Report on the brain of the monk seal (Monachus monachus, Hermann, 1779).

The Mediterranean monk seal (Monachus monachus, Hermann, 1779) is an endangered species of pinniped endemic to few areas of the Mediterranean Sea. Extensive hunting and poaching over the last two centuries have rendered it a rare sight, scattered mainly in the Aegean Sea and the western coast of North Africa. In a rare event, a female monk seal calf stranded and died in southern Italy (Brindisi, Puglia). During due necropsy, the brain was extracted and fixed. The present report is the first of a monk seal brain. The features reported are remarkably typical of a true seal brain, with some specific characteristics. The brain cortical circonvolutions, main fissures and the external parts are described, and an EQ was calculated. Overall, this carnivore adapted to aquatic life shares some aspects of its neuroanatomy and physiology with other seemingly distant aquatic mammals.

Fecal and skin microbiota of two rescued Mediterranean monk seal pups during rehabilitation.

IMPORTANCE: This study showed that during the rehabilitation of two rescued Mediterranean monk seal pups (Monachus monachus), the skin and fecal bacterial communities showed similar succession patterns between the two individuals. This finding means that co-housed pups share their microbiomes, and this needs to be considered in cases of infection outbreaks and their treatment. The housing conditions, along with the feeding scheme and care protocols, including the admission of antibiotics as prophylaxis, probiotics, and essential food supplements, resulted in bacterial communities with no apparent pathogenic bacteria. This is the first contribution to the microbiome of the protected seal species of M. monachus and contributes to the animal's conservation practices through its microbiome.

Monk seal faeces as a non-invasive technique to monitor the incidence of ingested microplastics and potential presence of plastic additives.

Anthropogenic debris, including plastics, has recently been identified as a major threat for marine mammals and the Marine Strategy Framework Directive aims to achieve the good environmental status of European waters by addressing among other criteria, the effects of marine litter on biota. This study implemented for the first time a non-invasive technique for collecting monk seal samples to assess microdebris ingestion in combination with identifying plastic additives and porphyrins biomarkers. A total of 12 samples of monk seal faeces were collected from marine caves in Zakynthos Island, Greece. A total of 166 microplastic particles were identified; 75 % of the particles were smaller than 3 mm. Nine phthalates and three porphyrins were detected. A strong correlation was found between the number of microplastics and the concentration of phthalates. The values of both phthalates and porphyrins were found lower than in other marine mammal tissues, suggesting that seals might not be impacted by them yet.

Study of medication use and effects of medication among hospitalized older Buddhist monks: An embedded mixed-method study.

AIM: The aim was to study medication use, effects of medication and perspective of participants involved in medication use among hospitalized older Buddhist monks. DESIGN: An embedded mixed-method study. METHODS: This study included 71 hospitalized older Buddhist monks and 23 participants involved in medication use. Quantitative data were collected from medical and medication records. Meanwhile, qualitative data were collected by using in-depth interviews. Data were analysed using descriptive statistics and content analysis. The study lasted from February to July 2021. RESULTS: Over 77% of the monks had chronic diseases. The median of medicine use was seven medicines/person and 6 days of use. Effects of the medication were as expected (52.04%), not as expected (2.22%) and unmeasurable results (45.74%). Unexpected results were hypo-hyperglycaemia, nausea/vomiting, high blood pressure and confusion. From the interview, participants perceived and did not perceive unique practices and medication use in Buddhist monks. In addition, the Buddhist monks received medication following standards and Buddhist doctrine. Finally, recommendations for medication use were adhering to the standard, following Buddhist doctrine and being flexible as deemed necessary. CONCLUSION: The results revealed medication use problems and medication effects among hospitalized older Buddhist monks. IMPACT: Older adults and Buddhist monks have specific needs and practices related to culture and religion, affecting typical treatment, especially medication use. Cultural diversity and sensitivity should be a concern for healthcare staff. The results can be utilized to promote an understanding of cultural diversity and increase the safety of medication administration for hospitalized older Buddhist monks. PATIENT AND PUBLIC CONTRIBUTION: Patient and public contributions were involved in this study. Participants involved in medication use were interviewed to answer the research objective. Moreover, a senior Buddhist monk at Wat Thai Washington D.C. reviewed content related to the Pali Canon for the final draft of the manuscript. CLINICAL TRIAL REGISTRATION NUMBER: https://osf.io/b6p3e.

Playing "hide and seek" with the Mediterranean monk seal: a citizen science dataset reveals its distribution from molecular traces (eDNA).

Animal conservation relies on assessing the distribution and habitat use of species, but for endangered/elusive animals this can prove difficult. The Monk Seal, Monachus monachus, is one of the world's most endangered species of pinniped, and the only one endemic to the Mediterranean Sea. During recent decades, direct observations have been few and scattered, making it difficult to determine its distribution away from the Aegean Sea (core distribution area of the post-decline relict population). This study relies on environmental DNA (eDNA) analysis to detect the presence of the Monk Seal in 135 samples collected in 120 locations of the central/western Mediterranean Sea, spanning about 1500 km longitudinally and 1000 km latitudinally. A recently described species-specific qPCR assay was used on marine-water samples, mostly collected during 2021 by a Citizen Science (CS) project. Positive detections occurred throughout the longitudinal range, including the westernmost surveyed area (Balearic archipelago). The distribution of the positive detections indicated six "hotspots", mostly overlapping with historical Monk Seal sites, suggesting that habitat-specific characteristics play a fundamental role. We applied single-season occupancy models to correct for detection probability and to assess the importance of site-specific characteristics. The distance from small islets and protected (or access-restricted) areas was correlated negatively with the detection probability. This novel molecular approach, applied here for the first time in an extensive CS study, proved its potential as a tool for monitoring the distribution of this endangered/elusive species.

The Friar with the Crutch: A Pictorial Hint of the Stroke Suffered by Bernardino da Fossa (1420-1503).

BACKGROUND: Works of art may serve as a source of evidence of diseases and help to better understand their natural history. SUMMARY: Bernardino da Fossa was a 15th-century Italian Franciscan friar who wrote sermons and historical works. He described the events of the Observance Reformation movement since its dawn, but the last chapter is unexplainably interrupted. This has been considered suggestive for an acute and disabling illness. A painting dating back 12 years after his death depicts Bernardino holding a crutch with his left arm. This may represent an important clue to establish a gait disturbance, whereas the permanent interruption in drafting his writing may be ascribed to a serious writing impairment. KEY MESSAGES: The historical detail of the writing suspension and the crutch in this painting represent important hints of the stroke suffered by Bernardino da Fossa.

Examining pathogen DNA recovery across the remains of a 14th century Italian friar (Blessed Sante) infected with Brucella melitensis.

OBJECTIVE: To investigate variation in ancient DNA recovery of Brucella melitensis, the causative agent of brucellosis, from multiple tissues belonging to one individual MATERIALS: 14 samples were analyzed from the mummified remains of the Blessed Sante, a 14 th century Franciscan friar from central Italy, with macroscopic diagnosis of probable brucellosis. METHODS: Shotgun sequencing data from was examined to determine the presence of Brucella DNA. RESULTS: Three of the 14 samples contained authentic ancient DNA, identified as belonging to B. melitensis. A genome (23.81X depth coverage, 0.98 breadth coverage) was recovered from a kidney stone. Nine of the samples contained reads classified as B. melitensis (7-169), but for many the data quality was insufficient to withstand our identification and authentication criteria. CONCLUSIONS: We identified significant variation in the preservation and abundance of B. melitensis DNA present across multiple tissues, with calcified nodules yielding the highest number of authenticated reads. This shows how greatly sample selection can impact pathogen identification. SIGNIFICANCE: Our results demonstrate variation in the preservation and recovery of pathogen DNA across tissues. This study highlights the importance of sample selection in the reconstruction of infectious disease burden and highlights the importance of a holistic approach to identifying disease. LIMITATIONS: Study focuses on pathogen recovery in a single individual. SUGGESTIONS FOR FURTHER RESEARCH: Further analysis of how sampling impacts aDNA recovery will improve pathogen aDNA recovery and advance our understanding of disease in past peoples.

Traditional Buddhist meditations reduce mismatch negativity in experienced monk- practitioners.

Thousand-year-old Buddhist traditions have developed a wide range of methods for the subjective exploration of consciousness through meditation. Combining their subjective research with the possibilities of modern neuroscience can help us better understand the physiological mechanisms of consciousness. Therefore, we have been guided by specifically Buddhist explanations when studying the physiological mechanisms of altered states of consciousness during Buddhist meditations. In Buddhism, meditations are generally divided into two large categories: (1) one-pointed concentration and (2) analytical meditation. Maintaining both one-pointed concentration and analytical meditation on 'bodhicitta' ("the thought of awakening") and 'emptiness' is a necessary condition for transitioning into tantric practices. Tantric practices involve sophisticated visualizations of Buddhist deities, the 'energy structure' of the human body, and the visualization of the stage-by-stage process of dying accompanied with the dissolution of body elements. According to Buddhism, these meditations are characterized by the gradual withdrawal from "gross levels" of consciousness associated with the five senses. From a psychophysiological perspective, this withdrawal of sensory consciousness can be considered as the decrease of sensory stimuli recognition and attentional disengagement from the external world. We concentrated on how considered meditations affect sensory and cognitive processing of external stimuli. Auditory event-related potentials (ERPs) in the passive oddball paradigm were studied both during meditations and in a controlled state of relaxed wakefulness. It was shown with a group of 115 Buddhist monks that during meditation, mismatch negativity amplitudes, amplitudes of N1 and P2 components of ERPs to deviant stimuli, and the amplitudes of the P3a component to novel stimuli all decrease. These outcomes suggest that the considered Buddhist meditations, compared to the control state of relaxed wakefulness, are accompanied by a decrease in physiological processes responsible for maintaining attention on the outside world and recognizing changes in the stream of sensory stimuli.

Intestinal parasite infection in the Augustinian friars and general population of medieval Cambridge, UK.

OBJECTIVE: To investigate how lifestyle may have impacted the risk of contracting intestinal parasites in medieval England . Regular clergy (such as those living in monasteries) and the lay population form interesting groups for comparison as diet and lifestyle varied significantly. Monasteries were built with latrine blocks and hand washing facilities, unlike houses of the poor. MATERIALS: Sediment samples from the pelvis, along with control samples from feet and skull, of 19 burials of Augustinian Friars (13th-16th century), and 25 burials from All Saints by the Castle parish cemetery (10th-14th century), Cambridge. METHODS: We analysed the sediment using micro-sieving and digital light microscopy to identify the eggs of intestinal parasites. RESULTS: Parasite prevalence (roundworm and whipworm) in the Augustinian friars was 58%, and in the All Saints by the Castle parishioners just 32% (Barnards Test score statistic 1.7176, p-value 0.092). CONCLUSIONS: It is interesting that the friars had nearly double the infection rate of parasites spread by poor hygiene, compared with the general population. We consider options that might explain this difference, and discuss descriptions and treatment of intestinal worms in medical texts circulating in Cambridge during the medieval period. SIGNIFICANCE: This is the first study to compare prevalence of parasite infection between groups with different socioeconomic status from the same location. LIMITATIONS: Quality of egg preservation was suboptimal, so our data may under-represent the true prevalence. SUGGESTIONS FOR FURTHER RESEARCH: Larger studies with greater statistical power, covering different time periods and regions.

The Effects of Health Behavior Changing Program for Systolic Blood Pressure Reduction Among Thai Buddhist Monks, Thailand.

Thai Buddhist monks' lifestyle has made them likely to get non-communicable diseases. Therefore, the Ministry of Public Health of Thailand has conducted a health behavior-changing program for non-communicable diseases prevention among Thai Buddhist monks. This study aims to examine the effectiveness of the health behavior-changing Program for Non- communicable diseases prevention among 4,786 Thai Buddhist monks who were risk group. They were on the program for 6 months. from January 1st, 2021 to June 30th, 2021. Descriptive statistics were used to describe the characteristics of the subjects and Paired t-test was used to compare the mean difference. The results showed that the health behavior-changing program can reduce Fasting Blood Sugar, Body Mass Index, Risk score, Hypertension, and Smoking scores. Therefore, this program should be used for reducing risk factors of non-communicable diseases among Thai monks in the Upper Northeast region of Thailand.

Characterization of Bipolar Disorder in Anton Chekhov's The Black Monk.

Anton Chekhov (1860-1904) was a famous Russian author and physician known for his dramas and short stories. Many of his works also address mental health problems. Here, the present paper is investigating his novella The Black Monk that was published in 1894. Its main protagonist, Kovrin, likely suffered from bipolar disorder as he exhibited elevated mood, grandiosity, lack of sleep, and delusions. His symptoms are analyzed based on current DSM-5 criteria, and he appears to meet diagnostic criteria for bipolar I disorder. Chekhov himself suffered from a mood disorder, but we speculate that he himself exhibited some bipolar symptoms. Those were likely an inspiration for when he wrote The Black Monk.

Turning grey is not a black-and-white experience: A phenomenological study on the lived experience of old age among Dutch Franciscan friars.

The lack of constructive cultural narratives of old age impedes older people from giving meaning to any difficult circumstances related to aging in which they might find themselves. In this study, we attempted to shed a different light on experiences of meaning in older age to contribute to sources for constructive counter narratives by gaining insight into (the experience of) meaning in old age of Dutch Franciscan friars. The research was a phenomenological in-depth interview study among twelve friars (mean age 80.6 years) following a reflective lifeworld design. The three main themes that emerged from the analysis were (i) 'brotherhood', illustrating a strong, axiomatic sense of connectedness, (ii) 'finitude', illustrating individual and relational confrontations with daily and existential finitude, and (iii) 'dynamic', illustrating opportunities for new possibilities, personal growth and being able to be receptive of the 'good' in daily life. Our findings showed that aging is a multidimensional process that is not exclusively characterized by decline and loss, but also offers substantial opportunities to experience (new) meaning. Occasionally, meaning seemed to arise as a result of (physical) decline. Our results illustrated that under circumstances of connectedness and togetherness, frailty and dependency do not necessarily form a threat to one's autonomy. Connectedness also showed itself to be a source for authenticity, which reinforced the Franciscans as autonomous moral agents.

The heart-brain axis: A proteomics study of meditation on the cardiovascular system of Tibetan Monks.

BACKGROUND: There have been mixed reports on the beneficial effects of meditation in cardiovascular disease (CVD), which is widely considered the leading cause of death worldwide. METHODS: To clarify the role of meditation in modulating the heart-brain axis, we implemented an extreme phenotype strategy, i.e., Tibetan monks (BMI > 30) who practised 19.20 ± 7.82 years of meditation on average and their strictly matched non-meditative Tibetan controls. Hypothesis-free advanced proteomics strategies (Data Independent Acquisition and Targeted Parallel Reaction Monitoring) were jointly applied to systematically investigate and target the plasma proteome underlying meditation. Total cholesterol, low-density lipoprotein cholesterol  (LDL-C), apolipoprotein B (Apo B) and lipoprotein (a) [Lp(a)] as the potential cardiovascular risk factors were evaluated. Heart rate variability (HRV) was assessed by electrocardiogram. FINDINGS: Obesity, hypertension, and reduced HRV is offset by long-term meditation. Notably, meditative monks have blood pressure and HRV comparable to their matched Tibetan controls. Meditative monks have a protective plasma proteome, related to decreased atherosclerosis, enhanced glycolysis, and oxygen release, that confers resilience to the development of CVD. In addition, clinical risk factors in plasma were significantly decreased in monks compared with controls, including total cholesterol, LDL-C, Apo B, and Lp(a). INTERPRETATION: To our knowledge, this work is the first well-controlled proteomics investigation of long-term meditation, which opens up a window for individuals characterized by a sedentary lifestyle to improve their cardiovascular health with an accessible method practised for more than two millennia. FUNDING: See the Acknowledgements section.

Noncommunicable diseases and social determinants of health in Buddhist monks: An integrative review.

The prevalence of noncommunicable diseases (NCDs) is increasing worldwide. Buddhist monks in Thailand play a critical role in health as community leaders accounting for 0.3% of the population. However, some monks require treatment and hospitalization to alleviate the burden of NCDs due to religious beliefs and practices during ordainment. Risk factors for NCDs among Buddhist monks, and the relationship to social determinants of health (SDH) remain unclear. This integrative review examined the prevalence of NCDs and explored the relationship between SDH and health outcomes among Buddhist monks. Cohort, descriptive, and correlational studies published in both English and Thai languages were identified from the PubMed, Science Direct, CINAHL, and Thai journal databases. Keywords included "Thai Buddhist monks," "non-communicable diseases," and "prevalence". Twenty-two studies were selected. Obesity and hypertension were the most prevalent NCDs. Religious beliefs and practices influence SDH domains and play an important role in the lifestyle and health behaviors among Buddhist monks. Further understanding of the impact of the religious lifestyle is needed, particularly given the role and influence of monks in society.

Rules We Live by: How Religious Beliefs Relate to Compliance with Precautionary Measures Against COVID-19 in Tibetan Buddhists.

The present studies investigated how particular religious beliefs shape compliance with preventive measures in adherents of Gelug and Nyingma schools of Tibetan Buddhism. In Study 1, Gelug and Nyingma monks were asked to report their compliance with various infection prevention measures surrounding COVID-19. Results showed that the former group showed higher compliance with public health guidelines than the latter. Extending beyond self-report measures, Study 2 added a behavioral outcome measure and observed the same effect. Together, our results provide the first empirical evidence that various Tibetan Buddhist traditions are related to different degrees of compliance with precautionary measures against COVID-19.

Field Study on Indoor Thermal Environments of Monastic Houses and Thermal Comfort of Monks.

Monastic houses are an essential part of the Tibetan monastic system in China. In this study, the monastic houses of Labrang in the Tibetan region of Gannan were used as the research objects. Physical parameters such as indoor temperature, humidity, and radiation temperature of the monastic houses were measured. The measured results were compared with the standard values, while the air temperature was linearly fitted using TSV, PMV, and aPMV. The results show that the temperature inside and outside the monastic houses fluctuates considerably; the theoretical thermal neutral temperature of the tested monks in winter is 22.46 °C, which is higher than the measured thermal neutral temperature in winter of 16.43 °C. When analyzing the results, it was found that the local climate, dress code, and the monks' specific habits all impact the perception of thermal comfort, which creates a discrepancy between the accurate results and the standard values. The above findings provide a more comprehensive reference for the thermal comfort requirements of the monks in cold areas, which can be used as a guide for the improvement and evaluation of the monastic houses in cold areas.

A para-religious setting for financial exploitation of the mentally incapacitated: when the habit doesn't make a monk.

ABSTRACT: Exploitation and circumvention of the mentally incapacitated is a criminal offence listed in the Italian penal code (Penal Code Art. 643). It involves the exploitation and circumvention of people who are fragile and vulnerable owing to their health conditions and/or mental status, and fits into the grey area between such subjects' freedom to make decisions about their physical conditions and economic assets, and the abuse of their trust perpetrated by third parties for personal gain. The authors describe a case of financial exploitation and circumven-tion of a married couple that is remarkable in view of both the huge sums extorted from the victims and the duration of the peculiar illicit activities (that lasted more than 10 years). These were perpetrated by a charismatic figure leading a "para-religious" group. He claimed to be a prophet, but his private life was highly questionable. The method of ascertainment used to verify the victims' mentally incapacitated state is described, analyzed and commented; the diagnosis could not be deferred in view of the characteristics of the prolonged penal offences committed.

Depressive symptoms among clients attending monk healers and primary care clinics in Thailand: a comparative follow-up study.

BACKGROUND: The aim of this study was to conduct a comparative follow-up assessment of clients with depressive symptoms attending monk healers or primary care clinics in Thailand. METHODS: Consecutively attending clients of three monk healing and three primary care centres who screened positive (a score of 9 or more) on the Primary Health Questionnaire (PHQ)-9 at the study site were followed up at 3 months after baseline assessment. RESULTS: In 3 monk healer sites, 448 clients agreed to be screened with the PHQ-9 for depression, and 94 screened positive, and in 3 health centres 582 clients agreed to be screened, and 92 screened positive for depressive symptoms on the PHQ-9. In 2 monk healing sites, 79 clients (84%) were followed up at 3 months, and in 3 health centres, 79 clients (85.9%) were followed up at 3 months. At 3-month follow-up, mixed modelling found significant interaction effects (a time-by-condition interaction, i.e., between-group changes) on depression scores (P = <0.001). Depressive symptoms significantly decreased over time, but there was no significant difference in decline between the two groups. CONCLUSION: Clients attending monk healers decreased more in depressive scores compared to clients attending primary care centres, though there was no group effect with respect to number of depressed clients.