Clinical Meaningfulness of the Changes in Muscle Performance and Physical Function Associated With Testosterone Administration in Older Men With Mobility Limitation

Context. Testosterone in Older Men with Mobility Limitations Trial determined the effects of testosterone on muscle performance and physical function in older men with mobility limitation. Trial's Data and Safety Monitoring Board recommended enrollment cessation due to increased frequency of adverse events in testosterone arm. The changes in muscle performance and physical function were evaluated in relation to participant's perception of change. Methods. Men aged 65 years and older, with mobility limitation, total testosterone 100-350 ng/dL, or free testosterone less than 50 pg/mL, were randomized to placebo or 10 g testosterone gel daily for 6 months. Primary outcome was leg-press strength. Secondary outcomes included chest-press strength, stair-climb, 40-m walk, muscle mass, physical activity, self-reported function, and fatigue. Proportions of participants exceeding minimally important difference in study arms were compared. Results. Of 209 randomized participants, 165 had follow-up efficacy measures. Mean (SD) age was 74 (5.4) years and short physical performance battery score 7.7 (1.4). Testosterone arm exhibited greater improvements in leg-press strength, chest-press strength and power, and loaded stair-climb than placebo. Compared with placebo, significantly greater proportion of men receiving testosterone improved their leg-press and chest-press strengths (43% vs 18%, p = .01) and stair-climbing power (28% vs 10%, p = .03) more than minimally important difference. Increases in leg-press strength and stair-climbing power were associated with changes in testosterone levels and muscle mass. Physical activity, walking speed, self-reported function, and fatigue did not change. Conclusions. Testosterone administration in older men with mobility limitation was associated with patient-important improvements in muscle strength and stair-climbing power. Improvements in muscle strength and only some physical function measures should be weighed against the risk of adverse events in this populatio

A long-term monthly surface water storage dataset for the Congo basin from 1992 to 2015

The spatio-temporal variation of surface water storage (SWS) in the Congo River basin (CRB), the second-largest watershed in the world, remains widely unknown. In this study, satellite-derived observations are combined to estimate SWS dynamics at the CRB and sub-basin scales over 1992-2015. Two methods are employed. The first one combines surface water extent (SWE) from the Global Inundation Extent from MultiSatellite (GIEMS-2) dataset and the long-term satellite-derived surface water height from multi-mission radar altimetry. The second one, based on the hypsometric curve approach, combines SWE from GIEMS-2 with topographic data from four global digital elevation models (DEMs), namely the Terra Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), Advanced Land Observing Satellite (ALOS), MultiError-Removed Improved Terrain (MERIT), and Forest And Buildings removed Copernicus DEM (FABDEM). The results provide SWS variations at monthly time steps from 1992 to 2015 characterized by a strong seasonal and interannual variability with an annual mean amplitude of similar to 101 +/- 23 km(3). The Middle Congo sub-basin shows a higher mean annual amplitude ( similar to 71 +/- 15 km(3)). The comparison of SWS derived from the two methods and four DEMs shows an overall fair agreement. The SWS estimates are assessed against satellite precipitation data and in situ river discharge and, in general, a relatively fair agreement is found between the three hydrological variables at the basin and sub-basin scales (linear correlation coefficient > 0 :5). We further characterize the spatial distribution of the major drought that occurred across the basin at the end of 2005 and in early 2006. The SWS estimates clearly reveal the widespread spatial distribution of this severe event ( similar to 40% deficit as compared to their long-term average), in accordance with the large negative anomaly observed in precipitation over that period. This new SWS long-term dataset over the Congo River basin is an unprecedented new source of information for improving our comprehension of hydrological and biogeochemical cycles in the basin. As the datasets used in our study are available globally, our study opens opportunities to further develop satellitederived SWS estimates at the global scale. The dataset of the CRB's SWS and the related Python code to run the reproducibility of the hypsometric curve approach dataset of SWS are respectively available for download at https://doi.org/10.5281/zenodo. 7299823 and https://doi.org/10.5281/zenodo.8011607 (Kitambo et al., 2022b, 2023)