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1. Thracians Among Others: A Study of “Thracianness” in Ancient Cross-Cultural Contexts

Author

Chu, Jeff

Subjects
Ancient history, History, Classical studies, Ancient Black Sea, Ancient Ethnic Identity, Ancient Ethnicity, Ancient Mediterranean, Ancient Thrace, Ancient Thracians
Abstract

Although widely attested in the historical record, the people known in antiquity as the Thracians (who inhabited a region north of Greece called Thrace) remain poorly understood on the whole and largely stand at the margins of mainstream scholarship. This dissertation seeks to improve our understanding of the Thracians by exploring how they came to be recognized as a distinct ethnic group to both themselves and outsiders as a result of various cross-cultural interactions. Centered around four case studies, my investigation covers a chronological span from the seventh to first centuries B.C.E. and analyzes a wide array of literary, epigraphic, papyrological, and archaeological data. I begin with a consideration of Thracian cultural influences in five Greek colonies in Thrace—Mesambria, Zone, Odessos, Dionysopolis, and Apollonia—the residents of which, I argue, possessed mixed Greco-Thracian identities. The second case study reconstructs the history of the Thracian slave and freed population in Attica and how they eventually developed a sense of ethno-religious solidarity. The third focuses on the Thracians’ encounters with the Achaemenid Persian Empire and the conceptualization of Thracians within ancient Near Eastern ideological paradigms of imperial space. The fourth discusses Thracian military service, resettlement, social mobility, and identity formation under Alexander the Great and the Macedonian “Successor” states of the Hellenistic East. Altogether, I attempt to demonstrate that both Thracians and non-Thracians contributed to the construction of Thracian identity over time, with expressions of “Thracianness”—that is, the experiences, practices, beliefs, and forms of self-identification that marked out Thracians in the eyes of their contemporaries—being most pronounced and noticeable in settings where Thracians constituted a minority.

Published
2022

2. Intensive care unit scoring systems outperform emergency department scoring systems for mortality prediction in critically ill patients: a prospective cohort study.

Author

Moseson, Erika M, Zhuo, Hanjing, Chu, Jeff, Stein, John C, Matthay, Michael A, Kangelaris, Kirsten N, Liu, Kathleen D, and Calfee, Carolyn S

Subjects
APACHE, Calibration, Critical illness, Emergency medicine, Intensive care unit, Mortality, SAPS, Health Services, Emergency Care, Clinical Research, Patient Safety, Good Health and Well Being, Clinical Sciences
Abstract

BackgroundMultiple scoring systems have been developed for both the intensive care unit (ICU) and the emergency department (ED) to risk stratify patients and predict mortality. However, it remains unclear whether the additional data needed to compute ICU scores improves mortality prediction for critically ill patients compared to the simpler ED scores.MethodsWe studied a prospective observational cohort of 227 critically ill patients admitted to the ICU directly from the ED at an academic, tertiary care medical center. We compared Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, Simplified Acute Physiology Score (SAPS) II, Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), Prince of Wales Emergency Department Score (PEDS), and a pre-hospital critical illness prediction score developed by Seymour et al. (JAMA 2010, 304(7):747-754). The primary endpoint was 60-day mortality. We compared the receiver operating characteristic (ROC) curves of the different scores and their calibration using the Hosmer-Lemeshow goodness-of-fit test and visual assessment.ResultsThe ICU scores outperformed the ED scores with higher area under the curve (AUC) values (p = 0.01). There were no differences in discrimination among the ED-based scoring systems (AUC 0.698 to 0.742; p = 0.45) or among the ICU-based scoring systems (AUC 0.779 to 0.799; p = 0.60). With the exception of the Seymour score, the ED-based scoring systems did not discriminate as well as the best-performing ICU-based scoring system, APACHE III (p = 0.005 to 0.01 for comparison of ED scores to APACHE III). The Seymour score had a superior AUC to other ED scores and, despite a lower AUC than all the ICU scores, was not significantly different than APACHE III (p = 0.09). When data from the first 24 h in the ICU was used to calculate the ED scores, the AUC for the ED scores improved numerically, but this improvement was not statistically significant. All scores had acceptable calibration.ConclusionsIn contrast to prior studies of patients based in the emergency department, ICU scores outperformed ED scores in critically ill patients admitted from the emergency department. This difference in performance seemed to be primarily due to the complexity of the scores rather than the time window from which the data was derived.

Published
2014

3. Intensive care unit scoring systems outperform emergency department scoring systems for mortality prediction in critically ill patients: a prospective cohort study.

Author

Moseson, Erika M, Zhuo, Hanjing, Chu, Jeff, Stein, John C, Matthay, Michael A, Kangelaris, Kirsten N, Liu, Kathleen D, and Calfee, Carolyn S

Subjects
APACHE, Calibration, Critical illness, Emergency medicine, Intensive care unit, Mortality, SAPS, Emergency Care, Clinical Research, Patient Safety, Health Services, Clinical Sciences
Abstract

BackgroundMultiple scoring systems have been developed for both the intensive care unit (ICU) and the emergency department (ED) to risk stratify patients and predict mortality. However, it remains unclear whether the additional data needed to compute ICU scores improves mortality prediction for critically ill patients compared to the simpler ED scores.MethodsWe studied a prospective observational cohort of 227 critically ill patients admitted to the ICU directly from the ED at an academic, tertiary care medical center. We compared Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, Simplified Acute Physiology Score (SAPS) II, Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), Prince of Wales Emergency Department Score (PEDS), and a pre-hospital critical illness prediction score developed by Seymour et al. (JAMA 2010, 304(7):747-754). The primary endpoint was 60-day mortality. We compared the receiver operating characteristic (ROC) curves of the different scores and their calibration using the Hosmer-Lemeshow goodness-of-fit test and visual assessment.ResultsThe ICU scores outperformed the ED scores with higher area under the curve (AUC) values (p = 0.01). There were no differences in discrimination among the ED-based scoring systems (AUC 0.698 to 0.742; p = 0.45) or among the ICU-based scoring systems (AUC 0.779 to 0.799; p = 0.60). With the exception of the Seymour score, the ED-based scoring systems did not discriminate as well as the best-performing ICU-based scoring system, APACHE III (p = 0.005 to 0.01 for comparison of ED scores to APACHE III). The Seymour score had a superior AUC to other ED scores and, despite a lower AUC than all the ICU scores, was not significantly different than APACHE III (p = 0.09). When data from the first 24 h in the ICU was used to calculate the ED scores, the AUC for the ED scores improved numerically, but this improvement was not statistically significant. All scores had acceptable calibration.ConclusionsIn contrast to prior studies of patients based in the emergency department, ICU scores outperformed ED scores in critically ill patients admitted from the emergency department. This difference in performance seemed to be primarily due to the complexity of the scores rather than the time window from which the data was derived.

Published
2014

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