Cultural Reflections in Virtual Reality: The Effects of User Ethnicity in Avatar Matching Experiences on Sense of Embodiment.

Matching avatar characteristics to a user can impact sense of embodiment (SoE) in YR. However, few studies have examined how participant demographics may interact with these matching effects. We recruited a diverse and racially balanced sample of 78 participants to investigate the differences among participant groups when embodying both demographically matched and unmatched avatars.

Action plans increase advance care planning documentation and engagement among English and Spanish-speaking older adults.

Background: Advance care planning (ACP) has been reconceptualized as a health behavior. Action plans (APs), or patient-directed mini contracts, improve behavior change. However, no prior studies have assessed whether APs can increase ACP documentation and engagement.

Making advance care planning easier for adults with kidney disease and their clinicians.

Advance care planning (ACP) has evolved from a narrow focus on end-of-life preference, such as resuscitation, to a continuum of care planning across the life course. Older adults with kidney disease have high morbidity and mortality, and easy-to-use tools can make ACP easier for patients and clinicians.

Stepping into the Right Shoes: The Effects of User-Matched Avatar Ethnicity and Gender on Sense of Embodiment in Virtual Reality.

In many consumer virtual reality (VR) applications, users embody predefined characters that offer minimal customization options, frequently emphasizing storytelling over user choice. We explore whether matching a user's physical characteristics, specifically ethnicity and gender, with their virtual self-avatar affects their sense of embodiment in VR. We conducted a $2\times 2$ within-subjects experiment ($\mathrm{n}=32$) with a diverse user population to explore the impact of matching or not matching a user's self-avatar to their ethnicity and gender on their sense of embodiment.

What Clinicians and Researchers Should Know About the Evolving Field of Advance Care Planning: a Narrative Review.

Advance care planning (ACP) has been recognized as crucial by patients, families, and clinicians; however, different definitions and measurements have led to inconsistencies in practice and mixed evidence in the literature. This narrative review explores ACP's evolution, innovations, and outcomes using thematic analysis to synthesize data from randomized controlled trials, reviews, and editorials. Key findings include (1) ACP has evolved over the past several decades from a sole focus on code status and advance directive (AD) forms to a continuum of care planning over the life course focused on tailored preparation for patients and surrogate decision-makers and (2) ACP measurement has evolved from traditional outcome metrics, such as AD completion, to a comprehensive outcomes framework that includes behavior change theory, systems, implementation science, and a focus on surrogate outcomes.

Surrogate Decision Makers Need Better Preparation for Their Role: Advice from Experienced Surrogates.

Surrogate decision makers are required to make difficult end-of-life decisions with little preparation. Little is known about what surrogates may need to adequately prepare for their role, and few resources exist to prepare them. To explore experiences and advice from surrogates about how best to prepare for the surrogate role.

The Cognitive Loads and Usability of Target-based and Steering-based Travel Techniques.

Target and steering-based techniques are two common approaches to travel in consumer VR applications. In this paper, we present two within-subject studies that employ a prior dual-task methodology to evaluate and compare the cognitive loads, travel performances, and simulator sickness of three common target-based travel techniques and three common steering-based travel techniques. We also present visual meta-analyses comparing our results to prior results using the same dual-task methodology.

Deconstructing the Complexities of Advance Care Planning Outcomes: What Do We Know and Where Do We Go? A Scoping Review.

Background/objectives: Advance care planning (ACP) has shown benefit in some, but not all, studies. It is important to understand the utility of ACP. We conducted a scoping review to identify promising interventions and outcomes.

Anxious, Depressed, and Planning for the Future: Advance Care Planning in Diverse Older Adults.

Objectives: To determine whether depression and anxiety are associated with advance care planning (ACP) engagement or values concerning future medical care.

Design: Cross-sectional.

Participants: English- and Spanish-speaking patients, aged 55 years and older, from a San Francisco, CA, county hospital.

Hematopoietic Cell-Expressed Endothelial Nitric Oxide Protects the Liver From Insulin Resistance.

Objective: Mice genetically deficient in endothelial nitric oxide synthase (Nos3) have fasting hyperinsulinemia and hepatic insulin resistance, indicating the importance of Nos3 (nitric oxide synthase) in maintaining metabolic homeostasis. Although the current paradigm holds that these metabolic effects are derived specifically from the expression of Nos3 in the endothelium, it has been established that bone marrow-derived cells also express Nos3. The aim of this study was to investigate whether bone marrow-derived cell Nos3 is important in maintaining metabolic homeostasis.

Leveraging In-Home Supportive Services Programs to Engage People in Advance Care Planning: Input from Staff, Providers, and Client Stakeholders.

In-Home Supportive Services (IHSS) cares for millions of Medicaid-eligible older adults who are often homebound and socially isolated. Advance care planning (ACP) can be challenging for this population, and IHSS programs may play an important role. To explore the feasibility of an IHSS ACP program for frail older adults.

Health Literacy Matters More Than Experience for Advance Care Planning Knowledge Among Older Adults.

Background: Advance care planning (ACP) engagement is low among vulnerable populations, including those with limited health literacy (LHL). Limited knowledge about ACP may be a modifiable mediator of the relationship between LHL and ACP. Our goal was to determine whether health literacy is associated with ACP knowledge.

Transcriptional and functional diversity of human macrophage repolarization.

Background: Macrophage plasticity allows cells to adopt different phenotypes, a property with important implications in disorders such as cystic fibrosis (CF) and asthma.

Objective: We sought to examine the transcriptional and functional significance of macrophage repolarization from an M1 to an M2 phenotype and assess the role of a common human genetic disorder (CF) and a prototypical allergic disease (asthma) in this transformation.

Methods: Monocyte-derived macrophages were collected from healthy subjects and patients with CF and polarized to an M2 state by using IL-4, IL-10, glucocorticoids, apoptotic PMNs, or azithromycin.

Patient Activation: A Key Component of Successful Advance Care Planning.

Patient activation-or knowledge, confidence, and skill managing overall health-is associated with improved health behaviors such as exercise; it is unknown whether it is associated with advance care planning (ACP). To determine whether patient activation is associated with ACP. This is a cross-sectional study.

Older Adult and Surrogate Perspectives on Serious, Difficult, and Important Medical Decisions.

Objectives: To elicit decisions that diverse older adults and surrogates perceive as serious, difficult, or important and explore what helped them make those decisions.

Design: Focus groups (N=13) in which participants were asked to recall serious, difficult, or important medical decisions and what helped them make those decisions.

Setting: Clinics, support groups and senior centers.

Symptom Assessment Solutions for In-Home Supportive Services and Diverse Older Adults: A Roadmap for Change.

Background: Millions of older adults require Medicaid-funded home care, referred to as In-Home Supportive Services (IHSS). Many of these individuals experience serious illness, disability, and common symptoms such as pain and shortness of breath.

Objective: To explore whether and how to integrate symptom assessment into an IHSS program to identify and manage symptoms in diverse older adults who receive in-home care.

Advance Care Planning Documentation Practices and Accessibility in the Electronic Health Record: Implications for Patient Safety.

Context: Documenting patients' advance care planning (ACP) wishes is essential to providing value-aligned care, as is having this documentation readily accessible. Little is known about ACP documentation practices in the electronic health record.

Objectives: The objective of this study was to describe ACP documentation practices and the accessibility of documented discussions in the electronic health record.

Effect of the PREPARE Website vs an Easy-to-Read Advance Directive on Advance Care Planning Documentation and Engagement Among Veterans: A Randomized Clinical Trial.

Importance: Documentation rates of patients' medical wishes are often low. It is unknown whether easy-to-use, patient-facing advance care planning (ACP) interventions can overcome barriers to planning in busy primary care settings.

Objective: To compare the efficacy of an interactive, patient-centered ACP website (PREPARE) with an easy-to-read advance directive (AD) to increase planning documentation.

Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel.

Context: Despite increasing interest in advance care planning (ACP) and previous ACP descriptions, a consensus definition does not yet exist to guide clinical, research, and policy initiatives.

Objective: The aim of this study was to develop a consensus definition of ACP for adults.

Methods: We convened a Delphi panel of multidisciplinary, international ACP experts consisting of 52 clinicians, researchers, and policy leaders from four countries and a patient/surrogate advisory committee.

MEK1/2 Inhibition Promotes Macrophage Reparative Properties.

Macrophages have important functional roles in regulating the timely promotion and resolution of inflammation. Although many of the intracellular signaling pathways involved in the proinflammatory responses of macrophages are well characterized, the components that regulate macrophage reparative properties are less well understood. We identified the MEK1/2 pathway as a key regulator of macrophage reparative properties.

Stromelysin-2 (MMP10) Moderates Inflammation by Controlling Macrophage Activation.

Several members of the matrix metalloproteinase (MMP) family control a range of immune processes, such as leukocyte influx and chemokine activity. Stromelysin-2 (MMP10) is expressed by macrophages in numerous tissues after injury; however, little is known of its function. In this study, we report that MMP10 is expressed by macrophages in human lungs from patients with cystic fibrosis and induced in mouse macrophages in response to Pseudomonas aeruginosa infection both in vivo and by isolated resident alveolar and bone marrow-derived macrophages (BMDM).

Emergency Physicians' Experience with Advance Care Planning Documentation in the Electronic Medical Record: Useful, Needed, and Elusive.

Objective: For patients' preferences to be honored, emergency department (ED) physicians must be able to find and use advance care planning (ACP) information in the electronic medical record (EMR). ED physicians' experiences with ACP EMR documentation and their documentation needs are unknown.

Methods: We surveyed 70 ED physicians (81% response rate) from a tertiary and county ED.