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1.
Nature ; 594(7864): 572-576, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34108687

RESUMO

Genetic recombination arises during meiosis through the repair of DNA double-strand breaks (DSBs) that are created by Spo11, a topoisomerase-like protein1,2. Spo11 DSBs form preferentially in nucleosome-depleted regions termed hotspots3,4, yet how Spo11 engages with its DNA substrate to catalyse DNA cleavage is poorly understood. Although most recombination events are initiated by a single Spo11 cut, here we show in Saccharomyces cerevisiae that hyperlocalized, concerted Spo11 DSBs separated by 33 to more than 100 base pairs also form, which we term 'double cuts'. Notably, the lengths of double cuts vary with a periodicity of 10.5 base pairs, which is conserved in yeast and mice. This finding suggests a model in which the orientation of adjacent Spo11 molecules is fixed relative to the DNA helix-a proposal supported by the in vitro DNA-binding properties of the Spo11 core complex. Deep sequencing of meiotic progeny identifies recombination scars that are consistent with repair initiated from gaps generated by adjacent Spo11 DSBs. Collectively, these results revise our present understanding of the mechanics of Spo11-DSB formation and expand on the original concepts of gap repair during meiosis to include DNA gaps that are generated by Spo11 itself.


Assuntos
Quebras de DNA de Cadeia Dupla , Endodesoxirribonucleases/genética , Meiose , Proteínas de Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/genética , Animais , Reparo do DNA , Camundongos , Camundongos Knockout
2.
PLoS Genet ; 20(3): e1011140, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38427688

RESUMO

During meiosis, genetic recombination is initiated by the formation of many DNA double-strand breaks (DSBs) catalysed by the evolutionarily conserved topoisomerase-like enzyme, Spo11, in preferred genomic sites known as hotspots. DSB formation activates the Tel1/ATM DNA damage responsive (DDR) kinase, locally inhibiting Spo11 activity in adjacent hotspots via a process known as DSB interference. Intriguingly, in S. cerevisiae, over short genomic distances (<15 kb), Spo11 activity displays characteristics of concerted activity or clustering, wherein the frequency of DSB formation in adjacent hotspots is greater than expected by chance. We have proposed that clustering is caused by a limited number of sub-chromosomal domains becoming primed for DSB formation. Here, we provide evidence that DSB clustering is abolished when meiotic prophase timing is extended via deletion of the NDT80 transcription factor. We propose that extension of meiotic prophase enables most cells, and therefore most chromosomal domains within them, to reach an equilibrium state of similar Spo11-DSB potential, reducing the impact that priming has on estimates of coincident DSB formation. Consistent with this view, when Tel1 is absent but Ndt80 is present and thus cells are able to rapidly exit meiotic prophase, genome-wide maps of Spo11-DSB formation are skewed towards pericentromeric regions and regions that load pro-DSB factors early-revealing regions of preferential priming-but this effect is abolished when NDT80 is deleted. Our work highlights how the stochastic nature of Spo11-DSB formation in individual cells within the limited temporal window of meiotic prophase can cause localised DSB clustering-a phenomenon that is exacerbated in tel1Δ cells due to the dual roles that Tel1 has in DSB interference and meiotic prophase checkpoint control.


Assuntos
Quebras de DNA de Cadeia Dupla , Proteínas de Saccharomyces cerevisiae , DNA , Proteínas de Ligação a DNA/genética , Endodesoxirribonucleases/genética , Peptídeos e Proteínas de Sinalização Intracelular/genética , Meiose/genética , Prófase/genética , Proteínas Serina-Treonina Quinases/genética , Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/genética
3.
Proc Natl Acad Sci U S A ; 121(12): e2312820121, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38478689

RESUMO

Meiotic recombination shows broad variations across species and along chromosomes and is often suppressed at and around genomic regions determining sexual compatibility such as mating type loci in fungi. Here, we show that the absence of Spo11-DSBs and meiotic recombination on Lakl0C-left, the chromosome arm containing the sex locus of the Lachancea kluyveri budding yeast, results from the absence of recruitment of the two chromosome axis proteins Red1 and Hop1, essential for proper Spo11-DSBs formation. Furthermore, cytological observation of spread pachytene meiotic chromosomes reveals that Lakl0C-left does not undergo synapsis. However, we show that the behavior of Lakl0C-left is independent of its particularly early replication timing and is not accompanied by any peculiar chromosome structure as detectable by Hi-C in this yet poorly studied yeast. Finally, we observed an accumulation of heterozygous mutations on Lakl0C-left and a sexual dimorphism of the haploid meiotic offspring, supporting a direct effect of this absence of meiotic recombination on L. kluyveri genome evolution and fitness. Because suppression of meiotic recombination on sex chromosomes is widely observed across eukaryotes, the mechanism for recombination suppression described here may apply to other species, with the potential to impact sex chromosome evolution.


Assuntos
Proteínas de Saccharomyces cerevisiae , Saccharomycetales , Cromossomos/metabolismo , Saccharomyces cerevisiae/metabolismo , Saccharomycetales/genética , Saccharomycetales/metabolismo , Recombinação Homóloga/genética , Meiose/genética , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/metabolismo
4.
Nucleic Acids Res ; 51(18): 9703-9715, 2023 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-37548404

RESUMO

DNA double-strand break (DSB) repair by homologous recombination (HR) uses a DNA template with similar sequence to restore genetic identity. Allelic DNA repair templates can be found on the sister chromatid or homologous chromosome. During meiotic recombination, DSBs preferentially repair from the homologous chromosome, with a proportion of HR events generating crossovers. Nevertheless, regions of similar DNA sequence exist throughout the genome, providing potential DNA repair templates. When DSB repair occurs at these non-allelic loci (termed ectopic recombination), chromosomal duplications, deletions and rearrangements can arise. Here, we characterize in detail ectopic recombination arising between a dispersed pair of inverted repeats in wild-type Saccharomyces cerevisiae at both a local and a chromosomal scale-the latter identified via gross chromosomal acentric and dicentric chromosome rearrangements. Mutation of the DNA damage checkpoint clamp loader Rad24 and the RecQ helicase Sgs1 causes an increase in ectopic recombination. Unexpectedly, additional mutation of the RecA orthologues Rad51 and Dmc1 alters-but does not abolish-the type of ectopic recombinants generated, revealing a novel class of inverted chromosomal rearrangement driven by the single-strand annealing pathway. These data provide important insights into the role of key DNA repair proteins in regulating DNA repair pathway and template choice during meiosis.


Assuntos
Reparo do DNA , Meiose , Proteínas de Saccharomyces cerevisiae , Saccharomyces cerevisiae , Humanos , Proteínas de Ciclo Celular/metabolismo , Aberrações Cromossômicas , DNA/metabolismo , Quebras de DNA de Cadeia Dupla , Recombinases/genética , Saccharomyces cerevisiae/citologia , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo
6.
Nature ; 477(7364): 317-20, 2011 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-21921915

RESUMO

Confidence is an essential ingredient of success in a wide range of domains ranging from job performance and mental health to sports, business and combat. Some authors have suggested that not just confidence but overconfidence--believing you are better than you are in reality--is advantageous because it serves to increase ambition, morale, resolve, persistence or the credibility of bluffing, generating a self-fulfilling prophecy in which exaggerated confidence actually increases the probability of success. However, overconfidence also leads to faulty assessments, unrealistic expectations and hazardous decisions, so it remains a puzzle how such a false belief could evolve or remain stable in a population of competing strategies that include accurate, unbiased beliefs. Here we present an evolutionary model showing that, counterintuitively, overconfidence maximizes individual fitness and populations tend to become overconfident, as long as benefits from contested resources are sufficiently large compared with the cost of competition. In contrast, unbiased strategies are only stable under limited conditions. The fact that overconfident populations are evolutionarily stable in a wide range of environments may help to explain why overconfidence remains prevalent today, even if it contributes to hubris, market bubbles, financial collapses, policy failures, disasters and costly wars.


Assuntos
Assertividade , Evolução Biológica , Ilusões , Personalidade , Animais , Caráter , Comportamento Competitivo , Conflito Psicológico , Tomada de Decisões , Teoria dos Jogos , Aptidão Genética , Humanos , Risco , Seleção Genética , Autoavaliação (Psicologia)
7.
Am Heart J ; 169(1): 102-7, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25497254

RESUMO

BACKGROUND: Cardiac rehabilitation (CR) improves coronary artery disease risk factors and mortality. Outcomes after CR in African Americans (AAs) compared with whites have not been studied extensively. METHODS: A total of 1,096 patients (169 AAs, 927 whites) were enrolled in a 36-session CR program for ischemic heart disease or postcardiac surgery. The program consisted of exercise, lifestyle modification, and pharmacotherapy. RESULTS: After CR, quality of life, blood pressure, and low-density lipoprotein cholesterol improved significantly in both AAs and whites, although to a lesser degree in AAs. Whites also had significant improvements in weight and triglyceride concentrations. Overall, mean peak exercise capacity, measured in metabolic equivalents (METs), improved by only 1.6 (95% CI 1.3-1.8) in AAs compared with 2.4 (2.3-2.6) in CCs (P< .001 for AAs vs CCs). African American women had the least improvement in METs, but changes were still significant (1.1 [CI 0.9-1.4]). The subgroup with the least improvement in METs was AA diabetic patients (1.4 (CI 1.1-1.7]). CONCLUSION: African Americans derive a significant benefit from CR, but not to the same degree as whites, based on changes in risk factors and in exercise capacity. Within both ethnic groups, both women and diabetic patients appeared to have markedly less improvement.


Assuntos
Negro ou Afro-Americano , Doença da Artéria Coronariana/reabilitação , Angiopatias Diabéticas/reabilitação , Avaliação de Resultados em Cuidados de Saúde , Idoso , LDL-Colesterol/sangue , Doença da Artéria Coronariana/prevenção & controle , Angiopatias Diabéticas/prevenção & controle , Tolerância ao Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , População Branca
8.
Pan Afr Med J ; 47: 186, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39092019

RESUMO

Introduction: the prevalence of human immunodeficiency virus (HIV) among people who inject drugs (PWIDs) in Tanzania is estimated at 35%, significantly surpassing the 4.6% HIV prevalence of the general population. People who inject drugs living with HIV have been reported to exhibit lower adherence to antiretroviral therapy (ART), leading to increased rates of mortality, morbidity, and HIV transmission. This study assessed adherence to ART and associated factors among PWIDs in Dar es Salaam. Methods: this cross-sectional study involved 277 PWIDs living with HIV who attended MAT clinics in Dar es Salaam from May to July 2022. Antiretroviral therapy adherence was assessed using a validated one-month self-recall medication adherence scale, and associated factors were obtained through a structured questionnaire. Statistical analyses included chi-square tests, Fisher exact tests, and log-binomial regression. Data were analyzed using STATA version 15, with a p-value of <0.05 considered statistically significant. Results: this study found that 83% of the study participants had a high level of adherence to ART. Additionally, the results revealed that PWIDS who consume alcohol were less likely to have high adherence to ART (aPR 0.820). On the other hand, higher odds of ART adherence were observed among participants who had family support (aPR 1.028) and those who had adequate knowledge of ART benefits (aPR 1.285). Conclusion: the government and development partners should implement novel interventions such as alcohol reduction programs, ART education, and expanded HIV community outreach services. These interventions have the potential to improve ART adherence and reduce HIV transmission among PWIDs.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Adesão à Medicação , Abuso de Substâncias por Via Intravenosa , Humanos , Estudos Transversais , Tanzânia/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Masculino , Adulto , Feminino , Adesão à Medicação/estatística & dados numéricos , Fármacos Anti-HIV/administração & dosagem , Inquéritos e Questionários , Pessoa de Meia-Idade , Adulto Jovem , Abuso de Substâncias por Via Intravenosa/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Adolescente
9.
Proc Natl Acad Sci U S A ; 106(7): 2118-23, 2009 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-19168625

RESUMO

Monoamine oxidase A gene (MAOA) has earned the nickname "warrior gene" because it has been linked to aggression in observational and survey-based studies. However, no controlled experimental studies have tested whether the warrior gene actually drives behavioral manifestations of these tendencies. We report an experiment, synthesizing work in psychology and behavioral economics, which demonstrates that aggression occurs with greater intensity and frequency as provocation is experimentally manipulated upwards, especially among low activity MAOA (MAOA-L) subjects. In this study, subjects paid to punish those they believed had taken money from them by administering varying amounts of unpleasantly hot (spicy) sauce to their opponent. There is some evidence of a main effect for genotype and some evidence for a gene by environment interaction, such that MAOA is less associated with the occurrence of aggression in a low provocation condition, but significantly predicts such behavior in a high provocation situation. This new evidence for genetic influences on aggression and punishment behavior complicates characterizations of humans as "altruistic" punishers and supports theories of cooperation that propose mixed strategies in the population. It also suggests important implications for the role of individual variance in genetic factors contributing to everyday behaviors and decisions.


Assuntos
Agressão , Monoaminoxidase/genética , Comportamento , Comportamento Cooperativo , Teoria dos Jogos , Frequência do Gene , Genótipo , Humanos , Comportamento Impulsivo , Relações Interpessoais , Modelos Genéticos , Mutação , Meio Social
10.
Inform Prim Care ; 20(2): 141-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23710778

RESUMO

BACKGROUND: The advent of more mobile, more reliable, and more affordable videoconferencing technology finally makes it realistic to offer remote foreign language interpretation in the office setting. Still, such technologies deserve proof of acceptability to clinicians and patients before there is widespread acceptance and routine use. OBJECTIVE: We sought to examine: (1) the audio and video technical fidelity of iPad/Facetime(TM) software, (2) the acceptability of videoconferencing to patients and clinicians. METHODS: The convenience sample included Spanish-speaking adult patients at a community health care medicine clinic in 2011. Videoconferencing was conducted using two iPads(TM) connecting patient/physician located in the clinic examination room, and the interpreter in a remote/separate office in the same building. A five-item survey was used to solicit opinions on overall quality of the videoconferencing device, audio/video integrity/fidelity, perception of encounter duration, and attitude toward future use. RESULTS: Twenty-five patients, 18 clinicians and 5 interpreters participated in the project. Most patients (24/25) rated overall quality of videoconferencing as good/excellent with only 1 'fair' rating. Eleven patients rated the amount of time as no longer than in-person, and nine reported it as shorter than inperson. Most patients, 94.0% (24/25), favoured using videoconferencing during future visits. For the 18 clinicians, the results were similar. CONCLUSIONS: Based on our experience at a singlesite community health centre, the videoconferencing technology appeared to be flawless, and both patients and clinicians were satisfied. Expansion of videoconferencing to other off-site healthcare professionals should be considered in the search for more cost-effective healthcare.


Assuntos
Atitude do Pessoal de Saúde , Satisfação do Paciente , Comunicação por Videoconferência/organização & administração , Adulto , Barreiras de Comunicação , Computadores de Mão , Feminino , Hispânico ou Latino , Humanos , Masculino , Relações Médico-Paciente , Projetos Piloto , Consulta Remota/economia , Consulta Remota/métodos , Tradução , Comunicação por Videoconferência/economia , Comunicação por Videoconferência/instrumentação
12.
Animals (Basel) ; 11(3)2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33809534

RESUMO

Averting the biodiversity crisis requires closing a gap between how humans tend to behave, individually and collectively, and how we ought to behave-"ought to" in the sense of behaviors required to avert the biodiversity crisis. Closing that gap requires synthesizing insight from ethics with insights from social and behavioral sciences. This article contributes to that synthesis, which presents in several provocative hypotheses: (i) Lessening the biodiversity crisis requires promoting pro-conservation behavior among humans. Doing so requires better scientific understanding of how one's sense of purpose in life affects conservation-relevant behaviors. Psychology and virtue-focused ethics indicate that behavior is importantly influenced by one's purpose. However, conservation psychology has neglected inquiries on (a) the influence of one's purpose (both the content and strength of one's purpose) on conservation-related behaviors and (b) how to foster pro-conservation purposes; (ii) lessening the biodiversity crisis requires governance-the regulation of behavior by governments, markets or other organization through various means, including laws, norms, and power-to explicitly take conservation as one of its fundamental purposes and to do so across scales of human behaviors, from local communities to nations and corporations; (iii) lessening the biodiversity crisis requires intervention via governance to nudge human behavior in line with the purpose of conservation without undue infringement on other basic values. Aligning human behavior with conservation is inhibited by the underlying purpose of conservation being underspecified. Adequate specification of conservation's purpose will require additional interdisciplinary research involving insights from ethics, social and behavioral sciences, and conservation biology.

13.
Nat Commun ; 10(1): 4846, 2019 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-31649282

RESUMO

DNA topoisomerases are required to resolve DNA topological stress. Despite this essential role, abortive topoisomerase activity generates aberrant protein-linked DNA breaks, jeopardising genome stability. Here, to understand the genomic distribution and mechanisms underpinning topoisomerase-induced DNA breaks, we map Top2 DNA cleavage with strand-specific nucleotide resolution across the S. cerevisiae and human genomes-and use the meiotic Spo11 protein to validate the broad applicability of this method to explore the role of diverse topoisomerase family members. Our data characterises Mre11-dependent repair in yeast and defines two strikingly different fractions of Top2 activity in humans: tightly localised CTCF-proximal, and broadly distributed transcription-proximal, the latter correlated with gene length and expression. Moreover, single nucleotide accuracy reveals the influence primary DNA sequence has upon Top2 cleavage-distinguishing sites likely to form canonical DNA double-strand breaks (DSBs) from those predisposed to form strand-biased DNA single-strand breaks (SSBs) induced by etoposide (VP16) in vivo.


Assuntos
Reparo do DNA , DNA Topoisomerases Tipo II/metabolismo , DNA/metabolismo , Endodesoxirribonucleases/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/genética , Antineoplásicos Fitogênicos/farmacologia , Sequência de Bases , Fator de Ligação a CCCTC/genética , DNA/efeitos dos fármacos , Quebras de DNA de Cadeia Dupla/efeitos dos fármacos , Quebras de DNA de Cadeia Simples/efeitos dos fármacos , Etoposídeo/farmacologia , Humanos , Mapeamento de Nucleotídeos
14.
Eur J Prosthodont Restor Dent ; 16(4): 181-4, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19177730

RESUMO

This study was designed to provide a broad estimate of the level of dental disease in a group of patients attending a Regional Addiction Unit, and outline some of the perceptions of this group with regard to the importance of dental health and gaining access to dental services. In a survey of consecutive patients admitted to a day Hospital Service at a Regional Addictions Psychiatry Unit, 50 patients were with either opiate or alcohol dependence were surveyed and asked a range of questions in relation to their dental health. A basic dental examination was carried out. The majority of patients had either moderate or severe dental disease. Disease levels were higher among opiate abusers compared to alcohol abusers. A large majority of patients had experienced dental problems within the preceding year and there was found to be a problem in accessing dental care for this group of patients. Improving dental care for this group of patients presents various challenges given the high rates of dental disease and poor access to dental services.


Assuntos
Alcoolismo/epidemiologia , Cárie Dentária/epidemiologia , Doenças Periodontais/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Atitude Frente a Saúde , Índice CPO , Assistência Odontológica/estatística & dados numéricos , Inglaterra/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Saúde Bucal , Higiene Bucal , Índice Periodontal , Projetos Piloto , Adulto Jovem
15.
Nat Commun ; 9(1): 4016, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30275497

RESUMO

DNA end resection plays a critical function in DNA double-strand break repair pathway choice. Resected DNA ends are refractory to end-joining mechanisms and are instead channeled to homology-directed repair. Using biochemical, genetic, and imaging methods, we show that phosphorylation of Saccharomyces cerevisiae Sae2 controls its capacity to promote the Mre11-Rad50-Xrs2 (MRX) nuclease to initiate resection of blocked DNA ends by at least two distinct mechanisms. First, DNA damage and cell cycle-dependent phosphorylation leads to Sae2 tetramerization. Second, and independently, phosphorylation of the conserved C-terminal domain of Sae2 is a prerequisite for its physical interaction with Rad50, which is also crucial to promote the MRX endonuclease. The lack of this interaction explains the phenotype of rad50S mutants defective in the processing of Spo11-bound DNA ends during meiotic recombination. Our results define how phosphorylation controls the initiation of DNA end resection and therefore the choice between the key DNA double-strand break repair mechanisms.


Assuntos
Quebras de DNA de Cadeia Dupla , Proteínas de Ligação a DNA/metabolismo , Endonucleases/metabolismo , Reparo de DNA por Recombinação/fisiologia , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/genética , Ciclo Celular , Reparo do DNA por Junção de Extremidades/fisiologia , DNA Fúngico/metabolismo , Proteínas de Ligação a DNA/genética , Endodesoxirribonucleases/metabolismo , Endonucleases/química , Endonucleases/genética , Exodesoxirribonucleases/metabolismo , Meiose/genética , Complexos Multiproteicos/química , Complexos Multiproteicos/metabolismo , Fosforilação , Ligação Proteica , Multimerização Proteica , Saccharomyces cerevisiae/enzimologia , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae/química , Proteínas de Saccharomyces cerevisiae/genética
16.
Proc Biol Sci ; 273(1600): 2513-20, 2006 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-16959643

RESUMO

Overconfidence has long been noted by historians and political scientists as a major cause of war. However, the origins of such overconfidence, and sources of variation, remain poorly understood. Mounting empirical studies now show that mentally healthy people tend to exhibit psychological biases that encourage optimism, collectively known as 'positive illusions'. Positive illusions are thought to have been adaptive in our evolutionary past because they served to cope with adversity, harden resolve, or bluff opponents. Today, however, positive illusions may contribute to costly conflicts and wars. Testosterone has been proposed as a proximate mediator of positive illusions, given its role in promoting dominance and challenge behaviour, particularly in men. To date, no studies have attempted to link overconfidence, decisions about war, gender, and testosterone. Here we report that, in experimental wargames: (i) people are overconfident about their expectations of success; (ii) those who are more overconfident are more likely to attack; (iii) overconfidence and attacks are more pronounced among males than females; and (iv) testosterone is related to expectations of success, but not within gender, so its influence on overconfidence cannot be distinguished from any other gender specific factor. Overall, these results constitute the first empirical support of recent theoretical work linking overconfidence and war.


Assuntos
Agressão/psicologia , Caracteres Sexuais , Testosterona/fisiologia , Guerra , Adolescente , Adulto , Idoso , Feminino , Jogos Experimentais , Humanos , Masculino , Pessoa de Meia-Idade , Autoeficácia
17.
Pharmacotherapy ; 36(2): e5-7, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26846610

RESUMO

Dabigatran, a direct thrombin inhibitor, is an oral anticoagulant indicated for the prevention of stroke in patients with atrial fibrillation (AF) and for the treatment and prevention of deep vein thrombosis and pulmonary embolism. Dabigatran, as well as the other new anticoagulants-rivaroxaban, apixaban, and edoxaban-are substrates for P-glycoprotein (P-gp). Although the U.S. labeling for rivaroxaban and apixaban states to avoid concomitant use with phenytoin, a known P-gp inducer, the U.S. labeling for dabigatran and edoxaban are less clear. We describe the first case report, to our knowledge, documenting a drug interaction between phenytoin and dabigatran by using laboratory measurements of dabigatran serum concentrations. A 45-year-old African-American man was admitted to the inpatient cardiology service following defibrillations from his implantable cardioverter defibrillator. The patient was evaluated and received appropriate antitachycardia pacing for atrial tachyarrhythmias for an episode of ventricular tachycardia (VT), and antiarrhythmic therapy with sotalol was initiated to reduce both his AF and VT burden. On review of the patient's medications for potential interactions, it was discovered that the patient was taking both dabigatran and phenytoin. To determine the magnitude of this drug interaction prior to making a change in his anticoagulation regimen, a dabigatran serum concentration was measured. This concentration was undetectable, indicating that phenytoin had a significant influence on dabigatran's metabolism and that this patient was at high risk for stroke. Clinicians should be aware of this interaction between phenytoin and dabigatran as well as with all other new oral anticoagulants. In patients taking phenytoin who require an anticoagulant, only warfarin should be prescribed to minimize the risk of stroke. In addition, the prescribing information for dabigatran should be updated to include other medications that result in a significant reduction in dabigatran serum concentrations, such as phenytoin.


Assuntos
Anticonvulsivantes/uso terapêutico , Antitrombinas/uso terapêutico , Dabigatrana/uso terapêutico , Fenitoína/uso terapêutico , Embolia Pulmonar/prevenção & controle , Convulsões/tratamento farmacológico , Trombose Venosa/prevenção & controle , Antitrombinas/sangue , Antitrombinas/farmacocinética , Dabigatrana/sangue , Dabigatrana/farmacocinética , Interações Medicamentosas , Monitoramento de Medicamentos , Humanos , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/sangue , Embolia Pulmonar/complicações , Prevenção Secundária , Convulsões/sangue , Convulsões/complicações , Resultado do Tratamento , Trombose Venosa/sangue , Trombose Venosa/complicações
18.
Politics Life Sci ; 35(1): 1-26, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27378020

RESUMO

Offensive realism, a theory of international relations, holds that states are disposed to competition and conflict because they are self-interested, power maximizing, and fearful of other states. Moreover, it argues that states are obliged to behave this way because doing so favors survival in the international system. Debate continues as to whether modern states actually do, or should, behave in this way, but we are struck by a different question. In this article, we ask whether the three core assumptions about behavior in offensive realism-self-help, power maximization, and outgroup fear-have any basis in scientific knowledge about human behavioral evolution. We find that these precise traits are not only evolutionarily adaptive but also empirically common across the animal kingdom, especially in primate and human societies. Based on these findings, we hypothesize that states behave as offensive realists predict not just because of anarchy in the modern international system but also because of the legacy of our evolution. In short, offensive realism may really be describing the nature of the human species more than the nature of the international system. If our hypothesis is correct, then evolutionary theory offers the following: (1) a novel ultimate cause of offensive realist behavior; (2) an extension of offensive realism to any domain in which humans compete for power; and (3) an explanation for why individual leaders themselves, and not just states, seek power. However, a key insight from evolution is that the primacy of self-help, power maximization, and outgroup fear does not necessarily condemn individuals or groups to competition and conflict; rather, these traits can in themselves give rise to cooperation and alliances.


Assuntos
Internacionalidade , Modelos Teóricos , Guerra , Comportamento Competitivo , Liderança
19.
Hum Nat ; 16(4): 410-46, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26189839

RESUMO

Cooperation towards public goods relies on credible threats of punishment to deter cheats. However, punishing is costly, so it remains unclear who incurred the costs of enforcement in our evolutionary past. Theoretical work suggests that human cooperation may be promoted if people believe in supernatural punishment for moral transgressions. This theory is supported by new work in cognitive psychology and by anecdotal ethnographic evidence, but formal quantitative tests remain to be done. Using data from 186 societies around the globe, I test whether the likelihood of supernatural punishment-indexed by the importance of moralizing "high gods"-is associated with cooperation.

20.
BMC Evol Biol ; 2: 15, 2002 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-12223117

RESUMO

BACKGROUND: The Prisoner's Dilemma (PD) is a widely used paradigm to study cooperation in evolutionary biology, as well as in fields as diverse as moral philosophy, sociology, economics and politics. Players are typically assumed to have fixed payoffs for adopting certain strategies, which depend only on the strategy played by the opponent. However, fixed payoffs are not realistic in nature. Utility functions and the associated payoffs from pursuing certain strategies vary among members of a population with numerous factors. In biology such factors include size, age, social status and expected life span; in economics they include socio-economic status, personal preference and past experience; and in politics they include ideology, political interests and public support. Thus, no outcome is identical for any two different players. RESULTS: We show that relaxing the assumption of fixed payoffs leads to frequent violations of the payoff structure required for a Prisoner's Dilemma. With variance twice the payoff interval in a linear PD matrix, for example, only 16% of matrices are valid. CONCLUSIONS: A single player lacking a valid PD matrix destroys the conditions for a Prisoner's Dilemma, so between any two players, PD games themselves are fewer still (3% in this case). This may explain why the Prisoner's Dilemma has hardly been found in nature, despite the fact that it has served as a ubiquitous (and still instructive) model in studies of the evolution of cooperation.


Assuntos
Evolução Biológica , Teoria dos Jogos , Análise de Variância , Simulação por Computador/estatística & dados numéricos , Comportamento Cooperativo , Humanos , Modelos Biológicos , Modelos Estatísticos
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