scholarly journals Outcomes in patients with gunshot wounds to the brain

2019 ◽  
Vol 4 (1) ◽  
pp. e000351
Author(s):  
Leigh Anna Robinson ◽  
Lauren M Turco ◽  
Bryce Robinson ◽  
Joshua G Corsa ◽  
Michael Mount ◽  
...  
Keyword(s):  
Organ Donation ◽  
Regression Models ◽  
Hormone Replacement ◽  
Gunshot Wounds ◽  
Trauma Resuscitation ◽  
Level Of Evidence ◽  
Resuscitation Room ◽  
Donation Rate ◽  
Starting Point ◽  
The Brain

IntroductionGunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, and furthermore whether patients with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought to determine the rates of survival and organ donation, as well as identify factors associated with both outcomes in patients with GSWB undergoing CPR.MethodsWe performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011 and December 31, 2017. Patients were included if they suffered isolated GSWB and required CPR at a referring hospital, in the field, or in the trauma resuscitation room. Patients were excluded for significant torso or extremity injuries, or if pregnant. Binomial regression models were used to determine predictors of survival/organ donation.Results825 patients met study criteria; the majority were male (87.6%) with a mean age of 36.5 years. Most (67%) underwent CPR in the field and 2.1% (n=17) survived to discharge. Of the non-survivors, 17.5% (n=141) were considered eligible donors, with a donation rate of 58.9% (n=83) in this group. Regression models found several predictors of survival. Hormone replacement was predictive of both survival and organ donation.ConclusionWe found that GSWB requiring CPR during trauma resuscitation was associated with a 2.1% survival rate and overall organ donation rate of 10.3%. Several factors appear to be favorably associated with survival, although predictions are uncertain due to the low number of survivors in this patient population. Hormone replacement was predictive of both survival and organ donation. These results are a starting point for determining appropriate treatment algorithms for this devastating clinical condition.Level of evidenceLevel II.

TEORI KECERDASAN, PENDIDIKAN ANAK, DAN KOMUNIKASI DALAM KELUARGA

1970 ◽  
Vol 6 (1) ◽  
Author(s):  
Muskinul Fuad
Keyword(s):  
Multiple Intelligences ◽  
Educational Activity ◽  
Howard Gardner ◽  
Human Beings ◽  
Brain Functions ◽  
Starting Point ◽  
The Family ◽  
Education Today ◽  
The Brain ◽  
Spatial Logics

The education system in Indonesia emphasize on academic intelligence, whichincludes only two or three aspects, more than on the other aspects of intelligence. For thatreason, many children who are not good at academic intelligence, but have good potentials inother aspects of intelligence, do not develop optimally. They are often considered and labeledas "stupid children" by the existing system. This phenomenon is on the contrary to the theoryof multiple intelligences proposed by Howard Gardner, who argues that intelligence is theability to solve various problems in life and produce products or services that are useful invarious aspects of life.Human intelligence is a combination of various general and specific abilities. Thistheory is different from the concept of IQ (intelligence quotient) that involves only languageskills, mathematical, and spatial logics. According to Gardner, there are nine aspects ofintelligence and its potential indicators to be developed by each child born without a braindefect. What Gardner suggested can be considered as a starting point to a perspective thatevery child has a unique individual intelligence. Parents have to treat and educate theirchildren proportionally and equitably. This treatment will lead to a pattern of education that isfriendly to the brain and to the plurality of children’s potential.More than the above points, the notion that multiple intelligences do not just comefrom the brain needs to be followed. Humans actually have different immaterial (spiritual)aspects that do not refer to brain functions. The belief in spiritual aspects and its potentialsmeans that human beings have various capacities and they differ from physical capacities.This is what needs to be addressed from the perspective of education today. The philosophyand perspective on education of the educators, education stakeholders, and especially parents,are the first major issue to be addressed. With this step, every educational activity andcommunication within the family is expected to develop every aspect of children'sintelligence, especially the spiritual intelligence.

scholarly journals Identification of Novel Cathepsin B Inhibitors with Implications in Alzheimer’s Disease: Computational Refining and Biochemical Evaluation

Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1946
Author(s):  
Nitin Chitranshi ◽  
Ashutosh Kumar ◽  
Samran Sheriff ◽  
Veer Gupta ◽  
Angela Godinez ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Hydrogen Bond ◽  
Virtual Screening ◽  
Cathepsin B ◽  
Amyloid Β ◽  
Proteolytic Degradation ◽  
Hydrogen Bond Acceptor ◽  
Starting Point ◽  
The Brain

Amyloid precursor protein (APP), upon proteolytic degradation, forms aggregates of amyloid β (Aβ) and plaques in the brain, which are pathological hallmarks of Alzheimer’s disease (AD). Cathepsin B is a cysteine protease enzyme that catalyzes the proteolytic degradation of APP in the brain. Thus, cathepsin B inhibition is a crucial therapeutic aspect for the discovery of new anti-Alzheimer’s drugs. In this study, we have employed mixed-feature ligand-based virtual screening (LBVS) by integrating pharmacophore mapping, docking, and molecular dynamics to detect small, potent molecules that act as cathepsin B inhibitors. The LBVS model was generated by using hydrophobic (HY), hydrogen bond acceptor (HBA), and hydrogen bond donor (HBD) features, using a dataset of 24 known cathepsin B inhibitors of both natural and synthetic origins. A validated eight-feature pharmacophore hypothesis (Hypo III) was utilized to screen the Maybridge chemical database. The docking score, MM-PBSA, and MM-GBSA methodology was applied to prioritize the lead compounds as virtual screening hits. These compounds share a common amide scaffold, and showed important interactions with Gln23, Cys29, His110, His111, Glu122, His199, and Trp221. The identified inhibitors were further evaluated for cathepsin-B-inhibitory activity. Our study suggests that pyridine, acetamide, and benzohydrazide compounds could be used as a starting point for the development of novel therapeutics.

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

Selected issues related to the use of firearms for unlawful killing of animals

2018 ◽  
Vol 301 ◽  
pp. 53-59
Author(s):  
Daniel Markiewicz ◽  
◽  
Bartłomiej J. Bartyzel ◽  
Michał Borusiński ◽  
Grzegorz Bogiel ◽  
...  
Keyword(s):  
Law Enforcement ◽  
Imaging Techniques ◽  
Gunshot Wounds ◽  
Legal Regulation ◽  
Post Mortem ◽  
Large Mammals ◽  
Law Enforcement Agencies ◽  
Scientific Institutions ◽  
Starting Point ◽  
Penal Sanctions

The issue of post-mortem examination of animals, whose death occurred as a result of suffered gunshot wounds, is very rarely discussed in literature, most often on the occasion of researching into and describing other problems. This article presents an attempt to bring together the achievements of veterinary forensics in this area. As a starting point, the current legal regulation was adopted, pointing to penal sanctions resulting from the illegal use of weapons in relation to animals. Subsequently, the possibilities of using modern imaging techniques in post-mortem examinations carried out by veterinarians at the request of law enforcement agencies were presented. The scientific reports discussed herein have been supplemented by examples of sectional examinations carried out at the request of law enforcement agencies in Polish scientific institutions. The article indicates that the results of examination of gunshot wounds suffered by people in various circumstances may be used for the purpose of issuing forensic veterinary opinions, just as the results of examination of gunshot wounds of large mammals may be helpful in examining the effects of gunshot injuries in humans.

417 Transgender Hormone Therapy and Sleep-Disordered Breathing

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A165-A165
Author(s):  
Ronald Gavidia ◽  
Galit Levi Dunietz ◽  
Lisa Matlen ◽  
Shelley Hershner ◽  
Daphna Stroumsa ◽  
...  
Keyword(s):  
Linear Regression ◽  
Regression Models ◽  
Sleep Disordered Breathing ◽  
Hormone Replacement ◽  
Apnea Hypopnea Index ◽  
Linear Regression Models ◽  
Sleep Complaints ◽  
Human Respiration ◽  
Lower Oxygen ◽  
Disordered Breathing

Abstract Introduction Sex hormones may affect human respiration during wakefulness and sleep. Testosterone has been associated with increased obstructive respiratory events contributing to sleep-disordered breathing (SDB) in men, whereas a protective effect against SDB has been attributed to estrogen in women. These associations, primarily observed in cisgender populations, have been rarely examined in transgender individuals on hormone replacement therapy (HRT). The present study investigated associations between HRT and SDB in transgender adults. Methods A chart review of medical records from transgender patients was conducted in a large academic sleep medicine center. Individuals were included if they were at least 18 years old, had one or more sleep complaints, and SDB testing results available. Participants were then stratified by affirmed gender (transmasculine and transfeminine) and by HRT status. We used descriptive statistics procedures to examine differences between gender and HRT groups. Associations between HRT and the apnea-hypopnea index (AHI) were estimated with age-adjusted linear regression models. Results Of the 194 individuals identified, 89 satisfied the inclusion criteria. Nearly half of participants were transmasculine (52%). The mean age was 38±13 years, and mean body mass index was 34.7±9.0 Kg/m2. Approximately 60% of participants were on HRT at the time of SDB evaluation. Transmasculine people who were prescribed testosterone had a significantly increased AHI and lower oxygen nadir in comparison to transmasculine individuals not on testosterone (AHI 36.8±37.8/hour vs.15.3±16.6/hour, p=0.01; oxygen nadir 83.4±8.3% vs. 89.1±2.4%, p=0.001). In contrast, differences between transfeminine people with and without feminizing HRT (androgen blocker + estrogen) were not statistically significant (AHI 21.4±27.7/hour vs. 27.7±26.0/hour, p=0.45; oxygen nadir 86.5±6.7% vs. 84.1±7.7%, p=0.29). Linear regression models adjusted for age found an association between HRT and AHI for transmasculine (β=16.7, 95% CI 2.7, 30.8), but not for transfeminine participants (β=-2.5, 95% CI -17.9, 12.9). Conclusion These findings suggest differential associations between HRT and AHI among transgender individuals, with transmasculine on testosterone having a significant increase in AHI. Prospective studies with large sample sizes are warranted to evaluate these associations. Support (if any) Dr. Gavidia’s work was supported by an NIH/NINDS T32-NS007222 grant

scholarly journals The joy of sharing knowledge: But what if there is no knowledge to share? A critical reflection on human capacity building in Africa

2007 ◽  
Vol 7 ◽  
pp. 18-28
Author(s):  
Johannes J Britz
Keyword(s):  
Research And Development ◽  
Capacity Building ◽  
Capacity Development ◽  
Clear Understanding ◽  
Political Will ◽  
Current Trends ◽  
Long Run ◽  
Starting Point ◽  
Human Capacity ◽  
The Brain

This article focuses on the current trends and initiatives in human capacity building in Africa. It takes as it starting point that human capacity development is essential for Africa to become an information and know-ledge society and therefore an equal partner in the global sharing of knowledge. Four knowledge areas are identified and discussed. These are education, research and development, brain drain and information and documentation drain. The paper concludes that there is a clear understanding in Africa that its future lies with education and that most African leaders have a strong political will to invest in human capacity building on the continent. It is also clear that much has been done, particularly primary education. Africa will most defi-nitely benefit from this in the long run. Problem areas remain however. These are in the needed growth of research and development and how to address the brain and information drain phenomena.

scholarly journals Brain as agent and conscious mind as action guide: from Libet-style experiments to necessary conditions for free will

2021 ◽  
Vol 22 (1) ◽  
pp. 78-83
Author(s):  
Jonas Gonçalves Coelho
Keyword(s):  
Free Will ◽  
Necessary Conditions ◽  
Brain Activity ◽  
The Body ◽  
General View ◽  
Conscious Mind ◽  
Sociocultural Environment ◽  
Starting Point ◽  
Conscious Intention ◽  
The Brain

Many neuroscientific experiments, based on monitoring brain activity, suggest that it is possible to predict the conscious intention/choice/decision of an agent before he himself knows that. Some neuroscientists and philosophers interpret the results of these experiments as showing that free will is an illusion, since it is the brain and not the conscious mind that intends/chooses/decides. Assuming that the methods and results of these experiments are reliable the question is if they really show that free will is an illusion. To address this problem, I argue that first it is needed to answer three questions related to the relationship between conscious mind and brain: 1. Do brain events cause conscious events? 2. Do conscious events cause brain events? 3. Who is the agent, that is, who consciously intends/chooses/ decides, the conscious mind, the brain, or both? I answer these questions by arguing that the conscious mind is a property of the brain due to which the brain has the causal capacity to interact adaptively with its body, and trough the body, with the physical and sociocultural environment. In other words, the brain is the agent and the conscious mind, in its various forms - cognitive, volitional and emotional - and contents, is its guide of action. Based on this general view I argue that the experiments aforementioned do not show that free will is an illusion, and as a starting point for examining this problem I point out, from some exemplary situations, what I believe to be some of the necessary conditions for free will.Key-words: Agent brain, conscious mind, free will, Libet-style experiments.

scholarly journals Situating allostasis and interoception at the core of human brain function

2021 ◽  
Author(s):  
Yuta Katsumi ◽  
Karen Quigley ◽  
Lisa Feldman Barrett
Keyword(s):  
Brain Function ◽  
Brain Evolution ◽  
Human Mind ◽  
Biological Mechanisms ◽  
The Core ◽  
Starting Point ◽  
Basic Functions ◽  
Mental Events ◽  
Physical Phenomena ◽  
The Brain

It is now well known that brain evolution, development, and structure do not respect Western folk categories of mind – that is, the boundaries of those folk categories have never been identified in nature, despite decades of search. Categories for cognitions, emotions, perceptions, and so on, may be useful for describing the mental phenomena that constitute a human mind, but they make a poor starting point for understanding the interplay of mechanisms that create those mental events in the first place. In this paper, we integrate evolutionary, developmental, anatomical, and functional evidence and propose that predictive regulation of the body’s internal systems (allostasis) and modeling the sensory consequences of this regulation (interoception) may be basic functions of the brain that are embedded in coordinated structural and functional gradients. Our approach offers the basis for a coherent, neurobiologically-inspired research program that attempts to explain how a variety of psychological and physical phenomena may emerge from the same biological mechanisms, thus providing an opportunity to unify them under a common explanatory framework that can be used to develop shared vocabulary for theory building and knowledge accumulation.

Gunshot wounds of the brain in civilians

1988 ◽  
Vol 94 (3-4) ◽  
pp. 133-136 ◽  
Author(s):  
R. Cavaliere ◽  
L. Cavenago ◽  
D. Siccardi ◽  
G. L. Viale
Keyword(s):  
Gunshot Wounds ◽  
The Brain
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