bluuebunny/crossref_metadata_2025 huggingface dataset:
Levantine Archaeology
Authors: Porter Benjamin
Published: June 2024

Levantine archaeology investigates the societies that lived along the eastern edge of the Mediterranean Sea between the Amanus Mountains of Turkey and Egypt’s Sinai Peninsula. The Levant’s geographic scope has shifted over the centuries in the minds of European audiences. Today’s definition includes all or parts of the modern nation-states that make up the Arabic toponym bilad al-sham, the “land of Damascus”: southeast Turkey, western Syria, Lebanon, the State of Israel and Palestine, and western Jordan. Scholars often make an artificial division between the Northern Levant (Syria, Turkey, Lebanon) and the Southern Levant (Israel, Jordan, Palestine) to narrow the geographic scope. The field of Levantine archaeology sits at the interstice of Middle (or Near) Eastern archaeology and Mediterranean archaeology. The earliest human ancestors entered the Levant 1.5 million years ago and have continuously occupied the region up to today, making the region one of the world’s oldest and continuously occupied locations on Earth. The Levant’s prehistoric Neolithic and Chalcolithic–era communities adopted sedentary lifestyles, a food economy largely based on domesticated plants and animals, and sparked new craft technologies based on stone, ceramic, and metal materials. The third through first millennia bce, the Bronze and Iron Ages, saw the establishment of territorial polities, the advancement of bronze and iron technologies, long-distance international trade, and the creation of the first administrative and literary written records in the region. Levantine societies fell under the sway of first Greek Hellenism, and later Roman imperialism and Byzantine Christianity between the fourth century bce and the sixth century ce. The seventh century ce saw the arrival of Islam in the Levant, followed by the successive wave of Islamic dynasties—the Umayyad, Abbasid, Ayyubid, Mamluk, and Ottoman Empires—save an uneven two-century interlude of control by the European Crusaders. Levantine archaeology ends with the Ottoman Empire’s collapse following World War I, although this time horizon will likely extend deeper into the twentieth century as the field evolves. Due to this chronological depth in human occupation, the Levant offers a productive venue for examining the origins and development of agriculture, animal husbandry, craft production, religious and political organization, mortuary practices, hydrology, and maritime and terrestrial economies, all topics that will be explored in this bibliography. The discipline’s scholarship has appeared and continues to appear in multiple European (e.g., French, German, Italian, and Spanish) and Middle Eastern languages (e.g., Arabic, Hebrew, Turkish). Scholarship written in English is prioritized in this bibliography for the sake of consistency.
Religion, Sexuality, and Queer Asylum
Authors: Greatrick Aydan
Published: June 2024

Religious beliefs are often considered to be a key driver of sexuality and gender-based persecution, perpetuating “backward” and “conservative” traditions that justify and encourage violence toward non-heteronormative people. However, this chapter draws on interdisciplinary research to demonstrate the important but often overlooked ways in which religion and faith can inspire solidarity, care, and strength in the face of adversity for queer refugees. Far from depicting a situation of unbridgeable difference, such examples highlight how a queer politics of inclusion is being developed through the ethical imperatives and practices of diverse faith traditions. Such examples demonstrate the value of engaging with faith, particularly among scholars working at the intersection of sexuality, migration, and displacement.
Philosophical Insights from Phra Chao Yu Hua (พระเจ้าอยู่หัว)
Authors: Niramittham Krit
Published: June 2024

Based on philosophical insights regarding Thai music education from Phra Chao Yu Hua (the title of the Thai King)—His Majesty King Bhumibol Adulyadej, King Rama IX of Thailand—the author discusses four subjects: (1) the philosophical underpinnings of Thai music education; (2) Phra Chao Yu Hua; (3) His Majesty King Bhumibol Adulyadej’s musical experiences; and (4) philosophical insights on Thai music education from Phra Chao Yu Hua. Phra Chao Yu Hua’s philosophical insights include the value of music, the need for creativity in music teaching, the importance of local music making, effective music teaching, the joy of music, music education through ensemble playing, the beauty and morality of music, and the unity of the Thai people in creative music making. The author argues that adopting these philosophical insights could offer new perspectives on music making.
Respect for Knowledge and Guru in Contemporary Music Education
Authors: Lakshmi Seetha
Published: June 2024

Gurus, responsible for imparting knowledge and guiding their shishyas, have historically fulfilled the role of imparting knowledge and core values. In Tamil culture, gurus are placed on a par with parents as nurturing individuals who instill knowledge imbued with values such as acceptance, tolerance toward humankind, and generosity to society. However, modernization and technical advancements have transformed the role of the guru, the dynamics of the guru-shishya relationship, and pedagogical techniques. The author traces the history and philosophy of the guru, which encompasses “respect for knowledge” and the time-honored system of guru-shishya parampara. Focusing on music education, this essay discusses factors that have contributed to the changes in the landscape. The author argues that, although the landscape has evolved, the basic concept of respect for knowledge and for the guru remains. The author also proposes strategies that can be undertaken to preserve the important aspects of the guru-shishya relationship.
On Daoist Philosophies of Music
Authors: Lu Mengchen , Tan Leonard
Published: June 2024

In this chapter, the authors draw on the ideas of Laozi and Zhuangzi to examine Daoist philosophies of music. In particular, the authors discuss the following musical themes: (1) “The Five Tones Deafen Humans’ Ears” (wuyin lingren erlong 五音令人耳聾), (2) “The Great Note Is Rarified Sound” (dayin xisheng 大音希聲), (3) “Harmony of Refined Notes and Raw Sounds” (yinsheng xianghe 音聲相和), and (4) “The Three Pipings” (sanlai 三籟). Next, the authors propose their implications for music education, highlighting in particular how Daoist philosophies of music are exemplified in the musical practice of the guqin and foreground the value of silence—which seems particularly relevant and timely in the modern world. The authors conclude by suggesting potential directions whereby Daoist philosophical ideas may continue to illuminate music education in the future.
Rethinking the Spanish-Aztec War of 1519–1521
Authors: Schwaller John F. , Restall Matthew
Published: June 2024

This chapter presents a rethinking of the Spanish-Aztec War of 1519–1521. For the past five centuries, narratives of the 1519 Spanish invasion of Mexico have tended to focus on the activities of the invading Spanish conquistadors and initial colonial settlers. The events triggered by the Spanish arrival on the Gulf Coast in April of that year, through to the fall of the besieged city of Tenochtitlan in August 1521, have traditionally been known as “the Conquest of Mexico.” As such, these narratives reflect the Spanish point of view. Within the last half-century, however, and especially in the last quarter-century, scholars have begun to look at the period using documents written in Indigenous languages that offer different perspectives on the events. By reading the sources more critically, another narrative is revealed, one that is less tidy, less reassuring, but more believable and far better supported by evidence. The chapter then considers the role of Hernando Cortés, the Indigenous groups of the region, and Mexica resistance and civilization.
Experiencing Ancient Landscapes
Authors: Parker Grant
Published: June 2024

This chapter canvases a selection of texts to frame what we might call ancient tourist literature. Odysseus’ ten-year return journey from Troy to Ithaca was involuntary, so that makes Homer’s Odyssey a poor candidate for antiquity’s tourist literature. While Herodotus’ Histories is well known for its author’s fascination with Egypt, less familiar texts help build out the picture: for example, the literary graffiti of Julia Balbilla, an aristocrat from Asia Minor, whose visit continues to be physically marked at the Colossi of Memnon near Thebes. Texts of this kind are, the author argues, the key to a mostly implicit ancient conception of tourism: while many journeys are famously recounted in epic and other genres, only a few are presented with a sense that they might potentially be emulated. An important element here is the Mediterranean landscape that emerges in key Greek and Latin geographical texts. Most notably, Pausanias in his Description of Greece richly bespeaks a notion of cultural landscape, at least with respect to the Greek mainland. With the ascendancy of Christianity in the early fourteenth century CE, the influential concept of a Holy Land emerged. While religion and tourism may seem odd bedfellows today, they show significant overlap in many early texts. Ancient tourism and its literature are characterized as the experience of particular landscapes. At issue are the literary genres by which those experiences become part of the collective memory of ancient societies and would also exert influence over subsequent readers.
Hebrews and the Catholic Epistles in Protestant Creeds, Confessions, Liturgy, and Song
Authors: Peeler Amy , Peeler Lance
Published: June 2024

Although Hebrews and the Catholic Epistles may not have always featured prominently in academic work, their influence is plentiful in the words of worshiping communities. They are so plentiful, in fact, that this essay can highlight only a portion of that influence. Taking the Anglican and Baptist traditions as examples, the essay traces the presence of Hebrews and the Catholic epistles in the Nicene Creed, the Revised Common Lectionary, the Book of Common Prayer, Baptist Confessions, and texts of Protestant hymnals with attention to historical development. The essay also offers a subset of the data that provides evidence of the ongoing impact of these biblical texts in Christian worship.
The Letter of James
Authors: Batten Alicia J.
Published: June 2024

This essay focuses on the Letter of James, reviewing several perennial issues that continue to puzzle scholars. Given the number of debates swirling around this intriguing letter, the essay is by no means exhaustive. It begins by surveying some of the basic historical questions, including the letter’s authorship, its possible provenance, and the tricky subjects of date and audience. Subsequently, the chapter turns to discussions concerning literary matters, including the genre of James, the various sources from which the letter may be drawing, as well as its literary structure, its use of rhetorical techniques, and its satirical features. The essay also explores a few interpretive matters. Is there, for example, a central theme in the Letter of James? What does James mean when it refers to the “word of truth” (1:18)? The long-standing debate about the relationship between James and the letters of Paul receives some attention, as does the manner in which James describes the divine. The final topic examined is James’s understanding of rich and poor.
Introduction
Authors: Singer P. N.
Published: June 2024

The introduction offers a detailed account of the layout and content of the handbook, followed by an outline of both Galen’s intellectual and cultural significance over the two millennia since his death and the recent history of Galenic scholarship. It discusses Galen’s enormous influence and cultural importance over a vast geographical area for more than millennium and a half, his almost complete neglect in the subsequent period, and the partial reversal of this neglect in the last thirty-five years or so within the world of classical studies. This chapter highlights the aim of the present volume, which is to offer a fresh contribution that both synthesizes some of these most important recent developments and functions as a reference work for scholars and students of the above topics.
Galen on the Signs of Disease
Authors: Tassinari Piero
Published: June 2024

This chapter discusses how Galen interacted with the historically crucial Hippocratic text Prognostic in setting out the basics of the doctor’s clinical methodology and approach to diagnostics. It places alongside each other the diagnostic and prognostic model of the Hippocratic text and Galen’s response to it, focusing on Galen’s definition of what constitutes a sign (sēmeion). The chapter analyses Galen’s account of the “power” (dunamis) of a sign; of how this can be measured; of how different kinds of signs can be compared; and of the relationship between a sign (sēmeion) and a tekmērion—an “evidence” or “valid sign,” where the former is taken to be a “weaker” version of the latter.
Ethical Works
Authors: Rosen Ralph M.
Published: June 2024

This chapter examines Galen’s works on ethical and psychological topics, including The Diagnosis and Treatment of the Affections and Errors Peculiar to Each Person’s Soul, Character Traits, and Avoiding Distress. It discusses the various philosophical influences on Galen’s ethical thinking—in particular Platonism and Stoicism—as well as Galen’s psychotherapeutic recommendations. Galen took seriously the various behavioral elements of a person’s life—such as emotions, impulses, temperament, and personality—as factors relevant to assessing someone’s overall health and happiness. This chapter explores Galen’s interests in behavioral psychology, personality, and virtue, as well as the philosophical background that informs these works.
Galen’s Return to the West
Authors: Fortuna Stefania
Published: June 2024

This chapter reconstructs the Latin tradition of Galen and its development from late antiquity to the fifteenth century, especially from the eleventh century, when Galen’s return to the West began. Galen’s works were summarized by Byzantine physicians from the fourth century and used in pedagogic contexts in Greek Alexandria until the seventh century, and also in sixth-century Latin Ravenna. Later on, Galen’s system survived in the Byzantine Empire and developed in the Arabic world, whereas it almost disappeared in the West. Only in the eleventh and twelfth centuries were Galen’s works rediscovered and translated into Latin from Greek and especially from Arabic, and henceforth, these translations dominated medical studies of all European universities until the fifteenth century.
Submerged Landscapes in Northern Europe
Authors: Astrup Peter Moe , Nilsson Björn
Published: June 2024

The sea floor of northern Europe contains numerous traces of submerged landscapes that were once important habitats for Mesolithic hunter–gatherers. In this chapter, the authors provide an overview of the status of the exploration of these landscapes and the Stone-Age sites within them. Their chronological focus is the time after the last Ice Age until approximately 4000 BC, a period when global sea levels were much lower than now, although rapidly rising. The geographical areas discussed include the North Sea, Norway, Denmark, northern Germany, and southern Sweden. Together they show what characterizes the submerged landscapes in northern Europe and the type of knowledge that archaeological and geological studies have generated so far. The authors also address some of the challenges associated with the exploration of submarine landscapes and present some of the archaeological research lacunae.
Law in the Books of Kings
Authors: Johnson Dylan R.
Published: June 2024

Law was a foundational social institution and a central motif of royal ideology in the ancient Near East. The biblical books of Kings, however, offer only limited insight into ancient Israel’s and Judah’s legal traditions. This chapter examines the themes of law and justice in 1–2 Kings as they appear in moralizing legal narratives, descriptions of judicial oaths, and the ratification of political treaties. The chapter assesses the obstacles confronted when trying to use biblical narratives as sources of juridical information and how to balance traditional methods of exegesis with legal interpretations of a given text. Nonetheless, it affirms that by comparing and contrasting the legal narratives of Kings, pentateuchal law, and extrabiblical evidence, a more holistic picture emerges of the relationship between biblical law and the legal cultures of Israel and Judah.
The Reception of the Books of Kings in Medieval Christianity
Authors: van Liere Frans
Published: June 2024

This chapter offers an overview of the medieval interpretation history of the books of Kings in light of the history of medieval exegesis and hermeneutics. The books were appreciated as historical records of the kingdom of Israel and Judah, first united under Solomon and later divided as two monarchies. They did not elicit much commentary in the Christian Middle Ages, with the exception of the passages that describe the temple of Solomon. Although they seemed to lack in theological or spiritual content, as historical records, the books held considerable interest for medieval chroniclers. The stories about the prophets Elijah and Elisha and the kings Solomon, Josiah, and Hezekiah inspired medieval monks and kings, respectively. Solomon was seen as a model wise king and Josiah as a reformer, and Elijah and Elisha were regarded as forerunners for the medieval monastic orders. All of them were interpreted as types of Christ.
Textual History of the Books of Kings
Authors: Tekoniemi Timo
Published: June 2024

The Septuagint (LXX) edition of Kings differs significantly from the Masoretic Text. These differences stem from a different Hebrew base text of the LXX (Vorlage). The LXX edition lacks many textual units added later through protomasoretic editing, but it also contains lengthy textual units not found in the Masoretic Text. Many verses and passages are transposed. Scholarly positions as to which edition has precedent have been highly polarized: while some believe that the LXX is the oldest preserved edition of Kings, others find its text secondary to the Masoretic Text. This question of the textual history and growth of the books of Kings has become one of the most pressing subjects in the contemporary study of Kings. This chapter discusses the methodological repercussions of this textual multiplicity for the study of Kings and gives examples of the major differences between the two extant editions.
Solomon and Jeroboam I
Authors: Robker Jonathan Miles
Published: June 2024

This chapter discusses the characterizations of the literary figures Solomon and Jeroboam I as they are presented in a synchronic reading of 1 Kgs 1–14. Then the chapter analyzes the text’s structure and contents. Following this analysis, the chapter goes on to unpack these monarchs’ similarities and their differences as presented throughout the books of Kings. Proceeding in this manner and engaging with traditional-historical elements of the Bible, the chapter also suggests that Solomon and Jeroboam both serve as literary critiques of institutional monarchy, albeit each for different reasons. In this way, both also thus implicitly commend clerical authority over secular leadership.
China and Global Land Use Change
Authors: Xu Yunan , Borras Saturnino M.
Published: June 2024

Recent decades have seen rapid, extensive, and profound changes to global land use. The role played by China in this dramatic process has been significant, but how, exactly, are we to understand that role? In the context of global land grabs, China figured prominently, especially in the earlier phase of the phenomenon, but some suggest that China’s role might have been overestimated. The argument this chapter makes overlaps with but diverges from the debate about China and land grabs and delves into the character and extent of China’s role in driving global land-use change, which, in turn, has profound implications for global social life. The chapter argues that both global land-use change and the role played by China are far more complex and more extensive than was previously understood. The chapter proposes a typology to facilitate the analysis through a matrix of multiple interactive variables: formal/informal, direct/indirect, and internal/external, centering on social relations. In so doing, its makes hidden informal land deals more visible, indistinct indirect land-use changes more transparent, and obscure internal/external linkages more obvious.
Material Culture in Pure Land Buddhist Practice
Authors: Marchman Kendall
Published: June 2024

Pure Land practitioners aim for rebirth in Sukhāvatī, Amitābha’s purified realm where inhabitants are guaranteed enlightenment. Although the most common contemporary Pure Land practice is nianfo 念佛 (Jp. nembutsu), keeping Amitābha in mind through chanting of his name, practitioners now and throughout history have created an abundant material culture to aid their practice. An analysis of these materials provides a more integrated view of Pure Land Buddhism, both past and present. This chapter introduces and considers the materials that have been critical to Pure Land practice across East Asia throughout its history: beans, rosaries, graphic representations (paintings, cave murals, mandalas), portable shrines, and monumental statues. Not only did these objects help Pure Land practitioners achieve their hope of being reborn in Sukhāvatī, but they also allowed them momentary experiences of Sukhāvatī through their imaginative practice. Thus, the objects helped transform spaces into the pure land.
Global War Finance in the Twenty-First Century
Authors: Cappella Zielinski Rosella , Shea Patrick E.
Published: June 2024

This chapter explores the landscape of war finance in the twenty-first century, emphasizing the globalized nature of funding mechanisms that support military operations across the world. War finance has shifted from a traditional, state-centric operation toward a more complex system involving a mix of state and non-state actors, leveraging global financial markets and technologies. The discussion highlights how these actors access international capital markets, utilize digital currencies, and engage in economic strategies that blur the lines between economic and military warfare. This comprehensive overview not only sheds light on the mechanisms of war financing in the modern era but also prompts a reevaluation of the implications for international security and economic policy.
Sanctions in an Era of Strategic Competition
Authors: Reddie Andrew W. , Walker Leah P.
Published: June 2024

The rise of sanctions as a preferred tool of state power is indicative of the current complex, tightly coupled, and occasionally volatile world order. In the days prior to and the months following Russia’s invasion of Ukraine, the United States along with a number of other countries applied new rounds of sanctions on Moscow—some deepening those already implemented following Russia’s annexation of Crimea in 2014 and others focused on elites with ties to the Kremlin. In theory, the pain of the sanctions regime should force Moscow to abandon its invasion and return to the status quo ante. The failure to achieve this policy outcome has renewed debates as to whether sanctions, despite being ubiquitous, represent an effective tool of economic statecraft. This chapter examines the theoretical literature surrounding the application of sanctions and pays particular attention to the question of whether existing theory needs to account for changing structural conditions in the international system.
John Calvin and Early Reformed Theology
Authors: Mosser Carl
Published: June 2024

Huldrych Zwingli inscribed deification into the very first statements of Reformed theology. It is also attested in the writings of his counterparts in Basel and Strasbourg, Johannes Oecolampadius and Martin Bucer. John Calvin inherited the tradition forged by these first-generation Reformers and deepened it. According to Calvin, the end of the Gospel is “to deify us.” He explained what that means in concert with the Greek patristic tradition. Following precedents established by Irenaeus and Cyril of Alexandria, Calvin usually taught deification without recourse to technical vocabulary. In his view, union with God requires the imputation of Christ’s righteousness. While justification is a forensic act, it is inseparable from the transforming work of the Spirit. A few scholars contend Calvin could not have affirmed a soteriology of deification because early Reformed Christology rejects patristic teaching about the divinization of Christ’s humanity. That supposition is disproved.
Deification and Ecumenical Dialogues
Authors: Vainio Olli-Pekka
Published: June 2024

The idea of deification has been discussed in various ecumenical dialogues since the 1970s. Initially this common point between the traditions was found in the Lutheran-Orthodox dialogues, but soon it was extended to Protestant-Catholic dialogues as well. Charismatic and Pentecostal theologies have also seen in deification a common denominator between their own lived experience and other theological traditions. Deification is perceived to be ecumenically fruitful because even if the term itself is not universally used, several traditions manifest similar biblical idea of salvation where the believers share the divine nature of Christ. The possible challenges that may hamper the use of deification in ecumenism include conflicting notions of deification in different traditions, for example, the connection between deification and other doctrines is perceived in different ways.
Dialogues with Jews and Muslims
Authors: George-Tvrtković Rita
Published: June 2024

This chapter highlights select cases, both historical and contemporary, in which the concept of deification has been raised by Latin Christians engaged in conversation with Jews or Muslims. It begins with an analysis of a medieval dialogue on deification between a fifteenth-century Latin Christian, Nicholas of Cusa, and an imaginary Muslim interlocutor. The chapter then moves to contemporary Christian-Jewish and Christian-Muslim discussions of deification that are more extended and more authentically dialogical, since it is only in recent decades that comparative theologians have begun to write explicitly on this topic. While deification may not be a proper theological category for mainstream circles in Judaism and Islam, correlate terms are found in more mystical strains of each. One finds angelification, intellectual union, and sonship through works of the Law in Judaism, and Islam speaks of indwelling, spiritual perfection, and remembrance of God’s name.
In vitro to in vivo extrapolation from 3D hiPSC-derived cardiac microtissues and physiologically based pharmacokinetic modeling to inform next-generation arrhythmia risk assessment
Authors: Daley Mark C , Moreau Marjory , Bronk Peter , Fisher Jeffrey , Kofron Celinda M , Mende Ulrike , McMullen Patrick , Choi Bum-Rak , Coulombe Kareen
Published: June 2024

Proarrhythmic cardiotoxicity remains a substantial barrier to drug development as well as a major global health challenge. In vitro human pluripotent stem cell-based new approach methodologies have been increasingly proposed and employed as alternatives to existing in vitro and in vivo models that do not accurately recapitulate human cardiac electrophysiology or cardiotoxicity risk. In this study, we expanded the capacity of our previously established 3D human cardiac microtissue model to perform quantitative risk assessment by combining it with a physiologically based pharmacokinetic model, allowing a direct comparison of potentially harmful concentrations predicted in vitro to in vivo therapeutic levels. This approach enabled the measurement of concentration responses and margins of exposure for 2 physiologically relevant metrics of proarrhythmic risk (i.e. action potential duration and triangulation assessed by optical mapping) across concentrations spanning 3 orders of magnitude. The combination of both metrics enabled accurate proarrhythmic risk assessment of 4 compounds with a range of known proarrhythmic risk profiles (i.e. quinidine, cisapride, ranolazine, and verapamil) and demonstrated close agreement with their known clinical effects. Action potential triangulation was found to be a more sensitive metric for predicting proarrhythmic risk associated with the primary mechanism of concern for pharmaceutical-induced fatal ventricular arrhythmias, delayed cardiac repolarization due to inhibition of the rapid delayed rectifier potassium channel, or hERG channel. This study advances human-induced pluripotent stem cell-based 3D cardiac tissue models as new approach methodologies that enable in vitro proarrhythmic risk assessment with high precision of quantitative metrics for understanding clinically relevant cardiotoxicity.
Altered oxidative stress and antioxidant biomarkers concentrations in pregnant individuals exposed to oil and gas sites in Northeastern British Columbia
Authors: Day Matthew W , Daley Coreen , Wu Yifan , Pathmaraj Maduomethaa , Verner Marc-André , Caron-Beaudoin Élyse
Published: June 2024

Northeastern British Columbia is a region of prolific unconventional oil and gas (UOG) activity. UOG activity can release volatile organic compounds (VOCs) which can elevate oxidative stress and disrupt antioxidant activity in exposed pregnant individuals, potentially increasing the risk of adverse pregnancy outcomes. This study measured biomarkers of oxidative stress and antioxidant activity in pooled urine samples of 85 pregnant individuals living in Northeastern British Columbia, to analyze associations between indoor air VOCs, oil and gas well density and proximity metrics, and biomarker concentrations. Concentrations of catalase, superoxide dismutase (SOD), glutathione S-transferase, total antioxidant capacity, 6-hydroxymelatonin sulfate (aMT6s), malondialdehyde (MDA), 8-hydroxy-2′-deoxyguanosine (8-OHdG), and 8-isoprostane were measured using assay kits. Associations between exposure metrics and biomarker concentrations were determined using multiple linear regression models adjusted for biomarker-specific covariables. UOG proximity was associated with decreased SOD and 8-OHdG. Decreased 8-OHdG was associated with increased proximity to all wells. Decreased aMT6s were observed with increased indoor air hexanal concentrations. MDA was negatively associated with indoor air 1,4-dioxane concentrations. No statistically significant associations were found between other biomarkers and exposure metrics. Although some associations linked oil and gas activity to altered oxidative stress and antioxidant activity, the possibility of chance findings due to the large number of tests cannot be discounted. This study shows that living near UOG wells may alter oxidative stress and antioxidant activity in pregnant individuals. More research is needed to elucidate underlying mechanisms and to what degree UOG activity affects oxidative stress and antioxidant activity.
This Could Be a Game Changer
Authors: Kirton Carl A.
Published: June 2024

Creating a potential solution to the nursing workforce issue
Are You Intimidated by a Systematic Search?
Authors: Kelley Cyndi B.
Published: June 2024

Don't let fear get in the way of greatness.
Implementing the Brøset Violence Checklist in the ED
Authors: Lawrence John , Emory Johanna , Sousa Sara , Thompson Danielle , Jenkins Kenya , Bettencourt Amanda P. , McLaughlin Maureen Kirkpatrick , Russell-Babin Kathleen
Published: June 2024

The emerging field of implementation science (IS) facilitates the sustainment of evidence-based practice in clinical care. This article, the second in a series on applying IS, describes how a nurse-led IS team at a multisite health system implemented the Brøset Violence Checklist—a validated, evidence-based tool to predict a patient's potential to become violent—in the system's adult EDs, with the aim of decreasing the rate of violence against staff. The authors discuss how they leveraged IS concepts, methods, and tools to achieve this goal.
Effectiveness of C. Difficile Prevention Framework Depends on How Measures Are Implemented
Authors: Rosenberg Karen
Published: June 2024

According to this study:
A Core Outcome Set for Research Evaluating Interventions to Enable Communication in Patients With an Artificial Airway: An International Delphi Consensus Study (Comm-COS)
Authors: Freeman-Sanderson Amy , Brodsky Martin B. , Dale Craig , Gupta Anushua , Haines Kimberley , Happ Mary Beth , Hart Nicholas , Hemsley Bronwyn , Istanboulian Laura , Spronk Peter , Sullivan Rebecca , Sutt Anna-Liisa , Rose Louise
Published: June 2024

OBJECTIVES:

Critically ill adults requiring artificial airways experience profound communication deficits. Studies of interventions supporting communication report disparate outcomes, creating subsequent challenges in the interpretation of their effectiveness. Therefore, we aimed to develop international consensus for a communication core outcome set (Comm-COS) for future trials of communication interventions in this population.

DESIGN:

1) Systematic review, 2) patient/family interviews, 3) two-round modified Delphi, and 4) virtual consensus meetings with a final voting round. A multidisciplinary expert steering committee oversaw all stages.

SETTING:

Interviews and consensus meetings were conducted via videoconferencing. Digital methods were used for Delphi and final Comm-COS voting.

SUBJECTS:

Three stakeholder groups: 1) patient and family members with lived experience within 3 years, 2) clinicians with experience working in critical care, and 3) researchers publishing in the field.

INTERVENTION:

None.

MEASUREMENTS AND MAIN RESULTS:

We identified 59 outcomes via our systematic review, 3 unique outcomes from qualitative interviews, and 2 outcomes from our steering committee. Following item reduction, 32 outcomes were presented in Delphi round 1; 134 participants voted; 15 patient/family (11%), 91 clinicians (68%), and 28 researchers (21%). Nine additional outcomes were generated and added to round 2; 106 (81%) participants voted. Following completion of the consensus processes, the Comm-COS includes seven outcomes: 1) changes in emotions and wellbeing associated with ability to communicate, 2) physical impact of communication aid use, 3) time to functional communication, 4) ability to communicate healthcare needs (comfort/care/safety/decisions), 5) conversation agency, 6) ability to establish a communication connection to develop and maintain relationships, and 7) acceptability of the communication intervention.

CONCLUSIONS:

This is the first COS to specifically focus on communication for critically ill adults. Limitations for operationalization include selection of measures to use with these outcomes. Identification of suitable measures and adoption of the Comm-COS in future trials will help establish effective interventions to ameliorate the highly prevalent and negative experience of communicative incapacity.
Maternal Immunizations: Past, Present, and Future
Authors: Rick Anne-Marie , Beigi Richard
Published: June 2024

Maternal vaccines during pregnancy offer crucial protection against infections for both the pregnant person and their newborn. Vaccines against influenza, pertussis, coronavirus disease 2019, and respiratory syncytial virus are routinely recommended by the Centers for Disease Control and Prevention to safeguard pregnant women and their infants from potentially severe complications. Administering these vaccines during pregnancy helps transfer protective antibodies from the mother to the baby, enhancing immunity during the vulnerable early months of life. Extensive research supports the safety and efficacy of maternal vaccines, with numerous studies demonstrating their protective benefits for both pregnant people and newborns.
Multidisciplinary treatment for patients with advanced hepatocellular carcinoma complicated by Vp4 portal vein tumor thrombosis: Combination of atezolizumab and bevacizumab after hepatic arterial infusion chemotherapy and radiotherapy: A case series
Authors: Yamaoka Kenji , Kawaoka Tomokazu , Fujii Yasutoshi , Uchikawa Shinsuke , Fujino Hatsue , Nakahara Takashi , Ohno Atsushi , Murakami Eisuke , Miki Daiki , Tsuge Masataka , Chosa Keigo , Awai Kazuo , Hirokawa Junichi , Nagata Yasushi , Oka Shiro
Published: June 2024

Rationale:

Various treatments are available for treating hepatocellular carcinoma (HCC). Among HCC, Vp4 portal vein tumor thrombosis (PVTT) has a poor prognosis. There have been reports of treatment with molecularly targeted agents in combination with hepatic arterial infusion chemotherapy (HAIC) and radiotherapy (RT) in HCC patients with Vp4 PVTT, but none with atezolizumab, the immune checkpoint inhibitor. Here, we present cases of unresectable HCC with Vp4 PVTT that were treated with the combination atezolizumab and bevacizumab (Atezo + Bev) after HAIC and RT. The purpose and significance of this study are to research the usefulness to precede HAIC and RT in the treatment of HCC with immune checkpoint inhibitors.

Patient concerns:

Sixty-six-year-old man, 74-year-old man, 83-year-old man, 69-year-old man, 62-year-old man, and 85-year-old woman were diagnosed with HCC with Vp4 PVTT.

Diagnosis:

Cirrhosis was classified as Child-Pugh class A or B. HCC was diagnosed as TNM stage IVa or IVb.

Interventions:

RT for PVTT was performed the same day or the day after HAIC. Atezo + Bev was started at least 1 week after RT was completed.

Outcomes:

Death was confirmed in 4 of the 6 patients; the median overall survival time was not reached. The survival times of the 4 patients were 18.7, 12.5, 5.1, and 1.7 months. Based on the modified response evaluation criteria in solid tumors criteria, the objective response rate of patients with best tumor response to Atezo + Bev therapy was 66.7%, and that of patients with best response of PVVT to Atezo + Bev was 66.7%.

Lessons:

These cases showed that in HCC with Vp4 PVTT, HAIC, and RT before Atezo + Bev may be useful to prolong survival.
Assessment of the response to kidney patients’ needs in disaster-stricken Syria
Authors: Sekkarie Mohamed , Murad Lina , Alasfar Sami
Published: June 2024

Purpose of review

The major fighting activities in the Syrian conflict have subsided, but the country continues to deal with significant political, economic, and psychosocial consequences that gravely impact the healthcare system, including the care of patients with kidney disease. The purpose of this manuscript is to review some of the problems faced by kidney patients in postconflict Syria and their available and proposed remedies.

Recent findings

Many challenges, such as unfair, poorly planned, and poorly organized distribution of resources, suboptimal quality-monitoring infrastructure, psychosocial barriers, and workforce shortages, impede the delivery of quality care and negatively impact outcomes. The negative impact of these problems is not uniform and tends to affect certain areas more than others because of geopolitical factors imposed by the conflict.

After prolonged conflicts, healthcare resources remain limited for prolonged periods, leading to inadequate care, poor outcomes, and worsening inequities. Involvement of the international community and expatriate nephrologists is essential to guide care delivery and improve outcomes. The lessons learned from the Syrian conflict apply to many limited resources and disaster situations.
Selection of endoscopic resection technique for large colorectal lesion treatment
Authors: Cronin Oliver , Mandarino Francesco Vito , Bourke Michael J.
Published: June 2024

Purpose of review

Large nonpedunculated colorectal polyps ≥ 20 mm (LNPCPs) comprise 1% of all colorectal lesions. LNPCPs are more likely to contain advanced histology such as high-grade dysplasia and submucosal invasive cancer (SMIC). Endoscopic resection is the first-line approach for management of these lesions. Endoscopic resection options include endoscopic mucosal resection (EMR), cold-snare EMR (EMR), endoscopic submucosal dissection (ESD) and endoscopic full-thickness resection (EFTR). This review aimed to critically evaluate current endoscopic resection techniques.

Recent findings

Evidence-based selective resection algorithms should inform the most appropriate endoscopic resection technique. Most LNPCPs are removed by conventional EMR but there has been a trend toward C-EMR for endoscopic resection of LNPCPs. More high-quality trials are required to better define the limitations of C-EMR. Advances in our understanding of ESD technique, has clarified its role within the colorectum. More recently, the development of a full thickness resection device (FTRD) has allowed the curative endoscopic resection of select lesions.

Endoscopic resection should be regarded as the principle approach for all LNPCPs. Underpinned by high-quality research, endoscopic resection has become more nuanced, leading to improved patient outcomes.
The Effect of a Physician Consultation on Patient Reported Outcomes in Urogynecology
Authors: Edwards Emily , Boyles Sarah , Gould Claire , Osmundsen Blake
Published: June 2024

Importance

It has not yet been determined whether there is an effect of the initial urogynecologic consultation and resultant management plan on the patient’s bother from her pelvic floor condition.

Objective

The aim of the study was to see whether patient-reported outcomes of bother were different before and after consultation with a specialist.

Study Design

Fifty patients completed both preconsultation and postconsultation Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7). Patients were eligible if they were naive to urogynecology care and had never had treatment for the chief complaint in the past. They were not eligible if they received treatment at their consultation visits. A paired t test was used for comparison. A linear model determined whether baseline PFDI-20 and PFIQ-7 scores as explanatory variables had an effect on the pre-post delta as outcome variable.

Results

There was no statistically significant difference between PFDI-20 scores before (mean, 86.5) and after (mean, 83.1) consultation. There was additionally no difference between PFIQ-7 scores before (mean, 61.1) and after (mean, 65.4) consultation. There was, however, a greater degree of change in scores if the patient presented with little bother versus large bother at the initial consultation.

Conclusions

For the new urogynecologic patients, those with lower baseline bother showed higher change (improvement) in scores after the consultation.
A clinical metagenomic study of biopsies from Mexican endophthalmitis patients reveals the presence of complex bacterial communities and a diversity of resistance genes
Authors: Vences-Guzmán Miguel Ángel , Jiménez-Rodríguez Martín , Lozano Luis , Rojas-Juárez Sergio , Ramírez-Estudillo Juan Abel , Hernández-Vázquez Ángeles Yahel , Pita-Ortiz Ingrid Yazmín , Ramírez-Ceballos Karol Guadalupe , Medina-Medina Silvia , Sohlenkamp Christian
Published: June 2024

Infectious endophthalmitis is a severe ophthalmic emergency. This infection can be caused by bacteria and fungi. For efficient treatment, the administration of antimicrobial drugs to which the microbes are susceptible is essential. The aim of this study was to identify micro-organisms in biopsies of Mexican endophthalmitis patients using metagenomic next-generation sequencing and determine which antibiotic resistance genes were present in the biopsy samples. In this prospective case study, 19 endophthalmitis patients were recruited. Samples of vitreous or aqueous humour were extracted for DNA extraction for metagenomic next-generation sequencing. Analysis of the sequencing results revealed the presence of a wide variety of bacteria in the biopsies. Resistome analysis showed that homologues of antibiotic resistance genes were present in several biopsy samples. Genes possibly conferring resistance to ceftazidime and vancomycin were detected in addition to various genes encoding efflux pumps. Our findings contrast with the widespread opinion that only one or a few bacterial strains are present in the infected tissues of endophthalmitis patients. These diverse communities might host many of the resistance genes that were detected, which can further complicate the infections.
Phenotypic antibiotic susceptibility profile of clinical Enterobacteriaceae isolates from Kaduna State, northwest Nigeria
Authors: Ezeh Peace Amarachukwu , Olayinka Busayo Olalekan , Bolaji Rebecca Olajumoke , Babangida Suleiman Ahmed , Olowo-okere Ahmed
Published: June 2024

Background. The increasing resistance of clinical Enterobacteriaceae isolates to commonly prescribed antibiotics has been reported around the world. Data are generally lacking on the prevalence and antibiotic susceptibility profile of clinical Enterobacteriaceae isolates from Kaduna, northwest Nigeria. This study thus aimed to determine the diversity and antibiotic resistance profile of clinical Enterobacteriaceae isolates recovered from clinical specimens from patients admitted to two selected healthcare institutions in Kaduna.

Methods. This was a prospective cross-sectional study conducted between September and December 2021. Non-duplicate clinical bacterial isolates recovered from various specimens were collected and identified using rapid biochemical identification kits. The susceptibility of identified Enterobacteriaceae to various antibiotics and phenotypic detection of carbapenemase enzymes were thereafter determined. The data were analysed and visualized using R software version 4.3.1.

Results. Of the 500 bacterial isolates recovered from specimens collected for the purpose of clinical bacteriology diagnostics, 108 (21.6 %) were identified as Enterobacteriaceae, with Pantoea agglomerans (52, 48.1 %) and Klebsiella oxytoca (19, 17.6 %) being the most prevalent. The isolates exhibited high resistance to azithromycin (69 %) and ceftazidime (42 %), while exhibiting low resistance to amikacin (7 %) and imipenem (10 %). Among the carbapenem-resistant Enterobacteriaceae (CRE) isolates, a significant proportion (12/17, 70.6 %) tested positive for carbapenemase activity.

Conclusion. This study reports a high prevalence of multidrug-resistant Enterobacteriaceae in Kaduna, northwest Nigeria. The emergence of pathogenic P. agglomerans and an alarmingly high prevalence of carbapenemase-producing CRE were also observed. The presence of carbapenemase producers in an area with low carbapenem usage and resistance rates raises significant concerns. Continuous surveillance and robust antibiotic stewardship policies are imperative to preserve the efficacy of carbapenems in this region.