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Hendra virus (HeV) continues to cause fatal infection in horses and threaten infection in close-contact humans in eastern Australia. Species of Pteropus bats (flying-foxes) are the natural reservoir of the virus. We caught and sampled flying-foxes from a multispecies roost in southeast Queensland, Australia on eight occasions between June 2013 and June 2014. The effects of sample date, species, sex, age class, body condition score (BCS), pregnancy and lactation on HeV antibody prevalence, log-transformed median fluorescent intensity (lnMFI) values and HeV RNA status were assessed using unbalanced generalised linear models. A total of 1968 flying-foxes were sampled, comprising 1012 Pteropus alecto, 742 P. poliocephalus and 214 P. scapulatus. Sample date, species and age class were each statistically associated with HeV RNA status, antibody status and lnMFI values; BCS was statistically associated with HeV RNA status and antibody status. The findings support immunologically naïve sub-adult P. alecto playing an important role in maintaining HeV infection at a population level. The biological significance of the association between BCS and HeV RNA status, and BCS and HeV antibody status, is less clear and warrants further investigation. Contrary to previous studies, we found no direct association between HeV infection and pregnancy or lactation. The findings in P. poliocephalus suggest that HeV exposure in this species may not result in systemic infection and virus excretion, or alternatively, may reflect assay cross-reactivity with another (unidentified) henipavirus.
Overweight and obesity may increase risk of disease progression in men with prostate cancer, but there have been few studies of weight loss interventions in this patient group. In this study overweight or obese men treated for prostate cancer were randomised to a self-help diet and activity intervention with telephone-based dietitian support or a wait-list mini-intervention group. The intervention group had an initial group meeting, a supporting letter from their urological consultant, three telephone dietitian consultations at 4-week intervals, a pedometer and access to web-based diet and physical activity resources. At 12 weeks, men in both groups were given digital scales for providing follow-up weight measurements, and the wait-list group received a mini-intervention of the supporting letter, a pedometer and access to the web-based resources. Sixty-two men were randomised; fifty-four completed baseline and 12-week measurements, and fifty-one and twenty-seven provided measurements at 6 and 12 months, respectively. In a repeated-measures model, mean difference in weight change between groups (wait-list mini-intervention minus intervention) at 12 weeks was −2·13 (95 % CI −3·44, −0·82) kg (P = 0·002). At 12 months the corresponding value was −2·43 (95 % CI −4·50, −0·37) kg (P = 0·022). Mean difference in global quality of life score change between groups at 12 weeks was 12·3 (95 % CI 4·93, 19·7) (P = 0·002); at 12 months there were no significant differences between groups. Results suggest the potential of self-help diet and physical activity intervention with trained support for modest but sustained weight loss in this patient group.
For a millennium heresy has been central to ‘the making of European culture’. Indeed, claims for its centrality could be pushed back to well before the year 1000, to the Nicene Council and even earlier debates around the nature of Christian orthodoxy. But the formative battles of the Roman period were long past by the eleventh century when western Europe began its economic, demographic, and intellectual ‘leap’ forward toward the modern world. From the Gregorian reforms to the Protestant Reformation and beyond, heresies and heretics helped to shape the religious, political, and institutional structures that medieval Europe would bequeath to the modern West. Within this sweeping history, the late medieval period, traditionally understood as the fourteenth and fifteenth centuries, presents a particularly diverse array of heterodox movements and modes of thought. Yet despite this richness, or perhaps because of it, some of the most intriguing heresies and heretics from this era of ‘paradox, tension, and unpredictability’ have been undervalued in wider studies, treated either as epilogues to the better-studied twelfth and thirteenth centuries or as preludes to the epoch-making religious revolutions of the sixteenth.
This introduction first addresses the historiographic landscape of medieval heresy, focusing in particular on periodization and its consequences. Then, as befitting a collection honoring the pioneering work of Robert E. Lerner, it outlines the elements of a ‘Lernerian’ approach to late medieval heresy and suggests ways in which this approach informs the new perspectives presented here.
The Historiographic Landscape
The work of the German historian Herbert Grundmann (1902–70) has profoundly influenced scholars of medieval religious history, including – as Richard Kieckhefer's preface notes – Robert Lerner. For the field as a whole, Grundmann's most influential work was undoubtedly his brilliant 1935 study of Religiöse Bewegungen im Mittelalter, which analyzed ways in which groups that cohered around spiritual, intellectual, and cultural ideals shared by broad swathes of European society could still end up forced into dissent or at least labeled as dissidents. In this analysis, a figure such as Valdes of Lyon partook in the apostolic impulses that animated many twelfth-century figures, but when his refusal to abandon lay preaching led to condemnation, he and his followers were labeled as heretics, and many ultimately came to understand themselves as opponents of the organized Church.
Detecting gastrointestinal (GI) infection transmission among men who have sex with men (MSM) in England is complicated by a lack of routine sexual behavioural data. We investigated whether gender distributions might generate signals for increased transmission of GI pathogens among MSM. We examined the percentage male of laboratory-confirmed patient-episodes for patients with no known travel history for 10 GI infections of public health interest in England between 2003 and 2013, stratified by age and region. An adult male excess was observed for Shigella spp. (annual maximum 71% male); most pronounced for those aged 25–49 years and living in London, Brighton and Manchester. An adult male excess was observed every year for Entamoeba histolytica (range 59.8–76.1% male), Giardia (53.1–57.6%) and Campylobacter (52.1–53.5%) and for a minority of years for hepatitis A (max. 69.8%) and typhoidal salmonella (max. 65.7%). This approach generated a signal for excess male episodes for six GI pathogens, including a characterised outbreak of Shigella among MSM. Stratified analyses by geography and age group were consistent with MSM transmission for Shigella. Optimisation and routine application of this technique by public health authorities elsewhere might help identify potential GI infection outbreaks due to sexual transmission among MSM, for further investigation.
Background: The NIH Toolbox - Cognition Battery (NIHTB-CB) is a computerized cognitive assessment designed for clinical research that is administered in-person. Here, we explored the feasibility and validity of a novel video-conference protocol for administering the NIHTB-CB. Since our protocol required repeated assessments, we further explored the NIHTB-CB’s practice effect. Methods: Twenty-five healthy participants completed the NIHTB-CB under two separate conditions four weeks apart. The standard condition followed the recommended administration protocol, whereas the video-conference condition had the examiner and participant in separate rooms but able to communicate over video-conference. A linear mixed-model analysis was performed to explore the fixed effect of testing condition and time on NIHTB-CB performance. Results: Across all three NIHTB-CB composite scores (total, fluid and crystallized cognition) no significant fixed effect of administration condition was found. A significant practice effect was observed for the fluid and total cognition composite scores over a 29.0 (± 2.1) day test-retest interval. Conclusions: Our novel video-conference protocol for the NIHTB-CB is equivalent to the standard protocol in healthy participants, and may provide a solution for researchers seeking to engage study participants at remote sites. If the NIHTB-CB is used longitudinally to monitor patients, corrections for repeated measures may be required.
Serious gaming is the use of games for purposes beyond entertainment. In this paper, we investigate the use of serious gaming as a tool for research into decision-making in engineering systems design. Serious gaming provides a fully controllable environment in which to study the decision-making behavior of engineers in simulated design scenarios. However, given the nature of games and their inherent association with entertainment, it is possible that gaming environments themselves induce unexpected, or unrepresentative behavior. We present two experiments in which we investigate serious gaming as a research tool. Both experiments deal with design decisions in the presence of sunk costs and compare two approaches for communicating the decision-making scenario: (1) an interactive game and (2) a written narrative. The written narrative approach for communicating decision-making scenarios is a widely used and accepted technique for decision-making research. We find that behavior observed in the game variants did not significantly differ from behavior observed in their written narrative equivalents. This result builds confidence for the use of game-based research approaches. However, the results in this paper suggest that response distributions collected from a game have more noise than those from an equivalent written narrative.
Understanding infection dynamics in animal hosts is fundamental to managing spillover and emergence of zoonotic infections. Hendra virus is endemic in Australian pteropodid bat populations and can be lethal to horses and humans. However, we know little about the factors driving Hendra virus prevalence in resevoir bat populations, making spillover difficult to predict. We use Hendra virus prevalence data collected from 13 000 pooled bat urine samples across space and time to determine if pulses of prevalence are periodic and synchronized across sites. We also test whether site-specific precipitation and temperature affect the amplitude of the largest annual prevalence pulses. We found little evidence for a periodic signal in Hendra virus prevalence. Although the largest amplitude pulses tended to occur over winter, pulses could also occur in other seasons. We found that Hendra virus prevalence was weakly synchronized across sites over short distances, suggesting that prevalence is driven by local-scale effects. Finally, we found that drier conditions in previous seasons and the abundance of Pteropus alecto were positively correlated with the peak annual values of Hendra virus prevalence. Our results suggest that in addition to seasonal effects, bat density and local climatic conditions interact to drive Hendra virus infection dynamics.
We combine a sophisticated model of maser propagation with a simple model of an accelerating molecular outflow and show that the observation of different OH maser frequencies is consistent with emission from different parts of the outflow.
In a study based on the analysis of an IR colour-colour diagram (see Figure 1) of galactic nuclei associated with OH megamasers and water megamasers we conclude that:
1) OH megamaser galaxies are usually associated with galactic nuclei which are undergoing a burst of star formation. The colour temperatures of infrared emission are 50-80 K. The far-infrared spectra of OH megamaser galaxies are characterised by high excess in the 60 pm band over the 25 μm and 100 μm bands.
2) The known water megamaser galaxies are associated with two kinds of galactic nuclei which are characterised by starburst and disc components and starburst and Seyfert components respectively. The luminosities of far-infrared emission are much less than for OH megamasers. The colour temperatures of T(100/60) are almost double the colour temperatures of T(60/25). The infrared spectra have less excess in the 60 μm band than do OH megamasers.
3) We understand the mechanism of OH megamaser amplification in broad outline but not in detail. To make progress a programme of detailed calculations of OH populations must be initiated. In this manner we may be able to establish the nature of the environment in the maser zone and important properties of the parent galaxies. In particular we need to be able to reproduce observed line ratios in the 1667 and 1665 MHz main lines and to be able to show why 1667 MHz is strongly dominant. The nature of water megamasers remains obscure although observations do suggest that, as for OH megamasers, they operate through amplification of the background continuum emission.
To develop consensus recommendations for training future clinician educators (CEs) in emergency medicine (EM).
A panel of EM education leaders was assembled from across Canada and met regularly by teleconference over the course of 1 year. Recommendations for CE training were drafted based on the panel’s experience, a literature review, and a survey of current and past EM education leaders in Canada. Feedback was sought from attendees at the Canadian Association of Emergency Physicians (CAEP) annual academic symposium. Recommendations were distributed to the society’s Academic Section for further feedback and updated by a consensus of the expert panel.
Recommendations were categorized for one of three audiences: 1) Future CEs; 2) Academic departments and divisions (AD&D) that support training to fulfill their education leadership goals; and 3) The CAEP Academic Section. Advanced medical education training is recommended for any emergency physician or resident who pursues an education leadership role. Individuals should seek out mentorship in making decisions about career opportunities and training options. AD&D should regularly perform a needs assessment of their future CE needs and identify and encourage potential individuals who fulfill education leadership roles. AD&D should develop training opportunities at their institution, provide support to complete this training, and advocate for the recognition of education scholarship in their institutional promotions process. The CAEP Academic Section should support mentorship of future CEs on a national scale.
These recommendations serve as a framework for training and supporting the next generation of Canadian EM medical educators.
The nutrient choline is necessary for membrane synthesis and methyl donation, with increased requirements during lactation. The majority of immune development occurs postnatally, but the importance of choline supply for immune development during this critical period is unknown. The objective of this study was to determine the importance of maternal supply of choline during suckling on immune function in their offspring among rodents. At parturition, Sprague–Dawley dams were randomised to either a choline-devoid (ChD; n 7) or choline-sufficient (ChS, 1 g/kg choline; n 10) diet with their offspring euthanised at 3 weeks of age. In a second experiment, offspring were weaned to a ChS diet until 10 weeks of age (ChD-ChS, n 5 and ChS-ChS, n 9). Splenocytes were isolated, and parameters of immune function were measured. The ChD offspring received less choline in breast milk and had lower final body and organ weight compared with ChS offspring (P<0·05), but this effect disappeared by week 10 with choline supplementation from weaning. ChD offspring had a higher proportion of T cells expressing activation markers (CD71 or CD28) and a lower proportion of total B cells (CD45RA+) and responded less to T cell stimulation (lower stimulation index and less IFN-γ production) ex vivo (P<0·05). ChD-ChS offspring had a lower proportion of total and activated CD4+ T cells, and produced less IL-6 after mitogen stimulation compared with cells from ChS-ChS (P<0·05). Our study suggests that choline is required in the suckling diet to facilitate immune development, and choline deprivation during this critical period has lasting effects on T cell function later in life.