Carbon isotope discrimination of arctic and boreal biomes inferred from remote atmospheric measurements and a biosphere-atmosphere model

Estimating discrimination against ^(13)C during photosynthesis at landscape, regional, and biome scales is difficult because of large-scale variability in plant stress, vegetation composition, and photosynthetic pathway. Here we present estimates of ^(13)C discrimination for northern biomes based on a biosphere-atmosphere model and on National Oceanic and Atmospheric Administration Climate Monitoring and Diagnostics Laboratory and Institute of Arctic and Alpine Research remote flask measurements. With our inversion approach, we solved for three ecophysiological parameters of the northern biosphere (^(13)C discrimination, a net primary production light use efficiency, and a temperature sensitivity of heterotrophic respiration (a Q10 factor)) that provided a best fit between modeled and observed δ^(13)C and CO_2. In our analysis we attempted to explicitly correct for fossil fuel emissions, remote C4 ecosystem fluxes, ocean exchange, and isotopic disequilibria of terrestrial heterotrophic respiration caused by the Suess effect. We obtained a photosynthetic discrimination for arctic and boreal biomes between 19.0 and 19.6‰. Our inversion analysis suggests that Q10 and light use efficiency values that minimize the cost function covary. The optimal light use efficiency was 0.47 gC MJ^(−1) photosynthetically active radiation, and the optimal Q10 value was 1.52. Fossil fuel and ocean exchange contributed proportionally more to month-to-month changes in the atmospheric growth rate of δ^(13)C and CO_2 during winter months, suggesting that remote atmospheric observations during the summer may yield more precise estimates of the isotopic composition of the biosphere

Ahmed glaucoma valve in uveitic patients with fluocinolone acetonide implant-induced glaucoma: 3-year follow-up

Buraa Kubaisi,1,2 Arash Maleki,1,2 Aseef Ahmed,1,2 Neel Lamba,1,2 Haitham Sahawneh,1,2 Andrew Stephenson,1,2 Alyssa Montieth,1,2 Shobha Topgi,3 C Stephen Foster1,2,4 1Massachusetts Eye Research and Surgery Institution, Waltham, MA, USA; 2Ocular Immunology & Uveitis Foundation, Waltham, MA, USA; 3The State University of New York Downstate, Brooklyn, NY, USA; 4Harvard Medical School, Boston, MA, USA Purpose: To evaluate the efficacy and safety of Ahmed glaucoma valve (AGV) in eyes with noninfectious uveitis that had fluocinolone acetonide intravitreal implant (Retisert™)-induced glaucoma. Methods: This retrospective study reviewed the safety and efficacy of AGV implantation in patients with persistently elevated intraocular pressure (IOP) after implantation of a fluocinolone acetonide intravitreal implant at the Massachusetts Eye Research and Surgery Institution between August 2006 and November 2015. Results: Nine patients with 10 uveitic eyes were included in this study, none of which had preexisting glaucoma in the study eye. Mean patient age was 42 years; 6 patients were female and 3 were male. Baseline mean IOP was 30.6 mmHg prior to AGV placement while mean IOP-lowering medications were 2.9. In the treatment groups, there was a statistically significant reduction in post-AGV IOP. IOP was lowest at 1-week after AGV implantation (9.0 mmHg). Nine out of 10 eyes achieved an IOP below target value of 22 mmHg and/or a 20% reduction in IOP from baseline 1 month and 1 year following AGV placement. All other postoperative time points showed all 10 eyes reaching this goal. A statistically significant decrease in IOP-lowering medication was seen at the 1-week, 1-month, and 3-year time points compared to baseline, while a statistically significant increase was seen at the 3-month, 6-month, and 2-year post-AGV time points. No significant change in retinal nerve thickness or visual field analysis was found. Conclusion: AGV is an effective and safe method of treatment in fluocinolone acetonide intravitreal implant-induced glaucoma. High survival rate is expected for at least 3 years. Keywords: uveitis, glaucoma, Ahmed glaucoma valve, fluocinolone acetonide intravitreal implant, ocular inflammatio

Treatment of Noninfectious Retinal Vasculitis Using Subcutaneous Repository Corticotropin Injection

Purpose: To show whether subcutaneous repository corticotropin injection (RCI, Acthar® Gel, a repository corticotropin injection, can be an effective potential therapeutic agent for noninfectious retinal vasculitis. Methods: Patients with active retinal vasculitis were followed with serial ultra-widefield fluorescein angiograms and treated with 80 units of subcutaneous repository corticotropin injection twice weekly. Results: Primary outcome of ≥50% improvement in response level (RL) for retinal vasculitis and percent improvement in retinal vasculitis severity scoring (RVSS) by more than one quartile (≥25%) at week 12 was met in 15 and 16 of the 30 total eyes, respectively, including 1 eye with severe retinal vasculitis in each group. Complete resolution of retinal vasculitis was seen in seven eyes with a mean time of 17.1 weeks. Intraocular pressure elevation requiring therapy and Cataract progression were noted in two and three eyes, respectively. One patient stopped medication due to side effects (injection site reaction). Conclusion: Repository corticotropin injection was well-tolerated overall. Repository corticotropin injection may be an effective therapeutic agent in the treatment of noninfectious retinal vasculitis