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Clozapine-induced inflammation, such as myocarditis and pneumonia, can occur during initial titration and can be fatal. Fever is often the first sign of severe inflammation, and early detection and prevention are essential. Few studies have investigated the effects of clozapine titration speed and concomitant medication use on the risk of clozapine-induced inflammation.
Aims
We evaluated the risk factors for clozapine-associated fever, including titration speed, concomitant medication use, gender and obesity, and their impact on the risk of fever and the fever onset date.
Method
We conducted a case-control study. The medical records of 539 Japanese participants with treatment-resistant schizophrenia at 21 hospitals in Japan who received clozapine for the first time between 2010 and 2022 were retrospectively investigated. Of these, 512 individuals were included in the analysis. Individuals were divided into three groups according to the titration rate recommended by international guidelines for East Asians: the faster titration group, the slower titration group and the ultra-slower titration group. The use of concomitant medications (such as antipsychotics, mood stabilisers, hypnotics and anxiolytics) at clozapine initiation was comprehensively investigated. Logistic regression analysis was performed to identify the explanatory variables for the risk of a fever of 37.5°C or higher lasting at least 2 days.
Results
Fever risk significantly increased with faster titration, male gender and concomitant use of valproic acid or quetiapine. No increased fever risk was detected with the use of other concomitant drugs, such as olanzapine, lithium or orexin receptor antagonists. Fever onset occurred significantly earlier with faster titration. Multivariate analysis identified obesity as being a factor that accelerated fever onset.
Conclusion
A faster titration speed and concomitant treatment with valproic acid and quetiapine at clozapine initiation increased the risk of clozapine-associated fever. Clinicians should titrate clozapine with caution and consider both the titration speed and concomitant medications.
The Maya used dress to help them structure social interaction. Taking a behavioral chain and practice approach, I define dress elements of male courtiers and how they were combined into outfits during the daily practices of dressing and attending court. I identify two groups of headgear, Standard and Special, among courtiers on vases showing historical interaction among humans. Each vase is considered commemorative and must communicate to an audience. I identified six Standard hat types that were widespread in the Maya Lowlands. The distribution implies a basic set of recognizable roles that provided the political-religious structure of the typical Maya court, perhaps as early as the Late Preclassic period. Four of the hat types are connected to glyphic titles. Each titleholder's position in the vase's visual space implies a hierarchy of roles. The results support my hypothesis that dress does identify social roles in the Maya court.
By the year 1000 the Andalusian caliphate constituted a highly urbanized society, where the largest cities in Europe were located, while the economy of the Christian kingdoms of Iberia was characterized by a low level of urbanization and a poor market development. Five hundred years later, the territory of al-Andalus had disappeared and its economy had been absorbed and transformed into the Christian kingdoms. The latter’s territorial expansion was marked by the growth of cities, the impact of trade on the agrarian economy and an increase in rural stratification that, at different levels, made the market important for the satisfaction of needs and peasant consumption. In the Christian kingdoms, a strong increase in noble spending, emulated by urban elites, dedicated to the conspicuous consumption of products partially purchased on the international market, occurred throughout the period. After the Black Death, with the consolidation of a rural elite, important sectors of the population were attracted by the lifestyle of the urban elites. This evolution can also be detectable in the lifestyle of vast sectors of the population, in the cities as well as in the rural areas.
The conclusion reviews the period and themes covered in the book. Different kinds of time played out in different sectors. Clothing reflects this temporal and spatial diversity. Viewed from the perspective of what people wore, however, this was the time of the Mao suit, or at least of the zhifu. Not everyone wore one; there were periods of light and shade in the intensity of dress conformity; there were differences between town and country, between male and female, even between decades. Throughout this period, however, zhifu had hegemonic status. In 1983, even as the Western suit was surging back into fashion, the Zhongshan suit was promoted as the ‘representative garment’ of men’s clothing in China, a garment that encapsulated national feeling, expressed the style of the Chinese people, and was also admired and loved by them.
This study considers the textiles made, traded, and exchanged across Eurasia from late antiquity to the late Middle Ages with special attention to the socio-political and cultural aspects of this universal medium. It presents a wide range of textiles used in both domestic and religious settings, as dress and furnishings, and for elite and ordinary owners. The introduction presents historiographical background to the study of textiles and explains the conditions of their survival in archaeological contexts and museums. A section on the materials and techniques used to produce textiles if followed by those outlining textile production, industry, and trade across Eurasia. Further sections examine the uses for dress and furnishing textiles and the appearance of imported fabrics in European contexts, addressing textiles' functions and uses in medieval societies. Lastly, a concluding section on textile aesthetics connects fabrics to their broader visual and material context.
Similarities in the imagery of Etruscan and Western Anatolian dress fashions, such as pointed shoes and Ionic chitons, indicate an obvious connection between the clothing systems of the two cultures. Indeed, Larissa Bonfante (2003) in her groundbreaking book Etruscan Dress classifies an “Ionian Phase” (550–475 BCE) in the development of the Etruscan clothing system. This chapter investigates the adaptation of Ionian dress items into the Etruscan dress repertoire through a comparative iconographic study of dress fashions in western Anatolia and Etruscan funerary art of the sixth and fifth centuries BCE. After an overview of prevailing dress fashions in both cultures, it explores the specific case of shoes with upturned toes (Etruscan/Hittite shoes, as they are commonly known) to show the changing meanings and cultural connections the adopted dress items conveyed.
When we think of Tolstoy we picture a man who looks as far from a typical Russian nobleman as possible: bearded and wearing peasant-style clothes. This chapter examines the clothing choices Tolstoy made throughout his life and sets them in the contexts of imperial dress codes and his own thinking about Christianity and his place in the world. After Peter the Great introduced European dress for the nobility in the early eighteenth century, a large cultural divide developed between peasants and nobles. Tolstoy grew up wearing the clothing of the European elite while the peasants on his family estate wore more traditional Russian dress. However, in the 1860s Tolstoy began to wear a peasant-style beard and long, loose shirts, albeit made from more luxurious materials than were worn by the peasants themselves. Then, in the 1880s he began to make his own leather boots. This was all part of his broader philosophical project and attempt to lead a simpler, more Christian life. Though Tolstoy’s lifestyle choices often made things more difficult for his family, he nonetheless inspired many followers who imitated his dress style.
Unlike many other monarchical courts in history, the Roman imperial court had no distinctive form of dress for courtiers. But dress, jewellery, and the presentation of the body were still important in the world of the court. The clothed, adorned, and groomed body was a crucial instrument of communication within court society. In the case of the emperor and his family especially, the clothed body and its presentation also communicated with the rest of society; the considerable inscriptional evidence for staff in the imperial household with tasks involving clothing, jewellery, or grooming hints at the message of magnificence often being conveyed. Magnificence was, however, a two-edged sword. The ancient literary sources display clear traces of moralizing discourses that sought to pressure the emperor into what were considered to be appropriate sartorial decisions.
Cinderella's Glass Slipper studies Renaissance material cultures through the literary prism of fairy-tale objects. The literary fairy-tale first arose in Renaissance Venice, originating from oral story-telling traditions that would later become the Arabian Nights, and subsequently in the Parisian salons of Louis XIV. Largely written by, for, and in the name of women, these literary fairy-tales took a lightly comic view of life's vicissitudes, especially female fortune in marriage. Connecting literary representations of bridal goods - dress, jewellery, carriages, toiletries, banqueting and confectionary foods - to the craft histories of their making, this Element offers a newly-contextualised socio-economic account of Renaissance luxe, from architectural interiors to sartorial fashioning and design. By coupling Renaissance luxury wares with their fairy-tale representation, it locates the recherché materialities of bridal goods - gold, silver, diamonds and silk - within expanding colonialist markets of a newly-global early modern economy in the age of discovery.
In the early modern period costume books and albums participated in the shaping of a new visual culture that displayed the diversity of the people of the known world on a variety of media including maps, atlases, screens, and scrolls. At the crossroads of early anthropology, geography, and travel literature, this textual and visual production blurred the lines between art and science. Costume books and albums were not a unique European production: in the Ottoman Empire and the Far East artists and geographers also pictured the dress of men and women of their own and faraway lands hybridizing the Renaissance western tradition. Acknowledging this circulation of knowledge and people through migration, travel, missionary and diplomatic encounters, this Element contributes to the expanding field of early modern cultural studies in a global perspective.
This chapter digs into the stuff of the city, examining the range of objects excavated from homes, garbage pits, moats, and even toilets to try to imagine the rhythms and character of daily life for the residents of Ichijōdani.
The Conradian fauna range from the albatross to the yearling and contain more than 150 different species of nonhuman animal. Despite the biodiversity, it is easy to overlook Conrad’s animals because they most frequently appear in metaphors and similes: at first sight, they lack agency, physical presence and independent meaning. But contrary to an articulated evaluative ideal of animal studies, Conrad’s animal metaphors invite reflection on human–animal relations, and demonstrate that an author can write attentively, sympathetically and thoughtfully on animals, despite primarily mentioning them in metaphors. The unreality effect, which I argue unites Conrad’s unconventional animal metaphors, confronts the reader to question the reality of the fictional construct. The unconventional sayings that produce this unreality effect all say: we have the appearance of a marginal, incidental detail but we are one of the most complicated structures in the text.
In Isis in a Global Empire, Lindsey Mazurek explores the growing popularity of Egyptian gods and its impact on Greek identity in the Roman Empire. Bringing together archaeological, art historical, and textual evidence, she demonstrates how the diverse devotees of gods such as Isis and Sarapis considered Greek ethnicity in ways that differed significantly from those of the Greek male elites whose opinions have long shaped our understanding of Roman Greece. These ideas were expressed in various ways - sculptures of Egyptian deities rendered in a Greek style, hymns to Isis that grounded her in Greek geography and mythology, funerary portraits that depicted devotees dressed as Isis, and sanctuaries that used natural and artistic features to evoke stereotypes of the Nile. Mazurek's volume offers a fresh, material history of ancient globalization, one that highlights the role that religion played in the self-identification of provincial Romans and their place in the Mediterranean world.
In both his writings and appearance, Richard Wright was acutely attuned to the power of dress to convey meaning and build identity. From his early stories collected in Uncle Tom’s Children, where the clothed and naked bodies of young Southern Black men signify poverty, innocence and, to whites, danger, through his late novel, Savage Holiday, where the naked body of a white man precipitates chaos and disaster, Wright’s attention to clothing and to the naked and nude bodies of Black and white men and women—including his meticulous self-presentation as an expatriate writer in Paris—allowed him to explore how attire and style produced sensations of self. The rituals of dressing (Lawd Today), the temptations of naked skin revealed beneath robes and coats (Native Son, The Outsider), the forms of nudity (“Big Boy Leaves Home,” Savage Holiday), the class dimensions of clothing (Black Boy) serve to display psychological and sociological forces of race, gender, sexuality, and power.
This article critically examines the prevalent nationalist interpretation of historical images featuring textiles from rural regions. In an effort to disentangle the threads of folk costumes, it proposes a conscious unlearning of the way we read images of rural material culture from the late 19th century. This period has entered historiography as a period of intensifying national movements and political use of rural culture, in particular in Central and Eastern Europe. So-called folk costumes have been viewed as a symbolic representation of the nation, whereas their broader social and economic role in the history of industrial society has been overshadowed. By bringing together the production, collection, and exhibition of rural material culture, this article reveals processes in industrial society that shaped the modern history of folk costumes. It draws on late-19th-century source material stemming from a network centered in Prague that promoted textiles from rural Bohemia, Moravia, Hungary, and Galicia as ethno-commodities. Textiles were integrated into women’s industrial education and presented at events promoting national economy and the latest technological innovations. Thus, this article contributes to nationalism studies by discussing capitalism and industrialism and seeks to further scrutinize the history of nationalism in Central and Eastern Europe.
This chapter examines debates about manners and civility in the first half of the twentieth century. Tensions between aristocrats and Western-educated civil and military government officials culminated in the overthrow of the absolute monarchy in 1932. This period saw an outpouring of works about politeness and manners targeting the bureaucratic elite and the emerging middle class. Thai statesmen devoted a remarkable amount of attention to what they perceived to be the problem of manners and morals. Leading political figures on all sides of politics wrote about the subject. The model of ideal conduct that the absolute monarchy had developed for bureaucrats in the late nineteenth and early twentieth centuries, a hybrid between the palace courtier and the English gentleman, began to be challenged by new and more diverse conceptualizations of social relations, pushed by supporters of a more progressive political order. Yet the new rules for how to behave were resisted by supporters of the old aristocratic order. Some of them attempted to salvage what was left of the old courtly ways in books and novels and their own etiquette manuals.
This chapter introduces the main tenet of the book: that tensions over public expressions of Islam in Egypt have a 130-year history, as they stem from decisions made in the half-century surrounding the turn of the twentieth century (1871–1922), and they first erupted into conflict during a ‘culture war’ that shaped the intellectual discourse of Egypt’s constitutional period (1923–52). Dar al-ʿUlum and its graduates, the darʿamiyya, are crucial to understanding this culture war. After providing historical background, this chapter explains a new approach to modernisation, nation-building, and sociocultural change. It presents modernity as a constellation of projects advanced by Egypt’s ruling Khedives, Europeans, and a range of Egyptian-based social groups. It uses the ideas of Pierre Bourdieu, Frederik Barth, and Mikhail Bakhtin to connect educational experiences with sociocultural outcomes using capital and habitus, to explore how sociocultural boundaries are crossed in productive ways, and to widen definitions of hybridity beyond combinations that are shockingly jarring. It uses these ideas to explore the sociocultural position of the darʿamiyya, a group that was suspended in between the modernising alumni of civil schools (efendiyya) and the traditionally trained alumni of religious schools (shaykhs) until a 1926 student strike.
Chapter 6 argues that evolutionary theories of crypsis and display served as models for thinking through the positions of disempowered, marginalised groups at the turn of the century. Israel Zangwill sometimes invoked protective mimicry to decry Jewish assimilation as the degenerate defence mechanism of helpless dependents. Persecution, he complained, had driven Jews to become invisible and, thus, alienated from their own nature. Conversely, Charlotte Perkins Gilman made sense of women’s perceived weakness via the conspicuous display of sexual selection. Gilman argued that women’s eye-catching, impractical clothes reflected their feeble dependence on men. Through their rhetoric of standing out and blending in, both authors sought to recover the imagined authentic essences of their group identities, which regimes of Gentile or male surveillance had repressed. Yet they also imagined this self-realisation being asserted through visual display. The intersubjectivity of display rendered it inherently inauthentic, mediated by arbitrary symbols. This contradiction caused Zangwill’s vision of Jewish self-realisation to vacillate between essentialism and anti-essentialism, between a return to pure origins and progression toward open-ended, heterogeneous identity. Gilman’s vision similarly vacillated between the restoration of a primordial female ‘modesty’ and the progressive transcendence of visible sex distinctions.
This chapter looks at the visual and material culture of Jacobitism focusing on a heterogeneous group of objects in the collections of the NMS, V&A and BM, that are defiantly Jacobite in their content and intent. These objects range across media, and across the artistic hierarchies of the so–called fine and decorative arts. There are one–off larger than life portraits of the Jacobite figure heads and their families painted by court artists in the cosmopolitan urban centres of Europe, which were then mass-produced as engravings and published as prints; objects with a distinctive cultural currency, like coins and medals, engraved glassware and embroidered textiles. There are items of dress and adornment, including fans, garters and snuffboxes, that formed part of a corporeal culture of display and concealment. Some of the objects are gendered; others are anamorphic and shape-shifting. Many objects carry inscribed textual mottoes, sometimes in Latin that quote directly from texts including Vergil’s Aeneid. Using the body as a synthesising thematic, the chapter aims to chart the associations of Jacobitism with Scotland though the use of cross–media images and objects, while at the same time, highlighting the possibilities of using such material as tools for historical enquiry.