This paper presents a pedagogical agent designed to support students in an embodied, discovery-based learning environment. Discovery-based learning guides students through a set of activities designed to foster particular insights. In this case, the animated agent explains how to use the Mathematical Imagery Trainer for Proportionality, provides performance feedback, leads students to have different experiences and provides remedial instruction when required. It is a challenging task for agent technology as the amount of concrete feedback from the learner is very limited, here restricted to the location of two markers on the screen. A Dynamic Decision Network is used to automatically determine agent behavior, based on a deep understanding of the tutorial protocol. A pilot evaluation showed that all participants developed movement schemes supporting proto-proportional reasoning. They were able to provide verbal proto-proportional expressions for one of the taught strategies, but not the other.

Federated learning (FL) is a method used for training artificial intelligence models with data from multiple sources while maintaining data anonymity, thus removing many barriers to data sharing. Here we used data from 20 institutes across the globe to train a FL model, called EXAM (electronic medical record (EMR) chest X-ray AI model), that predicts the future oxygen requirements of symptomatic patients with COVID-19 using inputs of vital signs, laboratory data and chest X-rays. EXAM achieved an average area under the curve (AUC) >0.92 for predicting outcomes at 24 and 72 h from the time of initial presentation to the emergency room, and it provided 16% improvement in average AUC measured across all participating sites and an average increase in generalizability of 38% when compared with models trained at a single site using that site's data. For prediction of mechanical ventilation treatment or death at 24 h at the largest independent test site, EXAM achieved a sensitivity of 0.950 and specificity of 0.882. In this study, FL facilitated rapid data science collaboration without data exchange and generated a model that generalized across heterogeneous, unharmonized datasets for prediction of clinical outcomes in patients with COVID-19, setting the stage for the broader use of FL in healthcare.