To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
At the beginning of the nineteenth century, the Ottoman Empire was composed of a patchwork of different polities. In the aftermath of the early nineteenth-century Napoleonic wars (1803–1815), the Ottoman state began to expand its control over its hinterlands. The violent centralization by three succeeding sultans between 1839 and 1876 might be compared to the centralization efforts of Germany, France, and Italy. In each of these cases, independent or semi-independent principalities were seized by the expanding power centers of Berlin, Paris, and the Piedmont. The processes that unfolded across Eurasia bore striking similarities due to three technologies. These technologies – firearms, steamboats, and the telegraph – were used to centralize Ottoman authority in the mountains. Through these technologies, the Ottoman state was able to first conquer and then, over the course of decades, entrench state rule in areas that had hitherto been autonomous. From the point of view of the inhabitants of highlands, this period of centralization or reordering (Tanzimat) represented nothing short of a violent conquest by the state. The Ottoman conquest of the mountains laid the groundwork for subsequent violence by dividing mountain people against each other.
The conquest of the mountains was represented in very different ways. Within a year of the violence, two broad stories had coalesced. As the Ottoman state monopolized the legitimate use of violence, it also sought to monopolize the use of narrative. Through tight control over the medium of print, it censored narratives deemed dangerous or seditious. Zeki Paşa, the commander of the Fourth Army, wrote the legitimized account of the Sasun violence. His account whitewashed all Ottoman culpability and placed the blame on Armenian "bandits." The other story emerged from the British press, which was not a monolith. The liberal press looked with suspicion at the Ottoman government and with sympathy at the Armenian population of the Empire. The conservative press urged the public to consider the Sultan as a well-meaning ruler and a key ally against Russian aggression. Some conservatives cast doubt on Armenian sources as suspect due to their "racial propensity" for deception. Two experienced journalists were able to reach the Ottoman east and reported detailed accounts based on interviews with Ottoman soldiers and Armenian survivors. The account of an Ottoman-born missionary became the contrasting narrative to the legitimized narrative of the Ottoman state.
The Ottoman conquest of the mountains resembled in many respects the process of upland colonization around the world from the eighteenth century until today. This particular expansion of state power into the mountains – variously termed centralization, internal colonization, or conquest – has led to dramatic transformations of governance, ideas of difference (race, ethnicity, national identity), religion, economy, class and society, and the environment. So dramatic were these transformations that they gave rise to conditions that would facilitate the extreme violence of the Armenian massacres in the 1890s and the Medz Yeghern during World War I.
As Fernand Braudel astutely noted six decades ago, the history of people living in the mountains has often been overlooked. This omission has real consequences. Out of the forty-five conflicts in the world at the beginning of the 2020s, thirty-four of them were taking place in mountainous regions. In many cases, the histories of these conflicts can be traced back to nineteenth-century turning points when lowland states gained the technological means to exercise power in mountain areas, changing the lives of the inhabitants forever.
The violence in Sasun was interpreted differently after investigations by missionaries, by foreign consuls, and by the regime of Sultan Abdülhamid II. The Ottomans relied almost exclusively on a single legitimist report that became the state’s measure of "truth." To retain a monopoly of legitimate narrative, the Ottoman state utilized various forms of censorship – banning newspapers from abroad, forbidding any independent discussion of Sasun in the Ottoman press, preventing peasants from the area from traveling, and eventually banning all foreign journalists. At the same time, news of the massacres spread through word of mouth, and rumors of the Sasun violence increased tensions throughout the Ottoman Empire. When news of the violence reached London through missionary networks in mid-November 1894, it ignited a much larger debate about the British government’s support for the autocracy of Sultan Abdülhamid II, a support understood by many as complicity. The same missionary networks in the United Kingdom and the United States that had taken up abolitionism in the early nineteenth century now focused their activist energy on the Armenian massacres in the Ottoman Empire.
In the late nineteenth century the Ottoman state grew increasingly anxious about perceived civil unrest in the mountainous eastern provinces. This concern was heightened by an uptick in reporting about the Armenian issue in the British press and by protests across central Anatolia. Convinced that history was repeating itself in the manner of the Bulgarian rebellion of 1876 – also highly reported in the British press – the Ottoman state sanctioned repression of any dissent. Some officials used this repression to enrich themselves by arresting and extorting Armenians. In the summer of 1894, the Governor General of Bitlis reported to the Sultan that there was an insurgency in the Sasun mountains, likely to distract from his own corruption. Orders were sent to the Ottoman military that “all of the bandits should be immediately violently obliterated in such a way that they are left with an extraordinary terror and this degree of discord would be prevented from repeating again.” The resulting state violence – clothed in the language of counterinsurgency against bandits – resulted in the massacre by Ottoman soldiers of 1,000 to 2,000 Armenian villagers. This massacre laid the groundwork for subsequent massacres throughout the Ottoman Empire in 1895–1897.
The efforts of the survivors of the Sasun massacre, and their allies in the ABCFM, to disseminate narratives of state violence were countered by the Ottoman state as it sought to maintain a monopolization of legitimate narrative. In both cases, the story of Sasun played on the global stage. Telegraph wires carried the story of Sasun, and the apologetics of the Ottoman government, to readers around the world. Like all technologies, the telegraph was a Janus-faced tool. It helped actors disseminate information, but it also helped them control it. In the Ottoman Empire, the telegraph allowed the state to centralize information. Never before had the Ottoman state possessed such control over information flows. Yet, the telegraph also disseminated narratives that largely circumvented Ottoman censors. These narratives, collected by missionaries, consuls, and journalists, contributed to protests in the United States and Great Britain. As more stories of massacres appeared in newspapers abroad, the Ottoman state clamped down to maintain its desired public image.
The interplay between local and global history is where the trials of empire are held. The Ottoman state overturned the autonomously ruled Kurdish Emirates in the mountainous east, bringing large numbers of Kurdish- and Armenian-speakers directly under Ottoman rule. The efforts to divide and conquer these populations created "Armenian" and "Kurdish" questions that have occupied ruling elites since the mid-nineteenth century. The "Armenian question," like many of the "questions" of the nineteenth century – "the Woman question," "the Negro question," or "the Jewish’ question" – related to the rights of those who had long been denied equality. This "question" intensified in a struggle in the Muş highlands between Armenian peasants and their warlord in the late 1880s. As elsewhere in the mountainous regions of the empire, the Ottomans backed local nobles who expressed loyalty. In the plain of Muş, the Ottoman central authorities continued to support the warlord Musa Bey, despite accusations of malfeasance, kidnapping, and murder. For many of the Armenian peasants, the final straw was in 1889 when Musa Bey kidnapped and raped Gülizar, a young daughter of a priest. Local protests spread through migrant networks to Istanbul, and then through the press to readers around the world.
Stories of the violence in the mountains spread quickly by word of mouth and telegraph. Before the end of September 1894, Armenian radicals, British consuls, American missionaries, and Ottoman state officials were beginning to struggle over their interpretations of the violence. Over the course of the next few weeks, two competing narratives coalesced. The first narrative, based on accounts of survivors of the massacres and participating Ottoman troops, reported by ABCFM missionaries and British consuls, stressed how Ottoman troops had been directed to murder large numbers of Armenian villagers under the pretext of destroying a rebellion. The second narrative, composed by the powerful commander of the Ottoman Fourth Army, stressed that the Ottomans restored the peace in a turbulent area at the mountainous edges of imperial control. Throughout this period, the Ottoman state labored to monopolize the legitimate narrative, certain reports were endlessly reproduced within the Ottoman bureaucracy, and those reports remain to this day the official interpretation of what took place in Sasun. At the same time, stories of violence appeared in the British and American presses, with calls for political reform and an impartial investigation of what had taken place.
In the late summer of 1894, Sultan Abdülhamid II ordered several battalions of Ottoman soldiers to destroy Armenian 'bandits' operating in the remote mountains of Sasun. Over a three-week period, these soldiers systematically murdered men, women, and children, beginning a chain of events which led directly to the Hamidian massacres of 1895 to 1897 and prefigured many of the patterns of the Medz Yeghern (Great Crime) of 1915–1917. Taking a microhistorical approach, Owen Robert Miller examines how the Ottoman State harnessed three nascent technologies (modern firearms, steamboats, and telegraphs) to centralize authority and envisage new methods of conquest. Alongside developing an understanding of how the violence took place, this study explores how competing narratives of the massacre unfolded and were both disseminated and repressed. Emphasizing the pivotal significance of geography and new technologies, The Conquest of the Mountains reveals how the tragic history of these massacres underscores the development of Ottoman State authoritarianism.
Genetic research on nicotine dependence has utilized multiple assessments that are in weak agreement.
Methods
We conducted a genome-wide association study (GWAS) of nicotine dependence defined using the Diagnostic and Statistical Manual of Mental Disorders (DSM-NicDep) in 61,861 individuals (47,884 of European ancestry [EUR], 10,231 of African ancestry, and 3,746 of East Asian ancestry) and compared the results to other nicotine-related phenotypes.
Results
We replicated the well-known association at the CHRNA5 locus (lead single-nucleotide polymorphism [SNP]: rs147144681, p = 1.27E−11 in EUR; lead SNP = rs2036527, p = 6.49e−13 in cross-ancestry analysis). DSM-NicDep showed strong positive genetic correlations with cannabis use disorder, opioid use disorder, problematic alcohol use, lung cancer, material deprivation, and several psychiatric disorders, and negative correlations with respiratory function and educational attainment. A polygenic score of DSM-NicDep predicted DSM-5 tobacco use disorder criterion count and all 11 individual diagnostic criteria in the independent National Epidemiologic Survey on Alcohol and Related Conditions-III sample. In genomic structural equation models, DSM-NicDep loaded more strongly on a previously identified factor of general addiction liability than a “problematic tobacco use” factor (a combination of cigarettes per day and nicotine dependence defined by the Fagerström Test for Nicotine Dependence). Finally, DSM-NicDep showed a strong genetic correlation with a GWAS of tobacco use disorder as defined in electronic health records (EHRs).
Conclusions
Our results suggest that combining the wide availability of diagnostic EHR data with nuanced criterion-level analyses of DSM tobacco use disorder may produce new insights into the genetics of this disorder.
Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
Paediatric patients with heart failure requiring ventricular assist devices are at heightened risk of neurologic injury and psychosocial adjustment challenges, resulting in a need for neurodevelopmental and psychosocial support following device placement. Through a descriptive survey developed in collaboration by the Advanced Cardiac Therapies Improving Outcomes Network and the Cardiac Neurodevelopmental Outcome Collaborative, the present study aimed to characterise current neurodevelopmental and psychosocial care practices for paediatric patients with ventricular assist devices.
Method:
Members of both learning networks developed a 25-item electronic survey assessing neurodevelopmental and psychosocial care practices specific to paediatric ventricular assist device patients. The survey was sent to Advanced Cardiac Therapies Improving Outcomes Network site primary investigators and co-primary investigators via email.
Results:
Of the 63 eligible sites contacted, responses were received from 24 unique North and South American cardiology centres. Access to neurodevelopmental providers, referral practices, and family neurodevelopmental education varied across sites. Inpatient neurodevelopmental care consults were available at many centres, as were inpatient family support services. Over half of heart centres had outpatient neurodevelopmental testing and individual psychotherapy services available to patients with ventricular assist devices, though few centres had outpatient group psychotherapy (12.5%) or parent support groups (16.7%) available. Barriers to inpatient and outpatient neurodevelopmental care included limited access to neurodevelopmental providers and parent/provider focus on the child’s medical status.
Conclusions:
Paediatric patients with ventricular assist devices often have access to neurodevelopmental providers in the inpatient setting, though supports vary by centre. Strengthening family neurodevelopmental education, referral processes, and family-centred psychosocial services may improve current neurodevelopmental/psychosocial care for paediatric ventricular assist device patients.