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The quiet ego refers to a self-construal that is balanced and growth-oriented in its stance toward the self and others. It is conceptualized as representing the intersection of four characteristics: inclusive identity, perspective taking, detached awareness, and growth-mindedness. As a relatively new construct, the quiet ego has been validated in domains relating to balance, compassion, and growth. However, its construct validity has rarely been examined with regard to other aspects of self-identity that are both conceptually similar and have implications for well-being. Building on existing work on the quiet ego and self-concept clarity, we first examined the quiet ego’s theoretical relation with self-concept clarity (Study 1, N = 1099) using a confirmatory factor analysis approach and then investigated its associations with psychological well-being and self-esteem from the perspective of self-concept clarity using path modeling (Study 2, pre-registered, N = 500). We found that the quiet ego was positively associated with self-concept clarity and that the quiet ego predicted psychological well-being and self-esteem indirectly via its association with self-concept clarity.

The quiet ego refers to a self-identity that is balanced and growth-oriented in its stance toward the self and others. As a relatively new construct, its validity has been examined in domains related to balance, compassion, and self-control, it has not been examined in other domains that appear to have conceptual overlap such as emotional intelligence (EI), a construct entailing both ability EI (construed as cognitive ability) and trait EI (construed as self-perception). This pre-registered study (N = 300) first examined the quiet ego’s construct validity in the domain of EI using a confirmatory factor analysis approach, and then investigated its associations with subjective well-being and psychological stress from the angle of EI using path models. Results showed that the quiet ego was positively associated with both ability and trait EI, thereby establishing its validity in this domain. Mediation analyses revealed trait EI mediated the relationship between the quiet ego and increased subjective well-being and decreased stress. Serial mediation analyses further revealed that the link between the quiet ego and trait EI was mediated by mindfulness such that the quiet ego transmitted its effects to subjective well-being and stress first via mindfulness and then trait EI. In contrast, there was no evidence that ability EI mediated the relationship between the quiet ego and subjective well-being or stress.

Background The external validity of the randomized controlled trial (RCT) refers to the extent to which the results of the RCT apply to the relevant, non-trial population and is impacted by its eligibility criteria, its organization, and its delivery of the intervention. Here, we compared the outcomes of mortality and hospitalization between an RCT and a cohort study that concurrently enrolled HIV-exposed uninfected (HEU) newborns in Botswana. Methods The Mpepu Study (the RCT) was a clinical trial which determined that co-trimoxazole (CTX) provided no survival benefit for HEUs, allowing both arms of the RCT to be used. The Maikaelelo study (the cohort study) was a prospective observational study that enrolled HEU newborns with telephone follow-up and no in-person visits. Rates of death and hospitalization in the pooled population, were modeled using cox-proportional hazards models for time to death or time to first hospitalization, with study setting (RCT vs. cohort study) as an independent variable. The causal effect of study setting on morbidity and mortality was obtained through a treatment effects approach. Results In total, 4,010 infants were included; 1,306 were enrolled into the cohort study and 2,704 were enrolled into the RCT. No significant differences in mortality were observed between the two study settings (HR: 1.28, 95% CI: 0.76, 2.13), but RCT participants had a lower risk of hospitalization (HR: 0.72, 95% CI: 0.58, 0.89) that decreased with age. However, RCT participants had a higher risk of hospitalization within the first six months of life. The causal risk difference in hospitalizations attributable to the RCT setting was -0.03 (95% CI: -0.05, -0.01). Conclusions Children in an RCT with rigorous application of national standard of care guidelines experienced a significantly lower risk of hospitalization than children participating in a cohort study that did not alter clinical care. Future research is needed to further investigate outcome disparities when real-world results fail to mirror those achieved in a clinical trial. Trial registration The Mpepu Trial was funded by the U.S. National Institutes of Health (No. NCT01229761) and the Maikaelelo Study was funded primarily by the U.S. Centers for Disease Control and Prevention (32AI007433-21).

Casein is a group of milk proteins with high nutritional value, and the exploitation of its techno-functional potentials has been investigated for decades. In this study, acid casein powder was dissolved in 0.1 mol/L phosphate buffers with different pH, resulting in casein solutions with pH 5.9, 6.6 and 7.3. During preparation and storage (40 °C) of the samples, casein hydrolysis was observed in size exclusion chromatography and gel electrophoresis. The degree of hydrolysis increased with increasing pH, and treatment of casein with commercial plasmin resulted in similar polypeptides, suggesting that the hydrolysis was caused by residual indigenous plasmin present in the acid casein powder. Most polypeptides could be cross-linked by microbial transglutaminase, except for one particular fraction which appeared at constant intensity in the chromatograms. The stiffness of acid-induced gels as determined in small amplitude oscillatory shear rheology decreased with increasing degree of hydrolysis, and was also lower for cross-linked samples when the preceding casein hydrolysis was more pronounced. Enzymatic cross-linking increased the resistance of casein against plasmin-related hydrolysis, presumably because of the resulting lysine modification. However, one particular fraction of polypeptides was released by hydrolysis in spite of cross-linking, suggesting that they did not contain lysine residues that are susceptible for mTGase. The results indicate that plasmin-related hydrolysis should be taken into account for the application of acid casein or sodium caseinate as additive in food design.

Highly automated smart production environments require robots with autonomous planning mechanisms as well as effect-based performance inference methods. This report discusses the possibilities of cognitive reasoning for compliant manipulation tasks to satisfy these demands. The article builds on the representations for compliant wiping actions and their effects which are fundamental to many tasks in industrial manufacturing. It is described how these actions can be planned, executed, and interpreted by means of generic action descriptions and qualitative models.

Despite the success of checkpoint blockade in some cancer patients, there is an unmet need to improve outcomes. Targeting alternative pathways, such as costimulatory molecules (e.g. OX40, GITR, and 4-1BB), can enhance T cell immunity in tumor-bearing hosts. Here we describe the results from a phase Ib clinical trial (NCT02274155) in which 17 patients with locally advanced head and neck squamous cell carcinoma (HNSCC) received a murine anti-human OX40 agonist antibody (MEDI6469) prior to definitive surgical resection. The primary endpoint was to determine safety and feasibility of the anti-OX40 neoadjuvant treatment. The secondary objective was to assess the effect of anti-OX40 on lymphocyte subsets in the tumor and blood. Neoadjuvant anti-OX40 was well tolerated and did not delay surgery, thus meeting the primary endpoint. Peripheral blood phenotyping data show increases in CD4+ and CD8+ T cell proliferation two weeks after anti-OX40 administration. Comparison of tumor biopsies before and after treatment reveals an increase of activated, conventional CD4+ tumor-infiltrating lymphocytes (TIL) in most patients and higher clonality by TCRβ sequencing. Analyses of CD8+ TIL show increases in tumor-antigen reactive, proliferating CD103+ CD39+ cells in 25% of patients with evaluable tumor tissue (N = 4/16), all of whom remain disease-free. These data provide evidence that anti-OX40 prior to surgery is safe and can increase activation and proliferation of CD4+ and CD8+ T cells in blood and tumor. Our work suggests that increases in the tumor-reactive CD103+ CD39+ CD8+ TIL could serve as a potential biomarker of anti-OX40 clinical activity., Different neoadjuvant therapies have been proposed to improve immunotherapy for cancer treatment. Here, the authors perform a phase Ib clinical trial where an agonist OX40 antibody provided prior to surgery is well tolerated and increases proliferation and activation of tumor antigen-specific T cells in head and neck cancer patients.

Most cost-effectiveness analyses of hepatitis C (HCV) therapy focus on the benefits of reducing liver-related morbidity and mortality. Our objective was to assess how cost-effectiveness estimates of HCV therapy can vary depending on assumptions regarding the potential impact of HCV therapy on non-hepatic mortality. We adapted a state-transition model to include potential effects of HCV therapy on non-hepatic mortality. We assumed successful treatment could reduce non-hepatic mortality by as little as 0 % to as much as 100 %. Incremental cost-effectiveness ratios were computed comparing immediate treatment versus delayed treatment and comparing immediate treatment versus non-treatment. Comparing immediate treatment versus delayed treatment, when we included a 44 % reduction in non-hepatic mortality following successful HCV treatment, the incremental cost per quality-adjusted life year (QALY) gained by HCV treatment fell by 76 % (from US$314,100 to US$76,900) for patients with no fibrosis and by 43 % (from US$62,500 to US$35,800) for patients with moderate fibrosis. Comparing immediate treatment versus non-treatment, assuming a 44 % reduction in non-hepatic mortality following successful HCV treatment, the incremental cost per QALY gained by HCV treatment fell by 64 % (from US$186,700 to US$67,300) for patients with no fibrosis and by 27 % (from US$35,000 to US$25,500) for patients with moderate fibrosis. Including reductions in non-hepatic mortality from HCV treatment can have substantial effects on the estimated cost-effectiveness of treatment.

To determine perfusion computed tomography (P-CT) findings for distinction of arterial pseudolesions (APL) from hepatocellular carcinoma (HCC) in the cirrhotic liver. 32 APL and 21 HCC in 20 cirrhotic patients (15 men; 65 ± 10 years), who underwent P-CT for evaluation of HCC pre- (N = 9) or post- (N = 11) transarterial chemoembolization, were retrospectively included using CT follow-up as the standard of reference. All 53 lesions were qualitatively (visual) and quantitatively (perfusion parameters) analysed according to their shape (wedge, irregular, nodular), location (not-/adjunct to a fistula), arterial liver perfusion (ALP), portal venous liver perfusion (PLP), hepatic perfusion index (HPI). Accuracy for diagnosis of HCC was determined using receiver operating characteristics. 18/32 (56 %) APL were wedge shaped, 10/32 (31 %) irregular and 4/32 (12 %) nodular, while 11/21 (52 %) HCC were nodular or 10/21 (48 %) irregular, but never wedge shaped. Significant difference between APL and HCC was seen for lesion shape in pretreated lesions (P

The total chromatic sum of a graph is the minimum sum of colors (natural numbers) taken over all proper colorings of vertices and edges of a graph. We construct infinite families of graphs for which the minimum number of colors to achieve the total chromatic sum is larger than the total chromatic number.

To compare a low-tube-voltage with or without high-iodine-load multidetector CT (MDCT) protocol with a normal-tube-voltage, normal-iodine-load (standard) protocol in patients with pancreatic ductal adenocarcinoma (PDAC) with respect to tumour conspicuity and image quality. Thirty consecutive patients (mean age: 66 years, men/women: 14/16) preoperatively underwent triple-phase 64-channel MDCT examinations twice according to: (i) 120-kV standard protocol (PS; 0.75 g iodine (I)/kg body weight, n = 30) and (ii) 80-kV protocol A (PA; 0.75 g I/kg, n = 14) or protocol B (PB; 1 g I/kg, n = 16). Two independent readers evaluated tumour delineation and image quality blindly for all protocols. A third reader estimated the pancreas-to-tumour contrast-to-noise ratio (CNR). Statistical analysis was performed with the Chi-square test. Tumour delineation was significantly better in PB and PA compared with PS (P = 0.02). The evaluation of image quality was similar for the three protocols (all, P > 0.05). The highest CNR was observed with PB and was significantly better compared to PA (P = 0.02) and PS (P = 0.0002). In patients with PDAC, a low-tube-voltage, high-iodine-load protocol improves tumour delineation and CNR leading to higher tumour conspicuity compared to standard protocol MDCT. • Low-tube-voltage high-iodine-load MDCT improves pancreatic cancer conspicuity compared to a standard protocol. • The pancreas-to-tumour attenuation difference increases significantly by reducing the tube voltage. • The radiation exposure dose decreases by reducing the tube voltage.

Compliant manipulation is one of the grand challenges for autonomous robots. Many household chores in human environments, such as cleaning the floor or wiping windows, rely on this principle. At the same time these tasks often require whole-body motions to cover a larger workspace. The performance of the actual task itself is thereby dependent on a large number of parameters that have to be taken into account. To tackle this issue we propose to utilize low-level compliant whole-body control strategies parameterized by high-level hybrid reasoning mechanisms. We categorize compliant wiping actions in order to determine relevant control parameters. According to these parameters we set up process models for each identified wiping action and implement generalized control strategies based on human task knowledge. We evaluate our approach experimentally on three whole-body manipulation tasks, namely scrubbing a mug with a sponge, skimming a window with a window wiper and bi-manually collecting the shards of a broken mug with a broom.

This review is focused on methods for detecting small molecules and, in particular, the characterisation of their interaction with natural proteins (e.g. receptors, ion channels). Because there are intrinsic advantages to using label-free methods over labelled methods (e.g. fluorescence, radioactivity), this review only covers label-free techniques. We briefly discuss available techniques and their advantages and disadvantages, especially as related to investigating the interaction between small molecules and proteins. The reviewed techniques include well-known and widely used standard analytical methods (e.g. HPLC-MS, NMR, calorimetry, and X-ray diffraction), newer and more specialised analytical methods (e.g. biosensors), biological systems (e.g. cell lines and animal models), and in-silico approaches.

To assess feasibility and image quality (IQ) of a new post-processing algorithm for retrospective extraction of an optimised multi-phase CT (time-resolved CT) of the liver from volumetric perfusion imaging.Sixteen patients underwent clinically indicated perfusion CT using 4D spiral mode of dual-source 128-slice CT. Three image sets were reconstructed: motion-corrected and noise-reduced (MCNR) images derived from 4D raw data; maximum and average intensity projections (time MIP/AVG) of the arterial/portal/portal-venous phases and all phases (total MIP/ AVG) derived from retrospective fusion of dedicated MCNR split series. Two readers assessed the IQ, detection rate and evaluation time; one reader assessed image noise and lesion-to-liver contrast.Time-resolved CT was feasible in all patients. Each post-processing step yielded a significant reduction of image noise and evaluation time, maintaining lesion-to-liver contrast. Time MIPs/AVGs showed the highest overall IQ without relevant motion artefacts and best depiction of arterial and portal/portal-venous phases respectively. Time MIPs demonstrated a significantly higher detection rate for arterialised liver lesions than total MIPs/AVGs and the raw data series.Time-resolved CT allows data from volumetric perfusion imaging to be condensed into an optimised multi-phase liver CT, yielding a superior IQ and higher detection rate for arterialised liver lesions than the raw data series.• Four-dimensional computed tomography is limited by motion artefacts and poor image quality. • Time-resolved-CT facilitates 4D-CT data visualisation, segmentation and analysis by condensing raw data. • Time-resolved CT demonstrates better image quality than raw data images. • Time-resolved CT improves detection of arterialised liver lesions in cirrhotic patients.

The article shrinks the Δ = 6 hole that exists in the family of planar graphs which satisfy the total coloring conjecture. Let G be a planar graph. If \({v_n^k}\) represents the number of vertices of degree n which lie on k distinct 3-cycles, for \({n, k \in \mathbb{N}}\) , then the conjecture is true for planar graphs which satisfy \({v_5^4 +2(v_5^{5^+} +v_6^4) +3v_6^5 +4v_6^{6^+} < 24}\).

We provide a retrospective of 25'years of the International Conference on AI and Law, which was first held in 1987. Fifty papers have been selected from the thirteen conferences and each of them is described in a short subsection individually written by one of the 24 authors. These subsections attempt to place the paper discussed in the context of the development of AI and Law, while often offering some personal reactions and reflections. As a whole, the subsections build into a history of the last quarter century of the field, and provide some insights into where it has come from, where it is now, and where it might go.

Exclusive breastfeeding has been associated with a reduced risk of late vertical HIV transmission as compared to an infant diet composed of breast milk mixed with supplemental foods or liquids. Hypothesized mechanisms include increased infectivity of breast milk from mothers who practice mixed breastfeeding (MBF), or mechanisms such as increased gastrointestinal permeability in the infant caused by mixed feeding. It has been proposed that MBF may result in subclinical mastitis and higher breast milk HIV titers. However, little is known about the relationship between feeding strategy and breast milk viral load. We measured the HIV-1 concentration in breast milk in a sub-cohort of women enrolled in a mother-to-child HIV transmission prevention trial (the "Mashi" study). We report no observed relationship between MBF and measured breast milk viral RNA load. Our findings suggest that the increased transmission risk associated with higher breast milk HIV-1 RNA during MBF is unlikely.

A grating coupler system has been developed to measure refractive index gradients with high spatial (6.7 μm) and temporal (milliseconds) resolution. The system was applied to two-phase model systems consisting of water and non-aqueous pollution liquids. Refractive index gradients at the interfaces between the aqueous and organic phase of 1-butanol, hexane, and 1-heptanol were monitored under steady-state conditions. The temporal resolution was utilized in diffusion experiments with glycerol and sodium chloride in water, where the formation of a concentration gradient was studied. In a further application, the grating coupler system was modified to monitor low-level concentrations of aqueous pollution profiles as are caused by bacterial degradation in the aqueous phase. Toluene was selected as contaminant. The sensor sensitivity was improved by coating the sensor with the pre-concentrating polymers polydimethylsiloxane and Teflon(®) AF-2400. With the grating coupler setup, a multi-purpose instrument was created to measure high-resolution refractive index gradients with high temporal and spatial resolution in different fields of application. The new sensor system can be used to measure absolute refractive indices by covering parts of the sensing area with cover media of known refractive index. Coatings can be used for sensitivity improvement by pre-concentrating the sample, for selectivity by utilizing filtering properties of the coating, and as calibration standard for absolute refractive index measurements.

Habitat loss and fragmentation are the major causes of biodiversity loss, and, increasingly, habitat is fragmented by urbanization. Yet, the degree to which urbanization creates barriers to animal dispersal remains poorly understood. We used population genetic techniques to determine whether urbanization and/or natural landscape features are dispersal barriers to a butterfly, Atrytonopsis new species 1, throughout its range on coastal sand dunes that are increasingly threatened by development. Using AFLP markers that produced 89 polymorphic loci, we found significant population structure across the range of Atrytonopsis sp1. We found no indication that existing levels of urbanization were barriers to Atrytonopsis sp1 dispersal. Rather, two natural barriers, an ocean inlet and maritime forest, explained the genetic structure. Even in areas with long histories of urbanization, we found no significant isolation-by-distance relationship, and there was very low genetic differentiation between sampling locations. Consequently, conservation strategies for Atrytonopsis sp1, and potentially for other mobile insects that use open-structured habitats, should not focus explicitly on habitat corridors through urban areas, but rather should seek to preserve and restore as much habitat as possible across the butterfly’s range.

The authors present the potential of using a preset CT protocol covering the whole body of the patient who has suffered blunt trauma to screen for injuries, based on a review of the literature and on 4 years' direct experience. Standardized whole-body CT is the fastest method of examining the whole body, capable of detecting a wide variety of traumatic lesions with a high sensitivity and specificity. Multidetector CT allows a full-body examination to be completed within 5 min, thus minimizing time to diagnosis and the institution of definitive clinical care. Current imaging algorithms that include abdominal ultrasonography and plain radiographic studies need to be reassessed in view of the technical advances in CT diagnosis, but should ultimately depend on the particular imaging capabilities and experience of a given trauma center.

In der vorliegenden Arbeit wird das Modell der periodenbezogenen Deckungsbeitragsrechnung aus [5] um den Einflusfaktor Storno erweitert. Die bisherige Gliederung des Deckungsbeitrags der Stufe 1 in die Bereiche Hauptversicherung und Gewinnbeteiligung mit weiterer Untergliederung in die Bereiche Kapital, Risiko, Abschluskosten und Verwaltungskosten mus dabei um den neuen Bereich „Storno“ erganzt werden. Durch diese Erweiterung wird nach der Analyse der Einflusgrosen Zins und Sterbewahrscheinlichkeiten eine genaue Analyse des Stornoeinflusses auf die Deckungsbeitrage der verschiedenen Bereiche ermoglicht.

Background Pancreatic ductal adenocarcinoma is associated with dismal prognosis. The detection of small pancreatic tumors which are still resectable is still a challenging problem. The aim of this study was to investigate the effect of decreasing the tube voltage from 120 to 80 kV on the detection of pancreatic tumors. Methods Three scanning protocols was used; one using the standard tube voltage (120 kV) and current (160 mA) and two using 80 kV but with different tube currents (500 and 675 mA) to achieve equivalent dose (15 mGy) and noise (15 HU) as that of the standard protocol. Tumors were simulated into collected CT phantom images. The attenuation in normal parenchyma at 120 kV was set at 130 HU, as measured previously in clinical examinations, and the tumor attenuation was assumed to differ 20 HU and was set at 110HU. By scanning and measuring of iodine solution with different concentrations the corresponding tumor and parenchyma attenuation at 80 kV was found to be 185 and 219 HU, respectively. To objectively evaluate the differences between the three protocols, a multi-reader multi-case receiver operating characteristic study was conducted, using three readers and 100 cases, each containing 0–3 lesions. Results The highest reader averaged figure-of-merit (FOM) was achieved for 80 kV and 675 mA (FOM = 0,850), and the lowest for 120 kV (FOM = 0,709). There was a significant difference between the three protocols (p t-test) shows that there was a significant difference between 120 and 80 kV, but not between the two levels of tube currents at 80 kV. Conclusion We conclude that when decreasing the tube voltage there is a significant improvement in tumor conspicuity.