Search Results (175)

This article examines two drawings by the Prussian artist Anton Möller the Elder (1563–1611), based in Danzig [Gdańsk]. In 1587, a Möller spent time in Marienburg [Malbork] near Dantzig, fresh from his post-apprenticeship travels. These drawings evidence his tuition in Northern Renaissance styles, subject matter, and disguised symbolism—embodying contemporary Lutheran ideologies of temperance, morality, and the powerful sway of music. While scholarship on Möller’s works is well established (mainly in Polish and German sources in brief catalogue-style entries), this article represents an in-depth analysis of the symbolism in his works—primarily missing from modern scholarship, especially in the English language. Möller’s Folk fair before Marienburg is entertaining, sensational, and serves as a graphic warning not to fall prey to alcohol’s destruction of moral character. Möller directly copies figures from Northern Renaissance artists working in the folk fair genre—I discuss these connections and symbolism. Musicians are given an incendiary role in the scene, spurring revelers on to indulge in base emotions and vices. In stark contrast, Möller’s An Elegant reception with Christburg [Dzierzgoń] Castle in the background, places music at the center of the scene, depicts “active listening” and provides a visual message on how music can cultivate a pure mind and heart, if one’s moral compass is properly attuned. Full article

Managing refractory cardiogenic shock is individualized, with few aspects considered routine or universally contraindicated. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a temporary mechanical circulatory support strategy, providing hemodynamic stabilization and gas exchange for patients with severe cardiogenic shock. It is increasingly used as salvage therapy for advanced cardiopulmonary failure and serves as a bridge to myocardial recovery, heart transplantation, or durable mechanical support such as a left ventricular assist device. Over the past decade, VA-ECMO utilization has risen, even though robust clinical trial evidence supporting its use remains limited. Furthermore, consensus is lacking on key aspects of care, including patient selection, cannulation strategy, weaning protocols, and complication management. This review outlines a structured approach to daily VA-ECMO care, emphasizing multidisciplinary coordination and individualized patient support to optimize outcomes and mitigate complications. We also address the implications of limited trial data and highlight the need for evidence-based frameworks to guide clinical decision-making. Full article

Background/Objectives: Intracerebral hemorrhage (ICH) is primarily a disease of older adults, commonly linked to chronic hypertension and cerebral amyloid angiopathy. In young adults, however, ICH is rare and often driven by distinct structural, hematologic, or vascular causes. Methods: Using the National Inpatient Sample (2016–2022), we identified hospitalizations with a primary diagnosis of ICH (ICD-10-CM: I61.x). Patients younger than 18 years were excluded. Patients were stratified into 18–39 vs. ≥40 years. Comorbidities were defined using validated ICD-10 codes (E08–E13 for diabetes mellitus, I10–I15 for hypertension), excluding transient hyperglycemia (R73.x). Weighted analyses using NIS discharge weights compared demographics, comorbidities, rare etiologies, and outcomes, including in-hospital mortality, length of stay (LOS), and total hospital charges. Survey-weighted multivariable logistic regression identified independent predictors of mortality. Results: Among 76,264 ICH hospitalizations, 4012 (5.3%) occurred in patients < 40 years. Compared with older adults, younger patients had lower prevalence of hypertension (47.8% vs. 84.1%) and diabetes (10.2% vs. 60.4%) but higher rates of substance use (27.7% vs. 15.6%). Rare etiologies were more frequent, including arteriovenous malformation/aneurysm (14.0% vs. 3.6%), Moyamoya disease (1.4% vs. 0.2%), sickle cell disease (1.1% vs. 0.1%), and pregnancy-related ICH (0.05%). In-hospital mortality was lower among young adults (15.7% vs. 21.7%, p < 0.001), though LOS was longer (12.1 vs. 8.7 days, p < 0.001), and mean hospital charges were higher ($228,000 vs. $125,000, p < 0.001). Conclusions: Young-adult ICH is uncommon but etiologically distinct, often associated with vascular malformations, hemoglobinopathies, and substance use. Despite lower mortality, these patients experience longer and more resource-intensive hospitalizations, underscoring a substantial clinical and economic burden. Full article

Background: Maternal and newborn morbidity and mortality remain a pressing challenge with uneven progress globally and in Tanzania. The capacity of health facilities to provide quality care is critical to improving outcomes. This study aimed to assess changes in health facilities’ readiness to provide quality maternal and newborn care, and hence aimed to inform improvements in quality-of-care interventions in Tanzania. Methods: A before and after assessment of 28 comprehensive emergency obstetric and newborn care health facilities implementing the Safer Births Bundle of Care package in five regions of Tanzania was carried out in December 2020 and January 2023. We adapted the World Health Organization’s Service Availability and Readiness Assessment tool, which covered amenities, equipment, staff, guidelines, medicines, and diagnostic facilities. Composite readiness scores were calculated for each category and results were compared at the health facility level. For categorical variables, we tested for differences by Fisher’s exact test; for readiness scores, differences were tested by linear fixed and mixed model analyses, considering dependencies within the regions. We used p < 0.05 as our level of significance and measured change from baseline using a paired t-test. Results: The overall readiness improved significantly from 67.6% to 83.7% (p < 0.05). Statistically significant improvements were seen in medical equipment (77.1% to 94.0%), diagnostic/treatment commodities (69.3% to 83.1%), and availability of guidelines (50.8% to 96.7%). Changes in amenities (78.1% to 84.2%) and staff (63.0% to 61.7%) were not significant. The overall readiness improved in all facility types and the change was statistically significant in district hospitals and health centres (p < 0.05). There were significant differences in improvement between regions (p < 0.05) Conclusions: The overall readiness has improved significantly, reflecting a positive change. However, there remains a need for further enhancement, particularly in terms of staffing, to ensure high-quality maternal and newborn care. Authorities should take swift action to address the identified gaps, selecting the most effective and practical interventions while closely monitoring progress in readiness and sustaining the gains. Full article

Early mathematical learning predicts later academic achievement, and creativity within mathematics plays a central role in higher-order thinking. This study examined the effects of linguistically responsive mathematics enrichment programs for nurturing mathematical creativity. Participants were 250 high-potential kindergarten English Learners across six urban schools in New York, Texas, and California. A linguistically responsive enrichment intervention adapted from the Mentoring Young Mathematicians (M²) math curriculum was implemented for 80 h across seven months. Using the Tangram Creativity Assessment, fluency, flexibility, and originality were measured in students’ tangram problem solving. Additional predictors included Tangram Problem Solving Speed (TPSS), general reasoning (CogAT), and mathematical achievement (NWEA MAP Math). ANCOVA showed significant post-test differences favoring the intervention group across all creativity components. Two-group structural equation modeling analysis supported measurement invariance and explained 55–60% of posttest creativity variance. TPSS emerged as the strongest predictor, with greater effects for the intervention group. These findings highlight the potential of enrichment programs and language-accessible geometry tasks to cultivate creativity in young gifted ELs by strengthening their mathematical foundation while supporting flexible and original problem solving. Full article

Protestant Christianity has, from the 16th century onward, developed an understanding of politics and the state that gives it a strong and independent role. This was the result of a process of differentiation between religion and politics, which strengthened both sides. In this paper, the result is described: how the state and how politics are understood within Protestant Christianity, what consequences this has and what misunderstandings can occur. Special explanation is given to the Lutheran concept of the two regiments of God. The peculiarities of the Protestant state concept are then further described with the Lutheran understanding of the social state and of the military service of Christians. Full article

Petrarch’s Liber sine nomine is a collection of satirical letters against the Avignon Curia, remarkable for its stylistic refinement. It offered later readers multiple possibilities of interpretation and reuse, serving both as a rhetorical model and as a resource for anti-papal argumentation. While literary application predominated in the fifteenth century, the collection was later repurposed in religious debates between Protestants and Catholics. This paper examines a little-known episode in its afterlife, namely the epistle on the fall of Constantinople in 1453 by Bernhard von Kraiburg, chancellor of the Archbishop of Salzburg and later Bishop of Chiemsee. Close philological analysis shows that Bernhard adapted extensive passages from the Liber sine nomine and, along with a few other authors, established a distinct line of reception by reinterpreting selected letters as prayers. In the second half of the seventeenth century, however, Bernhard’s work met an analogous fate to that of its model. It was read and reframed from a Lutheran perspective by Johann Konrad Dieterich, professor of Greek and history at the University of Gießen, and was subsequently subjected to indirect censorship in the Index librorum prohibitorum. Full article

Background: HPV infections with high-risk subtypes are a risk factor for developing cervical and anal cancer. Despite HPV vaccination, the incidence of cervical and anal cancer is increasing. There has been substantial research regarding the benefits of screening men who have sex with men (MSM) and those diagnosed with HIV for anal HPV and dysplasia, but little data exists for women diagnosed with cervical cancer. Methods: We constructed a Markov model in Python 3.13 to simulate the outcomes and financial impact of screening women newly diagnosed with cervical cancer for anal HPV and dysplasia. Two matrices were used to represent the screened group and the unscreened group. In the screening group, all women received initial anal HPV screening and high-resolution anoscopy with biopsy. If biopsy results confirmed HSIL, each would receive treatment with electrocautery. The screening group would also undergo annual surveillance and follow-up treatment as necessary. In the unscreened group, women did not receive screening or treatment, and the disease process was allowed to progress naturally. Results: The initial cohort consisted of 5555 women diagnosed with cervical cancer and concurrent anal HPV. The incidence of anal cancer in the screening group was 271 vs. 375 in the unscreened group after three years, 642 vs. 1236 after ten years, and 863 vs. 2039 after twenty years. Moreover, anal cancer deaths were 1236 in the screening group vs. 9041 in the unscreened group after 10 years and 31,118 vs. 51,553 after twenty years. The screened group saved 330.1 million dollars after ten years and 1.33 billion dollars after twenty years when compared to the unscreened group. Over the life of the study, the screened group would also accrue 102,000 discounted QALYs when compared to the unscreened group. Conclusions: Our model strongly suggests that screening women diagnosed with cervical cancer for anal HPV and treating anal dysplasia leads to less anal cancer, less deaths from anal cancer, less economic impact on the healthcare system, and more QALYs for patients. Full article

Background/Objectives: A high-performing blood biomarker (BBM) test for Alzheimer’s disease (AD) represents an accurate, accessible, and scalable tool to aid healthcare professionals (HCPs) evaluating patients presenting with signs or symptoms of mild cognitive impairment (MCI) or dementia. However, implementation of AD blood tests into clinical practice has not been extensively evaluated. The objective of this study was to assess the implementation of the multi-analyte PrecivityAD2™ blood test (C2N Diagnostics, LLC, St. Louis, MO, USA) into the clinical workflow of memory care clinics. Methods: A total of 8 HCPs (neurologists, geriatricians, geriatric psychiatrists) who served as site directors from 8 outpatient sites that evaluated 203 cognitively symptomatic patients were included in this sub-study of the real-world QUIP II Study (NCT06025877). Implementation of this blood test was assessed through surveying these HCPs using published frameworks including the Technology Acceptance Model, net promoter score, and forced choice preference questions. These assessments were analyzed using Wilcoxon signed-rank test, Fisher’s Exact test, and Wilcoxon signed-rank test, respectively. Results: HCPs reported acceptance scores that averaged 9.6 out of 10 (p < 0.0001, effect size 0.840): the test’s contribution to clinical decision-making as well as the ease of understanding test results received the highest ratings. The net promoter score was 75 (p < 0.0001), exceeding the typical benchmark of 30 reported as good levels of satisfaction in healthcare settings. The APS2 results and individual blood analyte results were rated with similar preference around their roles in HCP clinical decision-making. Conclusions: The results indicate early evidence of user acceptance and recognition by HCPs that this AD blood test can personalize the clinical care pathway for evaluating cognitively symptomatic patients. Full article

This study analyzes confessionally conditioned self-image and mutual perception of the Catholic and Evangelical Church of the Augsburg Confession in Upper Hungary in the context of the second confessionalization process. Based on comparative research of the contemporary press, including either the printed or handwritten homiletic and catechetical literature, predominantly from the area of Upper Hungary, the study examines which phenomena and processes taking place since the 1830s until the end of the 1850s signaled a renewal in confessional identities in both the Catholic and Evangelical Churches. A particular emphasis has been placed on indicators of the second confessionalization, such as the debate on mixed marriages, a rising number of conversions, or legislative interventions in the freedom of religion. Through discourse analysis, the study explores how the image and self-image of the Catholic and Evangelical Church of the Augsburg Confession evolved as a result of the expansion of the catechetical literature and apologetic works and identifies the narrative strategies employed in their respective confessional discourses. The Catholic discourse stressed maintaining dogmatic integrity and Church authority in particular, whereas the Evangelicals more frequently accentuated a thorough biblicality and rationality as a counterposition to Catholic piety. Both traditions claimed exclusive access to “true religion” and used apologetic genres to defend and enhance their identity. Polemical texts also served as tools to form confessionally conditioned collective consciousness, as well as a part of contemporary cultural and political debates. Full article

Introduction: Newborn mortality is unacceptably high, especially in low- and middle-income countries. The Safer Births Bundle of Care (SBBC) was implemented in Tanzania, including training of healthcare workers on neonatal resuscitation by means of frequent in situ simulation training using improved training tools. We aimed to assess the acceptability of this training model among healthcare providers in selected health facilities under SBBC intervention. Methods: A cross-sectional study was conducted among healthcare workers in labor wards and obstetric theaters in selected facilities one year after the introduction of the SBBC model. The theoretical framework for assessment of the acceptability of healthcare interventions was used to assess the acceptability of the training model and accompanying tools. The chi-square test was used to assess the association between acceptability in specific constructs and average individual practice per month, while a modified Poisson regression analysis was used to assess factors associated with acceptability in specific framework constructs. Results: A total of 227 healthcare workers were enrolled in the study. Overall, 223 (98.2%) accepted the intervention. However, 207 (91.2%) reported that the intervention increased their work burden, while 39 (17.2%) reported that it interfered with other equally important activities. The level of health facility was independently associated with the reporting that engaging in simulation practice interfered with other equally important activities. Conclusions: In situ, low-dose, high-frequency facility-based simulation training for neonatal resuscitation was highly acceptable among healthcare providers. However, the perceived increased work burden of this intervention and interference with other equally important activities were identified as potential threats to successful implementation. Full article

After the end of the Second World War, Hungary, like other war-torn countries, was left with countless orphaned children. The collapsed state structures were unable to care for them, so only various private or church initiatives—such as Gaudopolis, a children’s home set up by the Lutheran pastor Gábor Szehló—provided a means of survival. However, in East-Central Europe—including Hungary, Poland and Romania—where the Soviet Union had a sphere of influence, the emerging Soviet-style system was aimed at the political re-education of society. Ideological goals categorically excluded the possibility of churches being involved in the care and education of youth beyond the existing legal framework. Any person who engaged in such activities was cracked down upon. This study examines the role and responsibility of church persons in the care and upbringing of orphaned children through the fate of the Roman Catholic priest István Regőczi. In the decades of communist dictatorship, István Regőczi repeatedly reorganised orphanages, where he carried out youth education activities based on principles similar to scouting. The values he imparted to the children—such as the Christian religion, family protection, mutual help and social solidarity—were all values of Christian socialism. However, the communist dictatorship—promoting its own political ideology, Marxism—sought to take control of the upbringing and education of children by nationalising all institutions involved in this activity. Anyone who resisted this—as István Regőczi did—was made impossible in the people’s democracy of the 1950s and 1960s, and his child-saving, educating and teaching activities were prevented, even if the courts sentenced him to longer or shorter prison sentences for the crimes of illegal youth organisation, incitement and the abuse of freedom of association. This study, comparing what is described in István Regőczi’s memoirs with the surviving archival sources, shows how during these terrible decades it was possible to save orphaned, needy children and raise them in a Christian spirit, even against the will of the authorities. Full article

Background/Objectives: This study investigates disparities in physical fitness among Connecticut K-12 students post-COVID-19, highlighting persistent inequities across race, socioeconomic status, language proficiency, and dis/ability. Methods: Utilizing state-wide data from Connecticut’s EdSight portal, the research reveals a significant decline in student physical fitness compared to pre-pandemic levels, notably lagging behind academic recovery. Results: Findings underscore stark disparities, with marginalized groups such as students with disabilities, English learners, and racially minoritized students consistently performing lower than their peers. District-level analyses further illustrate pronounced inequities, where affluent, predominantly White districts achieved nearly four times higher fitness scores compared to economically disadvantaged, racially diverse districts. Conclusions: These disparities reflect systemic resource allocation issues and align with the framework of stratification economics, emphasizing structural inequities rather than individual deficits. The study advocates for equity-based funding, mandatory physical education monitoring, culturally responsive teaching practices, and systemic policy reforms to ensure equitable access to physical education resources and holistic student well-being. Full article

This paper investigates the cultural landscapes established by nineteenth-century German immigrants in South Australia and the southern Riverina of New South Wales, with particular attention to settlement patterns, architectural traditions and toponymic transformation. German immigration to Australia, though numerically modest compared to the Americas, significantly shaped local communities, especially due to religious cohesion among Lutheran migrants. These settlers established distinct, enduring rural enclaves characterized by linguistic, religious and architectural continuity. The paper examines three manifestations of these cultural landscapes. A rich toponymic landscape was created by imposing on natural landscape features and newly founded settlements the names of the communities from which the German settlers originated. It discusses the erosion of German toponyms under wartime nationalist pressures, the subsequent partial reinstatement and the implications for cultural memory. The study traces the second manifestation of a cultural landscapes in the form of nucleated villages such as Hahndorf, Bethanien and Lobethal, which often followed the Hufendorf or Straßendorf layout, integrating Silesian land-use principles into the Australian context. Intensification of land use through housing subdivisions in two communities as well as agricultural intensification through broad acre farming has led to the fragmentation (town) and obliteration (rural) of the uniquely German form of land use. The final focus is the material expression of cultural identity through architecture, particularly the use of traditional Fachwerk (half-timbered) construction and adaptations such as pug-and-pine walling suited to local materials and climate. The paper examines domestic forms, including the distinctive black kitchen, and highlights how environmental and functional adaptation reshaped German building traditions in the antipodes. Despite a conservation movement and despite considerable documentation research in the late twentieth century, the paper shows that most German rural structures remain unlisted and vulnerable. Heritage neglect, rural depopulation, economic rationalization, lack of commercial relevance and local government policy have accelerated the decline of many of these vernacular buildings. The study concludes by problematizing the sustainability of conserving German Australian rural heritage in the face of regulatory, economic and demographic pressures. With its layering of intangible (toponymic), structural (buildings) and land use (cadastral) features, the examination of the cultural landscape established by nineteenth-century German immigrants adds to the body of literature on immigrant communities, settler colonialism and landscape research. Full article

The subject of this article is the centuries-old religious heritage of Vilnius. The aim of the article is to analyse this heritage and its reflection in the gaze of tourists. In particular, it focuses on selected Catholic, Orthodox, Protestant, Jewish, and Karaite sites. The methods used in the empirical study include the analysis of reviews posted on the Tripadvisor website by tourists from different countries who visited five selected sites: (1) St. Anne’s Church, (2) Holy Spirit Orthodox Church, (3) Evangelical Lutheran Church, (4) Vilnius Choral Synagogue, and (5) Kenesa. The authors employed the method of desk research, which involves the analysis of existing data. The selection of objects was made by indicating the most commented sites of a given religious tradition for which the most comments were received. In the light of the pervasive influence of social media, it is noteworthy to observe the contemporary representation of multi-religious Vilnius that is disseminated through this medium. Urban sacred spaces are not only places of worship of interest to religious people, including local and foreign pilgrims. Furthermore, they constitute an attractive urban heritage for a significant number of cultural tourists. Committed tourists, including cultural tourists, meticulously document their impressions in various forms of narrative, offering either endorsement or criticism of a particular object. In this manner, they also interpret elements of the heritage in the local urban space. Full article