text:
Frailty and post-operative outcomes in older surgical patients: a systematic review
Hui-Shan Lin ORCID: orcid.org/0000-0003-4863-61741,
J. N. Watts1,
N. M. Peel1 &
R. E. Hubbard1
As the population ages, increasing numbers of older adults are undergoing surgery. Frailty is prevalent in older adults and may be a better predictor of post-operative morbidity and mortality than chronological age. The aim of this review was to examine the impact of frailty on adverse outcomes in the 'older old' and 'oldest old' surgical patients.
A systematic review was undertaken. Electronic databases from 2010 to 2015 were searched to identify articles which evaluated the relationship between frailty and post-operative outcomes in surgical populations with a mean age of 75 and older. Articles were excluded if they were in non-English languages or if frailty was measured using a single marker only. Demographic data, type of surgery performed, frailty measure and impact of frailty on adverse outcomes were extracted from the selected studies. Quality of the studies and risk of bias was assessed by the Epidemiological Appraisal Instrument.
Twenty-three studies were selected for the review and they were assessed as medium to high quality. The mean age ranged from 75 to 87 years, and included patients undergoing cardiac, oncological, general, vascular and hip fracture surgeries. There were 21 different instruments used to measure frailty. Regardless of how frailty was measured, the strongest evidence in terms of numbers of studies, consistency of results and study quality was for associations between frailty and increased mortality at 30 days, 90 days and one year follow-up, post-operative complications and length of stay. A small number of studies reported on discharge to institutional care, functional decline and lower quality of life after surgery, and also found a significant association with frailty.
There was strong evidence that frailty in older-old and oldest-old surgical patients predicts post-operative mortality, complications, and prolonged length of stay. Frailty assessment may be a valuable tool in peri-operative assessment. It is possible that different frailty tools are best suited for different acuity and type of surgical patients. The association between frailty and return to pre-morbid function, discharge destination, and quality of life after surgery warrants further research.
As the population ages, the rate of surgical procedures in the older population is rising. In England, 2.5 million people over the age of 75 years underwent surgery between years 2014 and 2015, as opposed to just under 1.5 million between 2006 and 2007 [1, 2]. Nearly 30 % of these 2.5 million were over 85 years old [1]. Similarly, women aged 85 years and over now represent the largest proportion in emergency surgical admissions in Australia compared with all other age and sex groups [3].
It has long been recognised that advanced age can carry increased risk of mortality and morbidity after surgery. However, new knowledge is emerging that frailty, an age-related cumulative decline in multiple physiological systems, is a better predictor of mortality and morbidity than chronological age [4, 5]. Patients of the same age do not all have the same risk. The identification and assessment of frailty may facilitate identification of vulnerable surgical patients so that appropriate surgical and anaesthetic management can be implemented.
Experienced clinicians may feel that they can identify frailty by end-of-bed 'gestalt' assessments. However, 'eyeballing' is subjective and tends to be inconsistent between different observers [6]. Currently there is no standardised method of measuring frailty, with more than 20 different frailty instruments identified in a systematic review [7]. These different scales are based on the two main models which characterise how frailty develops and manifests. In the 'phenotype' model described by Fried et al. [8], frailty manifests as decline in lean body mass, strength, endurance, balance, walking performance and low activity. Patients who have three or more of the five features of slowness, weakness, exhaustion, weight loss and low physical activity are deemed frail, while those who have none of the features are non-frail. Patients who display one or two of the five features are "pre-frail" [8].
The second model by Rockwood et al. is the Frailty Index (FI), or the cumulative deficit model, developed in the Canadian Study of Health and Aging (CSHA) [9]. This model conceptualises aging as the accumulation of deficits and views frailty as a multidimensional risk state quantified by the number of deficits rather than by the nature of the health problems. An FI can be based on comprehensive geriatric assessment and is calculated by counting the number of deficits present in an individual, divided by the total number of deficits measured [10]. The deficits encompass co-morbidities, physical and cognitive impairments, psychosocial risk factors and common geriatric syndromes [10]. The FI score ranges between 0 and 1, with higher scores indicating greater degree of frailty. FI represents a continuum; however, it can also be trichotomised to indicate low, intermediate and high level of frailty (FI ≤ 0.25, FI >0.25-0.4, FI >0.4) [11].
There has been a significant increase in literature over the last five years on the subject of frailty in surgical patients. A search for articles on Pubmed published between the years 2011 and 2015 using search terms 'frailty' AND 'surgical outcome' identified 173 titles, whereas the same search for publications between 2006 and 2010 yielded only 34 titles. The majority of the current literature investigating frailty and surgery has defined 'geriatric' as those above 60 or 65 years old. However, there has been a change in who is thought of as 'old'. Basing studies on someone 65 years old may not provide insight into appropriate treatment for the 'new' geriatric patient [12]. Despite frailty being more prevalent with increasing age, and the large proportion of those over 75 years old undergoing surgery, frailty in the 'old old' and the 'oldest old' (aged 75–85 and over 85 years) surgical patients has been less comprehensively explored.
The aim of this systematic review, therefore, was to examine the association between frailty and adverse post-surgical outcomes in patients aged 75 years and over.
PUBMED, MEDLINE, EMBASE and Cochrane online databases were searched using search terms of 'frail*' AND 'surg*' in combination with ('outcome' OR 'morbidity' OR 'complication'). An asterisk was used to indicate the term was truncated or had a variation in spelling. The search was conducted between October and December 2015 with filters applied to limit results to the English language, human research, and publications from year 2010 and onwards.
Publication selection
The inclusion criteria for the search were: 1) the mean participant age was over 75 years; 2) the patient population had a surgical procedure; 3) frailty was assessed as a composite measure of more than one domain of health deficit, which accords with the current conceptualisation of frailty [13, 14] and was the main factor of interest in the study; and 4) the relationship between frailty and adverse outcomes was evaluated. Exclusion criteria were review articles, conference abstracts, and studies which measured frailty as a single item, such as a scan finding, a blood marker, or a physical performance test such as gait speed.
Two reviewers (HL, JW) conducted the searches independently and compared results after assessing all identified abstracts for their compliance with the review criteria. Where agreement could not be reached a third independent reviewer (NP) was consulted. Reasons for exclusion were documented.
The following data were extracted from the eligible studies: sample size, mean age, country of origin of the study population, study design, type of surgery performed, frailty measure, and impact of frailty on adverse outcome.
Assessment of study quality and risk of bias
Two reviewers (HL, JW) independently assessed the quality of the included studies using a modified version of the Epidemiological Appraisal Instrument (EAI), a valid and reliable tool for rating the quality of observational studies [15]. The EAI checklist addressed the following five domains of risk of bias: reporting, subject selection, measurement quality, data analysis, and generalisation of results. Each of the 23 questions in the EAI applicable to the selected studies was scored as yes (=2), partial (=1), no or unable to determine (=0) with the highest possible score being 46.
An a priori decision was made to divide the total possible score into quartiles. Quartile 1 (Q1) was 35–46 (the highest quality), quartile 2 (Q2) was 23–34, quartile 3 (Q3) was 12–23 and quartile 4 (Q4) was 0–11 (the lowest quality). Any disagreement regarding the assessment of the quality of a study was resolved by consulting a third reviewer (NP).
Grading the overall strength of the evidence
The overall strength of the evidence was evaluated using principles outlined by the Agency for Healthcare Research and Quality [16]. The key elements of evaluation were quality (based on study design according to the hierarchy of evidence and study execution), quantity (based on the number of studies) and consistency.
The literature search identified 686 articles (187 from Pubmed, 169 from Medline, 300 from Embase and 28 from the Cochrane database). From these, 270 duplicate articles were removed. The titles, abstracts and the full texts of the articles were reviewed. Articles were selected based on inclusion and exclusion criteria. The references of selected articles were hand searched for further eligible articles. There were 23 articles included in the final analysis. The study selection process as well as the reasons for exclusion are shown in Fig. 1.
PRISMA flow diagram for study selection
In the 23 articles selected for this review, there were 16 cohorts of patients with a mean or median age ranging from 75 to 87 years. Twenty studies were of prospective design with sample sizes ranging from 30 to 450 [17–36], and three were of retrospective design [37–39], one of which contained a large sample size of nearly 13,000 participants [37]. Publications came from different countries, including USA [17, 18, 35, 37–39], UK [30, 32, 34, 36], Europe [19–28, 31], and Asia [29, 33]. The proportion of females ranged from 31 % [34] to 83 % [35]. Five studies did not report the gender distribution of the cohorts [22, 23, 29, 32, 38]. A meta-analysis was not conducted due to a lack of homogeneity of frailty measures and the diversity of surgical procedures.
Nine studies measured frailty in cardiac surgery [17–24, 39], six in oncological surgery (predominantly focusing on colorectal cancer) [25–29, 37], three in general surgery [30, 31, 33], three in hip fracture surgery [35, 36, 38] and two in vascular surgery [32, 34]. Sixteen articles involved participants undergoing elective surgery [17–29, 33, 37, 39], five involved those undergoing acute surgery [30, 31, 35, 36, 38], while two included those undergoing both elective and acute surgery [32, 34]. Table 1, grouped by the type of surgery, describes the demographics, measurement of frailty and adverse outcome predicted by frailty for the selected studies.
Table 1 Study demographics grouped by type of surgery
Study quality and risk of bias
The EAI scores of the 23 studies ranged from 31 to 45, indicating they were in the upper two quartiles of study methodological quality. The EAI scores were in the in the second quartile for eight studies [18, 19, 22–24, 28, 29, 32] while the remainder 15 studies were in the first quartile [17, 20, 21, 25–27, 30, 31, 33–39]. There was a high level of agreement of quality assessment between the two independent reviewers. The most poorly reported items across all studies were: sample size calculation, adjustment for covariates and the report of losses to follow up. Study quality scores are incorporated into Table 2.
Table 2 Adverse outcome associated with frailty, grouped by the quality of studies
Frailty instruments
Of the 23 included studies, 21 different instruments were used to measure frailty. Variations of the Fried Criteria or instruments based on Comprehensive Geriatric Assessment (CGA), including the Frailty Index, were used in the majority of studies. Scales based on CGA are obtainable from patient interview as well as clinical notes without physical performance based measures, and were used in both acute and elective surgical cohorts. In contrast, the Fried frailty measure required physical performance-based tests, and was used exclusively in elective surgical cohorts. Four instruments, such as Multidimensional Frailty Score [33] and Comprehensive Assessment of Frailty [22–24], combined aspects of CGA with performance based tests (e.g. balance assessments, chair rise, stair climb) and medical investigations (e.g. blood test and respiratory function test). Details of measurement of frailty are presented in Table 1.
Adverse outcomes predicted by frailty
Table 2 shows the adverse outcomes associated with frailty, grouped by the quality of the studies. Short, intermediate and long term mortality were assessed by 16 papers. Of ten studies evaluating the relationship between frailty and 12 month mortality, all found a significant relationship with frailty [18, 19, 21, 23, 24, 32, 33, 37–39]. Odds Ratios ranged between 1.1 and 4.97 for the frail patients compared with those who were non-frail [18, 21, 23, 24, 38, 39]. This association was found regardless of the instruments used to measure frailty and irrespective of the type of surgery performed.
In the two papers that assessed long term mortality, frailty was associated with increased two year mortality with an Odds Ratio of 4.01 [38] and increased five year mortality with an Odds Ratio of 3.6 [27]. The association between frailty and 90 day mortality was evaluated in two studies [30, 37]. One found a significant association with an Odds Ratio of 10.4 [37] while the other did not find a significant association [30]. Thirty day mortality was evaluated in six studies [21, 22, 26, 30, 31, 36]; all but one [30] found a significant association, with Odds Ratios ranging between 1.4 and 8.33 [21, 26, 31]. This latter study included only a small proportion (31 %, n = 105) of patients who underwent surgery [30].
Post-operative complications, as graded by the Clavian-Dindo severity classification [40] or pre-defined by the authors, were evaluated in nine papers [17, 18, 25, 29, 31, 33–35, 39]. Frailty was associated with increased post-operative complications in four studies with Odds Ratios ranging from 1.5 to 4.8 [18, 25, 29, 31]. The remaining five studies reported no significant association [17, 33–35, 39]. The definitions used for post-operative complications in these 10 studies were heterogeneous. Conditions pre-specified in the studies which counted as a post-operative complication included cardiac complications (namely myocardial infarction, heart failure, arrhythmia), pulmonary embolism, pneumonia, wound infection, major bleeding, renal failure, delirium, unplanned return to theatre and unplanned intensive care unit admission.
Specific items of post-operative complications were also examined by several studies. An association between frailty and major cardiac and cerebral adverse events (MACCE) was reported by one of the three studies evaluating this outcome [19, 21, 23]. One study explored the association between frailty and delirium and did not find a significant association [35]. Of two studies evaluating frailty and readmission rate, one study found a significant association [32] while the other did not [30]. One study showed a significant association between frailty and the need for resuscitation [23].
Of the six studies that included prolonged length of stay as an outcome, an association with frailty was found in five [18, 30, 32, 35, 36]. Three studies evaluated functional decline as an outcome, of which only one found a significant association [20]. Discharge to a residential care facility was found to be associated with frailty by both studies in which this outcome was evaluated [32, 33]. Quality of life was evaluated in one study and frailty was associated with the composite poor outcome of mortality or poorer quality of life [39].
Based on quality, quantity and consistency of the included studies, there is evidence for an association between frailty and adverse postoperative outcomes. Although cohort studies are lower on the hierarchy of evidence than randomised controlled trials, it is acknowledged that the cohort study design is entirely appropriate for investigating this particular research question. The literature search identified 23 studies that met the inclusion criteria and 15 of those were in the upper quartile of quality assessment, indicating the majority were methodologically sound. The consistency was evidenced by the finding that 20 of the included studies found evidence of an association between frailty and at least one adverse outcome.
The reviewed studies consistently found that in patients aged over 75 years, frailty was associated with increased mortality, post-operative complications, prolonged length of stay and discharge to residential care facility. The strongest evidence of association was between frailty and 30 day mortality. The association was consistent across different frailty instruments and regardless of the type of surgery performed.
Our findings are congruent with other reviews of frailty in surgical patients. Beggs et al. found eight out of 19 articles demonstrating frailty to be significantly associated with mortality and post-operative complications [41]. Other systematic reviews have concentrated on specific surgical subspecialties, namely oncologic surgery [42], cardiac surgery [43] and thoracic surgery [44]. They also found frailty to impact negatively on post-operative outcomes. Two other reviews written on cardiac surgery also identified frailty as a risk factor that provided important prognostic information in older adults needing surgical or transcatheter aortic valve replacement [45] and found that frailty increased the predictive power of conventional risk scores [46].
The strength of this review is that it is inclusive of all types of surgery, both elective and acute, and focuses on those over 75 years old. This review provided insight into how frailty is measured and how it correlates with adverse outcomes in the 'old-old' and the 'oldest old' surgical population. Our search was limited to English publications, so may have excluded relevant publications in other languages. Another limitation was that studies using single markers to determine frailty, such as measurement of muscle mass or gait speed, were excluded based on the consensus view of frailty being a multidimensional state of increased vulnerability. Finally, due to the differences in frailty instruments used and heterogeneity of the surgical patient population, meta-analysis could not be conducted, and the magnitude of the adverse impact of frailty on outcome could not be estimated.
There is evidence that frailty is associated with increased mortality and morbidity in the older surgical patients. As patients over 75 years old are presenting more commonly for surgery, frailty assessment may have considerable value as a tool for peri-operative assessment. However, for the value of frailty assessment to be realised, it must not only predict outcomes but also be easily incorporated into routine assessment or created from existing information, without placing further resource burden on clinical staff and the patient. Once established, such a tool may offer a valuable addition to the risk assessment of older persons undergoing surgery, alongside the standard surgical and anaesthetic assessment tools. With the increasing focus on patient centred care, the ongoing development of frailty assessment has the potential to improve how well patients can be informed by their surgeons and anaesthetists prior to their procedures, thus enhancing informed consent. The clinical utility, time taken to make frailty assessments and the ease of use of most of the tools in the 23 included studies were not reported, which would be useful in assisting clinicians to decide which tool to adopt into clinical practice.
This review found several important gaps in the current literature. Frailty in acute surgical patients is under-studied. Only 7 out of 23 studies assessed acute surgical patients and all of them used scales based on comprehensive geriatric assessment to measure frailty. Reliance on performance based tests may be impractical in the acute surgical patients. More research into how frailty impacts on surgical patients in the acute setting and how best to measure frailty in acute surgical patients is needed. An instrument which is robust and valid for measuring frailty in elective patients in a surgical pre-admission clinic may not be applicable to the acute patients. Despite the need to find a unified tool for measuring frailty, it is possible that different frailty tools are best suited for different acuity and type of surgical patients. Furthermore, these instruments need to be time-efficient and suitable for application at the bedside by staff who are not geriatricians.
Mortality and post-operative complications are the most commonly studied and reported outcomes in the 23 articles reviewed. Quality of life post-surgery was assessed in only one out of the 23 studies; similarly, functional decline and discharge to a care facility were only evaluated in three and two studies respectively. The association between frailty and functional outcome, discharge destination, and quality of life after surgery warrants further research. Factors and outcomes important to the individual elderly patient undergoing surgery must also be considered when performing pre-operative assessment, such as the consideration of premorbid status and return to the premorbid level of function.
Frailty is consistently found is to be associated with adverse outcomes after surgery. In the 23 articles reviewed, the strongest evidence lies in the association with increased 30 day, 90 day and 1 year mortality, post-operative complications and length of stay. This highlights the importance of detecting frailty in peri-operative assessment. The possibility that different frailty tools may be best suited for different acuity and type of surgical patients is worth exploring. The association between frailty and return to pre-morbid function, discharge destination, and quality of life after surgery warrants further research.
FI:
Frailty index
CSHA:
Canadian Study of Health and Aging
EAI:
Epidemiological appraisal instrument
CGA:
Comprehensive geriatric assessment
MACCE:
Major cardiac and cerebral adverse events
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This research was partially funded by the Princess Alexandra Research Support Scheme to support a Fellowship in Clinical Research for first author.
This paper is a systematic review. Articles selected for this review were referenced in bibliography. All data extracted from the selected studies were presented in the tables. There is no raw data to be made available.
HL and JW were responsible for the literature search, selection of articles for review, quality assessment of the articles and data extraction from the articles. HL was additionally responsible for writing the first draft of the paper and the synthesis of the results. NP and RH were responsible for the conception of the study design and aims and resolving any disagreement in the article assessment by HL and JW. All authors participated in the editing of the manuscript and have approved the final manuscript.
Centre for Research in Geriatric Medicine, Princess Alexandra Hospital, The University of Queensland, Level 2, Building 33, Ipswich Road, Woolloongabba, QLD, 4102, Australia
Hui-Shan Lin, J. N. Watts, N. M. Peel & R. E. Hubbard
Hui-Shan Lin
J. N. Watts
N. M. Peel
R. E. Hubbard
Correspondence to Hui-Shan Lin.
Lin, HS., Watts, J.N., Peel, N.M. et al. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr 16, 157 (2016). https://doi.org/10.1186/s12877-016-0329-8
Post-operative complications
Oldest old


William 'Bill' Coors, the former chairman of US brewer Adolph Coors Company, and who was instrumental in expanding the company to become Molson Coors, has died at the age of 102.
William 'Bill' Coors, the former chairman of the board of Adolph Coors Company, has died at the age of 102.
Coors died peacefully at his home on October 13th, a statement released by the company confirmed. No cause of death was indicated.
Coors was born in 1916, and was the grandson of Adolph Coors Company founder Adolph Coors. He attended Princeton University where he earned a bachelor's degree in chemical engineering in 1938 and a graduate degree in 1939.
He started his career at the family business that same year, later taking control of the company after his brother, Adolph III, was murdered at age 44 in a bungled kidnapping in 1960.
During his more than 65 years with the company, he contributed heavily to the company's rise from a regional brewer to one of the world's largest breweries, thriving at a time when many hundreds of breweries were going out of business.
"The fact that we survived and even grew over the years when so many breweries went out of business was an accomplishment that all Coors employees can be proud of," he would say.
He was also instrumental in the development of the aluminium can, which ultimately revolutionised the beer industry, and also developed filtration and packaging systems that eliminated the need for pasteurisation.
An early advocate of of corporate wellness, he founded one of the first employee wellness centres in the US, which still exists today.
Bill is survived by his children: Margaret Coors Beresford and her husband Michael; May Louise Coors and her husband Sharad Atre; and Williams Scott Coors and his partner David Hurt, along with seven grandchildren, four great-grandchildren and a great number of nieces, nephews, great-nieces and great-nephews.


text:
Technology at Work: CHURCH DOORS UNLOCKED REMOTELY OVER THE INTERNET
Brian Barrett, church operations manager at Bethel United Church of Christ, Elmhurst, Ill., demonstrates use of the access system at the church complex's rear entrance. Above the card reader is the video intercom system.
An access control system that can be operated remotely helps a church provide entrance without its employees being on-site and also helped provide information about a break-in.
The Bethel United Church of Christ, Elmhurst, Ill., had a small stained glass window broken out and clothing for the homeless stolen in December 2005 one month after the new access system had been installed.
The record it provided of when people had last left the building and first arrived was valuable in establishing the time line of the event, reported Brian Barrett, church operations manager. "It showed all activity so you could narrow it down," Barrett explained.
The clothing was abandoned and the burglar left through the church's automatic egress doors, but a large footprint was discovered in the church to provide some clue to the culprit's identity.
The remote entry control system at Bethel United Church of Christ, Elmhurst, Ill., helped provide information about a break-in. The front entrance to the right of the sign is one of three doors with the access system.
The remote access system replaces the "keys to the kingdom" used previously at the church — a standard lock and key management system.
"It was becoming increasingly difficult to track who had keys to the facilities," Barrett notes. "Also, our doors are locked from the outside. If someone needed to have the doors opened for a meeting, our system required that there be another person on the other end to open the doors."
Barrett began looking into access control solutions to help track usage, monitor door events and manage the system from a centralized location. "A church member highly recommended the system to help facilitate the ease of access," he declared.
Barrett can access the system by computer or see who is on the intercom phone at the right.
Bethel houses administrative offices, a pre-school, and several meeting rooms used for special events and functions by groups at varying times of the day and night, Barrett points out. Hence, the remote access feature keeps on-site staffing needs at the church lower.
Initial Electronics, Alsip, Ill., was chosen to install the ACS 5000-E two-reader Ethernet-based control panel from Brivo Systems LLC, Bethesda, Md., for the main door, rear entrance and a supply room closet where the control is located.
Staff and meeting group leaders were assigned ProxCards and PIN numbers from HID Corp., Irvine, Calif., to access the building doors.
Additionally, the sanctuary doors were placed on door timers to eliminate the need for someone to open them physically.
"Web-hosted access control was key for their application because it allows them to control their doors from any Web-browser without having to come to the church," explained Dan Cosgrove, Initial Electronics' account executive.
The ACS system automatically aggregates all customer data and management controls into one centralized system. It eliminated the costly chore of building a wide area network to link databases.
Dan Cosgrove, account executive for Initial Electronics, Alsip, Ill., appears on the Aiphone intercom system's screen at one of the church's two entrances equipped with the system.
All IT maintenance and networking of the system is outsourced to Brivo, which eliminated expensive IT resources and networking infrastructure to maintain the system or link facilities. Brivo estimates the total cost of ownership of its system is up to 50 percent less than traditional non-networked systems.
A video intercom from Aiphone Corp., Bellevue, Wash., also was installed at the same time as the access system to verify the identity of those requesting access.
All in all, the new access and intercom systems have eased access for those entering and those allowing entrance.
Sidebar: On the Job
Brivo ACS 5000-E Two-reader Ethernet-based control panel: www.brivo.com
Three HID Proximity with keypad readers: www.hidcorp.com
Aiphone LEF-5 5-call master
Aiphone MYH-CU pan-tilt monitor
Aiphone MK-DAC door unit with black-and-white camera intercom system: www.aiphone.com
Sidebar: Projects in the news
BEST Monitoring Ltd., New York, has MESH systems booked for 16 separate high-rise buildings in New York. BEST Monitoring has been providing a remote monitoring service, Cyberdoorman, for apartment buildings since 2001. As of December 2005, the integrator has incorporated the MESH touch screen telephone entry panel from Viscount Systems Inc., Burnaby, British Columbia, as part of the service. Currently the MESH panel is contracted in 16 buildings throughout the five boroughs of New York.
The Minneapolis-St. Paul International Airport will upgrade its security system with the Pro-Watch security management software platform from Honeywell, Syosset, N.Y. The upgrade will include installation of new head-end, intelligent controllers and a DESFire contactless smart card identification badge system. Card readers, controllers, and circuit boards will work with the DESFire open standard contactless card technology that will prepare the airport for biometric storage and transfer capabilities. The contactless card system is engineered to encode biometric information, such as fingerprints and hand geometry data.
Adesta LLC, Omaha, Neb., will design, build and install electronic and physical security systems for two additional dams on the Missouri River for the U.S. Army Corps of Engineers – Omaha District. The corps increased the scope of an original contract valued at $4.3 million to include security enhancements at these two dams, bringing the total number of dams that Adesta will secure on the Missouri River to six. This current project is valued at $1.9 million.
Brivo Systems
Technology at Work: VILLAGE INTEGRATES ACCESS AND VIDEO OVER 26 SQUARE MILES AND SEVERAL YEARS
Technology at Work: IP-BASED NETWORK SECURITY CAMERA SYSTEM GETS FANS CLOSER TO THE ACTION
Technology at Work: Ensuring the Insurers Fire Safety
From Visual Surveillance to Internet of Things: Technology and Applications
The Global Maritime and Border Security Market 2020-2030
The Complete Guide to Physical Security
The Monitoring Association
The Monitoring Association (TMA) is an internationally-recognized, non-profit trade association that represents professional monitoring companies, including those listed by a TMA-approved Nationally Recognized Testing Laboratory, such as UL, FM Global, or Intertek/ETL, as well as unlisted companies, security systems integrators, and providers of products and services to the industry. Incorporated in 1950, TMA represents its members before Congress and regulatory agencies on the local, state and federal levels, and other authorities having jurisdiction (AHJs) over the industry. Learn more online at https://tma.us/about-tma/.

redpajama_set_name: RedPajamaCommonCrawl


text:
You are here: Home › News › High testosterone drives risky investments
High testosterone drives risky investments
By Will Parker on September 30, 2008 in News
Higher levels of testosterone correlate strongly with financial risk-taking behavior, finds a new study in Evolution and Human Behavior that sheds light on the evolutionary function and biological origins of risk taking.
Undertaken by Anna Dreber and Coren Apicella, both from Harvard University, the study builds on previous work that demonstrated that stock market traders experienced greater profits on days their testosterone was above its median level. Now, this new study directly examines the relationship between testosterone and financial risk-taking. "Although our findings do not address causality, we believe that testosterone may influence how individuals make risky financial decisions," said Apicella.
In the study, saliva samples were taken from a group of men aged 18 to 23 before their participation in an investment game. The researchers also assessed facial masculinity, associated with testosterone levels at puberty.
All of the participants were given $250, and were asked to choose an amount between $0 and $250 to invest. The participants kept the money that was not invested. A coin toss determined the investment's outcome, and if the participant lost the coin toss, the money allocated to the investment was lost. However, if the coin toss was won, the participant would receive two and a half times the amount of their investment. At the end of the study, one person was selected by lottery to receive the cash amount of their investment, which created a monetary incentive for the participants.
The researchers found that a man whose testosterone levels were more than one standard deviation above the mean invested 12 percent more than the average man into the risky investment. A man with a facial masculinity score of one standard deviation higher than the mean invested 6 percent more than the average man.
The findings may help to explain the biological foundation of why some people are more inclined towards risk-taking than others, suggests Apicella. "Financial risk might be comparable to other risky male behaviors associated with reproduction," she offers. "Men may be more willing to take financial risks because the payoffs, in terms of attracting mates, could be higher for them. This is because women value wealth more than men when choosing for a mate."
Further research will examine changes in testosterone levels in response to financial wins and losses. "This will give us some insight into how changes in the market affect hormones, and in turn, affect decision-making," says Apicella. Finally, the researchers are also exploring the role of genetics in explaining risk preferences. "Maybe we will be able to predict who becomes a trader," muses Dreber.
Testosterone Apocalypse!
Testosterone Key In Disease Transmission
Pointing The Finger At Aggressive Men
Source: Harvard University
Medicos find more evidence of baldness and prostate cancer link Testosterone fails as menopausal magic bullet Testosterone enhances desire to sing, but not song quality Male testosterone levels surge with ovulation Unnatural selection: Courtesy of The Pill 3 Seconds To Choose A Mate
About Will Parker
View all posts by Will Parker →
investment, mate, Testosterone
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To make woven PP Bags, we use continuous fibers, which are then converted into fabric by using various types of looms (Weaving or knitting). Then the fabric is laminated or coated. We buy in woven PP fabric and make it into bags.
In a Spunlaid non-woven the fibers are directly taken onto a moving web arranging them randomly. The unprocessed web looks somewhat similar to that of a cotton. This fibers on this web are then bound together Thermally or Mechanically.
The important technical difference between a woven and non-woven fabric is the strength. Woven fabrics can have much higher strength than that of NW of same GSM. There are various other differences based on the method of manufacturing, material used, etc.


text:
module JSound
  module Midi
    module Devices

      # A Device that records incoming messages, and the timestamp at which they were received.
      class Recorder < Device

        # The recorded [message,timestamp] pairs.
        #
        # Timestamps are in floating point seconds.
        attr_reader :messages_with_timestamps

        # The recorded messages without timestamps
        def messages
          @messages_with_timestamps.map{|m,t| m }
        end

        def initialize(autostart=true)
          clear
          if autostart
            start
          else
            stop
          end
        end

        # clear any recorded messages
        def clear
          @messages_with_timestamps = []
        end

        # start recording
        def open
          @recording = true
        end
        alias start open

        # stop recording
        def close
          @recording = false
        end
        alias stop close

        # true if this object is currently recording
        def open?
          @recording
        end
        alias recording? open?

        def output= device
          raise "#{self.class} cannot be assigned an output"
        end

        def message(message)
          @messages_with_timestamps << [message, Time.now.to_f] if recording?
        end

      end

    end
  end
end

redpajama_set_name: RedPajamaGithub


text:
est le cinquième album du groupe de punk rock américain X, sorti en 1985.

Présentation

Cet album a été le premier à ne pas être produit par Ray Manzarek.

Poursuivant avec leur fusion du punk, du rockabilly et de la country, l'album a moins du son punk rock que les précédents opus, et comprend le petit hit radio .

La vidéo de cette chanson est essentiellement diffusée en fin de nuit sur la chaîne de télévision américaine MTV, mais le groupe a également exécuté la chanson sur l'American Bandstand en , leur apparition à la télévision la plus remarquée à ce jour.

L'album inclut également un cover de la chanson  de .

Le guitariste principal Billy Zoom quittera le groupe après cet album. Il retrouve, cependant, le groupe en 1998 à l'occasion d'une tournée.

En 2002,l'album est réédité, par Rhino Records, avec trois titres bonus.

Liste des titres

 Notes
 En 2002, l'album bénéficie d'une réédition CD remastérisée regroupant les faces A et B de l'édition originale, à laquelle viennent s'ajouter 3 titres bonus.
 Cependant, le titre  est listé comme un titre bonus dans cette ré-édition et n'apparaît qu'en .

Musiciens
 Exene Cervenka – voix
  – guitare, saxophone
  – Batterie, percussions
 John Doe – voix, Guitare basse

Notes et références

Liens externes

Album de punk rock américain
Album musical sorti en 1985
Album publié par Elektra Records
Album produit par Michael Wagener

redpajama_set_name: RedPajamaWikipedia


text:
IL-2:IL-15 cytokine receptor: implications for cancer therapy and vaccine
Waldmann, Thomas
Search 37 grants from Thomas Waldmann
Search grants from Clinical Sciences
Computational and Neural Modeling of Cue Reactivity in Addiction
Diagnostic and prognostic biomarkers for subtypes of addiction-related circuit dysfunction
Discovery of New Anti-Inflammatory Agents to Treat COPD
Vitamin B6 Effects on One-Carbon Metabolism
Antigen-specific CD4+ T cell responses to influenza
ATL is caused by the HTLV-1 retrovirus but it is unknown how this virus leads to cellular transformation. The only HTLV-1 gene product that is expressed in all ATL cells is HBZ but exactly how HBZ transforms T lymphocytes is unclear. Using genomic scale RNA interference, we identified a regulatory network involving the transcription factors BATF3 and IRF4 that is essential for ATL proliferation and survival. Through the use of available gene expression profiling data, we showed that BATF3/IRF4 downstream targets are a hallmark of ATL that distinguishes it from other T-cell lymphoma subsets. We hypothesize that HBZ might potentiate the regulatory network as its mechanism of action. Indeed, we showed using CRISPR mediated knockdown of HBZ and genomic wide profiling of HBZ binding sites that HBZ transactivates BATF3 and thereby augments the expression of BATF3/IRF-4 target genes. Finally, we showed that the BET protein inhibitor JQ1 extinguishes BATF3 expression providing a means to target the action of the HBZ oncoprotein therapeutically. Indeed, ATL xenografts were significantly retarded in their growth by BET inhibitor treatment. Our preclinical studies provide a solid rationale for the initiation of clinical trials of BET inhibitors in ATL. In additional studies, we demonstrated that disorders of common gamma cytokine receptor JAK/STAT pathway are pervasive in T-cell malignancy. As assessed by pSTAT3/pSTAT5 phosphorylation and nuclear translocation there is a proportion of from rare to 86% of virtually all subsets of T-cell lymphoma that manifest such activation of the pathway. In these T-cell malignancies with an activated JAK/STAT pathway activating mutations of STAT3/STAT5B, JAK1, JAK3 were frequent but not sufficient to initiate proliferation and only augmented signals from the cytokine receptor JAK/STAT pathway. pSTAT malignant T-cell lines were addicted to JAK1 and JAK3 whether or not they were mutated. Even with activating JAK mutations there was a requirement for expression of a functional cytokine receptor that played two roles, first as a scaffold for cross-activation of JAK kinases and second as a docking site for recruitment of STAT transcription factors. These studies support the development of a pure JAK1 or pure JAK3 inhibitor as an element in multidrug therapy of T-cell malignancy. A major focus of the Waldmann/Staudt Laboratory is to define molecular abnormalities of HTLV-1 associated ATL. Previously we demonstrated that HTLV-1 encoded Tax transactivates two autocrine (IL-2/IL-2R, IL-15/IL-15R alpha) and one paracrine (IL-9) pathway. To extend these observations we performed molecular interference Achilles' heel screening of ATL cell lines employing a library of retroviral vectors for inducible expression of short-hairpin RNAs (shRNAs) to identify genes essential for leukemic cell survival. Using this loss-of-function screen, 6 of 7 distinct cytokine-dependent ATL cell lines were shown to be critically dependent on JAK1 and JAK3 for proliferation and survival. The critical nature of the gamma cytokine, JAK1/JAK3 pathway for ATL was supported by our observation that the ex vivo 6-day culture of PBMCs from patients with smoldering and chronic ATL could be inhibited by the administration of antibodies to the IL-2 receptor, as well as by the pan-JAK inhibitor, tofacitinib and the JAK1/2 inhibitor, ruxolitinib. To translate these observations, the Waldmann and Conlon Group has initiated a phase II clinical trial involving the JAK1/2 inhibitor, ruxolitinib in patients with ATL. To extend these studies with Craig Thomas we searched for novel multicomponent (combination) drug therapies for ATL by applying high-throughput matrix screening for cellular signaling on ATL cell lines to define combination therapies that identify agents with synergy. Optimal synergy was demonstrated between the JAK1/2 inhibitor, ruxolitinib added in association with the Bcl-xL inhibitor navitoclax. In molecular analyses our laboratory with Masao Nakagawa, a postdoctoral fellow, using RNA-seq identified nonsense mutations of CCR4 in 26% of the malignant cells of patients with ATL leukemic cells. In translation CCR4 is the target of a collaborative clinical trial involving patients with ATL using the anti-CCR4 monoclonal antibody, mogamulizumab. Furthermore, Dr. Liyanage Perera in the Waldmann Laboratory has generated an anti-CCR4 CAR for use in clinical trials of patients with ATL to take advantage of the over 90% CCR4 expression on ATL leukemic cells. In summary, the Waldmann Laboratory has made major contributions concerning the translation of molecular insights concerning ATL into new novel therapeutic strategies for this malignancy and a greater understanding of retroviruses mechanisms of action.
Investigator-Initiated Intramural Research Projects (ZIA)
1ZIASC004002-48
Waldmann, Thomas A (2017) JAK/STAT pathway directed therapy of T-cell leukemia/lymphoma: Inspired by functional and structural genomics. Mol Cell Endocrinol 451:66-70
Sharma, Kamal; Janik, John E; O'Mahony, Deirdre et al. (2017) Phase II Study of Alemtuzumab (CAMPATH-1) in Patients with HTLV-1-Associated Adult T-cell Leukemia/lymphoma. Clin Cancer Res 23:35-42
Waldmann, Thomas A; Chen, Jing (2017) Disorders of the JAK/STAT Pathway in T Cell Lymphoma Pathogenesis: Implications for Immunotherapy. Annu Rev Immunol 35:533-550
Perera, Liyanage P; Zhang, Meili; Nakagawa, Masao et al. (2017) Chimeric antigen receptor modified T cells that target chemokine receptor CCR4 as a therapeutic modality for T-cell malignancies. Am J Hematol 92:892-901
Mocsár, Gábor; Volkó, Julianna; Rönnlund, Daniel et al. (2016) MHC I Expression Regulates Co-clustering and Mobility of Interleukin-2 and -15 Receptors in T Cells. Biophys J 111:100-12
Yeh, Chien-Hung; Bai, Xue Tao; Moles, Ramona et al. (2016) Mutation of epigenetic regulators TET2 and MLL3 in patients with HTLV-I-induced acute adult T-cell leukemia. Mol Cancer 15:15
Ju, Wei; Zhang, Meili; Wilson, Kelli M et al. (2016) Augmented efficacy of brentuximab vedotin combined with ruxolitinib and/or Navitoclax in a murine model of human Hodgkin's lymphoma. Proc Natl Acad Sci U S A 113:1624-9
Yeh, Chien-Hung; Bai, Xue Tao; Moles, Ramona et al. (2016) Erratum to: 'Mutation of epigenetic regulators TET2 and MLL3 in patients with HTLV-I-induced acute adult T-cell leukemia'. Mol Cancer 15:20
Yokoyama, Seiji; Perera, Pin-Yu; Terawaki, Seigo et al. (2015) Janus Kinase Inhibitor Tofacitinib Shows Potent Efficacy in a Mouse Model of Autoimmune Lymphoproliferative Syndrome (ALPS). J Clin Immunol 35:661-7
Zhang, Meili; Mathews Griner, Lesley A; Ju, Wei et al. (2015) Selective targeting of JAK/STAT signaling is potentiated by Bcl-xL blockade in IL-2-dependent adult T-cell leukemia. Proc Natl Acad Sci U S A 112:12480-5
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A new six-page brochure entitled 'Claims for Environmental Damage: An Overview' is now available.
The IOPC Funds' Claims Information Pack already contains Guidelines for presenting claims for environmental damage.
This shortened brochure summarises the key points of the Funds' policy on claims for environmental damage, presenting them in a more simplified, visual format.
The new brochure is available to download via the publications section of the website and in hard copy upon request.


One of the best ways to learn is to do. We don't want to just talk together, we want to practice what we preach. Our next series will be a closer look at our six core practices as we learn to C.R.E.A.T.E. together.
Our sixth and last core practice is to extend generosity. Generosity means more than giving to charity – it means putting others ahead of ourselves. And it means trusting God with our money and possessions, recognizing that He is more valuable than what we have.


text:
Q: Generating sequence of $\cosh a\sqrt{z}$ (recurrence) Let ($z\in\mathbb{C}$, $a\in\mathbb{C}\setminus\{0\}$)
$$w=\cosh a\sqrt{z}=\sum_{n\ge 0}\frac{a^{2n}z^n}{(2n)!}.$$
Then $w$ satisfies the ODE
$$4zw''+2w'-a^2w.$$
So if $w=\sum_{n\ge 0}a_n(z-1)^n$, then
$$4z(n+1)(n+2)a_{n+2}+2(n+1)a_{n+1}-a^2a_n=0.$$
But I should have gotten "another" recurrence for $a_n$, namely
$$4(n+1)(n+2)a_{n+2}+2(2n+1)(n+1)a_{n+1}-a^2a_n=0$$
where $a_0=\cosh a$ and $a_1=a/2 \sinh a$.
Are these even equivalent? If so, how can I prove it? Or is there an error in my approach?
How I got my recurrence:
$$\begin{align}4z\frac{d^2}{dz^2}\sum_{n\ge 0}a_n(z-1)^n+2\frac{d}{dz}\sum_{n\ge 0}a_n(z-1)^n-a^2\sum_{n\ge 0}a_n(z-1)^n&=0\\
4z\sum_{n\ge 0}a_nn(n-1)(z-1)^{n-2}+2\sum_{n\ge 0}a_nn(z-1)^{n-1}-a^2\sum_{n\ge 0}a_n(z-1)^n&=0\\
4z\sum_{n\ge 2}a_nn(n-1)(z-1)^{n-2}+2\sum_{n\ge 1}a_nn(z-1)^{n-1}-a^2\sum_{n\ge 0}a_n(z-1)^n&=0\\
4z\sum_{n\ge 0}a_{n+2}(n+2)(n+1)(z-1)^n+2\sum_{n\ge 0}a_{n+1}(n+1)(z-1)^n-a^2\sum_{n\ge 0}a_n(z-1)^n&=0\\
\sum_{n\ge 0}(z-1)^n(4za_{n+2}(n+2)(n+1)+2a_{n+1}(n+1)-a^2a_n)&=0\\
4za_{n+2}(n+2)(n+1)+2a_{n+1}(n+1)-a^2a_n&=0\end{align}$$

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UBC's Expenditure Guidelines help you determine reasonable and appropriate expenses while conducting university business.
UBC's Expenditure Guidelines are here to help faculty and staff improve transparency and enhance the stewardship of public funds. These guidelines and their guiding principles supplement UBC Policies #83, #84 and #115, and cover other operational activities and expenses. Granting agencies' guidelines, terms of contracts or a unit's own more stringent internal policies take precedence over these guidelines.
Working groups are being convened to review computer purchases and travel expenses. Visit our Frequently Asked Questions page for the latest updates.


The aim of this webpage is to explain the architecture of the USB Device stack.
Note that the same stack is available for both the mbed LPC11U24 and the mbed LPC1768.
It's also in this class that the enumeration step is performed for requests concerning standard descriptors. When a packet is received on the control endpoint (endpoint 0 OUT), it is decoded and analyzed. A response is then sent to the host. Descriptors are accessible via virtual functions such as getDeviceDesc() which returns a pointer on the descriptor. As these functions are virtual, all child classes are able to define their own descriptors.
USBHID: implements standard requests of the HID class specification. When you instantiate a USBHID object, the mbed is enumerated as a generic HID device so that you can send and receive raw data to and from a custom program running on the host side.
USBKeyboard: used to emulate a keyboard. This class also inherits from Stream which means that methods such as printf, puts, putc are available.
USBSerial: used to emulate a virtual serial port. This class also inherits from Stream which means that methods such as printf, scanf, puts, putc, gets and getc are available.
USBMSD_??: All users can implement their own class which inherits from USBMSD in order to access their storage chip.
If you just want an overview of all the capabilities of the USBDevice stack, visit the USBDevice capabilities webpage.
The USBDevice library is available here.


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sjgiants.com | The Official Site of the San Jose Giants
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San Jose Giants News
Giants July 4 Tickets on Sale Now
Celebrate Independence Day at Excite Ballpark with Baseball, Barbeque and Fireworks
San Jose, CA- Individual tickets for the San Jose Giants Fourth of July game at Excite Ballpark are on sale now! The Independence Day ballgame begins at 6:45 PM and finishes with the best fireworks show in the South Bay. Tickets are available for purchase online at sjgiants.com over the phone at 408.297.1435 or in person at the Excite Ballpark Box Office.
"Fireworks, barbecue and San Jose Giants baseball on the Fourth of July has become a summer hallmark and South Bay tradition," said San Jose Giants President and CEO, Daniel Orum. "Independence Day at Excite Ballpark is the biggest and most popular night of the year, so we encourage everyone to secure their seats as quickly as they can!"
The Fourth of July game offers a variety of individual ticket options ranging from $10 to $59. Ticket prices are as follows: Obstructed View Bleachers - $10, Bleacher Reserved - $12, ADA Seating - $12, Bowl Reserved - $18, Box Seats - $30, Upper Luxury Box Seats - $30 and Luxury Box Seats - $36 (including children and military). The Giants also offer a special City National Futures Club Buffet Ticket for $59. Included with this special ticket is 90 minutes of access to an all-you-can-eat buffet including ribs, hot dogs, hamburgers, potato salad, baked beans, soda and water. This option is limited to the first 200 fans and is first-come-first-serve seating in the City National Futures Club. Children under 4 are free if they do not require their own seat. Please note that all seating is reserved for the Fourth of July game.
The San Jose Giants celebrate America by wearing red, white and blue Stars and Stripes jerseys and caps. The gear worn by the players will be made available to fans as a part of an in-game silent auction. Bidding is now done through the LiveSource app which can be downloaded for free.
The San Jose Giants are home for a weeklong homestand from May 13 through May 19. Homestand highlights include Friday Night Fireworks presented by San Jose Water Company and an exclusive San Jose Giants Heliot Ramos bobblehead giveaway courtesy of the Sheet Metal Workers Local Union 104.
Purchase July 4th Tickets
View the 2019 San Jose Giants Schedule
ABOUT THE SAN JOSE GIANTS
The San Jose Giants are a professional baseball team in the Class A Advanced California League and have been an affiliate of the San Francisco Giants since 1988. San Jose has won six California League Championships as a Giants affiliate (2010, 2009, 2007, 2005, 2001 and 1998) and eleven overall. The San Jose Giants have graduated 206 Major League players, 149 of whom have played or currently play for the San Francisco Giants. Excite Ballpark, the home of the San Jose Giants, first opened in 1942 and has seen well over 7 million fans enter through its gates. The organization has been honored with the Larry MacPhail Award, presented to the club with the best creative marketing and promotions, and the President's Trophy, granted to the most complete franchise. For 2019 tickets or to reserve your group outing, please contact the San Jose Giants Box Office at 408.297.1435 or visit us online at sjgiants.com. San Jose Giants baseball in your backyard since 1942, Our Town, Our Team, Our Giants.


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Why Would Christianity Today Try Twisting the Bible to Fit Evolution?
By Tom Gilson Published on April 8, 2022 •
Tom Gilson
Christianity Today is asking how we can fit evolution with the Bible. I'm trying to figure out why. It's about as sensible as the homeowner whose picnic table got crushed under a fallen tree in a storm. It's his favorite picnic table. He can't part with it — even with three broken legs. So he takes limbs off that fallen tree, lashes them together with string and duct tape, and straps them on the table so it stands up — but then his ten-year-old comes by, kicks it, and it's gone.
He's scratching his head trying to think of a way to do it better. But this beloved table of his is entirely made of cheap plastic.
He's trying to figure out how to fix it, when instead he should be asking where he can go buy a new one instead. Because sometimes the best answer to a bad question is to ask a better one instead.
CT is Stuck on the Wrong Question
That's exactly what Christianity Today should have done with their recent article, "Evangelicals Have Four Proposals for Harmonizing Genesis and Evolution."
Their question was, "How harmonize human evolution with the Bible's teaching on Adam and Eve, and with original sin?" The right answer would have been, "Evolutionary theory is broken beyond repair, so why would anyone try to make it fit with anything?"
The article, written by Jay Johnson, is a review of Calvin University professor Loren Haarsma's book When Did Sin Begin? Human Evolution and the Doctrine of Original Sin. I haven't read the book, so my comments here are strictly about the review. The title says evangelicals have four proposals for harmonizing Genesis and evolution. No, we have five, and the fifth is to toss out evolution for broken, just like we'd toss out that smashed picnic table.
The problem isn't harmonizing evolution with theology. The problem is harmonizing evolution with anything in the real world at all.
I agree solidly with Johnson on this much: "Younger people have been leaving the faith in increasing numbers for decades, and one of the main reasons is the perceived anti-science mindset of the church." He's absolutely right on that point. It's a problem Christians haven't dealt with the way we should have or could have. But we can't do it by jury-rigging theology to fit a jury-rigged theory of human origins.
Biblical Problems with Naturalistic Evolution
I should note that I'm talking about naturalistic evolution here, the theory that says every living thing came to be with no guidance or direction from God. Although he doesn't say, I take it that Johnson has the same version of evolution in mind. It's either that or theistic evolution (evolution with God at the wheel), another option I'll address shortly.
Christians certainly have a problem with evolution. The Bible says God created Adam and Eve as special creations, out of the dust of the earth, and with nothing remotely like a mother or father to either of them. Evolution, in contrast, says that every living thing since the very, very first primordial cell had a parent (for single-celled organisms, for example) or parents (for more complex organisms). Therefore, Adam and Eve each had a mother and a father.
That's a problem already, and it gets even worse. Historic, orthodox Christian doctrine includes a firm belief in humans' original innocence, in full, unrestricted fellowship with God. Our first parents messed that up through disobedience to God, and since then, every human being is born with a sin nature. We don't acquire it by some corrupted set of genes, and we don't acquire it by learning. The one true and sufficient reason we have a sin nature is because we're humans, descended from Adam and Eve.
Original Sin?
Johnson doesn't even mention that original innocence, but it's hard to square with evolutionary theory. So is original sin. Both doctrines fit well with the account the way Genesis tells it, but neither fits well at all with evolutionary human origins.
Haarsma has four proposals to solve that. Two of them say that Adam and Eve weren't real people, views which Christians should reject even if they believe in evolution. Two of them make a sort of biblical sense if evolution is true — just like "fixing" that picnic table with splinters and scraps of wood from the falling tree makes sense.
The problem isn't harmonizing evolution with theology. The problem is harmonizing evolution with anything in the real world at all. Let's take a really quick look at what the theory says, and one way (out of many) it fails to fit reality.
Evolution Is No Master Builder
Evolutionary theory says random variation plus natural selection (NS) plus time are all it took to create every organism that's ever lived. Scientists have proposed variations on that theme, but they all agree that evolution is a master builder. Just look at all it has done!
Everyone in the field also agrees (with recent minor adjustments) that it does this craftsmanship on the smallest possible scale: DNA, or organisms' genetic makeup. That's how evolution has built all this magnificent biological diversity.
Except it hasn't. New research, just in the past two to three decades, has knocked that leg out from under evolution's table and sent it spinning back into the woods.
The truth is, evolution and I have a lot in common. I had a summer job once, where the first part of the summer we were tearing down greenhouses at a nursery, and then we were going to build new ones. We weren't far into the second phase before my boss sent me away, telling me, "Tom, you're no good at this." I was great at demolition, bad at construction. So is evolution. And the research proving it is surprisingly solid.
It starts with the one point of evolution everyone agrees on: Organisms can change in minor ways, to adapt to changes in their environment. The most famous example is bacteria developing resistance to antibiotics.
Evolution Doesn't Build Things, It Breaks Them
On the surface that looks a lot like our master builder, evolution, has been growing new capabilities into bacteria. That's what everyone used to think. Then a couple of decades or so ago, along came some serious advances in genetic biochemistry. And what it showed is that it's actually the other way around. Evolution doesn't build new genes. It breaks old ones.
Surprised? So were the scientists. But it's not only true, it's consistently true. Biochemist Michael Behe explains these findings in a series of podcasts you can find here, or you can read it at length in his book Darwin Devolves.
Evolution doesn't fit the facts of nature, so why should it fit the account in Genesis? Why even try to make it fit?
You're probably wondering how breaking things could make them work better. Behe shares this analogy. Suppose you're driving across the desert, it's hot, you're thirsty, and you absolutely have to get to the next water or you'll die. Your gas tank is so empty, though you know there's only one way you can make it. You have to lighten your load — a lot.
So you toss out the spare tire. You're pretty sure that's not good enough, though. So you yank off the dashboard, rip out the stereo, and even pull out the back seat. You leave it all on the side of the road, and now you can reach the gas station. Your car is broken, but you've survived.
Evolution Fails
That's a good analogy for how some bacteria have evolved survive penicillin: They break the genes where penicillin can harm them. And as I said already, it's consistent: Wherever evolution has actually been observed to work, that's how it works.
And this is supposedly the way nature created everything. It's like saying that we've built jet engines by tinkering with cars, but the only "tinkering" we've done has been to yank wires and belts out of engines.
This is just one of many ways evolution fails. It can't even get started without creating its own first cell. But science keeps finding, over and over again, natural processes can't do that. The highly distinguished synthetic chemist James Tour shows that in a series of videos.
I could go on. Instead I'll refer you to a book I just finished reading, Taking Leave of Darwin: A Longtime Agnostic Discovers the Case for Design by Neil Thomas. Or if it's audio you like, try Marcos Eberlin's "Foresight" podcasts.
Why Try Jury-Rigging the Bible to Fit a Failed Theory?
We can't solve that problem by adding God into the evolution equation. Most theistic evolutionists today are pretty stingy about what they'll let God do there anyway (as if it were up to them). They want Him in the background, so nature can run without Him. That's just the same evolution, though, with "God" sprinkled on top of it. It's an insult to both God and evolution.
Others say God gets involved from time to time. In that case, Genesis is just fine as is. There's no need to doubt that God that made Adam and Eve by special creation, just as it says in the Bible. (If you want more on this, here's more — 1,000 pages more!)
Can We Harmonize Christianity Today With Evangelical Christianity?
So where does this leave us? Christianity Today is supposed to be the voice of evangelical Christianity. Here, though, it has totally capitulated to a naturalized view of human origins. It's giving in to a view that many evangelicals reject for good scientific reasons.
I'd say that leaves us with one more "harmonization" problem to solve. Christianity Today has always been supposed to be the voice of evangelical Christianity. It's supposed to be biblical. How does that fit with reality today? Answer: It doesn't.
Tom Gilson (@TomGilsonAuthor) is a senior editor with The Stream and the author or editor of six books, including the recently released Too Good To Be False: How Jesus' Incomparable Character Reveals His Reality.
Sympathy for the Liberal, Part II: How To Be an Atheist
How Anti-Science Are Materialists? If They Saw Another Mt. Rushmore Floating in Space, They'd Attribute it to "Evolution"
The 'Faith vs. Science' Challenge: A Practical Ministry Explainer for Pastors


Angaza manages a cloud-based PAYG software platform called the Energy Hub, which integrates directly with mobile money platforms (like M-Pesa) and provides a suite of online services to help distributors manage and streamline PAYG financing of solar energy systems. It also works directly with manufacturers to develop custom PAYG hardware solutions that are optimized for the features of its existing product line. These products then become "PAYG-ready," which allows them to communicate with the Energy Hub and activate or deactivate depending on the customer's payment status. The tech platform is sold on a B2B basis to other companies seeking energy and time-based pricing, and rent-to-own as a service model.
This complete PAYG ecosystem enables Angaza to provide holistic support of PAYG financing while collecting lots and lots of data. How Angaza uses this data is, of course, the most powerful component.For example, let's say that one of Angaza's clients needs a microfinance company to lend them money for a sewing machine to make clothes from home and earn some extra income. The client can turn to Angaza and ask the company to release their solar repayment information, which can then help the client secure a loan they otherwise wouldn't be able to procure.
Having this data available allows a previously unbanked customer with no known payment streams to get a record and a proof of address, which can unlock other financial services.


Glen A. Larson's Battlestar Galactica only lasted for a single season, yet it earned its place among the most beloved science-fiction shows of all time. In 2003, Ronald D. Moore reimagined the story. This new take proved hugely popular, revitalizing the once-niche franchise. Moore's Galactica successfully accomplished something few reboots of classic TV shows have ever managed to do: surpassing the original in scope and longevity. Like the Cylons, Galactica had evolved.
Somewhere Beyond the Heavens: Exploring Battlestar Galactica, edited by Rich Handley and Lou Tambone, examines the entire mythos, both televised and published, from 40 different perspectives, just in time for the show's 40th anniversary. This anthology features insightful, analytical essays about Galactica's history, penned by popular comic historians, novelists, bloggers, subject-matter experts, and franchise insiders, including Corinna Bechko, Jeffrey A. Carver, Matthew J. Elliott, Robert Greenberger, Brandon Jerwa, Robert Jeschonek, John Kenneth Muir, Tony Simmons, and many more.
You say you want to know more about Battlestar Galactica? So say we all.
Rich Handley is the editor and cofounder of Hasslein Books and the managing editor of RFID Journal. He has written or co-written five books to date (Timeline of the Planet of the Apes, Lexicon of the Planet of the Apes, Conspiracy of the Planet of the Apes, The Back to the Future Lexicon, and The Back to the Future Chronology), and is currently working on Apes-related projects for BOOM! Studios and Titan Books. Rich has contributed numerous works to the licensed Star Wars franchise, and is co-editing a trio of Star Wars essay books for Sequart with Joe Berenato. He has penned essays for IDW's Star Trek newspaper strip reprint books, Sequart's New Life and New Civilizations: Exploring Star Trek Comics, and ATB Publishing's impending Star Trek anthology, Outside In: TOS 110. In addition, he has written for or edited numerous other publications, including Star Trek Communicator, Star Trek Magazine, Simian Scrolls, Cinefantastique, Sci-Fi Invasion, and Dungeon / Polyhedron.
See more, including free online content, on Rich Handley's author page.
Lou Tambone is an independent musician, freelance writer, and UI/UX designer from New Jersey. A lifelong fan of pop culture, he was an early HTML adopter, creating and maintaining some of the first Star Wars fan sites under the Starwarz.com banner. As well as the occasional magazine and web piece, he's made many contributions to essay anthologies from Sequart on the Planet of the Apes, Battlestar Galactica, and Star Wars franchises. His editing credits include The Cyberpunk Nexus: Exploring the Blade Runner Universe and Somewhere Beyond the Heavens: Exploring Battlestar Galactica. When he's not reading or writing stories, he's usually writing music or rehearsing with one of his many bands. During his "spare" time, he tries to remember to eat and breathe.
See more, including free online content, on Lou Tambone's author page.


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«Вельд» — фильм-антиутопия советского режиссёра Назима Туляходжаева, снятый в 1987 году по мотивам произведений Рэя Брэдбери.

Фильм создан на основе рассказа «Вельд», в который включены сюжетные линии из других текстов: «Дракон», «Вельд», «Пешеход», глава «Марсианин» из «Марсианских хроник» и эпизод смерти полковника Фрилея из «Вина из одуванчиков».

Сюжет
В огромном мрачном особняке живёт семья Стоунов — Майкл, его жена Линда и дети Питер и Венди. Особого взаимопонимания здесь нет — дети постоянно проводят время в особой электронной комнате, визуализирующей различные картины. Особенно их привлекает сцена охоты африканских львов. Майкл пытается запереть комнату, однако это только усиливает враждебность со стороны детей.

В хижине на берегу моря живут старый рыбак Эрнандо и его слепая жена Кора. Вся суть их жизни заключена в воспоминаниях об умершем сыне Томе. И вот однажды к ним приходит некий мальчик, абсолютно похожий на Тома. Однако идиллия продолжается недолго — к лачуге приезжает особая карантинная команда, которая уничтожает существ, живущих с людьми под видом их умерших близких.

Однако не только пришельцы оказываются жертвами карантинных команд — однажды ночью их встречает Майкл. Его отвозят в старый овраг и там бросают. Едва живой, Стоун набредает на развалины церкви, где встречает Эрнандо. Майкл пытается забрать семью и уехать подальше от этой кошмарной жизни, однако детей это совершенно не прельщает. Они заманивают родителей в детскую, где последние становятся жертвами львов.

Эрнандо, взяв из церкви огромный деревянный крест, пытается пахать дюны. За его работой наблюдает безумец «Ганди»…

В ролях
 Юрий Беляев — Майкл
 Нелли Пшенная — Линда
 Георгий Гегечкори — Эрнандо
 Тамара Схиртладзе — Кора
 Генрикас Кураускас — полковник Стоун
 Валентинас Масальскис — Дэвид Макклин
 Владас Багдонас — Бартон
 Дарюс Палекас — Питер
 Сигуте Ларионовайте — Венди
 Дарюс Цицинас — Том
 Гитис Падегимас — «Ганди»
 Кристина Андреяускайте — сиделка
 Александра Яковлева — монахиня-марионетка

См. также
 Будет ласковый дождь

Примечания

Ссылки

Научно-фантастические фильмы СССР
Фильмы студии «Узбекфильм»
Экранизации произведений Рэя Брэдбери
Фильмы СССР 1987 года
Фантастические фильмы 1987 года
Фильмы на русском языке


First of all, I should mention that my love affair with graphic novels started only a few years ago when I was taking a Reader's Advisory course at Algonquin College. Before that, I thought graphic novels were limited to the superhero genre which didn't attract me much. Now I know that this medium is as interesting and as varied as regular books. If you have never read graphic novels, I encourage you to try them. I'm sure you'll find something that you like in the wide range of stories available in this medium. Some of my favourite authors of graphic novels are Will Eisner, Greg Rucka, Adrian Tomine, Daniel Clowes, Hope Larson, Raina Telgemeier, Guy Delisle, Michel Rabagliati, Marjane Satrapi and Pénélope Bagieu.
"Page by Paige" by Laura Lee Gulledge tells the story of Paige, a 16-year old girl, who has just moved from Charlottesville, Virginia, to New York. She doesn't know anybody in this big city, and she feels lonely and scared. She decides to buy a sketchbook and record her thoughts and emotions with drawings. In her musings, she remarks: "I think I was born with my eyes facing the wrong way. Because they're always looking back into my head rather than looking out". This sentiment rings true to all of us introverts, and I could certainly identify with the feeling of not fitting in. But what I loved the most in this graphic novel is the fact that the story is semi-autobiographical. Laura Lee Gulledge also moved from Virginia to New York, and art helped her handling stress and depression. This is the author's first graphic novel.
The main character's full name is Paige Turner (her parents are writers).
Paige is 16-years old, but she doesn't know how to ride a bike.
Paige and her new friends form The Agents of Whimsy, a group of creative misfits.
The Page by Paige Soundtrack provided at the end of the book lists each character's favourite songs.
tres intéressant tres bon blog Cécile. Continue tu vas tres bien.
Hi Cecile! I think your blog is great! It looks so professional. I really like the section "you may also like". I love getting ideas for new things to read:) Is there a way for me to get notified when you post something new?
Fred and I are still working on the notification e-mails. I will let you know when they are up and running. In the meantime, I usually post something on Facebook and Twitter, so people will know when there is a new entry on my blog.