Male Age Research Articles

Prostatic androgen receptor signaling shows an age-related and lobe-specific alteration in mice

Benign prostatic hyperplasia (BPH) is an age-related disease that affects millions of aging males globally. While the pathogenesis of BPH remains incompletely understood, emerging evidence suggests a pivotal role for the androgen receptor (AR) in mediating prostate growth and function. Understanding age-related AR signaling alteration may inform novel BPH treatments. Here, we analyzed the prostatic protein expressions of AR, NKX3.1, and Ki-67 in young (2 months) and aged (24 months) mice. We also examined the potential mechanism of AR protein expression. Compared to young mice, decreased AR and NKX3.1 protein expression was observed in the anterior prostate (AP) and ventral prostate (VP) of aged mice, indicating reduced AR signaling in these prostate lobes. Additionally, we observed decreased protein expression of proliferation maker Ki-67 in aged AP, VP, and dorsal-lateral prostate (DLP), with no difference in apoptosis as compared to young counterparts. We conclude that prostatic androgen receptor signaling shows an age-related and lobe-specific alteration in mice.

From ocean to emotion: a pilot study exploring acute mood effects following consumption of a DHA-rich powder compared with placebo in middle-aged Australian men.

While there is evidence that long-chain n-3 PUFA supplementation benefits mood, the extent to which a single high dose of n-3 PUFA can induce acute mood effects has not been examined. The present study investigated whether a single dose of a DHA-rich powder affects self-reported mood in middle-aged males during elevated cognitive demand. In a randomised, double-blind, placebo-controlled trial with a balanced crossover design, twenty-nine healthy males (age M = 52.8 years, sd = 5.3) were administered a powder (in a meal) containing 4·74 g n-3 PUFA (DHA 4020 mg; EPA 720 mg) or placebo in random order on two different testing days separated by a washout period of 7 ± 3 d. Participants completed mood assessments before and after completing two cognitive test batteries at baseline and again 3·5-4·0 h following the consumption of the active treatment or placebo. While completion of the cognitive test batteries increased negative mood, differential effects for alertness (P = 0·008) and stress (P = 0·04) followed consumption of the DHA-rich powder compared with placebo. Although alertness declined when completing the cognitive batteries, it was higher following consumption of the DHA-rich powder compared with placebo (P = 0·006). Conversely, stress was lower following consumption of the DHA-rich powder relative to placebo, though this difference only approached significance (P = 0·05). Overall, results from this pilot study demonstrate that a single high dose of n-3 PUFA may deliver acute mood benefits following elevated cognitive demand in healthy middle-aged males.

Relationship between hand and wrist bone age assessment method and application to male children

Objective: To explore the interrelationship among three simplified hand and wrist bone age assessment methods and to establish corresponding bone ages for each substage in male children. Methods: This retrospective case series study included 169 left hand and wrist X-rays from 152 male children who underwent bone age assessments at the Pediatric Orthopedics and Pediatrics Departments,Beijing Jishuitan Hospital,Capital Medical University from January 2019 to December 2023. The age at the time of X-ray was (13.7±2.0) years (range:9.1 to 17.9 years). Reasons for bone age assessment included evaluating the progress of adolescent idiopathic scoliosis in 36 cases, predicting limb length discrepancies in 28 cases, and predicting the height of healthy adolescents in 88 cases. Bone age was first graded using the Chinese hand-wrist bone age assessment method. Three simplified hand and wrist bone age assessment methods were then applied:Sanders simplified skeletal maturity staging system(Sanders stage), the distal radius and ulna classification (DRU), and e thumb ossification composite index (TOCI). Somers'delta correlation test was used to analyze the relationship among the results of the three simplified methods. The bone age and standard deviation for each sub-stage were calculated, and gender differences in bone age for the same sub-stage were compared with previous study. Results: The DRU, TOCI and Sanders stages showed a strong correlation when assessing bone age in male children, with Somers'delta correlation coefficients ranging from 0.881 to 0.876 (all P<0.01). The sub-stages with the smallest standard deviations (shorter duration) in each of the three classifications can serve as a quick reference for determining precise bone age, included proximal thumb epiphysis covered, without sesamoid (12.0 years);proximal thumb epiphysis covered with sesamoid or distal radial covered (13.0 years), early capping of the thumb epiphysis, radial epiphysis medial side capping(13.5 years), all phalangeal epiphyses capping (14.0 years), distal phalangeal physes beginning to close (14.5 years), all distal phalangeal physes closed (15.0 years), middle or proximal phalangeal physes beginning to close (15.5 years), all digital epiphyses closed (16.5 years), and nearly complete distal radius fusion with a notch (17.5 years). On average, the bone ages of males were 2 years behind those of females in the same substage. Conclusions: The DRU, TOCI, and Sanders stages can be applied to male children, and it is showed good correlation between them. The subtypes with shorter duration can be used as a quick assessment method to determine the bone age.

Using Routinely Collected Health Data to Estimate the Prevalence of Alzheimer's Disease and Potentially Modifiable Risk Factors in Colombia.

With an increasing prevalence, Alzheimer's Disease (AD) is the most common cause of dementia. However, a percentage of potentially modifiable cases have been reported. This article describes the prevalence of four of these potentially modifiable risk factors: hearing loss, diabetes mellitus (DM), obesity, and hypertension. Descriptive cross-sectional study with data from 2018 to 2022, using the Colombian health system database SISPRO. The population of this study consisted of all people within the age range 50-100 with a main diagnosis of AD according to the ICD-10 codes. Subjects were divided by decades, and the prevalence ratio (PR) for the outcome of AD and each of its potentially modifiable risk factors was then calculated and adjusted by age using the Mantel-Haenszel formula. 167,556 cases of AD were identified, with 66.4% being females. Peak age was in octogenarians, and the five-years period prevalence for people older than 50 was 12.6 cases/1000 people. The PRs showed a positive association for all risk factors, except obesity. Following age correction, obesity's PR value shifted to positive in males and overall population but remained negative for females. The highest post-correction PR in the overall population was hypertension (1.44), followed by DM (1.34), hearing loss (1.31) and obesity (1.12). Notably, PRs had a greater magnitude in younger and male age groups. The results of this study are consistent with the fact that the prevalence of potentially modifiable risk factors is higher within the group of people with AD as their main diagnosis.

Ageing and environment affect female more than male color in a mutually ornamented bird

Abstract Color ornamentation is often sexually selected as a signal of condition, which may be affected by the environment and senescence, but long-term studies in mutually ornamented species are rare, limiting our understanding of sex-specific senescence. We measured color ornamentation of 60 common waxbills (Estrilda astrild) after capture from the wild and in 4 autumns in a large open-air mesocosm. We found longitudinal decreases in the size of the red mask and redness of plumage and bill color, consistent with senescence. Bill color decreased more in females. In males, there was a longitudinal increase in the size of the red breast patch. We also found increased color ornamentation, especially in females, when moving from the wild to the mesocosm, likely due to environmental effects. Monitoring waxbills in bird cages suggested that bill and plumage redness peak in the breeding season. Stronger senescence and environmental effects in females indicate cautious investment in ornamentation, while weaker senescence in males could be due to stronger sexual selection. Overall, although similarly ornamented, the sexes differ in their temporal investment in ornamentation, in line with their life-histories.

Role of Air Pollution in Development of Hepatocellular Carcinoma Among Chronic Hepatitis B Patients Treated With Nucleotide/Nucleoside Analogues.

To investigate the association between air pollution and hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients treated with nucleotide/nucleoside analogues. We enrolled 1298 CHB patients treated with nucleotide/nucleoside analogues and analysed the incidence and risk factors for HCC. Daily estimates of air pollutants were estimated since the previous year from the enrolment date. The annual incidence of HCC was 2.1/100 person-years after a follow-up period of over 4840.5 person-years. Factors with the strongest association with HCC development were liver cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 3.00/1.55-5.81; p = 0.001), male sex (2.98/1.51-5.90; p = 0.02), body mass index (1.11/1.04-1.18; p = 0.002) and age (1.06/1.04-1.09; p < 0.001). Among patients with cirrhosis, the factors associated with HCC development were male sex (HR/95% CI: 2.10/1.00-4.25; p = 0.04) and NO2 (per one-unit increment, parts per billion; 1.07/1.01-1.13; p = 0.01). Moreover, patients with the highest quartile of annual NO2 exposure had more than a three-fold risk of HCC than those with the lowest quartile of annual exposure (HR/95% CI: 3.26/1.34-7.93; p = 0.01). Among patients without cirrhosis, the strongest factors associated with HCC development were male sex (HR/95% CI: 5.86/1.79-19.23; p = 0.004), age (1.12/1.07-1.17; p < 0.001) and platelet count (0.99/0.98-1.00; p = 0.04). Air pollution influences HCC development in CHB patients who receive nucleotide/nucleoside analogue therapy. Long-term NO2 exposure might accelerate HCC development in CHB patients with cirrhosis receiving nucleotide/nucleoside analogue treatment.

Meta-analysis of the Effectiveness of Acupuncture Treatment in Shoulder Pain

In this meta analysis, it was aimed to evaluate effectiveness of acupuncture treatment in shoulder pain. Nine articles with 10 samples were chosen for the study out of the 668 acupuncture research studies that were evaluated on scholarly databases (15–23). The ages, female to male ratios, and initial and final Visual Analog Scale (VAS) pain levels of research participants were recorded. A total of 365 shoulder pain patients including 238 (65.20%) females and 127 (34.80%) males were subjected to acupuncture treatment. VAS difference mean was -2.66 with 0.87-4.80 range. Age means of shoulder pain patients ranged from 30.8 to 56.81 with 47.66 mean. In all study samples, VAS differences between control group and acupuncture group were significant (p&lt;0.05). Spearman’s rho correlation analysis results showed that only female frequency was significantly correlated with VAS difference (r=-0.760; p&lt;0.05). Correlation between male frequency and age were insignificant (p&gt;0.05). Generalized Linear model (Logit) results showed that effects of gender frequency and age were statistically insignificant (p&gt;0.05). Acupuncture treatment is effective in shoulder pain for individuals of all ages and genders, but this level of effectiveness is higher in men. However, more samples, clinical studies and meaningful regression analysis results are needed to make this generalization.

The Who’s, What’s, and “Y”s: Y Sex Chromosome Loss and Methylation for Analysis in Male Aging and Mortality and Forensic Science Applications

The Y chromosome plays a crucial role in understanding the overall landscape of male health. Incorporating the Y chromosome into genomic and epigenomic research may elucidate the male-specific mechanisms behind aging and the pathogenesis of certain conditions, both acute and chronic. Present epigenetic research focuses on the effects of modifications like methylation on autosomal chromosomes. However, little research has been conducted to further these investigations in sex chromosomes, especially the Y chromosome. Epigenetic analyses can identify age-associated CpG sites that may offer potential biomarkers for age estimation and disease risk assessment, among others. This review emphasizes interdisciplinary efforts that have been made in the construction of an assembly and the application of “epigenetic clocks” to the Y chromosome. The studies reviewed here examined the effects of aging on genes such as NLGN4Y, DDX3Y, and TBL1Y, and on male-specific health disparities and disease etiologies, as well as the potential for the use of these genes to assess the diagnostic and age algorithmic potential of Y-specific genes.

Circulating levels of blood biomarkers and risk of benign prostatic hyperplasia: Results from two large cohorts in Europe and East Asia.

As one of the most prevalent chronic non-communicable diseases affecting aging males, the burden of benign prostatic hyperplasia is growing over the world. Our study aims at investigating the potential relationships between various blood biomarkers and benign prostatic hyperplasia (BPH) in middle-aged and older men in European and East Asian population cohorts. We included 229 022 male adults from the UK Biobank (UKB) and 20 284 male adults from the China Health and Retirement Longitudinal Study (CHARLS) in this study. Forty-four blood biomarkers in UKB cohort and 16 blood biomarkers in the CHARLS cohort were analysed to examine their association with benign prostatic hyperplasia. Cox, logistic analyses and restricted cubic spline models were used to investigate linear and nonlinear longitudinal associations. In our research, elevated high-density lipoprotein cholesterol showed significant associations with a decreased risk of benign prostatic hyperplasia, and these associations remained significant after accounting for potential covariates both in UKB cohort (hazard ratio (HR) = 0.83; 95% CI = 0.79-0.88, P < 0.001) and CHARLS cohort (odds ratio (OR) = 0.992; 95% CI = 0.985-0.999, P = 0.033). Apolipoprotein A was also found to be inversely associated with BPH (HR = 0.76; 95% CI = 0.70-0.81, P < 0.001). L-shaped relationships were discovered between level of high-density lipoprotein cholesterol and apolipoprotein A with incidence of benign prostatic hyperplasia. This large prospective biomarker-based study highlights that high-density lipoprotein (HDL) cholesterol and apolipoprotein A are significant protective factors against the development of BPH, with L-shaped associations suggesting an optimal protective range. In contrast, biomarkers related to glucose metabolism, inflammation, and hormone levels were not found to significantly influence BPH progression. Our findings support the potential involvement of lipid biomarkers in the early stages of BPH development, suggesting that future strategies should prioritise lipid-related pathways in the prevention and management of BPH.

Specific aspects of considering the age of male swimmers age in a process of long-term training and sports excellence planning

Specific aspects of considering the age of male swimmers age in a process of long-term training and sports excellence planning

Perioperative and Oncologic Outcomes of Hepatic Arterial Infusion (HAI) Pump Chemotherapy for Patients with Unresectable Colorectal Liver Metastases at an Expanding HAI Program.

Hepatic arterial infusion (HAI) is an established treatment for patients with unresectable colorectal liver metastases (uCRLM). Until recently, HAI was only performed at a limited number of centers. We previously reported early outcomes suggesting that implementation of a new HAI program is safe and feasible. Here, we report perioperative and oncologic outcomes from an expanded series of patients with uCRLM treated with HAI. We analyzed outcomes from consecutive patients with uCRLM who underwent HAI pump (HAIP) placement at Duke University Hospital from 2018 to 2023. Demographics, prior treatment, and perioperative and oncologic outcomes were assessed. Overall, 102 patients underwent HAIP placement for uCRLM; 62% were male and median age was 51years. Most patients (97%) received a median of 12 (range 0-66) prior chemotherapy cycles. Postoperative HAI-specific complications occurred in 23% of patients, including biliary sclerosis in 6%, and the 90-day mortality rate was 3%. 20% converted to resection, 4% underwent transplant, and 2% achieved complete response at 6 months after floxuridine initiation. Median hepatic and extrahepatic progression-free survival (PFS) was 15.7 months and 11.6 months, respectively. Median overall survival (OS) was 38 months from the time of pump implantation (median follow-up time: 30 months). HAI for uCRLM is safe, feasible, and effective at a new center, with outcomes that recapitulate those previously reported by established centers. Future analysis of our institutional data, which includes mutation status, primary tumor sidedness, and extent of prior therapy could inform selection and treatment strategies for new HAI programs.

Reconstructing the Stem Leydig Cell Niche via the Testicular Extracellular Matrix for the Treatment of Testicular Leydig Cell Dysfunction

AbstractTherapies involving the use of stem Leydig cells (SLCs), as testicular mesenchymal stromal cells, have shown great promise in the treatment of Leydig cell (LC) dysfunction in aging males. However, the outcomes of these therapies are not satisfactory. In this study, it is demonstrated that the aging microenvironment of the testicular interstitium impairs the function of SLCs, leading to poor regeneration of LCs and, consequently, inefficient functional restoration. The study develops a decellularized testicular extracellular matrix (dTECM) hydrogel from young pigs and evaluates its safety and feasibility as a supportive niche for the expansion and differentiation of SLCs. dTECM hydrogel facilitates the steroidogenic differentiation of SLCs into LCs, the primary producers of testosterone. The combination of SLCs with a dTECM hydrogel leads to a significant and sustained increase in testosterone levels, which promotes the restoration of spermatogenesis and fertility in an LC‐deficient and aged mouse model. Mechanistically, collagen 1 within the dTECM is identified as a key factor contributing to these effects. Notably, symptoms associated with testosterone deficiency syndrome are significantly alleviated in aged mice. These findings may aid the design of therapeutic interventions for patients with testosterone deficiency in the clinic.

Determination of the Surgical Landmarks for the Anterior and Middle Cranial Fossa in Dry Skulls With the Photography System, Cadavers and 3-Dimensional Computed Tomography

The present paper was designed to analyze the dimensions of such important bony structures and surgical landmarks, which are used by many clinicians in many surgical interventions, in dry skull, cadaver, and healthy subjects on computed tomography (CT) images, and to determine whether there is a significant difference between these methods, and to obtain reference values from 3 different methods. Eight cadavers and 16 dry skulls and 100 three-dimensional (3D) CT images were studied. Necessary permissions for the study were obtained from Ethics Comittee. The 16 parameters were measured with an electronic digital caliper accurate 0.01 mm (LCD Digital Vernier Dial Microcaliper (INCA, DCLA-0605, 0.6–150 mm, USA). Also, the images obtained were transferred to the 3D Slicer (version 5.6.2) software program. Eight cadavers and 16 dry skulls of Turkish adults were unknown age and sex, whereas the mean age of females and males on CT images were 31.63±11.23 and 33.70±13.34 years, respectively. All values of the surgical landmarks for the anterior and middle cranial fossa obtained from cadavers, dry skulls, and 3D CT subjects (except length of lesser wing, anterior clinoid lengths for 2 sides, and width for right side) were statistically significant between 3 groups (P&lt;0.05). This paper was conducted for the morphometric analysis of the specific regions of the anterior cranial fossa (ACF), and middle cranial fossa (MCF), which are used in neurosurgical procedures This detailed anatomic and radiologic reference values will be an extremely important source in the planning of both clinical and surgical approaches for neurosurgeon, anatomist, and radiologists.

Predicting Barbell Release Speed from Peak Speed in the Bench Press Throw via a Linear Position Transducer

ABSTRACT Upper body force-velocity profiles to assess musculoskeletal performance are created using release speed (RS) of the barbell in a bench press throw (BPT). A more easily obtained variable is peak speed (PS) measured by a linear position transducer. We assessed the validity of predicting RS from measured PS. One hundred and seventy-eight throws from ten male participants age (mean ± SD) 27 ± 5 yrs, mass 88 ± 13 kg with minimum one year of resistance training performed the BPT with increasing loads on a Smith machine. Correlation revealed an exponential relationship of RS = 0.26e0.9(PS), (R2 = 0.96, p < .05). We assessed predictive validity by comparing the measured RS of the barbell in each throw to the RS estimated by this formula. Bland-Altman analysis showed the 95% limit of agreement was 0.26 m∙s−1 to 0.18 m∙s−1, with a mean difference of 0.04 m∙s−1 (2.92%), determining that PS may be used to estimate RS.

Investigating the Relationship between Emotion Regulation Strategies and Anxiety Caused by COVID-19 in Employees of Rehabilitation Centers

Background and Objectives: In the current situation, it is essential to determine the level of anxiety in medical and non-medical employees due to the pandemic. Therefore, this research aims to assess the relationship between corona anxiety, emotion regulation strategies, and stress tolerance among the staff of rehabilitation centers in Tehran Province, Iran. Methods: This study was descriptive, cross-sectional, and correlational. The statistical population of the present study included the entire staff of rehabilitation centers served by the Welfare Organization of Tehran Province in 2022. Using simple random sampling, 10 rehabilitation centers were selected as study centers. Subsequently, 200 employees of these centers were selected and tested using Morgan’s sampling table (the male age of the participants was 31.5 years). The data collection instruments included the corona disease anxiety scale, the emotional distress tolerance questionnaire (2005), and the March emotional self-regulation strategies scale (2007). Data were analyzed by SPSS software, version 26. Results: The results showed that the mean of corona anxiety was 18.94 out of a maximum of 54 and the proportion of psychological symptoms of corona anxiety was higher than physical symptoms. The highest score from the participant’s point of view from dimensions of distress tolerance was assigned to the subjective assessment of distress. The mean score for distress tolerance was 52.68 out of a maximum of 75 points and the mean score for employees’ emotion regulation strategies was 134.37 points, which shows that the use of emotional self-regulation strategies is strong. The results of the current research showed that corona anxiety decreases significantly by increasing distress tolerance, absorption of negative emotions, regulation of efforts to relieve distress and distress tolerance, and corona anxiety also decreases significantly. Also, with the increase in the level of emotion regulation strategies, the anxiety of corona decreases significantly. Distress tolerance showed a negative correlation with corona anxiety, and with the improvement of distress tolerance, corona anxiety decreased (P=0.014). Conclusion: Based on the results, increasing and improving distress tolerance and emotional regulation strategies significantly reduced corona anxiety. Also, the experiences and work of experts with more work experience alongside the younger and less experienced forces and their cooperation prepared the ground to reduce the effects of corona anxiety, as well as to improve the level of stress tolerance and emotion regulation strategies of employees.

Role of intra-individual variation in the detection of thresholds for DFI and for misclassification rates: A retrospective analysis of 14,775 SCSA® tests.

Sperm DNA damage is associated with reduced male fertility after natural conception and intrauterine insemination. However, the impact on in vitro fertilization (IVF) and especially intracytoplasmic sperm injection (ICSI) treatments is still unclear. Few studies have focused on the intra-individual variation in DFI even though it may have an important role to play in terms of detection of thresholds and for misclassification rates. Results for Sperm Chromatin Structure Assay (SCSA®) tests performed for 70 European fertility clinics between January 1st, 2008 and December 31st, 2022 were examined. A small retrospective study included 406 couples receiving their first treatment with IVF or ICSI. These results were then used for a mathematical simulation to investigate the role of intra-individual variation. The large retrospective study included a total of 14,138 diagnostic tests and 637 tests from an IUI study. The distribution of DFI was assessed for the IUI cohort and cohorts of patients attending Sims IVF and Fertility Center Hamburg (FCH). Descriptive analysis of the data was performed regarding time of year, male age, and year. When DFI was above the thresholds of 15 and 25, a significant reduction in ongoing pregnancies after 12weeks of gestation was observed for IVF and ICSI treatments, respectively. For IVF treatments, the pregnancy rate was reduced from 45.1% to 24.6%, odds ratio=2.58 (p=0.004). For ICSI treatments, the pregnancy rate was reduced from 48.6% to 29.6%, odds ratio=2.00 (p=0.032). Intra-individual variation was significantly related to the misclassification rate and the sample size required to identify a threshold. The percentage of patients with a DFI below 15 was 64.8% for the IUI cohort and 51.7% and 41.6% for cohorts of patients attending Sims IVF and FCH, respectively. The median DFI for these cohorts differed significantly and was 11.6, 15.0 and 17.2, respectively. DFI shows a seasonal variation, and increases with male age. During the past 15 years, the median DFI has increased by 0.05% per year (p=0.02). Ongoing pregnancy rates are reduced significantly for both IVF and ICSI treatments when DFI is above the thresholds of 15 and 25, respectively. The misclassification rate and the required sample size increase with increasing intra-individual variation. Couples with a DFI above 15 are more likely to experience failed assisted reproductive technology(ART) cycles. DFI appears to have increased during the past 15 years.

The effect of chemotherapy regimens in male germ cell tumors on the development of primary hypogonadism

Male germ cell tumors (GCT) have excellent survival. Long-term sequelae in cancer survivors are an evolving field. We evaluated the risk of patients with GCT to develop primary hypogonadism and adherence to guideline-recommended therapy in a real-world cohort. Monocentric study at a tertiary cancer centre to evaluate treated GCT-patients (2001–2019). Post therapeutic male endocrine function, International Index of Erectile Function (IIEF)-5 and The aging males’ symptoms rating scale (AMS) questionnaires were assessed. The overall response rates were low, with 44 of 402 contacted patients participating in the study. From these, 32(73%) underwent blood analysis, 42(95%) answered the IIEF-5 and 43(98%) the AMS. Latent hypogonadism (serum testosterone 8–12 nmol/l) was found in n = 9 (28%) and manifest hypogonadism (testosterone < 8 nmol/l) in n = 8 (25%). 50% (n = 21) indicated erectile dysfunction on IIEF-5 (cut off ≤ 21 pts.) and 62.8% (n = 27) reported symptomatic affection on AMS (cut off ≥ 27 pts.). Majority of tested patients revealed different degrees of hypogonadism. Standard instruments were able to detect gonadal damage in > 50%, which underscored the clinical need to evaluate endocrine function in cancer survivors. We further indicated the difficulties of today’s research and provided starting points to assess barriers for study participations.

Quality of Life as a Non-mortality Patient-centred Outcome in the Critically Ill: A Retrospective Analysis.

Mortality is a common gauged endpoint in critically ill patients. Reduced quality of life is an aligned repercussion of protracted critical illness. Baseline status, severity of illness and its trajectory influence the outcomes. Patient-oriented outcomes are those that matter the most to a patient. However, quite often, family approves of trade-offs with survivorship in the Indian context. We looked at non-mortality outcomes in patients on high-intensity life-sustaining interventions admitted to the intensive care unit (ICU) despite poor prognosis and died on full support or survived to be completely dependent. In this retrospective chart review study, we studied patients (1) who spent more than 1 month in the hospital enduring a myriad of distressing physical and psychological vicissitudes, (2) whose primary illness was fairly advanced (3) and either succumbed or survived to be impeded in their response to cognitive assessment and with severe functional impairment. Patient demographics, comorbidities, pre-morbid functional status, burden of critical illness, use of life-sustaining therapies, functional dependence in the last week of ICU stay, best neurological status in the last week pre-death or discharge, dying trajectories and economic analysis were noted. Trends of clinical progress of 23 patients were deliberated. The mean age of males was 65 years and 61 years for females. Five patients had a Barthel index score of 10-20, indicating total dependency and two patients had a score of 21-60, indicating severe dependency. Two patients were cognitively impaired at baseline. The worst neurological status in the week before death or discharge was eye1, motor1, and verbaltracheostomised. Thirteen patients succumbed during ongoing treatment. Daily discussions on the dynamics of illness progression need to take place with family on a regular basis for patients managed in ICU. Realistic perceptions and grounded expectations from the families and caregivers are necessary for patient-centred outcomes.

Penile constriction devices: a randomized survey study to compare preferences between two medical-grade devices.

Penile constriction devices offer a noninvasive approach to enhance the sexual experience and as the variety of penile constriction devices increases, it is crucial to assess patient preferences and device effectiveness to provide insights into their clinical utility. We aimed to compare the preferences for and effectiveness of two medical-grade penile constriction devices: Eddie by Giddy and FirmTech. Between May and July of 2023, males were recruited via social media and prospectively enrolled into an Institutional Review Board-approved, randomized, questionnaire-based study. Upon enrollment, the participants completed the Sexual Health Inventory for Men and Androgen Deficiency in Aging Males questionnaires. Participants were randomized to which device they received first. They used the device twice either during masturbation or intercourse in a two-week timeframe. Once utilized, the participants completed a 17-question, Likert scale, device satisfaction questionnaire, in which lower numbers indicated positive responses. The process was repeated with the second device. T-test and Chi-Square Analysis were run for statistical analysis. The primary outcomes of this study were patient-reported device satisfaction and efficacy and the secondary outcome was the device preference for patients with and without erectile dysfunction. Fifty men were enrolled and 49 completed the study. The average age was 40years old. Of the participants, 80% recommend the FirmTech device compared to 53% who recommend the Eddie by Giddy device (P= 0.0026). The FirmTech device was overall easier to put on both flaccid and erect (P= 0.0308 and 0.0002), was more comfortable, had better stretch, and was easier to adjust (P= 0.087, <0.0001, and 0.0119, respectively). The FirmTech device had a better overall impression amongst the participants (P= 0.0249). Eddie by Giddy was felt to improve erectile firmness more in those with ED than in those without (P = 0.0178). This study adds to the current literature on penile constriction devices that better guide providers as they counsel patients on these devices to enhance sexual function. The strength of this study is that this is a prospective randomized crossover study. The limitations of this study are that this is a single center study based on patient reported outcomes. The FirmTech device performed better than the Eddie by Giddy with respect to overall impression of the device, likelihood of using the device in the future, and recommending the device to a friend, while the Eddie by Giddy device performed better at improving erectile firmness. NCT05853822.

Global burden associated with rare infectious diseases of poverty in 2021: findings from the Global Burden of Disease Study 2021

BackgroundRare infectious diseases of poverty (rIDPs) involve more than hundreds of tropical diseases, which dominantly affect people living in impoverished and marginalized regions and fail to be prioritized in the global health agenda. The neglect of rIDPs could impede the progress toward sustainable development. This study aimed to estimate the disease burden of rIDPs in 2021, which would be pivotal for setting intervention priorities and mobilizing resources globally.MethodsLeveraging data from the Global Burden of Disease Study 2021, the study reported both numbers and age-standardized rates of prevalence, mortality, disability-adjusted life-years (DALYs), years lived with disability, and years of life lost of rIDPs with corresponding 95% uncertainty intervals (UIs) at global, regional, and national levels. The temporal trends between 1990 and 2021 were assessed by the joinpoint regression analysis. A Bayesian age-period-cohort model was used to project the disease burden for 2050.ResultsIn 2021, there were 103.76 million (95% UI: 102.13, 105.44 million) global population suffered from rIDPs with an age-standardized DALY rate of 58.44 per 100,000 population (95% UI: 42.92, 77.26 per 100,000 population). From 1990 to 2021, the age-standardized DALY rates showed an average annual percentage change of − 0.16% (95% confidence interval: − 0.22, − 0.11%). Higher age-standardized DALY rates were dominated in sub-Saharan Africa (126.35 per 100,000 population, 95% UI: 91.04, 161.73 per 100,000 population), South Asia (80.80 per 100,000 population, 95% UI: 57.31, 114.10 per 100,000 population), and countries with a low socio-demographic index. There was age heterogeneity in the DALY rates of rIDPs, with the population aged under 15 years being the most predominant. Females aged 15–49 years had four-times higher age-standardized DALY rates of rIDPs than males in the same age. The projections indicated a slight reduction in the disease burden of rIDPs by 2050.ConclusionsThere has been a slight reduction in the disease burden of rIDPs over the past three decades. Given that rIDPs mainly affect populations in impoverished regions, targeted health strategies and resource allocation are in great demand for these populations to further control rIDPs and end poverty in all its forms everywhere.Graphical