Developing genetic therapies for polyglutamine disorders

In this thesis various genetic therapies to reduce polyglutamine-induced toxicity are discussed. Although polyglutamine disorders are caused by CAG triplet repeat expansions in different genes, they all result in gain of toxic polyglutamine protein function and subsequently neurodegeneration. The polyglutamine disorders have a monogenic cause and thus far no therapies are available to delay the age of onset or slow the disease progression. These expanded polyglutamine proteins are known to undergo proteolytic processing and this results in polyglutamine-containing protein fragments that are considered to be the main toxic entities in polyglutamine disorders. In this thesis various novel genetic therapies for polyglutamine disorders are proposed. By targeting the polyglutamine-encoding transcripts, translation of mutant polyQ protein is reduced or the polyglutamine protein is modified. This is achieved by targeting the CAG repeat directly (chapter 3), removing the motifs that are implicated in the formation of polyglutamine fragments (chapter 4), or by removal of the CAG repeat-encoding exon (chapter 5).Vereniging van Huntington Prosensa Therapeutics B.V.UBL - phd migration 201

Quantum Hall ferromagnets, cooperative transport anisotropy, and the random field Ising model

We discuss the behaviour of a quantum Hall system when two Landau levels with opposite spin and combined filling factor near unity are brought into energetic coincidence using an in-plane component of magnetic field. We focus on the interpretation of recent experiments under these conditions [Zeitler et al, Phys. Rev. Lett. 86, 866 (2001); Pan et al, Phys. Rev. B 64, 121305 (2001)], in which a large resistance anisotropy develops at low temperatures. Modelling the systems involved as Ising quantum Hall ferromagnets, we suggest that this transport anisotropy reflects domain formation induced by a random field arising from isotropic sample surface roughness.Comment: 4 pages, submitted to Physical Review

Quasiclassical magnetotransport in a random array of antidots

We study theoretically the magnetoresistance $\rho_{xx}(B)$ of a two-dimensional electron gas scattered by a random ensemble of impenetrable discs in the presence of a long-range correlated random potential. We believe that this model describes a high-mobility semiconductor heterostructure with a random array of antidots. We show that the interplay of scattering by the two types of disorder generates new behavior of $\rho_{xx}(B)$ which is absent for only one kind of disorder. We demonstrate that even a weak long-range disorder becomes important with increasing $B$. In particular, although $\rho_{xx}(B)$ vanishes in the limit of large $B$ when only one type of disorder is present, we show that it keeps growing with increasing $B$ in the antidot array in the presence of smooth disorder. The reversal of the behavior of $\rho_{xx}(B)$ is due to a mutual destruction of the quasiclassical localization induced by a strong magnetic field: specifically, the adiabatic localization in the long-range Gaussian disorder is washed out by the scattering on hard discs, whereas the adiabatic drift and related percolation of cyclotron orbits destroys the localization in the dilute system of hard discs. For intermediate magnetic fields in a dilute antidot array, we show the existence of a strong negative magnetoresistance, which leads to a nonmonotonic dependence of $\rho_{xx}(B)$.Comment: 21 pages, 13 figure

Semiclassical theory of transport in a random magnetic field

We study the semiclassical kinetics of 2D fermions in a smoothly varying magnetic field $B({\bf r})$. The nature of the transport depends crucially on both the strength $B_0$ of the random component of $B({\bf r})$ and its mean value $\bar{B}$. For $\bar{B}=0$, the governing parameter is $\alpha=d/R_0$, where $d$ is the correlation length of disorder and $R_0$ is the Larmor radius in the field $B_0$. While for $\alpha\ll 1$ the Drude theory applies, at $\alpha\gg 1$ most particles drift adiabatically along closed contours and are localized in the adiabatic approximation. The conductivity is then determined by a special class of trajectories, the "snake states", which percolate by scattering at the saddle points of $B({\bf r})$ where the adiabaticity of their motion breaks down. The external field also suppresses the diffusion by creating a percolation network of drifting cyclotron orbits. This kind of percolation is due only to a weak violation of the adiabaticity of the cyclotron rotation, yielding an exponential drop of the conductivity at large $\bar{B}$. In the regime $\alpha\gg 1$ the crossover between the snake-state percolation and the percolation of the drift orbits with increasing $\bar{B}$ has the character of a phase transition (localization of snake states) smeared exponentially weakly by non-adiabatic effects. The ac conductivity also reflects the dynamical properties of particles moving on the fractal percolation network. In particular, it has a sharp kink at zero frequency and falls off exponentially at higher frequencies. We also discuss the nature of the quantum magnetooscillations. Detailed numerical studies confirm the analytical findings. The shape of the magnetoresistivity at $\alpha\sim 1$ is in good agreement with experimental data in the FQHE regime near $\nu=1/2$.Comment: 22 pages REVTEX, 14 figure

Exploring the identification, validation, and categorization of costs and benefits of education in mental health: the PECUNIA project

BackgroundMental health problems can lead to costs and benefits in other sectors (e.g. in the education sector) in addition to the healthcare sector. These related costs and benefits are known as intersectoral costs and benefits (ICBs). Although some ICBs within the education sector have been identified previously, little is known about their extensiveness and transferability, which is crucial for their inclusion in health economics research.ObjectivesThe aim of this study was to identify ICBs in the education sector, to validate the list of ICBs in a broader European context, and to categorize the ICBs using mental health as a case study.MethodsPreviously identified ICBs in the education sector were used as a basis for this study. Additional ICBs were extracted from peer-reviewed literature in PubMed and grey literature from six European countries. A comprehensive list of unique items was developed based on the identified ICBs. The list was validated by surveying an international group of educational experts. The survey results were used to finalize the list, which was categorized according to the care atom.ResultsAdditional ICBs in the education sector were retrieved from ninety-six sources. Fourteen experts from six European countries assessed the list for completeness, clarity, and relevance. The final list contained twenty-four ICBs categorized into input, throughput, and output.ConclusionBy providing a comprehensive list of ICBs in the education sector, this study laid further foundations for the inclusion of important societal costs in health economics research in the broader European context

International comparability of reference unit costs of education services: when harmonizing methodology is not enough (PECUNIA project)

Background: Health problems can lead to costs in the education sector. However, these costs are rarely incorporated in health economic evaluations due to the lack of reference unit costs (RUCs), cost per unit of service, of education services and of validated methods to obtain them. In this study, a standardized unit cost calculation tool developed in the PECUNIA project, the PECUNIA RUC Template for services, was applied to calculate the RUCs of selected education services in five European countries. Methods: The RUCs of special education services and of educational therapy were calculated using the information collected via an exploratory gray literature search and contact with service providers. Results: The RUCs of special education services ranged from €55 to €189 per school day. The RUCs of educational therapy ranged from €6 to €25 per contact and from €5 to €35 per day. Variation was observed in the type of input data and measurement unit, among other. Discussion: The tool helped reduce variability in the RUCs related to costing methodology and gain insights into other aspects that contribute to the variability (e.g. data availability). Further research and efforts to generate high quality input data are required to reduce the variability of the RUCs

Reconfiguring tissue banking consent through enrichment of a restricted debate

Tissue banks are thought to be an essential resource for medical research in the post-genomic age. Collections of tissue, usually removed in the course of diagnostic or therapeutic procedures, enable laboratory-based epidemiological studies to be carried out, linking abnormalities in the tissue to disease aetiology, prognosis and treatment responsiveness. There are, however, a number of technical, regulatory and ethical concerns that challenge those wishing to engage in tissue banking research. It is becoming increasingly apparent that tissue banking research is not without risk of harms, even though there is no direct physical risk to donors. This is because, in order to be most useful, banked specimens need to be linked to personal information about tissue donors and this poses the risk of inadvertent disclosure of personal─ particularly genetic─ information to those who might exploit such information (eg. insurance companies and employers). Furthermore, the long-term storage of specimens, and the impossibility of predicting all potential types of research programs for which they might be useful, raises the possibility that future projects will be carried out that are unacceptable to some (past) tissue donors. The ethical principles of autonomy and respect for persons demand that research subjects be informed of such risks and of the nature of the research, and that they participate willingly. On the other hand, there is a desire for science to progress unhindered by stringent consent requirements. For these reasons, a debate has emerged in the academic (bioethical and biomedical) literature and in the legal (law reform) sphere over what would constitute adequate consent. Despite an extensive discourse, it is still unclear whether it is permissible to carry out research on archival tissue that was originally taken for diagnostic purposes and whether project-specific (as opposed to open-ended) consent is required for research on tissue collected today. This lack of clarity is of concern to researchers, ethics committees and research subjects, all of whom recognise the importance of tissue banking research, yet fear that current consent procedures may be ethically or legally inadequate. Thus it is important that the consent dilemma be resolved as quickly and definitively as possible. Ongoing controversy and regulatory ambiguity are appropriate when morally contentious issues are at stake, and their existence does not, on its own, signal any flaws in the discourse process. There are, however, two reasons to suspect that the current 'consent to tissue banking' debate, as portrayed in the academic literature and law reform documentation, is problematic. Firstly, the debate appears to be mired in an intractable conflict between those who want to maximise personal autonomy through stringent consent requirements, and those who want the scientific endeavour to progress in a manner that is unconstrained by what are viewed as arduous consent procedures. Secondly, the possible practical options (consent models) being generated by the debate are all limited because they are underpinned by a restricted notion of consent as an individualistic, legalistic and static activity, without consideration of any alternative conceptualisations of consent. Through a thematic analysis of the current 'consent to tissue banking' debate in the academic and law reform literature (Section 3), this thesis shows that debate is essentially occurring between those who see individual autonomy (and stringent consent) as being of primary importance, and those who see unimpeded, market-driven scientific progress as the more important social good, which should not be impeded by unnecessarily stringent consent. Thematic analysis also confirms the existence of the two problems described above, and a failure of those engaged in the debate to reflect on, and challenge, the value-level assumptions underpinning their arguments and those of their opponents. It is argued that this lack of reflection accounts for the two problems: • Firstly, it precludes recognition of the cause of─ and, therefore, ways of resolving─ the intractable conflict at the centre of the debate. Value-level reflection shows that this is a result of the logical and moral conflict within western liberalism, between two modernist goods: individual freedom and scientific progress. • Secondly, it precludes the generation of varied conceptions of consent. Value-level reflection shows that the current range of consent models is restricted to procedures which are individualistic, abstract, static and legalistic, since they are underpinned by western liberal notions of autonomy and scientific progress. This recognition paves the way to consideration of alternative notions of autonomy, scientific progress and, therefore, consent, such as those derived from communitarian and feminist systems of values. A conceptually enriched model of tissue banking consent is then developed (Section 4). This model incorporates dominant (liberal) conceptions of autonomy and scientific progress as well as alternative notions of autonomy and scientific progress espoused by communitarian and feminist systems of values. It is argued that this conceptually-enriched model provides a practical solution to the two problems associated with the standard 'consent to tissue banking' debate. In relation to the philosophically intractable conflict─ or what is termed the 'modernist dilemma'─ between those privileging autonomy and those privileging scientific progress, it shows how the two apparently conflicting 'modernist' goods can both be accommodated at a practical level, thus making the 'consent to tissue banking' debate more tractable and fruitful. In relation to the restricted range of consent models being generated by the current debate, it provides new insights into the ways in which consent might be obtained such that a broader range of community values can be accommodated. More specifically, it stimulates the construction of a model that 1) involves communities, as opposed to merely individuals, in all stages of the scientific process; 2) is flexible and able to adapt consent procedures to specific contexts, rather than predefining procedures in abstract terms; and 3) is transactional and relational rather than static and legalistic. This outcome has interesting philosophical as well as practical implications. It shows that despite apparently unresolved, and possibly irresolvable, normative-level conflicts between the two modernist elements of western liberalism (autonomy and scientific progress), and between liberal, feminist and communitarian systems of values, a multi-perspectival, inclusive, model-building approach provides a practical solution that circumvents these normative-level conflicts

Origin and Properties of the Gap in the Half-Ferromagnetic Heusler Alloys

We study the origin of the gap and the role of chemical composition in the half-ferromagnetic Heusler alloys using the full-potential screened KKR method. In the paramagnetic phase the C1_b compounds, like NiMnSb, present a gap. Systems with 18 valence electrons, Z_t, per unit cell, like CoTiSb, are semiconductors, but when Z_t > 18 antibonding states are also populated, thus the paramagnetic phase becomes unstable and the half-ferromagnetic one is stabilized. The minority occupied bands accommodate a total of nine electrons and the total magnetic moment per unit cell in mu_B is just the difference between Z_t and $2 \times 9$. While the substitution of the transition metal atoms may preserve the half-ferromagnetic character, substituting the $sp$ atom results in a practically rigid shift of the bands and the loss of half-metallicity. Finally we show that expanding or contracting the lattice parameter by 2% preserves the minority-spin gap.Comment: 11 pages, 7 figures New figures, revised tex

The identification of economically relevant health and social care services for mental disorders in the PECUNIA project

Background: Health economic research is still facing significant problems regarding the standardization and international comparability of health care services. As a result, comparative effectiveness studies and cost-effectiveness analyses are often not comparable. This study is part of the PECUNIA project, which aimed to improve the comparability of economic evaluations by developing instruments for the internationally standardized measurement and valuation of health care services for mental disorders. The aim of this study was to identify internationally relevant services in the health and social care sectors relevant for health economic studies for mental disorders. Methods: A systematic literature review on cost-of-illness studies and economic evaluations was conducted to identify relevant services, complemented by an additional grey literature search and a search of resource use measurement (RUM) questionnaires. A preliminary long-list of identified services was explored and reduced to a short-list by multiple consolidation rounds within the international research team and an external international expert survey in six European countries. Results: After duplicate removal, the systematic search yielded 15,218 hits. From these 295 potential services could be identified. The grey literature search led to 368 and the RUM search to 36 additional potential services. The consolidation process resulted in a preliminary list of 186 health and social care services which underwent an external expert survey. A final consolidation step led to a basic list of 56 services grouped into residential care, daycare, outpatient care, information for care, accessibility to care, and self-help and voluntary care. Conclusions: The initial literature searches led to an extensive number of potential service items for health and social care. Many of these items turned out to be procedures, interventions or providing professionals rather than services and were removed from further analysis. The resulting list was used as a basis for typological coding, the development of RUM questionnaires and corresponding unit costs for international mental health economic studies in the PECUNIA project.</p