Of molecules and networks

This thesis takes the DNA molecule and its circulation between scientific researchers as an object of analysis. The study's objective was to investigate the techno-social mechanisms through which certain individual's genetic materials are imputed with research value. Two cases, representing two contrasting kinds of circulation practices, are presented. In the first, DNA samples from families diagnosed with hereditary disorders, which allow researchers a shot at the all-or-nothing game of finding genes, are a protected resource. In the second, the DNA reference panel of the CEPH (Centre d'Etude du Polymorphisme Humain), made up of samples from large multi-generation families, is a widely distributed public resource. The CEPH panel was originally intended for use in genome mapping, but more recently has acted as a technology that aids in the innovation of new techniques and theories. It is argued that the difference in utility (limited or flexible) between these two types of DNA (privately or publicly held) is not found in any inherent property of the samples themselves but rather derives from the extent of the molecule's network of circulation

From long-term savings to instant mortgages: financial demonstration and the role of interaction in markets

Accounts of the crisis have privileged 'high finance' innovations whereas retail banks constantly experimented with how they sell (new) products to consumers. I examine the case of product innovation at a home savings bank in Hungary during the pre-crisis credit boom. Turned from offering state-subsidized long-term savings-and-loans to promoting instant mortgages. Based on ethnographic observations of the bank's Direct Selling Organization, I trace the bank's shift from state-subsidized long-term savings-and-loans to instant mortgages, to problems with demonstrating the qualities of financial products, even ostensibly prudent ones. Drawing on concepts of scientific demonstration and proof, I compare how financial advisors explained the plan to consumers before and after it was combined with mortgages: first they drew the funds by hand, later they adopted software-generated scenarios. I suggest that as sellers perform products interactively with clients, consumers' needs appear. Thus, when organized differently, financial demonstrations yield different consumers-with-preferences. Based on this interactional perspective, I find that consumer finance is an 'economy of qualities' where preferences and product properties stabilize through consultation, and where "social" embedding can enable "economic" calculations. Based on this interactional perspective, I examine US and UK proposals for consumer financial protection

Effect of Urate-Elevating Inosine on Early Parkinson Disease Progression: The SURE-PD3 Randomized Clinical Trial

Importance: Urate elevation, despite associations with crystallopathic, cardiovascular, and metabolic disorders, has been pursued as a potential disease-modifying strategy for Parkinson disease (PD) based on convergent biological, epidemiological, and clinical data. Objective: To determine whether sustained urate-elevating treatment with the urate precursor inosine slows early PD progression. Design, Participants, and Setting: Randomized, double-blind, placebo-controlled, phase 3 trial of oral inosine treatment in early PD. A total of 587 individuals consented, and 298 with PD not yet requiring dopaminergic medication, striatal dopamine transporter deficiency, and serum urate below the population median concentration (\u3c5.8 mg/dL) were randomized between August 2016 and December 2017 at 58 US sites, and were followed up through June 2019. Interventions: Inosine, dosed by blinded titration to increase serum urate concentrations to 7.1-8.0 mg/dL (n = 149) or matching placebo (n = 149) for up to 2 years. Main Outcomes and Measures: The primary outcome was rate of change in the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS; parts I-III) total score (range, 0-236; higher scores indicate greater disability; minimum clinically important difference of 6.3 points) prior to dopaminergic drug therapy initiation. Secondary outcomes included serum urate to measure target engagement, adverse events to measure safety, and 29 efficacy measures of disability, quality of life, cognition, mood, autonomic function, and striatal dopamine transporter binding as a biomarker of neuronal integrity. Results: Based on a prespecified interim futility analysis, the study closed early, with 273 (92%) of the randomized participants (49% women; mean age, 63 years) completing the study. Clinical progression rates were not significantly different between participants randomized to inosine (MDS-UPDRS score, 11.1 [95% CI, 9.7-12.6] points per year) and placebo (MDS-UPDRS score, 9.9 [95% CI, 8.4-11.3] points per year; difference, 1.26 [95% CI, -0.59 to 3.11] points per year; P = .18). Sustained elevation of serum urate by 2.03 mg/dL (from a baseline level of 4.6 mg/dL; 44% increase) occurred in the inosine group vs a 0.01-mg/dL change in serum urate in the placebo group (difference, 2.02 mg/dL [95% CI, 1.85-2.19 mg/dL]; P\u3c.001). There were no significant differences for secondary efficacy outcomes including dopamine transporter binding loss. Participants randomized to inosine, compared with placebo, experienced fewer serious adverse events (7.4 vs 13.1 per 100 patient-years) but more kidney stones (7.0 vs 1.4 stones per 100 patient-years). Conclusions and Relevance: Among patients recently diagnosed as having PD, treatment with inosine, compared with placebo, did not result in a significant difference in the rate of clinical disease progression. The findings do not support the use of inosine as a treatment for early PD