Dogs were the first domestic animal, but little is known about their population history and to what extent it was linked to humans. We sequenced 27 ancient dog genomes and found that all dogs share a common ancestry distinct from present-day wolves, with limited gene flow from wolves since domestication but substantial dog-to-wolf gene flow. By 11,000 years ago, at least five major ancestry lineages had diversified, demonstrating a deep genetic history of dogs during the Paleolithic. Coanalysis with human genomes reveals aspects of dog population history that mirror humans, including Levant-related ancestry in Africa and early agricultural Europe. Other aspects differ, including the impacts of steppe pastoralist expansions in West and East Eurasia and a near-complete turnover of Neolithic European dog ancestry.
The COVID-19 pandemic has disrupted preventive care, including cancer screening. Studies from the United States and Europe have shown that cancer screening dropped dramatically during the pandemic, 1,2 with breast cancer screening and diagnostic mammograms falling by 58% and 38%, respectively. 1,2 A United Kingdom modeling study estimated that delayed and missed screenings would likely increase breast cancer deaths, a leading cancer among women, by 7.9% to 9.6%. 2,3 The adverse impact of COVID-19 on screening may differ among sociodemographic groups, given the disproportionate impact the pandemic has had on underserved racial and ethnic groups and other vulnerable population groups. 4 In this report, we used clinical data to examine differences in breast cancer screenings before and during the COVID-19 pandemic overall and among sociodemographic population groups. Methods DataData included completed screening mammograms within a large statewide nonprofit community health care system in Washington State between April 1, 2018, and December 31, 2020. This health care system included more than 230 primary care, specialty care, and urgent care clinics, and 8 hospitals across Washington State. The MultiCare institutional review board approved this study protocol and granted waivers of individual consent based on removal of individually identifying data. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline. Measures and Statistical AnalysisSociodemographic data included patients' race and ethnicity, insurance, and zip code of residence.Rural-urban commuting area codes differentiated between urban vs rural residence. Inclusion criteria included women who had at least 1 screening mammogram within the health system in 2018 or 2019.Frequency analysis and χ 2 tests were performed using a significance level of P < .05 to test for differences in screening in 2019 and 2020. Testing was 2-sided. Statistical analysis was performed using R statistical software version 4.03 (R Project for Statistical Computing). ResultsAmong the 55 678 screenings in April to December 2019, 45 572 patients were non-Hispanic White (81.8%), 54 620 patients lived in urban areas (98.1%), and 22 761 patients were commercially insured (40.9%); the mean (SD) age was 62.0 (11.3) years. From 2019 to the same period in 2020, there was a 49% decrease in screenings (55 678 screenings in 2019 vs 27 522 screenings in 2020), with some differences apparent in the demographic characteristics between the 2 years (Table ). We observed greater and significant reductions in the number of screenings from 2019 to 2020 for women who were Hispanic (1727 vs 619; −64.2%), American Indian/Alaska Native (215 vs 84; −60.9%), mixed race Author affiliations and article information are listed at the end of this article.
Objectives: To measure access to opioid treatment programs (OTPs) and office-based buprenorphine treatment (OBBTs) at the smallest geographic unit for which the Census Bureau publishes demographic and socioeconomic data (ie, block group) and to explore disparities in access to treatment across the rural-urban and area deprivation continua across the United States.Methods: Access to OTPs and OBBTs at the block group in 2019 was quantified using an innovative 2-step floating catchment area technique that accounts for the supply of treatment facilities relative to the population size, proximity of facilities relative to the location of population in block groups, and time as a barrier within catchments. Block groups were stratified into tertiles based on the rural-urban continuum codes (metropolitan, micropolitan, small town, or rural) and area deprivation index (least-deprived, middle-deprived, most-deprived). The Integrated Nested Laplace Approximation approach was used for statistical analysis.Results: Across the United States, 3329 block groups corresponding to 2 915 949 adults lacked access to OTPs within a 2-hour drive of their community and 130 block groups corresponding to 86 605 adults did not have access to OBBTs. Disparities in access to treatment were observed across the urban-rural and area deprivation continua including (1) lowest mean access score to OBBTs were found among most-deprived small towns, and (2) lower mean access score to OTPs were found among micropolitan and small towns. Conclusions:The results of this study revealed disparities in access to medication-assisted treatment. The findings call for creative initiatives and local and regional policies to develop to mitigate access problems.
Amidst the COVID-19 pandemic, interest in using telehealth to increase access to health and mental health care has grown, and school transitions to remote learning have heightened awareness of broadband inequities. The purpose of this study was to examine access and barriers to technology and broadband Internet service ("broadband") among rural and urban youth. Washington State public school districts were surveyed about youth's access to technology (ie, a device adequate for online learning) and broadband availability in spring 2020. Availability of and barriers to broadband (ie, geography, affordability, and smartphone-only connectivity) were assessed across rurality. Among responding districts, 64.2% (n = 172) were rural and 35.8% (n = 96) were urban. Rural districts reported significantly fewer students with access to an Internet-enabled device adequate for online learning (80.0% vs 90.1%, P < .01). Access to reliable broadband varied significantly across geography (P < .01). Compared with their urban peers, rural youth face more challenges in accessing the technology and connectivity needed for remote learning and telehealth. Given that inadequate broadband infrastructure is a critical barrier to the provision of telehealth services and remote learning in rural areas, efforts to improve policies and advance technology must consider geographical disparities to ensure health and education equity.
The Aceramic Neolithic (∼9600 to 7000 cal BC) period in the Zagros Mountains, western Iran, provides some of the earliest archaeological evidence of goat (Capra hircus) management and husbandry by circa 8200 cal BC, with detectable morphological change appearing ∼1,000 y later. To examine the genomic imprint of initial management and its implications for the goat domestication process, we analyzed 14 novel nuclear genomes (mean coverage 1.13X) and 32 mitochondrial (mtDNA) genomes (mean coverage 143X) from two such sites, Ganj Dareh and Tepe Abdul Hosein. These genomes show two distinct clusters: those with domestic affinity and a minority group with stronger wild affinity, indicating that managed goats were genetically distinct from wild goats at this early horizon. This genetic duality, the presence of long runs of homozygosity, shared ancestry with later Neolithic populations, a sex bias in archaeozoological remains, and demographic profiles from across all layers of Ganj Dareh support management of genetically domestic goat by circa 8200 cal BC, and represent the oldest to-this-date reported livestock genomes. In these sites a combination of high autosomal and mtDNA diversity, contrasting limited Y chromosomal lineage diversity, an absence of reported selection signatures for pigmentation, and the wild morphology of bone remains illustrates domestication as an extended process lacking a strong initial bottleneck, beginning with spatial control, demographic manipulation via biased male culling, captive breeding, and subsequently phenotypic and genomic selection.
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