Feasibility of MR-Based Body Composition Analysis in Large Scale Population Studies

Introduction Quantitative and accurate measurements of fat and muscle in the body are important for prevention and diagnosis of diseases related to obesity and muscle degeneration. Manually segmenting muscle and fat compartments in MR body-images is laborious and time-consuming, hindering implementation in large cohorts. In the present study, the feasibility and success-rate of a Dixon-based MR scan followed by an intensity-normalised, non-rigid, multi-atlas based segmentation was investigated in a cohort of 3,000 subjects. Materials and Methods 3,000 participants in the in-depth phenotyping arm of the UK Biobank imaging study underwent a comprehensive MR examination. All subjects were scanned using a 1.5 T MR-scanner with the dual-echo Dixon Vibe protocol, covering neck to knees. Subjects were scanned with six slabs in supine position, without localizer. Automated body composition analysis was performed using the AMRA Profiler™ system, to segment and quantify visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT) and thigh muscles. Technical quality assurance was performed and a standard set of acceptance/rejection criteria was established. Descriptive statistics were calculated for all volume measurements and quality assurance metrics. Results Of the 3,000 subjects, 2,995 (99.83%) were analysable for body fat, 2,828 (94.27%) were analysable when body fat and one thigh was included, and 2,775 (92.50%) were fully analysable for body fat and both thigh muscles. Reasons for not being able to analyse datasets were mainly due to missing slabs in the acquisition, or patient positioned so that large parts of the volume was outside of the field-of-view. Discussion and Conclusions In conclusion, this study showed that the rapid UK Biobank MR-protocol was well tolerated by most subjects and sufficiently robust to achieve very high success-rate for body composition analysis. This research has been conducted using the UK Biobank Resource.

Treatment of lean and diet-induced obesity (DIO) mice with a novel stable obestatin analogue alters plasma metabolite levels as detected by untargeted LC–MS metabolomics

Introduction: Obestatin is a controversial gastrointestinal peptide purported to have metabolic actions.

Objectives: This study investigated whether treatment with a stable obestatin analogue (PEG-OB(Cys10, Cys13)) changed plasma metabolite levels firstly in lean and subsequently in diet-induced obesity (DIO) C57BL6/J mice.

Methods: Untargeted LC-HRMS metabolomics experiments were carried out in ESI + mode with plasma extracts from both groups of animals. Data were normalised, multivariate and univariate statistical analysis performed and metabolites of interest putatively identified.

Results: In lean mice, 39 metabolites were significantly changed by obestatin treatment and the majority of these were increased, including various C16 and C18 moieties of phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine and monoacylglycerol, along with vitamin A, vitamin D3, tyrosine, acetylcarnitine and 2α-(hydroxymethyl)-5α-androstane-3β,17β-diol. Decreased concentrations of glycolithocholic acid, 3-dehydroteasterone and various phospholipids were observed. In DIO mice, 25 metabolites were significantly affected and strikingly, the magnitudes of changes here were generally much greater in DIO mice than in lean mice, and in contrast, the majority of metabolite changes were decreases. Four metabolites affected in both groups included glycolithocholic acid, and three different long-chain (C18) phospholipid molecules (phosphatidylethanolamine, platelet activating factor (PAF), and monoacylglycerol). Metabolites exclusively affected in DIO mice included various phosphatidylcholines, lysophosphatidylcholines and fatty acyls, as well as creatine and oxidised glutathione.

Conclusion: This investigation demonstrates that obestatin treatment affects phospholipid turnover and influences lipid homeostasis, whilst providing convincing evidence that obestatin may be acting to ameliorate diet-induced impairments in lipid metabolism, and it may influence steroid, bile acid, PAF and glutathione metabolism.

A 3D printed electromagnetic nonlinear vibration energy harvester

A 3D printed electromagnetic vibration energy harvester is presented. The motion of the device is in-plane with the excitation vibrations, and this is enabled through the exploitation of a leaf isosceles trapezoidal flexural pivot topology. This topology is ideally suited for systems requiring restricted out-of-plane motion and benefits from being fabricated monolithically. This is achieved by 3D printing the topology with materials having a low flexural modulus. The presented system has a nonlinear softening spring response, as a result of designed magnetic force interactions. A discussion of fatigue performance is presented and it is suggested that whilst fabricating, the raster of the suspension element is printed perpendicular to the flexural direction and that the experienced stress is as low as possible during operation, to ensure longevity. A demonstrated power of ~25 μW at 0.1 g is achieved and 2.9 mW is demonstrated at 1 g. The corresponding bandwidths reach up-to 4.5 Hz. The system's corresponding power density of ~0.48 mW cm−3 and normalised power integral density of 11.9 kg m−3 (at 1 g) are comparable to other in-plane systems found in the literature.

Two-year clinical outcome from the Iberian registry patients after left atrial appendage closure

AIMS: The aim of this study was to observe the percentage of thromboembolic and haemorrhagic events over a 2-year follow-up in patients with non-valvular atrial fibrillation (NVAF) undergoing closure of the left atrial appendage (LAA) with an occlusion device. Observed events and CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke history), CHA2DS2-VASc (also adding: vascular disease and sex) and HAS-BLED (hypertension, abnormal liver/renal function, stroke history, bleeding predisposition, labile international normalised ratios, elderly, drugs/alcohol use)-predicted events were compared. METHODS: LAA closure with an occlusion device was performed in 167 NVAF patients contraindicated for oral anticoagulants and recruited from 12 hospitals between 2009 and 2013. At least two transoesophageal echocardiograms were performed in the first 6 months postimplantation. Antithrombotics included clopidogrel and aspirin. Patients were monitored for death, stroke, major and relevant bleeding and hospitalisation for concomitant conditions. Mean age was 74.68±8.58, median follow-up was 24 months, 5.38% had intraoperative complications and implantation was successful in 94.6% of subjects. Mortality during follow-up was 10.8%, mostly (9.5%) non-cardiac related. Bleeding occurred in 10.1% of subjects, 5.7% major and 4.4% minor though relevant, and 4.4% suffered stroke. Major bleeding and stroke/transient ischaemic attack events within 2 years (annual event rates, 290 patients/year) were less frequent than expected from CHADS2 (2.4% vs 9.6%), CHA2DS2-VASc (2.4% vs 8.3%) and HAS-BLED (3.1% vs 6.6%) risk scores (p<0.001, p=0.003, p=0.047, respectively). CONCLUSIONS: LAA closure with an occlusion device in patients contraindicated for oral anticoagulants is a therapeutic option associated with fewer thromboembolic and haemorrhagic events than expected from risk scores, particularly in the second year postimplantation.

Social contact and trust: a study of a super diverse neighbourhood

This thesis presents an in-depth case study of a superdiverse neighbourhood in Glasgow where long-term white and ethnic minority communities reside alongside Roma migrants, asylum seekers and refugees, young professionals and other recent arrivals in traditional tenement housing. It focuses on the nature and extent of social contact and trust and on the role of context in shaping social relations. Employing the concepts of social milieu and intersectionality to identify social differences the research examines the relationships between five broad groupings of residents in the neighbourhood: Nostalgic Working Class, Scottish Asian, Liberal Homeowners, Kinship-sited Roma and Global Migrants. Ethnographic fieldwork was carried out in contexts within the neighbourhood, theorised as being potential sites for intergroup contact. Three types of interactions were examined: Group-based Interactions, Neighbour Interactions and Street Interactions. The data comprised documentary evidence, participant and direct observations, in-depth qualitative and walk-along interviews with residents and local organisations. Findings show that rather than individualising and isolating residents, superdiversity can stimulate community activism, yet there remains a preference for interaction within one’s own social milieu. The research has found that the concentration of poverty and material conditions has a more profound effect on social relations than historical diversity and the extent to which diversity is normalised within local discourses. Trust judgements in a superdiverse context may rely more on shared interests, moral outlook and assessments of the context rather than the extent of social contact. The quasi-private spaces of shared residential spaces and community activities can facilitate encounters with the potential to build trust, yet for this to occur cooperation through shared activities may not be sufficient. Interactions may need to move beyond co-presence and conviviality to increased understanding and empathy through dialogue. At an aggregate level, the extent to which superdiversity contributes to social contact and trust within the neighbourhood is strongly influenced by contextual factors and wider economic processes influencing housing tenure mix, private renting, property maintenance, residential churn and environmental conditions. Through examining different types of social contacts, the dynamics of trust as well as contextual influences, this thesis offers insights into the causal processes and factors that influence social relations at a local level.

Formation of seep carbonates along the makran convergent margin, northern Arabian sea and a molecular and isotopic approach to constrain the carbon isotopic composition of parent methane

Authigenic carbonate deposits have been sampled with the remotely operated vehicle ‘MARUM-QUEST 4000 m’ from five methane seeps between 731 and 1823 m water depth along the convergent Makran continental margin, offshore Pakistan (northern Arabian Sea). Two seeps on the upper slope are located within the oxygen minimum zone (OMZ; ca. 100 to 1100 m water depth), the other sites are situated in oxygenated water below the OMZ (below 1100 m water depth). The carbonate deposits vary with regard to their spatial extent, sedimentary fabrics, and associated seep fauna: Within the OMZ, carbonates are spatially restricted and associated with microbial mats, whereas in the oxygenated zone below the OMZ extensive carbonate crusts are exposed on the seafloor with abundant metazoans (bathymodiolin mussels, tube worms, galatheid crabs). Aragonite and Mg-calcite are the dominant carbonate minerals, forming common early diagenetic microcrystalline cement and clotted to radial-fibrous cement. The δ18Ocarbonate values range from 1.3 to 4.2‰ V-PDB, indicating carbonate precipitation at ambient bottom-water temperature in shallow sediment depth. Extremely low δ13Ccarbonate values (as low − 54.6‰ V-PDB) point to anaerobic oxidation of methane (AOM) as trigger for carbonate precipitation, with biogenic methane as dominant carbon source. Prevalence of biogenic methane in the seepage gas is corroborated by δ13Cmethane values ranging from − 70.3 to − 66.7‰ V-PDB, and also by back-calculations considering δ13Cmethane values of carbonate and incorporated lipid biomarkers. These calculations (Δδ13Cmethane–carbonate, Δδ13CANME–methane, Δδ13CMOX–methane) prove to be useful to assess the carbon stable isotope composition of seeping methane if this has not been determined in the first place; such an approach represents a useful tool to reconstruct fluid composition of ancient seeps. AOM is also revealed by lipid biomarkers of anaerobic methane oxidizing archaea such as crocetane, pentamethylicosane (PMI), and sn2-hydroxyarchaeol strongly depleted in 13C (δ13C values as low as − 127‰ V-PDB). Biomarkers of sulphate-reducing bacteria are also abundant, showing slightly less negative δ13C values, but still significantly 13C-depleted (average values as low as − 101‰). Other bacterial biomarkers, such as bacteriohopanepolyols (BHPs), hopanols, and hopanoic acids are detected in most carbonates, but are particularly common in seep carbonates from the non-OMZ sites. The BHP patterns of these carbonates and their low δ13C values resemble patterns of aerobic methanotrophic bacteria. In the shallower OMZ sites, BHPs revealed much lower contents and varying compositions, most likely reflecting other sources than aerobic methanotrophic bacteria. 230Th/U carbonate ages indicate that AOM-induced carbonate precipitation at the deeper non-OMZ seeps occurred mainly during the late Pleistocene-Holocene transition, i.e. between 19 and 15 ka before present, when the global sea level was lower than today.

Shadows of militarism: an ethnography of trauma and resistance among soldiers and veterans in post-9/11 USA.

This thesis critically examines the military disciplining of trauma through a detailed ethnographic study of post-9/11 lower-enlisted soldiers and veterans in the U.S. who have links to a national movement of resistance to, and healing from, militarism. Drawing on 12 months of ethnographic fieldwork at two G.I. coffeehouses and with the post-9/11 veteran anti-militarism movement in U.S., it analyses the journey of joining the military, becoming a soldier, leaving the military and veteran identities. It explores militarism and military power as a cultural process which reproduces and conceals itself within normative conceptions of the everyday, and military trauma as a site of contested power and resistance. In doing so, this research addresses an urgent need to critically engage with military trauma as a means to challenge normalised discourses of militarism. This research reveals a disjuncture between the imagined and lived reality of military identities in the post-9/11 era. It explores the politics of recognition of veterans’ public and private lives, their contested identities, and their constrained relationship to the state. It argues that veterans are silenced and their identities reduced to symbolic tools in a public military imaginary which constructs military trauma into politically manageable categories, while disciplining and silencing the nation from critically examining war and militarism. In this way, this thesis argues that veterans serve a vital function in U.S. society by absorbing and containing the violence of the state, which then becomes unspeakable, unhearable, and inescapable. This thesis shows how a small number of soldiers and veterans are pushing back against this narrative. In sum, this thesis seeks to challenge the disciplinary effects of militarism upon trauma and support veteran voices to speak their own truths.

Postoperative Treatment in a Patient After Hemithyroidectomy: the Therapeutic Challenges of a Hidden Thyrotropinoma

Objectives: We report the unusual case of a patient with a thyrotropinoma, discovered after a hemithyroidectomy for a suspicious thyroid nodule, and its therapeutic challenges. Materials and methods: In a patient who underwent hemithyroidectomy for cold thyroid nodule, hyperthyroid symptoms persisted, despite stopping levothyroxine treatment. Further investigation was carried out through the following laboratory tests: thyroid-stimulating hormone (TSH) test; free thyroxine (fT4) test; and the thyrotropin releasing hormone (TRH) test. A pituitary magnetic resonance imaging (MRI) scan and genetic analysis was also carried out. The test results confirmed the diagnosis of a thyrotropinoma. Results: Treatment with long-acting somatostatin analogues normalised thyroid hormones and symptoms of hyperthyroidism. Conclusion: The diagnostic approach to the thyroid nodule should include a detailed clinical and biochemical examination. Initial biochemical evaluation by TSH alone does not allow detecting inappropriate TSH secretion that may increase the risk of thyroid malignancy. In case of a thyrotropinoma, the ideal treatment consists of combined care of central and peripheral thyroid disease.

The pathophysiology of CADASIL: studies in a Scottish cohort

Since identification that mutations in NOTCH3 are responsible for cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) in the early 1990s, there has been extensive characterisation of the clinical and radiological features of the disease. However therapeutic interventions remain elusive, partly due to a limited understanding of the vascular pathophysiology and how it leads to the development of strokes, cognitive decline and disability. The apparent rarity and heterogenous natural history of CADASIL potentially make conducting any longitudinal or therapeutic trials difficult. The role of disease biomarkers is therefore of some interest. This thesis focuses on vascular function in CADASIL and how it may relate to clinical and radiological markers of disease. Establishing the prevalence of CADASIL in the West of Scotland was important to assess the impact of the disease, and how feasible a trial would be. A mutation prevalence of 10.7 per 100,000 was demonstrated, suggesting significant under diagnosis of the disease across much of Scotland. Cerebral hypoperfusion is thought to be important in CADASIL, and it has been shown that vascular abnormalities precede the development of brain pathology in mouse models. Investigation of vascular function in patients, both in the brain and systemically, requires less invasive measures. Arterial spin labelling magnetic resonance imaging (MRI) and transcranial Doppler ultrasound (TCD) can both be used to obtain non-invasive and quantifiable indices of vascular function. Monitoring patients with MRI whilst they receive different concentrations of inspired oxygen and carbon dioxide can provide information on brain function, and I reviewed the practicalities of this technique in order to guide the design of the studies in this thesis. 22 CADASIL patients were recruited to a longitudinal study. Testing included peripheral vascular assessment, assessment of disability, neurological dysfunction, mood and cognition. A CO2 reactivity challenge during both TCD and arterial spin labelling MRI, and detailed MRI sequences were obtained. I was able to demonstrate that vasoreactivity was associated with the number of lacunes and brain atrophy, as were carotid intima-media thickness, vessel stiffness, and age. Patients with greater disability, higher depressive symptoms and poorer processing speed showed a tendency to worse cerebral vasoreactivity but numbers were small. This observation suggests vasoreactivity may have potential as a therapeutic target, or a biomarker. I then wished to establish if arterial spin labelling MRI was useful for assessing change in cerebral blood flow in CADASIL patients. Cortical grey matter showed the highest blood flow, mean (SD), 55 (10) ml/100g/min and blood flow was significantly lower within hyperintensities (19 (4) ml/100g/min; p <0.001). Over one year, blood flow in both grey matter (mean -7 (10) %; p = 0.028) and deep white matter (-8 (13) %; p = 0.036) declined significantly. Cerebrovascular reactivity did not change over one year. I then investigated whether baseline vascular markers were able to predict change in radiological or neuropsychological measures of disease. Changes in brain volume, lacunes, microbleeds and normalised subcortical hyperintensity volume (increase of 0.8%) were shown over one year. Baseline vascular parameters were not able to predict these changes, or those in neuropsychological testing. NOTCH3 is found throughout the body and a systemic vasculopathy has been seen particularly affecting resistance vessels. Gluteal biopsies were obtained from 20 CADASIL patients, and ex vivo myography investigated the response to vasoactive agents. Evidence of impairment in both vasodilation and vasoconstriction was shown. The addition of antioxidants improved endothelium-dependent relaxation, indicating a role for oxidative stress in CADASIL pathology. Myography measures were not related to in vivo measures in the sub-group of patients who had taken part in both studies. The small vessels affected in CADASIL are unable to be imaged by conventional MR imaging so I aimed to establish which vessels might be responsible for lacunes with use of a microangiographic template overlaid onto brain images registered to a standard brain template. This showed most lacunes are small and associated with tertiary arterioles. On the basis of this thesis, it is concluded that vascular dysfunction plays an important role in the pathophysiology of CADASIL, and further assessment of vascular measures in longitudinal studies is needed. Arterial spin labelling MRI should be used as it is a reliable, non-invasive modality that can measure change over one year. Furthermore conventional cardiovascular risk factor prevention should be undertaken in CADASIL patients to delay the deleterious effects of the disease.

Hope for a peaceful death and organ donation

The therapeutic, social and economic benefits of organ transplantation are irrefutable; however, organ shortages contribute to avoidable patient deaths and burgeoning health care costs. This problem can be addressed by increasing family consent to deceased organ donation. There are high levels of community support for deceased organ donation in Australia and yet, almost fifty percent of families decline the request to donate. Increasing the number of families who agree to deceased organ donation is key to increasing national and international transplantation rates. The purpose of this study was to identify the major factors that influence a family to agree or decline deceased organ donation during the process of decision-making. The aims of the study were three-fold: to identify the key stages and the major influencers’ in the decisionmaking process; to determine if hope, deep hope and trust played a role in the decision, and to explore families’ perceptions of their decision-making experience. The study utilised an exploratory case study approach to examine the family decisionmaking process of deceased organ donation. Following ethics approval, recruitment was conducted utilising a qualitative purposive snowball strategy across Australia. A pilot study was conducted to test the study procedures prior to the main data collection, and 22 participants who had been involved in a deceased organ donation decision from nine families were interviewed. In five deaths family members had agreed to organ donation, and in four deaths the family declined. A theoretical framework based on the Precaution Adoption Process Model of decision-making was applied to propose trust, hope and deep hope underpin family organ donation decisions. Thematic analysis was conducted and three key themes comprising ‘In the fog drowning’, ‘Harvesting humanity’, and ‘It’s all up to Mum’ were revealed. The study found women, and in particular mothers, played a significant role in organ donation decision-making, and that the decision-making is bounded by family needs of trust, hope and deep hope across the continuum of time. It also found families who had their trust, hope and deep hope needs met expressed satisfaction about their decision-making experience and agreed to organ donation. Some families perceived that organ donation was a sacrifice that was too great to endure, even if the deceased had previously indicated intent to donate, and therefore declined donation. This study found that families’ ideas of a peaceful death and organ donation are not mutually exclusive. It concludes that when decision-makers’ trust and deep hope needs are met they are more willing to agree to donation. This study recommends that the idea of a ‘right’ to a peaceful death should be aligned with deceased organ donation practices and normalised.

Spatial distribution of triatomines in domiciles of an urban area of the Brazilian Southeast Region

Reports of triatomine infestation in urban areas have increased. We analysed the spatial distribution of infestation by triatomines in the urban area of Diamantina, in the state of Minas Gerais, Brazil. Triatomines were obtained by community-based entomological surveillance. Spatial patterns of infestation were analysed by Ripley’s K function and Kernel density estimator. Normalised difference vegetation index (NDVI) and land cover derived from satellite imagery were compared between infested and uninfested areas. A total of 140 adults of four species were captured (100 Triatoma vitticeps, 25 Panstrongylus geniculatus, 8 Panstrongylus megistus, and 7 Triatoma arthurneivai specimens). In total, 87.9% were captured within domiciles. Infection by trypanosomes was observed in 19.6% of 107 examined insects. The spatial distributions of T. vitticeps, P. geniculatus, T. arthurneivai, and trypanosome-positive triatomines were clustered, occurring mainly in peripheral areas. NDVI values were statistically higher in areas infested by T. vitticeps and P. geniculatus. Buildings infested by these species were located closer to open fields, whereas infestations of P. megistus and T. arthurneivai were closer to bare soil. Human occupation and modification of natural areas may be involved in triatomine invasion, exposing the population to these vectors.

Power, regulation and physically active identities : the experiences of rural and regional living adolescent girls

Drawing on interpretations of Foucault's techniques of power, we explored the discourses and power relations operative between groups of girls that appeared to influence their participation in Physical Education (PE) and outside of school in sport and physical activity (PA) in rural and regional communities. Interviews and focus groups were conducted in eight secondary schools with female students from Year 9 (n = 22) and 10 (n = 116). Dominant gendered and performance discourses were active in shaping girls’ construction of what it means to be active or ‘sporty’, and these identity positions were normalised and valued. The perceived and real threat of their peer's gaze as a form of surveillance acted to further perpetuate the power of performance discourses; whereby girls measured and (self) regulated their participation. Community settings were normalised as being exclusively for skilled performers and girls self-regulated their non-participation according to judgements made about their own physical abilities. These findings raise questions about the ways in which power relations, as forged in broader sociocultural and institutional discourse–power relations, can infiltrate the level of the PE classroom to regulate and normalise practices in relation to their, and others, PA participation.

The intensification of performativity in early childhood education

Operating within a neoliberal education reform context, performativity and teaching in schools has been a focus of study for a number of years. However, less is known about the effects of performativity on teaching and curriculum in the early childhood (preschool) context. Making a case for the intensification of performativity in Australian early childhood education, this paper reports on findings from a doctoral study and draws on research literature from the past fourteen years to illustrate how performative measures have increasingly affected teaching and curriculum. The way that performativity has intensified is discussed in three chronological phases, performativity emerging, consolidating and normalised. Teacher interview transcripts and curricular related policies were analysed using critical discourse analysis and Ranson’s typology of accountability regimes. Findings reveal that early childhood teachers have different ways of responding to performativity, with the teacher featured in this paper displaying three types of performative accountability: anxiety, confidence, and disregard. An implication arising from this paper’s findings illustrates how the effects of performativity on teaching and curriculum can be complex, contradictory and at times, unintended.

A comparison of the yaw constraining performance of SCARA-tau parallel manipulator variants via screw theory

The SCARA-Tau parallel manipulator was derived with the objective to overcome the limited workspace-to-footprint ratio of the DELTA parallel manipulator while maintaining its many benefits. The SCARA-Tau family has later been extended and a large number of variants have been proposed. In this paper, we analyse four of these variants, which together encompass the main differences between all the proposed SCARA-Tau manipulators. The analysed manipulator variants utilise an identical arrangement of five of the six linkages connecting the actuated arms and the manipulated platform and exhibit the same input-output Jacobian. The normalised reciprocal product between the wrench of the sixth linkage and the twist of the platform occurring without this linkage provides a measure on how effectively the sixth linkage constrains the manipulated platform. A comparison of the manipulator variants with respect to this measure demonstrates each variants suitability for specific applications.

Geographic variation in seasonality and its influence on the dynamics of an infectious disease

Seasonal changes in environmental drivers - such as temperature, rainfall, and resource availability - have the potential to shape infection dynamics through their reverberating effects on biological processes including host abundance and susceptibility to infection. However, seasonality varies geographically. We therefore expect marked differences in infection dynamics between regions with different seasonal patterns. By pairing extensive Avian Influenza Virus (AIV) surveillance data - 65 358 individual bird samples from 12 species of dabbling ducks sampled at 174 locations across North America - with quantification of seasonality using remote sensed data indicative for primary productivity (normalised differenced vegetation index, NDVI), we provide evidence that seasonal dynamics influence infection dynamics across a continent. More pronounced epidemics were seen to occur in regions experiencing a higher degree of seasonality, and epidemics of lower amplitude and longer duration occurred in regions with a more protracted and lower seasonal amplitude. These results demonstrate the potential importance of geographic variation in seasonality for explaining geographic variation in the dynamics of infectious diseases in wildlife.