Recent Advances in Systems and Network Medicine: Meeting Report from the First International Conference in Systems and Network Medicine.

The First International Conference in Systems and Network Medicine gathered together 200 global thought leaders, scientists, clinicians, academicians, industry and government experts, medical and graduate students, postdoctoral scholars and policymakers. Held at Georgetown University Conference Center in Washington D.C. on September 11-13, 2019, the event featured a day of pre-conference lectures and hands-on bioinformatic computational workshops followed by two days of deep and diverse scientific talks, panel discussions with eminent thought leaders, and scientific poster presentations. Topics ranged from: Systems and Network Medicine in Clinical Practice; the role of -omics technologies in Health Care; the role of Education and Ethics in Clinical Practice, Systems Thinking, and Rare Diseases; and the role of Artificial Intelligence in Medicine. The conference served as a unique nexus for interdisciplinary discovery and dialogue and fostered formation of new insights and possibilities for health care systems advances.

Regulating Ionizing Radiation Based on Metrics for Evaluation of Regulatory Science Claims.

This article attempts to reconcile differences within the relevant scientific community on the effect of exposure to low levels of ionizing radiation notably the applicability of linear nonthreshold (LNT) process at exposures below a certain limit. This article applies an updated version of Metrics for Evaluation of Regulatory Science Claims (MERSC) derived form Best Available Regulatory Science (BARS) to the arguments provided by the proponents and opponents of LNT. Based on BARS/MERSC, 3 categories of effects of exposure to ionizing radiation are identified. One category (designated as S) consists of reproducible and undisputed adverse effects. A second category (designated as U) consists of areas where the scientific evidence for potential adverse effects includes uncertainties. The scientific evidence in the U category leads to a threshold. In contrast, the scientific foundation of the third category (designated as P) is questionable, as the scientific evidence indicates that adverse effects of the exposure at this level are not only questionable but may be helpful. This article claims that the third area is the domain of policy makers including regulators. This article describes Jeffersonian Principle that categorizes the affected community into specialists, knowledgeable nonspecialists, and the general public. Based on Jeffersonian Principle, the relevant scientific information, particularly the U and P areas, must be translated into a language that at a minimum is understandable to the knowledgeable group. Once this process is completed, the policy makers including regulators may select exposure limits based on their judgment.

Scientific foundation of regulating ionizing radiation: application of metrics for evaluation of regulatory science information.

This paper starts by describing the historical evolution of assessment of biologic effects of ionizing radiation leading to the linear non-threshold (LNT) system currently used to regulate exposure to ionizing radiation. The paper describes briefly the concept of Best Available Science (BAS) and Metrics for Evaluation of Scientific Claims (MESC) derived for BAS. It identifies three phases of regulatory science consisting of the initial phase, when the regulators had to develop regulations without having the needed scientific information; the exploratory phase, when relevant tools were developed; and the standard operating phase, when the tools were applied to regulations. Subsequently, an attempt is made to apply the BAS/MESC system to various stages of LNT. This paper then compares the exposure limits imposed by regulatory agencies and also compares them with naturally occurring radiation at several cities. Controversies about LNT are addressed, including judgments of the U.S. National Academies and their French counterpart. The paper concludes that, based on the BAS/MESC system, there is no disagreement between the two academies on the scientific foundation of LNT; instead, the disagreement is based on their judgment or speculation.

The shaken baby syndrome: an odyssey. II Origins and further hypotheses.

Subdural bleeding in the so-called "shaken baby syndrome" is recognized as a hallmark of this syndrome, and is often noted as chronic in nature, indicating an earlier time of origin than clinical presentation. In infants and neonates, the timeframe for generating such chronic intracranial bleeding is therefore limited. Neurosurgical, obstetric, and pediatric literature all recognize the significance of birth trauma in the generation of intracranial bleeding. This possibility is explored further here, with emphasis on features peculiar to Homo sapiens predisposing to intracranial bleeding during this timeframe. Encephalization and bipedalism combine to render the infant and mother susceptible to injury at birth.

Mitigation of three types of stress on cognitive performance.

The development of reliable and valid generalizations about realworld behavior, based on laboratory and simulation experiments, continues to be a major challenge in the applied behavioral sciences, particularly cognitive psychology. This challenge, and the tradeoff between reliability and generalizability, is discussed in light of the principal goal of applied science, which is successful generalization, in contrast to basic science, which is the generation of successful theory. Cognitive psychology has been successful in providing useful guidance for the design of performance enhancing techniques to mitigate the effects of stress that can be found in military operations and other applied settings. The manuscripts in this section on Cognitive Foundations of Human Information Processing address three types of stress occurring in the operational environment-sleep deprivation, cognitive load, and physical exertion-and options that may aid in monitoring or counteracting their negative effects. Separately, the manuscripts focus on: the impairing effects of total sleep deprivation on attention versus cognitively demanding tasks, as well as language-based tasks and the utility of short probe tasks to monitor these effects; cognitive load during driving and the ability of supplemental cues to improve performance and subjective questionnaires to assess load status; and the degrading effects of physical exertion on vigilance aspects of cognitive performance and its implications in the military environment. In concluding remarks, based on Tinbergen's four fundamental interrogatives, the need is underscored for the field of cognitive psychology to go beyond descriptive findings of human behavior into the realm of scientific explanatory answers.