Tetrahydrogestrinone (18a-homo-pregna-4,9,11-trien-17beta-ol-3-one, THG) is an anabolic androgenic steroid sold to athletes as an undetectable performance enhancer. Being an unapproved substance, no legitimate in vivo human excretion studies could be performed to identify urinary markers of this doping agent. In vitro systems were used as an alternative approach to study the human metabolism of THG and the gestrinone analogue, which is a marketed drug. Incubations of both compounds in the presence of human hepatocytes led to formation of oxidative and glucuroconjugated metabolites. Microgram quantities of the major in vitro metabolites were biosynthesized using human hepatocytes, characterized by HPLC/MS/MS, and their structures elucidated by NMR. Due to high structure similarity, both THG and gestrinone had an analogous in vitro metabolic pathway leading to successive addition of a hydroxyl and a beta-glucuronic acid at C-18. This in vitro metabolite of gestrinone was consistent with a previously reported major but unknown human urinary metabolite. The structure of another metabolite of THG was proposed to be a glucuroconjugate of an oxidative product with a hydroxyl group most likely at C-16epsilon. In vitro information reported therein could significantly impact the identification of new urinary markers of THG for doping control purposes.

On 24 July 1900, Zelda Sayre was born into a prominent Southern family in Montgomery, Alabama, the youngest of six children. Her father had a distinguished career in Alabama politics and jurisprudence, eventually serving on the Supreme Court of Alabama. Much younger than her siblings, Zelda was independent, headstrong, and it was claimed, enjoyed being the centre of attention. She studied ballet during adolescence, but the demands of her social calendar overtook dance lessons in 1916. At the time, Montgomery was home to Camp Sheridan, a training facility preparing American soldiers for the First World War. Among Zelda’s many admirers was Francis Scott Key Fitzgerald. The couple first met at a dance in July 1918. After a tumultuous long-distance courtship and a broken engagement, they married on 3 April 1920, and Zelda moved north to New York City. The early years of their marriage saw the Fitzgeralds as the embodiment of the riotous ‘Jazz Age.’ With her bobbed hair, fondness for dancing and jazz, and rebellious sense of style, Zelda Fitzgerald was one of the original American flappers. The Fitzgeralds’ only child, a daughter named Frances Scott (Scottie), was born in October 1921.

Objective: Determine the relative effectiveness and safety profiles of percutaneous and minimally invasive interventions for chronic low back pain.Methods: A systematic search was performed for randomized controlled trials published in the past 20 years reporting on radiofrequency ablation of the basivertebral, disk annulus and facet nerve structures, steroid injection of the disk, facet joint, and medial branch, biological therapies, and multifidus muscle stimulation. Outcomes evaluated included Visual Analog Scale (VAS) pain scores, Oswestry Disability Index (ODI) scores, quality of life (SF-36 and EQ-5D) scores, and serious adverse event (SAE) rates. Basivertebral nerve (BVN) ablation was chosen as the subject of comparison to all other therapies using a random-effects metaanalysis.Results: Twenty-seven studies were included. BVN ablation was found to provide statistically significant improvements in VAS and ODI scores for 6-, 12-and 24-month follow-up (P ≤ 0.05). Biological therapy and multifidus muscle stimulation were the only 2 treatments with both VAS and ODI outcomes not significantly different from BVN ablation at 6-, 12-, and 24-month follow-up. All outcomes found to be statistically significant represented inferior results to those of BVN ablation. Insufficient data precluded meaningful comparisons of SF-36 and EQ-5D scores. The SAE rates for all therapies and all reported time points were not significantly different from BVN ablation except for biological therapy and multifidus muscle stimulation at the 6-month follow-up.Conclusions: BVN ablation, biological therapy, and multifidus stimulation all provide significant, durable improvements in both pain and disability compared with other interventions, which provided only short-term pain relief. Studies on BVN ablation reported no SAEs, a significantly better result than for studies of biological therapy and multifidus stimulation.

Francis Scott Key Fitzgerald was an American novelist, short-story writer, and cultural critic. Best-known for his 1925 novel The Great Gatsby, he coined the term "The Jazz Age" to refer to the riotous lifestyle of alcohol and excess that characterized the zeitgeist of the United States during the Roaring Twenties. Born in Saint Paul, Minnesota, Fitzgerald was named after a well-known distant relative, Francis Scott Key, author of "The Star Spangled Banner." He attended but did not graduate from Princeton University, where he was a member of the Princeton Triangle club—a theater group dedicated to musical-comedy—and where he wrote for the literary magazine as well as the campus paper. During his time at Princeton Fitzgerald began work on what would eventually become his first novel, This Side of Paradise (then titled The Romantic Egoist). The energy devoted to such extracurricular activities took its toll on Fitzgerald’s coursework, and he dropped out of the university in 1917 to enlist in the United States Army. Fitzgerald was stationed in Alabama at Camp Sheridan but did not see combat in World War I. He was in New York awaiting deployment when the armistice was signed in 1918.

The Waste Land is an influential and experimental 435-line poem written by Thomas Stearns Eliot and first published in 1922. Structurally, it is a pastiche of different verse forms, both traditional and contemporary. The poem is richly allusive and polyvocal. It contains several different languages, as well as allusions to texts as diverse as the Upanishads, Dante Alighieri’s Inferno, and Charles Baudelaire’s Les Fleurs du mal. A pre-publication manuscript of the poem reveals that both Eliot’s first wife Vivienne and his friend Ezra Pound helped revise the poem into its final form before its initial publication in 1922. At its core, The Waste Land is about life in London following the catastrophe of the First World War. The fragmentation of the verse form in The Waste Land mirrors the fragmentation of life in war-torn London and the increasing disorientation of urban experience.