What screening tests should you use to evaluate a man with low testosterone?

Obtain a repeat morning testosterone level, as well as levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin to help understand the cause of low testosterone when there is a lack of adequate empiric evidence to guide evaluation, advise the experts. When low or normal FSH and LH levels accompany low testosterone, evaluation of the pituitary gland is recommended. Chromosomal studies are indicated in prepubertal males with low testosterone and elevated FSH and LH levels to assess for Klinefelter syndrome. Perform a semen analysis if fertility is an issue. Bone densitometry is indicated in men with chronic hypogonadism to identify increased risk of hip fracture (strength of all recommendations: C, consensus guidelines and disease-oriented evidence)

Non-Coherent Ground-Based Moving Target Indicator

Control Systems Laboratory changed its name to Coordinated Science LaboratoryContract DA-11-022-ORD-72

Diamond photodetectors for next generation 157-nm deep-UV photolithography tools

Abstract Next generation photolithography stepper tools will operate at 157 nm and require robust solid state photodetectors to ensure efficient operation and facilitate direct beam monitoring for photoresist exposure dosimetry. There is currently no commercial detector system able to fully meet all the demanding requirements of this application. Diamond, which is intrinsically visible blind and radiation hard, is an obvious candidate for consideration. In this paper we report the results of the first study to assess the viability of thin film polycrystalline diamond photodetectors for use in 157 nm F2-He based laser lithography tools. Co-planar inter-digitated gold photoconductor structures were fabricated on free standing thin film diamond and exposed to pulses from an industrial F2-He laser in the fluence range 0-1.4 mJ cm-2. The electrical and optical characteristics of the devices have been measured and are compared to the response of a standard vacuum photodiode. The suitability of the diamond devices for use at 157 nm is discussed

Tailward propagation of magnetic energy density variations With respect to substorm onset times

During geomagnetic substorms, around 1015 J of energy is extracted from the solar wind and processed by the Earth's magnetosphere. Prior to the onset of substorm expansion phases, this energy is thought to be largely stored as an increase in the magnetic field in the magnetotail lobes. However, how, when, and where this energy is stored and released within the magnetotail is unclear. Using data from the Cluster spacecraft and substorm onsets from Substorm Onsets and Phases from Indices of the Electrojet (SOPHIE), we examine the variation in the lobe magnetic energy density with respect to substorm onset for 541 isolated onsets. Based on a cross‐correlation analysis and a simple model, we deduce the following: On average, the magnetic energy density increases approximately linearly in the hour preceding onset and decreases at a similar rate after onset. The timing and magnitude of these changes varies with downtail distance, with observations from the mid‐tail ( urn:x-wiley:jgra:media:jgra54303:jgra54303-math-0001) showing larger changes in the magnetic energy density that occur ∼20 min after changes in the near‐tail ( urn:x-wiley:jgra:media:jgra54303:jgra54303-math-0002). The decrease in energy density in the near‐tail region is observed before the ground onset identified by SOPHIE, implying that the substorm is driven from the magnetotail and propagates into the ionosphere. The implication of these results is that energy in the near‐tail region is released first during the substorm expansion phase, with energy conversion propagating away from the Earth with time

The Rising Prevalence of Chronic Low Back Pain

National or state-level estimates on trends in the prevalence of chronic low back pain (LBP) are lacking. The objective of this study was to determine whether the prevalence of chronic LBP, and the demographic, health-related, and care-seeking characteristics of individuals with the condition have changed over the past 14 years

New Frontiers-class Uranus Orbiter: Exploring the feasibility of achieving multidisciplinary science with a mid-scale mission

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The genetic landscape of high-risk neuroblastoma

Neuroblastoma is a malignancy of the developing sympathetic nervous system that often presents with widespread metastatic disease, resulting in survival rates of less than 50%1. To determine the spectrum of somatic mutation in high-risk neuroblastoma, we studied 240 cases using a combination of whole exome, genome and transcriptome sequencing as part of the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) initiative. Here we report a low median exonic mutation frequency of 0.60 per megabase (0.48 non-silent), and remarkably few recurrently mutated genes in these tumors. Genes with significant somatic mutation frequencies included ALK (9.2% of cases), PTPN11 (2.9%), ATRX (2.5%, an additional 7.1% had focal deletions), MYCN (1.7%, a recurrent p.Pro44Leu alteration), and NRAS (0.83%). Rare, potentially pathogenic germline variants were significantly enriched in ALK, CHEK2, PINK1, and BARD1. The relative paucity of recurrent somatic mutations in neuroblastoma challenges current therapeutic strategies reliant upon frequently altered oncogenic drivers

The Network Composition of Aggregate Unemployment

We develop a theory of unemployment in which workers search for jobs through a network of firms, the labor flow network (LFN). The lack of an edge between two companies indicates the impossibility of labor flows between them due to high frictions. In equilibrium, firms' hiring behavior correlates through the network, modulating labor flows and generating aggregate unemployment. This theory provides new micro-foundations for the aggregate matching function, the Beveridge curve, wage dispersion, and the employer-size premium. Using employer-employee matched records, we study the effect of the LFN topology through a new concept: `firm-specific unemployment'