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Traditionally, total shoulder arthroplasty is performed using a deltopectoral approach through which the glenohumeral joint is accessed by mobilization of the subscapularis. Despite several variations on the subscapularis management techniques, postoperative complications, including subscapularis deficiency and lower functional outcomes, remain an area for improvement. The purpose of this Technical Note is to describe in detail our technique for management of the subscapularis in the setting of a stemless humeral implant through which the repair is planned and almost entirely performed at the beginning of the case, prior to the subscapularis peel. This technique aims to improve outcomes after total shoulder arthroplasty by 1) avoiding the anatomic implant with anchor drilling, 2) improving procedure efficiency, and 3) anatomically "repairing" the subscapularis prior to takedown by placing anchors exactly at the repair-tension site.

The institutionalized status of markets is undoubtedly due to their presumed ability to aggregate individual bids into a single unbiased estimate of value. While not denying this emergent property of market processes, we propose and test an alternative perspective that explains how market processes can also generate the propagation of individual valuation errors that aggregate into price bubbles. Theoretically, we advance a microinstitutional perspective that draws from social and evolutionary psychology linking market processes to a more general process of institutionalization, whereby individuals seeking the adaptive benefits of conformity may—due to bounded and socially biased rationality—instead generate maladaptive individual and collective outcomes. Empirically, we craft an efficient experimental market and find three sets of evidence consistent with our microinstitutionalization perspective. We first show—at the individual level—that market participants exhibit a social bias toward conformity with the market’s collective valuation, even when the emergent market valuation is demonstrably incorrect. We then show—at the market level—that the range of valuations over time also decreases in a conforming direction, again independent of valuation accuracy. Last, we provide the first experimental test of the long-assumed effect of social ambiguity on institutionalization, finding that market participants’ over-attention to the collective valuation is indeed sensitive to variation in social ambiguity. We conclude by highlighting the relevance of our theoretical perspective, method, and findings for future research on institutions and institutionalization processes, as well as future studies on social influence and conformity-based errors. Funding: S. S. Levine acknowledges research grants from Singapore Management University; the University of Texas at Dallas; and the European Research Council (agreement 695256). Supplemental Material: The online appendix is available at https://doi.org/10.1287/stsc.2022.0173 .

This study advances and tests the notion that the phenomenon of guilt by association-- whereby innocent organizations are penalized due to their similarity to offending organizations-- is shaped by two distinct forms of generalization. We analyze how and why evaluators’ interpretative process following instances of corporate misconduct will likely include not only inductive generalization (rooted in similarity judgments and prototype-based categorization) but also deductive generalizing (rooted in evaluators’ theories and causal-based categorization). We highlight the role and relevance of this neglected distinction by extending guilt-by-association predictions to include two unique predictions based on deductive generalization. First, we posit a recipient effect: if an innocent organization falls under a negative stereotype that causally links the innocent firm with corporate misconduct, then that innocent firm will suffer a greater negative spillover effect, irrespective of its similarity to the offending firm. Second, we also posit a transmission effect: if the offending firm falls under the same negative stereotype, then the negative spillover effect to other similar firms will be lessened. We also analyze how media discourse can foster negative stereotypes, and thus amplify these two effects. We find support for our hypotheses in an analysis of stock market reactions to corporate misconduct for all U.S. and international firms using reverse mergers to gain publicly traded status in the United States. We discuss the implications of our theoretical perspective and empirical findings for research on corporate misconduct, guilt by association, and stock market prejudice.

Objective: The purpose of this preliminary study was to determine if cleft type and/or history of otitis media with effusion (OM) contribute to backing of /t/ and/or /s/ in young children with and without repaired cleft palate (CP). Method: Participants were 39 children ( M age = 36 months, range: 34–41). Ten children had repaired unilateral cleft lip and palate (CLP), nine had repaired CP only, 12 had no clefts but histories of OM, and eight were typically developing (TD) without clefts or OM history. All children were video- and audio-recorded during administration of the Goldman-Fristoe Test of Articulation–Third Edition (GFTA-3). Standard scores of articulation, frequency of alveolar backing, and first spectral moments of the /t/−/k/ and /s/−/ʃ/ phonetic contrasts were obtained. Results: Children with CLP had lower GFTA-3 scores than both TD ( p = .012) and OM ( p = .001) groups. Fisher's exact test showed that significantly more children with CLP backed alveolar targets, mostly /s/, than children with CP ( p = .020). Children with CLP also had (a) reduced /t/−/k/ spectral difference compared to TD children ( p = .016) and (b) reduced /s/−/ʃ/ spectral difference compared to both children with CP ( p = .010) and children with OM ( p = .018). Children with OM had reduced /t/−/k/ spectral difference compared to TD children ( p = .009). Conclusions: Cleft type contributes to alveolar backing and reduced spectral contrast of /s/−/ʃ/ in 3-year-old children with repaired CP. History of OM affects spectral contrast of /t/−/k/ in noncleft children. Etiology and clinical implications of alveolar backing are discussed.

SummaryApolipoprotein E4 (APOE4) is the strongest risk allele associated with the development of late onset Alzheimer’s disease (AD). Across the CNS, astrocytes are the predominant expressor ofAPOEwhile also being critical mediators of neuroinflammation and cerebral metabolism. APOE4 has been consistently linked with dysfunctional inflammation and metabolic processes, yet insights into the molecular constituents driving these responses remain unclear. Utilizing complementary approaches across humanized APOE mice and isogenic human iPSC astrocytes, we demonstrate that ApoE4 alters the astrocyte immunometabolic response to pro-inflammatory stimuli. Our findings show that ApoE4-expressing astrocytes acquire distinct transcriptional repertoires at single-cell and spatially-resolved domains, which are driven in-part by preferential utilization of the cRel transcription factor. Further, inhibiting cRel translocation in ApoE4 astrocytes abrogates inflammatory-induced glycolytic shifts and in tandem mitigates production of multiple pro-inflammatory cytokines. Altogether, our findings elucidate novel cellular underpinnings by which ApoE4 drives maladaptive immunometabolic responses of astrocytes.

Prior research on the internationalization of firms from emerging countries has fruitfully invoked institutional theory to emphasize the legitimacy benefits that firms that obtain from showing isomorphism with international norms such as Corporate Social Responsibility (CSR). Without denying the intuitive appeal for these firms to communicate acceptance of CSR, we suggest that firms face a legitimacy trade-off, where the hoped-for legitimacy benefits of isomorphism must be weighed against other home-country institutional considerations. We advance and test this notion that firms will navigate this institutional complexity by engaging in anisomorphism, i.e., espousing general acceptance with international values but selective “translation” based on home country differences. We test our predictions by analyzing firms’ communication of CSR, using a unique dataset comprised of 245 firms observed over the period from 2000 to 2018. Consistent with our predictions, we find that firms from countries more reliant on natural resource extraction (e.g., mining and fossil fuel industries) de-emphasize the environmental component of CSR, and firms from more autocratic countries de-emphasize the human rights component of CSR. Additionally, and consistent with our presumption of firms’ weighing the international versus home-country legitimacy trade-off, we find that these main effects are sensitive to changes in firms’ levels of internationalization.

The purpose of the current research was to compare the lexical–grammatical skills of two-year old children with and without repaired cleft palate (CP), accounting for the effect of variables such as vocabulary size at 18 months of age, maternal education level, and gender. Participants included 52 children with CP and 25 typically-developing (TD) children. The CDI-WS was employed to measure vocabulary and grammatical skills. Significant differences were observed between the CP and TD groups with respect to the number of words, word forms (irregular nouns and verbs), word endings (overuse of plural (-s) and past tense (-ed) markers), the mean number of morphemes in their three longest utterances (M3L), and sentence complexity. In addition, compared to TD children, significantly smaller proportions of children with CP were observed to use words to talk about past and future events or use words to talk about an absent object. The difference between the CP and TD groups in terms of the size of vocabulary at 24 months of age was explained by significantly smaller size of vocabulary at 18 months of age in the CP group. Among all predictors, the size of vocabulary at 18 months of age was identified as the most robust precursor of lexical and grammatical skills at 24 months of age. Gender was identified as a predictor of the M3L measure as an index for syntactic ability.

A common prediction in research on practice diffusion is a “strength in numbers” effect (i.e., that a growing number of past adopters will increase the number of future adopters). We advance and te...

The corporate scandals and market crashes of the 2000s generated significant criticism of the shareholder value orientation (SVO) in the USA. We offer a sociopolitical analysis of how this criticism triggered changes in stock-based executive compensation, a central practice associated with the SVO. We first analyze how corporate stakeholders redefined different forms of stock-based compensation, motivated new regulations and wielded direct challenges to specific firms. We then predict how firm-specific differences in external challenges and intra-firm power relationships were related to changes in the use of stock options and restricted stock grants (RSGs), testing our predictions using a longitudinal dataset of S&P 500 executives between 2002 and 2012. We find that firms facing negative media coverage of their executive compensation practices made less use of both forms of stock-based compensation, while firms facing shareholder activism only made less use of stock options, the form that was more heavily criticized. In addition, firms with more powerful CEOs utilized RSGs more heavily and did so even when facing media criticism. Our findings demonstrate that while stock options were vulnerable to change, stock-based compensation remained resilient because the structural power of CEOs, a core corporate governance feature of the SVO, also remained resilient.

While institutional theorists have long viewed governmental mandates as a prototypical coercive pressure generating homogeneous organizational compliance, we suggest that such mandates are often subject to enforcement uncertainty, resulting in a pressure more aptly characterized as “semicoercive” and a compliance result more aptly characterized as heterogeneous. We advance and test a theoretical framework to predict the specific form of heterogeneous compliance in semicoercive contexts, with particular attention to the differential sensitivity of firms to pressures to comply, based on differences in their specific legal, political, and social context. We use the setting of a mandated corporate governance reform in China requiring listed Chinese firms to add independent directors and find general evidence of noncompliance and more specific evidence consistent with the predictions from our sociopolitical framework. We discuss the implications of our theoretical approach and findings for future research on institutional environments, governmental regulations, organizational compliance, and corporate governance.

Scholars have found consistent evidence that directors who served on boards of firms accused of misconduct face reputational penalties in the director labor market. While commonly interpreted in te...

Background: Genetic variants in TREM2 are strongly associated with Alzheimer’s disease (AD) risk but alternative splicing in TREM2 transcripts has not been comprehensively described. Objective: Recognizing that alternative splice variants can result in reduced gene expression and/or altered function, we sought to fully characterize splice variation in TREM2. Methods: Human anterior cingulate autopsy tissue from 61 donors was used for end-point and quantitative PCR and western blotting to identify and quantify novel TREM2 isoforms. Results: In addition to previously described transcripts lacking exon 3 or exon 4, or retaining part of intron 3, we identified novel isoforms lacking exon 2, along with isoforms lacking multiple exons. Isoforms lacking exon 2 were predominant at approximately 10% of TREM2 mRNA in the brain. Expression of TREM2 and frequency of exon 2 skipping did not differ between AD samples and non-AD controls (p = 0.1268 and p = 0.4909, respectively). Further, these novel splice isoforms were also observed across multiple tissues with similar frequency (range 5.3 –13.0%). We found that the exon 2 skipped isoform D2-TREM2 is translated to protein and localizes similarly to full-length TREM2 protein, that both proteins are primarily retained in the Golgi complex, and that D2-TREM2 is expressed in AD and non-AD brain. Conclusion: Since the TREM2 ligand binding domain is encoded by exon 2, and skipping this exon retains reading frame while conserving localization, we hypothesize that D2-TREM2 acts as an inhibitor of TREM2 and targeting TREM2 splicing may be a novel therapeutic pathway for AD.

Here, we show that the capacity to manufacture IL-2 identifies constituents of the expanded CD8 T cell effector pool that display stem-like features, preferentially survive, rapidly attain memory traits, resist exhaustion, and control chronic viral challenges. The cell-intrinsic synthesis of IL-2 by CD8 T cells attenuates the ability to receive IL-2–dependent STAT5 signals, thereby limiting terminal effector formation, endowing the IL-2–producing effector subset with superior protective powers. In contrast, the non–IL-2–producing effector cells respond to IL-2 signals and gain effector traits at the expense of memory formation. Despite having distinct properties during the effector phase, IL-2–producing and nonproducing CD8 T cells appear to converge transcriptionally as memory matures to form populations with equal recall abilities. Therefore, the potential to produce IL-2 during the effector, but not memory stage, is a consequential feature that dictates the protective capabilities of the response.

Elucidating the impact of the gut microbiome on Alzheimer’s Disease (AD) is an area of intense interest. Short chain fatty acids (SCFAs) are major microbiota metabolites that have been implicated as a mediator of gut microbiome effects in the brain. Here, we tested the effects of SCFA-treated water vs. saline-treated water on APPswe/PSEN1dE9 mice maintained under standard laboratory conditions. Mice were treated with SCFAs from five months of age until ten months of age, when they were evaluated for microbiome profile, impaired spatial memory as evaluated with the radial arm water maze, astrocyte activation as measured by Gfap expression and amyloid burden as assessed by histochemistry and MSD ELISA. We report that SCFA treatment increased alpha-diversity and impacted the gut microbiome profile by increasing, in part, the relative abundance of several bacteria that typically produce SCFAs. However, SCFA treatment did not significantly affect behavior. Similarly, SCFAs did not affect cortical or hippocampal astrocyte activation observed in the APP/PS1 mice. Lastly, although robust levels of soluble and insoluble amyloid were present in the APP/PS1 mice, SCFA treatment had no effect on these indices. Overall, our findings are that SCFA treatment modifies the microbiome in a fashion that may increase further SCFA production. However, SCFA treatment did not alter behavior, astrocyte activation, nor amyloid neuropathology in APP/PS1 mice maintained with a conventional microbiome.

BackgroundGenetic variants in TREM2 are strongly associated with Alzheimer’s Disease (AD) risk but alternative splicing in TREM2 transcripts has not been comprehensively described.ObjectiveRecognizing that alternative splice variants can result in reduced gene expression and/or altered function, we sought to fully characterize splice variation in TREM2.MethodsHuman blood and anterior cingulate autopsy tissue from 61 donors were used for end-point and quantitative PCR and Western blotting to identify and quantify novel TREM2 isoforms.ResultsIn addition to previously described transcripts lacking exon 3 or exon 4, or retaining part of intron 3, we identified novel isoforms lacking exon 2, along with isoforms lacking multiple exons. Isoforms lacking exon 2 were predominant at approximately 10% of TREM2 mRNA in the brain. Expression of TREM2 and frequency of exon 2 skipping did not differ between AD samples and non-AD controls (p = 0.1268 and p = 0.4909, respectively). Further, these novel splice isoforms were also observed across multiple tissues with similar frequency (range 5.3 – 13.0%). We found that the exon 2 skipped isoform D2-TREM2 is translated to protein and localizes similarly to full-length TREM2 protein, that both proteins are primarily retained in the Golgi complex, and that D2-TREM2 is expressed in AD and non-AD brain.ConclusionSince the TREM2 ligand binding domain is encoded by exon 2, and skipping this exon retains reading frame while conserving localization, we hypothesize that D2-TREM2 acts as an inhibitor of TREM2 and targeting TREM2 splicing may be a novel therapeutic pathway for AD.

COMPASS addressed several physical processes that may explain the behaviour of important phenomena. This paper presents results related to the main fields of COMPASS research obtained in the recent two years, including studies of turbulence, L–H transition, plasma material interaction, runaway electron, and disruption physics: Tomographic reconstruction of the edge/SOL turbulence observed by a fast visible camera allowed to visualize turbulent structures without perturbing the plasma. Dependence of the power threshold on the X-point height was studied and related role of radial electric field in the edge/SOL plasma was identified. The effect of high-field-side error fields on the L–H transition was investigated in order to assess the influence of the central solenoid misalignment and the possibility to compensate these error fields by low-field-side coils. Results of fast measurements of electron temperature during ELMs show the ELM peak values at the divertor are around 80% of the initial temperature at the pedestal. Liquid metals were used for the first time as plasma facing material in ELMy H-mode in the tokamak divertor. Good power handling capability was observed for heat fluxes up to 12 MW m−2 and no direct droplet ejection was observed. Partial detachment regime was achieved by impurity seeding in the divertor. The evolution of the heat flux footprint at the outer target was studied. Runaway electrons were studied using new unique systems—impact calorimetry, carbon pellet injection technique, wide variety of magnetic perturbations. Radial feedback control was imposed on the beam. Forces during plasma disruptions were monitored by a number of new diagnostics for vacuum vessel (VV) motion in order to contribute to the scaling laws of sideways disruption forces for ITER. Current flows towards the divertor tiles, incl. possible short-circuiting through PFCs, were investigated during the VDE experiments. The results support ATEC model and improve understanding of disruption loads.

Summary Introduction Patients with dentofacial disharmonies (DFDs) seek orthodontic care and orthognathic surgery to address issues with mastication, esthetics, and speech. Speech distortions are seen 18 times more frequently in Class III DFD patients than the general population, with unclear causality. We hypothesize there are significant differences in spectral properties of stop (/t/ or /k/), fricative (/s/ or /ʃ/), and affricate (/tʃ/) consonants and that severity of Class III disharmony correlates with the degree of speech abnormality. Methods To understand how jaw disharmonies influence speech, orthodontic records and audio recordings were collected from Class III surgical candidates and reference subjects (n = 102 Class III, 62 controls). A speech pathologist evaluated subjects and recordings were quantitatively analysed by Spectral Moment Analysis for frequency distortions. Results A majority of Class III subjects exhibit speech distortions. A significant increase in the centroid frequency (M1) and spectral spread (M2) was seen in several consonants of Class III subjects compared to controls. Using regression analysis, correlations between Class III skeletal severity (assessed by cephalometric measures) and spectral distortion were found for /t/ and /k/ phones. Conclusions Class III DFD patients have a higher prevalence of articulation errors and significant spectral distortions in consonants relative to controls. This is the first demonstration that severity of malocclusion is quantitatively correlated with the degree of speech distortion for consonants, suggesting causation. These findings offer insight into the complex relationship between craniofacial structures and speech distortions.

COMPASS-U, a high magnetic field tokamak with hot walls, will be designed and built at IPP Prague. Unique features of this new device bring noticeable constraints and requirements on plasma diagnostics, which make their development highly demanding. In this paper, the main expected constraints influencing the conceptual design of diagnostic tools for COMPASS-U (high temperature of the vacuum vessel, high plasma density, high heat flux density, strong auxiliary plasma heating, spatial constraints, liquid metals in the divertor) are reviewed and possible solutions are indicated.

The present COMPASS tokamak at the Institute of Plasma Physics in Prague is equipped with the 2-mm interferometer, which gives a possibility to measure line-average electron densities up to 1.2×1020 m−3. A high magnetic field tokamak COMPASS-U will be designed and built to replace COMPASS. Higher line-average plasma densities in COMPASS-U of about 5×1020 m−3 will require a new design of the interferometer. This will provide measurements in a wide density range and will allow using a real-time gas puff density feedback. A solution based on the solid-state technology is proposed. The system will use two microwave transceivers with close sub-millimeter wavelengths and will fulfill the principle of the unambiguous measurement. An assessment of signal corrections corresponding to non-linearity effects caused by plasma refractive index is performed. The ray-tracing FIESTA-8 code was used to model the propagation of the probing waves through COMPASS-U plasmas.

This study contributes to the growing literature linking physical characteristics and behavioral tendencies by advancing the current debate on whether a person’s facial width-to-height ratio (fWHR) predicts a variety of antisocial tendencies. Specifically, our large-scale study avoided the social-desirability bias found in self-reports of behavioral tendencies by capturing survey data not only from more than 1,000 business executives but also from evaluators who reported knowing the focal individuals well. With this improved research design, and after conducting a variety of analyses, we found very little evidence of fWHR predicting antisocial tendencies. In light of prior research linking fWHR to social perceptions of evaluators, our results are suggestive of an evolutionary mismatch, whereby a physical characteristic once tied to antisocial tendencies in ancestral environments is—in modern environments—not predictive of such behaviors but instead predictive of biased perceptions.

Recurrent multidirectional shoulder instability (MDI) is a challenging clinical problem, particularly in the setting of connective tissue diseases, and there is a distinct lack of literature discussing strategies for operative management of this unique patient group. These patients frequently present with significant glenoid bone loss, patulous and abnormal capsulolabral structures, and a history of multiple failed arthroscopic or open instability procedures. Although the precise treatment algorithm requires tailoring to the individual patient, we have shown successful outcomes in correcting recurrent MDI in the setting of underlying connective tissue disorders by means of a modified T-plasty capsular shift and rotator interval closure in conjunction with distal tibial allograft bony augmentation. The purpose of this Technical Note was to describe a technique that combines a fresh distal tibial allograft for glenoid bony augmentation with a modified T-plasty capsular shift and rotator interval closure for the management of recurrent shoulder MDI in patients presenting with Ehlers-Danlos syndrome or other connective tissue disorders after failed Latarjet stabilization.

This study addresses the oft-debated questions of whether, when, and how corporate board members help shape firm strategy by advancing a new perspective on heterogeneous director influence that introduces the notion of the deep/broad director. Specifically, we take a sociocognitive and sociopolitical perspective on governance to suggest that deep/broad new outside directors, whose expertise results from a blend of depth and breadth of experience, will have an outsized influence in shaping firm strategy. We test our theory using an extensive multiyear data set that tracks all firms that went through an initial public offering in the United States across multiple business cycles (1997, 2001, and 2004) until 2011. Focusing on new outside directors in their first year of service (and controlling for selection issues), our results support our main prediction that those directors whose prior experiences are both deep and broad are the most influential directors for strategic change. We find this result to be robust for multiple indicators of strategic change. We also explore whether the outsized influence of the deep/broad director on strategic change may vary by differences in a board’s openness to strategic change. We conclude by highlighting the relevance of our approach and findings for future research and debates on director selection and director expertise. The supplementary file is available at https://doi.org/10.1287/orsc.2018.1258 .

Apolipoprotein E (APOE) alleles impact pathogenesis and risk for multiple human diseases, making them primary targets for disease treatment and prevention. Previously, we and others reported an association between APOE alleles and the gut microbiome. Here, we evaluated effects of APOE heterozygosity and tested whether these overall results extended to mice maintained under ideal conditions for microbiome analyses. To model human APOE alleles, this study used APOE targeted replacement (TR) mice on a C57Bl/6 background. To minimize genetic drift, homozygous APOE3 mice were crossed to homozygous APOE2 or homozygous APOE4 mice prior to the study, and the resulting heterozygous progeny crossed further to generate the study mice. To maximize environmental homogeneity, mice with mixed genotypes were housed together and used bedding from the cages was mixed and added back as a portion of new bedding. Fecal samples were obtained from mice at 3-, 5- and 7-months of age, and microbiota analyzed by 16S ribosomal RNA gene amplicon sequencing. Linear discriminant analysis of effect size (LefSe) identified taxa associated with APOE status, depicted as cladograms to show phylogenetic relatedness. The influence of APOE status was tested on alpha-diversity (Shannon H index) and beta-diversity (principal coordinate analyses and PERMANOVA). Individual taxa associated with APOE status were identified by classical univariate analysis. Whether findings in the APOE mice were replicated in humans was evaluated by using published microbiome genome wide association data. Cladograms revealed robust differences with APOE in male mice and limited differences in female mice. The richness and evenness (alpha-diversity) and microbial community composition (beta-diversity) of the fecal microbiome was robustly associated with APOE status in male but not female mice. Classical univariate analysis revealed individual taxa that were significantly increased or decreased with APOE, illustrating a stepwise APOE2-APOE3–APOE4 pattern of association with heterozygous animals trending as intermediate in the stepwise pattern. The relative abundance of bacteria from the class Clostridia, order Clostridiales, family Ruminococacceae and related genera increased with APOE2 status. The relative abundance of Erysipelotrichia increased with APOE4 status, a finding that extended to humans. In this study, wherein mice were maintained in an ideal fashion for microbiome studies, gut microbiome profiles were strongly and significantly associated with APOE status in male APOE-TR mice. Erysipelotrichia are increased with APOE4 in both mice and humans. APOE allelic effects appeared generally intermediate in heterozygous animals. Further evaluation of these findings in humans, as well as studies evaluating the impact of the APOE-associated microbiota on disease-relevant phenotypes, will be necessary to determine if alterations in the gut microbiome represent a novel mechanism whereby APOE alleles impact disease.

Purpose This case report describes the development, characteristics, and resolution of anterior nasal fricatives (ANFs)—a learned maladaptive articulation error—in a young girl with repaired bilateral cleft lip and palate. Method The girl was observed every 2 months from 12 to 24 months of age with follow-ups at 36, 48, and 67 months of age. Results At 12 months of age, the girl nasalized /b/ inconsistently and had mild conductive hearing loss. At 18 months of age, she exhibited audible nasal air emission on some plosives and used ANFs to replace /s/ and /z/, often with a nasal grimace. At 24 months of age, the child continued to experience mild conductive hearing loss, obligatory nasal air emission, and ANFs for /s/ and /z/. At 36 months of age, pressure-flow testing documented significant velopharyngeal (VP) dysfunction. The girl then used ANFs for /f/ and /s/, phonetically marked by different oral stops. At 48 months of age, although VP impairment continued, speech therapy largely eliminated ANFs. By 67 months of age, VP closure was nearly normal. Conclusions Multiple factors including VP dysfunction, audible nasal air emission, and conductive hearing loss contributed to the development of ANFs. Clinical and etiological implications are discussed.

COMPASS Upgrade is a new medium size, high magnetic field tokamak (R = 0.9 m, Bt = 5 T, Ip = 2 MA) currently under design in the Czech Republic. It will provide unique capabilities for addressing some of the key challenges in plasma exhaust physics, advanced confinement modes and advanced plasma configurations as well as testing new plasma facing materials and liquid metal divertor concepts. This paper contains an overview of the preliminary engineering design of the main systems of the COMPASS Upgrade tokamak (vacuum vessel, central solenoid and poloidal field coils, toroidal field coils, support structure, cryostat, cryogenic system, power supply system and machine monitoring and protection system). The description of foreseen auxiliary plasma heating systems and plasma diagnostics is also provided as well as a summary of expected plasma performance and available plasma configurations.

PurposeThis study determined the time course of the emergence of prevocalic stop consonants in young children with cleft palate following surgical repair.MethodA total of 120 children in four cohorts from three institutions were followed from 12 to 24 months of age: (a) 24 with repaired cleft lip and palate (CLP), (b) 36 with repaired cleft palate only (CP), (c) 33 without clefts but with histories of frequent otitis media and ventilation tubes (OM), and (d) 27 typically developing (TD) children without clefts or OM. Emergence of prevocalic stops and symbolic language skills were determined during administration of the Communication and Symbolic Behavioral Scales Developmental Profile. Parametric survival models were fitted with and without covariates—recruitment site, gender, maternal education level, middle ear status, language ability, and age at surgery for children with clefts—to describe the time course of the emergence of prevocalic stops.ResultsThe estimated age at which 80% of children demonstrated prevocalic stop emergence was 15.0, 15.3, 18.9, and 21.8 months for TD, OM, CP, and CLP groups, respectively (p< .001, unadjusted model). Both CP and CLP cohorts had a significantly longer time to stop emergence than either the TD or OM cohorts, even after adjusting for covariates. Abnormal middle ear status, lower symbolic language ability, and older age at palatal surgery were significantly associated with delayed stop emergence.ConclusionsSurvival model estimates show that four out of five children with repaired cleft palate will achieve emergence of prevocalic stop consonants by 19–22 months of age, corresponding to 9–12 months following palate repair. Clinical implications are discussed.

International audience; This paper examines how Facebook is used by political parties during elections to extend or accelerate their reach within the electorate and how successful these efforts are. Specifically, we compare the content and style of parties’ Facebook posts during the 2014 European parliament elections, and how this affects followers’ responses in terms of liking, sharing and commenting on the posts. Our findings reveal while that the timing and visual content of posts are important in increasing voters’ attention, interactivity matters most. Responsive party posts on Facebooks are significantly more likely to be shared, liked, and commented on by users. Given that follower reactions, particularly sharing, helps to increase the visibility of party communication through indirect or two-step flow communication (online and offline), these findings are important in advancing our understanding of how and why social media campaigns are able to influence voters and thus affect election outcomes. For parties themselves the results provide some useful insights into what makes for an ‘effective’ Facebook campaign in terms of how they can accelerate the reach of their communication.

The scale model measurements of the field distribution at various distances from the aperture of antennas based on oversized quasioptical waveguides are presented. The goal is to study their characteristics for introducing radiation into the plasma chamber of thermonuclear fusion reactors. It was found that such antennas provide the necessary parameters of the microwave beam (diameter and divergence) without the use of focusing mirrors.

Elevated IL-10 in aged mice suppresses immune responses and has implications for vaccine nonresponsiveness in the elderly., Aging results in profound immune dysfunction, resulting in the decline of vaccine responsiveness previously attributed to irreversible defects in the immune system. In addition to increased interleukin-6 (IL-6), we found aged mice exhibit increased systemic IL-10 that requires forkhead box P3–negative (FoxP3−), but not FoxP3+, CD4+T cells. Most IL-10–producing cells manifested a T follicular helper (Tfh) phenotype and required the Tfh cytokines IL-6 and IL-21 for their accrual, so we refer to them as Tfh10 cells. IL-21 was also required to maintain normal serum levels of IL-6 and IL-10. Notably, antigen-specific Tfh10 cells arose after immunization of aged mice, and neutralization of IL-10 receptor signaling significantly restored Tfh-dependent antibody responses, whereas depletion of FoxP3+ regulatory and follicular regulatory cells did not. Thus, these data demonstrate that immune suppression with age is reversible and implicate Tfh10 cells as an intriguing link between “inflammaging” and impaired immune responses with age.

Although researchers have devoted considerable attention to assessing how organizations benefit from ascriptions of high status, relatively little research has analyzed the financial costs that organizations may incur in actively managing such ascriptions. In this study, we analyze how and why organizations may pay a relatively steep economic price for the attainment and/or maintenance of social status. Specifically, we advance an original theoretical perspective, which suggests that firms engaged in economic competition are simultaneously engaged in social ceremony and that these dual processes can generate a combination of social gains (in terms of status) and economic losses (in terms of profitability). We theorize and test our perspective in the context of competitive bidding ceremonies using a unique, decade-long data set on repeated competitive market interactions among firms in the U.S. construction industry. We find support for our prediction that firms’ participation in bidding ceremonies can generate divergent outcomes, that is, higher social status and diminished economic performance. We discuss the implications of our theoretical and empirical analysis for the existing literature on social status, competitive bidding, and—more generally—on the role social forces play in competitive market behaviors and outcomes.

Objective: To determine vocabulary and lexical selectivity characteristics of children with and without repaired cleft palate at 24 months of age, based on parent report. Participants: Forty-nine children with repaired cleft palate, with or without cleft lip (CP±L; 25 males; 21 cleft lip and palate, 28 CP only), 29 children with a history of otitis media (OM) and ventilation tubes (21 males), and 25 typically developing (TD) children (13 males). Main Outcome Measure(s): Parent-reported expressive vocabulary was determined using the MacArthur Communicative Development Inventory: Words and Sentences. Results: Vocabulary size was reduced for children with repaired CP±L compared to children in the TD group ( P = .025) but not the OM group ( P = .403). Mean percentage of words beginning with sonorants did not differ across groups ( P = .383). Vocabulary size predicted sonorant use for all groups ( P = .001). Conclusions: Children with repaired CP±L exhibit similar lexical selectivity relative to word initial sounds compared to noncleft TD and OM peers at 24 months of age, based on parent report.

Posterior nasal fricatives (PNFs) are unusual articulations that occur in some children with and without cleft palate. The etiology of PNFs is unclear. A young girl with repaired cleft palate is described who exhibited inconsistent obligatory nasal turbulence during production of stops at 2 years of age. At 3 years of age, she exhibited various phonological processes and used PNFs to replace sibilants and affricates. Pressure-flow testing showed a relatively small velopharyngeal area during production of stops. These observations are consistent with obligatory nasal turbulence triggering the development of PNFs as an unusual phonological process, perhaps facilitated by reduced hearing.

The current time is characterized by the rapid development of modern production methods. These modern production methods are in many cases closely linked to progressive production methods, including EDM. The required high productivity and product quality is the reason for using such production methods. In addition to flawless production processes and highly sophisticated production equipment, these requirements can only be met using high-quality production tools. This paper, therefore, aims to describe the results of the analysis of current approaches in the field of modern trends in the development of electrical discharge machining, closely focusing on the development of control systems for generating electrical impulses in connection with the development of advanced tool electrodes. The performed analysis is also supplemented by the definition of mutual relations between selected properties of wire tool electrodes, their cutting power, and the achieved quality of the machined surface after electrical discharge machining. This should significantly help in increasing the quality level of the machined surface during wire electrical discharge machining and at the same time higher productivity of the electroerosive process. This will make this technology more competitive compared to other advanced technologies.