Impact of anti-fracture medications on bone material and strength properties: a systematic review and meta-analysis.

Background and aims: Reduced bone mineral density (BMD) and microarchitectural deterioration contribute to increased fracture risk. Although the effects of anti-fracture medications (AFMs) on BMD are well-documented, their impact on bone material properties (BMPs) remains poorly characterized. Accordingly, we conducted a systematic review and meta-analysis to evaluate the effects of AFMs on BMPs. Based on data availability, we further categorized AFMs into anti-resorptives, bisphosphonates alone, and strontium ranelate subgroups to perform additional analyses of BMPs in osteoporotic patients. Methods: We did a comprehensive search of three databases, namely, PubMed, Web of Science, and Google Scholar, using various permutation combinations, and used Comprehensive Meta-Analysis software to analyze the extracted data. Results: The 15 eligible studies (randomized and non-randomized) compared the following: (1) 301 AFM-treated patients with 225 on placebo; (2) 191 patients treated with anti-resorptives with 131 on placebo; (3) 86 bisphosphonate-treated patients with 66 on placebo; and (4) 84 strontium ranelate-treated patients with 70 on placebo. Pooled analysis showed that AFMs significantly decreased cortical bone crystallinity [standardized difference in means (SDM) -1.394] and collagen maturity [SDM -0.855], and collagen maturity in cancellous bone [SDM -0.631]. Additionally, anti-resorptives (bisphosphonates and denosumab) significantly increased crystallinity [SDM 0.387], mineral-matrix ratio [SDM 0.771], microhardness [SDM 0.858], and contact hardness [SDM 0.952] of cortical bone. Anti-resorptives increased mineral-matrix ratio [SDM 0.543] and microhardness [SDM 0.864] and decreased collagen maturity [SDM -0.539] in cancellous bone. Restricted analysis of only bisphosphonate-treated studies showed a significant decrease in collagen maturity [SDM -0.650] in cancellous bone and an increase in true hardness [SDM 1.277] in cortical bone. In strontium ranelate-treated patients, there was no difference in BMPs compared to placebo. Conclusion: Collectively, our study suggests that AFMs improve bone quality, which explains their anti-fracture ability that is not fully accounted for by increased BMD in osteoporosis patients.

Intelligence model on sequence-based prediction of PPI using AISSO deep concept with hyperparameter tuning process.

Protein-protein interaction (PPI) prediction is vital for interpreting biological activities. Even though many diverse sorts of data and machine learning approaches have been employed in PPI prediction, performance still has to be enhanced. As a result, we adopted an Aquilla Influenced Shark Smell (AISSO)-based hybrid prediction technique to construct a sequence-dependent PPI prediction model. This model has two stages of operation: feature extraction and prediction. Along with sequence-based and Gene Ontology features, unique features were produced in the feature extraction stage utilizing the improved semantic similarity technique, which may deliver reliable findings. These collected characteristics were then sent to the prediction step, and hybrid neural networks, such as the Improved Recurrent Neural Network and Deep Belief Networks, were used to predict the PPI using modified score level fusion. These neural networks' weight variables were adjusted utilizing a unique optimal methodology called Aquila Influenced Shark Smell (AISSO), and the outcomes showed that the developed model had attained an accuracy of around 88%, which is much better than the traditional methods; this model AISSO-based PPI prediction can provide precise and effective predictions.

Enhanced cardiovascular disease prediction through self-improved Aquila optimized feature selection in quantum neural network & LSTM model.

Introduction: Cardiovascular disease (CVD) stands as a pervasive catalyst for illness and mortality on a global scale, underscoring the imperative for sophisticated prediction methodologies within the ambit of healthcare data analysis. The vast volume of medical data available necessitates effective data mining techniques to extract valuable insights for decision-making and prediction. While machine learning algorithms are commonly employed for CVD diagnosis and prediction, the high dimensionality of datasets poses a performance challenge. Methods: This research paper presents a novel hybrid model for predicting CVD, focusing on an optimal feature set. The proposed model encompasses four main stages namely: preprocessing, feature extraction, feature selection (FS), and classification. Initially, data preprocessing eliminates missing and duplicate values. Subsequently, feature extraction is performed to address dimensionality issues, utilizing measures such as central tendency, qualitative variation, degree of dispersion, and symmetrical uncertainty. FS is optimized using the self-improved Aquila optimization approach. Finally, a hybridized model combining long short-term memory and a quantum neural network is trained using the selected features. An algorithm is devised to optimize the LSTM model's weights. Performance evaluation of the proposed approach is conducted against existing models using specific performance measures. Results: Far dataset-1, accuracy-96.69%, sensitivity-96.62%, specifity-96.77%, precision-96.03%, recall-97.86%, F1-score-96.84%, MCC-96.37%, NPV-96.25%, FPR-3.2%, FNR-3.37% and for dataset-2, accuracy-95.54%, sensitivity-95.86%, specifity-94.51%, precision-96.03%, F1-score-96.94%, MCC-93.03%, NPV-94.66%, FPR-5.4%, FNR-4.1%. The findings of this study contribute to improved CVD prediction by utilizing an efficient hybrid model with an optimized feature set. Discussion: We have proven that our method accurately predicts cardiovascular disease (CVD) with unmatched precision by conducting extensive experiments and validating our methodology on a large dataset of patient demographics and clinical factors. QNN and LSTM frameworks with Aquila feature tuning increase forecast accuracy and reveal cardiovascular risk-related physiological pathways. Our research shows how advanced computational tools may alter sickness prediction and management, contributing to the emerging field of machine learning in healthcare. Our research used a revolutionary methodology and produced significant advances in cardiovascular disease prediction.

Optimizing white light emission in Dy(iii) complexes: impact of energy transfer from mono and bidentate ligands on luminescence.

Complexes of dysprosium(iii) ions with 1,1,1,5,5,5-hexafluoro-2,4-pentanedione featuring various mono and bi-dentate neutral ligands have been prepared and thoroughly investigated. The synthesized complexes exhibit an octa-coordinated environment, achieved by stoichiometrically combining organic ligands and Dy(iii) ions. This octa-coordination environment of Dy(iii) ion was confirmed by FT-IR spectroscopy, thermogravimetry and elemental analysis. Near-white light (NWL) is emitted when complexes were exposed to UV radiation, indicating a significant flow of energy from the sensitizing moieties towards the Dy(iii) ion. This NWL emission might have resulted due to a balance between the intensities corresponding to emission peaks at 480 nm (blue) and 575 nm (yellow) in Dy1-Dy3. Emission spectra recorded at different excitation wavelength were utilized to study the tunability of CIE color coordinates. In addition to their high thermal stability, the complexes display bipolar paramagnetic shifts in their NMR spectra. The 4F9/2 → 6H13/2 transition, contributing ∼62% of the total emission, stands out as a promising candidate for laser amplification due to its dominance in the emission spectra. Additionally, NWL emission observed in a solid Dy(iii) complex opens intriguing possibilities for its application in next-generation white-light emitting devices.

Exploring the role of neutral ligands in modulating the photoluminescence of samarium complexes with 1,1,1,5,5,5-hexafluoro-2,4-pentanedione.

Four eight-coordinated luminescent samarium complexes of type [Sm(hfpd)3L2] and [Sm(hfpd)3L'] [where hfpd = 1,1,1,5,5,5-Hexafluoro-2,4-pentanedione L = tri-octyl-phosphine oxide (TOPO) and L' = 1,10-phenanthroline (phen), neocuproine (neoc) and bathocuproine (bathoc) were synthesized via a stoichiometrically controlled approach. This allows for precise control over the stoichiometry of the complexes, leading to reproducible properties. This investigation focuses on understanding the impact of secondary ligands on the luminescent properties of these complexes. Infrared (IR) spectra provided information about the molecular structures, whereas 1H and 13C nuclear magnetic resonance (NMR) spectra confirmed these structural details along with the coordination of ligands to trivalent Sm ion. The UV-vis spectra revealed the molar absorption coefficient and absorption bands associated with the hfpd ligand and photoluminescence (PL) spectroscopy demonstrated intense orange-red emission (648 nm relative to 4G5/2 → 6H9/2) from the complexes. The Commission Internationale de l'Éclairage (CIE) triangles indicated that the complexes emitted warm orange red light with color coordinates (x, y) ranging from (0.62, 0.36) to (0.40, 0.27). The investigation of the band gap as well as color parameters confirms the utility of these complexes in displays and LEDs.

Retinoic Acid Regulates Spermiogenesis Via Hoxb1 and Shh Signaling in Testicular Germ Cells.

Retinoic acid (RA) regulates all four major events in spermatogenesis; spermatogonial differentiation, meiotic entry, spermiogenesis, and spermiation. For the pre-meiotic phase, Sertoli cells are the source of RA and for the post-meiotic phase, pachytene spermatocytes are the source of RA. While the entire spermatogenic process is regulated by RA, how each of these phases is regulated by RA remains completely unknown. Homeobox B1 (Hoxb1) has two retinoic acid response elements (RARE) upstream and downstream of the gene. In this study, we investigated if RA facilitates spermatogenesis by its action on Hoxb1. The expressions of the Hoxb1 and Sonic hedgehog (Shh) genes were analyzed in the post-natal mouse testes and the testicular localizations of Hoxb1, Shh and Gli1 were analyzed by immunohistochemistry in the adult rat testis. To delineate the signaling mechanisms, Hoxb1 expression was altered in vitro and in vivo using retinoic acid and miR-361-3p. Finally, the levels of miR-361-3p and HOXB1 were analyzed in infertile human sperm samples. Hoxb1 and Shh gene expressions were found to be low in the testis of post-natal Swiss mice of 7, 14, 28, 35, and 60 days, after which the expressions of both spiked. Immunohistochemistry in the adult mouse testis showed the expressions of Hoxb1, Shh, and Gli1 in the elongating spermatids. Exposure of GC2 cells to RA and in vivo IP RA injection upregulated Hoxb1 and Shh signaling in the testis with increased expressions of Shh, Gli1, and Hdac1. Retinoic acid administration in Swiss mice compromised sperm production and reduced epididymal sperm count. The analysis of infertile human semen samples revealed an increased level of HOXB1 and a decreased level of miR-361-3p as compared to fertile controls. We conclude that retinoic acid regulates late stage of spermatogenesis (spermiogenesis) by affecting Hoxb1 and Shh signaling.

SPEM1 Gene Mutation in a Case with Sperm Morphological Defects Leading to Male Infertility.

The present study aimed at identifying the genetic mutation responsible for teratozoospermic infertility in a case with coiled sperm tails. A 33-year-old infertile male was diagnosed with teratozoospermic infertility, with sperm head in coiled (HIC) tail as the most common deformity. We employed whole exome sequencing to identify the genetic cause in this case. Exome sequencing data was filtered using the following criteria: MAF (< 0.003), ALFA project (< 0.001), 1000 Genomes (< 0.003), Granthem (> 50), Polyphen-2 (> 0.70), SIFT (< 0.03), and PhyloP (> = 0) scores. Shortlisted variants were looked in the in-house 29 exomes data available with us, and the variants that affected conserved amino acid residues or led to insertion/deletion or to protein-truncation with a Combined Annotation Dependent Depletion (CADD) score ≥ 10 were shortlisted. The variants thus populated were prioritized according to their roles in spermiogenesis. The study identified a heterozygous mutation c.826C > T (Arg276Trp) in the SPEM1 gene as a potential pathogenic variant that led to teratozoospermic infertility in the case under investigation. The mutation had a minor allele frequency of 0.00008176 in the gnomAd database and was absent in the Indian Genome Variations database. This is the first human study reporting a mutation in the SPEM1 gene as a cause of coiled sperm tails.

Computational and optoelectronic investigations of red-emissive europium (III) ß-diketonate with n-donor ligands for display applications.

Europium complexes exhibiting red luminescence were prepared by employing ß-diketone as main ligand and 1,10-phenanthroline as an additional ligand. Various methods, including 1H NMR, IR spectroscopy and analysis of optical band gap were employed to examine these complexes. The luminescent photophysical properties were investigated using PL spectroscopy and theoretical calculations were conducted to explore radiative transitions probabilities and Judd-Ofelt (J-O) parameters for transitions of type 5D0 → 7F2, 4. J-O parameters were determined using the JOES computer program and results were in good agreement with the outcomes obtained experimentally. The luminescence analysis results have verified the vibrant, single-color red emission of the prepared complexes. The band gap of ternary europium complexes, determined optically, electronically, and theoretically, falls within the range of 3-4 eV. This similarity indicates that these complexes are potentially suitable as semiconductor materials. The results from absorption, electrochemical and photophysical analyses indicate the potential use of synthesized complexes in lighting and display applications.

Resveratrol and male infertility: a systematic review of the literature.

INTRODUCTION: The aim of this study is to provide an updated and comprehensive systematic review on the effects of resveratrol (RSV) in male infertility and sperm preservation. EVIDENCE ACQUISITION: This systematic review followed the MOOSE guidelines for Meta-analyses and Systematic Reviews of Observational Studies and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). Only original articles evaluating the effect of RSV on human spermatozoa in vivo or in vitro were included. EVIDENCE SYNTHESIS: Of the 1806 abstracts evaluated for eligibility, only 12 studies were included in the qualitative synthesis, of which three were prospective in-vivo studies and nine were in-vitro studies. Out of three human studies on RSV, only two studies administered RSV alone, one of them reported a positive impact and the other reported no significant impact on semen parameters. Overall, the in-vitro studies have reported the ability of RSV to protect spermatozoa against damage due to freeze-thaw cycles during cryopreservation. Other in-vitro studies have reported positive effects of RSV in fresh samples and protective effects in cell lines. CONCLUSIONS: Available in-vivo studies are controversial with regard to the effect of RSV in improving semen parameters. In-vitro studies support the use of RSV before sperm cryopreservation. Further well-designed prospective studies on large sample sizes are needed to fully understand the role of RSV in the treatment of male infertility in vivo.

Exome sequencing identified mutations in the WNT1 and COL1A2 genes in osteogenesis imperfecta cases.

BACKGROUND: Osteogenesis imperfecta (OI) is a heritable connective tissue disorder characterized by bone deformities, fractures and reduced bone mass. OI can be inherited as a dominant, recessive, or X-linked disorder. The mutational spectrum has shown that autosomal dominant mutations in the type I collagen-encoding genes are responsible for OI in 85% of the cases. Apart from collagen genes, mutations in more than 20 other genes, such as CRTAP, CREB3L1, MBTPS2, P4HB, SEC24D, SPARC, FKBP10, LEPRE1, PLOD2, PPIB, SERPINF1, SERPINH1, SP7, WNT1, BMP1, TMEM38B, and IFITM5 have been reported in OI. METHODS AND RESULTS: To understand the genetic cause of OI in four cases, we conducted whole exome sequencing, followed by Sanger sequencing. In case #1, we identified a novel c.506delG homozygous mutation in the WNT1 gene, resulting in a frameshift and early truncation of the protein at the 197th amino acid. In cases #2, 3 and 4, we identified a heterozygous c.838G > A mutation in the COL1A2 gene, resulting in a p.Gly280Ser substitution. The clinvar frequency of this mutation is 0.000008 (GnomAD-exomes). This mutation has been identified by other studies as well and appears to be a mutational hot spot. These pathogenic mutations were found to be absent in 96 control samples analyzed for these sites. The presence of these mutations in the cases, their absence in controls, their absence or very low frequency in general population, and their evaluation using various in silico prediction tools suggested their pathogenic nature. CONCLUSIONS: Mutations in the WNT1 and COL1A2 genes explain these cases of osteogenesis imperfecta.

Polymorphisms in the Runx2 and osteocalcin genes affect BMD in postmenopausal women: a systematic review and meta-analysis.

PURPOSE: Runx2 and osteocalcin have pivotal roles in bone homeostasis. Polymorphism of these two genes could alter the function of osteoblasts and consequently bone mineral density (BMD). Attempts to understand the relationship between these polymorphisms and BMD in postmenopausal women across a variety of populations have yielded inconsistent results. This meta-analysis seeks to define the relationship between these polymorphisms with BMD in postmenopausal women. METHODS: Eligible studies were identified from three electronic databases. Data were extracted from the eligible studies (4 studies on Runx2 and 6 studies on osteocalcin), and associations of Runx2 T > C and osteocalcin HindIII polymorphisms with BMD in postmenopausal women were assessed using standard difference in means (SDM) and 95% confidence intervals (CI) as statistical measures. RESULTS: A significant difference in the lumbar spine (LS) BMD in postmenopausal women was observed between the TT and CC homozygotes for the Runx2 T > C (SDM = -0.445, p-value = 0.034). The mutant genotypes (CC) showed significantly lower LS BMD in comparison to wild type genotypes under recessive model of genetic analysis (TC + TT vs. CC: SDM = -0.451, p-value = 0.032). For osteocalcin, HindIII polymorphism, the mutant genotypes (HH) was associated with significantly higher BMD for both LS and femoral neck (FN) than the wild type (hh) homozygotes (SDM = 0.152, p-value = 0.008 and SDM = 0.139, p-value = 0.016 for LS and FN, respectively). There was no association between total hip (TH) BMD and the osteocalcin HindIII polymorphism. CONCLUSIONS: Runx2 T > C and osteocalcin HindIII polymorphisms influence the level of BMD in postmenopausal women and may be used as predictive markers of osteoporosis.

Small RNAs, spermatogenesis, and male infertility: a decade of retrospect.

Small non-coding RNAs (sncRNAs), being the top regulators of gene expression, have been thoroughly studied in various biological systems, including the testis. Research over the last decade has generated significant evidence in support of the crucial roles of sncRNAs in male reproduction, particularly in the maintenance of primordial germ cells, meiosis, spermiogenesis, sperm fertility, and early post-fertilization development. The most commonly studied small RNAs in spermatogenesis are microRNAs (miRNAs), PIWI-interacting RNA (piRNA), small interfering RNA (siRNA), and transfer RNA-derived small RNAs (ts-RNAs). Small non-coding RNAs are crucial in regulating the dynamic, spatial, and temporal gene expression profiles in developing germ cells. A number of small RNAs, particularly miRNAs and tsRNAs, are loaded on spermatozoa during their epididymal maturation. With regard to their roles in fertility, miRNAs have been studied most often, followed by piRNAs and tsRNAs. Dysregulation of more than 100 miRNAs has been shown to correlate with infertility. piRNA and tsRNA dysregulations in infertility have been studied in only 3-5 studies. Sperm-borne small RNAs hold great potential to act as biomarkers of sperm quality and fertility. In this article, we review the role of small RNAs in spermatogenesis, their association with infertility, and their potential as biomarkers of sperm quality and fertility.

Understanding the characteristics of idiopathic osteoporosis by a systematic review and meta-analysis.

PURPOSE: To understand the pathophysiology of idiopathic osteoporosis (IOP) better, we conducted a systematic review and meta-analysis of bone mineral density (BMD), hormones, and bone turnover markers (BTMs) between IOP patients and healthy controls. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an appropriate search query was created, and three databases, including PubMed, ScienceDirect, and Google Scholar, were searched for screening relevant original articles. Feasible information, both qualitative and quantitative, was extracted and used to conduct meta-analyses. Publication bias and heterogeneity among studies were evaluated using appropriate statistical tools. RESULTS: A total of 21 studies were included in the meta-analysis. There was reduced BMD at the lumbar spine (LS) (pooled: SDM: -2.38, p-value: 0.0001), femoral neck (FN) (pooled: SDM: -1.75 p-value: 0.0001), total hip (TH) (pooled: SDM: -1.825, p-value: 0.0001) and distal radius (DR) (pooled: SDM of -0.476, p-value: 0.0001), of which LS was the most affected site. There was no significant change in BTMs compared with healthy controls. Total estradiol (SDM: -1.357, p-value: 0.003) was reduced, and parathyroid hormone (PTH) (SDM: 1.51, p-value: 0.03) and sex hormone-binding globulin (SHBG) (SDM: 1.454, p-value: 0.0001) were elevated in IOP patients compared with healthy controls. CONCLUSION: Our meta-analysis, the first of its kind on IOP, defines it as showing BMD decline maximally at LS compared with healthy controls without any alterations in the BTMs. Further studies are required to understand gender differences and the significance of altered hormonal profiles in this condition.

Challenges and technological interventions in rice-wheat system for resilient food-water-energy-environment nexus in North-western Indo-Gangetic Plains: A review.

Rice (Oryza sativa L.)-wheat (Triticum aestivum L.) cropping system in north-western Indo-Gangetic Plains performed a crucial role in the national food security. However, the widespread and intensive cultivation of this system has led to serious problems such as declining groundwater table (~1 meter year-1) with sharp increase in number of districts under over-exploitation category, residue burning, higher greenhouse gases emission and herbicide resistance in weeds, causing stagnant crop productivity and lesser profitability. In this review article, an attempt has been made to discuss the major issues pertaining to intensive rice-wheat cultivation amidst climate vagaries and futuristic approach to address these challenges. Different tillage- and crop-specific recommendations such as adoption of direct seeded rice, diversification with lesser resource guzzling crops such as maize (Zea mays L.) at least on the periodic manner especially in light-medium soils, inclusion of summer legumes and alternative tillage systems (permanent beds and zero tillage with residue retention) have been suggested to address these issues. However, crop performance under these techniques has been found to be location, soil and cultivar specific. The absence of aerobic tailored genotypes and weeds have been identified as the major constraints in adoption of direct seeded rice. The integrated strategies of conservation tillage, crop breeding program and resource conserving region- and soil-specific agronomic measures with crop diversification would be helpful in tackling the sustainability issues. It requires future efforts on developing crop genotypes suited to conservation tillage, effective weed control strategies and trainings and demonstrations to farmers to switch from conventional rice-wheat system to alternative cropping systems.

A comprehensive review and update on human fertility cryopreservation methods and tools.

The broad conceptualization of fertility preservation and restoration has become already a major concern in the modern western world since a large number of individuals often face it in the everyday life. Driven by different health conditions and/or social reasons, a variety of patients currently rely on routinely and non-routinely applied assisted reproductive technologies, and mostly on the possibility to cryopreserve gametes and/or gonadal tissues for expanding their reproductive lifespan. This review embraces the data present in human-focused literature regarding the up-to-date methodologies and tools contemporarily applied in IVF laboratories' clinical setting of the oocyte, sperm, and embryo cryopreservation and explores the latest news and issues related to the optimization of methods used in ovarian and testicular tissue cryopreservation.

Radon and thoron exhalation rate in the soil of Western Haryana, India.

This study reports the exhalation rates of radon and thoron from surface soil collected from 60 rural sites of district Hisar, Haryana, India. The exhalation rates of Rn222 (radon) and Rn220 (thoron) were measured by portable SMART RnDuo (AQTEK SYSTEMS) using a mass accumulation chamber which was equipped with a scintillation material-coated cell. Dose rates due to natural gamma radiations ranged from 0.526 to 1.139 mSv y-1. The Rn222 mass exhalation rate in soil samples varied from 0.14 to 94.65 mBq kg-1 h-1. Thoron surface exhalation rates ranged from 46.42 to 619.88 Bq m-2 h-1. This study gives an idea about the differences in Rn222 and Rn220 exhalation at different locations which may be due to variations in geological features of the locations and characteristics of the topsoil. The findings show that usage of study area soil as building material is safe.

Optical, electrochemical and photophysical analyses of heteroleptic luminescent Ln(iii) complexes for lighting applications.

A series of lanthanide complexes have been synthesized with fluorinated 1,3-diketones and heteroaromatic ancillary moieties. Spectroscopic studies reveal the attachment of the respective lanthanide ion to the oxygen site of ß-diketone and nitrogen site of auxiliary moieties. The conducting behavior of the complexes is proposed by their optical energy gaps which lie in the range of semiconductors. The emission profiles of the lanthanide complexes demonstrate red and green luminescence owing to the distinctive transitions of Sm3+ and Tb3+ ions, respectively. Energy transfer via antenna effect clearly reveals the effective transfer of energy from the chromophoric moiety to the Ln3+ ion. The prepared conducting and luminescent Ln(iii) complexes might be employed as the emitting component in designing OLEDs.

Efficacy of antiresorptive agents bisphosphonates and denosumab in mitigating hypercalcemia and bone loss in primary hyperparathyroidism: A systematic review and meta-analysis.

Purpose: Primary hyperparathyroidism (PHPT) is characterized by increased bone remodeling and hypercalcemia. Parathyroidectomy (PTX), the current standard of care, is recommended in all symptomatic and some groups of asymptomatic patients. Anti-resorptive therapies (bisphosphonates and denosumab) have been used in patients where PTX is refused or contraindicated. In this meta-analysis, we investigated the effectiveness of anti-resorptives in preventing/treating PHPT-induced bone loss and mitigating hypercalcemia. Method: PubMed, Scopus, and Cochrane Library databases were searched for articles with keywords containing PHPT, bisphosphonates, and denosumab in various combinations. We extracted and tabulated areal BMD (aBMD), serum mineral, and bone turnover parameters from the qualified studies and used comprehensive meta-analysis software for analysis. Results: Of the 1,914 articles screened, 13 were eligible for meta-analysis. In the pooled analysis, 12 months of anti-resoptives (bisphosphonates and denosumab) therapy significantly increased aBMD at the lumbar spine (Standard difference in means (SDM)=0.447, 95% CI=0.230 to 0.664, p=0.0001), femoral neck (SDM=0.270, 95% CI=0.049 to 0.491, p=0.017) and increased serum PTH (SDM=0.489, 95% CI=0.139 to 0.839, p=0.006), and decreased serum calcium (SDM=-0.545, 95% CI=-0.937 to -0.154, p=0.006) compared with baseline. 12 months of bisphosphonate use significantly increased aBMD only at the lumbar spine (SDM=0.330, 95% CI=0.088 to 0.571, p=0.007) with a significant increased in serum PTH levels (SDM=0.546, 95% CI= 0.162 to 0.930, p=0.005), and a decreased in serum calcium (SDM=-0.608, 95% CI=-1.048 to -0.169, p=0.007) and bone-turnover markers (BTMs) compared with baseline. Denosumab use for 12 months significantly increased aBMD at both the lumbar spine (SDM=0.828, 95% CI=0.378 to 1.278, p=0.0001) and femur neck (SDM=0.575, 95% CI=0.135 to 1.015, p=0.010) compared with baseline. Mean lumbar spine aBMD (SDM=0.350, 95% CI=0.041 to 0.659, p=0.027) and serum PTH (SDM=0.602, 95% CI= 0.145 to 1.059, p=0.010) were significantly increased after 12 months of alendronate use compared with placebo. When compared with baseline, alendronate significantly decreased BTMs after 12 months and increased aBMD without altering the PTH and calcium levels after 24 months. Conclusion: Anti-resorptives are effective in mitigating bone loss and hypercalcemia in PHPT while maintaining or increasing aBMD. PTX reversed all changes in PHPT and normalized PTH levels.

Molecular determinants associated with temporal succession of SARS-CoV-2 variants in Uttar Pradesh, India.

The emergence and rapid evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a global crisis that required a detailed characterization of the dynamics of mutational pattern of the viral genome for comprehending its epidemiology, pathogenesis and containment. We investigated the molecular evolution of the SASR-CoV-2 genome during the first, second and third waves of COVID-19 in Uttar Pradesh, India. Nanopore sequencing of the SARS-CoV-2 genome was undertaken in 544 confirmed cases of COVID-19, which included vaccinated and unvaccinated individuals. In the first wave (unvaccinated population), the 20A clade (56.32%) was superior that was replaced by 21A Delta in the second wave, which was more often seen in vaccinated individuals in comparison to unvaccinated (75.84% versus 16.17%, respectively). Subsequently, 21A delta got outcompeted by Omicron (71.8%), especially the 21L variant, in the third wave. We noticed that Q677H appeared in 20A Alpha and stayed up to Delta, D614G appeared in 20A Alpha and stayed in Delta and Omicron variants (got fixed), and several other mutations appeared in Delta and stayed in Omicron. A cross-sectional analysis of the vaccinated and unvaccinated individuals during the second wave revealed signature combinations of E156G, F157Del, L452R, T478K, D614G mutations in the Spike protein that might have facilitated vaccination breach in India. Interestingly, some of these mutation combinations were carried forward from Delta to Omicron. In silico protein docking showed that Omicron had a higher binding affinity with the host ACE2 receptor, resulting in enhanced infectivity of Omicron over the Delta variant. This work has identified the combinations of key mutations causing vaccination breach in India and provided insights into the change of [virus's] binding affinity with evolution, resulting in more virulence in Delta and more infectivity in Omicron variants of SARS-CoV-2. Our findings will help in understanding the COVID-19 disease biology and guide further surveillance of the SARS-CoV-2 genome to facilitate the development of vaccines with better efficacies.

COVID-19 vaccination does not affect male sexual functions.

BACKGROUND: COVID-19 infection has been linked with erectile dysfunction, which has also raised apprehensions about the impact of COVID-19 vaccination on male sexual functions. The purpose of this study was to investigate the impact of COVID-19 vaccination on male sexual functions, such as erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. METHODS: We used International Index of Erectile Function (IIEF) questionnaire for data collection. Mixed methods were adopted for this study, which consisted of Google online form distribution and the distribution of hard copies of the form to those who were not internet friendly. All data were entered in a spreadsheet and scores were assigned to each response according to the standard scores given in the IIEF questionnaire. Fifteen questions, one corresponding to each question in the IIEF questionnaire, were included to assess the impact of COVID-19 vaccination on each sexual function. RESULTS: In the first part of analysis, we calculated sexual function scores and men reporting low sexual function scores (~ 15%) were excluded, providing us with 465 individuals for further analysis. Regarding the impact of COVID-19 vaccination on male sexual functions, 71% individuals reported no impact, 3% reported a decline, 2.7% reported an improvement, and 23.3% could not assess the impact. We also performed analysis on the basis of age-groups of the participants and the duration after vaccination, finding that there was no impact irrespective of the age of subjects or the length of period after vaccination. CONCLUSIONS: COVID-19 vaccination does not affect male sexual functions, including erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall sexual satisfaction.