The Christmas Truce: Myth, Memory, and the First World War

The 1914 Christmas truce, when enemy soldiers met, fraternized and even played football in No-Man’s-Land, is frequently used to support the popular view of the First World War as a “stupid, tragic and futile” conflict, the ultimate “bad” war. The truce, which one historian describes as “a candle lit in the darkness of Flanders,” is commonly perceived as a manifestation of the anger that soldiers felt towards the meaningless war which they had been tricked into fighting. However, contemporaneous sources show that the impromptu cease-fire was not an act of defiance, but rather arose from the professionalism of the soldiers involved, the conditions of static trench warfare, the adaptation of the soldiers to their new environment, the foul weather on the Western Front, the absence of major battles, and memories of traditional celebrations of Christmas. The truce, in short, was caused by rain, mud, curiosity, lack of personal animosity towards the enemy, and homesickness, rather than by frustration and rebellion. Although the conventional narrative of the truce maintains that soldiers defied their 0fficers to participate in it, this was rarely the case: in fact, Lieutenant-Colonel Fisher-Rowe, commander of the 1st Grenadier Guards, wrote his wife that the Germans “say they want the truce to go on till after New Year and I am sure I have no objection. A rest from bullets will be distinctly a change.” No soldiers were punished for their participation in the 1914 truce, and no troops refused to fire upon their enemies afterwards. Newspapers published accounts of the armistice openly and many regimental histories later featured the event prominently. An evaluation of sources from 1914 through 2013 that reference the truce demonstrates that the conventional narrative of the truce, like that of the war itself, took many decades to develop. This work examines the myths that have defined the truce over the past century, and contrasts them with the letters and diaries of British soldiers who participated in it, the reports of it in the official war diaries of the battalions involved, and the accounts of it published in the newspapers. By examining the support the soldiers felt for the war, as well as their willingness to return to fighting after the impromptu armistice ended, the book argues that the Christmas truce, which would seem to confirm the dominant view of the First World War, instead challenges the war’s popular narrative. A soldier involved described the temporary cease-fire as being “just like the interval between the rounds in a friendly boxing match.” The boxing match that was the First World War was in fact a deadly and tragic conflict, yet this soldier’s view of the truce broadly summed up the attitudes of participants toward the event, who remained determined to win the war, while enjoying a break from the battle

“A REMARKABLE INSTANCE”: THE CHRISTMAS TRUCE AND ITS ROLE IN THE CONTEMPORANEOUS NARRATIVE OF THE FIRST WORLD WAR

The orthodox narrative of the First World War, which maintains that the conflict was futile, unnecessary and wasteful, continues to dominate historical representations of the war. Attempts by revisionist historians to dispute this interpretation have made little impact on Britain’s collective memory of the conflict. The Christmas truce has come to represent the frustration and anger that soldiers felt towards the meaningless war they had been trapped into fighting. However, the Christmas truce, which at the time it occurred was seen as an event of minimal importance, was not an act of defiance, but one which arose from the unprecedented conditions of static trench warfare and the adaptation of the soldiers to that environment. An examination of contemporaneous accounts of the truce demonstrates that it was viewed by the soldiers involved as merely a brief holiday, and that British army commanders generally ignored or tolerated the truce, eventually releasing orders preventing its continuation or reoccurrence but taking no steps to punish any of the men who took part in it. A review of the letters and diaries of truce participants sheds light on the event itself, while simultaneously challenging the orthodox narrative of the First World War

Use of Semi-Structured Interviews to Explore Competing Demands in a Prostate Cancer Prevention Intervention Clinical Trial (PCPICT)

In this paper we report on findings from the first known study using qualitative methods to explore factors influencing physicians’ participation in an ongoing federally-funded prostate cancer chemoprevention clinical trial. We sought to identify ways to improve collaboration between researchers and physicians and enhance the success of future projects and employed purposive sampling to recruit physician/investigators who were involved or invited to participate in the trial. Using the data from open-ended semi-structured interviews, we examined patterns in their languaging and created themes. We found that individual and structural factors served as barriers and facilitators to participation. Willingness and desire to participate in the trial (individual factors) were not always enough to result in actual participation due to practice environment (structural) constraints. Our research provides a better understanding of the complex intersection of factors in this setting and through our findings we extend the theory of competing demands into the arena of prostate cancer prevention clinical trials, moving the science towards solutions to current challenges in recruitment to this type of trial

Body condition changes at sea: onboard calculation and telemetry of body density in diving animals

This study was supported by grants from the Office of Naval Research N00014-18-1-2822, DoD SERDP contract W912HQ20C0056, IPEV (Institut Paul Emile Victor) under the Antarctic research program 109 (C. Barbraud) and 1201 (C. Gilbert & C. Guinet), and CNES-TOSCA as part of the SNO-MEMO.The ability of marine mammals to accumulate sufficient lipid energy reserves is vital for mammals' survival and successful reproduction. However, long-term monitoring of at-sea changes in body condition, specifically lipid stores, has only been possible in elephant seals performing prolonged drift dives (low-density lipids alter the rates of depth change while drifting). This approach has limited applicability to other species. Using hydrodynamic performance analysis during transit glides, we developed and validated a novel satellite-linked data logger that calculates real-time changes in body density (∝lipid stores). As gliding is ubiquitous amongst divers, the system can assess body condition in a broad array of diving animals. The tag processes high sampling rate depth and three-axis acceleration data to identify 5 s high pitch angle glide segments at depths >100 m. Body density is estimated for each glide using gliding speed and pitch to quantify drag versus buoyancy forces acting on the gliding animal. We used tag data from 24 elephant seals (Mirounga spp.) to validate the onboard calculation of body density relative to drift rate. The new tags relayed body density estimates over 200 days and documented lipid store accumulation during migration with good correspondence between changes in body density and drift rate. Our study provided updated drag coefficient values for gliding (Cd,f = 0.03) and drifting (Cd,s = 0.12) elephant seals, both substantially lower than previous estimates. We also demonstrated post-hoc estimation of the gliding drag coefficient and body density using transmitted data, which is especially useful when drag parameters cannot be estimated with sufficient accuracy before tag deployment. Our method has the potential to advance the field of marine biology by switching the research paradigm from indirectly inferring animal body condition from foraging effort to directly measuring changes in body condition relative to foraging effort, habitat, ecological factors and anthropogenic stressors in the changing oceans. Expanding the method to account for diving air volumes will expand the system's applicability to shallower-diving (<100 m) species, facilitating real-time monitoring of body condition in a broad range of breath-hold divers.Publisher PDFPeer reviewe

Cancer Cachexia: Traditional Therapies and Novel Molecular Mechanism-Based Approaches to Treatment

The complex syndrome of cancer cachexia (CC) that occurs in 50% to 80% cancer patients has been identified as an independent predictor of shorter survival and increased risk of treatment failure and toxicity, contributing to the mortality and morbidity in this population. CC is a pathological state including a symptom cluster of loss of muscle (skeletal and visceral) and fat, manifested in the cardinal feature of emaciation, weakness affecting functional status, impaired immune system, and metabolic dysfunction. The most prominent feature of CC is its non-responsiveness to traditional treatment approaches; randomized clinical trials with appetite stimulants, 5-HT3 antagonists, nutrient supplementation, and Cox-2 inhibitors all have failed to demonstrate success in reversing the metabolic abnormalities seen in CC. Interventions based on a clear understanding of the mechanism of CC, using validated markers relevant to the underlying metabolic abnormalities implicated in CC are much needed. Although the etiopathogenesis of CC is poorly understood, studies have proposed that NFkB is upregulated in CC, modulating immune and inflammatory responses induce the cellular breakdown of muscle, resulting in sarcopenia. Several recent laboratory studies have shown that n-3 fatty acid may attenuate protein degradation, potentially by preventing NFkB accumulation in the nucleus, preventing the degradation of muscle proteins. However, clinical trials to date have produced mixed results potentially attributed to timing of interventions (end stage) and utilizing outcome markers such as weight which is confounded by hydration, cytotoxic therapies, and serum cytokines. We propose that selective targeting of proteasome activity with a standardized dose of omega-3-acid ethyl esters, administered to cancer patients diagnosed with early stage CC, in addition to a standard intervention with nutritionally adequate diet and appetite stimulants, will alter metabolic abnormalities by downregulating NFkB, preventing the breakdown of myofibrillar proteins and resulting in increasing serum protein markers, lean body mass, and functional status

Proton vs. Photon Radiation Therapy for Primary Gliomas: An Analysis of the National Cancer Data Base

Background: To investigate the impact of proton radiotherapy (PBT) on overall survival (OS) and evaluate PBT usage trends for patients with gliomas in the National Cancer Data Base (NCDB).Methods: Patients with a diagnosis of World Health Organization (WHO) Grade I-IV glioma treated with definitive radiation therapy (RT) between the years of 2004–13 were identified. Patients were stratified based on WHO Grade and photon radiotherapy (XRT) vs. PBT. Univariate (UVA) and multivariable analysis (MVA) with OS were performed by Cox proportional hazards model and log-rank tests. Propensity score (PS) weighting was utilized to account for differences in patient characteristics and to minimize selection bias.Results: There were a total of 49,405 patients treated with XRT and 170 patients treated with PBT. Median follow-up time was 62.1 months. On MVA, the following factors were associated with receipt of PBT (all p &lt; 0.05): WHO Grade I-II gliomas, treatment at an academic/research program, west geographic facility location, and surgical resection. After PS weighting, all patients treated with PBT were found to have superior median and 5 year survival than patients treated with XRT: 45.9 vs. 29.7 months (p = 0.009) and 46.1 vs. 35.5% (p = 0.0160), respectively.Conclusions: PBT is associated with improved OS compared to XRT for patients with gliomas. This finding warrants verification in the randomized trial setting in order to account for potential patient imbalances not adequately captured by the NCDB, such as tumor molecular characteristics and patient performance status.Importance of the Study: This is the first study that compares the outcomes of patients treated with photon based radiotherapy vs. proton based radiotherapy for patients with gliomas. In this retrospective analysis, the results demonstrate that proton therapy is associated with improved outcomes which support ongoing prospective, randomized clinical trials comparing the two modalities in patients with gliomas

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.

BACKGROUND: A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. METHODS: This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. FINDINGS: Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0-75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4-97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8-80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3-4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. INTERPRETATION: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials. FUNDING: UK Research and Innovation, National Institutes for Health Research (NIHR), Coalition for Epidemic Preparedness Innovations, Bill & Melinda Gates Foundation, Lemann Foundation, Rede D'Or, Brava and Telles Foundation, NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and AstraZeneca

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Background A safe and efficacious vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), if deployed with high coverage, could contribute to the control of the COVID-19 pandemic. We evaluated the safety and efficacy of the ChAdOx1 nCoV-19 vaccine in a pooled interim analysis of four trials. Methods This analysis includes data from four ongoing blinded, randomised, controlled trials done across the UK, Brazil, and South Africa. Participants aged 18 years and older were randomly assigned (1:1) to ChAdOx1 nCoV-19 vaccine or control (meningococcal group A, C, W, and Y conjugate vaccine or saline). Participants in the ChAdOx1 nCoV-19 group received two doses containing 5 × 1010 viral particles (standard dose; SD/SD cohort); a subset in the UK trial received a half dose as their first dose (low dose) and a standard dose as their second dose (LD/SD cohort). The primary efficacy analysis included symptomatic COVID-19 in seronegative participants with a nucleic acid amplification test-positive swab more than 14 days after a second dose of vaccine. Participants were analysed according to treatment received, with data cutoff on Nov 4, 2020. Vaccine efficacy was calculated as 1 - relative risk derived from a robust Poisson regression model adjusted for age. Studies are registered at ISRCTN89951424 and ClinicalTrials.gov, NCT04324606, NCT04400838, and NCT04444674. Findings Between April 23 and Nov 4, 2020, 23 848 participants were enrolled and 11 636 participants (7548 in the UK, 4088 in Brazil) were included in the interim primary efficacy analysis. In participants who received two standard doses, vaccine efficacy was 62·1% (95% CI 41·0–75·7; 27 [0·6%] of 4440 in the ChAdOx1 nCoV-19 group vs71 [1·6%] of 4455 in the control group) and in participants who received a low dose followed by a standard dose, efficacy was 90·0% (67·4–97·0; three [0·2%] of 1367 vs 30 [2·2%] of 1374; pinteraction=0·010). Overall vaccine efficacy across both groups was 70·4% (95·8% CI 54·8–80·6; 30 [0·5%] of 5807 vs 101 [1·7%] of 5829). From 21 days after the first dose, there were ten cases hospitalised for COVID-19, all in the control arm; two were classified as severe COVID-19, including one death. There were 74 341 person-months of safety follow-up (median 3·4 months, IQR 1·3–4·8): 175 severe adverse events occurred in 168 participants, 84 events in the ChAdOx1 nCoV-19 group and 91 in the control group. Three events were classified as possibly related to a vaccine: one in the ChAdOx1 nCoV-19 group, one in the control group, and one in a participant who remains masked to group allocation. Interpretation ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials

Physicians as Gatekeepers: Uncovering Barriers and Facilitators to Participation in a Prostate Cancer Prevention Intervention Clinical Trial

Clinical trials play an important role in advancing therapeutic and preventive care with many current modalities resulting from prior research. While prior research has described barriers to participation in therapeutic clinical trials, much less in known about barriers related to participation in trials aimed at prevention, prostate cancer prevention in particular. Physicians have been shown to play a critical role in access to trials; however, less is known about the individual and structural factors that influence their participation in prostate cancer prevention trials. This research provides rich ethnographic detail within the context of an ongoing trial. Research participants included physician/investigators who were either directly (serving as a co-investigator) or peripherally (referring patients for participation) involved in prostate cancer prevention intervention clinical trial (PCPICT), as well as those who were considered for participation but declined. Methods included open ended semi-structured interviews, participant-observation and a survey. Participants were recruited via direct inquiry, email and/or letter regarding participation. The results of this study show that individual and structural factors intersect, influencing both the willingness and ability of physician/investigators to participate or refer patients for participation in a prostate cancer prevention intervention clinical trial. Individual factors such as explanatory views on prevention, notions of risk and uncertainty, shared decision-making and duality of roles appear to have a greater influence on the willingness of physicians to participate while structural factors such as staffing, other resources and time are more influential in regards to the ability to participate. This research served as a critical first step towards providing an in-depth understanding of the individual and structural factors that influence a physician\u27s participation in this type of trial. It builds from prior work where a better understanding of barriers and identification of successful strategies to overcome them was a noted void. The researcher identifies areas where additional research would be beneficial and provides applied recommendations for those considering the design of future cancer prevention intervention projects