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The period of the crusades and the Latin settlement of the eastern Mediterranean was an important one for medieval historical writing. Indeed, it has been recently suggested that the chroniclers of the First Crusade (1095–99), faced with the need to couch events in a more overtly exegetical register, ‘pioneered a new way of writing about the recent past’. Whether or not one accepts the notion that such writers adopted a fundamentally new mode of composition, there can be little doubt that this initial expedition left a significant imprint on medieval literary cultures. For a start, the vast number of extant narratives is unusual by medieval standards. More than this, though, the enterprise is renowned for popularising the medieval monograph format, with many writers electing to compose standalone histories characterised by a narrow focus on the crusade. As the crusading movement progressed, some embedded crusade accounts into works with wider chronological and geographical scopes, but the free-standing ‘crusade’ history was an outcome of nearly all subsequent expeditions (or at least the major ‘numbered’ ones). It is perhaps a by-product of this textual tradition – among other factors, such as modern historians’ propensity to compartmentalise evidence to facilitate historical analysis and the hangover of nineteenth-century scholarly conventions – that crusading expeditions are often treated in isolation: a discrete series of holy wars related to, but somehow distinct from, the Latin Christian settlements established in the wake of the First Crusade, known collectively as the crusader states, the Latin East or, when viewed from the West, Outremer (‘the land across the sea’). One need only cast an eye over the many modern general histories of the crusades to appreciate that most devote comparatively little space to the crusader states. Instead, the history of those polities on the fringes of Latin Christendom has usually been detailed separately, so much so that even the validity of the long-standing descriptor ‘crusader states’ has been disputed.
Consequently, the historiography of the crusades and the crusader states has developed along slightly different contours. For the purposes of this volume, the most significant difference, to be discussed in greater detail below, is that whereas texts – especially historical narratives – pertaining to the crusades have been subjected to an unparalleled degree of literary scrutiny in recent years, the textual evidence for the Latin East has less frequently been examined through the same interpretative lens.
The constitution of any state, whether written or unwritten, is the set of political, governmental and legal structures and shared values within which the business of everyday politics and governance operate. In fourteenth-century England there occurred the first two depositions in post-Conquest English history, which were precipitated by ‘unconstitutional’ behaviour by the monarchs in question and were effected by ‘unconstitutional’ legal devices on the part of the community of the realm. It was a century of cataclysmic demographic transformation brought about by the Black Death, of almost constant warfare with Scotland and France and of spectacular governmental growth and legal change. It is therefore ironic that, when English constitutional history was at its height, in the late nineteenth and early twentieth centuries, the fourteenth century, parliamentary developments apart, was regarded as a sorry backwater. It was useful only to reflect on how a wrong turning had been taken. ‘We pass’, Bishop Stubbs lamented, ‘from an age of heroism to the age of chivalry, from a century ennobled by devotion and self-sacrifice to one in which the gloss of superficial refinement fails to hide the reality of heartless selfishness and moral degradation’.1
An alternative surgical approach for hypoplastic left heart syndrome is the Hybrid pathway, which delays the risk of acute kidney injury outside of the newborn period. We sought to determine the incidence, and associated morbidity, of acute kidney injury after the comprehensive stage 2 and the cumulative incidence after the first two operations in the Hybrid pathway.
Design:
A single centre, retrospective study was conducted of hypoplastic left heart patients completing the second-stage palliation in the Hybrid pathway from 2009 to 2018. Acute kidney injury was defined utilising Kidney Diseases Improving Global Outcomes criteria. Perioperative and post-operative characteristics were analysed.
Results:
Sixty-one patients were included in the study cohort. The incidence of acute kidney injury was 63.9%, with 36.1% developing severe injury. Cumulatively after the Hybrid Stage 1 and comprehensive stage 2 procedures, 69% developed acute kidney injury with 36% developing severe injury. The presence of post-operative acute kidney injury was not associated with an increase in 30-day mortality (acute kidney injury 7.7% versus none 9.1%; p = > 0.9). There was a significantly longer median duration of intubation among those with acute kidney injury (acute kidney injury 32 (8, 155) hours vs. no injury 9 (0, 94) hours; p = 0.018).
Conclusions:
Acute kidney injury after the comprehensive stage two procedure is common and accounts for most of the kidney injury in the first two operations of the Hybrid pathway. No difference in mortality was detected between those with acute kidney injury and those without, although there may be an increase in morbidity.
Thirteenth Century England 2019 brought together scholars from the UK and beyond, giving rise to papers that responded in varied ways to the conference's theme, the provocation ‘Exceptional England?’. It is a counterpart to the 2017 conference, which asked scholars to think explicitly about England in Europe. This pair of conferences were responding to long-term historiographical trends among British medievalists, one of which strove to Europeanise England and Britain and the other which sought instead, either explicitly or implicitly, to emphasise the differences between developments in England and those elsewhere. Both conferences took place within that window of British history between the EU referendum in 2016 and the Covid Pandemic of 2020, when talk of ‘Brexit’ dominated Westminster, the media, and university common rooms. While politics moves on, we hope that these two volumes provide a contribution by new and established scholars on issues that remain pertinent to any study of medieval Europe.
Scholars have long observed the perils of an insular outlook. The late Susan Reynolds, as Agata Zielinska notes in her essay, sounded a warning at the Thirteenth Century England Conference held in 1997 about the dangers of thinking and writing, consciously or not, within national frameworks. And yet, more than two decades later, Nicholas Vincent makes a similar point in the present volume about the ongoing ‘tendency of historians, on both sides of the Channel, to focus upon sources confined chiefly within (future) national bound¬aries’. Many of the essays collected respond to the challenge to think beyond those bounds. In so doing, they also help to set a new course for future confer¬ences. The 2019 iteration was also the first ‘Thirteenth Century’ conference, a title the gathering will continue to bear in future years. This institutionalises the broadened horizons reflected in this collection of essays, though the numbering from the Thirteenth Century England Series will be retained, recognising a vital continuity with the very significant corpus of scholarship accumulated during almost forty years of the conference's existence.
With the aim of producing a 3D representation of tumors, imaging and molecular annotation of xenografts and tumors (IMAXT) uses a large variety of modalities in order to acquire tumor samples and produce a map of every cell in the tumor and its host environment. With the large volume and variety of data produced in the project, we developed automatic data workflows and analysis pipelines. We introduce a research methodology where scientists connect to a cloud environment to perform analysis close to where data are located, instead of bringing data to their local computers. Here, we present the data and analysis infrastructure, discuss the unique computational challenges and describe the analysis chains developed and deployed to generate molecularly annotated tumor models. Registration is achieved by use of a novel technique involving spherical fiducial marks that are visible in all imaging modalities used within IMAXT. The automatic pipelines are highly optimized and allow to obtain processed datasets several times quicker than current solutions narrowing the gap between data acquisition and scientific exploitation.