The genetic history of Ice Age Europe.

Modern humans arrived in Europe ~45,000 years ago, but little is known about their genetic composition before the start of farming ~8,500 years ago. Here we analyse genome-wide data from 51 Eurasians from ~45,000-7,000 years ago. Over this time, the proportion of Neanderthal DNA decreased from 3-6% to around 2%, consistent with natural selection against Neanderthal variants in modern humans. Whereas there is no evidence of the earliest modern humans in Europe contributing to the genetic composition of present-day Europeans, all individuals between ~37,000 and ~14,000 years ago descended from a single founder population which forms part of the ancestry of present-day Europeans. An ~35,000-year-old individual from northwest Europe represents an early branch of this founder population which was then displaced across a broad region, before reappearing in southwest Europe at the height of the last Ice Age ~19,000 years ago. During the major warming period after ~14,000 years ago, a genetic component related to present-day Near Easterners became widespread in Europe. These results document how population turnover and migration have been recurring themes of European prehistory.

Evaluation of Apical Dimension, Canal Taper and Maintenance of Root Canal Morphology Using XP-endo Shaper.

AIM: To evaluate the shaping ability of the XP-endo shaper file system in maxillary molars, representing root canals with variation in morphology. MATERIALS AND METHODS: Twenty maxillary molars were instrumented according to recommended protocols. Pre- and postoperative microcomputed tomography (CT) scans were performed and the root canals classified according to canal type and curvature. The volume change, number of strokes needed to prepare the canals and the size of the 0.04-tapered gutta-percha cone that was adapted in the canal were recorded. RESULTS: XP-endo shaper created a significant change in volume after instrumentation in all the canals, with the biggest change found in the DB canals, followed by the MB1 and the P canals, both at full length and in the apical 4 mm. The number of strokes needed to achieve working length and final shape did not differ between the various root canals. Although not significant, the number of strokes needed to prepare the root canal increased with severity of the curvature, but the severity of the curvature did not result in increased removal of dentin in the apical 4 mm. It was possible to achieve a final root canal size where a 0.04-tapered gutta-percha cone could be adapted. CONCLUSION: The XP-endo shaper was a safe and effective instrument to achieve a root canal preparation of at least size 30 and a 0.04 taper. CLINICAL SIGNIFICANCE: The clinical performance of XP-endo shaper was to some extent dependent on preoperative volume and curvature of the root canal.

Inner ear morphology of the cioclovina early modern European calvaria from Romania.

OBJECTIVES: The morphology of the human bony labyrinth is thought to preserve a strong phylogenetic signal and to be minimally, if at all, affected by postnatal processes. The form of the semicircular canals is considered a derived feature of Neanderthals and different from the modern human anatomy. Among other hominins, European Middle Pleistocene humans have been found to be most similar to Neanderthals. Early modern humans have been proposed to show a pattern that is distinct, but most similar to that of Holocene people. Here we examine the inner ear structures of the Cioclovina calvaria, one of the earliest reliably dated and relatively complete modern human crania from Europe, in the context of recent and fossil human variation. MATERIALS AND METHODS: Bony labyrinths were virtually extracted from CT scans of recent Europeans and Cioclovina. Using univariate and multivariate methods, measurements of the semicircular canals were compared with published measurements of other fossil specimens. RESULTS: Our results show that Cioclovina's inner ear morphology falls within the range of modern variation, with affinities to both Late Pleistocene modern humans and recent Europeans. Using discriminant functions, the sex of the Cioclovina specimen is estimated as male. DISCUSSION: Results agree with previous work showing that Cioclovina exhibits fully modern cranial morphology.

The influence of diabetes mellitus on survival of abdominal perforator flaps: an experimental study in rats with slowly induced diabetes mellitus.

BACKGROUND: Lower limb ulcers are a major source of morbidity and mortality in diabetic patients. Surgical coverage of these wounds is fraught with a high complication rate. Although clinically perforator flaps lead to good results in diabetic patients, there is little experimental data to support this finding. METHODS: A total of 60 Wistar rats were randomly assigned either to the diabetic (n = 30) or control (n = 30) group. Diabetes was induced by streptozotocin injection at 50 mg/kg body weight and was confirmed by blood glucose levels > 180 mg/dL preoperatively. In all rats, a cranial epigastric artery perforator flap was raised. At postoperative day 7, all flaps were raised, photographed by digital planimetry, and analyzed histologically. RESULTS: Mean glycemic levels preoperatively were 207.8 ± 16 in the diabetic group and 82.8 ± 5.1 in the control group (p < 0.05). Ninety percent of the flaps survived completely in the control group, compared with 66.7% in the diabetic group (p < 0.05). The mean flap survival area was lower in the diabetic group (83.3 ± 16.5%) than in the control group (96 ± 4%). There were significantly more perioperative complications in the diabetic group (46.7%) than in the control group (16.7%), but these did not affect flap survival. Superficial ulceration appeared only in the diabetic group as a complication. CONCLUSION: Perforator flaps can be successfully used for coverage of cutaneous defects in a rat diabetic model. These flaps show higher complication rates in diabetic versus nondiabetic animals; however, this complication rate has little influence on flap survival.

The Concept of One Health for Allergic Diseases and Asthma.

The worldwide prevalence of allergic disease is rising as a result of complex gene-environment interactions that shape the immune system and host response. Climate change and loss of biodiversity are existential threats to humans, animals, plants, and ecosystems. While there is significant progress in the development of targeted therapeutic options to treat allergies and asthma, these approaches are inadequate to meet the challenges faced by climate change. The exposomic approach is needed with the recognition of the bidirectional effect between human beings and the environment. All stakeholders need to work together toward mitigating the effects of climate change and promoting a One Health concept in order to decrease the burden of asthma and allergy and to improve immune health. Healthcare professionals should strive to incorporate One Health counseling, environmental health precepts, and advocacy into their practice.

Predictive Factors of the Burnout Syndrome Occurrence in the Healthcare Workers During the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) pandemic is probably the most critical epidemiological situation that human civilization has faced in the last few decades. In this context, of all the professional categories involved in the management of patients with COVID-19 are the most likely to develop burnout syndrome. The main objective of this study is to analyze specific predictive factors of the occurrence and development of the burnout syndrome in the healthcare workers involved in the diagnosis and treatment of patients with COVID-19. The study focused on determining factors of the occurrence, development and maintaining the specific burnout syndrome related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic infection. The study was conducted on a sample of 959 participants, medical personnel from all the public medical entities in Romania(including 5 hospitals): 122 male and 755 female (82 participants did not declare their gender), with a mean age of 42.29 years (SD = 9.97). The sample included 219 doctors, 477 nurses, 214 auxiliary medical personnel and 49 other types of hospital workers. A cross-sectional design was used. Three predictors of the burnout syndrome were identified: Work conditions, Fear of the consequences (including death) determined by the COVID-19 and Need for emotional support. Meaning of work had a moderating role. Several moderated mediation models were tested. The indirect relationship of Work conditions with burnout via Fear of infection was statistically significant; in addition, the indirect effect of Work conditions on burnout through both fear of infection and need for support was statistically significant. The moderation analysis showed that Meaning of work buffer the relationship between Work conditions and Fear of infection. The variance explained by the model including the moderator (30%) was higher than the variance explained by Model 1 (27%), showing that adding the moderating effect of Meaning of work to the relationship of Work conditions with burnout was relevant. The results could be used to design specific interventions to reduce the occurrence of the burnout syndrome in healthcare workers, the implementation of a strategy to motivate employees by highlighting and recognizing the high significance of the work of those in the frontline of the fight against COVID-19.

Original targeted therapy for the management of the burnout syndrome in nurses: an innovative approach and a new opportunity in the context of predictive, preventive and personalized medicine.

BACKGROUND: Currently considered an occupational disease, the burnout syndrome affects 13-27% of the active population in multiple occupational sectors of the modern world. OBJECTIVES: Considering the burnout syndrome from the new perspective of the predictive, preventive, personalized medicine concept as a pathological entity with a predictable appearance and evolution which allows a preventive approach and a personalized therapy, the main objective of the study is to highlight the possibility of psychotherapeutic interventions for producing measurable psychological changes in order to decrease the burnout level of hospital nurses. METHOD: The research design is experimental, the independent variable being the participation or non-participation of nurses in psychotherapeutic sessions where specific classical psychodrama techniques are originally used. Nurses previously identified with medium or high levels of burnout participated in the clinical study, split into two groups: the experimental one, with 150-min weekly sessions, and the control one, without any intervention. Pre- and post-intervention questionnaires were administered to the members of both groups. RESULTS: The statistical analysis of the differences between pre- and post-intervention revealed (a) the decrease of the levels of personal burnout and of burnout generated by the working conditions and (b) the decrease of the depression and of anxiety on four dimensions (self-awareness, ergic tension, veiled and general anxiety). CONCLUSIONS: The classical psychodrama method can be an effective solution in the prophylaxis and treatment of the burnout syndrome. The multidisciplinary approach according to the PPPM concept including changes of the environmental factors within the professional framework associated with stress control programmes can be promising solutions for the management of this syndrome.

State of the art forensic techniques reveal evidence of interpersonal violence ca. 30,000 years ago.

The Cioclovina (Romania) calvaria, dated to ca. 33 cal ka BP and thought to be associated with the Aurignacian lithic industry, is one of the few relatively well preserved representatives of the earliest modern Europeans. Two large fractures on this specimen have been described as taphonomic modifications. Here we used gross and virtual forensic criteria and experimental simulations on synthetic bone models, to investigate their nature. Both forensic trauma pattern analysis and experimental models exclude a postmortem origin for the Cioclovina fractures. Rather, they indicate two incidents of blunt force trauma, the second clearly inflicted with a club-like object. The magnitude and extent of the lesions and the lack of signs of healing indicate a fatal injury. The Upper Paleolithic period is noted for intensified technological innovation, increased symbolic behavior, and cultural complexity. We show that the behavioural repertoire of the earliest modern Europeans also comprised violent inter-personal interactions and murder.

Pleistocene Mitochondrial Genomes Suggest a Single Major Dispersal of Non-Africans and a Late Glacial Population Turnover in Europe.

How modern humans dispersed into Eurasia and Australasia, including the number of separate expansions and their timings, is highly debated [1, 2]. Two categories of models are proposed for the dispersal of non-Africans: (1) single dispersal, i.e., a single major diffusion of modern humans across Eurasia and Australasia [3-5]; and (2) multiple dispersal, i.e., additional earlier population expansions that may have contributed to the genetic diversity of some present-day humans outside of Africa [6-9]. Many variants of these models focus largely on Asia and Australasia, neglecting human dispersal into Europe, thus explaining only a subset of the entire colonization process outside of Africa [3-5, 8, 9]. The genetic diversity of the first modern humans who spread into Europe during the Late Pleistocene and the impact of subsequent climatic events on their demography are largely unknown. Here we analyze 55 complete human mitochondrial genomes (mtDNAs) of hunter-gatherers spanning ∼35,000 years of European prehistory. We unexpectedly find mtDNA lineage M in individuals prior to the Last Glacial Maximum (LGM). This lineage is absent in contemporary Europeans, although it is found at high frequency in modern Asians, Australasians, and Native Americans. Dating the most recent common ancestor of each of the modern non-African mtDNA clades reveals their single, late, and rapid dispersal less than 55,000 years ago. Demographic modeling not only indicates an LGM genetic bottleneck, but also provides surprising evidence of a major population turnover in Europe around 14,500 years ago during the Late Glacial, a period of climatic instability at the end of the Pleistocene.

Virtual assessment of the endocranial morphology of the early modern European fossil calvaria from cioclovina, romania.

Endocasts provide evidence on size and shape characteristics, blood supply trajectories, and neurological features of the brain, allowing comparative analyses of fossil hominins crucial to our understanding of human brain evolution. Here, we assess the morphological features of the virtual endocast of the Cioclovina Upper Paleolithic calvarium, one of the earliest reliably dated European modern human fossils. Our study was conducted on a computed tomography (CT) scan of the original specimen. The endocranial profile was approximated via a semiautomatic segmentation of the CT data. Virtual reconstructions of the endocast were used for assessing the morphological features of the endocranium and for the estimation of the endocranial volume. Cioclovina exhibits a clockwise torque with a small anterior extension of the left frontal lobe over the right one and a protrusion of the right occipital lobe over the left, most likely due to the superior sagittal sinus coursing over the occipital pole. There is an obvious right predominance of the posterior drainage system. Interestingly, the area of the frontal sinus is occupied by dense bony tissue with small air cells corresponding probably to a natural bony loss in the diploë and to vascular spaces. An estimated endocranial volume of 1498.53 cc was calculated. The convolutional details of the third inferior frontal gyrus (Broca's caps) are indistinguishable from those found in modern Homo sapiens, and the left occipital lobe appears wider than the right, a possible correlate of right-handedness. Our metric analysis of endocranial measurements also aligns Cioclovina with modern humans.

Molecular characterization and antibiotic susceptibility of Staphylococcus aureus from a multidisciplinary hospital in Romania.

From 2004 to 2005, 60%-72% of invasive Staphylococcus aureus isolates from Romanian hospitals were resistant to methicillin (methicillin-resistant S. aureus [MRSA]), the highest frequency for any European nation. Few reports, however, have addressed the molecular characteristics of S. aureus in Romania. In this study, we utilized spa typing, multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec) typing, dru typing, pulsed-field gel electrophoresis, and detection of virulence factors to characterize 146 S. aureus strains isolated from 2004 to 2005 at the Clinic County Hospital in Brasov. Antibiotic susceptibility patterns for all MRSA isolates and patient demographic data were also obtained. Fifty-six strains (38.4%) were determined to be MRSA by susceptibility testing and SCCmec typing. All MRSA strains were resistant to beta-lactams and tetracycline, but susceptible to nitrofurans, vancomycin, and clindamycin, with inducible clindamycin resistance in 23/28 clindamycin-sensitive/erythromycin-resistant isolates. Molecular typing identified 15 clonal backgrounds (CC 1, 5, 8, 8/239, 9, 15, 20, 22, 25, 30, 45, 80, 97, 101, and 121), only 4 of which were associated with MRSA (CC 1, 8/239, 30, and 80). Spa types 35 (t127, CC 1) and 351 (t030, CC 8/239) accounted for 27.4% and 21.9% of all S. aureus strains, respectively, and 19.6% and 57.1% of all MRSA strains. Both hospital-associated (SCCmec type III) and community-associated (SCCmec type IV) elements were identified within MRSA strains, whereas Panton-Valentine leukocidin was detected in 10 MRSA and 12 methicillin-sensitive S. aureus strains. These results demonstrate the presence of various endemic S. aureus clones within the Clinic County Hospital in Brasov, suggestive of ongoing nosocomial and community transmission.

Cioclovina (Romania): affinities of an early modern European.

The current modern human origins debate centers on the possibility and degree of admixture between indigenous archaic humans and modern human populations migrating out of Africa into Europe and Asia in the Late Pleistocene. Evidence for such admixture must be sought in the earliest fossil record of modern humans outside Africa, as it is those populations that would have encountered, and possibly interbred with, archaic hominins. In the case of Europe, the recent application of direct dating techniques has eliminated several specimens from the Upper Paleolithic fossil record, while confirming early ages for others. Among these earliest reliably dated specimens is the Cioclovina calvaria from Romania. This individual is of highest importance for the understanding of modern human origins in Europe, and has recently been proposed to represent a Neanderthal-modern human hybrid. We present a short description and a three-dimensional (3D) geometric morphometric analysis of the Cioclovina specimen using a large geographic sample of recent humans, Neanderthals and Middle and Late Pleistocene fossil hominins from Europe, Africa, and the Levant, in order to establish its phenetic affinities and to evaluate its morphology for evidence of admixture between Neanderthals and early modern Europeans. Our results show Cioclovina to be entirely modern in its cranial shape, and do not support the hypothesis that it represents a hybrid.