Establishment of CD8+ T Cell Thymic Central Tolerance to Tissue-Restricted Antigen Requires PD-1.

Highly self-reactive T cells are censored from the repertoire by both central and peripheral tolerance mechanisms upon receipt of high-affinity TCR signals. Clonal deletion is considered a major driver of central tolerance; however, other mechanisms such as induction of regulatory T cells and functional impairment have been described. An understanding of the interplay between these different central tolerance mechanisms is still lacking. We previously showed that impaired clonal deletion to a model tissue-restricted Ag did not compromise tolerance. In this study, we determined that murine T cells that failed clonal deletion were rendered functionally impaired in the thymus. Programmed cell death protein 1 (PD-1) was induced in the thymus and was required to establish cell-intrinsic tolerance to tissue-restricted Ag in CD8+ thymocytes independently of clonal deletion. In bone marrow chimeras, tolerance was not observed in PD-L1-deficient recipients, but tolerance was largely maintained following adoptive transfer of tolerant thymocytes or T cells to PD-L1-deficient recipients. However, CRISPR-mediated ablation of PD-1 in tolerant T cells resulted in broken tolerance, suggesting different PD-1 signaling requirements for establishing versus maintaining tolerance. Finally, we showed that chronic exposure to high-affinity Ag supported the long-term maintenance of tolerance. Taken together, our study identifies a critical role for PD-1 in establishing central tolerance in autoreactive T cells that escape clonal deletion. It also sheds light on potential mechanisms of action of anti-PD-1 pathway immune checkpoint blockade and the development of immune-related adverse events.

A Comparison of Rapid Rule-Learning Strategies in Humans and Monkeys.

Interspecies comparisons are key to deriving an understanding of the behavioral and neural correlates of human cognition from animal models. We perform a detailed comparison of the strategies of female macaque monkeys to male and female humans on a variant of the Wisconsin Card Sorting Test (WCST), a widely studied and applied task that provides a multiattribute measure of cognitive function and depends on the frontal lobe. WCST performance requires the inference of a rule change given ambiguous feedback. We found that well-trained monkeys infer new rules three times more slowly than minimally instructed humans. Input-dependent hidden Markov model-generalized linear models were fit to their choices, revealing hidden states akin to feature-based attention in both species. Decision processes resembled a win-stay, lose-shift strategy with interspecies similarities as well as key differences. Monkeys and humans both test multiple rule hypotheses over a series of rule-search trials and perform inference-like computations to exclude candidate choice options. We quantitatively show that perseveration, random exploration, and poor sensitivity to negative feedback account for the slower task-switching performance in monkeys.

Unraveling materials Berry curvature and Chern numbers from real-time evolution of Bloch states.

Materials can be classified by the topological character of their electronic structure and, in this perspective, global attributes immune to local deformations have been discussed in terms of Berry curvature and Chern numbers. Except for instructional simple models, linear response theories have been ubiquitously used in calculations of topological properties of real materials. Here we propose a completely different and versatile approach to obtain the topological characteristics of materials by calculating physical observables from the real-time evolving Bloch states: The cell-averaged current density reveals the anomalous velocities that lead to the conductivity quantum. Results for prototypical cases are shown, including a spin-frozen valley Hall and a quantum anomalous Hall insulator. The advantage of this method is best illustrated by the example of a quantum spin Hall insulator: The quantized spin Hall conductivity is straightforwardly obtained irrespective of the non-Abelian nature in its Berry curvature. Moreover, the method can be extended to the description of real observables in nonequilibrium states of topological materials.

Space Target Classification Improvement by Generating Micro-Doppler Signatures Considering Incident Angle.

Classifying space targets from debris is critical for radar resource management as well as rapid response during the mid-course phase of space target flight. Due to advances in deep learning techniques, various approaches have been studied to classify space targets by using micro-Doppler signatures. Previous studies have only used micro-Doppler signatures such as spectrogram and cadence velocity diagram (CVD), but in this paper, we propose a method to generate micro-Doppler signatures taking into account the relative incident angle that a radar can obtain during the target tracking process. The AlexNet and ResNet-18 networks, which are representative convolutional neural network architectures, are transfer-learned using two types of datasets constructed using the proposed and conventional signatures to classify six classes of space targets and a debris-cone, rounded cone, cone with empennages, cylinder, curved plate, and square plate. Among the proposed signatures, the spectrogram had lower classification accuracy than the conventional spectrogram, but the classification accuracy increased from 88.97% to 92.11% for CVD. Furthermore, when recalculated not with six classes but simply with only two classes of precessing space targets and tumbling debris, the proposed spectrogram and CVD show the classification accuracy of over 99.82% for both AlexNet and ResNet-18. Specially, for two classes, CVD provided results with higher accuracy than the spectrogram.

Efficacy of 2-stage revision using a prosthesis of antibiotic-loaded acrylic cement spacer with or without cortical strut allograft in infected total elbow arthroplasty.

PURPOSE: We aimed to evaluate the efficacy of a self-manufactured prosthesis of antibiotic-loaded acrylic cement (PROSTALAC) spacer with or without cortical strut allograft in infected total elbow arthroplasty. METHODS: Between March 2009 and February 2018, we enrolled 18 patients (mean age, 66.9 years) who underwent 2-stage revision arthroplasty for prosthetic infection following total elbow arthroplasty. After implant removal in the first stage, we performed débridement and PROSTALAC insertion. During the second stage, we performed reimplantation using a cortical strut allograft for patients with a considerably severe bone defect. The mean follow-up period was 34 months (range, 25-60 months), during which we evaluated the Mayo Elbow Performance Score (MEPS), range of motion (ROM), and blood markers. RESULTS: In all 18 patients, infection control was ensured using intravenous (IV) antibiotic therapy for 6 weeks or IV antibiotics for 4 weeks converting to oral antibiotics for 2 weeks following PROSTALAC insertion. The mean visual analog scale score improved from 8 points preoperatively to 2 points postoperatively, and the mean MEPS improved from 32 points preoperatively to 82 points postoperatively (P < .05). The average ROMs at the last follow-up were 9° to 132° from extension to flexion, respectively. Two patients experienced ulnar nerve neuropraxia after surgery, from which they were resolved. Moreover, 2 and 4 patients developed superficial wound infection and triceps insufficiency, respectively, and there was no infection recurrence. CONCLUSION: In the management of elbow prosthetic infection, 2-stage revision arthroplasty using PROSTALAC spacer insertion in the first stage and cortical strut allograft in the second stage for patients with severe bone defect revealed good clinical results and relatively low infection recurrence rates. However, the complication rate is substantial.

Exploitable Magnetic Anisotropy of the Two-Dimensional Magnet CrI3.

Magnetic anisotropy often plays a central role in various static and dynamic properties of magnetic materials. In particular, for two-dimensional (2D) van der Waals materials, as inferred from the Mermin-Wagner theorem, it is an essential prerequisite for stabilizing ferromagnetic order. In this work, we carry out first-principles calculations for a CrI3 monolayer and investigate how its magnetic anisotropy is interrelated to adjustable parameters governing the underlying electronic structure. We explore various routes for controlled manipulation of magnetic anisotropy: chemical adsorption, substitutional doping, optical excitation, and charge transfer through a heterostructure. In particular, the vertical stacking of CrI3 and graphene is noteworthy in regard to controlling magnetic anisotropy: the spin anisotropy axis is switchable between the out-of-plane and in-plane directions, which is accompanied by a variation in the anisotropy energy of up to 500%. Our results show the possibility that dynamic control of the anisotropy of the 2D magnet CrI3 may enable the development of an advanced spintronic device with enhanced energy efficiency and high operation speed.

Spin-Split Band Hybridization in Graphene Proximitized with α-RuCl3 Nanosheets.

Proximity effects induced in the two-dimensional Dirac material graphene potentially open access to novel and intriguing physical phenomena. Thus far, the coupling between graphene and ferromagnetic insulators has been experimentally established. However, only very little is known about graphene's interaction with antiferromagnetic insulators. Here, we report a low-temperature study of the electronic properties of high quality van der Waals heterostructures composed of a single graphene layer proximitized with α-RuCl3. The latter is known to become antiferromagnetically ordered below 10 K. Shubnikov-de Haas oscillations in the longitudinal resistance together with Hall resistance measurements provide clear evidence for a band realignment that is accompanied by a transfer of electrons originally occupying the graphene's spin degenerate Dirac cones into α-RuCl3 band states with in-plane spin polarization. Left behind are holes in two separate Fermi pockets, only the dispersion of one of which is distorted near the Fermi energy due to spin selective hybridization with these spin polarized α-RuCl3 band states. This interpretation is supported by our density functional theory calculations. An unexpected damping of the quantum oscillations as well as a zero-field resistance upturn close to the Néel temperature of α-RuCl3 suggest the onset of additional spin scattering due to spin fluctuations in the α-RuCl3.

Effect of Distance on Photoluminescence Quenching and Proximity-Induced Spin-Orbit Coupling in Graphene/WSe2 Heterostructures.

Spin-orbit coupling (SOC) in graphene can be greatly enhanced by proximity coupling it to transition metal dichalcogenides (TMDs) such as WSe2. We find that the strength of the acquired SOC in graphene depends on the stacking order of the heterostructures when using hexagonal boron nitride ( h-BN) as the capping layer, i.e., SiO2/graphene/WSe2/ h-BN exhibiting stronger SOC than SiO2/WSe2/graphene/ h-BN. We utilize photoluminescence (PL) as an indicator to characterize the interaction between graphene and monolayer WSe2 grown by chemical vapor deposition. We observe much stronger PL quenching in the SiO2/graphene/WSe2/ h-BN stack than in the SiO2/WSe2/graphene/ h-BN stack and, correspondingly, a much larger weak antilocalization (WAL) effect or stronger induced SOC in the former than in the latter. We attribute these two effects to the interlayer distance between graphene and WSe2, which depends on whether graphene is in immediate contact with h-BN. Our observations and hypothesis are further supported by first-principles calculations, which reveal a clear difference in the interlayer distance between graphene and WSe2 in these two stacks.

Understanding the Giant Enhancement of Exchange Interaction in Bi_{2}Se_{3}-EuS Heterostructures.

A recent experiment indicated that a ferromagnetic EuS film in contact with a topological insulator Bi_{2}Se_{3} might show a largely enhanced Curie temperature and perpendicular magnetic anisotropy [F. Katmis et al., Nature (London) 533, 513 (2016).NATUAS0028-083610.1038/nature17635]. Through systematic density functional calculations, we demonstrate that in addition to the factor that Bi_{2}Se_{3} has a strong spin orbit coupling, the topological surface states are crucial to make these unusual behaviors robust as they hybridize with EuS states and extend rather far into the magnetic layers. The magnetic moments of Eu atoms are nevertheless not much enhanced, unlike what was reported in the experiment. Our results and model analyses provide useful insights for how these quantities are linked, and pave a way for the control of properties of magnetic films via contact with topological insulators.

IMA: Identifying disease-related genes using MeSH terms and association rules.

Genes play an important role in several diseases. Hence, in biology, identifying relationships between diseases and genes is important for the analysis of diseases, because mutated or dysregulated genes play an important role in pathogenesis. Here, we propose a method to identify disease-related genes using MeSH terms and association rules. We identified genes by analyzing the MeSH terms and extracted information on gene-gene interactions based on association rules. By integrating the extracted interactions, we constructed gene-gene networks and identified disease-related genes. We applied the proposed method to study five cancers, including prostate, lung, breast, stomach, and colorectal cancer, and demonstrated that the proposed method is more useful for identifying disease-related and candidate disease-related genes than previously published methods. In this study, we identified 20 genes for each disease. Among them, we presented 34 important candidate genes with evidence that supports the relationship of the candidate genes with diseases.

Engineering Topological Surface States of Cr-Doped Bi2Se3 Films by Spin Reorientation and Electric Field.

The tailoring of topological surface states in topological insulators is essential for device applications and for exploring new topological phase. Here, we propose a practical way to induce the quantum anomalous Hall phase and unusual metal-insulator transitions in Cr-doped Bi2Se3 films based on the model Hamiltonian and first-principles calculations. Using the combination of in-plane and plane-normal components of the spin along with external electric fields, we demonstrate that the topological state and band structures of topological insulating films exhibit rich features such as the shift of Dirac cones and the opening of nontrivial band gaps. We also show that the in-plane magnetization leads to significant suppression of inter-TSS scattering in Cr-doped Bi2Se3. Our work provides new strategies to obtain the desired electronic structures for the device, complementary to the efforts of an extensive material search.

The Effect of Reduced Graphene Oxide-Coated Biphasic Calcium Phosphate Bone Graft Material on Osteogenesis.

This study was conducted to evaluate the effect of biphasic calcium phosphate (BCP) coated with reduced graphene oxide (rGO) as bone graft materials on bone regeneration. The rGO-coated BCP bone graft material was fabricatied by mixing rGO and BCP at various concentrations. The surface charge of rGO-coated BCP was measured to be -14.43 mV, which formed a static electrostatic interaction. Cell viabilities were significantly diminished at higher concentrations of ≥100 µg/mL. The calvarial defects of 48 rats were implanted rGO-coated BCPs at a weight ratio of 2:1000 (rGO2), 4:1000 (rGO4), and 10:1000 (rGO10), repectively. BCP was used as a control group. The micro-CT and histological analysis were performed to evaluate new bone formation at 2 and 8 weeks after surgery. The results showed that the new bone volume (mm³) was significantly higher in the experimental groups than in the control group. Histological analysis showed that new bone areas (%) were significantly higher in the rGO2 and rGO10 than in the control, and significantly higher in rGO4 than in the rGO2 and rGO10. Conclusively, the rGO-coated BCP was found to be effective on osteogenesis and the concentration of the composite was an important factor.

Arthroscopic proximal versus open subpectoral biceps tenodesis with arthroscopic repair of small- or medium-sized rotator cuff tears.

PURPOSE: The study was aimed to compare arthroscopic proximal biceps tenodesis and open subpectoral biceps tenodesis in repair of small or medium rotator cuff tears. METHODS: Eighty-five patients underwent biceps tenodesis with arthroscopic repair of a rotator cuff tear, and 66 patients were followed for median of 26.8 (18-42) months with ultrasonography were reviewed. The arthroscopic biceps tenodesis group included 34 cases, and the open subpectoral biceps group included 32 cases. Patients were evaluated using visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES), and constant scores. Rotator cuff repair and fixation of the biceps tendon were assessed by ultrasonography. Fixation failure and degree of deformity were evaluated by the pain in the bicipital groove and biceps apex distance (BAD). RESULTS: VAS score and tenderness at the bicipital groove decreased significantly in the open subpectoral group at 3 months postoperative. In both groups, the range of motion, ASES score, and constant score increased significantly (P < 0.05). Rotator cuff retear occurred in three cases (8.8 %) in the arthroscopic group and two cases in the open subpectoral group (6.2 %). There was no significant difference in BAD between the two groups. CONCLUSION: There was no difference between open subpectoral tenodesis and arthroscopic proximal tenodesis at the time of the final follow-up; however, open subpectoral tenodesis showed encouraging results at 3-month follow-up. This early result of subpectoral tenodesis was related to removing most part of biceps tendinitis and using intra-bicipital groove tenodesis technique. LEVEL OF EVIDENCE: III.

LGscore: A method to identify disease-related genes using biological literature and Google data.

Since the genome project in 1990s, a number of studies associated with genes have been conducted and researchers have confirmed that genes are involved in disease. For this reason, the identification of the relationships between diseases and genes is important in biology. We propose a method called LGscore, which identifies disease-related genes using Google data and literature data. To implement this method, first, we construct a disease-related gene network using text-mining results. We then extract gene-gene interactions based on co-occurrences in abstract data obtained from PubMed, and calculate the weights of edges in the gene network by means of Z-scoring. The weights contain two values: the frequency and the Google search results. The frequency value is extracted from literature data, and the Google search result is obtained using Google. We assign a score to each gene through a network analysis. We assume that genes with a large number of links and numerous Google search results and frequency values are more likely to be involved in disease. For validation, we investigated the top 20 inferred genes for five different diseases using answer sets. The answer sets comprised six databases that contain information on disease-gene relationships. We identified a significant number of disease-related genes as well as candidate genes for Alzheimer's disease, diabetes, colon cancer, lung cancer, and prostate cancer. Our method was up to 40% more accurate than existing methods.

Tibial lengthening with a submuscular plate in adolescents.

BACKGROUND: Lengthening over an intramedullary nail has become a common technique for reducing the period of external fixation. However, the technique presents difficulties in patients with an open physis or a small marrow canal. Lengthening using a submuscular plate offers a new substitute in such situations, but few studies have been undertaken to determine its efficacy in teenagers. PATIENTS AND METHODS: A retrospective review was performed on 20 consecutive tibiae of 16 patients who underwent tibial lengthening with the aid of external fixator and submuscular plate. Charts and radiographs were reviewed for demographics, surgical details, and complications related to the technique. RESULTS: The average age of the 16 patients was 14.3 years (range 10-17), and the amount of lengthening averaged 4.1 cm (range 3.0-5.0 cm), which represented 12.7 % of preoperative bone length (range 9.1-15.8 %). Mean time in the fixator was 60.3 days, mean external fixation index was 14.8 days/cm (range 13.2-22.5 days/cm), and mean healing index was 49.1 days/cm (range 37-59.3 days/cm). Twenty-seven complications occurred giving an overall complication rate of 1.35. Twenty of the 27 were minor complications, but 7 were major. These major complications were resolved surgically or by a resolution period exceeding 3 months. There were 3 cases of transient angular deformity of distraction callus, 2 cases of transient peroneal nerve palsy, 1 case of clamp loosening, and 1 case of plate failure. Functional results were good or excellent with an average score of 95.6 according to modified Paley's criteria. CONCLUSIONS: Although complications were not uncommon, tibial lengthening with a submuscular plate proved to be a reliable technique for treating limb length discrepancy in adolescents with reduced external fixation duration. LEVEL OF EVIDENCE: Level IV, case series.

Continuous Template Growth of Large-Scale Tellurene Films on 1T'-MoTe2.

Use of a template triggers an epitaxial interaction with the depositing material during synthesis. Recent studies have demonstrated that two-dimensional tellurium (tellurene) can be directionally oriented when grown on transition metal dichalcogenide (TMD) templates. Specifically, employing a T-phase TMD, such as WTe2, restricts the growth direction even further due to its anisotropic nature, which allows for the synthesis of well-oriented tellurene films. Despite this, producing large-area epitaxial films still remains a significant challenge. Here, we report the continuous synthesis of a 1T'-MoTe2 template via chemical vapor deposition and tellurene via vapor transport. The interaction between helical Te and the 1T'-MoTe2 template facilitates the Te chains to collapse into ribbon shapes, enhancing lateral growth at a rate approximately 6 times higher than in the vertical direction, as confirmed by scanning electron microscopy and atomic force microscopy. Interestingly, despite the predominance of the lateral growth, cross-sectional transmission electron microscopy analysis of the tellurene ribbons revealed a consistent 60-degree incline at the edges. This suggests that the edges of the tellurene ribbons, where they contact the template surface, are favorable sites for additional Te absorption, which then stacks along the incline angle to expand. Furthermore, controlling the synthesis temperature, duration, and preheating time has facilitated the successful synthesis of tellurene films. The resultant tellurene exhibited hole mobility as high as ∼400 cm2/V s. After removing the underlying metallic template with plasma treatment, the film showed a current on/off ratio of ∼103. This ratio was confirmed by two-terminal field-effect transistor measurements and supported by near-field terahertz (THz) spectroscopy mapping.

Operative treatment of Freiberg disease using extra-articular dorsal closing-wedge osteotomy: technical tip and clinical outcomes in 13 patients.

BACKGROUND: Extra-articular dorsal closing wedge osteotomy has been used with successful results for Freiberg disease; however, there has been concern regarding the technical difficulty. The purpose of this study was to address technical tips and report on the clinical and radiographic outcome using Kirchner wire-assisted dorsal closing wedge osteotomy. METHODS: A retrospective review of 13 patients with a mean age of 29.1 years was conducted. Extra-articular dorsal wedge osteotomy was performed after debridement of the joint. Two Kirschner wires were inserted and used as a joystick to manipulate the osteotomized bone. The osteotomy site was fixed with crossed pins. Clinical outcome was assessed according to American Orthopaedic Foot and Ankle Society score, range of motion of the metatarsophalangeal joint, and visual analogue scale. Head necrosis was classified according to Smillie stage; time to bone union and metatarsal shortening were reviewed. Patients were followed for a mean period of 44.2 months. RESULTS: Mean American Orthopaedic Foot and Ankle Society score at the latest follow-up was 92.2 (range, 92-100). The range of motion of the metatarsophalangeal joint showed a mean increase of 6.2 degrees (range, -10 to 25) at the latest follow-up. The mean visual analogue scale score decreased from 7.5 (range, 5-10) preoperatively to 1 (range, 0-4) at the latest follow-up (P < .01). All osteotomies healed on average after 7.0 weeks (range, 4-13.6) without nonunion. The average metatarsal shortening was 0.5 mm (range, -3.1 to 3.5). None of the patients showed progression of osteonecrosis or joint space narrowing. CONCLUSION: Extra-articular closing dorsal wedge osteotomy can yield good articular congruity with bone remodeling, with easy performance of the procedure with temporary Kirschner wires without complication. LEVEL OF EVIDENCE: Level IV, retrospective case series.

Wives with long and high-quality hair have more frequent sex.

The image of an ideal woman often involves her having long, silky hair. However, the dearth of psychological research on hair limits the understanding of how women's hair functions in romantic relationships. While some scholars have found that the appearance of women's hair signals reproductive potential to men, whether women's hair may affect their sexual lives remains unknown. To investigate the function of hair in romantic relationships, we tested whether women's hair quality and length are associated with sexual frequency in marital dyads. We conducted a paid online survey involving 204 heterosexual marital dyads. The results indicated that women with long and high-quality hair experienced more frequent sexual intercourse with their spouse, as it heightened their husband's perception of their attractiveness and, consequently, intensified their husband's sexual desire toward them. Neither men's hair length nor quality was associated with sexual frequency. Implications of the study are further discussed.

Outcomes After Superior Capsular Reconstruction With an Achilles Tendon-Bone Allograft Using the Modified Keyhole Technique: A 2-Year Follow-up of a Novel Technique for Irreparable Rotator Cuff Tears.

Background: Despite improved outcomes, failure or nonhealing of graft materials has been reported after superior capsular reconstruction (SCR) for massive irreparable rotator cuff tears. Purpose: To evaluate the short-term clinical and radiological outcomes of a novel technique for SCR using an Achilles tendon-bone allograft. Study Design: Case series; Level of evidence, 4. Methods: We performed a retrospective review of patients who underwent SCR using an Achilles tendon-bone allograft with the modified keyhole technique and who had a minimum follow-up of 2 years. The visual analog scale score for pain, American Shoulder and Elbow Surgeons score, and Constant score were evaluated as subjective outcomes, while range of motion of the shoulder joint and isokinetic strength were evaluated as objective outcomes. The acromiohumeral interval (AHI), bone-to-bone healing of the allograft and humeral head on computed tomography, and graft integrity on magnetic resonance imaging were evaluated as radiological outcomes. Results: This study included 32 patients with a mean age of 56.8 ± 4.2 years and a mean follow-up of 28.4 ± 6.2 months. A significant improvement from preoperatively to the last follow-up was seen in the mean visual analog scale score for pain (from 6.7 to 1.8), American Shoulder and Elbow Surgeons score (from 42.7 to 83.8), Constant score (from 47.2 to 78.5), and AHI (from 4.8 to 8.2 mm) (P < .001 for all) as well as range of motion in forward elevation and internal rotation (P < .001 for both). Medial-to-lateral graft integrity was good in all patients. Nonunion at the fitting zone of the keyhole on the greater tuberosity was diagnosed in 1 case (3.1%), and failure of incorporation between the allograft and remnant tendon at the site of posterior margin convergence was observed in 4 cases (12.5%). Conclusion: The outcomes after SCR using an Achilles tendon-bone allograft and the keyhole technique improved, with an increased AHI and excellent integrity in the medial and lateral directions compared with preoperatively. This technique is a reasonable option for the surgical treatment of irreparable rotator cuff tears.

Effects of natural products on polycystic ovary syndrome: From traditional medicine to modern drug discovery.

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder with a worldwide prevalence of 6-10 % of women of reproductive age. PCOS is a risk factor for cardiometabolic disorders such as type 2 diabetes, myocardial infarction, and stroke in addition to exhibiting signs of hyperandrogenism and anovulation. However, there is no known cure for PCOS, and medications have only ever been used symptomatically, with a variety of adverse effects. Drugs made from natural plant products may help treat PCOS because several plant extracts have been widely recognized to lessen the symptoms of PCOS. In light of this, 72 current studies on natural products with the potential to control PCOS were examined. By controlling the PI3K/AKT signaling pathway and decreasing NF-κB and cytokines such as tumor necrosis factor (TNF), interleukin-1 (IL-1), and interleukin-6 (IL-6), certain plant-derived chemicals might reduce inflammation. Other substances altered the HPO axis, which normalized hormones. Additionally, other plant components increased glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) levels to reduce radiation-induced oxidative stress. The other substances prevented autophagy by impairing beclin 1, autophagy-related 5 (ATG5), and microtubule-associated protein 1A/1B-light chain 3 - II (LC3- II). The main focus of this comprehensive review is the possibility of plant extracts as natural bio-resources of PCOS treatment by regulating inflammation, hormones, reactive oxygen species (ROS), or autophagy.