EPIC Study Research Articles

DOP040 Plant-based diets mitigate incidence, disease course and comorbidity of inflammatory bowel disease: evidence across eight European countries

Abstract Background Many currently proposed diets for inflammatory bowel disease (IBD) focus on increasing plant-based foods, although a vegetarian diet can still contain products such as emulsifiers and refined grains that negatively impact IBD incidence and progression. To better inform dietary management in IBD, we investigated the association between different plant-based diets and the incidence and disease course of IBD. Methods We leveraged data from the UK Biobank (UKB) including 187,888 participants free of IBD at baseline and the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 341,539 individuals free of IBD, spanning eight European countries (Figure 1). Plant-based diet indexes (healthy and unhealthy PDI) were constructed based on the 24-h dietary recalls. The primary outcome was incidence of IBD, including Crohn’s disease (CD) and ulcerative colitis (UC), and the secondary outcome was the disease course. Cox regression was applied to estimate hazard ratios (HRs), and interactions between genetics and plant-based diets were explored. Results In the UKB (925 incident IBD, median follow-up 11.6 years), higher adherence to healthy PDI was associated with a lower IBD risk (HR 0·75, 95% CI 0·60-0·94), while higher alignment to an unhealthy PDI associated with an increased risk (HR 1·48, 95% CI 1·21-1·82) when comparing extreme quintiles of PDIs (Figure 2). Findings were consistent in the association between healthy and unhealthy PDIs and the risk of CD and UC. For the disease course and comorbidities, both a healthy PDI (HR 0·50, 95% CI 0·30-0·83) and unhealthy PDI (HR 2·12, 95% CI 1·30-3·44) were linked to related surgery among individuals with IBD, while the associations were not significant in other prognostic outcomes including cardiovascular disease, diabetes mellitus, and all-cause mortality. In the EPIC study (548 incident IBD, median follow-up 14·5 years), the HRs of incident IBD for healthy PDI (HR 0·71, 95% CI 0·59-0·85) and unhealthy PDI (HR 1·54, 95% CI 1·30-1·84) validate the results in UKB. Mediation analysis showed the associations of healthy and unhealthy PDIs were mediated by inflammation status and may be greater for participants with moderate or high genetic risk to develop IBD. Conclusion Our findings highlight the protective effect of healthy plant-based diets on IBD incidence and progression, while an adverse association was found for an unhealthy plant-based diet. Adherence to a healthy PDI might be a strategy to improve the natural history of IBD, especially in those with moderate or high genetic risk. These findings support that plant-based foods should be recommended yet underline the possible need for specialised dietetic counselling to ensure the overall quality of diet.

THE EXPRESSION OF THE ARMENIAN PEOPLE AS THE CARRIER OF THE CHRISTIAN VALUE SYSTEM IN THE "METS MHER" BRANCH OF THE ARMENIAN FOLK EPIC

The Armenian epic embodies the collective consciousness and values of the people, which, transcending space and time, have been distilled to retain only what is true, valuable, and intrinsic to their identity. At the core of these moral principles lies the Christian value system, which has evolved over centuries to form a stable and enduring foundation. This system is prominently reflected throughout the Armenian epic, including its "Mets Mher" branch, illustrating that the Armenian People, as the earliest adopters of Christianity as a state religion, were the primary custodians of these Christian beliefs and values. In the Armenian epic, God is subtly present in all aspects of the Armenian people's lives. Their deep faith is reflected not only in the actions and events involving the heroes and the nation as a whole but also in their speech, behavior, and interpretations of various occurrences. The Armenian epic stands as one of humanity's most brilliant artistic creations, highlighting the essential characteristics of the Armenian people. Their Christian faith is an inseparable part of their worldview and understanding of life. Therefore, to foster national self-awareness in the younger generation, it is important to develop a special program for a deeper and more comprehensive study of the Armenian epic in modern schools.

Predicting Mortality in Trauma Research: Evaluating the Performance of Trauma Scoring Tools in a South African Population.

Background Trauma is a leading cause of death and disability in low-resource settings, yet trauma severity scores are seldom validated in these contexts. There is a pressing need to better characterize and compare trauma scoring tools, especially within research frameworks. This study aimed to evaluate the performance of various trauma scoring tools in predicting in-hospital mortality among trauma patients in South Africa. Methods This study conducted a secondary analysis of existing data from the multicenter Epidemiology and Outcomes of Prolonged Trauma Care (EpiC) study, which included 13,548 adult trauma patients aged 18 years and older, collected between August 2021 and March 2024. The predictive ability of the scoring tools was assessed by calculating the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC). Results The mortality rate was 2.5% (n = 298). The Kampala Trauma Score (KTS) demonstrated the highest predictive ability for seven-day in-hospital mortality, with an AUROC of 0.95 and an AUPRC of 0.53. Similarly, the Trauma and Injury Severity Score (TRISS) and the New Injury Severity Score (NISS) also exhibited strong predictive capabilities, with AUROC values of 0.96 and AUPRC values of 0.62 for TRISS and an AUROC of 0.96 and AUPRC of 0.53 for NISS. In contrast, the Revised Trauma Score and Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP) showed lower predictive performance, with AUROC values of 0.87 (AUPRC = 0.51) and 0.86 (AUPRC = 0.47), respectively. Conclusions The KTS exhibited optimal performance characteristics for retrospectively predicting mortality in our cohort, outperforming other scoring tools. Notably, it is also the simplest scoring tool, featuring the fewest variables compared to other trauma severity assessments. These findings highlight the necessity for external validation of trauma scoring tools in resource-limited populations to ensure their applicability and effectiveness in trauma research across diverse healthcare settings.

Prognostic role of pre-diagnostic circulating inflammatory biomarkers in breast cancer survival: evidence from the EPIC cohort study

BackgroundInflammation influences tumour progression and cancer prognosis, but its role preceding breast cancer (BC) and its prognostic implications remain inconclusive.MethodsWe studied pre-diagnostic plasma inflammatory biomarkers in 1538 women with BC from the EPIC study. Cox proportional hazards models assessed their relationship with all-cause and BC-specific mortality, adjusting for tumour characteristics and lifestyle factors.ResultsOver a 7-year follow-up after diagnosis, 229 women died, 163 from BC. Elevated IL-6 levels were associated with increased all-cause mortality risk (HR1-SD 1.25, 95% CI 1.07–1.47). Among postmenopausal, IL-6 was associated with higher all-cause (HR1-SD 1.41, 95% CI 1.18–1.69) and BC-specific mortality (HR1-SD 1.31, 95% CI 1.03–1.66), (PHeterogeneity (pre/postmenopausal) < 0.05 for both), while IL-10 and TNFα were associated with all-cause mortality only (HR1-SD 1.19, 95% CI 1.02–1.40 and HR1-SD 1.28, 95% CI 1.06–1.56). Among ER+PR+, IL-10 was associated with all-cause and BC-specific mortality (HR1-SD 1.35, 95% CI 1.10–1.65 and HR1-SD 1.42 95% CI 1.08–1.86), while TNF-α was associated with all-cause mortality in HER2- (HR1-SD 1.31, 95% CI 1.07–1.61). An inflammatory score predicted higher all-cause mortality, especially in postmenopausal women (HR1-SD 1.30, 95% CI 1.07–1.58).ConclusionsHigher pre-diagnosis IL-6 levels suggest poorer long-term survival among BC survivors. In postmenopausal survivors, elevated IL-6, IL-10, and TNFα and inflammatory scores seem to predict all-cause mortality.

Adiposity assessed close to diagnosis and prostate cancer prognosis in the EPIC study.

Adiposity has been characterized as a modifiable risk factor for prostate cancer. Its association with outcomes after prostate cancer diagnosis, however, must be better understood, and more evidence is needed to facilitate the development of lifestyle guidance for patients with prostate cancer. We investigated the associations between adiposity indices close to prostate cancer diagnosis (up to 2 years before or up to 5 years after diagnosis) and mortality in 1968 men of the European Prospective Investigation into Cancer and Nutrition cohort. Men were followed up for a median of 9.5 years. Cox proportional hazards models were adjusted for age and year of diagnosis, disease stage and grade, and smoking history and stratified by country. Each 5-unit increment in prediagnosis or postdiagnosis body mass index combined was associated with a 30% higher rate of all-cause mortality and a 49% higher rate of prostate cancer-specific mortality. Similarly, each 5-unit increment in prediagnosis body mass index was associated with a 35% higher rate of all-cause mortality and a 51% higher rate of prostate cancer-specific mortality. The associations were less strong for postdiagnosis body mass index, with a lower number of men in analyses. Less clear positive associations were shown for waist circumference, hip circumference, and waist to hip ratio, but data were limited. Elevated levels of adiposity close to prostate cancer diagnosis could lead to higher risk of mortality; therefore, men are encouraged to maintain a healthy weight. Additional research is needed to confirm whether excessive adiposity after prostate cancer diagnosis could worsen prognosis.

The effect of HER2-targeted inhibitors as second-line or later-line regimens in the treatment of HER2-positive advanced colorectal cancer: A systematic review and meta-analysis.

e15542 Background: To systematically evaluate and meta-analyze the efficacy and safety of Human Epidermal Growth Factor Receptor-2 Inhibitor (HER2 Inhibitor) as a second-line or later-line antitumor regimen in the treatment of HER2-positive advanced colorectal cancer and provides a new method to treat metastatic colorectal cancer who failed with first-line treatment. Methods: Literature focusing on the use of HER2-targeted inhibitors in the treatment of HER2-positive mCRC was downloaded from Pubmed, Web of Science, EMBASE and Google Scholar databases from January 1, 2019 to October 31, 2022, and the final included articles were determined by screening and relevant data were extracted, including Objective Response Rate (ORR), disease control rate (DCR), Progression-Free-Survival (PFS), Overall Survival (OS), and Serious Adverse Events (SAEs) (Grade 3/4 adverse events). Binary variables were compared using 95% confidence intervals (CI) and odds ratios (OR); for continuous variables, heterogeneity was checked using Cochran's Q Test (p values and I²) and Weighted mean difference (WMD) and 95% CI. P &lt; 0.05 or I² &gt; 50% denote statistical significance, and results were combined using a random-effects model. The efficacy and safety of adding HER2-targeted inhibitors in treating HER2-positive mCRC were further discussed using the above methods. Results: The systematic review and meta-analysis included 17 studies with a total of 267 patients, with an overall DCR of 57% (95% CI: 43%-70%), an ORR of 29% (95% CI: 21%-37%), a median OS of 13.11 months (95% CI: 10.57-15.64), a median PFS of 4.40 months (95% CI: 3.64-5.15), and SAEs of 20% (95% CI: 0.11-0.29). The efficacy of the second-line and later-line treatment was significantly better than that of the well-known EPIC study, ML18147 study, CONCUR study and FRESCO-2 study. Conclusions: Systematic review and meta-analysis show that HER2-targeted inhibitors as second-line or later-line regimens demonstrate ideal antitumor efficacy and safety in HER2-positive mCRC, which is better than the standard regimen without anti-HER2 therapy. Specifically, the new ADC drug (A antibody-drug Conjugate, ADC) should be able to improve the treatment effect of these patients more effectively. Therefore, HER2-targeted inhibitors can effectively improve the efficacy of second-line and later-line therapy for HER2-positive mCRC. Furthermore, it is still worth exploring its therapeutic effects application as first-line therapy, which is expected to offer new strategies for the clinical diagnosis and treatment of HER2-positive advanced colorectal cancer.

МИФОЭПИЧЕСКИЕ ОСНОВЫ АДЫГСКОГО НОВОГО ГОДА

The article considers the traditional spring holiday “Alternation of heads of years” (Ilesyshye zablek1ygu) on March 21–23 among the Adygs (Circassians) people, dedicated to Shyuzeresh the patron saint of abundance and horsemen. The aim of the work is to study the mythoepic basis of the traditional holidays associated with the spring and winter solstices. Based on this goal, the tasks of identifying representations of sacred processes designed to create favorable conditions for the preparation and start of spring field work and seasonal agricultural completion of the year are solved. The relevance of the research topic is due to the insufficient knowledge of the calendar holidays of the Adygs, in this case, associated with the vernal equinox and winter solstice. The theoretical basis of the mythological rituals requires in-depth study, since the process of reanimation of folk festivals is one of the important components of the self-identification of the Adyghe. Travel essays by missionaries, the research activities of the Adyghe enlighteners of the 19th century Sultan Khan Giray, Shora Nogmov, Adil Giray Keshev, folklorists Askarbiy Shortanov, Mukhtar Meretukov, Adam Gutov, Aslan Tsipinov and other scholars served as the methodological basis of this work and determined the basic principles of research: the comparative-historical, historical-typological, and comparative analyses. The novelty of the study lies in the fact that it describes for the first time the rituals of the spring festival, symbolizing the onset of the Adyghe New Year, and the time of spring plowing, which began on the third day after the onset of the holiday “Alternating heads of Years”, as well as the winter solstice holiday. The result of the study was the conclusion that the worldview and worldview of the ancient Adyghe was at a high level for its time and evolved along with the process of progressive development of the Adyghe society. It is established that a historical and cultural excursion into the past about the existence of the New Year among the Adyghe (Circassians) and the winter solstice holiday makes it possible to know the depth of the processes of the mythoepic consciousness of the people. The theoretical and practical value of the work is seen in the possibility of using the results of the research in theoretical disciplines and practical research on folklore, epic studies, the study of the mythoepical basis of the Adyghe worldview, as well as in the educational process of educational institutions.

Nudging towards COVID-19 and influenza vaccination uptake in medically at-risk children: EPIC study protocol of randomised controlled trials in Australian paediatric outpatient clinics

IntroductionChildren with chronic medical diseases are at an unacceptable risk of hospitalisation and death from influenza and SARS-CoV-2 infections. Over the past two decades, behavioural scientists have learnt how to...

СЮЖЕТ БЫЛИНЫ О СТАВРЕ ГОДИНОВИЧЕ: РЕВИЗИЯ ИССЛЕДОВАТЕЛЬСКИХ ПОДХОДОВ

The article deals with the research of the Bylinas about Stavr Godinovich: a brief review is devoted to the works of the representatives of the theory of borrowings (V.V. Stasov, G.N. Potanin, A.N. Veselovsky, I.P. Sazonovich), more detailed - to the works of the representatives of the historical direction in epic studies. In particular, the methods and hypotheses of V.F. Miller, B.A. Rybakov, V.L. Yanin and M.N. Kozlov. The researchers correlated characters from written sources with the epic hero: the centurion Stavr from the annals of 1118, Vladimir Monomakh’s voivode named Stavko Gordyatich and the son of the Novgorod rebel Gyurata Rogovich. The biography of the “historical” Stavko and together with him the epic hero with each research and introduction of new sources (birch bark letters, graffiti inscriptions in the building of the Sofia Cathedral in Kiev) grew with facts and details. Researchers reconstructed practically all periods of life of “historical” Stavr: his young years, family ties, relations with representatives of power, life-changing events, etc. Thus, alternative realities were created for Stavr Godinovich, in which not only he, but also other epic characters (Vasilisa Mikulichna), events and details became “historical”.

МЕДИЦИНАЛЫК ЖОГОРКУ ОКУУ ЖАЙЛАРЫНДА “МАНАС” ЭПОСУ МЕНЕН “МАХАБХАРАТА” ЭПОСУН САЛЫШТЫРЫП ОКУТУУНУН АЙРЫМ БИР МАСЕЛЕЛЕРИ

The article deals with the problems of comparative study of the epic "Manas" and the epic "Mahabharata" in higher medical educational institutions in the discipline "Manas studies". Regardless of the form of ownership, the discipline "Manas Studies" is taught in higher educational institutions. Due to the increase in the number of young people studying in medical educational institutions from the Republic of India, in order to ensure effective teaching of the discipline "Manas Studies", the comparative study of the epic "Mahabharata" and the epic "Manas" is relevant today. The comparative study of epics on the world stage plays an effective role in the development of foreign medical students, first as individuals, and then as doctors, by studying the similarities and differences between the epics of the two peoples through the prism of history, literature, traditions, culture and religion. Using historical, sociological, comparative and statistical methods of comparative teaching when teaching the discipline "Manas Studies" in higher educational institutions, comparing the epics "Manas" and "Mahabharata", we strive to preserve and transmit national values from generation to generation to students studying in the medical field.

ЭПИЧЕСКОЕ НАСЛЕДИЕ БАШКИР РОССИЙСКОЙ ФЕДЕРАЦИИ В ЗАПИСЯХ СЕРЕДИНЫ ХХ В.

The article is devoted to the topical issue of studying archival records of epic monuments recorded outside the Republic of Bashkortostan, in particular in Orenburg, Kurgan, Chelyabinsk, Samara, and Saratov regions, some of which have been published, and variants are taken into account in the comments to the volumes. In the first monograph devoted to the Bashkir heroic epic, its author A. N. Kireev noted that expeditions to the regions of the Russian Federation listed above gave a lot of new information about the Bashkir folk epic. This article is aimed at the study of epic material recorded precisely outside the Republic of Bashkortostan. The objectives of the article are to identify texts included in the volumes of the scholarly code “Bashkir folk art” and texts that have not yet been published; possible repeated recordings; determining the area of distribution of this or that epic tale, the age and gender of the informants. To solve the tasks, a statistical method was used to characterize the repertoire; the method of comparative analysis was used as the main one, an element of structural analysis and a comparative-descriptive method was also used in the study of repeated recordings in line with experimental approaches developed by V. M. Gatsak in the field of the theory of the preservation of the epic in time. The methodological basis of the article was the works of Russian, including Bashkir, researchers-predecessors in the field of epic studies: A. N. Kireev, S. A. Galina, M. M. Sagitova, V. M. Gatsak, I. V. Pukhov, etc. The study will allow us to present the content, volume of material, distribution areas of the Bashkir epic in the regions of the Russian Federation where Bashkirs live compactly. When studying archival materials, it turned out that epic works about animals and social and everyday ones were particularly widespread there. In the future, archival texts will be published and put into active scientific circulation. It is a subject for special research, including dissertations, on various genres of folklore of the Bashkirs of the Russian Federation, both from the folkloristic and linguistic point of views (dialects are interesting, both archaisms and Russian words are used, even characters of Russian folklore are found in the texts).

Treatment-Free Remission in Ponatinib-Treated CML Patients: The Italy-Tfr Experience

Background: In recent years, treatment-free remission (TFR) has become a new therapeutic goal and is considered feasible even by international expert guidelines, at least in patients (pts) with a stable deep molecular response (DMR). From the EPIC study, we learned that many pts achieve a DMR very early, regardless of Sokal risk (Lipton, Lancet Oncol 2016). The Optic study showed that early dose reduction is associated with a containment of cardiovascular (CV) risk while maintaining therapeutic efficacy. In the cohort of pts initially treated with 45 mg QD, the number of events remained around 10% (Cortes, Blood 2021). Recommendations for treatment discontinuation suggest that it should be considered only after one line of treatment or after a second line if first-line TKI was switched for intolerance. Since 2016, there are case reports in the literature of imatinib-resistant pts, treated with ponatinib in second or following lines due to intolerance or resistance to previous TKIs, with or without ABL1 mutations, who reduced the daily dosage from 45 to 15 mg, still achieving a DMR and then discontinued ponatinib due to toxicity, obtaining a persistent TFR (Wisniowski, Blood 2016; Engel, J Oncol Pract 2016; Cohen, Leuk Lymphoma 2020). Methods: Within the context of the Italy-TFR retrospective and prospective study (NCT04769947) which is ongoing and actually includes 467 pts, we collected the data of 19 pts who attempted TFR after ponatinib treatment. Results: Median age was 44 years at diagnosis, 60 years at ponatinib discontinuation. 8 pts were male (42%); Sokal score was available for 14 pts: 5, 3 and 6 pts were low, intermediate and high risk, respectively. ELTS score was available for 11 pts: 6 pts, 4 and 1 were low, intermediate and high risk, respectively. 6 pts were treated with ponatinib in second line, 9 in third line, 3 in forth line. First-line therapy was available for 16 pts and was imatinib for 11 pts, nilotinib for 2 pts, dasatinib for 3 pts. Median duration of front-line treatment was 16 months (mos, IQR 11-34). Data on second line therapy was available for 11/12 pts: 5 pts were treated with nilotinib, 6 with dasatinib. Median duration of second-line treatment was 47 mos (IQR 19-58). Third line therapy was dasatinib for all 3 pts, with a duration of 1, 18 and 139 mos. Reason for starting ponatinib was intolerance for 8 pts, resistance for the others. For 7/11 resistant pts response at ponatinib start was CHR for one pt, MR1 for 3 pts, MR2 for 3 pts. 3 pts carried 1 ABL1 mutation at ponatinib start: 1 F359V, 1 M244V and 1 T315I; 1 pt carried 2 mutations: 1 Y253H and 1 E499E. Patients received ponatinib for a median of 47 mos (IQR 34-54). Starting dose was 45 mg for 6 pts, 30 mg for 8 pts and 15 mg for 5 pts. Response at 3 mos was available for 17 pts and was MR2 for 2 pts, MR3 for 9 pts and DMR for 6 pts. Median time to DMR was 18 mos (IQR 6-36). Ponatinib dose before treatment discontinuation was 15 mg for all but 4 pts: 1 was dose reduced from 45 mg to 30 mg, 1 stayed on 45 mg; 2 pts who had started with 15 mg dose reduced to 15 mg every other day. 11 pts discontinued in MR4, 7 pts in MR4.5 and 1 pt in MR5. Median duration of DMR before discontinuation was 25 mos (IQR 14-37). Reasons for discontinuation were: physician-patient shared choice for 9 pts, intolerance for 6 pts (among whom 1 had pancreatitis, 1 worsening of cardiac heart failure, 1 tachycardia, and 3 low-grade GI symptoms), need to start chemotherapy for a second neoplasia for 2 pts, pregnancy for 1 pt and auto-suspension for 1 pt. Only one pt had a CV adverse event (stroke) during treatment with ponatinib. 16/19 pts maintained TFR for a median time of 19 mos (IQR 8-32) and were still off treatment at the last follow-up. 3 pts had to resume treatment after 3, 4 and 9 mos. All 3 restarted treatment with ponatinib and reobtained DMR. All pts were alive at last follow-up, except for 2 pts who died for a gastric and a lung cancer. Conclusions: Our data confirmed the efficacy of ponatinib in second or later lines of treatment. All pts, including those treated for resistance, achieved optimal responses at 3 mos. We also showed that TFR may be feasible for some pts treated in second or subsequent lines, not only for intolerance. Follow-up time extension and collection of data from additional pts are desired to confirm our observations, and seem to be of utmost importance to better define the characteristics of pts who might benefit from ponatinib with the purpose of TFR attempt.

Body mass index and cancer risk among adults with and without cardiometabolic diseases: evidence from the EPIC and UK Biobank prospective cohort studies

BackgroundWhether cancer risk associated with a higher body mass index (BMI), a surrogate measure of adiposity, differs among adults with and without cardiovascular diseases (CVD) and/or type 2 diabetes (T2D) is unclear. The primary aim of this study was to evaluate separate and joint associations of BMI and CVD/T2D with the risk of cancer.MethodsThis is an individual participant data meta-analysis of two prospective cohort studies, the UK Biobank (UKB) and the European Prospective Investigation into Cancer and nutrition (EPIC), with a total of 577,343 adults, free of cancer, T2D, and CVD at recruitment. We used Cox proportional hazard regressions to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between BMI and incidence of obesity-related cancer and in turn overall cancer with a multiplicative interaction between BMI and the two cardiometabolic diseases (CMD). HRs and 95% CIs for separate and joint associations for categories of overweight/obesity and CMD status were estimated, and additive interaction was quantified through relative excess risk due to interaction (RERI).ResultsIn the meta-analysis of both cohorts, BMI (per ~ 5 kg/m2) was positively associated with the risk of obesity-related cancer among participants without a CMD (HR: 1.11, 95%CI: 1.07,1.16), among participants with T2D (HR: 1.11, 95% CI: 1.05,1.18), among participants with CVD (HR: 1.17, 95% CI: 1.11,1.24), and suggestively positive among those with both T2D and CVD (HR: 1.09, 95% CI: 0.94,1.25). An additive interaction between obesity (BMI ≥ 30 kg/m2) and CVD with the risk of overall cancer translated into a meta-analytical RERI of 0.28 (95% CI: 0.09–0.47).ConclusionsIrrespective of CMD status, higher BMI increased the risk of obesity-related cancer among European adults. The additive interaction between obesity and CVD suggests that obesity prevention would translate into a greater cancer risk reduction among population groups with CVD than among the general population.

Reading Turkey-Centered Epic Studies in the Context of the Founding Ideology of the Republic of Turkey and the "Nation-State" Idea

Türkiye Cumhuriyeti'nin ilk yüzyılındaki millileşme çabaları, Türk toplumunun ulusal kimlik oluşturma ve modern ulus devletin inşasında kritik bir rol oynamıştır. Bu çabalar, Osmanlı İmparatorluğu'nun çöküşünden sonra Türkiye'nin siyasi, sosyal ve kültürel dönüşümünü şekillendiren girişimlerden oluşmaktadır. Dünya siyasetinde büyük ölçüde savaşların ve ekonomik krizlerin etkili olduğu ilk dönem, Türkiye Cumhuriyeti Devleti’nin ulus devlet olma amacını birçok manada sekteye uğratmıştır. Yine de Türkiye Cumhuriyeti tarihinin ilk dönemleri ulus devlet inşasına yönelik adımların atıldığı önemli bir dönemdir. Özellikle dili, kültürü ve tarihi millileştirme adımları, modern bir ulus devletin temellerini atmıştır. Bu bakımdan Mustafa Kemal Atatürk dönemi, toplumu etnik temelli bağlardan daha ziyade milli bir kimlik etrafında birleşmeye amaçlamıştır. Bu dönemde Türk dilinin, tarihinin ve kültürünün korunması için kurumlar kurulmuş, milli eğitim politikaları geliştirilmiş, halk kültürünün ehemmiyetine dikkat çekilerek toplumsal kolektivizmin oluşturulması amaçlanmıştır. &#x0D; Bu bağlamda bu çalışmanın sınırlılığını Türkiye Cumhuriyetinin millileşme hamleleri oluşturmaktadır. Çalışmada millileşme süreci ilk olarak tarihsel, kültürel alanlarda ele alınacak daha sonra, Türkiye’de yapılmış destan çalışmaları millileşme ile birlikte değerlendirilecektir. Çalışma, destan anlatı türü hakkında yapılmış akademik çalışmaları kolektivizm ve köken inşası çerçevesinde incelerken Türkiye ve dünyadaki önemli tarihsel süreçleri de odak noktasına alacak ve ulus devletin inşa sürecine dolaylı veya doğrudan etki edebilecek tarihsel, siyasal, ekonomik olay/durumları birlikte değerlendirecektir. Dolayısıyla çalışmada, Türkiye Cumhuriyeti Devletini içte ve dışta etkileyen tarihsel, siyasal, ekonomik olaylara yer verilmiştir. Bu detayların tamamı değerlendirme ve sonuç bölümünde ulus devlet, millileşme, köken arayışı gibi kavramlar çerçevesinde okunacaktır.

Эпосоведение

Our purpose is to discover and describe the means of expression of comparative relations in the heroic tale Оchy-Bala, an outstanding Altaian heroic epic. The relevance of our study stems from the fact that the Altaian heroic epics remain relatively understudied, and its novelty lies in the fact that for the first time, we analyze the structural and semantic types of comparative constructions in Оchy-Bala. Our primary methods are descriptive methods and methods of structural modeling. In our study, we detect and describe comparative constructions denoting equative, similative, comparative, and superlative relations. To express equative and similative relations, essentially the same constructions are used in most cases, which makes their formal distinction difficult. Comparative and superlative constructions are represented by singular examples, unlike the highly common equative and similative constructions. Both objects and actions can serve as objects and standards of comparison. Parameters of comparison are often not expressed verbally. Standards of comparison in the Altai language are formed by comparison markers; therefore, special attention is paid to markers of comparison standards, which make comparative constructions comparative in the first place. They may be synthetic (expressed as affixes within comparison standards) and analytical (expressed through function words). We show that in Оchy-Bala, the means of expression of comparative relations are the same as in the modern Altai language; however, their numbers, frequency, and usage are not quite the same. For example, the comparative constructions in Оchy-Bala include three synthetic (=DYi, =DAŋ and =GAndYi) and six analytical markers of comparison: keptü ‘like, as if’, keberlü ‘like, as though’, chylap ‘like, as if, as though’, oshkosh / ushkush ‘like, as if, as though’, polup ‘like’, podoldu ‘as though’. We show that the functioning of the same constructions in folklore text and modern Altai language is different. In modern Altai, comparative constructions with function words chylap ‘like, as if, as though’ and oshkosh / ushkush ‘like, as if, as though’ are highly common; however, they aren’t as frequent in Оchy-Bala. We also list the comparative constructions used regularly for the figurative description of the main characters are highlighted.

Эпосоведение

This article is devoted to the study of the conceptual component of the Adyghe Nart epic. The purpose of this study is to identify and describe the key and basic emotional discourse-forming concepts representing the Adyghe linguoculture, based on the material of the Adyghe Nart epic. The realization of this goal provides for the solution of the following tasks: to analyze the cycles of the Adyghe Nart epic; to identify and describe the basic emotional concepts that form the epic discourse; to determine the key discourse-forming concept. To achieve the goal, the following methods were used: observation, analysis, continuous sampling method, descriptive method. The scientific novelty lies in the fact that the concept of “NART” is considered as the key nuclear concept of the Adyghe epic, which unites the basic supporting elements of the language around itself. It is noted that the proper names of the characters are always accompanied by the epithet “nart”. All actions, events, adventures, trials, exploits unfold around the Nart characters. As a result of the conducted research, we came to the conclusion that the basic discourse-forming concepts are the emotive concepts of “LOVE”, “PASSION”, “FAITH”, “LOYALTY”. The basic emotion “passion” of the Adyghe Nart epic has its own set of controlled and uncontrolled reactions of the subject. Controlled reactions of the subject are reflected in his speech behavior, and uncontrolled reactions are reflected in the non-speech behavior of the subject. Love and passion are correlated concepts for sleds. They form a single whole in all the passages where the love line of the main characters is described. You can notice a single way of word formation and a single root Shiu “good” in the words Shiulegunig ‘love’ and Shioigunig ‘passion’. The basic emotion “passion” of the Adyghe Nart epic has its own set of controlled and uncontrolled reactions of the subject. Controlled reactions of the subject are reflected in his speech behavior, and uncontrolled reactions are reflected in the non-speech behavior of the subject. Love and passion are correlated concepts for sleds. They form a single whole in all the passages where the love line of the main characters is described. You can notice a single way of word formation and a single root Shiu “good” in the words Shiulegunig “love” and Shioigunig “passion”. The present study is based on the scholarly works by L. S. Abrosimova, K. A. Andreeva, Z. H. Bizheva, L. Y. Buyanova, A. S. Goncharova, O. S. Makarova, O. G. Pocheptsov, E. A. Redkozubova, E. K. Spitsyna, A. Sh. Altruova, G. R. Nurekeshova and other scholars. The theoretical and practical value is seen in the possibility of using the results in theoretical disciplines and practical courses in general linguistics, Caucasian languages, theoretical, applied and comparative linguistics, epic studies, as well as in the process of teaching cognitive conceptual analysis of folklore text.

Эпосоведение

The article is devoted to the study of proverbs and sayings of the Khakas language, which are anthropocentric in nature and include animal names (zoonyms). The aim of the article is to identify and describe the semantics of zoonyms and the peculiarities of their functioning in Khakas paremic expressions. The relevance of the topic is conditioned by the insufficient development of the problems of studying small folklore genres in Khakas linguistics. The novelty of the conducted research consists in the fact that it attempts to study zoonyms as components of proverbs and sayings of the Khakas language. Descriptive, semantic-cognitive and linguostatistical methods, and a review of scientific literature were used in the course of the work. The material of the study was selected by continuous sampling from existing collections of Khakas proverbs and sayings. The results obtained in the course of the study showed the presence of a large number of paremi with zoonym components (more than 130 units), which is due to the significance of the animal world, in which the national features and mental peculiarities of the Khakas people have been fixed as a result of centuries of human observation of it. The ethnocultural specificity of the Khakas language is most fully represented by paremi with the zoolexeme at ‘horse’. The thematic classification of Khakas proverbs and sayings with zoonymic components includes about 12 value-oriented semantic groups, which are united within the framework of universal oppositions (good-bad, good-evil, truth-false, strength-weakness, intelligence-stupidity, etc.), as well as family and social relations. The dominance of the two-component parallel structure of Khakas paremi has been revealed, containing in one part the main idea in the form of a moral attitude, and in the second part – its argumentation with a zoonym component. The figurative meanings of Khakas animalistic paremiology are represented by associative links of animal morals and habits with human characteristics and traits: horse symbolizes strength, diligence; hare is associated with cowardice; dog – with anger, cruelty; snake – with pretense and meanness; wolf – with greed and calculating mind; bear – with fearlessness; magpie – with idle talk and chatter, etc. The ethnocultural semantics of zoonyms is presented both in metaphorical proverbs and sayings, and in paremi, representing good wishes, customs and omens of the Khakas people. Further implications – comparative studies of the topic under consideration with the involvement of materials of Russian and English languages.

Intake of the Total, Classes, and Subclasses of (Poly)Phenols and Risk of Prostate Cancer: A Prospective Analysis of the EPIC Study.

Existing epidemiological evidence regarding the potential role of (poly)phenol intake in prostate cancer (PCa) risk is scarce and, in the case of flavonoids, it has been suggested that their intake may increase PCa risk. We investigated the associations between the intake of the total and individual classes and subclasses of (poly)phenols and the risk of PCa, including clinically relevant subtypes. The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort included 131,425 adult men from seven European countries. (Poly)phenol intake at baseline was assessed by combining validated center/country-specific dietary questionnaires and the Phenol-Explorer database. Multivariable-adjusted Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI). In total, 6939 incident PCa cases (including 3501 low-grade and 710 high-grade, 2446 localized and 1268 advanced, and 914 fatal Pca cases) were identified during a mean follow-up of 14 years. No associations were observed between the total intake of (poly)phenols and the risk of PCa, either overall (HRlog2 = 0.99, 95% CI 0.94-1.04) or according to PCa subtype. Null associations were also found between all classes (phenolic acids, flavonoids, lignans, and stilbenes) and subclasses of (poly)phenol intake and the risk of PCa, overall and according to PCa subtype. The results of the current large prospective cohort study do not support any association between (poly)phenol intake and PCa incidence.

Randomised controlled trials of behavioural nudges delivered through text messages to increase influenza and COVID-19 vaccines among pregnant women (the EPIC study): study protocol

BackgroundInfluenza and COVID-19 infections during pregnancy may have serious adverse consequences for women as well as their infants. However, uptake of influenza and COVID-19 vaccines during pregnancy remains suboptimal. This study aims to assess the effectiveness of a multi-component nudge intervention to improve influenza and COVID-19 vaccine uptake among pregnant women.MethodsPregnant women who receive antenatal care at five tertiary hospitals in South Australia, Western Australia and Victoria will be recruited to two separate randomised controlled trials (RCTs). Women will be eligible for the COVID-19 RCT is they have received two or less doses of a COVID-19 vaccine. Women will be eligible for the influenza RCT if they have not received the 2023 seasonal influenza vaccine. Vaccination status at all stages of the trial will be confirmed by the Australian Immunisation Register (AIR). Participants will be randomised (1:1) to standard care or intervention group (n = 1038 for each RCT). The nudge intervention in each RCT will comprise three SMS text message reminders with links to short educational videos from obstetricians, pregnant women and midwives and vaccine safety information. The primary outcome is at least one dose of a COVID-19 or influenza vaccine during pregnancy, as applicable. Logistic regression will compare the proportion vaccinated between groups. The effect of treatment will be described using odds ratio with a 95% CI.DiscussionBehavioural nudges that facilitate individual choices within a complex context have been successfully used in other disciplines to stir preferred behaviour towards better health choices. If our text-based nudges prove to be successful in improving influenza and COVID-19 vaccine uptake among pregnant women, they can easily be implemented at a national level.Trial registrationClinicalTrials.gov Identifier NCT05613751. Registered on November 14, 2022.

Sex-Specific Dietary Patterns and Social Behaviour in Low-Risk Individuals.

Dietary and social behaviour are non-medical factors that influence health outcomes. Non-communicable diseases are related to dietary patterns. To date, little is known about how social behaviour is associated with health-related dietary patterns, and, in particular, we lack information about the role of sex within this possible relation. Our cross-sectional study investigated associations between dietary patterns and social behaviour including personality traits (self-control, risk taking), political preferences (conservative, liberal, ecological, social) and altruism (willingness to donate, club membership, time discounting) in men and women. We performed sex-specific correlation analyses to investigate relationships between dietary patterns based on self-reported protocols from the Mediterranean Diet Adherence Screener (MEDAS) and the validated Healthy Eating Index (HEI) from the EPIC Study and a self-reported social behaviour questionnaire. In linear regression models, we analysed associations between dietary and social behaviour patterns. Sex differences were measured by interaction analysis for each social behaviour item. The study sample consisted of N = 102 low-risk individuals. The median age of the study participants was 62.4 (25th/75th percentile 53.6, 69.1) years, and 26.5% were women. Analyses showed that a lower HEI score was correlated with a higher BMI in both women and men. MEDAS and HEI showed a positive correlation with each other in men. In men, a higher MEDAS showed a positive correlation when they estimated their ability as high, with the same for self-control and preference for ecological politics and MEDAS. A weak negative correlation has been shown between men with a preference for conservative politics and MEDAS. HEI showed a positive significant correlation with age in men. Male participants without club membership scored significantly higher in the HEI compared to non-members. A negative correlation was shown for time discounting in men. Linear regression models showed positive associations between preferences for ecological-oriented politics and nutrition for both HEI and MEDAS. No sex interactions were observed. We faced a few limitations, such as a small sample size, particularly for women, and a limited age spectrum in a European cohort. However, assuming that individuals with a preference for ecological-oriented politics act ecologically responsibly, our findings indicate that ecological behaviour in low-risk individuals might determine, at least in part, a healthy diet. Furthermore, we observed dietary patterns such as higher alcohol consumption in men or higher intake of butter, margarine and cream in women that indicate that women and men may have different needs for nutritional improvement. Thus, further investigations are needed to better understand how social behaviour affects nutrition, which could help to improve health. Our findings have the potential to inform researchers and practitioners who investigate the nature of the relationship between social behaviour and dietary patterns to implement strategies to create first-stage changes in health behaviour for individuals with a low cardiovascular risk profile.