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The Chinese American population is one of the fastest-growing communities in the United States, composed of ∼5.4 million people, and represents ∼5.5% of overseas Chinese populations. With an expected exponential population rise, Chinese American patients who experience serious illness or approach end-of-life (EOL) may find their cultural values influencing the medical care they receive. Palliative care clinicians must recognize diverse cultural beliefs and preferences of Chinese American patients and their families. In this study, we provide 10 cultural pearls to guide the provision of palliative and EOL care for Chinese American patients, including discussions of Chinese traditions, communication strategies for Chinese patients and families, advance care planning, and EOL care beliefs.

In collaboration with the American College of Veterinary Radiology

Context: A paucity of literature describes the growing Chinese American community’s end-of-life (EOL) priorities and preferences. Objective: Develop a culturally-tailored advance care planning (ACP) tool to understand the EOL preferences of this underserved minority group. Methods: Informed by the Cultural Appropriateness Theory, the Chinese American Coalition for Compassionate Care (CACCC) developed Heart to Heart (HTH) Cards using a 3-step approach. First, CACCC created and refined a list of bilingual, culturally relevant EOL issues. Next, CACCC organized the EOL issues into a card deck. Finally, CACCC developed a unique playstyle of the cards—the HTH Café. From 2014-2019, CACCC recruited Chinese American volunteers and participants for HTH Cafés. Following each Café, participants completed an anonymous survey describing their sociodemographics, top 3 cards, and café evaluation. Results: The 54 HTH Cards were organized into 4 suits (spiritual, physical, financial/legal, and social). Each card displayed a culturally-tailored EOL issue in English and Chinese. Playstyles included one-on-one and group formats (ie. HTH Café). CACCC volunteers conducted 316 HTH Cafés for 2,267 Chinese American adults. Most participants were female (61.6%), between 18-50 years old (56.7%), lived in California (80.2%) and born in Asia (74.3%). The top priority (25.5%) was “If I’m going to die anyway, I don’t want to be kept alive by machines.” Participants thought the session was pleasant (99.5%) and expressed intent to complete advance directives (86.5%). Conclusion: HTH Cards represents the first, theory-driven, culturally-tailored ACP tool for Chinese Americans. More research is needed to establish its impact on ACP conversations and outcomes.

In 2020, the COVID-19 pandemic caused mass devastation, drastically impacting the United States economy. As a result, despite severe political polarization the year before, the Biden administration attempted to make progress to ease the country into economic recovery by stimulating the economy which suffered an economic plunge at the fastest rate in its history. In March of 2021, the American Rescue Plan (ARP), a $1.9 trillion stimulus package, was passed by Congress and signed into law. Although major components of the ARP included extended unemployment benefits, emergency paid leave, expanded welfare, support for small businesses, additional funding, and various tax provisions, a crucial element of the plan was individual direct payments in the form of stimulus checks, making the ARP particularly unique. It is important to examine the effects of stimulus payments as well as improvements in healthcare, housing, and other areas. Using in-person fieldwork, online surveys, and the Pew Research Center’s Random Digit Dialing (RDD) method, this paper will be summarizing primary data from Americans nationwide to identify patterns that may exist between various socioeconomic groups, geographical regions, and similar demographics. Conducting evidence-based research, the paper will analyze correlational relationships between consumer spending, inflation, and unemployment due to fiscal policy.

Autophagy has a multifaceted role in cancer, and a growing body of evidence demonstrates a central role for autophagy in modulating adjuvanticity, which is essential for natural and therapy-induced immunosurveillance. Adjuvanticity in this context is conferred by the release of specific damage associated molecular patterns (DAMPs) from dying cancer cells acting as adjuvants communicating the state of danger to the tumor microenvironment and host. High pre-mortem autophagy has been linked to the increased release of DAMPs, which act as immunoadjuvant signals in the tumor microenvironment and exert their effect by bridging innate and adaptive arms of the immune system. Together with the immunogenicity of cancers, it is evident that proper adjuvanticity is required for a robust initiation of the cancer immunity cycle, and several clinical trial protocols are currently exploring the potential clinical benefit of increasing adjuvanticity in the context of immune checkpoint inhibitor (ICI) treatment regimens. While this is an appealing strategy, the research field is still in its infancy, and due to several experimental limitations, which will be discussed in detail here, the exact role of autophagy in these processes is still obscure. Here, we aim to review the current understanding regarding the role of autophagy in shaping tumor immunogenicity, the interdependent regulatory relationship between autophagy and DAMPs, and how this might be explored as a therapeutic strategy to “heat up” so-called immune “cold” tumors. Much is yet to be learned regarding how targeting autophagy might shift the polarization of immune cell phenotypes in a manner that might either support or repress anti-tumor immunity. Improved methodology, increased knowledge, and more specific inhibitors of autophagy will ultimately allow for the rational design of clinical trials where autophagy is being rigorously tested as a target for therapeutic benefit in cancer therapy.

Growing axons rely on local signaling at the growth cone for guidance cues. Semaphorin3A (Sema3A), a secreted repulsive axon guidance molecule, regulates synapse maturation and dendritic branching. We previously showed that local Sema3A signaling in the growth cones elicits retrograde retrograde signaling via PlexinA4 (PlexA4), one component of the Sema3A receptor, thereby regulating dendritic localization of AMPA receptor GluA2 and proper dendritic development. In present study, we found that nimodipine (voltage-gated L-type Ca(2+) channel blocker) and tetrodotoxin (TTX; voltage-gated Na(+) channel blocker) suppress Sema3A-induced dendritic localization of GluA2 and dendritic branch formation in cultured hippocampal neurons. The local application of nimodipine or TTX to distal axons suppresses retrograde transport of Venus-Sema3A that has been exogenously applied to the distal axons. Sema3A facilitates axonal transport of PlexA4, which is also suppressed in neurons treated with either TTX or nimodipine. These data suggest that voltage-gated calcium and sodium channels mediate Sema3A retrograde signaling that regulates dendritic GluA2 localization and branch formation.

In this paper, the warpages of a chip-first and die face-up fan-out wafer-level packaging (FOWLP) with a very large silicon chip (10 mm $\times \,\, 10$ mm $\times \,\, 0.15$ mm) and three redistributed layers are measured and characterized. Emphasis is placed on the measurement and 3-D finite-element simulation of the warpages during the FOWLP fabrication processes, especially for: 1) right after postmold cure; 2) right after backgrinding of the epoxy molding compound to expose the Cu-contact pads; and 3) the individual package (right after the solder ball mounting and dicing) versus surface mount technology reflow temperatures. The simulation results are compared to the measurement results. Some recommendations on controlling the warpages are provided.

Induced pluripotent stem (iPS) cells are promising tools to investigate disease mechanism and develop new drugs. Intraneuronal transport, which is fundamental for neuronal survival and function, is vulnerable to various pharmacological and chemical agents and is disrupted in some neurodegenerative disorders. We applied a quantification method for axonal transport by counting CM-DiI–labeled particles traveling along the neurite, which allowed us to monitor and quantitate, for the first time, intraneuronal transport in human neurons differentiated from iPS cells (iCell neurons). We evaluated the acute effects of several anti-neoplastic agents that have been previously shown to affect intraneuronal transport. Vincristine, paclitaxel and oxaliplatin decreased the number of moving particle along neurites. Cisplatin, however, produced no effect on intraneuronal transport, which is in contrast to our previous report indicating that it inhibits transport in chick dorsal root ganglion neurons. Our system may be a useful method for assessing intraneuronal transport and neurotoxicity in human iPS neurons.

This paper proposes a single-inductor bipolar-output (SIBO) switching converter with high efficiency over a wide load range for active matrix organic light-emitting diode (AMOLED) display. The SIBO converter provides a pair of positive and negative output voltages with only one external inductor. The proposed burst mode function can enhance the light load efficiency with low output ripples, 25mV and 10mV for positive and negative voltages, respectively. With the smooth start-up function, the inductor current can rise smoothly and have low peak value, reducing the current stress on inductor and power MOSFETs. The efficiency can be maintained higher than 80% with the load current from 20mA to 140mA. At light loads, the efficiency is higher than 60% when the load current is above 5mA. The maximum efficiency is 88% when the input voltage is 3.7V and the load current is 60mA.

l-3,4-Dihydroxyphenylalanine (DOPA) is the metabolic precursor of dopamine, and the single most effective agent in the treatment of Parkinson’s disease. One problem with DOPA therapy for Parkinson’s disease is its cardiovascular side effects including hypotension and syncope, the underlying mechanisms of which are largely unknown. We proposed that DOPA is a neurotransmitter in the central nervous system, but specific receptors for DOPA had not been identified. Recently, the gene product of ocular albinism 1 (OA1) was shown to possess DOPA-binding activity. It was unknown, however, whether or not OA1 is responsible for the actions of DOPA itself. Immunohistochemical examination revealed that OA1 was expressed in the nucleus tractus solitarii (NTS). OA1-positive cells adjacent to tyrosine hydroxylase–positive cell bodies and nerve fibers were detected in the depressor sites of the NTS. OA1 knockdown using oa1specific shRNA-adenovirus vectors in the NTS reduced the expression levels of OA1 in the NTS. The prior injection of the shRNA against OA1 suppressed the depressor and bradycardic responses to DOPA but not to glutamate in the NTS of anesthetized rats. Thus OA-1 is a functional receptor of DOPA in the NTS, which warrants reexamination of the mechanisms for the therapeutic and untoward actions of DOPA. Keywords:: DOPA, neurotransmitter, nucleus tractus solitarii, GPCR, baroreceptor reflex

LCD panel with the LED backlight can be controlled by the proposed linear regulation control (LRC) technique for high efficiency and low cost. The LRC technique removes most of the external passive components, which include inductor, E-cap, freewheel diode, and blocking diode. Due to single-stage operation without two-stage power consumption, small volume and high efficiency can be simultaneously ensured. Furthermore, the PLL function can guarantee the line voltage and current to be in phase so as to realize the high power factor (PF) for green power. High efficiency of 85% at 110Vrms and 87% at 220Vrms, high PF of 0.98 at 110Vrms and 0.96 at 220Vrms, and low THD of 18% at 110Vrms and 19% at 220Vrms are achieved.

Cholesteric liquid-crystal display (Ch-LCD) has the bi-stable characteristic to achieve the energy-saving for the green technology. Backlight is even unnecessary in the Ch-LCD system. The single-inductor bipolar-output (SIBO) converter is one of best candidate to supply the power management function for the Ch-LCD with dual positive and negative output voltages by using a single inductor for a compact solution. The energy control methodology with the current-mode control and the power conservation mechanism (PCM) can strengthen the voltage quality to get high display quality. The test chip fabricated by 0.25 μm CMOS technology demonstrates the non-noticeable cross-regulation at dual outputs with 90 % peak power conversion efficiency.

This paper presents a high integrated dual-side dual-output (DSDO) switched-capacitor (SC) regulator with only two flying capacitors. Generally, a dual-phase voltage doubler and an inverter are used to supply positive and negative voltage for TFT-LCD gate drivers, respectively. Four flying capacitors, eight pin-outs, and sixteen power switches are necessary for their operations in the driver integrated chip (IC). The proposed DSDO SC regulator combines both dual-phase voltage doubler and inverter converter into one channel through the use of time multiplexing technique at the cost of little performance degradation. As a result, it not only diminishes the number of flying capacitor from four to two but also removes four IC pin-outs for low cost and compact size. Beside, sixteen necessary power switches are reduced to twelve for decreasing about 27% silicon area.

The neural crest is a multipotent population of migratory cells that arises in the central nervous system and subsequently migrates along defined stereotypic pathways. In the present work, we analyzed the role of a repulsive axon guidance protein, draxin, in the migration of neural crest cells. Draxin is expressed in the roof plate of the chick trunk spinal cord and around the early migration pathway of neural crest cells. Draxin modulates chick neural crest cell migration in vitro by reducing the polarization of these cells. When exposed to draxin, the velocity of migrating neural crest cells was reduced, and the cells changed direction so frequently that the net migration distance was also reduced. Overexpression of draxin also caused some early migrating neural crest cells to change direction to the dorsolateral pathway in the chick trunk region, presumably due to draxin's inhibitory activity. These results demonstrate that draxin, an axon guidance protein, can also affect trunk neural crest migration in the chick embryo.

The mesencephalic V neurons and tectobulbar axons in chick embryo project over long distances that appear during the early development of the chick optic tectum. The mesencephalic V neuron and tectobulbar axonal growth begin at Hamburger and Hamilton stage 14 and stage 18, respectively. Both fibers proceed downward from the dorsal to the ventral side of the lateral wall of the optic tectum and then turn caudally and join the medial longitudinal fasciculus. Their axons appear in the most superficial layer of the tectum at early stages and do not cross the dorsal midline of the tectum. Here, we report the role of draxin, a recently identified axon guidance protein, in the formation of the ventrally directed tectum axonal tracts in chicken embryo. draxin is expressed in a high dorsal to low ventral gradient in chick optic tectum. In vitro experiments show that draxin repels neurite outgrowth from dorsal tectum explants. In vivo overexpression resulted in inhibition or misrouting of axon growth in the tectum. Therefore, draxin may be an important member of the collection of repulsive guidance molecules that regulate the formation of the ventrally directed tectum axon tracts.

Axon guidance proteins are critical for the correct wiring of the nervous system during development. Several axon guidance cues and their family members have been well characterized. More unidentified axon guidance cues are assumed to participate in the formation of the extremely complex nervous system. We identified a secreted protein, draxin, that shares no homology with known guidance cues. Draxin inhibited or repelled neurite outgrowth from dorsal spinal cord and cortical explants in vitro. Ectopically expressed draxin inhibited growth or caused misrouting of chick spinal cord commissural axons in vivo. draxin knockout mice showed defasciculation of spinal cord commissural axons and absence of all forebrain commissures. Thus, draxin is a previously unknown chemorepulsive axon guidance molecule required for the development of spinal cord and forebrain commissures.

As a volunteer-formed, community-based organization devoted to improving the quality of end-of-life care for Chinese Americans, the new Chinese-American Coalition for Compassionate Care (CACCC) is a unique and promising venture. This article has several aims: 1) to describe the history and development of the recently founded CACCC; 2) to introduce and critically evaluate one of CACCC's first public programs, a volunteer and caregiver training on end-of-life care, which prompted subsequent programs and activities; 3) to report on CACCC's current projects and short- and long-term goals; and 4) to discuss the implications for other similar community-based organizations devoted to the health and quality of life of a targeted population.

Background: Depression is a common mental health problem among Chinese elderly, but it often goes undiagnosed and untreated. Despite an increase in the population of elderly Chinese immigrants in the US, there have been few published studies on this topic. Objective: Our purpose was to determine the extent of depression in the participant population, using an updated Chinese translation of the original 30-item Geriatric Depression Scale (GDS; Yesavage et al., 1983). Study Design: A convenience sample of 102 Mandarin speaking Chinese elderly participants in two senior centers in Santa Clara County, CA was recruited. Results: A total of 29.4% of participants showed symptoms of depression, higher than the range found in the older adult American population (13-20%). Those most likely to be depressed ranged in age from 60 to 69 years (32%), lived with their children (37%), rated their financial and health status as below average, had less than a high school education, and lived in the US for less than...

A color switching and phase-transition phenomena in a blue-phase cell are observed and they exhibit the potential application of a fast display. A reflected color of blue phase is shifted to longer wavelength by modulating an electric field, and response times to switch different color are less than a few ms.

L-3,4-Dihydroxyphenylalanine (DOPA) has been believed to be a precursor of dopamine, and itself being an inert amino acid. Previously, we have proposed DOPA as a neurotransmitter candidate in the central nervous system (CNS). Recent findings have suggested DOPA as an endogenous agonist of a G-protein coupled receptor, ocular albinism 1 gene product (OA1), which is highly expressed in the retinal pigmental epithelium. However, whether OA1 functions as a receptor for DOPA in vivo, and whether this receptor-ligand interaction is responsible for a wide variety of DOPA actions have not been determined yet. To gain insight into the functional implication of OA1, we perform immunohistochemical examination with anti-OA1 antibody to localize OA1 in the adult rat brain. We observed OA1 immunoreactive cells in the hippocampus, cerebral cortex, cerebellum cortex, striatum, substantia nigra, hypothalamic median eminence and supraoptic nucleus, nucleus tractus solitarii and caudal ventrolateral medulla and rostral ventrolateral medulla, medial habenular nucleus and olfactory bulb. This study reveals, for the first time, the unique distribution pattern of OA1-immunoreactive neurons and/or cells in the rat CNS.

In this chapter, we will look at several other tools for bank analysis and valuation that are used in practice. These include operating performance ratios like the cost-income ratio, regulatory ratios like the Core Equity Tier 1 ratio and leverage ratio, and valuation ratios like P/E and Price-to-Tangible Book multiples.

This section shows how we do integrated analysis and valuation using the ROIC methodology. We will use a bank’s financial statements to calculate Invested Capital and ROIC, analysing those results along the way. We will then link that analysis to valuation, showing how the ROIC valuation model can be used to discover what the market expectations of a bank’s future sustainable profitability are. All this can then inform our own views on a bank’s valuation.

Over the past several years, banks have attracted a lot of (largely unwelcome) attention, not only from their customers, but from investors, regulators, and politicians. The high costs and uncertain benefits of government support for banks have been hotly debated, and the share prices of many banks have seesawed.

This study investigates current and predicted online activities of hospitality baccalaureate students including the use of the Internet for schoolwork and career development. Five hundred and forty students enrolled in a hospitality management program at a major Southwestern University volunteered to participate in the study. Responses from the study were analyzed with qualitative analysis, descriptive statistics, and factorial and one-way ANOVAs. Results of the study indicate that the average time spent online by each participant is approximately 11 hours per week. Participants' Internet activities are focused on communication, school projects and assignments, entertainment, and information search. Perceptions and online behaviors are different between demographic groups. However, no significant group differences are found on all the expectation variables. This study should be useful for educators who intend to make full use of websites that deliver class information and for researchers interested in hos...

The Dlx gene family encodes homeodomain proteins that are required for forebrain and craniofacial development. Towards elucidating the roles for each of these genes, we have isolated cDNA clones encoding the full-coding sequence for murine Dlx-5 and partial coding sequence for murine Dlx-6. Three different classes of sense Dlx-5 cDNA clones were characterized, two of which lack the homeobox. We also identified an antisense Dlx-6 transcript. Genomic analysis shows that the Dlx-5 and -6 genes are linked. Biochemical analysis using gel shift assays demonstrate that DLX-1, -2 and -5 have very similar DNA-binding properties. The expression of Dlx-1, -2, -5, -6 and antisense Dlx-1 and -6 was studied in the midgestation mouse brain. We found that the Dlx genes are expressed in overlapping patterns at different stages of differentiation within the primordia of the basal ganglia. Dlx-1 and -2 are expressed in the least mature cells (in the ventricular and subventricular zones). Dlx-5 appears to be co-expressed with Dlx-1 and -2 in the SVZ, but is also expressed in the postmitotic cells of the mantle. Dlx-6 expression is strongest in the mantle. Antisense Dlx-1 and -6 have their highest expression in the SVZ. These results suggest that each of these Dlx genes may have a distinct role in different steps of differentiation in the basal ganglia.

The dendritic targeting of neurotransmitter receptors is vital for dendritic development and function. However, how such localization is established remains unclear. Here we show that semaphorin 3A (Sema3A) signalling at the axonal growth cone is propagated towards the cell body by retrograde axonal transport and drives AMPA receptor GluA2 to the distal dendrites, which regulates dendritic development. Sema3A enhances glutamate receptor interacting protein 1-dependent localization of GluA2 in dendrites, which is blocked by knockdown of cytoplasmic dynein heavy chain. PlexinA (PlexA), a receptor component for Sema3A, interacts with GluA2 at the immunoglobulin-like Plexin-transcription-factor domain (PlexA-IPT) in somatodendritic regions. Overexpression of PlexA-IPT suppresses dendritic localization of GluA2 and induces aproximal bifurcation phenotype in the apical dendrites of CA1 hippocampal neurons. Thus, we propose a control mechanism by which retrograde Sema3A signalling regulates the glutamate receptor localization through trafficking of cis-interacting PlexA with GluA2 along dendrites.

Expression of the Emx-1 homeobox gene is largely restricted to the developing and mature cerebral cortex. To study its function, two lines of mice were generated using gene targeting methods that have a deletion that includes the N-terminal coding region of Emx-1. Mice homozygous for the deletion were viable and fertile and exhibited no obvious behavioral defects. However, 100% of homozygous mice lack most or all of their corpus callosum, the principle fiber tract that connects the left and right cerebral hemispheres. Heterozygotes show partial penetrance for the corpus callosum abnormality. The histology and various molecular properties of the cerebral cortex appear normal in the mutant mice.