Using the ADAM Questionnaire in Primary Care to Identify Hypoandrogenism in Males Aged 40 Years or Older

Testosterone replacement therapy (TRT) has been shown to improve the symptoms of metabolic syndrome by reducing Hemoglobin A1C, belly fat, cholesterol, and blood pressure (Cunningham, 2015). The ultimate goal for testosterone-deficient patients is to have an improved quality of life by starting TRT. This quality improvement project was conducted at a small primary care clinic in South Texas. The project was started by screening 84 male patients ≥ 40 years of age using the Androgen Deficiency in Aging Males (ADAM) questionnaire. The ADAM questionnaire was considered positive for anyone who answered “yes” to 3 or more questions or “yes” to questions 1 or 7 (Morley et al., 2000). Out of the 84 patients screened by the ADAM questionnaire, 57 screened positive for low testosterone. Only 23 of those 57 patients agreed a confirmatory testosterone blood test; 20 of those 23 had low testosterone blood levels. Any patient who had an abnormally low testosterone level was given the option to start TRT. Eleven of the 20 patients included in the project accepted TRT. After 6 to 8 weeks of testosterone replacement therapy, patients were given the ADAM questionnaire again to assess if improved scores had occurred. After starting TRT, only 1 of the 11 participants had an unchanged ADAM score although it was noted his testosterone levels were still subtherapeutic. Ten of the 11 participants who received TRT had improved ADAM scores at the end of the project window. The ADAM questionnaire has a sensitivity of 88-97%, so poor ADAM scores were highly linked to low total testosterone levels (Morley et al., 2000; Lunenfield et al., 2015)

Monsters in Common: Identity and Community in Postapocalyptic Science Fiction After 9/11

In the aftermath 11 September, 2001, postapocalyptic science fiction has offered a way to make sense of the events of that day, as well as the years of social, cultural and political upheaval that have followed. In many ways, 9/11 began immediately to take on apocalyptic significance in the American national narrative, seemingly marking the end of one period and the beginning of another, entirely different one. To think of 9/11 as a kind of apocalyptic break with the past, however, does not tell the whole story. Moreover, such thinking denies key historical linkages between the American response to 9/11 and to earlier moments of crisis or catastrophe, particularly during the latter half of the twentieth century. After 9/11, conversations about security quickly turned to discussions of the concepts of identity and community--discussions that recall the social, cultural and political pressures of the 1950s and the Cold War. Within this horizon, this study explores the ways in which postapocalyptic science fiction after 9/11 examines the limits and consequences of social, cultural and political definitions of identity and community in the dominant American narrative. Looking at the close symbolic relationship between masculine identity and the figure of the hero in postapocalyptic science fiction, I argue that postapocalyptic science fiction after 9/11 represents a cultural space dedicated to imagining new ways of thinking about identity and community, predominantly by deconstructing the traditional relationship between the twinned figures of man and monster. Indeed, such a focus is also evident in postapocalyptic science fiction from the 1950s onward, such that, when considered from a historical perspective, postapocalyptic science fiction after 9/11 participates in a rich tradition of using vampires, zombies and other monsters to explore the dangers of holding too tightly to a single definition of identity, as well as to promote the value of community

Intranasal Inhalation of Oxytocin Improves Face Processing in Developmental Prosopagnosia

Developmental prosopagnosia (DP) is characterised by a severe, lifelong impairment in face recognition. Little work has attempted to improve face processing in these individuals, but intriguingly, recent evidence suggests oxytocin can improve face processing in both healthy participants and individuals with autism. This study examined whether oxytocin could also improve face processing in individuals with DP. Ten adults with the condition and 10 matched controls were tested using a randomized placebo-controlled double-blind within-subject experimental design (AB-BA). Each participant took part in two testing sessions where they inhaled 24IU of oxytocin or placebo spray and completed two face processing tests: one assessing face memory and the other face perception. Results showed main effects of both participant group and treatment condition in both face processing tests, but the two did not interact. Specifically, the performance of DP participants was significantly lower than control performance under both oxytocin and placebo conditions, but oxytocin improved processing to a similar extent in both groups

Differential accumulation of storage bodies with aging defines discrete subsets of microglia in the healthy brain

Microglia are a unique type of immune cell found within the brain, spinal cord and retina. In the healthy brain, their job is to support neurons, defend against infectious microbes, clear extracellular debris and remove dead or dying cells through phagocytosis. This diverse array of functions presents the possibility of unique subsets of microglia existing in the healthy brain, yet none have been described thus far. By utilizing cellular autofluorescence as a discriminating characteristic, we identified two novel subsets of microglia present in the healthy brains of mice and non-human primates. Approximately 70% of microglia displayed autofluorescence (AF+) while the remaining 30% did not (AF–). While the proportion of AF+ and AF– microglia remained constant throughout most of adult life, the autofluorescence intensity increased exclusively in the AF+ subset at an almost linear rate with age. This gain in autofluorescence correlated with equivalent increases in the size and complexity of storage bodies, as detected by transmission electron microscopy and increases in LAMP1 levels, a key component of the lysosomal compartment. As the brain ages, lysosomal storage material builds up inside AF+ microglia, further increasing the accumulation of autofluorescence as a result. The analysis of protein content in autofluorescent subsets revealed that AF+ microglia produced more proteins and enzymes involved in the storage and degradation of waste material, as well as more proteins involved in the regulation of mTOR, a key cellular pathway governing nutrient availability and energy production. Interestingly, the disruption of lysosomal function in microglia through genetic mutations accelerated the accumulation of storage material in AF+ cells, which led to impaired microglia physiology and increased cell death, mimicking the effects observed during advanced aging. Increasing evidence suggests that the accumulation of waste materials inside the brain contributes to diseases of aging and these data are suggestive of a mechanistic convergence between aging and lysosomal storage disorders

The Image Machine

Architecture has always been an image machine. From the Lascaux cave paintings to the Sainte-Chapelle in Paris to the multimedia installations of the Eameses to the early projects of Diller Scofidio, images and architecture have cohabited persistently and productively for centuries. However, since the dawn of the digital age, the ontological status of images has changed; and in turn so has the relationship between images and architecture. Rather than being anchored to a specific material support, images exist as manipulable data. While some have viewed the digital turns as the transcendence of information beyond the human subject, an era of post-humanism, others, such as Mark Hansen, himself building on Bergson, have claimed that the \u27image\u27 has itself become a process...irreducibly bound with the activity of the body . The Image Machine creates a haptic image environment-an architecture for an active form of image reception that engages the whole body. New media may look like media, but it is only the surface. The Image Machine is a digital archive and display of MoMA\u27s 200,000 works of art that are, for the most part, locked away, as well as any visual document related to the MoMA including film stills, live performances, surveillance footage, and amateur photographs. These 7.4 billion images - one for every person on the planet - question the current boundaries associated with the word image and the ways institutions exploit image power. In 1997, Rem Koolhaas called the MoMA the aura machine . In contrast, this project is a machine of the after-aura,_ an environment that stages a haptic image experience of the body through the more distributive and manipulable capacity of new media

Has COVID-19 affected dementia diagnosis rates in England?

BACKGROUND: The COVID-19 pandemic impacted on the provision of care and routine activity of all National Health Service (NHS) services. While General Practitioner referrals to memory services in England have returned to pre-pandemic levels, the estimated dementia diagnosis rate (DDR) fell by 5.4% between March 2020 and February 2023. METHODS: In this paper we explore whether this reduction is accurate or is an artefact of the way the NHS collects data. RESULTS: We explore the processes that may have affected national dementia diagnosis rates during and following the COVID-19 pandemic. CONCLUSIONS: We discuss what action could be taken to improve the DDR in the future

Intact word processing in developmental prospagnosia

A wealth of evidence from behavioural, neuropsychological and neuroimaging research supports the view that face recognition is reliant upon a domain-specific network that does not process words. In contrast, the recent many-to-many model of visual recognition posits that brain areas involved in word and face recognition are functionally integrated. Developmental prosopagnosia (DP) is characterised by severe deficits in the recognition of faces, which the many-to-many model predicts should negatively affect word recognition. Alternatively, domain-specific accounts suggest that impairments in face and word processing need not go hand in hand. To test these possibilities, we ran a battery of 7 tasks examining word processing in a group of DP cases and controls. One of our prosopagnosia cases exhibited a severe reading impairment with delayed response times during reading aloud tasks, but not lexical decision tasks. Overall, however, we found no evidence of global word processing deficits in DP, consistent with a dissociation account for face and word processing

Big GAAP/Little GAAP: Will The Debate Ever End?

There has been an ongoing debate for decades, especially since the inception of the Financial Accounting Standards Board (FASB), over the appropriate application of generally accepted accounting principles (GAAP) to private companies. This so-called ‘Big GAAP vs. Little GAAP’ debate has now come to a crisis point. The Financial Accounting Foundation (FAF) has taken a position that is contrary to the recommendations of the Blue Ribbon Panel on Standard Setting for Private Companies (the Panel) presented in January 2011, despite having been represented on the Panel. The American Institute of Certified Public Accountants (AICPA), also represented on the Panel, has responded by taking a strong stand in favor of the Panel’s position and against the new FAF recommendation and Invitation to Comment, published on October 4, 2011. Additionally, the International Accounting Standards Board has developed a set of reporting standards for small and medium size enterprises (IFRS for SMEs) that has not been recognized in the US. In this paper, we examine the history of the Big GAAP/Little GAAP debate in the US and internationally. We find substantial support for reducing requirements of private companies and recommend that International Financial Reporting Standards for Small to Medium-Sized Enterprises (IFRS for SMEs) be used for public companies of all sizes to be consistent with standards that have been accepted globally

A Longitudinal Comparison of Course Delivery Modes of an Introductory Information Systems Course and Their Impact on a Subsequent Information Systems Course

This paper presents a robust longitudinal comparison of student learning in face-to-face (F2F), online, and hybrid delivery methods of a two-course sequence in information systems, required of all business majors, at a Midwestern land grant university. Student learning was evaluated by delivery method in the introductory first class of the sequence, using an ordered probit regression model of letter grade earned controlling for the effects of other possible explanatory variables. Cumulative grade point average was found to be a consistent determinant in student success, and students were found to have significantly better learning outcomes, as expressed through course grades, in the F2F delivery mode for the introductory class. Student grades were then evaluated in the next, more advanced information systems course, using a second ordered probit regression model. The results indicated that mode of delivery, online or F2F, for the more advanced course had no significant impact on student grades for that course, but students who had enrolled in the online and hybrid delivery modes in the first course of the sequence performed significantly better, as measured by course grade, in the more advanced course regardless of delivery mode

Acceptability and Feasibility of Universal Offer of Rapid Point of Care Testing for HIV in an Acute Admissions Unit: Results of the RAPID Project

UK guidance recommend all acute medical admissions be offered an HIV test. Our aim was to determine whether a dedicated staff member using a multimedia tool, a model found to be effective in the USA, is an acceptable, feasible, and cost-effective model when translated to a UK setting