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How to recognize late-onset hypogonadism in men wit sexual dysfunction

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Asian Journal of Andrology 2012年第2期14卷 251-259页

作者： Giovanni Corona Giulia Rastrelli linda vignozzi Edoardo Mannucci Mario Maggi Sexual Medicine and Andrology Unit Department of Clinical Physiopathology University of Florence Florence 50139 Italy Endocrinology Unit Maggiore-Bellaria Hospital Medical Department Azienda-Usl Bologna Bologna 40133 Italy Diabetes Section Geriatric Unit Department of Critical Care University of Florence Florence 50139 Italy

Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low serum testosterone （T） levels. However, its clinical presentation is often insidious and difficult to recognize because it is characterized by nonspecific symptoms that make differential diagnosis with physiological ageing problematic. Sexual dysfunction is the most important determinant for medical consultation and the most specific symptom associated with low T. We therefore analysed a consecutive series of 1734 subjects who attended our unit for sexual dysfunction to investigate the associations between low T （different thresholds）, sexual parameters, medical history data （delayed puberty, pituitary disease or cryptorchidism） and their physical exam results. Metabolic parameters, in particular waist circumference, display the greatest accuracy in detecting low T. We found that only the association of several symptoms and signs could significantly raise the clinical suspicion of low T. Structured inventories, which cluster together symptoms and signs of hypogonadism, can help clinicians suspect androgen deficiency. In particular, structured interviews, such as ANDROTEST, have been demonstrated to have a greater accuracy when compared to self reported questionnaires in detecting low T levels.

关键词： late-onset hypogonadism (LOH) male hypogonadism testosterone sexual dysfunction

Erectile dysfunction and central obesity： an Italian perspective

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Asian Journal of Andrology 2014年第4期16卷 581-591页

作者： Giovanni Corona Giulia Rastrelli Sandra Filippi linda vignozzi Edoardo Mannucci Mario Maggi Endocrinology Unit Maggiore-Bellaria Hospital Azienda-Usl Bologna Bologna Sexual Medicine and Andrology Unit Department of Experimental Clinical and Biomedical Sciences University of Florence Florence Diabetes Agency Careggi Hospital Florence Italy.

Erectile dysfunction （ED） is a frequent complication of obesity. The aim of this review is to critically analyze the framework of obesity and ED, dissecting the connections between the two pathological entities. Current clinical evidence shows that obesity, and in particular central obesity, is associated with both arteriogenic ED and reduced testosterone （T） levels. It is conceivable that obesity-associated hypogonadism and increased cardiovascular risk might partially justify the higher prevalence of ED in overweight and obese individuals. Conversely, the psychological disturbances related to obesity do not seem to play a major role in the pathogenesis of obesity-related ED. However, both clinical and preclinical data show that the association between ED and visceral fat accumulation is independent from known obesity-associated comorbidities. Therefore, how visceral fat could impair penile microcirculation still remains unknown. This point is particularly relevant since central obesity in ED subjects categorizes individuals at high cardiovascular risk, especially in the youngest ones. The presence of ED in obese subjects might help healthcare professionals in convincing them to initiate a virtuous cycle, where the correction of sexual dysfunction will be the reward for improved lifestyle behavior. Unsatisfying sexual activity represents a meaningful, straightforward motivation for consulting healthcare professionals, who, in turn, should take advantage of the opportunity to encourage obese patients to treat, besides ED, the underlying unfavorable conditions, thus not only restoring erectile function, but also overall health.

关键词： androgens erectile dysfunction impotence vasculogenic

Metabolic syndrome and prostate abnormalities in male subjects of infertile couples

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Asian Journal of Andrology 2014年第2期16卷 295-304,I0011页

作者： Francesco Lotti Giovanni Corona linda vignozzi Matteo Rossi Elisa Maseroli Sarah Cipriani Mauro Gacci Gianni Forti Mario Maggi Sexual Medicine and Andrology Unit Department of Experimental and Clinical Biomedical Sciences University of Florence Florence Endocrinology Unit Maggiore-Bellaria Hospital Bologna Department of Urology Careggi Hospital University of Florence Florence Italy

No previous study has evaluated systematically the relationship between metabolic syndrome （MetS） and prostate-related symptoms and signs in young infertile men. We studied 171 （36.5 ±8.3-years-old） males of infertile couples. MetS was defined based on the National Cholesterol Education Program Third Adult Treatment Panel. All men underwent hormonal （including total testosterone （TT） and insulin）, seminal （including interleukin-8 （IL-8）, seminal plasma IL-8 （sIL-8））, scrotal and transrectal ultrasound evaluations. Because we have previously assessed correlations between MetS and scrotal parameters in a larger cohort of infertile men, here, we focused on transrectal features. Prostate-related symptoms were assessed using the National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） and the International Prostate Symptom Score （IPSS）. Twenty-two subjects fulfilled MetS criteria. In an age-adjusted logistic ordinal model, insulin levels increased as a function of MetS components （Wald = 29.5, P〈 0.0001） and showed an inverse correlation with TT （adjusted r = -0.359, P 〈 0.0001）. No association between MetS and NIH-CPSI or IPSS scores was observed. In an age-, TT-, insulin-adjusted logistic ordinal model, an increase in number of MetS components correlated negatively with normal sperm morphology （Wald -- 5.59, P〈 0.02） and positively with slL-8 levels （Wald = 4.32, P〈 0.05）, which is a marker of prostate inflammation, with prostate total and transitional zone volume assessed using ultrasound （Wald = 17.6 and 12.5, both P〈 0.0001）, with arterial peak systolic velocity （Wald = 9.57, P= 0.002）, with texture nonhomogeneity （hazard ratio （HR） = 1.87 （1.05-3.33）, P 〈 0.05）, with calcification size （Wald = 3.11, P 〈 0.05）, but not with parameters of seminal vesicle size or function. In conclusion, in males of infertile couples, MetS is positively associated with prostate enlargement, biochemical （slL8） and ultrasound-derived signs of prostate inflammation but

关键词： infertile men interleukin-8 metabolic syndrome prostate-related symptoms and sisns semen analysis transrectal ultrasound

Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

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Asian Journal of Andrology 2014年第5期16卷 767-773,I0011页

作者： Giovanni Corona Mauro Gacci Elisa Maseroli Giulia Rastrelli linda vignozzi Alessandra Sforza Gianni Forti Edoardo Mannucci Mario Maggi Endocrinology Unit Maggiore-Bellaria Hospital Medical Department Azienda-Usl Bologna Bologna Italy Department of Urology Sexual Medicine and Andrology Unit Department of Clinical Physiopathology Endocrinology Unit Department of Clinical Physiopathology University of Florence Florence Italy Diabetes Agency Careggi Hospital Florence Italy

Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.

关键词： benign prostatic hyperplasia metabolic syndrome enlarged prostate size testosterone

Identification,Localization and Function in vitro and in vivo Activity of Oxytocin Receptor in the Rat Penis

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Identification,Localization and Function in vitro and in viv...

Opening the“Black Box”:How Out-of-Class Use of Duolingo Impacts Chinese Junior High School Students'Intrinsic Motivation for English

中华医学会第五次全国男科学学术会议

作者：张新华莫曾南 Sanara Filippi linda vignozzi Rosa Mancina Michaela Luconi Mirca Marini Gabriella Barbara Vannelli Gianni Forti Mario Maggi 广西医科大学泌尿外科研究所 Andrology Unit Department of Clinical PhysiopathologyDepartment of AnatomyHistology and Forensic MedicineUniversity of FlorenceFlorence 50139Italy

Purpose: We recently found that oxytocin receptor (OTR) is expressed by the human and rabbit corpus cavernosum (CC) and mediates contractility in vitro . In the present study we extended our investigation to rats, and explored whether OTR regulates penile detu-mescence in vivo. Materials and Methods: OTR was original identified ( l25I-OTR binding and Western - blot) , characterized (in vitro contractility) and immunolocalized (immunohistochemistry ) in the rat penis . The effect of intracavernous injection (ICI) of oxytocin (OT) on intracavernous pressure (ICP) increase induced by electro-stimulation of the cavernous nerve and papaverine was also

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ECNU Review of Education 2024年第2期7卷 283-307页

作者：曾成 linda Fisher 184 Hills Road Cambridge CB28PQUK

Purpose:Mobile-assisted language learning(MALL)apps such as Duolingo have great potential for promoting learners'motivation to learn a second language(L2).However,little research has investigated how this motivational impact takes ***,despite the flexibility of mobile learning,most existing studies are conducted in classroom settings,with less attention paid to out-of-school technology ***/Approach/Methods:To address these gaps,we present a model based on self-determination theory and propose the idea of“motivational transfer”to explain the psychological mechanism underpinning the impact of *** examine the model,we conducted a case study with 20 Year 8 Chinese junior school students who used Duolingo to learn English as a foreign language(EFL)after school for 6 ***:Questionnaire and group interview data support our hypothesized mechanism:learners'activity-specific intrinsic motivation(IM)for using Duolingo and their underlying psychological need for autonomy and competence can be transferred to a more general level,thereby enhancing learners'global ***:The proposed theoretical model expands our understanding of how digital technology stimulates learners'L2 motivation;it can help L2 educators design better technological affordances to promote learners'motivation both in and outside the classroom.

关键词： Digital game-based learning L2 motivation MALL self-determination theory

Reinventing Systems for Equity

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ECNU Review of Education 2024年第2期7卷 214-229页

作者： linda Darling-Hammond Learning Policy Institute I530 Page Mill Road SuitePalo AltoCAUSA

Highlights Around the world,nations are grappling with the longstanding inequalities in education and society that were made more visible during the pandemic-along with the increasing educational demands of our fast-changing,knowledge-based *** article outlines the anatomy of educational inequality and the demands for students to develop“learning ability.”

关键词： Educational equity education reform teacher development

A Comprehensive Survey for Privacy-Preserving Biometrics: Recent Approaches, Challenges, and Future Directions

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Computers, Materials & Continua 2024年第2期78卷 2087-2110页

作者： Shahriar Md Arman Tao Yang Shahadat Shahed Alanoud AlMazroa Afraa Attiah linda Mohaisen School of Computer Science and Technology Zhejiang Gongshang UniversityHangzhou310018China School of Computer Science and Technology Hangzhou Dianzi UniversityHangzhou310018China College of Computer and Information Sciences Princess Nourah bint Abdulrahman UniversityRiyadh84428Saudi Arabia Faculty of Computing and Information Technology King Abdulaziz UniversityJeddah21589Saudi Arabia

The rapid growth of smart technologies and services has intensified the challenges surrounding identity authenti-cation *** credentials are increasingly being used for verification due to their advantages over traditional methods,making it crucial to safeguard the privacy of people’s biometric data in various *** paper offers an in-depth exploration for privacy-preserving techniques and potential threats to biometric *** proposes a noble and thorough taxonomy survey for privacy-preserving techniques,as well as a systematic framework for categorizing the field’s existing *** review the state-of-the-art methods and address their advantages and limitations in the context of various biometric modalities,such as face,fingerprint,and eye *** survey encompasses various categories of privacy-preserving mechanisms and examines the trade-offs between security,privacy,and recognition performance,as well as the issues and future research *** aims to provide researchers,professionals,and decision-makers with a thorough understanding of the existing privacy-preserving solutions in biometric recognition systems and serves as the foundation of the development of more secure and privacy-preserving biometric technologies.

关键词： Biometric modalities biometric recognition biometric security privacy-preserving security threats

Dual mobility in primary total hip arthroplasty:A temptation from the devil or a blessing from above

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World Journal of Orthopedics 2024年第6期15卷 512-519页

作者： Raymond Klumpp linda Boerci Francesco Buonanotte Marco Zeppieri Unita Operativa Complessa Ortopedia e Traumatologia Ospedale Treviglio-Caravaggio ASSTBergamo Ovest 24047Italy Department of Orthopedics Universitàdegli Studi di Milano-BicoccaMonza 20090Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy

Dual mobility(DM)bearings have gained significant attention in the field of total hip arthroplasty(THA)as a valid treatment option in cases of revision for instability after THA whereas its use in primary THA is still a matter of *** manuscript explores the pathology,incidence,diagnosis,treatment options,prognosis,ongoing studies in the literature,and future perspectives related to the use of DM bearings employed in primary *** bearings are primarily designed to address one of the major concerns in THA:Instability of the prosthetic *** is both for the surgeon and the patient a devastating postoperative complication,leading to significant pain and subsequent apprehension by the patient and may require revision *** use of DM implants poses the worry of wear-related complications,such as accelerated polyethylene wear and osteolysis,which also pose challenges to long-term implant *** technique has seen a steady rise in recent years,with multiple studies reporting favorable *** incidence of their utilization varies among institutions and surgeons,reflecting differing preferences and patient *** diagnosis of instability and wear-related complications in THA often involves clinical assessment,imaging modalities such as X-rays,computed tomography scans,and sometimes advanced imaging techniques like magnetic resonance *** bearings can be considered as an option when patients present neurologic pathologies such as Parkinson's disease or recurrent dislocations after *** bearings provide an additional articulation point within the implant,facilitating a greater range of motion and inherent *** design allows for reduced risk of dislocation and improved functional *** implant manufacturers offer different designs and sizes of DM bearings to suit individual patient *** literature suggests that the use of DM bearings in primary THA has demonstrated promising outcomes in terms

关键词： Dual mobility First implant Hip arthroplasty Surgical technique Differential diagnosis