The word made flesh : Christianity and oral culture in Anglo-Saxon verse

The purpose of this paper is precisely to address the interface between written and spoken verse in Anglo-Saxon England, verse that is overwhelmingly Christian in tone and intent, drawn from the literate world of Latinate sources, but which nonetheless in its evident echoing of earlier verse, some of which still survives, preserves intact ancient oral traditions of remembered and recycled vernacular song. For if Caedmon's Hymn, crowned as the first English poem, seems to share aspects of both Latin and Germanic traditions, other poems throughout the Anglo-Saxon period also exhibit a deep sensitivity both to inherited vernacular poetic lore and to the new demands of imported Latin learning.Issue title: Sound Effects

Looking for an echo : The oral tradition in Anglo-Saxon literature

William of Malmesbury, writing more than four centuries later, tells a tale of the Anglo-Saxon Aldhelm standing on a bridge in seventh-century Malmesbury, charming passers-by with his Old English verse. William also tells us that no less an afficianado of vernacular poetry than King Alfred the Great himself valued Aldhelm's Old English verse more highly than that of anyone else, even though two hundred years and more had passed since it was first performed. But not a scrap of Aldhelm's Old English verse can be identified of the roughly 30,000 lines that survive.Not

A Study of the Effects of Altitude on Thermal Ice Protection System Performance

Thermal ice protection systems use heat energy to prevent a dangerous buildup of ice on an aircraft. As aircraft become more efficient, less heat energy is available to operate a thermal ice protections system. This requires that thermal ice protection systems be designed to more exacting standards so as to more efficiently prevent a dangerous ice buildup without adversely affecting aircraft safety. While the effects of altitude have always beeing taked into account in the design of thermal ice protection systems, a better understanding of these effects is needed so as to enable more exact design, testing, and evaluation of these systems

The production of fresh produce in Africa for export to the United Kingdom: mapping different value chains

This report maps the involvement of African smallholders in supplying produce to UK markets (with emphasis on detailed characterisation of UK markets) by determining origin of product, types of product, volumes, values and numbers of smallholders involved and destination markets. The study is important because there is strong evidence that exporters and importers are moving away from the smallest of growers, not because of product quality or productivity, but because of transaction costs associated with private retailer standards. At present, it is not clear whether production by small-scale farmers throughout Africa destined for export to retailers abroad can remain viable

A Study of the Effects of Altitude on Thermal Ice Protection System Performance

Thermal ice protection systems use heat energy to prevent a dangerous buildup of ice on an aircraft. As aircraft become more efficient, less heat energy is available to operate a thermal ice protections system. This requires that thermal ice protection systems be designed to more exacting standards so as to more efficiently prevent a dangerous ice buildup without adversely affecting aircraft safety. While the effects of altitude have always beeing taked into account in the design of thermal ice protection systems, a better understanding of these effects is needed so as to enable more exact design, testing, and evaluation of these systems

Evaluation of Alternative Altitude Scaling Methods for Thermal Ice Protection System in NASA Icing Research Tunnel

A test was conducted at NASA Icing Research Tunnel to evaluate altitude scaling methods for thermal ice protection system. Two scaling methods based on Weber number were compared against a method based on the Reynolds number. The results generally agreed with the previous set of tests conducted in NRCC Altitude Icing Wind Tunnel. The Weber number based scaling methods resulted in smaller runback ice mass than the Reynolds number based scaling method. The ice accretions from the Weber number based scaling method also formed farther upstream. However there were large differences in the accreted ice mass between the two Weber number based scaling methods. The difference became greater when the speed was increased. This indicated that there may be some Reynolds number effects that isnt fully accounted for and warrants further study

The Eldgjá eruption: timing, long-range impacts and influence on the Christianisation of Iceland.

The Eldgjá lava flood is considered Iceland's largest volcanic eruption of the Common Era. While it is well established that it occurred after the Settlement of Iceland (circa 874 CE), the date of this great event has remained uncertain. This has hampered investigation of the eruption's impacts, if any, on climate and society. Here, we use high-temporal resolution glaciochemical records from Greenland to show that the eruption began in spring 939 CE and continued, at least episodically, until at least autumn 940 CE. Contemporary chronicles identify the spread of a remarkable haze in 939 CE, and tree ring-based reconstructions reveal pronounced northern hemisphere summer cooling in 940 CE, consistent with the eruption's high yield of sulphur to the atmosphere. Consecutive severe winters and privations may also be associated with climatic effects of the volcanic aerosol veil. Iceland's formal conversion to Christianity dates to 999/1000 CE, within two generations or so of the Eldgjá eruption. The end of the pagan pantheon is foretold in Iceland's renowned medieval poem, Vǫluspá ('the prophecy of the seeress'). Several lines of the poem describe dramatic eruptive activity and attendant meteorological effects in an allusion to the fiery terminus of the pagan gods. We suggest that they draw on first-hand experiences of the Eldgjá eruption and that this retrospection of harrowing volcanic events in the poem was intentional, with the purpose of stimulating Iceland's Christianisation over the latter half of the tenth century

HLA-DQA1*05 carriage associated with development of anti-drug antibodies to infliximab and adalimumab in patients with Crohn's Disease

Anti-tumor necrosis factor (anti-TNF) therapies are the most widely used biologic drugs for treating immune-mediated diseases, but repeated administration can induce the formation of anti-drug antibodies. The ability to identify patients at increased risk for development of anti-drug antibodies would facilitate selection of therapy and use of preventative strategies.This article is freely available via Open Access. Click on Publisher URL to access the full-text

Efficacy and safety of autologous haematopoietic stem cell transplantation versus alemtuzumab, ocrelizumab, ofatumumab or cladribine in relapsing remitting multiple sclerosis (StarMS): protocol for a randomised controlled trial

Introduction: Autologous haematopoietic stem cell transplantation (aHSCT) is increasingly used as treatment for patients with active multiple sclerosis (MS), typically after failure of disease-modifying therapies (DMTs). A recent phase III trial, ‘Multiple Sclerosis International Stem Cell Transplant, MIST’, showed that aHSCT resulted in prolonged time to disability progression compared with DMTs in patients with relapsing remitting MS (RRMS). However, the MIST trial did not include many of the current high-efficacy DMTs (alemtuzumab, ocrelizumab, ofatumumab or cladribine) in use in the UK within the control arm, which are now offered to patients with rapidly evolving severe MS (RES-MS) who are treatment naïve. There remain, therefore, unanswered questions about the relative efficacy and safety of aHSCT over these high-efficacy DMTs in these patient groups. The StarMS trial (Autologous Stem Cell Transplantation versus Alemtuzumab, Ocrelizumab, Ofatumumab or Cladribine in Relapsing Remitting Multiple Sclerosis) will assess the efficacy, safety and long-term impact of aHSCT compared with high-efficacy DMTs in patients with highly active RRMS despite the use of standard DMTs or in patients with treatment naïve RES-MS. Methods and analysis: StarMS is a multicentre parallel-group rater-blinded randomised controlled trial with two arms. A total of 198 participants will be recruited from 19 regional neurology secondary care centres in the UK. Participants will be randomly allocated to the aHSCT arm or DMT arm in a 1:1 ratio. Participants will remain in the study for 2 years with follow-up visits at 3, 6, 9, 12, 18 and 24 months postrandomisation. The primary outcome is the proportion of patients who achieve ‘no evidence of disease activity’ during the 2-year postrandomisation follow-up period in an intention to treat analysis. Secondary outcomes include efficacy, safety, cost-effectiveness and immune reconstitution of aHSCT and the four high-efficacy DMTs. Ethics and dissemination: The study was approved by the Yorkshire and Humber—Leeds West Research Ethics Committee (20/YH/0061). Participants will provide written informed consent prior to any study specific procedures. The study results will be submitted to a peer-reviewed journal and abstracts will be submitted to relevant national and international conferences. Trial registration number: ISRCTN88667898

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely