The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis

STUDY QUESTION Is there an association between high levels of sperm DNA damage and miscarriage?SUMMARY ANSWERMiscarriage rates are positively correlated with sperm DNA damage levels.WHAT IS KNOWN ALREADYMost ejaculates contain a subpopulation of sperm with DNA damage, also referred to as DNA fragmentation, in the form of double or single-strand breaks which have been induced in the DNA prior to or following ejaculation. This DNA damage may be particularly elevated in some subfertile men, hence several studies have examined the link between sperm DNA damage levels and conception and miscarriage rates.STUDY DESIGN, SIZE, DURATIONA systematic review and meta-analysis of studies which examined the effect of sperm DNA damage on miscarriage rates was performed. Searches were conducted on MEDLINE, EMBASE and the Cochrane Library without any language restrictions from database inception to January 2012.PARTICIPANTS/MATERIALS, SETTING, METHODSWe used the terms 'DNA damage' or 'DNA fragmentation' combined with 'miscarriage', 'abortion' or 'pregnancy' to generate a set of relevant citations. Data extraction was performed by two reviewers. Study quality was assessed using the Newcastle-Ottawa Scale. Meta-analysis of relative risks of miscarriage was performed with a random effects model. Subgroup analyses were performed by the type of DNA damage test, whether the sperm examined were prepared or from raw semen and for pregnancies resulting from IVF or ICSI treatment.MAIN RESULTS AND THE ROLE OF CHANCEWe identified 16 cohort studies (2969 couples), 14 of which were prospective. Eight studies used acridine orange-based assays, six the TUNEL assay and two the COMET assay. Meta-analysis showed a significant increase in miscarriage in patients with high DNA damage compared with those with low DNA damage [risk ratio (RR) = 2.16 (1.54, 3.03), P <0.00001)]. A subgroup analysis showed that the miscarriage association is strongest for the TUNEL assay (RR = 3.94 (2.45, 6.32), P <0.00001).LIMITATIONS, REASONS FOR CAUTIONThere is some variation in study characteristics, including the use of different assays and different thresholds for DNA damage and the definition of pregnancy loss.WIDER IMPLICATIONS OF THE FINDINGSThe use of methods which select sperm without DNA damage for use in assisted conception treatment may reduce the risk of miscarriage. This finding indicates that assays detecting DNA damage could be considered in those suffering from recurrent pregnancy loss. Further research is necessary to study the mechanisms of DNA damage and the potential therapeutic effects of antioxidant therapy.STUDY FUNDING/COMPETING INTEREST(S)None.

An Analytical Study of Surplus Value using a Value Driven Design Methodology

People are now becoming more environmentally aware and as a consequence of this, industries such as the aviation industry are striving to design more environmentally friendly products. To achieve this, the current design methodologies must be modified to ensure these issues are considered from product conception through to disposal. This paper discusses the environmental problems in relation to the aviation industry and highlights some logic for making the change from the traditional Systems Engineering approach to the recent design paradigm known as Value Driven Design. Preliminary studies have been undertaken to aid in the understanding of this methodology and the existing surplus value objective function. The main results from the work demonstrate that surplus value works well bringing disparate issues such as manufacture and green taxes together to aid decision making. Further, to date studies on surplus value have used simple sensitivity analysis, but deeper consideration shows non-linear interactions between some of the variables and further work will be needed to fully account for complex issues such as environmental impact and taxes.

'Strange Visitor From Another Planet': Genre, Corporate Identity and the Arrival of American Telefantasy on British Television

While the BBC had been broadcasting television Science Fiction productions from as early as 1938, and Horror since the start of television in 1936, American Telefantasy had no place on British television until ITV’s broadcast of Adventures of Superman (1952-1958) in 1956. It would be easy to assign this absence to the avoidance of popular American programming, but this would ignore the presence of Western and adventure serials imported from the US and Canada for monopoly British television. Similarly, it would be inaccurate to suggest that these imports were purely purchased as thrilling fare to appease a child audience, as it was the commercial ITV that was first to broadcast the more adult-orientated Science Fiction Theatre (1955-7) and Inner Sanctum (1954). This article builds on the work of Paul Rixon and Rob Leggott to argue that these imports were used primarily to supply relatively cheap broadcast material for the new channel, but that they also served to appeal to the notion of spectacular entertainment attached to the new channel through its own productions, such as The Invisible Man (1958-1959) and swashbucklers such as The Adventures of Robin Hood (1955-60). However, the appeal was not just to the exciting, but also to the transatlantic, with ITV embracing this conception of America as a modern place of adventure through its imports and its creation of productions for export, incorporating an American lead into The Invisible Man and drawing upon an (inexpensive) American talent pool of blacklisted screenwriters to provide a transatlantic style and relevance to its own adventure series. Where the BBC used its imported serials as filler directed at children, ITV embraced this transatlantic entertainment as part of its identity and differentiation from the BBC.

Eternity, knowledge, and freedom

This article addresses the problem of divine foreknowledge and human freedom by developing a modi?ed version of Boethius’ solution to the problem–one that is meant to cohere with a dynamic theory of time and a conception of God as temporal. I begin the article by discussing the traditional Boethian solution, and a defence of it due to Kretzmann and Stump. After canvassing a few of the objections to this view, I then go on to o?er my own modi?ed Boethian solution, according to which temporal reality is fundamentally dynamic, but truth is not. My claim is that there are eternally existing, tenseless propositions, with determinate truth values, but that these are made true by events that come into existence, and are not themselves eternal.

Divine Events

I argue for a certain conception of events according to which they are essentially extended and temporal entities (contra Leftow), and then go on to argue that God is necessarily the subject of such events (even before creation--a claim which is particularly controversial). Together these claims entail that God is necessarily temporal.

Transformative Aesthetics: Between Remembrance and Reconciliation in Contemporary Northern Irish Theatre

This article explores the ways in which two recent plays by the Tinderbox Theatre Company in Belfast – Jimmy McAleavey's The Sign of the Whale and David Ireland's Everything Between Us – engage with current political debates in Northern Ireland about how to deal with the ‘legacy of the past’. Both plays dramatise the uneasy tension between the demands for remembrance and reconciliation. I suggest that they give rise to a ‘transformative aesthetics’ that proposes an un-remembering of the past to make way for a transformative re-remembering for the future. This process, however, does not imply an easy resolution or transcendence of the antagonisms, debates, and traumatic memories. Instead, it suggests an intense and complicated engagement that sits in vexed opposition to the restorative conception of reconciliation and both a politics and a political context of ameliorative forgetting that dominates the Northern Irish Peace Process.

‘Papers from ‘A Symposium with Professor Roger Brownsword: Super-stewardship in the Context of Public Health’’

This special issue seeks to engage the term 'stewardship' and the practical and theoretical work around it, both of which are destined to remain items of unfinished business as governance struggles to keep up and connect with its fast moving technological and societal targets. While this special issue is testament to that observation, it also helps to foster much needed scholarly discussion and critique – and to ensure this field is not unwittingly formed and deployed by and as a legitimating support for governance, but rather opened up, elaborated and contested. The articles provide innovative insights and food for thought on the conception and legal-political practice and potential of stewardship and ‘super-stewardship’ in national, supranational and international settings.

Justice as Improvisation:The Law of the Extempore

Justice as Improvisation: The Law of the Extempore theorises the relationship between justice and improvisation through the case of the New York City cabaret laws. Discourses around improvisation often imprison it in a quasi-ethical relationship with the authentic, singular ‘other’. The same can be said of justice. This book interrogates this relationship by highlighting the parallels between the aporetic conception of justice advanced by the late French philosopher Jacques Derrida and the nuanced approach to improvisation pursued by musicians and theorists alike in the new and emerging interdisciplinary field of Critical Studies in Improvisation (CSI). Justice as Improvisation re-imagines justice as a species of improvisation through the formal structure of the most basic of legal mechanisms, judicial decision-making, offering law and legal theory a richer, more concrete, understanding of justice. Not further mystery or mystique, but a negotiation between abstract notions of justice and the everyday practice of judging. Improvisation in judgment calls for ongoing, practical decision-making as the constant negotiation between the freedom of the judge to take account of the otherness or singularity of the case and the existing laws or rules that both allow for and constrain that freedom. Yes, it is necessary to judge, yes, it is necessary to decide, but to judge well, to decide justly, that is a music lesson perhaps best taught by critical improvisation scholars.

Events: Temporal and Eternal (in preparation)

This monograph develops a theory of events which provides the foundation for a plausible and coherent account of God’s relation to time, and which has independent appeal (independent, that is, of theological considerations). The book is divided into three parts. The first part involves an investigation of those fundamental aspects of time which have important implications for the nature of events, such as whether time is substantival or relational, and whether time is continuous, dense, or discrete. This part also includes a chapter on how these issues relate to different interpretations of the special theory of relativity. The second part involves a defense of the fundamentality of events, and the development of a theory of events in time. The third part considers ways in which we might plausibly conceive of events as eternal entities. This involves an investigation of different ways of characterizing divine eternity, and then an analysis of the possible relations these ways bear to the antecedently developed theory of temporal events. The thought here is that there are certain characteristics of temporal events which can be assimilated to eternity, and that by evaluating the extent to which different theories of divine eternity allow for this assimilation, we will be able to determine which of those theories is most plausible, and therefore which conception of God’s relation to time is most plausible. The basis of this evaluation will be the theory’s ability to coherently account for God’s knowledge of, and interaction with, the created temporal world. One specific issue here is how to account for God’s knowledge of the future free actions of humans (an issue that I address in 'Eternity, Knowledge, and Freedom'), but there are many other difficulties associated with God’s relation to time, such as God’s creation of contingent time, God’s knowledge of what is happening now, God’s dialogue with humans, and God’s causally interacting with the temporal world in general. A successful theory of eternal events, and, in particular, divine events, will provide a framework for dealing with these difficulties.

I have not yet sough a publisher for this work, but intend to do so in 2013, with a target publication date of 2014.

ARTICLE: Property and the Definition of Slavery

Currently there is no clear understanding of the meaning of ‘slavery’ in modern international law. While generally it is accepted that the
authoritative definition of slavery is provided by Article 1 of the Slavery Convention 1926, in recent times slavery has been understood in such a wide variety of ways that effectively it is a meaningless term. This paper reflects on this interpretation problem and aims to redress this balance by reclaiming the core meaning of the legal definition. It applies property law perspectives to explain the conception of ownership invoked by Article 1, to argue that it remains relevant and to explore how it might be applied in identifying modern cases of slavery.

The Other Side of the Fence:Reconceptualizing the “Camp” and Migration Zones at the Borders of Spain

This article explores the dynamics of the space of exception at the borders of Europe in the Spanish enclave of Melilla, and the neighboring Moroccan city of Oujda. Building upon field research conducted in the spring of 2008, I ask how we can understand the political space of migration not simply as exceptional, but as shaped by the mobility of the irregular migrants moving outside of the frameworks, policies, and practices of the state. By privileging the migrant narrative and making use of Rancière's conception of politics as shaped by the demands of those who “have no part,” I suggest an alternative way of understanding the politics of exception and agency of non-citizens—that is, one of disruption and demands to open up powerful potentials for change in an otherwise rigid regime.

Arguing with Regions

An analytical survey of how regions have entered into the arguments of the
social sciences serves to highlight the uses and limitations of different understandings of regions and their various theoretical biases. It also provides a way of introducing the articles in the rest of this special issue. It considers how regions have come to be used as a classificatory device across the social sciences, discusses the various meanings given to regions in empirical research, and examines the main philosophical and theoretical controversies that have been sparked by their use. Matching regions to purpose and avoiding a singular conception of ‘region’ that claims to fit all arguments are the main conclusions.

Identifying Economically Vulnerable Groups as the Economic Crisis Emerged

A frequent refrain during recent debates on welfare cuts and tax increases has related to the need to "protect the vulnerable". However, it is far from clear that a consensus exists on which individuals or groups are to be included under this heading with a consequent lack of clarity for the policy implications of pursuing this goal. In this paper, operating with a conception of social exclusion that incorporates notions of dynamics and multidimensionality, we make use of EU-SILC 2008 data for Ireland to clarify the distinction between income poverty and economic vulnerability. We then proceed to consider the relationship between these outcomes and multiple deprivation, financial pressures and perceptions of recent and future economic prospects. Our analysis is then extended to compare patterns of risk for poverty and vulnerability in relation to key socio-economic groups. Finally, we will consider the relationship between poverty and vulnerability and the distribution of welfare dependence. Our analysis suggests that the vulnerable but non-poor group may need to be a key focus of policy attention in the future.

From hyperactive children to ADHD adults:Observations on the expansion of medical categories

Medicalization is by definition, about the extension of medical boundaries. Analogous to "domain expansion," extant medicalized categories can expand to become broader and more inclusive. This paper examines the emergence of Attention Deficit Hyperactivity Disorder (ADHD) in adults. ADHD, commonly known as Hyperactivity, became established in the 1970s as a diagnosis for children; it expanded first to include "adult hyperactives" and, in the 1990s, "ADHD Adults." This allowed for the inclusion of an entire population of people and their problems that were excluded by the original conception of hyperactive children. We show how lay, professional, and media claims help establish the expanded diagnostic category. We identify particular aspects of the social context that contributed to the rise of adult ADHD and outline some of the social implications of ADHD in adults, especially the medicalization of underperformance and the availability of new disability rights. Adult ADHD serves as an exemplar of several cases of diagnostic expansion, an important avenue of increasing medicalization.