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Diagnosis and management of testosterone deficiency

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Asian Journal of Andrology 2015年第2期17卷 177-186,I0006页

作者： james A mcBride Culley C Carson Robert m Coward Department of Urology University of North Carolina School of Medicine NC USA.

Testosterone supplementation therapy （TST） use has dramatically increased over the past decade, due to the availability of newer agents, aggressive marketing, and an increasing incidence of testosterone deficiency （TD）. Despite the increase in TST, a degree of ambiguity remains as to the exact diagnostic criteria of TD, and administration and monitoring of TST. One explanation for this phenomenon is the complex role testosterone plays in multiple physiologic pathways. Numerous medical co-morbidities and medications can alter testosterone levels resulting in a wide range of nonspecific clinical signs and symptoms of TD. The diagnosis is also challenging due to the lack of a definitive serum total testosterone level that reliably correlates with symptoms. This observation is particularly true in the aging male and is exacerbated by inconsistencies between different laboratory assays. Several prominent medical societies have developed guideline statements to clarify the diagnosis, but they differ from each other and with expert opinion in several ways. Aside from diagnostic dilemmas, there are numerous subtle advantages and disadvantages of the various testosterone agents to appreciate. The available TST agents have changed significantly over the past decade similar to the trends in the diagnosis of TD. Therefore, as the usage of TST increases, clinicians will be challenged to maintain an up-to-date understanding of TD and TST. The purpose of this review is to provide a clear description of the current strategies for diagnosis and management of TD.

关键词： androgens erectile dysfunction hormones hypogonadism testosterone

High energy neutron and pion-decay gamma-ray emissions from solar flares

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Chinese Journal of Astronomy and Astrophysics 2009年第1期9卷 11-40页

作者： Edward L.Chupp james m.Ryan Physics Department and Space Science Center in the Institute for the Study of Earth Oceans and Space University of New Hampshire

Solar flare gamma-ray emissions from energetic ions and electrons have been detected and measured to GeV energies since 1980. In addition, neutrons produced in solar flares with 100 meV to GeV energies have been observed at the Earth. These emissions are produced by the highest energy ions and electrons accelerated at the Sun and they provide our only direct （albeit secondary） knowledge about the properties of the accelerator（s） acting in a solar flare. The solar flares, which have direct evidence for pion-decay gamma-rays, are unique and are the focus of this paper. We review our current knowledge of the highest energy solar emissions, and how the characteristics of the acceleration process are deduced from the observations. Results from the RHESSI, INTEGRAL and CORONAS missions will also be covered. The review will also cover the solar flare capabilities of the new mission, FERmI GAmmA RAY SPACE TELESCOPE, launched on 2008 June II. Finally, we discuss the requirements for future missions to advance this vital area of solar flare physics.

关键词： Sun -- Flares -- Particle Acceleration-meson Production

The effect of surface roughness on claw and adhesive hair performance in the dock beetle Gastrophysa viridula

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Insect Science 2011年第3期18卷 298-304页

作者： james m. R. Bullock Walter Federle Department of Zoology University of Cambridge Downing Street Cambridge UK

Natural adhesive systems are adapted to attach to rough surfaces, but the underlying mechanisms have not been fully clarified. Attachment forces for the beetle Gastrophysa viridula were recorded on epoxy casts of surfaces with different roughness using a centrifuge device. Replicas were made of standardized polishing paper with asperity sizes ranging from 0.05 to 30 μm and of dock leaves （Rumex obtusifolius）. Beetles adhered with a safety factor of up to 36 times body weight on smooth substrates or on casts of leaves of their host plant. On the rough substrates, forces were much lower and a minimum at small scale roughness （0.05μm asperity size, with a mean safety factor of S） was observed. Removal of the claws led to a significant reduction in force for rough substrates with asperity sizes ≥ 12 μm. Attachment forces of the hairy adhesive system itself（without the claws） slightly increased from small-scale to large-scale surface roughness, but remained below the level seen on the smooth substrate. This is explained by the inability of setal tips to make full contact to the surface.

关键词： adhesion biomechanics claws locomotion roughness tribology

Seismic behavior assessment for design of integral abutment bridges in Illinois

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Earthquake Engineering and Engineering Vibration 2022年第2期21卷 573-589页

作者： Derek L.Kozak Larry A.Fahnestock james m.LaFave KPFF Consulting Engineers Inc 1601 Fifth AvenueSuite 1600SeattleWA 98101USA Dept.of Civil and Environmental Engineering Univ.of Illinois Urbana-ChampaignUrbanaIL 61801USA

Integral abutment bridges(IABs)minimize deterioration and degradation of the abutment seats and bearings due to water,dirt,and deicing chemicals by eliminating bearings and expansion *** the continuity between superstructure and abutments in an IAB is beneficial for reducing maintenance costs,it leads to more complex behavior under strength and service loading(temperature and traffic)and extreme loading(earthquake).The coupling of superstructure and substructure behavior necessitates system-level analysis of *** seismic IAB studies have typically investigated the behavior of individual IAB components,however a gap of knowledge has developed due to the lack of studies and investigation about the behavior of all IAB components and their interactions with each other in a single analysis *** study uses nonlinear static and dynamic analyses to investigate and assess the seismic behavior of IABs typical to the state of *** analyses aim to bridge the gap of knowledge by evaluating IABs as a whole and utilizing the results to indicate potential vulnerabilities in the design and construction of IABs in Illinois during design-level and larger seismic events,which could not be identified by component-level IAB analyses alone.

关键词： structural analysis seismic design bridge design structural models seismic analysis

C2-Symmetric Dibenzosuberane-based Helicenes as Potential Chirochromic Optical Switches and Amorphous Hosts in OLED Applications

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Chemical Research in Chinese Universities 2001年第Z1期17卷 148-149页

作者： CHEN Chien-tien Department of Chemistry National Taiwan Normal University

Three C2-symmetric (10R,11R)-diethyl substituted dibenzosuberane (DBS)-based helicenes with varying steric and conjugation demands of their bottom fragments were synthesized. Only the helicene-7a[with the bottom part derived from tetralone was found photo-switchable in reasonable time scale. Photoisomerization of the diastereomerically pure (10R,11R,P)-helicene (7a) at 280 nm led to virtually exclusive formation of the opposite m form-diastereomer 7a′ (7a′/7a = 99.6/0.4). The preferential return of 7a′ to 7a can be effected upon irradiation at 254 nm (7a′/7a = 3G/67) or thermally at 130 7a′/7a = 0/100). The photo-induced switching process amounts to a 133% difference in d.e. (from 99.2% to-34%). The concomitant change of helicene chirality between these two diastereomeric photostationary states augurs well for their potential application as an optical switch in LC materials. To our knowledge, our system serves as the best chirochromic optical switch as compared to the examples possessing similar photochromic properties.

关键词： optical switch potential application time scale

most ankle sprain research is either false or clinically unimportant:A 30-year audit of randomized controlled trials

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Journal of Sport and Health Science 2021年第5期10卷 523-529页

作者： Chris m.Bleakley mark matthews james m.Smoliga School of Health Science Ulster UniversityCounty AntrimNorthern IrelandBT370QBUK School of Sport Ulster UniversityCounty AntrimNorthern IrelandBT370QBUK Department of Physical Therapy Congdon School of Health ScienceHigh Point UniversityHigh PointNC 27268USA

Background:Lateral ankle sprain is the most common musculoskeletal *** clinical research in this field is growing,there is a broader concern that clinical trial outcomes are often false and fail to translate into patient ***:We audited 30 years of experimental research related to lateral ankle sprain management(n=74 randomized controlled trials)to determine if reports of treatment effectiveness could be validated beyond statistical ***:A total of 77%of trials reported positive treatment effects,but there was a high risk of false *** trials were unregistered and relied solely on statistical significance,or lack of statistical significance,rather than on interpreting key measures of minimum clinical importance(e.g.,minimal detectable change,minimal clinically important difference).Conclusion:Future clinical trials must adopt higher standards of reporting and data *** includes consideration of the ethical responsibility to preregister their research and interpretation of clinical outcomes beyond statistical significance.

关键词： Ankle sprain False discovery mCID mDC

Cosmetic outcome of femtosecond laserassisted pterygium surgery

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Eye and Vision 2021年第1期8卷 59-66页

作者： Darren Shu Jeng Ting Yu-Chi Liu Yi Fang Lee Angel Jung Se Ji tien-En Tan Hla m.Htoon Jodhbir S.mehta Academic Ophthalmology Division of Clinical NeuroscienceSchool of MedicineUniversity of NottinghamNottinghamUK Department of Ophthalmology Queen’s Medical CentreNottinghamUK Singapore Eye Research Institute SingaporeSingapore Singapore National Eye Centre 11 Third Hospital AvenueSingapore 168751Singapore Duke-NUS Graduate medical School SingaporeSingapore.

Background:To examine the cosmetic outcome of femtosecond laser-assisted pterygium surgery(FLAPS)with conjunctival autograft(CAG)and its potential predictive ***:This was a prospective interventional case series(NCT02866968).We included 29 patients(29 eyes)with primary pterygium who underwent *** outcome was graded by two graders(an ophthalmology resident and an experienced ophthalmologist)using Hirst classification system(1-4=excellent-poor).Weighted Cohen’s kappa analysis was performed to examine the intra-and inter-rater *** relationship between cosmetic outcome and various factors were determined by Spearman’s correlation coefficients(r).Results:The preoperative severity of pterygium(Tan grading system)was mild/atrophic(7%),moderate/intermediate(62%),and severe/fleshy(31%).An ultrathin CAG(mean thickness of 74.5±9.8μm)was fashioned *** excellent cosmetic outcome of FLAPS(median±IQR)was observed at 3 months(1.0±1.0)and remained similar at 6months(1.0±0.0)and 12months(1.0±0.0)*** final follow-up,27(93%)patients achieved good-to-excellent cosmetic outcome,with 1(3%)patient having a poor outcome due to incomplete pterygium *** kappa analysis of Hirst grading system showed excellent intra-rater(κ=0.86-0.95)and inter-rater reliability(κ=0.84-0.88).There was a weak and borderline significant correlation between good cosmetic outcome and reduced postoperative CAG thickness(r=0.38,P=0.06)but not with age,gender,preoperative pterygium severity,or intraoperative CAG ***:FLAPS can result in an excellent cosmetic outcome,which may be attributed to the beneficial effect of an ultrathin CAG.

关键词： Cosmesis Cosmetic outcome Femtosecond laser Pterygium Pterygium surgery

Retransplantation for graft failure in chronic hepatitis C infection: A good use of a scarce resource?

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World Journal of Gastroenterology 2010年第40期16卷 5070-5076页

作者： Ian A Rowe Kerri m Barber Rhiannon Birch Elinor Curnow james m Neuberger Liver and Hepatobiliary Unit University Hospital Birmingham NHS Trust Queen Elizabeth Hospital NHS Blood and Transplant

AIm: To investigate the outcome of patients with hepatitis C virus (HCV) infection undergoing liver retransplantation. mETHODS: Using the UK National Registry, patients undergoing liver transplantation for HCV-related liver disease were identified. Data on patient and graft characteristics, as well as transplant and graft survival were collected to determine the outcome of HCV patients undergoing retransplantation and in order to identify factors associated with transplant survival. RESULTS: Between march 1994 and December 2007, 944 adult patients were transplanted for HCV-related liver disease. At the end of follow-up, 617 of these patients were alive. In total, 194 (21%) patients had first graft failure and of these, 80 underwent liver retransplantation, including 34 patients where the first graft failed due to recurrent disease. For those transplanted for HCV-related disease, the 5-year graft survival in those retransplanted for recurrent HCV was 45% [95% confidence interval (CI): 24%-64%] compared with 80% (95% CI: 62%-90%) for those retransplanted for other indications (P = 0.01, log-rank test); the 5-year transplant survival after retransplantation was 43% (95% CI: 23%-62%) and 46% (95% CI: 31%-60%), respectively (P = 0.8, log-rank test). In univariate analysis of all patients retransplanted, no factor analyzed was significantly associated with transplant survival. CONCLUSION: Outcomes for retransplantation in patients with HCV infection approach agreed criteria for minimum transplant benefit. These data support selective liver retransplantation in patients with HCV infection.

关键词： Hepatitis C Liver Recurrence Retransplantation Outcome

Effect of wall rougheners on cross-sectional flow characteristics for non-spherical particles in a horizontal rotating cylinder

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Particuology 2014年第1期12卷 44-53页

作者： Guang Lu james R.Third Christoph R.müller ETH Zürich Department of Mechanical and Process Engineering Institute of Energy Technology Laboratory of Energy Science and Engineering8092 Zürich Switzerland

Discrete-element-method （DEm） simulations have been performed to investigate the cross-sectional flow of non-spherical particles in horizontal rotating cylinders with and without wall rougheners. The non-spherical particles were modeled using the three-dimensional super-quadric equation. The influence of wall rougheners on flow behavior of grains was studied for increasing particle blockiness. moreover, for approximately cubic particles （squareness parameters [555]）, the rotational speed, gravitational acceleration and particle size were altered to investigate the effect of wall rougheners under a range of operating conditions. For spherical and near-spherical particles （approximately up to the squareness parameters [344]）, wall rougheners are necessary to prevent slippage of the bed against the cylinder wall. For highly cubic particle geometries （squareness parameters larger than [3441）, wall rougheners resulted in a counter-intuitive decrease in the angle of repose of the bed. In addition, wall rougheners employed in this study were demonstrated to have a higher impact on bed dynamics at higher rotational speeds and lower gravitational accelerations. Nevertheless, using wall rougheners had a comparatively small influence on particle-flow characteristics for a bed composed of finer grains.

关键词： Granular flowNon-spherical particlesRotating cylinderDiscrete element method (DEm)Kiln