Middle Ages Research Articles

Heatstroke characteristics and meteorological conditions in Hefei, China: thresholds and driving factors

BackgroundDue to climate change and rapid urbanization, the frequency of heatwave events in East China has increased considerably since the 21st century, which has a considerable influence on human health, such as heatstroke. However, few studies have been conducted in this region on the relationship between heatstroke and meteorological conditions. To address this point, this study aimed to analyze the characteristics of heatstroke and their relationship with meteorological conditions in Hefei, China.MethodsThe 2008–2022 heatstroke data from Hefei Center for Disease Control and Prevention was used. The relationship between heatstroke and meteorological conditions was discussed by statistical methods, such as correlation analysis, cluster analysis and linear regression analysis.ResultsThe number of heatstroke cases fluctuated upward from 36 cases in 2008 to 1051 cases in 2022, with 71.5% of all cases for males and females accounting for 28.5%. The highest frequency of heatstroke occurrence was found to be concentrated in the middle age group (40–59 years old). According to the statistical analysis, air temperature and relative humidity were the most important meteorological factors that influenced the occurrence of heatstroke. Then a threshold system of meteorological factors for heatstroke was established by utilizing the relationship: daily average temperature (T) ≥ 30 °C & daily average relative humidity (RH) ≤ 80% and daily maximum temperature (Tmax) ≥ 35 °C & daily minimum relative humidity (RHmin) ≤ 65%. The threshold in group outbreak areas was stricter than it in high incidence areas. Furthermore, the Pacific Subtropical High (PSH) was found to be the primary climatic factor that determined the occurrence of heatstroke occurrence on a seasonal scale. In addition, significant differences in heatstroke risk were found among different groups of people. Heatstroke risk was substantially higher in males than in females due to larger opportunities for outdoor labor. The reduced physical fitness of elderly people raised the risk of heatstroke more than other age groups in extremely high temperatures.ConclusionsA meteorological threshold system had been established to forecast heatstroke occurrence in a short-term time, and a key climate driving factor of heatstroke was found for long-term heatstroke prediction in Hefei. These findings could facilitate the disease control department to take preventive and control measures to reduce the impact of heatstroke on human health and society.

Ethiopian Churches Commemorating Military Victories of the Solomonic Kingdom over the Betä Ǝsraʾel (Ethiopian Jews)

During the Middle Ages and Early Modern Period, most Jews lived as a minority under Christian or Islamic rule. By contrast, the Ethiopian Jews, the Betä Ǝsraʾel, maintained political autonomy in parts of Ethiopia until the seventeenth century. From the fourteenth century, they were engaged in a series of wars against the Christian Solomonic Kingdom. Following Christian military victories over the Betä Ǝsraʾel, the victors erected churches in the newly conquered lands. Some were built on the sites of battles and over Betä Ǝsraʾel strongholds to commemorate the Solomonic victory. While churches dedicated to historical events are common, those memorializing Christian military victories over Jews are largely without parallel elsewhere. This article provides an overview of what is known about their location, characteristics, and symbolism, and discusses their contribution to understanding the Betä Ǝsraʾel polity.

P-11 A CASE OF TUBERCULOSIS ADRENAL INSUFFICIENCY

Abstract Introduction Adrenal tuberculosis is rare form of extrapulmonary tuberculosis, and may cause to primary adrenal insufficiency. This report presents a case of middle age male diagnosed with adrenal tuberculosis. Tuberculosis is a major health concern worldwide. The extrapulmonary manifestations account for 5% to 15% of all cases, although adrenal tuberculosis is uncommon, it can lead to primary adrenal insufficiency and has diagnostic challenges due to its nonspecific presentation. Pulmonary Tuberculosis is still common in Iraq, although no case reports exit up to our knowledge of adrenal Tuberculosis. Clinical Case 40-year-old man, sanitation worker, presents with 3 months history of significant weight loss and fever with night sweating. He complains of nausea, occasional vomiting, fatigue, unintentional weight loss of approximately 12 kg, decreased appetite, abdominal pain and joint pain. He also reports skin hyperpigmentation particularly in the hand creases, mouth and mucous membranes of the lips. There are no respiratory symptoms such as shortness of breath or cough. The past medical history is unremarkable. There is positive family history of pulmonary tuberculosis (grandmother). He does not smoke or drink alcohol. Physical examination reveals ill-looking malnourished patient, with BP of 100/60 with postural hypotension, PR of 80 bpm and RR of 24/min. There is diffuse hyperpigmentation particularly noted in palmer creases and oral cavity. The other system examinations are normal. Laboratory investigations revealed mild normochromic normocytic anemia (Hb 11.4), and mild lymphocytosis, Na 126 mEq/l, k 4.1 mEq/l, FBS 87 mg/dl, high ESR, mild elevation of TSB 1.8 mg/dl normal renal function, morning cortisol of 0.75 Mcg/dl and morning ACTH of 1808 pg/ml. Imaging studies show a normal chest X-ray. Abdominal CT reveals bilateral adrenal enlargement in size with lobulated irregular contours and heterogeneous density exhibiting foci of calcification and central cystic/necrotic non-enhancing centers, with predominantly peripheral enhancement seen on the contrast scan. The mean density of the solid parts of the glands is around 30-40 HU on the native scan, the right adrenal measures 2.7x1.7x2.7 cm, the left adrenal measures 5.6x3.2x2.5 cm. IGRA test is positive. Adrenal biopsy was not performed because the presentation was highly suggestive of adrenal tuberculosis.The diagnosis was primary adrenal insufficiency due to adrenal tuberculosis Anti TB drugs were initiated on standard regimen of INH, Rifampicin, Pyrazinamide, and Ethambutol. Hydrocortisone replacement was initiated. The patient required higher dose of hydrocortisone (20 mg in the morning, 10 mg at 6 pm) which could be due to CYP 3A4 induction by rifampicin Fludrocortisone 0.1mg daily was also started. The patient’s symptoms improve dramatically after initiation of treatments, with gradual increase in body weight.Figure 1:Hyperpigmentation of the patient hands

IForal: Automated Handwritten Text Transcription for Historical Medieval Manuscripts

The transcription of historical manuscripts aims at making our cultural heritage more accessible to experts and also to the larger public, but it is a challenging and time-intensive task. This paper contributes an automated solution for text layout recognition, segmentation, and recognition to speed up the transcription process of historical manuscripts. The focus is on transcribing Portuguese municipal documents from the Middle Ages in the context of the iForal project, including the contribution of an annotated dataset containing Portuguese medieval documents, notably a corpus of 67 Portuguese royal charter data. The proposed system can accurately identify document layouts, isolate the text, segment, and transcribe it. Results for the layout recognition model achieved 0.98 mAP@0.50 and 0.98 precision, while the text segmentation model achieved 0.91 mAP@0.50, detecting 95% of the lines. The text recognition model achieved 8.1% character error rate (CER) and 25.5% word error rate (WER) on the test set. These results can then be validated by palaeographers with less effort, contributing to achieving high-quality transcriptions faster. Moreover, the automatic models developed can be utilized as a basis for the creation of models that perform well for other historical handwriting styles, notably using transfer learning techniques. The contributed dataset has been made available on the HTR United catalogue, which includes training datasets to be used for automatic transcription or segmentation models. The models developed can be used, for instance, on the eSriptorium platform, which is used by a vast community of experts.

Adolescent mice exposed to TBI developed PD-like pathology in middle age

Traumatic brain injury (TBI) is identified as a risk factor for Parkinson’s disease (PD), which is a neurodegenerative disease characterized by the loss of dopaminergic neurons in the substantia nigra (SN). However, the precise mechanism by which chronic TBI initiates PD pathogenesis is not yet fully understood. In our present study, we assessed the chronic progression and pathogenesis of PD-like behavior at different intervals in TBI mice. More than half of the mice exhibited PD-like behavior at 6 months post injury. PD-like behavioral dysfunction and pathological changes were aggravated with the injured time extension in chronic phase of TBI. The loss of tyrosine hydroxylase positive (TH+) neurons in the SN were partly associated with the accumulation of misfolded a-Synuclein and the cytoplasmic translocation of TDP-43 from nuclear. Moreover, the present of chronic inflammation was observed in SN of TBI mice, as evidenced by the enhancement of proinflammatory cytokines and reactive astrocytes and microgliosis post lesion. The enhanced phagocytosis of reactive microglia accounted for the reduction of dendrite spines. Our results revealed that chronic inflammation associated with the damage of TH+ neurons and the development of progressive PD-like pathology after chronic TBI in mice. Our study shed new light on the TBI-triggered molecular events on PD-like pathology. Additional research is required to have a deeper understanding of the molecular factors underlying the impairment of dopaminergic neurons following TBI.

A cohort study on the association between blood pressure trajectories and variability in adolescence and subsequent target organ damage

Objective: To investigate the relationship between blood pressure trajectories and blood pressure variability with the risk of target organ damage in Chinese population from childhood to middle age. Methods: This study is a population-based, long-term follow-up cohort study. Participants who had their blood pressure measured at least 5 times in the Hanzhong Adolescent hypertension cohort from 1987 to 2023 were included in this study. Group-based trajectory modeling was used to identify different systolic and diastolic blood pressure trajectories, and the subjects were divided into low-increasing group, moderate-increasing group and high-increasing group according to blood pressure trajectories. Blood pressure variability was assessed using standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV). Target organ damage was evaluated during the final follow-up in 2023 (middle age). Logistic regression models were used to analyze the relationship between blood pressure trajectories and blood pressure variability with the risk of target organ damage. Results: A total of 2 447 subjects were included, with a median age of 48 years, of whom 1 373 were male (56.1%). Based on systolic blood pressure, 868 were in the low-increasing group, 1 238 in the moderate-increasing group, and 341 in the high-increasing group. For diastolic blood pressure, the distribution was 894, 1 263 and 290, respectively. Compared with the low-increasing group of systolic blood pressure, the moderate-increasing group (arteriosclerosis: OR=4.14, 95%CI 2.96-5.79; proteinuria: OR=2.06, 95%CI 1.38-3.07; left ventricular hypertrophy: OR=1.68, 95%CI 1.00-2.82) and high-increasing group (arterial stiffness: OR=15.44, 95%CI 10.14-23.50; proteinuria: OR=5.80, 95%CI 3.63-9.29; left ventricular hypertrophy: OR=2.93, 95%CI 1.55-5.53) had a higher risk of target organ damage (all P<0.005). The moderate-increasing group of diastolic blood pressure had a higher incidence of arterial stiffness (OR=3.72, 95%CI 2.69-5.12) and proteinuria (OR=1.67, 95%CI 1.15-2.42) than the low-increasing group (all P<0.005), while the high-increasing group had a significantly higher risk of all type of target organ damage compared to the low-increasing group (arterial stiffness: OR=10.84, 95%CI 7.08-16.61; proteinuria: OR=3.72, 95%CI 2.31-5.99; left ventricular hypertrophy: OR=2.38, 95%CI 1.23-4.59; all P<0.005). Additionally, higher systolic blood pressure variability was associated with an increased incidence of arterial stiffness (SD: OR=2.25, 95%CI 1.96-2.57; VIM: OR=1.64, 95%CI 1.45-1.86; ARV: OR=1.70, 95%CI 1.50-1.93) and proteinuria (SD: OR=1.65, 95%CI 1.44-1.89; VIM: OR=1.41, 95%CI 1.22-1.63; ARV: OR=1.45, 95%CI 1.26-1.67; all P<0.005). The results for diastolic blood pressure variability indicators were similar to those for systolic blood pressure. Conclusion: Early-life blood pressure trajectories are predictive of target organ damage risk in middle age. Higher blood pressure variability is related to an increased risk of arterial stiffness and proteinuria, but was less associated with left ventricular hypertrophy. Focusing on the risk of high blood pressure early in life can help prevent the occurrence of target organ damage in middle age.

Oct4, Sox2, Klf4, c-My (OSKM) gene therapy in the hypothalamus prolongs fertility and ovulation in female rats.

In middle-aged (MA) female rats, we have demonstrated that intrahypothalamic gene therapy for insulin-like growth factor-I (IGF-I) extends the regular cyclicity of the animals beyond 10 months (the age at which MA rats stop ovulating). Here, we implemented long-term OSKM gene therapy in the hypothalamus of young female rats. The main goal was to extend fertility in the treated animals. We constructed an adenovector that harbors the GFP gene as well as 4 Yamanaka genes. An adenovector that only carries the gene for GFP or DsRed was used as control. At 4 months of age 12 female rats received an intrahypothalamic injection of our OSKM vector (treated rats); 12 control rats received a vector expressing a marker gene (control rats). At 9.3 months of age control and treated rats were mated with young males. A group of 12 young intact female rats was also mated. The rate of pregnancy recorded was 83%, 8.3 and 25% for young, MA control and MA treated animals, respectively. Pup body weight (BW) at weaning was significantly higher in the MA OSKM rats than in MA controls. At the age of estropause (10 months), OSKM treated females still showed regular estrous cycles. The particular significance of the present results is that, for the first time, it is shown that long-term OSKM gene therapy in the hypothalamus is able to extend the functionality of such a complex system as the hypothalamo-pituitary-ovarian axis.

Book Review: Eastern Trade and the Mediterranean in the Middle Ages: Pegolotti’s Ayas–Tabriz Itinerary and Its Commercial Context by Thomas Sinclair

Book Review: <i>Eastern Trade and the Mediterranean in the Middle Ages: Pegolotti’s Ayas–Tabriz Itinerary and Its Commercial Context</i> by Thomas Sinclair

A Fountain and Other Remains from the Middle Ages in Ramla (with contributions by Nitzan Amitai-Preiss and Robert Kool) (Hebrew, pp. 51*–70*; English summary, pp. 173–174)

A Fountain and Other Remains from the Middle Ages in Ramla (with contributions by Nitzan Amitai-Preiss and Robert Kool) (Hebrew, pp. 51*–70*; English summary, pp. 173–174)

Yavne-Yam (North): An Agricultural Area and Cemeteries from the Middle and Late Bronze Ages, and the Persian, Hellenistic, Roman and Byzantine Periods (with contributions by Eriola Jakoel and Limor Talmi)(Hebrew, pp. 1–29; English summary, pp. 113*–115*)

Yavne-Yam (North): An Agricultural Area and Cemeteries from the Middle and Late Bronze Ages, and the Persian, Hellenistic, Roman and Byzantine Periods (with contributions by Eriola Jakoel and Limor Talmi)(Hebrew, pp. 1–29; English summary, pp. 113*–115*)

A Middle Bronze Age Tomb at ‘Atlit (pp. 111–130)

A Middle Bronze Age Tomb at ‘Atlit (pp. 111–130)

A Burial Cave from the Intermediate Bronze Age and Middle Bronze Age IIC near the Village of Ras ‘Ali, in Naḥal Zippori (Hebrew, pp. 1*–11*; English summary, p. 161)

A Burial Cave from the Intermediate Bronze Age and Middle Bronze Age IIC near the Village of Ras ‘Ali, in Naḥal Zippori (Hebrew, pp. 1*–11*; English summary, p. 161)

An Intermediate Bronze Age Settlement and a Middle Bronze Age II Cemetery at the ‘Third Mile Estate’, Ashqelon (pp. 143–165)

An Intermediate Bronze Age Settlement and a Middle Bronze Age II Cemetery at the ‘Third Mile Estate’, Ashqelon (pp. 143–165)

Middle Bronze Age IIA and Later Settlement Remains near Yehud on the Coastal Plain (pp. 131–174)

Middle Bronze Age IIA and Later Settlement Remains near Yehud on the Coastal Plain (pp. 131–174)

Excavations at Tel Lod: Remains from the Pottery Neolithic A, Chalcolithic, Early Bronze Age I, Middle Bronze Age I and Byzantine Periods (pp. 141–218)

Excavations at Tel Lod: Remains from the Pottery Neolithic A, Chalcolithic, Early Bronze Age I, Middle Bronze Age I and Byzantine Periods (pp. 141–218)

The effect of distraction and feedback on prefrontal cortex activity and balance in middle-aged adults: A functional near-infrared spectroscopy pilot study.

Maintaining balance while simultaneously performing other tasks is common during everyday activities. However, this dual-tasking (DT) divides attention and increases cognitive demand, which can be detrimental to stability in older adults. It is unknown if the focus of attention influences how a dual-task affects balance and whether this is detectable in middle-aged adults. This study investigates the effect of dual-task and attentional focus on prefrontal cortex (PFC) activity in young (YA) and middle-aged (MA) adults using functional-near infrared spectroscopy. Blood oxygen level of the PFC was measured during a quiet standing cognitive-motor dual-task where MA (n = 15, mean age 57.2 ± 4.8 years, 5 female) and YA (n = 20, mean age 24.9 ± 4.7 years, 9 female) stood on a forceplate while either fixating their gaze on a target ('fixed') or viewing their real-time postural oscillations in the anteroposterior direction ('sway') with and without serial 7 subtractions. It was expected that the MA group would show higher PFC activity, larger COP excursions, and poorer performance during DT than the YA group. PFC activity was larger during DT and during the fixed condition but did not differ between groups. COP excursion was also greater when attention was 'fixed' and was consistently larger in MA. MA drove a positive correlation between PFC activity and COP excursion during DT indicative of a higher attentional demand during distraction. Taken together, this study suggests that PFC processing and posture control are different in middle aged adults compared to young adults.

The Quest for Happiness: Medieval Perspectives for Our Future. Philosophical and Literary-Historical Investigations

Human life makes sense only if the individual can achieve a certain degree of happiness. In order to address this topic in an insightful and effective way, this paper turns to a selection of medieval literary narratives where the focus specifically rests on happiness that an individual might achieve when the circumstances and the ideals are right. As human beings, happiness does not simply come into our lives, at least not for adults. Instead, much intellectual education is required to gain the ability to distinguish between self-created meaning and relevance and alien control and enslavement as expressed in fake happiness. Hence, this paper intends to outline some preliminary thoughts and present literary and philosophical material from the Middle Ages where the issue of happiness has already been examined and discussed from various perspectives, inviting us to revisit them for our learning experience today and tomorrow. Since ancient times, philosophers have investigated the true meaning of happiness, offering the results of their experiences and insights. In order to reinvigorate the discourse on happiness, this paper draws from late antique philosophy, medieval verse narratives, and German literature from the nineteenth and twentieth centuries, including a modern-day movie. The quest for happiness has been ubiquitous, and it continues to matter for us universally across all cultures. The Humanities by themselves might not bring about happiness, but they certainly offer important perspectives toward the meaning of human life, individuality, the sense of community, communication, and compassion, all of which pave the way toward happiness.

A Middle Bronze Age IIB Site in the Kidron Valley, Jerusalem(Hebrew, pp. 1–18; English summary, p. 63*)

A Middle Bronze Age IIB Site in the Kidron Valley, Jerusalem(Hebrew, pp. 1–18; English summary, p. 63*)

Settlement Remains from the Chalcolithic Period and Middle Bronze Age II at Naḥal Guvrin (Hebrew, pp. 1*–32*; English summary, pp. 245–246)

Settlement Remains from the Chalcolithic Period and Middle Bronze Age II at Naḥal Guvrin (Hebrew, pp. 1*–32*; English summary, pp. 245–246)

A Middle Bronze Age Tomb at Kibbutz Ma‘alē Ha-Hamisha (Hebrew, pp. 15*–20*; English summary, p. 170)

A Middle Bronze Age Tomb at Kibbutz Ma‘alē Ha-Hamisha (Hebrew, pp. 15*–20*; English summary, p. 170)