Anonymous Masses in the Alamire Manuscripts: Toward a New Understanding of a Repertoire, an Atelier, and a Renaissance Court

This study examines eight anonymous masses preserved in the Alamire complex of fifty-one luxurious manuscripts prepared by scribes working at or near the courts of Burgundy-Habsburg between about 1498 and 1535. Chapter 1 introduces the problem of early Renaissance anonymity and situates this study within research on the Alamire complex and anonymous repertories. Chapters 2 through 5 provide analyses of eight anonymous masses that survive in the Alamire manuscripts. Where relevant, the history of their models and other polyphonic settings of these complement the analyses. Two canons are resolved, symbolism is explored, and the problem of incomplete or absent settings of the Agnus Dei is considered. The analyses allow for an evaluation of quality and reveal these composers as skilled and inventive. In Chapter 6, codicological and paleographic examinations of the Alamire manuscripts demonstrate that anonymity was largely the result of scribal initiative. Investigation of the use of exemplars by the scribes, however, confirms that they often copied from multiple exemplars, some probably lacking ascriptions, which produced anonymity. Using paleographic and codicological evidence to complement my conclusions regarding the use of exemplars, I identify a change in the manner of production of the Alamire codices occurring around 1518-1520. This separates the manuscripts into two distinct groups: the first encompasses mainly luxurious presentation manuscripts commissioned from Alamire by members of the Burgundian-Habsburg dynasty, while the second consists of plainer codices, probably ordered from Alamire directly by private patrons. In Chapter 7, I conclude that the contents of the Alamire manuscripts must not be considered a single repertory, and that the manuscripts, which were demonstrably prepared under varied circumstances, are not a homogenous group with a single context. Given that the lack of ascriptions in these sources was shown not to be a contemporary value judgment in Chapter 6, the quality of the eight unascribed masses is discussed here at length, as is their musicological significance. Appendices provide tables that detail codicological elements and scribal practices, and present the eight masses in modern notation, edited here for the first time

Understanding the Relationships Between Autistic Identity, Disclosure, and Camouflaging

Background: Camouflaging involves concealing an autistic identity, for example, by adopting nonautistic behaviors in social contexts. We currently know little about the relationship between autistic identity and camouflaging. Furthermore, other variables may mediate the relationship between camouflaging and identity, and this study examined whether disclosure (being openly autistic) might mediate the relationship. We predicted that fewer camouflaging behaviors would be associated with higher autistic identity when an individual is more open about being autistic. Methods: One hundred eighty autistic adults (52% female, 42% male, 5% other gender identities, and 1% preferred not to say) took part in the study. They completed an online survey with measures of camouflaging, autistic identity, and disclosure of autistic status. Results: We found a significant mediation effect such that autistic identity had an indirect negative effect on camouflaging mediated via disclosure. In other words, higher autistic identity linked to more disclosure, which in turn linked to fewer camouflaging behaviors. However, there was evidence for competitive mediation, such that the direct effect (the relationship between identity and camouflaging ignoring disclosure) was significant, with higher autistic identity linking directly to more camouflaging. Conclusions: The initial hypothesis was confirmed, with higher autistic identity linked to less camouflaging via disclosure. This finding indicates that camouflaging can reduce when there is high autistic identification, and someone has openly disclosed that they are autistic to others. However, the direct effect between identity and camouflaging suggests that there may be conflicts for someone who identifies strongly with being autistic but continues to camouflage. Other variables may play a role in the relationship between identity and camouflaging, such as fear of discrimination, self-awareness, timing of diagnosis, age, ethnicity, or gender. The findings indicate the importance of safe nondiscriminatory environments where individuals can disclose and express their autistic identity, which may in turn reduce camouflaging

Understanding the Reasons, Contexts and Costs of Camouflaging for Autistic Adults

Camouflaging entails ‘masking’ in or ‘passing’ social situations. Research suggests camouflaging behaviours are common in autistic people, and may negatively impact mental health. To enhance understanding of camouflaging, this study examined reasons, contexts and costs of camouflaging. 262 autistic people completed measures of camouflaging behaviours, camouflaging contexts (e.g. work vs. family), camouflaging reasons (e.g. to make friends) and mental health symptoms. Findings indicated a gender difference in reasons for camouflaging, with autistic women more likely to endorse “conventional” reasons (e.g. getting by in formal settings such as work). Both camouflaging highly across contexts and ‘switching’ between camouflaging in some contexts but not in others, related to poorer mental health. These findings have implications for understanding camouflaging in autistic adults

Shellfish Face Uncertain Future in High CO2 World: Influence of Acidification on Oyster Larvae Calcification and Growth in Estuaries

BACKGROUND: Human activities have increased atmospheric concentrations of carbon dioxide by 36% during the past 200 years. One third of all anthropogenic CO(2) has been absorbed by the oceans, reducing pH by about 0.1 of a unit and significantly altering their carbonate chemistry. There is widespread concern that these changes are altering marine habitats severely, but little or no attention has been given to the biota of estuarine and coastal settings, ecosystems that are less pH buffered because of naturally reduced alkalinity. METHODOLOGY/PRINCIPAL FINDINGS: To address CO(2)-induced changes to estuarine calcification, veliger larvae of two oyster species, the Eastern oyster (Crassostrea virginica), and the Suminoe oyster (Crassostrea ariakensis) were grown in estuarine water under four pCO(2) regimes, 280, 380, 560 and 800 microatm, to simulate atmospheric conditions in the pre-industrial era, present, and projected future concentrations in 50 and 100 years respectively. CO(2) manipulations were made using an automated negative feedback control system that allowed continuous and precise control over the pCO(2) in experimental aquaria. Larval growth was measured using image analysis, and calcification was measured by chemical analysis of calcium in their shells. C. virginica experienced a 16% decrease in shell area and a 42% reduction in calcium content when pre-industrial and end of 21(st) century pCO(2) treatments were compared. C. ariakensis showed no change to either growth or calcification. Both species demonstrated net calcification and growth, even when aragonite was undersaturated, a result that runs counter to previous expectations for invertebrate larvae that produce aragonite shells. CONCLUSIONS AND SIGNIFICANCE: Our results suggest that temperate estuarine and coastal ecosystems are vulnerable to the expected changes in water chemistry due to elevated atmospheric CO(2) and that biological responses to acidification, especially calcifying biota, will be species-specific and therefore much more variable and complex than reported previously

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London