bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperinclusivity, Hypercanonicity, and the Future of the Field
Authors: Güthenke Constanze , Holmes Brooke
Published: July 2018

The canon has long served as a means of controlling the information that the professional classicist, who is facing a vast field of potentially relevant material, can be expected to possess. But recent developments (e.g. the rise of reception studies, a broadened definition of the ancient Mediterranean, comparative antiquities) have put pressure on this strategy. In this chapter we consider the limitations of two possible responses to such a situation—what Sheldon Pollock has called ‘hypercanonicity’, a doubling down on the canon, and ‘hyperinclusivity’, an attempt to encompass everything—before advocating what we call the ‘open field’, an embrace of the many different and singular configurations of knowledge that are coming to define the classicist in the twenty-first century.
On the Alleged Bastardy of Rhesus
Authors: Fantuzzi Marco
Published: July 2018

The literary agenda and ambitions of the Rhesus ascribed to Euripides have not always received as much autonomous consideration as its authorship, a problem that has hindered a serious examination of the specific aspirations of poetics of this text as a late fourth-century play. The first part of this chapter will revisit past evaluations of the Rhesus’ authorship and quality, in order to ascertain when and how the condemnation of its artistic achievements joined and justified the doubts on its authenticity. The second part will show how the Rhesus engages in sophisticated intertextual and generic plays that give ample testimony to the skilfulness of its composition, so that many of what seemed embarrassingly non-Euripidean/non-fifth-century features turn out to be, possibly, suitable for a late fourth-century dating.
Mining, Political Settlements, and Inclusive Development in Peru
Authors: Bebbington Anthony , Abdulai Abdul-Gafaru , Bebbington Denise Humphreys , Hinfelaar Marja , Sanborn Cynthia A. , Achberger Jessica , Huber Celina Grisi , Hurtado Verónica , Ramírez Tania , Odell Scott D.
Published: July 2018

This chapter examines how political factors have influenced mineral extraction, governance, and development in Peru since the late nineteenth century. It argues that the legacies of the past have weighed heavily in contemporary governance, but also points to periods in which shifting political alliances and agency aimed to alter past legacies and introduce positive institutional change. The chapter identifies three periods with distinct and relatively stable arrangements for the distribution of power. For the most recent, post-2000 period, it discusses how government responses to social conflict included the creation of institutions to redistribute mining rents, regulate environmental impacts, and promote indigenous participation. However, it argues that political instability and fragmentation have inhibited the effectiveness of these institutions and of longer-term policymaking in general, which in turn explains Peru’s persistent reliance on natural resource extraction and the challenges to more inclusive and sustainable development.
Introduction
Authors: Trakakis N. N.
Published: July 2018

The ‘problem of evil’—whether conceived broadly as the challenge of reconciling evil and imperfection with a commitment to ultimate justice, goodness, or harmony in the universe, or more narrowly in (say) theistic terms as the problem of reconciling the existence of an absolutely perfect being with the existence of sin and suffering—has a long and venerable history, exercising some of the finest minds from ancient to modern times. However, as will be discussed below, in recent philosophy of religion the debate seems to have reached a stalemate, where opposing camps rehearse tired and familiar lines of argument that remain singularly unconvincing to one another, giving the entire debate the character of what Imre Lakatos called a ‘degenerating research program’. In reaction to this, signs have begun to emerge that the problem of evil and the discipline at large are on the cusp of a breakthrough that promises to bring to the forefront a series of imaginative, suggestive, and innovative, though unfortunately neglected, approaches to the nature of divinity and its relationship to evil. The present collection of dialogical essays is put forward as a contribution to this renewal....
The Problem of Suffering
Authors: Stump Eleonore
Published: July 2018

In this chapter, suffering is described as a function of what a person cares about, so that for a human being to suffer is for him or her to be kept from flourishing. But what we care about has a subjective side too—denoted as ‘the desires of the heart’. Thus, the ‘problem of suffering’ is the task of accounting for the fact that many people are kept from flourishing, or from having the desires of their heart, or both. With respect to flourishing, the chapter follows Aquinas in regarding suffering as “God’s medicine for human beings,” and this claim is supported by allusion to empirical studies on ‘adversarial growth’. But the more obstinate problem is why people fail to get the desires of their heart and are heartbroken as a result, and to answer this the chapter turns from Aquinas to the biographies of John Milton and Claiborne Park.
‘all things as they might be’
Authors: Hazzard Oli
Published: July 2018

Chapter 2 is the first critical consideration of the relationship between Ashbery and F. T. Prince. It attends to the extensive correspondence between the two poets—held at Harvard and the recently opened F. T. Prince archive at the University of Southampton—which is particularly rich in discussion of the subject of national literatures. Through analysis of Prince’s first volume, Poems, and Ashbery’s Some Trees, it suggests that Prince’s work provided a model for Ashbery’s ‘encrypted’ early lyrics addressing his homosexuality. In the sec section, the correspondence is employed to identify further points of interaction between the two poets’ work. ‘Clepsydra’ is read as building closely upon Prince’s ‘The Tears of a Muse in America’, and presented as an early elaboration of Ashbery’s incipient conception of a reciprocal influential model.
Divide and Conquer
Authors: Kronfeldner Maria
Published: July 2018

The term ‘human nature’ can refer to a classificatory nature, descriptive nature, or an explanatory nature. In the main, this chapter focuses on the explanatory concept and why this usage has led to the continual contestation of the term within the sciences. The claim is that even if the contents of talk about ‘nature’ varied historically, the term’s pragmatic function of demarcation stayed the same. Analysing this demarcation, which has social as well as epistemic aspects, in various historical contexts will help us to understand why the explanatory role has been important. The term ‘nature’ conveys scientific authority over a territory; ‘human nature’ is a concept used to divide causes, as well as experts, and thereby conquer others who threaten to invade one’s epistemic territory.
The Beginnings of Resistance
Authors: DeJonge Michael P.
Published: July 2018

With this chapter, the book transitions from a presentation of Bonhoeffer’s political thinking to an account of his resistance thinking in action. This chapter also begins the presentation of the first of the three phases of resistance, which lasts from 1932 until 1935. The chapter focuses on “The Church and the Jewish Question” (1933), the central text of this first phase, identifying in it the first two of Bonhoeffer’s six types of resistance: individual and humanitarian resistance to state injustice (type 1) and the church’s resistance through diaconal service to the victims of state injustice (type 2). These set the stage for Chapters 6–8’s considerations of resistance through the church’s preaching office, which is the central agent of resistance in the first phase.
The Indirectly Political Word of the Church
Authors: DeJonge Michael P.
Published: July 2018

This chapter continues the examination of Bonhoeffer’s first phase of resistance through an exposition of “The Church and the Jewish Question,” turning now to the modes of resistance proper to the church’s preaching office. Because such resistance involves the church speaking against the state, it appears to stand in contradiction with Bonhoeffer’s suggestion earlier in the essay that the church should not speak out against the state. This is in fact not a contradiction but rather the coherent expression of the political vision as outlined in the first several chapters of this book, which requires that the church criticize the state under certain circumstances but not others. The specific form of word examined here is the indirectly political word (type 3 resistance) by which the church reminds the messianic state of its mandate to preserve the world with neither “too little” nor “too much” order.
Into the Conspiracy
Authors: DeJonge Michael P.
Published: July 2018

This chapter begins examination of the third phase of Bonhoeffer’s resistance, beginning in 1939 and characterized by his participation in a conspiracy to kill Adolf Hitler and overthrow the Third Reich. Notwithstanding the novel character of this kind of resistance in Bonhoeffer’s resistance activity and thinking, much of his thinking about resistance remains stable in this third phase. As this chapter shows with reference especially to Ethics, the main text from this phase, Bonhoeffer remains committed to the two kingdoms, the orders (although these are now named mandates), and the relationship of church and state articulated early in the resistance. Similarly, Bonhoeffer continues to affirm the types of ecclesial resistance developed in the first two phases of resistance (types 2 through 5).
Theodore of Mopsuestia
Authors: Ondrey Hauna T.
Published: July 2018

Chapter 2, “Theodore of Mopsuestia: The Twelve within the First Age,” identifies the primary role Theodore assigns the Twelve Prophets in their ministry to Old Testament Israel as predicting future events in order to demonstrate God’s care, sovereignty, and providential oversight of Israel’s history. He additionally emphasizes the prophets’ revelatory role in educating Israel of the one creator God and his attributes. Consistent with his Commentary on John and catechetical homilies, Theodore is insistent that none of the Trinitarian hypostases was revealed prior to Christ’s Trinitarian command at Matthew 28. However, Theodore does identify some prophecies as having their literal fulfilment in the New Testament, distinct from both types and retrospective accommodation. Yet even as this reinstates christological prophecy within Theodore’s Old Testament exegesis, it exposes his problematic Christology, as he clearly separates the son of David from the Son of God.
Theodore of Mopsuestia
Authors: Ondrey Hauna T.
Published: July 2018

Chapter 4, “Theodore of Mopsuestia: The Twelve as Christian Scripture,” considers the meaning Theodore draws from the texts of the Twelve Prophets as Christian scripture. Whereas scholars have largely denied any Christian value to Theodore’s Old Testament interpretation, this chapter demonstrates that Theodore offers a self-consciously Christian reading of the Twelve. In Theodore’s reading, the texts bear witness to the continuity of God’s providential guidance of history that has Christ as its telos. Additionally, Theodore finds the prophetic and typological correspondences between the Two Ages established by God in order to highlight the superiority of the benefits secured by Christ and thus increase the faith of those who live after the inauguration of the Second Age, awaiting its consummation at the general resurrection. Finally, Theodore affirms the ongoing catechetical value of the prophets’ foundational teaching of monotheism and the absolute distinction between Creator and creation.
Science and Humanity
Authors: Steane Andrew
Published: July 2018

This volume offers an in-depth presentation of the structure of science and the nature of the physical world, with a view to showing how it complements and does not replace other types of human activity, such as the arts and humanities, spirituality and religion. The aim is to better inform scientists, science educators, and the general public. Many think that science can and does establish that the natural world is a vast machine, and this is the whole truth of ourselves and our environment. This is wrong. In fact, scientific models employ a rich network of interconnecting concepts, and the overall picture suggests the full validity of further forms of truth-seeking and truth-speaking, such as art, jurisprudence, and the like. In fundamental physics, the equations that describe physical behaviour interact in a subtle symbiotic way with symmetry principles which describe overarching guidelines. The relationship between physics and biology is similar, and so is the relationship between biology and the humanities. Darwinian evolution is an exploratory mechanism which allows richer patterns and truths to come to be expressed; it does not negate or replace those truths. The area of values, of what can or should command our allegiance, requires a different kind of response, a response that is not completely captured by logical argument, but which is central to human life. Religion, when it is understood correctly and done well, is the engagement with the idea that we have a meaningful role to play, and much to learn.
Purpose and Cause
Authors: Steane Andrew
Published: July 2018

The distinction between purpose (‘in order that what?’) and cause (‘owing to what?’) is spelled out. The aim is to unpick the confusion of these concepts that takes place in the writing of Richard Dawkins, especially in The Selfish Gene. Science is a discipline which is competent to address the second question, but which mostly does not address the first. However, it does not follow from this that scientific discourse must conclude that there is no purpose, or that the question of purpose is meaningless. To think that is to misunderstand the very nature of the discourse which scientific model-making embarks upon. Rather, intellectual discipline must be respected. The question of purpose is informed by science, but not answered by it. Furthermore, high-level languages applied to human life are valid and insightful. The products of Darwinian evolution are not defined by their role in multiplication of genes.
Encounter
Authors: Steane Andrew
Published: July 2018

This brief chapter summarizes the relationship between science and religion in four paragraphs of prose poetry.
Psychological Stability
Authors: Sugden Robert
Published: July 2018

Chapter 8 asks what properties a market economy must have if it is to be psychologically stable—that is, if it is to reproduce a general belief that its governing principles are fair. I argue that, because of the division of knowledge and because the opportunities open to each person depend on how other people choose to use their opportunities, full equality of opportunity is not compatible with a market economy. Psychological stability has to rest on continuing expectations of mutual benefit, defined relative to a baseline that evolves over time and that cannot be justified in terms of abstract principles of fairness. However, if the market is to be recommended to each individual separately, each individual must be able to expect to share in the benefits that markets create. Maintaining such expectations typically requires redistributive mechanisms.
The Law of the Sea and Natural Resources
Authors: Ranganathan Surabhi
Published: July 2018

Ranganathan’s chapter observes that the construction of the oceans as a global commons has changed over time. Once asserted as an arena of freedoms, the oceans are now enclosed in large part within national and international jurisdictions. However, sovereign rights are accompanied by community obligations. The deep seabed and its mineral resources, in particular, are designated the common heritage of mankind. The chapter traces the evolution of this concept. Following a roughly chronological approach, it situates legal developments in political and economic context. Noting that the concept does not conform to a broad narrative of progress—a high-water mark reached in the 1980s was followed by a period of recession—the chapter evaluates whether the current framework offers an appropriate expression. It supplies the tools for a fine-grained analysis of the degree to which international law realizes this particular community obligation in principle and in practice.
Community Interests in World Trade Law
Authors: Tietje Christian , Lang Andrej
Published: July 2018

The authors argue that WTO law protects the community interest of promoting an essentially rules-based and fair world market. The core concern of WTO law is to protect trade-conducive structures that enable and further global economic activity for the purpose of generating overall welfare. The foundational principles of national treatment and most favored nation aim at protecting the equality of competitive conditions between WTO members. Derogations from WTO law are strictly limited whenever these principles are affected. The WTO enforcement regime entitles virtually every member to bring a complaint if a nondiscrimination obligation is breached. Although bilateral elements have long been dominant and still prominently exist in the WTO legal order, communal elements are slowly overlapping and superseding bilateral elements as part of the legal and institutional transformation of the world trade system brought about by the founding of the WTO, in particular the establishment of the Appellate Body.
Expressivism
Authors: Ridley Aaron
Published: July 2018

This chapter distinguishes between two general approaches to agency in modern philosophy. The first, ‘empiricism’, regards will and action as related causally: the details vary widely, but proponents of empiricism include Descartes, Hume, and most contemporary philosophers of agency. The second approach, ‘expressivism’, regards will and action as related constitutively: again there are differences of detail, but proponents of expressivism include Hegel, Schopenhauer, and, on certain readings of him, Wittgenstein. This chapter argues that the empiricist approach has difficulty in accommodating some of the (highly plausible) intuitions that underpin the expressivist approach; and it defends and develops those intuitions in order to suggest that the emphases characteristic of expressivism still have a claim on our attention, current orthodoxies notwithstanding.
Richard Yeo, Notebooks, English Virtuosi, and Early Modern Science; Renée Raphael, Reading Galileo. Scribal Technologies and the Two New Sciences
Authors: Heilbron John
Published: July 2018

This chapter assesses the problems faced by the English virtuosi: how to record and retrieve items of interest encountered in reading, conversation, lectures, observations, and experiments. The arrangement of excerpts from reading under subjects or categories developed during the sixteenth century literally into a commonplace, a ‘common-place’ book being a compendium of excerpts classified by the subjects they had in common. This ancestry raises the problem that virtuosi who decried the ‘bookish practices’ of sixteenth-century scholarship nonetheless used a method characteristic of it. Moreover, some virtuosi sometimes criticized common-placing as inhibiting to reading and destructive of memory. Hence the second problem: how reliance on note-taking came to displace reliance on memory.
The Constitution of Mental Content in the imaginatio
Authors: Renz Ursula
Published: July 2018

This chapter addresses Spinoza’s concept of the imagination. It first shows that, given the usage of the term imaginatio in the Ethics, Spinoza’s understanding departs from tradition by comprising both perceptions and fantasies under one single concept. Consistently, Spinoza’s treatment of the process referred to as imaginari accounts for both the realist underpinning of any cognition and the tendency of human thought to represent the external world in a distorted manner. Finally, it is argued that Spinoza’s views on the imagination are such as to enable cultural, historical, or—more generally—semantic influences to play a considerable role in the determination of our actual mental content. In sum, the chapter shows how Spinoza’s treatment of the cognitive processing of imaginative ideas contributes to making his realist rationalism a plausible option as it allows for genetic reconstructions of mental contents in great detail.
Epistemology
Authors: Renz Ursula
Published: July 2018

This chapter discusses a handful of epistemological concepts that are crucial for the possibility of producing successful explanations. It begins by examining the distinction between truth and adequacy, which is interpreted as a prerequisite for Spinoza’s epistemic perfectionism. It continues by considering the claim that there are ideas of any idea in God. Rather than assuming that all ideas are accompanied by reflexive ideas, it is argued, Spinoza posits the possibility of forming ideas of any given idea. Next, it discusses the concept of common notions and shows that Spinoza uses it to defend a general principle for the reliable framing of concepts that allows us to obtain adequate knowledge of certain properties. Finally, the chapter examines what amounts to intuitive knowledge, arguing that it is the ultimate goal of all epistemic effort for Spinoza: to intuitively know some object is to have complete comprehension of its complete determinateness.
Gregory of Nyssa's Doctrinal Works
Authors: Radde-Gallwitz Andrew
Published: July 2018

The first monograph on Gregory of Nyssa’s entire corpus of works on the Trinity and the economy of Christ, this book argues that the numerous explicit parallels and links among the works suggest that the corpus is best studied synoptically. Despite differences of theme and intention, Gregory’s Trinitarian works center on the baptismal confession of Matthew 28:19, which Gregory reads as Christ’s own creed, and which, on his reading, presents an account of all divine activity as being accomplished in the Spirit. Gregory argues against both Eunomius and the Pneumatomachians that the Spirit’s act of giving the divine life in baptism should not be deemed inferior to the act of creation; Gregory’s metaphysical and epistemological arguments are subservient to this theme. The book also proposes a developmental reading of Gregory’s works Christ’s saving economy. Rather than assessing Gregory’s Christology by reference to a single systematic model, the book’s second part shows how the governing metaphors and models by which Gregory articulated his position shifted as he responded to various criticisms and addressed the various feasts of the Christian liturgical cycle. An integrated study of the various types of writing in Gregory’s corpus—from public orations proclaimed before imperially sponsored councils to festal homilies to extended treatises—the book offers new insights into the role of a leading bishop in the Theodosian empire and connects important parts of his literary output with the tasks given to him by the councils meeting in Constantinople in the years AD 381–3.
One Deity: A Reading of Against Eunomius 2 and To Ablabius
Authors: Radde-Gallwitz Andrew
Published: July 2018

This chapter demonstrates previously overlooked connections between Against Eunomius 2 and To Ablabius. It begins with a new interpretation of the former, starting from two texts that Gregory mentions explicitly there: Plato’s Cratylus and his own Apologia in Hexaemeron. Scholars have long taken Gregory’s claim that Eunomius was following Plato’s Cratylus at face value, without noting the deeper influences of that Platonic dialogue on Gregory’s own view of theological language, as evidenced in both Against Eunomius 2 and the Apologia in Hexaemeron. Gregory’s etymological approach to the term “God” as naming a divine activity draws on the Cratylus. It forms the basis for Gregory’s account of the divine unity in To Ablabius, where he responds to the allegation of teaching three gods. Gregory correlates the single activity of Father, Son, and Spirit with the unity of will, power, and activity in an intentional act.
The Virgin’s Child
Authors: Radde-Gallwitz Andrew
Published: July 2018

This chapter claims that in 382–3, Gregory devoted increasing attention to the incarnation as such and therefore to the constitutive elements of Christ’s humanity, and that he did so in response to criticisms of his own previous writings. As before, his account of Christ’s saving work relies upon chains of biblical imagery and metaphors, but in the Antirrheticus against Apollinarius and other works such as Epistle 3, the point of transformation is placed at the nativity rather than merely after the passion. The model of mixture accordingly shifts away from one of humanity’s absorption into divinity. A new account is offered for the situation lying behind Epistle 3, and the connection of that work to both the Council of Constantinople in 382 and the dispute over Cyril of Jerusalem’s legitimacy.
The Microstructure of Organizations
Authors: Puranam Phanish
Published: July 2018

This book synthesizes a decade of research by the author into fundamental issues in organization design. The result is a novel micro-structural perspective on organizations, which aims to both expand and narrow current thinking. The new perspective takes an expansive view on the kinds of phenomena that can be studied in terms of organization design- such as cross–functional teams, strategic partnerships, buyer-supplier relations, alliance networks, mega-projects, post-merger integration, business groups, open source communities, and crowdsourcing, besides traditional concerns with bureaucratic organizations. At the same time, this approach narrows focus by abstracting away from the variety and complexity of organizations to a few fundamental and universal problems of organizing (that relate to how they aggregate their members’ efforts), as well as a few reusable building blocks microstructures (which capture common patterns of interaction between members of an organization). The microstructural approach to organizations will be of interest to researchers and PhD students in management, organization science, and strategy
Formal and Informal Structure of Organization
Authors: Puranam Phanish
Published: July 2018

In this chapter, my aim is describe the links between the formal and informal structure of organizations, and propose a systematic approach to analyzing these links. I first discuss how the two are related and influence each other. Next, revisiting the theme of organizations as “marvels but not miracles” I argue that formal design can be useful even when it not predicated on high levels of comprehension or intelligence. This is because it can compensate for aspects of the informal organization, as well as shape the emergence of the informal organization. I discuss an instance of a micro-structural approach to such issues in some detail, and conclude by offering a multiplex network formulation that can help us make progress in studying the complex interactions between formal and informal organizational structures.
Inflectional morphology of medieval Hispano-Romance
Authors: Dworkin Steven N.
Published: July 2018

This chapter describes the inflectional nominal, pronominal, and verbal morphology of Old Spanish, a language whose texts show a great deal of formal variation. It first deals with nominal gender and plural marking before going on to describe the morphology of articles, demonstratives, and possessives. Attention next turns to the forms of subject and object pronouns, indefinite, interrogative, and relative pronouns, negators, and adverbs. The rest of the chapter deals with inflectional verbal morphology. It opens with a survey of the three conjugation classes, the relevant past participles, and morphophonological alternations involving monophthongs and diphthongs in verb stems, before examining for each synthetic and analytic tense the wide range of relevant verbal suffixes or endings and instances of stem alllomorphy in both the indicative and subjunctive.
CT Imaging of Primary Pulmonary Lymphoma
Authors: Lynch Peter , Landis Mark
Published: July 2018

Primary pulmonary lymphoma is a relatively uncommon disease in both the thoracic and lymphoproliferative spectrum of cancers, accounting for only up to 1% of primary pulmonary malignancies and fewer than 1% of all lymphomas.1 Diagnosis requires pathologic confirmation of the lymphoproliferative disorder in the lungs, with no detectable extrathoracic manifestations of the disease for at least 3 months after the initial diagnosis to avoid accidental inclusion of lymphoma that has secondarily progressed to involve the lungs.
Systematic Review: What Is the Evidence for the Side-Lying Position for Feeding Preterm Infants?
Authors: Park Jinhee , Pados Britt Frisk , Thoyre Suzanne M.
Published: July 2018

Background:

Side-lying position is an increasingly common feeding strategy used by parents, nurses, and feeding therapists to support oral feeding in preterm infants. Better understanding of the research evidence on the effect of the side-lying position will help clinicians make informed decisions and guide future research in this important area.

Purpose:

To identify and summarize the available evidence on the effect of side-lying position on oral feeding outcomes in preterm infants.

Methods/Search Strategy:

PubMed, CINAHL, Web of Science and PsycINFO were searched for (“preterm” OR “premature”) AND “feed*” AND “position*”. The full text of 47 articles was reviewed to identify eligible studies that use a quasi-experimental or experimental design to examine the intervention effectiveness; 4 studies met criteria.

Findings/Results:

Four studies compared the effect of the side-lying position with either the semi-upright, cradle-hold, or semi-reclined positions on various feeding outcomes. The findings were conflicting: 2 studies found the side-lying position to be beneficial for supporting physiologic stability during feeding compared with the semi-upright position whereas 2 studies did not find significant differences in any of their outcomes between the side-lying position and other feeding positions. However, this finding should be interpreted cautiously because of various methodological weaknesses and limited generalizability.

Implications for Practice:

This review does not provide strong or consistent evidence that the side-lying position improves preterm infants' oral feeding outcomes.

Implications for Research:

A large randomized controlled trial with a diverse group of preterm infants is needed to determine the effects of the side-lying position and identify infants who would receive the most benefit.

Video Abstract Available at
https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx.
Long-term (10 yr) MRI follow-up of paraspinal muscle quality after posterior fusion for adolescent idiopathic scoliosis
Authors: Faloon Michael , Widmann Roger F. , Blanco John S. , Cunningham Matthew E. , Rawlins Bernard A. , Green Daniel W.
Published: July 2018

Background:

Posterior muscle-splitting approaches are the most commonly performed surgery for spinal fusion in those diagnosed with adolescent idiopathic scoliosis (AIS). Although short-term postsurgical changes have been documented regarding the posterior paraspinal musculature, there is a paucity of studies regarding the long-term effects.

Methods:

Sixty-three consecutive patients with AIS were offered participation via mail invitation. Magnetic resonance imaging (MRI) studies were reviewed to analyze axial images at each level distal to the fusion mass. Symmetry, muscle quality, and fatty infiltration were graded according to the Goutallier classification of the iliocostalis, longissimus, and spinalis muscles.

Results:

Twenty patients were enrolled in this study with a mean age of 26 yr and a mean follow-up of 12 yr. These patients had a preoperative mean major curve of −55 degrees and a postoperative mean major curve of −25 degrees. The mean fusion length performed was approximately 11 levels. In total 49 levels were graded for change. Thirteen patients (65%) had no qualitative abnormalities across 34 levels (69.4%), and seven patients (35%) had abnormalities. Of those with abnormalities, five had unilateral greater than grade 2 right-sided changes and two had grade-4 changes in the spinalis muscle.

Conclusions:

The open posterior muscle splitting approach for spinal fusion demonstrates very little long-term qualitative fatty degeneration distal to the fusion mass on MRI. Future studies should focus on what patient-specific and surgery-specific factors may predispose someone to long-term damage to the paraspinal muscles after spinal fusion.
Determinants and Variations of Hospital Costs in Patients With Lumbar Radiculopathy Hospitalized for Spinal Surgery
Authors: Huysmans Eva , Pien Karen , Callens Lieselot , Van Loon Lesley , Ickmans Kelly , Nijs Jo , Buyl Ronald , Moens Maarten , Goudman Lisa , Van Belleghem Griet , Putman Koen
Published: July 2018

Study Design.

A retrospective study.

Objective.

The aim of this study was to determine hospital costs related to surgery for lumbar radiculopathy and identify determinants of intramural costs based on minimal hospital and claims data.

Summary of Background Data.

Costs related to the initial hospitalization of patients undergoing surgery for lumbar radiculopathy make up the major part of direct health care expenditure in this population. Identifying factors influencing intramural costs can be beneficial for health care policy makers, and clinicians working with patients with lumbar radiculopathy.

Methods.

The following data were collected from the University Hospital Brussels data warehouse for all patients undergoing surgery for lumbar radiculopathy in 2016 (n = 141): age, sex, primary diagnosis, secondary diagnoses, type of surgery, severity of illness (SOI), admission and discharge date, type of hospital admission, and all claims incurred for the particular hospital stay. Descriptive statistics for total hospital costs were performed. Univariate analyses were executed to explore associations between hospital costs and all other variables. Those showing a significant association (P < 0.05) were included in the multivariate general linear model analysis.

Results.

Mean total hospital costs were € 5016 ± 188 per patient. Costs related to the actual residence (i.e., “hotel costs”) comprised 53% of the total hospital costs, whereas 18% of the costs were claimed for the surgical procedure. Patients with moderate/major SOI had 44% higher hospital costs than minor SOI (P = 0.01). Presence of preadmission comorbidities incurred 46% higher costs (P = 0.03). Emergency procedures led to 72% higher costs than elective surgery (P < 0.001). Patients receiving spinal fusion had 211% higher hospital costs than patients not receiving this intervention (P < 0.001).

Conclusion.

Hospital costs in patients receiving surgery for lumbar radiculopathy are influenced by SOI, the presence of preadmission comorbidities, type of hospital admission (emergency vs. elective), and type of surgical procedure.

Level of Evidence: 3
Plasma Exeresis Treatment for Epidermoid Cysts: A Minimal Scarring Technique
Authors: Rossi Elena , Paganelli Alessia , Mandel Victor Desmond , Pellacani Giovanni
Published: July 2018

BACKGROUND

Epidermoid cysts are cutaneous benign tumors commonly seen in young or middle-aged adults. Plasma exeresis is an innovative technique for several skin conditions: it causes ionization of the atmospheric gas between the proximal tip of the device and the tissue to be treated, creating sublimation of the tissue.

OBJECTIVE

To remove the cyst with a novel technique that allows a good cosmetic result.

MATERIALS AND METHODS

Patients with clinical diagnosis of at least one epidermal cyst, aged between 18 and 70 years were enrolled. A standardized procedure was used. After administration of topical and sometimes local anesthesia (for cysts bigger than 1 cm), a tiny hole was created with plasma exeresis. The content of the cyst was then extruded and Micro Hartman Alligator Ear Forceps pulled out the loosened capsule.

RESULTS

Twenty patients aged between 18 and 68 years were enrolled: 11 males (55%) and 9 females (45%). Twenty-eight cysts were successfully removed. The diameter ranged from 3 to 24 mm. No side effects were observed. The scar measured not more than 3 mm.

CONCLUSION

This study suggests that plasma exeresis could represent a good and safe option to remove noninfected cysts on cosmetic areas, although further study is required.
A Prospective Randomized Crossover Study in Single Sided Deafness on the New Non-Invasive Adhesive Bone Conduction Hearing System
Authors: Mertens Griet , Gilles Annick , Bouzegta Rajae , Van de Heyning Paul
Published: July 2018

Background:

Recently, an adhesive bone conduction hearing system has been developed for conductive hearing loss or single-sided deafness (SSD). In SSD cases, this device may be a good solution for patients who are unsuitable for, or who do not wish to undergo, bone conduction implant or cochlear implant surgery. The study aimed to investigate the hearing outcomes with the adhesive hearing system in SSD.

Purpose of the Study:

The study aimed to investigate the hearing outcomes with the adhesive hearing system in SSD.

Methods:

A randomized crossover study was conducted in 17 SSD participants, using CROS (contralateral routing of signals) hearing aid as a control. Following outcome measurements were administered after a two-week trial: 1) Speech, Spatial and Qualities scale, Audio Processor Satisfaction Questionnaire, and a custom-made questionnaire about the use of the system, 2) sound localization, 3) speech perception in noise.

Results:

70% of the SSD subjects reported that the adhesive hearing system was partially useful or better. Using the APSQ, the adhesive test device was evaluated equally as the control device. Sound localization improved with the adhesive test device and deteriorated with the control device. There was no improvement in speech perception in noise measured with the adhesive test device. Speech perception in noise (SSSDNNH) with the control device improved significantly.

Conclusion:

To the best of our knowledge, this is the first study to report on the outcomes of the new adhesive system. Users’ satisfaction of the adhesive hearing system was found to be comparable to the control device. Since the hearing outcomes vary highly between patients, trials with applicable hearing systems are recommended in SSD patients.
Impact of immigration in presentation and outcomes of hepatocellular carcinoma in the USA
Authors: Ashhab Ashraf A. , Rodin Holly , Powell Jesse , Debes Jose D.
Published: July 2018

Background and aims

Hepatocellular carcinoma’s (HCC) epidemiology and prognosis differs among regions across the globe, largely because of environmental factors and underlying liver disease. Little is known about the changes led by immigration and the effect on HCC outcome. We aimed to understand the effect of immigration on HCC.

Patients and methods

A retrospective cohort study of patients diagnosed with HCC was carried out in a tertiary center in the USA between 2005 and 2016. We characterized individuals as US born or having immigrated there after being born elsewhere. Variables related to clinical presentation, surveillance, therapy, and survival were evaluated.

Results

A total of 232 HCC cases were included, 169 US born (73%) and 63 immigrants (27%). Both groups were diagnosed with HCC at similar ages (60 vs. 62 years, P=0.13). Hepatitis C was the most common underlying liver disease in the US-born population compared with the immigrant population (83 vs. 52%, P<0.001), whereas hepatitis B was more common in the latter (4 vs. 29%, P<0.001). Interestingly, hepatitis B virus-related HCC was diagnosed at similar ages in US-born and immigrant individuals (59 and 57 years). At the time of diagnosis, both populations had similar tumor sizes, rates of metastasis, and diagnosis during surveillance. One-year survival was similar in both groups (65 vs. 63%).

Conclusion

Immigrants that develop HCC have different underlying liver disease than those born in the USA, but similar HCC characteristics and outcomes, even when including hepatitis B virus-related HCCs. Our study, albeit small, suggests that changes in the environment by immigration leads to clinical adaptation of HCC.
Atherosclerosis in the single-cell era
Authors: Winkels Holger , Ehinger Erik , Ghosheh Yanal , Wolf Dennis , Ley Klaus
Published: July 2018

Purpose of review

The immune system plays a critical role in the development and modulation of atherosclerosis. New high-parameter technologies, including mass cytometry (CyTOF) and single-cell RNA sequencing (scRNAseq), allow for an encompassing analysis of immune cells. Unexplored marker combinations and transcriptomes can define new immune cell subsets and suggest their functions. Here, we review recent advances describing the immune cells in the artery wall of mice with and without atherosclerosis. We compare technologies and discuss limitations and advantages.

Recent findings

Both CyTOF and scRNAseq on leukocytes from digested aortae show 10–30 immune cell subsets. Myeloid, T, B and natural killer cells were confirmed. Although cellular functions can be inferred from RNA-Seq data, some subsets cannot be identified based on current knowledge, suggesting they may be new cell types. CyTOF and scRNAseq each identified four B-cell subsets and three macrophage subsets in the atherosclerotic aorta. Limitations include cell death caused by enzymatic digestion and the limited depth of the scRNAseq transcriptomes.

High-parameter methods are powerful tools for uncovering leukocyte diversity. CyTOF is currently more powerful at discerning leukocyte subsets in the atherosclerotic aorta, whereas scRNAseq provides more insight into their likely functions.
Pancreatic Pseudocysts and Parenchymal Necrosis in Patients With Autoimmune Pancreatitis
Authors: Donet Jean A. , Barkin Jodie A. , Keihanian Tara , Nemeth Zsuzsanna , Barkin Jamie S.
Published: July 2018

Objective

To investigate the prevalence and natural history of pancreatic pseudocysts (PCs) and parenchymal necrosis in autoimmune pancreatitis (AIP).

Method

A search using PubMed, Embase, Scopus, and Cochrane was performed. Search terms were AIP, PC, acute fluid collection, and pancreatic necrosis.

Results

Fifteen studies with 17 patients were included. In 8 of 17 patients, PC was noted concurrently with the AIP diagnosis, whereas in the other half, PC appeared months or years after. In 10 of 17 cases, PC appeared as solitary. The location was variable. Pseudocysts were small (<3 cm) in 4 cases and large (>3 cm) in 13 cases. A normal pancreatic duct was observed in 6 of 17 cases, whereas 9 of 17 had pancreatic duct stenosis. Steroids were given to 4 of 4 small and 10 of 13 large PC. All small PC resolved with steroids, whereas only 4 of 10 large PC treated had some response. Most (9/13) of large PC underwent endoscopic or surgical procedures. None of the 17 cases developed necrosis.

Conclusions

Pseudocysts in AIP are rare. Pancreatic pseudocyst can present in variable number, size, and location. Small PC resolved with steroids. Large PC had poor response to steroids requiring invasive interventions. Necrosis in AIP has not been reported.
Change in Children's Self Confidence and the Use of Defense Mechanisms
Authors: Cramer Phebe
Published: July 2018

Change in the personality trait of self-confidence was studied in a group of children from the Berkeley Guidance Longitudinal study. Self-confidence was assessed at age 6 (n = 99) and again at age 10 (n = 97). Results indicated that a change in level of self-confidence was related to the use of defense mechanisms, as assessed from Thematic Apperception Test stories. A decrease in self-confidence was positively related to the use of the immature defense of denial and negatively related to the use of the relatively mature defense of identification. In contrast, an increase in self-confidence was unrelated to the use of defense mechanisms.
Independent Computerized Cognitive Remediation for Psychosis
Authors: Hargreaves April , Daly-Ryan Niamh , Dillon Rachael , Donohoe Gary
Published: July 2018

Cognitive remediation (CR) training improves cognition and functioning in patients with psychosis. To date, however, few studies have investigated CR from a subjective patient perspective. We recently conducted a randomized control trial demonstrating the effectiveness of a new, low therapist support, computer-based training program. This study aims to assess the service user experience of this program. Twenty CR completers with psychosis were interviewed using both rated and open-ended questions. Thematic analysis identified three broad themes: a) benefits of doing CR, b) costs of doing CR, and c) experience of doing CR. Positive experiences of therapy participation included improved cognition, improved positive self-regard, a development of life skills, and a transfer of benefits to everyday life. Negative experiences included therapy being difficult and tiring, leading to frustration and anxiety. These findings demonstrate the feasibility of low therapist support CR and point to variables that might impact therapy adherence.
Atypical and Severe Nonsuicidal Self-Injury as an Indicator of Severe Psychopathology: Findings From a Sample of High-Risk Community Mental Health Clients
Authors: Hom Melanie A. , Rogers Megan L. , Schneider Matthew E. , Chiurliza Bruno , Doerfler Leonard A. , Walsh Barent W. , Joiner Thomas E.
Published: July 2018

This study examined whether atypical/severe nonsuicidal self-injury (NSSI; e.g., foreign body ingestion, cutting necessitating sutures) serves as a marker of severe psychopathology among 467 adult community mental health clients (n = 33 with an atypical/severe NSSI history). Information regarding psychiatric risk indicators was extracted from participants’ psychiatric records. Generalized linear models with negative binomial distribution and log link function, as well as chi-square tests, were used to address study aims. Clients with a lifetime atypical/severe NSSI history met criteria for a significantly greater number of psychiatric risk indicators than clients with a lifetime history of common NSSI only; however, these clients were not significantly more likely to report recent suicidal actions. Individuals with an atypical/severe NSSI history may demonstrate more severe psychopathology than those with a history of common NSSI only. Thus, it may be clinically useful to consider individuals with an atypical/severe NSSI history as a high-risk subgroup.