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ObjectiveTo characterize adverse events related to use of the perirectal spacing agent SpaceOAR, we examined the Manufacturer and User Facility Device Experience (MAUDE) database.MethodsThe MAUDE database was queried for "SpaceOAR" and "Augmenix" from June 2015 (when SpaceOAR was approved by the Food and Drug Administration) to October 2022. Reports were reviewed for adverse events (AEs), operative procedures performed because of the AE, and changes to the radiation plan. AEs were categorized using Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.ResultsSix hundred fifty-four reports were reviewed. Eighty-four were excluded and 4 reports reviewed 2 separate cases of SpaceOAR administration. Five hundred seventy-four cases were ultimately included. Three deaths were reported (0.5% of all AEs). One point six percent of cases represented CTCAE grade 4 injuries (life-threatening consequences; urgent intervention indicated), 15.9% grade 3 (severe but not immediately life-threatening; hospitalization), 24.2% grade 2 (moderate; local/noninvasive intervention), and 57% of events were CTCAE grade 1 (mild; asymptomatic or mild symptoms). Bowel diversion occurred in 29 cases (9%).ConclusionBoth asymptomatic (n = 311) and debilitating (n = 12) complications of SpaceOAR hydrogel use were identified. Death, gel embolization, anaphylaxis, rectal ulcerations, and infections requiring bowel or urinary diversions were among the complications reviewed. Providers should consider these potential complications before perirectal spacer administration and during patient counseling.

The editorial in Frontiers in Immunology discusses immune system disorders, focusing on molecular mechanisms and clinical implications. The research highlights the pathogenic consequences of immune system dysfunction, including immunodeficiencies, inflammatory, and autoimmune disorders. Various review articles explore autoimmune diseases, treatments, and potential biomarkers for rheumatic diseases. The research aims to enhance understanding of immune dysregulation and its impact on diseases, paving the way for targeted therapies. [Extracted from the article]

BACKGROUND: Percutaneous vertebroplasty has become the main treatment method for osteoporotic vertebral compression fractures due to its advantages of convenient operation and low trauma. However, the optimal bone cement-vertebral volume ratio has not been determined. OBJECTIVE: To investigate the effect of bone cement-vertebral volume ratio on percutaneous vertebroplasty for osteoporotic vertebral compression fractures. METHODS: The clinical data of 100 patients with single-stage osteoporotic vertebral compression fractures admitted to Xinjiang Bazhou People’s Hospital from July 2019 to July 2022 were retrospectively analyzed. All patients received percutaneous vertebroplasty. According to the bone cement-vertebral volume ratio, they were divided into the low volume group (15% ≤ ratio ≤ 20%) and the high volume group (20% < ratio ≤ 25%) with 50 cases in each group. The visual analog scale score, Oswestry disability index, vertebral anterior margin height, Cobb angle of injured vertebra, bone cement distribution pattern, and bone cement leakage rate were analyzed before surgery, 3 days and 1 year after surgery. RESULTS AND CONCLUSION: (1) Compared with the preoperative results, the visual analog scale scores, vertebral anterior margin height, Cobb angle of injured vertebra at 3 days and 1 year after surgery, and Oswestry disability index at 1 year after surgery were significantly improved in 100 patients (P < 0.05). There were no significant differences in visual analog scale scores at 3 days and 1 year after surgery and Oswestry disability index at 1 year after surgery between the low volume group and the high volume group (P > 0.05). The vertebral anterior margin height in the low volume group was lower than that in the high volume group at 3 days and 1 year after surgery (P < 0.05). The Cobb angle of the injured vertebrae in the low volume group was higher than that in the high volume group at 3 days and 1 year after surgery (P < 0.05). (2) There were 10 H-type and 40 O-type bone cement distributions in the low volume group. There were 36 H-type and 14 O-type bone cement distributions in the high volume group, and there was no significant difference in bone cement distributions between the two groups (P < 0.05). The bone cement leakage rate in the high volume group and low volume group was 10% and 6%, respectively. (3) It is indicated that both low and high bone cement-vertebral volume ratios can improve postoperative pain and functional dysfunction, but high bone cement-vertebral volume ratio can improve the morphological recovery of injured vertebral, which may be related to the fact that the distribution of bone cement in this group is more H-type. [ABSTRACT FROM AUTHOR]

Chronic active Epstein-Barr virus infection (CAEBV) is a progressive and life-threatening disease characterized by persistent or recurrent EBV activation. It has been reported that, γδ T cells, a type of cytotoxic lymphocyte, play a critical role in restricting EBV. However, the functional status of γδ T cells in pediatric CAEBV patients has not yet been described. In this study, flow cytometry analysis was conducted to explore the cytokine production capacity of γδ T cells in CAEBV patients. A diminished frequency of γδ T cells and decreased expression of cytolytic molecule granzyme B were found in CAEBV patients, suggesting a dysfunction in the immune regulatory function of γδ T cells in this disease. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to systematically retrieve and evaluate published risk prediction models for autogenous arteriovenous fistula (AVF) failure post‐formation in maintenance hemodialysis (MHD) patients, with the goal of assisting healthcare providers in selecting or developing appropriate risk assessment tools and providing a reference for future research. Methods: A systematic search of relevant studies was conducted in PubMed, Web of Science, Cochrane Library, CINAHL, Embase, CNKI, Wanfang Database, VIP Database, and CBM Database up to February 1, 2024. Two researchers independently performed literature screening, data extraction, and methodological quality assessment using the Prediction Model Risk of bias (ROB) Assessment Tool. Results: A total of 4869 studies were identified, from which 25 studies with 28 prediction models were ultimately included. The incidence of autogenous AVF failure in MHD patients ranged from 3.9% to 39%. The most commonly used predictors were age, vein diameter, history of diabetes, AVF blood flow, and sex. The reported area under the curve (AUC) ranged from 0.61 to 0.911. All studies were found to have a high ROB, primarily due to inappropriate data sources and a lack of rigorous reporting in the analysis domain. The pooled AUC of five validation models was 0.80 (95% confidence interval: 0.79–0.81), indicating good predictive accuracy. Conclusion: The included studies indicated that the predictive models for AVF failure post‐formation in MHD patients are biased to some extent. Future research should focus on developing new models with larger sample sizes, strict adherence to reporting procedures, and external validation across multiple centers. [ABSTRACT FROM AUTHOR]

AbstractBackgroundAimsStudy designMethodologyResultsConclusionPre-frontal cortex operates a combination of emotional, cognitive and behavioural functions. Understanding the symptoms of pre-frontal cortex lesions serves as paramount for accurate diagnosis and management.This review aims to determine an association between the causes of prefrontal cortex lesions and the resulting symptoms, as well as the ideal form of treatment.A systematic review through utilisation of 3 databases was done using the keywords “Prefrontal cortex lesions,” “dysfunction,” “symptoms,” &” treatment”RCTs, observational studies, and systematic reviews were searched using Cochrane/EMBASE, PubMed/Medline, and Pedro between 1948 and2024. Studies published in English only were included, and two reviewers were involved in the data extraction processResults showed a notable correlation between right-handed individuals and prefrontal cortex lesions with cognition impairment, particularly executive dysfunction, being the most prevalent symptom. Emotional instability followed as the second most common issue, while aphasia remained the primary language deficit. Noninvasive brain stimulation emerged as an effective treatment option for various prefrontal cortex-related disordersFurther investigation is needed to understand the mechanism linking handedness to lesion occurrence. Noninvasive brain stimulation should be prioritised for treating prefrontal injuries [ABSTRACT FROM AUTHOR]

OBJECTIVE: Endothelial cells play a critical role in maintaining vascular function and kinetic homeostasis, but excessive accumulation of palmitic acid (PA) may lead to endoplasmic reticulum stress and trigger endothelial cell dysfunction. Baicalin (BCL), a natural plant extract, has received widespread attention for its biological activities in anti-inflammation and anti-oxidative stress. However, the mechanism of BCL on PA-induced endothelial cell dysfunction is unclear. Therefore, the aim of this study was to investigate whether BCL could inhibit PA-induced endoplasmic reticulum stress and thus attenuate endothelial cell dysfunction. METHODS: Human umbilical vein endothelial cells (HUVECs) were divided into Control, PA, PA + BCL-10 μM, PA + BCL-20 μM, and PA + BCL-50 μM groups. The PA group was treated with PA (200 μM), while the PA + BCL groups were co-treated with different concentrations of BCL (10 μM, 20 μM, 50 μM) for 24 hours. Cell viability was detected by MTT. Cell migration ability was determined by Transwell assay, apoptosis level by flow cytometry, and tube formation ability by tube formation assay. Finally, the levels of apoptosis-related proteins (Bax, Bcl-2, and cleaved caspase-3) and angiogenesis-related proteins (VEGFA and FGF2) were detected by western blot, MMP-9, as well as the protein levels of endoplasmic reticulum stress biomarkers (GRP78, CHOP, PERK, and ATF4). RESULTS: The results at the cellular level showed that cell viability, migration ability and tube formation ability of PA-induced HUVECs were significantly reduced, while apoptosis level was significantly increased. However, administration of different concentrations of BCL significantly enhanced PA-induced cell viability, migration ability and tube formation ability of HUVECs while inhibiting apoptosis. The results of protein levels showed that the protein levels of Bax and cleaved caspase-3 were observably up-regulated in the cells of the PA group, while the protein level of Bcl-2 was significantly down-regulated; compared with the PA group, the protein levels of Bax and cleaved caspase-3 were much lower and the Bcl-2 protein level was much higher in the PA + BCL group. Additionally, the protein levels of VEGFA, FGF2 and MMP-9 were raised and those of GRP78, CHOP, PERK and ATF4 were lowered in the PA + BCL group of cells in a concentration-dependent manner. CONCLUSION: BCL significantly attenuates PA-induced endothelial cell dysfunction by inhibiting endoplasmic reticulum stress. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to compare gout patients and healthy subjects in terms of erectile dysfunction, carotid intima-media thickness (CIMT), and other variables and to investigate the relationship between CIMT and erectile dysfunction. Patients and methods: This cross-sectional study was conducted with 134 male gout patients (median age: 56 years; range, 48 to 62 years) and 104 healthy males (median age: 47 years; range, 40.5 to 54.5 years) between September 2022 and June 2023. Age, comorbidities, height, weight, laboratory results, gout treatment data, insulin resistance evaluated by the homeostatic model assessment for insulin resistance, presence and severity of erectile dysfunction evaluated by the six-item International Index of Erectile Function erectile function domain (IIEF-EF), and CIMT measured by ultrasound were assessed. Results: Hypertension, hyperlipidemia, greater insulin resistance, erectile dysfunction, and bilaterally increased CIMT were significantly more common in the gout group. The mean IIEF-EF score of gout patients was significantly lower than that of controls. Multivariable logistic regression revealed increased CIMT as the sole parameter independently associated with erectile dysfunction (p=0.010). When both groups were categorized into CIMT-based subsets, erectile dysfunction was present in 97.9% of patients with coexistence of gout and increased CIMT (≥0.9 mm), a significantly higher proportion compared to the other three subsets (p<0.001). Conclusion: Increased CIMT was the only factor independently associated with a greater likelihood of erectile dysfunction in patients with and without gout; however, coexistence of gout and increased CIMT appears to result in a significantly elevated risk for erectile dysfunction. [ABSTRACT FROM AUTHOR]

Objective: NK cells play a vital role in tumor immune resistance. Various factors affect NK cell activity. While NK cell dysfunction has been observed in numerous malignancies, the underlying mechanisms in gastric cancer remain unclear. Method: Flow cytometry was used to identify the phenotypic distribution and expression of activated receptors on NK cells. ELISA was used to determine the expression of cytokines. We examined the expression of NK cell-related genes and explored their association with survival and prognosis. Additionally, we conducted PCR detection of miR-552-5p expression levels in plasma exosomes of patients and investigated its correlation with phenotypic distribution and activated receptors. We used flow cytometry and ELISA to verify the role of miR-552-5p in NK cell dysfunction. Furthermore, we investigated the potential role of PD-1/PD-L1 in regulating NK cell dysfunction in patients' cells. Results: We observed a significant decrease in the percentage of NKG2D and NKp30 and IFN-γ and TNF-α in patients than in healthy volunteers. Patients with low levels of CD56, CD16, NKG2D, and NKP46 exhibited poorer survival prognoses. Moreover, increased expression levels of plasma exosomal miR-552-5p in patients were negatively associated with NK cell phenotypic distribution and activated receptor expression. MiR-552-5p downregulated the secretion of perforin, granzyme, and IFN-γ as well as the expression of NKp30, NKp46, and NKG2D. Additionally, it suppressed the cytotoxicity of NK cells. The inhibitory effect of miR-552-5p, on NK cell function was reversed when anti-PD-L1 antibodies were used. Conclusion: Exosomal miR-552-5p targets the PD-1/PD-L1 axis, leading to impaired NK cell function. [ABSTRACT FROM AUTHOR]

Objective: Craniopharyngiomas (CPG) have complex treatment challenges due to their proximity to vital structures, surgical and radiotherapeutic complexities, and the tendency for recurrence. The aim of this study was to identify the prevalence of endocrine and metabolic comorbidities observed during initial diagnosis and long-term follow-up in a nationwide cohort of pediatric CPG patients. A further aim was to highlight the difficulties associated with CPG management. Methods: Sixteen centers entered CPG patients into the ÇEDD NET data system. The clinical and laboratory characteristics at presentation, administered treatments, accompanying endocrine, metabolic, and other system involvements, and the patient's follow-up features were evaluated. Results: Of the 152 evaluated patients, 64 (42.1%) were female. At presentation, the mean age was 9.1±3.67, ranging from 1.46 to 16.92, years. The most common complaints at presentation were headache (68.4%), vision problems (42%), short stature (15%), and nausea and vomiting (7%). The surgical procedures were gross total resection (GTR) in 97 (63.8%) and subtotal resection in 55 (36.2%). Radiotherapy (RT) was initiated in 11.8% of the patients. Histopathological examination reported 92% were adamantinamatous type and 8% were papillary type. Postoperatively, hormone abnormalities consisted of thyroid-stimulating hormone (92.1%), adrenocorticotropic hormone (81%), antidiuretic hormone (79%), growth hormone (65.1%), and gonadotropin (43.4%) deficiencies. Recombinant growth hormone treatment (rhGH) was initiated in 27 (17.8%). The study showed hesitancy among physicians regarding rhGH. The median survival without relapse was 2.2 years. Median (range) time of relapse was 1.82 (0.13-10.35) years. Relapse was related to longer followups and reduced GTR rates. The median follow-up time was 3.13 years. Among the last follow-up visits, the prevalence of obesity was 38%, but of these, 46.5% were already obese at diagnosis. However, 20% who were not obese at baseline became obese on follow-up. Permanent visual impairment was observed in 26 (17.1%), neurological deficits in 13 (8.5%) and diabetes mellitus in 5 (3.3%) patients. Conclusion: Recurrence was predominantly due to incomplete resection and the low rate of postoperative RT. Challenges emerged for multidisciplinary regular follow ups. It is suggested that early interventions, such as dietary restrictions and increased exercise to prevent obesity, be implemented. [ABSTRACT FROM AUTHOR]

Abstract Chronic active Epstein-Barr virus infection (CAEBV) is a progressive and life-threatening disease characterized by persistent or recurrent EBV activation. It has been reported that, γδ T cells, a type of cytotoxic lymphocyte, play a critical role in restricting EBV. However, the functional status of γδ T cells in pediatric CAEBV patients has not yet been described. In this study, flow cytometry analysis was conducted to explore the cytokine production capacity of γδ T cells in CAEBV patients. A diminished frequency of γδ T cells and decreased expression of cytolytic molecule granzyme B were found in CAEBV patients, suggesting a dysfunction in the immune regulatory function of γδ T cells in this disease.

The pelvic floor biomechanics and sphincter functioning are essential for understanding pelvic floor dysfunction and the pathophysiology of the pelvic organs. The pelvic floor consists of muscles, fascial connections and ligaments. The Integral Theory Paradigm (ITP) explains the musculoskeletal entity of the sphincter mechanism and the pathophysiology of pelvic organ function. The ITP explains the pelvic floor function determined by 3 directional muscle forces: forward, backwards and downward-acting muscle vector forces that form an anterior and posterior resultant. The resultant equilibrium is essential for urinary continence, voiding and defecation. Loose ligaments disturb the equilibrium of the pelvic floor’s muscular function with consequences for the organ function’s continence, evacuation, and sensory perception.

INTRODUCTION: Craniopharyngiomas (CPG) have complex treatment challenges due to their proximity to vital structures, surgical and radiotherapeutic complexities, and the tendency for recurrence. The aim of this study was to identify the prevalence of endocrine and metabolic comorbidities observed during initial diagnosis and long-term follow-up in a nationwide cohort of pediatric CPG patients. A further aim was to highlight the difficulties associated with CPG management. METHODS: Sixteen centers entered CPG patients into the ÇEDD NET data system. The clinical and laboratory characteristics at presentation, administered treatments, accompanying endocrine, metabolic, and other system involvements, and the patient’s follow-up features were evaluated. RESULTS: Of the 152 evaluated patients, 64 (42.1%) were female. At presentation, the mean age was 9.1±3.67, ranging from 1.46 to 16.92, years. The most common complaints at presentation were headache (68.4%), vision problems (42%), short stature (15%), and nausea and vomiting (7%). The surgical procedures were gross total resection (GTR) in 97 (63.8%) and subtotal resection in 55 (36.2%). Radiotherapy (RT) was initiated in 11.8% of the patients. Histopathological examination reported 92% were adamantinamatous type and 8% were papillary type. Postoperatively, hormone abnormalities consisted of thyroid-stimulating hormone (92.1%), adrenocorticotropic hormone (81%), antidiuretic hormone (79%), growth hormone (65.1%), and gonadotropin (43.4%) deficiencies. Recombinant growth hormone treatment (rhGH) was initiated in 27 (17.8%). The study showed hesitancy among physicians regarding rhGH. The median survival without relapse was 2.2 years. Median (range) time of relapse was 1.82 (0.13-10.35) years. Relapse was related to longer followups and reduced GTR rates. The median follow-up time was 3.13 years. Among the last follow-up visits, the prevalence of obesity was 38%, but of these, 46.5% were already obese at diagnosis. However, 20% who were not obese at baseline became obese on follow-up. Permanent visual impairment was observed in 26 (17.1%), neurological deficits in 13 (8.5%) and diabetes mellitus in 5 (3.3%) patients. DISCUSSION AND CONCLUSION: Recurrence was predominantly due to incomplete resection and the low rate of postoperative RT. Challenges emerged for multidisciplinary regular follow ups. It is suggested that early interventions, such as dietary restrictions and increased exercise to prevent obesity, be implemented.

Nasal valve dysfunction can substantially impact nasal airflow and overall quality of life. This review provides a comprehensive examination of nasal valve dysfunction, including its mechanisms, classification, and surgical management. The nasal valves include internal and external valves, each of which plays a crucial role in regulating nasal airflow. Subclassification of the external nasal valve into alar and rim valves helps specify the site of obstruction when present and informs the choice of surgical intervention. Dynamic nasal valve obstruction, often characterized by inspiratory collapse of the nasal valve, must be distinguished from static obstruction, which refers to nasal valve stenosis. Accurate identification of the location and mechanism of nasal valve dysfunction is essential for effective management. Various surgical procedures target specific components of the nasal valve and can produce favorable functional outcomes. The selection of surgical procedures, whether individually or in combination, should be tailored to the characteristics of nasal valve dysfunction and the external nasal characteristics of the patient. Strict adherence to proper surgical techniques is imperative for achieving optimal treatment outcomes.

Abstract Background Male infertility presents global challenges, as current drug-based treatments demonstrate limited effectiveness due to an incomplete understanding of dysfunctions within the reproductive system. However, there is growing optimism surrounding natural products, particularly flavonoids, which offer promising therapeutic options. Extensive research has unveiled the positive impact of flavonoids on testicular structure, spermatogenesis, and sperm quality. Main body Flavonoids have diverse functions such as immune-stimulating, anti-inflammatory, and antioxidative effects. These properties make them potential inhibitors of male reproductive system problems. This narrative review aims to evaluate the effects of different flavonoids on male reproductive disorders by examining the phytochemical ingredients, traditional applications, potential pharmacological actions, documented effects, and therapeutic applications of flavonoids in functional abnormalities of the male reproductive system. Conclusion This review elaborates on the scientific study findings of flavonoids and recommends their use in male infertility.

Background: Carrying backpacks is believed to contribute to the musculoskeletal problems in school children. Studies on the use of backpacks by Nigerian school children are scanty. Objectives: To evaluate the use of backpack and associated problems among primary school children. Methods: A cross-sectional descriptive study was carried out on 813 children in six primary schools in Ado-Ekiti. Information about backpack use and associated problems were obtained. Results: 788 (96.9%) children carried backpacks daily. The backpacks were all double strapped and 85% pupils wore them on both shoulders. The backpacks of 64.1% of the pupils contained educational materials. In 79.1% of cases, the backpacks exceeded 10% of their body weights. Pain and loss of sporting time were associated with carrying backpacks in 23.2% and 8.2% respectively, 15.3% took analgesic and 5.5% had medical consultations because of backpack injuries. No pupil missed school and none was hospitalised for backpack injury. Complaint of pain was significantly associated with older subjects, carrying heavier backpack and longer period of carrying packs (p

Introduction There is limited knowledge on cognitive performance in Behçet’s disease (BD), the majority of which come from patients with neuro-Behçet’s disease. However, the influence of BD on cognitive function in patients without neurological involvement is still not well understood. The aim of the study was to determine the frequency of cognitive involvement in BD patients without evident neuropsychiatric symptoms and to identify associated clinical variables in those patients. Material and methods Forty BD patients who fulfilled the diagnostic International Criteria for Behçet ‘s Disease (ICBD) without obvious neuropsychiatric manifestations were studied and compared with forty healthy controls matched for age, sex, and education. A comprehensive medical history, rheumatological, neurological, psychiatric, and psychometric assessment were applied for all patients. Behçet’s disease Current Activity Form (BDCAF) was used to assess disease activity. For patients as well as controls, validated Arabic versions of the Wechsler Adult Intelligence Scale-Revised and Wechsler Memory Scale-Revised were used for assessment of cognitive function. Anxiety and depression were additionally assessed for both groups using the anxiety and depression subdivisions of the Arabic Version of Symptom Checklist 90 Revised. Results Cognitive impairment was identified in 37.5% of BD patients compared to none of the controls. Memory represents the cognitive domain most frequently affected. Cognitive involvement was significantly associated with current corticosteroid use and depression as measured by SCL-90-R. On the other hand, neither the activity of the disease nor the level of anxiety was associated with cognitive involvement. Conclusions Cognitive dysfunction is reported in BD patients distinctly and independently of clinically overt neurologic involvement. Prevalence of cognitive impairment in patients with BD is strikingly high at 37.5%, whereas the control group exhibited no such signs. Psychological assessment should be performed for every BD patient to reveal any cognitive involvement. It is highly recommended to encourage psychological intervention to prevent any further deterioration, especially in patients who are experiencing depression or currently using corticosteroids.

Introduction. Impaired liver transplant function in the long term often leads to graft loss and the recipient death. There are many causes for the development of a late liver allograft dysfunction and different types of its clinical presentation, but there is no generally accepted definition. This hinders its timely diagnosis, analysis of its prevalence, and also makes it difficult to compare the performance of transplantation programs.Objective. To determine the clinical and prognostic value of late liver allograft dysfunction.Material and methods. The study included 103 cases of cadaveric liver transplantation from donors diagnosed with brain death to 100 recipients, of whom 36% were men, aged 48 years old (40;56) (18–68) at the time of transplant, having MELD score 17 (14;21) (7–41). The follow-up period was 52 months (20;77) (8–180). The cases where the graft loss occurred earlier than 3 months were excluded.The late liver allograft dysfunction was defined as a dysfunction of the transplanted liver, which was manifested by at least one of three following signs and occurred at more than 3 months after transplantation: 1) increased aspartate aminotransferase, alanine aminotransferase and/or gamma glutamyl transferase, alkaline phosphatase, bilirubin; 2) impaired synthetic function (increased international normalized ratio, decreased antithrombin III, cholinesterase); 3) liver cirrhosis complications (signs of portal hypertension, ascites, encephalopathy). The following limits were chosen as a diagnostic threshold for laboratory parameter abnormalities: more than 2 upper limits of normal for total bilirubin, more than 1.5 upper limits of normal for the levels of alanine or aspartic aminotransferases, more than 1.5 upper limits of normal for gamma-glutamyltransferase or alkaline phosphatase, more than 1.6 of normal for international normalized ratio.Results. Late liver allograft dysfunction was diagnosed at least once in 64% of recipients. Through the postoperative course, the proportion of patients with late dysfunction varied from 22% to 40%. The etiology of late liver allograft dysfunction was viral (38%), unknown (25%), biliary (19%), immune (17%), and vascular (1%). Late liver allograft dysfunction was reversible in 75% of cases, persistent in 17%, progressive in 8% of cases. Progressive late liver allograft dysfunction led to a graft loss in all cases observed.Recipients with late liver allograft dysfunction were found to have had a 33% higher incidence of early allograft dysfunction (OR 4.7, 95% CI [1.8–12.3]); the incidence of biliary dysfunction was 3.1 times higher with distant choledochojejunostomy (OR 3.9, 95% CI [1.1–13.9]); in patients with autoimmune and cholestatic disease, the incidence of immune dysfunction was 4.8 times higher (OR 5.8, 95% CI [1.7–20.3]).Conclusion. The progressive nature of late liver allograft dysfunction negatively affects the results of transplantation and therefore should be considered as an indication for retransplantation. Reversible and persistent variants of late liver allograft dysfunction have favorable) prognosis. If the etiology of late dysfunction is not established, the regular surveillance with monitoring for fibrosis and repeated attempts to clarify the diagnosis should be continued.

Background: Male infertility presents global challenges, as current drug-based treatments demonstrate limited effectiveness due to an incomplete understanding of dysfunctions within the reproductive system. However, there is growing optimism surrounding natural products, particularly flavonoids, which offer promising therapeutic options. Extensive research has unveiled the positive impact of flavonoids on testicular structure, spermatogenesis, and sperm quality. Main body: Flavonoids have diverse functions such as immune-stimulating, anti-inflammatory, and antioxidative effects. These properties make them potential inhibitors of male reproductive system problems. This narrative review aims to evaluate the effects of different flavonoids on male reproductive disorders by examining the phytochemical ingredients, traditional applications, potential pharmacological actions, documented effects, and therapeutic applications of flavonoids in functional abnormalities of the male reproductive system. Conclusion: This review elaborates on the scientific study findings of flavonoids and recommends their use in male infertility. [ABSTRACT FROM AUTHOR]

Distant metastasis, the leading cause of cancer death, is efficiently kept in check by immune surveillance. Studies have uncovered peripheral natural killer (NK) cells as key antimetastatic effectors and their dysregulation during metastasis. However, the molecular mechanism governing NK cell dysfunction links to metastasis remains elusive. Herein, MAP4K1 encoding HPK1 is aberrantly overexpressed in dysfunctional NK cells in the periphery and the metastatic site. Conditional HPK1 overexpression in NK cells suffices to exacerbate melanoma lung metastasis but not primary tumor growth. Conversely, MAP4K1‐deficient mice are resistant to metastasis and further protected by combined immune‐checkpoint inhibitors. Mechanistically, HPK1 restrains NK cell cytotoxicity and expansion via activating receptors. Likewise, HPK1 limits human NK cell activation and associates with melanoma NK cell dysfunction couples to TGF‐β1 and patient response to immune checkpoint therapy. Thus, HPK1 is an intracellular checkpoint controlling NK‐target cell responses, which is dysregulated and hijacked by tumors during metastatic progression. [ABSTRACT FROM AUTHOR]

Objective：To investigate the effect of ultrasound combined with transcutaneous electrical nerve stimulation on pain and function of knee joint in patients with knee osteoarthritis. Method：A total of 122 patients with knee osteoarthritis graded 1 to 3 according to Kellgren-Lawrence (K-L) classification were randomly divided into the experimental group (n=61）and the control group（n=61). The patients in the experimental group were treated with ultrasound combined with transcutaneous electrical nerve stimulation on the basis of conventional rehabilitation treatment, and the patients in the control group were only treated with ultrasound on the basis of conventional rehabilitation treatment. The Visual Analogue Scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), walking ability rating scale and 6-minute walk distance were used to evaluate the pain and function of knee joint before treatment, 4 weeks after treatment and 3 months after treatment. Result：Before treatment, there was no significant difference between the experimental group and the control group. After 4 weeks of treatment, the VAS score, WOMAC pain and function scores of the two groups were significantly decreased （P<0.05). Improvements in walking ability scores and 6-minute walk distance were significant in both groups （P<0.05). No significant changes were observed in the WOMAC stiffness score between the two groups (P>0.05）, The VAS score, WOMAC pain and function score, walking ability score and 6-minute walk distance in the experimental group had statistical significance when compared with those in the control group (P<0.05). At follow- up, except for the WOMAC stiffness score and function score, there were significant differences when compared with those before treatment in the two groups (P< 0.05). The VAS score, WOMAC pain score, walking ability score and 6-minute walk distance in the experimental group were significantly improved than those in the control group (P<0.05). Conclusion: Ultrasound combined with transcutaneous electrical nerve stimulation could significantly relieve pain, enhances walking function and improve walking ability in people with knee osteoarthritis, but does not have a marked effect on joint stiffness. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is characterized by the accumulation of amyloid β and phosphorylated τ protein aggregates in the brain, which leads to the loss of neurons. Under the microscope, the function of mitochondria is uniquely primed to play a pivotal role in neuronal cell survival, energy metabolism, and cell death. Research studies indicate that mitochondrial dysfunction, excessive oxidative damage, and defective mitophagy in neurons are early indicators of AD. This review article summarizes the latest development of mitochondria in AD: 1) disease mechanism pathways, 2) the importance of mitochondria in neuronal functions, 3) metabolic pathways and functions, 4) the link between mitochondrial dysfunction and mitophagy mechanisms in AD, and 5) the development of potential mitochondrial-targeted therapeutics and interventions to treat patients with AD. [ABSTRACT FROM AUTHOR]

This report emphasizes the need for interdisciplinary collaboration in diagnosing and treating pediatric obstructive sleep apnea (OSA). OSA, affecting 1% to 4% of children, often results from adenotonsillar hypertrophy, craniofacial disorders, or obesity. While adenotonsillectomy is the primary treatment, about 75% of children, especially those with craniofacial disorders or obesity, continue to experience OSA symptoms post-surgery. To address these cases, several medical fields emphasize the necessity and demand for interdisciplinary collaboration in managing pediatric OSA. Therefore, the authors aimed to develop the Pediatric Obstructive Sleep Apnea Diagnostic Examination Form (POSADEF). This form, based on clinical experience and the literature, captures craniofacial and functional characteristics linked to pediatric OSA. A case study of an eight-year-old girl with OSA, who was unsuccessfully treated with adenotonsillectomy, underlines the importance of the diagnostic examination form. The orthodontic assessment revealed craniofacial disorders and subsequent treatment with maxillary expansion and functional appliance therapy resolved her OSA symptoms. This case demonstrates the value of POSADEF in enabling comprehensive evaluation and treatment across medical disciplines. POSADEF is designed to assist health care professionals in diagnosing craniofacial and orofacial anomalies contributing to pediatric OSA. [ABSTRACT FROM AUTHOR]

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Occult lymph node metastasis (OLNM) is one of the main causes of regional recurrence in inoperable N0 non‐small cell lung cancer (NSCLC) patients following stereotactic ablation body radiotherapy (SABR) treatment. The integration of immunotherapy and SABR (I‐SABR) has shown preliminary efficiency in mitigating this recurrence. Therefore, it is necessary to explore the functional dynamics of critical immune effectors, particularly CD8+ T cells in the development of OLNM. In this study, tissue microarrays (TMAs) and multiplex immunofluorescence (mIF) were used to identify CD8+ T cells and functional subsets (cytotoxic CD8+ T cells/predysfunctional CD8+ T cells (CD8+ Tpredys)/dysfunctional CD8+ T cells (CD8+ Tdys)/other CD8+ T cells) among the no lymph node metastasis, OLNM, and clinically evident lymph node metastasis (CLNM) groups. As the degree of lymph node metastasis escalated, the density of total CD8+ T cells and CD8+ Tdys cells, as well as their proximity to tumor cells, increased progressively and remarkably in the invasive margin (IM). In the tumor center (TC), both the density and proximity of CD8+ Tpredys cells to tumor cells notably decreased in the OLNM group compared with the group without metastasis. Furthermore, positive correlations were found between the dysfunction of CD8+ T cells and HIF‐1α+CD8 and cancer microvessels (CMVs). In conclusion, the deterioration in CD8+ T cell function and interactive dynamics between CD8+ T cells and tumor cells play a vital role in the development of OLNM in NSCLC. Strategies aimed at improving hypoxia or targeting CMVs could potentially enhance the efficacy of I‐SABR. [ABSTRACT FROM AUTHOR]

Arteriovenous fistula dysfunction (AVF) is a frequent and often unforeseeable complication in hemodialysis patients, and the most common cause is venous outflow stenosis resulting from neointimal hyperplasia and outward remodeling. Currently, there have been few effective prevention and treatment measures for AVF, therefore, this paper reviews the interventions and preventive measures of the AVF. [ABSTRACT FROM AUTHOR]

Considering the severe implications of risky behavior for the individual and society and the possible role of personality dysfunction in it, the present study was conducted to investigate the prevalence of personality dysfunction and its relation with risky, impulsive and selfdestructive behaviors in the general population. In an analytical cross-sectional study, 428 adults were selected from the general population of the country and were measured using risky, impulsive, and self-destructive behavior questionnaire and the short form of the severity indices of personality problems (SIPP-SF). The data was analyzed by correlation tests, t-test, confirmatory factor analysis and latent profile analysis (LPA) using SPSS-26 and Mplus-8 software. The prevalence of personality dysfunction was 59.3% with the estimate made through LPA. Each of the risky behaviors were more associated with a specific type of personality dysfunction, including substance use (r=-0.28, P<0.01) and risky sexual behavior (r=-0.24, P<0.01) with responsibility, aggression (r=-0.32, P<0.01) and criminal behavior (r=-0.28, P<0.01) with self-control and impulsive shopping and driving with social adaptation (r=-0.34, P<0.01) were more correlated. Due to the specific relationship of each personality dysfunction with a specific type of risky behaviors, it is necessary to develop interventions focused on specific personality dysfunction to reduce each of the risky behaviors. [ABSTRACT FROM AUTHOR]

Objectives: this study sheds light on disciplinary evidence and defines its features to ascertain if an employee has committed a disciplinary offence while carrying out his job duties. It demonstrates how the Administrative Investigation Committee can establish the burden of proof. Research Problem: the adequacy of organising special rules of evidence before the Administrative Investigation Committee to detect behavioural violations. The Jordanian legislator addressed these rules in Article 146/b/2 of the Jordanian Civil Service Law No. 9 of 2020. However, these rules are not integrated, as it is assumed that the administration has complete evidence of claims of behavioural violations. It does not have the right to accuse the employee of deviating from his job mandate without evidence. The employee is also entitled to present evidence refuting such claims. Thus, it falls to investigation committees to search for the necessary evidence to clarify the truth. Methods: this study adopts a descriptive and analytical approach that compares the Jordanian, Egyptian and Emirati legislation concerning the rules of evidence. Results and Conclusions: the paper concludes by with the following results such as: Jordanian Civil Service Law fails to organise the means of evidence and administrative papers, as the legislator did not explicitly grant the Administrative Investigation Committee the authority to review documents related to the violation. In contrast, they were expressly formulated in the Egyptian and Emirati legislations. As well as, the Jordanian legislator did not deal with the method of inspection before the administrative investigation committee in the Civil Service Law, unlike the Egyptian legislator who regulated that method in the law and provided instructions to the Administrative Prosecution. Such was also the case for the UAE federal legislator within the framework of the executive regulations of the human resources law in the federal government. [ABSTRACT FROM AUTHOR]

TMD pain and dysfunction were observed in up to 66 % and 41 % of patients seeking orthodontic treatment. Evidence-based knowledge of TMD etiology, detection, and management is thus paramount in contemporary orthodontic practice. This analytical review aims to introduce the biopsychosocial model, scrutinize the psychosocial construct, propose psychosocial screening tools, and clarify the effectiveness of psychological interventions for TMDs. The biopsychosocial model specifies that TMDs are the consequence of dynamic interactions between biological, psychological, and social factors across time. As the frequency of moderate-to-severe psychological distress and somatization/somatic symptoms burden is high in individuals with TMDs, prospective orthodontic patients should be screened for TMDs/psychosocial impairments to circumvent treatment and medico-legal complications. Among the available screening tools, an amalgamation of the quintessential 5 TMD symptoms (5Ts) of the DC/TMD, Physical Symptom Scale-8 (PSS-8), and Patient Health Questionnaire-4 (PHQ-4) provides an efficient way of identifying TMD, somatic, and psychological symptoms synchronously. For prospective orthodontic patients with considerable TMD pain/dysfunction and distress, tailored multimodal and multidisciplinary treatments incorporating psychosocial interventions, including counseling/self-management, cognitive-behavioral therapy, and behavior modification, may be warranted. Complementary positive psychological interventions could also be valuable in TMD management and the paradigm shift from "reactive" to "proactive" TMD care. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is a polygenic metabolic disorder characterized by insulin resistance in peripheral tissues and impaired insulin secretion by the pancreas. While the decline in insulin production and secretion was previously attributed to apoptosis of insulin-producing b-cells, recent studies indicate that b-cell apoptosis rates are relatively low in diabetes. Instead, b-cells primarily undergo dedifferentiation, a process where they lose their specialized identity and transition into non-functional endocrine progenitor-like cells, ultimately leading to b-cell failure. The underlying mechanisms driving b-cell dedifferentiation remain elusive due to the intricate interplay of genetic factors and cellular stress. Understanding these mechanisms holds the potential to inform innovative therapeutic approaches aimed at reversing b-cell dedifferentiation in T2D. This review explores the proposed drivers of b-cell dedifferentiation leading to b-cell failure, and discusses current interventions capable of reversing this process, thus restoring b-cell identity and function. [ABSTRACT FROM AUTHOR]

Functioning describes how well a person handles life, but the constituents of functioning and its measurement remain subjects of debate among researchers. However, approaches investigating how the concept of functioning is understood among laypeople and practitioners have received less attention. The present study uses a bottom‐up approach to explore the concept of functioning among laypeople and mental health professionals in a Scandinavian context. Participants were asked to describe a person doing well in life and a person not doing well in life, resulting in a total of 2,345 statements from 128 laypeople and 78 mental health professionals. Initially, statements were rated according to the meta‐concepts of Agency and Communion. This analysis revealed a dominant prevalence of Agency across groups, with laypeople demonstrating a heightened emphasis on Agency when characterizing an individual not doing well in life, suggesting an intensified focus on personal responsibility and achievement when describing dysfunction. Next, an independent semantic domain analysis was used to elucidate and identify distinctive features of functioning within the statements. This revealed a shared conceptualization of functioning among both laypeople and mental health professionals based on three main domains: (1) thriving; (2) daily activities and social roles; and (3) personality features. The findings underscore the importance of considering subjective experiences of thriving, efficacy in managing daily tasks and roles, and personality traits in attaining a comprehensive understanding of functioning levels. [ABSTRACT FROM AUTHOR]

Metaphysical realism about mental disorder is the thesis that mental disorder exists mind-independently. There are two ways to challenge metaphysical realism about mental disorder. The first is by denying that mental disorder exists. The second is by denying that mental disorder exists mind-independently. Or, differently put, by arguing that mental disorder is mind-dependent. The aim of this paper is three-fold: (a) to examine three ways in which mental disorder can be said to be mind-dependent (namely, by being causally dependent on the human mind, by being weakly dependent on human attitudes, and by being strongly dependent on human attitudes), (b) to clarify their differences, and (c) to discuss their implications regarding metaphysical realism about mental disorder. I argue that mental disorder being mind-dependent in the first two senses is compatible with metaphysical realism about mental disorder, whereas mental disorder being mind-dependent in the third sense is not. [ABSTRACT FROM AUTHOR]

Background: To investigate the differences in pelvic floor muscle (PFM) electromyography (EMG) parameters between women with or without sexual dysfunction (FSD) and their correlations. Methods: Women who voluntarily participated in a questionnaire-based survey on sexual function and underwent PFM EMG in Weifang People's Hospital during the period from March 2021 to December 2021 were retrospectively enrolled. The female sexual (dys)function was measured using the Female Sexual Function Index. Glazer PFM EMG was performed using a Melander instrument (MLD A2 Deluxe). The differences in PFM EMG parameters between women with or without FSD were compared, and the relationships between PFM EMG parameters and FSD were analysed using multiple linear regression models. Results: A total of 305 women were enrolled, with 163 in the FSD group and 142 in the non-FSD group. Comparisons of PFM EMG parameters between these two groups revealed that the FSD group had significantly higher peak EMG amplitude during the phasic (flick) contractions and shorter recovery latency during the tonic contractions than the non-FSD group (both P < 0.05). Multivariate linear regression suggested that the peak EMG amplitude during the phasic (flick) contractions was 5.39 μV higher in the FSD group than in the non-FSD group, whereas the recovery latency during the tonic contractions was 0.29 s shorter (both P < 0.05). Conclusions: The results of the pelvic floor EMG in this study suggest that the pelvic floor muscles of women with FSD may be more susceptible to fatigue, and may have poorer coordination of their pelvic floor muscles. Female sexual dysfunction brings great trouble to women. Evidence suggests that women with greater pelvic floor muscle (PFM) strength have better sexual function. Sexually active women have better PFM endurance than inactive women. However, it has also been reported that PFM strength is not correlated with sexual function. Here, we assessed female PFM function with electromyography, and explored the relationships between electromyography parameters and sexual dysfunction, in an attempt to provide an objective basis for sexual dysfunction diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Alpha-methyl acyl-CoA racemase deficiency (AMACRD) is a rare peroxisomal disorder that results in the accumulation of pristanic acid and 16 cases have been reported in the literature. Here, we present three additional patients, two confirmed by genomic study and one suspected. Three siblings who were born to healthy unrelated parents developed recurrent episodes of encephalopathy, seizures, and behavioral disturbances. In all 3, brain MRI showed lesions in the thalami, cerebral peduncles, and mesencephalic tegmentum, as well as brain volume loss. In addition, one patient had a chronic hemispheric infarct and an acute contralateral infarct, and another had a subacute infarct involving multiple vascular territories without abnormalities on MR angiography. [ABSTRACT FROM AUTHOR]

Abstract Purpose: The purpose of this research is to investigate the role of social capital components on explaining organizational pessimism as a behavioral challenge in Payam Noor universities in Guilan province.Methodology: The present research in terms of method; It is quantitative, with comparative logic, and in terms of purpose, it is practical and developmental. The statistical population of the research, the centers of Payam Noor University in Guilan province were selected in the number of 23 centers, the total number of human resources (academic faculty and administrative staff) is 588 people, and 220 people were selected as a sample using the cluster sampling method based on Cochran's formula. became The data collection tool is a researcher-made questionnaire. The questionnaire used was obtained from an exploratory study. In order to analyze the data, the mean, standard deviation method was used in the descriptive statistics section by SPSS23 statistical software, and in the inferential statistics section, the structural equation modeling method was used using Smart PLS3 statistical software.Research findings: The research findings indicate that the structural, relational and functional factors of social capital have an effect on organizational pessimism and explain it, and among the identified factors, the greatest intensity is related to the relational component, with the impact coefficient -0.672 and the factor load is 0.840.Conclusion: The special achievement of the present research shows the importance that by improving relations and increasing interactions among employees and professors and supporting management of such communication, the field of pessimism will be reduced to a great extent. Based on this, in terms of application, it can be claimed that by relying on the three elements of social capital, the level of organizational pessimism can be reduced in Payam Noor University, Guilan Province. Also, in terms of domestic research innovation with such a theme, it has not been seen in the country from a topical and spatial point of view.Introduction Considering that Payam Noor University is one of the active higher education centers in the country and provides a diverse range of services to students from various social categories, investigating negative behaviors and their consequences such as organizational pessimism and the prevalence of such malpractices , among its professors and employees, it can have long-term useful consequences for university managers and supervisors.Also, considering the high amount of work that Payam Noor University employees do and the fact that the dominant organizational structure of Iran's government organizations is bureaucratic, there is no doubt that the issue of job burnout, one of the most important aspects of which is organizational pessimism among The employees of government organizations, especially the employees of universities and educational centers, are increasing, and if such issues and problems are not addressed, in the long term, it will lead to a decrease in the job performance of employees and a decrease in organizational productivity.Therefore, dealing with behavioral issues with regard to the social capital component and playing its role can be very helpful. According to the explanations provided, the researchers in the current research are in line with answering this question, whether social capital can be the role of explaining behavioral dysfunctions such as organizational pessimism?Case study Payam Noor University of Guilan ProvinceMaterials and Methods The current research follows the paradigm of positivism in terms of philosophical foundations, and its orientation is of an applied and developmental type, because it seeks to apply the findings in the same context as the statistical community under investigation, and on the other hand, it adds to the boundaries of organizational and behavioral knowledge. Also, in terms of the research approach, it is of a comparative type and it aims to test the hypotheses by using a framework and a conceptual model. Also, the nature of the current research is quantitative research and the research environment is field and the collected data were collected in the real environment. In terms of the goal, the current research aims to explain and describe the investigated phenomena, the horizon of the research is also cross-sectional. The statistical population of the research, the centers of Payam Noor University in Guilan province were selected in the number of 23 centers, the total number of human resources (academic faculty and administrative staff) is 588 people and 220 people were selected as a sample based on the Cochran formula by cluster sampling method. . The data collection tool is a researcher-made questionnaire. The questionnaire used was obtained from an exploratory study. In order to analyze the data, the mean, standard deviation method was used in the descriptive statistics section by SPSS 23 statistical software, and in the inferential statistics section, the structural equation modeling method was used using SmartPLS statistical software.Discussion and Results The research findings indicate that the structural, relational and functional factors of social capital have an effect on organizational pessimism and explain it, and among the identified factors, the greatest intensity is related to the relational component, with the impact coefficient -0.672 and the factor load is 0.840.ConclusionThe special achievement of the present research shows the importance that by improving relations and increasing interactions among employees and professors and supporting management of such communication, the field of pessimism will be reduced to a great extent. Based on this, in terms of application, it can be claimed that by relying on the three elements of social capital, the level of organizational pessimism can be reduced in Payam Noor University, Guilan Province. Also, in terms of domestic research innovation with such a theme, it has not been seen in the country from a topical and spatial point of view.

Central 5-hydroxytryptaminergic dorsal raphe nucleus (5-HTDRN)-bed nucleus of stria terminalis (BNST) neural circuit dysfunction is one of the important neurobiological basis of anxiety and fear disorders. Under stress, 5-hydroxytryptamine (5-HT) neurons act on BNST receptors to attenuate anxiety and fear responses or enhance anxiety and fear. In BNST, corticotropin releasing factor neurons play a role in regulating emotions by reversely regulating excitatory or inhibitory 5-HT neurons. The composition of 5-HTDRNBNST neural circuit, the pathological changes of 5-HTDRN-BNST neural circuit function damage under stress, and the effects of 5-HTDRN-BNST neural circuit on anxiety disorder, panic disorder and post-traumatic stress disorder were analyzed and are summarized in this paper. The characteristics of functional changes of the neural circuit and its effects on brain functional activities provide a basis and ideas for the treatment of anxiety and fear disorders through the regulation of 5-HTDRN-BNST neural circuit, and they also provide a new perspective for understanding the pathological mechanism of such diseases. [ABSTRACT FROM AUTHOR]

Introduction: fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples' relationship or satisfaction. Thus, this systematic review and meta-analysis study was aimed to investigate the global prevalence of sexual dysfunction in men with thyroid gland disorders (TGD). Methods: this systematic review and meta-analysis study conducted based on PRISMA statement criteria regarding the available evidences representing the prevalence of sexual dysfunction in men with TGD. The initial searching process was applied on July, 2023. In this era, the main keywords of "Prevalence", "Sexual disorders", "Sexual disorder", "Sexual dysfunction", "Male sexual dysfunction", "Erectile dysfunction", "Males", "Men", "Thyroid disorders", "Thyroid diseases", "Hyperthyroidism", "Thyroid", and "Thyroiditis" were hired. Also, "AND" and "OR" operators were used for keywords combination. All intended studies were searched using the databases of Web of Science, Google Scholar, Scopus, ScienceDirect, PubMed, and Embase. Random effects model was used to perform the analysis and the heterogeneity of the studies was assessed through I2 index. Data analysis was applied with CMA software (v.2). Results: following the assessment of 17 eligible studies with a sample size of 501 individuals, the global prevalence of male sexual dysfunction with TGD was found 51.5% (95% CI:38.7–64). Also, the prevalence of male sexual dysfunction in hypothyroidism and hyperthyroidism cases was 59.1% (95% CI:37.2–77.8) and 41.5% (95% CI:25.9–59.1), respectively. The meta-regression analysis showed that following incremental trend in sample size, the global prevalence of male sexual dysfunction with TGD decreases. This assessment also revealed that the prevalence of male sexual dysfunction increases with the year of study conduction, significantly (p < 0.05). Conclusion: the global prevalence of sexual dysfunction in men with TGD was found relatively high. also, the highest prevalence of sexual disorders was reported in hypothyroid cases. Thus, health policymakers are suggested to inform the individuals prone to this pathology regarding the negative effects of TGD on sexual dysfunction. Besides, TGD-affected cases can prevent sexual disorders and unpleasant consequences through timely medical treatments. [ABSTRACT FROM AUTHOR]

Purpose: Neuromuscular deficits and atrophy after anterior cruciate ligament reconstruction (ACLR) may be accompanied by changes in muscle composition and poor quadriceps muscle quality (QMQ). Quadriceps atrophy occurs after ACLR but improves within the first three postoperative months, yet this hypertrophy could be attributable to increases in noncontractile tissue (i.e., poor QMQ). The purposes of this study were to evaluate changes in QMQ after ACLR and to determine if changes in QMQ and cross-sectional area (CSA) occur in parallel or independently. Methods: A longitudinal prospective cohort design was implemented to evaluate QMQ and CSA in 20 individuals with ACLR and 12 healthy controls. Participants completed three testing sessions (baseline/presurgery, 1 month, and 3 months) during which ultrasound images were obtained from the vastus lateralis (VL) and rectus femoris (RF). QMQ was calculated as the echo intensity (EI) of each image, with high EI representing poorer QMQ. Anatomical CSA was also obtained from each image. Results: RF and VL EI were greater at 1 and 3 months in the ACLR limb compared with baseline and the contralateral limb and did not change between 1 and 3 months. VL and RF CSA in the ACLR limb were smaller at 1 and 3 months compared with the contralateral limb and controls (VL only) but increased from 1 to 3 months. Changes in QMQ and CSA were not correlated. Conclusions: QMQ declines within the first month after ACLR and does not improve by 3 months although hypertrophy occurs, suggesting that these morphological characteristics change independently after ACLR. Poorer QMQ represents greater concentration of noncontractile tissues within the muscle and potentially contributes to chronic quadriceps dysfunction observed after ACLR. [ABSTRACT FROM AUTHOR]

Early evaluation of β-cell dysfunction of hyperglycemic patients in asymptomatic adults would be valuable for timely prevention of the diabetes. This study aimed to evaluate functional changes in the pancreas using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and determine whether it could be used as a non-invasive method of assessing β-cell dysfunction. This prospective cohort study was conducted from August 2022 to November 2022 in Jinan University Affiliated Guangdong Second General Hospital. Three groups were enrolled and underwent IVIM-DWI: confirmed patients with type 2 diabetes (T2DM); hyperglycemic patients in asymptomatic adults; and the volunteers with normal glucose tolerance (NGT). Imaging parameters were obtained: apparent diffusion coefficient (ADC), the true diffusion coefficient (D t), the pseudo-diffusion coefficient (D p), and the perfusion fraction (f). The β-cell function indexes were calculated from blood examinations: composite insulin sensitivity index (ISI), 60-min insulinogenic index (IGI60), and the disposition index (DI). We compared imaging parameters among three groups, calculated the diagnostic performance of them for differentiating different groups, and the reproducibility of them was evaluated using intraclass correlation coefficient (ICC). The imaging parameters except f gradually decreased among the groups with significant differences for ADC (p < 0.0001), D t (p < 0.0001), and D p (p = 0.013). D t demonstrated the best diagnostic performance for differentiating asymptomatic patients from NGT (Area Under Curve [AUC] = 0.815, p < 0.0001). IVIM-DWI parameters correlated with composite ISI and DI, of which, D t has the highest correlation with DI (Pearson correlation coefficient [r] = 0.546, p < 0.0001). The ICC of IVIM-DWI parameters was very good, D t was highest (Interobserver ICC = 0.938, 95% Confidence Interval [CI], 0.899–0.963; Intraobserver ICC = 0.941, 95% CI, 0.904–0.965). IVIM-DWI is a non-invasive quantitative method that can identify β-cell dysfunction in the pancreas. [ABSTRACT FROM AUTHOR]

Introduction: There is limited knowledge on cognitive performance in Behçet’s disease (BD), the majority of which come from patients with neuro-Behçet’s disease. However, the influence of BD on cognitive function in patients without neurological involvement is still not well understood. The aim of the study was to determine the frequency of cognitive involvement in BD patients without evident neuropsychiatric symptoms and to identify associated clinical variables in those patients. Material and methods: Forty BD patients who fulfilled the diagnostic International Criteria for Behçet ‘s Disease (ICBD) without obvious neuropsychiatric manifestations were studied and compared with forty healthy controls matched for age, sex, and education. A comprehensive medical history, rheumatological, neurological, psychiatric, and psychometric assessment were applied for all patients. Behçet’s disease Current Activity Form (BDCAF) was used to assess disease activity. For patients as well as controls, validated Arabic versions of the Wechsler Adult Intelligence Scale-Revised and Wechsler Memory Scale-Revised were used for assessment of cognitive function. Anxiety and depression were additionally assessed for both groups using the anxiety and depression subdivisions of the Arabic Version of Symptom Checklist 90 Revised. Results: Cognitive impairment was identified in 37.5% of BD patients compared to none of the controls. Memory represents the cognitive domain most frequently affected. Cognitive involvement was significantly associated with current corticosteroid use and depression as measured by SCL-90-R. On the other hand, neither the activity of the disease nor the level of anxiety was associated with cognitive involvement. Conclusions: Cognitive dysfunction is reported in BD patients distinctly and independently of clinically overt neurologic involvement. Prevalence of cognitive impairment in patients with BD is strikingly high at 37.5%, whereas the control group exhibited no such signs. Psychological assessment should be performed for every BD patient to reveal any cognitive involvement. It is highly recommended to encourage psychological intervention to prevent any further deterioration, especially in patients who are experiencing depression or currently using corticosteroids. [ABSTRACT FROM AUTHOR]

How do people understand the concepts of mental health and disorder? The objective of this paper is to examine the impact of several factors on people’s judgments about whether a condition constitutes a mental disorder or a healthy state. Specifically, this study examines the impact of the source of the condition, its outcome, individual valuation (i.e., the value the individual attaches to the condition), and group valuation (i.e., the value the relevant group attaches to the condition). While we find that people’s health and disorder judgments are driven by perceived dysfunction, we also find that health and disorder judgments are impacted differently by these factors. Health judgements are impacted by outcome and individual valuation, and disorder judgments are impacted by condition source. These results suggest that the folk concept of mental health is positive (i.e., mental health is more than the absence of mental disorder) and normativist (i.e., value judgments play a significant role in determining whether a condition counts as healthy), while the concept of mental disorder aligns with a naturalist perspective, at least to the extent that dysfunction plays an important role in categorizing a condition as a disorder. However, our finding that people’s dysfunction judgments are influenced by individual valuation and outcomes poses a strong challenge to naturalist accounts. [ABSTRACT FROM AUTHOR]

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Chronic fatigue syndrome (CFS) causes great harm to individuals and society. Elucidating the pathogenesis of CFS and developing safe and effective treatments are urgently needed. This paper reviews the functional changes in the hypothalamus-pituitary-adrenal (HPA) axis in patients with CFS and the associated neuroendocrine mechanisms. Despite some controversy, the current mainstream research evidence indicates that CFS patients have mild hypocortisolism, weakened daily variation in cortisol, a weakened response to the HPA axis, and an increase in negative feedback of the HPA axis. The relationship between dysfunction of the HPA axis and the typical symptoms of CFS are discussed, and the current treatment methods are reviewed. [ABSTRACT FROM AUTHOR]

Background: Diabetes, as the most common disease caused by metabolic disorders, is associated with several compli-cations, including ocular complications. The aim of this cross-sectional study was to determine the fre-quency of meibomian gland dysfunction and dry eye in patients with diabetes. Materials and Methods: In this descriptive-analytical cross-sectional study, patients with type 2 diabetes referred to the eye clinic of Farshchian Hospital (Sina) from December 2019 to October 2020 were included. Data were collected on the patients’ demographic characteristics, duration of diabetes, and HbA1c using a pre-designed checklist. The severity of dry eye was assessed by the tear breakup time (TBUT) test, while meibomian gland disorder and ocular complications were evaluated by a slit lamp. Results: In this study, 267 patients with type 2 diabetes participated. The mean age of the patients was 59.8 years, and 44.2% of them were male. Mild, moderate, and severe dry eye were observed in 34.1%, 18.0% and 5.2% of the patients, respectively. Grades 1, 2, and 3 of meibomian gland dysfunction were observed in 32.6%, 15.7%, and 5.2% of the patients respectively. Patients with poor glycemic control had higher se-verity of dry eye (p<0.001) and more meibomian gland dysfunction (p<0.001). Conclusion: Dry eye and meibomian gland dysfunction have a high prevalence in patients with diabetes mellitus, and more severe dry eye and meibomian gland dysfunction are associated with poor glycemic control and longer duration of diabetes diagnosis. [ABSTRACT FROM AUTHOR]