Four Scottish indulgences at Sens

English interest in the great Cistercian abbey of Pontigny was stimulated by the exiles there of two archbishops of Canterbury, Thomas Becket and Stephen Langton.1 As archbishops of Canterbury, Langton and Edmund of Abingdon made gifts to Pontigny abbey in consideration of the welcome given to Becket.2 Edmund did not die at Pontigny, but was a confrater of the community, and the abbot claimed the body, asserting that Edmund had expressed a wish to be buried there. The process of canonisation was rapid.3 After Edmund's canonisation, Henry III sent a chasuble and a chalice for the first celebration of the feast, and granted money to maintain four candles round the saint's shrine.4 In 1254, en route from Gascony to meet Louis IX in Chartres and Paris,5 Henry visited Pontigny, as his brother Richard of Cornwall, who seems to have pressed for canonisation, had done in 1247.6 Archbishop Boniface of Canterbury ordered the celebration of the feast to be observed throughout his province.7 Pope Alexander IV granted a dispensation to allow Englishwomen to enter the precinct of Pontigny abbey on the feast of the translation of the relics of St Edmund8 (women were normally forbidden to enter a Cistercian monastery). Matthew Paris, the greatest English chronicler of the age, wrote a life of the saint.9 English interest continued into the fourteenth century. In 1331 an English priest was given a licence to visit the shrine,10 but it seems likely that the Hundred Years’ War made pilgrimage to Pontigny difficult.11 The indulgences preserved by the abbey reveal an interest in the shrine throughout the Western Church, granted as they were by prelates from Tortosa to Livonia and Estonia, and from Messina to Lübeck.1

An Incidence of Multi-Year Sediment Storage on Channel Snowpack in the Canadian High Arctic

During June 2005, we identified the presence of sediment buried within multi-year channel snowpack of a small river located near Cape Bounty, Melville Island, Nunavut (74°55' N, 109°35' W). Photographic evidence indicates that the sediment was deposited during the 2003 season by the initial meltwater flowing on the snowpack, which was dammed by snow upstream of a channel constriction. The resulting pond covered a minimum area of 180 m2 and contained an estimated minimum 27 Mg of sediment. Suspended sediment measurements during the 2003 season indicate that deposition on the snowpack at this location represented 49%–65% of the sediment transport prior to the ponding and emplacement of the sediment on the snow, and approximately 20% of the measured sediment flux for the entire season. Multi-year snow accumulations immediately downstream exhibited similar sediment deposition on snow, but no evidence of multi-year sediment storage was present. By contrast, a similar stream in an adjacent watershed channelized rapidly, with minimal sediment deposition on the snow, and delivered a large pulse of sediment to the downstream lake. These results provide quantitative evidence for the magnitude of sediment storage on snowpack and point to the unique role that snow plays in the fluvial geomorphology of High Arctic watersheds.En juin 2005, nous avons dénoté la présence de sédiment enterré dans une plaque de neige datant de plusieurs années d’une petite rivière située près de cap Bounty, sur l’île Melville, au Nunavut (74°55' N, 109°35' O). D’après des preuves photographiques, le sédiment a été déposé pendant la saison 2003 par l’eau de fusion initiale s’écoulant sur la plaque de neige, qui avait été endiguée par la neige en amont d’un canal confiné. L’étang qui en a découlé recouvrait une aire minimale de 180 m2 et contenait, selon les estimations, au moins 27 Mg de sédiment. Les mesures de sédiment en suspension pendant la saison 2003 indiquent que ce dépôt sur la plaque de neige à cet endroit représentait entre 49 % et 65 % du transport de sédiment avant l’accumulation d’eau et l’emplacement de sédiment sur la neige, et environ 20 % du flux de sédiment mesuré pour toute la saison. Les accumulations de neige de plusieurs années immédiatement en aval comptaient des dépôts de sédiment semblables sur la neige, quoi qu’aucun emmagasinage de sédiment sur plusieurs années n’était présent. Par contraste, un cours d’eau similaire d’un bassin hydrographique adjacent s’est canalisé rapidement, avec peu de dépôts de sédiment sur la neige, puis a laissé une grande quantité de sédiment au lac en aval. Ces résultats fournissent des preuves quantitatives quant à l’ampleur de l’emmagasinage de sédiment sur la plaque de neige et laissent envisager le rôle unique que joue la neige sur la géomorphologie fluviale des bassins hydrographiques de l’Extrême-Arctique

Plasmodium falciparum:Rosettes do not protect merozoites from invasion-inhibitory antibodies

Rosetting is a parasite adhesion phenotype associated with severe malaria in African children. Why parasites form rosettes is unknown, although enhanced invasion or immune evasion have been suggested as possible functions. Previous work showed that rosetting does not enhance parasite invasion under standard in vitro conditions. We hypothesised that rosetting might promote invasion in the presence of host invasion-inhibitory antibodies, by allowing merozoites direct entry into the erythrocytes in the rosette and so minimising exposure to plasma antibodies. We therefore investigated whether rosetting influences invasion in the presence of invasion-inhibitory antibodies to MSP-1. We found no difference in invasion rates between isogenic rosetting and non-rosetting lines from two parasite strains, R29 and TM284, in the presence of MSP-1 antibodies (P=0.62 and P=0.63, Student's t test, TM284 and R29, respectively). These results do not support the hypothesis that rosettes protect merozoites from inhibitory antibodies during invasion. The biological function of rosetting remains unknown

The Next Generation of Human-Drone Partnerships: Co-Designing an Emergency Response System

The use of semi-autonomous Unmanned Aerial Vehicles (UAV) to support emergency response scenarios, such as fire surveillance and search and rescue, offers the potential for huge societal benefits. However, designing an effective solution in this complex domain represents a "wicked design" problem, requiring a careful balance between trade-offs associated with drone autonomy versus human control, mission functionality versus safety, and the diverse needs of different stakeholders. This paper focuses on designing for situational awareness (SA) using a scenario-driven, participatory design process. We developed SA cards describing six common design-problems, known as SA demons, and three new demons of importance to our domain. We then used these SA cards to equip domain experts with SA knowledge so that they could more fully engage in the design process. We designed a potentially reusable solution for achieving SA in multi-stakeholder, multi-UAV, emergency response applications.Comment: 10 Pages, 5 Figures, 2 Tables. This article is publishing in CHI202

Increased Microerythrocyte Count in Homozygous α+-Thalassaemia Contributes to Protection against Severe Malarial Anaemia

Karen Day and colleagues show that increased microcytic erythrocyte count may contribute substantially to the protection of α+-thalassaemia-homozygous children against severe malaria anaemia

Levels of State and Trait Anxiety in Patients Referred to Ophthalmology by Primary Care Clinicians: A Cross Sectional Study

Purpose There is a high level of over-referral from primary eye care leading to significant numbers of people without ocular pathology (false positives) being referred to secondary eye care. The present study used a psychometric instrument to determine whether there is a psychological burden on patients due to referral to secondary eye care, and used Rasch analysis to convert the data from an ordinal to an interval scale. Design Cross sectional study. Participants and Controls 322 participants and 80 control participants. Methods State (i.e. current) and trait (i.e. propensity to) anxiety were measured in a group of patients referred to a hospital eye department in the UK and in a control group who have had a sight test but were not referred. Response category analysis plus infit and outfit Rasch statistics and person separation indices were used to determine the usefulness of individual items and the response categories. Principal components analysis was used to determine dimensionality. Main Outcome Measure Levels of state and trait anxiety measured using the State-Trait Anxiety Inventory. Results State anxiety scores were significantly higher in the patients referred to secondary eye care than the controls (p0.1). Rasch analysis highlighted that the questionnaire results needed to be split into “anxiety-absent” and “anxiety-present” items for both state and trait anxiety, but both subscales showed the same profile of results between patients and controls. Conclusions State anxiety was shown to be higher in patients referred to secondary eye care than the controls, and at similar levels to people with moderate to high perceived susceptibility to breast cancer. This suggests that referral from primary to secondary eye care can result in a significant psychological burden on some patients

The 2003 Australian Breast Health Survey: survey design and preliminary results

<p>Abstract</p> <p>Background</p> <p>The Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC) in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening.</p> <p>Methods</p> <p>The 2003 BHS surveyed English-speaking Australian women aged 30–69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01.</p> <p>Results</p> <p>Of the 3,144 respondents who consented to being interviewed, 138 (4.4%) had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1%) reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9%) had heard of the BreastScreen Australia (BSA) program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys.</p> <p>Conclusion</p> <p>The NBCC Breast Health Surveys provide a valuable picture of the knowledge of Australian women about a range of issues. The present analysis shows significant gains in knowledge and behaviours relating to mammographic screening, while identifying additional areas for targeted improvement, as in the need to better communicate with women about screening and diagnostic services. Further analysis of additional core topic areas (eg., incidence, mortality, risk and treatment) will provide equally noteworthy insight.</p

Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform.

BACKGROUND: Hydroxychloroquine has been shown to inhibit entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into epithelial cells in vitro, but clinical studies found no evidence of reduced mortality when treating patients with COVID-19. We aimed to evaluate the effectiveness of hydroxychloroquine for prevention of COVID-19 mortality, as opposed to treatment for the disease. METHODS: We did a prespecified observational, population-based cohort study using national primary care data and linked death registrations in the OpenSAFELY platform, which covers approximately 40% of the general population in England, UK. We included all adults aged 18 years and older registered with a general practice for 1 year or more on March 1, 2020. We used Cox regression to estimate the association between ongoing routine hydroxychloroquine use before the COVID-19 outbreak in England (considered as March 1, 2020) compared with non-users of hydroxychloroquine and risk of COVID-19 mortality among people with rheumatoid arthritis or systemic lupus erythematosus. Model adjustment was informed by a directed acyclic graph. FINDINGS: Between Sept 1, 2019, and March 1, 2020, of 194 637 people with rheumatoid arthritis or systemic lupus erythematosus, 30 569 (15·7%) received two or more prescriptions of hydroxychloroquine. Between March 1 and July 13, 2020, there were 547 COVID-19 deaths, 70 among hydroxychloroquine users. Estimated standardised cumulative COVID-19 mortality was 0·23% (95% CI 0·18 to 0·29) among users and 0·22% (0·20 to 0·25) among non-users; an absolute difference of 0·008% (-0·051 to 0·066). After accounting for age, sex, ethnicity, use of other immunosuppressive drugs, and geographical region, no association with COVID-19 mortality was observed (HR 1·03, 95% CI 0·80 to 1·33). We found no evidence of interactions with age or other immunosuppressive drugs. Quantitative bias analyses indicated that our observed associations were robust to missing information for additional biologic treatments for rheumatological disease. We observed similar associations with the negative control outcome of non-COVID-19 mortality. INTERPRETATION: We found no evidence of a difference in COVID-19 mortality among people who received hydroxychloroquine for treatment of rheumatological disease before the COVID-19 outbreak in England. Therefore, completion of randomised trials investigating pre-exposure prophylactic use of hydroxychloroquine for prevention of severe outcomes from COVID-19 are warranted. FUNDING: Medical Research Council