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1.
Proc Natl Acad Sci U S A ; 119(35): e2123366119, 2022 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-35994633

RESUMO

Variability in resource availability is hypothesized to be a significant driver of primate adaptation and evolution, but most paleoclimate proxies cannot recover environmental seasonality on the scale of an individual lifespan. Oxygen isotope compositions (δ18O values) sampled at high spatial resolution in the dentitions of modern African primates (n = 2,352 near weekly measurements from 26 teeth) track concurrent seasonal precipitation, regional climatic patterns, discrete meteorological events, and niche partitioning. We leverage these data to contextualize the first δ18O values of two 17 Ma Afropithecus turkanensis individuals from Kalodirr, Kenya, from which we infer variably bimodal wet seasons, supported by rainfall reconstructions in a global Earth system model. Afropithecus' δ18O fluctuations are intermediate in magnitude between those measured at high resolution in baboons (Papio spp.) living across a gradient of aridity and modern forest-dwelling chimpanzees (Pan troglodytes verus). This large-bodied Miocene ape consumed seasonally variable food and water sources enriched in 18O compared to contemporaneous terrestrial fauna (n = 66 fossil specimens). Reliance on fallback foods during documented dry seasons potentially contributed to novel dental features long considered adaptations to hard-object feeding. Developmentally informed microsampling recovers greater ecological complexity than conventional isotope sampling; the two Miocene apes (n = 248 near weekly measurements) evince as great a range of seasonal δ18O variation as more time-averaged bulk measurements from 101 eastern African Plio-Pleistocene hominins and 42 papionins spanning 4 million y. These results reveal unprecedented environmental histories in primate teeth and suggest a framework for evaluating climate change and primate paleoecology throughout the Cenozoic.


Assuntos
Evolução Biológica , Mudança Climática , Fósseis , Isótopos de Oxigênio , Pan troglodytes , Dente , África , Animais , Guiné Equatorial , Fósseis/anatomia & histologia , História do Século XXI , Hominidae/anatomia & histologia , Quênia , Isótopos de Oxigênio/análise , Pan troglodytes/anatomia & histologia , Papio/anatomia & histologia , Primatas/anatomia & histologia , Dente/anatomia & histologia , Dente/química
2.
Bioessays ; 43(9): e2000298, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33721363

RESUMO

Integrated developmental and elemental information in teeth provide a unique framework for documenting breastfeeding histories, physiological disruptions, and neurotoxicant exposure in humans and our primate relatives, including ancient hominins. Here we detail our method for detecting the consumption of mothers' milk and exploring health history through the use of laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) mapping of sectioned nonhuman primate teeth. Calcium-normalized barium and lead concentrations in tooth enamel and dentine may reflect milk and formula consumption with minimal modification during subsequent tooth mineralization, particularly in dentine. However, skeletal resorption during severe illness, and bioavailable metals in nonmilk foods, can complicate interpretations of nursing behavior. We show that explorations of the patterning of multiple elements may aid in the distinction of these important etiologies. Targeted studies of skeletal chemistry, gastrointestinal maturation, and the dietary bioavailability of metals are needed to optimize these unique records of human health and behavior.


Assuntos
Dente , Oligoelementos , Animais , Dieta , Periodicidade , Estudos Retrospectivos
3.
Telemed J E Health ; 28(9): 1317-1323, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35076292

RESUMO

Introduction: Telemedicine retains potential for increasing access to specialty providers in underserved and rural communities. COVID-19 accelerated adoption of telehealth beyond rural populations, serving as a primary modality of patient-provider encounters for many nonemergent diagnoses. Methods: From 2020 to 2021, telemedicine was incorporated in management of stereotactic radiosurgery patients. Retrospective data on diagnoses, demographics, distance to primary clinic, and encounter type were captured and statistically analyzed using descriptive measures and Cox proportional regression modeling. Graphical representation of service areas was created using geo-mapping software. Results: Patients (n = 208) completed 331 telemedicine encounters over 12 months. Metastases and meningiomas comprised 60% of diagnoses. Median age was 62 years with median household income and residential population of $44,752 and 7,634 people. The one-way mean and median travel distances were 74.6 and 66.3 miles. The total potential road mileage for all patients was 44,596 miles. A total of 118 (57%) patients completed video visits during the first encounter, whereas 90 (43%) opted for telephone encounters. At 12 months, 138 patients (66%) utilized video visits and 70 (34%) used telephone visits. Predictors of video visit use were video-enabled visit during the first encounter (hazard ratio [HR] 2.806, p < 0.001), total potential distance traveled (HR 1.681, p < 0.05), and the need for more than one visit per year (HR 2.903, p < 0.001). Discussion: Telemedicine can be effective in radiosurgery practice with predictors of video-enabled use being pre-existing patient comfort levels with videoconferencing, total annual travel distance, and number of visits per year. Age, rural population status, and household income did not impact telemedicine use in our patient cohort.


Assuntos
COVID-19 , Radiocirurgia , Telemedicina , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , População Rural
4.
Int J Geriatr Psychiatry ; 37(1)2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34564898

RESUMO

OBJECTIVES: Evidence in mouse models has found that the antidepressant trazodone may be protective against neurodegeneration. We therefore aimed to compare cognitive decline of people with dementia taking trazodone with those taking other antidepressants. METHODS: Three identical naturalistic cohort studies using UK clinical registers. We included all people with dementia assessed during 2008-16 who were recorded taking trazodone, citalopram or mirtazapine for at least 6 weeks. Linear mixed models examined age, time and sex-adjusted Mini-mental state examination (MMSE) change in people with all-cause dementia taking trazodone compared with those taking citalopram and mirtazapine. In secondary analyses, we examined those with non-vascular dementia; mild dementia; and adjusted results for neuropsychiatric symptoms. We combined results from the three study sites using random-effects meta-analysis. RESULTS: We included 2,199 people with dementia, including 406 taking trazodone, with mean 2.2 years follow-up. There was no difference in adjusted cognitive decline in people with all-cause or non-vascular dementia taking trazodone, citalopram or mirtazapine in any of the three study sites. When data from the three sites were combined in meta-analysis, we found greater mean MMSE decline in people with all-cause dementia taking trazodone compared to those taking citalopram (0·26 points per successive MMSE measurement, 95% CI 0·03-0·49; p = 0·03). Results in sensitivity analyses were consistent with primary analyses. CONCLUSIONS: There was no evidence of cognitive benefit from trazodone compared to other antidepressants in people with dementia in three naturalistic cohort studies. Despite preclinical evidence, trazodone should not be advocated for cognition in dementia.

5.
J Anat ; 237(2): 367-378, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32266720

RESUMO

Dentine- and enamel-forming cells secrete matrix in consistent rhythmic phases, resulting in the formation of successive microscopic growth lines inside tooth crowns and roots. Experimental studies of various mammals have proven that these lines are laid down in subdaily, daily (circadian), and multidaily rhythms, but it is less clear how these rhythms are initiated and maintained. In 2001, researchers reported that lesioning the so-called master biological clock, the suprachiasmatic nucleus (SCN), halted daily line formation in rat dentine, whereas subdaily lines persisted. More recently, a key clock gene (Bmal1) expressed in the SCN in a circadian manner was also found to be active in dentine- and enamel- secretory cells. To probe these potential neurological and local mechanisms for the production of rhythmic lines in teeth, we reexamined the role of the SCN in growth line formation in Wistar rats and investigated the presence of daily lines in Bmal1 knockout mice (Bmal1-/- ). In contrast to the results of the 2001 study, we found that both daily and subdaily growth lines persisted in rat dentine after complete or partial SCN lesion in the majority of individuals. In mice, after transfer into constant darkness, daily rhythms continued to manifest as incremental lines in the dentine of each Bmal1 genotype (wild-type, Bmal+/- , and Bmal1-/- ). These results affirm that the manifestation of biological rhythms in teeth is a robust phenomenon, imply a more autonomous role of local biological clocks in tooth growth than previously suggested, and underscore the need further to elucidate tissue-specific circadian biology and its role in incremental line formation. Investigations of this nature will strengthen an invaluable system for determining growth rates and calendar ages from mammalian hard tissues, as well as documenting the early lives of fossil hominins and other primates.


Assuntos
Relógios Biológicos/genética , Ritmo Circadiano/genética , Dentina/crescimento & desenvolvimento , Fatores de Transcrição ARNTL/genética , Animais , Camundongos , Camundongos Knockout , Ratos , Ratos Wistar
6.
J Hum Evol ; 145: 102823, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32652259

RESUMO

Age at lower first molar (M1) emergence is a commonly used proxy for inferring life-history scheduling in fossil primates, but its utility is dependent on knowing to what extent extant populations vary in this datum and how this variation correlates with the scheduling of life-history variables. Here, we address the first of these issues among extant chimpanzees. While age at M1 emergence has been documented in several live individuals from the Kanyawara population of Pan troglodytes schweinfurthii in Uganda, it has been estimated for only one individual of Pan troglodytes verus, based on a deceased animal from the Taï Forest in Côte d'Ivoire. To further explore interpopulation variation in this variable in chimpanzees, and using dental histology, we calculated ages at death for two wild-shot individuals of P. t. verus with erupting M1, both collected in Liberia during the mid-1950s, and estimated ages at M1 emergence from the ages at death. The overall range for these two individuals is ∼4.2-4.6 yr, compared with an age of ∼3.7 yr for the individual from the Taï Forest, and <2.5-3.3 yr for the several individuals of P. t. schweinfurthii. While the absolute range of ∼2 yr in these samples combined is little greater than in captive chimpanzees, the disparity between the samples of P. t. schweinfurthii and P. t. verus is striking, although it cannot be determined if this disparity represents a subspecies difference or simply population differences expressed in two different subspecies. While life-history data are unavailable for the population to which the Liberian chimpanzees belonged, the difference in M1 emergence ages between these individuals and those from Kanyawara still suggests caution when attempting even broad life-history inference in fossil apes and hominins based on age at M1 emergence.


Assuntos
Longevidade/fisiologia , Dente Molar/fisiologia , Pan troglodytes/fisiologia , Erupção Dentária/fisiologia , Animais , Côte d'Ivoire , Arco Dental/anatomia & histologia , Fósseis/anatomia & histologia , Dente Molar/anatomia & histologia , Pan troglodytes/anatomia & histologia , Uganda
7.
Paediatr Child Health ; 25(3): 180-194, 2020 Apr.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-32296280

RESUMO

Child sexual abuse is an important and not uncommon problem. Children who have been sexually abused may present to a physician's office, urgent care centre, or emergency department for medical evaluation. A medical evaluation can provide reassurance to both child and caregiver, identify care needs, and offer an accurate interpretation of findings to the justice and child welfare systems involved. Given the potential medico-legal implications of these assessments, the performance of a comprehensive evaluation requires both current knowledge and clinical proficiency. This position statement presents an evidence-based, trauma-informed approach to the medical evaluation of prepubertal children with suspected or confirmed sexual abuse.

8.
J Hum Evol ; 136: 102649, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31542560

RESUMO

The fossil record of middle and late Miocene Eurasian hominoids has expanded considerably over the past few decades, particularly with the recovery of numerous isolated teeth and jaws. Scholars have turned to assessments of internal tooth structure and growth to make sense of the evolutionary radiations of these primates as well as their affinities to the living great apes (hominids). Here we characterize full-dentition enamel thickness and dental development in several juvenile Rudapithecus hungaricus individuals using multiple imaging modalities. Relative enamel thickness (RET) values for the anterior teeth and premolars of Rudapithecus are broadly akin to those of gorillas and chimpanzees and are thinner than those of orangutans. First molar RET values are most similar to chimpanzees, while posterior molar values are closer to thicker-enameled orangutans. When compared to Miocene hominoids, Rudapithecus shows an intermediate molar RET condition that is especially similar to other dryopithecines. Long-period line periodicity values are comparable to African apes and most Miocene hominoids, and lower than living and fossil orangutans. The mean cuspal daily secretion rate is similar to that of several other Miocene hominoids but is greater than extant great apes. Cusp-specific molar crown formation times generally exceed those of chimpanzees, are lower than those of orangutans, and are broadly like those of other Miocene apes. While Rudapithecus appears to have a somewhat unique pattern of enamel thickness and dental development relative to individual great ape genera, these structural and developmental features are consistent with its designation as a hominid.


Assuntos
Esmalte Dentário/anatomia & histologia , Fósseis/anatomia & histologia , Hominidae/anatomia & histologia , Hominidae/crescimento & desenvolvimento , Dente/crescimento & desenvolvimento , Animais , Hungria , Dente/anatomia & histologia
9.
J Hum Evol ; 132: 227-246, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31203849

RESUMO

The early Miocene site of Moroto II, Uganda has yielded some of the oldest known hominoid fossils. A new partial mandible (UMP MORII 03'551) is notable for its long tooth row and large, narrow M2 with well-developed cristids - a morphological combination previously unknown for large bodied catarrhines of the Early Miocene and suggesting folivory. The tooth proportions are compatible with belonging to the same taxon as the maxilla UMP 62-11, the holotype of Morotopithecus bishopi; likewise, the long tooth row and vertical planum of UMP MORII 03'551 suggest that it may represent the same taxon as mandible(s) UMP 66-01 and UMP 62-10. Canine size strongly suggests UMP MORII 03'551 is a female. Comparisons of the tooth crown morphology and tooth row proportions, relative enamel thickness, enamel-dentine junction morphology, long-period line periodicity, and dental wear patterns support significant morphological, developmental, and inferred dietary differentiation, and therefore generic-level distinctiveness, among Afropithecus, Morotopithecus and the Proconsul clade. An isolated M1 (UMP MORII 03'559) is morphologically dissimilar, and much smaller than the actual or inferred size of molars in UMP MORII 03'551, UMP 66-01 and UMP 62-10, supporting the presence of two hominoid taxa at Moroto II, M. bishopi and a smaller bodied proconsulid. Given the high level of body mass dimorphism inferred for Morotopithecus and other early Miocene catarrhines, the known postcrania from Moroto II could be attributable to either taxon. However, UMP MORII 03'551 and the femora UMP MORII 94'80 derive from the same stratigraphic interval, while the isolated M1 was deposited later, increasing the likelihood that the mandible and femora are from the same individual. These new fossils expand our understanding of the taxonomic and adaptive diversity of early Miocene catarrhines.


Assuntos
Catarrinos/anatomia & histologia , Fósseis/anatomia & histologia , Mandíbula/anatomia & histologia , Dente/anatomia & histologia , Animais , Catarrinos/classificação , Feminino , Masculino , Uganda
10.
Pediatr Transplant ; 23(4): e13412, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30983080

RESUMO

Parents of pediatric liver and kidney transplant recipients were surveyed regarding their current education plans (eg, Individualized Education Program, 504), satisfaction with these plans, and interest in educational support from the psychosocial transplant team. Survey results indicate high rates of IEP and 504 plans, academic and related services, and accommodations among this population. The majority of parents/guardians reported satisfaction with their child's current school plan and did not report need for additional transplant team support specific to school services on the survey measure. However, other information highlights the importance for pediatric transplant teams to consider other ways to support this population's educational needs.


Assuntos
Doença Hepática Terminal/cirurgia , Falência Renal Crônica/cirurgia , Transplante de Rim , Transplante de Fígado , Avaliação das Necessidades , Melhoria de Qualidade , Adolescente , Criança , Pré-Escolar , Educação Inclusiva , Doença Hepática Terminal/psicologia , Família/psicologia , Feminino , Humanos , Falência Renal Crônica/psicologia , Acontecimentos que Mudam a Vida , Masculino , Pais/psicologia , Planejamento de Assistência ao Paciente , Satisfação do Paciente , Cuidados Pós-Operatórios , Instituições Acadêmicas , Estudantes/psicologia
11.
Nature ; 498(7453): 216-9, 2013 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-23698370

RESUMO

Early-life dietary transitions reflect fundamental aspects of primate evolution and are important determinants of health in contemporary human populations. Weaning is critical to developmental and reproductive rates; early weaning can have detrimental health effects but enables shorter inter-birth intervals, which influences population growth. Uncovering early-life dietary history in fossils is hampered by the absence of prospectively validated biomarkers that are not modified during fossilization. Here we show that large dietary shifts in early life manifest as compositional variations in dental tissues. Teeth from human children and captive macaques, with prospectively recorded diet histories, demonstrate that barium (Ba) distributions accurately reflect dietary transitions from the introduction of mother's milk through the weaning process. We also document dietary transitions in a Middle Palaeolithic juvenile Neanderthal, which shows a pattern of exclusive breastfeeding for seven months, followed by seven months of supplementation. After this point, Ba levels in enamel returned to baseline prenatal levels, indicating an abrupt cessation of breastfeeding at 1.2 years of age. Integration of Ba spatial distributions and histological mapping of tooth formation enables novel studies of the evolution of human life history, dietary ontogeny in wild primates, and human health investigations through accurate reconstructions of breastfeeding history.


Assuntos
Bário/análise , Dieta , Fósseis , Macaca/fisiologia , Homem de Neandertal/fisiologia , Dente/química , Desmame , Adulto , Animais , Aleitamento Materno/história , Cálcio/análise , Pré-Escolar , Dieta/veterinária , Feminino , História Antiga , Humanos , Lactente , Reprodutibilidade dos Testes
12.
Paediatr Child Health ; 24(4): 213-215, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31239806

RESUMO

We are witnessing a momentous cultural shift in how we understand, respond to, and resist sexual violence. Rise of the #MeToo movement has ignited a viral wave of consciousness raising, dialogue, and advocacy on an international scale. Women and girls have been empowered to share their stories of sexual assault, bringing to light the widespread prevalence of gender-based violence. As the shame and blame that have silenced victims gradually diminish, we anticipate a continued upward trend in sexual assault disclosure among youth, and corresponding increase in demand for trauma-informed paediatric sexual assault services. It is our collective responsibility to prevent revictimization and retraumatization by the very systems designed to help. In this critical lens commentary, we strongly advocate for heightened awareness and improved responsiveness among paediatric health care providers and policymakers to effectively and ethically meet the diverse needs of the growing number of young survivors who take the brave step of speaking out and reaching out.

13.
Paediatr Child Health ; 23(2): 116-118, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29686496

RESUMO

While often a silent and invisible issue, childhood trauma is pervasive, and has profound individual, societal and economic impacts. Many forms of childhood trauma exist, including child physical and sexual abuse. Given the prevalence, impact and availability of prevention and intervention approaches, child abuse deserves the same level of awareness, policy priority and investment as is directed to other issues of significant public health importance. The complex issue of child abuse requires a coordinated multifaceted response, which minimizes system trauma and revictimization for the child and family. The Child and Youth Advocacy Centre (CYAC) model brings together various sectors to create an integrated, multidisciplinary response that is client-centred and trauma-informed. To ensure that all children, youth and their families who have experienced maltreatment have access to the CYAC model of care when needed, sustainable funding investment in CYACs should be a priority for government at all levels.

14.
Cochrane Database Syst Rev ; 10: CD012234, 2017 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-29083473

RESUMO

BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after an operative procedure. A preventable complication, they are costly and associated with poorer patient outcomes, increased mortality, morbidity and reoperation rates. Surgical wound irrigation is an intraoperative technique, which may reduce the rate of SSIs through removal of dead or damaged tissue, metabolic waste, and wound exudate. Irrigation can be undertaken prior to wound closure or postoperatively. Intracavity lavage is a similar technique used in operations that expose a bodily cavity; such as procedures on the abdominal cavity and during joint replacement surgery. OBJECTIVES: To assess the effects of wound irrigation and intracavity lavage on the prevention of surgical site infection (SSI). SEARCH METHODS: In February 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase and EBSCO CINAHL Plus. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions on language, date of publication or study setting. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) of participants undergoing surgical procedures in which the use of a particular type of intraoperative washout (irrigation or lavage) was the only systematic difference between groups, and in which wounds underwent primary closure. The primary outcomes were SSI and wound dehiscence. Secondary outcomes were mortality, use of systemic antibiotics, antibiotic resistance, adverse events, re-intervention, length of hospital stay, and readmissions. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion at each stage. Two review authors also undertook data extraction, assessment of risk of bias and GRADE assessment. We calculated risk ratios or differences in means with 95% confidence intervals where possible. MAIN RESULTS: We included 59 RCTs with 14,738 participants. Studies assessed comparisons between irrigation and no irrigation, between antibacterial and non-antibacterial irrigation, between different antibiotics, different antiseptics or different non-antibacterial agents, or between different methods of irrigation delivery. No studies compared antiseptic with antibiotic irrigation. Surgical site infectionIrrigation compared with no irrigation (20 studies; 7192 participants): there is no clear difference in risk of SSI between irrigation and no irrigation (RR 0.87, 95% CI 0.68 to 1.11; I2 = 28%; 14 studies, 6106 participants). This would represent an absolute difference of 13 fewer SSIs per 1000 people treated with irrigation compared with no irrigation; the 95% CI spanned from 31 fewer to 10 more SSIs. This was low-certainty evidence downgraded for risk of bias and imprecision.Antibacterial irrigation compared with non-antibacterial irrigation (36 studies, 6163 participants): there may be a lower incidence of SSI in participants treated with antibacterial irrigation compared with non-antibacterial irrigation (RR 0.57, 95% CI 0.44 to 0.75; I2 = 53%; 30 studies, 5141 participants). This would represent an absolute difference of 60 fewer SSIs per 1000 people treated with antibacterial irrigation than with non-antibacterial (95% CI 35 fewer to 78 fewer). This was low-certainty evidence downgraded for risk of bias and suspected publication bias.Comparison of irrigation of two agents of the same class (10 studies; 2118 participants): there may be a higher incidence of SSI in participants treated with povidone iodine compared with superoxidised water (Dermacyn) (RR 2.80, 95% CI 1.05 to 7.47; low-certainty evidence from one study, 190 participants). This would represent an absolute difference of 95 more SSIs per 1000 people treated with povidone iodine than with superoxidised water (95% CI 3 more to 341 more). All other comparisons found low- or very low-certainty evidence of no clear difference between groups.Comparison of two irrigation techniques: two studies compared standard (non-pulsed) methods with pulsatile methods. There may, on average, be fewer SSIs in participants treated with pulsatile methods compared with standard methods (RR 0.34, 95% CI 0.19 to 0.62; I2 = 0%; two studies, 484 participants). This would represent an absolute difference of 109 fewer SSIs occurring per 1000 with pulsatile irrigation compared with standard (95% CI 62 fewer to 134 fewer). This was low-certainty evidence downgraded twice for risks of bias across multiple domains. Wound dehiscenceFew studies reported wound dehiscence. No comparison had evidence for a difference between intervention groups. This included comparisons between irrigation and no irrigation (one study, low-certainty evidence); antibacterial and non-antibacterial irrigation (three studies, very low-certainty evidence) and pulsatile and standard irrigation (one study, low-certainty evidence). Secondary outcomesFew studies reported outcomes such as use of systemic antibiotics and antibiotic resistance and they were poorly and incompletely reported. There was limited reporting of mortality; this may have been partially due to failure to specify zero events in participants at low risk of death. Adverse event reporting was variable and often limited to individual event types. The evidence for the impact of interventions on length of hospital stay was low or moderate certainty; where differences were seen they were too small to be clinically important. AUTHORS' CONCLUSIONS: The evidence base for intracavity lavage and wound irrigation is generally of low certainty. Therefore where we identified a possible difference in the incidence of SSI (in comparisons of antibacterial and non-antibacterial interventions, and pulsatile versus standard methods) these should be considered in the context of uncertainty, particularly given the possibility of publication bias for the comparison of antibacterial and non-antibacterial interventions. Clinicians should also consider whether the evidence is relevant to the surgical populations under consideration, the varying reporting of other prophylactic antibiotics, and concerns about antibiotic resistance.We did not identify any trials that compared an antibiotic with an antiseptic. This gap in the direct evidence base may merit further investigation, potentially using network meta-analysis; to inform the direction of new primary research. Any new trial should be adequately powered to detect a difference in SSIs in eligible participants, should use robust research methodology to reduce the risks of bias and internationally recognised criteria for diagnosis of SSI, and should have adequate duration and follow-up.


Assuntos
Infecção da Ferida Cirúrgica/prevenção & controle , Abscesso/epidemiologia , Antibacterianos/administração & dosagem , Anti-Infecciosos Locais/administração & dosagem , Combinação de Medicamentos , Humanos , Ácido Hipocloroso/administração & dosagem , Incidência , Povidona-Iodo/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Hipoclorito de Sódio/administração & dosagem , Deiscência da Ferida Operatória/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Irrigação Terapêutica/métodos
15.
J Hum Evol ; 94: 92-105, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27178461

RESUMO

Numerous studies have investigated molar development in extant and fossil hominoids, yet relatively little is known about orangutans, the only great ape with an extensive fossil record. This study characterizes aspects of dental development, including cuspal enamel daily secretion rate, long-period line periodicities, cusp-specific molar crown formation times and extension rates, and initiation and completion ages in living and fossil orangutan postcanine teeth. Daily secretion rate and periodicities in living orangutans are similar to previous reports, while crown formation times often exceed published values, although direct comparisons are limited. One wild Bornean individual died at 4.5 years of age with fully erupted first molars (M1s), while a captive individual and a wild Sumatran individual likely erupted their M1s around five or six years of age. These data underscore the need for additional samples of orangutans of known sex, species, and developmental environment to explore potential sources of variation in molar emergence and their relationship to life history variables. Fossil orangutans possess larger crowns than living orangutans, show similarities in periodicities, and have faster daily secretion rate, longer crown formation times, and slower extension rates. Molar crown formation times exceed reported values for other fossil apes, including Gigantopithecus blacki. When compared to African apes, both living and fossil orangutans show greater cuspal enamel thickness values and periodicities, resulting in longer crown formation times and slower extension rates. Several of these variables are similar to modern humans, representing examples of convergent evolution. Molar crown formation does not appear to be equivalent among extant great apes or consistent within living and fossil members of Pongo or Homo.


Assuntos
Pongo/crescimento & desenvolvimento , Dente/crescimento & desenvolvimento , Animais , Feminino , Fósseis/anatomia & histologia , Masculino
16.
Proc Natl Acad Sci U S A ; 110(8): 2787-91, 2013 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-23359695

RESUMO

Understanding dental development in chimpanzees, our closest living relatives, is of fundamental importance for reconstructing the evolution of human development. Most early hominin species are believed to show rapid ape-like patterns of development, implying that a prolonged modern human childhood evolved quite recently. However, chimpanzee developmental standards are uncertain because they have never been based on living wild individuals. Furthermore, although it is well established that first molar tooth emergence (movement into the mouth) is correlated with the scheduling of growth and reproduction across primates broadly, its precise relation to solid food consumption, nursing behavior, or maternal life history is unknown. To address these concerns we conducted a photographic study of subadult chimpanzees (Pan troglodytes schweinfurthii) in Kanyawara, Kibale National Park, Uganda. Five healthy infants emerged their lower first molars (M1s) by or before 3.3 y of age, nearly identical to captive chimpanzee mean ages (∼3.2 y, n = 53). First molar emergence in these chimpanzees does not directly or consistently predict the introduction of solid foods, resumption of maternal estrous cycling, cessation of nursing, or maternal interbirth intervals. Kanyawara chimpanzees showed adult patterns of solid food consumption by the time M1 reached functional occlusion, spent a greater amount of time on the nipple while M1 was erupting than in the preceding year, and continued to suckle during the following year. Estimates of M1 emergence age in australopiths are remarkably similar to the Kanyawara chimpanzees, and recent reconstructions of their life histories should be reconsidered in light of these findings.


Assuntos
Dente Molar , Pan troglodytes/fisiologia , Erupção Dentária , Animais , Feminino , Masculino
17.
Environ Manage ; 58(6): 972-983, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27688257

RESUMO

The Western Cape population of Blue Cranes (Anthropoides paradiseus) in South Africa is of great importance as the largest population throughout its range. However, Blue Cranes are strongly associated with agricultural lands in the Western Cape, and therefore may come into conflict with farmers who perceive them as damaging to crops. We investigated the viability of this population by exploring farmer attitudes toward crane damage in two regions of the Western Cape, the Swartland and Overberg, using semi-structured interviews. Perceptions of cranes differed widely between regions: farmers in the Swartland perceived crane flocks to be particularly damaging to the feed crop sweet lupin (65 % of farmers reported some level of damage by cranes), and 40 % of these farmers perceived cranes as more problematic than other common bird pests. Farmers in the Overberg did not perceive cranes as highly damaging, although there was concern about cranes eating feed at sheep troughs. Farmers who had experienced large flocks on their farms and farmers who ranked cranes as more problematic than other bird pests more often perceived cranes to be damaging to their livelihoods. Biographical variables and crop profiles could not be related to the perception of damage, indicating the complexity of this human-wildlife conflict. Farmers' need for management alternatives was related to the perceived severity of damage. These results highlight the need for location-specific management solutions to crop damage by cranes, and contribute to the management of this vulnerable species.


Assuntos
Agricultura/métodos , Comportamento Animal , Aves/fisiologia , Produtos Agrícolas/crescimento & desenvolvimento , Fazendeiros , Controle de Pragas/métodos , Animais , Animais Selvagens , Atitude , Produtos Agrícolas/economia , Fazendeiros/psicologia , Humanos , Percepção , Fatores Socioeconômicos , África do Sul , Inquéritos e Questionários
18.
J Hum Evol ; 82: 137-44, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25796539

RESUMO

Knowledge of chimpanzee development has played an essential role in our understanding of the evolution of human ontogeny. However, recent studies of wild ape dentitions have cast doubt on the use of developmental standards derived from captive individuals. Others have called into question the use of deceased wild individuals to infer normative development. We conducted a high resolution photographic study of living known-age subadults in the Kanyawara community (Kibale National Park, Uganda) to generate a comprehensive three year record of dental eruption (including tooth emergence ages). These non-invasive data allow comparisons of captive and wild chimpanzees, establish accurate developmental standards for relatively healthy wild individuals, and facilitate direct assessments of primate-wide associations between dental development and life history. Emergence ages in the Kanyawara chimpanzees are very similar to living Gombe chimpanzees, and are broadly comparable to deceased Taï Forest chimpanzees. Early-emerging teeth such as the deciduous dentition and first molar (M1) appear during a time of maternal dependence, and are almost indistinguishable from captive chimpanzee emergence ages, while later forming teeth in the Kanyawara population emerge in the latter half of captive age ranges or beyond. Five juveniles whose lower M1s emerged by or before 3.3 years of age continued to nurse for a year or more beyond M1 emergence, and their mothers showed considerable variation in reproductive rates. The third molars of two adolescent females emerged several months to several years prior to the birth of their first offspring. Given that broad primate-wide relationships between molar emergence and life history do not necessarily hold within this population of chimpanzees, particularly for variables that are reported to be coincident with molar emergence, we suggest that further study is required in order to predict life history variables in hominins or hominoids.


Assuntos
Dente Molar/fisiologia , Pan troglodytes/fisiologia , Erupção Dentária/fisiologia , Adaptação Fisiológica/fisiologia , África Oriental , Envelhecimento/fisiologia , Animais , Evolução Biológica , Feminino , Masculino , Dente Molar/anatomia & histologia , Pan troglodytes/anatomia & histologia
19.
Am J Phys Anthropol ; 157(4): 556-70, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25820182

RESUMO

OBJECTIVES: Developmental defects in teeth (accentuated lines and hypoplasias) have played a critical role in studies of childhood disease, nutrition, weaning, environmental variation, and early mortality. While these enigmatic structures have been lauded for their potential insights into human evolution, few studies have examined defects in individuals of known histories. MATERIALS AND METHODS: Here we document defects in the molars of three wild juvenile chimpanzees from the Taï forest (Pan troglodytes verus) and compare them with behavioral, epidemiological, and environmental records. RESULTS: Accentuated lines of differing intensities were found throughout molar crown and root growth, and were most common in a juvenile who demonstrated slow skeletal growth and prolonged maternal dependence. These defects were observed in association with some but not all injuries and disease outbreaks in this community. A 10-year record of accentuated line frequency across individuals shows a significant negative correlation with rainfall, but does not correlate with fruit availability or reveal significant annual trends. Several hypoplasias formed between ∼0.6 and 5.8 years of age on molar crowns and roots of the three individuals, however, available behavioral and epidemiological records do not explain their causation. DISCUSSION: While teeth may provide precise and accurate records of illness and trauma in some cases, inferring seasonal cycles, social stress, or weaning in living or fossil primate dentitions requires additional evidence beyond the presence, absence, or degree of expression of these defects. Studies that microsample bulk and trace elements may provide a more secure context for the interpretation of environmental, physiological, and dietary changes that impact dental tissue formation.


Assuntos
Hipoplasia do Esmalte Dentário/patologia , Hipoplasia do Esmalte Dentário/veterinária , Dente Molar/patologia , Pan troglodytes , Animais , Feminino , Masculino
20.
Am J Phys Anthropol ; 155(3): 447-59, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25146639

RESUMO

Enamel thickness has played an important role in studies of primate taxonomy, phylogeny, and functional morphology, although its variation among hominins is poorly understood. Macaques parallel hominins in their widespread geographic distribution, relative range of body sizes, and radiation during the last five million years. To explore enamel thickness variation, we quantified average and relative enamel thickness (AET and RET) in Macaca arctoides, Macaca fascicularis, Macaca fuscata, Macaca mulatta, Macaca nemestrina, and Macaca sylvanus. Enamel area, dentine area, and enamel-dentine junction length were measured from mesial sections of 386 molars scanned with micro-computed tomography, yielding AET and RET indices. Intraspecific sex differences were not found in AET or RET. Macaca fuscata had the highest AET and RET, M. fascicularis showed the lowest AET, and M. arctoides had the lowest RET. The latitudinal distribution of macaque species was associated with AET for these six species. Temperate macaques had thicker molar enamel than did tropical macaques, suggesting that thick enamel may be adaptive in seasonal environments. Additional research is needed to determine if thick enamel in temperate macaques is a response to intensified hard-object feeding, increased abrasion, and/or a broader diet with a greater range of food material properties. The extreme ecological flexibility of macaques may prohibit identification of consistent trends between specific diets and enamel thickness conditions. Such complications of interpretation of ecological variability, dietary diversity, and enamel thickness may similarly apply for fossil Homo species.


Assuntos
Esmalte Dentário/anatomia & histologia , Macaca/anatomia & histologia , Animais , Antropologia Física , Dieta , Ecologia , Feminino , Masculino , Dente Molar/anatomia & histologia , Especificidade da Espécie
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