Against autonomy: How proposed solutions to the problems of living wills forgot its underlying principle

Significant criticisms have been raised regarding the ethical and psychological basis of living wills. Various solutions to address these criticisms have been advanced, such as the use of surrogate decision makers alone or data science-driven algorithms. These proposals share a fundamental weakness: they focus on resolving the problems of living wills, and, in the process, lose sight of the underlying ethical principle of advance care planning, autonomy. By suggesting that the same sweeping solutions, without opportunities for choice, be applied to all, individual patients are treated as population-level groups—as a theoretical patient who represents a population, not the specific patient crafting his or her individualized future care plans. Instead, advance care planning can be improved through a multimodal approach that both mitigates cognitive biases and allows for customization of the decision-making process by allowing for the incorporation of a variety of methods of advance care planning.     

Comparisons of Some Chi-Squared Goodness-of-Fit Test Statistics in Sparse One-Way Multinomials

The behavior of Pearson's X² test, the likelihood ratio test Y² and the two of its derivatives, G² and G_k², the Freeman-Tukey test (FT) and the Cressie and Read test Statistic I(2/3) are examined in this study. Estimated attained α levels based on 1000 simulated samples when the approximating distribution is χ_k-1², are computed for these tests for the various values of k, n and seven null hypotheses. Results from estimated power computations indicate that none of the test statistics has a clear advantage over any others, and that the choice of which test to use must therefore rest mainly on the performances with regards to the attained α levels when the χ² approximation is invoked. In this respect, the log-normal approximation proposed by Lawal and Upton (1980) is strongly recommended. This is closely followed by the I(2/3).     

Biosensors based on peptide exposure show single molecule conformations in live cells

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Diet of wild chimpanzees (Pan troglodytes verus) at Mt. Assirik,Senegal: I. Composition

The composition of the diet of a savanna-living population of wild chimpanzees (Pan troglodytes verus) at Mt. Assirik in Senegal is presented. The study site had a prolonged dry season, high temperatures, and vegetation dominated by grasses. Data came from direct observation, fecal specimens, and feeding traces; thus, strict criteria for acceptance of the indirect data were specified. Composition of diet was given in terms of species and family of prey, parts eaten, life-form, type of habitat, and criteria for inclusion. Forty-three species of plants with 60 parts were eaten; mostly fruits, from trees, in woodland. Nine species of animal prey were eaten, mostly social insects. An additional 41 species of plants with 53 parts were classed as likely to be eaten by chimpanzees, mostly on the grounds of their being eaten by sympatric anthropoids. Overall, the diet of the apes at Mt. Assirik resembles that of this species elsewhere in Africa, but the size of the dietary repertoire seems small and the proportion of low-quality foodstuffs high. The latter are mostly time-consuming to collect or tedious to obtain or process, and include underground storage organs.     

Electric pulses to prepare feeder cells for sustaining and culturing of undifferentiated embryonic stem cells

Current challenges in embryonic-stem cell (ESC) research include the inability of sustaining and culturing of undifferentiated ESCs over time. Growth-arrested feeder cells are essential to the culture and sustaining of undifferentiated ESCs, and they are currently prepared using gamma-radiation and chemical inactivation. Both techniques have severe limitations. In this study, we developed a new, simple and effective technique (pulsed electric fields, PEFs) to produce viable growth-arrested cells (RTS34st) and used them as high-quality feeder cells to culture and sustain undifferentiated zebrafish ESCs over time. The cells were exposed to 25 sequential 10-ns electric pulses (10nsEPs) of 25, 40 and 150 kV/cm with 1-s pulse interval, or 2 sequential 50-μs electric pulses (50μsEPs) of 2.83, 1.78 and 0.78 kV/cm with 5-s pulse interval, respectively. We found that the cellular effects of PEFs depended directly upon the duration, number and electric field strength of the pulses, showing the feasibility of tuning them to produce various types of growth-arrested cells for culturing undifferentiated ESCs. Both 10nsEPs of 40 kV/cm produced by a 10nsEP generator and 50μsEPs of 1.78 kV/cm provided by inexpensive and widely available conventional electroporators, generated high-quality growth-arrested feeder cells for proliferation of undifferentiated ESCs over time. PEFs can therefore be used to replace radiation and chemical inactivation methods for preparation of growth-arrested feeder cells for advancing ESC research.     

Coccolithus pelagicus, a productivity proxy related to moderate fronts off Western Iberia

The traditional interpretation of Coccolithus pelagicus as a cold water proxy is examined based on its distribution patterns in the water column off the Portuguese coast (using data from eleven cruises) and in Holocene surface sediment samples and Quaternary cores from the same region.Coccolithus pelagicus is common in the Portuguese upwelling system, an area where surface waters are predominantly of subtropical origin. Although revealing an affinity for low temperature upwelled waters, the species was found in waters up to 18°C associated with riverine plume and shelf-break fronts. C. pelagicus seemed to consistently occupy a particular ecological niche, between other phytoplankton groups, related to moderate turbulence conditions combined with nutrient availability. From this behaviour, it is proposed that C. pelagicus can be used as a tracer of the periphery of areas of enhanced productivity.Coccolithus pelagicus preferences for fronts of moderate temperature and salinity gradients are tentatively used to explain particular features of its sedimentary record. The repeated increase of C. pelagicus in thanatocoenoses (surface sediment assemblages) close to three river mouths, on the Portuguese shelf, are interpreted as a positive response to the development of riverine plumes. On the other hand, inconsistencies in the correlation between sea surface cooler-glacial and warmer-interglacial isotope stages and the relative abundance pattern of C. pelagicus during the Late Quaternary, as registered in two Galicia Bank piston cores (42°N), are tentatively explained in terms of shifts in the extent of the outer limit of the local palaeoproductivity belt off the Iberian Peninsula.     

A Comparison of Bone Mineral Density and Its Predictors in HIV-Infected and HIV-Uninfected Older Men

ObjectiveBone health in older individuals with HIV infection has not been well studied. This study aimed to compare bone mineral density (BMD), trabecular bone score (TBS), and bone markers between HIV-infected men and age- and body mass index (BMI)-matched HIV-uninfected men aged ≥60 years. We investigated the associations of risk factors related to fracture with BMD, TBS, and bone markers in HIV-infected men.MethodsThis cross-sectional study included 45 HIV-infected men receiving antiretroviral therapy and 42 HIV-uninfected men. Medical history, BMD and TBS measurements, and laboratory tests related to bone health were assessed in all the participants. HIV-related factors known to be associated with bone loss were assessed in the HIV-infected men.ResultsThe mean BMD, TBS, and osteopenia or osteoporosis prevalence were similar among the cases and controls. The HIV-infected men had significantly higher mean N-terminal propeptide of type 1 procollagen and C-terminal cross-linking telopeptide of type I collagen levels. Stepwise multiple linear regression analysis demonstrated that low BMI (lumbar spine, P = .015; femoral neck, P = .018; and total hip, P = .005), high C-terminal cross-linking telopeptide of type I collagen concentration (total hip, P = .042; and TBS, P = .010), and low vitamin D supplementation (TBS, P = .035) were independently associated with low BMD and TBS.ConclusionIn older HIV-infected men with a low fracture risk, the mean BMD and TBS were similar to those of the age- and BMI-matched controls. The mean bone marker levels were higher in the HIV group. Traditional risk factors for fracture, including low BMI, high C-terminal cross-linking telopeptide of type I collagen level, and low vitamin D supplementation, were significant predictors of low BMD and TBS.     

Influence of long term treatment with 3-methylcholanthrene or carbaryl on mixed-function oxidase activity in 3T3 fibroblasts: Studies by microspectrofluorimetry on single cells

Using benzo(a)pyrene (BaP) as a probe for aryl hydrocarbon hydroxylase (AHH) activity, differences in mixed-function oxidase (MFO) activity were observed using microspectrofluorimetry in single living cells during long term treatment with 3-methylcholanthrene (3-MC) or carbaryl. Although these two compounds differ in chemical structure, similar effects were observed in 3T3 cell populations. The results suggest that the two compounds activate the same enzymatic system and that individual cells of a supposed homogeneous cell population are not equally sensitive to xenobiotics, i.e. subpopulations were observed which have differences in AHH activity.     

Glutathione Restricts Serine Metabolism to Preserve Regulatory T Cell Function

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