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The rapid growth of cultural evolutionary science, its expansion into numerous fields, its use of diverse methods, and several conceptual problems have outpaced corollary developments in theory and philosophy of science. This has led to concern, exemplified in results from a recent survey conducted with members of the Cultural Evolution Society, that the field lacks 'knowledge synthesis', is poorly supported by 'theory', has an ambiguous relation to biological evolution and uses key terms (e.g. 'culture', 'social learning', 'cumulative culture') in ways that hamper operationalization in models, experiments and field studies. Although numerous review papers in the field represent and categorize its empirical findings, the field's theoretical challenges receive less critical attention even though challenges of a theoretical or conceptual nature underlie most of the problems identified by Cultural Evolution Society members. Guided by the heterogeneous 'grand challenges' emergent in this survey, this paper restates those challenges and adopts an organizational style requisite to discussion of them. The paper's goal is to contribute to increasing conceptual clarity and theoretical discernment around the most pressing challenges facing the field of cultural evolutionary science. It will be of most interest to cultural evolutionary scientists, theoreticians, philosophers of science and interdisciplinary researchers.

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BACKGROUND: The appropriate use of medicines has long been recognized as a fundamental component of medicine policies. We aimed to extract lessons from published research on how policy contexts and mechanisms can affect the outcomes of national- or health-system level interventions to promote appropriate medicine use (defined as an increase in underutilized medications or decrease in inappropriate medication use). METHODS: We conducted a rapid realist review of published evidence concerning system-level policies to promote the appropriate use of medicines in high-income countries with universal prescription drug coverage. We searched MEDLINE and Embase to identify relevant publications. We used a realist evaluation framework to identify contexts, mechanisms, and outcomes for each intervention and to hypothesize which policy contexts and mechanisms supported successful outcomes in terms of relative changes in the prevalence of use of the specific medication classes targeted. RESULTS: From 1,318 identified studies, 18 met our inclusion criteria. 13 distinct policies were identified. Three main policy-related factors underpinned successful interventions: involving providers and patients through program interventions; central coordination through national agencies dedicated to medicine policies; and the establishment of an explicit and integrated national medicine policy strategy. CONCLUSION: Policymakers can improve coordination of national pharmaceutical policies to reduce harms from inappropriate medicines use, thus improving health outcomes through cost-effective programs.

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The cultural transmission of technical know-how has proven vital to the success of our species. The broad diversity of learning contexts and social configurations, as well as the various kinds of coordinated interactions they involve, speaks to our capacity to flexibly adapt to and succeed in transmitting vital knowledge in various learning contexts. Although often recognized by ethnographers, the flexibility of cultural learning has so far received little attention in terms of cognitive mechanisms. We argue that a key feature of the flexibility of cultural learning is that both the models and learners recruit cognitive mechanisms of action coordination to modulate their behavior contingently on the behavior of their partner, generating a process of mutual adaptation supporting the successful transmission of technical skills in diverse and fluctuating learning environments. We propose that the study of cultural learning would benefit from the experimental methods, results, and insights of joint-action research and, complementarily, that the field of joint-action research could expand its scope by integrating a learning and cultural dimension. Bringing these two fields of research together promises to enrich our understanding of cultural learning, its contextual flexibility, and joint action coordination.

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Biomechanics and training load monitoring are important for performance evaluation and injury prevention in elite swimming. Monitoring of performance and swim stroke parameters is possible with inertial measurement units (IMU) but has not been validated in para-swimmers. The purpose of this study was to validate a single IMU-based system to accurately estimate pool-swam lap time, stroke count (SC), stroke duration, instantaneous stroke rate (ISR), and distance per stroke (DPS). Eight Paralympic athletes completed 4 × 50 m swims with an IMU worn on the sacrum. Strokes cycles were identified using a zero-crossing algorithm on the medio-lateral (freestyle and backstroke) or forward-backward (butterfly and breaststroke) instantaneous velocity data. Video-derived metrics were estimated using Dartfish and Kinovea. Agreement analyses, including Bland-Altman and Intraclass Correlation Coefficient (ICC), were performed on all outcome variables. SC Bland-Altman bias was 0.13 strokes, and ICC was 0.97. ISR Bland-Altman biases were within 1.5 strokes/min, and ICCs ranged from 0.26 to 0.96. DPS Bland-Altman biases were within 0.20 m, and ICCs ranged from 0.39 to 0.93. A single-IMU system can provide highly valid performance and swim stroke monitoring data for elite para-swimmers for the majority of strokes, with the exception of backstroke. Future work should improve bilateral stroke detection algorithms in this population.

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The bifocal stance theory posits two stances - the ritual and the instrumental - each a learning strategy with different fidelity outcomes. These differences in turn have long-term consequences for cultural stability. Yet we suggest the key concept of "fidelity" is insufficiently explicated. Pointing to counterexamples and gaps in the theory, we suggest that explicating "fidelity" reveals the stances to be heuristic explanatory strategies: first-pass explanatory glosses of learning and its consequences, not descriptions of the inner machinery of agents.

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The ability to transmit information between individuals through social learning is a foundational component of cultural evolution. However, how this transmission occurs is still debated. On the one hand, the copying account draws parallels with biological mechanisms for genetic inheritance, arguing that learners copy what they observe and novel variations occur through random copying errors. On the other hand, the reconstruction account claims that, rather than directly copying behaviour, learners reconstruct the information that they believe to be most relevant on the basis of pragmatic inference, environmental and contextual cues. Distinguishing these two accounts empirically is difficult based on data from typical transmission chain studies because the predictions they generate frequently overlap. In this study we present a methodological approach that generates different predictions of these accounts by manipulating the task context between model and learner in a transmission episode. We then report an empirical proof-of-concept that applies this approach. The results show that, when a model introduces context-dependent embedded signals to their actions that are not intended to be transmitted, it is possible to empirically distinguish between competing predictions made by these two accounts. Our approach can therefore serve to understand the underlying cognitive mechanisms at play in cultural transmission and can make important contributions to the debate between preservative and reconstructive schools of thought.

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Inertial measurement unit systems (IMU) are increasingly used in sports. However, no algorithm evaluating the instantaneous swimming velocity has been validated on the four swimming strokes, or on dive start. Our objective is to develop and validate a new method to measure instantaneous swimming velocity on athletes presenting various musculoskeletal and neurological impairments and swimming one of the four swimming strokes. Seven Paralympic athletes were involved and performed a total of 18 trials of 50 m in real conditions. All trials were recorded with a 3-axis accelerometer, a tethered device and a video camera. The instantaneous velocity was computed by drift-free integration of the forward acceleration. For all trials, Bland-Altman analyses showed a bias of 0.03-0.06 m.s-1 with the tethered device, with 95% LOA lower than 0.31-0.80 m.s-1, RMSE was 0.14-0.39 m.s-1, and ICC amounted 0.494-0.941. No significant difference was found for the mean 50 m velocities between the accelerometer, the tethered device and the video camera. The results obtained for freestyle were comparable to those obtained with GPS in outdoor pools. Those obtained for backstroke, breaststroke and butterfly were very encouraging. Our method is simple, reliable, advantageous compared to tethered devices, and could be easily used in the field by coaches.

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Typical examples of cultural phenomena all exhibit a degree of similarity across time and space at the level of the population. As such, a fundamental question for any science of culture is, what ensures this stability in the first place? Here we focus on the evolutionary and stabilising role of 'convergent transformation', in which one item causes the production of another item whose form tends to deviate from the original in a directed, non-random way. We present a series of stochastic models of cultural evolution investigating its effects. The results show that cultural stability can emerge and be maintained by virtue of convergent transformation alone, in the absence of any form of copying or selection process. We show how high-fidelity copying and convergent transformation need not be opposing forces, and can jointly contribute to cultural stability. We finally analyse how non-random transformation and high-fidelity copying can have different evolutionary signatures at population level, and hence how their distinct effects can be distinguished in empirical records. Collectively, these results supplement existing approaches to cultural evolution based on the Darwinian analogy, while also providing formal support for other frameworks - such as Cultural Attraction Theory - that entail its further loosening. Social media summary: Culture can be produced and maintained by convergent transformation, without copying or selection involved.

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PURPOSE: The purpose of this study was to report the long-term results of women treated in one center with accelerated partial-breast irradiation (APBI) with interstitial high-dose-rate (HDR) brachytherapy. MATERIALS AND METHODS: We analyzed data from women treated in one center with adjuvant interstitial HDR brachytherapy for early-stage breast cancer. Treatment regimen was homogeneous for all women with treatment dose 32Gy in 8 fractions twice daily given to the tumor bed with interstitial HDR brachytherapy. RESULTS: About 364 women were treated with interstitial HDR brachytherapy as APBI from March 2000 to March 2014. Mean age at diagnosis was 62 years. Stage distribution was as follows: T1a = 12%, T1b = 33%, T1c = 40%, T2 = 14%, and Tis = 1%. 97% of patients were N0. 88% had invasive ductal carcinoma. 86% had positive hormone receptor status. 14 ipsilateral breast tumor recurrences were identified with 12 deemed local recurrences and 2 deemed to be second ipsilateral primaries. Actuarial 5-year and 10-year overall survival rates were 95.1% and 92.2%, respectively. Actuarial 5-year and 10-year local relapse-free survival rates were 96.2% and 88.8%, respectively. CONCLUSIONS: The results of this previously unreported series of women treated with a homogeneous APBI method exclusively with interstitial HDR brachytherapy present further data justifying that in appropriately selected women, APBI with interstitial brachytherapy provides rates of local control and survival comparable with whole-breast irradiation.

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The purpose of this study was to verify the metrological properties of portable force plates that are used to assess countermovement jump performance. While 88 participants (38 males, 50 females) were included in the agreement analyses, 84 participants (37 males and 47 females) completed the reliability part of the study. This randomized crossover design suggests that portable force plates could be used interchangeably with a reference system. Indeed, the differences between both devices were all considered trivial (effect size (ES) < 0.20), and the mean bias was never greater than 3.41% in comparison to the reference system. In addition, the absolute and relative reliability parameters were found to be acceptable for clinical use, even when used on different floor surfaces. However, it was found that the ratio between flight time and contraction time (FTCT) showed questionable reliability when tests were conducted on different surfaces (intraclass correlation coefficient = 0.49; coefficient of variation = 26.72%). Therefore, practitioners should be careful when installing the portable device on different floor surfaces in order to optimize the reliability and the ability to detect real change in the context of a countermovement jump monitoring process.

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The Canadian patchwork system of prescription drug coverage and the employer sponsored private health benefits group plans appear vulnerable to cost growth due to insufficient balance of power between fragmented public and private buyers, and pharmaceutical manufacturers. The emergence of "bad" insurance risks caused by new and very expensive treatments featuring high cost specialty medicines - also known as niche buster drugs - exposes this vulnerability. This study fills a gap in knowledge by seeking to better understanding how Canadian private insurers face the arrival of specialty pharmaceuticals. It completes an overview of a body of grey literature composed of publicly available online articles from the employment benefits and group insurance consulting and administration industry; online documents from group benefits sector conferences; and online or on demand materials from Canadian life and health insurers. Claims for high cost specialty drugs generate new bad insurance risks that Canadian health insurers attempt to mitigate through isolated corporate initiatives, industry-wide strategies and calls for universal, public catastrophic coverage. The outcomes of these strategies are limited cost-control measures as well as risk and cost transfers onto plan sponsors, patients and provincial public programs.

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In the last decade, cultural transmission experiments (transmission chains, replacement, closed groups and seeded groups) have become important experimental tools in investigating cultural evolution. However, these methods face important challenges, especially regarding the operationalization of theoretical claims. In this review, we focus on the study of cumulative cultural evolution, the process by which traditions are gradually modified and, for technological traditions in particular, improved upon over time. We identify several mismatches between theoretical definitions of cumulative culture and their implementation in cultural transmission experiments. We argue that observed performance increase can be the result of participants learning faster in a group context rather than effectively leading to a cumulative effect. We also show that in laboratory experiments, participants are asked to complete quite simple tasks, which can undermine the evidential value of the diagnostic criterion traditionally used for cumulative culture (i.e. that cumulative culture is a process that produces solutions that no single individual could have invented on their own). We show that the use of unidimensional metrics of cumulativeness drastically curtail the variation that may be observed, which raises specific issues in the interpretation of the experimental evidence. We suggest several solutions to these mismatches (learning times, task complexity and variation) and develop the use of design spaces in experimentally investigating old and new questions about cumulative culture.

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PURPOSE: Nitrate supplementation can increase tolerance to high-intensity work rates; however, limited data exist on the recovery of performance. The authors tested whether 5 d of nitrate supplementation could improve repeated time-trial performance in speed skating. METHODS: Using a double-blind, placebo-controlled, crossover design, 9 international-level short-track speed skaters ingested 1 high (juice blend, ∼6.5 mmol nitrate; HI) or low dose (juice blend, ∼1 mmol nitrate; LO) per day on days 1-4. After a double dose of either HI or LO on day 5, athletes performed 2 on-ice 1000-m time trials, separated by 35 min, to simulate competition races. Differences between HI and LO were compared with the smallest practically important difference. RESULTS: Salivary [nitrate] and [nitrite] were higher in HI than LO before the first (nitrate: 81%, effect size [ES]: 1.76; nitrite: 72%, ES: 1.73) and second pursuits (nitrate: 81%, ES: 1.92; nitrite: 71%, ES: 1.78). However, there was no difference in performance in the first (LO: 90.92 [4.08] s; HI: 90.95 [4.06] s, ES: 0.01) or the second time trial (LO: 91.16 [4.06] s; HI: 91.55 [4.40] s, ES: 0.09). Plasma [lactate] measured after the trials (LO: 14.8 [1.1] mM; HI: 14.8 [1.2] mM, ES: 0.01) and at the end of the recovery period (LO: 9.8 [2.1] mM; HI: 10.2 [1.9] mM, ES: 0.05) was not different between treatments. CONCLUSION: Five days of high-dose nitrate supplementation did not change physiological responses and failed to improve single and repeated time-trial performances in world-class short-track speed skaters. These data suggest that nitrate ingestion up to 6.5 mmol does not enhance recovery from supramaximal exercise in world-class athletes.

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PURPOSE: To determine the acute toxicity and effect on health-related quality of life of a two-fraction regimen of high-dose-rate (HDR) prostate brachytherapy. METHODS AND MATERIALS: Patients with low- or intermediate-risk prostate cancer were treated with HDR brachytherapy as monotherapy in two implants of 13.5 Gy spaced 7-14 days apart. Patients completed International Prostate Symptom Score (IPSS) and Expanded Prostate Index Composite (EPIC) questionnaires at 1, 3, 6, 9, 12, 16, 20, and 24 months after brachytherapy. Proportion of patients in each IPSS category (mild = 0-7, moderate = 8-18, severe = 19+) was evaluated at each of the intervals above. Paired t tests with baseline values were done for IPSS and EPIC scores. RESULTS: Thirty patients were accrued to the study. Median prostate-specific antigen was 8,7 (range 4.1-17.5). T stages were T1c = 65%, T2a = 21%, and T2b = 14%. Twenty-seven percent of patients had a Gleason score of 6 and 73% had a Gleason score of 7. IPSS categories at baseline, 1, 3, 6, 12, and 24 months were mild (81%, 43%, 58%, 62%, 76%, 64%), moderate (19%, 32%, 29%, 30%, 20%, 29%), and severe (0%, 25%, 13%, 7%, 4%, 6%), respectively. There was a significant decrease in EPIC sexual summary scores at 1, 3, 6, and 12 months of 0 points (p < 0.001), 17 points (p = 0.01), 18 points (p = 0.02), and 17 points (p = 0.01), respectively. CONCLUSIONS: This is the first report of this cohort of patients treated with two-fraction HDR monotherapy. This regimen shows rates of toxicity and health-related quality of life that appear acceptable as compared to other treatment modalities. These results are also comparable with other reports with similar treatment regimens.

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The use of physical models of molecular structures as research tools has been central to the development of biochemistry and molecular biology. Intriguingly, it has received little attention from scholars of science. In this paper, I argue that these physical models are not mere three-dimensional representations but that they are in fact very special research tools: they are cognitive augmentations. Despite the fact that they are external props, these models serve as cognitive tools that augment and extend the modeler's cognitive capacities and performance in molecular modeling tasks. This cognitive enhancement is obtained because of the way the modeler interacts with these models, the models' materiality contributing to the solving of the molecule's structure. Furthermore, I argue that these material models and their component parts were designed, built and used specifically to serve as cognitive facilitators and cognitive augmentations.

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Herein, we present the first example of a benzimidazolium-based artificial transmembrane chloride transporter and a synthetic calcium ionophore that can regulate intracellular calcium concentrations in bacteria.

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This study examined the influence of a mechanical perturbation of the ankle joint on obstacle avoidance pattern. A decoupled control between the distal joint and the combined (hip-knee) proximal joints was observed according to the task requirement. In this context, a greater mechanical friction at the ankle should be compensated at this joint (local compensation) or alternatively, by regulating more combined proximal joints (knee and/or hip). The leading limb inter-segmental coordination was evaluated in both no constraint and constraint conditions in calculating ranges of motion (ROM), moments of force and powers (from heel-off to obstacle) at the ankle, knee and hip joints. Electromyographic activities were also analyzed. With the constraint, the dorsiflexor moment and the tibialis anterior activity remained unchanged while both ROM and power bursts (absorbed and generated) decreased. The hip and knee ROM remain invariant. At heel-off the absorption by hip extensors decreased and the forthcoming generation by knee flexors increased in the constraint condition. To quantify the inter-joint coordination, principal component analysis was used and indicated a high level of inter-joint coupling (synergy) that decreased with the constraint (i.e. less inter-joint coupling). At the ankle joint, the results suggest that the central command was the same in both conditions thus, not be adapted. At both the hip and knee joints, a combined joints modulation occurred to overcome additional friction.

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