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Hypogonadism is a common clinical condition affecting men, with older men having an increased incidence. Clinicians (endocrinologists and urologists) who may be involved in providing testosterone therapy should be familiar with the effects of testosterone on the prostate. Before initiating testosterone therapy, physicians and patients should partake in shared decision-making, including pretreatment testing, risks and benefits of testosterone therapy relating to benign prostatic hyperplasia and lower urinary tract symptoms, a discussion on prostate cancer in those who have not been diagnosed with malignancy, and a thorough discussion with patients who may have a previous diagnosis of prostate cancer.

The majority of peripheral endovascular interventions are performed with access through the groin, followed by brachial and radial artery approaches. We describe a unique case of successful iliac artery endovascular intervention, performed via a left upper limb brachiocephalic fistula access site.

Energy-resolved neutron imaging is employed for in-situ measurements of dopant transport in a simple experiment performed before the crystal growth of the scintillator BaBrCl:5%Eu via a vertical gradient freeze technique. During a stabilization period preceding growth, we observed the diffusion of Eu from the solid phase into the melt over a period of approximately 4 hours. Comparing the measured centerline concentration profile with a mathematical model for the system, we estimate the solid-state diffusivity of Eu in BaBrCl as D 1 = 1.9 × 10 − 10 m2/s and an upper limit for the liquid-phase diffusivity of Eu in the melt as D 2 * = 2.5 × 10 − 10 m2/s, at temperatures near the melting point. We compare this experiment, where diffusion is driven by a concentration discontinuity arising from segregation, to the classical diffusion couple technique. Suggestions are offered on how this segregation-driven couple might be improved as a tool for measuring diffusion coefficients, and we draw attention to the great promise of neutron imaging for in-situ measurements of the distribution of elements, with sufficiently high neutron attenuation coefficients, in difficult environments.

An effective and highly efficient curriculum is the foundation of an optimal content delivery to students and may lead to the success of the academic program. Ensuring the effectiveness of curricular processes goes beyond the successful design of individual courses and it is subject to careful planning in accordance to appropriate policies and procedures that enable a high level of curriculum coherence. Such curriculum can guarantee that students are presented with a complete set of interrelated topics related to the area of study that can enable students to connect topics in individual courses and apply them in professional settings. The goal of this article is to evaluate the curriculum coherence of an Information Science program using ontologies and natural language processing techniques. Curricular coherence is evaluated using a possibilistic approach which evaluates academic gaps and overlaps that exist in the core courses offered in the degree. The use of ontologies enables us to perform a qualitative study of curricular coherence at different levels of ontological abstraction using mereotopological principles. The knowledge inferred from this process can be used at the universities to optimize their course offering and content for better academic content.

There are 3 reasons to generate a new human kidney. The first is to learn more about the biology of the developing and mature organ. The second is to generate tissues with which to model congenital and acquired kidney diseases. In particular, growing human kidneys in this manner ultimately should help us understand the mechanisms of common chronic kidney diseases such as diabetic nephropathy and others featuring fibrosis, as well as nephrotoxicity. The third reason is to provide functional kidney tissues that can be used directly in regenerative medicine therapies. The second and third reasons to grow new human kidneys are especially compelling given the millions of persons worldwide whose lives depend on a functioning kidney transplant or long-term dialysis, as well as those with end-stage renal disease who die prematurely because they are unable to access these treatments. As shown in this review, the aim to create healthy human kidney tissues has been partially realized. Moreover, the technology shows promise in terms of modeling genetic disease. In contrast, barely the first steps have been taken toward modeling nongenetic chronic kidney diseases or using newly grown human kidney tissue for regenerative medicine therapies.

A key limitation for the use of aluminum alloys in multi-material structural components is effective surface cleaning and texturing techniques to improve the quality of structural joints. In this study, the surface and sub-surface chemistries are investigated for a novel surface treatment method using laser interferometry produced by two beams of a pulsed Nd:YAG laser. Surfaces of AA 5128 aluminum alloy were treated using a two-beam laser interference setup, enabling the structuring of the surface at length scales much less than that of the laser beam. Periodic and patterned surface structures were created by the interference power profile through ablation of deposits and debris and melting and re-solidification of the near-surface region during laser-treatment. Chemical changes to the Al alloy surface induced by laser treatment were examined in detail in this study using both x-ray photoelectron spectroscopy (XPS) and scanning Auger microanalysis (SAM) as a function of number of interfering laser shots. XPS surface analysis indicates that this laser technique is effective at cleaning aluminum surfaces. Moreover, SAM data indicated that there is a compositional-induced variation of Mg due to laser-interference as Mg-rich areas were found in periodic interference-structured ridges. Notice: The United States Government retains and the publisher, by accepting the article for publication, acknowledges that the United States Government retains a non-exclusive, paid-up, irrevocable, world-wide license to publish or reproduce the published form of this manuscript, or allow others to do so, for United States Government purposes. The Department of Energy will provide public access to these results of federally sponsored research in accordance with the DOE Public Access Plan ( http://energy.gov/downloads/doe-public-access-plan ).

With recent advancements in advanced manufacturing techniques, it is now possible to fabricate complex geometries that take advantage of well known principles of heat transfer. Therefore, unconventional configurations to enhance effectiveness beyond conventional designs can now be considered for practical application. Thermal performance and overall cost of a new design of heat exchangers in counter cross-flow configurations are studied using a simplified but accurate computational method. The new heat exchanger design was introduced and studied previously for a cross-flow configuration by Sabau et al. (2016, 2018). This new design concept uses multi-scale configurations with successive plenums for the working fluid. At the smallest scale the tubes are sized to be equal to the hydraulic entrance length of the inside fluid, in accord with constructal design. Results indicate that compared to the earlier cross-flow configuration, the counter cross-flow arrangement improves the thermal performance of the heat exchanger by as much as 17% and lowers the total cost by as much as 14%.

To examine changes in urinary continence for post-acute, Complex Continuing Care hospital patients from time of admission to short-term follow-up, either in hospital or after discharge to long-term care or home with services.Retrospective cohort study of patients in Complex Continuing Care hospitals using clinical data collected with interRAI Minimum Data Set 2.0 and interRAI Resident Assessment Instrument Home Care.Adults aged 18 years and older, admitted to Complex Continuing Care hospitals in Ontario, Canada, between 2009 and 2015 (n = 78,913).A multistate transition model was used to characterize the association between patient characteristics measured at admission and changes in urinary continence state transitions (continent, sometimes continent, and incontinent) between admission and follow-up.The cohort included 27,896 patients. At admission, 9583 (34.3%) patients belonged to the continent state, 6441 (23.09%) patients belonged to the sometimes incontinent state, and the remaining 11,872 (42.6%) patients belonged to the incontinent state. For patients who were continent at admission, the majority (62.7%) remained continent at follow-up. However, nearly a quarter (23.9%) transitioned to the sometimes continent state, and an additional 13.4% became incontinent at follow-up. Several factors were associated with continence state transitions, including cognitive impairment, rehabilitation potential, stroke, Parkinson's disease, Alzheimer's disease and related dementias, and hip fracture.This study suggests that urinary incontinence is a prevalent problem for Complex Continuing Care hospital patients and multiple factors are associated with continence state transitions. Standardized assessment of urinary incontinence is helpful in this setting to identify patients in need of further assessment and patient-centered intervention and as a quality improvement metric to examine changes in continence from admission to discharge.