Search Results (269)

Malignant gastric outlet obstruction (MGOO) is a serious complication arising from advanced gastric or pancreatic head cancer, significantly impairing patients’ quality of life by disrupting oral intake and inducing severe gastrointestinal symptoms. With benign causes such as peptic ulcer disease on the decline, malignancies now account for 50–80% of gastric outlet obstruction (GOO) cases globally. This review outlines the pathophysiology, evolving epidemiology, and treatment modalities for MGOO. Therapeutic approaches include conservative management, endoscopic stenting, surgical gastrojejunostomy (GJ), stomach partitioning gastrojejunostomy (SPGJ), and endoscopic ultrasound-guided gastroenterostomy (EUS-GE). While endoscopic stenting offers rapid symptom relief with minimal invasiveness, it has higher rates of re-obstruction. Surgical options like GJ and SPGJ provide more durable palliation, especially for patients with longer expected survival. SPGJ, a modified surgical technique, demonstrates reduced incidence of delayed gastric emptying and may improve postoperative oral intake and survival compared to conventional GJ. EUS-GE represents a promising, minimally invasive alternative that combines surgical durability with endoscopic efficiency, although long-term data remain limited. Treatment selection should consider patient performance status, tumor characteristics, prognosis, and institutional resources. This comprehensive review underscores the need for individualized, multidisciplinary decision-making to optimize symptom relief, nutritional status, and overall outcomes in patients with MGOO. Full article

This article examines the epistemological and homiletical implications of postmodernity for Christian preaching. It addresses the communicative crisis introduced by postmodern skepticism toward metanarratives. It proposes a constructive theological response through the re-articulation of the gospel as a coherent, storied, and transformative metanarrative. Drawing on interdisciplinary scholarship in theology, homiletics, epistemology, and cultural theory, this study argues that a thoughtful engagement with postmodern critique can serve as a catalytic force for ecclesial renewal. The article advocates for a homiletic method that re-engages Scripture’s narrative form while emphasizing relational epistemology, incarnational witness, and contextual sensitivity. By utilizing narrative theology, post-critical epistemologies, and performative models of preaching, this study proposes a recalibrated approach to gospel proclamation, adapted for fragmented and skeptical audiences, while safeguarding theological orthodoxy. Full article

Some studies have pointed to the Jewish background of the prayer that, according to the gospels of Matthew and Luke, Jesus taught his disciples. However, the formulations of LP’s words do not necessarily presuppose the conclusion of the formation of Jewish prayers and do not necessarily presuppose a unidirectional influence of Jewish prayers on the formation of LP. This prayer and its “midrash” in John 17 may have influenced the formulation and final formation of some Jewish prayers. The differences between these prayers may indicate the mutual influence that, in some cases, took place throughout the history of their formation. This reciprocity may be due to the intention to establish and define the differences between the religious groups of Judaic origin that inherited these prayers and between the communities that recited them. The crystallization of biblical themes in these prayers highlights the common heritage of these groups and a different understanding of the fulfilment of God’s word in relation to the coming of his kingdom. While this process, characterized by a conflict of interpretations, took place “within Judaism,” it also led to the parting of the ways of Judeo-Christians from the Synagogue. Full article

This article explores Michel Henry’s interpretation of the canonical Gospels in his Christian Trilogy. While Henry’s phenomenology emphasizes the immanent self-manifestation of a truth transcending all linguistic mediations, he recognizes the canonical authority of the Gospels as authentic sources of Christ’s words, granting privileged access to that same truth. His surprising focus on Synoptic Gospels, especially in Words of Christ, contrasts with his usual preference for Johannine and Pauline writings. However, his interpretation of the Synoptics tends to uniformize their literary and theological diversity and ignore the narratives and particularities of each Gospel. We suggest that Henry’s hermeneutics is guided less by an exegetical intention than by the principles of his radical phenomenology of life. In short, the article shows the clear risk of eisegetical projection at the core of Henry’s philosophy of Christianity. Full article

Proclamation of the gospel is a perennial practice of congregational leadership demanding responsiveness to issues, trends, and events impacting congregations, their local and regional communities, and the challenges of the world. How do congregational leaders equip themselves for the important and ever-changing task of preaching? Lifelong learning, the fastest-growing and least-resourced aspect of theological education in North America, provides this opportunity. Through a 2024 survey, this quantitative study provides insight into the lifelong learning needs of Methodist preachers, including differences based on gender and race/ethnicity. Time for additional learning is the major perceived obstacle for preachers desiring to improve their craft. Thus, lifelong learning programs must make the case for how the required time and energy will benefit the preacher participating in such programs. Specifically, the activities of reviewing recordings of sermons (both one’s own and those of other preachers), receiving constructive feedback on sermons, and realizing the collaborative potential of preaching must be structured in ways that prove the value of these investments for preachers. This data on the lifelong learning needs of Methodist preachers has implications on multiple levels: conceptual, institutional, congregational, and personal. Full article

The theology of deification in the Christian tradition is fraught with misconceptions. Although it embodies the core teaching of the faith, it is not only a neglected theme of theology, but often critiqued as a Promethean distortion of the gospel and/or a semi-Pelagian heterodoxy. Hans Urs von Balthasar, through his examination of the teachings of the early Church Fathers, presents the doctrine in its Christocentric context, emphasizing its kenotic and inherently relational character. Deification is thus revealed as an antidote to the narrowly conceived notion of “justification” as salvation, which is rooted in a juridic understanding of God’s grace. Conceived as the dynamic incorporation of the believer into the life of Christ himself, deification is rightly understood as a present, existential process and thus far more than a mere eschatological hope. Full article

This article argues that truth can be disclosed and found in incarnation and eucharistic repetition in a proportion between things and mind. Truth as a Christian concept is explored in the Gospel of John, and more specifically in the interaction between Jesus and Pilate, where Pilate at Jesus’ trial asks the question: ‘What is truth?’ The work of biblical commentators is examined in relation to truth in John’s Gospel. The importance of the Word made flesh and its eucharistic repetition is seen as central to truth. This is expanded using the concept of non-identical repetition, as discussed by several scholars, including David Ford and Catherine Pickstock, arguing that Jesus Christ in his incarnate form and in eucharistic repetition calls attention to truth as the proportion between things and mind. The implications of an ontological approach, as opposed to an epistemological approach are drawn in relation to eucharistic theology, with reference to signs (things of this world) and reflective processes (mind) in such a way that where there is a proportion between things and mind, truth is disclosed and found in incarnation and eucharistic repetition. Full article

This article examines the ‘King Jesus Gospel’ concept proposed by Matthew Bates and Scott McKnight, which frames the biblical gospel as a proclamation of Jesus’ kingship. It addresses the ‘Failure Objection’ that Jesus was merely a failed apocalyptic prophet who died without fulfilling his predictions. Drawing on N.T. Wright’s work, this article constructs the ‘King Jesus Hypothesis’ and evaluates it using evidence from religious transformation, cultural values, and human progress. Employing the Criterion of Predictive Power, it argues that historical religious innovations (drawing on the work of Larry Hurtado), Western moral values (drawing on the work of Tom Holland), and measurable human flourishing (drawing on the work of Steven Pinker) are best explained by Jesus successfully inaugurating God’s Kingdom through cultural transformation rather than apocalyptic intervention. Through this analysis, the article demonstrates that compelling evidence supports Jesus’ kingship despite the Failure Objection. Full article

The definitive demonstration of effective leadership is the ability to communicate with purpose in such a way that gives life to ideas and accomplishes organizational objectives. God’s message of grace to humanity was the Word, his Son Jesus Christ. God’s mode of communication is an example to us. As “The Word became flesh”—a living reality testifying of God’s grace—so must our communication have purpose and fulfillment. Because of its emphasis on building relationships through the communication process, leader–member exchange (LMX) theory provides a valid framework that describes how God demonstrated leadership and facilitated reconciliation with humanity through the Word. An exegetical analysis of John 1:1–18 considering LMX theory offered seven principles of effective communication. Full article

Background/Objective: BRCA1 and BRCA2 genes contain functional domains that operate at different stages of the DNA damage response. Although studies have suggested that the location of BRCA1/2 mutations may influence clinical outcomes, no discernible pattern has been observed indicating which mutation location influences clinical outcomes in patients with ovarian cancer with BRCA1/2 mutations. Therefore, this study aimed to evaluate the differences in survival outcomes between BRCA1/2 mutation locations, with a specific focus on exon 11, in patients with epithelial ovarian cancer. Methods: A comprehensive literature review was conducted using PubMed, Embase, and Cochrane Library databases, including articles published up to 13 August 2024. Progression-free survival (PFS) and overall survival (OS) were assessed based on the BRCA mutation location, with subgroup analyses focusing on exon 11 mutations in BRCA1 and BRCA2. Statistical heterogeneity was evaluated using the I² index. Results: Seven studies involving 1535 patients were included. BRCA2 exon 11 mutations demonstrated a significant PFS advantage (HR, 0.586; 95% CI, 0.346–0.994, I² = 55%), whereas BRCA1 exon 11 mutations had no significant effect on PFS or OS. Conclusions: These findings suggest differential prognostic outcomes based on the BRCA mutation location, highlighting the clinical relevance of BRCA2 exon 11. BRCA2 exon 11 mutations were associated with improved PFS, which underscores the prognostic significance of the BRCA mutation location, particularly exon 11, in ovarian cancer. These findings reinforce the biological relevance of exon 11 by consolidating evidence from multiple studies that suggest potential prognostic implications of mutations within this region. Full article

The Catholic Church in the United States is no longer a Euro-American church receiving immigrants. Rather, it is an immigrant church, the cross-cultural Body of Christ. Serving such a diverse church is difficult and complex, providing both prophetic and pragmatic challenges for pastoral leaders seeking to build the parish as a dynamic, relational, multicultural community, living out the Gospel of Christ. The challenges of creating vibrant parishes in the light of growing diversity was the subject of a qualitative research study that interviewed more than 500 Catholic pastors, staff, and parishioners, from 40 parishes across the US. This study discovered that, while parishioners from different cultures want the same things—good liturgy, leadership, community, and faith formation—they want it in culturally distinct ways. This has created challenges not previously encountered by parish leaders. Effective leaders in these communities exhibited the skills of adaptive leadership, learning to put aside biases and assumptions, in a synodal style of ministry in which they listen deeply, and respond to, the needs of their faith community while using intercultural competencies. Together, pastoral leaders are becoming bridges, bringing together the faithful across cultures, enriching the life of the community. Full article

Background/Objectives: To quantitatively assess the long-term volume stability of acellular dermal matrix (ADM) in oncoplastic breast-conserving surgery (OBCS) and analyze surgical and aesthetic outcomes. Methods: This retrospective study examined 172 breast cancer patients who underwent OBCS with immediate ADM-based volume replacement (2020–2022). Patients received either diced ADM with sheet ADM (n = 102) or diced ADM with paste ADM (n = 70). The ADM volume was evaluated using MRI at 6, 12, and 24 months postoperatively. Results: Long-term volume stability was achieved in both groups with minimal volume reduction (4.3–4.5%) at 24 months (p < 0.001). Early surgical complications included hematoma (4.1%), seroma (2.3%), and wound issues (1.2%), with no infections or ADM non-incorporation. Contour irregularities occurred in 16.3% of cases. Radiotherapy (87% of patients) did not significantly impact ADM volume retention. Conclusions: ADM provides predictable, durable volume replacement in OBCS, with excellent volume stability even with radiotherapy. This quantitative assessment of ADM volume retention over two years supports ADM as a reliable option for breast-conserving surgery, potentially expanding treatment options for patients with unfavorable tumor-to-breast volume ratios. Full article

This paper will explore the background of how the first-century cult of Artemis was central to the economy of Ephesus, and subsequently, how Paul’s preaching of the gospel caused an economic disruption during his visit to the city, as narrated in Acts 19:21–41. The goal will be to show how theology and economics are interrelated and, as a result, establish the proper domain for advancing human flourishing in our modern society. The lens through which this paper is seeking to understand economics is through what is known as substantivism over and against formalism, or an empirical-based approach against a deductive–abstract methodology. The substantivist position is undertaken here primarily to explain how economic life is embedded in non-economic structures (here, the cult of Artemis). Full article

Studies on the presence of the Old Testament (OT) in the New Testament (NT) have evolved significantly over time. Scholars have moved from a focus on identifying the textual version employed by the evangelists to attempts to systematize the various levels of the OT’s presence, classifying them as quotations, allusions, or echoes. In reality, biblical references permeate the NT, often going unnoticed. Unveiling them and, above all, approaching them through the interpretative logic characteristic of Judaism at the turn of the era imparts a surplus of meaning to the NT text. This is what this article demonstrates through an example from the Gospel according to Mark. There is no doubt about the strong biblical resonances in the passage describing Jesus’ entry into Jerusalem (Mk 11:1-11). In addition to a quotation from Psalm 118 (Mk 11:9-10), scholars recognize an allusion to Genesis and multiple references to texts from the book of Zechariah. This article will illustrate how drawing upon Jewish exegetical tradition from the turn of the era sheds light both on the way these OT references are interpreted and on how the various biblical references interconnect, enriching and expanding the meaning of the Gospel passage. Full article

The theme of the current Special Issue, ‘Faith in Action: Examining the Power and Purpose of a Public Theology in Contemporary Society’, leaves a lot of scope for definition. Here, the theme is addressed via the lens of the public life and practice of a Christian congregation and its generative qualities pertaining to public trust. Such an approach contrasts with more formal public theologies which tend to favour intellectual or academic discourse. It will be argued that the life of a local faith community and its embodied public interface provides a better starting point as it can be seen as the most directly presupposed concrete and public context of the phrase ‘faith in action’. As an analytical conduit, the congregation is a neglected category for rendering a public theology, even as it lies at the heart of the Christian faith’s constitutive practice. Here, a particular form of public exchange drawn from local experience will be set against the background of the recent trend in ecclesiology to turn away from abstracted notions of the church towards more practice-orientated understandings. The dynamics of developing public trust will be considered through reflection on an oft repeated response offered from non-practicing observers of my local church’s work: ‘You do so much good in the community’. Although a seemingly simple (and positive) sentiment, such a comment in fact bears complex layers of meaning and subtextual inflections to which a minister and congregation might give heed in search of public trust. Full article