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1.
J Hum Evol ; 186: 103465, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38064862

RESUMO

Olduvai Gorge in northern Tanzania is part of a globally important archeological and paleoanthropological World Heritage Site location critical to our understanding of modern human evolution. The Ndutu Beds in the upper part of the geological sequence at Olduvai Gorge represent the oldest unit to yield modern Homo sapiens skeletal material and Middle Stone Age technology. However, the timing of the deposition of the Ndutu Beds is poorly constrained at present, which limits our understanding of the paleoenvironments critical for contextualizing H. sapiens and related technologies in the Olduvai Basin. Using a suite of 15 luminescence ages of sedimentary core samples, combined with Bayesian statistics, this study provides a new higher-resolution age-depth model for the deposition of the uppermost Upper Ndutu and Naisiuiu Beds cored by the Olduvai Gorge Coring Project. The luminescence and modeled ages are presented as ±1 σ uncertainties. The Ndutu Beds intersected by the Olduvai Gorge Coring Project cores are dated to between 117.1 ± 17.9 and 45.3 ± 4.2 ka (between 125.9 ± 26.5 and 45.8 ± 8.2 ka modeled ages), while a probable overlying layer of Naisiusiu Beds dates to 23.7 ± 10.9 to 12.1 ± 1.7 ka (25.7 ± 18.9 ka and 12.0 ± 3.4 ka modeled age). Time-averaged accretion rates are derived during this time: (1) initially low rates (<5 cm ka-1) from the bottom of the core at 117.1 ± 17.9 ka up to 95.3 ± 11.1 ka (125.9 ± 26.5 to 95.5 ± 23.3 ka modeled ages); (2) the middle section spanning between 95.3 ± 11.1 and 62.7 ± 5.7 ka (95.5 ± 23.3 to 61.9 ± 10.4 ka modeled ages) with mean rates above 15 cm ka-1; and (3) the last 62.7 ± 5.7 ka (61.9 ± 10.4 ka modeled age) where the accretion rate reduces to below 5 cm ka-1. This reduction can be explained by the evolution of the gorge system that was likely driven by subsidence of the Olbalbal depression and changes in climate, particularly precipitation and resulting lake and base level changes. Older Upper Ndutu and Lower Ndutu Beds are contained within proto-gorges within the modern gorge system.


Assuntos
Hominidae , Paleontologia , Animais , Humanos , Fósseis , Tanzânia , Teorema de Bayes , Lagos , Tecnologia , Arqueologia
2.
AIDS Res Ther ; 21(1): 22, 2024 04 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627722

RESUMO

BACKGROUND: Initiation of ART among people living with HIV (PLWH) having a CD4 count ≤ 350cells/µl, produces poor immunological recovery, putting them at a high risk of opportunistic infections. To mitigate this, PLWH on ART in Uganda frequently use herbal remedies like Artemisia annua and Moringa oleifera, but their clinical benefits and potential antiretroviral (ARV) interactions remain unknown. This study examined the impact of A. annua and M. oleifera on CD4 count, viral load, and potential ARV interactions among PLWH on ART at an HIV clinic in Uganda. METHODS: 282 HIV-positive participants on antiretroviral therapy (ART) with a CD4 count ≤ 350cells/µl were randomized in a double-blind clinical trial to receive daily, in addition to their routine standard of care either; 1) A. annua leaf powder, 2) A. annua plus M. oleifera, and 3) routine standard of care only. Change in the CD4 count at 12 months was our primary outcome. Secondary outcomes included changes in viral load, complete blood count, and ARV plasma levels. Participants were followed up for a year and outcomes were measured at baseline, 6 and 12 months. RESULTS: At 12 months of patient follow-up, in addition to standard of care, administration of A. annua + M. oleifera resulted in an absolute mean CD4 increment of 105.06 cells/µl, (p < 0.001), while administration of A. annua plus routine standard of care registered an absolute mean CD4 increment of 60.84 cells/µl, (p = 0.001) compared to the control group. The A. annua plus M. oleifera treatment significantly reduced viral load (p = 0.022) and increased platelet count (p = 0.025) and white blood cell counts (p = 0.003) compared to standard care alone, with no significant difference in ARV plasma levels across the groups. CONCLUSION: A combination of A. annua and M. oleifera leaf powders taken once a day together with the routine standard of care produced a significant increase in CD4 count, WBCs, platelets, and viral load suppression among individuals on ART. A. annua and M. oleifera have potential to offer an affordable alternative remedy for managing HIV infection, particularly in low-resource communities lacking ART access. TRIAL REGISTRATION: ClinicalTrials.gov NCT03366922.


Assuntos
Fármacos Anti-HIV , Artemisia annua , Infecções por HIV , Moringa oleifera , Humanos , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Hospitais , Encaminhamento e Consulta , Uganda , Carga Viral , Método Duplo-Cego
3.
J Environ Manage ; 366: 121596, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38991335

RESUMO

We developed a biomarker-based approach to quantify in-sewer dilution by measuring wastewater quality parameters (ammoniacal-N, orthophosphate, crAssphage). This approach can enhance the environmental management of wastewater treatment works (WWTW) by optimising their operation and providing cost-effective information on the health and behaviour of populations and their interactions with the environment through wastewater-based epidemiology (WBE). Our method relies on site specific baselines calculated for each biomarker. These baselines reflect the sewer conditions without the influence of rainfall-derived inflow and infiltration (RDII). Ammoniacal-N was the best candidate to use as proxy for dilution. We demonstrated that the dilution calculated using biomarkers correlates well with the dilution indicated by measured flow. In some instances, the biomarkers showed much higher dilution than measured flows. These differences were attributed to the loss of flow volume at wastewater treatment works due to the activation of combined sewer overflows (CSOs) and/or storm tanks. Using flow measured directly at the WWTW could therefore result in underestimation of target analyte loads.


Assuntos
Biomarcadores , Águas Residuárias , Águas Residuárias/análise , Águas Residuárias/química , Biomarcadores/análise , Eliminação de Resíduos Líquidos/métodos , Esgotos , Monitoramento Ambiental/métodos
4.
Hum Mol Genet ; 30(13): 1188-1199, 2021 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-33783477

RESUMO

Age-related macular degeneration (AMD) is a complex neurodegenerative eye disease with behavioral and genetic etiology and is the leading cause of irreversible vision loss among elderly Caucasians. Functionally significant genetic variants in the alternative pathway of complement have been strongly linked to disease. More recently, a rare variant in the terminal pathway of complement has been associated with increased risk, Complement component 9 (C9) P167S. To assess the functional consequence of this variant, C9 levels were measured in two independent cohorts of AMD patients. In both cohorts, it was demonstrated that the P167S variant was associated with low C9 plasma levels. Further analysis showed that patients with advanced AMD had elevated sC5b-9 compared to those with non-advanced AMD, although this was not associated with the P167S polymorphism. Electron microscopy of membrane attack complexes (MACs) generated using recombinantly produced wild type or P167S C9 demonstrated identical MAC ring structures. In functional assays, the P167S variant displayed a higher propensity to polymerize and a small increase in its ability to induce hemolysis of sheep erythrocytes when added to C9-depleted serum. The demonstration that this C9 P167S AMD risk polymorphism displays increased polymerization and functional activity provides a rationale for the gene therapy trials of sCD59 to inhibit the terminal pathway of complement in AMD that are underway.


Assuntos
Complemento C9/genética , Predisposição Genética para Doença/genética , Degeneração Macular/genética , Mutação , Idoso , Animais , Células CHO , Estudos de Casos e Controles , Estudos de Coortes , Complemento C9/metabolismo , Complexo de Ataque à Membrana do Sistema Complemento/metabolismo , Proteínas do Sistema Complemento/genética , Proteínas do Sistema Complemento/metabolismo , Cricetinae , Cricetulus , Feminino , Cobaias , Hemólise , Humanos , Degeneração Macular/sangue , Degeneração Macular/metabolismo , Masculino , Polimerização , Fatores de Risco , Ovinos
5.
Am J Orthod Dentofacial Orthop ; 163(3): 328-337, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36411229

RESUMO

INTRODUCTION: Teledentistry in orthodontics is growing, yet patient preferences for its use is unknown. This study aimed to determine the perceived value of doctor-to-patient face-to-face interaction, convenience, and attitudes toward specific uses of teledentistry among orthodontic patients. METHODS: Private practice orthodontists emailed an electronic survey to active patients. Patients aged ≥18 years completed the survey regarding their treatment. Parents of patients aged <18 years completed a separate survey regarding their child's treatment. Responses were compared on the basis of patient characteristics (adult vs child, braces vs clear aligners, etc). RESULTS: Three hundred and seventy-seven respondents from 8 orthodontic practices participated in the survey. Eighty-five percent of parents considered face-to-face interaction important, and 85% said that their child's treatment fit conveniently into their schedule. Adult responses were 86% and 89%, respectively. Adult preference for face-to-face was significantly higher than parents of adolescent patients (83% vs 78%; P = 0.038). Adults treated with clear aligners were less likely to strongly agree that their treatment fitted conveniently in their schedule (51% vs 76% in braces; P = 0.0490) and were more likely to be interested in using teledentistry (27% vs 18% in braces; P = 0.0429). CONCLUSIONS: Most orthodontic patients prefer to be seen face-to-face. This is due to the high value placed on face-to-face interaction with the orthodontist. Most patients do not consider their treatment inconvenient. Patients prefer that teledentistry be used to enhance communication as opposed to replacing face-to-face interaction. Implementing teledentistry in orthodontics should be applied on a patient-to-patient basis with continued emphasis on the doctor-patient relationship.


Assuntos
Braquetes Ortodônticos , Ortodontia , Adulto , Criança , Adolescente , Humanos , Relações Médico-Paciente , Ortodontistas , Assistência Odontológica , Inquéritos e Questionários
6.
Proteins ; 90(3): 670-679, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34664307

RESUMO

Microviridins, tricyclic peptide natural products originally isolated from cyanobacteria, function as inhibitors of diverse serine-type proteases. Here we report the structure and biochemical characterization of AMdnB, a unique iterative macrocyclase involved in a microviridin biosynthetic pathway from Anabaena sp. PCC 7120. The ATP-dependent cyclase, along with the homologous AMdnC, introduce up to nine macrocyclizations on three distinct core regions of a precursor peptide, AMdnA. The results presented here provide structural and mechanistic insight into the iterative chemistry of AMdnB. In vitro AMdnB-catalyzed cyclization reactions demonstrate the synthesis of the two predicted tricyclic products from a multi-core precursor peptide substrate, consistent with a distributive mode of catalysis. The X-ray structure of AMdnB shows a structural motif common to ATP-grasp cyclases involved in RiPPs biosynthesis. Additionally, comparison with the noniterative MdnB allows insight into the structural basis for the iterative chemistry. Overall, the presented results provide insight into the general mechanism of iterative enzymes in ribosomally synthesized and post-translationally modified peptide biosynthetic pathways.


Assuntos
Produtos Biológicos/química , Cianobactérias/metabolismo , Peptídeos Cíclicos/química , Ribossomos/metabolismo , Sequência de Aminoácidos , Benchmarking , Vias Biossintéticas , Catálise , Cristalografia por Raios X , Ciclização , Modelos Moleculares , Biossíntese Peptídica , Ligação Proteica , Conformação Proteica , Processamento de Proteína Pós-Traducional
7.
J Clin Pharm Ther ; 47(2): 135-138, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34254326

RESUMO

WHAT IS KNOWN AND OBJECTIVE: The Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD) methodology is a WHO gold standard for ensuring systematic Drug Utilization Research (DUR) and has been mainly used in the developed world. This article examines the challenges and way forward for using this methodology in resource-limited countries. CONTENT: The ATC/DDD is superior over other methods employed in DUR as it offers a unified medicines regulation and management system at all care levels. The ATC/DDD allows access to standardized and validated information on DUR by: assessing patterns of utilization, defining optimal use levels, identification of gaps, aggregating and analysing statistics for reporting adverse drug reactions, as well as assisting in developing rational medicines use interventions and monitoring their outcomes. WHAT IS NEW AND CONCLUSION: Application of the ATC/DDD methodology is crucial for improved patient management, optimal consumption of national pharmaceutical budgets and policy formulation in resource-limited countries.


Assuntos
Uso de Medicamentos/normas , Países em Desenvolvimento , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Humanos , Uso Excessivo dos Serviços de Saúde/prevenção & controle , Assistência Centrada no Paciente , Organização Mundial da Saúde
8.
Molecules ; 27(20)2022 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-36296528

RESUMO

The ambident electrophilic character of the 5-bromo-2-hydroxychalcones and the binucleophilic nature of 2-aminothiophenol were exploited to construct the 2-aryl-4-(4-bromo-2-hydroxyphenyl)benzo[1,5]thiazepines. The structures and conformation of these 2-aryl-4-(4-bromo-2-hydroxyphenyl)benzo[1,5]thiazepines were established with the use of spectroscopic techniques complemented with a single crystal X-ray diffraction method. Both 1H-NMR and IR spectroscopic techniques confirmed participation of the hydroxyl group in the intramolecular hydrogen-bonding interaction with a nitrogen atom. SC-XRD confirmed the presence of a six-membered intramolecularly hydrogen-bonded pseudo-aromatic ring, which was corroborated by the DFT method on 2b as a representative example in the gas phase. Compounds 2a (Ar = -C6H5), 2c (Ar = -C6H4(4-Cl)) and 2f (Ar = -C6H4(4-CH(CH3)2) exhibited increased inhibitory activity against α-glucosidase compared to acarbose (IC50 = 7.56 ± 0.42 µM), with IC50 values of 6.70 ± 0.15 µM, 2.69 ± 0.27 µM and 6.54 ± 0.11 µM, respectively. Compound 2f, which exhibited increased activity against α-glucosidase, also exhibited a significant inhibitory effect against α-amylase (IC50 = 9.71 ± 0.50 µM). The results of some computational approaches on aspects such as noncovalent interactions, calculated binding energies for α-glucosidase and α-amylase, ADME (absorption, distribution, metabolism and excretion) and bioavailability properties, gastrointestinal absorption and blood-brain barrier permeability are also presented.


Assuntos
Tiazepinas , alfa-Glucosidases , alfa-Glucosidases/metabolismo , Inibidores de Glicosídeo Hidrolases/química , Acarbose/farmacologia , Simulação de Acoplamento Molecular , alfa-Amilases , Hidrogênio , Nitrogênio , Relação Estrutura-Atividade , Estrutura Molecular
9.
J Hum Evol ; 150: 102910, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33271475

RESUMO

Previously, Olduvai Bed I excavations revealed Oldowan assemblages <1.85 Ma, mainly in the eastern gorge. New western gorge excavations locate a much older ∼2.0 Ma assemblage between the Coarse Feldspar Crystal Tuff (∼2.015 Ma) and Tuff IA (∼1.98 Ma) of Lower Bed I, predating the oldest eastern gorge DK assemblage below Tuff IB by ∼150 kyr. We characterize this newly discovered fossil and artifact assemblage, adding information on landscape and hominin resource use during the ∼2.3-2.0 Ma period, scarce in Oldowan sites. Assemblage lithics and bones, lithofacies boundaries, and phytolith samples were surveyed and mapped. Sedimentological facies analysis, tephrostratigraphic and sequence stratigraphic principles were applied to reconstruct paleoenvironments and sedimentary processes of sandy claystone (lake), sandstone (fluvial), and sandy diamictite (debris flow) as principal lithofacies. Artifacts, sized, weighed, categorized, were examined for petrography, retouch, and flake scar size. Taxonomic classifications and taphonomic descriptions of faunal remains were made, and phytoliths were categorized based on reference collections. Lithics are dominantly quartzite, mainly debitage and less frequently simple cores, retouched pieces, and percussors. Well-rounded spheroids and retouched flakes are rare. Identifiable taxa, Ceratotherium cf. simum (white rhinoceros) and Equus cf. oldowayensis (extinct zebra), accord with nearby open savanna grasslands, inferred from C3 grass, mixed and/or alternating with C4 grass-dominated phytolith assemblages. Palms, sedges, and dicots were also identified from phytoliths. Diatoms and sponge spicules imply nearby freshwater. The assemblage accumulated at the toe of a Ngorongoro Volcano-sourced fan-delta apron of stacked debris flows, fluvials, and tuffs, preserving fossil tree stumps and wooded grassland phytoliths farther upfan. It formed after the climax of Ngorongoro volcanic activity during a Paleolake Olduvai lowstand and was then buried and preserved by lacustrine clays, marking the first of two lake transgressions, signifying wetter climates. Orbital precessional lake cycles were superposed upon multimillennial (∼4.9 kyr) lake fluctuations.


Assuntos
Evolução Cultural , Meio Ambiente , Hominidae , Tecnologia , Animais , Arqueologia , Paleontologia , Tanzânia
10.
Nutr Res Rev ; 34(2): 222-239, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33280615

RESUMO

There is increasing evidence for the health benefits of dietary nitrates including lowering blood pressure and enhancing cardiovascular health. Although commensal oral bacteria play an important role in converting dietary nitrate to nitrite, very little is known about the potential role of these bacteria in blood pressure regulation and maintenance of vascular tone. The main purpose of this review is to present the current evidence on the involvement of the oral microbiome in mediating the beneficial effects of dietary nitrate on vascular function and to identify sources of inter-individual differences in bacterial composition. A systematic approach was used to identify the relevant articles published on PubMed and Web of Science in English from January 1950 until September 2019 examining the effects of dietary nitrate on oral microbiome composition and association with blood pressure and vascular tone. To date, only a limited number of studies have been conducted, with nine in human subjects and three in animals focusing mainly on blood pressure. In general, elimination of oral bacteria with use of a chlorhexidine-based antiseptic mouthwash reduced the conversion of nitrate to nitrite and was accompanied in some studies by an increase in blood pressure in normotensive subjects. In conclusion, our findings suggest that oral bacteria may play an important role in mediating the beneficial effects of nitrate-rich foods on blood pressure. Further human intervention studies assessing the potential effects of dietary nitrate on oral bacteria composition and relationship to real-time measures of vascular function are needed, particularly in individuals with hypertension and those at risk of developing CVD.


Assuntos
Microbiota , Nitratos , Animais , Pressão Sanguínea , Humanos , Antissépticos Bucais , Óxido Nítrico , Nitritos
11.
Am J Primatol ; 83(4): e23218, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33232524

RESUMO

Human communities living near nonhuman primate habitats often depend on wood from forests for their energy needs. Improving the efficiency of local cook stoves is a potential "win-win" solution that is commonly promoted to protect forests and improve human health and development. Despite the popularity of improved stove projects in primate conservation, few outcomes have been formally published. As a result, it is currently unclear whether this approach is a wise investment of limited conservation funds. This paper describes a pilot study conducted by the Gorilla Rehabilitation and Conservation Education Center to evaluate the potential for using improved stoves for the conservation of an important habitat for Grauer's gorillas and chimpanzees in eastern Democratic Republic of Congo. Community surveys and observations of human forest use revealed a heavy local reliance on forest-derived wood. Wood was the main source of fuel used in households, the most highly valued forest resource, and the primary resource extracted during forest observations. It was primarily collected by women and children. The use of traditional, inefficient three-stone hearths for cooking was also widespread. A 2-year campaign using a community-based social marketing approach resulted in an increase in improved stove installations from 18% to 78% of households in one village. After stove adoption, weekly household wood consumption was reduced by half. Campaign elements that showed promise include promotion using women's networks and intensive follow-up assessment and support. We conclude that, if scaled up, improved stoves may be a useful strategy for reducing encroachment into our target protected area but that successful implementation will require a significant long-term commitment with evaluation and oversight. It is recommended that before investing in improved stoves, primate conservation projects take long-term and evaluation requirements into consideration.


Assuntos
Utensílios Domésticos , Animais , Culinária , República Democrática do Congo , Gorilla gorilla , Projetos Piloto
12.
Proc Natl Acad Sci U S A ; 115(8): 1718-1723, 2018 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-29439203

RESUMO

Marine sponges are prolific sources of unique bioactive natural products. The sponge Theonella swinhoei is represented by several distinct variants with largely nonoverlapping chemistry. For the Japanese chemotype Y harboring diverse complex polyketides and peptides, we previously provided genomic and functional evidence that a single symbiont, the filamentous, multicellular organism "Candidatus Entotheonella factor," produces almost all of these compounds. To obtain further insights into the chemistry of "Entotheonella," we investigated another phylotype, "Candidatus Entotheonella serta," present in the T. swinhoei WA sponge chemotype, a source of theonellamide- and misakinolide-type compounds. Unexpectedly, considering the lower chemical diversity, sequencing of individual bacterial filaments revealed an even larger number of biosynthetic gene regions than for Ca E. factor, with virtually no overlap. These included genes for misakinolide and theonellamide biosynthesis, the latter assigned by comparative genomic and metabolic analysis of a T. swinhoei chemotype from Israel, and by biochemical studies. The data suggest that both compound families, which were among the earliest model substances to study bacterial producers in sponges, originate from the same bacterium in T. swinhoei WA. They also add evidence that metabolic richness and variability could be a more general feature of Entotheonella symbionts.


Assuntos
Fenômenos Fisiológicos Bacterianos , Simbiose , Theonella/microbiologia , Animais , Bactérias/química , Bactérias/genética , Bactérias/isolamento & purificação , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Genoma Bacteriano , Genômica , Policetídeos/metabolismo , Theonella/química , Theonella/fisiologia
13.
Angew Chem Int Ed Engl ; 60(34): 18412-18428, 2021 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-30748086

RESUMO

The diverse microbes that produce natural products represent an important source of novel therapeutics, drug leads, and scientific tools. However, the vast majority have not been grown in axenic culture and are members of complex communities. While meta-'omic methods such as metagenomics, -transcriptomics, and -proteomics reveal collective molecular features of this "microbial dark matter", the study of individual microbiome members can be challenging. To address these limits, a number of techniques with single-bacterial resolution have been developed in the last decade and a half. While several of these are embraced by microbial ecologists, there has been less use by researchers interested in mining microbes for natural products. In this review, we discuss the available and emerging techniques for targeted single-cell analysis with a particular focus on applications to the discovery and study of natural products.


Assuntos
Produtos Biológicos/análise , Microbiota , Análise de Célula Única
14.
Chembiochem ; 21(4): 564-571, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-31430416

RESUMO

Uncultivated bacterial symbionts from the candidate genus "Entotheonella" have been shown to produce diverse natural products previously attributed to their sponge hosts. In addition to these known compounds, "Entotheonella" genomes contain rich sets of biosynthetic gene clusters that lack identified natural products. Among these is a small type III polyketide synthase (PKS) cluster, one of only three clusters present in all known "Entotheonella" genomes. This conserved "Entotheonella" PKS (cep) cluster encodes the type III PKS CepA and the putative methyltransferase CepB. Herein, the characterization of CepA as an enzyme involved in phenolic lipid biosynthesis is reported. In vitro analysis showed a specificity for alkyl starter substrates and the production of tri- and tetraketide pyrones and tetraketide resorcinols. The conserved distribution of the cep cluster suggests an important role for the phenolic lipid polyketides produced in "Entotheonella" variants.


Assuntos
Bactérias/enzimologia , Proteínas de Bactérias/química , Policetídeo Sintases/química , Theonella/microbiologia , Animais , Bactérias/genética , Proteínas de Bactérias/genética , Família Multigênica , Policetídeo Sintases/genética , Simbiose
15.
Acute Med ; 19(1): 43-48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32226957

RESUMO

A 61 year old male presented to chest clinic with a lung abscess. This ruptured and resulted in an empyema that required a small bore chest drain. Pus started bypassing the drain, spilling out subcutaneously. This was probably due to the impending formation of an empyema necessitans. To stem the flow, a large bore drain was inserted. An ambulatory bag was connected to the end of that drain which enabled outpatient management through the ambulatory care unit over a ten week period. The chest drain stayed in for nine weeks. Risk stratification using the RAPID score was applied. This is a routine medical presentation with well-known and accepted investigations with routine organisms (mixed aerobic and anaerobic microbiota) and treatment with classical broad spectrum antibiotics. The striking feature of the case is that with strict supervision, patient education and motivation, ambulatory management is perfectly feasible and safe.


Assuntos
Drenagem , Empiema Pleural/terapia , Assistência Ambulatorial , Antibacterianos , Tubos Torácicos , Humanos , Masculino , Pessoa de Meia-Idade
16.
Dis Aquat Organ ; 135(1): 1-31, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31219432

RESUMO

Seventy mortalities of North Atlantic right whales Eubalaena glacialis (NARW) were documented between 2003 and 2018 from Florida, USA, to the Gulf of St. Lawrence, Canada. These included 29 adults, 14 juveniles, 10 calves, and 17 of unknown age class. Females represented 65.5% (19/29) of known-sex adults. Fourteen cases had photos only; 56 carcasses received external examinations, 44 of which were also necropsied. Cause of death was determined in 43 cases, of which 38 (88.4%) were due to anthropogenic trauma: 22 (57.9%) from entanglement, and 16 (42.1%) from vessel strike. Gross and histopathologic lesions associated with entanglement were often severe and included deep lacerations caused by constricting line wraps around the flippers, flukes, and head/mouth; baleen plate mutilation; chronic extensive bone lesions from impinging line, and traumatic scoliosis resulting in compromised mobility in a calf. Chronically entangled whales were often in poor body condition and had increased cyamid burden, reflecting compromised health. Vessel strike blunt force injuries included skull and vertebral fractures, blubber and muscle contusions, and large blood clots. Propeller-induced wounds often caused extensive damage to blubber, muscle, viscera, and bone. Overall prevalence of NARW entanglement mortalities increased from 21% (1970-2002) to 51% during this study period. This demonstrates that despite mitigation efforts, entanglements and vessel strikes continue to inflict profound physical trauma and suffering on individual NARWs. These cumulative mortalities are also unsustainable at the population level, so urgent and aggressive intervention is needed to end anthropogenic mortality in this critically endangered species.


Assuntos
Espécies em Perigo de Extinção , Baleias , Animais , Oceano Atlântico , Canadá , Feminino , Florida
17.
Clin Infect Dis ; 67(5): 785-790, 2018 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-30124823

RESUMO

Background: A clinical trial showed that efavirenz 400 mg once daily (EFV400) is as effective as the standard adult dose. World Health Organization recommends EFV400 as an alternative first-line agent, but data are lacking in the third trimester of pregnancy (TT). We investigated the pharmacokinetics, efficacy, and CYP2B6 pharmacogenetics in HIV-infected women (WLWH) on EFV400 during TT and post-partum (PP). Methods: An open-label 2-center study (United Kingdom, Uganda) was conducted in WLWH receiving antiretroviral regimens containing efavirenz 600 mg, who had their efavirenz dose reduced to EFV400. Weekly therapeutic drug monitoring (TDM), steady-state pharmacokinetic profiles (TT and PP), safety, virological efficacy, and CYP2B6 polymorphisms at positions 516 (C > T) and 938 (T > C) were evaluated. Results: Twenty-five WLWH of African origin were enrolled. All had viral loads <50 copies/mL at baseline, which were maintained throughout the study. No infant was HIV infected. No WLWH were withdrawn due to low EFV400 TDM results. Geometric mean ratios (TT/PP; 90% confidence interval) for EFV400 maximum observed plasma concentration, area under the curve, and plasma concentration measured 24 hours after the observed dose were 0.97 (.85-1.10), 0.87 (.76-.99), and 0.77 (.65-.91), respectively. Five of 25 WLWH were slow metabolizers. Conclusions: Although EFV400 pharmacokinetic parameters were slightly lower for TT compared with PP values, efavirenz concentrations exceeded cutoff levels established by the study and those measured in antiretroviral-naive patients receiving EFV400 in ENCORE1. All subjects maintained a viral load <50 copies/mL, suggesting that EFV400 can be used in pregnant WLWH.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/farmacocinética , Benzoxazinas/administração & dosagem , Benzoxazinas/farmacocinética , Infecções por HIV/tratamento farmacológico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto , Alcinos , Ciclopropanos , Monitoramento de Medicamentos , Feminino , HIV-1/efeitos dos fármacos , Humanos , Farmacogenética , Período Pós-Parto , Gravidez , Complicações Infecciosas na Gravidez/virologia , Uganda , Reino Unido , Carga Viral
18.
J Am Chem Soc ; 140(23): 7256-7266, 2018 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-29712420

RESUMO

Allosteric enzymes contain a wealth of catalytic diversity that remains distinctly underutilized for biocatalysis. Tryptophan synthase is a model allosteric system and a valuable enzyme for the synthesis of noncanonical amino acids (ncAA). Previously, we evolved the ß-subunit from Pyrococcus furiosus, PfTrpB, for ncAA synthase activity in the absence of its native partner protein PfTrpA. However, the precise mechanism by which mutation activated TrpB to afford a stand-alone catalyst remained enigmatic. Here, we show that directed evolution caused a gradual change in the rate-limiting step of the catalytic cycle. Concomitantly, the steady-state distribution of the intermediates shifts to favor covalently bound Trp adducts, which have increased thermodynamic stability. The biochemical properties of these evolved, stand-alone TrpBs converge on those induced in the native system by allosteric activation. High-resolution crystal structures of the wild-type enzyme, an intermediate in the lineage, and the final variant, encompassing five distinct chemical states, show that activating mutations have only minor structural effects on their immediate environment. Instead, mutation stabilizes the large-scale motion of a subdomain to favor an otherwise transiently populated closed conformational state. This increase in stability enabled the first structural description of Trp covalently bound in a catalytically active TrpB, confirming key features of catalysis. These data combine to show that sophisticated models of allostery are not a prerequisite to recapitulating its complex effects via directed evolution, opening the way to engineering stand-alone versions of diverse allosteric enzymes.


Assuntos
Regulação Alostérica/genética , Proteínas Arqueais/genética , Triptofano Sintase/genética , Proteínas Arqueais/química , Biocatálise , Domínio Catalítico , Evolução Molecular Direcionada , Cinética , Ligantes , Mutação , Conformação Proteica , Pyrococcus furiosus/enzimologia , Serina/química , Triptofano/química , Triptofano Sintase/química
19.
J Hum Evol ; 120: 32-47, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29458978

RESUMO

Fossil bird data (community composition and taphonomic profiles) are used here to infer the environmental context of the Oldowan-Acheulean transitional period at Olduvai Gorge, Tanzania. This is the first comprehensive report on the Middle Bed II avifauna and includes fossils excavated by the Olduvai Geochronology and Archaeology Project (OGAP) and recently rediscovered fossils collected by Mary Leakey. Crane, ibis, darter, owl, raptor, crow, and vulture are reported from Bed II for the first time. The presence of these taxa, absent earlier in this Bed, point to a general opening and drying of the landscape with grassland and open woodland expansion. Taxa associated with dense, emergent wetland vegetation, such as dabbling ducks and rails, are uncommon and less diverse than earlier in Bed II. This suggests more mature wetlands with clearer waters. Cormorants continue to be common, but are less diverse. Cormorants and other roosting taxa provide evidence of trees in the area. Compared to lowermost Bed II, the Middle to Upper Bed II landscape is interpreted here as more open and drier (but not necessarily more arid), with matured wetlands, scattered trees, and a greater expansion of grasslands.


Assuntos
Arqueologia , Aves , Evolução Cultural , Meio Ambiente , Fósseis , Hominidae , Animais , Biota , Paleontologia , Tanzânia , Tecnologia
20.
J Hum Evol ; 120: 215-235, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-28797516

RESUMO

The regular consumption of large mammal carcasses, as evidenced by butchery marks on fossils recovered from Early Stone Age archaeological sites, roughly coincides with the appearance of Homo habilis. However, the significance of this niche expansion cannot be appreciated without an understanding of hominin feeding behavior and their ecological interactions with mammalian carnivores. The Olduvai Geochronology and Archaeology Project (OGAP) has recovered a large and well-preserved fossil assemblage from the HWK EE site, which was deposited just prior to the first appearance of Acheulean technology at Olduvai Gorge and likely represents one of the last H. habilis sites at Olduvai. This taphonomic analysis of the larger mammal fossil assemblage excavated from HWK EE shows evidence of multiple occupations over a long period of time, suggesting the site offered resources that were attractive to hominins. There was a water source indicated by the presence of fish, crocodiles, and hippos, and there was possible tree cover in an otherwise open habitat. The site preserves several stratigraphic intervals with large fossil and artifact assemblages within two of these intervals. Feeding traces on bone surfaces suggest hominins at the site obtained substantial amounts of flesh and marrow, particularly from smaller size group 1-2 carcasses, and exploited a wide range of taxa, including megafauna. A strong carnivore signal suggests hominins scavenged much of their animal foods during the two main stratigraphic intervals. In the later interval, lower carnivore tooth mark and hammerstone percussion mark frequencies, in addition to high epiphyseal to shaft fragment ratios, suggest hominins and carnivores did not fully exploit bone marrow and grease, which may have been acquired from nutritionally-stressed animals that died during a dry period at Olduvai. The diversity of fauna that preserve evidence of butchery suggests that the HWK EE hominins were opportunistic in their acquisition of carcass foods.


Assuntos
Dieta , Comportamento Alimentar , Fósseis , Hominidae/fisiologia , Animais , Arqueologia , Paleontologia , Tanzânia
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