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Importance: The effect of testosterone replacement therapy (TRT) in men with hypogonadism on the risk of progression from prediabetes to diabetes or of inducing glycemic remission in those with diabetes is unknown., Objective: To evaluate the efficacy of TRT in preventing progression from prediabetes to diabetes in men with hypogonadism who had prediabetes and in inducing glycemic remission in those with diabetes., Design, Setting, and Participants: This nested substudy, an intention-to-treat analysis, within a placebo-controlled randomized clinical trial (Testosterone Replacement Therapy for Assessment of Long-Term Vascular Events and Efficacy Response in Hypogonadal Men [TRAVERSE]) was conducted at 316 trial sites in the US. Participants included men aged 45 to 80 years with hypogonadism and prediabetes or diabetes who were enrolled in TRAVERSE between May 23, 2018, and February 1, 2022., Intervention: Participants were randomized 1:1 to receive 1.62% testosterone gel or placebo gel until study completion., Main Outcomes and Measures: The primary end point was the risk of progression from prediabetes to diabetes, analyzed using repeated-measures log-binomial regression. The secondary end point was the risk of glycemic remission (hemoglobin A1c level <6.5% [to convert to proportion of total hemoglobin, multiply by 0.01] or 2 fasting glucose measurements <126 mg/dL [to convert to mmol/L, multiply by 0.0555] without diabetes medication) in men who had diabetes., Results: Of 5204 randomized participants, 1175 with prediabetes (mean [SD] age, 63.8 [8.1] years) and 3880 with diabetes (mean [SD] age, 63.2 [7.8] years) were included in this study. Mean (SD) hemoglobin A1c level in men with prediabetes was 5.8% (0.4%). Risk of progression to diabetes did not differ significantly between testosterone and placebo groups: 4 of 598 (0.7%) vs 8 of 562 (1.4%) at 6 months, 45 of 575 (7.8%) vs 57 of 533 (10.7%) at 12 months, 50 of 494 (10.1%) vs 67 of 460 (14.6%) at 24 months, 46 of 359 (12.8%) vs 52 of 330 (15.8%) at 36 months, and 22 of 164 (13.4%) vs 19 of 121 (15.7%) at 48 months (omnibus test P = .49). The proportions of participants with diabetes who experienced glycemic remission and the changes in glucose and hemoglobin A1c levels were similar in testosterone- and placebo-treated men with prediabetes or diabetes., Conclusions and Relevance: In men with hypogonadism and prediabetes, the incidence of progression from prediabetes to diabetes did not differ significantly between testosterone- and placebo-treated men. Testosterone replacement therapy did not improve glycemic control in men with hypogonadism and prediabetes or diabetes. These findings suggest that TRT alone should not be used as a therapeutic intervention to prevent or treat diabetes in men with hypogonadism., Trial Registration: ClinicalTrials.gov Identifier: NCT03518034.

Ultrafiltration (UF) membranes, particularly membranes fabricated from self-assembled diblock copolymers, hold promise in wastewater treatment, dairy, and food industries. Membrane development goals involve combining a highly porous selective layer with a narrow pore size distribution with a mechanically stable supporting layer to achieve constant flux. To date, isoporous integral asymmetric membranes have been formed either as flat sheets or hollow fibers, and a surface-selective layer determines membrane separation performance. A unique isoporous membrane of the poly(4-vinylbenzocyclobutene)- b -poly(4-vinylpyridine) (PVBCB- b -P4VP) diblock copolymer with a substructure of almost homogeneous porosity throughout the body of the material (three-dimensional porosity) has been developed. Moreover, the matrix of the membrane (PVCB) enables it to undergo cross-linking, allowing the membrane to be thermally sterilized and applied in high-temperature UF applications.

Background: The incidence of systemic lupus in children with discoid lupus is unknown., Objective: This study assessed the baseline characteristics of patients with pediatric discoid lupus erythematosus (pDLE)., Methods: Medical records at 17 sites were reviewed for pediatric dermatology and rheumatology patients with discoid lupus erythematosus. The inclusion criteria were clinical and/or histopathologic diagnosis of discoid lupus erythematosus with an age at onset of <18 years. Baseline data were collected at the first documented visit. Outcomes included diagnosis of systemic lupus erythematosus (SLE) at the baseline visit using the 1997 American College of Rheumatology (primary) and the 2012 Systemic Lupus International Collaborating Clinics (secondary) criteria., Results: Of the >1500 charts reviewed, 438 patients met the inclusion criteria. The cohort was predominantly female (72%) and racially/ethnically diverse. A diagnosis of SLE at the baseline visit (pDLE + SLE) was rendered in 162 (37%) patients using the American College of Rheumatology and in 181 (41%) patients using the Systemic Lupus International Collaborating Clinics criteria. Patients with pDLE + SLE were older at the time of rash onset (median, 12.9 vs 8.9 years; P < .001), with shorter time from discoid lupus erythematosus onset to diagnosis, compared with patients with pDLE-only (median, 2 vs 7 months; P < .001). Patients with pDLE + SLE were more likely to be female (P = .004), with generalized discoid lupus erythematosus and clinically aggressive disease, including end-organ involvement, positive serologies, and higher- titer levels of antinuclear antibodies (P < .001)., Limitations: Retrospective study., Conclusion: A diagnosis of discoid lupus erythematosus in adolescence should prompt thorough screening for SLE., Competing Interests: Conflicts of interest Dr Ardoin is a consultant for Aurinia. Dr Chong is an investigator for Daavlin Corporation, Pfizer Incorporated, Biogen Incorporated, and Amgen Incorporated; is a consultant for Viela Bio, Beacon Bioscience, Bristol Meyers Squibb, EMD Serono, and Principia Biopharma; reports research grants (paid to his institution) from Daavlin Corporation and Biogen Incorporated; reports honoraria from Viela Bio, Beacon Bioscience, Bristol Meyers Squibb, EMD Serono, and Principia Biopharma as a consultant. Dr von Scheven is the President of the Childhood Arthritis and Rheumatology Alliance. Drs Ezeh, Ardalan, Buhr, Nguyen, Ahmed, Barton, Bell, Brandling-Bennett, Castelo-Soccio, Chiu, Co, Lara-Corrales, Cinosun, Curran, Diaz, Elman, Fernandez-Faith, Garcia-Romero, Grossman-Kranseler, Hogeling, Hudson, Hunt, Ibler, Marques, Monir, Oza, Paller, Putterman, Rodriguez-Salgado, Schoch, Truong, Wang, Wine Lee, Vleugels, Klein-Gitelman, Werth, and Arkin have no conflicts of interest to declare., (Copyright © 2022. Published by Elsevier Inc.)

Since membranes made of open porous polymer foams can eliminate the use of organic solvents during their manufacturing, a series of previous studies have explored the foaming process of various polymers including polyethersulfone (PESU) using physical blowing agents but failed to produce ultrafiltration membranes. In this study, blends containing different ratios of PESU and poly( N -vinylpyrrolidone) (PVP) were used for preparation of open-celled polymer foams. In batch foaming experiments involving a combination of supercritical CO 2 and superheated water as blowing agents, blends with low concentration of PVP delivered uniform open-celled foams that consisted of cells with average cell size less than 20 µm and cell walls containing open pores with average pore size less than 100 nm. A novel sample preparation method was developed to eliminate the non-foamed skin layer and to achieve a high porosity. Flat sheet membranes with an average cell size of 50 nm in the selective layer and average internal pore size of 200 nm were manufactured by batch foaming a PESU blend with higher concentration of PVP and post-treatment with an aqueous solution of sodium hypochlorite. These foams are associated with a water-flux up to 45 L/(h m 2 bar). Retention tests confirmed their applicability as ultrafiltration membranes.

Background: Children with discoid lupus erythematosus (DLE) are at risk for disfigurement and progression to systemic lupus erythematosus (SLE). Consensus is lacking regarding optimal care for children with DLE., Objectives: The aim of this study was to compare practice patterns among paediatric dermatologists/rheumatologists treating paediatric DLE., Methods: An online survey was sent to 292 paediatric rheumatologists in the Childhood Arthritis and Rheumatology Research Alliance and 200 paediatric dermatologists in the Pediatric Dermatology Research Alliance. Consensus was defined as ≥ 70% agreement., Results: Survey response rates were 38% (76 of 200) for dermatology and 21% (60 of 292) for rheumatology. Both specialties agreed that screening labs should include complete blood counts with differential, urinalysis, complement levels, erythrocyte sedimentation rate, antinuclear antibody and other autoantibodies, hepatic function and renal function/electrolytes. Both specialties agreed that arthritis or nephritis should prompt intensified evaluation for SLE. No other patient features achieved consensus as disease-modifying risk factors. Hydroxychloroquine was agreed upon as first-line systemic therapy, but consensus was lacking for second- or third-line treatment., Conclusions: We found few areas of consensus and significant practice differences between paediatric dermatologists and rheumatologists treating DLE. Knowledge gaps include risk factors for SLE, optimal screening and treatment of refractory skin disease., (© 2019 British Association of Dermatologists.)

Objective: Despite the social impairment associated with social anxiety disorder (SAD), little research has examined the impact of treatment on positive relational functioning. Accordingly, the authors conducted a treatment outcome study to evaluate a cognitive behavior therapy (CBT) regimen augmented by a relational focus (CBT-R) relative to a graduated exposure-applied relaxation (GEAR) regimen and wait list (WL) control. To examine the mechanism(s) that underlies treatment effects, they used structural equation modeling (SEM) to evaluate two potential mediators, change in judgment biases and in safety behaviors., Method: Treatment-seeking adults who met SAD diagnostic criteria (n = 100; 50% women; mean age = 32.9 years.; 36% ethnic minority) were randomly assigned to CBT-R, GEAR, or WL. CBT-R and GEAR participants received 14 group treatment sessions. Social initiation, relationship satisfaction, and a SAD symptom composite were assessed at pre- and postassessment, and 6- and 12-month follow-ups., Results: Intent-to-treat multilevel modeling analyses indicated that the CBT-R regimen resulted in significantly greater improvement relative to GEAR on relationship satisfaction and SAD symptoms. SEM results revealed that change in safety behaviors partially mediated the superior performance of CBT-R on both variables with confidence intervals set at .90., Conclusions: These findings indicate that CBT-based regimens can improve social approach processes in individuals with SAD and that safety behavior reduction contributes to positive outcomes. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Graphene, graphene-based nanomaterials (GBNs), and carbon nanotubes (CNTs) are being investigated as potential substrates for the growth of neural cells. However, in most in vitro studies, the cells were seeded on these materials coated with various proteins implying that the observed effects on the cells could not solely be attributed to the GBN and CNT properties. Here, we studied the biocompatibility of uncoated thermally reduced graphene (TRG) and poly(vinylidene fluoride) (PVDF) membranes loaded with multi-walled CNTs (MWCNTs) using neural stem cells isolated from the adult mouse olfactory bulb (termed aOBSCs). When aOBSCs were induced to differentiate on coverslips treated with TRG or control materials (polyethyleneimine-PEI and polyornithine plus fibronectin-PLO/F) in a serum-free medium, neurons, astrocytes, and oligodendrocytes were generated in all conditions, indicating that TRG permits the multi-lineage differentiation of aOBSCs. However, the total number of cells was reduced on both PEI and TRG. In a serum-containing medium, aOBSC-derived neurons and oligodendrocytes grown on TRG were more numerous than in controls; the neurons developed synaptic boutons and oligodendrocytes were more branched. In contrast, neurons growing on PVDF membranes had reduced neurite branching, and on MWCNTs-loaded membranes oligodendrocytes were lower in numbers than in controls. Overall, these findings indicate that uncoated TRG may be biocompatible with the generation, differentiation, and maturation of aOBSC-derived neurons and glial cells, implying a potential use for TRG to study functional neuronal networks.

Introduction: Risk factors for employment difficulties after cancer diagnosis are incompletely understood, and interventions to improve post-cancer employment remain few. New targets for intervention are needed., Methods: We assessed a cohort of 530 nonmetastatic cancer patients (aged ≤ 65 years, >6 months from diagnosis, off chemo- or radiotherapy) from the observational multi-site Symptom Outcomes and Practice Patterns study. Participants reported employment change, current employment, and symptoms. Groups were based on employment at survey (working full- or part-time versus not working) and whether there had been a change due to illness (yes versus no). The predictive power of symptom interference with work was evaluated for employment group (working stably versus no longer working). Race/ethnicity, gender, cancer type, therapy, and time since diagnosis were also assessed. Association between employment group and specific symptoms was examined., Results: The cohort was largely non-Hispanic white (76 %), female (85 %), and diagnosed with breast cancer (75 %); 24 % reported a change in employment. On multivariable analysis, participants with at least moderate symptom interference were more likely to report no longer working than their less effected counterparts (odds ratio (OR) = 8.0, 95 % CI, 4.2-15.4), as were minority participants compared with their non-Hispanic white counterparts (OR = 3.2, 95 % CI, 1.8-5.6). Results from the multiple regression model indicated the combination of fatigue (OR = 2.3, 95 % CI, 1.1-4.7), distress (OR = 3.9, 95 % CI, 1.7-9.0), and dry mouth (OR = 2.6, 95 % CI, 1.1-6.2) together with race/ethnicity and time since diagnosis adequately accounted for employment group., Conclusions: Our findings support the hypothesis that residual symptom burden is related to post-cancer employment: Residual symptoms may be targets for intervention to improve work outcomes among cancer survivors., Implications for Cancer Survivors: This analysis examines whether increased symptom burden is associated with a change to not working following a cancer diagnosis. We also examined individual symptoms to assess which symptoms were most strongly associated with not working after a cancer diagnosis. Our hope is that we will be able to use this information to both screen survivors post-active treatment as well as target high-risk symptoms for further and more aggressive intervention, in an attempt to improve post-cancer work outcomes.

Objectives: The purpose of this study is to determine if access to medical care and utilization of cancer screenings differs between women in the United States and Canada. This study examined this question by comparing women in Canada to women in the United States who have insurance coverage and those who do not., Method: This study used data from the 2002/03 Joint Canada United States Survey of Health and examined access to medical care and cancer screenings. A binary probit model was used to address several measures of access to medical care and cancer screening utilization., Results: This study finds five significant differences between insured American and Canadian women. Canadian women are better off in terms of ever having a mammogram, having a regular doctor, and having access to needed medicine, but fare worse in terms of having had a recent mammogram and having perceived unmet healthcare needs. With the exception of having recent mammograms, there is no statistical difference between uninsured and insured American women., Conclusion: Although this study does not show that one group is strictly better off, it does show that there are significant differences between the two groups of women., (Copyright © 2013 Elsevier Inc. All rights reserved.)

The formation of integral asymmetric membranes from ABC triblock terpolymers by non-solvent-induced phase separation is shown. They are compared with the AB diblock copolymer precursors. Triblock terpolymers of polystyrene-block-poly(2-vinylpyridine)-block-poly(ethylene oxide) (PS-b-P2VP-b-PEO) with two compositions are investigated. The third block supports the formation of a membrane in a case, where the corresponding diblock copolymer does not form a good membrane. In addition, the hydrophilicity is increased by the third block and due to the hydroxyl group the possibility of post-functionalization is given. The morphologies are imaged by scanning electron microscopy. The influence of the PEO on the membrane properties is analyzed by water flux, retention, and dynamic contact angle measurements., (Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Highly porous polystyrene-block-poly(4-vinylpyridine) (PS-b-P4VP) diblock copolymer membranes are prepared using carbohydrates as additives. Therefore α-cyclodextrine, α-(D)-glucose, and saccharose (cane sugar) are tested for the membrane formation of three different PS-b-P4VP polymers. The addition of the carbohydrates leads to an increasing viscosity of the membrane solutions due to hydrogen bonding between hydroxyl groups of the carbohydrates and pyridine units of the block copolymer. In all cases, the membranes made from solution with carbohydrates have higher porosity, an improved narrow pore distribution on the surface and a higher water flux as membranes made without carbohydrates with the same polymer, solvent ratio, and polymer concentration., (Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

The tendency to fear emotional experiences, such as anxiety, may be an important factor in the maintenance of excessive worry, which is the central feature of generalized anxiety disorder (GAD). The goal of the present study was to clarify the role of fear of anxiety in worry by assessing whether the experimental manipulation of fear of anxiety affects worry level. The study also assessed the combined effects of fear of anxious responding and intolerance of uncertainty (a factor already linked to pathological worry) on level of worry by grouping participants according to their tolerance for uncertainty. The results indicated that participants whose fear of anxiety was increased showed higher levels of worry compared to participants whose fear of anxiety was decreased. This finding provides preliminary support for the causal role of fear of anxiety in worry. Moreover, the results showed that increased fear of anxiety in combination with an intolerance for uncertainty led to the highest levels of worry, which suggests that these constructs have an additive effect on worry. The findings lend support to the integration of new conceptualizations of psychopathology with existing models of excessive worry, which could ultimately increase treatment efficacy for GAD.

A mass-tagged N-mesityl imidazolinium salt with four additional -CH(2)NCy(2) substituents was synthesized, leading to a molecular mass of nearly 1100 g mol(-1) in the corresponding carbene ligand. This mass-tagged ligand was used to generate the respective Grubbs II and Grubbs-Hoveyda type complexes. The catalytic activity of the latter complex was tested in several olefin metathesis reactions and found to be slightly superior to that of the related N-mesityl based complex. In batchwise solvent resistant nanofiltration experiments the ruthenium complex dissolved in toluene and following a metathesis reactions was efficiently retained (>99.8 %) by a single nanofiltration; the permeate contained less than 4 ppm of Ru. Equally efficient catalyst retention was observed in a membrane reactor utilized for the continuous synthesis of a RCM product.

Although recent findings suggest that intolerance of uncertainty is a fundamental construct involved in excessive worry, additional research is required to further establish the construct validity of intolerance of uncertainty and demonstrate its unique contribution to the understanding of worry. The present study examined the relationships among measures of worry, intolerance of uncertainty, intolerance of ambiguity, perfectionism, and perceived control in a sample of 197 university students. The findings indicated that intolerance of uncertainty moderately overlaps with earlier conceptualizations of intolerance of ambiguity; however, worry was more highly related to intolerance of uncertainty than to intolerance of ambiguity. Intolerance of uncertainty also emerged as the most salient predictor of worry compared to other cognitive processes such as perfectionism and perceived control. Worry and intolerance of uncertainty continued to be significantly related after controlling for intolerance of ambiguity, perfectionism, and perceived control, which implies that intolerance of uncertainty shares a unique association with worry that is not accounted for by these other cognitive factors. Overall, the findings provide evidence of construct validity and underscore the role of intolerance of uncertainty in the conceptualization of worry.

Late blight caused by the oomycete Phytophthora infestans is the economically most important and destructive disease in potato cultivation. Quantitative resistance to late blight available in tetraploid cultivars is correlated with late maturity in temperate climates, which is an undesirable characteristic. A total of 30 DNA-based markers known to be linked to loci for pathogen resistance in diploid potato were selected and tested as polymerase chain reaction-based markers for linkage with quantitative trait loci (QTL) for late blight resistance and plant maturity in two half-sib families of tetraploid potatoes. Most markers originated from within or were physically closely linked to candidate genes for quantitative resistance factors. The families were repeatedly evaluated in the field for quantitative resistance to late blight and maturity. Resistance was corrected for the maturity effect. Nine of eleven different map segments tagged by the markers harbored QTL affecting maturity-corrected resistance. Interactions were found between unlinked resistance QTL, providing testable strategies for marker-assisted selection in tetraploid potato. Based on the linkage observed between QTL for resistance and plant maturity and based on the genetic interactions observed between candidate genes tagging resistance QTL, we discuss models for the molecular basis of quantitative resistance and maturity.

Research is now suggesting that intolerance of uncertainty may be very important in understanding worry and may play a key role in the etiology and maintenance of worry. The present study attempted to further our understanding of intolerance of uncertainty by examining the psychometric properties of the English version of the Intolerance of Uncertainty Scale (IUS), which has already been validated in French. Factor analysis indicated that the IUS has a four-factor structure that represents the idea that uncertainty is stressful and upsetting, uncertainty leads to the inability to act, uncertain events are negative and should be avoided, and being uncertain is unfair. The IUS has excellent internal consistency, good test-retest reliability over a five-week period, and convergent and divergent validity when assessed with symptom measures of worry, depression, and anxiety. Overall, this study suggests that the IUS is a sound measure of intolerance of uncertainty and supports the idea that intolerance of uncertainty is an important construct involved in worry.