Deconstructing the Reflection in the Mirror:

Women facing middle age and beyond are pressured by a cultural ideal of slimness. Literature pertaining to the factors affecting the societal perceptions of body image will be reviewed. Authors also will address relevant counseling interventions aimed at this population, specifically group therapy based in Narrative theory

From Koszul duality to Poincar\'e duality

We discuss the notion of Poincar\'e duality for graded algebras and its connections with the Koszul duality for quadratic Koszul algebras. The relevance of the Poincar\'e duality is pointed out for the existence of twisted potentials associated to Koszul algebras as well as for the extraction of a good generalization of Lie algebras among the quadratic-linear algebras.Comment: Dedicated to Raymond Stora. 27 page

(Contravariant) Koszul duality for DG algebras

A DG algebras $A$ over a field $k$ with $H(A)$ connected and $H_{<0}(A)=0$ has a unique up to isomorphism DG module $K$ with $H(K)\cong k$. It is proved that if $H(A)$ is degreewise finite, then RHom_A(?,K): D^{df}_{+}(A)^{op} \equiv D_{df}^{+}}(RHom_A(K,K)) is an exact equivalence of derived categories of DG modules with degreewise finite-dimensional homology. It induces an equivalences of $D^{df}_{b}(A)^{op}$ and the category of perfect DG $RHom_A(K,K)$-modules, and vice-versa. Corresponding statements are proved also when $H(A)$ is simply connected and $H^{<0}(A)=0$.Comment: 33 page

Sedimentology and isotope geochemistry of transitional evaporitic environments within arid continental settings: From erg to saline lakes

Arid continental basins typically contain a spectrum of coeval environments that coexist and interact from proximal to distal. Within the distal portion, aeolian ergs often border playa, or perennial, desert lakes, fed by fluvial incursions or elevated groundwaters. Evaporites are common features in these dryland, siliciclastic dominant settings. However, sedimentary controls upon evaporite deposition are not widely understood, especially within transitional zones between coeval clastic environments that are dominantly controlled by larger scale allocyclic processes, such as climate. The sulphur (δ34S) and oxygen (δ18O, Δ17O) isotope systematics of evaporites can reveal cryptic aspects of sedimentary cycling and sulphate sources in dryland settings. However, due to the lack of sedimentological understanding of evaporitic systems, isotopic data can be easily misinterpreted. This work presents detailed sedimentological and petrographic observations, coupled with δ34S, δ18O and Δ17O data, for the early Permian Cedar Mesa Sandstone Formation (western USA). Depositional models for mixed evaporitic / clastic sedimentation, which occurs either in erg‐marginal or lacustrine‐marginal settings, are presented to detail the sedimentary interactions present in terms of climate variations that control them. Sedimentological and petrographical analysis of the evaporites within the Cedar Mesa Sandstone Formation reveal a continental depositional environment and two end member depositional models have been developed: erg‐margin and lake‐margin. The δ34S values of gypsum deposits within the Cedar Mesa Sandstone Formation are consistent with late Carboniferous to early Permian marine settings. However, a marine interpretation is inconsistent with sedimentological and petrographic evidence. Consequently, δ34S, δ18O and Δ17O values are probably recycled and do not reflect ocean‐atmosphere values at the time of evaporite precipitation. They are most likely derived from the weathering of older marine evaporites in the hinterland. Thus, the results demonstrate the need for a combination of both sedimentological and geochemical analysis of evaporitic systems to better understand their depositional setting and conditions

Supersymmetric Deformations of Maximally Supersymmetric Gauge Theories

We study supersymmetric and super Poincar\'e invariant deformations of ten-dimensional super Yang-Mills theory and of its dimensional reductions. We describe all infinitesimal super Poincar\'e invariant deformations of equations of motion of ten-dimensional super Yang-Mills theory and its reduction to a point; we discuss the extension of them to formal deformations. Our methods are based on homological algebra, in particular, on the theory of L-infinity and A-infinity algebras. The exposition of this theory as well as of some basic facts about Lie algebra homology and Hochschild homology is given in appendices.Comment: New results added. 111 page

Institutional review of the management of type II odontoid fractures: associations and outcomes with fibrous union

OBJECTIVE Type II odontoid fractures may be managed operatively or nonoperatively. If managed with bracing, bony union may never occur despite stability. This phenomenon is termed fibrous union. The authors aimed to determine associations with stable fibrous union and compare the morbidity of patients managed operatively and nonoperatively. METHODS The authors performed a retrospective review of their spine trauma database for adults with type II odontoid fractures between 2015 and 2019. Two-sample t-tests and Fisher’s exact tests identified associations with follow-up stability and were used to compare operative and nonoperative outcomes. Sensitivity, specificity, and predictive values were calculated to validate initial stable upright cervical radiographs related to follow-up stability. RESULTS Among 88 patients, 10% received upfront surgical fixation, and 90% were managed nonoperatively, of whom 22% had fracture instability on follow-up. Associations with instability after nonoperative management include myelopathy (OR 0.04, 95% CI 0.0–0.92), cerebrovascular disease (OR 0.23, 95% CI 0.06–1.0), and dens displacement ≥ 2 mm (OR 0.29, 95% CI 0.07–1.0). Advanced age was not associated with follow-up instability. Initial stability on upright radiographs was associated with stability on follow-up (OR 4.29, 95% CI 1.0–18) with excellent sensitivity and positive predictive value (sensitivity 89%, specificity 35%, positive predictive value 83%, and negative predictive value 46%). The overall complication rate and respiratory failure requiring ventilation on individual complication analysis were more common in operatively managed patients (33% vs 3%, respectively; p = 0.007), even though they were generally younger and healthier than those managed nonoperatively. Operative or nonoperative management conferred no difference in length of hospital or ICU stay, discharge disposition, or mortality. CONCLUSIONS The authors delineate the validity of upright cervical radiographs on presentation in association with follow-up stability in type II odontoid fractures. In their experience, factors associated with instability included cervical myelopathy, cerebrovascular disease, and fracture displacement but not increased age. Operatively managed patients had higher complication rates than those managed without surgery. Fibrous union, which can occur with nonoperative management, provided adequate stability

Mapping HIV-1 Vaccine Induced T-Cell Responses: Bias towards Less-Conserved Regions and Potential Impact on Vaccine Efficacy in the Step Study

T cell directed HIV vaccines are based upon the induction of CD8+ T cell memory responses that would be effective in inhibiting infection and subsequent replication of an infecting HIV-1 strain, a process that requires a match or near-match between the epitope induced by vaccination and the infecting viral strain. We compared the frequency and specificity of the CTL epitope responses elicited by the replication-defective Ad5 gag/pol/nef vaccine used in the Step trial with the likelihood of encountering those epitopes among recently sequenced Clade B isolates of HIV-1. Among vaccinees with detectable 15-mer peptide pool ELISpot responses, there was a median of four (one Gag, one Nef and two Pol) CD8 epitopes per vaccinee detected by 9-mer peptide ELISpot assay. Importantly, frequency analysis of the mapped epitopes indicated that there was a significant skewing of the T cell response; variable epitopes were detected more frequently than would be expected from an unbiased sampling of the vaccine sequences. Correspondingly, the most highly conserved epitopes in Gag, Pol, and Nef (defined by presence in >80% of sequences currently in the Los Alamos database www.hiv.lanl.gov) were detected at a lower frequency than unbiased sampling, similar to the frequency reported for responses to natural infection, suggesting potential epitope masking of these responses. This may be a generic mechanism used by the virus in both contexts to escape effective T cell immune surveillance. The disappointing results of the Step trial raise the bar for future HIV vaccine candidates. This report highlights the bias towards less-conserved epitopes present in the same vaccine used in the Step trial. Development of vaccine strategies that can elicit a greater breadth of responses, and towards conserved regions of the genome in particular, are critical requirements for effective T-cell based vaccines against HIV-1

Balancing collective responsibility, individual opportunities and risks: a qualitative study on how police officers reason around volunteering in an HIV vaccine trial in Dar es Salaam, Tanzania

Results from HIV vaccine trials on potential volunteers will contribute to global efforts to develop an HIV vaccine. The purpose of this study among police officers in Dar es Salaam, Tanzania, was to explore the underlying reasons that induce people to enrol in an HIV vaccine trial.\ud We conducted discussions with eight focus groups, containing a total of 66 police officers. The information collected was analyzed using interpretive description. The results showed that participants were motivated to participate in the trial by altruism, and that the participants experienced some concerns about their participation. They stated that altruism in the fight against HIV infection was the main reason for enrolling in the trial. However, young participants were seriously concerned about a possible loss of close relationships if they enrolled in the HIV vaccine trial. Both men and women feared the effect of the trial on their reproductive biology, and they feared interference with pregnancy norms. They were unsure about risks such as the risks of acquiring HIV infection and of suffering physical harm, and they were unsure of the intentions of the researchers conducting the trial. Further, enrolling in the trial required medical examination, and this led some participants to fear that unknown diseases would be revealed. Other participants, however, saw an opportunity to obtain free health services.\ud We have shown that specific fears are important concerns when recruiting volunteers to an HIV vaccine trial. More knowledge is needed to determine participants' views and to ensure that they understand the conduct of the trial and the reasons it is being carried out

Real World Data in Adaptive Biomedical Innovation: A Framework for Generating Evidence Fit for Decision-Making

Analyses of healthcare databases (claims, electronic health records [EHRs]) are useful supplements to clinical trials for generating evidence on the effectiveness, harm, use, and value of medical products in routine care. A constant stream of data from the routine operation of modern healthcare systems, which can be analyzed in rapid cycles, enables incremental evidence development to support accelerated and appropriate access to innovative medicines. Evidentiary needs by regulators, Health Technology Assessment, payers, clinicians, and patients after marketing authorization comprise (1) monitoring of medication performance in routine care, including the materialized effectiveness, harm, and value; (2) identifying new patient strata with added value or unacceptable harms; and (3) monitoring targeted utilization. Adaptive biomedical innovation (ABI) with rapid cycle database analytics is successfully enabled if evidence is meaningful, valid, expedited, and transparent. These principles will bring rigor and credibility to current efforts to increase research efficiency while upholding evidentiary standards required for effective decision-making in healthcare