Cancer-associated point mutations within the extracellular domain of PTPRD affect protein stability and HSPG interaction.

PTPRD, a well-established tumor suppressor gene, encodes the protein tyrosine phosphatase-type D. This protein consists of three immunoglobulin-like (Ig) domains, four to eight fibronectin type 3 (FN) domains, a single transmembrane segment, and two cytoplasmic tandem tyrosine phosphatase domains. PTPRD is known to harbor various cancer-associated point mutations. While it is assumed that PTPRD regulates cellular functions as a tumor suppressor through the tyrosine phosphatase activity in the intracellular region, the function of its extracellular domain (ECD) in cancer is not well understood. In this study, we systematically examined the impact of 92 cancer-associated point mutations within the ECD. We found that 69.6% (64 out of 92) of these mutations suppressed total protein expression and/or plasma membrane localization. Notably, almost all mutations (20 out of 21) within the region between the last FN domain and transmembrane segment affected protein expression and/or localization, highlighting the importance of this region for protein stability. We further found that some mutations within the Ig domains adjacent to the glycosaminoglycan-binding pocket enhanced PTPRD's binding ability to heparan sulfate proteoglycans (HSPGs). This interaction is proposed to suppress phosphatase activity. Our findings therefore suggest that HSPG-mediated attenuation of phosphatase activity may be involved in tumorigenic processes through PTPRD dysregulation.

Tandem mass spectrometric assay of N-acetylglucosamine-6-sulfatase for multiplex analysis of mucopolysaccharidosis-IIID in dried blood spots.

Previously we developed a multiplex liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay using dried blood spots for all subtypes of mucopolysaccharidoses (MPS) except MPS-IIID. Here we show that the MPS-IIID enzyme N-acetylglucosamine-6-sulfatase (GNS) is inhibited in dried blood spot (DBS) extracts, but activity can be recovered if the extract is diluted to reduce the concentrations of endogenous inhibitors. The new GNS assay displays acceptable characteristics including linearity in product formation with incubation time and amount of enzyme, low variability, and ability to distinguish MPS-IIID-affected from healthy patients using DBS. The assay can be added to the LC-MS/MS multiplex panel for all MPS subtypes requiring ∼2 min per newborn for the LC-MS/MS run.

The associations among type D personality and nomophobia, metacognitions about smartphone use, smartphone addiction in Chinese university freshmen: a two-wave study.

OBJECTIVE: This study aimed to examine longitudinal associations of Type D personality and smartphone addiction, while also exploring the mediating roles of nomophobia and metacognitions about smartphone use. METHODS: Type D Personality Scale-14 (T1), Nomophobia Questionnaire (T2), Metacognitions about Smartphone Use Questionnaire (T2) and Smartphone Addiction Scale Short Version (T2) were applied at two time points. 653 university freshmen (Mage= 18.56, SD = 0.65) from a university in China were surveyed. RESULTS: (1) Type D personality was significantly and positively correlated with nomophobia, negative metacognition, and smartphone addiction. In contrast, the correlation between Type D personality and positive metacognition did not reach the significant level. (2) Compared with individuals with non-Type D personality, those with Type D personality scored significantly higher on nomophobia, negative metacognition, and smartphone addiction. However, the difference was not significant for positive metacognition. (3) Nomophobia and metacognitions about smartphone use fully mediated the relationship between Type D personality and smartphone addiction. While the mediating effects of nomophobia and negative metacognition were significant, the mediating effect of positive metacognition was not significant. CONCLUSIONS: Type D personality can not only affect smartphone addiction directly but also indirectly through nomophobia and negative metacognition. Therefore, to prevent and intervene in smartphone addiction, we can start from both affect (nomophobia) and metacognition (negative metacognitions about smartphone use).

The DS-14 questionnaire: psychometric characteristics and utility in patients with obstructive sleep apnea.

Little is known about type D personality in patients with obstructive sleep apnea (OSA). The DS-14 questionnaire is the standard tool to assess this personality type, but it has not been properly validated in patients with OSA, nor has it been correlated with clinical features in these patients. PURPOSE: To determine the internal consistency and test-retest reliability of the DS-14 questionnaire, as well as the prevalence of type D personality in the overall OSA sample and subgroups. We assessed the influence of type D on perceived symptoms and its congruence with self-reported measures of personality, depression, fatigue, anxiety, quality of life, and quality of sleep. METHODS: Patients with OSA completed the DS-14 questionnaire, Big Five Inventory-2 questionnaire, Hospital Anxiety and Depression Scale, SF-36 Health Survey Questionnaire, Epworth Sleepiness Scale and Stanford Sleepiness Scale, Pittsburgh Sleep Quality Index and Insomnia Severity Index, Fatigue Assessment Scale, and Checklist Individual Strength. After 1 month, the DS-14 questionnaire was repeated. RESULTS: The overall prevalence of type D personality was 32%. Internal consistency (negative affectivity: α = 0.880, social inhibition: α = 0.851) and diagnostic test-retest reliability (kappa value = 0.664) of the DS-14 questionnaire were high. Significantly more symptoms of anxiety, depression, poor sleep quality, fatigue, and a worse health perception were found in OSA with type D. Neither OSA severity nor REM predominance altered these observations. CONCLUSION: The DS-14 questionnaire showed excellent psychometric properties in patients with OSA. The prevalence of type D personality in patients with OSA was higher than in the general population. The presence of type D personality was associated with higher symptom burden.

Intestinal pathology in goats challenged with Clostridium perfringens type D strain CN1020 wild-type and its genetically modified derivatives.

Clostridium perfringens type D is the causative agent of enterotoxemia in sheep, goats, and cattle. Although in sheep and cattle, the disease is mainly characterized by neurological clinical signs and lesions, goats with type D enterotoxemia frequently have alterations of the alimentary system. Epsilon toxin (ETX) is the main virulence factor of C. perfringens type D, although the role of ETX in intestinal lesions in goats with type D enterotoxemia has not been fully characterized. We evaluated the contribution of ETX to C. perfringens type D enteric pathogenicity using an intraduodenal challenge model in young goats, with the virulent C. perfringens type D wild-type strain CN1020; its isogenic etx null mutant; an etx-complemented strain; and sterile, non-toxic culture medium. The intestinal tract of each animal was evaluated grossly, microscopically, and immunohistochemically for activated caspase-3. Both ETX-producing strains induced extensive enterocolitis characterized by severe mucosal necrosis, apoptosis, and diffuse suppurative infiltrates. No significant gross or microscopic lesions were observed in goats inoculated with the non-ETX-containing inocula. These results confirm that ETX is essential for the production of intestinal lesions in goats with type D disease. Also, our results suggest that the intestinal pathology of type D enterotoxemia in goats is, at least in part, associated with apoptosis.

Association between personality traits and psychological distress among postmenopausal women with coronary heart disease: A cross-sectional survey and mediation analysis.

Postmenopausal women with negative personality characteristics are at an increased risk of psychological disorders, yet little is known about the mechanism underlying the relationship between type D personality and psychological distress in postmenopausal women with coronary disease. This study assessed the mediating roles of perceived social support and self-perceived burden in the relationship between type D and psychological distress based on the equity theory and stress-buffering model. Demographic characteristics, type D, psychological distress, perceived social support, and self-perceived burden were completed by 335 participants with self-reported questionnaires using a cross-sectional design in Southeast China. The results revealed that perceived social support and self-perceived burden both separately and serially mediated the relationship between type D personality and psychological distress. Effective intervention strategies aimed at improving perceived social support or reducing self-perceived burden may be beneficial in reducing psychological distress.

Two novel recombinant human mastadenovirus D genotypes associated with acute respiratory illness.

Two novel genotypes of species human mastadenovirus D designated 109 and 110 were isolated from three epidemiologically unrelated cases of acute respiratory disease detected in January 2018 by surveillance efforts at the California/Mexico border. Both genotypes represent examples of intertypic recombination. Genotype D109 is most closely related to genotype D56 (97.68% genomic similarity) and features a type D22-like penton base, a type D19-like hexon gene, and a type D9-like fiber [P22/H19/F9]. On the other hand, genotype D110 is most closely related to type D22 (96.94% genomic similarity) and features a type D67-like penton base, a novel hexon gene, and a type D9-like fiber [P67/H110/F9]. Importantly, the fibers of both novel genotypes are highly similar to those of genotypes D56 and D59, which have also been isolated from a few cases of respiratory infections. The present report shows data contributing to the understanding of the molecular determinants of the expanded tissue tropism of certain members of species HAdV-D.

The combined impact of Type D personality and depression on cardiovascular events after acute myocardial infarction.

BACKGROUND: Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI). METHODS: This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period. RESULTS: A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (-) groups had a higher risk of MACE [95% confidence interval (CI) 1.74-6.07] (95% CI 1.25-2.96) and ISR (95% CI 3.09-8.28) (95% CI 1.85-6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (-) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients. CONCLUSIONS: These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.

Patient-reported outcome measures on mental health and psychosocial factors in patients with Brugada syndrome.

AIMS: Brugada syndrome (BrS) is a hereditary arrhythmic disease, associated with sudden cardiac death. To date, little is known about the psychosocial correlates and impacts associated with this disease. The aim of this study was to assess a set of patient-reported psychosocial outcomes, to better profile these patients, and to propose a tailored psychosocial care. METHODS AND RESULTS: Patients were recruited at the European reference Centre for BrS at Universitair Ziekenhuis Brussel, Belgium. Recruitment was undertaken in two phases: phase 1 (retrospective), patients with confirmed BrS, and phase 2 (prospective), patients referred for ajmaline testing who had an either positive or negative diagnosis. BrS patients were compared to controls from the general population. Two hundred and nine questionnaires were analysed (144 retrospective and 65 prospective). Collected patient-reported outcomes were on mental health (12 item General Health Questionnaire; GHQ-12), social support (Oslo Social Support Scale), health-related quality of life, presence of Type-D personality (Type-D Scale; DS14), coping styles (Brief-COPE), and personality dimensions (Ten Item Personality Inventory). Results showed higher mental distress (GHQ-12) in BrS patients (2.53 ± 3.03) than in the general population (P < 0.001) and higher prevalence (32.7%) of Type D personality (P < 0.001) in patients with confirmed Brugada syndrome (BrS +). A strong correlation was found in the BrS + group (0.611, P < 0.001) between DS14 negative affectivity subscale and mental distress (GHQ-12). CONCLUSION: Mental distress and type D personality are significantly more common in BrS patients compared to the general population. This clearly illustrates the necessity to include mental health screening and care as standard for BrS.

Predictive value of type D personality for cardiac events in Chinese patients with acute myocardial infarction.

BACKGROUND: Our study aimed to investigate the association between type D personality and adverse cardiac events in chinese patients after acute myocardial infarction (AMI). METHODS: Patients with AMI admitted to cardiac care unit (CCU) of China-Japan Friendship Hospital, Beijing, China between January 2016 and December 2017 were enrolled. 257 patients completed psychological questionnaires at enrollment. Type D personality was assessed with 14-item Type D Scale-14 (DS14). Anxiety and depression were quantified using Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regression analysis was used to determine the independent predictors of in-hospital major adverse cardiac events (MACEs), while cox regression analysis was used to evaluate post-discharge endpoints. RESULTS: 54 patients (21%) were classified as Type D personality defined by the combination of a negative affectivity (NA) score ≥ 10 and a social inhibition (SI) score ≥ 10 on the DS14. Patients with Type D personality displayed significantly higher scores of anxiety (7.4 ± 3.1 vs. 4.2 ± 3.1, p < .001) and depression (7.2 ± 3.8 vs. 4.0 ± 3.4, p < .001). AMI patients with Type D personality had higher prevalence rates of anxiety (χ2 = 30.095, P < .001) and depression (χ2 = 27.082, P < .001). Type D group also displayed a significantly higher level of blood lipoprotein(a) (177.2 ± 200.7 vs. 118.1 ± 255.7 mg/L, P = .048). The incidence of in-hospital MACEs was higher in type D than in non-Type D patients (24.1% vs. 11.3%, χ2 = 5.751, P = .026). Multivariable logistic regression showed three significant independent predictors of in-hospital MACEs: age [odds ratio(OR) = 1.055; 95%CI 1.016-1.095, p = .004], type-D personality(OR 3.332; 95% CI 1.149-9.661, p = .014) and killip classification(OR 2.275, 95% CI 1.506-3.437, p < .001). The average follow-up time was 31 (23-37.5) months. Type D patients had higher incidences of post-discharge events(23.1% vs. 11.5%, p = .032). In the analysis of post-discharge events by Cox regression, χ2 of the Cox regression equation was 16.795 (P = .032). Smoking (HR 2.602; 95% CI1.266-5.347, p = .009) and type-D personality (HR 2.265; 95%CI 1.028-4.988, p = .042) were independent predictors of long-term cardiac events. Kaplan-Meier curves showed significant difference in event-free survival between type D and non-type D group (p = .043). CONCLUSIONS: Type D personality is an independent predictor of in-hospital and post-discharge cardiac events after AMI in Chinese patients.

Association between type D personality and supportive care needs in elderly patients with breast cancer: a prospective longitudinal observational study.

BACKGROUND: Elderly patients with breast cancer often have more unmet needs after receiving common treatments such as surgery and chemotherapy. Type D personality has been related to supportive care needs in the general population. However, its association with supportive care needs in elderly breast cancer patients has not been prospectively explored. This study aimed to address this gap. OBJECTIVES: The aim was to understand the impact of Type D personality on the supportive care needs of elderly breast cancer patients at diagnosis, 2 weeks postoperatively, 3 months postoperatively, and 6 months postoperatively and to analyse the impact of Type D personality on the changing trajectory of supportive care needs after controlling for confounding factors such as demographics, symptom distress and social support. METHODS: A total of 122 elderly patients (≥ 65 years) with breast cancer in Ruijin Hospital, Shanghai, China, were included from September 2021 until August 2022. Supportive care needs were measured by the Supportive Care Needs Survey Short Form and tracked at diagnosis, 2 weeks postoperatively, 3 months postoperatively, and 6 months postoperatively. To investigate changes in the supportive care needs of elderly breast cancer patients and the effect of Type D personality on these needs, a linear mixed model was applied. RESULTS: A total of 122 elderly patients participated. There was an overall decreasing trend in supportive care needs, with Type D personality patients having significantly higher levels of supportive care needs than the non-Type D personality patients at all stages. Through linear mixed models, it was found that the Type D personality group had a lower overall downward trend than the non-Type D personality group, with need levels remaining consistently higher. This difference persisted after controlling for demographic information, symptom burden, social support. CONCLUSIONS: Elderly breast cancer patients with Type D personality had higher levels of supportive care needs and a slower rate of decline that was maintained over a longer period than those with non-Type D personality.

The relation of psychological status and type D personality with central sensitization in knee osteoarthritis: everything is in your mind!

To evaluate the relation of psychosocial parameters and type D personality with central sensitization in knee osteoarthritis (OA). The study included 126 patients with knee OA according to the American College of Rheumatology criteria. Sociodemographic variables (age, gender, education, marital status, annual income), alcohol consumption/smoking, body mass index, comorbidities, and duration of symptoms were noted. Radiographic evaluation was performed according to the Kellgren-Lawrence grading system. The Western Ontario and McMaster Universities Osteoarthritis Index was used for clinical evaluation. Type D personality, negative affectivity, and social inhibition were evaluated using the type D Scale-14 (DS14). Central sensitization was assessed by the central sensitization inventory (CSI), while psychological status, quality of life, and sleep were assessed by the Hospital Anxiety and Depression Scale (HADS), an abbreviated version of the World Health Organization Quality of Life Instrument (WHOQOL-BREF), and the Jenkins Sleep Evaluation Scale (JSS), respectively. The effect of type D personality on study parameters including central sensitization, as well as the risk factors for the development of central sensitization were assessed by regression analyses. Patients with type D personality had higher CSI, HADS scores and lower WHOQOL-BREF scores for psychological health, social relationship, environment and general quality of life. Linear regression analysis showed that the DS14 total score has a significant positive relation with CSI (ß = 0.4, p < 0.05), HADS-depression (ß = 0.4, p < 0.05), HADS-anxiety (ß = 0.5, p < 0.05), and HADS-total scores (ß = 0.5, p < 0.05). It also had a significant negative effect on all domains of WHOQOL-BREF (p < 0.05 for all). Logistic regression analysis revealed that JSS [Odds ratio (OR) 0.83, 95% CI 0.73-0.94; p = 0.003] and negative affectivity (OR 0.78, 95% CI 0.65-0.94; p = 0.008) were independent risk factors for the development of central sensitization in knee OA. Type D personality has an impact on quality of life, central sensitization, and psychological health, with negative affectivity and sleep impairment serving as independent risk factors for central sensitization. While managing patients with knee OA, these intimate relationships should be taken into consideration.

Experimental acute Clostridium perfringens type D enterotoxemia in sheep is not characterized by specific renal lesions.

Type D enterotoxemia, caused by Clostridium perfringens epsilon toxin (ETX), is one of the most economically important clostridial diseases of sheep. Acute type D enterotoxemia is characterized by well-documented lesions in the nervous, cardiocirculatory, and pulmonary systems. However, discrepancies and confusion exist as to whether renal lesions are part of the spectrum of lesions of this condition, which is controversial considering that for many decades it has been colloquially referred to as "pulpy kidney disease." Here, the authors assess renal changes in an experimental model of acute type D enterotoxemia in sheep and evaluate the possible role of ETX in their genesis. Four groups of 6 sheep each were intraduodenally inoculated with either a wild-type virulent C. perfringens type D strain, an etx knockout mutant unable to produce ETX, the etx mutant strain complemented with the wild-type etx gene that regains the ETX toxin production, or sterile culture medium (control group). All sheep were autopsied less than 24 hours after inoculation; none of them developed gross lesions in the kidneys. Ten predefined histologic renal changes were scored in each sheep. The proportion of sheep with microscopic changes and their severity scores did not differ significantly between groups. Mild intratubular medullary hemorrhage was observed in only 2 of the 12 sheep inoculated with the wild-type or etx-complemented bacterial strains, but not in the 12 sheep of the other 2 groups. The authors conclude that no specific gross or histologic renal lesions are observed in sheep with experimental acute type D enterotoxemia.

Relationships among Symptoms, Disability, Type D Personality, and Quality of Life in Patients with Migraine: A Cross-Sectional Study in South Korea.

BACKGROUND: Type D personality as a personality vulnerable to stress consists of negative affectivity and social inhibition, and it is related to symptoms and decreased quality of life in patients with chronic illness. AIM: This study aimed to explore the relationships among migraine symptoms, disability, type D personality, and quality of life in patients with migraine. METHODS: A convenience sample of 135 patients with migraine was collected at the neurologic outpatient clinics of two tertiary hospitals in South Korea. Frequency and severity of migraine symptoms, Migraine Disability Assessment, type D personality, and quality of life were investigated using a structured questionnaire. A descriptive cross-sectional design was used. RESULTS: Sixty-one (45.2%) were classified as type D personality. The intensity of the most severe migraine and Migraine Disability Assessment scores in subjects with type D personality were significantly higher than those in subjects without type D personality. In addition, the quality of life score of subjects with type D personality was significantly lower than in subjects without type D personality. The intensity of the migraine, Migraine Disability Assessment score, and type D personality were significant factors influencing quality of life on stepwise multiple regression analysis. CONCLUSIONS: Type D personality was related to migraine symptoms, disability, and quality of life in patients with migraine.

Diagnosis and management of congenital type D esophageal atresia.

This study was performed to describe the current clinical practice and outcomes of type D esophageal atresia. We retrospectively analyzed 10 patients who were diagnosed with type D esophageal atresia and underwent esophageal atresia and tracheoesophageal fistula repair in the Capital Institute of Pediatrics and Beijing Children's Hospital from January 2017 to May 2022. Ten patients include three newborns and seven non-newborns. Seven (70%) cases were misdiagnosed as type C esophageal atresia before the first operation. Three neonatal children underwent thoracoscopic distal tracheoesophageal fistula ligation and esophageal anastomosis: the proximal tracheoesophageal fistula was simultaneously repaired with thoracoscopy in one of these children, and the proximal tracheoesophageal fistula was not detected under thoracoscopy in the other two children. Among the seven non-neonatal children, one underwent repair of the proximal tracheoesophageal fistula through the chest and the other six underwent repair through the neck. Nine patients were cured, and one died of complications of severe congenital heart disease. Type D esophageal atresia lacks specific clinical manifestations. Misdiagnosis as type C esophageal atresia is the main cause of an unplanned reoperation. Patients without severe malformations have a good prognosis.

Psychiatric disorders, rumination, and metacognitions in patients with type D personality and coronary heart disease.

BACKGROUND: Little is known regarding the prevalence of psychiatric disorders in patients with both coronary heart disease (CHD) and type D personality, and whether these patients may benefit from psychotherapy that modifies metacognitive beliefs implicated in disorder maintenance. This study explored prevalence rates among these patients and associations between type D characteristics, rumination and metacognitions. METHODS: Forty-seven consecutive patients with CHD who scored positive for type D personality were included in this pre-planned study. Participants underwent structured clinical interviews for mental and personality disorders and completed questionnaires assessing rumination and metacognitions. RESULTS: Mean age was 53.8 (SD 8.1) years and 21.3% were female. At least one mood disorder or anxiety disorder was found in 70.2% and 61.7% of the patients. The most common disorders were major depressive disorder (59.6%), social phobia (40.4%), and generalized anxiety disorder (29.8%). At least one personality disorder was detected in 42.6%. Only 21% reported ongoing treatment with psychotropic medication whereas none had psychotherapy. Metacognitions and rumination were significantly associated with negative affectivity (0.53-0.72, p < .001) but not social inhibition. CONCLUSION: Mood and anxiety disorders were highly prevalent and relatively untreated among these patients. Future studies should test the metacognitive model for type D personality.

A Controlled Community Study of Distress and Resilience in Women Diagnosed with Fibromyalgia and Systemic Lupus Erythematosus.

This study examines psychological and physical influences on the distress and well-being of patients with chronic rheumatic diseases. The study aims were to (1) evaluate the relative contribution of objective disease activity and psychological factors on the wellbeing of patients with systemic lupus erythematosus (SLE); (2) to compare the psychological distress of SLE patients to fibromyalgia (FM) patients and healthy controls, and to (3) characterize subgroups of patients by performing cluster analysis using psychological variables. Participants were ascertained from closed forums and social media channels resulting in 41 women with a diagnosis of SLE, 47 with a diagnosis of FM, and 77 healthy controls (HC). Hierarchical linear regression for well-being of SLE patients found that most of the variance was accounted for by social support. Cluster analysis performed on the entire sample identified two clusters, a distressed group tending to Type D personality, anxiety and depression, low in well-being and social support, and a resilient group; the proportion of resilient individuals was highest in the HC intermediate in the SLE group and lowest in the FM group. The importance of psychological variables vs disease severity in these two rheumatic diseases for wellbeing is demonstrated by these results. The results suggest that psychological interventions that enhance the experience of social support in medical settings, might benefit patients with both diseases, and be of particular importance to the well-being of patients who are more distressed.

ICA agenesis with transcavernous anastomosis: a systematic review.

PURPOSE: To present two cases of Internal Carotid Artery (ICA) agenesis and conduct a systematic review to assess for associations with other anomalies and intracranial aneurysms. METHODOLOGY: We performed a retrospective review of published cases of patients with ICA agenesis with intercavernous anastomosis in MEDLINE database on August 2022 using search terms "internal carotid artery", "agenesis" and "transcavernous anastomosis". We also included two cases of ICA agenesis with type D collateral that we encountered. RESULTS: Total of 46 studies that included 48 patients and two of our cases resulted in 50 patients. Only 70% of studies reported the location of a collateral vessel of which more than two-thirds were on the floor of sella. More than half of the vessels connected cavernous segments of ICA. A1 segment ipsilateral to the side of ICA agenesis was absent in most of the cases but was not true for all cases. Aneurysm was seen in more than one-quarter of the patients. It can also mimic microadenoma as in prior reported cases as well as in one of our cases. CONCLUSION: ICA agenesis with type D collateral is a rare anomaly but clinically relevant due to the increased risk of an aneurysm or mimic microadenoma or false alarm for occlusion of ICA but knowledge of this rare variant can help in better management of these patients.

Type D Personality Independently Predicts Erectile Dysfunction in Taiwanese Young Men.

BACKGROUND: Studies have demonstrated that erectile dysfunction has a well-established bidirectional relationship with depression and have indicated an independent association of type D personality (TDP) with depression. Nevertheless, the relationship of erectile dysfunction with TDP has not been sufficiently examined. AIM: To examine the associations among depression symptoms, TDP, and erectile dysfunction. METHODS: The cross-sectional study recruited 1740 sexually active Taiwanese men (age: 20-40 years) with erectile dysfunction. Participants completed an online questionnaire collecting general demographic information and containing the International Index of Erectile Function-5, Type D Scale-14, and Depression and Somatic Symptom Scale. Pearson's chi squared or Student's t'test was conducted for comparisons between participants with vs without TDP. We conducted multivariate and univariate logistic regression analysis to investigate the predictors of moderate/severe erectile dysfunction. OUTCOMES: The prevalence of TDP and moderate/severe erectile dysfunction, the associations between TDP and the severities of depression symptoms and erectile dysfunction, and independent risk factors for moderate/severe erectile dysfunction. RESULTS: A total of 360 (15.9%) and 941 (54.08%) men had moderate/severe erectile dysfunction and TDP, respectively. Men with TDP reported significantly higher total and subscale scores in the International Index of Erectile Function-5 and the Depression and Somatic Symptom Scale; this group also exhibited higher prevalence of moderate or severe erectile dysfunction. According to the univariate analysis, all variables significantly predicted moderate or severe erectile dysfunction except for age and body mass index. A multivariate analysis revealed TDP status and depression symptoms to be independent predictors of moderate or severe erectile dysfunction. With regard to subscales of the Type D Scale-14, we discovered that social inhibition had a greater influence on moderate or severe erectile dysfunction than had negative affectivity. A mediation analysis indicated that the relationship between TDP and erectile dysfunction was mediated by depressive symptoms. CLINICAL IMPLICATIONS: Research has suggested that compared with the general population, individuals with TDP are less willing to seek medical consultation, have lower medication adherence, and have heightened risk of depression; urologists should strive to identify patients with TDP. STRENGTHS & LIMITATIONS: This study is the first to investigate the association of TDP with erectile dysfunction in a large population of young men by using validated instruments. Conclusions on causality cannot be drawn due to the study's cross-sectional nature. CONCLUSION: This research revealed relationships among TDP, depression symptoms, and erectile dysfunction in Taiwanese young men. Fan Y-H, Liou Y-J, Cheng W-M. Type D Personality Independently Predicts Erectile Dysfunction in Taiwanese Young Men. J Sex Med 2022;19:1397-1403.

Type D personality and self-esteem in patients with fibromyalgia: a cross-sectional case-control study.

Fibromyalgia (FM) is a complex disease related to several factors. Psychosocial elements, such as type D personality and low level of self-esteem, might increase disease burden. The current study aimed to investigate type D personality and self-esteem in patients with FM. Female patients with FM and age-matched, healthy controls were enrolled in this cross-sectional study. Type D personality was evaluated using the type D scale (DS-14). The Rosenberg self-esteem scale (RSES) was used to assess self-esteem and psychosomatic symptoms. Type D personality was observed in 58.6% of the patients (n = 70) and in 21.7% of the controls (n = 60) (p < 0.001). When compared to patients with non-type D personality, those with type D personality revealed lower self-esteem and poorer health status (p < 0.05 for both), and higher anxiety and depression scores (p < 0.001 for both). In binary logistic regression analysis, the odds of FM were 3.6 times higher (OR = 3.653, 95% CI 1.547-8.625) for patients with type D personality, after adjusting for age and education level. In addition, depression (OR= 1.178, Cl 95% 1.055 - 1.316) and lower education level (OR= 0.818, Cl 95% 0.682 - 0.982) were significantly related to type D personality in FM. Type D personality is closely associated with FM. Type D personality is more common in female patients with FM when compared to healthy women. Depression and lower education level are potential confounders of type D personality in FM.