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Furthermore, modelling by site of onset and gender sub-groups revealed that this difference was greatest in male spinal onset cases. Joint models further indicated that occluded SNIP values were of prognostic importance. Conclusions Our results confirm findings from Portugal that the C9orf72 repeat expansion is associated with accelerated respiratory function decline. Analysis via joint models indicate that respiratory function is of prognostic importance and may explain previous observations of poorer prognosis in male spinal onset patients carrying the C9orf72 expansion. Copyright © 2019 Rooney J et al.Background Current thinking in health recognises the influence of early life experiences (health and otherwise) on later life outcomes. The life course approach has been embedded in the work of the World Health Organisation since the Ageing and Health programme was established in 1995. Yet there has been limited debate on the relevancy of a life course lens to understanding health service utilisation. Aim The aim of the review was twofold. Firstly, identify existing healthcare utilisation frameworks other than the dominant Andersen's behavioural model currently in use. Secondly, to identify if current frameworks incorporate the advocated life course perspective in understanding health service utilisation.     Methods A scoping review of PubMed, Cinahl Plus, Emerald, PsycINFO, Web of Knowledge and Scopus was conducted. Data extraction used a framework approach with meta-synthesis guided by the four domains of the life course proposed by Elder (1979) human agency, location, temporality and relationships, and interdependencies. Results A total of 551 papers were identified, with 70 unique frameworks (other than Andersen's Behavioural Model) meeting the inclusion criteria and included in the review. Conclusion To date there has been limited explicit discussion of health service utilisation from a life course perspective. The current review highlights a range of frameworks that draw on aspects of the life course, but have been used with this perspective in mind. The life course approach highlights important gaps in understanding and assessing health service utilisation (HSU), such as utilisation over time. HSU is a complex phenomenon and applying a structured framework from a life course perspective would be of benefit to researchers, practitioners and policy makers. Copyright © 2019 O'Donovan MA et al.Machine learning as a field of artificial intelligence is increasingly applied in medicine to assist patients and physicians. Growing datasets provide a sound basis with which to apply machine learning methods that learn from previous experiences. This review explains the basics of machine learning and its subfields of supervised learning, unsupervised learning, reinforcement learning and deep learning. We provide an overview of current machine learning applications in rheumatology, mainly supervised learning methods for e-diagnosis, disease detection and medical image analysis. In the future, machine learning will be likely to assist rheumatologists in predicting the course of the disease and identifying important disease factors. Even more interestingly, machine learning will probably be able to make treatment propositions and estimate their expected benefit (e.g. by reinforcement learning). Thus, in future, shared decision-making will not only include the patient's opinion and the rheumatologist's empirical and evidence-based experience, but it will also be influenced by machine-learned evidence. © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.Background Food security is defined as physical and economic access to sufficient food to meet the dietary requirements for a productive and healthy life. Evidence from the literature suggests that >800 million people worldwide are food insecure. Vulnerable Group Development (VGD) is the largest social safety net of the Government of Bangladesh targeting ultra-poor women to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture. Objectives The objective of this study is to explore the factors associated with food security among VGD women in Bangladesh. Trastuzumab Emtansine Methods A total of 870 women (435/group) participated in the baseline survey and another 800 women (400/group) participated in the endline survey. Participants in the intervention group received monthly rations of 30 kg fortified rice (FFR) and the control group received 30 kg of non-FFR for 12 mo. Multiple logistic regression analysis was used to establish both crude and confounder-adjusted relations between the primary outcopyright © The Author(s) 2020.Ectopic hormone production is well recognized, but ectopic production of prolactin has been reported infrequently. We report here the case of a 47-year-old woman who had hyperprolactinemia (213-224 ng/mL) causing galactorrhea and hypogonadism. Cabergoline treatment, 1.0 mg twice a week, did not lower the prolactin level at all, but excision of a large uterine leiomyoma corrected the hyperprolactinemia and the hypogonadism. The excised leiomyoma tissue exhibited immunostaining for prolactin, confirming by this method for the first time that a uterine leiomyoma was the cause of hyperprolactinemia. This case illustrates the need to consider an ectopic source of prolactin in a patient who has hyperprolactinemia that is not associated with a large sellar mass and is completely resistant to cabergoline. © Endocrine Society 2020.The US annually produces 79 million dry tons of liquid organic waste including sewage sludge. Anaerobic digestion can only reduce the sludge volume by 50% in mass, leaving the other half as a growing waste management and hygienic problem. Hydrothermal processing (HTP), a set of several chemical digestion processes, could be used to convert sewage sludge into valuable products and minimize potential environmental pollution risks. Specifically, hydrothermal carbonization and hydrothermal liquefaction have been extensively studied to sustainably manage sludge. Two of the main reasons for this are the high upscalability of HTP for public waste management and that it is estimated that HTP can recover eleven times more energy from waste products than landfilling. An integration of HTP with anaerobic digestion or recycling the soluble organics (in the HTP aqueous products) into the HTP process could lead to a higher overall rate of energy recovery for municipal sewage sludge. © 2020 Elsevier B.V. All rights reserved.