Introduction Prader-Willi syndrome (PWS) is a rare neurobehavioral-metabolic disease caused by the lack of paternally expressed genes in the chromosome 15q11-q13 region, characterized by hypotonia, neurocognitive problems, behavioral difficulties, endocrinopathies, and hyperphagia resulting in severe obesity if not controlled. Materials and Methods In DESTINY PWS, a 13-week, randomized, double-blind, placebo-controlled, Phase 3 trial, 127 participants with PWS age ≥4 years with hyperphagia were randomized 2:1 to diazoxide choline extended-release tablet (DCCR) or placebo. The primary endpoint was change from baseline in hyperphagia using the Hyperphagia Questionnaire for Clinical Trials (HQ-CT). Other endpoints included Global Impression Scores, and changes in body composition, behaviors, and hormones. Results DCCR did not significantly improve hyperphagia (HQ-CT Least-square mean (LSmean) [SE] -5.94 [0.879] vs -4.27 [1.145], p=0.198), but did so in participants with severe hyperphagia (LSmean [SE] -9.67 [1.429] vs -4.26 [1.896], p=0.012). Two of three secondary endpoints were improved (Clinical Global Impression of Improvement [CGI-I], p=0.029; fat mass, p=0.023). In an analysis of results generated Pre-COVID, the primary (HQ-CT, p=0.037) and secondary endpoints were all improved (CGI-I p=0.015, Caregiver Global Impression of Change p=0.031, fat mass p=0.003). In general, DCCR was well tolerated with 83.3% in the DCCR group experiencing a treatment emergent adverse event and 73.8% in the placebo group (NS). Discussion DCCR did not significantly improve hyperphagia in the primary analysis but did in participants with severe baseline hyperphagia and in the Pre-COVID analysis. DCCR treatment was associated with significant improvements in body composition and clinician reported outcomes.
Although the presence of Nestorian Christianity in China under the Tang dynasty is a familiar enough matter to students of religion, many scholars in Chinese studies were until very recently reluctant to undertake substantial research into this topic, for the very good reason that they had been expecting the appearance of posthumous work on one of our main sources for this episode by Paul Pelliot (1878-1945), who was probably the greatest Asianist of the twentieth century.1 In 1984 Pelliot's translation of the source in question, the 'Nestorian stele of Xian', originally erected in 781 but first rediscovered in the seventeenth century, was actually published as part of a posthumous publication by another scholar, J. Dauvillier, who had been concerned primarily with the Syriac portions of the stele inscription. Since, however, Dauvillier's volume did not include any of Pelliot's copious notes to his translation, sinological scholarship was not substantially advanced by the appearance of this monograph.2 At last, however, Antonino Forte, who had initiated a series of epigraphic monographs at the Italian School of East Asian Studies in Kyoto, succeeded in 1996 in bringing Pelliot's complex manuscript, with its many scrawled marginal annotations, to publication, an endeavour which clearly involved a great deal of editorial work, for all the assistance that is generously acknowledged.3 Not unnaturally, this remarkable achievement formed the main contribution of recent date to the Tang section of the subsequent Handbook of Christianity in China, Vol. I, published under the editorship of N. Standaert in 2001, though most recently another volume, by Martin Palmer, has appeared which has unfortunately not consulted either Forte's work or the review of the state of the field in the Handbook.4 Of course, some compromises were necessary in retrieving Pelliot's study-no one, it seems, was prepared to undertake the work of producing a general index for such a complex volume, nor yet a general bibliography. Forte's own contributions, by contrast, are scrupulously provided with individual bibliographies throughout. For by discovering the extent of Pelliot's researches-virtually definitive on the history of Chinese and Western studies of the stele up to Pelliot's time, but only preliminary or even missing on some other topics mentioned, such as the Prester John question-Forte has been able in areas of particular personal
The following remarks were originally drafted to serve as the thirty-seventh Evans-Wentz Lecture in Asian Philosophy, Religion and Ethics at Stanford University in May 2006, and take therefore as their tacit point of departure the work of Walter Y Evans-Wentz (1878–1965). His Tibetan Book of the Dead, first published by Oxford University Press in 1927, long remained the most influential account of the way in which Buddhists confronted their future as mortal beings, though in this lecture the scope of my own inquiry is widened from the individual to encompass fears concerning the transience of human society as a whole. This broader approach, moreover, allows for a degree of innovation. Ever since the era of Evans-Wentz, if not earlier, the problem of presenting the impulses behind traditions as unfamiliar as those of South and East Asia without simply confirming their apparent ‘exoticism’ has been difficult to solve, but over recent years our greatly increased knowledge of the history of the planetary environment that we all inhabit has offered an unprecedented perspective on the widely shared hopes and fears of the past. This is because we now know that at times different regions of the planet were subjected to events caused by the same catastrophic upheavals in climate. By taking one of the best known of these in the sixth century CE – and the information given below by no means exhausts what has been discovered about this phenomenon – and looking at its impact in terms of the sense of foreboding it engendered, it is therefore possible to trace the extent to which Europe and East Asia reacted in similar ways.
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