The progressive nature of Parkinson’s disease, its complex treatment regimens and the high rates of comorbid conditions make self-management and treatment adherence a challenge. Clinicians have limited face-to-face consultation time with Parkinson’s disease patients, making it difficult to comprehensively address non-adherence. Here we share the results from a multi-centre (seven centres) randomised controlled trial conducted in England and Scotland to assess the impact of using a smartphone-based Parkinson’s tracker app to promote patient self-management, enhance treatment adherence and quality of clinical consultation. Eligible Parkinson’s disease patients were randomised using a 1:1 ratio according to a computer-generated random sequence, stratified by centre and using blocks of variable size, to intervention Parkinson’s Tracker App or control (Treatment as Usual). Primary outcome was the self-reported score of adherence to treatment (Morisky medication adherence scale −8) at 16 weeks. Secondary outcomes were Quality of Life (Parkinson’s disease questionnaire −39), quality of consultation for Parkinson’s disease patients (Patient-centred questionnaire for Parkinson’s disease), impact on non-motor symptoms (Non-motor symptoms questionnaire), depression and anxiety (Hospital anxiety and depression scale) and beliefs about medication (Beliefs about Medication Questionnaire) at 16 weeks. Primary and secondary endpoints were analysed using a generalised linear model with treatment as the fixed effect and baseline measurement as the covariate. 158 patients completed the study (Parkinson’s tracker app = 68 and TAU = 90). At 16 weeks Parkinson’s tracker app significantly improved adherence, compared to treatment as usual (mean difference: 0.39, 95%CI 0.04–0.74; p = 0.0304) with no confounding effects of gender, number of comorbidities and age. Among secondary outcomes, Parkinson’s tracker app significantly improved patients’ perception of quality of consultation (0.15, 95% CI 0.03 to 0.27; p = 0.0110). The change in non-motor symptoms was −0.82 (95% CI −1.75 to 0.10; p = 0.0822). 72% of participants in the Parkinson’s tracker app group continued to use and engage with the application throughout the 16-week trial period. The Parkinson’s tracker app can be an effective and novel way of enhancing self-reported medication adherence and quality of clinical consultation by supporting self-management in Parkinson’s disease in patients owning smartphones. Further work is recommended to determine whether the benefits of the intervention are maintained beyond the 16 week study period.

Human lymphoblastoid cells derived from different healthy individuals display considerable variation in their transcription profiles.Here we show that such variation in gene expression underlies interindividual susceptibility to DNA damaging agents. The results demonstrate the massive differences in sensitivity across a diverse cell line panel exposed to an alkylating agent. Computational models identified 48 genes with basal expression that predicts susceptibility with 94% accuracy. Modulating transcript levels for two member genes, MYH and C21ORF56, confirmed that their expression does indeed influence alkylation sensitivity. Many proteins encoded by these genes are interconnected in cellular networks related to human cancer and tumorigenesis. The interindividual differences in disease susceptibility, responsiveness to chemotherapeutics, and susceptibility to environmental exposures across human populations are influenced by a combination of gene-environment interactions. Over the past few years, studies aimed at dissecting the genetic basis underlying human phenotypic variation have built off of the dense genotyping established by the HapMap Consortium. A wealth of genome-wide association studies (GWAS) have described how human genetic variation, at the level of single nucleotide differences, is linked to such complex diseases as diabetes and breast cancer (Hunter et al. 2007;Zeggini and McCarthy 2007). In addition, GWAS have also linked DNA polymorphic variants to gene expression variation across populations (Cheung et al. 2005;Stranger et al. 2005Stranger et al. , 2007Dixon et al. 2007).However, while it is known that human lymphoblastoid cells derived from different healthy individuals display considerable variation in their transcription profiles (Cheung et al. 2003(Cheung et al. , 2005Stranger et al. 2005Stranger et al. , 2007Dixon et al. 2007), the influence this variation has on the response to environmental and chemotherapeutic agents is unknown. In this study, a panel of 24 cell lines previously derived from unrelated, healthy individuals with diverse ancestry (Collins et al. 1998) was tested for variation in sensitivity to the DNA damaging agent, N-methyl-NЈ-nitro-N-nitrosoguanidine (MNNG). MNNG induces a variety of alkylated DNA bases, among which O 6 -methylguanine (O 6 MeG) is known to be particularly toxic as well as mutagenic because it pairs with thymine during replication. O 6 MeG can be repaired by the MGMT DNA repair methyltransferase (Pegg 1990(Pegg , 2000, but left unrepaired, the ensuing O 6 MeG:T base pair can be processed by the DNA mismatch repair (MMR) pathway, and such processing actually triggers apoptotic cell death and cytotoxicity (Kaina et al. 1997; Samson 1999, 2004). Therefore, cells deficient in MGMT but proficient for MMR are extremely sensitive to MNNG-induced killing, whereas cells deficient in both MGMT and MMR are extremely resistant or tolerant to MNNG, but at the cost of increased mutation (Karran 2001). While MGMT and MMR status are thus known to be associated w...

In the original version of this article the copyright notice was missing from Tables 1 and 3. This has now been added alongside the three relevant references inserted as refs. 21–23. The correction has been published and is appended to both the HTML and PDF versions of this paper. The errors have been fixed in the paper.

IMPORTANCEThe association of micronutrient supplementation during pregnancy with the intellectual development of adolescent offspring is unknown.OBJECTIVE To assess the long-term association of antenatal micronutrient supplementation with adolescent intellectual development.DESIGN, SETTING, AND PARTICIPANTS This 14-year follow-up study of a randomized clinical trial of micronutrient supplementation in pregnancy was conducted in 2 counties in rural western China in 2118 adolescent offspring (aged 10 to 14 years) of mothers who were randomized to take a daily capsule of either folic acid, folic acid plus iron, or multiple micronutrients from

We investigated the ethnic differences in the risk of several cancers in the population of Nairobi, Kenya, using data from the Nairobi Cancer Registry. The registry records the variable "Tribe" for each case, a categorisation that includes, as well as 22 tribal groups, categories for Kenyans of European and of Asian origin, and non-Kenyan Africans. Tribes included in the final analysis were Kikuyu, Kamba, Kisii, Kalenjin, Luo, Luhya, Somalis, Asians, non-Kenyans, Caucasians, Other tribes and unknown. The largest group was taken as the reference category for the calculation of odds ratios; this was African Kenyans (for comparisons by race), and Kikuyus (the tribe with the largest numbers of cancer registrations (38% of the total)) for comparisons between the Kenyan tribes. P-values are obtained from the Wald test. Cancers that were more common among the white population than in black Kenyans were skin cancers and cancers of the bladder, while cancers that are more common in Kenyan Asians include colorectal, lung, breast, ovary, corpus uteri and non-Hodgkin lymphoma. Cancers that were less common among Asians and Caucasians were oesophagus, stomach and cervix cancer. Within the African population, there were marked differences in cancer risk by tribe. Among the tribes of Bantu ethnicity, the Kamba had higher risks of melanoma, Kaposi sarcoma, liver and cervix cancer, and lower risks of oesophagus, stomach, corpus uteri and nervous system cancers. Luo and Luhya had much higher odds of Kaposi sarcoma and Burkitt lymphoma.