Character Traits Predict Health and Well-Being beyond Personality.

We examined the incremental validity of character in predicting health outcomes and well-being beyond personality traits and investigated the extent to which health-related behaviors mediate the relationship between character and well-being. Findings indicate that several character cores (e.g., transcendence, fortitude) predict well-being, health behaviors, and health outcomes beyond different measures of personality traits, indicating that character is discriminable from personality as indicated by incremental prediction. In particular, fortitude, temperance, transcendence, and sincerity appear to be key players. Implications for character research are discussed.

The British Society for Sexual Medicine Guidelines on Male Adult Testosterone Deficiency, with Statements for Practice.

Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but its diagnosis and management can be challenging. A multi-disciplinary panel from BSSM reviewed the available literature on TD and provide evidence-based statements for clinical practice. Evidence was derived from Medline, EMBASE and Cochrane searches on hypogonadism, testosterone therapy (T Therapy) and cardiovascular safety from May 2017 to September 2022. This revealed 1,714 articles, including 52 clinical trials and 32 placebo-controlled randomised controlled trials. A total of twenty-five statements are provided, relating to five key areas: screening, diagnosis, initiating T Therapy, benefits and risks of T Therapy, and follow-up. Seven statements are supported by level 1 evidence, eight by level 2, five by level 3, and five by level 4. Recent studies have demonstrated that low levels of testosterone in men are associated with increased risk of incident type 2 diabetes mellitus, worse outcomes in chronic kidney disease and COVID 19 infection with increased all-cause mortality, along with significant quality of life implications. These guidelines should help practitioners to effectively diagnose and manage primary and age-related TD.

Reducing Immunogenicity of Pegloticase With Concomitant Use of Mycophenolate Mofetil in Patients With Refractory Gout: A Phase II, Randomized, Double-Blind, Placebo-Controlled Trial.

OBJECTIVE: Pegloticase is used for the treatment of severe gout, but its use is limited by immunogenicity. This study was undertaken to evaluate whether mycophenolate mofetil (MMF) prolongs the efficacy of pegloticase. METHODS: Participants were randomized 3:1 to receive 1,000 mg MMF twice daily or placebo for 14 weeks, starting 2 weeks before receiving pegloticase and continuing while receiving intravenous pegloticase 8 mg biweekly for 12 weeks. Participants then received pegloticase alone from week 12 to week 24. The primary end points were the proportion of patients who sustained a serum urate level of ≤6 mg/dl at 12 weeks and the rate of adverse events (AEs). Secondary end points included 24-week durability of serum urate level ≤6 mg/dl. Fisher's exact test and Wilcoxon's 2-sample test were used for analyses, along with Kaplan-Meier estimates and log rank tests. RESULTS: A total of 32 participants received ≥1 dose of pegloticase. Participants were predominantly men (88%), with a mean age of 55.2 years, mean gout duration of 13.4 years, and mean baseline serum urate level of 9.2 mg/dl. At 12 weeks, a serum urate level of ≤6 mg/dl was achieved in 19 (86%) of 22 participants in the MMF arm compared to 4 (40%) of 10 in the placebo arm (P = 0.01). At week 24, the serum urate level was ≤6 mg/dl in 68% of MMF-treated patients versus 30% of placebo-treated patients (P = 0.06), and rates of AEs were similar between groups, with more infusion reactions occurring in the placebo arm (30% versus 0%). CONCLUSION: Our findings indicate that MMF therapy with pegloticase is well tolerated and shows a clinically meaningful improvement in targeted serum urate level of ≤6 mg/dl at 12 and 24 weeks. This study suggests an innovative approach to pegloticase therapy in gout.

Low-volume high-intensity interval training rapidly improves cardiopulmonary function in postmenopausal women.

OBJECTIVE: This study compared the effects of a 2-week program of low-volume high-intensity interval training (HIT) with the effects of higher-volume moderate-intensity continuous training (CT) on cardiopulmonary and vascular functions in postmenopausal women. METHODS: Twenty-two postmenopausal women were randomly assigned to undertake six HIT (n = 12) or CT (n = 10) sessions for 2 weeks. HIT sessions consisted of ten 1-minute intervals of cycling exercise at 100% of peak power output separated by 1 minute of active recovery. CT sessions involved 40 minutes of continuous cycling at 65% of peak power output. Variables assessed at baseline and 2 weeks included cardiopulmonary function (ventilatory threshold, peak oxygen uptake), macrovascular endothelial function (flow-mediated dilation of the brachial artery), and microvascular function (reactive hyperemia and local thermal hyperemia of forearm skin). RESULTS: Eighteen participants completed the study (HIT, 11; CT, 7). Adherence to the exercise programs was excellent, with 107 of 108 sessions completed. Despite substantially lower total time commitment (∼2.5 vs. ∼5 h) and training volume (558 vs. 1,237 kJ) for HIT versus CT, increases from baseline in peak oxygen uptake achieved significance (P = 0.01) for the HIT group only (Δ = 2.2 mL kg min; P for interaction = 0.688). Improvements in exercise test duration were observed in both groups (HIT, 13%; CT, 5%; P for interaction = 0.194). There were no significant changes in macrovascular or microvascular function in either group. CONCLUSIONS: The findings suggest that low-volume HIT is feasible and can lead to rapid improvements in cardiopulmonary function in postmenopausal women.

Bond strength of an amorphous calcium phosphate-containing orthodontic adhesive.

OBJECTIVE: To determine whether an amorphous calcium phosphate (ACP)-containing adhesive has an acceptable level of shear bond strength to be used as an orthodontic adhesive. MATERIALS AND METHODS: Sixty extracted premolars were randomly divided into three groups for orthodontic bonding. Group 1 used a composite resin adhesive (Transbond XT), group 2 was bonded with an ACP-containing adhesive (Aegis Ortho), and group 3 used a resin-modified glass ionomer (Fuji Ortho LC). All bonded teeth were stored in distilled water at 37 degrees C for 40 +/- 2 hours prior to debonding. Shear bond strength and adhesive remnant index (ARI) were recorded for each specimen. RESULTS: The mean shear bond strengths for the three test groups were: group 1 (15.2 +/- 3.6 MPa), group 2 (6.6 +/- 1.5 MPa), and group 3 (8.3 +/- 2.8 MPa). A one-way analysis of variance showed a significant difference in bond strengths between the groups. A post hoc Tukey test showed group 1 to be significantly (P < .001) greater than groups 2 and 3. A Kruskal-Wallis test and a Mann-Whitney U-test showed groups 1 and 3 exhibited lower ARI scores than group 2, but a majority of specimens in each group had greater than 50% of the cement removed along with the bracket during debonding. CONCLUSIONS: The ACP-containing adhesive demonstrated a low, but satisfactory bond strength needed to function as an orthodontic adhesive.