Improving the economic value of photographic screening for optical coherence tomography-detectable macular oedema:a prospective, multicentre, UK study

Objectives: To determine the best photographic surrogate markers for detecting sight-threatening macular oedema (MO) in people with diabetes attending UK national screening programmes. Design: A multicentre, prospective, observational cohort study of 3170 patients with photographic signs of diabetic retinopathy visible within the macular region [exudates within two disc diameters, microaneurysms/dot haemorrhages (M/DHs) and blot haemorrhages (BHs)] who were recruited from seven study centres. Setting: All patients were recruited and imaged at one of seven study centres in Aberdeen, Birmingham, Dundee, Dunfermline, Edinburgh, Liverpool and Oxford. Participants: Subjects with features of diabetic retinopathy visible within the macular region attending one of seven diabetic retinal screening programmes. Interventions: Alternative referral criteria for suspected MO based on photographic surrogate markers; an optical coherence tomographic examination in addition to the standard digital retinal photograph. Main outcome measures: (1) To determine the best method to detect sight-threatening MO in people with diabetes using photographic surrogate markers. (2) Sensitivity and specificity estimates to assess the costs and consequences of using alternative strategies. (3) Modelled long-term costs and quality-adjusted life-years (QALYs). Results: Prevalence of MO was strongly related to the presence of lesions and was roughly five times higher in subjects with exudates or BHs or more than two M/DHs within one disc diameter. Having worse visual acuity was associated with about a fivefold higher prevalence of MO. Current manual screening grading schemes that ignore visual acuity or the presence of M/DHs could be improved by taking these into account. Health service costs increase substantially with more sensitive/less specific strategies. A fully automated strategy, using the automated detection of patterns of photographic surrogate markers, is superior to all current manual grading schemes for detecting MO in people with diabetes. The addition of optical coherence tomography (OCT) to each strategy, prior to referral, results in a reduction in costs to the health service with no decrement in the number of MO cases detected. Conclusions: Compared with all current manual grading schemes, for the same sensitivity, a fully automated strategy, using the automated detection of patterns of photographic surrogate markers, achieves a higher specificity for detecting MO in people with diabetes, especially if visual acuity is included in the automated strategy. Overall, costs to the health service are likely to increase if more sensitive referral strategies are adopted over more specific screening strategies for MO, for only very small gains in QALYs. The addition of OCT to each screening strategy, prior to referral, results in a reduction in costs to the health service with no decrement in the number of MO cases detected. © Queen's Printer and Controller of HMSO 2013.

Absolute abundances of dinoflagellate cysts in surface sediment samples from four sites: Lycopodium marker-grain method

Absolute abundances (concentrations) of dinoflagellate cysts are often determined through the addition of Lycopodium clavatum marker-grains as a spike to a sample before palynological processing. An inter-laboratory calibration exercise was set up in order to test the comparability of results obtained in different laboratories, each using its own preparation method. Each of the 23 laboratories received the same amount of homogenized splits of four Quaternary sediment samples. The samples originate from different localities and consisted of a variety of lithologies. Dinoflagellate cysts were extracted and counted, and relative and absolute abundances were calculated. The relative abundances proved to be fairly reproducible, notwithstanding a need for taxonomic calibration. By contrast, excessive loss of Lycopodium spores during sample preparation resulted in non-reproducibility of absolute abundances. Use of oxidation, KOH, warm acids, acetolysis, mesh sizes larger than 15 µm and long ultrasonication (> 1 min) must be avoided to determine reproducible absolute abundances. The results of this work therefore indicate that the dinoflagellate cyst worker should make a choice between using the proposed standard method which circumvents critical steps, adding Lycopodium tablets at the end of the preparation and using an alternative method.

Data compilation on the biological response to ocean acidification: environmental and experimental context of data sets and related literature

The exponential growth of studies on the biological response to ocean acidification over the last few decades has generated a large amount of data. To facilitate data comparison, a data compilation hosted at the data publisher PANGAEA was initiated in 2008 and is updated on a regular basis (doi:10.1594/PANGAEA.149999). By January 2015, a total of 581 data sets (over 4 000 000 data points) from 539 papers had been archived. Here we present the developments of this data compilation five years since its first description by Nisumaa et al. (2010). Most of study sites from which data archived are still in the Northern Hemisphere and the number of archived data from studies from the Southern Hemisphere and polar oceans are still relatively low. Data from 60 studies that investigated the response of a mix of organisms or natural communities were all added after 2010, indicating a welcomed shift from the study of individual organisms to communities and ecosystems. The initial imbalance of considerably more data archived on calcification and primary production than on other processes has improved. There is also a clear tendency towards more data archived from multifactorial studies after 2010. For easier and more effective access to ocean acidification data, the ocean acidification community is strongly encouraged to contribute to the data archiving effort, and help develop standard vocabularies describing the variables and define best practices for archiving ocean acidification data.

Progress in upscaling Miscanthus biomass production for the European bio-economy with seed-based hybrids

Funded by UK's Biotechnology and Biological Sciences Research Council (BBSRC) Department for Environment, Food and Rural Affairs (DEFRA). Grant Number: LK0863 BBSRC strategic programme Grant on Energy Grasses & Bio-refining. Grant Number: BBS/E/W/10963A01 OPTIMISC. Grant Number: FP7-289159 WATBIO. Grant Number: FP7-311929 Innovate UK/BBSRC ‘MUST’. Grant Number: BB/N016149/1

Le sport comme espace de reproduction et de contestation des représentations stéréotypées de la féminité

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Chaucer and the Disconsolations of Philosophy: Boethius, Agency, and Literary Form in Late Medieval Literature

This study argues that Chaucer's poetry belongs to a far-reaching conversation about the forms of consolation (philosophical, theological, and poetic) that are available to human persons. Chaucer's entry point to this conversation was Boethius's Consolation of Philosophy, a sixth-century dialogue that tried to show how the Stoic ideals of autonomy and self-possession are not simply normative for human beings but remain within the grasp of every individual. Drawing on biblical commentary, consolation literature, and political theory, this study contends that Chaucer's interrogation of the moral and intellectual ideals of the Consolation took the form of philosophical disconsolations: scenes of profound poetic rupture in which a character, sometimes even Chaucer himself, turns to philosophy for solace and yet fails to be consoled. Indeed, philosophy itself becomes a source of despair. In staging these disconsolations, I contend that Chaucer asks his readers to consider the moral dimensions of the aspirations internal to ancient philosophy and the assumptions about the self that must be true if its insights are to console and instruct. For Chaucer, the self must be seen as a gift that flowers through reciprocity (both human and divine) and not as an object to be disciplined and regulated.

Chapter one focuses on the Consolation of Philosophy. I argue that recent attempts to characterize Chaucer's relationship to this text as skeptical fail to engage the Consolation on its own terms. The allegory of Lady Philosophy's revelation to a disconsolate Boethius enables philosophy to become both an agent and an object of inquiry. I argue that Boethius's initial skepticism about the pretentions of philosophy is in part what Philosophy's therapies are meant to respond to. The pressures that Chaucer's poetry exerts on the ideals of autonomy and self-possession sharpen one of the major absences of the Consolation: viz., the unanswered question of whether Philosophy's therapies have actually consoled Boethius. Chapter two considers one of the Consolation's fascinating and paradoxical afterlives: Robert Holcot's Postilla super librum sapientiae (1340-43). I argue that Holcot's Stoic conception of wisdom, a conception he explicitly links with Boethius's Consolation, relies on a model of agency that is strikingly similar to the powers of self-knowledge that Philosophy argues Boethius to posses. Chapter three examines Chaucer's fullest exploration of the Boethian model of selfhood and his ultimate rejection of it in Troilus and Criseyde. The poem, which Chaucer called his "tragedy," belonged to a genre of classical writing he knew of only from Philosophy's brief mention of it in the Consolation. Chaucer appropriates the genre to explore and recover mourning as a meaningful act. In Chapter four, I turn to Dante and the House of Fame to consider Chaucer's self-reflections about his ambitions as a poet and the demands of truth-telling.

Tooth wear in Irish teenagers: a laboratory and epidemiological study

Aim: To investigate the characteristics, development and determinants of toothwear among Irish schoolchildren. Methods: A cross-sectional (examination at 16-years-old) and longitudinal (examinations at 5-,12-,14-years) study were conducted. Two indices were used to measure toothwear, children/parents completed a demographic profile and questionnaire on oral hygiene and dietary practices, health, and lifestyle in both studies. Saliva was collected from consenting 16-year-olds. The explanatory variables for the cross-sectional and longitudinal study were derived from children/parents responses. Differences in salivary profiles were determined for subsets; the protein concentration was determined with Bradford protein assay and protein carbonyl concentration (a protein oxidation marker) was determined spectrophotometrically. Gel-electrophoresis and mass spectrometry determined proteins and ion chromatography inorganic ions. Statistical significance was accepted at p<0.05. Results: At 16-years-old the prevalence of toothwear with dentine visible was 44%. No difference in salivary flow rates existed. In unstimulated saliva a higher mean, protein carbonyl (p<0.0001) and total calcium concentration (p<0.002) existed for the group with moderate toothwear. In stimulated saliva the moderate toothwear group had a lower mean protein concentration(p<0.0001). The 2-DE protein spots prepared for a sub-group differed between those with toothwear and without. Mass spectrometry, identified one of the different proteins as IgA. For 16-year-olds, the self-reported factors indicated that brushing after breakfast was associated with lower toothwear scores(p<0.03). Nail-biting, being asthmatic or reporting a dry mouth were associated with higher toothwear scores(all p<0.05). Eating an apple daily or less was associated with less toothwear(p<0.002). In the longitudinal study toothwear into dentine at age five or 12-years was associated with more toothwear at age 14(all p<0.05). Discussion: The results illustrate the multifactorial aetiology of toothwear. The biochemical and physical correlates of saliva with toothwear requires further research. Conclusion: The impact of previous toothwear, salivary, dietary and personal factors on toothwear in the early permanent dentition is demonstrated.

Adult orthodontics: internet information and a national survey

Aims: 1. To investigate the reliability and readability of information on the Internet on adult orthodontics. 2. To evaluate the profile and treatment of adults by specialist orthodontists in the Republic of Ireland (ROI). Materials and methods: 1. An Internet search was conducted in May 2015 using three search engines (Google, Yahoo and Bing), with two search terms (“adult orthodontics” and “adult braces”). The first 50 websites from each engine were screened and exclusion criteria applied. Included websites were then assessed for reliability using the JAMA benchmarks, the DISCERN and LIDA tools and the presence of the HON seal. Readability was assessed using the FRES. 2. A pilot-tested questionnaire about adult orthodontics was distributed to 122 eligible specialist orthodontists in the ROI. Questions addressed general and treatment information about adult orthodontic patients, methods of information provision and respondent demographics. Results: 1. Thirteen websites met the inclusion criteria. Three websites contained all JAMA benchmarks and one displayed the HON Seal. The mean overall score for DISCERN was 3.9/5 and the mean total LIDA score was 115/120. The average FRES score was 63.1. 2. The questionnaire yielded a response rate of 83%. The typical demographic profile of adult orthodontic patients was professional females between 25-35 years. The most common incisor relationship and skeletal base was Class II, division 1 (51%) and Class II (61%) respectively. Aesthetic upper brackets and metal lower brackets were the most frequently used appliances. Only 30% of orthodontists advise their adult patients to find extra information on the Internet. Conclusions: 1. The reliability and readability of information on the Internet on adult orthodontics is of moderate quality. 2. The provision of adult orthodontic treatment is common among specialist orthodontists in the Republic of Ireland.

Le sport comme espace de reproduction et de contestation des représentations stéréotypées de la féminité

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Considering Efficacy of an Outdoor Environmental Education Program: Facilitating Elementary Students’ Environmental Knowledge, Attitudes, and Behaviours

Various sources have sought to consider the educational interventions that foster changes in perception of and attitudes toward nature, with the ultimate intent of understanding how education can be used to encourage environmentally responsible behaviours. With these in mind, the current study identified an outdoor environmental education program incorporating these empirically supported interventions, and assessed its ability to influence environmental knowledge, attitudes, and behaviours. Specifically, this study considered the following research questions: 1) To what degree can participation in this outdoor education program foster environmental knowledge and encourage pro-environmental attitudes and self-reported pro-environmental behaviours? 2) How is this effect different among students of different genders, and those who have different prior experiences in nature? Two motivational frameworks guided inquiry in the current study: the Value-Belief-Norm Model of Environmentalism (VBN) and the Theory of Planned Behaviour (TPB). The study employed a quantitative survey methodology, combining contemporary data measuring knowledge, attitudes, and behaviours with archived data collected by program staff, reflecting frequency of environmentally responsible behaviour. Further, a single qualitative item was included for which students provided “the first three words that [came] to mind when [they] think of the word nature.” Terms provided before and after the program were compared for differences in theme to detect subtle or underlying changes. Quantitative results indicated no significant change in student knowledge or attitudes through the outdoor environmental education program. However, a significant change in self-reported behaviour was identified from both the contemporary and archived data. This agreement in positive findings across the two data sets, collected using different measures and different participants, lends evidence of the program’s ability to encourage self-reported pro-environmental behaviour. Further, qualitative results showed some change in students’ perceptions of nature through the program, providing direction for future research. These findings suggest that this particular outdoor education program was successful in encouraging students’ self-reported environmentally responsible behaviour. This change was achieved without significant change in knowledge or environmental attitudes, suggesting that external factors not measured in this study might have played a role in affecting behaviour.

Poly(3-hydroxyoctanoate), a promising new material for cardiac tissue engineering

Cardiac tissue engineering (CTE) is currently a prime focus of research due to an enormous clinical need. In this work, a novel functional material, Poly(3-hydroxyoctanoate), P(3HO), a medium chain length polyhydroxyalkanoate (PHA), produced using bacterial fermentation, was studied as a new potential material for CTE. Engineered constructs with improved mechanical properties, crucial for supporting the organ during new tissue regeneration, and enhanced surface topography, to allow efficient cell adhesion and proliferation, were fabricated. Our results showed that the mechanical properties of the final patches were close to that of cardiac muscle. Biocompatibility of the P(3HO) neat patches, assessed using Neonatal ventricular rat myocytes (NVRM), showed that the polymer was as good as collagen in terms of cell viability, proliferation and adhesion. Enhanced cell adhesion and proliferation properties were observed when porous and fibrous structures were incorporated to the patches. Also, no deleterious effect was observed on the adults cardiomyocytes’ contraction when cardiomyocytes were seeded on the P(3HO) patches. Hence, P(3HO) based multifunctional cardiac patches are promising constructs for efficient CTE. This work will provide a positive impact on the development of P(3HO) and other PHAs as a novel new family of biodegradable functional materials with huge potential in a range of different biomedical applications, particularly CTE, leading to further interest and exploitation of these materials.

Las estatuas-menhir noroccidentales en contexto: conectividad y conexiones materiales durante el Bronce Tardío/Final

Este artículo analiza las estatuas-menhir noroccidentales que se distribuyen en el área comprendida entre los valles del río Duero y el río Miño, pero que descubrimientos recientes han extendido a regiones fuera de este área nuclear. Partiendo de tres aspectos claves para su interpretación (la cronología, su relación con el paisaje y su sentido iconográfico), se examinan las relaciones entre estas formas materiales y un paisaje socio-material de acción específico (las formas socio-materiales de interacción propias del Bronce final atlántico). Para ello, se tiene en cuenta diferentes conexiones materiales (presencia, encuentro, coexistencia, hibridación, etc.) que permiten contextualizar las estatuasmenhir dentro de un proceso histórico particular: la integración del noroeste de la península Ibérica en un contexto de relaciones mediterráneo-atlánticas, en la segunda mitad del II milenio a.C.

Argaric Sociology: Sex and Death

The detailed, rich and diverse Argaric funerary record offers an opportunity to explore social dimensions that usually remain elusive for prehistoric research, such us social rules on kinship rights and obligations, sexual tolerance and the role of funerary practices in preserving the economic and political organization. This paper addresses these topics through an analysis of the social meaning of Argaric double tombs by looking at body treatment and composition of grave goods assemblages according to gender and class affiliation. The Argaric seems to have been a conservative society, scarcely tolerant regarding homosexuality, and willing to celebrate ancestry associated to certain places as a means of asserting residence and property rights.

Crisis Económica en África Occidental: el caso de Dakar, 1929-1939

En este artículo se explora el impacto socio-económico de la crisis internacional de 1929 en Senegal y más concretamente en la ciudad-puerto de Dakar. Se analizan las consecuencias de la dependencia externa y la extroversión económica que caracterizaba a las estructuras productivas coloniales, destacando también la respuesta organizada de los movimientos sociales africanos. Por otra parte, se estudia la evolución de las infraestructuras y actividad portuaria, observando la metropolización regional de Dakar durante este periodo.

Item and task difficulty in a B2 reading examination: perceptions of test-takers and CEFR alignment experts compared with psychometric measurements

The article presents a study of a CEFR B2-level reading subtest that is part of the Slovenian national secondary school leaving examination in English as a foreign language, and compares the test-taker actual performance (objective difficulty) with the test-taker and expert perceptions of item difficulty (subjective difficulty). The study also analyses the test-takers’ comments on item difficulty obtained from a while-reading questionnaire. The results are discussed in the framework of the existing research in the fields of (the assessment of) reading comprehension, and are addressed with regard to their implications for item-writing, FL teaching and curriculum development.