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This chapter asks whether Jean de Meun's references in the Roman de la Rose to relics as a euphemism for genitals actually allude to a much larger debate in Paris between 1250 and 1280 about significatio in general, and about the religious and political significance of relics in particular, a debate in which Thomas Aquinas played an important role. Scholars have noted the influence of Ovid and Alain de Lille upon the Roman de la Rose, but have not tended to consider Jean de Meun's scholastic sources, particularly his deployment of the theology of Thomas Aquinas.
Keywords: Thomas Aquinas, Jean de Meun, Relics, Roman de la Rose, Significatio
Constant Mews’ research on relics and on Abelard and Heloise intersect in the second part of the Roman de la Rose by Jean de Meun. Mews discusses specifically how Jean de Meun refers to an exchange of letters between the famed lovers where Heloise, in declaring her love for Abelard, affirms that she would rather be his whore (meretrix) than the empress of Augustus (imperatrix). Jean's allusion to this passage later assumed particular prominence during the late fourteenth-century quarrel over the Roman de la Rose. It is, however, first useful to turn the clock back a century from the translation of Thomas’ relics in France in 1368-1369 to the 1270s, when Jean de Meun appears to have written his continuation of the Roman de la Rose, to a time and place when both Thomas and Jean took up the question of relics themselves, admittedly from very different perspectives. The intersection between Mews’ work on relics and on the fortune of Heloise’s and Abelard's correspondence (which Jean de Meun also translated) leads to the underlying question of this chapter in Mews’ honor: did Jean de Meun’s references in the Rose to relics as a euphemism for genitals actually allude to a much larger debate in Paris between 1250 and 1280 about significatio in general, and about the religious and political significance of relics in particular, a debate in which Thomas Aquinas played an important role? After all, the opening of Guillaume de Lorris’ part of the Rose proclaims that dreams contain significance (v. 16, ‘songes est senfiance,’ which also can mean ‘a dream is a sign’), and Jean de Meun spends thousands of lines repeatedly promising, but never delivering, the glose of this dream.
Multifetal pregnancies are at risk of adverse maternal, neonatal and long-term health outcomes, and gestational weight gain (GWG) is a potentially modifiable risk factor for several of these. However, studies assessing the associations of GWG with long-term health in twins are rare, and studies which do assess these associations in twins often do not account for gestational age. Since longer gestations are likely to lead to larger GWG and lower risk of adverse outcomes, adjusting for gestational age is necessary to better understand the association of GWG with twin health outcomes. We aimed to explore long-term associations of GWG-for-gestational-age with twin anthropometric measures. The Peri/Postnatal Epigenetic Twins Study (PETS) is a prospective cohort study, which recruited women pregnant with twins from 2007 to 2009. Twins were followed-up at 18 months and 6 years of age. GWG-for-gestational-age z-scores were calculated from pre-pregnancy weight and weight at delivery. We fitted regression models to assess associations of GWG with twin weight, height and BMI at birth, 18 months, and 6 years. Of the 250 women in the PETS, 172 had GWG measured throughout pregnancy. Overall, higher GWG-for-gestational-age z-scores were associated with higher birthweight (β: 0.32 z-scores, 95% Confidence Interval (95% CI): 0.19, 0.45), BMI (β: 0.29 z-scores, 95% CI: 0.14, 0.43) and length (β: 0.27 z-scores, 95% CI: 0.09, 0.45). However, these associations were not observed at 18 months or 6 years of age. GWG was associated with twin length, weight and BMI at birth but not during childhood. Further research is needed to determine the long-term effects of GWG on twin health outcomes.
Evidence-based psychotherapies (EBPs) are underused in health care settings. Aligning implementation of EBPs with the needs of health care leaders (i.e., operational stakeholders) can potentially accelerate their uptake into routine practice. Operational stakeholders (such as hospital leaders, clinical directors, and national program officers) can influence development and oversight of clinical programs as well as policy directives at local, regional, and national levels. Thus, engaging these stakeholders during the implementation and dissemination of EBPs is critical when targeting wider use in health care settings. This article describes how research–operations partnerships were leveraged to increase implementation of an empirically supported psychotherapy – brief Cognitive Behavioral Therapy (brief CBT) – in Veterans Health Administration (VA) primary care settings. The partnered implementation and dissemination efforts were informed by the empirically derived World Health Organization’s ExpandNet framework. A steering committee was formed and included several VA operational stakeholders who helped align the brief CBT program with the implementation needs of VA primary care settings. During the first 18 months of the project, partnerships facilitated rapid implementation of brief CBT at eight VA facilities, including training of 12 providers who saw 120 patients, in addition to expanded program elements to better support sustainability (e.g., train-the-trainer procedures).
The purpose of this study was to determine if estimated center of pressure (COP) from plantar force data collected using three-sensor loadsol insoles was comparable to the COP from plantar pressure data collected using pedar insoles during walking and running. Ten healthy adults walked and ran at self-selected speeds on a treadmill while wearing both a loadsol and pedar insole in their right shoe. Plantar force recorded from the loadsol was used to estimate COP along mediolateral (COPx) and anteroposterior (COPy) axes. The estimated COPx and COPy were compared with the COPx and COPy from pedar using limits of agreement and Spearman’s rank correlation. There were significant relationships and agreement within 5 mm in COPx and 20 mm in COPy between loadsol and pedar at 20–40% of stance during walking and running. However, loadsol demonstrated biases of 7 mm in COPx and 10 mm in COPy compared to pedar near initial contact and toe-off.
United States certified organic and conventional dairy farms are compared on the basis of economic, financial, and technological measures using dairy data from the 2016 USDA Agricultural Resource Management Survey. A stochastic production frontier model using an input distance function framework is estimated for U.S. dairy farms to examine technical efficiency and returns to scale (RTS) of farms of both systems and by multiple size categories. Financial and economic measures such as net return on assets and input costs, as well as technological adoption measures are compared by system and size. For both systems, size is the major determinant of competitiveness based on selected measures of productivity and RTS.
Endovascular thrombectomy (EVT) is effective in reducing disability in selected patients with stroke and large vessel occlusion (LVO), but access to this treatment is suboptimal.
We examined the proportion of patients with LVO who did not receive EVT, the reasons for non-treatment, and the association between time from onset and probability of treatment.
We conducted a retrospective cohort study of consecutive patients with acute stroke and LVO presenting between January 2017 and June 2018. We used multivariable log-binomial models to determine the association between time and probability of treatment with and without adjustment for age, sex, dementia, active cancer, baseline disability, stroke severity, and evidence of ischemia on computerized tomography.
We identified 256 patients (51% female, median age 74 [interquartile range, IQR 63.5, 82.5]), of whom 59% did not receive EVT. The main reasons for not treating with EVT were related to occlusion characteristics or infarct size. The median time from onset to EVT center arrival was longer among non-treated patients (218 minutes [142, 302]) than those who were treated (180 minutes [104, 265], p = 0.03). Among patients presenting within 6 hours of onset, the relative risk (RR) of receiving EVT decreased by 3% with every 10-minute delay in arrival to EVT center (adjusted RR 0.97 CI95 [0.95, 0.99]). This association was not found in the overall cohort.
The proportion of patients with acute stroke and confirmed LVO who do not undergo EVT is substantial. Minimizing delays in arrival to EVT center may optimize the delivery of this treatment.
Neurodevelopment is sensitive to genetic and pre/postnatal environmental influences. These effects are likely mediated by epigenetic factors, yet current knowledge is limited. Longitudinal twin studies can delineate the link between genetic and environmental factors, epigenetic state at birth and neurodevelopment later in childhood. Building upon our study of the Peri/postnatal Epigenetic Twin Study (PETS) from gestation to 6 years of age, here we describe the PETS 11-year follow-up in which we will use neuroimaging and cognitive testing to examine the relationship between early-life environment, epigenetics and neurocognitive outcomes in mid-childhood. Using a within-pair twin model, the primary aims are to (1) identify early-life epigenetic correlates of neurocognitive outcomes; (2) determine the developmental stability of epigenetic effects and (3) identify modifiable environmental risk factors. Secondary aims are to identify factors influencing gut microbiota between 6 and 11 years of age to investigate links between gut microbiota and neurodevelopmental outcomes in mid-childhood. Approximately 210 twin pairs will undergo an assessment at 11 years of age. This includes a direct child cognitive assessment, multimodal magnetic resonance imaging, biological sampling, anthropometric measurements and a range of questionnaires on health and development, behavior, dietary habits and sleeping patterns. Data from complementary data sources, including the National Assessment Program — Literacy and Numeracy and the Australian Early Development Census, will also be sought. Following on from our previous focus on relationships between growth, cardiovascular health and oral health, this next phase of PETS will significantly advance our understanding of the environmental interactions that shape the developing brain.
Essential variables to consider for an efficient control strategy for invasive plants include dispersion pattern (i.e., satellite or invasion front) and patch expansion rate. These variables were demonstrated for buffelgrass [Pennisetum ciliare (L.) Link], a C4 perennial grass introduced from Africa, which has invaded broadly around the world. The study site was along a roadway in southern Arizona (USA). The P. ciliare plant distributions show the pattern of clumping associated with the satellite (nascent foci) colonization pattern (average nearest neighbor test, z-score −47.2, P<0.01). The distance between patches ranged from 0.743 to 12.8 km, with an average distance between patches of 5.6 km. Median patch expansion rate was 271% over the 3-yr monitoring period versus 136% found in other studies of established P. ciliare patches. Targeting P. ciliare satellite patches as a control strategy may exponentially reduce the areal doubling time, while targeting the largest patches may have less effect on the invasion speed.
Lithium-ion capacitors (LICs) and Hybrid LICs (H-LICs) were assembled as three-layered pouch cells in an asymmetric configuration employing Faradaic pre-lithiated hard carbon anodes and non-Faradaic ion adsorption-desorption activated carbon (AC) cathodes for LICs and lithium iron phosphate (LiFePO4-LFP)/AC composite cathodes for H-LICs. The room temperature rate performance was evaluated after the initial LIC and H-LIC cell formation as a function of the electrolyte additives. The capacity retention was measured after charging at high temperature conditions, while the design factor explored was electrolyte additive formulation, with a focus on their stability. The high temperature potential holds simulate electrochemical energy materials under extreme environments and act to accelerate the failure mechanisms associated with cell degradation to determine robust electrolyte/additive combinations.
We commend Rotolo et al. (2018) for introducing a new lens for viewing the well-known gap between industrial and organizational (I-O) psychology research and human resource (HR) practices in organizations. However, Rotolo et al.’s characterization of practitioner behavior as “anti I-O” suggests a particularly negative view of scientific research among some HR practitioners. The label implies that some HR practitioners are intentionally ignoring or actively resisting academic research. More likely, the behavior stems from a passive indifference to academia, which may be the appropriate attitude for some practitioners to adopt when a great deal of academic research is too slow, too theoretical, and too cryptically communicated to be useful in applied settings. We agree with Rotolo et al. when they say, “we are a discipline that is not geared for being cutting edge” (p. 182), and we appreciate their recommendations for addressing this lack of relevance. However, most recommendations in this broader discussion do not address the foundational problem within our field: a systemic mismatch between the incentives of practitioners and academics. To support this point, we briefly describe a typology of I-O psychologists as well as the varying contexts and incentives that drive their behavior. We then close with our own recommendations for how academia can improve its relevance to practitioners and close the gap. These changes are not easy, but we agree with Rotolo and colleagues that if any field can address such foundational problems, it is ours.
Objective: The human gut microbiota has been demonstrated to be associated with a number of host phenotypes, including obesity and a number of obesity-associated phenotypes. This study is aimed at further understanding and describing the relationship between the gut microbiota and obesity-associated measurements obtained from human participants. Subjects/Methods: Here, we utilize genetically informative study designs, including a four-corners design (extremes of genetic risk for BMI and of observed BMI; N = 50) and the BMI monozygotic (MZ) discordant twin pair design (N = 30), in order to help delineate the role of host genetics and the gut microbiota in the development of obesity. Results: Our results highlight a negative association between BMI and alpha diversity of the gut microbiota. The low genetic risk/high BMI group of individuals had a lower gut microbiota alpha diversity when compared to the other three groups. Although the difference in alpha diversity between the lean and heavy groups of the BMI-discordant MZ twin design did not achieve significance, this difference was observed to be in the expected direction, with the heavier participants having a lower average alpha diversity. We have also identified nine OTUs observed to be associated with either a leaner or heavier phenotype, with enrichment for OTUs classified to the Ruminococcaceae and Oxalobacteraceae taxonomic families. Conclusion: Our study presents evidence of a relationship between BMI and alpha diversity of the gut microbiota. In addition to these findings, a number of OTUs were found to be significantly associated with host BMI. These findings may highlight separate subtypes of obesity, one driven by genetic factors, the other more heavily influenced by environmental factors.
To explore the prevalence and drivers of hospital-level variability in antibiotic utilization among hematopoietic cell transplant (HCT) recipients to inform antimicrobial stewardship initiatives.
Retrospective cohort study using data merged from the Pediatric Health Information System and the Center for International Blood and Marrow Transplant Research.
The study included 27 transplant centers in freestanding children’s hospitals.
The primary outcome was days of broad-spectrum antibiotic use in the interval from day of HCT through neutrophil engraftment. Hospital antibiotic utilization rates were reported as days of therapy (DOTs) per 1,000 neutropenic days. Negative binomial regression was used to estimate hospital utilization rates, adjusting for patient covariates including demographics, transplant characteristics, and severity of illness. To better quantify the magnitude of hospital variation and to explore hospital-level drivers in addition to patient-level drivers of variation, mixed-effects negative binomial models were also constructed.
Adjusted hospital rates of antipseudomonal antibiotic use varied from 436 to 1121 DOTs per 1,000 neutropenic days, and rates of broad-spectrum, gram-positive antibiotic use varied from 153 to 728 DOTs per 1,000 neutropenic days. We detected variability by hospital in choice of antipseudomonal agent (ie, cephalosporins, penicillins, and carbapenems), but gram-positive coverage was primarily driven by vancomycin use. Considerable center-level variability remained even after controlling for additional hospital-level factors. Antibiotic use was not strongly associated with days of significant illness or mortality.
Among a homogenous population of children undergoing HCT for acute leukemia, both the quantity and spectrum of antibiotic exposure in the immediate posttransplant period varied widely. Antimicrobial stewardship initiatives can apply these data to optimize the use of antibiotics in transplant patients.
The Arctic marine environment is undergoing a transition from thick multi-year to first-year sea-ice cover with coincident lengthening of the melt season. Such changes are evident in the Baffin Bay-Davis Strait-Labrador Sea (BDL) region where melt onset has occurred ~8 days decade−1 earlier from 1979 to 2015. A series of anomalously early events has occurred since the mid-1990s, overlapping a period of increased upper-air ridging across Greenland and the northwestern North Atlantic. We investigate an extreme early melt event observed in spring 2013. (~6σ below the 1981–2010 melt climatology), with respect to preceding sub-seasonal mid-tropospheric circulation conditions as described by a daily Greenland Blocking Index (GBI). The 40-days prior to the 2013 BDL melt onset are characterized by a persistent, strong 500 hPa anticyclone over the region (GBI >+1 on >75% of days). This circulation pattern advected warm air from northeastern Canada and the northwestern Atlantic poleward onto the thin, first-year sea ice and caused melt ~50 days earlier than normal. The episodic increase in the ridging atmospheric pattern near western Greenland as in 2013, exemplified by large positive GBI values, is an important recent process impacting the atmospheric circulation over a North Atlantic cryosphere undergoing accelerated regional climate change.
National security is one of many fields where experts make vague probability assessments when evaluating high-stakes decisions. This practice has always been controversial, and it is often justified on the grounds that making probability assessments too precise could bias analysts or decision makers. Yet these claims have rarely been submitted to rigorous testing. In this paper, we specify behavioral concerns about probabilistic precision into falsifiable hypotheses which we evaluate through survey experiments involving national security professionals. Contrary to conventional wisdom, we find that decision makers responding to quantitative probability assessments are less willing to support risky actions and more receptive to gathering additional information. Yet we also find that when respondents estimate probabilities themselves, quantification magnifies overconfidence, particularly among low-performing assessors. These results hone wide-ranging concerns about probabilistic precision into a specific and previously undocumented bias that training may be able to correct.
Those of us who study human cognition have no easy task. We try to understand how people functionally represent and process information in performing cognitive activities such as vision, perception, memory, language, and decision making. Fortunately, experimental psychology has a rich theoretical tradition, and there is no shortage of insightful theoretical proposals. Also, it has a rich experimental tradition, with a multitude of experimental techniques for isolating purported processes. What it lacks, however, is a rich statistical tradition to link theory to data. At the heart of the field is the difficult task of trying to use data from experiments to inform theory, that is, to understand accurately the relationships within the data and how they provide evidence for or against various theoretical positions.
The difficulty in linking data to theory can be seen in a classic example from Estes (1956). Estes considered two different theories of learning: one in which learning was gradual, and another where learning happened all at once. These two accounts are shown in Figure 9.1A. Because these accounts are so different, adjudicating between them should be trivial: one simply examines the data for either a step function or a gradual change. Yet, in many cases, this task is surprisingly difficult. To see this difficulty, consider the data of Reder and Ritter (1992), who studied the speed up in response times from repeated practice of a mathematics tasks. The data are shown in Figure 9.1B, and the gray lines show the data from individuals. These individual data are highly variable, making it impossible to spot trends. A first-order approach is to simply take the means across individuals at different levels of practice, and these means (points) decrease gradually, seemingly providing support for the gradual theory of learning. Estes, however, noted that this pattern does not necessarily imply that learning is gradual. Instead, learning might be all-at-once, but the time at which different individuals transition may be different. Figure 9.1C shows an example; for demonstration purposes, hypothetical data are shown without noise. If data are generated from the all-at-once model and there is variation in this transition time, then the mean will reflect the proportion of individuals in the unlearned state at a given level of practice.
Objectives: Following pediatric moderate-to-severe traumatic brain injury (msTBI), few predictors have been identified that can reliably identify which individuals are at risk for long-term cognitive difficulties. This study sought to determine the relative contribution of detailed descriptors of injury severity as well as demographic and psychosocial factors to long-term cognitive outcomes after pediatric msTBI. Methods: Participants included 8- to 19-year-olds, 46 with msTBI and 53 uninjured healthy controls (HC). Assessments were conducted in the post-acute and chronic stages of recovery. Medical record review provided details regarding acute injury severity. Parents also completed a measure of premorbid functioning and behavioral problems. The outcome of interest was four neurocognitive measures sensitive to msTBI combined to create an index of cognitive performance. Results: Results indicated that none of the detailed descriptors of acute injury severity predicted cognitive performance. Only the occurrence of injury, parental education, and premorbid academic competence predicted post-acute cognitive functioning. Long-term cognitive outcomes were best predicted by post-acute cognitive functioning. Discussion: The findings suggest that premorbid factors influence cognitive outcomes nearly as much as the occurrence of a msTBI. Furthermore, of youth with msTBI who initially recover to a level of moderate disability or better, a brief cognitive battery administered within several months after injury can best predict which individuals will experience poor long-term cognitive outcomes and require additional services. (JINS, 2016, 22, 1–8)
We analyzed birth order differences in means and variances of height and body mass index (BMI) in monozygotic (MZ) and dizygotic (DZ) twins from infancy to old age. The data were derived from the international CODATwins database. The total number of height and BMI measures from 0.5 to 79.5 years of age was 397,466. As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood. After adjusting the results for birth weight, the birth order differences decreased and were no longer statistically significant. First-born twins had greater BMI than the second-born twins over childhood and adolescence. After adjusting the results for birth weight, birth order was still associated with BMI until 12 years of age. No interaction effect between birth order and zygosity was found. Only limited evidence was found that birth order influenced variances of height or BMI. The results were similar among boys and girls and also in MZ and DZ twins. Overall, the differences in height and BMI between first- and second-born twins were modest even in early childhood, while adjustment for birth weight reduced the birth order differences but did not remove them for BMI.