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The article demonstrates the connection between metaphor and theology and shows how, by tracing the development of the metaphor of the felled tree and its regrowth, it is possible to point to the development of certain theological trends. It argues that Nebuchadnezzar’s dream of the tree in Daniel (3:31–4:34) serves as an »inner-biblical interpretation« for the prophecy regarding the »shoot from the stump of Jesse« (Isaiah 10:33–11:9), identifying three stages in the development of the metaphor of the felled tree.

PURPOSE Cancer is the second leading cause of death globally. However, by implementing evidence-based prevention strategies, 30%-50% of cancers can be detected early with improved outcomes. At the integrated cancer prevention center (ICPC), we aimed to increase early detection by screening for multiple cancers during one visit. METHODS Self-referred asymptomatic individuals, age 20-80 years, were included prospectively. Clinical, laboratory, and epidemiological data were obtained by multiple specialists, and further testing was obtained based on symptoms, family history, individual risk factors, and abnormalities identified during the visit. Follow-up recommendations and diagnoses were given as appropriate. RESULTS Between January 1, 2006, and December 31, 2019, 8,618 men and 8,486 women, average age 47.11 ± 11.71 years, were screened. Of 259 cancers detected through the ICPC, 49 (19.8%) were stage 0, 113 (45.6%) stage I, 30 (12.1%) stage II, 25 (10.1%) stage III, and 31(12.5%) stage IV. Seventeen cancers were missed, six of which were within the scope of the ICPC. Compared with the Israeli registry, at the ICPC, less cancers were diagnosed at a metastatic stage for breast (none v 3.7%), lung (6.7% v 11.4%), colon (20.0% v 46.2%), prostate (5.6% v 10.5%), and cervical/uterine (none v 8.5%) cancers. When compared with the average stage of detection in the United States, detection was earlier for breast, lung, prostate, and female reproductive cancers. Patient satisfaction rate was 8.35 ± 1.85 (scale 1-10). CONCLUSION We present a proof of concept study for a one-stop-shop approach to cancer screening in a multidisciplinary outpatient clinic. We successfully detected cancers at an early stage, which has the potential to reduce morbidity and mortality as well as offer substantial cost savings. [Media: see text]

International audience; A common practice in many auctions is to offer bidders an opportunity to improve their bids, known as a best and final offer stage. This improved bid can depend on new information either about the asset or about the competitors. This paper examines the effects of new information regarding competitors, seeking to determine what information the auctioneer should provide assuming the set of allowable bids is discrete. The rational strategy profile that maximizes the revenue of the auctioneer is the one where each bidder makes the highest possible bid that is lower than his valuation of the item. This strategy profile is an equilibrium for a large enough number of bidders, regardless of the information released. We compare the number of bidders needed for this profile to be an equilibrium under different information structures. We find that it becomes an equilibrium with fewer bidders when less additional information is made available to the bidders regarding the competition. It follows that when the number of bidders is a priori unknown, there are some advantages to the auctioneer not revealing information and conducting a one-stage auction instead.

Despite the global norm favoring women’s participation in peace negotiations, women continue to face constraints in accessing, influencing, and benefitting from peace settlements. This special issue of International Negotiation lays the groundwork for a future research agenda, calling for attention to gender-based analysis; mixed-method research designs, comparative case studies, and attention to “negative” cases; more examination of the relationship between gender-inclusivity at peace talks and the subsequent conditions for women; and policy recommendations for international actors. This introduction to the issue provides a review of the literature on women and peace negotiations, offers an overview of the issue’s six articles, and proposes a future research agenda.

Tujuan dari penelitian ini adalah untuk mengetahui pengaruh Online Trust dan Repurchase Intention terhadap perilaku konsumen dalam Belanja Online di E-Commerce. Studi ini menyelidiki lima faktor; Risiko yang Dirasakan, Kegunaan yang Dirasakan, Tampilan Situs Web, Promosi Online, dan Keamanan. Teknik pengumpulan data dilakukan dengan menggunakan kuesioner dan disebarluaskan melalui media sosial online. Penelitian ini menggunakan 356 responden. Data dianalisis menggunakan PLS-SEM. Hasil penelitian ini menunjukkan bahwa Perceived Risk, Tampilan Website, Keamanan, dan Promosi Online memiliki hubungan yang signifikan terhadap Kepercayaan Online. Perceived Usefulness memiliki efek negatif pada Kepercayaan Online. Penelitian ini juga menegaskan bahwa Perceived Risk, Perceived Usefulness, Tampilan Website, Keamanan, dan Promosi Online berpengaruh positif terhadap Repurchase Intention. Terakhir, Kepercayaan Online mempengaruhi Niat Pembelian Kembali di E-Commerce. Kata kunci: E-Commerce, Minat Pembelian Ulang, Risiko yang dirasakan, Kegunaan yang dirasakan, Kepercayaan.

Pancreatic ductal adenocarcinoma (PDA) is characterized by aggressive local invasion and metastatic spread, leading to high lethality. Although driver gene mutations during PDA progression are conserved, no specific mutation is correlated with the dissemination of metastases1–3. Here we analysed RNA splicing data of a large cohort of primary and metastatic PDA tumours to identify differentially spliced events that correlate with PDA progression. De novo motif analysis of these events detected enrichment of motifs with high similarity to the RBFOX2 motif. Overexpression of RBFOX2 in a patient-derived xenograft (PDX) metastatic PDA cell line drastically reduced the metastatic potential of these cells in vitro and in vivo, whereas depletion of RBFOX2 in primary pancreatic tumour cell lines increased the metastatic potential of these cells. These findings support the role of RBFOX2 as a potent metastatic suppressor in PDA. RNA-sequencing and splicing analysis of RBFOX2 target genes revealed enrichment of genes in the RHO GTPase pathways, suggesting a role of RBFOX2 splicing activity in cytoskeletal organization and focal adhesion formation. Modulation of RBFOX2-regulated splicing events, such as via myosin phosphatase RHO-interacting protein (MPRIP), is associated with PDA metastases, altered cytoskeletal organization and the induction of focal adhesion formation. Our results implicate the splicing-regulatory function of RBFOX2 as a tumour suppressor in PDA and suggest a therapeutic approach for metastatic PDA.

Inhaled nitric oxide (iNO) has potential anti-inflammatory, anti-microbial, and anti-viral properties for patients with lower respiratory tract infections.We compared the safety and efficacy of iNO administered in two concentrations in addition to standard supportive treatment (SST) compared to SST alone with the aim to improve clinical outcomes of infants with bronchiolitis.In this prospective, multicenter, double-blind, randomized-controlled study, 89 infants hospitalized with moderate-severe bronchiolitis were randomly assigned to three treatment groups: 150 parts per million (ppm) NO+SST(1); 85 ppm NO+SST(2); and the control treatment O2/air+SST(3). Treatment was given for 40 minutes, 4 times/day for up to 5 days. The primary endpoint was time to reach "fit for discharge". This was a composite endpoint comprised of both reaching a sustained oxygen saturation (SpO2) ≥92% in room air, and reaching a clinical score ≤5. Secondary endpoints included time to reach sustained SpO2 ≥92% in room air, time to clinical score ≤5, and time to hospital discharge. Safety was assessed by the number of treatment-related adverse-events (AEs) or serious adverse-events (SAEs). Time-to-event efficacy outcomes were analyzed by Cox proportional-hazards regression-model. Hazard ratio (HR) describes how many times more likely an individual is to experience an event, if such an individual receives the NO rather than the control treatment during the observational period.Group 1 demonstrated significant efficacy for time to reach "fit to discharge" compared to Groups 2 (HR=2.11, p=0.041) and 3 (HR=2.32, p=0.049). Group 1 also demonstrated significant efficacy for time to hospital discharge compared to Groups 2 (HR=2.01, p=0.046) and 3 (HR=2.28, p=0.043). No significant differences were observed between Groups 2 and 3 for either endpoint. There were no differences between treatment groups in time to reach clinical score ≤5. The iNO therapy was well-tolerated with no treatment-related SAEs.Treatment with high dose intermittent iNO at 150 ppm showed reduced time to clinical improvement when compared to 85 ppm or control treatment of hospitalized infants with acute bronchiolitis. The 150 ppm iNO dose is well-tolerated, with significant benefit compared to both standard therapy and 85 ppm iNO, improving respiratory outcome and reducing length of stay.

Medications for opioid use disorder (MOUDs) – including methadone, buprenorphine, and naltrexone – are the most effective treatments for opioid use disorder (OUD). Historically, insurers have required prior authorization for MOUD, but prior authorization is often reported as a key barrier to MOUD prescribing. Some states have passed laws prohibiting MOUD prior authorization requirements. We sought to identify the frequency of MOUD prior authorization prohibitions in state laws and to categorize types of prohibitions. We searched for regulations and statutes present in all U.S. states and Washington DC between 2005 and 2019 using MOUD-related terms in Westlaw legal software. In qualitative software, we coded laws discussing MOUD prior authorization using template analysis – a mixed deductive/inductive approach. Finally, we used coded laws to identify frequencies of states with prior authorization prohibitions, including changes over time. No states had laws prohibiting MOUD prior authorization between 2005 and 2015, with the first prohibition appearing in 2016. By 2019, fifteen states had MOUD prior authorization prohibitions. States varied significantly in their approach to prohibiting MOUD prior authorization. In 2019, it was more common for states to have MOUD prior authorization prohibitions applying to all insurers (n = 10 states) than to only Medicaid (n = 7 states) or only non-Medicaid insurers (n = 1 state). In 2019, general prior authorization prohibitions (n = 10 states) were more common than prohibitions only applicable to medications on the formulary, prohibitions only applicable to medications on the preferred drug list, prohibitions only applicable during the first 5 days of treatment, and prohibitions only applicable during the first 30 days of treatment. The number of states with an MOUD prior authorization law prohibition increased in recent years. Such laws could help expand access to life-saving OUD treatments by making it easier for clinicians to prescribe MOUD.KEY MESSAGESNo states had MOUD prior authorization prohibitions between 2005 and 2015 in state statutes or regulations, and only one state had such a prohibition in 2016.By 2019, fifteen states had an MOUD prior authorization prohibition law.States varied significantly in their approach to prohibiting MOUD prior authorization, including with respect to the insurer type, duration of the prohibition, and applicable medication. No states had MOUD prior authorization prohibitions between 2005 and 2015 in state statutes or regulations, and only one state had such a prohibition in 2016. By 2019, fifteen states had an MOUD prior authorization prohibition law. States varied significantly in their approach to prohibiting MOUD prior authorization, including with respect to the insurer type, duration of the prohibition, and applicable medication.

A better understanding the effects of rainfall and evapotranspiration statistics on groundwater recharge (GR) requires long time series of these variables. However, long records of the relevant variables are scarce. To overcome this limitation, time series of rainfall and evapotranspiration are often synthesized using different methods. Here, we attempt to study the dependence of estimated GR on the synthesis methods used. We focus on regions with semi-arid climate conditions and soil types. For this purpose, we used longer than 40 year records of the daily rain and climate variables that are required to calculate the potential evapotranspiration (ETref), which were measured in two semi-arid locations.These locations, Beit Dagan and Shenmu, have aridity indices of 0.39 and 0.41, respectively, and similar seasonal and annual ETref rates (1370 and 1030 mm yr−1, respectively) but different seasonal rain distributions. Stochastic daily rain and ETref time series were synthesized according to the monthly empirical distributions. This synthesis method does not preserve the monthly and annual rain and ETref distributions. Therefore, we propose different correction methods to match the synthesized and measured time series' annual or monthly statistics. GR fluxes were calculated using the 1D Richards equation for four typical semi-arid soil types, and by prescribing the synthesized rain and ETref as atmospheric conditions. The estimated GR fluxes are sensitive to the synthesis method. However, the ratio between the GR and the total rain does not show the same sensitivity. The effects of the synthesis methods are shown to be the same for both locations, and correction of the monthly mean and SD of the synthesized time series results in the best agreement with independent estimates of the GR. These findings suggest that the assessment of GR under current and future climate conditions depends on the synthesis method used for rain and ETref.

Advances in technology significantly transform the means of communication between users and companies. The music industry is also experiencing technological innovation as more consumers subscribe to paid and free online streaming services. Therefore, this study aimed to determine the effect of usefulness, entertainment, interaction, enjoyment, and familiarity on purchase intention for music streaming platform subscriptions in millennials and gen-z communities in Batam City through trust mediation. A quantitative method was adopted with data collected through questionnaires from 348 respondents and processed using the Partial Least Square program. The results indicated that familiarity and interaction significantly influenced purchase intention through trust mediation. As managerial implications, familiarity must be increased for trust and interaction to influence purchase intention. This study only focused on millennials and gen-z communities and conducted a survey through Google Forms. Therefore, future studies could expand the scope beyond a single generation or region.

High-flow nasal cannula (HFNC) therapy may be better tolerated than traditional noninvasive ventilation (NIV) and is rapidly gaining acceptance in pediatric acute care. In Israel, HFNC is approved for domestic use. We aim to describe its indications, efficacy, parental satisfaction, and safety.Retrospective study of children treated with home HFNC therapy in three pediatric centers. Data included demographic parameters, indication of use, weight and days of hospitalization before and after initiation. Safety, tolerability, and parental satisfaction were assessed via standardized telephone questionnaire.Median (interquartile range [IQR]) age of initiating home HFNC in 75 children was 8.3 (2.2, 29.6) months. Indications were obstructive sleep apnea (33; 44%), airway malacia (19; 25%), chronic lung disease (15; 20%), neuromuscular disease (4; 5%), and postextubation support (4; 5%). Weight standard deviation score rose from -2.3 pre-HFNC to -1.7 at 6.7 months post-HFNC initiation, p 0.001. Hospital admission days during the 2 months pre- versus post-HFNC initiation were 22 (5.5, 60) and 5 (0, 14.7) respectively, p 0.008. Median (IQR) parental satisfaction score was 5/5 (4, 5). Fifty of 60 (83%) respondents would recommend home HFNC to other families in a similar situation. There were no serious adverse events.In our population, domestic HFNC appeared safe and well tolerated for a variety of indications. Its introduction was associated with improved weight gain, fewer hospitalization days and high parental satisfaction. Further work is required to characterize groups of children most likely to benefit from HFNC, as opposed to traditional modes of NIV.

Graham Priest has formulated the minimally inconsistent logic of paradox (MiLP), which is paraconsistent like Priest’s logic of paradox (LP), while staying closer to classical logic. We present logics that stand to (the propositional fragments of) strong Kleene logic (K3) and the logic of first-degree entailment (FDE) as MiLP stands to LP. That is, our logics share the paracomplete and the paraconsistent-cum-paracomplete nature of K3 and FDE, respectively, while keeping these features to a minimum in order to stay closer to classical logic. We give semantic and sequent-calculus formulations of these logics, and we highlight some reasons why these logics may be interesting in their own right.

This service program involves one of the MSME partners in Batam City, namely Berry Catszone Batam. At the moment, partners issues only pertain to offline sales. The online sales system is still very limited and only relies on consumers who have settled or subscribed. This situation results from partners ignorance of the value of apllying digital strategies and using digital technology to run a corporation. This issue can be resolved by giving partners guidance and input through the use social media's built-in features, the creation of e-catalog and business growth promotion efforth. The activities are designed to improve business actors' understanding how to implement digital marketing strategies and the value of running promotions, which is expected to improve sales turnover and increase brand awareness as among public at large. The mentoring method is the one employed in this project. As a result of this volunteer activities, a catalog was created on the WhatsApp Business account, flyers were created for various kinds of promotions, and digital strategies were employed to encourage more active usage of instastories and other social media features

Translating preclinical studies to effective treatment protocols and identifying specific therapeutic responses in individuals with cancer is challenging. This may arise due to the complex genetic makeup of tumor cells and the impact of their multifaceted tumor microenvironment on drug response. To find new clinically relevant drug combinations for colorectal cancer (CRC), we prioritized the top five synergistic combinations from a large in vitro screen for ex vivo testing on 29 freshly resected human CRC tumors and found that only the combination of mitogen-activated protein kinase kinase (MEK) and proto-oncogene tyrosine-protein kinase Src (Src) inhibition was effective when tested ex vivo. Pretreatment phosphorylated Src (pSrc) was identified as a predictive biomarker for MEK and Src inhibition only in the absence of KRAS

The aim of the study was to determine the influence of habitat, cultivar and developmental growth stage on catalase activity in soil under two amaranth cultivars – Rawa (Amaranthus cruentus L.) and Aztek (Amaranthus hypochondriacus × Amaranthus hybridus L.). In a 3-year field experiment (2013–2015), amaranth’s plants were grown in a wide-row spacing on the soil of the good wheat complex in south-eastern Poland (50°71'N, 23°04'E). The field experiment included 4 variable factors: weather conditions; selected amaranth growth stages (5-leaf, full flowering and seed maturity stages); NPK dose combinations (I: 40 kg N ∙ ha–1, 30 kg P ∙ ha–1, 30 kg K ∙ ha–1; II: 60 kg N ∙ ha–1, 40 kg P ∙ ha–1, 40 kg K ∙ ha–1; III: 80 kg N ∙ ha–1, 50 kg P ∙ ha–1, 50 kg K ∙ ha–1; IV: 120 kg N ∙ ha–1, 70 kg P ∙ ha–1, 70 kg K ∙ ha–1) and two cultivars (‘Rawa’ and ‘Aztek’). No pesticides are applied in the cultivation due to the absence of pathogens and pests of this plant in Poland. Plant protection was limited to reducing weed infestation twice. The conducted research showed that weather conditions were the main factor affecting catalase activity in the soil under amaranth cultivation, followed by other factors, such as fertilization, cultivar and growth stage. All the analyzed factors proved to exert a significant impact on organic matter content in the soil, while only the applied NPK fertilization had effect on sorption capacity. Moreover, it was found that the cv. Aztek positively influenced the activity of catalase and humus accumulation in the soil in comparison to the cv. Rawa. The beneficial effect of amaranth on the soil environment and its enzymatic activity was ascribed to the lack of introduced pesticides.

This study evaluates the impact of a student program for mentoring incarcerated persons. Mentoring has multiple goals for both incarcerated persons and mentors; this article focuses on its contributions to incarcerated persons. The program encourages incarcerated persons to think positively and constructively, apply anger management, and learn about the normative society they will enter. Twenty-one incarcerated persons participated in semi-structured in-depth interviews in this qualitative research. The findings show that the students eventually became significant others for the incarcerated persons, most of whom reported on forming excellent relations with the students, and learning to act more deliberately and less violently due to the students. They also described reducing their self-absorption, expanding their horizons, and better understanding their criminal choices. Some mentioned acquiring more structured worldviews and improving their behavior. The findings point to significant benefits gained from the incarcerated person–student interaction in the mentoring framework, and the importance of expanding the program.

Perkembangan teknologi yang sangat pesat di era globalisasi saat ini telah memberikan banyak manfaat dalam kemajuan diberbagai aspek sosial. Penggunaan teknologi oleh manusia dalam membantu menyelesaikan pekerjaan merupakan hal yang menjadi keharusan dalam kehidupan. Perkembangan teknologi ini juga harus diikuti dengan perkembangan pada Sumber Daya Manusia. Perkembangan teknologi dan internet membawa dampak besar bagi kehidupan manusia. Kemajuan teknologi adalah sesuatu yang tidak bisa kita hindari dalam kehidupan ini, karena kemajuan teknologi akan berjalan sesuai dengan kemajuan ilmu pengetahuan. Teknologi yang sebenarnya merupakan alat bentu/ekstensi kemampuan diri manusia. Dewasa ini, telah menjadi sebuah kekuatan yang justru membelenggu perilaku dan gaya hidup kita sendiri. Dengan daya pengaruhnya yang sangat besar, karena ditopang pula oleh systemsistem sosial yang kuat, dan dalam kecepatan yang makin tinggi, teknologi telah menjadi pengarah hidup manusia. Gadget merupakan alat elektronik yang dirancang berukuran kecil, memiliki berbagai fitur dan aplikasi untuk mempermudah mengakses segala informasi. Penggunaan gadget secara continue akan berdampak positif maupun berdampak negatif pada perilaku sosial anak. Perilaku sosial merupakan tindakan yang berkaitan dengan perbuatan manusia yang berhubungan secara langsung dengan nilai sosial dalam lingkungannya. Perilaku sosial anak ini meliputi menghormati orang lain, sikap tolong menolong, perilaku sopan santun, sikap peka dan peduli, serta terima kasih.Abstract: The very rapid development of technology in the current era of globalization has provided many benefits in progress in various social aspects. The use of technology by humans in helping to complete work is a must in life. This technological development must also be followed by developments in Human Resources. The development of technology and the internet has had a major impact on human life. Technological progress is something that we cannot avoid in this life, because technological progress will run in accordance with scientific advances. Technology is actually a tool for the formation/extension of human abilities. Today, it has become a force that actually shackles our own behavior and lifestyle. With a very large influence, because it is also supported by a strong social system, and at an increasingly higher speed, technology has become the direction of human life. Gadgets are electronic devices that are designed to be small in size, have various features and applications to make it easier to access all information. Continuous use of gadgets will have a positive or negative impact on children's social behavior. Social behavior is an action related to human actions that are directly related to social values in their environment. This child's social behavior includes respect for others, an attitude of helping, polite behavior, a sensitive and caring attitude, and gratitude.

Despite social expectations of parenthood, the proportion of people in the Western world who wish to have children is declining, and the proportion who do not want children is growing. We explored the effect of being “childfree by choice” on women's subjective well-being (SWB) by examining their level of differentiation of self, based on Bowen's family system theory. Fifty-one voluntarily child-free women and 62 mothers (control group) completed a demographic information questionnaire, the Personal Wellbeing Index – Adult (PWI-A), and the Differentiation of Self-Inventory – Revised (DSI-R). No differences were found between child-free women and mothers for four components of differentiation of self and life satisfaction and well-being. Women who chose to remain childfree for internal reasons expressed higher levels of satisfaction with life and SWB, and lower levels of emotional reactivity than those who remained childfree for external reasons. Self-differentiation (I-position) and emotional disengagement (emotional cutoff) significantly contributed to child-free women's well-being. Our results show the importance of emphasizing self-differentiation and emotional disengagement in the context of personal and marital therapy sessions and in therapeutic work with young women facing major life decisions on motherhood/voluntary childlessness.

Background Despite vaccination, many remain vulnerable to coronavirus disease 2019 (COVID-19) and its complications. Oral antivirals to prevent COVID-19 progression are vital. Based on perceived potency and clinical efficacy, favipiravir is widely used to treat COVID-19. Evidence from large randomized controlled trials (RCT) is lacking. Methods In this multicenter double-blinded placebo-controlled RCT, adults with early mild-to-moderate COVID-19 were 1:1 randomized to favipiravir or placebo. The study evaluated time to sustained clinical recovery (TT-SCR), COVID-19 progression, and cessation of viral shedding. Results Of 1187 analyzed patients across 40 centers, 83.3% were Hispanic, 89.0% unvaccinated, 70.3% severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seronegative, and 77.8% had risk factors for COVID-19 progression. The median time from symptom presentation and from positive test to randomization was 3 and 2 days, respectively. There was no difference in TT-SCR (median of 7 days for both groups; P = .80), COVID-19 progression [11 patients each (1.9% vs 1.8%); P = .96], time to undetectable virus (median = 6 days, 95% confidence interval [CI] [6–8] vs 7 days, 95% CI [6-9]), or in undetectable virus by end of therapy (73.4% vs 72.3%; P = .94). Outcomes were consistent across the analyzed sub-groups. Adverse events were observed in 13.8% and 14.8% of favipiravir-treated and placebo-treated subjects, respectively. Uric acid elevation was more frequent among favipiravir-treated subjects (19.9% vs 2.8%). Conclusions Favipiravir was well tolerated but lacked efficacy in TT-SCR, progression to severe COVID-19, or cessation of viral shedding and should not be used to treat patients with COVID-19. (Supported by Appili Therapeutics) Clinical Trials Registration NCT04600895

Pathogenic variants in LRBA, encoding the LPS Responsive Beige-Like Anchor (LRBA) protein, are responsible for recessive, early-onset hypogammaglobulinemia, severe multi-organ autoimmunity, and lymphoproliferation, with increased risk for malignancy. LRBA deficiency has a wide clinical spectrum with variable age of onset and disease severity. Three apparently unrelated patients with LRBA deficiency, of Georgian Jewish descent, were homozygous for LRBA c.6640C T, p.R2214*, leading to a stop upstream of the LRBA BEACH domain. Despite carrying the same LRBA genotype, the three patients differed in clinical course: the first patient was asymptomatic until age 25 years; the second presented with failure to thrive at age 3 months; and the third presented at age 7 years with immune cytopenias and severe infections. Two of the patients developed malignancies: the first patient was diagnosed with recurrent Hodgkin's disease at age 36 years, and the second patient developed aggressive gastric cancer at age 15 years. Among Georgian Jews, the carrier frequency of the LRBA p.R2214* allele was 1.6% (4 of 236 Georgian Jewish controls). The allele was absent from other populations. Haplotype analysis showed a shared origin of the mutation. These three patients revealed a pathogenic LRBA founder allele in the Georgian Jewish population, support the diverse and complex clinical spectrum of LRBA deficiency, and support the possibility that LRBA deficiency predisposes to malignancy.

Current guidelines are inconsistent regarding the follow-up of patients with 1-2 diminutive (1-5 mm) non-advanced adenomas (DNAAs).To evaluate the risk of metachronous advanced neoplasia (AN), defined as cancer or advanced adenoma (AA), among patients with either normal colonoscopy or 1-2 DNAAs.A retrospective cohort study. Cohort I included 2,347 subjects with normal colonoscopy and 483 subjects with polypectomy of 1-2 DNAAs followed by colonoscopy. Cohort II included 11,881 subjects with normal colonoscopy and 1,342 subjects with 1-2 DNAAs followed through the cancer registry.In cohort I, the rate of AN, cancer and AA among the polypectomy group vs. normal colonoscopy was 5.0% vs. 2.5%, Hazard Ratio (HR) 2.96 (95%CI [Confidence Interval]1.86-4.78) for AN; 0.6% vs. 0.3%, HR 3.32 (95%CI 0.85-13) for cancer; 4.3% vs. 2.2% HR 2.91 (95%CI 1.75-4.86) for AA. In cohort II, cancer occurred in 0.4% of the polypectomy group and 0.2% of the normal colonoscopy group, HR 2.27 (95% CI 0.56-9.19).Compared to subjects with normal colonoscopy, subjects with polypectomy of 1-2 DNAAs, are at increased risk for AA when followed by colonoscopy, while the risk for cancer is non-significantly increased. Our findings suggest that patients with 1-2 DNNAs should be followed more tightly than patients with normal colonoscopy.

To distinguish the various characteristics of medical malpractice lawsuits involving trainees to prevent future litigation.LexisNexis, an online legal research database containing legal records from the United States, was retrospectively reviewed for malpractice cases involving urology interns, residents, or fellows from January 1, 1988 to December 31, 2020.A total of 16 cases were included, of which 7 (43.8%) involved urological allegations while 9 (56.2%) involved non-urological allegations. 5 of the cases consisting of non-urological adverse outcomes led to mortality. Procedural error was claimed in 12 (75.0%) cases, negligence in 7 (43.8%), delayed evaluation in 6 (37.5%), lack of informed consent of procedure or complications in 5 (31.2.%), failure to pursue treatment in 4 (25.0%), inexperienced trainee in 2 (12.5%), failure to supervise trainee in 2, lack of informed consent of trainee involvement in 1, incorrect diagnosis in 1, and prolonged operative time in 1 case.Malpractice education, careful supervision, awareness during perioperative care, and detailed communication between patients and physicians should be highlighted in training programs to improve patient outcomes and mitigate risk of future malpractice.

Quantum sensing is an ever-evolving research field describing the use of a quantum phenomenon to perform measurement of a physical quantity. Amongst different types of quantum sensors, atomic vapor-based quantum effects are extensively used to measure quantities such as time, velocity, acceleration, and electric and magnetic fields. Here, we propose and demonstrate remote quantum sensing using a chip-scale atomic vapor cell. Specifically, we remotely interrogate mm-scale micromachined vapor cells, and measure the ambient Earth's magnetic field at a standoff distance of ~10 meters and a sensitivity of ~1 pT/Hz^0.5 . Simultaneously we are able measure the distance between micro-cell and the interrogating system by means of time-of-flight measurements, thus correlating between position and magnetic field. Consequently, we provide a novel toolset to measure and map arbitrary, remote, and hard to access magnetic field in unshielded environments with high sensitivity and spatial resolution, paving the way to a variety of novel applications in diverse fields such as medicine, communication, defense, space-exploration, and quantum technologies.