Counting the Founders: The Matrilineal Genetic Ancestry of the Jewish Diaspora

The history of the Jewish Diaspora dates back to the Assyrian and Babylonian conquests in the Levant, followed by complex demographic and migratory trajectories over the ensuing millennia which pose a serious challenge to unraveling population genetic patterns. Here we ask whether phylogenetic analysis, based on highly resolved mitochondrial DNA (mtDNA) phylogenies can discern among maternal ancestries of the Diaspora. Accordingly, 1,142 samples from 14 different non-Ashkenazi Jewish communities were analyzed. A list of complete mtDNA sequences was established for all variants present at high frequency in the communities studied, along with high-resolution genotyping of all samples. Unlike the previously reported pattern observed among Ashkenazi Jews, the numerically major portion of the non-Ashkenazi Jews, currently estimated at 5 million people and comprised of the Moroccan, Iraqi, Iranian and Iberian Exile Jewish communities showed no evidence for a narrow founder effect, which did however characterize the smaller and more remote Belmonte, Indian and the two Caucasus communities. The Indian and Ethiopian Jewish sample sets suggested local female introgression, while mtDNAs in all other communities studied belong to a well-characterized West Eurasian pool of maternal lineages. Absence of sub-Saharan African mtDNA lineages among the North African Jewish communities suggests negligible or low level of admixture with females of the host populations among whom the African haplogroup (Hg) L0-L3 sub-clades variants are common. In contrast, the North African and Iberian Exile Jewish communities show influence of putative Iberian admixture as documented by mtDNA Hg HV0 variants. These findings highlight striking differences in the demographic history of the widespread Jewish Diaspora

Prospective Randomized Trial of Bispectral Index Monitoring of Sedation Depth during Flexible Bronchoscopy

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; The clinical benefits associated with the use of the bispectral index (BIS) to monitor the depth of sedation during flexible fiberoptic bronchoscopy (FFB) are questionable. &lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; To evaluate the added value in terms of procedural safety and patients' awareness of monitoring sedation depth using the BIS compared to conventional clinical judgment alone in patients undergoing FFB under propofol sedation. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The cohort included 81 patients undergoing diagnostic or therapeutic bronchoscopy under propofol sedation that were prospectively randomized to guide the depth of sedation by BIS monitoring (BIS group; n = 40) or conventional monitoring (control group; n = 41). &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The mean durations of the procedure were 18 and 19 min in the BIS and control groups, respectively. No significant difference was noted in the dosage of propofol used between the BIS and control groups (168.7 vs. 167.3 mg, respectively). Average sedation-related oxygen saturation drop and transcutaneous CO&lt;sub&gt;2&lt;/sub&gt; rise were not significantly different between groups. There was also no significant difference in the percentage of patients that required either hemodynamic support (5 vs. 7.5%, respectively), oxygen supplementation by 100% O&lt;sub&gt;2&lt;/sub&gt; mask (67.5 vs. 82.5%, respectively) or Ambu face mask manual ventilation (2.5 vs. 5%, respectively) between the groups. No significant difference was noted in terms of patients' awareness during the procedure, which was assessed following recovery by a structured Brice interview. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Using BIS to guide the depth of sedation during propofol sedation in patients undergoing FFB of relatively short duration offers no clinically significant advantages over conventional monitoring.</jats:p

Propofol Safety in Bronchoscopy: Prospective Randomized Trial Using Transcutaneous Carbon Dioxide Tension Monitoring

&lt;i&gt;Background:&lt;/i&gt; Midazolam is commonly used for sedation during flexible bronchoscopy because of its relatively wide therapeutic window. Recently, sedation with propofol for bronchoscopy has gained popularity, although concern has been raised regarding its potential ability to induce severe respiratory depression. &lt;i&gt;Objectives:&lt;/i&gt; The aim of this study was to evaluate the safety of sedation under midazolam + alfentanil compared to propofol. &lt;i&gt;Methods:&lt;/i&gt; We conducted a prospective randomized trial using continuous transcutaneous carbon dioxide tension monitoring. The study group included 115 patients undergoing bronchoscopy, prospectively randomized to receive sedation with either midazolam + alfentanil (n = 59) or propofol (n = 56). &lt;i&gt;Results:&lt;/i&gt; Intra-procedural carbon dioxide tension values were higher in the midazolam + alfentanil group than in the propofol group (maximum 53.72 vs. 49.49 mm Hg, mean 46.78 vs. 43.78 mm Hg), but the differences did not reach statistical significance (p = 0.149 and 0.193, respectively). Carbon dioxide tension values were significantly higher in the midazolam + alfentanil group than in the propofol group at 5 and 10 min following procedure (51.7 vs. 49.3 mm Hg, p = 0.026, and 50.8 vs. 42.7 mm Hg, p &lt; 0.01, respectively), and significantly more patients in the midazolam + alfentanil group needed oxygen supplementation or airway support (24 vs. 8 patients, respectively). &lt;i&gt;Conclusion:&lt;/i&gt; Midazolam + alfentanil and propofol are equally safe for sedation during bronchoscopy. Sedation with propofol, using small boluses at short intervals, does not cause excessive respiratory drive depression and represents an excellent alternative to traditional sedation agents.</jats:p

Quantitation of Silica Contents in Lung Explants of Transplanted Patients: Artificial Stone-Induced Silicosis vs. Idiopathic Pulmonary Fibrosis

Spectrophotometric techniques provide qualitative but not quantitative data on lung particles. We aimed to quantitate silica content in biopsies of lung-transplanted silicosis patients by applying X-ray fluorescence (XRF) spectrometry. Lung biopsies of 17 lung-transplanted artificial patients were quantitated for silica and other minerals particles by Niton XL3 XRF spectrometry. Occupational and clinical history data were assessed. Lung biopsies of artificial stone-induced silicosis (ASIS) patients contained significantly higher levels of silica compared to those of idiopathic pulmonary fibrosis (IPF) patients (7284.29 ± 4693.75 ppm vs. 898.88 ± 365.66 ppm, p &lt; 0.0001). Silica content correlated negatively with age, body mass index, and pulmonary function test results. A 1128 ppm silica cut-off value yielded 100% sensitivity and 94% specificity for predicting ASIS (AUC = 0.94, p &lt; 0.0001). In conclusion, XRF measurements in lung biopsies can differentiate between silica and mineral particles in ASIS and IPF.</jats:p