The Sugar Masters: Slavery, Economic Development, and Modernization on Louisiana Sugar Plantations, 1820-1860.

In this dissertation, I contend that sugar planters in the antebellum South managed their estates progressively, efficiently, and with a capitalist political economy and ideology. By embracing slavery, technology, and a host of improvements, sugar planters strove to create integrated units producing, manufacturing, and marketing sugar on an agro-industrial scale. Despite a century of historiographical debate, historians remain divided over the incompatibility of slavery with industrial and agricultural innovation. Whether they look to Adam Smith or Karl Marx, most historians deem free labor a necessity for technology and growth. This, however, appears inaccurate, as antebellum sugar planters confidently advocated improvement and saw no contradiction between capitalism and slavery. The quantitative and qualitative growth of the antebellum sugar industry remains testament to that fact. In the past twenty years, a group of scholars challenged the notion that slavery and the antebellum South were pre-capitalist. Their work, while underpinning my own study, failed to satisfactorily prove that antebellum planters operated as entrepreneurial capitalists. My dissertation hopefully fills this void as few scholars have systematically analyzed the growth of a single planter class that was so reliant on the synchronization of agriculture and industry as the Louisiana sugar masters. These agricultural magnates responded to a burgeoning market for sugar by spatially expanding their cane crops, adopting modern agricultural techniques, embracing technological improvement, practicing innovative management and shaping the dynamics of slavery to maximize labor productivity. Progressive and entrepreneurial, the sugar planters brought south Louisiana into an age of capitalist modernity. Southern progress, however, differed fundamentally from that of the North because the laborers who transformed the sugar industry and manned the steam engines were African-American slaves who materially advanced the process of modernization. By imposing order and discipline in the work-place, the planters hoped to transform their laborers into industrial workers who toiled at the mechanical pace of the steam age. To a large extent, they were successful, but to obtain the labor they required, the planters adopted both the lash and a complex system of rewards to motivate their workers during the harvest season

Genomewide Association Studies of LRRK2 Modifiers of Parkinson's Disease.

OBJECTIVE: The aim of this study was to search for genes/variants that modify the effect of LRRK2 mutations in terms of penetrance and age-at-onset of Parkinson's disease. METHODS: We performed the first genomewide association study of penetrance and age-at-onset of Parkinson's disease in LRRK2 mutation carriers (776 cases and 1,103 non-cases at their last evaluation). Cox proportional hazard models and linear mixed models were used to identify modifiers of penetrance and age-at-onset of LRRK2 mutations, respectively. We also investigated whether a polygenic risk score derived from a published genomewide association study of Parkinson's disease was able to explain variability in penetrance and age-at-onset in LRRK2 mutation carriers. RESULTS: A variant located in the intronic region of CORO1C on chromosome 12 (rs77395454; p value = 2.5E-08, beta = 1.27, SE = 0.23, risk allele: C) met genomewide significance for the penetrance model. Co-immunoprecipitation analyses of LRRK2 and CORO1C supported an interaction between these 2 proteins. A region on chromosome 3, within a previously reported linkage peak for Parkinson's disease susceptibility, showed suggestive associations in both models (penetrance top variant: p value = 1.1E-07; age-at-onset top variant: p value = 9.3E-07). A polygenic risk score derived from publicly available Parkinson's disease summary statistics was a significant predictor of penetrance, but not of age-at-onset. INTERPRETATION: This study suggests that variants within or near CORO1C may modify the penetrance of LRRK2 mutations. In addition, common Parkinson's disease associated variants collectively increase the penetrance of LRRK2 mutations. ANN NEUROL 2021;90:82-94

Power and Agency in Antebellum Slavery

This essay synthesizes conclusions about the agency of enslaved people drawn from three books by William Dusinberre: Them Dark Days; Slavemaster President; and Strategies for Survival

Randomized trial of deep brain stimulation for Parkinson disease

ObjectivesOur objective was to compare long-term outcomes of deep brain stimulation (DBS) of the globus pallidus interna (GPi) and subthalamic nucleus (STN) for patients with Parkinson disease (PD) in a multicenter randomized controlled trial.MethodsPatients randomly assigned to GPi (n = 89) or STN DBS (n = 70) were followed for 36 months. The primary outcome was motor function on stimulation/off medication using the Unified Parkinson's Disease Rating Scale motor subscale. Secondary outcomes included quality of life and neurocognitive function.ResultsMotor function improved between baseline and 36 months for GPi (41.1 to 27.1; 95% confidence interval [CI] -16.4 to -10.8; p < 0.001) and STN (42.5 to 29.7; 95% CI -15.8 to -9.4; p < 0.001); improvements were similar between targets and stable over time (p = 0.59). Health-related quality of life improved at 6 months on all subscales (all p values significant), but improvement diminished over time. Mattis Dementia Rating Scale scores declined faster for STN than GPi patients (p = 0.01); other neurocognitive measures showed gradual decline overall.ConclusionsThe beneficial effect of DBS on motor function was stable and comparable by target over 36 months. Slight declines in quality of life following initial gains and gradual decline in neurocognitive function likely reflect underlying disease progression and highlight the importance of nonmotor symptoms in determining quality of life.Classification of evidenceThis study provides Class III evidence that improvement of motor symptoms of PD by DBS remains stable over 3 years and does not differ by surgical target. Neurology® 2012;79:55-65

Subthalamic deep brain stimulation with a constant-current device in Parkinson's disease: an open-label randomised controlled trial

Background: The effects of constant-current deep brain stimulation (DBS) have not been studied in controlled trials in patients with Parkinson\u27s disease. We aimed to assess the safety and efficacy of bilateral constant-current DBS of the subthalamic nucleus. Methods: This prospective, randomised, multicentre controlled trial was done between Sept 26, 2005, and Aug 13, 2010, at 15 clinical sites specialising in movement disorders in the USA. Patients were eligible if they were aged 18-80 years, had Parkinson\u27s disease for 5 years or more, and had either 6 h or more daily off time reported in a patient diary of moderate to severe dyskinesia during waking hours. The patients received bilateral implantation in the subthalamic nucleus of a constant-current DBS device. After implantation, computer-generated randomisation was done with a block size of four, and patients were randomly assigned to the stimulation or control group (stimulation:control ratio 3:1). The control group received implantation without activation for 3 months. No blinding occurred during this study, and both patients and investigators were aware of the treatment group. The primary outcome variable was the change in on time without bothersome dyskinesia (ie, good quality on time) at 3 months as recorded in patients\u27 diaries. Patients were followed up for 1 year. This trial is registered with ClinicalTrials.gov, number NCT00552474. Findings: Of 168 patients assessed for eligibility, 136 had implantation of the constant-current device and were randomly assigned to receive immediate (101 patients) or delayed (35 patients) stimulation. Both study groups reported a mean increase of good quality on time after 3 months, and the increase was greater in the stimulation group (4·27 h vs 1·77 h, difference 2·51 [95% CI 0·87-4·16]; p=0·003). Unified Parkinson\u27s disease rating scale motor scores in the off-medication, on-stimulation condition improved by 39% from baseline (24·8 vs 40·8). Some serious adverse events occurred after DBS implantation, including infections in five (4%) of 136 patients and intracranial haemorrhage in four (3%) patients. Stimulation of the subthalamic nucleus was associated with dysarthria, fatigue, paraesthesias, and oedema, whereas gait problems, disequilibrium, dyskinesia, and falls were reported in both groups. Interpretation: Constant-current DBS of the subthalamic nucleus produced significant improvements in good quality on time when compared with a control group without stimulation. Future trials should compare the effects of constant-current DBS with those of voltage-controlled stimulation. Funding: St Jude Medical Neuromodulation Division. © 2012 Elsevier Ltd