subordinate-95.2.1 all consisted of singleton representations before revisions. Acquiesce-95.1 used a single As discussed above, as a broad coverage verb lexicon with detailed syntactic and semantic information, VerbNet has already been used in various NLP tasks, primarily as an aid to semantic role labeling or ensuring broad syntactic coverage for a parser. The richer and more coherent representations described in this article offer opportunities for additional types of downstream applications that focus more on the semantic consequences of an event. The clearer specification of pre- and post-conditions has been useful for automatic story generation  even though these state changes are implicit rather than explicitly mentioned. A clear example of that utility of VerbNet semantic representations in uncovering implicit information is in a sentence with a verb such as “carry” (or any verb in the VerbNet carry-11.4 class for that matter). If we have ◂ XcarriedYtoZ▸, we know that by the end of this event, both Y and X have changed their location state to Z. This is not recoverable even if we know that “carry” is a motion event . This is in contrast to a “throw” event where only the theme moves to the destination and the agent remains in the original location. Such semantic nuances have been captured in the new GL-VerbNet semantic representations, and Lexis, the system introduced by Kazeminejad et al., One of the downstream NLP tasks in which VerbNet semantic representations have been used is tracking entity states at the sentence level  to being (be) enables us to infer that at the end of this event, the result argument, i.e., “a stream,” has been created.As an example, for the sentence “The water forms a stream,”(27)    GL-Verbnet representation instantiated by SemParseThe water forms a stream.            ¬has_state            ¬be            do            has_state            be            Theme (urea and carbon dioxide) and Agent (blood) start together at an uninstantiated/unknown Initial Location. A Motion event occurs to both the Theme and the Agent and as a result, both move away from the Initial Location, both move along a Trajectory, and, finally, both arrive together at the Destination (kidneys). This change of location (moved) for urea, carbon dioxide, and blood and the resulting ending up in the kidneys is exactly what human annotators had indicated in the ProPara dataset . Evidently, the (28)    GL-Verbnet representationThe blood carries the urea and carbon dioxide to the kidneys.            has_location            has_locationmotion            motion¬has_location            ¬has_locationhas_location            has_locationco-temporal            Take In fails to instantiate the Goal argument. However, from the PropBank parse of this sentence we have A0: The roots, A1: water and minerals, A2: from the soil. On the other hand, from the semantics of the primitive predicate Take In, we know that the Goal is the same as A0 (protoAgent). As a result, we can complete the VerbNet semantic representation for the missing value for Goal with the value for A0, The roots. This is to maximize the symbolic predictive power of Lexis.In addition to VerbNet semantic representations, SemParse returns the PropBank parse for the input sentence. In some cases where the VerbNet parser fails to instantiate an argument , there is still a chance that the PropBank parser succeeds in doing so. For example, in the sentence “The roots absorb water and minerals from the soil,” the VerbNet semantic representation We evaluated Lexis on the ProPara dataset , in which the feature value for a specific verb can replace V_Emotion when instantiating the representation from actual text. Likewise, in the calibratable_cos-45.6.1 class, the predicate change_value includes the argument V_Direction, whose value can be found in context from a particular verb's verb-specific feature: either increase , decrease  or fluctuate .We have begun experimenting with incorporating the features into our semantic representations to further increase their expressive power. The admire-31.2 class, for example, includes the predicate (29)    GL-Verbnet representationThe price of oil rose by 500% from $5 to $25.            has_attribute            has_val            change_value            has_val            oblige, impel) and verbs with connotation of persuasion  These verbs could be assigned a +compel or +persuade value, respectively.We are exploring how to add slots for other new features in a class's representations. Some already have roles or constants that could accommodate feature values, such as the admire class did with its Emotion constant. We are also working in the opposite direction, using our representations as inspiration for additional features for some classes. The compel-59.1 class, for example, now has a manner predicate, with a V_Manner role that could be replaced with a verb-specific value. The verbs of the class split primarily between verbs with a compel connotation of compelling  can be found at: VerbNet GitHub SB led the effort. SB and JB did the work and wrote the majority of the paper. GK did the evaluation and wrote that section. JP, AZ, and MP provided input and feedback over several years of conference calls.We gratefully acknowledge the support of DTRAl-16-1-0002/Project # 1553695, eTASC-Empirical Evidence for a Theoretical Approach to Semantic Components; DARPA 15-18-CwC-FP-032 Communicating with Computers, C3 Cognitively Coherent Human-Computer Communication (sub from UIUC) and Elementary Composable Ideas (ECI) Repository (sub from SIFT); DARPA KAIROS Program No. FA8750-19-2-1004; and DARPA FA8750-18-2-0016-AIDA—RAMFIS: Representations of vectors and Abstract Meanings for Information Synthesis. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of DTRA or the U.S. government.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Malnutrition is common in patients with gastrointestinal cancer. The first step in the diagnosis of malnutrition is to evaluate the malnutrition risk by validated screening tools according to the Global Leadership Initiative on Malnutrition (GLIM). This study aimed to determine the best nutritional screening tool for identifying GLIM malnutrition and validate the performance of these tools in different age subgroups.We did a prospective cohort study of patients who were diagnosed with gastrointestinal cancer from February 2016 to November 2019. The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and area under the receiver operating characteristic (ROC) curve (AUC) of three screening tools , Geriatric Nutritional Risk Index (GNRI), MNA-SF) were calculated.A total of 488 patients were enrolled, and 138 patients (28.27%) were malnutrition according to the GLIM criteria. The consistency of NRS 2002, GNRI, and MNA-SF with GLIM-defined malnutrition was 74.8, 72.1, and 71.1%, respectively. In the subgroup analysis of young patients (<65 years), NRS 2002 exhibited the best discrimination with the AUC of 0.724 , the sensitivity of 64.3% , and the specificity of 80.6% . In patients older than 65 years, MNA-SF exhibited the best discrimination with the AUC of 0.764 , the sensitivity of 82.3% , and the specificity of 70.5% .Nutritional risk screening 2002 (NRS 2002) is the best malnutrition screening tool in gastrointestinal cancer patients younger than 65 years, and MNA-SF is the best malnutrition screening tool in patients older than 65 years. It is necessary to select targeted nutritional screening tools according to the difference in age. Malnutrition is common in geriatric gastrointestinal cancer patients. Many studies have found that malnutrition is associated with a high frequency of complications and mortality in patients with gastrointestinal cancer , 2. ThusThe diagnostic criteria for malnutrition are constantly being updated and improved. A newly published malnutrition criterion of The Global Leadership Initiative on Malnutrition (GLIM) has gathered many global clinical nutrition societies and incorporated multiple common malnutrition criteria which aimed to standardize the malnutrition diagnosis. GLIM criteria for diagnosis of malnutrition consist of two steps risk screening and malnutrition diagnosis. The key first step is to use any validated malnutrition screening tool to identify “at risk” status, to choose the best malnutrition screening tool that can improve the efficiency of malnutrition detection and avoid the waste of human resources . HoweverNutritional risk screening 2002 (NRS 2002), the Geriatric Nutritional Risk Index (GNRI), and mini nutritional assessment short form (MNA-SF) are commonly used nutritional screening scales. In terms of specific evaluation indicators, NRS 2002 includes three parts disease severity, nutritional impairment and age, GNRI based on serum albumin level and body weight, and MNA-SF consists of 6 questions on food intake, weight loss, mobility, psychological stress or acute disease, presence of dementia or depression, and body mass index (BMI).The aim of our study was to compare the three common malnutrition risk screening tools , aiming to find the best screening tool for identifying GLIM malnutrition and to validate their performance in different age subgroups, which helps to improve the efficiency of malnutrition detection and avoid the waste of medical resources.The study included patients who underwent curative surgery for gastrointestinal cancer from February 2016 to November 2019 in two centers. Inclusion criteria included: (1) Patients who underwent elective curative surgery for gastrointestinal cancer; (2) Patients who signed informed consent and agreed to participate in this study. The exclusion criteria were: (1) Patients who have undergone a palliative or emergency operation; (2) Patients who had difficulty in data collection during NRS 2002, GNRI, and MNA-SF surveys; and (3) Patients who refused to take part in this study.Three scales were collected within 24 h of admission aiming to record the baseline nutritional risk status and are carried out by a trained specialist. NRS 2002, GNRI, and MNA-SF were used as the tools to screen malnutrition risk by clinical investigators. For NRS 2002 scale, patients with a total score ≥ 3 were considered at nutritional risk . The MNAMalnutrition was diagnosed according to GLIM criteria. A two-step approach for the malnutrition diagnosis was selected, first screening to identify “at risk” status by the use of any validated screening tool, and second, assessment for diagnosis and grading of the severity of malnutrition. Patients were diagnosed as malnourished if any of three phenotypic criteria  and either of two etiological criteria  were met. Non-volitional weight loss was defined as > 5% within the past 6 months or > 10% beyond 6 months. We assessed low body mass index using Asian BMI data  . Reducedt-test. Continuous variables with non-normal distribution were presented as the median and interquartile range (IQR) and analyzed using Mann–Whitney U test, and categorical variables were presented as frequencies and analyzed using Pearson’s χ2 test (or Fisher’s exact test). Univariate logistic analysis was performed for potential baseline predictors and the odds ratios (ORs) with their 95% CIs were calculated. Variables with a trend (p < 0.10) in the univariate analysis were selected as potential parameters, and then, a forward stepwise variable selection was used to establish a multivariate logistic regression. Receiver operating characteristic (ROC) curves were conducted to evaluate the performance of the NRS 2002, GNRI, and MNA-SF in identifying malnutrition. The area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio, and negative likelihood ratio were also calculated. The p-value of < 0.05 was considered statistically significant. All data were analyzed using SPSS software Version.23.0 .Continuous variables with normal distribution were presented as mean ± standard deviation (SD) and analyzed using a A total of 488 geriatric gastrointestinal cancer patients enrolled in the study, there were 317 (65%) males and 171 (35%) females. For cancer types, there were 151 (30.9%) gastric cancer and 337 (69.1%) colorectal cancer. A total of 138 patients (28.27%) were diagnosed with malnutrition according to GLIM criteria. The baseline characteristics between malnutrition and non-malnutrition groups are shown in Supplementary Table 1 lists the results of univariate and multivariate analyses for predictors of GLIM malnutrition. Baseline characteristics with p < 0.01 were included in the multivariate analyses with NRS 2002, GNRI, and MNA-SF, respectively. In the model with NRS 2002, we found that the NRS 2002, BMI, and serum were independent factors of malnutrition; in the model with MNA-SF, the MNA-SF, BMI, serum, and hemoglobin were independent factors of malnutrition; however, in the model with GNRI, GNRI were excluded in the multivariate analysis.The prevalence of malnutrition risk based on GNRI, MNA-SF, and NRS 2002 was shown in To examine the discriminative ability of screening tools, the ROC curves of NRS 2002, GNRI, and MNA-SF were plotted using GLIM-defined malnutrition as a control in The sensitivity, specificity, PPV, and NPV were also calculated in The GLIM is a consensus report from the global clinical nutrition community for the diagnosis of malnutrition. Since the first key step is to identify “at risk” patients, nutritional screening tools should be effective and easy to perform. Although malnutrition is a frequent problem in patients with gastrointestinal cancer, few studies investigated the efficiency of screening tools in identifying GLIM-defined malnutrition. As far as we know, this is the first study investigating the efficiency of the malnutrition risk tool for identifying GLIM-defined malnutrition in the gastrointestinal cancer population of both sexes.Nutritional risk varied greatly, ranging from 40 to 90%, depending on the nutritional screening tool used . In contAccording to previous studies, the prevalence of malnutrition in the gastrointestinal is about 30–50% –13. AccoThe higher the sensitivity of the malnutrition screening scale, the fewer patients diagnosed malnourished by GLIM were missed by the nutrition screening scale. The sensitivity is the proportion of the positive samples that were correctly classified, and the specificity represents the proportion of the negative samples that were correctly classified. A higher sensitivity helps us to identify more patients at risk of malnutrition, while a higher specificity helps to save medical resources. In our study, in patients younger than 65 years, MNA-SF had the highest sensitivity (71.4%) but lowest specificity (54.2%), while GNRI and NRS 2002 had the highest specificity (80.6%). Additionally, NRS 2002 had the greatest AUC compared with GNRI and MNA-SF. Although MNA-SF had the highest sensitivity, NRS 2002 had the highest sensitivity and the greatest AUC, therefore, we considered NRS 2002 prior to GNRI and MNA-SF as the malnutrition screening tool in gastrointestinal cancer patients younger than 65 years. In patients older than 65 years, MNA-SF had the highest sensitivity (82.3%), GNRI had the highest specificity (75.5%), and MNA-SF had the greatest AUC compared with GNRI and NRS 2002. Thus, we considered that MNA-SF is prior to NRS 2002 and GNRI as the malnutrition screening tool in identifying malnutrition risk in geriatric patients with gastrointestinal cancer.The varying results of this comparison can be attributed to differences in the original design of the three screening tools. The NRS 2002 was designed to identify patients at increased nutritional risk expected to benefit from nutritional support . NRS 200We can see both NRS 2002 and MNA-SF have several similar diagnostic criteria to GLIM. In NRS 2002, three criteria  were similar to GLIM, and in MNA-SF, four criteria  were similar to GLIM. These criteria were feasible and easy to operate, but only reduced muscle mass which only GLIM had was labor-intensive. Therefore, it is practical to use NRS 2002 and MNA-SF as screening tools for gastrointestinal cancer patients.This study has some limitations. Firstly, the screening tools can be used only if the patient is able to communicate or if a family member is able to answer the interviewer’s questions. This could bias the study by excluding some malnourished elderly patients who could not participate. Secondly, this study was obviously limited by the inclusion of only patients with curable gastric cancer.The first step of GLIM criteria requires identifying “at risk” patients by the use of any validated screening tool. In our study, we demonstrated that NRS 2002 was the best malnutrition screening tool in gastrointestinal cancer patients younger than 65 years, and MNA-SF was the best malnutrition screening tool in patients older than 65 years. Therefore, choosing a suitable malnutrition screening tool for different ages helps to detect more malnutrition and contributes to the early detection and treatment of malnutrition.The original contributions presented in this study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.The studies involving human participants were reviewed and approved by Ethics Committees of Shanghai Tenth People’s Hospital and the First Affiliated Hospital of Wenzhou Medical University. The patients/participants provided their written informed consent to participate in this study.LH planned the work. YH, LW, and YYH carried out the statistical analysis. YYH and YC wrote and reported the work. LH played a critical role in revising the manuscript. All authors critically assessed and reviewed the manuscript, approved the version to be published, and made a significant contribution to this article.


N = 437) were recruited to complete a set of questionnaires voluntarily in June 2022. Through the mediating effect analysis, the results found that (1) relational victimization was positively associated with female college students’ video game addiction; (2) social anxiety and parasocial relationships with virtual characters could independently mediate this relation; (3) social anxiety and parasocial relationships with virtual characters were also the serial mediators in this association. These findings not only expand previous studies by revealing the social motivation of video game usage and the underlying mechanism accounting for video game addiction, but also provide basis and guidance for the prevention and intervention of video game addiction in the current context of the COVID-19 pandemic.Video game addiction, a common behavioral problem among college students, has been more prominent during the COVID-19 pandemic; at the same time, females’ video game usage has also attracted considerable research attention. Against this background and under the perspective of social interaction, this study aimed to examine the relationship between relational victimization and video game addiction among female college students, as well as its underlying mechanism—the mediating roles of social anxiety and parasocial relationships with virtual characters. Female college students ( Nowadays, with the prevalence of Internet technology, video games have become a popular mode of entertainment worldwide, with great appeal to young teenagers such as college students . There wIn addition, under the background of the COVID-19 pandemic in recent years, college students’ daily life, especially social relationships, has been greatly interrupted . In addiIt has been well established that stressful life events or adversities were closely associated with video game addiction ,15. AccoHypothesis 1.Relational victimization would be positively related to video game addiction among female college students.Social anxiety is defined as an excessive and persistent fear in social or performance situations that are either avoided or painfully and reluctantly endured . It’s anNegative social interactions are crucial predisposing factors of social anxiety . PreviouHypothesis 2.Relational victimization would predict female college students’ video game addiction via the mediating role of social anxiety.In addition, the experience in video games  is another factor influencing video game addiction ,43. A paThe parasocial compensation hypothesis also indicated that parasocial relationships are associated with unsatisfying social life and social deficits . PreviouHypothesis 3.Relational victimization would predict female college students’ video game addiction via the mediating role of parasocial relationships.Moreover, social anxiety is also closely associated with parasocial relationships. Social anxious individuals often experience negative relationship quality and experience, and these hinder the realization of interpersonal communication and belongingness needs . RecentlHypothesis 4.Social anxiety and parasocial relationship operated as serial mediators between relational victimization and female college students’ video game addiction .Combining the parasocial compensation hypothesis with psychological-decompensation model, the present study constructed a serial mediation model to examine the mechanisms underlying the relationship between relational victimization and video game addiction among female college students.Through convenience sampling, 464 female students from an educational college in central China were recruited to voluntarily participate in this study in June 2022, when college students were required to live in their dormitory on campus unless necessary after March because of the COVID-19. In the end, 437 female college students completed the survey, whose ages ranged between 16 and 25 years . The participants frequently play video games with a score of 4.5 on a 6-likert scale ; more than half of them like to play King of Glory, and the others like to play mobile romantic video games, Genshin impact, and so on, all of which provide opportunities to interact with virtual characters. The study was approved by the ethics committee of the author’s organization, and the participants were informed of the principles of anonymity, independence, and confidentiality.The relational victimization was measured by the Chinese version of the Olweus Bully/Victim questionnaire (OBVQ) ,61. The Social anxiety was assessed by the Chinese version of Social Anxiety Scale ,63. ThisParasocial relationship was measured using the Chinese 11-item version of the Parasocial Relationship Scale ,65,66, wVideo game addiction was assessed with a widely used 7-item Game Addiction Scale (GAS) ,68. SeveIBM SPSS 26.0 and the PROCESS macro  were adop < 0.001), parasocial relationship with virtual characters , and video game addiction . Social anxiety was positively correlated with parasocial relationship  and video game addiction . Parasocial relationship was positively correlated with video game addiction .The results of descriptive statistics and Pearson’s correlation analysis for all the observed variables that relational victimization, social anxiety, parasocial relationship with virtual characters, and video game addiction were shown in p < 0.001). Thus, the Hypothesis 1 was supported. It also can be seen that relational victimization was positively associated with social anxiety , and social anxiety was positively associated with video game addiction . Social anxiety served a mediating role between relational victimization and video game addiction and, therefore, Hypothesis 2 was supported. In addition, relational victimization was positively associated with parasocial relationships , and parasocial relationships were positively associated with video game addiction  after controlling for age. Therefore, the Hypothesis 3 was supported.It was hypothesized that social anxiety and parasocial relationships with virtual characters in video games would mediate the relationship between relational victimization and video game addiction. The PROCESS macro for SPSS (model 6) by Hayes was used to examine the possible mediating roles of social anxiety and parasocial relationships with virtual characters. The main results of the serial mediation analysis are presented in Then, a bootstrap program was adopted to further test and compute the mediating effects. As shown in In the current information era, with the increasing popularity of video games, the problem of video game addiction has also been increasingly prominently, especially in the context of the COVID-19 pandemic. The pandemic has taken a toll on interpersonal relationships, and females’ use of video games is increasing and needs more attention. Against this background, this study aimed to examine the association between relational victimization and female college students’ video game addiction, as well as its internal mechanisms. The results indicated that the experience of relational victimization was positively associated with female college students’ video game addiction through the mediating effects of social anxiety and parasocial relationships with virtual characters. The mediating effects include three mediating paths: the separate mediating effects of social anxiety and parasocial relationships, as well as the serial mediating effect of them. Specifically, parasocial relationships may play a relatively more important role in the internal mediating mechanism. This study may expand previous studies and have significant theoretical and practical significance.Interpersonal relationship is an important factor affecting individual developments and adaptations . PositivThe further mediating analyses found that social anxiety and parasocial relationships could mediate the relationship between relational victimization and video game addiction. Regarding the simple mediating effects of social anxiety and parasocial relationships, they were consistent with the main points of the Cognitive-Behavioral model and the parasocial compensation hypothesis ,48. TherThis is true for parasocial relationships; the negative feelings and the damaged social relation may push individuals to seek compensation through other means. For example, they may use video games to alleviate the stress and form parasocial relationships with characters in games to compensate for basic needs, especially during the COVID-19 pandemic ,85. ParaThe current finding is also consistent with the uses and gratification theory. This theory indicated that the level of game use is predicted by the strength of player motivations determining such uses  and seekFurthermore, the serial mediating effect of social anxiety and parasocial relationships between relational victimization and video game addiction was also found in the present study, suggesting that parasocial relationships are a more direct factor contributing to video game addiction. This further suggests that game experience and feelings are key factors that influence game use behavior, including addiction ,93. AlthThe present findings may have some theoretical and practical implications. Theoretically, this study expanded previous studies by firstly focusing on the female video game user other than the male users. Secondly, these findings deepen our understanding of the influencing factors and underlying mechanisms of video game addiction by integrating the social experience of real life and the specific experience of the game. It may also provide a wider perspective on the influences of relational victimization and the risk factors of video game addiction, under the context of the COVID-19 pandemic. Practically, this study may provide guidance for the prevention and intervention of video game addiction among females, since it is a common social phenomenon, especially during lockdown : FirstlyHowever, some limitations should also be acknowledged. First, the study only used cross-sectional data. To facilitate the inference of causal effects, longitudinal design or experimental design should be adopted in future research. Second, all the participants were Chinese female college students. Studies suggested that collectivist culture in east Asia places a high value on harmonious interpersonal relationships . Future


The survey assessed changes in tobacco, alcohol and other substance use during the COVID-19 pandemic.The survey was carried out in Moscow and Nizhegorodskaya Oblast in December, 2020 - February, 2021 and included 650 medical organizations’ employees and 344 individuals with harmful alcohol or other substances use.The instrument included ASSIST, Kessler-10 and IES-R tests modified for self-reporting about different pandemic periods.Among medical workers 36.8% smoked last 12 months; during the COVID-19 pandemic 13% maintained usual cigarette smoking level, 2.4% increased smoking during incidence rises. 71.2% drank alcohol last 12 months; during incidence rises 20.4% drank as usual, 15.0% drank less frequently; 2.4% increased frequency of drinking, 1.8% volumes on drinking days, 1.3% frequency of heavy episodic drinking. In harmful substance use group 61.9% smoked last 12 months; during COVID-19 incidence rises 40% kept their usual level of smoking; 13.4% increased their smoking during the first and 8.7% during the second ‘wave’ of the pandemic. 90.1% drank alcohol last 12 months; during incidence rises 49% kept drinking as usual, 20% reduced drinking and 17.3% increased drinking frequency, 21.0% volumes on drinking days, 16.4% heavy episodic drinking frequency. Wastewater-based epidemiology analysis performed in Moscow Oblast location demonstrated significant increase during COVID-19 pandemic, compared to same period 2 years earlier: inhaled nicotine use by average of 40%, ethanol consumption by average of 49%.Changes in cigarette smoking and alcohol use during the COVID-19 pandemic had significant variation. Increases were more likely to occur during the pandemic ‘waves’ among individual from harmful users’ group.No significant relationships.


The median overall survival was longer in the DEC + VEN group than in the DEC group . The median event-free survivals were 8.6 and 5.8 months in the DEC + VEN and DEC groups, respectively (p = 0.02). The response rate  was significantly higher in the DEC + VEN group than in the DEC group . The 30-day  and 60-day  mortality rates did not differ between the two groups, nor did the median hospitalization and transfusion rates . Of those who received DEC + VEN and became leukemia-free, 29% underwent allogeneic stem cell transplantation and had excellent survival outcomes . This study is the first to provide real-world evidence that DEC + VEN has superior outcomes to DEC monotherapy.Venetoclax (VEN) combined with azacitidine (AZA) or decitabine (DEC) has been approved for older adults with acute myeloid leukemia (AML) unfit for intensive chemotherapy based on the pivotal VIALE-A trial. However, this trial only compared AZA + VEN with AZA monotherapy. Therefore, we compared the outcomes of consecutive older adults (65 years or older) with newly diagnosed AML who received DEC ( Older adults with acute myeloid leukemia (AML) have inferior survival outcomes compared to younger patients since they often have diseases with higher risk factors, a decreased performance status, and acquired comorbidities . Older aB-cell lymphoma-2 (BCL-2) is an anti-apoptotic protein that allows cancer cells to evade apoptosis by sequestering pro-apoptotic proteins . Moreove2 intravenous DEC daily for five days. The response was evaluated through a bone marrow (BM) study after cycle 2 unless disease progression was firmly not suspected in cycle 1. If the patient remained stable, the subsequent BM evaluation was performed after cycle 4, then every four cycles after that. The DEC + VEN group received the same daily dose of DEC for five days combined with 28 days of VEN (400 mg daily) per cycle. The cycle 1 ramp-up, disease response evaluation, VEN dose reduction in concomitant with azoles, and the resting period between cycles were the same as in the VIALE-A trial [9/L by hydroxyurea, low-dose intravenous cytarabine, or leukapheresis before DEC or DEC + VEN treatment. Uric acid reducing agents  and intravenous fluid hydration were administered for the prevention of tumor lysis syndrome. We used fluconazole 400 mg/day during the neutropenic period in all patients as antifungal prophylaxis without antibacterial prophylaxis [This single-center, retrospective study enrolled newly diagnosed patients with AML aged 65 years or older who received DEC + VEN or DEC monotherapy as front-line treatment from February 2013 to December 2021. None of these patients received DEC or DEC + VEN treatment in a clinical trial or any other targeted agents. DEC monotherapy consisted of administering 20 mg/m-A trial , 14, 15.de novo or secondary AML), WBC count, platelet count, blast cells in peripheral blood (%), and the serum albumin and creatinine levels. These variables are known prognostic factors associated with early death and OS [n = 74) using the nearest-neighbor algorithm. After matching, we confirmed that the matched cohort was well balanced through the standardized mean difference of the calculated variables [VEN has been available in our institution for patients with AML aged 65 years or older since March 2020. Before the introduction of DEC + VEN, DEC monotherapy was the standard treatment for older adults with AML unfit for intensive chemotherapy. Therefore, we constructed a propensity score-matched cohort to minimize bias between the DEC + VEN and DEC groups. We calculated the propensity score using a logistic regression model that included age, performance status , karyotype  assays  for escribed . MutatedP-values < 0.05 were considered statistically significant.Baseline characteristics or values are presented as medians with interquartile ranges (IQRs) or counts with percentages. We used the European Leukemia Net (ELN) 2010 classification to categorize the patient’s genetic risk group since a full mutation profile was lacking in the DEC group . The Wilp = 0.72). The number of patients with decreased performance (ECOG score of 2 or higher)  or secondary AML  did not differ between the groups. Furthermore, the WBC and platelet counts, peripheral blood chemistry findings, and BM blast rates at diagnosis were similar between the groups. The cytogenetic and genomic risk distributions also did not differ; 23% of patients in both groups were classified with adverse risk. Both groups had a similar proportion of patients with poor risk based on the Wheatley index  and high-risk based on the TRM score  [p < 0.01). Of them, two DEC + VEN patients switched to other treatments before the HSCT due to intolerance, and 2 others did not reach remission before the HSCT; one had a partial response, and the other reached a stable disease state. All patients were in remission before the HSCT in the DEC group.Table p < 0.01). Regarding the best response, significantly more patients in the DEC + VEN group obtained a leukemia-free state than in the DEC group . In the DEC + VEN patients, three patients were MLFS status at the best response, and their initial responses were MLFS, partial response, and stable disease, respectively. One of the two patients whose initial response was MLFS improved to CR after the second cycle .Table p = 0.17; 60-day mortality: 18.9% vs. 9.5%, p = 0.16). There were two deaths within 30 days due to pneumonia with sepsis and tumor lysis syndrome, respectively, in the DEC + VEN group, and 5 additional deaths  by infection occurred until day 60. In the DEC group, mortality was caused by infection, hemorrhage, and pulmonary thromboembolism . However, the early mortality rate did not differ between the groups for high TRM risk patients .Overall, the 30-day and 60-day mortality rates did not differ between the groups  was 11.5 months and 22.3 months. OS was significantly longer in the DEC + VEN group than in the DEC group . However, the groups did not differ for patients with high TRM risk , as was the proportion of outpatient-treated patients without hospitalization . Among those who achieved a leukemia-free state, transfusion independence did not differ between the groups  was similar between the groups.  underwent allogeneic HSCT. The time from DEC + VEN treatment to HSCT was 5.1  months. The median age was 67  years, and the ELN 2017 risk distribution was 73.3% and 26.7% in the intermediate and adverse risk groups, respectively. The MRD negative remission was 60.0%. Approximately half of the donors were haploidentical (53.3%), followed by matched unrelated (33.3%), matched sibling (6.7%), and mismatched unrelated (6.7%). Most patients (91.9%) received reduced-intensity conditioning. The one-year OS rate after HSCT was 79.4%, and no patient died within 100 days after HSCT  based on the disease subgroup to determine whether the VEN + DEC treatment differentially affected patients with various disease subtypes  and the OS of all included patients , NPM1 (91.7%), CEBPA (80.0%), DNMT3A (80.0%), DDX41 (80.0%), and IDH2 (100%) mutations had excellent responses, but those with NRAS (33.3%), KRAS (0%) TP53 (50.0%), KIT (50.0%), RUNX1 (28.6%), and ASXL1 (50.0%) mutations had suboptimal responses . However, the OS did not differ based on the TRM risk . In the DEC + VEN group, OS did not differ between the Wheatley index poor risk and non-poor risk groups , but the OS was significantly worse in the high TRM risk group than in the low TRM risk group .Finally, we analyzed the prognostic role of the entire cohort’s two indexes (the Wheatley index and TRM score) per treatment group  had similar response rates and survival outcomes to the results of previous studies, such as DEC + VEN (n = 31) and AZA + VEN (n = 84) in a phase 1b HMA + VEN study (400 mg dose of VEN) and AZA + VEN (n = 286) in the VIALE-A study  and did not demonstrate superior survival after AZA + VEN treatment in this subgroup [Exploratory analyses in the VIALE-A study suggest significantly superior outcomes in patients with subgroup . Our stuInterestingly, the DEC + VEN group had better OS than the DEC group, regardless of the Wheatley index risk assessment. However, the survival benefit of DEC + VEN was not observed in the high TRM risk group. Moreover, the Wheatley index score was not associated with OS in the DEC + VEN group but was significantly associated with the DEC group. Conversely, the TRM score was significantly associated with OS in the DEC + VEN group but not in the DEC group. Regarding early mortality, the 30-day mortality rate in DEC + VEN group (2.7%) was comparable to that of HMA + VEN in other clinical studies  , 29. OurA recent report indicated that newly diagnosed patients with AML treated with ten days of DEC with VEN (DEC10 + VEN) had better outcomes than those receiving intensive chemotherapy, particularly those at high risk of TRM , 30. OurIn total, 15 patients (29%) in the DEC + VEN group who became fit for allogeneic HSCT after achieving a leukemia-free state showed favorable outcomes, such as a one-year OS rate of 79.4%, a one-year relapse rate of 20.0%, and one-year NRM rate of 13.3%. Moreover, the HSCT results of patients receiving DEC + VEN were better than those who underwent allogeneic HSCT after intensive chemotherapy , 32, aliThe current study has inherent limitations due to its retrospective design. We used propensity score matching to minimize the bias, but unexpected confounders could have influenced these results. The relatively short follow-up period is another potential limitation. However, the superior survival outcomes of the DEC + VEN group are unlikely to change because only a small number of patents were censored before the median survival point. In addition, our cohort is characterized by the high proportion of patients at high risk based on the Wheatley index and TRM scores, which are well-known prognostic models validated in older adults with AML. Finally, we could not conclude the outcome differences based on specific genomic abnormalities since a complete mutation profile was lacking in a subset of the DEC monotherapy group. Nonetheless, given the lack of prospective comparative data, the current study is the first to provide real-world evidence that DEC + VEN has superior outcomes to DEC monotherapy.DEC + VEN therapy had a better and faster treatment response than DEC monotherapy in older adults with newly diagnosed AML, resulting in superior OS and EFS without affecting the hospital stay or blood transfusion rates. Furthermore, DEC + VEN is a feasible bridge to an allogeneic HSCT in this population, providing strong evidence for choosing not only AZA but also DEC when combined with VEN. Finally, our data highlight the necessity of novel prognostic models for patients treated with VEN-based regimens and clinical trials comparing DEC + VEN and DEC10 + VEN or intensive chemotherapy treatments.Supplemental material