Characterization of vitamin D supplementation and clinical outcomes in a large cohort of early Parkinson's disease.

BackgroundVitamin D (VitD) deficiency is common in Parkinson's disease (PD) and has been raised as a possible PD risk factor. In the past decade, VitD supplementation for potential prevention of age related conditions has become more common. In this study, we sought to characterize VitD supplementation in early PD and determine as an exploratory analysis whether baseline characteristics or disease progression differed according to reported VitD use.MethodsWe analyzed data from the National Institutes of Health Exploratory Trials in Parkinson's Disease (NET-PD) Long-term study (LS-1), a longitudinal study of 1741 participants. Subjects were divided into following supplement groups according to subject exposure (6 months prior to baseline and during the study): no VitD supplement, multivitamin (MVI), VitD ≥400 IU/day, and VitD + multivitamin (VitD+MVI). Clinical status was followed using the Unified Parkinson's Disease Rating Scale, Symbol Digit Modalities Test, total daily levodopa equivalent dose, and Parkinson's Disease Questionnaire.ResultsAbout 5% of subjects took VitD alone, 7% took VitD+MVI, 34% took MVI alone, while 54% took no supplement. Clinical outcomes at 3 years were similar across all groups.ConclusionThis study shows VitD supplementation ≥400 IU/day was not common in early PD and that its use was similar to that seen in the US population. At 3 years, there was no difference in disease progression according to vitamin D supplement use

Enforcement of Contracts in Vietnam and the Risks of Bilateral Investment Treaty (BIT) Disputes

The Constitution in force (1992) consists of 147 articles divided into twelve chapters after a preamble, embodying the policy and legislation of Doi Moi. As for the political system, it is stipulated that: “The State promotes a multi-component commodity economy functioning in accordance with market mechanisms under the management of the State and following a socialist orientation. The multi-component economic structure with various forms of organization of production and trading is based on a system of ownership by the entire people, by collectives, and by private individuals, of which ownership by the entire people and by collectives constitutes the foundation.” This article provides an acute analysis of the structural and procedural provisions of the frameworks for contract enforcement in Vietnam, addressing both domestic and foreign transactional disputes and the key issues associated with these. The link between Doi Moi, and consequential integration with the international economy and the influence of collective interests stipulated in the Constitution are discussed in this article, and we also consider examples from other jurisdictions to provide both insight and an understanding into this relationship that defines contract enforcement in Vietnam

Comparison of the two most commonly used treatments for pyoderma gangrenosum: results of the STOP GAP randomised controlled trial

Objective To determine whether ciclosporin is superior to prednisolone for the treatment of pyoderma gangrenosum, a painful, ulcerating skin disease with a poor evidence base for management. Design Multicentre, parallel group, observer blind, randomised controlled trial. Setting 39 UK hospitals, recruiting from June 2009 to November 2012. Participants 121 patients (73 women, mean age 54 years) with clinician diagnosed pyoderma gangrenosum. Clinical diagnosis was revised in nine participants after randomisation, leaving 112 participants in the analysis set (59 ciclosporin; 53 rednisolone). Intervention Oral prednisolone 0.75 mg/kg/day compared with ciclosporin 4 mg/kg/day, to a maximum dose of 75 and 400 mg/day, respectively. Main outcome measures The primary outcome was speed of healing over six weeks, captured using digital images and assessed by blinded investigators. Secondary outcomes were time to healing, global treatment response, resolution of inflammation, self reported pain, quality of life, number of treatment failures, adverse reactions, and time to recurrence. Outcomes were assessed at baseline and six weeks and when the ulcer had healed (to a maximum of six months). Results Of the 112 participants, 108 had complete primary outcome data at baseline and six weeks (57 ciclosporin; 51 rednisolone). Groups were balanced at baseline. The mean (SD) speed of healing at six weeks was −0.21 (1.00) cm2/day in the ciclosporin group compared with −0.14 (0.42) cm2/day in the prednisolone group. The adjusted mean difference showed no between group difference (0.003 cm2/day, 95% confidence interval −0.20 to 0.21; P=0.97). By six months, ulcers had healed in 28/59 (47%) participants in the ciclosporin group compared with 25/53 (47%) in the prednisolone group. In those with healed ulcers, eight (30%) receiving ciclosporin and seven (28%) receiving prednisolone had a recurrence. Adverse reactions were similar for the two groups (68% ciclosporin and 66% prednisolone), but serious adverse reactions, especially infections, were more common in the prednisolone group. Conclusion Prednisolone and ciclosporin did not differ across a range of objective and patient reported outcomes. Treatment decisions for individual patients may be guided by the different side effect profiles of the two drugs and patient preference. Trial registration Current Controlled Trials ISRCTN35898459

Target and beam-target spin asymmetries in exclusive pion electroproduction for Q2>1GeV2 . I. ep→eπ+n

Beam-target double-spin asymmetries and target single-spin asymmetries were measured for the exclusive π + electroproduction reaction γ ∗ p → n π + . The results were obtained from scattering of 6-GeV longitudinally polarized electrons off longitudinally polarized protons using the CEBAF Large Acceptance Spectrometer at Jefferson Laboratory. The kinematic range covered is 1.1 < W < 3 GeV and 1 < Q 2 < 6 GeV 2 . Results were obtained for about 6000 bins in W ,   Q 2 ,   cos ( θ ∗ ) , and ϕ ∗ . Except at forward angles, very large target-spin asymmetries are observed over the entire W region. Reasonable agreement is found with phenomenological fits to previous data for W < 1.6 GeV, but very large differences are seen at higher values of W . A generalized parton distributions (GPD)-based model is in poor agreement with the data. When combined with cross-sectional measurements, the present results provide powerful constraints on nucleon resonance amplitudes at moderate and large values of Q 2 , for resonances with masses as high as 2.4 GeV

From Disease Association to Risk Assessment: An Optimistic View from Genome-Wide Association Studies on Type 1 Diabetes

Genome-wide association studies (GWAS) have been fruitful in identifying disease susceptibility loci for common and complex diseases. A remaining question is whether we can quantify individual disease risk based on genotype data, in order to facilitate personalized prevention and treatment for complex diseases. Previous studies have typically failed to achieve satisfactory performance, primarily due to the use of only a limited number of confirmed susceptibility loci. Here we propose that sophisticated machine-learning approaches with a large ensemble of markers may improve the performance of disease risk assessment. We applied a Support Vector Machine (SVM) algorithm on a GWAS dataset generated on the Affymetrix genotyping platform for type 1 diabetes (T1D) and optimized a risk assessment model with hundreds of markers. We subsequently tested this model on an independent Illumina-genotyped dataset with imputed genotypes (1,008 cases and 1,000 controls), as well as a separate Affymetrix-genotyped dataset (1,529 cases and 1,458 controls), resulting in area under ROC curve (AUC) of ∼0.84 in both datasets. In contrast, poor performance was achieved when limited to dozens of known susceptibility loci in the SVM model or logistic regression model. Our study suggests that improved disease risk assessment can be achieved by using algorithms that take into account interactions between a large ensemble of markers. We are optimistic that genotype-based disease risk assessment may be feasible for diseases where a notable proportion of the risk has already been captured by SNP arrays

TGF-β in tolerance, development and regulation of immunity

AbstractThe TGF-β superfamily is an ancient metazoan protein class which cuts across cell and tissue differentiation, developmental biology and immunology. Its many members are regulated at multiple levels from intricate control of gene transcription, post-translational processing and activation, and signaling through overlapping receptor structures and downstream intracellular messengers. We have been interested in TGF-β homologues firstly as key players in the induction of immunological tolerance, the topic so closely associated with Ray Owen. Secondly, our interests in how parasites may manipulate the immune system of their host has also brought us to study the TGF-β pathway in infections with longlived, essentially tolerogenic, helminth parasites. Finally, within the spectrum of mammalian TGF-β proteins is an exquisitely tightly-regulated gene, anti-Müllerian hormone (AMH), whose role in sex determination underpins the phenotype of freemartin calves that formed the focus of Ray’s seminal work on immunological tolerance

Beam-target double-spin asymmetry in quasielastic electron scattering off the deuteron with CLAS

Background: The deuteron plays a pivotal role in nuclear and hadronic physics, as both the simplest bound multinucleon system and as an effective neutron target. Quasielastic electron scattering on the deuteron is a benchmark reaction to test our understanding of deuteron structure and the properties and interactions of the two nucleons bound in the deuteron. Purpose: The experimental data presented here can be used to test state-of-the-art models of the deuteron and the two-nucleon interaction in the final state after two-body breakup of the deuteron. Focusing on polarization degrees of freedom, we gain information on spin-momentum correlations in the deuteron ground state (due to the D -state admixture) and on the limits of the impulse approximation (IA) picture as it applies to measurements of spin-dependent observables like spin structure functions for bound nucleons. Information on this reaction can also be used to reduce systematic uncertainties on the determination of neutron form factors or deuteron polarization through quasielastic polarized electron scattering. Method: We measured the beam-target double-spin asymmetry ( A | | ) for quasielastic electron scattering off the deuteron at several beam energies ( 1.6 – 1.7 , 2.5, 4.2, and 5.6 – 5.8 GeV ), using the CEBAF Large Acceptance Spectrometer (CLAS) at the Thomas Jefferson National Accelerator Facility. The deuterons were polarized along (or opposite to) the beam direction. The double-spin asymmetries were measured as a function of photon virtuality Q 2 ( 0.13 – 3.17 ( GeV / c ) 2 ) , missing momentum ( p m = 0.0 – 0.5 GeV / c ) , and the angle between the (inferred) spectator neutron and the momentum transfer direction ( θ n q ) . Results: The results are compared with a recent model that includes final-state interactions (FSI) using a complete parametrization of nucleon-nucleon scattering, as well as a simplified model using the plane wave impulse approximation (PWIA). We find overall good agreement with both the PWIA and FSI expectations at low to medium missing momenta ( p m ≤ 0.25 GeV / c ) , including the change of the asymmetry due to the contribution of the deuteron D state at higher momenta. At the highest missing momenta, our data clearly agree better with the calculations including FSI. Conclusions: Final-state interactions seem to play a lesser role for polarization observables in deuteron two-body electrodisintegration than for absolute cross sections. Our data, while limited in statistical power, indicate that PWIA models work reasonably well to understand the asymmetries at lower missing momenta. In turn, this information can be used to extract the product of beam and target polarization ( P b P t ) from quasielastic electron-deuteron scattering, which is useful for measurements of spin observables in electron-neutron inelastic scattering. However, at the highest missing (neutron) momenta, FSI effects become important and must be accounted for

Cross Sections for the Exclusive Photon Electroproduction on the Proton and Generalized Parton Distributions

International audienceUnpolarized and beam-polarized fourfold cross sections ðd4σ=dQ2dxBdtdϕÞ for the ep → e0p0γreaction were measured using the CLAS detector and the 5.75-GeV polarized electron beam of theJefferson Lab accelerator, for 110 (Q2; xB; t) bins over the widest phase space ever explored in the valencequarkregion. Several models of generalized parton distributions (GPDs) describe the data well at most ofour kinematics. This increases our confidence that we understand the GPD H, expected to be the dominantcontributor to these observables. Through a leading-twist extraction of Compton form factors, these resultssupport the model predictions of a larger nucleon size at lower quark-momentum fraction xB