Transcriptional repression of the glycoprotein hormone alpha subunit gene by androgen may involve direct binding of androgen receptor to the proximal promoter.

Testicular androgens suppress the synthesis and secretion of the pituitary gonadotropins, in particular, luteinizing hormone. This suppressive effect includes transcription of both the common a subunit gene and the unique β subunit genes. Herein, we demonstrate that 1600 base pairs (bp) of proximal 5'-flanking region derived from the human α subunit gene and a shorter 315-bp segment of the bovine α subunit gene confer negative regulation by androgen to the gene encoding bacterial chloramphenicol acetyltransferase in transgenic mice.Testicular androgens suppress the synthesis and secretion of the pituitary gonadotropins, in particular, luteinizing hormone. This suppressive effect includes transcription of both the common a subunit gene and the unique β subunit genes. Herein, we demonstrate that 1600 base pairs (bp) of proximal 5'-flanking region derived from the human α subunit gene and a shorter 315-bp segment of the bovine α subunit gene confer negative regulation by androgen to the gene encoding bacterial chloramphenicol acetyltransferase in transgenic mice

Rates and Risk Factors for Anastomotic Leak Following Blunt Trauma-Associated Bucket Handle Intestinal Injuries: A Multicenter Study

OBJECTIVES: The risk factors for anastomotic leak (AL) after resection and primary anastomosis for traumatic bucket handle injury (BHI) have not been previously defined. This multicenter study was conducted to address this knowledge gap. METHODS: This is a multicenter retrospective study on small intestine and colonic BHIs from blunt trauma between 2010 and 2021. Baseline patient characteristics, risk factors, presence of shock and transfusion, operative details, and clinical outcomes were compared using R. RESULTS: Data on 395 subjects were submitted by 12 trauma centers, of whom 33 (8.1%) patients developed AL. Baseline details were similar, except for a higher proportion of patients in the AL group who had medical comorbidities such as diabetes, hypertension, and obesity (60.6% vs. 37.3%, p=0.015). AL had higher rates of surgical site infections (13.4% vs. 5.3%, p=0.004) and organ space infections (65.2% vs. 11.7%, p0.05). More patients with AL were discharged with an ostomy (69.7% vs. 7.3%, p6 units of packed red blood cells, and site of injury (adjusted RR=2.32 (1.13, 5.17)), none of which were independent risk factors in themselves. CONCLUSION: Damage control surgery performed as the initial operation appears to double the risk of AL after intestinal BHI, even after controlling for other markers of injury severity. LEVEL OF EVIDENCE: III

Livelihood and vulnerability in the wake of Typhoon Yolanda: lessons of community and resilience

Livelihood strategies that are crafted in ‘extra-ordinary’ post-disaster conditions should also be able to function once some semblance of normalcy has resumed. This article aims to show that the vulnerability experienced in relation to Typhoon Yolanda was, and continues to be, directly linked to inadequate livelihood assets and opportunities. We examine the extent to which various livelihood strategies lessened vulnerability post-Typhoon Yolanda and argue that creating conditions under which disaster survivors have the freedom to pursue sustainable livelihood is essential in order to foster resilience and reduce vulnerability against future disasters. We offer suggestions to improve future relief efforts, including suggestions made by the survivors themselves. We caution against rehabilitation strategies that knowingly or unknowingly, resurrect pre-disaster vulnerability. Strategies that foster dependency, fail to appreciate local political or ecological conditions or undermine cooperation and cohesion in already vulnerable communities will be bound to fail. Some of the livelihood strategies that we observed post-Typhoon Yolanda failed on some or all of these points. It is important for future policy that these failings are addressed

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Leadership Orientation and Stress Perceptions of American Business Students

The leadership tendencies of people are likely to be influenced by their education and other personal traits. For example, it is expected that managers are likely to be more focused on building and maintaining strong relationships as they deal with people most of the time on the job. To explore the behavioral tendencies of working adult business students in the cities of Miami, Fort Lauderdale, Tampa, and Orlando, this study focused on comparing the leadership and stress perceptions of 813business students based on their education, religion, age, and gender. These respondents have a significantly higher score on relationship orientation. Females are significantly more relationship-oriented and less task-oriented than their male colleagues.The more educated respondents have a significantly higher score on the stress overload perception. Practical suggestions for stress managementalong with implications for the creation of a wellness program are presented.Investing in human capital can position the company above others in the marketplace as it helps with high morale and employee retention

How should we prioritise incident management deployment

With perpetual strains on resources and traffic increasing at a steady rate, transport agencies need to evaluate the road network and make informed decisions to determine which roads have the greatest risk of adverse impacts and therefore identify the roads that have the greatest case for intervention. This is especially the case for Intelligent Transport Systems (ITS) and in particular incident management services where decision-making techniques are immature relative to conventional road engineering. This problem is compounded by the fact that common evaluation tools are insufficient for ITS applications. Historical information for ITS impacts is not always readily available, impacts are not transferable and impacts are incremental to the individual user. For these reasons, a new network evaluation framework is presented in this paper for incident management deployment. The framework aims to analyse the road network and prioritise roads with respect to two factors: the historical risk associated with incidents; and the cost effectiveness of implementation. To assess the historical risk, the framework initially converts social, economic and environmental impacts to a common monetary base, enabling the addition of the incident impacts. The economic impact values must be treated as relative values of measurement, not absolute costs. The second part of the framework assesses the historical risk, taking into account both the consequence of an event, measured in economic terms described above, and the probability of an event occurring based on historical information. The third uses a cost-effective ratio comparing the reduced impacts with the project costs. The economic risk analysis presented in Figure 1 below integrates safety, reliability and environmental impacts, providing an integrated decision-making tool for proactive ITS deployment decision-making