R, Ramachandran S, Priya C, Yuvarani G, Tharani G, KamatchI K, Muthu Raj G. Prevalence of forward neck posture and influence of smartphones in physiotherapy students

Introduction and Aim: InAsia, the prevalence of forward neck posture is 66%. Forward neck posture is the anterior positioning of cervical spine. This posture is sometimes called as “scholar’s neck. Forward neck posture can lead to musculoskeletal disorders such as injuries in muscles, tendons, and peripheral vessels, vascular vessels caused by repetitive or continuous use of certain body part. In forward neck posture, the sternocleidomastoid muscle and trapezius are largely responsible for turning and nodding the head. When the head moves front, the spine follows, pulling the shoulder blades forward as well.They make contact with the upper ribs and begin to drag it forward with them.Therefore, this study aims to quantify forward neck posture in prolonged smart phone users.   Methodology:An observational study was done in smartphone using student population comparing the control group students with forward neck posture studentsfor the duration of 3weeks. This study has included 100 students with forward neck posturewho were recruited fromDr. MGR Educational & Research Institute. Goniometer, Craniovertebral angle and Plumb line were used as the outcome measure.   Results:The findings of this research exhibit there is a statistically significant changes inforward neck posture studentscompared with control group and the mean difference is 14.97 in two groups students.   Conclusion:The present study concluded that 3 weeks after assessing the students. Forward neck posture students found to have decreased craniovertebral angle and range of motion compared to normal neck posture students and also found that forward neck posture students spent 5-6 hours using smart phones per day.

Observation of D_{s}^{±}/D^{0} Enhancement in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the first measurement of charm-strange meson D_{s}^{±} production at midrapidity in Au+Au collisions at sqrt[s_{NN}]=200  GeV from the STAR experiment. The yield ratio between strange (D_{s}^{±}) and nonstrange (D^{0}) open-charm mesons is presented and compared to model calculations. A significant enhancement, relative to a pythia simulation of p+p collisions, is observed in the D_{s}^{±}/D^{0} yield ratio in Au+Au collisions over a large range of collision centralities. Model calculations incorporating abundant strange-quark production in the quark-gluon plasma and coalescence hadronization qualitatively reproduce the data. The transverse-momentum integrated yield ratio of D_{s}^{±}/D^{0} at midrapidity is consistent with a prediction from a statistical hadronization model with the parameters constrained by the yields of light and strange hadrons measured at the same collision energy. These results suggest that the coalescence of charm quarks with strange quarks in the quark-gluon plasma plays an important role in D_{s}^{±}-meson production in heavy-ion collisions.

Measurement of e^{+}e^{-} Momentum and Angular Distributions from Linearly Polarized Photon Collisions

The Breit-Wheeler process which produces matter and antimatter from photon collisions is experimentally investigated through the observation of 6085 exclusive electron-positron pairs in ultraperipheral Au+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements reveal a large fourth-order angular modulation of cos4Δϕ=(16.8±2.5)% and smooth invariant mass distribution absent of vector mesons (ϕ, ω, and ρ) at the experimental limit of ≤0.2% of the observed yields. The differential cross section as a function of e^{+}e^{-} pair transverse momentum P_{⊥} peaks at low value with sqrt[⟨P_{⊥}^{2}⟩]=38.1±0.9  MeV and displays a significant centrality dependence. These features are consistent with QED calculations for the collision of linearly polarized photons quantized from the extremely strong electromagnetic fields generated by the highly charged Au nuclei at ultrarelativistic speed. The experimental results have implications for vacuum birefringence and for mapping the magnetic field which is important for emergent QCD phenomena.

Detectable respiratory SARS-CoV-2 RNA is associated with low vitamin D levels and high social deprivation

BACKGROUND

Accumulating evidence links COVID-19 incidence and outcomes with vitamin D status. We investigated if an interaction existed between vitamin D levels and social deprivation in those with and without COVID-19 infection.

METHODS

Upper or lower respiratory tract samples from 104 patients were tested for SARS-CoV-2 RNA in accordance with Public Health England criteria (January-May 2020) using RT-PCR. The latest serum total 25-hydroxyvitamin D(25-OHD) levels, quantified by LC-MS/MS, was obtained for each patient (September 2019-April 2020). Index of Multiple Deprivation (IMD) was generated for each patient. Univariate and logistic regression analyses examined associations between age, gender, 25-OHD, IMD score and SARS-CoV-2 result in the total cohort and subgroups.

RESULTS

In the total cohort, a positive SARS-CoV-2 test was significantly associated with lower 25-OHD levels and higher IMD. A positive test was associated with higher IMD in the male subgroup and with lower 25-OHD levels in those aged >72 years. Low 25-OHD and IMD quintile 5 were separately associated with positive COVID-19 outcome in the cohort. Patients in IMD quintile 5 with vitamin D levels ≤ 34.4 nmol/L were most likely to have a positive COVID-19 outcome, even more so if aged >72 years (OR: 19.07, 95%CI: 1.71-212.25; P = .016).

CONCLUSIONS

In this cohort, combined low vitamin D levels and higher social deprivation were most associated with COVID-19 infection. In older age, this combination was even more significant. Our data support the recommendations for normalising vitamin D levels in those with deficient / insufficient levels and in groups at high risk for deficiency.

Is a fasting testosterone level really necessary for the determination of androgen status in men?

BACKGROUND

As circulating testosterone may be suppressed in the post-prandial state, it has been recommended that measurements are carried out with the patient fasted.

OBJECTIVES

In this regard, we assessed the effect of fasting/non-fasting status on total testosterone (T) levels in men.

MATERIALS AND METHODS

Data was collected in a single UK Hospital in men with two serum T requests taken within a 6-month period of each other and sampled at a time of day ≤ 2 h apart. Three groups were established, with T levels compared via signed-rank test in men with both a fasting and non-fasting sample (Group 1; n = 69), and in men with paired non-fasting (Group 2; n = 126) and paired fasting (Group 3; n = 18) samples. The differences in T levels between the paired samples was compared between the three groups using the rank-sum test and also via multiple regression analysis with the groups factorised.

RESULTS

Median (Interquartile Range, IQR) age did not vary significantly between Groups 1, 2 and 3 at 49 (38-56), 51.5 (42-60) and 51.5 (40-59) years, respectively. No significant difference (p = 0.89) was found between the T levels in Group 1 with non-fasting (median (IQR) T = 11.1 (9.3-13.6) nmol/L) versus fasting samples T = 10.8 (8.9-14.1) nmol/L). Paired T levels did not significantly differ in each of the other two groups (2 and 3). There was no significant association between the differences in paired T levels between the three groups, even when the model was adjusted for age and time, with Group 1 (as reference) versus Group 2 (p = 0.79) and versus Group 3 (p = 0.63).

DISCUSSION

We found no significant differences between fasting and non-fasting T levels. A definitive confirmatory study is required to determine whether fasting status is necessary to diagnose hypogonadism.

CONCLUSION

Non-requirement of fasting status when checking testosterone levels would remove a major hurdle in the diagnosis of hypogonadism.

Converting noise into solitons: optical self-organization through intermodal nonlinearity

We experimentally demonstrate a pump-pulse-induced conversion of noise into solitons in multimode optical fibers. The process is based on the recently discovered phenomenon of soliton self-mode conversion, where a pump soliton in a higher-order spatial mode crafts another well-defined soliton, originating purely from noise, in a lower-order mode at a longer wavelength through intermodal Raman scattering. The lack of the need for any seed or cavity feedback demonstrates that soliton self-mode conversion is a fundamentally unavoidable, but nevertheless tailorable and hence useful, self-organizing nonlinear optical effect capable of turning noise into transform limited solitons.

Global Polarization of Ξ and Ω Hyperons in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

Global polarization of Ξ and Ω hyperons has been measured for the first time in Au+Au collisions at sqrt[s_{NN}]=200  GeV. The measurements of the Ξ^{-} and Ξ[over ¯]^{+} hyperon polarization have been performed by two independent methods, via analysis of the angular distribution of the daughter particles in the parity violating weak decay Ξ→Λ+π, as well as by measuring the polarization of the daughter Λ hyperon, polarized via polarization transfer from its parent. The polarization, obtained by combining the results from the two methods and averaged over Ξ^{-} and Ξ[over ¯]^{+}, is measured to be ⟨P_{Ξ}⟩=0.47±0.10(stat)±0.23(syst)% for the collision centrality 20%-80%. The ⟨P_{Ξ}⟩ is found to be slightly larger than the inclusive Λ polarization and in reasonable agreement with a multiphase transport model. The ⟨P_{Ξ}⟩ is found to follow the centrality dependence of the vorticity predicted in the model, increasing toward more peripheral collisions. The global polarization of Ω, ⟨P_{Ω}⟩=1.11±0.87(stat)±1.97(syst)% was obtained by measuring the polarization of daughter Λ in the decay Ω→Λ+K, assuming the polarization transfer factor C_{ΩΛ}=1.

Measurement of the Positive Muon Anomalous Magnetic Moment to 0.46 ppm

We present the first results of the Fermilab National Accelerator Laboratory (FNAL) Muon g-2 Experiment for the positive muon magnetic anomaly a_{μ}≡(g_{μ}-2)/2. The anomaly is determined from the precision measurements of two angular frequencies. Intensity variation of high-energy positrons from muon decays directly encodes the difference frequency ω_{a} between the spin-precession and cyclotron frequencies for polarized muons in a magnetic storage ring. The storage ring magnetic field is measured using nuclear magnetic resonance probes calibrated in terms of the equivalent proton spin precession frequency ω[over ˜]_{p}^{'} in a spherical water sample at 34.7 °C. The ratio ω_{a}/ω[over ˜]_{p}^{'}, together with known fundamental constants, determines a_{μ}(FNAL)=116 592 040(54)×10^{-11} (0.46 ppm). The result is 3.3 standard deviations greater than the standard model prediction and is in excellent agreement with the previous Brookhaven National Laboratory (BNL) E821 measurement. After combination with previous measurements of both μ^{+} and μ^{-}, the new experimental average of a_{μ}(Exp)=116 592 061(41)×10^{-11} (0.35 ppm) increases the tension between experiment and theory to 4.2 standard deviations.

The association of peak systolic velocity in the carotid artery with coronary heart disease: A study based on portable ultrasound

Cardiovascular disease (CVD) is the highest cause of death globally with more people dying annually from it than from any other cause. CVD is associated with modifiable risk factors (dyslipidaemia, hypertension and diabetes) and treating each of these factors lowers the risk of CVD. It is impossible to estimate the benefit of risk factor modification in the individual patient and extrapolating data from multiple trials is difficult. It would be useful to have a marker of risk that accurately estimates real time risk by measuring blood flow factors associated with the pathogenesis of atheroma. The aim of this preliminary study was to validate a low-cost measurement technique for obtaining blood flow velocity profiles and assess whether any of the measured and calculated factors, based on computational fluid dynamics (CFD) simulation, known to be associated with atheroma was associated with coronary heart disease (CHD), thus establishing its feasibility and acceptability as a clinical tool and suggesting areas for future research. Our study identified (i) that mean peak systolic (PS) velocity being associated with CHD; individuals without CHD: mean (SD) = 62.8 (16.1) cm/s, with CHD: mean (SD)  = 53.6 (17.3) cm/s, p = 0.042; and (ii) that low-cost, portable ultrasound, which is routinely available in general practice, is a suitable assessment tool.

Nonmonotonic Energy Dependence of Net-Proton Number Fluctuations

Nonmonotonic variation with collision energy (sqrt[s_{NN}]) of the moments of the net-baryon number distribution in heavy-ion collisions, related to the correlation length and the susceptibilities of the system, is suggested as a signature for the quantum chromodynamics critical point. We report the first evidence of a nonmonotonic variation in the kurtosis times variance of the net-proton number (proxy for net-baryon number) distribution as a function of sqrt[s_{NN}] with 3.1  σ significance for head-on (central) gold-on-gold (Au+Au) collisions measured solenoidal tracker at Relativistic Heavy Ion Collider. Data in noncentral Au+Au collisions and models of heavy-ion collisions without a critical point show a monotonic variation as a function of sqrt[s_{NN}].

Improved multiplex TaqMan qPCR assay with universal internal control offers reliable and accurate detection of Clavibacter michiganensis

AIM

Clavibacter michiganensis (Cm) is a seed-borne plant pathogen that significantly reduces tomato production worldwide. Due to repeated outbreaks and rapid spread of the disease, seeds/transplants need to be certified free of the pathogen before planting. To this end, we developed a multiplex TaqMan qPCR assay that can accurately detect Cm in infected samples.

METHODS AND RESULTS

A specific region of Cm (clvG gene) was selected for primer design using comparative genomics approach. A fully synthetic universal internal control (UIC) was also designed to detect PCR inhibitors and false-negative results in qPCRs. The Cm primers can be used alone or in a triplex TaqMan qPCR assay with UIC and previously described Clavibacter primers. The assay was specific for Cm and detected up to 10 fg of Cm DNA in sensitivity and spiked assays. Addition of the UIC did not change the specificity or sensitivity of the multiplex TaqMan qPCR assay.

CONCLUSION

The triplex TaqMan qPCR provides a specific and sensitive diagnostic assay for Cm.

SIGNIFICANCE AND IMPACT OF THE STUDY

This assay can be used for biosecurity surveillance, routine diagnostics, estimating bacterial titres in infected material and for epidemiological studies. The UIC is fully synthetic, efficiently amplified and multiplex compatible with any other qPCR assay.

Aerosol-induced atmospheric heating rate decreases over South and East Asia as a result of changing content and composition

Aerosol emissions from human activities are extensive and changing rapidly over Asia. Model simulations and satellite observations indicate a dipole pattern in aerosol emissions and loading between South Asia and East Asia, two of the most heavily polluted regions of the world. We examine the previously unexplored diverging trends in the existing dipole pattern of aerosols between East and South Asia using the high quality, two-decade long ground-based time series of observations of aerosol properties from the Aerosol Robotic Network (AERONET), from satellites (Moderate Resolution Imaging Spectroradiometer (MODIS) and Ozone Monitoring Instrument (OMI)), and from model simulations (Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2). The data cover the period since 2001 for Kanpur (South Asia) and Beijing (East Asia), two locations taken as being broadly representative of the respective regions. Since 2010 a dipole in aerosol optical depth (AOD) is maintained, but the trend is reversed—the decrease in AOD over Beijing (East Asia) is rapid since 2010, being 17% less in current decade compared to first decade of twenty-first century, while the AOD over South Asia increased by 12% during the same period. Furthermore, we find that the aerosol composition is also changing over time. The single scattering albedo (SSA), a measure of aerosol’s absorption capacity and related to aerosol composition, is slightly higher over Beijing than Kanpur, and has increased from 0.91 in 2002 to 0.93 in 2017 over Beijing and from 0.89 to 0.92 during the same period over Kanpur, confirming that aerosols in this region have on an average become more scattering in nature. These changes have led to a notable decrease in aerosol-induced atmospheric heating rate (HR) over both regions between the two decades, decreasing considerably more over East Asia (− 31%) than over South Asia (− 9%). The annual mean HR is lower now, it is still large (≥ 0.6 K per day), which has significant climate implications. The seasonal trends in AOD, SSA and HR are more pronounced than their respective annual trends over both regions. The seasonal trends are caused mainly by the increase/decrease in anthropogenic aerosol emissions (sulfate, black carbon and organic carbon) while the natural aerosols (dust and sea salt) did not change significantly over South and East Asia during the last two decades. The MERRA-2 model is able to simulate the observed trends in AODs well but not the magnitude, while it also did not simulate the SSA values or trends well. These robust findings based on observations of key aerosol parameters and previously unrecognized diverging trends over South and East Asia need to be accounted for in current state-of-the-art climate models to ensure accurate quantification of the complex and evolving impact of aerosols on the regional climate over Asia.

An audit of the measurement and reporting of male testosterone levels in UK clinical biochemistry laboratories

INTRODUCTION

A number of guidance documents have been published in recent years for the diagnosis and management of hypogonadism (HG). Laboratory practice has a major role in supporting guidelines with accurate and precise serum total testosterone (TT) methods and standardised pre- and post-analytical protocols. Our study investigated whether laboratory practice currently supports the management guidelines for HG.

METHODS

An internet-based questionnaire survey of senior laboratory biochemists (UK/Republic of Ireland) was conducted (April-May 2018). Questions reflected sampling, laboratory practice, reference ranges and reporting of results. The results were analysed in conjunction with data obtained from the UK National External Quality Assurance Service (UK NEQAS) on testosterone assay performance.

RESULTS

Analyses of 96 laboratory surveys returned the following: 74 laboratories stated that the optimal sampling time was communicated to users; 81 laboratories used immunoassays; 76 laboratories included reference ranges for adult men (31 had dual/multiple age-related intervals). Wide variability in lower/upper limits was evident in the common immunoassays; the majority of reference ranges were from manufacturers (50.0%) or historical (18.8%). Action limits based on TT levels were used by 64 laboratories, but 63 did not report a borderline range as suggested by the guidelines. Protocols for cascading tests based on TT were evident in 58 laboratories, with 50 laboratories offering estimated free testosterone; interpretative comments were provided by 67 laboratories, but no references were made to the management guidelines. Data from UK NEQAS demonstrated considerable variation in testosterone assay performance.

CONCLUSIONS

Our survey has highlighted inconsistencies that could lead to HG (and other conditions requiring measurement of TT) not being managed appropriately. The results from this survey and from UK NEQAS reinforce the requirement for action to be considered regarding the standardisation of testosterone assays and harmonisation of laboratory practice.

Fragility of a soliton's shot-to-shot coherence

We show that a soliton in a high-order spatial mode of a multi-mode fiber can completely lose its shot-to-shot coherence due to a noise seed with energy orders of magnitude below that of the soliton. The total degradation of shot-to-shot coherence is caused by a very strong recently demonstrated intermodal nonlinear effect, soliton self-mode conversion. The results indicate that the robustness of solitons against perturbations is not entirely applicable in the presence of intermodal nonlinearities, and, more generally, that certain single-mode results cannot be trivially extrapolated to multi-mode fibers.

Inter-annual and seasonal variations in columnar aerosol characteristics and radiative effects over the Pokhara Valley in the Himalayan foothills - Composition, radiative forcing, and atmospheric heating

This study reports comprehensive analysis of seasonal and inter-annual variations of aerosol properties (optical, physical and chemical) and radiative effects over Pokhara Valley in the foothills of central Himalayas in Nepal utilizing the high-quality multi-year columnar aerosol data observed recently from January 2010 to December 2017. This paper focusses on the seasonal and inter-annual variations of chemical (composition), and absorption properties of aerosols and their radiative effects. The single scattering albedo (SSA) either decreases as a function of wavelength or remains independent of wavelength. The seasonal mean aerosol absorption optical depth (AAOD) exhibits a behavior opposite to that of SSA. Carbonaceous aerosols (CA) dominate (≥60%) aerosol absorption during the whole year. Black carbon (BC) alone contributes >60% to AAOD_CA while brown carbon (BrC) shares the rest. The absorbing aerosol types are determined to be BC, and mixed (BC and dust) only. Dust as absorbing aerosol type is absent over the Himalayan foothills. The ARF_SFC is ≥ -50 Wm^-2 except in monsoon almost every year. The ARF_ATM is ≥ 50 Wm^-2 during winter and pre-monsoon in all the years. ARFE_SFC, ARFE_TOA and ARFE_ATM follow a similar pattern as that of ARF. High values of ARFE at SFC, TOA and ATM (except during monsoon when values are slightly lower) suggest that aerosols are efficient in significantly modulating the incoming solar flux throughout the year. The annual average aerosol-induced atmospheric heating rate (HR) over Pokhara is nearly 1 K day^-1 every year during 8-year observation, and is highest in 2015 (∼2.5 K day^-1). The HR is about 1 K day^-1 or more over all the locations in IGP during the year. These quantitative results can be used as inputs in global/regional climate models to assess the climate impact of aerosols, including on regional temperature, hydrological cycle and melting of glaciers and snowfields in the region.

Black carbon dominates the aerosol absorption over the Indo-Gangetic Plain and the Himalayan foothills

This study, based on new and high quality in situ observations, quantifies for the first time, the individual contributions of light-absorbing aerosols (black carbon (BC), brown carbon (BrC) and dust) to aerosol absorption over the Indo-Gangetic Plain (IGP) and the Himalayan foothill region, a relatively poorly studied region with several sensitive ecosystems of global importance, as well as highly vulnerable populations. The annual and seasonal average single scattering albedo (SSA) over Kathmandu is the lowest of all the locations. The SSA over Kathmandu is < 0.89 during all seasons, which confirms the dominance of light-absorbing carbonaceous aerosols from local and regional sources over Kathmandu. It is observed here that the SSA decreases with increasing elevation, confirming the dominance of light absorbing carbonaceous aerosols at higher elevations. In contrast, the SSA over the IGP does not exhibit a pronounced spatial variation. BC dominates (≥75%) the aerosol absorption over the IGP and the Himalayan foothills throughout the year. Higher BC concentration at elevated locations in the Himalayas leads to lower SSA at elevated locations in the Himalayas. The contribution of dust to aerosol absorption is higher throughout the year over the IGP than over the Himalayan foothills. The aerosol absorption over South Asia is very high, exceeding available observations over East Asia, and also exceeds previous model estimates. This quantification will be valuable as observational constraints to help improve regional simulations of climate change, impacts on the glaciers and the hydrological cycle, and will help to direct the focus towards BC as the main contributor to aerosol-induced warming in the region.

Circulation of Asian-I and Cosmopolitan genotypes of Dengue-2 virus in northeast India, 2016-2017

BACKGROUND & OBJECTIVES

Dengue is a major public health problem in northeast India where the majority of the cases go unreported and undiagnosed. Even though all four dengue serotypes are reported, there is a dearth of information on genetic diversity. The present cross-sectional study was undertaken during 2016-17 to determine the genetic variance of dengue virus serotype 2 (DENV-2) based on the envelope (E) glycoprotein gene.

METHODS

The serum samples collected from the northeast parts of India, as a part of hospital-based acute febrile illness surveillance, were serotyped. Viral RNA was extracted from DENV-2 serum samples using QIAquick® RNA Extraction Kit. The E gene was amplified by conventional reverse-transcriptase polymerase chain reaction (RT-PCR) and the PCR products were sequenced.

RESULTS

The E glycoprotein gene of nine serum samples with high viral RNA concentration (Ct <25) was sequenced. The E gene sequences of eight DENV-2 strains from Assam and Meghalaya aligned with genotype IV (Cosmopolitan) and one strain from Tripura segregated with Asian-I genotype.

INTERPRETATION & CONCLUSION

Ongoing laboratory-based surveillance is mandatory to understand the transmission dynamics of dengue in endemic countries. This study concluded that in northeast India, presently two distinct genotypes of DENV-2, namely genotype IVb (Cosmopolitan) and Asian-I genotype are in circulation.

A junior doctor's experience of critical illness: from treating patients to becoming a patient with COVID-19

When the coronavirus disease 2019 (COVID‐19) pandemic was declared, it was clear that severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) would have far‐reaching impacts on medicine, society and everyday life. As a junior doctor working closely with patients with SARS‐CoV‐2 infection, I was aware of my personal risk of exposure to the virus. I assumed that as a fit and well 26‐year‐old with no comorbidities, if I were to become infected, it was unlikely that COVID‐19 would be severe. However, I became critically unwell following a week of clinical work, necessitating hospital admission, tracheal intubation and mechanical ventilation. I remained mechanically ventilated for 6 days and was then transferred to a medical ward 2 days later. After two further days of rehabilitation, I was discharged home. This reflection is not a junior doctor’s view of how COVID‐19 was managed by the NHS, but a personal view of my illness from ‘the other side of the curtain’. My reflections focus upon the psychological aspects of my experiences, exploring the memories that I formed around the time of critical care, how the fears that I possessed were managed with exceptional communication, and the importance of the wider healthcare team in my recovery.

Testosterone replacement therapy: Pre-treatment sex hormone-binding globulin levels and age may identify clinical subgroups

BACKGROUND

Testosterone replacement therapy (TRT) improves health in some but not all men with type 2 diabetes (T2DM) and adult-onset testosterone deficiency (TD). Such heterogeneity is compatible with the concept of patient subgroups that respond differently to therapy.

OBJECTIVES

Use baseline SHBG and age to identify putative subgroups that demonstrate different responses in variables such as waist circumference and HbA1c following TRT.

MATERIALS AND METHODS

A randomized double-blind trial approach was used to recruit and randomize men with T2DM and adult-onset TD into placebo and TRT-treated groups. Multiple regression was used to study differences between groups.

RESULTS

Baseline SHBG and change in SHBG (∆SHBG) were inversely related in the TRT group. Both median values of SHBG and age mediated the effect of TRT on ∆SHBG depending on whether baseline values were ≤ or>median (28.1 nmol/L, 63 years, respectively). In men with both SHBG ≤ 28.1 nmol/L and age ≤ 63 years (subgroup 1), TRT was positively associated with ∆SHBG (c = 4.67, 95%CI 1.17-8.16, P = .010) while in those with SHBG > 28.1 nmol/L and age > 63.1 years (subgroup 4) the association was inverse (c = -7.07, 95%CI -11.64 to -2.49, P = .003). The association between TRT and change (∆) in waist circumference, HbA1c and International Index of Erectile Function (IIEF) score differed between subgroups; in subgroup 4 but not subgroup 1, the therapy was significantly associated with ∆waist circumference, ∆HbA1c and ∆IIEF.

DISCUSSION

Though the mechanism remains unclear, our finding of different responses to TRT in terms of change in waist circumference, HbA1c and IIEF score supports the concept of subgroups in men with T2DM and adult-onset TD.

CONCLUSION

Our approach may provide a basis for identifying men who will or will not derive benefit from TRT though a larger study is required.

First Measurement of Λ_{c} Baryon Production in Au+Au Collisions at sqrt[s_{NN}]=200 GeV

We report on the first measurement of the charmed baryon Λ_{c}^{±} production at midrapidity (|y|<1) in Au+Au collisions at sqrt[s_{NN}]=200  GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider. The Λ_{c}/D^{0} [denoting (Λ_{c}^{+}+Λ_{c}^{-})/(D^{0}+D[over ¯]^{0})] yield ratio is measured to be 1.08±0.16  (stat)±0.26  (sys) in the 0%-20% most central Au+Au collisions for the transverse momentum (p_{T}) range 3<p_{T}<6  GeV/c. This is significantly larger than the pythia model calculations for p+p collisions. The measured Λ_{c}/D^{0} ratio, as a function of p_{T} and collision centrality, is comparable to the baryon-to-meson ratios for light and strange hadrons in Au+Au collisions. Model calculations including coalescence hadronization for charmed baryon and meson formation reproduce the features of our measured Λ_{c}/D^{0} ratio.