173 research outputs found
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Yeast require redox switching in DNA primase
Eukaryotic DNA primases contain a [4Fe4S] cluster in the C-terminal domain of the p58 subunit (p58C) that affects substrate affinity but is not required for catalysis. We show that, in yeast primase, the cluster serves as a DNA-mediated redox switch governing DNA binding, just as in human primase. Despite a different structural arrangement of tyrosines to facilitate electron transfer between the DNA substrate and [4Fe4S] cluster, in yeast, mutation of tyrosines Y395 and Y397 alters the same electron transfer chemistry and redox switch. Mutation of conserved tyrosine 395 diminishes the extent of p58C participation in normal redox-switching reactions, whereas mutation of conserved tyrosine 397 causes oxidative cluster degradation to the [3Fe4S]^+ species during p58C redox signaling. Switching between oxidized and reduced states in the presence of the Y397 mutations thus puts primase [4Fe4S] cluster integrity and function at risk. Consistent with these observations, we find that yeast tolerate mutations to Y395 in p58C, but the single-residue mutation Y397L in p58C is lethal. Our data thus show that a constellation of tyrosines for protein-DNA electron transfer mediates the redox switch in eukaryotic primases and is required for primase function in vivo
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Personalized Genetic Risk Counseling to Motivate Diabetes Prevention: A randomized trial
OBJECTIVE To examine whether diabetes genetic risk testing and counseling can improve diabetes prevention behaviors. RESEARCH DESIGN AND METHODS We conducted a randomized trial of diabetes genetic risk counseling among overweight patients at increased phenotypic risk for type 2 diabetes. Participants were randomly allocated to genetic testing versus no testing. Genetic risk was calculated by summing 36 single nucleotide polymorphisms associated with type 2 diabetes. Participants in the top and bottom score quartiles received individual genetic counseling before being enrolled with untested control participants in a 12-week, validated, diabetes prevention program. Middle-risk quartile participants were not studied further. We examined the effect of this genetic counseling intervention on patient self-reported attitudes, program attendance, and weight loss, separately comparing higher-risk and lower-risk result recipients with control participants. RESULTS The 108 participants enrolled in the diabetes prevention program included 42 participants at higher diabetes genetic risk, 32 at lower diabetes genetic risk, and 34 untested control subjects. Mean age was 57.9 ± 10.6 years, 61% were men, and average BMI was 34.8 kg/m2, with no differences among randomization groups. Participants attended 6.8 ± 4.3 group sessions and lost 8.5 ± 10.1 pounds, with 33 of 108 (30.6%) losing ≥5% body weight. There were few statistically significant differences in self-reported motivation, program attendance, or mean weight loss when higher-risk recipients and lower-risk recipients were compared with control subjects (P > 0.05 for all but one comparison). CONCLUSIONS Diabetes genetic risk counseling with currently available variants does not significantly alter self-reported motivation or prevention program adherence for overweight individuals at risk for diabetes
Frequency-dependent selection can forecast evolution in Streptococcus pneumoniae
Predicting how pathogen populations will change over time is challenging. Such has been the case withStreptococcus pneumoniae, an important human pathogen, and the pneumococcal conjugate vaccines (PCVs), which target only a fraction of the strains in the population. Here, we use the frequencies of accessory genes to predict changes in the pneumococcal population after vaccination, hypothesizing that these frequencies reflect negative frequency-dependent selection (NFDS) on the gene products. We find that the standardized predicted fitness of a strain, estimated by an NFDS-based model at the time the vaccine is introduced, enables us to predict whether the strain increases or decreases in prevalence following vaccination. Further, we are able to forecast the equilibrium post-vaccine population composition and assess the invasion capacity of emerging lineages. Overall, we provide a method for predicting the impact of an intervention on pneumococcal populations with potential application to other bacterial pathogens in which NFDS is a driving force.Peer reviewe
Identification and Selection of Cases and Controls in the Pneumonia Etiology Research for Child Health Project
Methods for the identification and selection of patients (cases) with severe or very severe pneumonia and controls for the Pneumonia Etiology Research for Child Health (PERCH) project were needed. Issues considered include eligibility criteria and sampling strategies, whether to enroll hospital or community controls, whether to exclude controls with upper respiratory tract infection (URTI) or nonsevere pneumonia, and matching criteria, among others. PERCH ultimately decided to enroll community controls and an additional human immunodeficiency virus (HIV)–infected control group at high HIV-prevalence sites matched on age and enrollment date of cases; controls with symptoms of URTI or nonsevere pneumonia will not be excluded. Systematic sampling of cases (when necessary) and random sampling of controls will be implemented. For each issue, we present the options that were considered, the advantages and disadvantages of each, the rationale for the methods selected for PERCH, and remaining implications and limitations
Eff ectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in South African children: a case-control study
Background The 13-valent pneumococcal conjugate vaccine (PCV13) was designed to include disease-causing
serotypes that are important in low-income and middle-income countries. Vaccine eff ectiveness estimates are scarce
in these settings. South Africa replaced PCV7 with PCV13 in 2011 using a 2 + 1 schedule. We aimed to assess the
eff ectiveness of two or more doses of PCV13 against invasive pneumococcal disease in children with HIV infection
and in those not infected with HIV.
Methods Cases of invasive pneumococcal disease in children aged 5 years or younger were identifi ed through national
laboratory-based surveillance. Isolates were serotyped with the Quellung reaction or PCR. We sought in-hospital
controls for every case, matched for age, HIV status, and study site. We aimed to enrol four controls for every case not
infected with HIV and six controls for every case with HIV infection (case-control sets). With conditional logistic
regression, we calculated vaccine eff ectiveness as a percentage, with the equation 1 – [adjusted odds ratio for
vaccination] × 100. We included data from an earlier investigation of PCV7 to assess vaccine eff ectiveness in children
exposed to but not infected with HIV and in malnourished children not infected with HIV.
Findings Between January, 2012, and December, 2014, we enrolled children aged 16 weeks or older to our study:
240 were cases not infected with HIV, 75 were cases with HIV infection, 1118 were controls not infected with HIV,
and 283 were controls with HIV infection. The eff ectiveness of two or more doses of PCV13 against PCV13-serotype
invasive pneumococcal disease was 85% (95% CI 37 to 96) among 11 case-control sets of children not infected with
HIV and 91% (–35 to 100) among three case-control sets of children with HIV infection. PCV13 eff ectiveness among
26 case-control sets of children not infected with HIV was 52% (95% CI –12 to 79) against all-serotype invasive
pneumococcal disease and 94% (44 to 100) for serotype 19A. Vaccine eff ectiveness against PCV7-serotype
invasive pneumococcal disease was 87% (95% CI 38 to 97) in children exposed to HIV but uninfected and 90%
(53 to 98) in malnourished children not infected with HIV.
Interpretation Our results indicate that PCV13 in a 2 + 1 schedule is eff ective for preventing vaccine-type
pneumococcal infections in young children not infected with HIV, including those who are malnourished or who
have been exposed to HIV. Although the point estimate for PCV13 vaccine eff ectiveness in children infected with
HIV was high, it did not reach signifi cance, possibly because of the small sample size. These fi ndings support
recommendations for widespread use of pneumococcal conjugate vaccine in low-income and middle-income
countries
The Definition of Pneumonia, the Assessment of Severity, and Clinical Standardization in the Pneumonia Etiology Research for Child Health Study
To develop a case definition for the Pneumonia Etiology Research for Child Health (PERCH) project, we sought a widely acceptable classification that was linked to existing pneumonia research and focused on very severe cases. We began with the World Health Organization’s classification of severe/very severe pneumonia and refined it through literature reviews and a 2-stage process of expert consultation. PERCH will study hospitalized children, aged 1–59 months, with pneumonia who present with cough or difficulty breathing and have either severe pneumonia (lower chest wall indrawing) or very severe pneumonia (central cyanosis, difficulty breastfeeding/drinking, vomiting everything, convulsions, lethargy, unconsciousness, or head nodding). It will exclude patients with recent hospitalization and children with wheeze whose indrawing resolves after bronchodilator therapy. The PERCH investigators agreed upon standard interpretations of the symptoms and signs. These will be maintained by a clinical standardization monitor who conducts repeated instruction at each site and by recurrent local training and testing
The Incremental Value of Repeated Induced Sputum and Gastric Aspirate Samples for the Diagnosis of Pulmonary Tuberculosis in Young Children With Acute Community-Acquired Pneumonia
Background.
Mycobacterium tuberculosis (Mtb) contributes to the pathogenesis of childhood acute community-acquired pneumonia in settings with a high tuberculosis burden. The incremental value of a repeated induced sputum (IS) sample, compared with a single IS or gastric aspirate (GA) sample, is not well known.
Methods.
Two IS samples were obtained for Mtb culture from children enrolled as cases in the Pneumonia Etiology Research for Child Health (PERCH) study in South Africa. Nonstudy attending physicians requested GA if pulmonary tuberculosis was clinically suspected. We compared the Mtb yield of 2 IS samples to that of 1 IS sample and GA samples.
Results
. Twenty-seven (3.0%) culture-confirmed pulmonary tuberculosis cases were identified among 906 children investigated with IS and GA samples for Mtb. Results from 2 IS samples were available for 719 children (79.4%). Of 12 culture-confirmed pulmonary tuberculosis cases identified among children with ≥2 IS samples, 4 (33.3%) were negative at the first IS sample. In head-to-head comparisons among children with both GA and IS samples collected, the yield of 1 GA sample (8 of 427; 1.9%) was similar to that of 1 IS sample (5 of 427, 1.2%), and the yield of 2 GA samples (10 of 300; 3.3%) was similar to that of 2 IS samples (5 of 300; 1.7%). IS samples identified 8 (42.1%) of the 19 culture-confirmed pulmonary tuberculosis cases that were identified through submission of IS and GA samples.
Conclusions.
A single IS sample underestimated the presence of Mtb in children hospitalized with severe or very severe pneumonia. Detection of Mtb is enhanced by combining 2 IS with GA sample collections in young children with acute severe pneumonia
Carrying out research across the arts and humanities and social sciences: developing the methodology for Dementia and Imagination
This paper analyses how the methodological approach for a major Arts and Humanities Research Council and Economic and Social Research Council-funded project entitled Dementia and Imagination1 was formulated. This multidisciplinary project brings together the arts and humanities with the social sciences with their different epistemological philosophies and subsequent understandings of research methods. The main objective was to determine how visual arts activities may change, sustain and catalyse community cultures, beliefs, attitudes and behaviours to create dementia-friendly communities. This project involves 6 different UK universities, 14 researchers, 10 formal partners, 7 project artists, 3 research artists and a large number of civil society organisations. The analysis presents a series of themes that have been identified as influencing the approach taken to develop methods which aimed to speak to different audiences in the social sciences, arts and humanities, policy/practice and public domains. It is concluded that a research project of this type needs to embrace a wide variety of epistemological positions if it is to successfully achieve its objectives. This paper contributes to knowledge about how the methodology of large-scale multidisciplinary projects may be constructed which will be of value to those building research consortia across different universities and between universities and community partners. © 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
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