From Poe to South Park: The Influence and Development of Lovecraft’s ‘Cosmic Horror’ in American Culture

H.P. Lovecraft’s ‘Cosmic Horror’ has been a staple of horror and gothic fiction, and therefore American culture, for more than 80 years. In this paper, I examine the development of the genre of horror, starting with Edgar Allen Poe’s influence, and trace its development up to contemporary popular American culture exemplified by the TV show South Park. While Lovecraft’s material has always been drawing from the same concept of the fear of the unknown and human powerlessness in the face of greater forces, the context, sources and reasons for this powerlessness have constantly changed over the decades. In this paper I offer an examination of where this idea of ‘Cosmic Horror’ originally came from, how Lovecraft developed it further and, ultimately, how American culture has adapted the source material to fit a contemporary context. By contrasting Lovecraft’s early works with Poe’s, I shed light on the beginnings of the sub-genre before taking a look at the height of ‘Cosmic Horror’ in Lovecraft’s most famous texts of the Cthulhu myth and ultimately look at a trilogy of South Park episodes to put all of this into a modern American perspective. By doing so, I reveal how Lovecraft’s tales and the underlying philosophy have always been an important part of American culture and how they continue to be relevant even today

From Poe to South Park: The Influence and Development of Lovecraft’s ‘Cosmic Horror’ in American Culture

H.P. Lovecraft’s ‘Cosmic Horror’ has been a staple of horror and gothic fiction, and therefore American culture, for more than 80 years. In this paper, I examine the development of the genre of horror, starting with Edgar Allen Poe’s influence, and trace its development up to contemporary popular American culture exemplified by the TV show South Park. While Lovecraft’s material has always been drawing from the same concept of the fear of the unknown and human powerlessness in the face of greater forces, the context, sources and reasons for this powerlessness have constantly changed over the decades. In this paper I offer an examination of where this idea of ‘Cosmic Horror’ originally came from, how Lovecraft developed it further and, ultimately, how American culture has adapted the source material to fit a contemporary context. By contrasting Lovecraft’s early works with Poe’s, I shed light on the beginnings of the sub-genre before taking a look at the height of ‘Cosmic Horror’ in Lovecraft’s most famous texts of the Cthulhu myth and ultimately look at a trilogy of South Park episodes to put all of this into a modern American perspective. By doing so, I reveal how Lovecraft’s tales and the underlying philosophy have always been an important part of American culture and how they continue to be relevant even today

Dynamic optical coherence tomography. a non-invasive imaging tool for the distinction of nevi and melanomas

Along with the rising melanoma incidence in recent decades and bad prognoses resulting from late diagnoses, distinguishing between benign and malignant melanocytic lesions has become essential. Unclear cases may require the aid of non-invasive imaging to reduce unnecessary biopsies. This multicentric, case-control study evaluated the potential of dynamic optical coherence tomography (D-OCT) to identify distinguishing microvascular features in nevi. A total of 167 nevi, including dysplastic ones, on 130 participants of all ages and sexes were examined by D-OCT and dermoscopy with a histological reference. Three blinded analyzers evaluated the lesions. Then, we compared the features to those in 159 melanomas of a prior D-OCT study and determined if a differential diagnosis was possible. We identified specific microvascular features in nevi and a differential diagnosis of melanomas and nevi was achieved with excellent predictive values. We conclude that D-OCT overcomes OCT´s inability to distinguish melanocytic lesions based on its focus on microvascularization. To determine if an addition to the gold standard of a clinical-dermoscopic examination improves the diagnosis of unclear lesions, further studies, including a larger sample of dysplastic nevi and artificial intelligence, should be conducted

Dynamic optical coherence tomography: a non-invasive imaging tool for the distinction of nevi and melanomas

Along with the rising melanoma incidence in recent decades and bad prognoses resulting from late diagnoses, distinguishing between benign and malignant melanocytic lesions has become essential. Unclear cases may require the aid of non-invasive imaging to reduce unnecessary biopsies. This multicentric, case-control study evaluated the potential of dynamic optical coherence tomography (D-OCT) to identify distinguishing microvascular features in nevi. A total of 167 nevi, including dysplastic ones, on 130 participants of all ages and sexes were examined by D-OCT and dermoscopy with a histological reference. Three blinded analyzers evaluated the lesions. Then, we compared the features to those in 159 melanomas of a prior D-OCT study and determined if a differential diagnosis was possible. We identified specific microvascular features in nevi and a differential diagnosis of melanomas and nevi was achieved with excellent predictive values. We conclude that D-OCT overcomes OCT´s inability to distinguish melanocytic lesions based on its focus on microvascularization. To determine if an addition to the gold standard of a clinical-dermoscopic examination improves the diagnosis of unclear lesions, further studies, including a larger sample of dysplastic nevi and artificial intelligence, should be conducted

Line-field confocal optical coherence tomography: a new tool for the differentiation between nevi and melanomas?

SIMPLE SUMMARY: Typical benign nevi and advanced melanomas can be easily discriminated, but there are still some melanocytic lesions where even experts are not sure about the correct diagnosis and degree of malignity. The high penetration depth of optical coherence tomography (OCT) allows an assessment of tumor thickness of the lesion precisely, but without cellular resolution the differentiation of melanocytic lesions remains difficult. On the other hand, reflectance confocal microscopy (RCM) allows for very good morphological identification of either a nevus or a melanoma, but cannot show the infiltration depth of the lesion because of its low penetration depth. Since the new device of line-field confocal optical coherence tomography (LC-OCT) technically closes the gap between these other two devices, in this study, we wanted to examine if it is possible to differentiate between nevi and melanomas with LC-OCT, and which criteria are the most important for it. ABSTRACT: Until now, the clinical differentiation between a nevus and a melanoma is still challenging in some cases. Line-field confocal optical coherence tomography (LC-OCT) is a new tool with the aim to change that. The aim of the study was to evaluate LC-OCT for the discrimination between nevi and melanomas. A total of 84 melanocytic lesions were examined with LC-OCT and 36 were also imaged with RCM. The observers recorded the diagnoses, and the presence or absence of the 18 most common imaging parameters for melanocytic lesions, nevi, and melanomas in the LC-OCT images. Their confidence in diagnosis and the image quality of LC-OCT and RCM were evaluated. The most useful criteria, the sensitivity and specificity of LC-OCT vs. RCM vs. histology, to differentiate a (dysplastic) nevus from a melanoma were analyzed. Good image quality correlated with better diagnostic performance (Spearman correlation: 0.4). LC-OCT had a 93% sensitivity and 100% specificity compared to RCM (93% sensitivity, 95% specificity) for diagnosing a melanoma (vs. all types of nevi). No difference in performance between RCM and LC-OCT was observed (McNemar’s p value = 1). Both devices falsely diagnosed dysplastic nevi as non-dysplastic (43% sensitivity for dysplastic nevus diagnosis). The most significant criteria for diagnosing a melanoma with LC-OCT were irregular honeycombed patterns (92% occurrence rate; 31.7 odds ratio (OR)), the presence of pagetoid spread (89% occurrence rate; 23.6 OR) and the absence of dermal nests (23% occurrence rate, 0.02 OR). In conclusion LC-OCT is useful for the discrimination between melanomas and nevi

Transitioning to molecular diagnostics in pediatric high-grade glioma: Experiences with the 2016 WHO classification of CNS tumors

BACKGROUND: Pediatric neuro-oncology was profoundly changed in the wake of the 2016 revision of the WHO Classification of Tumors of the Central Nervous System. Practitioners were challenged to quickly adapt to a system of tumor classification redefined by molecular diagnostics. METHODS: We designed a 22-question survey studying the impact of the revised WHO classification on pediatric high-grade glioma. The survey collected basic demographics, general attitudes, issues encountered, and opinions on pediatric subtypes. Participant answers were analyzed along socioeconomic lines utilizing the human development index (HDI) of the United Nations and membership in the group of seven (G7) world economic forum. RESULTS: Four hundred and sixty-five participants from 53 countries were included, 187 pediatric neurooncologists (40%), 160 neuropathologists (34%), and 118 other experts (26%). When asked about pediatric high-grade glioma entities, participants from very high development countries preferred treating a patient based on genetic findings. Participants from high and medium development countries indicated using traditional histology and tumor location as mainstays for therapeutic decisions. Non-G7 countries tended to regard the introduction of molecularly characterized tumor entities as a problem for daily routine due to lack of resources. CONCLUSIONS: Our findings demonstrate an overall greater reliance and favorability to molecular diagnostics among very high development countries. A disparity in resources and access to molecular diagnostics has left some centers unable to classify pediatric high-grade glioma per the WHO classification. The forthcoming edition should strain to abate disparities in molecular diagnostic availability and work toward universal adaptation

Pediatric high-grade gliomas and the WHO CNS Tumor Classification - Perspectives of pediatric neuro-oncologists and neuropathologists in light of recent updates

Background: The WHO Classification of Tumors of the Central Nervous System has undergone major restructuring. Molecularly defined diagnostic criteria were introduced in 2016 (revised 4th edition) and expanded in 2021 (5th edition) to incorporate further essential diagnostic molecular parameters. We investigated potential differences between specialists in perception of these molecularly defined subtypes for pediatric high-grade gliomas (pedHGG). Methods: We designed a 22-question survey studying the impact of the revised 4th edition of the WHO classification on pedHGG. Data were collected and statistically analyzed to examine the spectrum of viewpoints and possible differences between neuro-oncologists and neuropathologists. Results: 465 participants from 53 countries were included; 187 pediatric neuro-oncologists (40%), 160 neuropathologists (34%), and 118 additional experts (26%). Neuro-oncologists reported issues with the introduction of molecularly defined tumor types, as well as the abolishment or renaming of established tumor entities, while neuropathologists did not to the same extent. Both groups indicated less relevant or insufficient diagnostic definitions were available in 2016. Reported issues were classified and assessed in the 2021 WHO classification and a substantial improvement was perceived. However, issues of high clinical relevance remain to be addressed, including the definition of clinical phenotypes for diffuse intrinsic pontine glioma and gliomatosis cerebri. Conclusions: Within the WHO classification of pediatric brain tumors, such as pedHGG, rapid changes in molecular characterization have been introduced. This study highlights the ongoing need for cross talk between pathologist and oncologist to advance the classification of pedHGG subtypes and ensure biological relevance and clinical impact

Somatic late effects in 5-year survivors of neuroblastoma : a population-based cohort study within the Adult Life after Childhood Cancer in Scandinavia study

Because of the rarity of neuroblastoma and poor survival until the 1990s, information on late effects in neuroblastoma survivors is sparse. We comprehensively reviewed the long-term risk for somatic disease in neuroblastoma survivors. We identified 721 5-year survivors of neuroblastoma in Nordic population-based cancer registries and identified late effects in national hospital registries covering the period 1977-2012. Detailed treatment information was available for 46% of the survivors. The disease-specific rates of hospitalization of survivors and of 152,231 randomly selected population comparisons were used to calculate standardized hospitalization rate ratios (SHRRs) and absolute excess risks (AERs). During 5,500 person-years of follow-up, 501 5-year survivors had a first hospital contact yielding a SHRR of 2.3 (95% CI 2.1-2.6) and a corresponding AER of 52 (95% CI 44-60) per 1,000 person-years. The highest relative risks were for diseases of blood and blood-forming organs (SHRR 3.8; 95% CI 2.7-5.4), endocrine diseases (3.6 [3.1-4.2]), circulatory system diseases (3.1 [2.5-3.8]), and diseases of the nervous system (3.0 [2.6-3.3]). Approximately 60% of the excess new hospitalizations of survivors were for diseases of the nervous system, urinary system, endocrine system, and bone and soft tissue. The relative risks and AERs were highest for the survivors most intensively treated. Survivors of neuroblastoma have a highly increased long-term risk for somatic late effects in all the main disease groups as compared to background levels. Our results are useful for counseling survivors and should contribute to improving health care planning in post-therapy clinics.Peer reviewe

The good, the bad, and everything in between : transnational America in the works of Ryu Murakami

Die Beziehung zwischen Amerika und Japan wurde im Laufe von mehr als 200 Jahren von unterschiedlichen Phasen geprägt. Beginnend als unverständliche Fremde wurden sie zu bedeutenden Handelspartnern, zu erbitterten Feinden und schlussendlich zu gegenseitigen Vorbildern. Viel von dieser vielschichtigen Vergangenheit lässt sich heute in den kulturellen Erzeugnissen der beiden Länder finden. Durch die Anwendung eines transnationalen Ansatzes auf die Werke des bedeutenden japanischen Autors Ryu Murakami, veranschaulicht diese Arbeit zum einen die Einflüsse die Amerika auf Japan hatte und zum anderen versinnbildlicht es die dadurch entstandene Impression der USA in Japan. Basierend auf Shelley Fisher Fishkins Definition von transnationalen Amerikastudien wurden die zahlreichen amerikanischen Einflüsse in Murakamis Werken in drei Kategorien eingeteilt: positive Einflüsse, negative Einflüsse und die Grauzone - inmitten der beiden Extremen. Zuzüglich wurde eine kurze Übersicht über die gemeinsame Geschichte der beiden Nationen gegeben, fokussierend auf die Zeit nach dem Zweiten Weltkrieg, mit dem Ziel die Einsichten zu kontextualisieren.Die Analyse der Texte ergab das Amerika in Murakamis Japan als allgegenwärtige und zerstörerische Präsenz dargestellt wird, die viele historische Parallelen zur Realität aufweist. Es überwiegen zwar die negativen Eigenschaften des fiktiven Amerikas, wie etwa ein Verstärken und Unterstützen der Gewaltbereitschaft, ein Anbieten hedonistischer Verführungen, und das Verbreiten von Gefühlen der Unzulänglichkeit, doch dahinter verbirgt sich immer ein Schimmer von Optimismus. Letzten Endes werden die Vereinigten Staaten von Murakami als Herausforderung für Japan dargestellt an der es sich zu messen, zu reflektieren, und sie zu überwinden gilt, hinnehmend, dass dies viele Opfer zur Folge hat. Dennoch zeigt sich, dass das Überwinden dieser Herausforderung schlussendlich wertvolle Einsichten bringt und dadurch Japan über sich selbst hinauswachsen kann.The relationship between America and Japan spans more than 200 years and is made up of numerous phases. From curious strangers to partners to bitter enemies to important model, the two nations have interacted with each other in both destructive and fruitful ways. Much of this complex history can be found in present day cultural products. Applying a transnational approach to the translated writings of acclaimed Japanese writer Ryu Murakami, this paper aims to illuminate the effect America has had on Japan and what kind of image about the United States this has created in more detail. By using Shelley Fisher Fishkins definition of transnational American studies, the manifold influences America has had on Murakamis Japan were categorized in three distinct groups: positives, negatives, and the grey areas in between them. Additionally, a concise historical overview over the relationship between the two states focusing on the period post-WWII was provided to contextualize the findings. Doing so revealed that America is presented as an ever-present and destructive force in the Japan that Murakami creates, resembling various historical phases. However, while the negatives, like amplifying violence, temptation, and spreading feelings of inadequacy, are more prevalent than the positives there is always a glimpse of positivity shining through. Ultimately, America is presented as a challenge for Japan to overcome and reflect upon. Even though this leads to many victims and sacrifices, it is made evident that surviving these imposed challenges offers Japan and its society a chance to grow beyond them.vorgelegt von Christian Perwein, BAZusammenfassungen in Deutsch und EnglischKarl-Franzens-Universität Graz, Masterarbeit, 2018(VLID)258170