Turcinoemacheilus ekmekciae, a new dwarf loach from upper Tigris and Euphrates (Teleostei: Nemacheilidae)

Turcinoemacheilus ekmekciae, new species, from upper Euphrates and Tigris drainages is distinguished from other species of Turcinoemacheilus in Western Asia by having a dark stripe broader than the eye diameter along the lateral line, rarely possessing roundish blotches, 5-6 mandibular pores in mandibular canal, a comperatvely smaller head, a deeper body, and a greater pre-pelvic distance. Our specimens collected from the upper Great Zab, near the type locality of Turcinoemacheilus kosswigi, showed notable genetic divergence (a minimum K2P of 3.3%) from sequences reported as T. kosswigi in previous studies. Despite morphological similarities, this molecular difference suggests that the populations analysed in previous studies may represent a potential new species of Turcinoemacheilus, which we tentatively named as Turcinoemacheius cf. kosswigi. Molecular data also suggest that T. ekmekciae is characterized by a minimum K2P distance of 3.5% from Turcinoemacheilus minimus and T. cf. kosswigi. The three methods for species delimitation (assemble species by automatic partitioning [ASAP], Poisson tree processes [PTP], and multi-rate PTP [mPTP]) that were utilized for testing species assignments consistently identified our test group as a distinct species.

The rise of coastal Middle Bronze Age Levant - A multidisciplinary approach for investigating in Sidon, Lebanon

OBJECTIVES

The Levantine Middle Bronze Age (MBA, circa 2000-1500 BCE) marks a period of increased trade and regional interaction, spurred on by technological developments. In light of previous research exhibiting limited mobility in Sidon, further investigation was conducted using biodistance analysis to understand local population history and site development.

MATERIALS AND METHODS

Dental nonmetric traits, a proxy for genetic information, were explored using ASUDAS on a sub-sample of primary inhumations (n = 35). The biodistance matrix was generated using Gower distance measures, and further tested using PERMDISP, PERMANOVA, Mantel test and hierarchical cluster analysis. The data was also contrasted to 87 Sr/86 Sr and δ18 O as well as δ13 C and δ15 N values.

RESULTS

There were no significant diachronic differences in isotopes values, and there was biological continuity (n = 35, Mantel test r = 0.11, p = 0.02, comparing local phases and biodistance). The analysis also suggested of a sub-group of individuals with biological proximity shared a more limited range of mobility and dietary habits.

CONCLUSIONS

The isotopes (87 Sr/86 Sr, δ18 O, δ13 C, δ15 N) and biodistance analysis conducted on the Sidon College site skeletal assemblage exhibits stability and continuity of the people, despite the site's increasing role in the maritime network. This continuity may have been a key factor in Sidon's success, allowing it to accumulate wealth and resources for centuries to come.

Defining the burden of febrile illness in rural South and Southeast Asia: an open letter to announce the launch of the Rural Febrile Illness project

In rural areas of South and Southeast Asia malaria is declining but febrile illnesses still account for substantial morbidity and mortality. Village health workers (VHWs) are often the first point of contact with the formal health system, and for patients with febrile illnesses they can provide early diagnosis and treatment of malaria. However, for the majority of febrile patients, VHWs lack the training, support and resources to provide further care. Consequently, treatable bacterial illnesses are missed, antibiotics are overused and poorly targeted, and patient attendance wanes along with declining malaria. This Open Letter announces the start of a new initiative, the Rural Febrile Illness (RFI) project, the first in a series of projects to be implemented as part of the South and Southeast Asian Community-based Trials Network (SEACTN) research programme. This multi-country, multi-site project will begin in Bangladesh, Cambodia, Lao PDR, and Myanmar and will define the epidemiological baseline of febrile illness in five remote and underserved areas of Asia where malaria endemicity is declining and access to health services is limited. The RFI project aims to determine the incidence, causes and outcomes of febrile illness; understand the opportunities, barriers and appetite for adjustment of the role of VHWs to include management of non-malarial febrile illnesses; and establish a network of community healthcare providers and facilities capable of implementing interventions designed to triage, diagnose and treat patients presenting with febrile illnesses within these communities in the future.

Molecular phylogeny and intraspecific differentiation of the Trapelus agilis species complex in Iran (Squamata: Agamidae) inferred from mitochondrial DNA sequences

Background

Trapelus agilis consists of different morphotypes with restricted distributions in the Iranian Plateau. The phylogeny of the species complex has not been resolved so far, but recently Trapelus sanguinolentus were elevated from this complex into a full species. Other populations of the species complex need to be evaluated taxonomically.

Methods

In the present study, several populations of this species complex along with specimens of its closely related taxa in Iran, T. sanguinolentus, T. ruderatus and T. persicus, were examined using partial nucleotide sequences of two mitochondrial genes (cytb and ND2) (total length 1,322 bp).

Result

Populations of T. sanguinolentus clustered within the T. agilis species complex, thus indicating its paraphyly, but T. sanguinolentus was previously determined to be a species based on morphological features. The T. agilis species complex forms two distinct major clades, each of which is represented by several local populations on the Iranian Plateau. At least five distinct taxa can be identified within this traditional group. Our biogeographic evaluation of the molecular dataset suggested that the Trapelus complex originated in the Late Oligocene (30 mya) and subsequently diversified during the early to middle Miocene (22–13 mya). At first, the predominantly western clade of Trapelus ruderatus diverged from the other clades (22 mya). Afterward, Trapelus persicus diverged around 18 mya ago. The broader T. agilis complex started to diverge about 16 mya, forming several clades on the Iranian Plateau and in Central Asia. The different lineages within this species complex appear to be the result of vicariance events and dispersal waives. The corresponding vicariance events are the formation of the Zagros and Kopet Dagh basins (16–14 mya), and consequently, the aridification of the Iranian Plateau in the late Miocene (11–6 Mya).

Burden of Clostridium (Clostridioides) difficile Infection among Patients in Western Asia: A Systematic Review and Meta-Analysis

BACKGROUND

Clostridium difficile is the most common causes of hospital-acquired diarrhea affecting particularly hospitalized patients globally. This organism has re-emerged in recent years with significant morbidity and mortality. The present study aimed to estimate the burden of C. difficile infection (CDI) and to acquire information on the overall rates of community- and hospital-acquired CDI in western Asia.

METHODS

A systematic literature search was performed to identify articles published from the eight Persian Gulf countries in western Asia including Iran, Iraq, Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates in the electronic databases within Jan of 2000 to Dec of 2017. Then, 20 publications which met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software.

RESULTS

Twenty studies reported the prevalence of toxigenic strains of C. difficile among patients from Persian Gulf countries, of these the pooled prevalence of CDI was 9% (95% CI: 6.5%-12.5%). Totally, 8 studies showed the prevalence of hospital-acquired CDI, from those studies the prevalence of CDI was estimated 8.4% (95% CI: 4.9%-14.1%). Moreover, 7 studies reported the prevalence of community-acquired CDI, from those studies the prevalence of CDI was estimated 1.8% (95% CI: 1.2%-2.9%).

CONCLUSION

The prevalence of CDI in western Asia is lower than southern and eastern region. Moreover, the lower prevalence of community-acquired CDI compared to hospital-acquired CDI, indicate that the source of infection in western Asia is more likely in the hospitals.

Cutaneous Leishmaniasis among Syrian Refugees in Jordan: a Retrospective Study

The aim of this study is to investigate cutaneous leishmaniasis (CL) among Syrian refugees residing in Jordan. A total of 558 Syrian refugee patients were clinically diagnosed with cutaneous leishmaniasis during 2010-2016. For each patient, sex, age, location, and number of lesions were recorded. Of the total 558 CL cases among Syrian refugees, 514 (92.1%) were classified as imported, 14 (2.5%) as locally acquired infection, and 30 (3.4%) of cases unclassified due to lack of information. By gender, 306 (55%) were males and 252 (45%) were females. Ages ranged between 1 and 78 years (17.3 ± 16.3), with the age group 1-10 years (48.2%) being the most affected group. The face was the most affected (171 cases, 30.6%), followed by the hands and arms in 95 cases (17%), while lesions on the legs were observed in 69 cases (12.4%), and 65 cases (11.6%) on the trunk. The number of lesions ranged from 1 to 5 (1.39 ± 0.985) on the face, 1 to 3 (1.32 ± 0.898) on the trunk, 1 to 17 (1.5 ± 41.39) on the arms, and 1 to 5 (1.5 ± 1.473) on the legs. Extensive efforts should be undertaken by the health officials in Jordan to confine the spread of this disease by strengthening surveillance, diagnosis of new cases, proper treatment of all cases, and entomological surveys for the presence of the vector sandflies as well as the reservoir hosts within the refugee camps. Most cases were considered as imported (92.1%) and require immediate attention at the port of entry.

Urinary Myiasis Caused by Clogmia albipunctata from the Palestinian Territories

This is the first record of a case of urinary myiasis in the Palestinian Territories caused by Clogmia albipunctata. Larvae were discharged through urine by a 28-year-old pregnant female whom complained of mild abdominal pain associated with burning sensation while urinating over the past 3 months. Detailed description of the larva was provided.

Medicine Shortages: Gaps Between Countries and Global Perspectives

Introduction: Over the last decade, global health policies and different research areas have focused on the relevance and impact of medicine shortages. Published studies suggest there have been difficulties with access to medicines since the beginning of the 20th century, and there have been advances in our understanding and management of the problem since then. However, in view of global and regional health care concerns with shortages, we believe this phenomenon needs to be characterized and described more fully regarding the types of medicines affected, possible causes, and potential strategies to address these. The aim of this scoping review was to identify, compare if possible, and characterize the recent literature regarding the situation of medicines shortages between countries, and provide different perspectives, including a global context and national approaches.

Methodology: A scoping study presented as a narrative review of the situation and findings principally based on published articles.

Results: Based on the reported cases in the literature, a typology of medicines shortage and supply interruption episodes and their causes were proposed; national approaches to notify and manage the medicines shortages cases were described and classified by update frequency; principal differences between market and supply chain management perspectives of the situation were identified and global and countries’ perspectives were described.

Conclusion: Policy makers require solutions that prevent those cases in which the population’s health is affected by episodes of medicine shortages and/or interruption in the supply chain. There is also a need to generate a glossary related to logistics management and the availability of medicines which will be useful to understand and overcome shortages. In addition, recognize that potential solutions are not only related with actions linked to research, development and innovation, but much wider. Overall, we believe this article can act as a basis for future discussions in this important area.

Exploring the Causes of the Low Incidence of Cervical Cancer in Western Asia

Anecdotal epidemiologic observations can provide valuable tools to study various biologic elements in complex diseases such as cancer. Although cervical cancer is one of the most frequent malignancy affecting women in the world, it displays wide geographical variations remnant of socioeconomic, ethnic and genetic predisposing factors. The observed low incidence of cervical cancer in western Asia has triggered scientists to try to delineate the causes of this reduced occurrence. Although this region including Saudi Arabia is known for being conservative societies with low incidence of sexually transmitted infections including human papillomavirus (HPV) and associated cervical cancer, scientific research points out multifaceted biological explanations including host genetic variations. Researchers observed that a protective genetic variant TP53 codon 72 proline allele was more commonly found in this population and appear to be over-transmitted compared to others known for their high rate of cervical cancer. Thus, the combination of relative low rate of HPV infection, over-transmission of protective genetic variant along with societal variables are the rationale behind the low incidence of cervical cancer in women in the region of western Asia. The influence of the genetic makeup of the patients has impact on personalized preventive medicine to gauge the risk of developing cervical cancer.

Systemic Measures and Legislative and Organizational Frameworks Aimed at Preventing or Mitigating Drug Shortages in 28 European and Western Asian Countries

Drug shortages have been identified as a public health problem in an increasing number of countries. This can negatively impact on the quality and efficiency of patient care, as well as contribute to increases in the cost of treatment and the workload of health care providers. Shortages also raise ethical and political issues. The scientific evidence on drug shortages is still scarce, but many lessons can be drawn from cross-country analyses. The objective of this study was to characterize, compare, and evaluate the current systemic measures and legislative and organizational frameworks aimed at preventing or mitigating drug shortages within health care systems across a range of European and Western Asian countries. The study design was retrospective, cross-sectional, descriptive, and observational. Information was gathered through a survey distributed among senior personnel from ministries of health, state medicines agencies, local health authorities, other health or pharmaceutical pricing and reimbursement authorities, health insurance companies and academic institutions, with knowledge of the pharmaceutical markets in the 28 countries studied. Our study found that formal definitions of drug shortages currently exist in only a few countries. The characteristics of drug shortages, including their assortment, duration, frequency, and dynamics, were found to be variable and sometimes difficult to assess. Numerous information hubs were identified. Providing public access to information on drug shortages to the maximum possible extent is a prerequisite for performing more advanced studies on the problem and identifying solutions. Imposing public service obligations, providing the formal possibility to prescribe unlicensed medicines, and temporary bans on parallel exports are widespread measures. A positive finding of our study was the identification of numerous bottom-up initiatives and organizational frameworks aimed at preventing or mitigating drug shortages. The experiences and lessons drawn from these initiatives should be carefully evaluated, monitored, and presented to a wider international audience for careful appraisal. To be able to find solutions to the problem of drug shortages, there is an urgent need to develop a set of agreed definitions for drug shortages, as well as methodologies for their evaluation and monitoring. This is being progressed.

Higher body mass index in 16-19 year-old Jewish Adolescents of North African, Middle Eastern and European Origins is a Predictor of Acute Myeloid Leukemia: a cohort of 2.3 million Israelis

PURPOSE

Studies evaluating adolescent risk factors for developing acute myeloid leukemia (AML) are virtually nonexistent. We assessed adolescent predictors of AML in adults, with a main focus on adolescent BMI.

METHODS

The study included 2,310,922 16-19-year-old Jewish Israeli adolescents (mean age 17.3 ± 0.4, 59.5% male), called up for an obligatory health examination. Sociodemographic and health data, including measured weight and height, were gathered. Body mass index (BMI) was examined both as a continuous variable and grouped according to the World Health Organization (WHO) classification and US-CDC percentiles. Bone-marrow-biopsy-verified AML cases diagnosed up to 31 December 2012 were identified by linkage to the Israel national cancer registry. Multivariable-adjusted Cox proportional-hazards models were used to model time to diagnosis.

RESULTS

During 47 million person years of follow-up, 568 AML cases were identified (crude incidence rate 1.21/100,000 person years). There was a multivariable-adjusted hazard ratio (HR) of 1.041 (95% CI 1.015-1.068, p = 0.002) per unit BMI. The association was evident in those of Middle Eastern, North African, and European origin. A graded association was evident across the overweight and obese WHO grouping. With the US-CDC grouping, excess risk was evident in overweight but not in obese adolescents, although a test for trend in percentiles was significant (p = 0.004). Borderline associations were noted for origin (p = 0.065) (higher in the predominantly Ashkenazi European origin), sex (higher in women: HR = 1.24 (95% CI 0.99-1.55), and stature (HR = 1.013, 95% CI 1.000-1.026, per cm).

CONCLUSIONS

Higher BMI in adolescence was associated with increased AML incidence in adulthood in this multiethnic population.

Modes of labor market incorporation and occupational cost among new immigrants to Israel

"The present study contributes to the literature on international migration by examining social, demographic and contextual factors that influence modes of labor market incorporation and occupational cost among new immigrants during their first years after migration. The data for the analysis were obtained from the 1983 Census of Population conducted by Israel's Central Bureau of Statistics. The analysis focuses on men who immigrated to Israel between 1979 to 1983.... The data reveal that the likelihood of finding employment, the mode of labor market incorporation, and the size of the occupational cost are significantly affected by geocultural origin, occupation in the country of origin, and individual-level demographic and human capital resources. The meaning of the differentiated effects are discussed in detail. The findings point toward two central aspects that should be examined in the study of labor market incorporation of new immigrants: employment status and occupational cost."

Clustering of provinces according to socio-economic variables

This study is concerned with the identification of provinces in Turkey with similar characteristics. The author suggests that "it is possible to form groups of observations in terms of the differences of values of a set of variables and order them according to their relative positions. In this study, using 45 variables derived from 1985 General Census, 18 provinces with first degree priority in development were clustered.... Provinces with high priority could be displayed more explicitly and efficient action could be taken to improve the conditions in those provinces." (SUMMARY IN TUR)

[Consanguineous marriage in Turkey and its effects on infant mortality]

The authors examine the effects of consanguineous marriage on infant mortality in Turkey. An attempt is made to distinguish the influence of consanguineous marriage from that of selected regional and socioeconomic factors. It is found that "the differences of the average infant mortality rates between consanguineous and non-consanguineous marriages are parallel to the development differences between the regions as well as the conditions of the house which are thought to signify the socioeconomic differences. Although the differences in averages are insignificant statistically, this trend [indicates] that consanguineous marriages [affect] infant mortality." Data are from the 1983 Turkish Fertility, Contraceptive Prevalence and Family Health Status Survey. (SUMMARY IN ENG)

Law No. 5 of 1985 (Civil Code), 1985

Among other things this Law contains the following provisions: Article 71. (1) The personality (status of person) of a human being shall commence at the moment of being born alive. It shall terminate upon his death. (2) The law shall lay down the rights of a foetus in utero. Article 72. (1) The facts of birth and death shall be recorded (or: proved) by entries in registers kept for that purpose. (2) If there is no such evidence or if it should appear that the entries in the register are incorrect, it shall be permissible to prove the same by any legal means of proof. Article 76. (1) The family of a person shall consist of his spouse and relatives. (2) All persons coming from a common stock shall be deemed to be relatives. Article 77. (1) A direct relationship is the relationship of root and branch (direct lineage). An indirect relationship is the link between persons of common stock without direct lineage, whether or not within the degree of consanguinity precluding marriage. Article 78. In calculating the degree of direct relationship each upwards stage of generation to the source shall be regarded as one degree away from that source. In calculating the degree of indirect relationship degrees of ascent from the descendants to the common origin shall be taken into account, and then downwards from him to the last generation, and each stage shall be counted as a degree with the exception of the common source. Article 79. One of the relations of the spouses shall be regarded as having the same degree of relationship to the other spouse.

[The migration of Jews from the former Soviet Union: a new challenge for Israel?]

"This article is a contribution to the knowledge on the migratory results stemming from the collapse of the communist bloc. Since 1989, more than half a million... Jews have left the former Soviet Union for Israel. Thus, the Jewish state [has become] one of the major countries [to feel] the effects of this important geopolitical event. So, in this contribution, we will try to expose, with the first results of research, the patterns of this migration and to answer the inherent questions in this kind of [problem]: who are these migrants and what are their motives? and what are the effects of this migration for this area...." (SUMMARY IN ENG AND SPA)

The impact of this involuntary mass "return" to Jordan in the wake of the Gulf crisis

"This article investigates the impact of the involuntary movement to Jordan of about 300,000 Palestinians in the wake of the Gulf crisis of 1990-91. It explores the character of the population that arrived en masse in Jordan and whether their arrival burdened or benefitted that country.... The involuntary migration compounded other effects of the Gulf crisis on Jordan and exacerbated the country's already serious economic problems. Integration of the returnees was painful. But contrary to initial expectations, the mass arrival did not result in unmitigated disaster and may have contributed to an economic recovery in Jordan, suggesting that there may be potentially beneficial windfall effects of sudden population influxes, even when they are involuntary and disorderly."

The changing role of Asian labour migration in the Middle East

"The paper explores the changing role and origins of foreign labour in two labour importing states, Kuwait and Jordan.... Because Asian labour is cheaper, politically quiescent and more readily reexportable than Arab labour migrants it has become an increasingly important element of these labour forces.... The paper argues that the strategy of dependent development based on the state's import of large amounts of capital, labour and technology has emphasised specific national identities over a regional pan-Arab one." (SUMMARY IN FRE AND SPA)

Failure to absorb: remigration by immigrants into Israel

"Hypotheses about remigration by immigrants are investigated using longitudinal data from the 1970s for immigrants to Israel. The main finding is that experience of unemployment during the first year in Israel does not, on the whole, help predict subsequent remigration. The propensity to remigrate varies inversely with age for most groups, and it increases if the immigrant has not acquired permanent housing. Immigrants on temporary resident visas are naturally more prone to remigrate in the short run. The well-educated and the young are more likely to be temporary residents."