Sensitivity as outcome measure of androgen replacement: the AMS scale

BACKGROUND: The capacity of the AMS scale as clinical utility and as outcome measure still needs validation. METHODS: An open post-marketing study was performed by office-based physicians in Germany in 2004. We analysed data of 1670 androgen-deficient males who were treated with testosterone gel. The AMS scale was applied prior to and after 3 months treatment. RESULTS: The improvement of complaints under treatment relative to the baseline score was 30.7% (total score), 27.3% (psychological domain), 30.5% (somatic domain), and 30.7% (sexual domain), respectively. Patients with little or no symptoms before therapy improved by 9%, those with mild complaints at entry by 24%, with moderate by 32%, and with severe symptoms by 39% – compared with the baseline score. We showed that the distribution of complaints of testosterone deficient men before therapy almost returned to norm values after 12 weeks of testosterone treatment. Age, BMI, and total testosterone level at baseline did not modify the positive effect of androgen therapy. We also demonstrated that the AMS results can predict the independent (physician's) opinion about the individual treatment effect. Both, sensitivity (correct prediction of a positive assessment by the physician) and specificity (correct prediction of a negative assessment by the physician) were over 70%, if about 22% improvement of the AMS total score was used as cut-off point. CONCLUSION: The AMS scale showed a convincing ability to measure treatment effects on quality of life across the full range of severity of complaints. Effect modification by other variables at baseline was not observed. In addition, results of the scale can predict the subjective clinical expert opinion on the treatment efficiency

Resistive double-diffusive instability in the dead-zones of protostellar disks

We outline a novel linear instability that may arise in the dead-zones of protostellar disks, and possibly the fluid interiors of planets and protoplanets. In essence it is an axisymmetric buoyancy instability, but one that would not be present in a purely hydrodynamical gas. The necessary ingredients for growth include a negative radial entropy gradient (of any magnitude), weak magnetic fields, and efficient resistive diffusion (in comparison with thermal diffusion). The character of the instability is local, axisymmetric, and double-diffusive, and it attacks lengths much shorter than the resistive scale. Like the axisymmetric convective instability, it draws its energy from the negative radial entropy gradient; but by utilising the diffusing magnetic field, it can negate the stabilising influence of rotation. Its nonlinear saturated state, while not transporting appreciable angular momentum, could drive radial and vertical mixing, which may influence the temperature structure of the disk, dust dynamics and, potentially, planet formation.Comment: 16 pages, 5 figures. MNRAS Accepted. V2: cosmetic changes to bring in line with MNRAS versio

Large-Scale Magnetic-Field Generation by Randomly Forced Shearing Waves

A rigorous theory for the generation of a large-scale magnetic field by random non-helically forced motions of a conducting fluid combined with a linear shear is presented in the analytically tractable limit of low Rm and weak shear. The dynamo is kinematic and due to fluctuations in the net (volume-averaged) electromotive force. This is a minimal proof-of-concept quasilinear calculation aiming to put the shear dynamo, a new effect recently found in numerical experiments, on a firm theoretical footing. Numerically observed scalings of the wavenumber and growth rate of the fastest growing mode, previously not understood, are derived analytically. The simplicity of the model suggests that shear dynamo action may be a generic property of sheared magnetohydrodynamic turbulence.Comment: Paper substantially rewritten, results changed (relative to v1). Revised versio

Open source automated insulin delivery: addressing the challenge

Do-it-yourself automated insulin delivery systems for people living with type 1 diabetes use commercially available continuous glucose sensors and insulin pumps linked by unregulated open source software. Uptake of these systems is increasing, with growing evidence suggesting that positive glucose outcomes may be feasible. Increasing interest from people living with, or affected by, type 1 diabetes presents challenges to healthcare professionals, device manufacturers and regulators as the legal, governance and risk frameworks for such devices are not defined. We discuss the data, education, policy, technology and medicolegal obstacles to wider implementation of DIY systems and outline the next steps required for a co-ordinated approach to reducing variation in access to a technology that has potential to enable glucose self-management closer to target

Clusterkopfschmerz und Rechts-Links-Shunt:Beobachtung an Clusterkopfschmerzpatienten in einer Fall-Kontroll-Studie

Auf dem Hintergrund einer mehrfach nachgewiesenen Assoziation zwischen Migräne mit Aura und einem persistierenden Foramen ovale (PFO) soll in dieser Arbeit der Zusammenhang eines PFO mit dem Clusterkopfschmerz ermittelt werden. Dazu wurden 73 Clusterkopfschmerzpatienten und 73 alters- und geschlechtsgematchte Kontrollpersonen per transkranieller Dopplersonographie auf einen Rechts- Links- Shunt (RLS) untersucht. Die Prävalenz eines PFO lag bei 36% innerhalb der Patientengruppe und 41% innerhalb der Kontrollgruppe (p=0.897). Das einzig signifikante Ergebnis unter den Analysen der Untergruppen zeigte, dass Clusterkopfschmerzpatienten mit RLS zum Zeitpunkt der Erstmanifestation sowie auch zum Untersuchungszeitpunkt im Durchschnitt signifikant jünger waren (p=0.046, p= 0.009). Zusammenfassend geben unsere Ergebnisse keinen Hinweis auf eine Assoziation zwischen dem Clusterkopfschmerz und einem PFO bzw. RLS

Comparação da eficiência de fontes de fósforo na produção de arroz de terras altas.

O arroz de terras altas é importante componente dos sistemas de produção na região do Cerrado do Brasil. A deficiência de fósforo é um dos fatores limitantes na produção das culturas nessa região. Foi conduzido um ensaio em casa de vegetação com o objetivo de avaliar fontes de fósforo na produção de arroz de terras altas. Foram utilizadas seis fontes de P, i. e. Superfosfato simples (SFS), superfosfato simples policote (SFSP), superfosfato triplo (SFT), superfosfato triplo policote SFTP), fosfato monoamômico (FMA) e fosfato monoamômicopolicote (FMAP). As doses de P utilizados foram 50, 100, 200 e 400 mg kg-1 + testemunha. Houve resposta significativa e quadrática à aplicação de fontes de P na produção de grãos. Baseado na produção máxima, as fontes de P foram classificadas na ordem de fosfato monoamômicopolicote> superfosfato simples = fosfato monoamômico>superfosfatosimples policote > superfosfato triplo > superfosfato triplo policote

Generation of Magnetic Field by Combined Action of Turbulence and Shear

The feasibility of a mean-field dynamo in nonhelical turbulence with superimposed linear shear is studied numerically in elongated shearing boxes. Exponential growth of magnetic field at scales much larger than the outer scale of the turbulence is found. The charateristic scale of the field is l_B ~ S^{-1/2} and growth rate is gamma ~ S, where S is the shearing rate. This newly discovered shear dynamo effect potentially represents a very generic mechanism for generating large-scale magnetic fields in a broad class of astrophysical systems with spatially coherent mean flows.Comment: 4 pages, 5 figures; replaced with revised version that matches the published PR

Nanostructural organization of naturally occurring composites - part II: silica-chitin-based biocomposites

Investigations of the micro- and nanostructures and chemical composition of the sponge skeletons as examples for natural structural biocomposites are of fundamental scientific relevance. Recently, we show that some demosponges (Verongula gigantea, Aplysina sp.) and glass sponges (Farrea occa, Euplectella aspergillum) possess chitin as a component of their skeletons. The main practical approach we used for chitin isolation was based on alkali treatment of corresponding external layers of spicules sponge material with the aim of obtaining alkali-resistant compounds for detailed analysis. Here, we present a detailed study of the structural and physicochemical properties of spicules of the glass sponge Rossella fibulata. The structural similarity of chitin derived from this sponge to invertebrate alpha chitin has been confirmed by us unambiguously using physicochemical and biochemical methods. This is the first report of a silica-chitin composite biomaterial found in Rossella species. Finally, the present work includes a discussion related to strategies for the practical application of silica-chitin-based composites as biomaterials