To decode the function and molecular recognition of several recently discovered cytosine derivatives in the human genome – 5-hydroxymethylcytosine, 5-formylcytosine, and 5-carboxylcytosine – a detailed understanding of their effects on the structural, chemical, and biophysical properties of DNA is essential. Here, we review recent literature in this area, with particular emphasis on features that have been proposed to enable the specific recognition of modified cytosine bases by DNA-binding proteins. These include electronic factors, modulation of base-pair stability, flexibility, and radical changes (...) in duplex conformation. We explore these proposals and assess whether or not they are supported by current biophysical data. This analysis is focused primarily on the properties of epigenetically modified DNA itself, which provides a basis for discussion of the mechanisms of recognition by different proteins. 5-hydroxymethylcytosine, 5-formylcytosine, and 5-carboxylcytosine have recently been discovered in mammalian DNA and appear to have essential regulatory roles. Here, we summarize recent investigations into their effects on the structural, chemical, and biophysical properties of DNA, an understanding of which is essential to decoding their behavior in the genome. (shrink)

Physicians play a critical role in preventing and treating firearm injury, although the scope of that role remains contentious and lacks systematic definition. This piece aims to utilize the fundamental principles of medical ethics to present a framework for physician involvement in firearm violence. Physicians' agency relationship with their patients creates ethical obligations grounded on three principles of medical ethics — patient autonomy, beneficence, and nonmaleficence. Taken together, they suggest that physicians ought to engage in clinical screening and treatment related (...) to firearm violence. The principle of beneficence also applies more generally, but more weakly, to relations between physicians and society, creating nonobligatory moral ideals. Balanced against physicians' primary obligations to patient agency relationships, general beneficence suggests that physicians may engage in public advocacy to address gun violence, although they are not ethically obligated to do so. A fourth foundational principle — justice — requires that clinicians attempt to ensure that the benefits and burdens of healthcare are distributed fairly. (shrink)

Proceedings of the Steklov Institute of Mathematics is a cover-to-cover translation of the Trudy Matematicheskogo Instituta imeni V.A. Steklova of the Russian Academy of Sciences. Each issue ordinarily contains either one book-length article or a collection of articles pertaining to the same topic.

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.

This paper proposes an ethical framework for rationing publicly financed health care. We begin by classifying alternative rationing criteria according to their ethical basis. We then examine the ethical arguments for four rationing criteria. These alternatives include rationing high technology services, non-basic services, services to patients who receive the least medical benefit, and services that are not equally available to all. We submit that a just health care system will not limit basic health care to persons unable to pay for (...) it. Furthermore, justice in health care requires limiting publicly-financed non-basic health care, striving for equality in access to basic health care, and relying on medical benefit to ration non-basic health care. (shrink)

Precision agriculture is a breakthrough in digital farming technology, which facilitates the application of precise and exact amount of input level of water and fertilizer to the crop at the required time for increasing the yield. Since agriculture relies on direct rainfall than irrigation and the prediction of rainfall date is easily available from web source, the integration of rainfall prediction with precision agriculture helps to regulate the water consumption in farms. In this work, an edge computing model is developed (...) for predicting soil moisture in real time and managing the water usage in accordance with rain prediction. A soil moisture prediction hybrid algorithm has been developed that revolves around the decision-making techniques with live environmental parameters including weather parameters for the prediction of soil moisture through the impact of precipitation. Numerous algorithms with the combination of regression + clustering are estimated, and it is inferred that XGBoost + k-means outperforms other algorithmic combinations that is deployed in edge model. This model is used as an intermediary between the end IoT devices and cloud that results in the saving of computationally intensive processing performed on cloud servers. The servers located on a local edge network perform the developed algorithmic computations. Avoiding transmission over the cloud results in significant latency, response time, and computation power savings and therefore increases the efficiency of data transfer. The proposed edge computing model is implemented in Raspberry Pi as an edge, Heroku as cloud, and edge nodes as the combination of Pi with actuators and sensors. The monitored data from Pi are stored in MongoDB webserver that is controlled by Web dashboard. Finally, the developed model is implemented in cloud and edge where the edge server implementation performs better in terms of latency, bandwidth, throughput, response time, and CPU memory usage. (shrink)

Background: Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing (...) the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making. Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments. DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system. Trial RegistrationISRCTN89993391. (shrink)

Although psychologists study both the objective (behavior) and the subjective (phenomenology) components of cognition, we argue that an overemphasis on the subjective drives a wedge between psychology and other closely related scientific disciplines, such as comparative studies of cognition and artificial intelligence. This wedge is particularly apparent in contemporary studies of episodic recollection and future planning, two related abilities that many have assumed to be unique to humans. We shall challenge this doctrine. To do so, we shall adopt an ethological (...) approach to comparative cognition and this necessitates two requirements. The first is that memory and planning need to be characterized in terms of objectively defined properties as opposed to purely phenomenological ones; the ability to remember what happened, where, and how long ago is a critical behavioral criterion for episodic memory. The second requirement is the identification of an ethological context in which these memories would confer a selective advantage. As a consequence, we turn this debate into an empirical evaluation in nonlinguistic animals and one embodied in synthetic creatures. Indeed, our behavioral conception of flexibly deployable information about “what, where, and when” has so far supported a comparative cognition in animals as diverse as corvids and primates. We argue that this approach may clarify and challenge ideas that have been based solely on research with human subjects, without the need to be constrained by phenomenological assumptions based on human‐centric ways of thinking. (shrink)

Contributed articles on psychological aspect of Hindu philosophical system.