bluuebunny/crossref_metadata_2025 huggingface dataset:
Desiderius Erasmus
Authors: Miola Robert S
Published: October 2023

Great Dutch humanist, scholar, and priest, Desiderius Erasmus (1459–1536) applied new philological methods to biblical texts, producing the Novum Instrumentum in 1516, an annotated Greek text of the New Testament with a revision of the Vulgate (the standard Latin translation by St Jerome). Erasmus diligently revised this work, Wnding many supporters in the Church, and many opponents, notably Gregory Martin, later translator of the Rheims New Testament (1582). Moreover, contributing to the great controversy over Luther’s doctrine of predestination, Erasmus aYrmed the freedom of the will in De libero arbitrio (On Free Will, 1524) and Hyperaspistes (1526). He wrote schoolbooks for Europe and urged reform of the clergy and of church practices (see fiction).
Alban Langdale
Authors: Miola Robert S
Published: October 2023

The Act of Uniformity (1559) stipulated harsh penalties for those who refused to attend Church of England services: Wrst oVence, forfeiture of one year’s proWt of beneWces and six months ‘ imprisonment; second oVence, deprivation and one year’s imprisonment; third oVence, deprivation and imprisonment for life. For those not beneWced, the Wrst oVence brought imprisonment for one year; the second oVence, for life (1 Elizabeth I, c. 2). The Church strongly urged recusancy, however, and Robert Persons, SJ articulated the oYcial position in A Brief Discourse containing Certain Reasons why Catholics refuse to go to Church (1580). (On Persons see histories.) Persons argued that attendance at state services brought danger of infection, gave scandal, assented to a sign distinctive between the religions, fostered schism, signalled participation in a forbidden rite, dissimulated in a matter of conscience, accepted heresies and blasphemies, removed one from the beneWts of Catholicism, and ran counter to the example even of inWdels and heretics who absented themselves from proscribed services.
Robert Bellarmine
Authors: Miola Robert S
Published: October 2023

Italian cardinal and Doctor of the Church, Robert Bellarmine (1542–1621) taught theology at Louvain and Rome, wrote a Hebrew grammar and catechisms, and emerged as the leading Catholic voice against Protestants with his Disputationes de Controversiis (1586–93). Whether. poison Mariana will answer the title question in the negative, arguing, remarkably, that such a method of assassination puts the victim’s soul at risk, implicating him in a kind of suicide.
Augustine of Hippo
Authors: Miola Robert S
Published: October 2023

Saint Augustine of Hippo (354–430) adapted classical thought to Christian doctrine and in various writings, including De civitate Dei, established the foundations for medieval and modern Christian theology. Born in north Africa, Augustine started out as a teacher, orator, and worldly man. He took a concubine for some years and had a son, Adeodatus. He fell in with the Manicheans, who believed that good and evil, light and darkness, were equal powers in conXict with each other. In 386, two years after taking the prestigious chair in rhetoric at Milan, Augustine experienced the conversion to Christ for which his mother Monica had long and fervently prayed. After giving up his post and his plans for marriage, Augustine became a priest and then bishop of Hippo (in Algeria today) until his death.
Teresa of Avila
Authors: Miola Robert S
Published: October 2023

Teresa of Avila (1515–82), a Carmelite nun, experienced a rare state of mystical union with God. Although contemporary Catholic reform movements encouraged mental prayer and the private experience of illumination, Teresa’s visions aroused scepticism and opposition. At the request of her superiors Teresa recounted her spiritual experiences in her Vida, or ‘Life’ (1562, revised several times), which the Inquisition impounded until 1586, distrustful of a woman’s claim to such unusual (and unregulated) manifestations. Teresa went on to found a number of convents in Spain, received canonization in 1622, and became a doctor of the Church in 1970.
Thomas More
Authors: Miola Robert S
Published: October 2023

Thomas More (c.1477–1535) lived as a brilliant polemicist and Lord Chancellor of England but died for refusing to assent to the Act of Supremacy, which declared King Henry VIII Supreme Head of the Church in England (see controversies). According to an act of Parliament (1534: 26 Henry VIII, c. 13), such refusal constituted high treason. Recounting the trial and execution, William Roper, his son-in-law, depicts Thomas More as a new kind of martyr, as one who died for the unity of the Catholic faith. Largely ignoring the Lord Chancellor who burned books and heretics, Roper’s account energetically counters the emergent Protestant martyrology created by John Bale and John Foxe. His Thomas More, loyal Wrst to God then king, is Wt to join St Thomas the Apostle and St Thomas Becket in the holy triumvirate of the Tres Thomae, ‘three Thomases’ (T. Stapleton, Douai, 1588). The selections below show More’s conviction and equanimity, his Xashes of wit and learning, and his profound humility in the service of God. Such qualities have made his story a mixture of high tragedy, saint’s life, and myth, compelling from its beginnings up through modern times in Robert Bolt’s moving adaptation, A Man for All Seasons.
John Donne
Authors: Miola Robert S
Published: October 2023

Descended from Thomas More, the Heywoods, and the Rastells, John Donne (1572–1631) grew up Catholic amidst the ancient Catholic nobility—the Percies, Stanleys, and Howards. Donne wrote that he had his ‘Wrst breeding and conversation with men of a suppressed and aZicted religion, accustomed to the despite of death and hungry of an imagined martyrdom ‘ (Biathanatos, 1648, sig. C). Meditation on martyrdom, inspired by his family and upbringing, he said elsewhere, kept him ‘ever. . . awake ‘ (Pseudo-martyr, 1610, sig. }1).
Ben Jonson
Authors: Miola Robert S
Published: October 2023

Cranky, learned, satirical, and brilliant, Ben Jonson (1572–1637) is one of the most distinguished poets and playwrights of the Renaissance. He wrote court masques, influential ‘humours ‘ comedy, satirical dramas, critical prefaces, and poems, much admired and imitated. According to his own testimony (Conversations with Drummond, 1. 205), Jonson was Catholic during the period of his greatest productivity, converting in 1598 through the ministrations of a priest who visited him in prison, and remaining as such until 1610. In 1604 Jonson’s Wrst version of the play Sejanus occasioned charges of popery and treason; in 1605, after the Gunpowder Plot, he used his connections in Catholic circles to assist the government; in 1606 the Consistory Court asked for certiWcation of his attendance at church and communion, indicted him as ‘a seducer of youth to the popish religion ‘, and required him to engage in theological disputation with learned Protestants.
Richard Crashaw
Authors: Miola Robert S
Published: October 2023

Son of an anti-Catholic preacher who died in 1626, Richard Crashaw (1612–49) in 1635 became a fellow of Peterhouse College, centre of Laudianism (High Church Anglicanism) or, as the Puritans charged, popery. He contributed money and wrote poems to support the restoration of the Peterhouse chapel in Roman style. From 1639 he also held the curacy at Little St Mary’s , a church adjoining Peterhouse. Crashaw’s Catholic predilections, particularly his love of iconic adornment and the Virgin, aroused the ire of Puritans.
Ignatius Loyola
Authors: Miola Robert S
Published: October 2023

A worldly soldier recovering from a wound in 1521, Ignatius of Loyola (1491–1556) read saints ‘ lives and turned his life to Christ. Undertaking a regimen of penance, study, and prayer, he attracted a small group of followers who became the Society of Jesus (the Jesuits) in 1540, founded ‘ad maiorem Dei gloriam et bonum animarum ‘ (for the greater glory of God and the good of souls). The Society diVered from other orders in its long period of formation, its refusal of ecclesiastical dignities for members, its lack of a habit and rule, and its constitutional commitment to active ministries (preaching, teaching, retreats, schools), the sacraments, and works of mercy (in hospitals, prisons, and orphanages).
Roger Martin
Authors: Miola Robert S
Published: October 2023

Roger Martin (1527?–1615) experienced the turmoil of the Protestant revolution in Long Melford, a town in SuVolk. During the reign of Queen Mary (1553–8) he became churchwarden and worked to revive Catholic ceremonies and traditions. Later, he suVered several indictments for recusancy, Wnancial penalties, and imprisonments. In an extraordinary memoir Martin recalls the Catholic church, chapels, and services of his youth—the processions, liturgies, and festivals that once ordered life and gave it meaning.
Augustine Baker
Authors: Miola Robert S
Published: October 2023

A Welsh convert to Catholicism, Augustine Baker (1575–1641) joined the Benedictines in Padua (1605) and produced (with others) Apostalatus Benedictinorum in Anglia (1626), a scholarly history of the order in Great Britain. Baker spent nine years (1624–33) in Cambrai (NE France) as spiritual adviser to Benedictine nuns, including Gertrude More (see poetry). There he wrote over forty spiritual treatises, later digested and published by Father Serenus Cressy as Sancta Sophia, ‘Holy Wisdom ‘ (1657), a guidebook to prayer now recognized as a classic of mystical theology. Drawing upon many previous writers, Sancta Sophia teaches the prayer of mystic contemplation. In this sublime prayer, the soul, without thoughts or images, experiences God directly as inWnite and incomprehensible truth and goodness (cf. Crashaw’s ‘The Flaming Heart ‘ and ‘Ode ‘, poetry).
Pericles, 1606–8
Authors: Miola Robert S
Published: October 2023

5. 1 On Pericles ‘ ship, outside Mytilene diana [appears to the sleeping Pericles] diana My temple stands in Ephesus. Hie thee thither And do upon mine altar sacriWce. 91. suVerance torture. 92. aVection passion. 95. Did If I did. 98. Either. . . approof Either to condemn or approve. 100. Hooking bending. 102. prompture impulse. 104. tender down lay down in payment. pericles Pericles adapts Catholic miracle-play traditions into romance. It formed part of the repertory of Cholmeley’s Players, a touring company which performed for Catholic households, and appeared on a book-list of mostly devotional and theological works from the Jesuit college at Saint-Omer, where it also may have been staged. At the end of the play (established as Shakespearean by B.
The Alchemist, 1610
Authors: Miola Robert S
Published: October 2023

Enter tribulation wholesome, ananias tribulation These chastisements are common to the saints, And such rebukes we of the Separation Must bear with willing shoulders, as the trials Sent forth to tempt our frailties. ananias In pure zeal, I do not like the man. He is a heathen 5 And speaks the language of Canaan, truly. tribulation I think him a profane person, indeed. ananias He bears The visible mark of the Beast in his forehead. And for his stone, it is a work of darkness, And with philosophy blinds the eyes of man. 10 tribulation Good brother, we must bend unto all means That may give furtherance to the holy cause.
Prosopopeia: The Tears of Mary, 1596
Authors: Miola Robert S
Published: October 2023

I lift not up my voice with Esau to weep. He found a brother, I have lost a son. Jacob kissed Rachel and wept for joy to see her; I kiss the body of my son and weep because I see him not. Oh, would my Rachel might be his wounds, would my concubine were his 101. let him provided that he (the man). 105. Player Devil an actor. 106–7. against impression before the next onset (of a play). 107. shift evade (me). conjure summon. 109. Eutrapelian from the Greek eutrapelia (pleasant in conversation), considered a moral virtue by Aristotle. 113. Council of Trent nineteenth ecumenical council of the Church (1545– 63), convened to combat Protestant heresies. Promulgating decrees concerning the publication and use of Scripture, Session IV (1556) concluded as follows: ‘Besides the above, wishing to repress that temerity, by which the words and sentences of sacred Scripture are turned and twisted to all sorts of profane uses, to wit, to things scurrilous, fabulous, vain, to Xatteries, detractions, superstitions, impious and diabolical incantations, sorceries, and defamatory libels; (the Synod) commands and enjoins, for the doing away with this kind of irreverence and contempt, and that no one may hence forth dare in any way to apply the words of sacred Scripture to these and such like purposes; that all men of this description, profaners and violators of the word of God, be by the bishops restrained by the penalties of law, and others of their own appointment ‘ (The Canons and Decrees of the Council of Trent, tr. J. Waterworth, 1848: 20–1). 120. bewrayed revealed.
The Excommunication of Elizabeth I (Regnans in excelsis), 1570
Authors: Miola Robert S
Published: October 2023

Pius, bishop, a servant of the servants of God, for the future memory of the business. He that rules in the heavens above and to whom all power is given both in heaven and earth gave unto one only on earth, namely, to Peter, the chiefest amongst the apostles, and to the pope of Rome, Peter’s successor, a holy, catholic, and apostolic church (without which there is no salvation), to govern it in the fullness of power.
A Reconstruction of the Intervention
Authors: Goodhart Charles , Dai Lu
Published: October 2023

As already noted in Chapter 1, the government’s intervention was not only important for Hong Kong’s financial markets, but perhaps also instructive for any future analysis of capital markets. In the foreign exchange market, central bank interventions are a fairly regular phenomenon, but, in equity markets, an intervention on such a large scale has seldom, if ever, been seen before. Moreover, it was unusually successful by most criteria (as demonstrated subsequently in Chapter 7).
Evaluation of the Intervention
Authors: Goodhart Charles , Dai Lu
Published: October 2023

The Hong Kong government’s stock market intervention was such an extraordinary and unexpected event that it at once became the focus of both local and international financial news. It immediately became controversial, and views were very divided. Supporters thought that the Hong Kong government had the right to fight back against the speculators and to protect the economy and financial markets.
Cross-national Analysis of Women in the Labour Market
Authors: Clark Robert L , york Anne , Anker Richard
Published: October 2023

Despite the continuing high levels of sexual inequality in the labour market, an increasing proportion of women joined the labour force and entered male dominated occupations in the final decades of the twentieth century. This paper documents and explains recent levels, trends, and patterns in female labour force activity in both developed and developing countries. First, the chapter examines the increasing proportion of women who are in the labour force and how activity rates vary around the world along with economic development and the accompanying higher income and lower fertility. Second, the diffusion of women throughout the labour force is assessed based on recent evidence on occupational segregation by sex.
The Rise of Conservation in South Africa
Authors: Beinart William
Published: October 2023

This book is an innovative contribution to the growing comparative field of environmental history. Beinart’s major theme is the history of conservationist ideas in South Africa. He focuses largely on the livestock farming districts of the semi-arid Karoo and the neighbouring eastern Cape grasslands, conquered and occupied by white settlers before the middle of the nineteenth century. The Cape, like Australia, became a major exporter of wool. Vast numbers of sheep flooded its plains and rapidly transformed its fragile natural pastures. Cattle also remained vital for ox-wagon transport and internal markets. Concerns about environmental degradation reached a crescendo in the early decades of the twentieth century, when a Dust Bowl of kinds was predicted, and formed the basis for far-reaching state intervention aimed at conserving natural resources. Soil erosion, overstocking, and water supplies stood alongside wildlife protection as the central preoccupations of South African conservationists. The book traces debates about environmental degradation in successive eras of South African history. It offers a reinterpretation of South Africa’s economic development, and of aspects of the Cape colonial and South African states. It expands the understanding of English-speaking South Africans and their role both as farmers and as protagonists of conservationist ideas. The book is also a contribution to the history of science, exploring the way in which new scientific knowledge shaped environmental understanding and formed a significant element in settler intellectual life. It paints an evocative picture of the post-conquest Karoo, analysing the impact of self-consciously progressive farmers and officials in their attempts to secure private property, curtail transhumance and kraaling, control animal diseases, enhance water supplies, eradicate jackals, destroy alien weeds such as the prickly pear, and combat drought. It concludes by analysing conservationist interventions in the African areas, and discussing evidence for a stabilization of environmental conditions over the longer term.
Debating Conservation in the African Areas of the Cape, 1920–1950
Authors: Beinart William
Published: October 2023

My research for this book as a whole was initially sparked by the issues addressed in the present chapter: what were the origins of the conservationist ideas that underpinned environmental regulation in African districts?1 African opposition to such conservationist intervention, apparently conceived in their best interests, is now a richly researched field.2 In both the settler states of South Africa and Zimbabwe, as well as in British colonies, the most acute phase of rural anti-colonial struggle in the 1940s and 1950s coincided with heightened government commitment to conservation and development. Agricultural schemes, which touched on the arrangement of settlements, and the control of land, labour, and livestock, were sometimes highly effective in mobilizing rural communities against the state.
Dialogues with Grand Theory
Authors: James Wendy , Lambek Michael
Published: October 2023

Modern efforts (since, say, the late eighteenth century) to make systematic, scientific investigations into the foundations of human life have been driven by a search for relatively simple explanatory principles lying beneath immediate appearances, and behind what people might actually say are the reasons for their actions. Anthropologists have played a role in developing various branches of this search, but just as often they have sought to use the enormous archive of ethnographic evidence to criticize, qualify, and contradict the generalizing theorists. It is in fact not difficult to do this, to find some group of people somewhere who do not fit a given theory.
Fuseli’s Milton Gallery
Authors: Calè Luisa Cal
Published: October 2023

Fuseli’s Milton Gallery challenges the antipictorial theories and canons of Romantic period culture. Between 1791 and 1799 Swiss painter Henry Fuseli turned Milton’s Paradise Lost into a series of 40 pictures. Fuseli’s project and other literary galleries developed within an expanding market for illustrated books and a culture of anthologization used to reading British and other ‘classics’ in terms of the visualization of key moments in the text. Thus transformed into repositories of virtual pictures literary texts became ideal sources of subjects for painters. Illustrating British literature was a way of inventing a national ‘grand style’ to fit the needs of a consumer society. Cale calls into question the separation of reading and viewing as autonomous aesthetic practices. To ‘turn readers into spectators’ meant to place readers and reading within the dizzying world of associations offered by an emerging culture of exhibitions. Attending to the energized reading effects developed by Fuseli’s Gallery we rediscover a new side of the Romantic imagination which is not the solitary mentalist experience preferred by Wordsworth and Coleridge, nor divorced from the senses, let alone a refuge from the crowded public spaces of the Revolutionary period. Rather, Fuseli’s embodied aesthetic exemplifies the associationist psychology espoused by the radical circle convening around the publisher Joseph Johnson, including Joseph Priestley and Mary Wollstonecraft. This book analyses exhibitions as important sites of Romantic sociability and one of many interrelated mediums for the literature, debates and controversies of the Revolutionary period.
All that Falls: Barthes and the Everyday
Authors: Sheringham Michael
Published: October 2023

As it happens, Henri Lefebvre was a lifelong friend of Barthes’s, who must have been familiar with Lefebvre’s 1947 Critique de la vie quotidienne when he started composing his ‘mythologies’ in the early 1950s, for publication in the review Lettres nouvelles. Biographers of the two men evoke regular meetings in Paris and in the Basque country where both had family attachments and summer residences.
Counter-terrorism measures undertaken under UN Security Council auspices
Authors: Biersteker Thomas J
Published: October 2023

An intensive debate has been carried out since 11 September 2001, within the academic community and in policy-making circles across the globe, about both the depth and the permanence of the changes in national and international policy that have taken place since the attacks. Although much uncertainty surrounds the consequences and future of practices of preventive intervention, and the acceptance of compromises of civil liberties in the pursuit of national security, one area where change has been significant is financial re-regulation. The leading and innovative role which the United Nations has played in the process is often underestimated.
Introduction
Authors: Melman Billie
Published: October 2023

Maurice Birley was rescued from the rubbish heap of history. Literally. Some-time in the summer of 2003, John T. Price, an antiquarian book dealer and collector, travelled to north Wiltshire to a sale of fans in a house previously owned by a deceased London dealer in antiques. In an adjacent old barn he came upon one lot of books piled on the floor, including a number of particularly dusty and mildewy volumes which seemed of little interest. After he had successfully bid for the lot and unearthed an additional volume from a nearby shed, Price discovered that he had become the owner of fifteen volumes of a manuscript entitled ‘Illustrations of British History’, by one Maurice Birley. Having found out that Birley had served as warden of Toynbee Hall in Whitechapel, London, between 1911 and 1914, Price appropriately made a first offer of the collection to the Hall, which accepted it.
History as a Panorama: Spectacle and the People in Thomas Carlyle, The French Revolution
Authors: Melman Billie
Published: October 2023

If anyone would have recognized the role wax shows and models came to play in the expanding and democratized urban culture and in popular politics, it would have been Thomas Carlyle. For him, ominous historical changes, involving the appearance of new actors on a distinctly urban scene, begin in the French Revolution. He breaks off his account of the days before the storming of the Bastille, pauses and ruminates on the revolutionary crowd’s parading Curtius’s busts of Jacques Necker, France’s Controller-General, and the Duc d’Orle´ans, the king’s revolutionary brother. It is 12 July 1789 and France So long shaken and wind-parched, is probably at the right inflammable point.
Self-Expression, ‘Asian Values’, and Democracy: East Asia in Global Perspective
Authors: Wang Zhengxu , Tan Ern-Ser
Published: October 2023

The emergence of a socially and politically active public has been a major factor contributing to democratization across the globe. In various societies, we are observing a public increasingly more oriented toward secular–rational and self-expression values. This process of value change is itself an outcome of modernization, a process set in motion by economic growth, urbanization, and development in information technology and mass communications. Modernization scholars, such as Inglehart and Welzel (see Chapter 2), argue that the rapid economic gains experienced by the past generations globally have predictable consequences for political modernization and democratization across a broad range of countries, including those in East Asia.
Civil Society, Social Capital, and Democracy1
Authors: Dalton Russell J
Published: October 2023

Many researchers hold that a vibrant civil society is integral for the democratic development of a nation (Diamond 1994; Linz and Stepan 1996; Inkeles 2000; Edwards, Foley, and Diani 2001). Participation in autonomous social groups supposedly produces the interpersonal skills and resources that benefit democratic participation, encourage tolerance and trust in others, broaden world perspectives, and provide practice in deliberation and decision-making. These citizen-building benefits seemingly create the ‘social capital’ that supports democratic politics. Thus, the democratic transition literature on Eastern Europe maintains that civil society is a stimulus for regime change and a foundation for consolidating democracy in post- communist nations (Rueschemeyer, Rueschemeyer, and Wittrock 1998; Howard 2003).
‘The Mobiles Are Out and the Hoods Are Up’
Authors: Bhatti Adrian
Published: October 2023

This chapter explores the relationship between policing and the communities around us. It is based on ‘gnosis’, a form of experience as learning rather than taught knowledge and seeks to demonstrate what is meant by consilience and its practical application to the ‘seven C’s’ which Thames Valley Police have identified as being at the very core of assessing the significance of events on communities and their structures. The title of this paper encourages the reader to acknowledge the different component parts of an event and how an integrated map of thinking will inform our opinion that ‘something’ is about to happen. The component parts of the assessment can be defined as the ‘seven C’s’.
Europol and the Understanding of Intelligence
Authors: Kleiven Maren Eline , Harfield Clive
Published: October 2023

Historically, intelligence has often played a peripheral role in approaches to policing, being something that added to the investigative picture (Ratcliffe, 2004b; Kleiven, 2007) or supported the operations (Nicholl, 2004: 55) rather than informing policing strategy and style. Expert advocates have long argued that intelligence is the key to success in policing (Grieve, 2004), but only recently has intelligence enjoyed strategic pre-eminence. The 1990s saw the emergence of intelligence-led policing, with resources reassigned from investigation to intelligence gathering and processing. The implementation of intelligence-led policing has not been without problems. Many police organizations have lacked an inherent intelligence-focused culture. Definitions of intelligence have been problematic, with consequential confusion about function and purpose, about the necessary knowledge required of the intelligence generators and users, about different sources of intelligence and the operational implications thereof, and the purposes for gathering and using intelligence (Kleiven, 2007).
Knowledge Management and the Effective Working of Crime and
Disorder Reduction Partnerships
Authors: Kelly Catherine
Published: October 2023

The management and structuring of the police services has experienced much change in recent years, in an effort to create services which meet the needs of a rapidly changing society. This is at a time when, as Crawford (2006) discusses, there is an increasingly contested debate in the UK focusing on the effective regulation of conduct and the politics of behaviour.
Increasing Levels of Positive End-expiratory Pressure Cause Stepwise Biventricular Stroke Work Reduction in a Porcine Model
Authors: Wood Gregory , Madsen Tobias Lynge , Kim Won Yong , Lyhne Mads Dam
Published: October 2023

Background

Positive end-expiratory pressure (PEEP) is commonly applied to avoid atelectasis and improve oxygenation in patients during general anesthesia but affects cardiac pressures, volumes, and loading conditions through cardiorespiratory interactions. PEEP may therefore alter stroke work, which is the area enclosed by the pressure-volume loop and corresponds to the external work performed by the ventricles to eject blood. The low-pressure right ventricle may be even more susceptible to PEEP than the left ventricle. The authors hypothesized that increasing levels of PEEP would reduce stroke work in both ventricles.

Methods

This was a prospective, observational, experimental study. Six healthy female pigs of approximately 60 kg were used. PEEP was stepwise increased from 0 to 5, 7, 9, 11, 13, 15, 17, and 20 cm H2O to cover the clinical spectrum of PEEP. Simultaneous, biventricular invasive pressure-volume loops, invasive blood pressures, and ventilator data were recorded.

Results

Increasing PEEP resulted in stepwise reductions in left (5,740 ± 973 vs. 2,303 ± 1,154 mmHg · ml; P < 0.001) and right (2,064 ± 769 vs. 468 ± 133 mmHg · ml; P < 0.001) ventricular stroke work. The relative stroke work reduction was similar between the two ventricles. Left ventricular ejection fraction, afterload, and coupling were preserved. On the contrary, PEEP increased right ventricular afterload and caused right ventriculo-arterial uncoupling (0.74 ± 0.30 vs. 0.19 ± 0.13; P = 0.01) with right ventricular ejection fraction reduction (64 ± 8% vs. 37 ± 7%, P < 0.001).

Conclusions

A stepwise increase in PEEP caused stepwise reduction in biventricular stroke work. However, there are important interventricular differences in response to increased PEEP levels. PEEP increased right ventricular afterload leading to uncoupling and right ventricular ejection fraction decline. These findings may support clinical decision-making to further optimize PEEP as a means to balance between improving lung ventilation and preserving right ventricular function.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
A deep learning–based system for mediastinum station localization in linear EUS (with video)
Authors: Yao Liwen , Zhang Chenxia , Xu Bo , Yi Shanshan , Li Juan , Ding Xiangwu , Yu Honggang
Published: October 2023

Background and Objectives

EUS is a crucial diagnostic and therapeutic method for many anatomical regions, especially in the evaluation of mediastinal diseases and related pathologies. Rapidly finding the standard stations is the key to achieving efficient and complete mediastinal EUS imaging. However, it requires substantial technical skills and extensive knowledge of mediastinal anatomy. We constructed a system, named EUS-MPS (EUS–mediastinal position system), for real-time mediastinal EUS station recognition.

Methods

The standard scanning of mediastinum EUS was divided into 7 stations. There were 33 010 images in mediastinum EUS examination collected to construct a station classification model. Then, we used 151 videos clips for video validation and used 1212 EUS images from 2 other hospitals for external validation. An independent data set containing 230 EUS images was applied for the man-machine contest. We conducted a crossover study to evaluate the effectiveness of this system in reducing the difficulty of mediastinal ultrasound image interpretation.

Results

For station classification, the model achieved an accuracy of 90.49% in image validation and 83.80% in video validation. At external validation, the models achieved 89.85% accuracy. In the man-machine contest, the model achieved an accuracy of 84.78%, which was comparable to that of expert (83.91%). The accuracy of the trainees' station recognition was significantly improved in the crossover study, with an increase of 13.26% (95% confidence interval, 11.04%–15.48%; P < 0.05).

Conclusions

This deep learning–based system shows great performance in mediastinum station localization, having the potential to play an important role in shortening the learning curve and establishing standard mediastinal scanning in the future.
Vulvar Ulcers: An Algorithm to Assist With Diagnosis and Treatment
Authors: Saunders Natalie A. , Welch Kathryn C. , Haefner Hope K. , Rasmussen Cindy , Margesson Lynne
Published: October 2023

Objectives

Vulvar ulcers can be challenging to diagnose, manage, and treat. Ulcers can be nonspecific in appearance and have many etiologies. Description of the lesion is very important.

Methods

An interactive vulvar ulcer algorithm was created to aid in the evaluation, diagnosis, and treatment of vulvar ulcers

Results

The algorithm flowchart begins with careful history and physical examination. Pending these, specific tests can be obtained to aid in diagnosis. The algorithm also links to appropriate treatments. The algorithm can be accessed on the International Society for the Study of Vulvovaginal Disease Web site (issvd.org). Each underlined word in the algorithm is a hyperlink that leads to a wealth of information on the topic that providers can use to direct testing and aid in diagnosis and treatment.

Conclusions

The vulvar ulcer algorithm can help clinicians with diagnosis and treatment plans.
The International Society for the Study of Vulvovaginal Disease (ISSVD) Vulvar Awareness Day Campaign: Knowledge of Vulvovaginal Diseases Among Italian Obstetrics and Gynecology Residents
Authors: Bevilacqua Federica , Selk Amanda , Stockdale Colleen , Vieira-Baptista Pedro , Adedipe Tolu , Bohl Tanja , Marozio Luca , Borella Fulvio , Gallio Niccolò , Pollano Benedetta , Robba Eleonora , Barbierato Ilaria , Benedetto Chiara , Preti Mario
Published: October 2023

Objectives

The objective of this study is to investigate vulvovaginal disease (VVD) awareness in Italian obstetrics and gynecology (Ob/Gyn) residents.

Materials and Methods

A 25-question survey on VVD basic knowledge (17 questions) and willingness to improve it (8 questions) was distributed through Ob/Gyn resident online group chats, from different Italian Universities in January 2023. A total number of 250 residents were invited to participate; 124 responses were obtained (response rate: 50%). Data were collected and analyzed using descriptive statistics through REDCap.

Results

Overall, 87 of the 124 respondents (70%) fully completed the questionnaire and represented the study group. Residents were distributed among years of residency: 15% first year, 31% second year, 23% third year, 11% fourth year, and 20% fifth year. Most (60%) never attended a VVD clinic during residency, with an increasing percentage of attendance in later residency years (15% at first year vs 65% at fifth).

Participants reported low knowledge of vulvar precancerous lesions and vulvoscopy but better knowledge of vaginitis, vulvar self-examination, and lichen sclerosus. Of the respondents, 50% were not satisfied with the education provided during residency, and more than 60% lacked confidence in managing VVD.

All participants expressed a strong desire to improve their knowledge and skills, with 100% agreeing that every gynecologist should know the “basics” and 98% wanting to improve their knowledge through webinars (45%), lessons (34%), newsletters, and videos (19%).

Conclusion

Our findings indicate a significant need to improve VVD knowledge among Italian Ob/Gyn residents. Further efforts are necessary to provide information about VVD and comprehensive training programs in Italian Universities.
Adenomyomatosis of the Gallbladder as a Cause of Abdominal Pain in Pediatrics: A Case Report of an Adolescent and a Literature Review
Authors: Almasoud Abdullah , Alvarez Fernando , Deslandres Colette
Published: October 2023

Objectives:

Adenomyomatosis (ADM) of the gallbladder is a benign condition, which is characterized by mucosal hyperplasia of the gallbladder and formation of intramucosal invagination through the thickened mucosal layer. The pathogenesis is unclear. This condition is rare in children. The aim of this publication is to present the case of a teenager with ADM of the gallbladder and review the pediatric literature on this topic.

Methods:

A 17-year-old female presented with severe postprandial right upper quadrant abdominal pains. The abdominal ultrasound revealed ADM of the gallbladder.

Results:

A curative laparoscopic cholecystectomy was performed. Since 1998, eleven of the 13 pediatrics cases reported with ADM of the gallbladder were symptomatic and a cholecystectomy was curative in all of them.

Conclusion:

ADM of the gallbladder should be considered in the differential diagnosis of recurrent right abdominal upper quadrant pains in pediatrics. Abdominal ultrasound is the best diagnostic procedure. In symptomatic patients, a cholecystectomy is curative.
Incidence of altered level of consciousness in hemorrhagic stroke survivors: associated factors from a Korean nationwide study
Authors: Ko Nayeon , Lee Hyun Haeng , Sohn Min Kyun , Kim Deog Young , Shin Yong-Il , Oh Gyung-Jae , Lee Yang-Soo , Joo Min Cheol , Lee So Young , Song Min-Keun , Han Junhee , Ahn Jeonghoon , Chang Won Hyuk , Lee Jongmin , Kim Yun-Hee
Published: October 2023

Objective

This study aimed to demonstrate the incidence of altered level of consciousness (ALOC) after hemorrhagic stroke and identify factors associated with ALOC at 3 months post-stroke.

Design

This study used data from a prospective multicenter cohort study conducted in nine hospitals in Korea, and included 1,677 patients with first-ever hemorrhagic stroke. Patients were dichotomized into those with and without ALOC at 3 months post-stroke. Multivariate logistic regression analysis was performed to identify factors associated with subacute to chronic stage ALOC.

Results

Among patients with hemorrhagic stroke (age: 20–99 years, female 50.21%), the prevalence of ALOC at admission was 38.58% (25.4% [drowsy], 6.38% [stupor], and 6.8% [coma]) and 17.29% 3 months post-stroke. Multivariate logistic regression analysis revealed that independent factors associated with ALOC at 3 months post-stroke included late seizure (odds ratio [95% confidence interval]: 5.93 [1.78–20.00]), stroke progression (3.84 [1.48–9.64]), craniectomy (2.19 [1.19–4.00]), history of complications (1.74 [1.18–2.55]), age at stroke onset (1.08 [1.07–1.10]), and initial GCS score category (0.36 [0.30–0.44]).

Conclusion

The factors associated with ALOC at 3 months post-stroke should be considered when explaining long-term consciousness status and focused management of modifiable factors in acute care hospitals could help ameliorate ALOC and promote recovery after stroke.
Surgical Occlusion Setup and Skeletal Stability of Correcting Cleft-Associated Class III Deformity Using Surgery-First Bimaxillary Surgery
Authors: Liao Yu-Fang , Lu Ting-Chen , Chang Chun-Shin , Chen Ying-An , Chen Yun-Fang , Chen Yu-Ray
Published: October 2023

Background:

This study aimed to assess the 3-dimensional quantitative characteristics of the surgical occlusion setup in surgery-first cleft orthognathic surgery, and to evaluate its influence on postsurgical skeletal stability.

Methods:

This prospective study was composed of 35 patients with unilateral cleft lip and palate and class III deformity who consecutively underwent 2-jaw surgery with the surgery-first approach. Digitized dental models were analyzed to quantify the 3-dimensional characteristics of the final surgical occlusion setup. Cone-beam computed tomography was used to measure the 3-dimensional surgical skeletal movement and postsurgical skeletal stability. The correlation between skeletal stability and surgical occlusal contact or surgical skeletal movement was also evaluated.

Results:

Patients treated with the surgical occlusion setup had a large incisor overjet and positive overbite, as well as buccal cross-bite and open bite on second molars. Occlusal contact on 3 segments was present in 51.4% of the patients, and the average number for tooth contact was 4.3 teeth. No correlation was found between maxillary or mandibular stability and surgical occlusal contact. However, a significant correlation was found between maxillary and mandibular stability and the surgical skeletal movement.

Conclusions:

The surgical occlusion for correction of cleft-associated class III deformity using the surgery-first approach was characterized by large overjet and positive overbite, along with posterior cross-bite and open bite. On average, there was occlusal contact on 4 to 5 teeth; half of surgical occlusion setups had contact on 3 segments. The postsurgical skeletal stability was related not to the surgical occlusal contact but to the surgical skeletal movement.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, III.
Characterization and Risk Factors of Folliculitis after Hair Transplantation: A Multicenter Retrospective Study
Authors: Zhou Yi , Zhang Jiaxian , Yi Yanhua , Xie Xiang , Lei Rui , Fan Zhexiang , Sun Pingping , Hu Zhiqi , Qu Qian , Miao Yong
Published: October 2023

Background:

Postoperative folliculitis is a common complication of hair transplantation (HT) requiring effective preventive interventions. This study characterized postoperative folliculitis and determined risk factors in patients undergoing HT.

Methods:

The authors retrospectively reviewed 1317 patients who underwent HT and completed 9-month follow-up between January of 2018 and June of 2021 at 4 medical centers. The incidence of postoperative folliculitis and demographic characteristics were assessed. Logistic regression analysis was used to identify risk factors, and the characteristics of different types of folliculitis were compared.

Results:

The overall incidence of postoperative folliculitis was 12.11%, and clinical characteristics varied among the different types of folliculitis. Surgery in summer (OR, 1.772 [95% CI, 1.05 to 2.992]), number of transplant grafts 4000 or greater (OR, 4.818 [95% CI, 1.45 to 16.014]), transplant density greater than 45 grafts/cm2 (OR, 2.152 [95% CI, 1.376 to 3.367]), and first nursing time greater than 3 days (OR, 1.555 [95% CI, 1.088 to 2.223]) were the main risk factors for postoperative folliculitis.

Conclusions:

Postoperative folliculitis after HT presents different characteristics. Surgical factors and postoperative nursing care were demonstrated to be related to folliculitis. The authors propose a preventive folliculitis model based on preoperative, intraoperative, and postoperative factors.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
The Donut DIEP Flap: A Novel Scarless Technique
Authors: Jwa Seung Jun , Choi Jae Hyeok , Lee Seung Jun , Yang Eun Jung , Song Seung Yong , Lew Dae Hyun , Lee Dong Won
Published: October 2023

Deep inferior epigastric perforator (DIEP) flap surgery is a common technique for breast reconstruction. However, the long and noticeable abdominal scar is one of its greatest disadvantages. Here, the authors suggest a minimal scarring DIEP flap harvest with a novel abdominal design. The key to this method is to preserve more skin tissue with a circular design centered around the navel. Three circular incisions are made: (1) the smallest circle represents an incision around the umbilicus; (2) the middle circle with a radius of less than 3.5 cm indicates another skin incision because the donut-like skin paddle between the small and middle circles is included in the flap; and (3) the largest circle with a radius of greater than 10 cm represents the extent of flap dissection that was performed diagonally from the skin toward the Scarpa fascia. Pedicle dissection proceeds with the conventional method. For closure, a purse-string suture is performed with the umbilicus at its center, leaving only a single small circular scar around the umbilicus as the final scar. Closure of the donor-site is possible with the patient in a supine or slightly flexed position because of less skin excision.
Life expectancy of people with HIV on antiretroviral therapy in Spain
Authors: Jarrín Inma , Rava Marta , Del Romero Raposo Jorge , Rivero Antonio , Del Romero Guerrero Jorge , De Lagarde María , Martínez Sanz Javier , Navarro Gemma , Dalmau David , Blanco José Ramón , Koerting Ana , Gomez Castell Javier , Del Amo Julia ,   CoRIS∗
Published: October 2023

Objective:

To estimate life expectancy of people with HIV (PWH) and describe causes of death.

Design:

Antiretroviral therapy (ART)-naive adults from the CoRIS cohort starting ART in 2004–2019.

Methods:

We calculated life expectancy at age 40 for men and women according to their ART initiation period, and stratified by transmission category, CD4+ cell count and AIDS diagnosis. We estimated life expectancy in 10-year age bands using life tables constructed from mortality rates, estimated through Poisson models.

Results:

Life expectancy increased from 65.8 [95% confidence interval (CI) 65.0–66.6] in 2004–2008 to 72.9 (72.2–73.7) in 2014–2019 in men [general population comparators (GPC): 79.1 and 81.2 years, respectively] and from 65.8 (65.0–66.6) to 72.5 (71.8–73.3) in women (GPC: 84.9 and 86.4, respectively). Non-AIDS-related deaths accounted for 68% of deaths among men and 78% among women. Life expectancy was longer when starting ART with higher CD4+ cell counts and without AIDS. For men acquiring HIV through sex with men, starting ART in 2014–2019 without AIDS, life expectancy was 75.0 (74.2–75.7) with CD4+ cell count less than 200 cells/μl, rising to 78.1 (77.5–78.8) with CD4+ cell count at least 350 cells/μl. Corresponding figures were 70.1 (69.4–70.9) and 76.0 (75.3–76.7) for men acquiring HIV heterosexually (HTX) and 61.5 (60.7–62.3) and 69.0 (68.2–69.8) for those acquiring HIV through injection drug use (IDU). For women starting ART from 2014 without AIDS, life expectancy increased from 71.7 (71.0–72.4) to 77.3 (76.7–77.9) among HTX and from 63.7 (62.9–64.5) to 70.7 (70.0–71.5) among IDU.

Conclusion:

Our findings confirm the progressive improvement of life expectancy in PWH in Spain over the last decades, supporting the insurability of PWH on suppressive ART in our current setting and time.
Base-to-apex Gradient Pattern Assessed by Cardiovascular Magnetic Resonance in Takotsubo Cardiomyopathy
Authors: Cau Riccardo , Muscogiuri Giuseppe , Palmisano Vitanio , Porcu Michele , Pintus Alessandra , Montisci Roberta , Mannelli Lorenzo , Suri Jasjit S. , Francone Marco , Saba Luca
Published: October 2023

Objectives:

The purpose of this study was to investigate the base-to-apex gradient strain pattern as a noncontrast cardiovascular magnetic resonance (CMR) parameter in patients with Takotsubo cardiomyopathy (TTC) and determine whether this pattern may help discriminate TTC from patients with anterior myocardial infarction (AMI).

Materials and Methods:

A total of 80 patients were included in the analysis: 30 patients with apical ballooning TTC and 50 patients with AMI. Global and regional ventricular function, including longitudinal (LS), circumferential (CS), and radial strain (RS), were assessed using CMR. The base-to-apex LS, RS, and CS gradients, defined as the peak gradient difference between averaged basal and apical strain, were calculated.

Results:

The base-to-apex RS gradient was impaired in TTC patients compared with the AMI group (14.04 ± 15.50 vs. -0.43 ± 11.59, P=0.001). Conversely, there were no significant differences in the base-to-apex LS and CS gradients between the AMI group and TTC patients (0.14 ± 2.71 vs. -1.5 ± 3.69, P=0.054: -0.99 ± 6.49 vs. ±1.4 ± 5.43, P=0.47, respectively). Beyond the presence and extension of LGE, base-to-apex RS gradient was the only independent discriminator between TTC and AMI (OR 1.28; 95% CI 1.08, 1.52, P=0.006) in multivariate logistic regression analysis.

Conclusion:

The findings of this study suggest that the pattern of regional myocardial strain impairment could serve as an additional noncontrast CMR tool to refine the diagnosis of TTC. A pronounced base-to-apex RS gradient may be a specific left ventricle strain pattern of TTC.