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The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)–pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D–pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (Prace difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (Prace difference=0·56). Among EA, the 25(OH)D–FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.
The history of British saints on the Continent is notoriously difficult to research – and I deliberately use the word ‘British’ and ‘Briton’ even where others might prefer ‘Breton’, because for the sixth century it is usually impossible to make a definite distinction between those who originated in Great Britain and those who came from Brittany. The majority of our sources are late: the most substantial body of material is hagiographic, but the Vita Winwaloei was written by Wrdestin and Clement in the first years of the ninth century, that of Machutus (Malo) by Bili around 860, and that of Paul Aurelian by Wrmonoc in 884. Of the two Lives of Gildas, the earliest appears to belong to the eleventh century, and the second, by Caradoc of Llancarfan, to the twelfth. The first Life of Samson (VIS) would seem to have been composed initially during the seventh century, which is when the author himself claims to have been active, and there are certain linguistic and terminological features in the Life that support such a date. There may, of course, have been a subsequent moment of what French scholars are now describing as réécriture, but even so the fact that the text makes no mention of a diocese of Dol surely indicates that the work as we have it antedates the foundation of the see, whose existence is not clearly attested before the mid-ninth century.
For Samson, unlike Gildas, Paul Aurelian, Winwaloe (Gwennolé), and Malo, we at least have the evidence of the subscription list of the Council of Paris, which can be dated by means of the other signatories to the period 556 to 573. The Council provides us with a useful point of departure for considering the activities of British ascetics in the Merovingian world. Having considered the early evidence for Samson, I will turn to that relating to the Irish saint Columbanus, which arguably gives us our most extensive block of dateable evidence for the influence of Britons on the Continent, before returning to what the Vita Samsonis has to say about the saint's Continental career, and the ways in which it complements and differs from the Columbanian material.
Depression and obesity are highly prevalent, and major impacts on public health frequently co-occur. Recently, we reported that having depression moderates the effect of the FTO gene, suggesting its implication in the association between depression and obesity.
To confirm these findings by investigating the FTO polymorphism rs9939609 in new cohorts, and subsequently in a meta-analysis.
The sample consists of 6902 individuals with depression and 6799 controls from three replication cohorts and two original discovery cohorts. Linear regression models were performed to test for association between rs9939609 and body mass index (BMI), and for the interaction between rs9939609 and depression status for an effect on BMI. Fixed and random effects meta-analyses were performed using METASOFT.
In the replication cohorts, we observed a significant interaction between FTO, BMI and depression with fixed effects meta-analysis (β=0.12, P = 2.7 × 10−4) and with the Han/Eskin random effects method (P = 1.4 × 10−7) but not with traditional random effects (β = 0.1, P = 0.35). When combined with the discovery cohorts, random effects meta-analysis also supports the interaction (β = 0.12, P = 0.027) being highly significant based on the Han/Eskin model (P = 6.9 × 10−8). On average, carriers of the risk allele who have depression have a 2.2% higher BMI for each risk allele, over and above the main effect of FTO.
This meta-analysis provides additional support for a significant interaction between FTO, depression and BMI, indicating that depression increases the effect of FTO on BMI. The findings provide a useful starting point in understanding the biological mechanism involved in the association between obesity and depression.
We sought to conduct a major objective of the CAEP Academic Section, an environmental scan of the academic emergency medicine programs across the 17 Canadian medical schools.
We developed an 84-question questionnaire, which was distributed to academic heads. The responses were validated by phone by the lead author to ensure that the questions were answered completely and consistently. Details of pediatric emergency medicine units were excluded from the scan.
At eight of 17 universities, emergency medicine has full departmental status and at two it has no official academic status. Canadian academic emergency medicine is practiced at 46 major teaching hospitals and 13 specialized pediatric hospitals. Another 69 Canadian hospital EDs regularly take clinical clerks and emergency medicine residents. There are 31 full professors of emergency medicine in Canada. Teaching programs are strong with clerkships offered at 16/17 universities, CCFP(EM) programs at 17/17, and RCPSC residency programs at 14/17. Fourteen sites have at least one physician with a Master’s degree in education. There are 55 clinical researchers with salary support at 13 universities. Sixteen sites have published peer-reviewed papers in the past five years, ranging from four to 235 per site. Annual budgets range from $200,000 to $5,900,000.
This comprehensive review of academic activities in emergency medicine across Canada identifies areas of strengths as well as opportunities for improvement. CAEP and the Academic Section hope we can ultimately improve ED patient care by sharing best academic practices and becoming better teachers, educators, and researchers.
To characterize the current state of Canadian emergency medicine (EM) resident research and develop recommendations to promote excellence in this area.
We performed a systematic review of MEDLINE, Embase, and ERIC using search terms relevant to EM resident research. We conducted an online survey of EM residency program directors from the Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC). An expert panel reviewed these data, presented recommendations at the Canadian Association of Emergency Physicians 2014 Academic Symposium, and refined them based on feedback received.
Of 654 potentially relevant citations, 35 articles were included. These were categorized into four themes: 1) expectations and requirements, 2) training and assessment, 3) infrastructure and support, and 4) dissemination. We received 31 responses from all 31 RCPSC-EM and CFPC-EM programs. The majority of EM programs reported requiring a resident scholarly project; however, we found wide-ranging expectations for the type of resident research performed and how results were disseminated, as well as the degree of completion expected. Although 93% of RCPSC-EM programs reported providing formal training on how to conduct research, only 53% of CFPC-EM programs reported doing so. Almost all programs (94%) reported having infrastructure in place to support resident research, but the nature of support was highly variable. Finally, there was marked variability regarding the number of resident-published abstracts and manuscripts.
Based on the literature, our national survey, and discussions with stakeholders, we offer 14 recommendations encompassing goals, expectations, training, assessment, infrastructure, and dissemination in order to improve Canadian EM resident research.
There is good evidence for the benefits of short-term cognitive stimulation therapy for dementia but little is known about possible long-term effects.
To evaluate the effectiveness of maintenance cognitive stimulation therapy (CST) for people with dementia in a single-blind, pragmatic randomised controlled trial including a substudy with participants taking acetylcholinesterase inhibitors (AChEIs).
The participants were 236 people with dementia from 9 care homes and 9 community services. Prior to randomisation all participants received the 7-week, 14-session CST programme. The intervention group received the weekly maintenance CST group programme for 24 weeks. The control group received usual care. Primary outcomes were cognition and quality of life (clinical trial registration: ISRCTN26286067).
For the intervention group at the 6-month primary end-point there were significant benefits for self-rated quality of life (Quality of Life in Alzheimer's Disease (QoL-AD) P = 0.03). At 3 months there were improvements for proxy-rated quality of life (QoL-AD P = 0.01, Dementia Quality of Life scale (DEMQOL) P = 0.03) and activities of daily living (P = 0.04). The intervention subgroup taking AChEIs showed cognitive benefits (on the Mini-Mental State Examination) at 3 (P = 0.03) and 6 months (P = 0.03).
Continuing CST improves quality of life; and improves cognition for those taking AChEIs.
Although there had been substantial donations to the church in the course of the last two centuries of the Roman Empire, the amount of property transferred to the episcopal church and to monasteries in the following two and a half centuries would seem to have been immense. Probably rather more than 30 per cent of the Frankish kingdom was given to ecclesiastical institutions; although the Anglo-Saxon church was only established after 597, it also acquired huge amounts of land, as did the churches of Spain and Italy, although the extent conveyed in the two peninsulas is harder to estimate. The scale of endowments helps explain the occasional criticisms of the extent of church property, and also the secularisations and reallocation of church land, and indeed suggest that the transfer of property out of the control of the church in Francia and England in the eighth century may have been greater than is often assumed. The transfer of land should probably also be seen as something other than a simple change of ownership. Church property provided the economic basis for cult, for the maintenance of clergy, who were unquestionably numerous, and for the poor. In social and economic, as well as religious terms, this marked a major break with the Classical World.
A new hydrate of magnesium chromate is synthesized by quenching aqueous solutions of MgCrO4 in liquid nitrogen. MgCrO4·11H2O is isostructural with the rare mineral meridianiite (MgSO4·11H2O) being triclinic, , Z = 2, with unit-cell parameters a = 6.811 33(8) Å, b = 6.958 39(9) Å, c = 17.3850(2) Å, α = 87.920(1)°, β = 89.480(1)°, γ = 62.772(1)°, and V = 732.17(1) Å3 at −15 °C. The difference in unit-cell parameters between SO4- and CrO4-bearing species is only partially accounted for by the difference in S–O and Cr–O bond lengths; the remainder of the difference (over 90% in the cell volume) is attributed to weakening of the interpolyhedral hydrogen-bond network.
Wearmouth-Jarrow is famously a single monastery in two places. This is what both Bede's History of the Abbots (chs. 7, 15, 18) and the anonymous Life of Ceolfrith (chs. 11, 16, 19, 25) tell us on numerous occasions. However, the fact that the point is repeated in both these texts suggests either that it was not common knowledge, or that it was not universally accepted. It is not difficult to see that in certain respects the description of the two houses as forming a single monastery is misleading, hiding a rather more complex reality. St Peter's, Wearmouth, was after all founded in 674 and St Paul's, Jarrow, around seven years later in 681/2. Moreover, the fact that the two houseswere founded some years apart meant that their standing in canon law was initially distinct. Thus, when Benedict Biscop secured a privilege from Pope Agatho in 678/80, it only covered the foundation at Wearmouth, since the sister-house was not yet in existence (HA, ch. 6; LC, ch. 16). Ceolfrith, therefore, had to secure a separate privilege for Jarrow, which he did from Pope Sergius in 701 (HA, chs. 16, 18; LC, ch. 20). There was, therefore, a period when the part of the monastery based at Wearmouth held a papal privilege, while Jarrow did not. One might assume that the distinction between the two houses evaporated after Ceolfrith had secured a privilege for Jarrow.
In 1953 or thereabouts a London concert was announced containing the British première of Pierrot Lunaire, an epoch-making work as appeared to be the case from every book on music history I had been able to lay my hands on. So I got the score from the Pendlebury Library in the Cambridge Music School and duly became fascinated and perplexed. I then had a visit from David Drew, an undergraduate one year ahead of me. He had also wanted to see the score and had asked Charles Cudworth, the Pendelbury Librarian, how he could get in touch with the person who had taken it out. This was how I got to know David.