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Androgen deprivation therapy and cognitive decline-associations with brain connectomes, endocrine status, and risk genotypes – DocWire News
This article was originally published here
Prostate Cancer Prostatic Dis. 2021 Jun 4. doi: 10.1038/s41391-021-00398-1. Online ahead of print.
ABSTRACT
BACKGROUND: Evidence suggests that prostate cancer (PC) patients undergoing androgen deprivation therapy (ADT) are at risk for cognitive decline (CD), but the underlying mechanisms are less clear. In the present study, changes in cognitive performance and structural brain connectomes in PC patients undergoing ADT were assessed, and associations of cognitive changes with endocrine status and risk genotypes were explored.
METHODS: Thirty-seven PC patients underwent cognitive assessment, structural MRI, and provided blood samples prior to ADT and after 6 months of treatment. Twenty-seven age- and education-matched healthy controls (HCs) underwent the same assessments. CD was determined using a standardized regression-based approach and defined as z-scores -1.64. Changes in brain connectomes were evaluated using graph theory. Associations of CD with testosterone levels and genotypes (APOE, COMT, BDNF) were explored.
RESULTS: Compared with HCs, PC patients demonstrated reduced testosterone levels (p < 0.01) and higher rates of decline for 13 out of 15 cognitive outcomes, with three outcomes related to two cognitive domains, i.e., verbal memory and visuospatial learning and memory, reaching statistical significance (p 0.01-0.04). Testosterone level changes did not predict CD. COMT Met homozygote PC patients evidenced larger reductions in visuospatial memory compared with Val carriers (p = 0.02). No between-group differences were observed in brain connectomes across time, and no effects were found of APOE and BDNF.
CONCLUSIONS: Our results indicate that PC patients undergoing ADT may evidence CD, and that COMT Met homozygotes may be at increased risk of CD. The results did not reveal changes in brain connectomes or testosterone levels as underlying mechanisms. More research evaluating the role of ADT-related disruption of the dynamics of the hypothalamic-pituitary-gonadal axis is needed.
PMID:34088994 | DOI:10.1038/s41391-021-00398-1
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Targeted Radiotherapy Might Help Men Battling Advanced Prostate Cancer – HealthDay News
FRIDAY, June 4, 2021 (HealthDay News) -- Patients with advanced prostate cancers may have newfound hope: Researchers identified a new potential treatment for men with metastatic castration-resistant prostate cancer, which has no cure.
Metastatic castration-resistant prostate cancer means the disease continues to spread despite therapies that deplete male hormones (androgens) such as testosterone, which are thought to "feed" tumors.
When added to standard care, this novel targeted radiotherapy improved survival for these cancer patients, researchers report.
The study "offers the treatment possibility where there was really very little for the most advanced patient, but it opens a doorway for exploring the benefits of this drug in multiple earlier patient populations," said Dr. Michael Morris, head of the Prostate Cancer Section at Memorial Sloan Kettering Cancer Center in New York City.
In about 80% of prostate cancers, there is a protein on the surface of the cancer cell that is called prostate-specific membrane antigen (PSMA). It is also distributed on prostate cancer that has spread to the bone, lymph nodes or soft tissues. Yet, PSMA is not on normal tissues, so it was a good target for both diagnostics and therapeutics, Morris explained.
The new drug has two components, a targeting molecule and a payload delivers radiation. It is given intravenously.
"Each of the molecules of drug is seeking to bind with the cells containing PSMA, which generally are the prostate cancer cell. As the drug binds to it, the cell brings the drug into the interior of the cell. The radiation, which is attached to the drug, it's the payload of the drug, is also brought into the interior of the cell. And there, it irradiates the cell and kills it as well as the cells that are neighboring to it," Morris said.
To be a part of the trial, the patients had to have disease that had progressed through testosterone-lowering therapy, which has been the standard for decades, Morris said. They also had to have progressed through another class of drugs known as androgen-receptor pathway inhibitors and through chemotherapy.
"What happens when you go on to treatment with prostate cancer is that if you respond, you stay on that therapy or stay on that regimen until either side effects preclude continuing the therapy or it no longer works because the disease has become resistant to it," Morris explained.
The trial included 831 participants. Patients were randomized two-to-one to receive the new treatment, called lutetium-labeled PSMA-617, plus standard care or just standard care between June 2018 and October 2019.
The new treatment increased overall median survival to 15.3 months versus 11.3 months for these patients who had very advanced disease. It also increased a measure called radiographic progression-free survival, which reflects disease control while on the drug, from a median of 3.4 months to 8.7 months.
The study is being presented online at the American Society of Clinical Oncology annual meeting, which will be held June 4-8. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal. Drug maker Novartis funded the study and plans to submit the data to regulatory authorities for review and potential approval.
Prostate cancer is both the most common cancer in American men and the second leading cause of cancer-related death. The study's positive results mean that patients who have very advanced disease might have a new treatment option.
"It also means that, usually in prostate cancer as well as other diseases, what you develop and discover as a new therapy for the most advanced patients usually benefits earlier patients and frequently we'll see those benefits amplified in less sick patients who have less-resistant disease," Morris said.
Current studies are now looking at the therapy for patients who have earlier disease who have not yet received chemotherapy, as well as those who are just beginning treatments for prostate cancer.
Dr. Ash Tewari, system chair in the Milton and Carroll Petrie Department of Urology at Mount Sinai Health System in New York City, said the study offers a lot of promise for patients, giving those with advanced prostate cancer new hope. It also has a reasonable side effect profile, said Tewari, who was not involved in the study.
"Androgen deprivation is the mainstay of therapy of advanced prostate cancer, but the cure rate is low and patients eventually become castrate-resistant," Tewari said. "There is a need to more closely tailor therapies to individual patient profiles."
Noting the median results for overall survival that the study found, Tewari said that extra four months of life can be very meaningful for someone who lives to see an important family milestone, such as a grandchild's wedding.
"This is a good example of when a well-conducted clinical trial backed by scientific data can make an impact in patient's life. And we should always be curiously, cautiously looking at these options," he said.
More information
The U.S. National Cancer Institute offers more on prostate cancer.
SOURCES: Michael Morris, MD, medical oncologist, head, Prostate Cancer Section, Memorial Sloan Kettering Cancer Center, New York City; Ash Tewari, MD, professor and system chair, Milton and Carroll Petrie Department of Urology, Mount Sinai Health System, New York City; 2021 American Society of Clinical Oncology annual meeting, June 4-8, 2021
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Targeted Radiotherapy Might Help Men Battling Advanced Prostate Cancer - HealthDay News
Prostate cancer: Thousands of men to benefit from new drug approved for use on NHS – Sky News
Thousands of men are set to benefit from a new prostate cancer drug which has been approved for use on the NHS.
The National Institute for Health and Care Excellence (Nice) has recommended enzalutamide as an option for treating some types of the disease.
Prostate Cancer UK said the news was welcome for thousands of men, especially those who are unable to have chemotherapy.
The drug has been used during the pandemic as a so-called "COVID-friendly" cancer drug, which patients can take at home instead of needing intravenous medication in a health setting.
Now new draft guidance from Nice should enable wider use.
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The guidance says the drug, also known as Xtandi and made by Astellas, can be used with androgen deprivation therapy (ADT), as an option for treating hormone-sensitive metastatic prostate cancer in adults.
Angela Culhane, chief executive at Prostate Cancer UK, said: "This is fantastic news for thousands of men with advanced prostate cancer, especially those who have additional illnesses that make them unsuitable for chemotherapy.
"It finally guarantees them access to a treatment which is just as effective as chemotherapy and can give them back precious time with their families."
There are an estimated 8,500 men who will be able to access the drug, which works by blocking the effect of the hormone testosterone on prostate cancer cells.
Without testosterone, the prostate cancer cells cannot grow, even if they have spread to other parts of the body.
Clinical trials have shown that the treatment increases the time until the disease gets worse and how long people live.
Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at Nice, said: "Enzalutamide plus ADT offers another option for people with hormone-sensitive metastatic prostate cancer, especially for people who cannot have docetaxel, or who choose not to have it because of its side effects."
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Prostate cancer: Thousands of men to benefit from new drug approved for use on NHS - Sky News
Can This Denver Teacher Make Biology Class More Inclusive? – 5280 | The Denver Magazine
Samuel Long is a Denver teacher advocating to incorporate gender inclusive biology in high school curriculum. Photo courtesy of Samuel LongCelebrating Denver Pride: Community, Resilience, and Change
Samuel Long has a history of working for equity for LGBTQ students and staff in education. His work on gender inclusive biology carries on that tradition.
Samuel Long had always loved science. But in 2015, when he began his career as a high school biology teacher at DSST Stapleton High School (now called DSST Montview High School), he started to notice details in the curriculum that didnt sit right with him. Classroom materials never defined the difference between sex and gender, for example, and they consistently used words like male and female without much nuance. Readings called testosterone a male hormone even though it plays a role in every persons development, Long says.
At first, Long didnt say anything. This was how biology had been taught for a long time, after all, and he figured students wouldnt be interested in digging deeper into research about the complexities of gender and sex.
But then, during one lesson, a reading referred to intersex chromosomal arrangementssex chromosomes other than XX or XYas disorders of sexual development. The phrasing, while accepted in some medical literature, obscured the robust debate being had amongst researchers, doctors, and advocates about the proper way to classify members of the intersex community. Many argue that the phrase disorder carries a negative connotation and obscures the fact that some intersex people live perfectly happy and healthy lives. Others point out that certain chromosomal variations do lead to health consequences, like short stature and heart defects associated with Turner syndrome (when a female is missing some or all of an X chromosome).
Long didnt want to gloss over those conversations or risk alienating or invalidating his intersex and transgender students, including those who were not yet out. So, one day in 2015, he began class by telling students that sex and gender are separate, and that both can be on a spectrum. He was nervous, but the class was unfazed.
I remember that day was the first time I had ever heard about chromosomes as they really are, says Max Gregg, then a student in Longs class. There is all of this complication. And you can actually wind up having an unusually high number of sex chromosomes and have a completely normal and human life.
And thus, an initiative to change how biology is taught was born.
The high school biology curriculum most teachers and schools use still takes a highly binary approach to sex, gender, and sexuality, even though scientists are learning more about how complex these topics can be. Students themselves, Long says, can undoubtedly see the shades and colors of sex, gender, and sexuality all around them.
Teaching biology the traditional way can leave students who arent straight or cisgender confused, isolated, disenfranchised, and disinterested in engaging in the classroom, Long says. According to the Gay, Lesbian, and Straight Educators Network (GLSEN)s 2013 National School Climate Survey, LGBT high school seniors were more likely to be interested in studying STEM (Science, Technology, Engineering, or Math) in college if their relevant high school classes had included positive LGBT content (35.8% vs. 18.5%). The report also noted that LGBT students at schools with inclusive curricula were less likely by about half to have missed school in the past month and felt more connected to the school community.
Reading materials that emphasize that the male/female binary is rooted in biology can lead to more prejudice against trans people, according to research published in 2018.
A 2019 study from Colorado Springs BSCS Science Learning (the nonprofit studies and improves science curricula and instruction), came up with a similar finding: Something as simple as teaching high school students about plant sexual differences made students more likely to believe in neurogenetic essentialismthe idea that the differences between men and women can be solely attributed to innate, biological variations in their genes and brains, even though most researchers agree that external factors like societal expectations play a role. One problem with neurogenetic essentialism? It can often lead girls to believe incorrectly they arent well-suited for science. Its validating a broader cultural idea theyve acquired by growing up in our sexist society, says Brian Donovan, a senior research scientist at BSCS that worked on the study. The kids take that knowledge, and it reinforces their underlying ideas about gender.
Thats why, in 2019, Long and two other biology teachers (Lewis Stellar, in Seattle, and River Suh, in San Francisco) co-founded Gender Inclusive Biology (GIB), an initiative aimed at developing, promoting, and training educators on teaching biology in a way that is inclusive of LGBTQ identities. They run a website with resources for other teachers, curate a monthly newsletter that reaches 322 educators across the United States, and lead workshops for educators, curriculum developers, and administrators both privately and at conferences.
GIBs tools provide educators with actionable, accurate methods for making the curriculum more inclusive. The language guide, for example, points out binary terminology normally used in textbooks and classrooms, such as Women produce eggs and men produce sperm. The guide suggests focusing on the organ, functional activity, or role, instead of gender. So, a teacher might say ovaries produce eggs. Its scientifically accurate, and wont leave a young trans woman feeling less-than.
Long knows all too well the challenges of being a trans kid in non-supportive environments. When he came out as a transgender man in high school and began gender-affirming treatments, he faced push-back from his schools principal. She said you shouldnt use the boys bathroom because youre not a boy. But you shouldnt use the girls bathroom because your appearance is going to scare other girls. And so that didnt leave me with any options, Long says.
After graduating in 2009 from Don Mills Collegiate, a high school in Toronto, Canada, he got in touch with the Ontario Human Rights Legal Support Center and filed a lawsuit against the school. The suit was settled out of court, but Long says it created change for other students like him. The school district had to create a policy for exactly how to accommodate trans students in restrooms and other places, Long says. The school district declined to comment.
That victory showed Long the benefits of advocacy. When he moved to Colorado to start his first teaching job, he surprised himself by coming out to the staff the summer before classes started. I didnt expect that I would do that so soon. But I really felt in the midst of all these icebreakers and reflectiveness and getting to know people, that it was what I wanted to do. His fellow teachers reactions were positive, and with the support of the principal, Long decided he would come out to not only his students but to the whole school that November.
The school invited the students parents and family members to an assembly about transgender issues. There, Long came out, taking care to teach the students the correct definition of transgender and making it clear that his story was personal to him, not universal. I rehearsed what I said so much that I even remembered it the next year and said the same thing, Long says.
Some students watched silently. Others snapped emphatically in support when Long mentioned returning to his high school to file a lawsuit and became even more emphatic when he told them he won and got to consult on creating new policies for the district. Several students and parents came up afterward to shake his hand. Later, Long met with some queer-identifying students who wanted to ask more questions.
Long points out that many of the themes of his story resonate with high school students. He tells them about his arguments with his mom. She would say Im losing you. And that just made no sense to me because I was right there. But I realized that she couldnt see me for who I was, Long says. I think a lot of high schoolers have an experience where they arent being seen for who they are. And similarly, I think a lot of people in high school can relate to this idea of having to live with injustice, and trying to think about what you can do about it.
Along that vein, Long advocates for the rights of trans educators. Trans teachers fill a role that nobody else really can, which is to show young people who are trans or questioning that its possible to have a happy life, Long says. But he knows many who moved to tutoring or left teaching entirely because of pushback when they wanted to come out. Thats a big loss for schools in Colorado, he says.
To make sure more trans teachers can be true to their identities at work, Long founded the Colorado chapter of the Transgender/Nonbinary Educators Network (TEN). Last year, TEN successfully advocated for a change to Colorados Civil Rights Commission rules and regulations that meant schools cant prevent educators from being open about their gender identity.
Long and his team are just one part of a growing movement to make biology education more affirming. BSCS founded an Equity and Social Justice Initiative in 2018 that focuses on making sure science education is inclusive, relevant, and actively antiracist and anti-oppressive in all its forms. Long works with BSCS as an advisor and consultant on certain initiatives, and BSCS now uses the GIBs language guide.
Donovan, the researcher from BSCS, points out that Long is ahead of BSCSs research, but hopes to see studies done on the GIB curriculum. Do those changes when implemented in the curriculum itself lead to feelings of greater social belonging among trans students? Donovan asks.
Still, others in the education world continue to seek out Longs knowledge. He consults with textbook and curriculum developers like Gale In Context, Gale Health & Wellness databases, and OpenStax. The GIB founders have presented at conferences and written feature articles for the National Science Teaching Association. Long is currently consulting on interactive biology lab simulation software for HHMI Biointeractive, a philanthropy that creates classroom resources based on peer-reviewed science. He received and Upstander Award from the Human Rights Campaign last year, and the National Education Association awarded him the NEA Human and Civil Rights (HCR) Award, the groups highest honor, this month.
That doesnt mean GIB is free from pushback. Sometimes students or their parents ask why were learning about gender in science class, Long says. Usually, explaining that the content is scientifically accurate and inclusive quells concerns, but Long once had a GIB workshop canceled because schools were worried they might face backlash.
One teacher spoke to 5280 anonymously to avoid possible vitriol. After many years of teaching, she is adapting some of her lessons because she wants students to feel like theyre part of the community and the learning environment, not just observers, not just outsiders. She wants people to understand that educators like her arent changing the science. Were including this gender identity in the curriculum, just as we included material to empower girls, just as were including material to empower Black scientists.
She notes that she has seen queer-identified students in her class cringe and get uncomfortable when she teaches about something as simple as pedigree analysis, where the square means male, the circle means female. If a student isnt comfortable in the classroom, their ability to learn is harmed, she says. You lost them, you lost the education. And we would like to develop these future scientists no matter what their gender identity is.
Long hopes to play a part in revising the Colorado state science standards to include gender inclusive biology. He also envisions something similar to the 2019 law, HB19-1192 Inclusion Of American Minorities In Teaching Civil Government, which requires Colorado schools to teach the history, culture, and social contributions of minorities in social studies curriculum. (Long is a representative on the commission that was created by that bill.)
But for gender-inclusive biology, Long intends to take a slightly different tack. I dont know what the bill will be called or anything. It could be similar to the social studies one, but I would like to frame it as a standard of quality in some way. To teach biology in a way that doesnt acknowledge gender and sexual diversity is not the traditional way. Its of inferior quality and care to our students.
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Can This Denver Teacher Make Biology Class More Inclusive? - 5280 | The Denver Magazine
Global Region to Remain one of The Leading Outlook for Testosterone undecanoate Market Through 2028 Clark County Blog – Clark County Blog
Global Testosterone undecanoate Market By Type (Injection,Oral), By Application (Primary hypogonadism,Hypogonadotropic hypogonadism,Late-onset hypogonadism) Geography (North America (United States, Canada and Mexico), South America (China, Japan, Korea, India and Southeast Asia), Europe (Germany, France, UK, Russia and Italy), Asia-Pacific (China, Japan, Korea, India and Southeast Asia), Middle East and Africa (Saudi Arabia, Egypt, Nigeria and South Africa)) Industry Trends 2021-2028
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Top Listed Companies in the Testosterone undecanoate Market Include
Bayer AG,Taro Pharmaceutical,Endo Pharmaceuticals,Zhejiang Medicine Co.,Merck Sharp & Dohme,Zhejiang Xianju Pharmaceutical,Cipla
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Global Region to Remain one of The Leading Outlook for Testosterone undecanoate Market Through 2028 Clark County Blog - Clark County Blog
Coronavirus may cause sperm damage; Ways to boost male fertility – TheHealthSite
As we know, the impact of coronavirus is not limited to the respiratory system. It can lead to several complications, including fertility. A new study has finally found a link between coronavirus and male fertility. According to the study published in the Justus Liebig University Giessen, Germany found that severe cases of COVID-19 can impact the quality of sperm quality, thus affecting male fertility. Another study published in the Asian Journal of Urology found that SARS-CoV-2 could impact a mens reproductive health, including spermatogenic failure. Also Read - Here's how COVID-19 is affecting liver cancer patients and treatment
Although some studies have shown the negative impact of the coronavirus on male fertility, researchers said that more research is needed to draw definite conclusions. Meanwhile, there are certain things you could do to improve sperm count. Also Read - Jharkhand health staffer dies two days after getting COVID-19 vaccine
We cant stress the importance of exercise enough. Not only does it helps boost testosterone levels, but it also improves the quality of life. A study published in the European Journal of Applied Psychology, men who exercise regularly have higher testosterone levels and better semen quality as compared to men who dont exercise. Also Read - COVAX announces initial COVID-19 vaccine roll out: 336ml doses from AstraZeneca-SII, 1.2ml from Pfizer-BioNTech by March end
You probably know that vitamin C is an important nutrient that helps boost the immune system, but did you know that it is good for male fertility? Some studies have shown that including vitamin C can help improve fertility. It has also been reported that vitamin C supplements also enhanced sperm count and motility (bodys ability to move food through its digestive tract).
Studies have found that elevated cortisol levels (stress hormone) can have a negative effect on testosterone. Managing stress by exercising, spending time with your loved ones, meditating, and walking in nature can help.
A popular culinary ingredient, fenugreek contains properties that improve sexual health. A study published in the International Journal of Sports Nutrition and Exercise Metabolism studied the data of 30 men. They concluded that men who included fenugreek in their diet experienced a significant increase in testosterone levels and strength. Another study showed that consuming fenugreek regularly can help improve libido, sexual performance and strength.
A traditional medicinal herb, ashwagandha may boost testosterone levels, thus improving male fertility. Several studies have shown that ashwagandha supplements can help better sperm count, sperm motility, and antioxidant status, all of which is good for male fertility.
While the above methods may help, some lifestyle changes may help too. Here are some tips that might help.
Published : February 1, 2021 5:37 pm
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Coronavirus may cause sperm damage; Ways to boost male fertility - TheHealthSite
2021 Ford F-150 Raptor is high-speed off-roader with cult following – Detroit Free Press
The third generation 2021 Ford F-150 Raptor is an epic high-speed off-road performance pickup truck that goes on sale this summer. Wochit
This insane truck was once killed in development.
Then resurrected.
On sale this summer, the third generation 2021 Ford F-150 Raptor is a high-speed, off-road, performance pickupwith what has become a cult following, owners whowantto go 100 mph in the desertand fly through the air over ruts and rocks. The Raptor that debuted on Wednesday adds new features, including a built-in generator to power anything fromcampsites to power tools.
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The beefy 37-inch tires and wheels and cutting-edgesuspension deliver stability despite the extreme terrain even while you're holding onto the "oh, sh*t" handle.
Normally, you'd have to tear apart a vehicle to get it to fit such enormous tires. These are stock, not special order. And they're 2 inches bigger than earlier models.
More: Top designer of Ford F-150 Raptor gets ideas from fighter jets, Hollywood
Getting this level of equipment, once custom, is now turnkey. Itlifts the truck to a new level. And the sound of the exhaust is a "deeper more menacing sound."
If testosterone had a soundtrack, this would be it.
This is a high-performance war that started a decade ago.
"We couldn't be more excited. Ford invented the off-road high performance pickup segment withthe first generation Raptorin 2009. It was truly inspired by the trophytrucks thatraced the Baja 1000," said Todd Eckert, Ford Truck Group marketing manager.
The Raptorwas so different from anything that had been done before that it took awhile for some people at Ford towake up to the fact the company could create a whole new category of high performance off-road pickups. So initial plans were shelved.
The passion of the Fordteam internally played a role in resurrecting the idea. Butas soon as the internet spreadrumors and spy photosof the truck, the groundswell ofenthusiast demand was enough to help get it resurrected.
This latest version will debut with the popular heavy metal song"Enter Sandman" by Metallica.
The 2021 Ford F-150 Raptor is known for its smooth flights through the air and comfortable landings.(Photo: Ford Motor Co.)
"Raptor was born not only to speed over rough terrain but also jump and catch air. It was a one-of-a-kind entry in the performance market," he said. "Over the last fouryears, thepresent generation Raptor cumulatively outsold Porsche'sentire line of sports cars and also outsoldChevrolet's Corvette."
2021 Ford F-150 Raptor has 37 inch tires and big wheels and all-new suspension.(Photo: Ford Motor Co.)
In 2018,Sergio Marchionne, then-CEO of Fiat Chrysler Automobiles,rolled out afive-year plan that included a vow tocompete with the Ford Raptor. The battle has been fierce;MotorTrend namedthe Ram 1500 TRX, a more powerful and expensive desert-racer,the 2021 Truck of the Year in December.
Ford will reveal the new Raptor's power, fuel economy, priceandspecifications closer to when sales begin. The previousRaptor runs $55,150 to $76,290 with destination and delivery fees included, Ford said..
The TRX's challenge to Raptorsupremacy as the ultimate racing truck won't go unanswered. Ford is expected to add a more powerful and expensive Raptor R model with a V-8 engine in 2022.
The 2021 Ram 1500 TRX pickup in rock climbing mode.(Photo: Mark Phelan, Detroit Free Press)
Battles to build sporty pickups have gone on for years.
The Detroit Three builtthe Ford Lightning, Chevy Silverado SS and Ram SRT-10 like the Mustang, Camaro and Dodge Challenger of pickupsin the early 2000s. Great for street racing.
More: Ford just revealed 2021 F-150: Why this new model is different
More: New F-150 design consumed his life and inspired his house
This is the modern day encore for desert racing.
"Off-road performance is in our blood," Eckert said.
2021 Ford F-150 Raptor sketches by exterior designer Tom Liu.(Photo: Ford Motor Co.)
The Raptor is for buyerswho want a truck to drive off-road straight from the factory while not compromising onpayload, towing, comfort ortechnology for daily use.
Features include a terrain management system, trail control and one-pedal drive. Terrain management allows owners to choose settings for driving conditions including sport, rock crawl andthedune-jumping, frequently airborne, Baja mode.
Thesystem automatically modifies steering feel, active valve exhaust, position-sensitive damping, throttle mapping and transmissionshift points to optimize Raptor's performance to conditions. Trail control is standard.
"Think of it as cruise control for low-speed driving," Eckert said. "Drivers just set a speed up to 20 mph and the Raptor manages throttle and braking to allow the driverto focus really only on steering.It makes it easier for drivers to maintain constant speeds over difficult terrain ... or for getting throughdeep snow or sand. It's activated simply using a button on the center console."
Sketch of the 2021 Ford F-150 Raptor by exterior designer Tom Liu.(Photo: Ford Motor Co.)
One pedal drive combines acceleration and braking; press to accelerate and release to brake. Just one footisneeded for off-road activity like rock crawling.
Raptor also has an onboard generator that prevents the need for a portable generator tocampor work, a key feature cited whenthe F-150 won the North American Truck of the Year.
More: Ford reveals new F-150 Tremor series in plan to dominate off-road action
Here is an animation of the new Fox shock system featured on the Ford F-150 Raptor. Detroit Free Press
The Ford team spent months in the desert torture testing.
"We start with a high-strength steel F-150 frame, which has been modified and reinforced for Raptor's extreme usage," said Tony Greco, Raptor program manager."The modifications and reinforcements which we makeinclude taller and stronger shock towers, unique control arm pivot locations, a lower front axle which is needed for increased travel, stronger bracketry for suspension, shocks and spring attachments and a Raptor-specific trailer hitch."
The Ford Raptor front shock.(Photo: Ford Motor Company)
Raptor's front and rear suspensions were redesignedto improve off-road traction and stability and on-road ride andhandling quality, he said.
"The new five-link suspension design ...stabilizes the rear axle laterally and dramatically improves traction, which allows more torque to the rear wheels to be put to the ground," Greco said. Result: faster acceleration and better throttle responsiveness.
A sketch of the 2021 Ford F-150 Raptor by exterior designer Tom Liu.(Photo: Ford Motor Co.)
There's moreto shareabout ball joints, knuckles, wheel bearingsand coil springsbut you get the idea. Anytime designers talk about "geometry changes" in vehicle discussions, well, it's a good thing.
This is about aggressive control and stability off-road and smooth plush ride on road.
If youre jumping, the further down your wheels are hanging, the more absorption you're going to get when you land, due to the shock absorbers stroking.
"That's where we see the big value in off-road events, when you're often up and down quite a bit. The shock technology and how we've deployed that on this vehicle," architecture engineer Jack Cooper said. "You can go faster in the desert, you can hit bigger things. If youdon't have as much travel and can't absorb that energy, you'll hit harder, the suspension will bottom harder, and it'll be less comfortable and not as durable in theend."
Jack Cooper with his daughter, Allison Cooper, outside his Ford office in Allen Park in 2018. The architecture engineer played a key role in developing the 2021 Ford F-150 Raptor.(Photo: Jack Cooper)
"We learn more and moreevery time we push the envelope. It's one of the best parts of my job, working with the vehicle dynamics team." said Cooper, whose brother is a software developer at Google."I have a dream job."
This Molten Orange first generation 2010 Ford F-150 Raptor is seen here in November 2008, possibly in Anza Borrego, California. The vehicle went on sale in 2009.(Photo: Ford Motor Co.)
Ford builds the Raptor in Dearborn.
Contact Phoebe Wall Howard: 313-222-6512or phoward@freepress.com. Follow her on Twitter @phoebesaid. Read more on Ford and sign up for our autos newsletter.
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2021 Ford F-150 Raptor is high-speed off-roader with cult following - Detroit Free Press
All Creatures Great and Small Recap: The One With the Snack Hamper – Vulture
We love the things that help get us through hard times with a love that surpasseth understanding. With that in mind, I think you will understand when I say that this remake of All Creatures Great and Small is among the greatest things bestowed upon humankind in this last year. It is a gentle human drama filled with well-intentioned gentle humans trying their best, and the few times they are not trying their best, they are gently ashamed. I go into every new episode with the relief of I am about to watch a very nice thing. In these times, the appeal of that cannot be overestimated.
This entire episode revolves around a Pekingese. Yes, correct, it is the extremely wealthy Mrs. Pumphreys dog Tricki Woo, a dog I could not possibly love more, played by Derek. Wonderful dog acting from Derek once again this episode. Tricki is a pile of fluff. A Tribble of a dog. What is the greatest thing about Tricki? Is it his absurd leonine mane? The giant cushions he sleeps on? The fact that he shakes paws (I LITERALLY screamed when this happened)? His little snuffling noises? That Mrs. Pumphrey calls him my boofums? OR E, ALL OF THE ABOVE.
But before we get to Tricki, we also have Tristan. Or Tris, as I am forever calling him after last episode. Tris spends the episode asking Siegfried for money so he can go back to school and, presumably, have more fun than answering the phone at the practice and mixing horse medicine. Siegfried is understandably reticent because Tris keeps failing his exams, so Tris must prove himself. This somehow comes down to taking Tricki on walks, making the latter am I going to say it, yes I am a perambulating Pekingese (we have fun here). The practice has possession of Tricki because he is dangerously overweight. When asked if Mrs. Pumphrey has been sticking to his diet of dry dog biscuits, she says yes, to the letter, and then charmingly adds, perhaps not every letter. I AM STEALING THIS, DIANA RIGG. (RIP.)
She has been feeding Tricki calfs foot jelly, cod liver oil, Beef Wellington, and a bowl of Horlicks. If you are, like I am, an American, you might have said is that like ice cream? Nope! Think about milk, but its hot and also you add malt to it. I know, I dont get it either. Its slogan in 1961 was Horlicks the food drink of the night. NOPE. It was actually created in the United States and brought on expeditions to the North and South Pole, and then eventually that trickled on down to it being fed to the overly pampered Pekingese set.
James is concerned enough about Tricki that he takes him to stay at the practice so they can feed him appropriately and take him on walks. My notes for his visit at Mrs. Pumphreys just say GIMME THAT DOG, but we now need to move onto the very important fact that Tricki has a tiny, dog-size chaise longue. Has anyone made a website for Extravagant Pet Furniture, because I will look at that site every single day.
The drama of the episode hinges around the Hamper o Snacks, which Tris and Siegfried spend the following days pilfering. Despite Tris taking Tricki on very long walks and feeding him the presumably joyless dry dog food he must now consume for his health, Tricki is gaining rather than losing weight. This is because Siegfried left the hamper open and Tricki has been merrily dragging whole slices of ham out of it with his tiny dog strength. There is a big TO-DO about this, but! Lets talk about Clive real quick.
Dyou remember Clive? The massive bull who looks like one of those 18th-century paintings where you think that cows proportions are off, but really we just arent used to breeds of cow that arent Holsteins? Clive belongs to Helen and he has been sired out, i.e. hired to do it with someone elses cows, but hes not doing it, so James has to give him a shot of testosterone.
This is an unremarkable plot point, because the testosterone, undramatically, works, but its there to (1) let us once again see Clive, who is truly amazing and I love him, (2) show us everyone wearing velvet pants, or what I think are velvet pants, and it makes me want velvet pants, and (3) get James to give Helen a lift home, until they run into Hot Neville, who seems to have forgiven James for killing his horse. James has a Jessies Girl moment as he looks at the two flirting, but this dynamic remains the least interesting to me, because we know James and Helen are probably going to get married. Its very, yes, yes, check this off the list, now lets look at the others.
The relationships that are of true import here are Siegfried/Mrs. Hall and Mrs. Pumphrey/Tricki Woo. I cant nail down Siegfried and Mrs. Halls situation, and it makes me love it all the more. He knows more about her and her difficulties with her son than were allowed to know. He clearly feels something more for her, but its under enough layers of subtext that it seems hes not allowed to properly express it. They have this unspoken arrangement in their dynamic that I am all about and it feels like the actors have sat down and had a good discussion about their backstory and ITS JUST SO GOOD. As for Mrs. Pumphrey and Tricki Woo, that is a love for the ages.
Will we ever find out Whats Up With Edward?
Do velvet pants wear well?
When Helen inevitably dumps Hot Neville, will he find solace in the world of botany?
Will I descend into the uttermost depths of the All Creatures fandom, and now that weve found out the practices telephone number, change my WiFi Network to Darrowby2297?
Keep up with all the drama of your favorite shows!
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All Creatures Great and Small Recap: The One With the Snack Hamper - Vulture
Testosterone for Managing Treatment-related Fatigue in Patients With Metastatic Renal Cell Carcinoma: A Pha… – UroToday
Fatigue is one of the most common adverse events of systemic therapy in patients with metastatic renal cell carcinoma (RCC). The aim of multicenter randomized phase 2 study was to determine the efficacy and safety of testosterone in patients with fatigue developed during targeted therapy.
Male patients with metastatic clear-cell RCC, normal prostate-specific antigen level, low testosterone level, and no evidence of hypothyroidism receiving first-line sunitinib or pazopanib with fatigue were randomly assigned (1:1) to either testosterone undecanoate (1000mg) and targeted therapy or targeted therapy alone. The primary endpoint was the mean change of fatigue from baseline to 28 days according to the Functional Assessment of Chronic Illness Therapy-Fatigue scale. Secondary endpoints were safety, Functional Assessment of Cancer Therapy-Kidney Symptom Index 19, testosterone serum concentrations, red blood cell count, and hemoglobin level.
Sixty patients were assigned to receive testosterone and targeted therapy (N=30) or targeted therapy alone (N=30). As of the data cutoff on December 30, 2019, median follow-up was 18.2 months. The study achieved its primary endpoint based on the significant differences at day 28 favoring testosterone over targeted therapy alone regarding the decreased level of fatigue (difference between groups, 22.5 points; 95% confidence interval, 18.4-26.6; P=0.012). Significant changes in scores demonstrating the enhanced quality of life with testosterone compared with targeted therapy were also observed for Functional Assessment of Cancer Therapy-Kidney Symptom Index 19 disease-related symptoms (P=0.01). There were nonsignificant differences in red blood cell count and hemoglobin level between the 2 groups (all P>0.05).
Male patients with metastatic RCC and hypogonadism receiving testosterone had less fatigue and better symptom control during targeted therapy.
American journal of clinical oncology. 2021 Jan 27 [Epub ahead of print]
Ilya Tsimafeyeu, Yulia Tishova, Ruslan Zukov, Pavel Borisov, Anastasia Bondarenko, Kristina Zakurdaeva
Kidney Cancer Research Bureau Institute of Oncology, Hadassah Medical Moscow RUDN University I.M. Sechenov First Moscow State Medical University RakFond, Moscow V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk City Clinical Oncology Center, St. Petersburg, Russia.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/33512910
Association of Metabolic Obesity Phenotypes and Total Testosterone in | DMSO – Dove Medical Press
Luna Liu,1,2 Shuang Liu,1,2 Qianmei Song,1,2 Dandan Luo,1,2 Yu Su,1,2 Xiangyu Qi,1,2 Qian Wang,3 Jing Ning,1,2 Youyuan Lv,1,2 Qingbo Guan1,2,4
1Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, Peoples Republic of China; 2Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, Shandong 250021, Peoples Republic of China; 3Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, Peoples Republic of China; 4Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, Peoples Republic of China
Correspondence: Qingbo Guan Tel +86-531-68776375Fax +86-531-87068707Email doctorguanqingbo@163.com
Objective: Obesity and metabolic syndrome have been reported to exert an impact on the male reproductive system with decreasing levels of serum total testosterone (TT); however, the effect of different metabolic obesity phenotypes on testosterone has been poorly studied. We aimed to evaluate the association of metabolic obesity phenotypes and total testosterone levels in a Chinese male population.Methods: We performed a retrospective study based on an epidemiological investigation, a total of 4,081 male individuals aged from 40 75 years old were recruited. The population was classified as metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO) according to normal weight (BMI< 25.0) and overweight/obesity (BMI 25.0) with or without metabolic syndrome.Results: We collected 563 hypotestosteronemia among 4,081 male individuals. The odds ratios (ORs) (95% CIs) of hypotestosteronemia in obesity and metabolic syndrome were 3.072 (2.414 3.911) and 3.294 (2.631 4.125), respectively, after adjusting for age, luteinizing hormone, smoking status, and alcohol consumption. Compared to the MHNW group, male subjects in MHO, MUNW, and MUO groups had decreased serum TT levels. Additionally, the MUO group had a lowest concentration of serum TT and a highest proportion of hypotestosteronemia. There was no significant difference of TT levels between the MHO and MUNW groups.Conclusion: Obesity and metabolic syndrome are independent risk factors of hypotestosteronemia in Chinese male populations. Our study also suggested that individuals with MHO, MUNW, and MUO have a higher risk of developing hypotestosteronemia.
Keywords: metabolic obesity phenotypes, testosterone, metabolically healthy overweight/obese, metabolically unhealthy normal weight, hypotestosteronemia
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Association of Metabolic Obesity Phenotypes and Total Testosterone in | DMSO - Dove Medical Press