bluuebunny/crossref_metadata_2025 huggingface dataset:
Martin Luther's Practice of Old Testament Commentary
Authors: Maxfield John A.
Published: March 2017

Scholarly analysis of biblical interpretation and commentary in the history of Christianity has become an important subfield in history as well as biblical studies and theology. From the Reformation and into the modern era, Martin Luther has been appreciated first of all as an expositor of the Bible and a confessor of its teachings. His vocation as a theologian called to teach in the University of Wittenberg was especially focused on the exposition of scripture, and his development as a theologian and eventually as an evangelical reformer was deeply tied to his experience in interpreting the Bible in his university classroom, in the Augustinian cloister, and in his household. His interpretation of scripture was the basis of his “Reformation discovery” of justification by faith, and his conflict with the papal church was largely the result of Luther’s conviction that the message of scripture, in particular “the gospel,” was being overwhelmed in the theology and churchly practice of his time by “human teachings” not supported by and contradicting scripture. As a result, Luther and other evangelical reformers of the 16th century appealed to scripture alone (sola scriptura) as the highest authority in shaping their theology and proposals for reform.

Luther’s teachings and leadership in the Reformation were shared and celebrated not only through his doctrinal and polemical treatises and catechetical writings, but also through the many sermons, biblical commentaries on both Old and New Testament books, and prefaces on the books of the Bible that were published in his lifetime and thereafter. Old Testament commentary was an especially important genre of Luther’s published works, as it encapsulated much of his work as a university professor of theology and evangelical reformer.
Martin Luther and the Lord’s Prayer
Authors: Mikoteit Matthias
Published: March 2017

Martin Luther critically engaged with tradition in his interpretations of the Lord’s Prayer. As a result, he occasionally departed from a line of interpretation even in later years because he had taken up an idea from the traditional canon. His spiritual approach to prayer, reflected in his interpretations of the Lord’s Prayer, was also developed in critical dialogue with tradition. Luther’s spiritual treatment of the Lord’s Prayer either remained within its linguistic realm or became an element in a practice that reinterpreted the classical model of lectio—meditatio—oratio—contemplatio. When he established the three rules of the study of theology with his oratio, meditatio, and tentatio, this was informed by the fact that he identified existential need as the context for this exercise. Regarding the inner qualities of the spirituality of prayer, Luther called for prayer to be made up of words within a dialectic of law and the gospel rather than deliberately imagined internal images. This also held true when it came to Luther’s view on the particular experience of the Holy Spirit. For him, the only difference was that the petitioner should actively pray with his own words before and after experiencing the Spirit, but remain passive during the actual experience, shifting into a listening mode and praying with the words that flowed into him through the Holy Spirit from the Word of God Himself. This experience represented the pinnacle of this complex spiritual practice, being a specific form of contemplatio. Luther also developed his understanding, with regard to the theology of repentance, of the Lord’s Prayer in particular and of prayer in general by critically engaging with tradition. The fact that he interpreted other petitions of the Lord’s Prayer in terms of the fifth petition, confession, was a sign of his rethinking of the theology of repentance. This reevaluation was the result of Luther’s taking his doctrine of justification as the basis for the doctrine of prayer at the same time as adhering to the framework, in terms of the theology of repentance, for the interpretation of prayer that was defined by tradition.
Martin Luther’s Treatises and Essays
Authors: Tranvik Mark D.
Published: March 2017

The treatise or essay has played a key role in the transmission of ideas in the Western intellectual tradition and the Church in particular. Generally shorter than a book or monograph, the treatise attempts to examine a topic in a manner that is thorough yet avoids systematic treatment. The tone of the treatise usually avoids polemics and favors instead a more dispassionate treatment of its subject. In the middle ages, treatises in scholastic theology often became highly abstract and lifeless, focusing more on logical precision designed to appeal to the mind (intellectus). Entreaties to the heart (affectus) were often suspect because they were thought to lack intellectual rigor. Martin Luther’s “rhetoric of faith” results in a different view of the form of the treatise. Luther’s theological revolution centered on justification by grace through faith alone meant that theology was no longer aimed at only the mind. The whole person, mind and heart (intellectus and affectus), was now the proper object of instruction and persuasion. Luther stresses that faith, or pistis in the New Testament sense, involves a trust that encompasses thinking and feeling. Accordingly, Luther’s treatises and essays often exhibit this new rhetoric. The tone is often warm and embracing but certainly not to the exclusion of the mind. Evidence of this can be seen in five treatises he composes in the crucial year of 1520. This is the period just before he is excommunicated. To say the least, his future is highly uncertain. It is not surprising that he turns to the genre of the treatise as a format well suited to his program of reform. The Freedom of a Christian, The Treatise on Good Works, On the Papacy in Rome, To the Christian Nobility of the German Nation, and The Babylonian Captivity of the Church are the result. Together they comprise a radical proposal for change that envisions a Church grounded in God’s Word and sacraments from which springs forth a people freed to love and serve their neighbors in all of their callings.
Martin Luther and John Calvin
Authors: Gordon Bruce
Published: March 2017

It has long been recognized that John Calvin admired Martin Luther and that the Frenchman’s theology at various moments approached the teaching of Wittenberg. This relationship, however, was always mediated, particularly through the work of Philip Melanchthon. The literature on Calvin has not fully appreciated the manner in which his epistolary and literary references to Luther formed part of the French reformer’s rhetorical strategies for forging unity among the churches of the Protestant Reformation. Calvin believed that the divide between Wittenberg and Zurich formed the central stumbling block to a full reform of the church, and saw himself, as an outsider, as uniquely placed to break the impasse. How the reformers understood the catholicity of the churches extended well beyond the localities in which they found themselves. Their interpretations of unity were closely related to readings of ecclesiastical and doctrinal history, and the manner in which they understood the Reformation to stand in continuity with apostolic traditions. Reform, catholicity, and tradition were essential components of the reformers’ thought that need to be investigated through a more organic approach that takes into account the ways in which they were interwoven, while at the same time recognizing how they exposed conundrums that often served to expose divisions within the movement.
Martin Luther in Modern European Philosophy
Authors: Podmore Simon D.
Published: March 2017

Principally, Luther defers from philosophy’s authority to the authority of theology owing to an intense recognition of theology’s ultimate foundation in revelation. Allied to this is a suspicion about philosophy’s intellectual hubris and speculative neglect of the individual coram Deo (“before God”)—the “God” who is only known as revealed pro me (“for me”). As it transpires in modern philosophy’s emergence from its “service” to theology, variations of such concerns come to shape a new philosophical horizon which, for better or ill, come closer to Luther’s own in important and underexamined ways. Under implicit or explicit influence from Luther, key figures in modern European philosophy reconfigure critical new modes of philosophy which can be read to reflect Lutheran concerns about the nature of philosophy and reason itself. This story is related through key figures in modern philosophy (Leibniz, Kant, Hegel, Feuerbach, Kierkegaard, Heidegger), leading from the birth and apotheosis of the modern, through to the critical emergence of the postmodern. Through the critical reception of Luther in these philosophers, it is shown that modern European philosophy regularly deals with Lutheran tensions but often produces visions of the role of reason and selfhood which would have deeply troubled Luther himself. Nonetheless, there are also signs of a recovery of Luther’s suspicions about the possibilities of knowing which also bring into question the parameters of postmodern philosophy itself.
Martin Luther in Denmark
Authors: Gregersen Niels Henrik
Published: March 2017

In Denmark, Martin Luther was initially seen as a humanist reformer on a par with other humanists, but during the 1520s he increasingly became a divisive figure separating those wanting only to reform the Roman Catholic church from within, and those working for a break with Rome. Ways of understanding Luther differed widely within the evangelical camp too. Early “Lutherans” in Denmark, such as Hans Tausen and the drafters of the Confessio Hafniensis of 1530, presented legalistic and spiritualistic elements. In 1536, however, King Christian III announced the Reformation of Denmark, using robust Wittenberg theologians such as Johann Bugenhagen and Peder Palladius to reform the church, the university, and the society at large. Since then Denmark has been an unusually homogeneous Lutheran country, compared to Lutheran areas of Germany in the 17th and 18th centuries, including Luther’s own Sachsen. Yet Danish views of Luther have changed significantly over the centuries, especially after the national awakening in the 19th century. Thereafter, Luther was seen as a church father, though also as a somewhat remote figure. In 20th-century theology, N. F. S. Grundtvig and Søren Kierkegaard served as mediating figures between premodern Lutheranism and contemporary theology. After World War II, the Reformation is still widely regarded as formative for Danish history, albeit in combination with other inspirations. A secular mindset grew stronger both within and outside the Evangelical-Lutheran Church, with some promoting a liberalist interpretation of Luther’s two-kingdoms doctrine, and others challenging the Evangelical-Lutheran Church’s status as the “People’s Church.” By January 1, 2016, 76.9 percent of the Danish population were tax-paying members of the Evangelical-Lutheran Church in Denmark.
Jesus Christ in Martin Luther’s Theology
Authors: Zachhuber Johannes
Published: March 2017

Luther’s theology is strongly Christocentric, but Christology is rarely the central focus of his writings. In some of his most considered summaries of his own faith, he presents Chalcedonian Christology alongside the church’s teaching on the Trinity as the uncontroversial foundation of the Catholic faith, which he shared with his opponents. At the same time, it is evident that Luther’s most celebrated theological innovations, including his teaching on justification by faith, his theology of the cross, his soteriology, and in particular his doctrine of the Eucharist, had considerable Christological implications that sometimes seem at variance with received orthodoxy.

Luther’s Christology must therefore be largely reconstructed from these various strands in his thought. The result is a distinctive albeit not systematic Christology that is focused on the paradoxical unity of divine and human in Christ. In this, Luther often appears close to the teaching of the Alexandrian fathers, but with a much fuller emphasis on the concrete humanity of the savior. His historical debt to late scholasticism is most evident in his few, albeit consequential, attempts to enter into the field of technical Christological doctrine, especially his affirmation in his controversy with Zwingli of the ubiquity of Christ’s human nature after the ascension.
The Distinction between Law and Gospel in Martin Luther’s Theological Development
Authors: Arand Charles P.
Published: March 2017

Martin Luther’s insistence on the proper distinction between law and gospel in theology marks one of his most important contributions to the Reformation movement and subsequent Protestant theology. In particular, it played the critical role in Luther’s “breakthrough” by which he came to his understanding of God’s righteousness and his justification of the sinner. The distinction between law and gospel served at least two key functions in his thought. First, it kept the story of Christ focused on the benefits to people achieved by his death and resurrection. In this way, it magnified Christ’s work in accomplishing a person’s justification. As a corollary, it provided consolation to Christians struggling with the burden of their sins. Second, the distinction of law and gospel served as a hermeneutical tool for pastors not only to interpret the scriptures in line with their purpose, but also to apply the scriptures in a pastoral way to the lives of their people in order to comfort them and to strengthen their faith. Luther’s distinction of law and gospel raised questions for his followers regarding the law and whether or not it had any positive role to play within the Christian life.

Luther’s distinction between law and gospel is closely related to several other distinctions in his theology. First, it bears a number of similarities with Luther’s distinction of the two kinds of righteousness. But whereas the latter focuses on a description of anthropology, law and gospel focuses on the works of God by which he brings about two kinds of righteousness in the life of a person. Second, law and gospel is also related to Luther’s distinction of the two realms. But whereas the latter focuses on how God rules with his left hand for the well-being of creation and with his right hand for the well-being of the church, law and gospel deal with the two works of God by which he brings about his goals for creation and the church. In the centuries since, scholars have debated aspects of Luther’s distinction, particularly as it impinged on the understanding of the third use of the law.
Martin Luther and Economic Life
Authors: Rössner Philipp Robinson
Published: March 2017

Martin Luther is often considered, by historians, theologians, and economists alike, to have had no, primitive, or antiquated knowledge on economic matters. New research has suggested the opposite. Luther’s economic insights were deep, sharp, and modern and even carry much relevance for today. The misinterpretation of Luther as a medieval ignoramus shouting helplessly against the forces of emerging capitalism of his day rests on a double misconception. First, it is often assumed that capitalism broke through in the early Luther age (1480–1520s). But at that time, the German economy, which served as a source for inspiration to Luther, contracted: incomes, output and real wages went down after 1500. Moreover, capitalism had been there for centuries when Luther came forth. Secondly, Luther’s dismissal as a contributor to modern economic knowledge also rests on a decisive misconception of what “modern” economic knowledge entails. Only if we define “modern economics” as neoclassical economics, i.e., the post-1940 academic mainstream consensus in the Western world, based on the assumption of perfect competition, fully transparent information, rational actors, and a free-market economy, does Luther’s economic vision appear out of tune. How could Luther have been ignorant of the rise of the new economy when there was no such rise at his time, or “modern” economic knowledge when neither this type of knowledge nor a modern neoclassical vision of the economy existed?
Martin Luther, Bible Translation, and the German Language
Authors: Lobenstein-Reichmann Anja
Published: March 2017

In the history of the German language, hardly any other author’s linguistic work is as closely associated with the German language as Martin Luther’s. From the start, Luther as a linguistic event became the embodiment of German culture and was even elevated as the birth of the language itself; his style was emulated by some, scorned by others. Luther forces one to take a position, even on linguistic terms. The Bible is at the heart of the argument, being the most important work of Luther’s translation. However, it is only one particular type of text in the general work of the reformer. The role that the Bible plays both on its own and in connection with Luther’s other works, as well as the traditions Luther drew on and the way he worked with language, will be examined within the matrix of Early New High German, with all its peculiarities.
America’s Interactions with Islam and Judaism in North Africa
Authors: Peskin Lawrence A.
Published: March 2017

Encounters between Americans, Muslims, and Jews in North Africa played a foundational role in Americans’ early understanding of Islam and Judaism. At a time when the United States population had few Jews and virtually no free Muslims, North Africa was one of the places Americans were most likely to meet individuals from these groups.

Initially, American sailors and diplomats encountered North African Muslims and Jews as the result of frequent ship captures by Barbary corsairs beginning in the colonial period and culminating in the 1780s and 1790s. After 1815, the sailors and diplomats were joined by missionaries journeying to the Mediterranean region to convert Jews and Muslims as well as non-Protestant Christians.

These encounters prompted a good deal of literature published in the United States, including captivity narratives, novels, plays, histories, and missionary journals. These publications reinforced two dominant views of Islam. First, the early focus on Barbary corsairs capturing American “slaves” reinforced old notions of Islam as despotic and Muslims as “savages” similar to Native Americans. Missionary accounts prompted more thoughtful approaches to Muslim theology at the same time that they reinforced existing notions of Islam as a deceitful religion and revivified millenarian hopes that the declining Ottoman Empire foretold the Second Coming.

As a result of the captivity crises, Americans often had to deal with the area’s small but influential group of Jewish merchants in order to get terms and credit to free their countrymen. These fraught negotiations reinforced older European stereotypes of Jews as sharpers and Shylocks. As with Islam, the missionary period brought more thoughtful consideration of Jewish theology as Americans engaged in chiliastic hopes of bringing the Jews to Jerusalem.

After 1850 or so, Americans interested in Jews or Muslims looked less frequently to North Africa. Growing immigrant populations, first of Jews and then of Muslims, meant that Americans could encounter people of all three Abrahamic faiths at home. At the same time, missionary interests moved east, into the Holy Land, Syria, Turkey, and ultimately East Asia. Nevertheless, the early impact of North Africa on American thinking retained its influence, as is evident from President Barack Obama’s 2009 speech on American-Islamic relations delivered in Cairo.
The Transatlantic Financial Crisis of 1837
Authors: Campbell Stephen W.
Published: March 2017

The Transatlantic Financial Crisis of 1837 produced a global depression that lasted until the mid-1840s. Falling cotton prices, a collapsing land bubble, and fiscal and monetary policies pursued by individual actors and financial institutions in the United States and Great Britain were all responsible. A comprehensive understanding of the panic must take into account the global movements of gold and silver that linked Mexico, China, the United States, and Great Britain in complex networks of credit and debt. In the United States, businesses, banks, and individuals declared bankruptcy; states defaulted on their debts; commodity prices dropped; credit instruments lost their value; and unemployment rose amid a general atmosphere of pessimism and an erosion of confidence. The severity of the panic prompted politicians and financial theorists to reevaluate their ideological assumptions regarding the proper role of governmental regulation in an economy. In a larger sense, the panic demonstrated how the expansion of slavery in the United States, British imperialism, financial speculation, and recurring cycles of boom and bust were emerging as defining features of modern capitalism.
Charlatans and Medicine in 19th-Century Latin America
Authors: Podgorny Irina
Published: March 2017

In the long view of history, the charlatan is a merchant in unconventional knowledge defined on the basis of his itinerant existence. Traveling from one marketplace to another, dealing in exotic objects and remedies, organizing shows and exhibitions, performing miraculous healings by appealing to the curative power of words and liniments, charlatans have traversed Europe since early modern times.

Charlatans also crossed the boundaries between popular and learned cultures. Both celebrated and opposed by physicians, scientists and philosophers, the rich and the poor, women and men, they circulated and traded knowledge and artifacts, penetrating the most diverse cultural spheres. Far from being confined to certain countries or regions, they were everywhere, repeating almost the same sales strategies, words, and performances. The repetition of fictitious stories down the centuries and on different continents raises the question of assessing the persistence of tradition in such different contexts.

Charlatans were able not only to discover what local people liked but also to speak their “local language,” as well as adopting the most sophisticated technological innovations as part of their performances. They were sharp observers of traditions and habits in the settings they visited, and they reacted quickly to what was new for attracting audiences and customers. One can say that charlatans combined very ancient products with the most innovative media.
Human-Environmental Interrelationships and the Origins of Agriculture in Egypt and Sudan
Authors: Holdaway Simon , Phillipps Rebecca
Published: March 2017

Northeast Africa forms an interesting case study for investigating the relationship between changes in environment and agriculture. Major climatic changes in the early Holocene led to dramatic changes in the environment of the eastern Sahara and to the habitation of previously uninhabitable regions. Research programs in the eastern Sahara have uncovered a wealth of archaeological evidence for sustained occupation during the African Humid Period, from about 11,000 years ago. Initial studies of faunal remains seemed to indicate early shifts in economic practice toward cattle pastoralism. Although this interpretation was much debated when it was first proposed, the possibility of early pastoralism stimulated discussion concerning the relationships between people and animals in particular environmental contexts, and ultimately led to questions concerning the role of agriculture imported from elsewhere in contrast to local developments. Did agriculture, or indeed cultivation and domestication more generally (sensu Fuller & Hildebrand, 2013), develop in North Africa, or were the concepts and species imported from Southwest Asia? And if agriculture did spread from elsewhere, were just the plants and animals involved, or was the shift part of a full socioeconomic suite that included new subsistence strategies, settlement patterns, technologies, and an agricultural “culture”? And finally, was this shift, wherever and however it originated, related to changes in the environment during the early to mid-Holocene?

These questions refer to the “big ideas” that archaeologists explore, but before answers can be formed it is important to consider the nature of the material evidence on which they are based. Archaeologists must consider not only what they discover but also what might be missing. Materials from the past are preserved only in certain places, and of course some materials can be preserved better than others. In addition, people left behind the material remains of their activities, but in doing so they did not intend these remains to be an accurate historical record of their actions. Archaeologists need to consider how the remains found in one place may inform us about a range of activities that occurred elsewhere for which the evidence may be less abundant or missing. This is particularly true for Northeast Africa where environmental shifts and consequent changes in resource abundance often resulted in considerable mobility. This article considers the origins of agriculture in the region covering modern-day Egypt and Sudan, paying particular attention to the nature of the evidence from which inferences about past socioeconomies may be drawn.
Classification and Mitigation of Soil Salinization
Authors: Tóth Tibor
Published: March 2017

Soil salinity has been causing problems for agriculturists for millennia, primarily in irrigated lands. The importance of salinity issues is increasing, since large areas are affected by irrigation-induced salt accumulation. A wide knowledge base has been collected to better understand the major processes of salt accumulation and choose the right method of mitigation. There are two major types of soil salinity that are distinguished because of different properties and mitigation requirements. The first is caused mostly by the large salt concentration and is called saline soil, typically corresponding to Solonchak soils. The second is caused mainly by the dominance of sodium in the soil solution or on the soil exchange complex. This latter type is called “sodic” soil, corresponding to Solonetz soils. Saline soils have homogeneous soil profiles with relatively good soil structure, and their appropriate mitigation measure is leaching. Naturally sodic soils have markedly different horizons and unfavorable physical properties, such as low permeability, swelling, plasticity when wet, and hardness when dry, and their limitation for agriculture is mitigated typically by applying gypsum. Salinity and sodicity need to be chemically quantified before deciding on the proper management strategy. The most complex management and mitigation of salinized irrigated lands involves modern engineering including calculations of irrigation water rates and reclamation materials, provisions for drainage, and drainage disposal. Mapping-oriented soil classification was developed for naturally saline and sodic soils and inherited the first soil categories introduced more than a century ago, such as Solonchak and Solonetz in most of the total of 24 soil classification systems used currently. USDA Soil Taxonomy is one exception, which uses names composed of formative elements.
Students’ Rights
Authors: Palley Elizabeth
Published: March 2017

To help their clients and to further the goal of “challeng[ing] social injustice,” all social work practitioners must be aware of students’ rights. Though school law is largely regulated by states, there are some overarching federal laws and Constitutional provisions that provide rights to all students. This article includes a review of the major federal laws and cases that affect students’ rights.
School Climate and School Social Work Practice
Authors: Iachini Aidyn , Berkowitz Ruth , Moore Hadass , Pitner Ronald , Astor Ron Avi , Benbenishty Rami
Published: March 2017

School climate is critical for school improvement efforts, yet questions remain regarding how best to define and measure the construct. Research demonstrates relationships between a positive school climate and important youth development and academic learning outcomes. As school climate policies continue to develop, clarification regarding the dimensions of school climate and continued research on how school climate impacts school and student outcomes remains important.
Coronary Tortuosity: A Clue to the Diagnosis of Fibromuscular Dysplasia?
Authors: van Twist Daan J. L. , de Leeuw Peter W. , Kroon Abraham A.
Published: March 2017

BACKGROUND

Fibromuscular dysplasia (FMD) is a systemic, nonatherosclerotic, noninflammatory vasculopathy that is often overlooked by clinicians. Clinical clues could help in selecting patients for further evaluation for the presence of FMD. Recently, it was observed that tortuosity of the coronary arteries is often present in patients with FMD-related abnormalities of the coronary artery. Therefore, we wondered if the presence of coronary tortuosity might provide a clinical clue to the diagnosis of extracoronary FMD.

CASES

We describe 5 cases of FMD in whom diagnostic studies for FMD were initiated because of the presence of coronary tortuosity. FMD was found in all 5 patients in the renal and/or cervical arteries.

CONCLUSIONS

Our 5 cases suggest that exertional chest pain in the presence of coronary tortuosity may be helpful in selecting patients for further evaluation for the presence of FMD. Further research should focus on the prevalence of FMD among patients with coronary tortuosity and whether the presence of additional clinical clues (such as the presence of hypertension at young age or pulsatile tinnitus) next to coronary tortuosity can predict the risk for FMD in individual patients.
Linking ecosystem processes to communities of practice through commercially fished species in the Gulf of Alaska
Authors: Zador Stephani G. , Gaichas Sarah K. , Kasperski Stephen , Ward Colette L. , Blake Rachael E. , Ban Natalie C. , Himes-Cornell Amber , Koehn J. Zachary
Published: March 2017

Marine ecosystems are complex, and there is increasing recognition that environmental, ecological, and human systems are linked inextricably in coastal regions. The purpose of this article was to integrate environmental, ecological and human dimensions information important for fisheries management into a common analytical framework. We then used the framework to examine the linkages between these traditionally separate subject areas. We focused on synthesis of linkages between the Gulf of Alaska marine ecosystem and human communities of practice, defined as different fisheries sectors. Our specific objective was to document the individual directional linkages among environmental, ecological, and human dimensions variables in conceptual models, then build qualitative network models to perform simulation analyses to test how bottom-up and top-down perturbations might propagate through these linkages. We found that it is both possible and beneficial to integrate environmental, ecological, and human dimensions information important for fisheries into a common framework. First, the conceptual models allowed us to synthesize information across a broad array of data types, representing disciplines such as ecology and economics that are more commonly investigated separately, often with distinct methods. Second, the qualitative network analysis demonstrated how ecological signals can propagate to human communities, and how fishery management measures may influence the system. Third, we found that incorporating multi-species interactions changed outcomes because the merged model reversed some of the ecological and human outcomes compared with single species analyses. Overall, we demonstrated the value of linking information from the natural and social sciences to better understand complex social–ecological systems, and the value of incorporating ecosystem-level processes into a traditionally single species management framework. We advocate for conceptual and qualitative network modelling as efficient foundational steps to inform ecosystem-based fisheries management.
Arteriogenesis versus angiogenesis
Authors: Carmeliet Peter , Eelen Guy , Kalucka Joanna
Published: March 2017

Higher organisms have a cardiovascular circulatory system with blood vessels to supply vital nutrients and oxygen to distant tissues. It is therefore not surprising that vascular disorders are leading causes of mortality. Understanding how new blood vessels form, creates opportunities to cure these life-threatening diseases. After birth, growth of blood vessels mainly occurs via two distinct mechanisms depending on the initial trigger: angiogenesis (referred here as capillary sprouting) is induced primarily by hypoxia, whereas arteriogenesis (referred here as the rapid enlargement of pre-existing collateral arteries, induced by vascular occlusion) is mainly driven by fluid shear stress. Arteriogenesis allows conductance of much larger volumes of blood per unit of time than does the increase in capillary density during angiogenesis. Notwithstanding these major differences, angiogenesis and arteriogenesis share a number of underlying mechanisms, e.g. the involvement of growth factor signalling. This chapter highlights the cellular and molecular events driving the two processes and discusses the therapeutic potential of targeting angiogenesis in cancer and arteriogenesis in cardiovascular diseases.
Atherosclerosis—a short history
Authors: Monaco Claudia , Lutgens Esther
Published: March 2017

The pathogenesis of human atherosclerotic lesions has long been debated and is still evolving nowadays. First conceptualized as chronically evolving degenerative disease initiating in the mother’s womb, then increasingly accepted as a dynamic process causing severe acute complications that jeopardize the blood flow to the heart. Evolution of the hypothesis mirrored the progress of cellular and molecular biology, leading to progressive broadening of the understanding of cell types and molecules involved in atherogenesis. This chapter describes the current histopathological view on the pathogenesis of atherosclerosis, and touches on a historical perspective weaving in the fundamental discoveries that still influence the perception of this disease in humans.
Pathogenesis of atherosclerosis: lipid metabolism
Authors: Wiklund Olov , Borén Jan
Published: March 2017

Lipids are carried in plasma as microparticles, lipoproteins, composed of a core of hydrophobic lipids and a surface of amphipathic lipids. In addition, the particles carry proteins (i.e. apolipoproteins). The proteins have key functions in the metabolism as receptor ligands, enzymes or activators. Lipoproteins are classified based on density into: chylomicrons, VLDL, IDL, LDL, and HDL. Retention of apoB-containing lipoproteins (LDL, IDL, and VLDL) in the arterial intima is the initiating event in the development of atherosclerosis. Retention is mediated by binding of apoB to structural proteoglycans in the intima. Increased plasma concentration of apoB-containing lipoproteins is the main risk factor for atherosclerotic cardiovascular disease (CVD) and the causative role of LDL has been demonstrated in several studies. Lp(a) is a subclass of LDL and elevated Lp(a) is an independent risk-factor, primarily genetically mediated. Genetic data support that high Lp(a) causes atherosclerosis. Elevated triglycerides in plasma are associated with increased risk for CVD. Whether triglycerides directly induce atherogenesis is still unclear, but current data strongly support that remnant particles from triglyceride-rich lipoproteins are causal. HDL are lipoproteins that have been considered to be important for reversed cholesterol transport. Low HDL is a strong risk-factor for CVD. However, the causative role of HDL is debated and intervention studies to raise HDL have not been successful. Reduction of LDL is the main target for prevention and treatment, using drugs that inhibit the enzyme HMG-CoA reductase, i.e. statins. Other drugs for LDL reduction and to modify other lipoproteins may further reduce risk, and new therapeutic targets are explored.
Biomechanical theories of atherosclerosis
Authors: Wentzel Jolanda J. , Rowland Ethan M. , Weinberg Peter D. , Krams Robert
Published: March 2017

Atherosclerosis, the disease underlying most heart attacks and strokes, occurs predominantly at certain well-defined sites within the arterial system. Its development may therefore depend not only on systemic risk factors but also on locally varying biomechanical forces. There are three inter-related theories explaining the effect of biomechanics on atherosclerosis. In the first theory, a central role is played by lipid transport into the vessel wall, which varies as a result of mechanical forces. In the second theory, haemodynamic wall shear stress-the frictional force per unit area of endothelium arising from the movement of blood-activates signalling pathways that affect endothelial cell properties. In the third, strain-the stretch of the wall arising from changes in blood pressure-is the key biomechanical trigger. All three theories are discussed from historical, molecular, and clinical perspectives.
Atherosclerosis: cellular mechanisms
Authors: Lutgens Esther , Bochaton-Piallat Marie-Luce , Weber Christian
Published: March 2017

Atherosclerosis is a lipid-driven, chronic inflammatory disease of the large and middle-sized arteries that affects every human being and slowly progresses with age. The disease is characterized by the presence of atherosclerotic plaques consisting of lipids, (immune) cells, and debris that form in the arterial intima. Plaques develop at predisposed regions characterized by disturbed blood flow dynamics, such as curvatures and branch points. In the past decades, experimental and patient studies have revealed the role of the different cell-types of the innate and adaptive immune system, and of non-immune cells such as platelets, endothelial, and vascular smooth muscle cells, in its pathogenesis. This chapter highlights the roles of these individual cell types in atherogenesis and explains their modes of communication using chemokines, cytokines, and co-stimulatory molecules.
Molecular mechanisms
Authors: Monaco Claudia , Caligiuri Giuseppina
Published: March 2017

The development of the atherosclerotic plaque relies on specific cognate interactions between ligands and receptors with the ability to regulate cell recruitment, inflammatory signalling, and the production of powerful inflammatory and bioactive lipid mediators. This chapter describes how signalling is engaged by cell-cell surface interactions when the endothelium interacts with platelets and leukocytes enhancing leukocyte recruitment during atherogenesis. It also exemplifies intracellular signalling pathways induced by the activation of innate immune receptors, the most potent activators of inflammation in physiology and disease. Differences are highlighted in innate signalling pathways in metabolic diseases such as atherosclerosis compared to canonical immunological responses. Finally, the key lipid mediators whose production can affect endothelial function, inflammation, and atherosclerosis development are summarized. This Chapter will take you through these fundamental steps in the development of the atherosclerotic plaque by summarizing very recent knowledge in the field and highlighting recent or ongoing clinical trials that may enrich our ability to target cardiovascular disease in the future.
Pathophysiology of vasculitis
Authors: Tombetti Enrico , Mason Justin C.
Published: March 2017

Vasculitis represents a spectrum of disorders that are often divided on the basis of the predominant vessel size affected into large-, medium- and small-vessel vasculitides. This chapter will focus on the pathogenesis of the anti-neutrophil cytoplasmic antibody (ANCA)-associated medium- and small-vessel vasculitides (AAV), and large-vessel vasculitis, Takayasu arteritis, and giant cell arteritis. Underlying pathogenic mechanisms in vasculitis remain to be fully understood. In particular, the initiating event(s) are not known. A combination of infectious or other environmental triggers on a susceptible genetic background is currently favoured. In addition to the vessel size affected, the mechanisms of vascular injury vary. Moreover, extravascular granulomatosis may play an important role in disease manifestations. The innate and adaptive immune systems contribute to its pathogenesis. Although pathogenic antibodies have not been identified in large-vessel vasculitis, ANCA are directly implicated in small- and medium-vessel AAV. Disease manifestations are varied and diverse and may include arterial stenosis or aneurysms, glomerulonephritis and renal failure, gastro-intestinal, pulmonary, cutaneous, and neurological complications, visual disturbance, deafness, and nasal bridge collapse. Life-threatening cardiovascular disease is also seen, with myocarditis, pericarditis, valvular heart disease, thrombosis, systemic and pulmonary arterial hypertension, and accelerated coronary heart disease all reported. Despite this, the prognosis for patients with vasculitis has improved significantly in recent decades. Further understanding of the pathogenesis of vasculitis will lead to the discovery of further therapeutic targets and novel, safer biologic therapies.
Wound healing
Authors: Harrison Mark
Published: March 2017

This chapter describes the pathology of wound healing as it applies to Emergency Medicine, and in particular the Primary FRCEM examination. The chapter outlines the key details of haemostasis, inflammation, reconstruction, epithelialization, and maturation, and the specific tissues affected, including skin, tendon, peripheral nerve, bone, myocardium, and brain. This chapter is laid out exactly following the RCEM syllabus, to allow easy reference and consolidation of learning.
Supportive and End-of-Life Care in the Pediatric Intensive Care Unit
Authors: Michelson Kelly N. , Frader Joel E.
Published: March 2017

Providing supportive end-of-life care is an essential component of critical care. Intensivists require excellent communication skills to convey painful information in a compassionate manner and to assist families in making difficult decisions. Both aggressive life-supporting treatment and care following a decision to withdraw or withhold life-support require attention to providing adequate comfort care, including relief of pain, anxiety, delirium, agitation, nausea, and other gastrointestinal complaints. Understanding the use of a variety of drugs, including their interactions and side effects, as well as nonpharmacological therapies, is essential. Following a decision to withdraw life support, intensivists should develop a plan that is clear to other care providers and families, minimizes further interventions, and provides as much privacy as possible. After a child dies, numerous tasks must be completed; most important among them are offering parents an opportunity for follow-up support and giving involved staff members time to gather their thoughts and feelings.
Amyotrophic Lateral Sclerosis
Authors: Harms Matthew B. , Miller Timothy M.
Published: March 2017

Recent advances in sequencing technologies have dramatically expanded the number of genes associated with amyotrophic lateral sclerosis, including rare but highly penetrant causative mutations as well as common risk alleles. This chapter discusses these gene discoveries and how they have implicated a diverse array of biological pathways essential for motor neuron health and have begun to inform our understanding of ALS pathogenesis as a heterogeneous and multistep process. Insights from these discoveries are leading to a new generation of targeted therapies directed at specific genes and are poised to inform how patients with amyotrophic lateral sclerosis are evaluated and treated in the clinic.
Nervous System Lyme Disease
Authors: Halperin John J.
Published: March 2017

Nervous system involvement occurs in 10% to 15% of patients infected with Borrelia burgdorferi, B. afzelii, or B. garinii, the tick-borne spirochetes responsible for Lyme disease and its European counterparts. Common clinical manifestations include lymphocytic meningitis, facial and other cranial neuropathies, and painful mononeuropathies such as Lyme radiculitis. Diagnosis requires appropriate clinical, epidemiological, and laboratory evidence. Appropriately interpreted serologic testing is highly reliable; cerebrospinal fluid examination is often informative if the central nervous system is involved. Several week courses of widely available oral or parenteral antimicrobials are curative in most patients.
The Concept of Trauma in Relation to the Development of the Individual Within the Family
Authors: Winnicott Donald W.
Published: March 2017

Winnicott here describes the role of the (the good enough) family as giving the growing child a protection from trauma by gradual adaptation to the child’s needs. In his work with psychiatric child cases, he is aware where this role of the family may be inadequate or indeed damaging. He draws on a variety of clinical cases to elaborate his ideas. He also writes of the first interview or therapeutic consultation with a child as important in respect of determining what the family situation may or may not provide for the work in hand. He gives a picture of what trauma and its impact is both for a child and a family.
The Psychology of Madness
Authors: Winnicott Donald W.
Published: March 2017

In this paper to the British Psychoanalytic Society, Winnicott addresses both the fear of madness met with in patients and also the actual madness of schizophrenia. He brings in the subject of early infantile development and environmental failure and proposes that a patient’s fear of madness may actually be a fear of the return of a madness already experienced. The patient in such a condition may have to come back to re-experience the madness in a regressed and nonverbal phase of unconscious process with the analyst. The danger of this work is indicated, but Winnicott also asserts there can be the hope of recovery.
The Use of an Object and Relating Through Identifications
Authors: Winnicott Donald W.
Published: March 2017

In this paper, Winnicott elaborates on a concept that occupied him in various forms and formulations towards the end of his life: the capacity of the self to relate to the object (or other) in such a way that the object (or other) is recognized as having a place outside the subjective experience of self. Winnicott refers to this as a sophisticated use of reality. He elaborates on this subject using his extensive clinical experience with patients in primitive and less primitive stages of emotional development.