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Introduction: This is a case report of a spontaneous reattachment of Descemet-stripping automated endothelial keratoplasty (DSAEK). This graft was primarily sutured, and 20% sulfur hexafluoride (SF6) was injected into the anterior chamber, followed by graft detachment and spontaneous reattachment, 3 months later. Case Presentation: A 78-year-old male presented with DSAEK graft detachment, which was the patient's second DSAEK (the first also did not adhere). During the second surgery, the DSAEK graft was sutured and 20% SF6 was injected intraoperatively. Graft reattachment occurred without any intervention or repositioning 3 months after the 2nd DSAEK surgery. Conclusion: Spontaneous DSEAK late graft reattachment is possible, particularly in the setting of an anchoring suture. In some patients, waiting can be an option that can spare the patient the possible risks of graft repositioning, rebubbling, or repeating the DSAEK. Suturing the DSAEK graft primarily may have served as an anchor to keep the graft approximate and aid in attachment. A graft suture can be considered in the setting of a previously failed DSAEK due to DSAEK graft detachment. [ABSTRACT FROM AUTHOR]

Pandemic diseases have a nasty history of racialization. COVID-19 is no exception. Beyond the obvious racist invocations of the "China virus" or the "Wuhan Flu" are subtler racializing dynamics that are often veiled in more benign motives but are nonetheless deeply problematic. The racialization of COVID-19 proceeded along two distinct trajectories each of which threatened to reinforce inaccurate biologized conceptions of race while diverting attention from the social, legal, and political forces historically structuring race-based health disparities. First, early on as significant racial disparities in disease incidence and mortality became evident, a frame of race-based genetic difference came to the fore as a possible explanation. Second, as vaccine development ramped up there came widespread calls for racially "diversifying" clinical trials for the vaccines being tested. The rationales for such diversification were varied but tended to reinforce genetic frames of racial difference. Most common was the assertion (without substantial evidence) that vaccines might work differently in Black or Brown bodies and so racial diversity in trials was imperative for reasons of safety and efficacy. Derrick Bell cautioned 20 years ago that "the concept of diversity . . . is a serious distraction in the ongoing efforts to achieve racial justice." (Derrick Bell, Diversity's Distractions, 103 COLUM. L. REV. 1622, 1622 (2003).) This article explores the dynamics of how the concept of "diversity" racialized responses to COVID-19 and considers their broader implications for understanding and responding to racial disparities in the face of pandemic emergencies and beyond. In the short term, vaccine developers did a decent job of enrolling minorities in their clinical trials and the vaccines have proven to have the same safety and efficacy across races. In the long term, diversity in the biomedical context of pandemic response not only distracts attention from important structural causes of health injustice, but it also focuses attention on the genetics of disparities in a manner that has the potential to reinforce pernicious and false ideas of essential biological difference among racial groups. This article argues that an uncritical embrace of the idea of diversity in analyzing and responding to emergent health crises has the potential to distract us from considering deeper historical and structural formations contributing to racial health disparities. It proceeds first by exploring the dynamics through which initial responses to racial disparities in COVID-19 became geneticized. It will then move on to unpack the rationales for such racialization, examine their merits (or lack thereof), and consider their implications for developing an equitable response to pandemic emergencies. The next section will examine the subsequent racialization of clinical trials for COVID-19 vaccines through the concept of "diversity." It then moves on to explore how the geneticization of COVID-19 racial disparities laid the foundations for a similar geneticization of race in vaccine development. It will argue that in failing to clearly distinguish social and biological rationales for diversity, such framings, while generally well-intentioned, are poorly supported and work in tandem with the geneticization of racial disparities in COVID-19 morbidity and mortality to locate the causes of disparities in the minds and bodies of minoritized populations; again this distracts attention from the historical and structural forces contributing to such disparities. The article concludes by recognizing a certain intractability to the problems of using race in biomedical research and practice, particularly in the context of public health emergencies. It offers modest suggestions for improvement that could have significant practical effects if taken to heart by researchers, clinicians, and policy makers. [ABSTRACT FROM AUTHOR]

The article offers information on use of racial categories in biomedical research and practice. Topics discussed include relationship between social realities and biological realities of race; need to be careful about conflating genetics and biology; and etiology of diabetes to understand the gene and environment interactions.

The article examines the rising use of racial categories in biomedical patents in the aftermath of the successful completion of the Human Genome Project in the U.S. Topics discussed include laws governing patents in the country; role of U.S. Patent and Trademark Office and the Food and Drug Administration on same; and role of legal system in addressing the same.

The article focuses on the issues of racism in medical science. Topics discussed include use of cognitive psychology and neuroscience in studies of implicit bias; use of Implicit Association Test with functional Magnetic Resonance Imaging for analyzing racism in brain; and threats to biologize racism.

A response is offered to the article "A Post-Genomic Surprise:The Molecular Reinscription of Race in Science, Law, and Medicine," by Troy Duster, which appears within the issue. The article discusses the attribution of race to primarily genetic factors and DNA in molecular biology throughout history from 1980s through the mid 2010s. An overview of conceptions of ancestry, including implications about time and space regard the allegedly false notion of static populations and Dutch South African's perspective that they are not African but rather Dutch or European, is provided.

This article is concerned about what may be happening to race and medicine in the 'meantime' between today's clinical realities and the promised land of pharmacogenomics where the need for using race in medicine is supposed to fade away. It argues that previous debates over the use of race in medicine are being side-stepped as race is being reconfigured from a 'crude surrogate' for genetic variation into a purportedly viable placeholder for variable drug response - to be used here and now until the specific genetic underpinnings of drug response are more fully understood. Embracing the trope of 'promise' in pharmacogenomics alongside the idea of using race as a useful interim proxy for genetic variation raises concerns that new diagnostic and therapeutic interventions may reflect or be mapped upon existing social categories of race, class, gender, and ethnicity in a harmful or dangerous manner. At the most basic level, the politics of the meantime in pharmacogenomics may be promoting the scientifically unjustified and socially dangerous recasting of race as a social and historical construct into a reified genetic category. [ABSTRACT FROM AUTHOR]

C. P Snow's famous Two Cultures essay has become a foil for decades of discussions over the relation between science and the humanities. The problem of the "two cultures" is often framed in terms of how the particular epistemological claims or general intellectual orientations of particular individuals on either side of this purported divide obstruct interdisciplinary dialogue or cooperation This formulation, however, fails to consider the institutional frameworks within which such debates occur. This article examines the broader structural constraints that provide incentives, erect barriers, or otherwise shape the potential for interdisciplinary research and practice, with particular attention to work involving the life sciences. It argues that in order to understand the nature and scope of the problems facing interdisciplinary work, we must focus on the institutional constraints that shape how individuals frame questions, pursue investigations, develop careers, and collaborate. [ABSTRACT FROM AUTHOR]

The article discusses possible ways of reevaluating relations between science and law amid changing social and technological developments. It analyzes the utility of race itself in forensic deoxyribonucleic acid (DNA) and the race that serves the ability of an investigator to release fair and accurate decisions. The author asserts that such evidence must be considered irrelevant, or if relevant, it must be pointed as inadmissible due to the dangers affecting the proceedings with racial prejudice surpass the benefit that showing race-based statistics could give. The author concludes that there is not justification in employing race-specific databases in presenting DNA evidence to a jury.

Ehrlichia canis is the etiologic agent of canine monocytic ehrlichiosis (CME) and is a useful model for zoonotic tick-borne pathogens, many of which infect dogs. The purpose of this study was to evaluate rifampin and doxycycline regimens for clearance of E. canis infections in addition to alleviation of CME. Beagles were infected with E. canis by intravenous inoculation with carrier blood and treated with either rifampin or doxycycline after the acute phase of CME. Improved hematological values demonstrated that both treatments effectively relieved signs of the disease. Peripheral blood from all dogs became PCR negative after antibiotic treatment, suggesting that these infections were eliminated and that rifampin is an effective alternative chemotherapeutic agent for treatment of CME. [ABSTRACT FROM AUTHOR]

The article discusses the function of patent law in the promotion of new discoveries. It is stated that patent law serves as a powerful channel to reach information to the public on how people could benefit on the scientific inventions and to promote the new discovery for further development in the field of science. On the other hand, government is obliged to improvise the patent law to provide mutual relationship between race and genetics being mobilized to serve both biomedical and commercial projects and to promote the invention as useful products.

This paper explores events surrounding the US Food and Drug Administration's formal approval of the heart failure drug BiDil in 2005. BiDil is the first drug ever to be approved with a race-specific indication, in this case to treat heart failure in 'self-identified black patients'. BiDil has been cast by many as a step toward the promised land of individualized pharmacogenomic therapies. This paper argues, however, that when examined in context, the approval of BiDil emerges as a new model of how a pharmaceutical company may exploit race in the marketplace by literally capitalizing on the racial identity of minority populations and leveraging the disproportionate risk of adverse health outcomes they suffer into a cheaper, more efficient way to gain the US Food and Drug Administration's approval for drugs. Discussions of BiDil in both popular media and professional journals have repeatedly elided the difference between pharmacogenomic and race-based medicine. In fact, broad-based true pharmacogenomic therapies remain years—perhaps decades—in the future. The story of BiDil's development elucidates an alternative model to developing tailored therapies that promises to fill in the gap between the promise and reality of pharmacogenomic medicine. It is a model that exploits race to gain regulatory and commercial advantage, while ignoring its power to promote a regeneticization of racial categories in society at large. [ABSTRACT FROM AUTHOR]

The article examines the emerging phenomenon of using race as a genetic category in biotechnology and related patents in order to obtain patent protection and drug approval. It claims that this phenomenon is generating a new political geography of intellectual property. It points out that corporations are investing their patents and products with race to obtain commercial advantage in the research, development and marketing of new biotechnology products. It tackles the approval of the heart-failure drug Bidil by the U.S. Food and Drugs Administration.

Abstract: We compare the rate of drug release through the degradation of 50:50 polylactic-co-glycolic acid polymer pellets, for six different drugs: Thiothixene, Haloperidol, Hydrochlorothiozide, Corticosterone, Ibuprofen, and Aspirin. Despite using the same polymer matrix and drug loading (20% by weight), we find that the rate of polymer degradation and the drug release profile differ significantly between the drugs. We conclude that the design of biodegradable polymeric drug carriers with high drug loadings must account for the effect of the drug on the polymer degradation and drug release rate. [Copyright &y& Elsevier]

A wide array of federal mandates have a profound impact on the use of racial and ethnic categories in biomedical research, clinical practice, product development, and health policy. Current discussions over the appropriate use of racial and ethnic categories in biomedical contexts have largely focused on the practices of individual researchers. By contrast, our discussion focuses on relations between the daily practices of biomedical professionals and federal regulatory mandates. It draws upon the legal doctrine of equal protection to move beyond such debates and to propose guidelines to address the structural forces imposed by federal regulations that mandate how data about race and ethnicity are used in biomedical research. It offers a framework to manage the tension involved in using existing federally mandated categories of race and ethnicity alongside new scientific findings about human genetic variation. (Am J Public Health. 2006;96:1965-1970.doi:10.2105/AJPH.2005.067926) [ABSTRACT FROM AUTHOR]

Focuses on the controversies surrounding racial profiling in heart failure research. Legitimacy of using social categories of race in biomedical research; Study of the black and white mortality ratio for heart failure; Implications for the allocation of resources to combat disease and to expand the study of the nature and meaning of race.

Focuses on the impact of budget reform on citizenship in New York City during 1908-1911. Publicity and political discourse; Citizens' interest in budget exhibits; Drawbacks of budget exhibits.

The article discusses the race requirement imposed by the U.S. Patent and Trademark Office (USPTO) on biotechnology (biotech) patents. It is said that examiners at the USPTO have been requiring applicants to indicate racial categories in the claims sections of some the biotech patent applications. It notes that race is important to a patent claim as it serves as the legally operative section of a patent that determines the territory that it covers. One problem resulting from such requirement is the concept that race is a genetic category.

The article discusses the strategic use of race as a genetic category to obtain patent protection and drug approval. Such use of race to obtain extended patent protection for biotechnological inventions indicate a serious distortion of this relationship as commercial imperatives drive simplistic and scientifically weak conceptions of the complex relationship between social categories of race and genetics.

Gary Puckrein's paper ‘BiDil: From Another Vantage Point’ misrepresents rather than refutes our previously published analysis of BiDil. Puckrein claims that if our analysis were to prevail, patients would be denied life-saving therapy. Any reasonable reading of our paper suggests exactly the opposite. Indeed, based on the evidence, we urge doctors to prescribe the generics or BiDil itself as they see fit, but without regard to the race of their patient. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "An audience with Francis Collins" by A. Mullard in the 2011 issue.

Presents a letter to the editor on race and genomics.

A letter to the editor is presented which stresses on the issues concerning the approval of the U.S. Food and Drugs Administration on Bidil, a drug for heart failure, manufactured by NitroMed Inc.

The article discusses on issues related to medicine accessibility as a fundamental consideration in assessing the compliance with the right to health, as being called by the World Health Organization. It explains that in considering the value of medicine, it is necessary to avoid giving more emphasis on pharmaceuticals as the solution to the world's major health problems. Public interests have been an issue with regard to product patenting. In the U.S., patent assignments are based on research conducted with funding from the state.

Presents a letter to the editor in response to the article "Pharmacogenetics and ethnically targeted therapies," by T. Rahemtulla, and R. Bhopal, in the May 7, 2005 issue.

Protein transport between the nucleus and cytoplasm of eukaryotic cells is tightly regulated, providing a mechanism for controlling intracellular localization of proteins, and regulating gene expression. In this study, we have investigated the importance of nucleocytoplasmic transport mediated by the karyopherin Kap108 in regulating cellular responses to oxidative stress in Saccharomyces cerevisiae. We carried out microarray analyses on wild-type and kap108 mutant cells grown under normal conditions, shortly after introduction of oxidative stress, after 1 hr of oxidative stress, and 1 hr after oxidative stress was removed. We observe more than 500 genes that undergo a 40% or greater change in differential expression between wild-type and kap108Δ cells under at least one of these conditions. Genes undergoing changes in expression can be categorized in two general groups: 1) those that are differentially expressed between wild-type and kap108Δ cells, no matter the oxidative stress conditions; and 2) those that have patterns of response dependent upon both the absence of Kap108, and introduction or removal of oxidative stress. Gene ontology analysis reveals that, among the genes whose expression is reduced in the absence of Kap108 are those involved in stress response and intracellular transport, while those overexpressed are largely involved in mating and pheromone response. We also identified 25 clusters of genes that undergo similar patterns of change in gene expression when oxidative stresses are added and subsequently removed, including genes involved in stress response, oxidation-reduction processing, iron homeostasis, ascospore wall assembly, transmembrane transport, and cell fusion during mating. These data suggest that Kap108 is important for regulating expression of genes involved in a variety of specific cell functions. [ABSTRACT FROM AUTHOR]

Non-adherence with medication remains the major correctable cause of poor outcome in schizophrenia. However, few treatments have addressed this major determinant of outcome with novel long-term delivery systems. The aim of this study was to provide biological proof of concept for a long-term implantable antipsychotic delivery system in rodents and rabbits. Implantable formulations of haloperidol were created using biodegradable polymers. Implants were characterized for in vitro release and in vivo behavior using prepulse inhibition of startle in rats and mice, as well as pharmacokinetics in rabbits. Behavioral measures demonstrate the effectiveness of haloperidol implants delivering 1 mg/kg in mice and 0.6 mg/kg in rats to block amphetamine (10 mg/kg) in mice or apomorphine (0.5 mg/kg) in rats. Additionally, we demonstrate the pattern of release from single polymer implants for 1 year in rabbits. The current study suggests that implantable formulations are a viable approach to providing long-term delivery of antipsychotic medications in vivo using animal models of behavior and pharmacokinetics. In contrast to depot formulations, implantable formulations could last 6 months or longer. Additionally, implants can be removed throughout the delivery interval, offering a degree of reversibility not available with depot formulations. [ABSTRACT FROM AUTHOR]

1. A seasonally replicated experimental design was used to address the question of how differences within and among host tree species affect arboreal caterpillar communities. 2. Seasonal variation influenced caterpillar community composition most significantly, and the similarity among caterpillar assemblages did not necessarily follow the pattern of phylogenetic relatedness among host trees. 3. Species richness and abundance of caterpillars were higher on oaks and maples than on American beech. Diversity partitioning models revealed that β diversity was only occasionally greater or less than expected by chance alone. 4. When β diversity was significant, values tended to be greater than expected by chance among replicate trees within each species and lower than expected by chance among the four tree species. 5. Differences among trees appeared important for determining patterns of species presence/absence for rare species and influencing patterns of species dominance within caterpillar assemblages. Differences among tree species had a significant effect on overall lepidopteran community composition and mean species diversity (i.e. α diversity). 6. Because β diversity of caterpillars among host trees was lower than expected by chance, host specificity within the Lepidoptera may be less prevalent than thought previously. [ABSTRACT FROM AUTHOR]

The U.S. Food and Drug Administration's (FDA) rationale for supporting the development and approval of BiDil (a combination of hydralazine hydrochloride and isosorbide dinitrate; H-I) for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials (V-HeFT I and II), which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because the accepted baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial (A-HeFT) amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. [ABSTRACT FROM AUTHOR]

A response to a letter to the editor about his article "The Science and Business of Genetic Ancestry Testing," by D. A. Bolnick and colleagues in the October 19, 2007 issue is presented.

The article discusses several issues regarding the genetic ancestry testing (GAT) which is often described as recreational genetics. It is argued that many companies have marketed these tests to help consumers reconstruct their family histories and the geographic origins of their ancestors. It also cites that some scientists have approved this enterprise because it makes genetics accessible and relevant. However, it is noted that scientists as well as consumers must approach GAT with caution because the tests can have a significant impact on individuals and communities, the limitations of these tests make them less informative, and commercialization has led to misleading practices and misconceptions.