A comparison of salivary testosterone measurement using immunoassays and tandem mass spectrometry

Enzyme immunoassays (EIAs) are widely used to measure salivary testosterone. However, little is known about how accurately different EIAs assess testosterone, partially because estimates across various EIAs differ considerably. We compared testosterone concentrations across EIAs of three commonly used manufacturers (DRG International, Salimetrics, and IBL International) to liquid chromatography tandem mass spectrometry (LC–MS/MS). Relative to EIAs from Salimetrics and IBL International, EIAs supplied by DRG International provided the closest approximation to LC–MS/MS testosterone concentrations, followed closely by EIAs from Salimetrics, and then IBL. Additionally, EIAs tended to inflate estimates of lower testosterone concentrations in women. Examining our results and comparing them to existing data revealed that testosterone EIAs had decreased linear correspondence with LC–MS/MS in comparison to cortisol EIAs. Overall, this paper provides researchers with information to better measure testosterone in their research and more accurately compare testosterone measurements across different methods

Schwannoma of the external auditory canal: a case report

BACKGROUND: Schwannomas are uncommon benign tumors of the external auditory canal. The clinical features, the differential diagnosis, and the surgical treatment of these lesions are discussed. CASE PRESENTATION: A 51-year-old patient presented with a mass obliterating the external auditory meatus. Excisional biopsy was performed. Diagnosis was reported to be schwannoma by histopathologic examination. CONCLUSION: Schwannoma, rarely seen in the external auditory canal, can be managed by a precise excision of the tumor via transmeatal approach

Ten steps or climbing a mountain: A study of Australian health professionals' perceptions of implementing the baby friendly health initiative to protect, promote and support breastfeeding

Background: The Baby Friendly Hospital (Health) Initiative (BFHI) is a global initiative aimed at protecting, promoting and supporting breastfeeding and is based on the ten steps to successful breastfeeding. Worldwide, over 20,000 health facilities have attained BFHI accreditation but only 77 Australian hospitals (approximately 23%) have received accreditation. Few studies have investigated the factors that facilitate or hinder implementation of BFHI but it is acknowledged this is a major undertaking requiring strategic planning and change management throughout an institution. This paper examines the perceptions of BFHI held by midwives and nurses working in one Area Health Service in NSW, Australia. Methods: The study used an interpretive, qualitative approach. A total of 132 health professionals, working across four maternity units, two neonatal intensive care units and related community services, participated in 10 focus groups. Data were analysed using thematic analysis. Results: Three main themes were identified: ‘Belief and Commitment’; ‘Interpreting BFHI’ and ‘Climbing a Mountain’. Participants considered the BFHI implementation a high priority; an essential set of practices that would have positive benefits for babies and mothers both locally and globally as well as for health professionals. It was considered achievable but would take commitment and hard work to overcome the numerous challenges including a number of organisational constraints. There were, however, differing interpretations of what was required to attain BFHI accreditation with the potential that misinterpretation could hinder implementation. A model described by Greenhalgh and colleagues on adoption of innovation is drawn on to interpret the findings. Conclusion: Despite strong support for BFHI, the principles of this global strategy are interpreted differently by health professionals and further education and accurate information is required. It may be that the current processes used to disseminate and implement BFHI need to be reviewed. The findings suggest that there is a contradiction between the broad philosophical stance and best practice approach of this global strategy and the tendency for health professionals to focus on the ten steps as a set of tasks or a checklist to be accomplished. The perceived procedural approach to implementation may be contributing to lower rates of breastfeeding continuation

Neonatal umbilical cord blood transplantation halts skeletal disease progression in the murine model of MPS-I

Umbilical cord blood (UCB) is a promising source of stem cells to use in early haematopoietic stem cell transplantation (HSCT) approaches for several genetic diseases that can be diagnosed at birth. Mucopolysaccharidosis type I (MPS-I) is a progressive multi-system disorder caused by deficiency of lysosomal enzyme α-L-iduronidase, and patients treated with allogeneic HSCT at the onset have improved outcome, suggesting to administer such therapy as early as possible. Given that the best characterized MPS-I murine model is an immunocompetent mouse, we here developed a transplantation system based on murine UCB. With the final aim of testing the therapeutic efficacy of UCB in MPS-I mice transplanted at birth, we first defined the features of murine UCB cells and demonstrated that they are capable of multi-lineage haematopoietic repopulation of myeloablated adult mice similarly to bone marrow cells. We then assessed the effectiveness of murine UCB cells transplantation in busulfan-conditioned newborn MPS-I mice. Twenty weeks after treatment, iduronidase activity was increased in visceral organs of MPS-I animals, glycosaminoglycans storage was reduced, and skeletal phenotype was ameliorated. This study explores a potential therapy for MPS-I at a very early stage in life and represents a novel model to test UCB-based transplantation approaches for various diseases

Common carotid intima media thickness and ankle-brachial pressure index correlate with local but not global atheroma burden:a cross sectional study using whole body magnetic resonance angiography

Common carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) are used as surrogate marker of atherosclerosis, and have been shown to correlate with arterial stiffness, however their correlation with global atherosclerotic burden has not been previously assessed. We compare CIMT and ABPI with atheroma burden as measured by whole body magnetic resonance angiography (WB-MRA).50 patients with symptomatic peripheral arterial disease were recruited. CIMT was measured using ultrasound while rest and exercise ABPI were performed. WB-MRA was performed in a 1.5T MRI scanner using 4 volume acquisitions with a divided dose of intravenous gadolinium gadoterate meglumine (Dotarem, Guerbet, FR). The WB-MRA data was divided into 31 anatomical arterial segments with each scored according to degree of luminal narrowing: 0 = normal, 1 = <50%, 2 = 50-70%, 3 = 70-99%, 4 = vessel occlusion. The segment scores were summed and from this a standardized atheroma score was calculated.The atherosclerotic burden was high with a standardised atheroma score of 39.5±11. Common CIMT showed a positive correlation with the whole body atheroma score (β 0.32, p = 0.045), however this was due to its strong correlation with the neck and thoracic segments (β 0.42 p = 0.01) with no correlation with the rest of the body. ABPI correlated with the whole body atheroma score (β -0.39, p = 0.012), which was due to a strong correlation with the ilio-femoral vessels with no correlation with the thoracic or neck vessels. On multiple linear regression, no correlation between CIMT and global atheroma burden was present (β 0.13 p = 0.45), while the correlation between ABPI and atheroma burden persisted (β -0.45 p = 0.005).ABPI but not CIMT correlates with global atheroma burden as measured by whole body contrast enhanced magnetic resonance angiography in a population with symptomatic peripheral arterial disease. However this is primarily due to a strong correlation with ilio-femoral atheroma burden

Estimating the Associations between Big Five Personality Traits, Testosterone, and Cortisol

OBJECTIVE: Hormones are often conceptualized as biological markers of individual differences and have been associated with a variety of behavioral indicators and characteristics, such as mating behavior or acquiring and maintaining dominance. However, before researchers create strong theoretical models for how hormones modulate individual and social behavior, information on how hormones are associated with dominant models of personality is needed. Although there have been some studies attempting to quantify the associations between personality traits, testosterone, and cortisol, there are many inconsistencies across these studies. METHODS: In this registered report, we examined associations between testosterone, cortisol, and Big Five personality traits. We aggregated 25 separate samples to yield a single sample of 3964 (50.3% women; 27.7% of women were on hormonal contraceptives). Participants completed measures of personality and provided saliva samples for testosterone and cortisol assays. RESULTS: The results from multi-level models and meta-analyses revealed mostly weak, non-significant associations between testosterone or cortisol and personality traits. The few significant effects were still very small in magnitude (e.g., testosterone and conscientiousness: r = −0.05). A series of moderation tests revealed that hormone-personality associations were mostly similar in men and women, those using hormonal contraceptives or not, and regardless of the interaction between testosterone and cortisol (i.e., a variant of the dual-hormone hypothesis). CONCLUSIONS: Altogether, we did not detect many robust associations between Big Five personality traits and testosterone or cortisol. The findings are discussed in the context of biological models of personality and the utility of examining heterogeneity in hormone-personality associations

Employers’ Perception on the Antecedents of Graduate Employability for the Information Technology Sector

This chapter aims to analyze the perceptions of the employers in the Information Technology (IT) sector in India on the antecedents of graduate employability. With an increased emphasis on Organizational flexibility in today’s volatile and complex Business environment, the employability of the workforce has gained crucial significance. Flexibility has been acknowledged as a predictor of Organizational performance (Sushil, Global J Flex Syst Manag 16(4):309–311, 2015) and its Strategic driver (Sharma et al., Global J Flex Syst Manag 11(3):51–68, 2010). Flexible strategies and business plan often demand the need to scale up the quality of manpower or shift the required skill set to swiftly adapt to the Market changes accordingly. This Flexibility is not confined to the quantity of manpower only but also encompasses the quality of skills deployed by the manpower (Srivastava, Global J Flex Syst Manag 17(1):105–108, 2016). Therefore, it is imperative for the potential Job seeker to understand and continuously adapt to the changing knowledge and skill requirements of the employers to develop and maintain their employability. The employers in this dynamic sector demand a range of knowledge, skills, and other attributes from potential job seekers. However, the graduates passing out of Higher Education Institutions fail to meet these expectations of the employers. Therefore, the sector is struggling with the challenges of talent crunch and qualitative demand–Demand–supply mismatch of manpower. The identification of factors that influence graduate employability is based on literature review. This chapter is empirical and examines the perceptions of the employers on the factors that impact employability and validates the association between the research constructs. Opinion surveys are used to elicit responses from a sample of 236 respondents, i.e., Technical/HR personnel at the middle-level/upper middle-level management positions spanning across 71 reputed IT companies in India. These respondents are actively involved in the staffing of graduates seeking Technical jobs in IT sector. The perception of these employers has been investigated using bivariate and multivariate analysis techniques. The key insights drawn in this chapter enable potential job seekers to clearly understand the employer demands in the IT sector and equip themselves with the required knowledge and skills. This also contributes to enhancing the manpower Flexibility in organizations. The chapter has significant implications for the policy-makers and key stakeholders to bridge the Employability gap in this sector

Imaging of Hereditary Hemorrhagic Telangiectasia

This pictorial review is based on our experience of the follow-up of 120 patients at our multidisciplinary center for hereditary hemorrhagic telangiectasia (HHT). Rendu-Osler-Weber disease or HHT is a multiorgan autosomal dominant disorder with high penetrance, characterized by epistaxis, mucocutaneous telangiectasis, and visceral arteriovenous malformations (AVMs). The research on gene mutations is fundamental and family screening by clinical examination, chest X-ray, research of pulmonary shunting, and abdominal color Doppler sonography is absolutely necessary. The angioarchitecture of pulmonary AVMs can be studied by unenhanced multidetector computed tomography; however, all other explorations of liver, digestive bowels, or brain require administration of contrast media. Magnetic resonance angiography is helpful for central nervous system screening, in particular for the spinal cord, but also for pulmonary, hepatic, and pelvic AVMs. Knowledge of the multiorgan involvement of HHT, mechanism of complications, and radiologic findings is fundamental for the correct management of these patients

Interactions of Cathinone NPS with Human Transporters and Receptors in Transfected Cells

Pharmacological assays carried out in transfected cells have been very useful for describing the mechanism of action of cathinone new psychoactive substances (NPS). These in vitro characterizations provide fast and reliable information on psychoactive substances soon after they emerge for recreational use. Well-investigated comparator compounds, such as methamphetamine, 3,4-methylenedioxymethamphetamine, cocaine, and lysergic acid diethylamide, should always be included in the characterization to enhance the translation of the in vitro data into clinically useful information. We classified cathinone NPS according to their pharmacology at monoamine transporters and receptors. Cathinone NPS are monoamine uptake inhibitors and most induce transporter-mediated monoamine efflux with weak to no activity at pre- or postsynaptic receptors. Cathinones with a nitrogen-containing pyrrolidine ring emerged as NPS that are extremely potent transporter inhibitors but not monoamine releasers. Cathinones exhibit clinically relevant differences in relative potencies at serotonin vs. dopamine transporters. Additionally, cathinone NPS have more dopaminergic vs. serotonergic properties compared with their non-β-keto amphetamine analogs, suggesting more stimulant and reinforcing properties. In conclusion, in vitro pharmacological assays in heterologous expression systems help to predict the psychoactive and toxicological effects of NPS

Therapeutic aims of drugs offering only progression-free survival are misunderstood by patients, and oncologists may be overly optimistic about likely benefits

PURPOSE: The use of novel and often expensive drugs offering limited survival benefit in advanced disease is controversial. Treatment recommendations are influenced by patient characteristics and trial data showing overall response rates (ORR), progression-free survival (PFS) and overall survival (OS). PFS is frequently the primary outcome in licencing studies. PATIENTS AND METHODS: As part of a longitudinal study Assessing the 'VALue' to patients of PROgression Free Survival (AVALPROFS), oncologists completed checklists at baseline following consultations with patients. Questions probed perceived clinical benefits of the drugs to populations in general. Patients completed study-specific interview schedules at baseline, 6 weeks into treatment, and at withdrawal due to toxicity or progression. Patients also completed tumour- and treatment-specific quality of life questionnaires monthly for their time in the study. Only baseline results are reported here. RESULTS: Thirty-two UK oncologists discussed management options with 90 patients with heterogeneous advanced cancers. Oncologists' estimates of medical benefit in general from treatment varied between 10 and 80 %. They expected 46/90 (51 %) of their patients to derive some clinical benefit from the prescribed treatment but were either unsure or expected none for 44/90 (49 %). Predictions of life expectancy were variable but 62 % (56/90) of patients were expected to survive longer with treatment. A majority of patients 51/90 (57 %) had 'no idea' or were 'unclear' what PFS meant and 45/90 (50 %) thought extension of life was the primary therapeutic aim of treatment. CONCLUSION: Discussions between doctors and patients with metastatic disease about future management plans and likely therapeutic gains are challenging. Factors influencing decisions about putative benefits of novel drugs are often applied inconsistently can be overly optimistic and may even contradict published data