15q26.1 microdeletion encompassing only CHD2 and RGMA in two adults with moderate intellectual disability, epilepsy and truncal obesity

We report two patients with microdeletions in chromosomal subdomain 15q26.1 encompassing only two genes, CHD2 and RGMA. Both patients present a distinct phenotype with intellectual disability, epilepsy, behavioral issues, truncal obesity, scoliosis and facial dysmorphism. CHD2 haploinsufficiency is known to cause intellectual disability and epilepsy, RGMA haploinsufficiency might explain truncal obesity with onset around puberty observed in our two patients.

Using Bayes' rule to define the value of evidence from syndromic surveillance

In this work we propose the adoption of a statistical framework used in the evaluation of forensic evidence as a tool for evaluating and presenting circumstantial "evidence" of a disease outbreak from syndromic surveillance. The basic idea is to exploit the predicted distributions of reported cases to calculate the ratio of the likelihood of observing n cases given an ongoing outbreak over the likelihood of observing n cases given no outbreak. The likelihood ratio defines the Value of Evidence (V). Using Bayes' rule, the prior odds for an ongoing outbreak are multiplied by V to obtain the posterior odds. This approach was applied to time series on the number of horses showing clinical respiratory symptoms or neurological symptoms. The separation between prior beliefs about the probability of an outbreak and the strength of evidence from syndromic surveillance offers a transparent reasoning process suitable for supporting decision makers. The value of evidence can be translated into a verbal statement, as often done in forensics or used for the production of risk maps. Furthermore, a Bayesian approach offers seamless integration of data from syndromic surveillance with results from predictive modeling and with information from other sources such as disease introduction risk assessments.

Genome-Wide Analyses Suggest Mechanisms Involving Early B-Cell Development in Canine IgA Deficiency.

Immunoglobulin A deficiency (IgAD) is the most common primary immune deficiency disorder in both humans and dogs, characterized by recurrent mucosal tract infections and a predisposition for allergic and other immune mediated diseases. In several dog breeds, low IgA levels have been observed at a high frequency and with a clinical resemblance to human IgAD. In this study, we used genome-wide association studies (GWAS) to identify genomic regions associated with low IgA levels in dogs as a comparative model for human IgAD. We used a novel percentile groups-approach to establish breed-specific cut-offs and to perform analyses in a close to continuous manner. GWAS performed in four breeds prone to low IgA levels (German shepherd, Golden retriever, Labrador retriever and Shar-Pei) identified 35 genomic loci suggestively associated (p <0.0005) to IgA levels. In German shepherd, three genomic regions (candidate genes include KIRREL3 and SERPINA9) were genome-wide significantly associated (p <0.0002) with IgA levels. A ~20kb long haplotype on CFA28, significantly associated (p = 0.0005) to IgA levels in Shar-Pei, was positioned within the first intron of the gene SLIT1. Both KIRREL3 and SLIT1 are highly expressed in the central nervous system and in bone marrow and are potentially important during B-cell development. SERPINA9 expression is restricted to B-cells and peaks at the time-point when B-cells proliferate into antibody-producing plasma cells. The suggestively associated regions were enriched for genes in Gene Ontology gene sets involving inflammation and early immune cell development.

Biomarkers of the involvement of mast cells, basophils and eosinophils in asthma and allergic diseases.

Biomarkers of disease activity have come into wide use in the study of mechanisms of human disease and in clinical medicine to both diagnose and predict disease course; as well as to monitor response to therapeutic intervention. Here we review biomarkers of the involvement of mast cells, basophils, and eosinophils in human allergic inflammation. Included are surface markers of cell activation as well as specific products of these inflammatory cells that implicate specific cell types in the inflammatory process and are of possible value in clinical research as well as within decisions made in the practice of allergy-immunology.

PCSK9 Plasma Concentrations Are Independent of GFR and Do Not Predict Cardiovascular Events in Patients with Decreased GFR.

BACKGROUND Impaired renal function causes dyslipidemia that contributes to elevated cardiovascular risk in patients with chronic kidney disease (CKD). The proprotein convertase subtilisin/kexin type 9 (PCSK9) is a regulator of the LDL receptor and plasma cholesterol concentrations. Its relationship to kidney function and cardiovascular events in patients with reduced glomerular filtration rate (GFR) has not been explored. METHODS Lipid parameters including PCSK9 were measured in two independent cohorts. CARE FOR HOMe (Cardiovascular and Renal Outcome in CKD 2-4 Patients-The Forth Homburg evaluation) enrolled 443 patients with reduced GFR (between 90 and 15 ml/min/1.73 m2) referred for nephrological care that were prospectively followed for the occurrence of a composite cardiovascular endpoint. As a replication cohort, PCSK9 was quantitated in 1450 patients with GFR between 90 and 15 ml/min/1.73 m2 enrolled in the Ludwigshafen Risk and Cardiovascular Health Study (LURIC) that were prospectively followed for cardiovascular deaths. RESULTS PCSK9 concentrations did not correlate with baseline GFR (CARE FOR HOMe: r = -0.034; p = 0.479; LURIC: r = -0.017; p = 0.512). 91 patients in CARE FOR HOMe and 335 patients in LURIC reached an endpoint during a median follow-up of 3.0 [1.8-4.1] years and 10.0 [7.3-10.6] years, respectively. Kaplan-Meier analyses showed that PCSK9 concentrations did not predict cardiovascular events in either cohort [CARE FOR HOMe (p = 0.622); LURIC (p = 0.729)]. Sensitivity analyses according to statin intake yielded similar results. CONCLUSION In two well characterized independent cohort studies, PCSK9 plasma levels did not correlate with kidney function. Furthermore, PCSK9 plasma concentrations were not associated with cardiovascular events in patients with reduced renal function.

Die Entwicklungsgeschichte der skandinavischen Flora

Von Dr. Gunnar Andersson

De la discapacidad como constructo social a las formas alternas del ser y estar en el mundo

La constitución del campo de la discapacidad expresa las condiciones históricas que responden a un concepto particular de hombre y de lo que una cultura pretende ofertar como condición de vida, sentido de vida para sus integrantes. Cada cultura instaura una promesa de proyección para que la existencia de cada uno encuentre una posición, valor y transcendencia. En esto radica el sustento filosófico de vida. Nos interesa para el caso del concepto de discapacidad ubicarla en el marco de la gestión social de su enunciado. Hay una separación abismal entre el discurso de Séguin, el apóstol de los sin razón y el discurso de Galton. Tal pareciera que Galton iba en búsqueda de ofrecer las condiciones para que el hombre alcanzara su perfectibilidad y la civilización el progreso, lo cual derivó en la comparación de los más avanzados en el proceso evolutivo y con ello se apoyó la diferenciación de umbrales de normalidad-anormalidad, en tanto que Séguin parecía seguidor de una ética de la fraternidad. Esta ética reconoce un mundo plural caracterizado por la heterogeneidad. Desde nuestra perspectiva la heterogeneidad requiere ser enfocada desde la diferencia, una diferencia que no se disuelva en los discursos de igualdad o equidad. Se trata de reconocer justamente las dimensiones de la diferencia, de explicitarla, comprenderla, investigarla y hacerla converger con el sentido originario de la educación. A cada diferencia le corresponde una posibilidad de vida dentro del mundo plural que posiblemente está por construirse. Se plantea en el trabajo un decálogo de reflexiones en los que se introduce una reconversión del significante “discapacidad" por la pluralidad de las formas de la existencia humana.

Accumulation rates for western Dronning Maud Land from firn cores and snow pits

As a result of intensive field activities carried out by several nations over the past 15 years, a set of accumulation measurements for western Dronning Maud Land, Antarctica, was collected, based on firn-core drilling and snow-pit sampling. This new information was supplemented by earlier data taken from the literature, resulting in 111 accumulation values. Using Geographical Information Systems software, a first region-wide mean annual snow-accumulation field was derived. In order to define suitable interpolation criteria, the accumulation records were analyzed with respect to their spatial autocorrelation and statistical properties. The resulting accumulation pattern resembles well known characteristics such as a relatively wet coastal area with a sharp transition to the dry interior, but also reveals complex topographic effects. Furthermore, this work identifies new high-return shallow drilling sites by uncovering areas of insufficient sampling density.