Collective physician perspectives on non-oral medication approaches for the management of clinically relevant unresolved issues in Parkinson's disease: Consensus from an international survey and discussion program

Navigate PD was an educational program established to supplement existing guidelines and provide recommendations on the management of Parkinson's disease (PD) refractory to oral/transdermal therapies. It involved 103 experts from 13 countries overseen by an International Steering Committee (ISC) of 13 movement disorder specialists. The ISC identified 71 clinical questions important for device-aided management of PD. Fifty-six experts responded to a web-based survey, rating 15 questions as ‘critically important;’ these were refined to 10 questions by the ISC to be addressed through available evidence and expert opinion. Draft guidance was presented at international/national meetings and revised based on feedback. Key take-home points are: • Patients requiring levodopa >5 times daily who have severe, troublesome ‘off’ periods (>1–2 h/day) despite optimal oral/transdermal levodopa or non-levodopa-based therapies should be referred for specialist assessment even if disease duration is <4 years. • Cognitive decline related to non-motor fluctuations is an indication for device-aided therapies. If cognitive impairment is mild, use deep brain stimulation (DBS) with caution. For patients who have cognitive impairment or dementia, intrajejunal levodopa infusion is considered as both therapeutic and palliative in some countries. Falls are linked to cognitive decline and are likely to become more frequent with device-aided therapies. • Insufficient control of motor complications (or drug-resistant tremor in the case of DBS) are indications for device-aided therapies. Levodopa-carbidopa intestinal gel infusions or subcutaneous apomorphine pump may be considered for patients aged >70 years who have mild or moderate cognitive impairment, severe depression or other contraindications to DBS

Transition metal dichalcogenide dimer nanoantennas for tailored light–matter interactions

Transition metal dichalcogenides have emerged as promising materials for nanophotonic resonators because of their large refractive index, low absorption within a large portion of the visible spectrum, and compatibility with a wide range of substrates. Herein, we use these properties to fabricate WS2 double-pillar nanoantennas in a variety of geometries enabled by the anisotropy in the crystal structure. Using dark-field spectroscopy, we reveal multiple Mie resonances, to which we couple WSe2 monolayer photoluminescence and achieve Purcell enhancement and an increased fluorescence by factors up to 240 for dimer gaps of 150 nm. We introduce postfabrication atomic force microscope repositioning and rotation of dimer nanoantennas, achieving gaps as small as 10 ± 5 nm, which enables a host of potential applications, including strong Purcell enhancement of single-photon emitters and optical trapping, which we study in simulations. Our findings highlight the advantages of using transition metal dichalcogenides for nanophotonics by exploring applications enabled by their properties

Radiative Decay of a Long-Lived Particle and Big-Bang Nucleosynthesis

The effects of radiatively decaying, long-lived particles on big-bang nucleosynthesis (BBN) are discussed. If high-energy photons are emitted after BBN, they may change the abundances of the light elements through photodissociation processes, which may result in a significant discrepancy between the BBN theory and observation. We calculate the abundances of the light elements, including the effects of photodissociation induced by a radiatively decaying particle, but neglecting the hadronic branching ratio. Using these calculated abundances, we derive a constraint on such particles by comparing our theoretical results with observations. Taking into account the recent controversies regarding the observations of the light-element abundances, we derive constraints for various combinations of the measurements. We also discuss several models which predict such radiatively decaying particles, and we derive constraints on such models.Comment: Published version in Phys. Rev. D. Typos in figure captions correcte

Dimensionless cosmology

Although it is well known that any consideration of the variations of fundamental constants should be restricted to their dimensionless combinations, the literature on variations of the gravitational constant $G$ is entirely dimensionful. To illustrate applications of this to cosmology, we explicitly give a dimensionless version of the parameters of the standard cosmological model, and describe the physics of Big Bang Neucleosynthesis and recombination in a dimensionless manner. The issue that appears to have been missed in many studies is that in cosmology the strength of gravity is bound up in the cosmological equations, and the epoch at which we live is a crucial part of the model. We argue that it is useful to consider the hypothetical situation of communicating with another civilization (with entirely different units), comparing only dimensionless constants, in order to decide if we live in a Universe governed by precisely the same physical laws. In this thought experiment, we would also have to compare epochs, which can be defined by giving the value of any {\it one} of the evolving cosmological parameters. By setting things up carefully in this way one can avoid inconsistent results when considering variable constants, caused by effectively fixing more than one parameter today. We show examples of this effect by considering microwave background anisotropies, being careful to maintain dimensionlessness throughout. We present Fisher matrix calculations to estimate how well the fine structure constants for electromagnetism and gravity can be determined with future microwave background experiments. We highlight how one can be misled by simply adding $G$ to the usual cosmological parameter set

Dystonia management: what to expect from the future? The perspectives of patients and clinicians within DystoniaNet Europe

Improved care for people with dystonia presents a number of challenges. Major gaps in knowledge exist with regard to how to optimize the diagnostic process, how to leverage discoveries in pathophysiology into biomarkers, and how to develop an evidence base for current and novel treatments. These challenges are made greater by the realization of the wide spectrum of symptoms and difficulties faced by people with dystonia, which go well-beyond motor symptoms. A network of clinicians, scientists, and patients could provide resources to facilitate information exchange at different levels, share mutual experiences, and support each other's innovative projects. In the past, collaborative initiatives have been launched, including the American Dystonia Coalition, the European Cooperation in Science and Technology (COST-which however only existed for a limited time), and the Dutch DystonieNet project. The European Reference Network on Rare Neurological Diseases includes dystonia among other rare conditions affecting the central nervous system in a dedicated stream. Currently, we aim to broaden the scope of these initiatives to a comprehensive European level by further expanding the DystoniaNet network, in close collaboration with the ERN-RND. In line with the ERN-RND, the mission of DystoniaNet Europe is to improve care and quality of life for people with dystonia by, among other endeavors, facilitating access to specialized care, overcoming the disparity in education of medical professionals, and serving as a solid platform to foster international clinical and research collaborations. In this review, both professionals within the dystonia field and patients and caregivers representing Dystonia Europe highlight important unsolved issues and promising new strategies and the role that a European network can play in activating them.Neurological Motor Disorder

Gender Matters: The Influence of Acculturation and Acculturative Stress on Latino College Student Depressive Symptomatology

The purpose of the study was to examine the relationship between acculturation-related variables with depressive symptomatology among Latino college students and the extent to which acculturative stress mediates the association. The extent to which gender moderates these relationships was also examined. Participants were 758 Latina and 264 Latino college students from 30 colleges and universities around the United States. Participants completed measures of acculturation, acculturative stress, and depression. Multigroup path analysis provided excellent model fit and suggested moderation by gender. Acculturative stress mediated the acculturation–depression relationship. One indirect effect was moderated by gender with effects stronger for men: Heritage-culture retention to depressive symptoms via Spanish Competency Pressures. Acculturation and acculturative stress contribute to depression differently for male and female Latino college students. Future research should note the influence of gender socialization on the acculturation process and mental health

Measurement of Z/gamma*+jet+X angular distributions in ppbar collisions at sqrt{s}=1.96 TeV

We present the first measurements at a hadron collider of differential cross sections for Z+jet+X production in delta phi(Z, jet), |delta y(Z, jet)| and |y_boost(Z, jet)|. Vector boson production in association with jets is an excellent probe of QCD and constitutes the main background to many small cross section processes, such as associated Higgs production. These measurements are crucial tests of the predictions of perturbative QCD and current event generators, which have varied success in describing the data. Using these measurements as inputs in tuning event generators will increase the experimental sensitivity to rare signals.Comment: Published in Physics Letters B 682 (2010), pp. 370-380. 15 pages, 6 figure

Mechanisms of international influence on domestic elite sport policy

In the analysis of sport policy the permeability of domestic policy processes and the significance of non-domestic policy influences is increasingly acknowledged. There is also a growing awareness of the role of domestic institutional arrangements in mediating influences external to the domestic policy system. Taking the interaction between non-domestic influences and domestic policy processes as its starting point the article evaluates, in relation to elite sport, the variety of mechanisms that have been identified as linking the domestic and non-domestic policy spheres. It is argued that the mechanisms vary in relation to the locus of initiative, the basis of engagement, the key relationships and the nature of power relationships. It is also argued that in many countries in relation to elite sport policy there is a dual process in operation of domestically initiated policy learning and non-domestically initiated policy harmonisation through policy regimes