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Age-Dependent Relationships Between Disease Risk and Testosterone Levels: Relevance to COVID-19 Disease.
Muehlenbein, M, Gassen, J, Nowak, T, Henderson, A, Morris, B, Weaver, S, Baker, E
American journal of men's health. 2023;17(2):15579883221130195
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Plain language summary
A growing body of research finds that in men, testosterone levels may be prognostic of clinical outcomes related to coronavirus disease 2019 (COVID-19 disease). The presence of pre-existing chronic conditions in many patients with COVID-19 disease further complicates the relationship among testosterone and severe outcomes. The aim of this study was to examine whether pre-existing conditions for severe COVID-19 disease were related to serum-free testosterone levels in men who had not been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. This study obtained data from men (n = 142) who participated in the longitudinal study Waco COVID Survey. All data included in the study was collected as part of the initial intake survey and first laboratory appointment. Results show that serum-free testosterone levels decreased as a function of age. In fact, greater burden of pre-existing conditions for severe COVID-19 disease was related to lower testosterone levels among men younger than 40 years of age. Furthermore, in men older than 40 years of age the decrease in testosterone that accompanies aging attenuated the effect of the clinical risk score on free testosterone levels. Authors conclude that their findings add important insights into the complex role of androgens in chronic and infectious diseases and contribute to the growing body of literature on the relationship between chronic disease and men’s testosterone levels.
Abstract
Testosterone levels in men appear to be prognostic of a number of disease outcomes, including severe COVID-19 disease. Testosterone levels naturally decline with age and are lower in individuals with a number of comorbidities and chronic conditions. Low testosterone may therefore be both a cause and a consequence of illness, including COVID-19 disease. The present project examines whether preexisting conditions for severe COVID-19 disease were themselves related to serum-free testosterone levels in men who had not been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. A clinical risk score for severe COVID-19 disease was computed based on the results of previously published meta-analyses and cohort studies, and relationships between this score and testosterone levels were tested in 142 men ages 19 to 82 years. Greater burden of preexisting conditions for severe COVID-19 disease was related to lower testosterone levels among men younger than 40 years of age. In older men, the decrease in testosterone that accompanies aging attenuated the effect of the clinical risk score on free testosterone levels. Given that older age itself is a predictor of COVID-19 disease severity, these results together suggest that the presence of preexisting conditions may confound the relationship between testosterone levels and COVID-19 disease outcomes in men. Future research examining relationships among testosterone and outcomes related to infectious and chronic diseases should consider potential confounds, such as the role of preexisting conditions.
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Strain-induced vibrational properties of few layer black phosphorus and MoTe2 via Raman spectroscopy.
Karki, B, Freelon, B, Rajapakse, M, Musa, R, Riyadh, SMS, Morris, B, Abu, U, Yu, M, Sumanasekera, G, Jasinski, JB
Nanotechnology. 2020;(42):425707
Abstract
We studied and compared the effect of tensile strain on the Raman spectra of black phosphorus (BP) and molybdenum ditelluride (MoTe2) crystals by using a simple custom strain device. In-situ Raman spectroscopy on BP revealed clear red shifting of all three phonon modes, A1 g, B2g and A2 g, under tensile stress. From our theoretical analyses, we found that such red shifting strongly depends on the direction of the strain exerted on the system even within the elastic deformation limit (i.e. strain ≤ 1 %). In particular, calculated results for the strain along the armchair direction are consistent with our experimental data, confirming that the strain applied to the sample acts effectively along the armchair direction. In a comparative study, we found that the effect of strain on the Raman shifting is larger for BP than that for MoTe2, presumably due to the smaller Young's modulus of BP. We also see a remarkable resemblance between donor-type intercalation induced vibrational properties and tensile stress-induced vibrational properties in BP. We anticipate that our method of in-situ Raman spectroscopy can be an effective tool that can allow observation of strain effect directly which is critical for future flexible electronic devices.
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The importance of anal cancer screening and high-resolution anoscopy to gastroenterology practice.
Bull-Henry, K, Morris, B, Buchwald, UK
Current opinion in gastroenterology. 2020;(5):393-401
Abstract
PURPOSE OF REVIEW Although human papillomavirus (HPV)-related anal squamous cell cancer (ASCC) is rare, its incidence has been rising and in high-risk populations exceeds the incidence of cancers for which screening programs are implemented. Therefore, targeted screening techniques are being evaluated with high-resolution anoscopy (HRA) as the current gold standard because of its ability to detect anal intraepithelial dysplasia (AIN) and premalignant high-grade squamous intraepithelial lesions (HSILs). However, a scarcity of trained providers presents a barrier to screening. RECENT FINDINGS ASCC incidence is rising especially in elderly women and young black men. Premalignant HSIL may not only progress to ASCC but also regress. Biomarkers such as HPV type, p16 immunostaining and DNA methylation markers may emerge as predictors of disease progression.HRA with acetic acid and Lugol's iodine staining can be used to detect HSIL and ASCC. Recent studies suggest that anal cancer screening may have an impact on the stage of ASCC at diagnosis and the incidence of anal cancer.The Anal Cancer HSIL Outcomes Research (ANCHOR) study is underway to determine whether treating HSIL effects ASCC incidence. SUMMARY Although there are no consensus screening guidelines for anal cancer, it is reasonable to screen high-risk populations with physical examination, anal cytology and HRA. Gastroenterologists can support anal cancer screening programmes through identifying patients at risk, performing noninvasive screening and considering to incorporate endoscopic techniques to examine the anal canal. VIDEO ABSTRACT http://links.lww.com/COG/A32.
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Use of active video gaming in children with neuromotor dysfunction: a systematic review.
Hickman, R, Popescu, L, Manzanares, R, Morris, B, Lee, SP, Dufek, JS
Developmental medicine and child neurology. 2017;(9):903-911
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Abstract
AIM: To examine current evidence on use of active video gaming (AVG) to improve motor function in children with movement disorders including cerebral palsy, developmental coordination disorder, and Down syndrome. METHOD Scopus, MEDLINE, Cochrane Library, EMBASE, and CINAHL were searched. Included papers studied the use of AVG for improving movement-related outcomes in these populations. Parameters studied included health condition, strength of evidence, AVG delivery methods, capacity for individualizing play, outcomes addressed, effectiveness for achieving outcomes, and challenges/limitations. RESULTS The 20 extracted articles varied in quality. Studies involved children with six different conditions using AVG in clinical, home, or school settings for 49 different motor outcomes. Dosage varied in frequency and duration. Choice of games played and difficulty level were therapist determined (n=6) or child controlled (n=14). The most common study limitations were small sample sizes and difficulty individualizing treatment. All articles showed improvement in outcomes with AVG, although differences were not consistently significant compared with conventional therapy. INTERPRETATION Heterogeneity of measurement tools and target outcomes prevented meta-analysis or development of formal recommendations. However, AVG is feasible and shows potential for improving outcomes in this population. Additional investigations of dosing variables, utility as a home supplement to clinical care, and outcomes with larger sample sizes are merited.
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'Ready. Set. ACTION!' A theater-based obesity prevention program for children: a feasibility study.
Neumark-Sztainer, D, Haines, J, Robinson-O'Brien, R, Hannan, PJ, Robins, M, Morris, B, Petrich, CA
Health education research. 2009;(3):407-20
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Abstract
This study examined the feasibility of implementing an innovative theater-based after-school program, 'Ready. Set. ACTION!', to reach ethnically diverse and low-income children and their parents with obesity prevention messages. The study population included 96 children and 61 parents. Children were in fourth to sixth grade and 41% were overweight at baseline. Program impact was evaluated with a pre/post-randomized controlled study design, but a major focus was placed on the process evaluation conducted in the intervention schools. Intervention children and parents reported high program satisfaction and that they had made changes or intended to make positive changes in their behaviors due to program participation. However, few meaningful differences between the intervention and control conditions were found at follow-up. Thus, the combined process and impact evaluation results suggest that the intervention was effective in leading to increased awareness of the need for behavioral change, but was not powerful enough on its own to lead to behavioral change. From this feasibility study, we concluded that Ready. Set. ACTION! offers promise as a creative intervention strategy. The next research step may be to incorporate theater-based programs into more comprehensive school-based interventions, with both educational and environmental components, and evaluate program impact.
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Caffeine prolongs exercise duration in heart failure.
Notarius, CF, Morris, B, Floras, JS
Journal of cardiac failure. 2006;(3):220-6
Abstract
BACKGROUND Caffeine increases submaximal exercise performance in healthy young subjects; its effects on exercise tolerance in heart failure (HF) have not been characterized. METHODS AND RESULTS To determine whether caffeine increases exercise tolerance in HF, caffeine (4 mg/kg intravenously, equivalent to 2 cups of coffee) or vehicle were infused into 10 treated HF patients (left ventricular ejection fraction 25 +/- 2 %), and 10 age-matched normal subjects (N) on 2 separate days in a double-blind, randomized, crossover design. We measured heart rate, blood pressure, and ventilation at rest and during graded cycling (15 W/minute) to peak effort. Peak oxygen consumption was unaffected in either group. Mean exercise time was unchanged in N (1,013 +/- 87 versus 988 +/- 107 seconds; P = .86) but was significantly increased by caffeine in HF (from 511 +/- 28 to 560 +/- 37 seconds; P = .004) despite an increase in peak minute ventilation (P < .05). Resting and peak blood pressures were higher after caffeine (P < .05) in HF, not N. CONCLUSION Caffeine allows HF patients to exercise longer at peak effort.