Pathogenesis, presentation, and treatment of keratoconus within the United States

Thesis (M.A.)--Boston UniversityKeratoconus is a non-inflammatory thinning of the cornea that can lead to an irregular conical shaped protrusion generally of the lower mid-peripheral nasal or temporal hemisphere of the cornea. This degenerative disorder has no known individual cause, nor does it have a known cure. Causes have been theorized to be multifactorial ranging from genetic disorders to environmental stimuli. Overall roughly 1 in 2,000 people suffer from the disorder. The treatment for keratoconus has generally focused on a broad range of different types of contact lenses, with the patients whose corneas degrade to dangerously thin limits or where visual acuity can no longer be corrected, become candidates for corneal transplant surgery. It is today the third most common cause for corneal transplant. This study focused on detailing the various treatment options keratoconus patients have, as well as what advances these treatments have each made in recent years. These treatments generally focus on maximizing visual acuity while attempting to retain the corneal protrusion. The other goal of these treatments is to push off the necessity for corneal transplant due to the risks of graft rejection, the risks of surgery, and the overall decrease in quality of life an implant can have on a patient’s life. The studies showed that treatment has come a long way, though there still remains to be a treatment that can appropriately halt the progression of keratoconus. This brings the paper to examine the role and potential impact corneal collage cross linking could have on keratoconus patients in the U.S. Corneal Collagen Cross Linking is a procedure where through riboflavin (vitamin B2) and UV-A light, collagen cross links can be induced within the corneal stroma. By linking the collagen polymers, it is theorized that this could permanently halt the progression of keratoconus. This treatment has been approved in Europe since 2006 and in Canada since 2008, but only entered into clinical trials within the U.S. in 2008. By performing an extensive literature review, it was concluded that corneal cross linking is a safe and effective method of treatment for keratoconus. Enough literature has been published by the international community over the past 15 years that the U.S. could have begun and concluded FDA clinical trials sooner. The treatment has the potential to halt the progression of keratoconus before it has any debilitating effects, though as of now is not available to most Americans. With the FDA likely to approve the procedure within the next year, keratoconus patients will have a new treatment option that will very likely substantially improve their quality of life

Spectroscopic and Mechanistic Studies of Heterodimetallic Forms of Metallo-β-lactamase NDM-1

In an effort to characterize the roles of each metal ion in metallo-β-lactamase NDM-1, heterodimetallic analogues (CoCo-, ZnCo-, and CoCd-) of the enzyme were generated and characterized. UV–vis, 1H NMR, EPR, and EXAFS spectroscopies were used to confirm the fidelity of the metal substitutions, including the presence of a homogeneous, heterodimetallic cluster, with a single-atom bridge. This marks the first preparation of a metallo-β-lactamase selectively substituted with a paramagnetic metal ion, Co(II), either in the Zn1 (CoCd-NDM-1) or in the Zn2 site (ZnCo-NDM-1), as well as both (CoCo-NDM-1). We then used these metal-substituted forms of the enzyme to probe the reaction mechanism, using steady-state and stopped-flow kinetics, stopped-flow fluorescence, and rapid-freeze-quench EPR. Both metal sites show significant effects on the kinetic constants, and both paramagnetic variants (CoCd- and ZnCo-NDM-1) showed significant structural changes on reaction with substrate. These changes are discussed in terms of a minimal kinetic mechanism that incorporates all of the data

A Meta-Analysis of Seaweed Impacts on Seagrasses: Generalities and Knowledge Gaps

Seagrasses are important habitat-formers and ecosystem engineers that are under threat from bloom-forming seaweeds. These seaweeds have been suggested to outcompete the seagrasses, particularly when facilitated by eutrophication, causing regime shifts where green meadows and clear waters are replaced with unstable sediments, turbid waters, hypoxia, and poor habitat conditions for fishes and invertebrates. Understanding the situations under which seaweeds impact seagrasses on local patch scales can help proactive management and prevent losses at greater scales. Here, we provide a quantitative review of available published manipulative experiments (all conducted at the patch-scale), to test which attributes of seaweeds and seagrasses (e.g., their abundances, sizes, morphology, taxonomy, attachment type, or origin) influence impacts. Weighted and unweighted meta-analyses (Hedges d metric) of 59 experiments showed generally high variability in attribute-impact relationships. Our main significant findings were that (a) abundant seaweeds had stronger negative impacts on seagrasses than sparse seaweeds, (b) unattached and epiphytic seaweeds had stronger impacts than ‘rooted’ seaweeds, and (c) small seagrass species were more susceptible than larger species. Findings (a) and (c) were rather intuitive. It was more surprising that ‘rooted’ seaweeds had comparatively small impacts, particularly given that this category included the infamous invasive Caulerpa species. This result may reflect that seaweed biomass and/or shading and metabolic by-products like anoxia and sulphides could be lower for rooted seaweeds. In conclusion, our results represent simple and robust first-order generalities about seaweed impacts on seagrasses. This review also documented a limited number of primary studies. We therefore identified major knowledge gaps that need to be addressed before general predictive models on seaweed-seagrass interactions can be build, in order to effectively protect seagrass habitats from detrimental competition from seaweeds

Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer's disease

We identified rare coding variants associated with Alzheimer’s disease (AD) in a 3-stage case-control study of 85,133 subjects. In stage 1, 34,174 samples were genotyped using a whole-exome microarray. In stage 2, we tested associated variants (P<1×10-4) in 35,962 independent samples using de novo genotyping and imputed genotypes. In stage 3, an additional 14,997 samples were used to test the most significant stage 2 associations (P<5×10-8) using imputed genotypes. We observed 3 novel genome-wide significant (GWS) AD associated non-synonymous variants; a protective variant in PLCG2 (rs72824905/p.P522R, P=5.38×10-10, OR=0.68, MAFcases=0.0059, MAFcontrols=0.0093), a risk variant in ABI3 (rs616338/p.S209F, P=4.56×10-10, OR=1.43, MAFcases=0.011, MAFcontrols=0.008), and a novel GWS variant in TREM2 (rs143332484/p.R62H, P=1.55×10-14, OR=1.67, MAFcases=0.0143, MAFcontrols=0.0089), a known AD susceptibility gene. These protein-coding changes are in genes highly expressed in microglia and highlight an immune-related protein-protein interaction network enriched for previously identified AD risk genes. These genetic findings provide additional evidence that the microglia-mediated innate immune response contributes directly to AD development

A novel Alzheimer disease locus located near the gene encoding tau protein

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordAPOE ε4, the most significant genetic risk factor for Alzheimer disease (AD), may mask effects of other loci. We re-analyzed genome-wide association study (GWAS) data from the International Genomics of Alzheimer's Project (IGAP) Consortium in APOE ε4+ (10 352 cases and 9207 controls) and APOE ε4- (7184 cases and 26 968 controls) subgroups as well as in the total sample testing for interaction between a single-nucleotide polymorphism (SNP) and APOE ε4 status. Suggestive associations (P<1 × 10-4) in stage 1 were evaluated in an independent sample (stage 2) containing 4203 subjects (APOE ε4+: 1250 cases and 536 controls; APOE ε4-: 718 cases and 1699 controls). Among APOE ε4- subjects, novel genome-wide significant (GWS) association was observed with 17 SNPs (all between KANSL1 and LRRC37A on chromosome 17 near MAPT) in a meta-analysis of the stage 1 and stage 2 data sets (best SNP, rs2732703, P=5·8 × 10-9). Conditional analysis revealed that rs2732703 accounted for association signals in the entire 100-kilobase region that includes MAPT. Except for previously identified AD loci showing stronger association in APOE ε4+ subjects (CR1 and CLU) or APOE ε4- subjects (MS4A6A/MS4A4A/MS4A6E), no other SNPs were significantly associated with AD in a specific APOE genotype subgroup. In addition, the finding in the stage 1 sample that AD risk is significantly influenced by the interaction of APOE with rs1595014 in TMEM106B (P=1·6 × 10-7) is noteworthy, because TMEM106B variants have previously been associated with risk of frontotemporal dementia. Expression quantitative trait locus analysis revealed that rs113986870, one of the GWS SNPs near rs2732703, is significantly associated with four KANSL1 probes that target transcription of the first translated exon and an untranslated exon in hippocampus (P≤1.3 × 10-8), frontal cortex (P≤1.3 × 10-9) and temporal cortex (P≤1.2 × 10-11). Rs113986870 is also strongly associated with a MAPT probe that targets transcription of alternatively spliced exon 3 in frontal cortex (P=9.2 × 10-6) and temporal cortex (P=2.6 × 10-6). Our APOE-stratified GWAS is the first to show GWS association for AD with SNPs in the chromosome 17q21.31 region. Replication of this finding in independent samples is needed to verify that SNPs in this region have significantly stronger effects on AD risk in persons lacking APOE ε4 compared with persons carrying this allele, and if this is found to hold, further examination of this region and studies aimed at deciphering the mechanism(s) are warranted

Diversity - a new mode of incorporation?

Faist T. Diversity - a new mode of incorporation? Ethnic and Racial Studies. 2009;32(1):171-190.Lately, cultural diversity in Western societies has, in terms of religions, languages, ethnic we-groups, transnational ties, and countries of origin, once more undergone immense growth. Modes of migrant incorporation reflect endeavours to respond to this change. While some approaches such as assimilation and multiculturalism emphasize the social integration of migrants in the host societies, the vague term 'diversity' harbours innovative measures in two respects. First, diversity addresses not only the incorporation of migrants, but also how societies and particularly their organizations deal with cultural pluralism. Second, diversity can then be understood both as an individual competence of migrants as members of organizations and the civil sphere, and as a set of programmes which organizations adopt to address cultural pluralism. Also, novel forms of diversity have emerged, such as transnationality. Yet in the absence of a rights-based foundation the question arises of how social inequality can be dealt with