1,752 research outputs found

    Firearm-Related Traumatic Brain Injuries in Adults: A Scoping Review.

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    BACKGROUND AND OBJECTIVES: Firearm-related traumatic brain injury (TBI) has emerged as a significant public health issue in the United States, coinciding with a rapid increase in gun-related deaths. This scoping review aims to update our understanding of firearm-related TBI in adult populations. METHODS: A comprehensive search of 6 online databases yielded 22 studies that met the inclusion criteria. The reviewed studies predominantly focused on young adult men who were victims of assault, although other vulnerable populations were also affected. RESULTS: Key factors in evaluating patients with firearm-related TBI included low Glasgow Coma Scale scores, central nervous system involvement, hypotension, and coagulopathies at presentation. Poor outcomes in firearm-related TBIs were influenced by various factors, including the location and trajectory of the gunshot wound, hypercoagulability, hemodynamic instability, insurance status, and specific clinical findings at hospital admission. CONCLUSION: Proposed interventions aimed to reduce the incidence and mortality of penetrating TBIs, including medical interventions such as coagulopathy reversal and changes to prehospital stabilization procedures. However, further research is needed to demonstrate the effectiveness of these interventions. The findings of this scoping review hope to inform future policy research, advocacy efforts, and the training of neurosurgeons and other treating clinicians in the management of firearm-related TBI

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    Otra nueva especie de rana Pristimantis (Anura: Terrarana) de las estribaciones occidentales del Volcán Pichincha, Ecuador

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    We describe a new species of terrestrial frog Pristimantis from the western slopes of the Ecuadorian Andes, in the province of Pichincha, Ecuador. The species is a member of the P. devillei species-group and is characterized by having cranial crests with high frontoparietals, concealed tympanum, glandular dorsolateral folds and flanks, and subconical tubercles on the upper eyelid, ulnar region and heel.Describimos una nueva especie de rana terrestre Pristimantis de las estribaciones occidentales de los Andes de Ecuador, en la provincia de Pichincha, Ecuador. La especie forma parte del grupo de especies P. devillei y se caracteriza por presentar cresta craneal elevada frontoparietalmente, tímpano oculto, pliegues dorsolaterales, flancos glandulares, y tubérculos subcónicos en el párpado, región ulnar y talón

    Antilymphoid antibody preconditioning and tacrolimus monotherapy for pediatric kidney transplantation

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    Objective: Heavy post-transplant immunosuppression may contribute to long-term immunosuppression dependence by subverting tolerogenic mechanisms; thus, we sought to determine if this undesirable consequence could be mitigated by pretransplant lymphoid depletion and minimalistic post-transplant monotherapy. Study design: Lymphoid depletion in 17 unselected pediatric recipients of live (n = 14) or deceased donor kidneys (n = 3) was accomplished with antithymocyte globulin (ATG) (n = 8) or alemtuzumab (n = 9). Tacrolimus was begun post-transplantation with subsequent lengthening of intervals between doses (spaced weaning). Maintenance immunosuppression, morbidity, graft function, and patient/graft survival were collated. Results: Steroids were added temporarily to treat rejection in two patients (both ATG subgroup) or to treat hemolytic anemia in two others. After 16 to 31 months (mean 22), patient and graft survival was 100% and 94%, respectively. The only graft loss was in a nonweaned noncompliant recipient. In the other 16, serum creatinine was 0.85 ± 0.35 mg/dL and creatinine clearance was 90.8 ± 22.1 mL/1.73 m2. All 16 patients are on monotherapy (15 tacrolimus, one sirolimus), and 14 receive every other day or 3 times per week doses. There were no wound or other infections. Two patients developed insulin-dependent diabetes. Conclusion: The strategy of lymphoid depletion and minimum post-transplant immunosuppression appears safe and effective for pediatric kidney recipients. © 2006 Elsevier Inc. All rights reserved

    Structure of the first representative of Pfam family PF04016 (DUF364) reveals enolase and Rossmann-like folds that combine to form a unique active site with a possible role in heavy-metal chelation.

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    The crystal structure of Dhaf4260 from Desulfitobacterium hafniense DCB-2 was determined by single-wavelength anomalous diffraction (SAD) to a resolution of 2.01 Å using the semi-automated high-throughput pipeline of the Joint Center for Structural Genomics (JCSG) as part of the NIGMS Protein Structure Initiative (PSI). This protein structure is the first representative of the PF04016 (DUF364) Pfam family and reveals a novel combination of two well known domains (an enolase N-terminal-like fold followed by a Rossmann-like domain). Structural and bioinformatic analyses reveal partial similarities to Rossmann-like methyltransferases, with residues from the enolase-like fold combining to form a unique active site that is likely to be involved in the condensation or hydrolysis of molecules implicated in the synthesis of flavins, pterins or other siderophores. The genome context of Dhaf4260 and homologs additionally supports a role in heavy-metal chelation

    Rediscovery of the Endangered Carchi Andean Toad, \u3cem\u3eRhaebo colomai\u3c/em\u3e (Hoogmoed, 1985), in Ecuador, with Comments on Its Conservation Status and Extinction Risk

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    Since 1984 there have been no records of Rhaebo colomai (Hoogmoed, 1985) within the territory of Ecuador. This species was known from 2 localities in the province of Carchi, northwestern Ecuador, and the department of Nariño, southwestern Colombia, which were reported in 1979 and 2015, respectively. We report the recent sightings of R. colomai at 3 new localities in Ecuador and discuss and evaluate this species’ extinction risk and conservation status

    A new species of terrestrial frog Pristimantis (Strabomantidae) from the upper basin of the Pastaza River, Ecuador

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    We describe a new species of Pristimantis from the montane forest of the Río Zuñag Ecological Reserve, upper basin of the Pastaza River, Ecuador. Pristimantis mallii sp. n. is characterized by a snout-vent length of 11.6–21.3 mm in adult males (n = 12), 22.6–34.3 mm in adult females (n = 8), and is compared morphologically and genetically with Pristimantis miktos and with other relevant species of Pristimantis. The new species is characterized by having skin on dorsum and flanks shagreen, distinctive scapular folds, snout broadly rounded in dorsal view, upper eyelid bearing one or two subconical tubercles and some rounded tubercles, dorsum and flanks light brown to brown, with irregular dark brown marks bounded by dirty cream and groin with irregular yellowish marks

    Structure of a putative NTP pyrophosphohydrolase: YP_001813558.1 from Exiguobacterium sibiricum 255-15.

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    The crystal structure of a putative NTPase, YP_001813558.1 from Exiguobacterium sibiricum 255-15 (PF09934, DUF2166) was determined to 1.78 Å resolution. YP_001813558.1 and its homologs (dimeric dUTPases, MazG proteins and HisE-encoded phosphoribosyl ATP pyrophosphohydrolases) form a superfamily of all-α-helical NTP pyrophosphatases. In dimeric dUTPase-like proteins, a central four-helix bundle forms the active site. However, in YP_001813558.1, an unexpected intertwined swapping of two of the helices that compose the conserved helix bundle results in a `linked dimer' that has not previously been observed for this family. Interestingly, despite this novel mode of dimerization, the metal-binding site for divalent cations, such as magnesium, that are essential for NTPase activity is still conserved. Furthermore, the active-site residues that are involved in sugar binding of the NTPs are also conserved when compared with other α-helical NTPases, but those that recognize the nucleotide bases are not conserved, suggesting a different substrate specificity

    Structure of the Îł-D-glutamyl-L-diamino acid endopeptidase YkfC from Bacillus cereus in complex with L-Ala-Îł-D-Glu: insights into substrate recognition by NlpC/P60 cysteine peptidases.

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    Dipeptidyl-peptidase VI from Bacillus sphaericus and YkfC from Bacillus subtilis have both previously been characterized as highly specific γ-D-glutamyl-L-diamino acid endopeptidases. The crystal structure of a YkfC ortholog from Bacillus cereus (BcYkfC) at 1.8 Å resolution revealed that it contains two N-terminal bacterial SH3 (SH3b) domains in addition to the C-terminal catalytic NlpC/P60 domain that is ubiquitous in the very large family of cell-wall-related cysteine peptidases. A bound reaction product (L-Ala-γ-D-Glu) enabled the identification of conserved sequence and structural signatures for recognition of L-Ala and γ-D-Glu and, therefore, provides a clear framework for understanding the substrate specificity observed in dipeptidyl-peptidase VI, YkfC and other NlpC/P60 domains in general. The first SH3b domain plays an important role in defining substrate specificity by contributing to the formation of the active site, such that only murein peptides with a free N-terminal alanine are allowed. A conserved tyrosine in the SH3b domain of the YkfC subfamily is correlated with the presence of a conserved acidic residue in the NlpC/P60 domain and both residues interact with the free amine group of the alanine. This structural feature allows the definition of a subfamily of NlpC/P60 enzymes with the same N-terminal substrate requirements, including a previously characterized cyanobacterial L-alanine-γ-D-glutamate endopeptidase that contains the two key components (an NlpC/P60 domain attached to an SH3b domain) for assembly of a YkfC-like active site
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