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    1. Analyse des Biais Cognitifs et de leur Impact sur les Interactions Sociales

      Ce document propose une synthèse approfondie des mécanismes psychologiques qui influencent la perception de soi et des autres, telle qu'analysée dans l'étude des biais cognitifs sociaux.

      Il examine comment ces erreurs de jugement innées façonnent nos relations, notre sentiment d'isolement et nos interactions avec les systèmes d'autorité.

      Résumé Analytique

      Le fonctionnement social de l'être humain est régi par une série de biais cognitifs qui créent un décalage systématique entre la réalité vécue et la réalité perçue. Les principaux points à retenir sont :

      • L'illusion de transparence nous fait croire que nos états internes (stress, mensonge, peur) sont visibles par autrui, alors que nous restons largement opaques pour les observateurs.

      • L'effet de projecteur amplifie notre sentiment d'être observé et jugé lors de nos maladresses, alors que l'attention des autres est majoritairement centrée sur eux-mêmes.

      • L'illusion de connaissance asymétrique nous donne l'impression de mieux comprendre les autres qu'ils ne nous comprennent, nous enfermant dans un paradoxe d'incompréhension.

      • Ces mécanismes ne sont pas des défauts de caractère, mais des outils de survie évolutionnaires destinés à prévenir l'exclusion du groupe et à économiser l'énergie cérébrale.


      1. L'Illusion de Transparence : Le Mythe de l'Introspection Visible

      L'illusion de transparence est la tendance à surestimer la mesure dans laquelle nos états mentaux internes sont "lisibles" par les autres.

      Le mécanisme d'ancrage et d'ajustement

      Ce biais repose sur une heuristique spécifique :

      • L'ancre : Lorsque nous ressentons une émotion intense (peur, culpabilité), notre cerveau prend ce ressenti comme point de départ absolu.

      • L'ajustement : Nous essayons de corriger cette perception en admettant que les autres ne sont pas dans notre tête, mais cet ajustement est toujours insuffisant.

      Nous restons "bloqués" près de l'ancre émotionnelle, persuadés qu'une partie de notre émotion "fuit" à l'extérieur.

      Conséquences dans le domaine judiciaire

      Ce biais est activement exploité par les forces de l'ordre :

      • Le cas Chris Watts : Accusé d'un triple meurtre, Watts a échoué au détecteur de mensonges non pas parce que la machine est fiable, mais parce qu'il a succombé à l'illusion de transparence.

      Persuadé que l'enquêtrice voyait ses mensonges, il a fini par craquer.

      • Fiabilité des méthodes : Les méta-analyses montrent que les professionnels (détectives, interrogateurs) n'atteignent qu'un taux de réussite de 54,5 % pour détecter les mensonges, soit à peine plus que le hasard (50 %).

      L'expérience des "Tapoteurs"

      Une étude illustre parfaitement ce décalage de perception :

      • Tâche : Des participants doivent tapoter le rythme d'une chanson connue pour le faire deviner à un auditeur.- Prédictions vs Réalité :

      | Groupe | Estimation de réussite | Réussite réelle | | --- | --- | --- | | Tapoteurs | 50 % à 95 % | 2,5 % |

      Analyse : Le tapoteur entend la mélodie, les paroles et les instruments dans sa tête (sa "bande son interne"), ce qui rend la réponse évidente pour lui.

      L'auditeur, lui, n'entend que des bruits de doigts désincarnés.


      2. L'Effet de Projecteur et la Paranoïa Sociale

      L'effet de projecteur nous fait croire que nos erreurs sociales ou nos particularités physiques attirent l'attention de tous.

      • L'expérience du T-shirt (Barry Manilow) : Des étudiants devaient porter un vêtement jugé embarrassant devant un groupe.

      Alors que les porteurs du t-shirt estimaient que 50 % des gens remarqueraient l'image, la réalité était de seulement 20 %.

      • L'oubli social : Le document souligne que lorsque nous commettons une erreur (chute, bruit étrange), les témoins l'oublient presque instantanément car ils sont eux-mêmes préoccupés par leur propre image sociale.

      3. L'Illusion de Connaissance Asymétrique

      Ce biais crée un déséquilibre profond dans la perception mutuelle : nous nous percevons comme des êtres nuancés et complexes, tout en simplifiant les autres au rang de "PNJ" (Personnages Non-Joueurs).

      • Le paradoxe de l'iceberg : Nous souhaitons que les autres voient l'intégralité de notre "paysage intérieur" (l'iceberg complet), mais nous jugeons les autres uniquement sur la "pointe" de leurs actions visibles.

      • Étude sur les colocataires : Les expériences montrent que les individus estiment systématiquement avoir récolté plus d'informations sur la personnalité de leur colocataire que ce dernier n'en a perçu chez eux ("You don't know me but I know you").


      4. Fondements Évolutionnaires et Énergétiques

      Les biais cognitifs ne sont pas arbitraires ; ils répondent à des besoins biologiques stricts.

      La survie par la paranoïa

      À l'époque des chasseurs-cueilleurs, être rejeté par la tribu équivalait à une condamnation à mort.

      La sélection naturelle a donc favorisé un cerveau "réglé" sur une paranoïa sociale maximale.

      Il est plus sûr, pour la survie, de paniquer inutilement pour une maladresse sociale que de manquer un signe de désapprobation réel qui mènerait à l'exclusion.

      L'économie d'énergie cérébrale

      Le cerveau est un organe extrêmement coûteux :

      • Poids : < 2 % du poids total du corps.

      • Consommation : 20 % de l'énergie totale.

      Pour éviter la surchauffe, le cerveau simplifie les interactions avec les inconnus (le mode "PNJ").

      Il ne déploie sa pleine puissance de modélisation complexe (la "haute définition") que pour les membres du cercle restreint (famille, amis proches), car comprendre leurs intentions est vital pour la cohésion de la "tribu".


      Conclusion

      Les illusions de transparence et de connaissance asymétrique créent un environnement social où chacun se sent potentiellement exposé lors de ses moments de faiblesse, tout en se sentant globalement incompris.

      Comprendre que ces mécanismes sont des reliquats de notre évolution permet de relativiser notre peur du jugement d'autrui : la plupart des gens sont trop occupés à gérer leur propre "projecteur" pour remarquer le nôtre.

    1. 創業夥伴的價值,更多來自彼此的判斷力、觀點碰撞,以及面對關鍵決策時的討論品質。

      不只是創業時需要這樣的夥伴,平時工作與生活做決策時,就需要這樣的夥伴,透過提高討論的張力來確保決定不是草率且高成功率

    1. Le Décrochage Scolaire des Filles au Québec : Enjeux, Impacts et Perspectives de Raccrochage

      Résumé Analytique

      Le décrochage scolaire chez les filles au Québec, bien que statistiquement moins fréquent que chez les garçons, engendre des conséquences socio-économiques disproportionnées et persistantes.

      Ce phénomène est alimenté par une convergence de facteurs : la pauvreté systémique, l'absence de ressources spécialisées pour les troubles d'apprentissage (comme le TDAH), et le poids des stéréotypes sexuels qui orientent les jeunes filles vers des rôles de soin familial au détriment de leur propre réussite.

      Les répercussions sont marquées par une précarité économique sévère, les décrocheuses gagnant en moyenne 37 % de moins que leurs homologues masculins dans la même situation.

      Si la maternité peut initialement constituer un obstacle au retour aux études, elle devient souvent, avec le temps, le principal moteur du « raccrochage », les mères souhaitant briser le cycle de la pauvreté et servir de modèle à leurs enfants.

      La lutte contre ce phénomène nécessite une déconstruction des stéréotypes de genre et un investissement massif dans les services professionnels au sein des écoles.


      I. Les Déterminants du Décrochage Scolaire

      L'analyse des témoignages et des données met en lumière plusieurs facteurs critiques qui prédisposent les jeunes filles à l'abandon scolaire.

      1. La Pauvreté et l'Environnement Familial

      La pauvreté est identifiée comme le premier facteur de décrochage.

      Elle se manifeste par :

      • Le mode survie : Les familles en situation de précarité n'ont pas toujours les ressources ou le bagage nécessaire pour soutenir le parcours scolaire.

      • La priorité au travail : Dans certains milieux, l'emploi immédiat est valorisé par rapport aux études pour répondre aux besoins financiers urgents de la famille.

      • Le niveau de scolarité de la mère : Il existe une corrélation directe entre la faible scolarité de la mère et les difficultés scolaires des enfants, créant un cycle de reproduction de l'échec.

      2. Les Défis Neurodéveloppementaux et le Manque de Ressources

      Le système scolaire échoue souvent à identifier les besoins spécifiques des filles :

      • TDAH et troubles de l'opposition : Historiquement, les filles présentant ces troubles étaient souvent classées comme « délinquantes » plutôt que de recevoir un soutien médical ou pédagogique, faute de reconnaissance de ces conditions à l'époque.

      • Surcharge des classes : Le ratio élevé élèves-enseignant limite le temps disponible pour un encadrement individualisé.

      • Manque de soutien professionnel : L'absence ou l'insuffisance de psychologues, de travailleurs sociaux et d'infirmières en milieu scolaire prive les élèves vulnérables d'un filet de sécurité.

      3. Le Poids des Stéréotypes Sexuels

      Les filles sont socialisées dès leur plus jeune âge pour veiller au bien-être de la famille.

      En milieu défavorisé, cette adhésion aux stéréotypes est plus forte :

      • Absorption du stress familial : Les filles consacrent une énergie considérable à compenser les difficultés de leur foyer, une énergie qui n'est alors plus disponible pour leur réussite scolaire.

      • Priorité aux soins : Elles sont incitées à assumer des responsabilités domestiques et de soins, ce qui fragilise leur lien avec l'école.


      II. Conséquences du Décrochage : Une Précarité Sexuée

      Le décrochage scolaire n'affecte pas les hommes et les femmes de la même manière sur le marché du travail.

      Comparaison des impacts économiques

      | Indicateur | Femmes Décrocheuses | Hommes Décrocheurs | | --- | --- | --- | | Revenu moyen annuel | ~ 17 000 $ | ~ 27 000 $ | | Écart de revenus | Gagne 37 % de moins que l'homme | Revenu nettement supérieur à la femme | | Conditions de travail | Horaires de soir/fin de semaine, salaire minimum, pas d'assurances | Souvent accès à des métiers manuels mieux rémunérés |

      Impact sur la trajectoire de vie

      Le document souligne des conséquences humaines graves :

      • Instabilité résidentielle : Risques d'itinérance et absence de logement stable.

      • Dépendance économique : Une dépendance accrue envers le conjoint ou l'aide sociale, limitant l'autonomie en cas de séparation.

      • Santé mentale : Sentiment de vide intérieur, perte d'estime de soi et isolement social.


      III. La Maternité : Obstacle et Vecteur de Changement

      La maternité occupe une place centrale et paradoxale dans le parcours des décrocheuses.

      • L'obstacle initial : Une grossesse à l'adolescence est une cause majeure de décrochage.

      Par la suite, la charge monoparentale et le manque de ressources (comme l'accès difficile aux services de garde pour les mères sans emploi) freinent le retour aux études.

      • Le levier de motivation : Pour de nombreuses femmes, le désir d'offrir une vie meilleure à leurs enfants devient le catalyseur du raccrochage.

      Elles souhaitent devenir des modèles de réussite et éviter que leurs enfants ne reproduisent leur parcours de précarité.


      IV. Pistes de Solution et Recommandations

      Pour lutter efficacement contre le décrochage scolaire des filles, plusieurs axes d'intervention sont proposés :

      1. Interventions Systémiques à l'École

      • Soutien professionnel accru : Intégration massive de psychologues, travailleurs sociaux et infirmières dans les établissements.

      • Mesures pour les mères adolescentes : Mise en place de structures permettant aux jeunes mères de poursuivre leurs études malgré leurs responsabilités parentales.

      • Accompagnement individualisé : Réduction du ratio élèves-enseignant pour mieux soutenir les élèves ayant des difficultés d'apprentissage ou des troubles comportementaux.

      2. Déconstruction des Stéréotypes de Genre

      • Éducation égalitaire : Intégrer la promotion de rapports égalitaires directement dans les programmes éducatifs.

      • Éviter les approches sexuées : Le document critique les initiatives qui renforcent les stéréotypes (ex: activités physiques uniquement « viriles » pour les garçons) et préconise plutôt une déconstruction de ces modèles pour favoriser l'égalité.

      3. Valorisation du Raccrochage

      Le retour aux études est décrit comme un processus de redécouverte de soi.

      Les bénéfices identifiés incluent :

      • Le développement de l'estime de soi par la réussite professionnelle.

      • L'acquisition d'une autonomie financière et d'un sentiment de compétence (ex: obtention d'un DEP, accès à des métiers passionnants comme les soins ou l'esthétique).

      • La sortie du cercle vicieux de la pauvreté et de la dépendance aux aides étatiques.

      Conclusion

      Le décrochage scolaire des filles est un problème de société profond qui dépasse le cadre strictement pédagogique.

      Il est intimement lié à la pauvreté et aux attentes sociales sexuées.

      La réussite du raccrochage montre toutefois qu'avec de la détermination et un soutien adéquat, il est possible de transformer une trajectoire de précarité en un parcours d'accomplissement personnel et professionnel.

    1. Le Décrochage Scolaire : Analyse des Causes, Manifestations et Pistes de Résilience

      Résumé Exécutif

      Le décrochage scolaire, ou « trébuchage » selon le terme privilégié par les experts, ne doit pas être perçu comme un manque de volonté, mais comme le symptôme d'une souffrance profonde et d'un décalage entre l'individu et le système éducatif traditionnel.

      L'analyse des témoignages de Thomas, Lucas et Jérôme, croisée avec l'expertise d'Emmanuel Piquet, révèle que les ruptures scolaires sont souvent catalysées par des événements précis (redoublement, harcèlement, instabilité familiale) et se manifestent par des mécanismes de défense variés (comportement perturbateur, désinvestissement total, anxiété).

      La résolution de ces crises passe par une identification de la source de la souffrance (angoisse, autodéception ou démotivation) et par la transition vers des modèles pédagogiques plus concrets et personnalisés, tels que l'alternance ou les établissements spécialisés.

      La clé de la réussite réside dans le rétablissement de la confiance et le transfert de la responsabilité de l'apprentissage à l'élève, soutenu par des parents présents mais non envahissants.


      I. Les Catalyseurs de la Rupture Scolaire

      Le décrochage est rarement un événement soudain ; il s'inscrit dans une spirale déclenchée par des facteurs structurels ou personnels.

      • L'impact du redoublement : Pour Thomas (redoublement de la 5ème) et Lucas (redoublement du CM2), cette décision a été le point de départ de l'échec.

      Elle est vécue comme une séparation violente du cercle amical et une remise en cause de la capacité de l'élève.

      • Le harcèlement scolaire et la pression sociale : Thomas souligne que le harcèlement, couplé à une exigence personnelle trop élevée et des standards inadaptés, crée une pression insupportable.

      Emmanuel Piquet précise que le harcèlement représente environ 60 % des causes de décrochage physique.

      • Le contexte familial : L'instabilité au domicile (comme le non-acceptation du nouveau conjoint de la mère dans le cas de Lucas) peut détourner l'énergie de l'adolescent des enjeux académiques.

      • Le manque de sens : Pour Jérôme, le système général (théorique) n'avait « aucun sens ».

      Les notes faibles (4 à 6 de moyenne) et l'obligation de rester assis toute la journée génèrent un sentiment d'inutilité.


      II. Profils et Manifestations du « Trébucheur »

      Les comportements adoptés par les élèves en difficulté sont souvent des stratégies de survie psychique.

      Mécanismes de défense courants

      | Comportement | Fonction psychologique | | --- | --- | | Le « Clown » / Perturbateur | Faire rire pour que la vie soit moins douloureuse ; éviter l'étiquette d'« intello » (perçue comme une insulte). | | L'invisibilité / Somnolence | Être présent physiquement mais absent mentalement pour se protéger du stress (cas de Thomas). | | Le désinvestissement total | Préférer décrocher plutôt que de subir l'« autodéception » (blessure narcissique liée à l'échec). | | Les conduites à risque | Consommation de substances (cannabis pour Lucas) et mauvaises fréquentations comme fuite devant l'échec. |


      III. Analyse du Rôle des Intervenants

      Le système scolaire traditionnel

      Le système est critiqué pour sa tendance à traiter les élèves comme une collectivité plutôt que comme des individus.

      Les enseignants peuvent parfois paraître impuissants ou absents face au harcèlement ou au désengagement d'un élève qui ne « suit plus ».

      La posture parentale

      Emmanuel Piquet insiste sur la distinction entre « accompagner » et « prendre en charge de manière excessive » :

      • Le risque de l'hyper-intervention : Chercher des stages ou faire les devoirs à la place de l'enfant lui envoie le message qu'il est incapable.

      • La posture recommandée : Être à côté de l'enfant et non entre lui et le monde.

      Il est parfois nécessaire de laisser l'enfant « se prendre des portes » pour qu'il mobilise ses propres ressources.

      • Le transfert de responsabilité : Dire à l'adolescent « tu sais mieux que moi ce qui est bon pour toi » est une marque de confiance essentielle pour sa reconstruction.

      IV. Voies de Remédiation et Modèles de Réussite

      Le retour à une scolarité épanouie passe souvent par un changement radical d'environnement et de méthode.

      1. Les Maisons Familiales Rurales (MFR)

      Le modèle des MFR repose sur l'alternance (15 jours à l'école, 15 jours en entreprise).

      Pour Jérôme, cela a permis :

      • De retrouver le goût d'apprendre via des compétences concrètes (sylviculture).

      • De se sentir valorisé par la maîtrise de gestes techniques (utilisation d'une tronçonneuse).

      • De gagner en maturité grâce au contact avec le milieu professionnel.

      2. Les Apprentis d'Auteuil

      Cette structure offre un suivi personnalisé où l'enseignant agit comme un éducateur, accompagnant le jeune dans sa vie quotidienne et professionnelle.

      Lucas y a trouvé la passion pour le métier de barman après plusieurs échecs dans le système classique.

      3. Les établissements adaptés et le tutorat

      Thomas a réussi sa transition vers les études supérieures (Lettres Modernes) grâce à :

      • Un établissement à effectif réduit.

      • Un travail autonome sur classeurs, proche du cours particulier.

      • Le soutien de professeurs ayant su redonner le goût de la lecture.


      V. Synthèse des Recommandations Experts

      | Problématique identifiée | Action préconisée | | --- | --- | | Angoisse / Phobie sociale | Traitement thérapeutique spécialisé pour diminuer le niveau de stress. | | Autodéception | Travail sur l'estime de soi pour dissocier la valeur de la personne de ses résultats scolaires. | | Démotivation | Ne pas enjoindre à la volonté (injonction paradoxale), mais chercher le levier du désir et de la passion. | | Incertitude de l'avenir | Proposer des alternatives concrètes (vie active, jobs peu qualifiés) pour confronter le jeune aux conséquences de ses choix. |

      Conclusion : Le parcours de Thomas et Lucas démontre que le décrochage n'est pas une fatalité.

      La réussite réside dans la capacité des parents et des éducateurs à maintenir un lien de confiance infini, tout en acceptant que le chemin vers l'accomplissement puisse être tortueux et non conventionnel.

    1. 決断の先送りは未来にゴミを捨てるようなもの

      これは確認しただけで記録しないinajobのプロジェクトにも言えそう

    1. ST Rates & Exemptions by Category — Table A.3 (2022)

      As per the GST (Amendment) Act of Bhutan 2026, exemptions expanded from 9 to about 32 items — retroactively effective from 18 May 2026 with active enforcement starting 25–26 June 2026.https://www.drc.gov.bt/wp-content/uploads/2026/06/GST_Public_Notification_2026.pdf Newly exempted:

      19 categories of cooking oils (soybean, palm, sunflower, mustard, sesame, coconut, etc.) More rice varieties — husked brown rice, red rice (Yeechum), semi-milled and wholly milled rice Butter Motorised/automatic wheelchairs (manual ones were already exempt) Salt, sanitary napkins, and diapers carried over from the original list

    1. nishioの観点から言えば:LLMは利用を効率化したが、探索を疎かにしている

      確かにもっと探索下ほうがよい、時間の無駄になっている

    1. Annual Education Statistics 2022 (Table E)

      Cheku 39 mins ago The Table heading (Socio-Economic Indicators — Annual Education Statistics 2022 (Table E)), reflects the report heading: https://education.gov.bt/download/annual-education-statistics-2022/ and the data year is mostly for 2017. In this report, they have compiled the data from different sources including from 2017 PHCB. Do we reflect the primary source such as the 2017 PHCB? If we intend to have the updated data for 2022, we have data from 2022 BLSS.

    1. A mandatory permanent scheme where the government provides a Nu. 108 subsidy toward the annual Nu. 195 premium, with the individual paying the remaining Nu. 87.

      All individuals who have civil registration in the rural areas are included. In other words, someone living in an urban area but his civil registration in his village is being included.

    1. 分子克隆还让作者能够把一个蛋白的不同功能拆开研究,而不是只比较“这个蛋白存在还是不存在”。

      这部分是研究irf1,它本身是一个蛋白,但也是一种能结合dna的转录因子。为了探测他是不是通过结合DNA来增强cyld、casp8的转录。通过构建irf1 wt、irf1 w11r的突变体,W11R突变破坏了IRF1的DNA结合和转录激活功能,但突变蛋白本身仍可以被表达。这两种载体导入细胞后

    2. 分子克隆的另一类重要应用是构建过表达载体,用来进行与敲除相反的验证。

      除了敲除外,还要有gain of function的实验。试试把这个蛋白的表达量提高后,细胞会不会更容易死亡。

    3. 除了完全敲除基因,作者还构建了shRNA慢病毒载体

      分子克隆也可以帮助我们敲低某一个基因的表达量。因为在这篇文献中,把cyld、casp8完全敲除后,细胞确实能存活,但是他们在细胞中本来就具有一定的基础表达量。我们不知道通过诱导额外增加的表达量对于细胞死亡是不是重要的。所以通过分子克隆构建了针对他们的shRNA慢病毒载体,再利用293t细胞包装病毒并感染hela细胞,使IFNγ处理后升高的caspase-8或CYLD被压低到接近未处理细胞的水平。

    4. 最基础的一类应用,是构建基因敲除或敲低工具。

      针对你模拟的问题或情况,通过分子克隆去把这个抽象的问题导入到细胞中进行实现。比如针对某种基因的ko细胞,就是通过构建含有能识别该基因片段的sgRNA载体,转染进细胞中,使得他能敲除某一个片段。

    1. Patient 4 (P4)

      Case#: Patient 4 (P4) is a 60-year-old Chinese woman.

      DiseaseAssertion: Patients are asserted to have "CTLA4 haploinsufficiency (CTLA-4 h).

      FamilyInfo: Patient's daughter is Patient 3 and harbors the same CTLA4 variant.

      CasePresentingHPOs: HP:0001954 (Recurrent fever) HP:0011110 (Recurent tonsillitis), HP:0000155 (Oral ulcer), HP:0005558 (Chronic leukemia)

      CaseHPOFreeText: Patient's symptoms onset in childhood with recurrent fever and tonsillitis. She experienced recurrent oral ulcers starting around age 50. She was diagnosed with large granular lymphocytic (LGL) leukemia for which she was treated with long-term corticosteroids for three years. She is currently treated with oral cyclosporine.

      CaseNotHPOs: HP:0000988 (Skin rash)

      CaseNotHPOFreeText: Patient denied history of rash, dry mouth, or dry eyes.

      CasePreviousTesting: None reported.

      GenotypingMethod: Genotyping was performed via whole exome sequencing.

      PreviouslyPublished No prior article is known to contain information on the same proband.

      Variant: The patient is heterozygous for the NM_005214.4 CTLA4):c.347T>A (p.Ile116Asn) variant.

      ClinVar: 2430678

      gnomAD: The variant was not found in gnomAD v4.1.1

      SupplementalData: There is no supplemental data.

    1. P10FGerman2425G109EReduced7.58Pathogenic––[5]33.33Severely affectedAlive

      Case#: P10, Female, German, 24 years old at the time of clinical diagnosis, 25 years old at the time of genetic diagnosis, alive at the time of publication

      DiseaseAssertion: Severely affected based on a CHAI score of 33.33%

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs:N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The percentage of transendocytosis using either CD80-GFP or CD80-mScarlet CHO cells was determined in eight LRBA-deficient patients. No difference in the percentage of transendocytosis was observed between CTLA4-variant carriers (GFP median=5.4%; mScarlet median= 49.8%) and LRBA-deficient patients (GFP median=9.9%; mScarlet median, 48.6%). However, significantly lower percentages of transendocytosis were observed in LRBA-deficient patients compared to healthy donors (HD) when using CD80-mScarlet CHO cells (median, 48.6% vs. 65.5% in HD) (Fig. ​(Fig.4e),4e). This difference was not observed with CD80-GFP CHO cells (patients median of 9.9% in patients vs. 13.9% in HD). In conclusion, the CTLA4 transendocytosis method using CD80-mScarlet CHO cells enables the functional verification of LRBA deficiency, but it cannot differentiate between LRBA deficiency and CTLA4 insufficiency.

      GenotypingMethod: NGS and Sanger sequencing

      PreviouslyPublished: N/A

      Variant: NM_005214.5(CTLA4):c.326G>A (p.Gly109Glu)

      ClinVar ID: 542071

      gnomAD: 0.0002354 https://gnomad.broadinstitute.org/variant/2-203870802-G-A?dataset=gnomad_r4

      SupplementalData: Yes, all data regarding the patient was found in Table1.

    2. P09Mukukuk*Y89HNormal––58.5Non-pathogenicukNANAAlive

      Case#: P09, Male, age: n/a, ethnicity: n/a, alive at the time of publication

      DiseaseAssertion: n/a

      FamilyInfo: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: N/A

      CaseNotHPOs:N/A

      CaseNotHPOFreeText: N/A

      CasePreviousTesting: The percentage of transendocytosis using either CD80-GFP or CD80-mScarlet CHO cells was determined in eight LRBA-deficient patients. No difference in the percentage of transendocytosis was observed between CTLA4-variant carriers (GFP median=5.4%; mScarlet median= 49.8%) and LRBA-deficient patients (GFP median=9.9%; mScarlet median, 48.6%). However, significantly lower percentages of transendocytosis were observed in LRBA-deficient patients compared to healthy donors (HD) when using CD80-mScarlet CHO cells (median, 48.6% vs. 65.5% in HD) (Fig. ​(Fig.4e),4e). This difference was not observed with CD80-GFP CHO cells (patients median of 9.9% in patients vs. 13.9% in HD). In conclusion, the CTLA4 transendocytosis method using CD80-mScarlet CHO cells enables the functional verification of LRBA deficiency, but it cannot differentiate between LRBA deficiency and CTLA4 insufficiency.

      GenotypingMethod: NGS and Sanger sequencing

      PreviouslyPublished: N/A

      Variant: NM_005214.5(CTLA4):c.265T>C (p.Tyr89His)

      ClinVar ID: 1391402

      gnomAD: 0.000003717 https://gnomad.broadinstitute.org/variant/2-203870741-T-C?dataset=gnomad_r4

      SupplementalData: Yes, all data regarding the patient was found in Table1.

    1. 17-year-old female

      Case#: 17-year-old female, F, Age of Report:17 y.o., Ethnicity: Cuban descent.

      CasePresentingHPOs: HP:0001510 (Growth delay), HP:0004322 (Short stature), HP:0000696 (Delayed eruption of permanent teeth/secondary tooth eruption delay), HP:0000858 (Irregular menstruation/irregular menses), HP:0100607 (Dysmenorrhea), HP:0012384 (Rhinitis), HP:0002099 (Asthma), HP:0001025 (Urticaria), HP:0031796 (Recurrent), HP:0000403 (Recurrent otitis media), HP:0010606 (Hordeolum/hordeolums), HP:0031796 (Recurrent), HP:0012204 (Recurrent vulvovaginal candidiasis/vaginal candidiasis), HP:0032168 (Clostridium difficile colitis), HP:0004315 (Decreased circulating IgG concentration/low IgG levels), HP:0045082 (Decreased body mass index/low BMI), HP:0001382 (Joint hypermobility/hyperextensible joints), HP:0011220 (Prominent forehead), HP:0000325 (Triangular face/Facial dysmorphim Triangular shape), HP:0009765 (Low hanging columella), HP:0000219 (Thin upper lip vermilion/thin upper lip), HP:0007495 (Prematurely aged appearance/aged appearance), HP:0010976 (B lymphocytopenia/low absolute B cells), HP:0410376 (Increased proportion of naive CD8 T cells/elevated CD8 T cell),

      CaseHPOFreeText: This is a 17-year-old female of Cuban descent, born to nonconsanguineous parents at 36 weeks gestational age to an uncomplicated pregnancy. Her birth weight and length were average for gestational age (7 pounds, 18 in.). She presented with a history of growth delay, short stature, and secondary tooth eruption delay. She measured below her growth curve at 1 year of age. She had growth hormone testing which resulted normal; however, she received growth hormone therapy from 3 to 10 years of age with a good response. At that time, she underwent genetic testing for short stature; however, no genetic causes of short stature were found. She has a history of irregular menses and dysmenorrhea with work-up for possible etiologies, including polycystic ovarian syndrome (PCOS), resulting negative. She has met all developmental milestones appropriately and has normal cognition.

      She has nonallergic rhinitis, mild intermittent asthma, and acute recurrent urticaria. Her history of infections includes recurrent episodes of otitis media since she was toddler requiring placement of 3 sets of ear tubes and tonsillectomy and adenoidectomy. She has a history of recurrent hordeolums and frequent episodes of vaginal candidiasis attributed to the many courses of antibiotics she has received for her various infections. She had one episode of Clostridium difficile colitis 6 months prior to presentation to our clinic. Prior immunologic evaluation at a different institution at 9 years of age was remarkable for low IgG levels, which ranged from 435 to 511 mg/dL [ref 759–1549 mg/dL]. A skin prick test to aeroallergens resulted negative. She did not receive intravenous immunoglobulin (IVIG) or subcutaneous immunoglobulin therapy at that time.

      Her physical exam was relevant for short stature (1 percentile, z = − 2.33), low weight for age (< 1 percentile, z = − 2.69), low BMI (15 percentile), and hyperextensible joints. Her facial features were significant for a prominent forehead, triangular face, low-hanging columella, thin upper lip, and aged appearance. Given concern for immune deficiency, a complete immune evaluation was obtained. Her results revealed hypogammaglobulinemia (IgG of 610 mg/dL [ref 694–1618 mg/dL]), with IgM and IgA within the reference range. The lymphocyte subset panel revealed remarkably low absolute B cells (34 cells/μL [ref 130–800 cells/μL]) and percentage (1% [ref 9–30%]). CD4 T cells were within the reference range, and CD8 T cell counts (1091 cells/μL [ref 240–890 cells/μL]) and percentage (40% [ref 17–36%]) were elevated. She had low CD4:CD8 ratio (0.84 [ref 1.00–2.90]). Follow-up B cell panel corroborated the finding of low absolute B cells (70 cells/μL [ref 100–500 cells/μL]) and revealed increased transitional B cells (6.6% CD19 + CD27-CD21-IgM+ [ref 0.5–2.8%]) and naïve B cells (5.9% CD19 + CD27-CD21-CD38- [ref 0.3–2.3%]). ImmunoCAP IgE to aeroallergens was negative, and total IgE was 2 kU/L [ref < 114 kU/L]. Vaccine boosters to S. pneumoniae, H. influenzae, diphtheria, and tetanus were given. Subsequent titers revealed protective antibodies to S. pneumoniae, H. influenzae, and diphtheria and absent response to tetanus. Her lymphocyte mitogen proliferation showed normal lymphocyte responses to phytohaemagglutinin, concanavalin A, and pokeweed mitogen. Viral testing was not performed. At this time, the decision was made to start amoxicillin prophylaxis and monthly IVIG replacement therapy.

      After initiating treatment with IVIG, our patient did not have new episodes of ear or sinus infections. IgG levels have remained within normal limits with monthly IVIG therapy. Given the finding of a PIK3R1 pathogenic variant and its known associations with SHORT syndrome, she was referred to ophthalmology and endocrinology. Of note, she started complaining of frequent headaches, not associated with administration of IVIG. Brain and cervical spine MRI revealed a Chiari I malformation for which she is being evaluated by neurosurgery.

      CaseNotHPOs: N/A.

      CaseNotHPOFreeText: She did not have protective titers to tetanus, diphtheria, pneumococcus, or influenzae.

      CasePreviousTesting: N/A.

      CaseMethod1: N/A.

      CaseMethod2: N/A.

      CaseGenotypingMethod: Invitae primary immunodeficiency 207-gene panel was obtained.

      Variant: NM_181523.3:c.1425+1G>C (n.336+1G>C).

      ClinVar: 156009.

      CAID: CA170736.

      gnomAD: N/A.

      VariantEvidence: Results revealed a heterozygous “pathogenic variant” in PIK3R1 (c.1425 + 1G > C) with an autosomal dominant mode of inheritance in association with APDS2. This variant is a missense point mutation affecting a donor splice site in intron 11, resulting in exclusion of exon 11 (Fig. 1). Her parents are not carriers of this pathogenic variant, indicating this is a de novo mutation.

      CaseAddInfo: N/A.

      CasePMIDs: N/A.

    1. Patient 3

      Case#: Patient 3, Korean, 13 year old, female

      DiseaseAssertion: APDS1

      CaseHPOFreeText: Previously diagnosed with selective IgA deficiency was reevaluated for other PIDs when she presented with multiple episodes of prolonged fever and enlargement of several lymph nodes. Patient 3 had a history of hospitalizations attributable to recurrent respiratory tract infections, cellulitis, and osteomyelitis. She was diagnosed with selective IgA deficiency at the age of 4 years at our hospital. Cervical lymph node enlargement was first noticed at the age of 6 years; hematochezia was also noted. Colon and cervical lymph node biopsies showed atypical lymphocyte proliferation with polyclonality, and persistent atypical lymphoid proliferation of the colon was observed at the age of 10 years. One colon biopsy specimen was suspicious for mucosa-associated lymphoid tissue lymphoma. The oncologists decided to observe the patient without special chemotherapy. During the follow-up period, we diagnosed and treated Patient 1 from the present case series, leading the clinicians to reevaluate Patient 3 for other PIDs. Upon reevaluation, the height and weight of Patient 3 were below the 5th percentile and development was normal. At the age of 12 years, laboratory values were WBC, 5410/µL; Hb, 8.5 g/dL; and PLT, 285k/µL. Immunological values were CD3, 391/µL (normal, 800–3500/µL); CD4, 194/µL (normal, 400–2100/µL); CD8, 190/µL (normal, 200–1200/µL); and CD19, 54/µL (normal, 200–600/µL). The CD4:CD8 ratio was 1.02. The response to phytohemagglutinin mitogen was reduced, while results from the same test performed 8 years prior were normal. Serum IgG, A, and M levels were 1920 mg/dL (normal, 639–1349 mg/dL), 3 mg/dL (normal, 70–312 mg/dL), and 1138 mg/dL (normal, 56–352 mg/dL), respectively. Hypermetabolic enlarged lymph nodes, splenomegaly, and bronchiectatic changes in the middle lobe of the right lung were observed on PET/CT. Summary of symptoms in Table 1.

      CasePreviousTesting: exome sequencing

      GenotypingMethod: Diagnostic exome sequencing confirmed by Sanger

      Variant: E1021K, heterozygous

      CAID: CA145460

      gnomAD: variant is absent in gnomAD v2.1.1

    2. Patient 2

      Case#: Patient 2, Korean, 4 year old, male

      DiseaseAssertion: APDS1

      CaseHPOFreeText: history of idiopathic thrombocytopenic purpura, Bacillus Calmette-Guérin vaccine site infection, and respiratory tract infection requiring hospitalization was referred to our clinic for enlargement of multiple lymph nodes suspicious for lymphoma. Cervical lymph node enlargement was first noticed at 31 months old. At the age of 3 years, decreased IgG (89 mg/dL) with elevated IgM (347 mg/dL) and normal IgA (16 mg/dL) were detected at a prior hospital. He received regular IGRT under the interim diagnosis of CVID; however, trough IgG levels remained below 400 mg/dL despite receiving a higher IGRT dose (800 mg/kg) every 3 weeks. Patient 2 had a head circumference of 52.8 cm (95th percentile) and body weight of 17 kg (25–50th percentile). Multiple enlarged lymph nodes in the cervical, supraclavicular, and inguinal areas were palpated, and massive splenomegaly was noted. Molloscum contagiosum was observed on his buttocks. Complete blood count results included WBC, 3300/µL; Hb, 13.1 g/dL; and PLT, 157k/µL. Immunological values were CD3, 867/µL (normal, 1578–3707/µL); CD4, 241/µL (normal, 870–2144/µL); CD8, 613/µL (normal, 472–1107/µL); and CD19, 24/µL (normal, 276–640/µL). The CD4:CD8 ratio was 0.39 (Table 1). Positron emission tomography/computed tomography (PET/CT) findings showed enlargement of multiple lymph nodes, including the bilateral cervical, supraclavicular, and inguinal areas, and abnormal uptake in the whole intestine. A colonoscopy revealed multiple nodules and masses throughout the entire length of the colon. Cervical lymph node and large intestine biopsies revealed atypical lymphocyte proliferation with polyclonality (Fig. 1A–C) (Supplementary Fig. 1A and B, only online). A colon biopsy revealed CMV, and the patient complained of diarrhea. Summary of symptoms in Table 1.

      CasePreviousTesting: exome sequencing

      GenotypingMethod: Diagnostic exome sequencing confirmed by Sanger

      Variant: E1021K, heterozygous

      CAID: CA145460

      gnomAD: variant is absent in gnomAD v2.1.1

    1. c.494G>A

      Case#: U.II.1, subject 50. Male. Age of Onset: 3.75 y.o. Age of evaluation: 9 y.o. Origin in Japan, Asian

      DiseaseAssertion: Diagnosis with CVID (later with CTLA4 insufficiency)

      FamilyInfo: Patient is oldest of three siblings. All three have been genotyped, but only this proband is affected. Variant inherited from the father, who is also unaffected (pedigree in Figure 1).

      CasePresentingHPOs: HP:0001873, HP:0001973, HP:0004313, HP:0002720, HP:0004315, HP:0002719, HP:0005353

      CaseHPOFreeText: Cytopenia, Autoimmune cytopenia, hypogammaglobulinemia, low IgG, low IgA, Clinically reactivated/apparent Infections, Herpes Infection, clinical EBV infection (possibly chronic?), ITP, positive Coombs test

      CaseNotHPOs: large phenotype table with unreported symptoms in table S1

      CaseNotHPOFreeText: Patient was checked for a number of additional phenotypes but none were identified. Please see Supplementary table S1 for details.

      CasePreviousTesting: Genome-wide methods were not used (sequencing of CTLA4 was performed, but no reference made to other genes tested). Some families received whole-exome sequencing but we are unsure if this patient was included.

      GenotypingMethod: The authors imply that they sequenced the four exons of CTLA4.

      PreviouslyPublished: Unpublished

      Variant: NM_005214.5(CTLA4):c.494G>A (p.W165*)

      ClinVarID: N/A

      CAID: CA350138939

      gnomAD: This variant is not found in gnomAD v2.1.1.

      SupplementalData: Extensive data in S1, including some phenotypes that were tested for but found to be absent.

      Note: Not functionally tested using transendocytosis.

    1. The first case is that of a female whose clinical onset was at 56 years old with a diagnosis of hemolytic anemia due to the presence of warm antibodies and inguinal lymphadenopathies in 2006.

      Case#: Female, age of onset: 56, age at testing: 69, age of last documented clinical stability: 74

      DiseaseAssertion: suspected hyperactivation of the PI3K pathway; implied earlier in the paper as "activated PI3Kδ syndrome (APDS)"

      FamilyInfo: no relevant family history

      CasePresentingHPOs: HP:0001878, HP:0012735, HP:0000975, HP:0002716, HP:0012387, HP:0001744, HP:6000143, HP:0004313, HP:0002721, HP:0006530, HP:0002788 (hemolytic anemia, cough, diaphoresis, lymphadenopathy, bronchitis, splenomegaly, perforated appendicitis, hypogammaglobulinemia, immunodeficiency, interstitial lung disease, recurrent upper respiratory tract infections)

      CaseHPOFreeText: asthenia, sarcoidosis due to chronic granulomatous sarcoid-type inflammation without necrosis, bronchiectasis with bronchiolitis, wound infection, abdominal wall dehiscence, common variable immunodeficiency (CVID) with immune dysregulation, CVID-associated interstitial lung disease, granulomatous-lymphocytic interstitial lung disease

      CaseNotHPOs: HP:0012759 (neurodevelopmental abnormalities)

      CaseNotHPOFreeText: dysmorphic features, learning difficulties

      CasePreviousTesting: clinical exome sequencing targeting genes associated with primary immunodeficiencies

      GenotypingMethod: sequencing

      PreviouslyPublished: No prior article is known to contain information on the same proband.

      Variant: NM_181504.3(PIK3R1):c.5A > T (p.Tyr2Phe)

      ClinVar: not found

      CAID:CA3290217

      gnomAD: 0.3004% https://gnomad.broadinstitute.org/variant/5-67586561-A-T?dataset=gnomad_r2_1

      SupplementalData: There is no supplemental data, clinical timeline and schematic with noted variants are in Figure 2 and Figure 3

    1. For patient 1 (P1)

      Case#: P1, 13 year old boy

      DiseaseAssertion: APDS

      FamilyInfo: no relevant family history was reported.

      CaseHPOFreeText: He presented with hypogammaglobulinemia with decreased IgG and IgA but normal IgM serum levels (Table 1). Current complications include bronchiectasis, a lymphoproliferative syndrome with splenomegaly and hepatic fibrosis responsible for portal hypertension associated with gastrointestinal bleedings.

      CasePreviousTesting: Thus, mutations known to cause APDS1 or APDS2 were searched and excluded by Sanger sequencing.

      GenotypingMethod: Subsequently, to identify the genetic cause of the disease, whole exome sequencing was performed in P1. A heterozygous G to A mutation at position 9775698 (GRCh37; NM_005026.3) on chromosome 1, c.241 G>A in the PIK3CD gene was detected.

      Variant: The variation encodes an amino acid substitution from glutamic acid to lysine at position 81 (E81K) located in the ABD at the N-terminal part of p110δ (Figure 1A). Sanger sequencing confirmed the mutation in the patient, which was not present in either parents.

      CAID: CA338300169

      gnomAD: absent from gnomAD v2.1.1

    1. Case#: Wang_2018_P4, M, 8 y.o. (onset), origin in China

      DiseaseAssertion: APDS

      FamilyInfo:

      CasePresentingHPOs: ----- clincal characteristics at diagnosis (1) RRTI Pneumonia Diarrhea Lymphadenopathy (HP:0002716) Hepatomegaly (HP:0002240) Splenomegaly (HP:0001744) Rash Inguinal hernia Parotitis Urinary tract infection Perianal abscess --- Routine immunological (2) decreased wbc counts decreased T cells increased NK cells decreased b cells decreased CD4/CD8 decreased IgG increased IgM undetectable IgA ---- lymphocyte subpopulations (2) decreased CD19 increased transitional b cells decreased naive be cells dereased memory b cells increased plasmablasts decreased CD3 decreased CD4 naive decreased CD4 CM increased CD4 EM Increased CD8 decreased CD8 naive decreased CD8 CM ---- clinical manifestations (doc) AIC enteropathy LAD splenectomy short stature

      CaseHPOFreeText: EBV DNA, fungus negative, CMV-IgM negative

      CaseNotHPOs:<br /> abnormal CD4 autoantibodies

      CaseNotHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: WES + Sanger

      PreviouslyPublished: Additional info published in 2022 (PMID:35799777)

      Variant: NM_005026.5(PIK3CD):c.3061G>A (p.Glu1021Lys)

      ClinVarID: 88675

      CAID: CA145460

      gnomAD: Not present in gnomAD

      SupplementalData: Phenotypic info in table S4

    2. Case#: Wang_2018_P3, M, 1 y.o. (onset), origin in China

      DiseaseAssertion: APDS

      FamilyInfo:

      CasePresentingHPOs: ----- clincal characteristics at diagnosis (1) Otitis Tonsilitis Pneumonia Mucosanguineous feces Lymphadenopathy (HP:0002716) Hepatomegaly (HP:0002240) Splenomegaly (HP:0001744) Megasplenia Mild anemia Thrombocytopenia Conjunctivitis Left atrial and ventricular enlarged --- Routine immunological (2) decreased b cells decreased CD4/CD8 decreased IgG increased IgM increased IgA ---- clinical manifestations (doc) RRTIs keratitis LAD HSM AIC enteropathy died of infection

      CaseHPOFreeText: EBV DNA, fungus negative, CMV-IgM negative

      CaseNotHPOs: abnormal wbc counts abnormal IgE abnormal T cells abnormal NK cells autoantibodies

      CaseNotHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: WES + Sanger

      PreviouslyPublished: Additional info published in 2022 (PMID:35799777)

      Variant: NM_005026.5(PIK3CD):c.3061G>A (p.Glu1021Lys)

      ClinVarID: 88675

      CAID: CA145460

      gnomAD: Not present in gnomAD

      SupplementalData: Phenotypic info in table S4

    1. 15-year-old female

      Case#: 15-year-old female, F, Age of Report: 15 y.o., Ethnicity: From China.

      CasePresentingHPOs: HP:0001511 (Intrauterine growth retardation/Intrauterine growth restriction), HP:0004322 (Short stature), HP:0000684 (Delayed eruption of teeth/teething delay), HP:0000858 (Irregular menstruation/irregular menstrual cycle), HP:0001007 (Hirsutism), HP:0000820 (Abnormality of the thyroid gland/thyroid disease), HP:0005328 (Progeroid facial appearance/Progeroid facial appearance), HP:0000545 (Myopia), HP:0000678 (Dental crowding/overcrowded teeth), HP:0000855 (Insulin resistance)

      CaseHPOFreeText: Proband was noted to have "characteristic facial gestalts/"characteristic facial dysmorphim", low weight at birth,

      The proband was admitted to our department due to irregular menstrual cycle and hirsutism with short stature, who had a history of intrauterine growth restriction and presented with short stature, teething delay, characteristic facial gestalts, hirsutism, and thyroid disease. Whole-exome sequencing and Sanger sequencing revealed c.1960C > T, a novel de novo nonsense mutation, leading to the termination of protein translation (p. Gln654*).

      This is the first case report of SHORT syndrome complicated with thyroid disease in China, identifying a novel de novo heterozygous nonsense mutation in PIK3R1 gene (p. Gln654*).

      The phenotypes are mildly different from other cases previously described in the literature, in which our patient presents with lipoatrophy, facial feature, and first reported thyroid disease. Thyroid disease may be a new clinical symptom of patients with SHORT syndrome.

      The patient was a girl born to a physically healthy and non-consanguineous couple by spontaneous delivery at the 37th week. Birth weight was 2150 g (− 3.39SD) and birth length was 44 cm (− 3.41SD), indicating that the patient had intrauterine growth restriction (IUGR). The proband also had teething delay, getting the first tooth at 1 year old. During childhood, the patient was bothered by short stature. Psychomotor and speech development was normal. The height of proband’s father and mother was 168 cm and 155 cm respectively. The patient also had a healthy 20-month-old brother.

      At the age of 15 years and 4 months, the proband was referred to our department due to irregular menstrual cycle and hirsutism with a height of 149 cm (− 2.04SD), weight of 43 kg (− 1.22SD) and body mass index (BMI) of 19.4 kg/m2. The height of the proband had remained 149 cm, ever since 13 years old. Physical examination showed a triangular-shaped face, small chin, large low-set ears, thin lip, downturned mouth, obvious beard and bushy eyebrows (Fig. 1a,b,c,d). Oral examination showed overcrowded and irregular teeth, hypodontia, and severe dental caries (Fig. 1g). Pubertal development was assessed according to the Tanner stage, with pubic hair at PH5 stage and breast at B2 stage. The second phalanx of little finger in the left hand was short and thicken, which was confirmed with X-ray (Fig. 1e,f). Ultrasound of neck showed diffuse thyroid disease. Ultrasound biomicroscopy of the eyes, examination of ocular fundus, abdominal ultrasound, reproductive system ultrasound, and chest X-ray were normal. The cranial magnetic resonance imaging (MRI) indicated a small posterior pituitary.

      Not evaluated on the proband: OFC at birth, thin, wrinkled skin with readily visible veins, inguinal hernia,

      CaseNotHPOs: N/A.

      CaseNotHPOFreeText: Proband was noted to not have: Hyperextensibility of joints, ocular depression, Riegar anomaly, lipoatrophy, glaucoma, hyperopia, astigmatism, delayed bone age, intellectual deficiency, speech delay, diabetes, hearing loss, frequent infections, congenital heart diseases, pulmonary stenosis and ovarian cysts.

      CasePreviousTesting: N/A.

      CaseMethod1: N/A.

      CaseMethod2: N/A.

      CaseGenotypingMethod: Whole-exome sequencing and Sanger sequencing.

      Variant: NM_181523.3:c.1960C>T (p.Gln654Ter).

      ClinVar: N/A.

      CAID: CA359884699.

      gnomAD: N/A.

      VariantEvidence: A novel de novo heterozygous nonsense mutation in the PIK3R1 gene (p. Gln654*) was found in the proband.

      WES was performed to make a clear clinical diagnose. The candidate variants were first screened by a minor allele frequency < 3% against the 1000 Genomes Project, the NHLBI exome variant server or in 50 HapMap control exomes. Then, short stature, facial abnormalities were selected as the filtering clinical symptoms to analyze the screened candidate variants. According to the guidelines recommended by the American College of Medical Genetics and Genomics, a pathogenic variant of PIK3R1 gene was identified to contribute to the patient’s conditions. Sequencing result indicated c.1960C > T of PIK3R1 gene a novel nonsense mutation, leading to the termination of protein translation (p. Gln654*), which was confirmed by sanger sequencing (Fig. 2). In addition, direct sequencing results showed the genotypes of proband’s parents were wild-type, suggesting it was a de novo mutation.

      CaseAddInfo: The height of proband’s father and mother was 168 cm and 155 cm respectively. The patient also had a healthy 20-month-old brother.

      CasePMIDs: N/A.

    1. Patient 2

      Case#: Collen_2022_Patient_2, female, <1 y.o. (onset) 14 y.o. (report), Ethnicity reported: Hispanic

      DiseaseAssertion: CTLA4 haploinsufficiency

      FamilyInfo: reported de novo, but no evidence

      CasePresentingHPOs: HP:0002014, HP:0002013, HP:0001508, HP:0001508, HP:0001510, HP:0002018, HP:0002027, HP:0032249, HP:0031035, HP:0005263, HP:0010783, HP:0004313, (diarrhea, vomiting, failure to thrive, lack of growth, chronic nausea, abdominal pain, lung coccidiomycosis, persistent villous atrophy, diffuse stomach inflammation, erythema, mucus plaques, hypogammaglobulinemia)

      CaseHPOFreeText: Patient is from an endemic coccidiomyosis region. Increased intra-epithelial lymphocytes, mucoid plaque, scalloping of the duodenum, lamina proprietor expansion, poor response to polysaccharide pneumoccal vaccine

      CaseNotHPOs: HP:0002608 (celiac serologies)

      CaseNotHPOFreeText: TTG, IgA, EMA, HLA, DQ2, and DQ8 were negative. Bowel wall thickening. abnormal ileocolonoscopy

      CasePreviousTesting: Primary immunodeficiency gene panel testing by Invitae

      GenotypingMethod: Primary immunodeficiency gene panel testing by Invitae

      PreviouslyPublished: not reported

      Variant: de novo heterozygous c.71_72del (p.Leu24Profs*35) in exon 1 (NM_005214.5:c.71_72del)

      ClinVarID: 1439020

      CAID: CA2573320555

      gnomAD: not reported

      SupplementalData: n/a

      MultipleGeneVariants: A heterozygous variant in PLCG2 (c.802C>T, p.Arg268Trp) detected (ClinVarID:403319, CAID:CA8193460). It is not usually reported in the panel. The authors ruled it out because the variant was found in 5 of 66 patients with disseminated coccidiomycosis in PMID:PMC7776098. The variant has been associated with autoimmune diseases according to OMIM. It is present in gnomAD (MAF: 0.101, Ashkenazi Jewish). It has been classified as benign in ClinVar.

    1. challenge of working effectively with CLD students continues to emphasize ways to balance students’ personal and academic needs within the larger framework of standardized testing.

      PERFECT FOR HELPING DIVERSITY AND ENCOURAGING LEARNING FOR THE FUTURE

    2. Rather than viewing this background knowledge as a deficiency, educators can use it to enhance the educational experiences of all students in the classroom.

      Don't just help some, help them all at the same time

    3. Educators who link cultural and linguistic diversity to limited intellectual capability may have low expectations for students and provide less challenging assignments, thus inhibiting their cognitive development

      How will this affect the child in the future????

    4. To overcome these challenges and work effectively with CLD students, educators are encouraged to develop an understanding of their student's cultural and linguistic backgrounds and their relevance in classroom instruction and practice.

      WORK AROUNDS. Allows for more understanding and help in the future for the child. Though, how is this going to be forced for all education systems?

    5. Culturally and linguistically diverse students often face challenges in the classroom due to perceptions of deficiencies in their intellectual capability linked to the existence of these sociocultural differences

      They don't get the right treatment in classes because they are seen as different. How will this affect them after in life?

    6. Linguistic diversity itself not only includes language differences but also the use of nondominant dialects and indigenous languages.

      Language diversity for those with lesser known dialect

    7. Variations in socioeconomic status (SES) are also included as poverty and/or the availability of resources can influence classroom instruction and participation.

      Something seen everywhere

    1. Three out of the six teachers described the importance of correctness in the Japanese language inrelation to formal settings and different levels of formality.

      Important point that begins the differentiation between formality and whether or not it is proper in the standard language conventions.

    2. All six participants considered the Japanese language to be linguistically and culturally diverse inrelation to place and culture. For example, Yamada sensei, a teacher from the Chubu region, focusedon the specificity of language practices, widening this out from Japanese to all languages, and notingthe variation that distances can cause. The cultural background was inextricable from regionallanguage practices, and he made this point a number of times during the interview and emailexchanges

      It has been agreed upon that Japanese does have a lot of language diversity.

    3. Overall, it appeared that language was understood by the teachers in relation to both diversity andstandardisation, which were often inextricably intertwined. This will be addressed with regard tolanguage awareness associated with Japanese language diversity, English language diversity, and thecontext of ELT.

      A very useful discovery regarding language diversity and the standard conventions of English.

    4. n Europe, LA has been employed as a pedagogical approach to improve education in schools (Hélotet al., 2018). It takes into account the growing diversity of languages spoken by students, which areregarded as students’ full linguistic repertoire through which knowledge is shared. LA researchers (e.g.,Hélot et al., 2018; Putjata, 2018) have studied language practices in multilingual classrooms wherestudents speak different languages at home. In contrast, Japanese high school classrooms are generallyconsidered to be “monolingual” where students speak the same language at school and home. However,research on multilingualism in Japan disagrees with this “monolingual” assumption (Fujita-Round,2019; Maher & Yashiro, 1995; Shoji, 2019). Likewise, this study adopts LA to investigate language,language practices, and speakers in the field of ELT in Japan from a holistic perspective.

      Good paragraph that discusses multilingual research and discovery.

    5. Before the monolingual assumption—that everyone in Japan speaks the same language—becameprevalent, Japan was considered to be linguistically diverse (Gottlieb, 2005). Under the TokugawaShogunate (1603–1867), Japan was divided into 250 autonomous domains called “han” where localdialects flourished

      Discusses multilingualism.

    1. I personally struggle with reading and annotating. I have never tried doing so in a group setting before. Maybe that is how I will improve upon my skills with annotating. As I have always found both really boring and uninteresting, but seeing others opinions on a piece of literature actually really intrigues me and I enjoy it

    2. I have shared annotations with friends when we leave comments on each other google docs. I have also come across annotations in school books or books I've gotten from thrift stores. personally, I prefer annotating physically over digital.

    1. art. 1.814

      INDIGINIDADE

      Art. 1.814. São excluídos da sucessão os herdeiros ou legatários:

      I - que houverem sido autores, co-autores ou partícipes de homicídio doloso, ou tentativa deste, contra a pessoa de cuja sucessão se tratar, seu cônjuge, companheiro, ascendente ou descendente;

      II - que houverem acusado caluniosamente em juízo o autor da herança ou incorrerem em crime contra a sua honra, ou de seu cônjuge ou companheiro;

      III - que, por violência ou meios fraudulentos, inibirem ou obstarem o autor da herança de dispor livremente de seus bens por ato de última vontade.


      • Diversamente da deserdação, a exclusão da sucessão por indignidade não depende de vontade testamentária. Será somente declarada judicialmente e pode ser requerida pelo MP.

      • Na indignidade, qualquer tipo de sucessor poderá excluído da sucessão, <u>não apenas</u> os herdeiros necessários.

    1. These varied pathways to teacher certification offered in theUS context would work well in Ontario

      It is a good way to address the low representation of BIPOC population in teachers in Ontario. Right now the bar to acquire the OCT in Ontario is still set high and that intimidates BIPOC people from applying. Also there is a need to inform potential BIPOC candidates of the option and properly guide them through application process.

    2. critical and collaborative dialogue

      One way to understand where the disadvantaged group is to generate a space where dialogues with different racial, ethnic, and gender groups take place. Dialogues provide a space for people of different power posions come to convene and understand each other. Knowing the pain of the disadvantaged groups generates a start to address the problem of inequality.

    3. mentorship programs for BIPOC aspiring and in-service leaders by other BIPOC leaders

      memtorship program for BIPOC should focus on the cultivation of a critical mind to carefully examine one's social location, gender, sexual orientation, and race etc to situate oneself within an intersectional positionalities, to acknowledge them and activate change to reclaim one's own rights within the arena of education.

    4. intersections of oppression

      True, if you are a person of color, female, and someone from a non conforming religious background, it is more difficult evan to get an interview opportunity. Similar cases are found when there is an implicit rule for the recruiters to just look at candidates' last names to decide whether they will be invited for an interview or not.

    5. White, feminine and middle-class profession

      That's probably when a teacher of color arrives new at a school, kids come and curiously ask the quesion of "where are you from". As much as these children did not mean to hurt teachers of BIPOC, they are engrained with the stereotype that teachers are white, female, and from middle-class background.

    6. unpacking their respective social locations, positionality and privilege

      This is not to be achieved easily. One has to constantly exercise reflexivity, critical analyze where one is socially located, compared to those whose are located in a socially more disadvangeous position. Understanding one's location in comparison to that of BIPOC is critical to recognize one's own privilege and to generate changes.

    7. White and middle-class, in contrastto over 29 per cent of Ontarians who self-identify as BIPOC, specifically. Black, Indigenous and Peopleof Colour.

      I see how disportionately the demographics of school admins are represented, but I was wondering should the proportaion be represented in a way that exactly reflects the demographic representation between the BIPOC population and the white? What should be the best practice to address this disproportion?

    1. The useful question now is not whether the old paper should be revived unchanged. It is what, if anything, is worth testing under current technology and policy.

      another annoying AI dichotomy. Just list the thing that IS important

    2. gument in an Essex Economics discussion paper and an unfinished theory project

      That paper was related to the project, but it doesn't matter that it was "Essex economics", just say "discussion paper".