International Index Research Articles

Clinical Characteristics and Outcomes of AIDS-Related Burkitt Lymphoma in China: A Retrospective Single-Center Study.

Objectives: Studies on the prognosis and risk stratification of patients with acquired immune deficiency syndrome (AIDS) - related Burkitt lymphoma (AR-BL) are rare. We aim to construct a novel model to improve the risk assessment of these patients. Methods: We retrospectively analyzed the clinical data of 34 patients over the past 10 years and the factors associated with progression-free survival (PFS) and overall survival (OS) were evaluated in univariate and multivariate Cox models. Then, the novel model consisting of screened factors was compared with the existing models. Results: With a 37-month median follow-up, the overall 2-year PFS and OS rates were 40.50% and 36.18%, respectively. The OS of patients who received chemotherapy was better compared with those without chemotherapy (P = .0012). Treatment with an etoposide, prednisone, oncovin, cyclophosphamide, and hydroxydaunorubicin-based regimen was associated with longer OS and PFS compared with a cyclophosphamide, doxorubicin, vincristine, and prednisone-based regimen (OS, P = .0002; PFS, P = .0158). Chemotherapy (hazard ratio [HR] = 0.075; 95% confidence interval [CI], 0.009-0.614) and Eastern Cooperative Oncology Group Performance Status (ECOG PS) 2 to 4 (HR = 4.738; 95% CI, 1.178-19.061) were independent prognostic factors of OS in multivariate analysis and we established a novel prognostic risk stratification model named GZ8H model with chemotherapy and ECOG PS. Conclusion: GZ8H showed better stratification ability than the international prognostic index (IPI) or Burkitt lymphoma IPI (BL-IPI). Furthermore, the C-index of the nomogram used to predict OS was 0.884 in the entire cohort and the calibration curve showed excellent agreement between the predicted and actual results of OS. No human immunodeficiency virus-related factors were found to be associated with OS and PFS of AR-BL patients in our study. Overall, the clinical characteristics and outcomes in AR-BL were shown and prognostic factors for OS and PFS were identified in this study.

Epidemiological, clinical and therapeutic profiles of mantle cell lymphoma cared for in a Moroccan center: a review of 14 cases.

Mantle cell lymphoma (MCL) accounts for 3-10% of non-Hodgkin's lymphomas (NHL). We identified 14 patients with mantle cell lymphoma, with an average number of 3.5 new cases/year. A male predominance was observed with a sex ratio equal to 6. The average age of our patients was 64.4±14.1 years, with an average diagnostic delay of 6.57 months. Regarding the clinical presentation, adenopathy was the most reported physical sign (78.6%) followed by B symptoms (57.1%). Disseminated stages were the most frequent in our series: stages IV (78.5%) and III (7.1%) versus stages I (0%) and II (7.1%). The extra-ganglionic localizations observed were hepatic 5 cases (31.1%), pulmonary 04 cases (25%), medullary 4 cases (25%), pleural 2 cases (12.5%) and prostate 1 case (6.2%). All diagnosed cases are mantle cell lymphomas, of which 12 cases (85.7%) are classical and 2 cases (14.3%) indolent. The high-risk group is, according to international prognostic index (MIPI) MCL prognostic score, the most represented in our series: 0-3 = 6 cases (42.9%), 6-11 = 8 cases (57.1%). The therapeutic protocol chosen 1st line: 9 patients treated with R-DHAP, three with R-CHOP, one with DHAOX and one with R-CVP. Second line: two patients treated with R-DHAP, one after R-CHOP and the other after R-CVP. Two patients received autologous hematopoietic stem cell transplant at the end of the treatment. The evolution was marked by the death of 7 patients, 3 lost to follow-up and 4 still followed. Additionally, the study highlights characteristics and treatment patterns of mantle cell lymphoma, emphasizing its predominance in males, delayed diagnosis, frequent dissemination, and high-risk classification, with chemotherapy as the primary treatment modality and a challenging prognosis contributing to a comprehensive understanding of mantle cell lymphoma presentation and management.

Research on international trade flow analysis based on potential clustering network

Abstract International trade is an important part of the world economy, and the rapid development of big data and complex network theory provides the possibility of an in-depth study of international trade networks. This study constructs the international trade flow gravity model and international trade flow index system on the basis of the clustered dynamic panel gravity model. It explores the influencing factors of national trade flow and the fitting effect of the international trade gravity model through factor analysis and regression analysis of variables in the system. The sample data’s KMO value is 0.834, according to the results, and there is a significant correlation between the variables. The degree of explanation of the public factors to the original variables is more than 0.5, and the variance contribution rate of trade structure, marketized structure, population and macroeconomics, international capital, and exchange rate reaches 71.832%, which makes the factor analysis more effective. The R² value of the trade gravity model reaches 0.837, with a remarkable effect. Among the sample countries, the highest trade flow potential is the United States (125,467.0), while the lowest is Portugal (512.4). The national GDP and population have a significant effect on international trade flows. The volume of each trading country should be used as a reference basis for conducting trade transactions when conducting international trade.

Yin Yang 1 expression predicts a favourable survival in diffuse large B-cell lymphoma

AimsYin Yang 1 (YY1) is a multifunctional transcription factor that plays an important role in tumour development and progression, while its clinical significance in diffuse large B-cell lymphoma (DLBCL) remains largely unexplored. This study aimed to investigate the expression and clinical implications of YY1 in DLBCL. MethodsYY1 expression in 198 cases of DLBCL was determined using immunohistochemistry. The correlation between YY1 expression and clinicopathological parameters as well as the overall survival (OS) and progression-free survival (PFS) of patients was analyzed. ResultsYY1 protein expression was observed in 121 out of 198 (61.1 %) DLBCL cases. YY1 expression was significantly more frequent in cases of the GCB subgroup than in the non-GCB subgroup (P = 0.005). YY1 was positively correlated with the expression of MUM1, BCL6, pAKT and MYC/BCL2 but was negatively associated with the expression of CXCR4. No significant relationships were identified between YY1 and clinical characteristics, including age, sex, stage, localization, and B symptoms. Univariate analysis showed that the OS (P = 0.003) and PFS (P = 0.005) of patients in the YY1-negative group were significantly worse than those in the YY1-positive group. Multivariate analysis indicated that negative YY1 was a risk factor for inferior OS (P < 0.001) and PFS (P = 0.017) independent of the international prognostic index (IPI) score, treatment and Ann Arbor stage. Furthermore, YY1 is more powerful for stratifying DLBCL patients into different risk groups when combined with MYC/BCL2 double-expression (DE) status. ConclusionsYY1 was frequently expressed in DLBCL, especially in those of GCB phenotype and with MYC/BCL2-DE. As an independent prognostic factor, YY1 expression could predict a favourable outcome in DLBCL. In addition, a complex regulatory mechanism might be involved in the interactions between YY1 and MYC, pAKT as well as CXCR4 in DLBCL, which warrants further investigation.

Pavement Sections’ Reliability Based on Deterioration Model Using Artificial Neural Network (ANN)

Pavement distresses, such as cracks and ruts, reduce pavements’ effectiveness and serviceability and can lead to failure. This underlines the importance of predicting pavements’ deterioration in pavement management systems (PMSs) for effective maintenance and rehabilitation (M&amp;R) strategies. Consequently, it is essential to understand the concept of service life, which represents how long a pavement will remain in service based on how reliable it is. This study introduces a pavement deterioration model using data from the Long-Term Pavement Performance program for the international roughness index (IRI) and other factors. Different machine learning methods were utilized in developing the model to incorporate eight factors that significantly affect pavement roughness; these methods are: linear regression, regression tree, Gaussian Process Regression (GPR), Support Vector Machine (SVM), Ensemble Trees, and Artificial Neural Network (ANN). For comparison, the models’ performances were evaluated using Root Mean Squared Error (RMSE), Mean Squared Error (MSE), and R squared (R2). The weights and biases of the best model and the Federal Highway Administration (FHWA) recommended IRI ranges were utilized to create the limit state function. A reliability analysis using Monte Carlo Simulation (MCS) was determined to calculate the sections’ probability of failure. This study concluded that pavement sections in the US and Canada are reliable and that the mean yearly Kilo Equivalent Single Axle Load (KESAL) significantly contributes to pavement failure. Keywords: Pavement deterioration, IRI, Machine learning, Neural network, Pavement reliability, Probability of failure.

Use of Soft Penile Prosthesis in Grafting Surgery for Peyronie's Disease and Mild Erectile Dysfunction: Still an Option?

Plaque incision and grafting (PEG) is a primary surgical therapy for severe penile curvature in Peyronie's disease (PD); However, it can increase the risk of erectile dysfunction (ED), particularly in patients with pre-operative mild ED. Soft penile prosthesis (SPP) implantation is a viable treatment option in such cases. This study aims to compare the outcomes of PEG-only approach to PEG plus SPP implantation. Between 2010 and 2019, 32 patients with PD and mild ED (5-item version of the International Index of Erectile Function scores: 17-21) underwent PEG surgery. Two groups were defined based on the surgery type: PEG-only and PEG plus SPP. The long-term outcomes included correction of penile bending, erection quality, intercourse ability, penile length and sensitivity. The overall satisfaction and impact of surgery on sexual activity and quality of life were also assessed. Of the 32 patients, 13 (40.6%) underwent PEG-only surgery, whereas 19 (59.4%) underwent PEG plus SPP. No significant differences were noted between the groups regarding pre-operative characteristics (all p > 0.1) or intra- and post-operative complication rates (all p > 0.2). The median patch area was larger in the PEG-only group (28 cm2 vs. 16.2 cm2; p = 0.001), whereas patients in the PEG plus SPP group were more likely to receive a single patch implant (100% vs. 53.8%; p < 0.001). The penile length increased in 18 patients (61.6%), with significant differences between the two groups (30% vs. 81.2%; p = 0.03). Overall, 14 patients (53.8%) reported greater satisfaction with their sexual life post-operatively, with comparable rates between the groups (p = 0.2). No significant differences were found in the post-operative 5-item version of the International Index of Erectile Function scores or severe post-operative ED (all p > 0.5). SPP placement during corporoplasty in patients with mild ED is safe and feasible, and it may be a suitable option for patients uncertain about inflatable prosthesis placement. The use of SPP resulted in longer penile lengths and necessitated smaller grafts. However, further data are required to understand the long-term clinical implications of this approach.

Erectile dysfunction in ankylosing spondylitis - associations with disease-related parameters

Introduction/Objective. Patients with AS often experience chronic musculoskeletal pain, fatigue and stiffness, which may contribute to psychological distress and sexual dysfunction. This study aims to assess prevalence of ED in patients with AS and identify potential associations between clinical parameters related to AS with the presence of ED. Methods. Forty consecutive male patients with the AS (mean age 42.8 ? 8.9 years) and 60 healthy men (mean age 38.9 ? 10.9 years) were included. All subjects filled-in the International Index of Erectile Function (IIEF) questionnaire, as well as the Beck anxiety inventory (BAI) and the Beck depression inventory (BDI). In patients with AS disease activity was evaluated using the Ankylosing Spondylitis Disease Activity Score (ASDAS) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), functionality using the Bath Ankylosing Spondylitis Functional Index (BASFI), and quality of life using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire. Results. ED was significantly more frequent in patients with AS compared to controls (52.5%: 25%, p = 0.049). AS patients with ED had more severe symptoms of depression, than AS patients without ED (p = 0.034). Ac-cording to ASQoL scores, patients with AS and ED had a worse quality of life, compared to patients with AS without ED (p = 0.022). The increase in one unit of ASQoL increased the odds of having ED for 17.5% (p = 0.035). Conclusion. ASQoL score, as a measure of quality of life, was the only independently associated parameter with the presence of ED. It is necessary to raise awareness of ED in patients with AS.

Meta-analysis of the effectiveness and safety of magnetic stimulation for chronic pelvic pain.

To systematically assess the effectiveness and safety of magnetic stimulation (MS) for treating chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS) through a meta-analysis. A comprehensive search of databases including PubMed, The Cochrane Library, EMbase, VIP, Web of Science, WanFang, China Biology Medicine disc (CBMdisc), and China National Knowledge Internet (CNKI) databases was conducted to retrieve randomized controlled trials (RCTs) on MS interventions for CPPS from inception to the present. The search employed keywords such as "MS", "CPPS", and "prostatitis". Data analysis was performed using RevMan 5.4 software, focusing on NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), maximal urinary flow rate (Qmax), and international index of erectile function-5 (IIEF-5) score. Eight RCTs involving 636 patients were included. Our meta-analysis revealed that extracorporeal MS significantly reduced NIH-CPSI scores [MD = -6.65; 95% CI (-8.15, -5.15), P < 0.00001] and improved Qmax [MD = 2.98; 95% CI (1.36, 4.59), P = 0.0003] compared to the control group. Although a trend toward improved IIEF-5 scores was observed [MD = 0.81; 95% CI (-0.34, 1.95), P = 0.17], the results were not significant. MS is effective in alleviating clinical symptoms and enhancing Qmax in patients with CP/CPPS.

Регіональні рейтинги: статистичні аспекти оцінювання готовності до інтелектуальної автоматизації

The article focuses on the issues of harmonization of the international methodology of the index of readiness of the countries of the world for automation with the specifics of the functioning of the innovative and educational regional environment in Ukraine. The relevance of the chosen topic is substantiated. The problems of breaking the connection between intellectual automation and strategies for the development of education, innovative environment and employment policy in the country are outlined. The need to develop a balanced regional policy based on solving the problem of ensuring constant monitoring of the situation in the field of readiness of regions, territorial communities or cities of Ukraine for future automation is emphasized. In the course of the study, the theoretical and methodological foundations of building the international index of «readiness for automation» of the countries of the world are considered. A similar methodology is used to build the index of «readiness for automation» of the regions of Ukraine. It is also structured as a composite index, and the overall scores for each region are obtained by weighting and combining the three sub-indices corresponding to the components: «Innovation Environment», «Education Policy» and «Labor Market Policy». When combining sub-indices into a general index, weighting coefficients were used to reflect the importance of the relevant component: innovation environment – 40%, educational policy – 40%, labor market policy – 20%. In turn, the estimates of sub-indices are calculated as the weighted average value of normalized estimates of individual indicators. The choice of indicators for the components of the proposed methodology is due to the availability of official data published by the State Statistics Service of Ukraine for 2020 and 2021. The highest level of the overall index of readiness for automation was recorded in the city of Kyiv (92.2), the lowest level (1.82) – in the Chernihiv region. The city of Kyiv stands out as a leader not only in terms of the general index, but also in all sub-indices of readiness for automation, determining its first place in the ranking in terms of the level of development of the innovation environment, education policy and labor market. Dnipropetrovsk region ranks second in the overall ranking of regions of Ukraine in terms of the general index of readiness for automation and all its components.

Erectile dysfunction among men with chronic kidney disease undergoing hemodialysis in a Brazilian Amazon urban setting: an epidemiological study.

Erectile dysfunction (ED) is a common sexual problem among men with chronic kidney disease (CKD). The severity of sexual dysfunction tends to worsen with kidney damage. This study aims to evaluate the erectile function and sexual quality of life of adult male CKD patients undergoing hemodialysis (HD) in a hospital located in the Brazilian Amazon. A cross-sectional quantitative study was performed within the HD Sector of the Nephrology Unit including men with CKD aged ≥ 18 years, undergoing ≥ 3 weekly HD sessions for ≥ 3 months who had been sexually active for ≥ 6 months. We used the Male Sexual Quotient (MSQ) to measure sexual satisfaction and the International Index of Erectile Function (IIEF5) to establish erectile function. Statistical analysis was performed with SPSS 21.0 using appropriate tests, such as Mann-Whitney and Kruskal-Wallis (P < 0.05). Ninety-eight patients (51.68 ± 15.28 years) were evaluated. They were primarily married/or living with a partner (60.20%), with HD time between 1 to 5 years (55.10%), and an average KTV of 1.17. ED prevalence was 66.30%, and it was associated with a higher age group (p = 0.01), lower family income (p = 0.02), diabetes (p = 0.01), lower mean corpuscular hemoglobin (p = 0.04), higher total calcium (p = 0.04), and lower albumin (p = 0.03). Around 75% classified their sex life as regular to excellent. Despite the high ED prevalence, most men with CKD in HD reported experiencing regular to excellent sex life. The study underscores the importance of establishing effective screening and conducting routine evaluations regarding sexual issues in these men.

The association between the severity of erectile dysfunction and left ventricular diastolic dysfunction in patients with and without cardiovascular disease.

Erectile dysfunction (ED) is considered a microvascular disorder and serves as an indicator for the potential development of cardiovascular disease (CVD). Although left ventricular diastolic dysfunction (LVDD) reflects early myocardial damage caused by microvascular disorders, the association between ED and LVDD remains poorly elucidated. A cross-sectional study was conducted on 123 patients with ED. They underwent RigiScan, and conventional echocardiography, and attempted International Index of Erectile Function (IIEF) questionnaire. ED severity was evaluated by measuring changes in the penile base circumference and duration of penile rigidity (≥70%) during erection. The early diastolic velocity of mitral inflow (E) and early diastolic velocity of the mitral annulus (e') were measured using echocardiography. The patients were grouped based on the presence of CVD. Among 123 patients, 29 had CVD and 94 did not. Patients with CVD exhibited more pronounced ED and more severe LVDD. Associations between increased penile circumference with echocardiographic parameters were more prominent in patients with CVD than in those without CVD (ΔTtop and e' wave, r=0.508 and r=0.282, respectively, p for interaction=0.033; ΔTbase and E/e' ratio, r=-0.338 and r=-0.293, respectively, p for interaction <0.001). In the multivariate linear regression, the increase of penile base circumference was an independent risk factor for LVDD (e', B=0.503; E/e' ratio, B=-1.416, respectively, p<0.001). ED severity correlated well with LV diastolic dysfunction, particularly in the presence of CVD. This study highlighted the potential role of ED assessment as early indicator of CVD development.

Risk and benefits of penile length preservation techniques during penile prosthesis implantation: a systematic review by the young academic urologists sexual and reproductive health working group.

Penile shortening, frequently resulting from end-stage Peyronie's disease (PD), has a negative impact on patients' sexual activity and overall quality of life, especially when accompanied by Erectile dysfunction (ED). Various surgical techniques have been described to manage concomitant ED and penile shortening through penile prosthesis (PP) implantation. To evaluate the benefits and risks of different penile length preservation techniques during PP implantation. A systematic review of the available literature on the use of penile length preservation maneuvers in conjunction with PP implantation was conducted. For this systematic review, three databases (Medline, Embase and Cochrane) and clinical trial.gov were queried for relevant publications from 1 January 1990 to 1 September 2022. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The qualitative analysis included 15 relevant articles involving 1186 adult patients who underwent penile length preservation techniques during PP implantation. Penile lengthening of 1-7 cm was reported. Overall, postoperative complications were described in up to 21.7% of cases. Only five studies reported functional outcomes, showing a significant improvement in postoperative period based on the administered questionnaire (e.g. IIEF - International Index of Erectile Function, EDITS - Erectile Dysfunction Inventory of Treatment Satisfaction). Penile length preservation procedures appear to offer a viable option for managing acquired penile shortening, particularly in cases of PD. However, they are associated with a significant risk of complications. Proper patient selection, thorough discussion of risks and benefits, and referral to high-volume centers are mandatory to achieve optimal outcomes and minimizing complications. PROSPERO database registration CRD42022360758.

Predicting Anxiety and Depression Among Erectile Dysfunction Patients: A Cross-Sectional Study.

In Vietnam, erectile dysfunction (ED) is prevalent and recognized to be associated with mental disorders; however, societal taboos impede a comprehensive understanding of this connection. Our study aims to investigate the factors related to higher levels of anxiety and/or depression (HAD) in individuals with ED. Between November 2022 and March 2023, a face-to-face survey was conducted at the Center for Andrology of Viet Duc University Hospital, involving 390 patients diagnosed with ED. The survey included 51 questions covering general patient information, the International Index of Erectile Function-15 (IIEF-15), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). The stepwise Akaike Information Criterion (AIC) method was used to identify factors associated with HAD. The study revealed an average age of 37.63 (11.84) years among participants, with a HAD prevalence of 17.69%. Several factors were associated with a higher likelihood of belonging to the HAD group in ED patients. These factors included non-office workers (OR: 1.11; 95% CI: [1.01, 1.21], p = .025), medium and high levels of work-related stress (OR: 1.23; [1.06, 1.44], p = .008; OR: 1.22; [1.04, 1.45], p = .018), multiple shameful experiences related to ED (OR: 1.16; [1.08, 1.25], p < .001), moderate and severe ED (OR: 1.17; [1.03, 1.32], p = .013; OR: 1.31; [1.14, 1.51], p < .001), and dissatisfaction with intercourse skills (OR: 1.09; [1.01, 1.17], p = .028). Our findings suggest a 16% higher likelihood of HAD status in individuals with multiple shameful experiences related to ED, while moderate and severe ED are associated with respective increases of 17% and 31% in the likelihood. These findings emphasize the importance of considering mental health in the care of individuals with ED.

Sexuality and sexual dysfunction in patients with psoriatic arthritis: A cross-sectional study.

Psoriatic arthritis (PsA) is a chronic inflammatory disorder affecting the joints, skin and entheses. Despite the importance of the topic, few studies have investigated the association between PsA and sexual function. The purpose of this study was to assess sexuality and the prevalence of sexual dysfunction (SD) in patients with PsA. This was an observational, cross-sectional single-center study on 23 PsA patients (male=12; female=11) evaluated with 2 male questionnaires (MSQ= Male Sexual Quotient, and IIEF=International Index of Erectile Function) and 2 female questionnaires (FSQ= Female Sexual Quotient, and FSFI=Female Sexual Function Index) validated for Brazilian Portuguese, in order to determine changes in sexual function. Clinical parameters, musculoskeletal activity and skin activity were also analyzed to identify factors associated with SD. The mean age was 52.1±9.7 years (males) and 49.1±9.6 years (females). Clinically, the patients had low skin and peripheral joint disease activity or were in remission. The mean time of PsA was 10±6.2 years, and 65.2% had a steady sexual partner. The mean MSQ score was 75.8±16.8. The prevalence of SD was 91.7% in men (IIEF), with a predominance of mild SD. The mean FSQ score was 64.9±24.1. The prevalence of SD was 72.7% in women (FSFI), with low domain scores. Also, a significant association was found between female age and total and domain-specific FSFI scores. PASI (Psoriasis Area and Severity Index) and the general satisfaction domain (IIEF) were significantly correlated. This study found a high prevalence of SD in PsA patients. Age had a negative impact on female sexual function. Physicians need to be more aware of SD in this population to provide early multidisciplinary treatment and minimize the impact of the disease on the quality of life of patients and their partners.

Study of Association of Erectile Dysfunction in male subjects with the severity of Alcohol Dependence

Background: Alcohol dependence syndrome is a major public health problem, and it impacts the social, psychological, medical, economic, and religious spheres of our existence. Persistent alcohol abuse impacts sexual functioning negatively and leads to the onset of sexual dysfunction. Aim: This study was conducted to determine erectile dysfunction in males diagnosed with alcohol dependence syndrome and its association with the severity of alcohol dependence. Materials and Methods: The descriptive, non-interventional, cross-sectional study was conducted at the Department of Psychiatry in a tertiary care hospital where 78 subjects diagnosed with alcohol dependence syndrome were assessed for severity of dependence with the Severity of Alcohol Dependence Questionnaire (SADQ-C). Erectile dysfunction in these subjects was assessed with the International Index of Erectile Function scale (IIEF) and the severity of the same was correlated with the severity of alcohol dependence. Results: The results of our study indicated that erectile dysfunction was common in individuals having alcohol dependence syndrome and its severity was positively correlated with the severity of alcohol dependence. Unidentified sexual dysfunction may perpetuate alcohol dependence with poor response to deaddiction therapy. This information about sexual dysfunction due to alcohol dependence can also be used in motivational counseling of heavy drinkers to provide an impetus for change. Conclusions: The prevalence of erectile dysfunction was significantly higher than that of the general population. The same was significantly elevated in patients with severe alcohol dependence as compared to those with mild/moderate alcohol dependence.

Exploring the Correlation Between Sexual Function, Mental Health, and Quality of Life among Stroke Survivors in South-East Nigeria

Stroke’s multifaceted impact necessitates understanding its effects on survivors’ psychological well-being, daily functioning, and sexual health. This study aimed to investigate the correlation between sexual function, mental health, and quality of life (QoL) among stroke survivors. This cross-sectional survey involved 82 stroke survivors recruited from selected healthcare centers in Nnewi. The stroke-specific QoL scale and Mental health inventory-38 were used to evaluate the QoL and mental health status of the participants, respectively. Male and female sexual functions were assessed using the International Index for Erectile Function and Female sexual index, respectively. Mann–Whitney U test and Spearman’s rank order correlation were used to analyze data. The participants’ mean total QoL score was 112.57±37.67, representing 46% of the maximum possible score, with the highest and lowest scores in vision (68.94%) and social role (24.39%) domains. The participants scored &lt;50% in seven quality-of-life domains. The mean total mental health score was 141.76±13.70, with the highest and lowest scores in anxiety (70.75%) and emotional tie (50.71%) domains, respectively. Males had a mean total sexual function score of 30.80%, with none reaching the 50th percentile, except overall satisfaction (50.61%), while females scored 16.41%, with none reaching the 50th percentile and 0.0% in the pain domain. This study highlights the significant challenges stroke survivors face in QoL, mental health, and sexual function. The findings underscore the need for holistic and tailored interventions addressing these multidimensional aspects of post-stroke care, focusing on improving sexual well-being to enhance overall life satisfaction in male survivors.

Personalized Treatment Strategy in "Low-Risk Prostate Cancer Active Surveillance Candidates" Using Irreversible Electroporation: Prospective Evaluation of Feasibility, Morbidity, Functional and Oncological Outcomes.

To evaluate the morbidity, functional and oncological outcome of irreversible electroporation (IRE) as a focal therapy for prostate cancer (PCa) when used in "active surveillance (AS)" candidates refusing standard treatment options. IRE was performed under general anaesthesia, and the transurethral catheter was removed one day after intervention in all patients. Pre- and post-interventional voiding parameters (measured by International Prostate Symptom Score Questionnaire [IPSS], uroflowmetry and post-void residue) were compared. Follow-up (FU) was observed over a minimum of six months, including oncological outcome (controlled by multiparametric magnetic resonance imaging, rebiopsy, prostate-specific antigen dynamic as well as the need and type of secondary treatment) and general functional outcome (International Index of Erectile Function Questionnaire, satisfaction of the procedure). Twenty-four patients refusing AS or standard treatment with a median FU of 18.7 months were included. IPSS showed nine patients with mild, 12 with moderate and two with severe obstructive voiding symptoms pre-intervention (focal IRE). Median IPSS pre-IRE was 9 points, 8.5 (p=0.341) at six months and 10 (p=0.392) after 12 months, respectively. Pre-IRE maximum urinary flow (Qmax) (median: 16.1±8.0 mL/sec) and Qmax after catheter removal (16.2±7.6 mL/sec) did not differ significantly (p=0.904). Thirteen PCa recurrences occurred (54.2%). Out-of-lesion-PCa was found in 12/13 patients (92.3%), while 4/13 patients showed in-lesion-PCa recurrence simultaneously (30.8%). In one patient, there was an in-lesion-PCa recurrence only (7.7%). Six out of 24 patients (25.0%) received a secondary treatment. All patients were satisfied with the IRE procedure. Focal IRE underperforms regarding the overall oncological outcome and should not be offered as an equivalent therapy to established curative treatment strategies. Nevertheless, under a strict FU regimen, its lack of significant additional morbidity compared to an active surveillance strategy makes IRE a feasible alternative for low-risk PCa in highly selected patients as a personalised approach.

Variations in Low Intensity Shockwave Treatment Protocols for Erectile Dysfunction: A Review of the Literature and Guide to Offering Treatment.

Low-intensity shockwave therapy (LiSWT) for erectile dysfunction (ED) continues to gain popularity in both clinical practice and the academic literature. The majority of trials and meta-analysis studies have shown LiSWT to be low risk with a trend toward positive improvements in International Index of Erectile Function (IIEF) scores. However, there is still debate over the clinical utility of LiSWT and there is no agreed upon optimal treatment protocol. In this review article we summarize published meta-analysis studies of LiSWT for ED, and review the treatment protocols from randomized sham-control trials published in the last 10 years. We found the most common device settings were an energy of 0.09 mJ/mm² and a frequency of 5 Hz. Shock number and location varied, but the most common protocol was 1,500 shocks per session, with 900 shocks to the penis (shaft, base, or hilum) and 600 shocks to the proximal corpora/crura. Protocols ranged from 4 to 12 treatment sessions. We also describe our institutional experience with LiSWT, including patient counseling and treatment protocol.

Penile Erection Morphometry: The Need for a Novel Approach.

For many males, sexual function holds significant value in determining their quality of life. Despite the importance of male erectile function, no quantitative method to measure it accurately is currently available. Standardized assessment methods such as RigiScan™, International Index of Erectile Function (IIEF-5), and the stamp test are used to evaluate sexual function, but those methods cannot repetitively and quantitatively measure erectile function. Only direct measurement can quantitatively assess the shape of an erect penis. This paper presents the essential requirements for developing an ideal measurement method for penile erection. It also introduces current approaches for diagnosing male sexual function and reviews ongoing research to quantitatively measure erectile function. The paper further summarizes and analyzes the advantages and disadvantages of each method with respect to the essential requirements. Finally, the paper discusses the future direction toward the development of Penile Erection Morphometry.

ИСПОЛЬЗОВАНИЕ ИНДЕКСА ТРИГЛИЦЕРИДОВ-ГЛЮКОЗЫ (TYG) В ДИАГНОСТИКЕ ЭРЕКТИЛЬНОЙ ДИСФУНКЦИИ

Aim. The study aims to assess the degree of significance of the triglyceride-glucose (TyG) index in the diagnosis of erectile function. Materials and Methods. The study involved 120 patients examined from 2021 to 2022 at the Federal State Budgetary Institution State Scientific Center FMBC named after A.I. Burnazyan FMBA of Russia. Patients filled out the International Index of Erectile Function scale, and the TyG index was calculated. The patients were divided into two groups: Group 1 comprised patients with mild and moderate severity of erectile dysfunction (ED) (n=60), while Group 2 included patients not clinically manifesting ED (reference group) (n=60). The TyG index was analyzed in both groups to determine its relationship with ED. Results. The analysis revealed that the risk of developing ED occurs when the TyG index value exceeds 4.49. Increasing the threshold level to 5.0 was found to be nonsignificant. A TyG index value exceeding 4.49 corresponded to an odds ratio of 114.0 (95% CI 13.7-947.7, z=4.383, p&lt;0.0001), making it a reference value for determining the risk of ED. Conclusions. Currently, widely available methods for diagnosing and assessing the risk of ED, including for treatment decisions, are lacking. The triglyceride/glucose (TyG) index has the potential to serve as a quick and accessible test for this purpose.