A genomic snapshot of demographic and cultural dynamism in Upper Mesopotamia during the Neolithic Transition

Upper Mesopotamia played a key role in the Neolithic Transition in Southwest Asia through marked innovations in symbolism, technology, and foodways. We present thirteen ancient genomes (c.8500-7500 calBCE) from Pre-Pottery Neolithic Çayönü in the Tigris basin together with bioarchaeological and material culture data. Our findings reveal that Çayönü was a genetically diverse population, carrying a mixed ancestry from western and eastern Fertile Crescent, and that the community received immigrants. Our results further suggest that the community was organised along biological family lines. We document bodily interventions such as head-shaping and cauterization among the individuals examined, reflecting Çayönü's cultural ingenuity. Finally, we identify Upper Mesopotamia as the likely source of eastern gene flow into Neolithic Anatolia, in line with material culture evidence. We hypothesise that Upper Mesopotamia's cultural dynamism during the Neolithic Transition was the product not only of its fertile lands but also of its interregional demographic connections

Spatial and temporal heterogeneity in human mobility patterns in Holocene Southwest Asia and the East Mediterranean

We present a spatiotemporal picture of human genetic diversity in Anatolia, Iran, Levant, South Caucasus, and the Aegean, a broad region that experienced the earliest Neolithic transition and the emergence of complex hierarchical societies. Combining 35 new ancient shotgun genomes with 382 ancient and 23 present-day published genomes, we found that genetic diversity within each region steadily increased through the Holocene. We further observed that the inferred sources of gene flow shifted in time. In the first half of the Holocene, Southwest Asian and the East Mediterranean populations homogenized among themselves. Starting with the Bronze Age, however, regional populations diverged from each other, most likely driven by gene flow from external sources, which we term “the expanding mobility model.” Interestingly, this increase in inter-regional divergence can be captured by outgroup-f$_3$-based genetic distances, but not by the commonly used F$_{ST}$ statistic, due to the sensitivity of F$_{ST}$, but not outgroup-f$_3$, to within-population diversity. Finally, we report a temporal trend of increasing male bias in admixture events through the Holocene

Is there still a necessity for awareness and information about HPV infection and vaccine for adolescent in developing countries?

Increasing awareness of human papilloma virus (HPV) and vaccines among the target population is an important factor for decreasing the rate of malignancies related to HPV. The aim of this cross-sectional study was to determine Turkish high school and college students’ knowledge level of HPV and vaccines via a survey. The HPV knowledge scale (HPV-KS) has been developed to measure the level of knowledge about HPV and vaccination. The response rate of ‘Yes’ to the question of whether the participants have heard of HPV and the vaccine was 60.8% and 58.8%, respectively. The lack of information was the commonest reason for not being vaccinated in 54% of the participants. According to the HPV-KS, the median value of the knowledge level of the participants was 35.7 (IQR; 14.3–57.1). The HPV-KS scores were significantly higher among those with parents who had graduated from university and had an income above the minimum wage than those who did not (p = .013 and p = .029, respectively). Current evidence suggests that Turkish adolescents have limited HPV knowledge. Gender, age, education (particularly university and health-related departments), parents’ level of education and income were all important factors in determining the outcome variables. Therefore, it is very important to apply educational programs to raise awareness by medical staff.Impact Statement What is already known on this subject? Human papilloma virus (HPV) infection is a major threat due to the reason of many malignancies, especially cervical cancer, and this problem can be overcome by informing the target population about the screening program and vaccination. What do the results of this study add? Lack of knowledge about HPV infection and cost of the vaccine were the main reasons for insufficient vaccination rate among the adolescents. What are the implications of these findings for clinical practice and/or further research? In developing countries such as Turkey, the necessity to raise awareness about HPV infection and vaccination has emerged. As a result, it is critical to implement educational campaigns to enhance awareness, particularly by medical staff

Does lactate clearance prognosticates outcomes in ECMO therapy: a retrospective observational study

Abstract Background ECMO support is a final treatment modality for patients in the refractory cardiogenic arrest and postcardiotomy cardiogenic shock with an utmost importance. Eventhough it is linked to high mortality, its usage gains popularity worldwide. We assessed the fluctuation of lactate levels and the clearance of lactate during the ECMO therapy and its prognostic role on mortality. Methods Data were gathered on all patients receiving ECMO therapy longer than 48 h between January 2015 and December 2017 retrospectively. Blood lactate had been recorded before ECMO implantation and at specific time points during ECMO support as a routine procedure. In this study, the Lactate clearance at specific time points (Lactate clearance-1) and the duration that lactate cleared more than 10% of the initial lactate level (Lactate clearance-2) was measured. Statistical analysis included Mann Whitney U-test and ROC-curves to predict 30-day mortality. Results Fourty-eight patients underwent ECMO therapy for refractory cardiogenic shock resulting in 70.8% mortality. The lactate levels before and after ECMO therapy as well as the dynamic changes were significantly correlated with mortality variable. With AUC calculation, LC-2 has a strong discrimination (AUC = 0.97) on 30-day survivors and nonsurvivors. LAE-LBE (AUC = 0.785), L48-LBE (AUC = 0.706) showed moderate predictive power on 30-day mortality. Conclusions Changes in lactate levels after ECMO implantation is an important tool to assess effective circulatory support and it is found superior to single lactate measurements as a prognostic sign of mortality in our study. Based on our results, an early insertion of ECMO before lactate gets high was suggested. Serial changes on lactate levels and calculation of its clearance may be superior to single lactate on both effective circulatory support and as prognostic prediction. LC-2 showed a strong discrimination on 30-day mortality

Early Against Classic Extubation Outcomes Following Cardiac Surgery and Correlation With Rapid Shallow Breath Index

AbstractBackground/Aims:Overnight postoperative ventilation following cardiovascular surgery was a routine procedure since 1960 and the usage of high-dose opioid anesthetic techniques strengthens the need. However early extubation of postcardiac patients has been claimed as safer and more cost-effective approach. Rapid shallow breath index (RSBI) is used widely to standardize weaning from Mechanical ventilatory support (MVS) and to predict failure of attempt. The aim of this retrospective study was to determine the impact of early extubation on post-cardiovasular surgery patients and the possible correlations of RSBI values.  Methods:This retrospective analysis was performed including 230 consecutive patients -who underwent cardiac surgery from September 2017 to January 2018 in a tertiary state hospital.Results:There was significant difference between early extubated group and conventional group in the prevalence of comorbidities, duration of surgery, LOS in hospital and in the ICU. There was no significant difference between groups either in mechanical ventilation parameters including RSBI, mortality or morbidity.Conclusions: Early extubation offers a substantial advantage in terms of accelerated recovery, shorter intensive care unit, and hospital stay, suggesting that efforts to reduce extubation times are cost-effective. Early Extubation following cardiac surgery can be managed in a successful manner and comparing to conventional practices it saves valuable hours of patients. RSBI, in the original cut-off point, was found useless as a weaning parameter while the threshold value for weaning failure was 31

First Genomic Insights into Pre-pottery Neolithic of Upper Mesopotamia

Recent studies showed that Neolithic populations in southwest Asia included distinct gene pools in the Levant, in Central Anatolia, and in the Zagros. Further, genomic comparisons suggested that all three populations adopted sedentism and farming without major admixture or replacement from other regions. Meanwhile, the population genetic characteristics of the geographic midpoint of these regions, namely upper Mesopotamia, has not been investigated so far. Here in this study, we present the first genomic data of individuals excavated from the PPNB phase of Çayönü. Çayönü, near the upper stretches of river Tigris, is one of the early settlements discovered in southeast Anatolia at the upper-most edge of Fertile Crescent. Material culture data indicate that the Çayönü population interacted intensely with nearby regions - Anatolia, Levant, and Zagros. Despite poor DNA preservation due to harsh environmental conditions, after screening the remains of 33 individuals we managed to obtain genomic data enough for population genetics analyses from 14 individuals. We revealed that Çayönü individuals were genetically similar to early Holocene groups of C Anatolia, Levant, and Zagros, with higher affinity to the C Anatolia-Levant cline. We also modelled Çayönü as a three-way admixture utilizing qpAdm and found that pre-pottery Neolithic population of Çayönü harbored ancestry from all surrounding populations. Overall, in line with archaeological evidence, Çayönü appears to have been a melting pot of neighbouring Neolithic populations during the 9th and 8th millennia BC