The purpose of this study is to evaluate endothelial function in postural tachycardia syndrome (PoTS), a poorly understood chronic condition characterized by a state of consistent orthostatic tachycardia (delta heart rate ≥30 beats per minute) upon standing without orthostatic hypotension. Nineteen patients with PoTS and 9 healthy controls were studied after 3 days of a fixed, caffeine-free, normal sodium (150 milliequivalents/day) diet. All participants underwent autonomic function testing, including sinus arrhythmia, valsalva maneuver, hyperventilation, cold pressor, handgrip, and a standing test with catecholamine measurements, followed by endothelial function testing. We analyzed 3 measures of endothelial function: percent brachial flow-mediated dilation, digital pulsatile arterial tonometry, and postischemic percent leg blood flow. Flow-mediated dilation was significantly lower in patients with PoTS (6.23±3.54% for PoTS) than in healthy controls (10.6±4.37% for controls versus, P =0.014). PoTS and controls had similar digital pulsatile arterial tonometry (1.93±0.40 arbitrary units for controls versus 2.13±0.63 arbitrary units for PoTS). PoTS had similar but suggestive percent leg blood flow to controls (313±158% for PoTS versus 468±236% for controls, P =0.098). Patients with PoTS have significantly reduced flow-mediated dilation compared with healthy controls, suggesting that PoTS is characterized by endothelial dysfunction in conduit arteries. REGISTRATION: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01308099.

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As a uniquely human behavior, language is crucial to our understanding of ourselves and of the world around us. Despite centuries of research into how languages have historically developed and how people learn them, fully understanding the origin and evolution of language remains an ongoing challenge. In parallel, researchers have studied the divergence of birdsong in vocal-learning songbirds to uncover broader patterns of cultural evolution. One approach to studying cultural change over time, adapted from biology, focuses on the transmission of socially learned traits, including language, in a population. By studying how learning and the distribution of cultural traits interact at the population level, we can better understand the processes that underlie cultural evolution. Here, we take a two-fold approach to understanding the cultural evolution of vocalizations, with a focus on the role of the learner in cultural transmission. First, we explore previous research on the evolution of social learning, focusing on recent progress regarding the origin and ongoing cultural evolution of both language and birdsong. We then use a spatially explicit population model to investigate the coevolution of culture and learning preferences, with the assumption that selection acts directly on cultural phenotypes and indirectly on learning preferences. Our results suggest that the spatial distribution of learned behaviors can cause unexpected evolutionary patterns of learning. We find that, intuitively, selection for rare cultural phenotypes can indirectly favor a novelty-biased learning strategy. In contrast, selection for common cultural phenotypes leads to cultural homogeneity; we find that there is no selective pressure on learning strategy without cultural variation. Thus, counterintuitively, selection for common cultural traits does not consistently favor conformity bias, and novelty bias can stably persist in this cultural context. We propose that the evolutionary dynamics of learning preferences and cultural biases can depend on the existing variation of learned behaviors, and that this interaction could be important to understanding the origin and evolution of cultural systems such as language and birdsong. Selection acting on learned behaviors may indirectly impose counterintuitive selective pressures on learning strategies, and understanding the cultural landscape is crucial to understanding how patterns of learning might change over time.