udy.com). The battery of assessments takes approximately 1 h to complete.

Informed consent
Participant consent is gained upon enrolment within the online RAPSODI GD portal (www.rapsodistudy.com), or the PD FRONTLINE portal for participants with idiopathic PD (www.pdfrontline.com).

Self-report rating scales
The RAPSODI GD study uses three self-administered scales to assess: anxiety and depression, motor symptoms of PD, REM sleep disturbance. Anxiety and depression are examined through the Hospital Anxiety and Depression Scale (HADS) [54]. This 14-item scale determines separate scores for anxiety and depression, between 0 and 21, distinguishing between mild, moderate, severe and noncases. Motor symptoms of PD are assessed via the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part II [55]. This 13-item section of the MDS-UPDRS, rates motor experiences in daily living such as eating and walking, on a scale of 0-4 from normal to severely dysfunctional. REM sleep disturbance is measured via the REM Sleep behaviour Disorder Screening Questionnaire (RBDSQ) [56]. This 10-item scale assesses clinical features of REM sleep behaviour disorder, such as dream content and sleep movement.

Bradykinesia akinesia incoordination test
Motor dysfunction is assessed via the Bradykinesia Akinesia Incoordination (BRAIN) Test [57]. On a standard physical computer/laptop keyboard, participants must alternate between tapping the's' key and ';' key for 30 s per hand. Incoordination, akinesia, dysmetria and kinesia are assigned scores based on the variance in time travelling between the keys, the time spent on keys, the accuracy of pressing the correct keys and the total number of key presses, respectively.

Cognitive testing
Several aspects of cognitive function are assessed via a battery of precision cognitive tests. This was historically delivered via the online platform 'CogTrack™' [58], until the platform expired, and cognitive testing moved to a new platform 'NeurOn' in November 2020 (www.neuropsychology.online). The battery includes tasks of image encoding, simple reaction time, digit span backwards, spatial working memory and image recall. Within this battery participants are scored on dysfunction in working and episodic memory, disturbances in attention focus and sustainment and memory retrieval rate.

Hyposmia assessment
Olfactory function is assessed on a biennial basis via the University of Pennsylvania Smell Identification Test (UP-SIT) [59]. The UPSIT is delivered remotely through the post, and scores are uploaded directly onto the RAPSODI GD portal by participants. The UPSIT utilizes a series of booklets, each containing ten microencapsulated odorant panels. Participants apply mechanical pressure to the panels to release the odorants, and then select which of four options they believe each odorant to represent. The participants are assigned a score of olfaction sensitivity from 0 to 40 depending on the accuracy of their responses.

Genotyping
In their baseline year with RAPSODI GD, participants are posted a saliva sample collection kit (DNA Genotek Oragene.DNA OG-500), with biological substance category B compliant return packaging. Genomic DNA is extracted via the protocol provided in the DNA purification handbook published by DNA Genotek, for use with the Oragene.DNA OG-500 kits [60]. The full 8.9 kb amplicon of the GBA gene is sequenced for all known deleterious variants, on the Oxford Nanopore MinION, via a protocol validated by Leija-Salazar et al. [61]. Due to RAPSODI GD's active selection of individuals with GBA mutations, there is a likelihood that individuals from an Ashkenazi Jewish population will be overrepresented within the cohort [23]. As such, genomic DNA samples are also MinION sequenced for the most common LRRK2 mutation, G2019S, as this is a common, salient and potentially confounding PD associated risk factor for Ashkenazi Jewish individuals [62].
Upon detection of mutation positive cases, DNA samples will be sent for external confirmatory Sanger sequencing in an NHS accredited lab.

Follow-up
The self-reporting scales, Bradykinesia akinesia incoordination test, and cognitive testing are repeated once a year from baseline. The UPSIT is repeated once every other year from baseline.

Conclusion
The RAPSODI GD study described here aims to define prodromal features of PD in a large cohort of GBA mutation carriers, to accurately predict clinical diagnosis. The study also looks to stratify the risk of phenoconversion to PD in homozygote and heterozygote GBA mutation carriers, and to clarify the variable penetrance of the GBAassociated PD phenotype, while developing a platform that will allow for the assessment of biomarkers of disease. The postulated outcome of the RAPSODI GD study is to allow for the identification and earlier diagnosis of individuals at risk of developing PD, so that neuroprotective interventions can be administered within an efficacious therapeutic timeframe.

Future perspective
The development and validation of clearly defined features of prodromal PD for GBA mutation carriers, could eventually allow for the accurate detection of at-risk individuals. Clinical detection of disease in this latent phase, would lend itself to the identification of earlier therapeutic timeframes to deliver neuroprotective interventions before irreversible neurodegeneration can take place. As the mechanisms of pathogenesis in the GCase-mediated pathway of PD are elucidated, biomarkers and therapeutic targets characterized for GBA PD may also prove salient in developing preventative measures within sPD as well.Bank the borrower’s payment default. After the bankruptcy court and district court disallowed the lender’s claim, it appealed to the 5th Circuit.
The note included a provision that stated that if any payment was not paid within 10 days after the due date, the loan, including principal and interest, became immediately due and payable. The note also contained a section on prepayment. During an initial lockout period, the borrower was prohibited from prepaying. After that, the borrower could prepay all (but not less than all) of the principal and interest on the condition that it paid “Prepayment Consideration.” The prepayment section also referenced the concept of “Default Prepayment,” which meant a prepayment made during a period of default or after an acceleration of the maturity date. In particular:
Borrower shall pay the Prepayment Consideration due hereunder whether the prepayment is voluntary or involuntary (including without limitation in connection with the Lender’s acceleration of the unpaid principal balance of the Note) or the Security Instrument is satisfied or reduced by foreclosure (whether by power of sale or judicial proceeding), deed in lieu of foreclosure or by any other means.
The court framed this matter as a question of contract interpretation under state law. Under applicable state law:
- A lender may refuse early payment, but may waive this right by contract.
- If a lender does not waive this right, the borrower may not prepay without paying all future interest as well.
- However, if a lender does waive its right to refuse prepayment, then it is not entitled to any prepayment penalty unless expressly provided for in the contract.
- Generally acceleration of a note constitutes a waiver of a prepayment penalty.
- This is subject to the exception that a court may elect to impose a prepayment penalty if it appears that the borrower defaulted in order to avoid paying the additional interest.
The 5th Circuit noted that the prepayment premium was not a remedy for a breach of contract, but rather consideration for the privilege of prepaying. Consequently (1) payment was not subject to a liquidated damages analysis, and (2) thus was not subject to a rule of reasonableness, (3) which in turn meant that the payment should not trigger Section 506(b) of the Bankruptcy Code (which requires charges to be reasonable).
In this case, the bankruptcy court concluded that the prepayment penalty applied only to payments that were actually made. Since the borrower defaulted and did not pay, there was no prepayment. Further, there was nothing that would deem acceleration to be a prepayment.
The 5th Circuit found this analysis to be persuasive. It distinguished the language on this case from the following language from another case where a prepayment claim was upheld:
The undersigned [borrower] agrees that if the holder of this Note [lender] accelerates the sum or any part of the principal sum… the undersigned waives any right to prepaid said principal sum in whole or in part without premium and agrees to pay a prepayment premium. (emphasis added)
The court felt that this quoted language evidenced a clear intent that the prepayment premium would be applicable in the case of acceleration, and found no comparable expression of intent in this case. Instead, the note in this case “plainly provides” that nothing is owed “unless there is an actual prepayment, whether voluntary or involuntary.” Accordingly, the 5th Circuit affirmed the lower court decisions disallowing the lender’s prepayment claim.
It seems likely that the lender fully expected that it would be entitled to collect a prepayment premium even though it accelerated the note – otherwise, why specifically reference acceleration? In drafting documents, it is important to consider and address the possibility of an unexpected literal interpretation of the language, since there is no assurance that a court will interpret the language in context or as intended.
Vicki R. Harding, Esq.This is a copy of the Facts about Public Education e-newsletter sent weekly during the