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A letter to the editor is presented in response to the article "The correlation of Helicobacter pylori with the development of cholelithiasis and cholecystitis: the results of a prospective clinical study in Saudi Arabia" by Guraya and colleagues in the previous issue.

The North Pontic region, which encompasses present-day Ukraine, was a crossroads of migration, connecting the vast Eurasian Steppe with Central Europe. We generated shotgun-sequenced genomic data for 91 individuals dating from around 7000 BCE to 1800 CE to study migration and mobility history in the region, with a particular focus on historically attested migrating groups during the Iron Age and the medieval period. We infer a high degree of temporal heterogeneity in ancestry, with fluctuating genetic affinities to different present-day Eurasian groups. We also infer high heterogeneity in ancestry within geographically, culturally, and socially defined groups. Despite this, we find that ancestry components which are widespread in Eastern and Central Europe have been present in the Ukraine region since the Bronze Age. In short, our study reveals a diverse range of ancestries in the Ukraine region through time as a result of frequent movements, assimilation, and contacts.

Many known and unknown historical events have remained below detection thresholds of genetic studies because subtle ancestry changes are challenging to reconstruct. Methods based on shared haplotypes 1,2 and rare variants 3,4 improve power but are not explicitly temporal and have not been possible to adopt in unbiased ancestry models. Here we develop Twigstats, an approach of time-stratified ancestry analysis that can improve statistical power by an order of magnitude by focusing on coalescences in recent times, while remaining unbiased by population-specific drift. We apply this framework to 1,556 available ancient whole genomes from Europe in the historical period. We are able to model individual-level ancestry using preceding genomes to provide high resolution. During the first half of the first millennium CE, we observe at least two different streams of Scandinavian-related ancestry expanding across western, central and eastern Europe. By contrast, during the second half of the first millennium CE, ancestry patterns suggest the regional disappearance or substantial admixture of these ancestries. In Scandinavia, we document a major ancestry influx by approximately 800 CE, when a large proportion of Viking Age individuals carried ancestry from groups related to central Europe not seen in individuals from the early Iron Age. Our findings suggest that time-stratified ancestry analysis can provide a higher-resolution lens for genetic history., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Ancient DNA is a valuable tool for investigating genetic and evolutionary history that can also provide detailed profiles of the lives of ancient individuals. In this study, we develop a generalised computational approach to detect aneuploidies (atypical autosomal and sex chromosome karyotypes) in the ancient genetic record and distinguish such karyotypes from contamination. We confirm that aneuploidies can be detected even in low-coverage genomes ( ~ 0.0001-fold), common in ancient DNA. We apply this method to ancient skeletal remains from Britain to document the first instance of mosaic Turner syndrome (45,X0/46,XX) in the ancient genetic record in an Iron Age individual sequenced to average 9-fold coverage, the earliest known incidence of an individual with a 47,XYY karyotype from the Early Medieval period, as well as individuals with Klinefelter (47,XXY) and Down syndrome (47,XY, + 21). Overall, our approach provides an accessible and automated framework allowing for the detection of individuals with aneuploidies, which extends previous binary approaches. This tool can facilitate the interpretation of burial context and living conditions, as well as elucidate past perceptions of biological sex and people with diverse biological traits., (© 2024. The Author(s).)

In the second century CE the Roman Empire had increasing contact with Sarmatians, nomadic Iranian speakers occupying an area stretching from the Pontic-Caspian steppe to the Carpathian mountains, both in the Caucasus and in the Danubian borders of the empire. 1 , 2 , 3 In 175 CE, following their defeat in the Marcomannic Wars, emperor Marcus Aurelius drafted Sarmatian cavalry into Roman legions and deployed 5,500 Sarmatian soldiers to Britain, as recorded by contemporary historian Cassius Dio. 4 , 5 Little is known about where the Sarmatian cavalry were stationed, and no individuals connected with this historically attested event have been identified to date, leaving its impact on Britain largely unknown. Here we document Caucasus- and Sarmatian-related ancestry in the whole genome of a Roman-period individual (126-228 calibrated [cal.] CE)-an outlier without traceable ancestry related to local populations in Britain-recovered from a farmstead site in present-day Cambridgeshire, UK. Stable isotopes support a life history of mobility during childhood. Although several scenarios are possible, the historical deployment of Sarmatians to Britain provides a parsimonious explanation for this individual's extraordinary life history. Regardless of the factors behind his migrations, these results highlight how long-range mobility facilitated by the Roman Empire impacted provincial locations outside of urban centers., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Extinct lineages of Yersinia pestis, the causative agent of the plague, have been identified in several individuals from Eurasia between 5000 and 2500 years before present (BP). One of these, termed the 'LNBA lineage' (Late Neolithic and Bronze Age), has been suggested to have spread into Europe with human groups expanding from the Eurasian steppe. Here, we show that the LNBA plague was spread to Europe's northwestern periphery by sequencing three Yersinia pestis genomes from Britain, all dating to ~4000 cal BP. Two individuals were from an unusual mass burial context in Charterhouse Warren, Somerset, and one individual was from a single burial under a ring cairn monument in Levens, Cumbria. To our knowledge, this represents the earliest evidence of LNBA plague in Britain documented to date. All three British Yersinia pestis genomes belong to a sublineage previously observed in Bronze Age individuals from Central Europe that had lost the putative virulence factor yapC. This sublineage is later found in Eastern Asia ~3200 cal BP. While the severity of the disease is currently unclear, the wide geographic distribution within a few centuries suggests substantial transmissibility., (© 2023. The Author(s).)

Group B Streptococcus (GBS) is a leading cause of neonatal meningitis, pneumonia, and sepsis. The biggest contributing factor of neonatal infections is due to vertical transmission from maternal colonisation of GBS in the genitourinary tract. Multiple serotype colonisation is often not investigated in epidemiological studies, but it is an important consideration for serotype-based vaccine development and implementation to ensure less abundant serotypes are not under-represented. In this study, we show that RAPD PCR is a quick tool useful in screening the presence of genetically different strains using multiple colony picks from a single patient swab. We observed a maximum of five different GBS strains colonising a single patient at a specific time., (Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.)

Background: Endoscopic mucosal resection (EMR) is an established technique for treating large laterally spreading type (LST) lesions ≥20 mm. The aim of our study was to compare the use of argon plasma (APC) versus snare-tip coagulation on the recurrence rate of large LST lesions., Methods: All patients with large LST lesions resected by EMR between January 2006 and December 2014 were enrolled. After piecemeal resection, patients underwent either APC or snare-tip coagulation of the rim of the resection area and any residual adenomatous tissue. Follow up included colonoscopy and biopsies. Medical records, including characteristics of patients and polyps, complications and recurrence were retrieved and collected., Results: One hundred one patients were included in the final analysis. They were divided into the APC group (n=50) and the snare-tip coagulation group (n=51). The 2 groups were similar concerning patients' characteristics, size of polyps and histology. Post-polypectomy coagulation syndrome was observed in 8 patients (7.9%) (APC group: n=5 and snare tip group: n=3). EMR-related bleeding occurred in 9 patients (8.9%) (APC group: n=4 and snare tip group: n=5). Total recurrence rate was 14.85% (16% and 13.7% in APC and snare-tip groups, respectively, P=0.34)., Conclusion: The effectiveness of snare-tip coagulation is comparable with that of APC with respect to recurrence rate after resection of large LST lesions. It thus represents a cost-effective alternative to APC., Competing Interests: Conflict of Interest: None

Background: With advancing age there is progressive pancreatic atrophy and fibrosis, leading to tissue destruction and chronic pancreatitis that has been found to be protective against post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). However, there are no reports regarding the potential effect of the aging pancreatic changes on the incidence and severity of PEP. Therefore, the aim of the present study was to investigate the impact of senile changes in the pancreas on the incidence and severity of PEP., Methods: A total of 2688 patients who underwent the first therapeutic ERCP at a single center were included in the final analysis of the study. Patients were classified into two groups: 1644 patients aged ≤75 years (mean age 61.56+1.26 years), group A; and 1044 patients aged >75 years (mean age 81.97+4.29 years), group B. Patients' files were identified using a retrospective database linked to the endoscopy reporting system. Patients' characteristic, endoscopic findings, details of intervention and rate and severity of PEP were evaluated., Results: No significant differences between the two groups were observed with regard to ERCP indication, patient- and technique-related risk factors for PEP, presence of periampullary diverticulum, and type of therapeutic intervention. The incidence of PEP was 5.2% in group A and 4% in group B (P=NS) with comparable grades of severity. All episodes of pancreatitis had full recovery with conventional treatment. One death occurred from respiratory arrest in each group of patients., Conclusion: This study shows that the pancreatic changes associated with aging do not influence the incidence and severity of PEP., Competing Interests: Conflict of Interest: None

Helicobacter pylori (H. pylori) induces reactive oxygen species (ROS) production that contribute to pathogenesis of a variety of H. pylori-related gastric diseases, as shown in animal and human studies. Helicobacter pylori infection is also associated with variety of systemic extragastric diseases in which H. pylori-related ROS production might also be involved in the pathogenesis of these systemic conditions. We proposed that Hp-related ROS may play a crucial role in the pathophysiology of Hp-related systemic diseases including Alzheimer's disease, multiple sclerosis, glaucoma and other relative neurodegenerative diseases, thereby suggesting introduction of relative ROS scavengers as therapeutic strategies against these diseases which are among the leading causes of disability and are associated with a large public health global burden. Moreover, we postulated that H. pylori-related ROS might also be involved in the pathogenesis of extragastric common malignancies, thereby suggesting that H. pylori eradication might inhibit the development or delay the progression of aforementioned diseases. However, large-scale future studies are warranted to elucidate the proposed pathophysiological mechanisms, including H. pylori-related ROS, involved in H. pylori-associated systemic and malignant conditions.

Objective: Easy common bile duct (CBD) cannulation is associated with low complication rate. This study aimed to investigate the potential impact of nitroglycerin and glucagon administration on selective CBD cannulation and prevention of post-ERCP pancreatitis., Methods: A prospective single center, double-blind randomized study in which a total of 455 patients were randomly assigned to CBD cannulation by receiving 6 puffs (2.4 mg) sublingual nitroglycerin and glucagon 1 mg intravenously (n = 227, group A) or 6 puffs sterile water and 20 mg hyoscine-n-butyl bromide intravenously (n = 228, group B). After ERCP, patients were followed for the development of drugs' side-effects and post-ERCP complications., Results: There were no statistically significant differences between the two groups regarding demographic data and ERCP findings. Success rate of selective CΒD cannulation was 95.15% in group A versus 82.29% in group B (p < .001). Time required for CBD cannulation was 2.82 ± 2.31 min in group A versus 4.27 ± 3.84 min in group B (p = .021). Needle-knife papillotomy was used in 11 (4.85%) patients of group A and 39 (17.11%) patients of group B (p = .001). The frequency of post-ERCP pancreatitis was significantly lower in group A than in group B (3.08% versus 7.46%, p = .037). No difference was observed between the two groups with regard to the occurrence of post-procedure hemorrhage. There was no procedure-related mortality; no adverse event related to the combination regimen was observed., Conclusions: Combined nitroglycerin and glucagon administration achieves a high selective CBC cannulation rates with concomitant reduction of post-ERCP pancreatitis incidence. However, further relative large-scale studies are needed to confirm our findings before definite conclusions can be drawn (Clinical trial registration number: NT: 4321).

Background: Fully covered self-expandable metal stents (FCSEMS) have been used successfully in the treatment of malignant and benign biliary strictures. However, stent migration is a major complication. We investigated the efficacy of anchoring FCSEMS with a 10-Fr double-pigtail plastic stent to prevent migration in patients with biliary strictures., Methods: Between January 2012 and May 2013, 10 patients with malignant biliary strictures and one patient with a suprapapillary benign biliary stenosis were enrolled in the study. The primary endpoint of the study was to record the migration rate of FCSEMS., Results: The placement of FCSEMSs and the anchoring with a 10-Fr double-pigtail plastic stent were successful in all patients. During a median follow-up period of eight months, proximal or distal migration of FCSEMS was not observed. No procedural complications related to the placement of FCSEMS and/or the anchoring plastic stent were recorded., Conclusions: The placement of an anchoring 10-Fr double-pigtail stent is a simple and effective anti-migration technique for FCSEMS in patients with malignant biliary strictures., Competing Interests: None

In the present work, bottom and fly ash, generated from incinerated medical waste, was used as a raw material for the production of geopolymers. The stabilization (S/S) process studied in this paper has been evaluated by means of the leaching and mechanical properties of the S/S solids obtained. Hospital waste ash, sodium hydroxide, sodium silicate solution and metakaolin were mixed. Geopolymers were cured at 50°C for 24h. After a certain aging time of 7 and 28 days, the strength of the geopolymer specimens, the leachability of heavy metals and the mineralogical phase of the produced geopolymers were studied. The effects of the additions of fly ash and calcium compounds were also investigated. The results showed that hospital waste ash can be utilized as source material for the production of geopolymers. The addition of fly ash and calcium compounds considerably improves the strength of the geopolymer specimens (2-8 MPa). Finally, the solidified matrices indicated that geopolymerization process is able to reduce the amount of the heavy metals found in the leachate of the hospital waste ash., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: Clinical data regarding Helicobacter pylori (Hp) infection in nonalcoholic fatty liver disease (NAFLD) are limited. The aim was the evaluation of Hp infection in patients with NAFLD and its association with disease severity., Methods: 28 patients with biopsy-proven NAFLD (15 with simple nonalcoholic fatty liver [NAFL], 13 with nonalcoholic steatohepatitis [NASH]) and 25 matched healthy controls were recruited. Blood samples for anti-Hp Immunoglobulin G (IgG) and standard biochemical tests were obtained after overnight fasting, and (13)C urea breath test was performed before liver biopsy in NAFLD group., Results: Higher rates of anti-Hp IgG (P=.038) were observed in NAFLD compared to control group. Only two NAFLD patients neither were Hp IgG seropositive nor did they have a history of eradication treatment compared to 11 control subjects (P=.002). Both Hp infection (assessed by history of Hp eradication treatment and/or Hp IgG seropositivity) (P=.034) and log(HOMA-IR) (P=.007) could independently predict NAFLD in logistic regression analysis. There were similar rates of Hp IgG seropositivity or positivity in (13)C urea breath test or their combination between NAFL and NASH patients. There were no significant differences in steatosis grade, fibrosis stage, lobular or portal inflammation, or ballooning, when NAFLD patients were divided according to Hp IgG seropositivity or (13)C urea breath test positivity., Conclusions: Hp infection may represent one more hit contributing to the pathogenesis of NAFL, though not to the progression from NAFL to NASH. These results warrant further validation. If confirmed, eradicating Hp infection may have certain therapeutic perspectives in NAFLD treatment., (Copyright © 2013 Elsevier Inc. All rights reserved.)

In this study, the adsorption of Cu(II) from aqueous solutions by agricultural by-products, such as rice husks, olive pomace and orange waste, as well as compost, was evaluated. The aim was to obtain sorbent materials (biochars) through hydrothermal treatment (300 °C) and pyrolysis (300 °C and 600 °C). The effect of adsorbent dose, pH, contact time and initial Cu(II) concentration in batch-mode experiments was investigated. The optimum Cu(II) adsorption conditions was found to occur at 5-12 g/L adsorbent dose, initial pH 5-6, and reaction time 2-4 h. Furthermore, the adsorption kinetics were best described by the pseudo-second order model for all the tested materials, while the adsorption equilibrium best fitted by the linear and Freundlich isotherms. Comparing rice husks and olive pomace, the higher adsorption capacity resulted after pyrolysis at 300 °C. With respect to the orange waste and compost, the highest adsorption capacity was observed using biochars obtained after hydrothermal treatment and pyrolysis at 300 °C., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

In the present work, the stabilization/solidification of fly and bottom ash generated from incinerated hospital waste was studied. The objectives of the solidification/stabilization treatment were therefore to reduce the leachability of the heavy metals present in these materials so as to permit their disposal in a sanitary landfill requiring only a lower degree of environmental protection. Another objective of the applied treatment was to increase the mechanical characteristics of the bottom ash using different amounts of Ordinary Portland Cement (OPC) as a binder. The solidified matrix showed that the cement is able to immobilize the heavy metals found in fly and bottom ash. The TCLP leachates of the untreated fly ash contain high concentrations of Zn (13.2 mg/l) and Pb (5.21 mg/l), and lesser amounts of Cr, Fe, Ni, Cu, Cd and Ba. Cement-based solidification exhibited a compressive strength of 0.55-16.12 MPa. The strength decreased as the percentage of cement loading was reduced; the compressive strength was 2.52-12.7 MPa for 60% cement mixed with 40% fly ash and 6.62-16.12 MPa for a mixture of 60% cement and 40% bottom ash. The compressive strength reduced to 0.55-1.30 MPa when 30% cement was mixed with 70% fly ash, and to 0.90-7.95 MPa when 30% cement was mixed with 70% bottom ash, respectively., (Copyright © 2011 Elsevier B.V. All rights reserved.)

The present research investigates, develops and evaluates the transformation of chrysotile asbestos into a non-hazardous material, such as forsterite, using an economically viable and safe method. The aim of this study is to convert fibrous chrysotile asbestos into an anhydrous magnesium silicate with a non-hazardous lamellar morphology using supercritical steam. The treatment method is characterized as hydrothermal in a temperature and pressure range of 300-700 degrees C and 1.75-5.80 MPa, respectively. Small amounts of asbestos (2.5 g) were treated in each experiment. Deionised water was used as the treatment solution. The treatment duration varied from approximately 1-5 h. Additional experiments took place using solutions of distilled water and small amounts of acetic acid, with the aim of attaining optimal treatment conditions. Crystal phases of the samples were determined by X-ray diffraction (XRD). The main phases present in the treated samples were forsterite, enstatite, and chrysotile asbestos. Lizardite and periclase were also found. The morphology of the treated chrysotile asbestos fibers was identified by scanning electron microscope (SEM). The fibrous form of chrysotile asbestos was converted into non-fibrous form of forsterite. In fact, none of the fibrous-needle-like morphology, with length equal to or greater than 5 microm and diameter less than 3 microm, which was responsible for the toxicity of the original material, was visible in the solid phase. The dissolution of magnesium from chrysotile asbestos was measured using volumetric determination by titration with EDTA. Leaching of magnesium into the liquid phase was observed. Clearly, the highest concentrations of dissolved magnesium are observed after hydrothermal treatment of chrysotile asbestos using acetic acid 1% (8.4-14.6%). Lowest concentrations of dissolved magnesium are obtained after hydrothermal treatment of chrysotile asbestos without using additives. Observing the results of the hydrothermal treatment using additives, the mineralogical conversion does not depend on the presence of a small quantity of weak organic acid (<1%). The addition of acetic acid 1% during hydrothermal treatment did not involve changes in the conditions of the chrysotile asbestos' mineral conversion., (2010 Elsevier B.V. All rights reserved.)

The uncontrolled disposal of bottom ash from incineration units of hazardous and infected wastes in many countries causes significant scale damage, since it contaminates the soil as well as surface and underground waters, putting both the environment and the public health at risk. In view of the above, a study of bottom ash produced at a hospital medical waste incinerator (HMWI) in Greece was conducted, in order to detect the presence of heavy metals and therefore assess its toxicity; this led to conclusions on the possible contamination of the soil as well as surface and underground waters as a result of its disposal in landfills. The study was conducted at a typical general hospital with 500-bed capacity. About 880 kg of infectious waste coming from a general hospital with all medical departments are pyrolyticly incinerated at the HMWI every day. International literature contains many references to research that characterizes bottom ash as either dangerous, not dangerous, or inert, in an effort to diagnose its proper management and disposal. For this reason, this study focuses on the characterization of bottom ash. Samples were collected from a combustion chamber, over a period of 1 year, and a series of tests were conducted, including an analysis of particle size distribution, morphology, mineralogical and chemical composition, heavy metal leaching behavior and PCDD/F.

Objective: To evaluate the effect of estradiol addition to progesterone supplementation during the luteal phase on pregnancy and implantation rates in patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles., Methods: In this prospective, randomized study, carried out in an IVF unit of a university hospital, we studied patients who were undergoing IVF/ICSI with controlled ovarian hyperstimulation using a gonadotropin-releasing hormone agonist/human recombinant gonadotropin long protocol. The main outcome measures were the pregnancy and implantation rates measured in the two groups., Results: Our results suggest higher pregnancy and implantation rates in IVF/ICSI-ET cycles that were supplemented with estradiol in the luteal phase., Conclusions: Estradiol supplementation during the luteal phase in women undergoing IVF/ICSI-ET has a beneficial effect on the outcome without (at least, as seems from this study) having any adverse effects.

The existing data regarding the quality of the environment in the asbestos mine of northern Greece (MABE) region related to the presence of asbestos are insufficient to determine the current pollution problem. In the present work, a first approach to this problem has been taken through a toxicity risk assessment. The environmental quality of an open air asbestos mine was evaluated over a long period of time by measuring and monitoring the concentration of asbestos fibres in air, soil and water. Air measurements were made to determine the concentration of asbestos fibres in the atmospheric air of the mine, the depositions and the nearby villages. The asbestos fibre concentration was also specified inside the building facilities of MABE. Analyses of soil, dust and water samples were carried out showing the presence of enormous quantities of chrysotile asbestos. The concentration of asbestos fibres in the atmospheric air was compared to older measurements that were taken at the same sampling points during the operation of the mine. The results of this work, in conjunction with individual researches that have been carried out in the past and with the evaluation of international standards of scientific and experience-based findings, provide a reliable framework with which to estimate the threat of MABE to its surrounding environment, and help to determine a basic criterion for the remediation and rehabilitation of the region. In addition, mathematical models based on human and animal studies were used to estimate the probability of a person developing cancer from breathing air containing asbestos fibres in the wider vicinity of the mine in order to define appropriate procedures for evaluating asbestos-related risk.

Three of 2000 diagnostic hysteroscopies revealed residual fetal bony fragments in women with abnormal uterine bleeding. Removal of bony fragments by hysteroscopy is associated with therapeutic success.

In a 74-year old female patient suffering from acute thoracic pain, vomiting, and dyspnoea, the diagnosis of Boerhaave's syndrome was made. After medical treatment the patient was dismissed in a sufficiently satisfactory condition. If symptoms like vomiting, severe thoracic pain, pneumomediastinum, pneumothorax or hydropneumothorax on the left side occur, a rupture of the oesophagus should be taken into account especially in case of abuse of alcohol. The early diagnosis is decisive for the course of the disease and a lethality reduction.

Tracheobronchomegaly is a rare disorder of the lower respiratory tract characterised by marked dilatation of the trachea and the central bronchi associated with recurrent respiratory tract infections. However, some patients with tracheobronchomegaly are not detected because the symptoms are overlooked if chest radiographs alone are used for diagnosis. We encountered two cases of tracheobronchomegaly that were not diagnosed by chest radiographic examinations but were shown clearly with CT. We believe that patients with recurrent pulmonary infection must be examined with the use of CT.