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Researchers argue that third parties help sustain human cooperation, yet how they contribute remains unclear, especially in small-scale, politically decentralized societies. Studying justice among Mentawai horticulturalists in Indonesia, we examined evidence for punishment and mediation by third parties. Across a sample of 444 transgressions we find no evidence of direct third-party punishment. Most victims and aggrieved parties demanded payment, and if a transgressor faced punishment, this was never imposed by third parties. We find little evidence of indirect sanctions by third parties. Nearly 20% of transgressions were followed by no payment, and as predicted by dyadic models of sanctions, payments were less likely when transgressions were among related individuals. Approximately 75% of all mediators called were third parties, especially shamans and elders, and mediators were called more as cooperation was threatened. Our findings suggest that, among the Mentawai, institutionalized penalties function more to restore dyadic cooperation than to enforce norms.

Cellular senescence and the senescence-associated secretory phenotype (SASP) are implicated in aging and age-related disease, and SASP-related inflammation is thought to contribute to tissue dysfunction in aging and diseased animals. However, whether and how SASP factors influence the regenerative capacity of tissues remains unclear. Here, using intestinal organoids as a model of tissue regeneration, we show that SASP factors released by senescent fibroblasts deregulate stem cell activity and differentiation and ultimately impair crypt formation. We identify the secreted N-terminal domain of Ptk7 as a key component of the SASP that activates non-canonical Wnt / Ca2+ signaling through FZD7 in intestinal stem cells (ISCs). Changes in cytosolic [Ca2+] elicited by Ptk7 promote nuclear translocation of YAP and induce expression of YAP/TEAD target genes, impairing symmetry breaking and stem cell differentiation. Our study discovers secreted Ptk7 as a factor released by senescent cells and provides insight into the mechanism by which cellular senescence contributes to tissue dysfunction in aging and disease.

Glaucoma is a prevalent neurodegenerative disease that is characterized by progressive visual field loss. It is the leading cause of irreversible blindness in the world. The main risk factor for glaucoma is elevated intraocular pressure that results in the damage and death of retinal ganglion cells (RGCs) and their axons. The death of RGCs has been shown to be apoptotic. We tested the hypothesis that blocking the activation of apoptosis may be an effective strategy to prevent RGC death and preserve functional vision in glaucoma. In the magnetic microbead mouse model of induced ocular hypertension, inhibition of RGC apoptosis was targeted through viral-mediated ocular delivery of the X-linked inhibitor of apoptosis (XIAP) gene, a potent caspase inhibitor. Pattern electroretinograms revealed that XIAP therapy resulted in significant protection of both somal and axonal RGC function in glaucomatous eyes. Histology confirmed that the treated optic nerves showed preservation of axon counts and reduced glial cell infiltration. These results show that XIAP is able to provide both functional and structural protection of RGCs in the microbead model of glaucoma and provide important proof-of-principle for XIAP's efficacy as a neuroprotective treatment for glaucoma.

Paternal mental health is beginning to be recognized as an essential part of perinatal health. Historically, fathers were not recognized as being at risk for perinatal mental illnesses or relevant to maternal and infant health outcomes. The purpose of this paper is to provide an overview of paternal perinatal mental health, leading tools to assess paternal depression and anxiety, the impact of paternal mental health on mother and child health, and future directions for the field. An international team of paternal perinatal mental health experts summarized the key findings of the field. Fathers have an elevated risk of depression and anxiety disorders during the perinatal period that is associated with maternal depression and can impact their ability to support mothers. Paternal mental health is uniquely associated with child mental health and developmental outcomes starting from infancy and continuing through the child lifespan. Tailored screening approaches for paternal mental health are essential to support fathers early in the perinatal period, which would offset health risks for the family. Recommendations on paternal mental health are provided on four key areas to support father perinatal mental health: (1) intervention research, (2) clinical training, (3) national policy, and (4) the inclusion of fathers in the focus of the International Marce Society for Perinatal Mental Health.

Past research suggests that people with opioid dependence show increased consumption of sweet food, but it is unclear if this is influenced by altered taste preference and/or taste perception. We tested whether people prescribed opioid substitution therapy (OST) exhibited a shift in preference towards sweeter flavours, and altered perception of sweetness, and explored whether these measures of taste preference/perception were associated with measures of opioid use. Three groups of participants (people prescribed OST, n=36; people with past opioid dependence, but now abstinent from all opioids, n=18; and controls with no history of substance dependence other than nicotine, n=29) provided ratings of “sweetness”, “liking”, and “desire” of 4 solutions with varying concentrations of sucrose. We did not find significant differences between groups in the effect of sucrose concentration on “sweetness”, “liking”, or “desire” ratings. However, among those prescribed OST, frequency of recent illicit opioid use was associated with reduced perception of “sweetness” of low sucrose concentrations. Higher methadone dose was associated with a shift towards liking sweeter concentrations. Among those with past opioid dependence, longer duration of abstinence from opioids was associated with a shift towards liking sweeter concentrations. Among people currently dependent on opioids, reduced sensitivity to low levels of sweetness and increased preference for sweeter flavours may be associated with increased dependence on opioids. Among those who have ceased opioid use, the association between preference for sweeter flavours and duration of abstinence is a novel finding that deserves further investigation.

The bioelectrical signals that produce uterine contractions during parturition are not completely understood. The objectives are as follows: (1) to review the literature and information concerning uterine biopotential waveforms generated by the uterus, known to produce contractions, and evaluate mechanotransduction in pregnant patients using electromyographic (EMG) recording methods and (2) to study a new approach, uterine vector analysis, commonly used for the heart: vectorcardiography analysis. The patients used in this study were as follows: (1) patients at term not in labor (n = 3); (2) patients during the 1st stage of labor at cervical dilations from 2 to 10 cm (n = 30); and (3) patients in the 2nd stage of labor and during delivery (n = 3). We used DC-coupled electrodes and PowerLab hardware (model no. PL2604, ADInstruments, Castle Hill, Australia), with software (LabChart, ADInstruments) for storage and analysis of biopotentials. Uterine and abdominal EMG recordings were made from the surface of each patient using 3 electrode pairs with 1 pair (+ and −, with a 31-cm spacing distance) placed in the right/left position (X position) and with 1 pair placed in an up/down position (Y position, also 31 cm apart) and with the third pair at the front/back (Z position). Using signals from the three X, Y, and Z electrodes, slow (0.03 to 0.1 Hz, high amplitude) and fast wave (0.3 to 1 Hz, low amplitude) biopotentials were recorded. The amplitudes of the slow waves and fast waves were significantly higher during the 2nd stage of labor compared to the 1st stage (respectively, p = 9.54 × e−3 and p = 3.94 × e−7). When 2 channels were used, for example, the X vs. Y, for 2-D vector analysis or 3 channels, X vs. Y vs. Z, for 3-D analysis, are plotted against each other on their axes, this produces a vector electromyometriogram (EMMG) that shows no directionality for fast waves and a downward direction for slow waves. Similarly, during the 2nd stage of labor during abdominal contractions (“pushing”), the slow and fast waves were enlarged. Manual applied pressure was used to evoke bioelectrical activity to examine the mechanosensitivity of the uterus. Conclusions: (1) Phasic contractility of the uterus is a product of slow waves and groups of fast waves (bursts of spikes) to produce myometrial contractile responses. (2) 2-D and 3-D uterine vector analyses (uterine vector electromyometriogram) demonstrate no directionality of small fast waves while the larger slow waves represent the downward direction of biopotentials towards the cervical opening. (3) Myometrial cell action event excitability and subsequent contractility likely amplify slow wave activity input and uterine muscle contractility via mechanotransduction systems. (4) Models illustrate the possible relationships of slow to fast waves and the association of a mechanotransduction system and pacemaker activity as observed for slow waves and pacemakers in gastrointestinal muscle. (5) The interaction of these systems is thought to regulate uterine contractility. (6) This study suggests a potential indicator of delivery time. Such vector approaches might help us predict the progress of gestation and better estimate the timing of delivery, gestational pathologies reflected in bioelectric events, and perhaps the potential for premature delivery drug and mechanical interventions.

This article addresses the problematic perspectives of drone culture. In critiquing focus on the drone’s apparent ‘autonomy’, it argues that such devices function as part of a socio-technical network. They are relational parts of human-machine interaction that, in our changing geopolitical realities, have a powerful influence on politics, reputation and warfare. Drawing on Žižek’s conception of parallax, the article stresses the importance of culture and perception in forming the role of the drone in widening power asymmetries. It examines how perceptions of autonomy are evoked by drones, to claim that this misperception is a smokescreen that obscures the relational socio-technical realities of the drone. The article therefore argues that a more critical culture of the drone emerges by shifting the focus and perception from autonomy to anonymity. This allows us to engage more fully with the distributed agency and decision-making that define how drones are developed and deployed. Rather than focusing on the drone as a singular, fetishised, technical object, a relational approach to the drone assemblage is proposed that highlights the competing human interests that define and resist drones in global politics and culture.

U.S. policy interventions encourage earlier provision of Vocational Rehabilitation (VR) services to support students and youth with disabilities such as autism spectrum disorder (ASD) during the transition from school to work. We analyzed Rehabilitation Services Administration (RSA-911) data using multivariable logistic regression to determine the association of VR services receipt with employment outcomes for students ages 16-21, same-age non-student youth and young adults with ASD. Students with autism received job-related services (job search, job placement, and on-the-job supports) at rates significantly below comparison groups, even though odds of successful employment at VR exit were significantly higher if they received these services. Findings suggest that rates of employment among students with autism might be improved with intentional delivery of job-related services.

Histopathologic assessment of melanocytic neoplasms is the current gold standard of diagnosis. However, there are well recognized limitations including inter-observer diagnostic discordance. This study aimed to determine if integrating dermoscopy with histopathology of melanocytic neoplasms impacts diagnosis and improves inter-observer agreement. We conducted a prospective cohort study in a pigmented lesion clinic. Consecutive melanocytic lesions were identified for biopsy based on atypical gross or dermoscopic features. Standardized immunohistochemistry and levels were ordered on each specimen. The cases were randomized. Three dermatopathologists blinded to the clinical impression assessed each lesion. The cases were then re-randomized and re-assessed with addition of gross clinical and dermoscopic images. Inter-rater reliability (IRR) using Fleiss' kappa statistic revealed an increase from 0.447 without to 0.496 with dermoscopy amongst all dermatopathologists. The kappa increased from 0.495 before to 0.511 with dermoscopy in separating high-grade atypia or melanoma from moderate atypia or less. In 16 of 136 cases, at least 2 of 3 dermatopathologists favored a diagnosis of melanoma only after dermoscopy. In total, the consensus grade of atypia changed in 24.3% (33/ 136) of cases thereby representing changes to excisional margins and patient follow up. This study is limited by the cohort size. Dermoscopy significantly impacts diagnosis and improves identification of early melanomas in high risk populations and improves inter-observer agreement.

To evaluate the association of exposure to adverse childhood experiences (ACEs) and being a child with special health care needs (CSHCNs), and risks of specific ACE exposures with CSHCN status. An analysis of 91,219 children from the 2011–2012 National Survey of Children’s Health. Multivariable logistic regression was used to compare the odds of CSHCN status based on total ACE exposure and on distinct types of ACE exposure. Overall, 20% of children met CSHCN criteria. Although 57% of children had no ACEs, 23% had experienced 1, 13% had experienced 2–3 ACEs, and

Background Approximately one in ten men experience mental health difficulties during the early years of fatherhood, and these can have negative impacts on children and families. However, few evidence-based interventions targeting fathers’ mental health are available. The aim of the trial is to evaluate the effectiveness and cost-effectiveness of Working Out Dads (WOD) – a facilitated peer support group intervention for fathers of young children, in reducing psychological distress and other mental health symptoms. Methods This trial will employ a parallel-arm randomised controlled trial (RCT) to evaluate the effectiveness and cost effectiveness of WOD peer support group intervention compared to usual care (a 30-min mental health and service focused phone consultation with a health professional). A total of 280 fathers of young children (aged 0-4 years) who are experiencing mental health difficulties and/or are at risk of poor mental health will be recruited. Randomisation and analyses will be at the level of the individual participant. The primary outcome is psychological distress symptoms, measured by the Kessler Psychological Distress Scale (K10) from baseline to 24 weeks post randomisation. A range of secondary outcomes will be assessed including suicidal ideation; mental health disorders, specific symptoms of depression, anxiety, and stress; social support, quality of life, health service use, and health care costs. Data will be collected at baseline, 10- and 24 weeks post-randomisation. Discussion This trial will examine the effectiveness of a novel group-based peer support intervention in reducing the psychological distress and other mental health symptoms of fathers compared to usual care. The economic and process evaluation will guide policy decision making along with informing the future implementation of WOD on a larger scale if effectiveness is demonstrated. Trial registration The current trial has been registered with ClinicalTrials.gov (Registration ID - NCT04813042). Date of Registration: March 22nd, 2021.

This is a reply to the essays by Catherin Prueitt, Sonam Kachru, and Roy Tzohar on the problem of intersubjectivity in Yogācāra, from a panel at the American Academy of Religion. I argue that the problem of explaining genuine intersubjectivity, as opposed to parallel subjectivity remains unsolved.

This study tested four theoretical models of leadership with data from the ethnographic record. The first was a game-theoretical model of leadership in collective actions, in which followers prefer and reward a leader who monitors and sanctions free-riders as group size increases. The second was the dominance model, in which dominant leaders threaten followers with physical or social harm. The third, the prestige model, suggests leaders with valued skills and expertise are chosen by followers who strive to emulate them. The fourth proposes that in small-scale, kin-based societies, men with high neural capital are best able to achieve and maintain positions of social influence (e.g., as headmen) and thereby often become polygynous and have more offspring than other men, which positively selects for greater neural capital. Using multiple search strategies we identified more than 1000 texts relevant to leadership in the Probability Sample of 60 cultures from the Human Relations Area Files (HRAF). We operationalized the model with variables and then coded all retrieved text records on the presence or absence of evidence for each of these 24 variables. We found mixed support for the collective action model, broad support for components of the prestige leadership style and the importance of neural capital and polygyny among leaders, but more limited support for the dominance leadership style. We found little evidence, however, of emulation of, or prestige-biased learning toward, leaders. We found that improving collective actions, having expertise, providing counsel, and being respected, having high neural capital, and being polygynous are common properties of leaders, which warrants a synthesis of the collective action, prestige, and neural capital and reproductive skew models. We sketch one such synthesis involving high-quality decision-making and other computational services.

Background Prosthetic joint infection (PJI) following total hip replacement (THR) surgery is a serious complication that negatively impacts patients’ lives and is financially burdensome for healthcare providers. As the number of THRs increases, so does this financial burden. This research estimates the economic burden with respect to inpatient and day case hospital admissions for patients receiving revision surgery for PJI following primary THR. Methods In this matched cohort study, the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) was used to identify patients. Patients revised for PJI with a one- or two-stage revision following THR and patients not revised for PJI were matched on several characteristics using exact and radius matching. Hospital inpatient and day case healthcare records from the English Hospital Episode Statistics database were obtained for 5 years following the identified patient’s primary THR. UK national unit costs were applied to hospital admissions and the 5-year total cost was estimated. A two-part model (Probit and generalised linear model) was employed to estimate the incremental difference in costs between those revised and not revised for PJI. Results Between 2006 and 2009, 1914 revisions for PJI were identified in the NJR. The matching resulted in 422 patients revised for PJI and 1923 matches not revised for PJI who were included in the analysis. The average cost of inpatient and day case admissions in the 5 years following primary THR was approximately £42,000 for patients revised for PJI and £8000 for patients not revised for PJI. The difference in costs over the 5 years was £33,452 (95% CI £30,828 to £36,077; p Conclusions In the 5 years following primary THR, patients who develop PJI and have revision surgery cost approximately £33,000 (over 5-fold) more than patients not revised for PJI based on their hospital inpatient and day case admissions alone. The total burden of PJI is likely to be much higher when also considering outpatient, primary and community care costs. This highlights the need to find both ways to reduce the incidence of PJI following THR and cost-effective treatment strategies if PJI occurs.

Purpose of Review We review original research about services for adults on the autism spectrum published from January 2013 through December 2018. The main aim is to characterize the topical and methodological aspects of research about services. We review research on services related to employment, living in the community, and social participation. We compare our results with those from a similar review published in 2012 to assess progress and identify where new directions in research about services for adults with autism are needed. Recent Findings We found the evidence base about services for adults on the autism spectrum remains very small and highly variable in aims and methods. There is wide variability in methods used to define sampling frames and recruit participants. Most studies focus on employment. Almost no studies examine the overall ecosystem of services serving autistic adults. Few studies use a conceptual framework for understanding access to, or improvement of, services. Summary The small size of the extant research coupled with inconsistent quality prevents the accumulation of new knowledge in ways that would significantly inform the improvement of systems of care for the growing population of adults on the autism spectrum.

India has been independent for 70 years now, and it is a good time to reflect on the political philosophy that underwrote the movement that gained that independence. When we do so, we discover the origins of a political vocabulary that is still in use today, although sadly not used with the same rigor and precision with which it was used then. We also find that those who recur to Indian political thought from the pre-independence period tend to return to a single strand of that thought—the theorization of ahimsa by Mohandas K. Gandhi, as for instance in the recent essay on Indian political thought in The New York Times by Gopalkrishna Gandhi (Gandhi won’t leave India 2017). In this discussion, we hope to draw attention to some of the less well-known resources offered by pre-independence Indian philosophy and in particular the political thought of the Arya samaji Congressman, philosopher and political activist, Lajpat Rai. His political philosophy is important for understanding the theorization of and debates within the Indian independence movement; we think that it also suggests ways to think about contemporary political and revolutionary movements and merits consideration in current debates in political philosophy.