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Background: Sexual behavior disorders in intellectual disability form several challenges, despite evolutions in treatment options and risk assessment. The use of antilibidinal pharmacotherapy in this population is controversial and research is inconclusive about the most appropriate treatment strategy., Aim: To highlight pharmacotherapeutic management of sexual behavior disorders in intellectual disability, its medical and ethical considerations., Method: A literature review to provide an overview of the available literature, which was elaborated based on clinical experience., Results: We found a lack of scientific evidence on the efficacy of pharmacotherapy specifically for sexual behavior disorders in people with intellectual disabilities. The routine use of antilibidinal medication is contraindicated. Medical and ethical guidelines have been published as well as contraindications for initiating androgen deprivation therapy in the general population. The necessity of pharmacotherapy should be closely monitored and supplemented with psychotherapeutic care to cultivate the patient’s sexual skills, attitudes and knowledge. A distinction should be made between sexual behavior disorders of the ‘paraphilic type’ and of the ‘sexually maladjusted or naive type’., Conclusion: Multidisciplinary evaluation, risk assessment and an individualized approach are the cornerstones of high-quality treatment of sexual behavior disorders in persons with intellectual disability.

Articular cartilage defects represent an unsolved clinical challenge. Photopolymerizable hydrogels are attractive candidates supporting repair. This study investigates the short-term safety and efficacy of two novel hyaluronic acid (HA)-triethylene glycol (TEG)-coumarin hydrogels photocrosslinked in situ in a clinically relevant large animal model. It is hypothesized that HA-hydrogel-augmented microfracture (MFX) is superior to MFX in enhancing early cartilage repair, and that the molar degree of substitution and concentration of HA affects repair. Chondral full-thickness defects in the knees of adult minipigs are treated with either 1) debridement (No MFX), 2) debridement and MFX, 3) debridement, MFX, and HA hydrogel (30% molar derivatization, 30 mg mL -1 HA; F3) (MFX+F3), and 4) debridement, MFX, and HA hydrogel (40% molar derivatization, 20 mg mL -1 HA; F4) (MFX+F4). After 8 weeks postoperatively, MFX+F3 significantly improves total macroscopic and histological scores compared with all other groups without negative effects, besides significantly enhancing the individual repair parameters "defect architecture," "repair tissue surface" (compared with No MFX, MFX), and "subchondral bone" (compared with MFX). These data indicate that photopolymerizable HA hydrogels enable a favorable metastable microenvironment promoting early chondrogenesis in vivo. This work also uncovers a mechanism for effective HA-augmented cartilage repair by combining lower molar derivatization with higher concentrations., (© 2023 The Authors. Advanced Healthcare Materials published by Wiley-VCH GmbH.)

Glycerol is commonly employed for denitrification purposes in full-scale wastewater treatment. In non-acclimatized biomass, the glycerol is very inefficient resulting in a high C/N ratio and low-standard denitrification rates. The acclimatization is driven by the microbial enrichment of Saccharimonadales and Propionibacteriales as found in different sampled municipal sludges flanking the dominant presence of Burkholderiales. The selective strategy is based on a very efficient process in terms of C/N ratios and standard denitrification rates, but it leads to nitrite accumulation. As a result, severe and unexpected nitrous oxide emissions were found in full-scale with emission factors up to 2.5% kgN 2 O (kgKJN removed ) -1 . Simultaneous dosage of isobutirate in a full-scale experiment could counter the nitrous oxide emissions. As nitrous oxide emissions were found proportional to the dosed glycerol-based COD, the authors suggest that, in case of acclimatization of biomass to glycerol, an emission factor based on the dosed COD should substitute the general nitrous oxide emission factors based on incoming or removed nitrogen to the plant.

The quality of communication between romantic partners has consistently been found to be associated with relationship well-being and stability. Studies on sexual and nonsexual communication, however, have typically assessed communication skills and behaviors using self-report measures. The use of observational methods has several advantages, including the ability to capture and allow for the independent coding of both partners' communication behaviors. With few exceptions, research applying observational methods has not distinguished between sexual and nonsexual communication behaviors. In the present study, we asked 126 young, mixed-sex couples to engage in sexual and nonsexual conflict discussions. The two 7-min discussions were videotaped and rated by trained coders on nine behavioral dimensions using an adaptation of the specific affect coding system (Gottman & Krokoff, 1989) and the system for coding interactions and family functioning (Lindahl & Malik, 2001). Coder ratings applied to the discussion as a whole. Analyses included factor analysis on the behavioral dimensions and multilevel modeling incorporating the actor-partner interdependence model (APIM). We found significant differences in how couples interacted during the two discussions, with more positive (affectionate and validating) and less negative behaviors during sexual discussions as compared to nonsexual discussions. In both women and men, expressions of positivity during the two types of conflict discussions were associated with higher relationship satisfaction. Gender differences were found in the association between negative behaviors during sexual discussions and relationship satisfaction, with men but not women's negative behaviors being associated with lower relationship satisfaction. These findings point at distinct qualities of sexual communication and its association with couples' relational well-being and contribute to a better scientific understanding, with clinical relevance, of sexual and nonsexual communication., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

We examined if and to what degree attachment orientations of both partners moderate the link between different behavioral characteristics of the sexual relationship and relationship satisfaction in the early stages of romantic attachment. A sample of 126 young, mixed-sex couples ( N  = 252, mean age = 23.3, SD  = 2.4; average relationship duration = 1.9 years, SD  = 0.9) filled out questionnaires assessing attachment anxiety and avoidance, a range of intimate and sexual couple behaviors, and relationship satisfaction. Exploratory factor analyses revealed two behavioral factors: Intimate behavior (kissing, cuddling) and sexual behavior (oral sex, coitus). Although frequency of sexual behavior was not directly associated with relationship satisfaction, we found a significant positive interaction with anxious attachment, indicating that higher frequencies of sexual behavior were associated with greater self-reported relationship satisfaction in more anxiously attached individuals. Exploration of the effects of intimate behaviors on relationship satisfaction revealed significant positive associations as well, but, unexpectedly, only for avoidantly attached individuals. These results call for a dyadic and differentiated approach to the study of sexuality in couples and are in line with prior findings that the impact of intimate and sexual behaviors on relationship satisfaction varies depending on attachment orientations.

The role of oxytocin (OT) in close relationships is complex, as both positive and negative associations have been found between OT and relationship processes. Also, with most research focusing on the effects of exogenous OT administration on communication and couple behaviors, our knowledge about the association between endogenous OT and couple dynamics remains limited. This study is the first to assess the link between peripheral OT levels and observed communication behaviors during sexual and nonsexual conflict discussions in romantic relationships. A sample of 126 young, heterosexual couples (Mean age = 23.3, SD = 2.4; average relationship duration = 1.9 years, SD = 0.9) participated in videotaped sexual and nonsexual couple conflict discussions of 7 min each. Communication behaviors were coded using an adaptation of the Specific Affect Coding System (SPAFF) and the System for Coding Interactions and Family Functioning (SCIFF). Blood samples were collected prior to the couple discussions, during a separate lab visit, and OT plasma levels were determined using enzyme-linked immunosorbent assays (ELISA). Plasma OT levels were positively associated with validating behaviors during sexual discussions in both women (r = +.24, p = .008) and men (r = +.18, p = .052). No significant associations were found between OT levels and validating behaviors during nonsexual discussions and between OT and affectionate and negative behaviors during either sexual or nonsexual discussions. Analyses revealed significant associations between OT levels and one's own validating behaviors during sexual discussions (b = 47.82, t(201.16) = 3.81, p < .001) and one's partner's (b = 32.12, t(216.35) = 2.62, p = .009). The results highlight the biobehavioral aspects of couples' sexual communication and may contribute to a better understanding of the processes involved in individual and relational well-being. This study is the first to report an association between peripheral OT levels and validating behaviors during sexual communication, indicating neurophysiological involvement in dyadic sexual communication patterns., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Although their individual contributions to sexual and relational outcomes are well-established, there has been a lack of research on the importance of sexual frequency and sexual communication to sexual and relationship satisfaction., Aim: To examine the contribution of sexual frequency and sexual communication to sexual and relationship satisfaction in the early stages of couple relationships., Methods: A sample of 126 young, heterosexual couples (mean age = 23.3 years, SD = 2.4; average relationship duration = 1.9 years, SD = 0.9) filled out questionnaires about sexual frequency, sexual communication, and sexual and relationship satisfaction. Analyses were guided by the actor-partner interdependence model., Outcomes: Main outcome variables were sexual satisfaction and relationship satisfaction, measured by the Quality of Sex Inventory and the Couple Satisfaction Index, respectively., Results: Analyses revealed a significant actor effect of both sexual communication and sexual frequency for sexual satisfaction. Only sexual communication, not sexual frequency, predicted relationship satisfaction. No significant partner or gender effects were found., Clinical Translation: These findings lend support to the notion that couples could benefit from focusing on non-behavioral processes (eg, sexual communication), rather than sexual behavior per se, when pursuing a fulfilling partnership., Strengths & Limitations: Strengths of the study include the dyadic nature of the data and analyses, allowing for the evaluation of both individual- and couple-level processes. Also, to our knowledge, this is the first study to specifically examine the importance of sexual frequency and sexual communication to both sexual and relationship satisfaction. Limitations include the reliance on self-report measures and a relatively homogeneous sample., Conclusion: Although both sexual frequency and sexual communication were relevant to the prediction of sexual satisfaction, only sexual communication predicted relationship satisfaction in this sample of young, heterosexual couples. Roels R, Janssen E. Sexual and Relationship Satisfaction in Young, Heterosexual Couples: The Role of Sexual Frequency and Sexual Communication. J Sex Med 2020;17:1643-1652., (Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.)

In patients with a deep brain stimulator (DBS), electroconvulsive therapy (ECT) has proven to be a safe and effective treatment option after several medication failures in major depression, especially in the presence of psychotic symptoms. Electroconvulsive therapy has also proven to be effective in the treatment of Parkinson's disease (PD). To date, there have been no reports on the effect of ECT on motor function in PD patients with a functioning DBS. We present the case of a woman with DBS as a treatment for PD, safely treated with ECT for a psychotic depression. Depression severity and motor changes were evaluated on a weekly basis using the Montgomery-Åsberg Depression Rating Scale and the Unified Parkinson's Disease Rating Scale. During the course of ECT, the Montgomery-Åsberg Depression Rating Scale score declined from 34 to 13, and the Unified Parkinson's Disease Rating Scale motor score from 44 to 12 with positive impact on rigidity. Considering the positive impact of ECT on the motor function in our patient, new research should look into ECT as an augmentation strategy in motor dysfunction in patients treated with DBS for PD.