bluuebunny/crossref_metadata_2025 huggingface dataset:
RADI-31. MULTI-INSTITUTIONAL VALIDATION OF BRAIN METASTASIS VELOCITY, A RECENTLY DEFINED PREDICTOR OF OUTCOMES FOLLOWING STEREOTACTIC RADIOSURGERY
Authors: Chan Michael , McTyre Emory , Soike Michael , Ayala-Peacock Diandra , Hepel Jaroslaw , Page Brandi , Contessa Joseph , Chiang Veronica , Attia Albert , Braunstein Steve , Chung Caroline , Ruiz Jimmy , Fiveash John , Chao Samuel , Farris Michael
Published: August 2019

INTRODUCTION: Brain metastasis velocity (BMV) is a prognostic metric that describes the recurrence rate of new brain metastases after initial treatment with radiosurgery (SRS). We have previously risk stratified patients into high, intermediate, and low-risk BMV groups, which correlates with overall survival (OS). We sought to externally validate BMV in a multi-institutional setting. METHODS: Patients from nine academic centers were treated with upfront SRS; the validation cohort consisted of data from eight institutions not previously used to define BMV. Patients were classified by BMV into low (< 4 BMV), intermediate (4–13 BMV), and high-risk groups (>13 BMV). Time-to-event outcomes were estimated using the Kaplan-Meier method. Cox proportional hazards methods were used to estimate the effect of BMV and salvage modality on OS. RESULTS: Of 2829 patients, 2092 patients were included in the validation dataset. Of these, 921 (44.0%) experienced distant brain failure (DBF). Median OS from initial SRS was 11.2 mo. Median OS for BMV < 4, BMV 4–13, and BMV > 13 were 12.5 mo, 7.0 mo, and 4.6 mo (p < 0.0001). Compared to initial salvage with WBRT, salvage SRS was associated with improved OS following DBF for BMV < 4 (p = 0.05), BMV 4–13 (p = 0.002) and BMV > 13 (p = 0.0001). CONCLUSIONS: This multi-institutional dataset validates BMV as a predictor of OS following initial SRS. BMV is being utilized in upcoming multi-institutional randomized controlled trials as a stratification variable for salvage whole brain radiation vs salvage SRS after DBF.
RADI-33. DISTRIBUTED FRAMELESS GAMMA KNIFE RADIOSURGERY: A NEW TREATMENT PARADIGM FOR PATIENTS WITH BRAIN METASTASES
Authors: Patel Ankur , Mendel Jameson , Plitt Aaron , Nedzi Lucien , Timmerman Robert , Dan Tu , Barnett Samuel , Mickey Bruce , Patel Toral , Wardak Zabi
Published: August 2019

INTRODUCTION: Stereotactic radiosurgery (SRS) has excellent efficacy for patients with limited intracranial disease. Its use in patients with >10 brain metastases remains controversial. Nonetheless, cancer patients are living longer due to advancements in systemic therapeutics and avoiding the neurocognitive toxicities of whole brain radiation therapy is critical. Recent reports suggest that SRS may be effective in patients with ≥10 metastases. Treating large numbers of brain metastases in a single Gamma Knife radiosurgery (GKRS) treatment session poses several challenges. Treatment of metastases in close proximity to one another leads to an increased dose to normal brain, potentially increasing the risk of necrosis. Furthermore, single session treatment of multiple metastases may last several hours, causing significant patient discomfort. Here, we describe a novel treatment paradigm to address these issues: distributed frameless GKRS. Patients with ≥6 brain metastases undergo multi-session frameless GKRS with both temporal and spatial distribution over 2–5 sessions, decreasing treatment time per day and not treating adjacent metastases simultaneously. METHODS: We evaluated all patients with brain metastases who underwent distributed frameless SRS, using the Gamma Knife ICON, between January 2017 and November 2018. Fifty-one patients with 1097 unique lesions were included in this analysis. RESULTS: Mean patient age was 58.8 (range 29–89) years. Median follow-up was 4.1 (range: 0–20.4) months. The median number of metastases treated was 5 (range: 1–19) per treatment session and 11.5 (range: 3–82) per treatment course. The median number of treatment sessions per treatment course was 3 (range: 2–10). The median number of treatment courses, per patient, was 1 (range: 1–4). The median margin dose was 15 Gy. The median overall survival was 5.9 (range: 0.2–20.9) months. CONCLUSIONS: Distributed frameless Gamma Knife radiosurgery is technically feasible and should be considered in lieu of single session GKRS for patients with ≥6 brain metastases.
RADI-34. USE OF LOW-DOSE STEREOTACTIC RADIOSURGERY FOR ADVANCED BRAIN METASTASES
Authors: Yang Daniel , Yu James , Chiang Veronica
Published: August 2019

BACKGROUND: Gamma knife stereotactic radiosurgery (GKSRS) is commonly used to treat brain metastases. However, treatment time significantly increases as a function of increasing dose and number of lesions treated. In patients with large number of brain metastases, advanced disease, and poor performance status, low-dose GKSRS may be better tolerated and allows for safer re-treatment with radiotherapy should tumors recur. METHODS: We queried our institutional GKSRS database and identified patients treated with low-dose GKSRS for brain metastases as defined by a prescription of 12–15 Gy margin dose. Overall survival was measured from time of initial low-dose GKSRS to death or study exit. A composite endpoint of time to additional GKSRS, whole brain radiotherapy (WBRT), craniotomy, or death was used to examine disease progression. RESULTS: We identified 30 patients treated with low-dose GKSRS at a single institution between 2008 to 2018. A total of 428 brain metastases were treated, with a median of 12 (IQR=4–20) brain metastases per patient. Thirteen patients received immunotherapy concurrent with low-dose GKSRS, and 23 patients received mutation-targeted therapy or immunotherapy. Median overall survival was 238 (IQR 91–580) days, and median composite time to disease progression was 121 (IQR = 33–371) days. The two longest survivors in our cohort are alive at over three years. One had testicular cancer, and the other had melanoma. The metastatic melanoma patient had a BRAF V600E tumor and received mutation-targeted systemic therapy. He received standard-dose GKSRS and WBRT prior to low-dose GKSRS, as well as immunotherapy prior to and concurrent with low-dose GKSRS. CONCLUSIONS: A heterogenous population with large number of brain metastases was treated with low-dose GKSRS, with acceptable but varied results in terms of survival and tumor control. Further study with larger cohorts is warranted to optimize selection criteria and timing of low-dose GKSRS with other radiotherapy and systemic agent.
RADI-35. AN ANALYSIS OF RESPONSE ENDPOINTS FOR BRAIN METASTASIS PATIENTS TREATED WITH STEREOTACTIC RADIOSURGERY AND PD(L)-1 INHIBITORS
Authors: Kotecha Rupesh , Miller Jacob , Kim Joseph , Juloori Aditya , Chao Samuel , Murphy Erin , Peereboom David , Mohammadi Alireza , Barnett Gene , Vogelbaum Michael , Angelov Lilyana , Suh John , Ahluwalia Manmeet
Published: August 2019

PURPOSE: Recent trials have evaluated the role of anti-PD(L)-1 inhibitors alone in patients with newly diagnosed brain metastasis, resulting in a suggested paradigm shift. In the absence of randomized comparisons, an evaluation of outcomes for similar patients treated with radiotherapy are needed to provide baseline comparative data. METHODS: This retrospective cohort study included patients diagnosed with brain metastasis from 2010–2017 at a single tertiary care institution who received SRS and at least one anti-PD(L)-1 inhibitor. Primary endpoints included the rate of best intracranial response (either a complete [CR] or partial response [PR]), rate of intracranial benefit (percentage of patients with stable disease [SD] for at least 6 months), and overall objective response rates. RESULTS: 150 patients met the eligibility criteria for this study and the median follow-up time was 10 months (Range: 1–130 months). Only a minority of patients from this cohort would have been eligible for comparative systemic therapy alone trials: 8 (CheckMate 204, CM), 8 (ABC), and 50 patients (Yale Institutional trial, YI). Best intracranial objective response rates for these trial eligible patients were 64% (CM), 64% (ABC), and 72% (YI), respectively. The 6-month rates of intracranial benefit across patients were 75% (CM), 75% (ABC), and 93% (YI), respectively. The rates of either a CR, PR, or SD across trial eligible patients were 100% (CM), 100% (ABC), and 94% (YI), respectively. More than 50% of patients experienced out-of-field progression in each of the patient subgroups. CONCLUSIONS: Over a seven year period, very few patients treated with SRS and anti-PD(L)-1 inhibitor therapy in a busy academic practice would have been eligible for systemic therapy alone per trial eligibility criteria. In these highly favorable subgroups, patients experience high rates of objective response, best intracranial response, and intracranial benefit after SRS and anti-PD(L)-1 therapy, representing optimal brain metastasis management.
RADI-36. FRAME-BASED VERSUS FRAMELESS GAMMA KNIFE RADIOSURGERY FOR BRAIN METASTASES
Authors: Patel Ankur , Plitt Aaron , Mendel Jameson , Nedzi Lucien , Timmerman Robert , Dan Tu , Barnett Samuel , Mickey Bruce , Wardak Zabi , Patel Toral
Published: August 2019

INTRODUCTION: Brain metastases occur in 10 to 40% of cancer patients. In an effort to avoid the neurocognitive toxicities of whole brain radiation therapy, stereotactic radiosurgery (SRS) has become the preferred treatment option for most brain metastases. Many cancer patients will require several rounds of SRS during the course of their disease. Frame-based radiosurgery causes physical discomfort with each treatment session. We present our experience with frameless Gamma Knife radiosurgery (GKRS) and compare the clinical outcomes to frame-based treatments in the same patient cohort. METHODS: We evaluated all patients with brain metastases who underwent both frame-based and frameless SRS, using the Gamma Knife ICON, between January 2017 and November 2018. 11 patients with 110 unique lesions were included in this analysis. Clinical outcomes, including local control, were compared between the two treatment modalities. RESULTS: Mean patient age was 60.0 (range: 41 – 76) years. Median follow-up was 7.9 (range: 0 – 22.1) months. Median number of metastases treated was 4 (range: 1 – 9) per frame-based treatment and 3 (range: 1 – 10) per frameless treatment. Median number of frame-based and frameless procedures, per patient, was 1 (range: 1 – 3) and 1 (range: 1 – 2), respectively. Median tumor volume was 0.06 (range: 0.01 – 11.49) cm3 in the frame-based treatments and 0.14 (range: 0.01 – 4.22) cm3 in the frameless treatments. Median margin dose was 18 Gy for both the frame-based and frameless treatments. Local control was 86.5 and 91.5% at 6 and 9 months post-treatment, respectively in the frame-based treatments and 82.8 and 87.5% at 6 and 9 months post-treatment, respectively in the frameless treatments. CONCLUSIONS: Frameless GKRS results in similar rates of local control compared to frame-based GKRS. This treatment option should be considered in patients undergoing GKRS, as it balances clinical outcomes with patient comfort.
RADI-42. ASSOCIATION BETWEEN TUMOR LOCATION AND TOXICITY OUTCOMES AFTER STEREOTACTIC RADIOSURGERY FOR BRAIN METASTASES
Authors: Wang Boya , Kaidar-Person Orit , Sasaki-Adams Deanna , Jaikumar Sivakumar , Ewend Matthew , Nakamura Zev , Chen Ronald , Zagar Timothy , Tepper Joel , Marks Lawrence , Khagi Simon , Shen Colette
Published: August 2019

OBJECTIVE: The toxicities associated with stereotactic radiosurgery (SRS) are important factors when considering treatment options and supportive management for patients with brain metastases. We assessed the association between brain metastasis location and rates of toxicity after SRS. METHODS: We conducted a retrospective single-institution review of 170 patients treated with SRS for brain metastases from 2008–2016 with median follow-up of 8.6 months. Typical SRS doses were 18-20Gy in 1 fraction (lesions < 2cm), 18-21Gy in 3 fractions (lesions 2-3cm), and 25-30Gy in 5 fractions (lesions >3cm). Toxicity measures evaluated included radiation necrosis, seizure, and dexamethasone requirement. RESULTS: A total of 221 lesions were treated among frontal (29%), cerebellar (23%), parietal (16%), temporal (15%), occipital (14%), and other (brainstem, thalamus, basal ganglia) (4%) regions. The rate of SRS-related radionecrosis was 4% for all patients and significantly correlated with metastasis volume (increasing from 1% to 7% for lesions ≤1cm3 to >3cm3) and prior whole brain radiotherapy (WBRT) but not with metastasis location or prior resection on multi-variable analysis (P< 0.05). Post-SRS seizure occurred in 9% of all patients but was significantly higher for primary motor cortex and sensory cortex lesions, associated with 52% and 33% seizure rates, respectively (P< 0.05). Of patients who initially presented with seizure and were on anti-epileptic medication during SRS, 53% had no further seizures, while 47% did have post-SRS seizures, nearly all with motor cortex lesions. Only 5% of patients had new-onset seizure after SRS, related to lesion hemorrhage or motor cortex location. Dexamethasone use >3 months post-SRS was higher for motor strip lesions. CONCLUSION: Brain metastasis location in the primary motor cortex was associated with higher rates of post-SRS seizure, including new-onset seizures and breakthrough seizures on anti-epileptic medication during SRS. Rates of radionecrosis were associated with lesion volume and prior WBRT but not with metastasis location.
SURG-01. LITT FOR IN-FIELD RECURRENCE OF BRAIN METASTASIS AFTER STEREOTACTIC RADIOSURGERY: OUTCOMES AND MECHANISMS OF DEATH
Authors: Danish Shabbar , Kaye Joel
Published: August 2019

INTRODUCTION: Brain metastasis (BM) affects up to one-third of adults with cancer and carries a historically bleak prognosis. Thanks to advances in stereotactic radiosurgery (SRS), patients can live longer, and fewer succumb to their intracranial disease. However, rates of in-field recurrence after SRS range from 10–25%, either as true tumor re-growth or radiation necrosis (RN). In this setting, repeat SRS is not recommended and craniotomy may not be feasible or desired by the patient. Laser interstitial thermal therapy (LITT) is an emerging option with promising outcomes. In this study, we investigated outcomes and determined the mechanisms of death among patients with BM who underwent LITT for in-field recurrence after SRS. METHODS: Single institution retrospective review of patients with BM who underwent LITT for in-field recurrence after SRS. RESULTS: Between 2010–2018, seventy (70) patients with BM underwent LITT for in-field recurrence after SRS. At the time of review, 51/70 (72.9%) patients died, 16/70 (22.9%) were alive, and the status of 3/70 (4.3%) was undetermined. Among those who died, death was neurologic in 17/51 (33.3%), non-neurologic in 21/51 (41.2%), and undetermined in 13/51 (25.5%). Median survival after LITT for patients who died from neurologic and non-neurologic causes were 8.9 and 14.3 months, respectively. Mechanisms of neurologic death included progressive intracranial metastatic disease in eight patients and progressive RN in two. Mechanisms of non-neurologic death were nearly all related to progression of primary or systemic disease. CONCLUSIONS: For patients with BM who develop in-field recurrence after SRS, LITT is a viable alternative to craniotomy and can attenuate the neurological burden of this devastating disease. Among our patient population, very few died as the result of intracranial progression. Future studies that investigate which factors predispose patients to intracranial progression despite LITT will further improve its efficacy and ultimately improve the lives of cancer patients.
The Politics of Global Health Inequalities
Authors: Shawar Yusra Ribhi , Ruger Jennifer Prah
Published: August 2019

Careful investigations of the political determinants of health that include the role of power in health inequalities—systematic differences in health achievements among different population groups—are increasing but remain inadequate. Historically, much of the research examining health inequalities has been influenced by biomedical perspectives and focused, as such, on ‘downstream’ factors. More recently, there has been greater recognition of more ‘distal’ and ‘upstream’ drivers of health inequalities, including the impacts of power as expressed by actors, as well as embedded in societal structures, institutions, and processes. The goal of this chapter is to examine how power has been conceptualised and analysed to date in relation to health inequalities. After reviewing the state of health inequality scholarship and the emerging interest in studying power in global health, the chapter presents varied conceptualisations of power and how they are used in the literature to understand health inequalities. The chapter highlights the particular disciplinary influences in studying power across the social sciences, including anthropology, political science, and sociology, as well as cross-cutting perspectives such as critical theory and health capability. It concludes by highlighting strengths and limitations of the existing research in this area and discussing power conceptualisations and frameworks that so far have been underused in health inequalities research. This includes potential areas for future inquiry and approaches that may expand the study of as well as action on addressing health inequality.
Civil Society and Global Health Politics
Authors: McCoy David , Gafton Joseph
Published: August 2019

Civil society may be defined as both a space in society and a collection of certain types of actor. As a space, it exists alongside the state and markets; as a set of actors, it interacts with a range of governmental bodies and businesses. Over the past three or four decades, neoliberal globalisation has dramatically changed the distribution of power across society, while also institutionalising a set of policies that have diminished the role of the state, undermined democracy, and established the dominance of market logic. These developments have influenced both international health policy and the structures of global governance. Furthermore, they have also shaped the nature of civil society’s participation in global health policy and governance. Crucially, civil society does not merely intervene in global health politics from outside, but is itself sculpted by the ideologies and political conditions that surround it. This chapter explores the political nature of civil society and its relationship to global health politics, including the political nature of new non-state actors such as the Bill and Melinda Gates Foundation and the emergence of global health partnerships, which have ostensibly increased civil society involvement in global health governance. It argues that civil society participation in global health governance tends to represent powerful and hegemonic interests rather than those most in need. It also discusses how current political, economic and technological developments will influence civil society’s participation in global health politics, and shape the challenges faced by society more generally.
The Global Politics of Neglected Tropical Diseases
Authors: Aginam Obijiofor
Published: August 2019

Neglected tropical diseases (NTDs) are a diverse group of diseases that are prevalent among the poorest populations of the world. They pose a formidable obstacle to the socioeconomic development of the already impoverished communities where they are prevalent. Over the past several decades the World Health Organization (WHO)—as the directing and coordinating authority on international health work—has led global efforts to tackle the mortality and morbidity burdens of NTDs. In partnership with other actors, WHO’s global NTD Plan and Roadmap have oscillated between the politics and financial constraints of the organisation as an intergovernmental organisation of sovereign states and the lack of incentives to catalyse private and corporate actors towards effective action. The global politics of NTDs is now firmly anchored on public-private partnerships. These partnerships nonetheless raise questions about the moral obligation towards underwriting the cost of eradicating these diseases in the developing world. The chapter argues that enlightened self-interest and humanitarianism should compel the industrialised world towards a pragmatic action to address the mortality and morbidity burdens of NTDs among the poorest populations of the world.
Burmese Spirit Worship
Authors: Becker Judith
Published: August 2019

An exposition of the Burmese Nat Pwe spirit possession ceremony provides the vehicle for Judith Becker to explore the uses of music for imaginative transformations of the autobiographical self. In these rituals, the spirits of historical personages, nats, bestow their powers on the androgynous, transgendered person of the medium, whose autobiographical self is transposed to that of the nat, who is then able to bestow favors on supplicants. Becker makes the case that it is the power of the rituals’ musical accompaniment that provides the means through sensory overload and high emotion to actualize the imaginative realm of the nats.
Building Worlds Together with Sound and Music
Authors: Tuuri Kai , Peltola Henna-Riikka
Published: August 2019

By conforming to the enactive approach to human cognition, and by adopting the Tia DeNora’s concept of human–music interaction as an “in-action” perspective, Kai Tuuri and Henna-Riikka Peltola explore socially extended imagining with sounds and music. This is done through a question of how “shared places” of imagining with sound are established and maintained. Defining the activity of imagining as an essentially dynamic and generative process that takes place in a social reality, the authors propose that the processes of imagining are not only individual but also become exhibited and jointly engaged in social dialogues as well. By first discussing the theoretical foundations of this shared imagining with sound, then by examining two case examples, the authors focus on the ways that imagination—as a joint active engagement—becomes shared in an interaction between individuals.
Sound and Emotion
Authors: Asutay Erkin , Västfjäll Daniel
Published: August 2019

The focus of Erkin Asutay and Daniel Västfjäll’s chapter is the relationship between sound and emotion. Evidence from behavioral and neuroimaging studies is presented that documents how sound can evoke emotions and how emotional processes affect sound perception. This leads to a discussion of different forms of emotional responses to auditory stimuli, such as responses to vocal signals, responses to environmental sounds, and responses to music. The authors view the auditory system as an adaptive network that governs both how auditory stimuli influence emotional reactions and how the affective significance of sound influences auditory attention. In conclusion, they argue that affective experience is integral to auditory perception.
Playing the Inner Ear
Authors: Emmerson Simon
Published: August 2019

Conceiving of an evocative synthesis engine from our imagining of sound is the substance of Simon Emmerson’s chapter. Emmerson surveys recent neurological experiments in the synthesis of speech and music, and he focuses his attention on how our imagining of sound might be synthesized at some future date. The purpose of this speculative chapter is not to map out the design and interface of such a system but rather to conceive of what the act of imagining sound is and how the tool to extract such sound imagery might be used for musical purposes and to externalize these formally private sounds.
A Hopeful Tone
Authors: Parkhurst Bryan J.
Published: August 2019

Bryan J. Parkhurst uses contemporary analytic normativist aesthetics as a lens through which to view Leftist/Marxian normative aesthetics of music appreciation. In order to do this, Parkhurst situates the key theses of Ernst Bloch’s theory of utopian musical listening within the framework of Kendall Walton’s theories of musical fictionality and emotionality. The aim of this task is to make Bloch’s fundamental position perspicuous enough that it can be assessed and evaluated. Parkhurst concludes that Bloch’s contention that music should be heard as a utopian allegory, and that the distinguished office of (Western classical) music is to contribute to the political project of the imagining of a better, more humane world (a “regnum humanum”), faces difficult objections.
Improvisation
Authors: Christensen Justin
Published: August 2019

Justin Christensen deals with the bond between improvisation and imagination in artistic experience. Starting with a reassessment in continental philosophy both of how imagination is conceived and can be demonstrated, Christensen observes that the connection between improvisation and imagination has previously had little value in classic aesthetic theories. He then goes on to argue for the value of improvisation as a reflection of perception–action coupling that is central to newer theories that favor embodied approaches to music cognition. In the light of such theories, where perception, action, and imagination are seen as interdependent properties, Christensen proposes a greater recognition of the processes of musicking—including improvisation—to better understand meaning-making and the role of imagination in musical experience.
Dynamics of Attention and Public Opinion in Social Media
Authors: Ferrara Emilio
Published: August 2019

Sociotechnical systems such as online social media play a central role in today’s society, connecting millions of people all over the world. From a research perspective, a multitude of studies have gathered data from these environments to frame and unveil major questions on human social behavior. The goal of this chapter is to overview some theory of social communication behaviors, attention, and opinion formation in techno-social systems and their effects on individuals’ and group behavior. Examples of data-driven studies on large social media illustrate how users of techno-social systems behave during social protests, how they engage in political conversation, how they contribute to diffuse misinformation, and how they react to the spreading of fear and panic during a crisis. A quantitative analysis of the Twitter conversation during two global events (the Gezi Park protest in Turkey and the 2014 Ebola crisis) is presented as a case study to illustrate these phenomena. Understanding the dynamics of attention and opinion formation online allows people to build safer social media environments, hindering the spread of misinformation campaigns, hate speech, and stigmas.
The Tophet and Infant Sacrifice
Authors: McCarty Matthew M.
Published: August 2019

This chapter introduces the major debates surrounding a type of archaeological site conventionally called a “tophet.” While study of these sites has continued almost unabated for the last hundred years, two major developments—apart from postcolonialism spurring efforts to reject child sacrifice as an Orientalist fantasy—necessitate a comprehensive analysis. The first is the availability of new archaeological data that has been carefully collected and analyzed by interdisciplinary teams. The results of the ASOR excavations at Salammbô (1976–1979) are reaching publication, and a host of first-century bce tophets have been excavated in Tunisia in the past three decades. Given the late date of many of these new finds, the second development is renewed interest in Hellenistic/Roman tophets that had not been examined systematically since Marcel Le Glay’s Saturne africain. After introducing the archaeological traits of these sites and reconstructing the ritualized practice that resulted in such site formation, the author explores key questions about the nature of these sites (whether they represent child sacrifice, and in what form), the origin of the rites, and their apparent persistence into the Roman Empire (and eventual end). The central argument here is that there was not one monolithic tophet phenomenon but, rather, a range of practices that must be localized and historicized.
Levantine Art in the “Orientalizing” Period
Authors: Feldman Marian H.
Published: August 2019

The “Orientalizing period” represents a scholarly designation used to describe the eighth and seventh centuries bce when regions in Greece, Italy, and farther west witnessed a flourishing of arts and cultures attributed to contact with cultural areas to the east—in particular that of the Phoenicians. This chapter surveys Orientalizing as an intellectual and historiographic concept and reconsiders the role of purportedly Phoenician arts within the existing scholarly narratives. The Orientalizing period should be understood as a construct of nineteenth- and twentieth-century scholarship that was structured around a false dichotomy between the Orient (the East) and the West. The designation “Phoenician” has a similarly complex historiographic past rooted in ancient Greek stereotyping that has profoundly shaped modern scholarly interpretations. This chapter argues that the luxury arts most often credited as agents of Orientalization—most prominent among them being carved ivories, decorated metal bowls, and engraved tridacna shells—cannot be exclusively associated with a Phoenician cultural origin, thus calling into question the primacy of the Phoenicians in Orientalizing processes. Each of these types of objects appears to have a much broader production sphere than is indicated by the attribute as Phoenician. In addition, the notion of unidirectional influences flowing from east to west is challenged, and instead concepts of connectivity and networking are proposed as more useful frameworks for approaching the problem of cultural relations during the early part of the first millennium bce.
Metallurgy and other Technologies
Authors: Johnston Philip Andrew , Kaufman Brett
Published: August 2019

Metallurgy and other technologies were a crucial component of the Phoenician political economy and expansion to the western Mediterranean. Technological prowess was one of the outstanding features of Phoenician culture remembered in ancient documentary sources. The archaeological record bears this out, and provides a complementary perspective to the texts, in particular for the metals that were major drivers and products of the Phoenician colonial diaspora: silver, gold, copper, tin, iron, and lead. Once these products were in the West, interactions with different environments and societies led to a variety of technological innovations. The introduction of novel technologies and their adaptation to suit local contexts and mineralizations were key factors in the rapid development of regions affected by the Phoenicians, and set the stage for the next 2,500 years of Mediterranean economic history.
Phoenicians in Portugal
Authors: Arruda Ana Margarida
Published: August 2019

The data retrieved in the past two decades in the Portuguese territory have confirmed the early arrival of Phoenician communities on the western coasts of the Iberian Peninsula. Groups of western Phoenicians, probably originating in the areas of Cádiz and Málaga, settled during the eighth century bce first in the estuary of the Tagus River and afterwards in Mondego, Sado, Guadiana, and Gilão. In some spaces, such as the Tagus, the density of sites is significant, and every indication suggests they functioned as a coordinated network, the success of which required negotiation between the indigenous society and the newcomers. It seems that the exogenous model prevailed, which resulted in profound economic, social, political, and cultural changes. A new network also reached the inner areas at least since the late seventh century bce, namely through the inner Alentejo, where at an early date (eighth century bce) an apparently failed attempt of Orientalization had already taken place. If the specific motivations for the “conquest” of the far west were certainly multiple, including among others its metal sources (mainly tin, but also copper and even gold), the permanence of these communities seems undeniable, even if they took the form of genetically and culturally hybrid realities.
The Gadir–Tyre Axis
Authors: Martí-Aguilar Manuel Álvarez
Published: August 2019

This chapter focuses on the connection between Tyre and its colony Gadir via the foundational figure of Melqart and his respective temples in these cities, a relationship which is well-known thanks to historiographical and literary testimonies dating to the Roman period. The chapter also draws a comparison with the case of the other main Tyrian colony of Carthage. This comparison allows us to note, among other things, that the religious and cultural axis which united Gadir with its metropoleis was not restricted to the colonial period itself (ninth–sixth centuries bce) but, rather, continued to actively develop until at least the fourth century bce.
Neo-Phoenician Identities in the Roman Empire
Authors: Kaldellis Anthony
Published: August 2019

By the later empire, Phoenician cultural traits that might have sustained a separate ethnic identity had either disappeared (e.g., language) or been amalgamated into the Greco-Roman mainstream (e.g., the ancient cults). A “Phoenician” was now a person or city from one of the provinces which the Romans labeled Phoenice. Discussion of Phoenician culture by scholars from those provinces (such as Maximos and Porphyry of Tyre) and local constructions of Phoenician identity relied instead on Greek cultural resources—e.g., the tale of Cadmus. The sociological concept of “symbolic ethnicity” is appropriate for these antiquarian constructions, which accommodated the Roman order. Yet perhaps more durable survivals can be detected behind the conventions of classical tropes, for example Philon of Byblos did have access to authentic ancient traditions and Punic survived in the Roman west. In the third century, the city of Emesa became a focal point for discussions of Phoenician culture, especially when the emperor Elabagalus sought to promote its sun-god at Rome. The emperor Julian developed a largely fictitious Phoenician theology based on the creative ethnophilosophy of the Platonist Iamblichus. Finally, Phoenicians feature prominently in the Greek and Latin novels of the Imperial period, prompting questions about the stereotypical traits that made them so suitable for stories about romantic adventures.
Punic Heritage in Tunisia
Authors: Samuels Kathryn Lafrenz , van Dommelen Peter
Published: August 2019

Phoenician and Punic studies have an enduring impact today, as the Phoenician and Punic past has become interwoven with contemporary society in Tunisia and elsewhere. In this chapter the authors address the political, economic, and symbolic contexts of Phoenician and Punic heritage within contemporary Tunisia, and also position Tunisia within the wider Mediterranean and international community more broadly. The modern significance of Punic heritage is primarily defined by tourism. The cultural content of Tunisia’s heritage has been used to project an image of intercultural coexistence and tolerance to foreign audiences of tourists, at the same time that heritage tourism has contributed to increasing economic inequality. The entanglement of conservation and economic development in Tunisia means that continuing international calls “to save Carthage” will prove ineffective unless development is made a central pillar of management plans for the site. This would mean taking seriously the political and economic contexts of Punic heritage in Tunisia, and especially recognizing the dire economic straits that Tunisia faces, in which tourism—including heritage tourism—constitutes a core economic sector. The difficult economic foundations of Ben Ali’s repressive rule, the 2010–2011 revolution in response, and the protracted recovery from both, together embed Punic heritage and its economic functions within a precarious time for Tunisian society and its future.
Phoenicia in the Later Iron Age
Authors: Bunnens Guy
Published: August 2019

A coherent history of Phoenicia between 1000 and 550 bce is difficult to write. The internal development of individual city-states is almost completely unknown. We can only get a glimpse of their foreign relations. Owing to geographical constraints, Phoenician cities were split into a northern group, from Arwad to Byblos, and a southern one, essentially Tyre and Sidon. These two cities may have been associated in one political unit from the ninth to the late eighth–early seventh centuries bce. A Phoenician presence is noticeable in the northeast corner of the Mediterranean, with political control of Tyre on part of Cyprus. Tyrians and Sidonians also had interests in North Syria and in the Euphrates River valley. All Phoenician city-states adopted an accommodating policy toward foreign powers, especially Assyria, and, despite violent clashes from the mid-eighth century bce onward, they could manage to preserve their role as middlemen in the trade relations of the ancient world.
Presbyterians in Africa
Authors: Quarshie Benhardt Yemo
Published: August 2019

The Presbyterian presence in Africa goes back mainly to the nineteenth-century Protestant missionary enterprise on the continent. Presbyterianism spread all over the continent through missionary activity, but especially through the work of Africans themselves. African Presbyterians have much in common with Presbyterians worldwide in terms of beliefs, values, and practices, but the African cultural context offers unique dimensions to these commonalities. Presbyterians in Africa continue to face challenges generated by their context in areas such as the engagement between the gospel and African culture, which is intertwined with Africa’s primal religions, worldviews, and many local languages. A major challenge confronting Presbyterians today is how to engage with people of other faiths, especially Muslims, in Africa’s multireligious setting. Other challenges are African multiethnicity and the implications for Presbyterian worship and polity; globalization and its impact on values and ethics; denominationalism and its ramifications for ecumenism and church unity; and the shift in the center of gravity of Christianity to Africa and other southern continents and the impact on mission, theological engagement, and reflection. Presbyterians in Africa have a rich history that should shape their continuing contribution to the development of the continent and the global church.
Presbyterians in Britain and Europe
Authors: Shaw Ian J.
Published: August 2019

European Presbyterianism was forged in a crucible of immense change occasioned by the Reformation. Unique theological, political, and social pressures helped shape its foundational documents. In the following centuries, Presbyterianism became a significant religious and cultural influence in parts of Europe and played a particularly influential role in Scotland. Presbyterianism has lived with the tension of the need for continuity and change. The degree to which the entire acceptance of its original formularies and theology was required was accentuated during the Enlightenment. A propensity toward division characterized European Presbyterianism, fueled by tension between its democratic emphasis on both personal and local expression, and its hierarchical structure with a commitment to a role for the magistrate in the maintenance of religion. However, twentieth-century European Presbyterianism was also marked by moves for reunion, although a declining membership became a feature many denominations in the latter decades of that century.
The Doctrine of the Church
Authors: Case-Winters Anna
Published: August 2019

The Presbyterian Church may be said to be catholic, evangelical, and Reformed. It is catholic in its continuity with the early ecumenical councils and their formulation of basic doctrine, as well as in its acceptance of the traditional marks of the church as one, holy, catholic, and apostolic. It is also part of the shared “evangelical” revolt of the sixteenth century, with its affirmations of sola scriptura, sola gratia, and sola fide and its conviction that the true church exists wherever the word is rightly preached and the sacraments are rightly administered. As Reformed, the church understands and articulates all the forgoing in distinctive ways and adds particular Reformed emphases on the sovereignty of God, election for service and salvation, the church as reformed and always being reformed, and the distinction between visible and invisible church.
Presbyterians, Religious Diversity, and World Religions
Authors: Moore-Keish Martha L.
Published: August 2019

This chapter on Presbyterians, religious diversity, and world religions offers a few important caveats and then describes major themes in Presbyterian engagement of religious diversity: the sovereignty and freedom of God, the significance of Jesus Christ, the work of the Holy Spirit, the nature of revelation, the role of scripture, and the church. It then walks through the five centuries of Presbyterianism, noting how Presbyterians have engaged with and interpreted the changing world of many religions, drawing from philosophical, theological, and historical sources. It briefly describes Presbyterian interaction with the particular religious traditions of Judaism, Islam, African traditional religions, and Hinduism. The chapter concludes with a brief discussion of contemporary challenges and theological trajectories.
Presbyterians and Church-State Relations
Authors: Noll Mark A.
Published: August 2019

The historically predominant Presbyterian stance on church and state grew from sixteenth-century Reformed confessions, many of which advocated close cooperation between churches and governments aimed at promoting godliness comprehensively throughout society. Presbyterians in several parts of Europe tried to set up established Presbyterian churches, but they succeeded only in Scotland and (partially) in the Netherlands. Elsewhere, including North America, South Africa, Australia, and New Zealand, Presbyterians eventually accepted—in some cases reluctantly—the separation of church and state and general religious freedom. Most Presbyterians, nonetheless, continued to insist that they should still strive to create and maintain a godly society. The interpretive question remains, because Presbyterians sought to achieve informally what they had once hoped to achieve through formal church-state establishments: Have they rescued positive legacies of Christendom or retained elements that undermine Christian integrity, despite their belief that formal church-state unions undercut that integrity?
Presbyterians and Higher Education
Authors: Guthrie David S. , Derreth R. Tyler
Published: August 2019

This chapter explores Presbyterian influences and involvement in higher education. It begins by using Princeton as an historic lens to examine the “Presbyterian ideals” of reason and education, liberty, and differentiation. The Presbyterian regard for freedom of thought and intellectual edification produced denominational schools throughout the history of higher education, especially in the United States, that differed substantially in their overarching philosophies, approaches to learning, curricula, and emphases on Christian piety. The second part of the chapter identifies the proliferating diversity at the intersection of Presbyterianism and the higher education landscape in the twentieth century. It describes differentiation by theology, denominations, geography, and culture. The chapter ends with brief ruminations on the future roles and stability of Presbyterian higher education.
The Seventeenth Century and the Westminster Assembly
Authors: van Dixhoorn Chad
Published: August 2019

The seventeenth century marked a high point in the Presbyterian experiment. A variety of models were tested internationally, and apologists for its polity offered a rigorous defense against Episcopalians, Congregationalists, and Erastians. The Westminster Assembly offered Presbyterians the first opportunity since the Reformation to model a fully Reformed church in England, and the gathering looked closely not only at the teachings of Scripture on ecclesial governance, but also at historical and contemporary models of connectional, nonhierarchical government to guide their formulations on church polity. The century also saw some of the worst persecution of Presbyterians, especially in France and Scotland, but also in England and central Europe. During their seasons of suffering, some Presbyterians found subtle ways to articulate their polity or identify essential elements of Presbyterianism. Others fought or fled hostile authorities, supplying a legacy of martyr narratives and missionary impulses for later Presbyterians.
The Role of Heuristics in Alliance Collaboration for Entrepreneurial Firms
Authors: Hesterly William , Smith Jenny Su Bing
Published: August 2019

This chapter argues that reliance on either contracts or trust poses problems for many entrepreneurial firms in both the search for and the selection of potential alliance partners and in the governance of alliances once they have begun. Although effective contracts and trust are both desirable, this chapter notes that it is likely that entrepreneurial firms must often proceed with alliances in the absence of both conditions. It draws on a small but provocative body of research in the strategy field that examines the role of heuristics in strategy. It reviews three different approaches to heuristics and how they might apply generally to the understanding of alliances. The chapter focuses particularly on what it labels as deliberate heuristics and suggests different mechanisms by which entrepreneurs might develop such heuristics. It concludes by exploring several research questions that might enhance the understanding of the role of heuristics in the interfirm collaborations of entrepreneurial firms.
The Crowdfunding Paradigm
Authors: Matusik Sharon F. , Jones Jessica
Published: August 2019

Crowdfunding has become a major consideration for individuals looking to fund their ideas, endeavors, and businesses. This phenomenon raises interesting questions for management scholars, such as what theories help to explain the nuance of crowdfunding as a form of entrepreneurial financing. With regard to what leads to crowdfunding campaign success, this chapter argues that there are mixed motives associated with contributing to these campaigns, and theoretical dynamics vary according to these different motives. The chapter also notes two fundamental differences of crowdfunding from more traditional means of funding early-stage ventures: the nature of engagement and preference toward product or person. Drawing on theory related to capabilities, the chapter identifies conditions under which crowdfunding is likely to be more and less advantageous based on these two dimensions. In summary, it provides a model that explains important sources of heterogeneity (i.e., motives) and homogeneity (i.e., diffused engagement and product lock-in) within the crowdfunding phenomenon that add nuance to theory in the entrepreneurial financing literature.
The Effects of Venture Capital Firms on Entrepreneurial Firms’ Strategic Alliances and Liquidity Events
Authors: Ragozzino Roberto
Published: August 2019

This chapter aims to provide a succinct review of the state-of-the-art academic literature on the topic of venture capital firms and their involvement in entrepreneurial ventures. Specifically, the chapter focuses on the relationship between the presence of VC firms and two key entrepreneurial outcomes: (a) strategic alliances, defined as the formation of cooperative agreements with strategic partners for the purpose of advancing the entrepreneurial firm’s competitiveness, and (b) liquidity events, defined as the sale of ownership to the general public through an initial public offering (IPO), or to a specific buyer through an acquisition. The chapter also highlights some key questions that remain unanswered, as well as a few areas of inquiry that challenge our common wisdom and give rise to controversy.