Search Results (451)

This review aimed to be comprehensive and to critically analyze the factors that may affect the macronutrient and energy content of breast milk. Systematic reviews were prioritized, even though other types of literature reviews on the subject, as well as studies not included in these reviews, were included. Reported factors that potentially affect the macronutrient and energy content of breast milk comprise: maternal factors, such as age, nutritional status, dietary intake, smoking habits, lactation stage, circadian rhythmicity, and the use of galactagogues; obstetrical factors, such as parity, preterm delivery, multiple pregnancies, labor and delivery, and pregnancy morbidities including intrauterine growth restriction, hypertensive disorders, and gestational diabetes mellitus; and newborn factors, including sexual dimorphism, and anthropometry at birth. Some factors underwent a less robust assessment, while others underwent a more in-depth analysis. For example, the milk from overweight and obese mothers has been reported to be richer in energy and fat. A progressive decrease in protein content and an increase in fat content was described over time during lactation. The milk from mothers with hypertensive disorders may have a higher protein content. Higher protein and energy content has been found in early milk from mothers who delivered prematurely. Full article

Background/Objective: Puberphonia is a voice disorder characterized by the persistence of a high-pitched voice in sexually mature males. In phoniatrics and speech-language pathology, it is also known as post-mutational voice instability, mutational falsetto, persistent fistulous voice, or functional falsetto. The absence of an age-appropriate vocal pitch may adversely affect psychological well-being and hinder personal, social, and occupational functioning. The aim of this study was to evaluate of the impact of phoniatric and logopedic rehabilitation on voice quality in patients with puberphonia. Methods: The study included 18 male patients, aged 16 to 34 years, rehabilitated for voice mutation disorders. Phoniatric and logopedic rehabilitation included voice therapy tailored to each subject. A logopedist led exercises aimed at lowering and stabilizing the pitch of the voice and improving its quality. A phoniatrician supervised the therapy, monitoring the condition of the vocal apparatus and providing additional diagnostic and therapeutic recommendations as needed. The duration and intensity of the therapy were adjusted for each patient. Before and after voice rehabilitation, the subjects completed the following questionnaires: the Voice Handicap Index (VHI), the Vocal Tract Discomfort (VTD) scale, and the Voice-Related Quality of Life (V-RQOL). They also underwent an acoustic voice analysis. Results: Statistical analysis of the VHI, VTD, and V-RQOL scores, as well as the voice’s acoustic parameters, showed statistically significant differences before and after rehabilitation (p < 0.005). Conclusions: Phoniatric and logopedic rehabilitation is an effective method of reducing and maintaining a stable, euphonic male voice in patients with functional puberphonia. Effective voice therapy positively impacts selected aspects of psychosocial functioning reported by patients, improves voice-related quality of life, and reduces physical discomfort in the vocal tract. Full article

Geometric morphometrics is performed on different species in different contexts. Here, the aim was to investigate morphological differences in the head of the Sanmartinero Creole bovine to examine head shape variations between sexes using geometric morphometric methods. A sample of cranial pictures of 43 animals (13 males and 30 females) was obtained, and form (size + shape) was studied by means of geometric morphometric techniques using a set of 14 landmarks. This approach eliminated potential dietary effects, ensuring that the observed shape variations were primarily due to intrinsic morphological differences. Sexual dimorphism was found in form (for both size and shape) of the head of the Sanmartinero Creole bovine breed. Males had significantly larger heads based on centroid size (U = 714, p = 0.0004), confirming true sexual size differences, and Principal Component Analysis revealed overlapping head shapes with sexual dimorphism concentrated at midline sagittal landmarks (between the most rostral and caudal orbit points) and paired lateral points, indicating that males have broader and longer heads. The two evaluated characters (head size and shape) are of special interest for the conservation of the breed, especially in those cases whose objectives are to maintain the uniqueness, distinctiveness, and uniformity of the populations. This study analyzed animals subjected to the same feeding program, ensuring the elimination of additional variables. Full article

This essay examines two hybrid poetic texts that emerged from a period of feminist activism in U.S. and global poetry communities from 2014 to 2017: the collaboratively, anonymously authored “No Manifesto” (2015) and the radically revised second edition of the book of poetry and visual art YOU DA ONE by Jennif(f)er Tamayo. “No Manifesto” and YOU DA ONE embrace the hybrid tactics of collectivity, incongruity, and nonresolution as ways of protesting sexism and sexual violence in poetry communities. Synthesizing theories of hybridity from poetry criticism as well as immigrant and borderlands studies, the essay defines hybridity as a literary representation of cultural positions forcefully imposed upon subjects. Born out of the domination of sexual and state violence, hybridity marks the wound that remakes the subject, who develops strategies for resistance. By refusing to play by the rules of poetic or social discourse—the logics of domination that would have them be singular, cohesive, and compliant—Tamayo and the authors of “No Manifesto” insist on alternative ways of performing activism, composing literature, and entering the public sphere. These socially engaged, hybrid poetic texts demonstrate the power of the collective to disrupt the social and literary status quo. Full article

Background and objectives: Duloxetine is widely used for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and various types of neuropathic pain. While its efficacy is well documented in clinical trials, less is known about how it is perceived and utilized in routine psychiatric practice. To address this knowledge gap, we conducted a cross-sectional observational study involving 80 psychiatrists from Spain to assess real-world clinical attitudes toward duloxetine. Methods: Participants completed a 20-item multiple-choice questionnaire that examined familiarity, perceived efficacy in multiple conditions (MDD, GAD, neuropathic pain, somatization, and quality of life), and perspectives on tolerability, safety, adherence, and overall satisfaction. Results: Survey results indicated that a large majority of psychiatrists frequently prescribe duloxetine, particularly for patients with MDD and comorbid chronic pain. Notably, 94% rated it as either “more effective” or “much more effective” for diabetic peripheral neuropathic pain. Psychiatrists reported a high perceived efficacy of duloxetine: 94% rated it as “more effective” or “much more effective” for diabetic peripheral neuropathy, and 93% gave similarly positive ratings for general neuropathic pain. For somatization, 70% found it “effective” or “very effective”, and 83% observed improvements in quality of life for many of their patients. Psychiatrists generally reported favorable perceptions of duloxetine’s tolerability profile: 97.5% rated it as the antidepressant associated with the least weight gain, and 82.5% perceived fewer sexual side effects compared to other options. Sedation and gastrointestinal side effects were generally considered mild or less severe. In terms of treatment adherence, 69% rated it as “better” or “much better” than other antidepressants, and 80% found its combination with other antidepressants to be “favorable” or “very favorable”. Overall satisfaction was high, with 99% of psychiatrists reporting being either “satisfied” or “very satisfied” with its use. The side effect profile was generally viewed as manageable, with low perceived rates of weight gain, sedation, and sexual dysfunction. Furthermore, 96% of respondents expressed a willingness to recommend duloxetine to their colleagues. Conclusions: Psychiatrists reported highly favorable attitudes toward duloxetine, viewing it as a flexible treatment option in routine care. However, these findings reflect clinicians’ subjective perceptions rather than objective clinical outcomes and should be interpreted accordingly. Full article

Background/Objectives: The male prepuce that covers the glans penis is richly innervated by low-threshold mechanoreceptors, which form cutaneous end-organ complexes (Meissner, Pacinian and Ruffini corpuscles) and mucous end-organ complexes (especially Krause-like corpuscles). The mechanosensory inputs from these formations are the beginning for spinal reflexes that regulate movements of intercourse and erection and, therefore, are required for sexual function. The study was aimed at analyzing the age-dependent changes in prepuce innervation. Methods: Here we used immunohistochemistry to investigate whether the innervation of the male prepuce undergoes age-dependent changes, analyzing subjects aged 4 months to 61 years. Results: Abundant Meissner corpuscles and Krause-like corpuscles were regularly found whose morphology, size, and topography were variable and were not correlated with age; however, Ruffini’s and Pacinian corpuscles were scarcely observed. The earliest evidence of Meissner corpuscles was observed at 4 months, and thereafter they undergo significant age-dependent variations in density. Until the age of 20 years increases progressively, remains stable until 40 years, and then the density decreases. Meissner’s corpuscle index paralleled that of density. Regarding Kause-like corpuscles already resemble the skin of 4-month-old subjects and from the age of 3 years they can be identified at all ages. Its density significantly increased until 10 years and then remained stable. Conclusions: Present results state that the mechanosensory innervation of the human foreskin reaches its maximum value around the age of 20, remains stable during adulthood and decreases with maturity. These findings contribute to a more complete understanding of foreskin innervation and add to the scientific knowledge base surrounding the potential harm of removing a richly innervated structure. Full article

Behavioral stress is a recognized triggering factor for systemic diseases, including psychiatric disorders. The stress response is subjected to circadian regulation and many factors shape the susceptibility to its maladaptive consequences, including the biological sex. Accordingly, circadian dysregulation of the stress response, often occurring in a sexually dimorphic manner, is typically associated with psychiatric disorders. However, the interaction between stress, sex, circadian phases, and behavior is still largely unknown. Here, we used the chronic restraint stress (CRS) model in male and female mice to assess the impact of sex and circadian phases on the behavioral consequences of chronic stress. Animals were stressed either in the light or dark phase, and anxious-/depressive-/anhedonic-like behaviors were assessed. Associated transcriptional changes in clock genes were measured in the prefrontal cortex. A significant interaction of stress, sex, and circadian phase was found in most of the parameters evaluated, with no behavioral response to stress in males stressed in the dark phase, and an exaggerated response in females stressed in the dark phase compared to the light phase. We also found some molecular changes in corticosterone serum levels and expression of clock genes in the prefrontal cortex. Full article

Background and Objectives: Infection, trauma, skin cancer, foreign substance injections and lymphedema are among the most frequent causes of penile skin defects. Scrotal flaps are a promising reconstructive option for penile resurfacing, offering improved functional and aesthetic outcomes; however, there is no clear consensus on their superiority. Materials and Methods: A review of the literature was performed in PubMed Central and Scopus, and multiple keywords were employed. The initial search retrieved 9181 articles; 32 articles were finally selected, of which 13 were case reports and 19 were case series. Results: A total of 368 patients were included, the majority (71%) consulting for sclerosing lipogranuloma. Seven types of scrotal flaps were used: unilateral scrotal flap (n = 1), bilateral anterior scrotal flaps (n = 149), two-stage scrotal flap (n = 57), bipedicled bilateral anterior scrotal flaps (n = 140), apron-style scrotal flap (n = 1), scrotal pull-up (n = 13), and island dartos musculocutaneous flap (n = 7). Patient satisfaction was high in all studies. Outcome evaluation was typically conducted using subjective questionnaires with 2 or 5 items or visual analog scales. Few studies employed validated sexual function questionnaires, as the IIEF-5 or the EHS. Conclusions: Scrotal flaps provide good quality tissue for penile resurfacing, having the closest resemblance to normal penis skin. For a better understanding of the outcomes of different scrotal flaps, a thorough evaluation of postoperative complications should be made. The LOS and revision surgery rates may serve as surrogates for the financial burden of the procedure. Erectile function should be thoroughly evaluated with a 10-item Likert scale, IIEF-5, EHS, and POSAS. Full article

Dinoflagellates are unicellular organisms that are crucial components of aquatic ecosystems, known as important primary producers and causes of harmful blooms. They have complex life cycles, including immotile stages, which contribute to their distribution and survival in unfavorable conditions. Temperature changes, primarily cold stress, significantly impact dinoflagellate physiology, influencing metabolic processes, growth rates, and encystment/excystment cycles. This study investigates the transcriptome of temporary cold-induced cysts in the marine planktonic dinoflagellate Prorocentrum cordatum. We compared gene expression in cysts subjected to a 7-h cold incubation with those returned to standard cultivation conditions and motile vegetative cells. Our results showed a marked predominance of downregulated genes in cold-induced cysts. Encystment affected signaling pathways, including calcium and protein kinase signaling, as well as RNA and protein metabolism. Upon returning to standard conditions, RNA metabolism was reactivated; upregulation of genes encoding some calcium-binding proteins and kinases was observed. Additionally, we analyzed RNA-binding pentatricopeptide repeat-containing proteins, the genes encoding which changed their expression in P. cordatum cysts, for similarities to plant MRL1 proteins. Finally, we focused on MEI2-like proteins to confirm their role in non-sexual cyst formation and position them within the diversity of MEI2 homologs in dinoflagellates. Full article

Background: The morphology of the occipital condyles (OCs) and foramen magnum (FM) is critical for neurosurgical planning and forensic identification. However, pooled reference values and the impact of study-level moderators on morphometric estimates remain underexplored. Methods: A systematic review and meta-analysis were conducted to estimate pooled morphometric values of the OCs and FM. Databases were searched for studies reporting relevant data in adult human subjects. A random-effects model was used to calculate pooled means and mean differences (MDs) by sex and side (left vs. right). Risk of bias and study quality were assessed. Subgroup analyses were conducted based on study design (osteological vs. imaging) and geographical region. Meta-CART (classification and regression trees) was used to explore moderator interactions and identify data-driven subgroups contributing to heterogeneity. Results: A total of 61 studies comprising 8010 adult skulls met the inclusion criteria. Substantial heterogeneity was observed across studies; most were assessed as having low-to-moderate methodological quality and a high risk of bias. The pooled mean values were as follows: OC length (OCL): 21.51 mm, OC width (OCW): 11.23 mm, OC thickness (OCT): 9.11 mm, FM length (FML): 35.02 mm, and FM width (FMW): 28.94 mm. Morphometric values reported in imaging-based studies were consistently lower than those from osteological studies. Evident sexual dimorphism was identified, with males exhibiting larger dimensions than females. The most pronounced sex-based mean differences (MDs)—approximately 2 mm—were found in OCL, FML, and FMW. In contrast, differences in OCT and OCW were under 1 mm. No significant side-related asymmetries were observed overall. Subgroup analysis revealed that sex-related MDs were more prominent in imaging studies, particularly for the right OCL and OCW. Meta-CART analysis identified study design as the strongest moderator for OCL, OCW, and FML. Sexual dimorphism was more pronounced in imaging studies but statistically insignificant in osteological samples. Furthermore, sex emerged as a stronger predictor for OCL than OCW, while geographical region had a greater impact on OCW. For OCT, geographical region was the main influencing factor, whereas sex was the primary moderator for FMW. Conclusions: OC and FM morphometry exhibit substantial heterogeneity across studies. Imaging-based methods more effectively detect sex-related differences, underscoring their utility in forensic identification and neurosurgical planning. These findings emphasize the need for more standardized, high-quality morphometric research to support population-specific anatomical reference data. Full article

Background/Objectives: The presence of autoimmune thyroiditis was found to be associated with an increased prevalence of sexual dysfunction. Women’s sexual health was not investigated in postpartum disorders of the thyroid gland. The aim of this study was to assess female sexual functioning and depressive symptoms in postpartum thyroiditis. Methods: This study compared four groups of non-lactating women who gave birth within 12 months before the beginning of the study: women with postpartum thyroiditis and overt hypothyroidism (group A), women with postpartum thyroiditis and subclinical hypothyroidism (group B), euthyroid females with postpartum thyroiditis (group C) and healthy euthyroid females without thyroid disease (group D). All patients completed questionnaires assessing female sexual function (FSFI), and the presence and severity of depressive symptoms (BDI-II). Moreover, we assessed thyroid peroxidase and thyroglobulin antibodies, as well as serum levels of thyroid-stimulating hormone (TSH), free thyroid hormones, testosterone, dehydroepiandrosterone sulfate (DHEAS), estradiol and prolactin. Results: The mean total FSFI score was lower in women with overt hypothyroidism (22.74 ± 4.12) than in the remaining groups of women, lower in groups B (25.71 ± 3.84) and C (29.67 ± 4.00) than in group D (32.15 ± 2.98), as well as lower in group B than in group C. Compared to healthy controls, both groups of women with postpartum thyroiditis and thyroid hypofunction had lower scores for all domains, while euthyroid patients with postpartum thyroiditis had lower scores for sexual desire, sexual arousal and lubrication. The total BDI-II score was highest in group A (15.6 ± 3.2) and lowest in group D (7.8 ± 3.2). Serum testosterone and DHEAS levels were lower while serum prolactin levels were higher in women with postpartum thyroiditis than in healthy subjects. The lowest testosterone levels (1.02 ± 0.35 nmol/L) and estradiol levels (190 ± 80 pmol/L) and the highest prolactin concentration (39.9 ± 13.9 ng/mL) were found in group A. Conclusions: The obtained results show that postpartum thyroiditis is complicated by multidimensional impairment of female sexual functioning, which is accompanied by mood deterioration. Severity of sexual dysfunction and depressive symptoms in this clinical entity depends on the degree of thyroid autoimmunity and hypothyroidism. It seems that assessment of sexual functioning and mood should be recommended to all women with postpartum thyroiditis. Full article

This study explores how ideological, relational, and sociodemographic factors predict women’s perceptions of severity and self-responsibility across different types of intimate partner violence (IPV). Using an intra-subject design, 257 women completed the measures of interest, 191 experiencing IPV and 66 non-victims, according to their responses to WHO instruments. Participants were recruited via dissemination of the study through WhatsApp, Instagram, Facebook and institutional email. The results indicated that the primary predictors of perceived severity were ambivalent sexism in physical violence; favorable attitudes toward IPV (all forms of violence); feminist identity (physical violence and controlling behaviors); dependency (psychological violence); commitment (physical sexual, and controlling behaviors); education level (physical violence); and age (sexual violence). For attributed self-responsibility, ambivalent sexism and favorable attitudes toward IPV were predictors for controlling behaviors. Commitment and dependency, being a victim and age-influenced psychological violence, whereas being a victim predicted sexual violence. In addition, physical violence is perceived as the most severe and controlling behavior, eliciting greater levels of attributed self-responsibility than other forms of IPV. These results highlight the main predictors of cognitive distortions (perceived severity of violence and attributed self-responsibility), offering insight into the processes that victims in IPV situations undergo. Full article

The special metabolite of Fusarium spp. zearalenone (ZEN) exerts estrogenic effects on mammals, stimulates plant growth, stimulates sexual development in fungi, and inhibits fungal growth. These activities inspired hypotheses about the biological function of ZEN. We briefly review the discovery of ZEN and its implications. The main subject of this review is a critical assessment of the hypotheses that ZEN is a fungal hormone, a plant hormone, a virulence factor, or a fungal defense metabolite. Conceptual and technical issues related to testing these hypotheses, such as inadequate analytical methods, confusion of incidental effects with biological functions, and lack of normalization, are illuminated. Based on these considerations, gene knockout experiments, and on the effects of biotic interactions on ZEN synthesis, we argue that ZEN is a defense metabolite protecting Fusarium spp. against mycoparasites and competitors. Similar reasoning and published data suggest that the Fusarium metabolite fusaristatin A fulfils the same function. Fungi produce many macrolactones of resorcylic acid (RALs) and dihydroxyphenylacetic acid (DHPLs) with properties similar to ZEN. Their widespread occurrence, antifungal activity, and further considerations prompt us to hypothesize that the fundamental function of fungal RALs and DHPLs lies in defense and interference competition. Full article

While the development of the Empedocles figure in the various versions of Hölderlin’s unfinished tragedy has long been the subject of scholarship, the shifts in his relationships to the women around him have largely gone unnoticed. Yet these changes are anything but subtle: in the Frankfurt Plan, Empedocles is married with children, and his wife plays a significant role in the outline of the plot; in the first draft, Empedocles is unmarried but adored by Panthea, a young Agrigentine woman; in the last draft, the figure of Panthea has been reconfigured as Empedocles’ biological sister. With each successive draft Hölderlin imposed new barriers, the crossing of which would imply sexual transgression or incest, in order to set Empedocles apart from potential sexual or erotic entanglements with the dramatis personae. But at the same time, we observe language suited for erotic settings (and used thus by Hölderlin here and in other works) being displaced to ever new objects throughout the drafts. In other words, while the author as editor of his material successively deleted or prohibited the sexual/erotic relationships of his titular hero, at the same time he allowed this fluidly metonymic, multivalent erotic language to flow, continuously redirected, throughout the entire Empedocles project. With Empedocles’ leap into Mount Etna, we find the culmination of this meandering erotic diction, imagined in the last draft as an hybristic, incestuous union with his divine parents. Full article

Background/Objectives: Despite the rising tendency to depend on ChatGPT for medical counselling, it is imperative to evaluate ChatGPT’s capacity to address sensitive subjects that patients often hesitate to discuss with their physicians. The objective of this study was to evaluate the recommendations provided by ChatGPT for sexual activity subsequent to total hip arthroplasty (THA) by orthopaedic surgeons with varying degrees of experience, as well as using standardized scoring systems. Methods: Four patient scenarios were developed, reflecting different ages and indications for THA. Twenty-four questions were asked to ChatGPT 4.0, and responses were evaluated by three different orthopaedic surgeons. All responses were also scored using defined standardized scales. Results: No response was found to be ‘faulty’ or ‘partial’ by any of the observers. While the lowest mean score was attributed by the orthopaedic surgeon with less than five years of experience, the highest mean score was attributed by the orthopaedic surgeon with more than 15 years of experience but not actively working in the field of arthroplasty. An analysis of the data across scenarios revealed that in general, the scores decreased in the more specialized scenarios (p > 0.05). Conclusions: ChatGPT shows potential as a supplementary resource for addressing sensitive postoperative questions such as sexual activity after THA. However, its limitations in providing nuanced, patient-specific recommendations highlight the need for further refinement. While ChatGPT can support general patient education, expert clinical guidance remains essential for addressing complex or individualized concerns. Full article