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Concept: Mediterranean


The Canaanites inhabited the Levant region during the Bronze Age and established a culture that became influential in the Near East and beyond. However, the Canaanites, unlike most other ancient Near Easterners of this period, left few surviving textual records and thus their origin and relationship to ancient and present-day populations remain unclear. In this study, we sequenced five whole genomes from ∼3,700-year-old individuals from the city of Sidon, a major Canaanite city-state on the Eastern Mediterranean coast. We also sequenced the genomes of 99 individuals from present-day Lebanon to catalog modern Levantine genetic diversity. We find that a Bronze Age Canaanite-related ancestry was widespread in the region, shared among urban populations inhabiting the coast (Sidon) and inland populations (Jordan) who likely lived in farming societies or were pastoral nomads. This Canaanite-related ancestry derived from mixture between local Neolithic populations and eastern migrants genetically related to Chalcolithic Iranians. We estimate, using linkage-disequilibrium decay patterns, that admixture occurred 6,600-3,550 years ago, coinciding with recorded massive population movements in Mesopotamia during the mid-Holocene. We show that present-day Lebanese derive most of their ancestry from a Canaanite-related population, which therefore implies substantial genetic continuity in the Levant since at least the Bronze Age. In addition, we find Eurasian ancestry in the Lebanese not present in Bronze Age or earlier Levantines. We estimate that this Eurasian ancestry arrived in the Levant around 3,750-2,170 years ago during a period of successive conquests by distant populations.

Concepts: Mediterranean Sea, Neolithic, Fertile Crescent, Lebanon, Levant, Syria, Mesopotamia, Mediterranean


The eastern Mediterranean is a hotspot of biological invasions. Numerous species of Indo-pacific origin have colonized the Mediterranean in recent times, including tropical symbiont-bearing foraminifera. Among these is the species Pararotalia calcariformata. Unlike other invasive foraminifera, this species was discovered only two decades ago and is restricted to the eastern Mediterranean coast. Combining ecological, genetic and physiological observations, we attempt to explain the recent invasion of this species in the Mediterranean Sea. Using morphological and genetic data, we confirm the species attribution to P. calcariformata McCulloch 1977 and identify its symbionts as a consortium of diatom species dominated by Minutocellus polymorphus. We document photosynthetic activity of its endosymbionts using Pulse Amplitude Modulated Fluorometry and test the effects of elevated temperatures on growth rates of asexual offspring. The culturing of asexual offspring for 120 days shows a 30-day period of rapid growth followed by a period of slower growth. A subsequent 48-day temperature sensitivity experiment indicates a similar developmental pathway and high growth rate at 28°C, whereas an almost complete inhibition of growth was observed at 20°C and 35°C. This indicates that the offspring of this species may have lower tolerance to cold temperatures than what would be expected for species native to the Mediterranean. We expand this hypothesis by applying a Species Distribution Model (SDM) based on modern occurrences in the Mediterranean using three environmental variables: irradiance, turbidity and yearly minimum temperature. The model reproduces the observed restricted distribution and indicates that the range of the species will drastically expand westwards under future global change scenarios. We conclude that P. calcariformata established a population in the Levant because of the recent warming in the region. In line with observations from other groups of organisms, our results indicate that continued warming of the eastern Mediterranean will facilitate the invasion of more tropical marine taxa into the Mediterranean, disturbing local biodiversity and ecosystem structure.

Concepts: Biology, Ecology, Mediterranean Sea, Temperature, Cyprus, Levant, Mediterranean, Eastern Mediterranean


Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease, but many rheumatologists are not well acquainted with its management. The objective of this report is to produce evidence-based recommendations to guide rheumatologists and other health professionals in the treatment and follow-up of patients with FMF. A multidisciplinary panel, including rheumatologists, internists, paediatricians, a nurse, a methodologist and a patient representative, was assembled. Panellists came from the Eastern Mediterranean area, Europe and North America. A preliminary systematic literature search on the pharmacological treatment of FMF was performed following which the expert group convened to define aims, scope and users of the guidelines and established the need for additional reviews on controversial topics. In a second meeting, recommendations were discussed and refined in light of available evidence. Finally, agreement with the recommendations was obtained from a larger group of experts through a Delphi survey. The level of evidence (LoE) and grade of recommendation (GR) were then incorporated. The final document comprises 18 recommendations, each presented with its degree of agreement (0-10), LoE, GR and rationale. The degree of agreement was greater than 7/10 in all instances. The more controversial statements were those related to follow-up and dose change, for which supporting evidence is limited. A set of widely accepted recommendations for the treatment and monitoring of FMF is presented, supported by the best available evidence and expert opinion. It is believed that these recommendations will be useful in guiding physicians in the care of patients with FMF.

Concepts: Mediterranean Sea, Familial Mediterranean fever, Rheumatology, Physician, Arthritis, Expert, Expert witness, Mediterranean


We analyzed the conjoint effects of sewage inputs and hydrological alteration on the occurrence of teratological forms and on the assemblage composition of stream benthic diatoms. The study was performed in 11 Mediterranean streams which received treated or untreated urban sewage (Impact sites, I), whose composition and morphological anomalies were compared to upstream unaffected (Control, C) sites. The impact sites had high concentrations of ammonium, phosphorus, and pharmaceutical compounds (antibiotics, analgesics, and anti-inflammatories), particularly in those receiving untreated sewage. Impact sites had a higher proportion of teratological forms as well as a prevalence of diatom taxa tolerant to pollution. The differences in the diatom assemblage composition between the paired C and I sites were the largest in the impacted sites that received untreated sewage inputs as well as in the systems with lower dilution capacity. In these sites, the diatom assemblage was composed by a few pollution-tolerant species. Mediterranean river systems facing hydrological stress are highly sensitive to chemical contamination, leading to the homogenization of their diatom assemblages.

Concepts: River, Stream, Sewage, Impact event, Diatom, Composition, Stream bed, Mediterranean


Development of road network is one of the strongest drivers of habitat fragmentation. It interferes with ecological processes that are based on material and energy flows between landscape patches. Therefore, changes in temporal patterns of roads may be regarded as important landscape-level environmental indicators. The aim of this study is to analyze road development and associated agricultural land use change near the town of Erdemli located in the eastern Mediterranean coast of Turkey. The study area has witnessed an unprecedented development of agriculture since the 2000s. This process has resulted with the expansion of the road network. Associations between agricultural expansion and road development were investigated. High-resolution satellite images of 2004 and 2015 were used to analyze spatial and temporal dimensions of change. Satellite images were classified using a binary approach, in which land areas were labeled as either “agriculture” or “non-agriculture.” Road networks were digitized manually. The study area was divided into 23 sublandscapes using a regular grid with 1-km cell spacing. Percentage of landscape (PL) for agriculture and road density (RD) metrics were calculated for the earlier (2004) and later (2015) years. Metric calculations were performed separately for each of the 23 sublandscapes in order to understand spatial diversity of agriculture and road density. Study results showed that both RD and PL exhibited similar increasing trends between 2004 and 2015.

Concepts: Conservation biology, Agriculture, Mediterranean Sea, Sustainability, Road, The Road, Mediterranean, Zoning


Although familial Mediterranean fever (FMF) is inherited autosomal recessively, some heterozygotes may express disease phenotype and require therapy. To date, there is no study in the literature about how to follow-up Mediterranean fever (MEFV) heterozygotes who do not fulfil FMF criteria in the paediatric age group. This study aims to share a single-centre experience of the long-term clinical and laboratory follow-up of paediatric MEFV carriers. We reviewed the charts of 69 children who were heterozygous for MEFV variants. All children were followed-up with their routine analysis and serum amyloid A levels every 6 months. Thirty-nine children had pathogenic mutations and 30 children had variants of unknown significance. The mean follow-up was 3.2 ± 1.6 years (min 2 years, max 6 years). The children with pathogenic mutations had significantly higher mean SAA levels than the children with variants of unknown significance (p = 0.018); however, the mean CRP and ESR were similar. Besides, the children with pathogenic mutations complained of fever episodes significantly more than the children with variants of unknown significance (p = 0.04). None of the children had persistent proteinuria in the follow-up. We started colchicine in only two patients who were M694V heterozygous. Both patients had family history for FMF and fulfilled the disease criteria after 2 years of follow-up. Neither of these patients had persistently elevated acute phase reactants in their routine follow-up. This study suggested that routine clinical follow-up is useful; however, routine periodic laboratory workup is not necessary among MEFV carriers.

Concepts: Immune system, Inflammation, Mediterranean Sea, Familial Mediterranean fever, Colchicine, Mediterranean, MEFV


Seagriculture, which can provide offshore grown macroalgae biomass would play a significant role in bioeconomy. Nevertheless, seagriculture development has been hindered by the lack of laboratory photobioreactors that enable fundamental and pilot scale macroalgae research. In this work, a macroalgae photobioreactor (MPBR) was developed and integrated into the building. The MPBR operation was demonstrated for 6months with cultivation of Cladophora sp., Ulva compressa and Ulva rigida green macroalgae species isolated from 3 sites at the Eastern Mediterranean coast. The growth rate, protein, ash, specific energy density, rhamnose, xylose, arabinose, glucose, galactose and glucuronic acid content of the cultivated species were quantified. The maximum accumulated energy rates were 0.033WhL(-1)d(-1) for Cladophora sp., 0.081WhL(-1)d(-1) for U. compressa and 0.029WhL(-1)d(-1) for U. rigida. This work provides a detailed design of an indoor, urban photobioreactor for cultivation, maintenance and energy balance analysis of macroalgae biomass for biorefinery.

Concepts: Energy, Density, Ethanol, Mediterranean Sea, Capacitor, Energy density, Mediterranean, Specific energy


Wild greens are considered a rich source of phenolic compounds and antioxidants and an essential part of the so-called Mediterranean diet. In the present study, Cichorium spinosum L. ecotypes, cultivated or collected in situ from wild plants from the eastern Mediterranean were evaluated regarding their phenolic composition and antioxidant activity.

Concepts: Present, Nutrition, Antioxidant, Mediterranean Sea, Resveratrol, Olive oil, Mediterranean


There is no established treatment of AA amyloidosis, a long-term complication of various chronic inflammatory diseases associated with increased mortality, such as familial Mediterranian fever (FMF). Recently there are few reports pointing out that tocilizumab(TCZ), an anti IL-6 agent may be effective in AA amyloidosis resistant to conventional treatments. We report our data on the effect of TCZ in patients with FMF complicated with AA amyloidosis.

Concepts: Inflammation, Medical terms, Mediterranean Sea, Familial Mediterranean fever, Mediterranean


Different studies have demonstrated changes in chitotriosidase (ChT) activity and concentrations in multiple diseases. However, changes in ChT activity and concentrations have not been concurrently evaluated in patients with Familial Mediterranean Fever (FMF). In this study, we analyzed the changes in serum ChT activity and concentrations in patients with FMF. The study included a total of 80 patients with FMF and 80 healthy controls. ChT enzyme activity and concentrations were measured and then compared between the groups. ChT activity was measured by using fluorometric ELISA and ChT concentrations were measured by using colorimetric ELISA methods. The median ChT activity was 10.00 (6.00-15.00) nmol/mL/hr in the patients and 14.00 (6.25-20.75) nmol/mL/hr in the controls. There was a statistically significant difference in the ChT activity between the controls and patients (P = 0.027). The median ChT concentrations were 65.40 (46.20-84.92) pg/mL and 125.00 (75.72-143.95) pg/mL in the patients and controls, respectively (P < 0.001), which were expressed as median percentiles (25th-75th). Additionally, we found no correlation between C-reactive protein and ChT activity (P = 0.978, r = 0.003) and concentrations (P = 0.446, r = -0.87). Serum ChT enzyme activity and concentrations may not be considered as a biomarker in FMF patients taking colchicine. New studies are needed to evaluate the changes of enzyme activity and concentration in colchicine-negative patients.

Concepts: Statistical significance, Mediterranean Sea, Familial Mediterranean fever, Chemical equilibrium, Colchicine, Mediterranean