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1.
Annu Rev Immunol ; 40: 271-294, 2022 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-35080919

RESUMO

Vertebrate immune systems suppress viral infection using both innate restriction factors and adaptive immunity. Viruses mutate to escape these defenses, driving hosts to counterevolve to regain fitness. This cycle recurs repeatedly, resulting in an evolutionary arms race whose outcome depends on the pace and likelihood of adaptation by host and viral genes. Although viruses evolve faster than their vertebrate hosts, their proteins are subject to numerous functional constraints that impact the probability of adaptation. These constraints are globally defined by evolutionary landscapes, which describe the fitness and adaptive potential of all possible mutations. We review deep mutational scanning experiments mapping the evolutionary landscapes of both host and viral proteins engaged in arms races. For restriction factors and some broadly neutralizing antibodies, landscapes favor the host, which may help to level the evolutionary playing field against rapidly evolving viruses. We discuss the biophysical underpinnings of these landscapes and their therapeutic implications.


Assuntos
Viroses , Vírus , Animais , Evolução Biológica , Humanos , Mutação , Proteínas Virais , Viroses/genética , Vírus/genética
2.
Cell ; 186(15): 3196-3207.e17, 2023 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-37369204

RESUMO

Pathogens produce diverse effector proteins to manipulate host cellular processes. However, how functional diversity is generated in an effector repertoire is poorly understood. Many effectors in the devastating plant pathogen Phytophthora contain tandem repeats of the "(L)WY" motif, which are structurally conserved but variable in sequences. Here, we discovered a functional module formed by a specific (L)WY-LWY combination in multiple Phytophthora effectors, which efficiently recruits the serine/threonine protein phosphatase 2A (PP2A) core enzyme in plant hosts. Crystal structure of an effector-PP2A complex shows that the (L)WY-LWY module enables hijacking of the host PP2A core enzyme to form functional holoenzymes. While sharing the PP2A-interacting module at the amino terminus, these effectors possess divergent C-terminal LWY units and regulate distinct sets of phosphoproteins in the host. Our results highlight the appropriation of an essential host phosphatase through molecular mimicry by pathogens and diversification promoted by protein modularity in an effector repertoire.


Assuntos
Monoéster Fosfórico Hidrolases , Phytophthora , Monoéster Fosfórico Hidrolases/metabolismo , Proteínas/metabolismo , Phytophthora/química , Phytophthora/metabolismo , Plantas/metabolismo , Processamento de Proteína Pós-Traducional , Proteína Fosfatase 2/metabolismo , Doenças das Plantas
3.
Cell ; 185(21): 3980-3991.e18, 2022 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-36182704

RESUMO

Simian arteriviruses are endemic in some African primates and can cause fatal hemorrhagic fevers when they cross into primate hosts of new species. We find that CD163 acts as an intracellular receptor for simian hemorrhagic fever virus (SHFV; a simian arterivirus), a rare mode of virus entry that is shared with other hemorrhagic fever-causing viruses (e.g., Ebola and Lassa viruses). Further, SHFV enters and replicates in human monocytes, indicating full functionality of all of the human cellular proteins required for viral replication. Thus, simian arteriviruses in nature may not require major adaptations to the human host. Given that at least three distinct simian arteriviruses have caused fatal infections in captive macaques after host-switching, and that humans are immunologically naive to this family of viruses, development of serology tests for human surveillance should be a priority.


Assuntos
Arterivirus , Febres Hemorrágicas Virais , Animais , Arterivirus/fisiologia , Febres Hemorrágicas Virais/veterinária , Febres Hemorrágicas Virais/virologia , Humanos , Macaca , Primatas , Zoonoses Virais , Internalização do Vírus , Replicação Viral
4.
Cell ; 184(19): 4904-4918.e11, 2021 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-34433012

RESUMO

Selfish centromere DNA sequences bias their transmission to the egg in female meiosis. Evolutionary theory suggests that centromere proteins evolve to suppress costs of this "centromere drive." In hybrid mouse models with genetically different maternal and paternal centromeres, selfish centromere DNA exploits a kinetochore pathway to recruit microtubule-destabilizing proteins that act as drive effectors. We show that such functional differences are suppressed by a parallel pathway for effector recruitment by heterochromatin, which is similar between centromeres in this system. Disrupting the kinetochore pathway with a divergent allele of CENP-C reduces functional differences between centromeres, whereas disrupting heterochromatin by CENP-B deletion amplifies the differences. Molecular evolution analyses using Murinae genomes identify adaptive evolution in proteins in both pathways. We propose that centromere proteins have recurrently evolved to minimize the kinetochore pathway, which is exploited by selfish DNA, relative to the heterochromatin pathway that equalizes centromeres, while maintaining essential functions.


Assuntos
Proteína B de Centrômero/metabolismo , Centrômero/metabolismo , Proteínas Cromossômicas não Histona/metabolismo , Alelos , Sequência de Aminoácidos , Animais , Evolução Biológica , Sistemas CRISPR-Cas/genética , Proteína Centromérica A/metabolismo , Proteínas Cromossômicas não Histona/química , Cromossomos de Mamíferos/metabolismo , Feminino , Heterocromatina/metabolismo , Cinetocoros/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Modelos Biológicos , Oócitos/metabolismo , Domínios Proteicos
5.
Cell ; 174(6): 1537-1548.e29, 2018 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-30122351

RESUMO

LINE-1 retrotransposition is tightly restricted by layers of regulatory control, with epigenetic pathways being the best characterized. Looking at post-transcriptional regulation, we now show that LINE-1 mRNA 3' ends are pervasively uridylated in various human cellular models and in mouse testes. TUT4 and TUT7 uridyltransferases catalyze the modification and function in cooperation with the helicase/RNPase MOV10 to counteract the RNA chaperone activity of the L1-ORF1p retrotransposon protein. Uridylation potently restricts LINE-1 retrotransposition by a multilayer mechanism depending on differential subcellular localization of the uridyltransferases. We propose that uridine residues added by TUT7 in the cytoplasm inhibit initiation of reverse transcription of LINE-1 mRNAs once they are reimported to the nucleus, whereas uridylation by TUT4, which is enriched in cytoplasmic foci, destabilizes mRNAs. These results provide a model for the post-transcriptional restriction of LINE-1, revealing a key physiological role for TUT4/7-mediated uridylation in maintaining genome stability.


Assuntos
Proteínas de Ligação a DNA/metabolismo , Proteínas Nucleares/metabolismo , RNA Nucleotidiltransferases/metabolismo , Proteínas de Ligação a RNA/metabolismo , Uridina/metabolismo , Animais , Proteínas de Ligação a DNA/antagonistas & inibidores , Proteínas de Ligação a DNA/genética , Células HEK293 , Humanos , Camundongos , Proteínas Nucleares/genética , Ligação Proteica , RNA Helicases/antagonistas & inibidores , RNA Helicases/genética , RNA Helicases/metabolismo , Interferência de RNA , RNA Nucleotidiltransferases/antagonistas & inibidores , RNA Nucleotidiltransferases/genética , Estabilidade de RNA , RNA Mensageiro/metabolismo , RNA Interferente Pequeno/metabolismo , Proteínas de Ligação a RNA/genética , Retroelementos/genética
6.
CA Cancer J Clin ; 74(2): 136-166, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37962495

RESUMO

In 2021, the American Cancer Society published its first biennial report on the status of cancer disparities in the United States. In this second report, the authors provide updated data on racial, ethnic, socioeconomic (educational attainment as a marker), and geographic (metropolitan status) disparities in cancer occurrence and outcomes and contributing factors to these disparities in the country. The authors also review programs that have reduced cancer disparities and provide policy recommendations to further mitigate these inequalities. There are substantial variations in risk factors, stage at diagnosis, receipt of care, survival, and mortality for many cancers by race/ethnicity, educational attainment, and metropolitan status. During 2016 through 2020, Black and American Indian/Alaska Native people continued to bear a disproportionately higher burden of cancer deaths, both overall and from major cancers. By educational attainment, overall cancer mortality rates were about 1.6-2.8 times higher in individuals with ≤12 years of education than in those with ≥16 years of education among Black and White men and women. These disparities by educational attainment within each race were considerably larger than the Black-White disparities in overall cancer mortality within each educational attainment, ranging from 1.03 to 1.5 times higher among Black people, suggesting a major role for socioeconomic status disparities in racial disparities in cancer mortality given the disproportionally larger representation of Black people in lower socioeconomic status groups. Of note, the largest Black-White disparities in overall cancer mortality were among those who had ≥16 years of education. By area of residence, mortality from all cancer and from leading causes of cancer death were substantially higher in nonmetropolitan areas than in large metropolitan areas. For colorectal cancer, for example, mortality rates in nonmetropolitan areas versus large metropolitan areas were 23% higher among males and 21% higher among females. By age group, the racial and geographic disparities in cancer mortality were greater among individuals younger than 65 years than among those aged 65 years and older. Many of the observed racial, socioeconomic, and geographic disparities in cancer mortality align with disparities in exposure to risk factors and access to cancer prevention, early detection, and treatment, which are largely rooted in fundamental inequities in social determinants of health. Equitable policies at all levels of government, broad interdisciplinary engagement to address these inequities, and equitable implementation of evidence-based interventions, such as increasing health insurance coverage, are needed to reduce cancer disparities.


Assuntos
Etnicidade , Neoplasias , Masculino , Humanos , Feminino , Estados Unidos/epidemiologia , American Cancer Society , Neoplasias/epidemiologia , Neoplasias/terapia , Atenção à Saúde , População Negra , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde
7.
CA Cancer J Clin ; 72(2): 112-143, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34878180

RESUMO

In this report, the authors provide comprehensive and up-to-date US data on disparities in cancer occurrence, major risk factors, and access to and utilization of preventive measures and screening by sociodemographic characteristics. They also review programs and resources that have reduced cancer disparities and provide policy recommendations to further mitigate these inequalities. The overall cancer death rate is 19% higher among Black males than among White males. Black females also have a 12% higher overall cancer death rate than their White counterparts despite having an 8% lower incidence rate. There are also substantial variations in death rates for specific cancer types and in stage at diagnosis, survival, exposure to risk factors, and receipt of preventive measures and screening by race/ethnicity, socioeconomic status, and geographic location. For example, kidney cancer death rates by sex among American Indian/Alaska Native people are ≥64% higher than the corresponding rates in each of the other racial/ethnic groups, and the 5-year relative survival for all cancers combined is 14% lower among residents of poorer counties than among residents of more affluent counties. Broad and equitable implementation of evidence-based interventions, such as increasing health insurance coverage through Medicaid expansion or other initiatives, could substantially reduce cancer disparities. However, progress will require not only equitable local, state, and federal policies but also broad interdisciplinary engagement to elevate and address fundamental social inequities and longstanding systemic racism.


Assuntos
Etnicidade , Neoplasias , American Cancer Society , Feminino , Humanos , Masculino , Medicaid , Neoplasias/epidemiologia , Neoplasias/terapia , Grupos Raciais , Estados Unidos/epidemiologia
8.
Mol Cell ; 77(1): 39-50.e10, 2020 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-31735642

RESUMO

CRISPR-Cas systems encode RNA-guided surveillance complexes to find and cleave invading DNA elements. While it is thought that invaders are neutralized minutes after cell entry, the mechanism and kinetics of target search and its impact on CRISPR protection levels have remained unknown. Here, we visualize individual Cascade complexes in a native type I CRISPR-Cas system. We uncover an exponential relation between Cascade copy number and CRISPR interference levels, pointing to a time-driven arms race between invader replication and target search, in which 20 Cascade complexes provide 50% protection. Driven by PAM-interacting subunit Cas8e, Cascade spends half its search time rapidly probing DNA (∼30 ms) in the nucleoid. We further demonstrate that target DNA transcription and CRISPR arrays affect the integrity of Cascade and affect CRISPR interference. Our work establishes the mechanism of cellular DNA surveillance by Cascade that allows the timely detection of invading DNA in a crowded, DNA-packed environment.


Assuntos
Bactérias/genética , Proteínas Associadas a CRISPR/genética , Sistemas CRISPR-Cas/genética , DNA/genética , RNA Guia de Cinetoplastídeos/genética , Repetições Palindrômicas Curtas Agrupadas e Regularmente Espaçadas , Replicação do DNA/genética , Dosagem de Genes/genética
9.
Am J Hum Genet ; 111(3): 456-472, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38367619

RESUMO

The impact of tobacco exposure on health varies by race and ethnicity and is closely tied to internal nicotine dose, a marker of carcinogen uptake. DNA methylation is strongly responsive to smoking status and may mediate health effects, but study of associations with internal dose is limited. We performed a blood leukocyte epigenome-wide association study (EWAS) of urinary total nicotine equivalents (TNEs; a measure of nicotine uptake) and DNA methylation measured using the MethylationEPIC v1.0 BeadChip (EPIC) in six racial and ethnic groups across three cohort studies. In the Multiethnic Cohort Study (discovery, n = 1994), TNEs were associated with differential methylation at 408 CpG sites across >250 genomic regions (p < 9 × 10-8). The top significant sites were annotated to AHRR, F2RL3, RARA, GPR15, PRSS23, and 2q37.1, all of which had decreasing methylation with increasing TNEs. We identified 45 novel CpG sites, of which 42 were unique to the EPIC array and eight annotated to genes not previously linked with smoking-related DNA methylation. The most significant signal in a novel gene was cg03748458 in MIR383;SGCZ. Fifty-one of the 408 discovery sites were validated in the Singapore Chinese Health Study (n = 340) and the Southern Community Cohort Study (n = 394) (Bonferroni corrected p < 1.23 × 10-4). Significant heterogeneity by race and ethnicity was detected for CpG sites in MYO1G and CYTH1. Furthermore, TNEs significantly mediated the association between cigarettes per day and DNA methylation at 15 sites (average 22.5%-44.3% proportion mediated). Our multiethnic study highlights the transethnic and ethnic-specific methylation associations with internal nicotine dose, a strong predictor of smoking-related morbidities.


Assuntos
MicroRNAs , Fumantes , Humanos , Nicotina , Epigênese Genética/genética , Epigenoma , Estudos de Coortes , Estudos Prospectivos , Estudo de Associação Genômica Ampla , Metilação de DNA/genética , Ilhas de CpG/genética , Receptores de Peptídeos/genética , Receptores Acoplados a Proteínas G/genética
10.
Annu Rev Genet ; 53: 393-416, 2019 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-31518518

RESUMO

Nearly half of the human genome consists of endogenous retroelements (EREs) and their genetic remnants, a small fraction of which carry the potential to propagate in the host genome, posing a threat to genome integrity and cell/organismal survival. The largest family of transcription factors in tetrapods, the Krüppel-associated box domain zinc finger proteins (KRAB-ZFPs), binds to specific EREs and represses their transcription. Since their first appearance over 400 million years ago, KRAB-ZFPs have undergone dramatic expansion and diversification in mammals, correlating with the invasions of new EREs. In this article we review our current understanding of the structure, function, and evolution of KRAB-ZFPs and discuss growing evidence that the arms race between KRAB-ZFPs and the EREs they target is a major driving force for the evolution of new traits in mammals, often accompanied by domestication of EREs themselves.


Assuntos
Imunidade Celular/fisiologia , Mamíferos/genética , Retroelementos , Dedos de Zinco/fisiologia , Animais , Regulação da Expressão Gênica , Impressão Genômica , Interações Hospedeiro-Patógeno/genética , Interações Hospedeiro-Patógeno/imunologia , Meiose , Família Multigênica , Domínios Proteicos
11.
Proc Natl Acad Sci U S A ; 121(16): e2313878121, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38588425

RESUMO

Many mainstream organizations celebrate their historical successes. In their history, however, they often marginalized racial minorities, women, and other underrepresented groups. We suggest that when organizations celebrate their histories, even without mentioning historical marginalization, they can undermine belonging and intentions to join the organization among historically marginalized groups. Four experiments demonstrate that Black participants who were exposed to an organization that celebrated their history versus the present showed reduced belonging and intentions to participate in the organization. These effects were mediated by expectations of biased treatment in the organization. Further, when organizations had a history of Black people in power, celebrating history was no longer threatening, highlighting that the negative effects of celebrating history are most likely when organizations are or are assumed to be majority-White and have treated Black Americans poorly. Taken together, these findings suggest that emphasizing organizational history can be a source of social identity threat among Black Americans.


Assuntos
Negro ou Afro-Americano , Identificação Social , Humanos , População Negra , Brancos
12.
Proc Natl Acad Sci U S A ; 121(9): e2307505121, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38377190

RESUMO

This study investigates Black and White consumers' preferences for Black versus White people in United States advertising contexts over 66 y, from 1956 until 2022, a time in which the United States has experienced significant ethno-racial diversification. Examining Black and White consumers' reactions to visual advertising over more than half a century offers a unique and dynamic view of interracial preferences. Mass advertising reaches an audience of billions and can shape people's attitudes and behavior, emphasizing the relevance of clarifying the influence of race in advertising, how it has evolved over time, and how it may contribute to mitigating discrimination based on racial perceptions. A meta-analysis of extant experiments into the relationship between the depicted endorser's race (i.e., the model in a visual ad) and the reaction of Black and White viewers pertains to 332 effect sizes from 62 studies reported in 52 scientific papers, comprising 10,186 Black and White participants. Our results are anchored in a conceptual framework, including a comprehensive set of perceiver (viewer), target (endorser), social/societal context, and publication characteristics. Without accounting for temporal dynamics, the results indicate ingroup favoritism, such that White viewers prefer White models and Black viewers prefer Black models. But by controlling for the publication year, it is possible to observe a time-dependent trend: Historically, White consumers preferred endorsers of the same race, but this preference has significantly shifted toward Black endorsers in recent years. In contrast, the level of Black consumers' reactions to endorsers of the same race remains largely unchanged over time.


Assuntos
Publicidade , Comportamento do Consumidor , Brancos , Humanos , Atitude , Estados Unidos , Negro ou Afro-Americano
13.
Trends Genet ; 39(4): 320-333, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36681580

RESUMO

Studies using highly sensitive targeted RNA enrichment methods have shown that a large portion of the human transcriptome remains to be discovered and that most of the genome is transcribed in a complex, interleaved fashion characterized by a complex web of transcripts emanating from protein coding and noncoding loci. These results resonate with those from single-cell transcriptome profiling endeavors that reveal the existence of multiple novel, cell type-specific transcripts and clearly demonstrate that our understanding of the complexities of the human transcriptome is far from being complete. Here, we review the current status of the targeted RNA enrichment techniques, their application to the discovery of novel cell type-specific transcripts, and their impact on our understanding of the human genome and transcriptome.


Assuntos
RNA Longo não Codificante , Transcriptoma , Animais , Humanos , Transcriptoma/genética , RNA/genética , Análise de Sequência de RNA/métodos , Perfilação da Expressão Gênica/métodos , Genoma Humano , RNA Longo não Codificante/genética , Mamíferos/genética
14.
Proc Natl Acad Sci U S A ; 120(7): e2217114120, 2023 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-36753463

RESUMO

Nicotinamide adenine dinucleotide (NAD+) has emerged as a key component in prokaryotic and eukaryotic immune systems. The recent discovery that Toll/interleukin-1 receptor (TIR) proteins function as NAD+ hydrolases (NADase) links NAD+-derived small molecules with immune signaling. We investigated pathogen manipulation of host NAD+ metabolism as a virulence strategy. Using the pangenome of the model bacterial pathogen Pseudomonas syringae, we conducted a structure-based similarity search from 35,000 orthogroups for type III effectors (T3Es) with potential NADase activity. Thirteen T3Es, including five newly identified candidates, were identified that possess domain(s) characteristic of seven NAD+-hydrolyzing enzyme families. Most Pseudomonas syringae strains that depend on the type III secretion system to cause disease, encode at least one NAD+-manipulating T3E, and many have several. We experimentally confirmed the type III-dependent secretion of a novel T3E, named HopBY, which shows structural similarity to both TIR and adenosine diphosphate ribose (ADPR) cyclase. Homologs of HopBY were predicted to be type VI effectors in diverse bacterial species, indicating potential recruitment of this activity by microbial proteins secreted during various interspecies interactions. HopBY efficiently hydrolyzes NAD+ and specifically produces 2'cADPR, which can also be produced by TIR immune receptors of plants and by other bacteria. Intriguingly, this effector promoted bacterial virulence, indicating that 2'cADPR may not be the signaling molecule that directly initiates immunity. This study highlights a host-pathogen battleground centered around NAD+ metabolism and provides insight into the NAD+-derived molecules involved in plant immunity.


Assuntos
ADP-Ribose Cíclica , NAD , Virulência , NAD/metabolismo , ADP-Ribose Cíclica/metabolismo , Bactérias/metabolismo , Plantas/metabolismo , Pseudomonas syringae/metabolismo , NAD+ Nucleosidase/genética , NAD+ Nucleosidase/metabolismo , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Doenças das Plantas/microbiologia
15.
Proc Natl Acad Sci U S A ; 120(35): e2303370120, 2023 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-37607231

RESUMO

The use of race measures in clinical prediction models is contentious. We seek to inform the discourse by evaluating the inclusion of race in probabilistic predictions of illness that support clinical decision making. Adopting a static utilitarian framework to formalize social welfare, we show that patients of all races benefit when clinical decisions are jointly guided by patient race and other observable covariates. Similar conclusions emerge when the model is extended to a two-period setting where prevention activities target systemic drivers of disease. We also discuss non-utilitarian concepts that have been proposed to guide allocation of health care resources.


Assuntos
Tomada de Decisão Clínica , Pacientes , Humanos , Tomada de Decisões
16.
Proc Natl Acad Sci U S A ; 120(13): e2215324120, 2023 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-36940343

RESUMO

Disparities continue to pose major challenges in various aspects of science. One such aspect is editorial board composition, which has been shown to exhibit racial and geographical disparities. However, the literature on this subject lacks longitudinal studies quantifying the degree to which the racial composition of editors reflects that of scientists. Other aspects that may exhibit racial disparities include the time spent between the submission and acceptance of a manuscript and the number of citations a paper receives relative to textually similar papers, but these have not been studied to date. To fill this gap, we compile a dataset of 1,000,000 papers published between 2001 and 2020 by six publishers, while identifying the handling editor of each paper. Using this dataset, we show that most countries in Asia, Africa, and South America (where the majority of the population is ethnically non-White) have fewer editors than would be expected based on their share of authorship. Focusing on US-based scientists reveals Black as the most underrepresented race. In terms of acceptance delay, we find, again, that papers from Asia, Africa, and South America spend more time compared to other papers published in the same journal and the same year. Regression analysis of US-based papers reveals that Black authors suffer from the greatest delay. Finally, by analyzing citation rates of US-based papers, we find that Black and Hispanic scientists receive significantly fewer citations compared to White ones doing similar research. Taken together, these findings highlight significant challenges facing non-White scientists.


Assuntos
Autoria , Publicações , Humanos , Ásia , População Negra , Hispânico ou Latino
17.
Proc Natl Acad Sci U S A ; 120(6): e2212875120, 2023 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-36719918

RESUMO

We examine trends in racial and ethnic discrimination in hiring in six European and North American countries: Canada, France, Germany, Great Britain, the Netherlands, and the United States. Our sample includes all available discrimination estimates from 90 field experimental studies of hiring discrimination, encompassing more than 170,000 applications for jobs. The years covered vary by country, ranging from 1969 to 2017 for Great Britain to 1994 to 2017 for Germany. We examine trends in discrimination against four racial-ethnic origin groups: African/Black, Asian, Latin American/Hispanic, and Middle Eastern or North African. The results indicate that levels of discrimination in callbacks have remained either unchanged or slightly increased overall for most countries and origin categories. There are three notable exceptions. First, hiring discrimination against ethnic groups with origins in the Middle East and North Africa increased during the 2000s relative to the 1990s. Second, we find that discrimination in France declined, although from very high to "merely" high levels. Third, we find evidence that discrimination in the Netherlands has increased over time. Controls for study characteristics do not change these trends. Contrary to the idea that discrimination will tend to decline in Western countries, we find that discrimination has not fallen over the last few decades in five of the six Western countries we examine.


Assuntos
Emprego , Grupos Raciais , Racismo , Humanos , Etnicidade , Hispânico ou Latino , Estados Unidos , População Branca , Canadá , França , Alemanha , Países Baixos , Reino Unido , População Negra , População do Oriente Médio
18.
Proc Natl Acad Sci U S A ; 120(23): e2216162120, 2023 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-37253013

RESUMO

Across the United States, police chiefs, city officials, and community leaders alike have highlighted the need to de-escalate police encounters with the public. This concern about escalation extends from encounters involving use of force to routine car stops, where Black drivers are disproportionately pulled over. Yet, despite the calls for action, we know little about the trajectory of police stops or how escalation unfolds. In study 1, we use methods from computational linguistics to analyze police body-worn camera footage from 577 stops of Black drivers. We find that stops with escalated outcomes (those ending in arrest, handcuffing, or a search) diverge from stops without these outcomes in their earliest moments-even in the first 45 words spoken by the officer. In stops that result in escalation, officers are more likely to issue commands as their opening words to the driver and less likely to tell drivers the reason why they are being stopped. In study 2, we expose Black males to audio clips of the same stops and find differences in how escalated stops are perceived: Participants report more negative emotion, appraise officers more negatively, worry about force being used, and predict worse outcomes after hearing only the officer's initial words in escalated versus non-escalated stops. Our findings show that car stops that end in escalated outcomes sometimes begin in an escalated fashion, with adverse effects for Black male drivers and, in turn, police-community relations.


Assuntos
Negro ou Afro-Americano , Aplicação da Lei , Polícia , Humanos , Masculino , Aplicação da Lei/métodos , Estados Unidos , Racismo , Emoções
19.
Circulation ; 149(19): e1143-e1163, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38567497

RESUMO

Guideline-directed medical therapies and guideline-directed nonpharmacological therapies improve quality of life and survival in patients with heart failure (HF), but eligible patients, particularly women and individuals from underrepresented racial and ethnic groups, are often not treated with these therapies. Implementation science uses evidence-based theories and frameworks to identify strategies that facilitate uptake of evidence to improve health. In this scientific statement, we provide an overview of implementation trials in HF, assess their use of conceptual frameworks and health equity principles, and provide pragmatic guidance for equity in HF. Overall, behavioral nudges, multidisciplinary care, and digital health strategies increased uptake of therapies in HF effectively but did not include equity goals. Few HF studies focused on achieving equity in HF by engaging stakeholders, quantifying barriers and facilitators to HF therapies, developing strategies for equity informed by theory or frameworks, evaluating implementation measures for equity, and titrating strategies for equity. Among these HF equity studies, feasibility was established in using various educational strategies to promote organizational change and equitable care. A couple include ongoing randomized controlled pragmatic trials for HF equity. There is great need for additional HF implementation trials designed to promote delivery of equitable guideline-directed therapy.


Assuntos
American Heart Association , Equidade em Saúde , Insuficiência Cardíaca , Ciência da Implementação , Insuficiência Cardíaca/terapia , Insuficiência Cardíaca/diagnóstico , Humanos , Estados Unidos , Disparidades em Assistência à Saúde
20.
Annu Rev Med ; 74: 385-400, 2023 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-36706748

RESUMO

In 2020, the nephrology community formally interrogated long-standing race-based clinical algorithms used in the field, including the kidney function estimation equations. A comprehensive understanding of the history of kidney function estimation and racial essentialism is necessary to understand underpinnings of the incorporation of a Black race coefficient into prior equations. We provide a review of this history, as well as the considerations used to develop race-free equations that are a guidepost for a more equity-oriented, scientifically rigorous future for kidney function estimation and other clinical algorithms and processes in which race may be embedded as a variable.


Assuntos
Rim , Grupos Raciais , Humanos , Rim/fisiologia , População Negra
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