testosterone and libido in surgically and naturally menopausal women

The assessment and then treatment of a change in libido, or a change in the desire to partake in sexual activity, during the menopausal transition and beyond has been a challenging and elusive area of clinical research. This is partly due to the multidimensional nature of female sexuality, the difficulties of measuring testosterone in women in a reliable and accurate manner, and the complexity of the neurobiology and neurobehavior of female sexual desire. In addition, there is a lack of evidence for diagnostic specificity of low free testosterone levels for the symptom of low libido in women for whom there are no confounding interpersonal or psychological factors; although, in the symptomatic population of surgically or naturally menopausal women, a low level of free testosterone often accompanies a complaint of reduced desire/libido. The randomized clinical trial research on testosterone replacement for naturally and/or surgically menopausal women with sexual dysfunction has been criticized for a high placebo response rate, supraphysiological replacement levels of testosterone, the perception of modest clinical outcome when measuring objective data such as the frequency of sexual intercourse relative to placebo, and the unknown safety of long-term testosterone replacement in the estrogen-replete surgically or naturally menopausal woman. A careful review of current evidence from randomized, controlled trials lends support to the value of the replacement of testosterone in the estrogen-replete menopausal woman for whom libido and desire has declined. The issue of long-term safety remains to be answered. Multifactorial nature of female sexuality The assessment and then treatment of a change in libido, or a change in the desire to partake in sexual activity, during the menopausal transition and beyond has been a challenging and elusive area of clinical research. There is a lack of evidence for the diagnostic specificity of low free testosterone levels for the symptom of low libido in the women for whom there are no confounding interpersonal or psychological factors; although, in the symptomatic population of surgically or naturally menopausal women, a low level of free testosterone often accompanies a complaint of reduced desire/libido [1–6]. Female sexuality is dependent on biological, psychosexual, sociocultural and context-related factors [7–9]. As a consequence, any movement or change in any of these realms may increase or decrease a woman's perception of her drive or motivation to participate in sexual activity. The presence of any chronic medical illness such as diabetes, pulmonary or cardiovascular problems, or depression will in many instances impact a woman's sexuality concurrent with changes related to age [10,11]. The length of the relationship with a partner, as well as aging, has been demonstrated to impact sexual interest and frequency of sexual activity [12,13]. The menopause has been shown to have an incremental effect on a woman's sexuality, separate from the change brought about by aging [14]. The quality of her intimate relationship and the degree to which she feels empowered in it have been demonstrated to affect sexual desire [15]. The culture in which she lives has been shown to affect frequency of sexual intercourse [16]. The degree of stress she is under, as well as her general wellbeing, has also been shown to affect her libido. A recent longitudinal study demonstrated that higher stress lowers wellbeing, resulting in a decrease in sexual arousal, enjoyment, orgasm and desire [17]. In addition, the balance between sexual inhibition and sexual excitement may be unique to each woman and may change according to her circumstances, along with any other change she may have with regard to these opposing forces [18]. Thus, the treatment of any woman distressed by a change in desire at midlife and beyond is driven by many factors. The clinician's task is to elucidate which one or more of these many variables changed in her life, concurrent with her change in sexual desire, and then to determine whether or not these changes are related to her change in sexual desire

An Examination of Performance of First Year Students at an Ontario University: An Admission Perspective

Major changes in the Ontario secondary school system over the last 15 years have increased the concerns within some universities about the use of Grade 13 marks as the principal criterion for evaluating applicants. These concerns focus on grade inflation, variability of marks among schools, and how appropriate some subjects are for university admission. This paper reports on a study of these issues conducted at McMaster University. The relationship between Grade 13 admission and Year I university averages was examined. Two issues that have received little attention elsewhere were also examined: how Year I performance varied by applicant status, and the relationship between individual Grade 13 subjects and Year I performance. The results indicate that Grade 13 marks, which are the only measure of a student's achievement available, continue to be a reasonable predictor of subsequent performance in Year I. Grade 13 subjects were identified that were more consistently associated with Year I performance than others. There was also evidence that some Grade 13 subjects may be contributing to an "inflated" admission average. The results of this study should be useful in evaluating existing admission policies and in the development of the new Ontario Academic Courses.Au cours des 15 dernières années, de sérieux changements dans le système des écoles secondaires de l'Ontario ont ajouté à l'inquiétude qui règne au sein de certaines universités face à l'emploi des notes de la 13e année comme critère principal d'évaluation des candidats universitaires. Ces craintes se centrent sur des notes "gonflées", sur une notation variable d'école en école et sur la pertinence de certains cours à l'entrée universitaire. Ce papier traite d'une étude à ce sujet, menée à l'université McMaster, qui visait à percevoir les rapports entre la moyenne d'admission de la 13e année et celle de la lere année universitaire. L'étude porta également sur l'écart entre la performance universitaire et le statut du candidat et sur la performance universitaire reliée à certaines matières de la 13e année, deux questions qui avaient suscité jusqu 'ici peu d'intérêt. Les résultats de cette étude indiquent que les notes de la 13e année, qui sont le seul système de mesure actuel du rendement scolaire, n'en demeurent pas moins un indice valide de la performance post-secondaire. Dans ce rapport, certaines matières de 13e année furent identifiées et étroite-ment associées au succès universitaire. Les découvertes signalèrent également un rapport probable entre certains sujets de 13e année et la hausse dans la moyenne d'admission. Toutes ces données devraient servira évaluer les procédures actuelles d'admission et servir à la mise sur pied de nouveaux 'cours pré-universitaires'

Consistency of Global Modis Aerosol Optical Depths over Ocean on Terra and Aqua Ceres SSF Datasets

Aerosol retrievals over ocean from the Moderate Resolution Imaging Spectroradiometer (MODIS) onboard Terra and Aqua platforms are available from the Clouds and the Earth's Radiant Energy System (CERES) Single Scanner Footprint (SSF) datasets generated at NASA Langley Research Center (LaRC). Two aerosol products are reported side-by-side. The primary M product is generated by sub-setting and remapping the multi-spectral (0.47-2.1 micrometer) MODIS produced oceanic aerosol (MOD04/MYD04 for Terra/Aqua) onto CERES footprints. M*D04 processing uses cloud screening and aerosol algorithms developed by the MODIS science team. The secondary AVHRR-like A product is generated in only two MODIS bands 1 and 6 (on Aqua, bands 1 and 7). The A processing uses the CERES cloud screening algorithm, and NOAA/NESDIS glint identification, and single-channel aerosol retrieval algorithms. The M and A products have been documented elsewhere and preliminarily compared using 2 weeks of global Terra CERES SSF Edition 1A data in which the M product was based on MOD04 collection 3. In this study, the comparisons between the M and A aerosol optical depths (AOD) in MODIS band 1 (0.64 micrometers), tau(sub 1M) and tau(sub 1A) are re-examined using 9 days of global CERES SSF Terra Edition 2A and Aqua Edition 1B data from 13 - 21 October 2002, and extended to include cross-platform comparisons. The M and A products on the new CERES SSF release are generated using the same aerosol algorithms as before, but with different preprocessing and sampling procedures, lending themselves to a simple sensitivity check to non-aerosol factors. Both tau(sub 1M) and tau(sub 1A) generally compare well across platforms. However, the M product shows some differences, which increase with ambient cloud amount and towards the solar side of the orbit. Three types of comparisons conducted in this study - cross-platform, cross-product, and cross-release confirm the previously made observation that the major area for improvement in the current aerosol processing lies in a more formalized and standardized sampling (and most importantly, cloud screening) whereas optimization of the aerosol algorithm is deemed to be an important yet less critical element

Exploring Aerosols near Clouds with High-Spatial-Resolution Aircraft Remote Sensing During SEAC4RS

Since aerosols are important to our climate system, we seek to observe the variability of aerosol properties within cloud systems. When applied to the satelliteborne Moderateresolution Imaging Spectroradiometer (MODIS), the Dark Target retrieval algorithm provides global aerosol optical depth (AOD; at 0.55 m) in cloudfree scenes. Since MODIS' resolution (500m pixels, 3 or 10km product) is too coarse for studying nearcloud aerosol, we ported the Dark Target algorithm to the highresolution (~50m pixels) enhancedMODIS Airborne Simulator (eMAS), which flew on the highaltitude ER2 during the Studies of Emissions, Atmospheric Composition, Clouds, and Climate Coupling by Regional Surveys Airborne Science Campaign over the United States in 2013. We find that even with aggressive cloud screening, the ~0.5km eMAS retrievals show enhanced AOD, especially within 6 km of a detected cloud. To determine the cause of the enhanced AOD, we analyze additional eMAS products (cloud retrievals and degradedresolution AOD), coregistered Cloud Physics Lidar profiles, MODIS aerosol retrievals, and groundbased Aerosol Robotic Network observations. We also define spatial metrics to indicate local cloud distributions near each retrieval and then separate into nearcloud and farfromcloud environments. The comparisons show that low cloud masking is robust, and unscreened thin cirrus would have only a small impact on retrieved AOD. Some of the enhancement is consistent with clearcloud transition zone microphysics such as aerosol swelling. However, 3D radiation interaction between clouds and the surrounding clear air appears to be the primary cause of the high AOD near clouds

Engaging in Collaboration: Piloting an Interprofessional Population Health Course in a School of Public Health

In 2015 The Gillings School of Global Public Health engaged in an interprofessional collaboration across health affairs schools (medicine, nursing, social work, pharmacy) at the University of North Carolina at Chapel Hill to develop and implement an interprofessional graduate-level course on population health. This presentation will describe course development and implementation and describe case-based team building opportunities built into the didactic portion of the hybrid online/face-to-face course which was piloted with more than 20 students in the Fall of 2015. The presentation will also describe accompanying project-based activities at community clinical sites where students collaborated with primary care providers in quality improvement activities. Evaluation data from the pilot course will also be discussed

Topoisomerase II inhibitors induce DNA damage-dependent interferon responses circumventing Ebola virus immune evasion

Ebola virus (EBOV) protein VP35 inhibits production of interferon alpha/beta (IFN) by blocking RIG-I-like receptor signaling pathways, thereby promoting virus replication and pathogenesis. A high-throughput screening assay, developed to identify compounds that either inhibit or bypass VP35 IFN-antagonist function, identified five DNA intercalators as reproducible hits from a library of bioactive compounds. Four, including doxorubicin and daunorubicin, are anthracycline antibiotics that inhibit topoisomerase II and are used clinically as chemotherapeutic drugs. These compounds were demonstrated to induce IFN responses in an ATM kinase-dependent manner and to also trigger the DNA-sensing cGAS-STING pathway of IFN induction. These compounds also suppress EBOV replication in vitro and induce IFN in the presence of IFN-antagonist proteins from multiple negative-sense RNA viruses. These findings provide new insights into signaling pathways activated by important chemotherapy drugs and identify a novel therapeutic approach for IFN induction that may be exploited to inhibit RNA virus replication