Botanicals in health and disease of the testis and male fertility: A scoping review.

BACKGROUND: Male factor infertility often results from testicular disorders leading to inadequate sperm quantity and quality. Both beneficial and detrimental effects of botanical products, especially herbal medicines, on testicular functions and male fertility have been reported in the literature. PURPOSE: This scoping review aims to map the main clinical evidence on different impacts of botanical entities on the testis and to critically appraise relevant randomized controlled trials (RCTs) published in the recent 5 years, so as to inform the future. METHODS: Systematic reviews, meta-analyses and RCT reports on botanical impacts on testicular functions and male fertility were retrieved and synthesized from Pubmed, Web of Science, Scopus, Embase, ProQuest, Cochrane Library and Google Scholar up to 10th May 2022. RCTs published since 2018 were critically appraised against good practice guidelines for RCT and for reporting herbal studies. RESULTS: We identified 24 systematic reviews and meta-analyses published since 2005, by authors from Iran (25%), China (21%), USA (12.5%) and 9 other countries. All but two were published in English. Only 3 systematic review protocols were identified, all published in English from China in the recent 3 years. We identified 125 RCTs published in six languages, mainly English (55%) and Chinese (42%). They were published since 1994 from 23 countries on all the six inhabitable continents, with China (46%), Australia (8%), USA (8%), India (7%) and Iran (5%) being the leading contributors. 72% and 28% RCTs published in English were on efficacy (botanicals vs placebo) and comparative effectiveness (a botanical vs other treatments), respectively. In contrast, 98% RCT reports in Chinese were on comparative effectiveness, with merely 2% on efficacy. Among all the 125 RCTs, 57% were studies in patients with semen abnormality and/or male infertility, 22% investigated herbal effects in healthy men, 14% were on patients with male sexual dysfunction and hypogonadism, and 7% were conducted in men with non-sexual disorders. Since 2018, 32 RCTs have been published, in English (69%) or Chinese (31%). Nineteen RCT reports from China, India, Japan and Korea all studied herbal formulae while the 13 RCT reports from Australia, Brazil, Czech and Italy, Iran, Malaysia, Spain, the UK and the USA all exclusively studied extracts of a single species. Putting geo-cultural differences aside, gossypol and extracts of Tripterygium wilfordii Hook. f. were found to be detrimental to the testis and male fertility, while the extracts of Withania somnifera (L.) Dunal and traditional Chinese medicine Qilin Pill, etc., might improve testosterone levels and semen parameters, thus could be therapeutic for male sexual dysfunction and infertility. However, all still require further evaluation in view of recurring weaknesses in quality control of herbal materials, RCT design and reporting. For example, only 9%-23% of the RCTs published since 2018 provided information on voucher samples, chemical profiling, herbal authentication and herbal extraction. CONCLUSION: Research on botanicals and the testis has been reported worldwide, demonstrating clear geo-cultural differences in studied plant species, botanical types, study objectives and quality of research design, implementation and reporting. Due to a few recurring weaknesses in the literature, this study is unable to recommend the use of any specific botanicals, however, current evidence does indicate that botanicals can be double-edged swords to the testis and male fertility. To secure better clinical evidence, future studies must faithfully implement existing and emerging good practice guidelines.

Ontologies of transition(s) in healthcare practice: examining the lived experiences and representations of transgender adults transitioning in healthcare.

In this article, we examine the ways transitions are constructed and represented within healthcare settings vis-à-vis lived experiences. Drawing on in-depth interviews with transgender people and data from a document analysis, we examine how transgender peoples' experiences fit within conceptualisations of transition(s) in healthcare guidance documents used in England. We take up Pearce's ([2018]. Understanding trans health. Bristol: Policy Press) suggestion to (re)think trans beyond 'condition', and rather as 'movement', to view being trans as a social identity rather than a defect. Our findings show how trans people and transitions are imagined through often linear narratives of movement in/out of transition. Through this framing, fluidity and gender liminal spaces are made invisible, where health care is imagined for certain transitions but not others. Our analysis attends to tensions that emerge in the complexity of transition(s) as well as the intricate ways in which transgender people are responding to often restrictive ontologies of medical transition. As a conceptual tool, 'trans as movement' can be used to create space for more expansive ontologies of gender that confront the harms and restrictions imposed by the gender binary, and offer alternative ways of (re)imagining multiplicity in transition trajectories and futures for both those in healthcare delivery, and for trans patients.

Development of an Ocean Protein Portal for Interactive Discovery and Education.

Proteins are critical in catalyzing chemical reactions, forming key cellular structures, and in regulating cellular processes. Investigation of marine microbial proteins by metaproteomics methods enables the discovery of numerous aspects of microbial biogeochemical processes. However, these datasets present big data challenges as they often involve many samples collected across broad geospatial and temporal scales, resulting in thousands of protein identifications, abundances, and corresponding annotation information. The Ocean Protein Portal (OPP) was created to enable data sharing and discovery among multiple scientific domains and serve both research and education functions. The portal focuses on three use case questions: "Where is my protein of interest?", "Who makes it?", and "How much is there?" and provides profile and section visualizations, real-time taxonomic analysis, and links to metadata, sequence analysis, and other external resources to enable connections to be made between biogeochemical and proteomics datasets.

METATRYP v 2.0: Metaproteomic Least Common Ancestor Analysis for Taxonomic Inference Using Specialized Sequence Assemblies-Standalone Software and Web Servers for Marine Microorganisms and Coronaviruses.

We present METATRYP version 2 software that identifies shared peptides across the predicted proteomes of organisms within environmental metaproteomics studies to enable accurate taxonomic attribution of peptides during protein inference. Improvements include ingestion of complex sequence assembly data categories (metagenomic and metatranscriptomic assemblies, single cell amplified genomes, and metagenome assembled genomes), prediction of the least common ancestor (LCA) for a peptide shared across multiple organisms, increased performance through updates to the backend architecture, and development of a web portal (https://metatryp.whoi.edu). Major expansion of the marine METATRYP database with predicted proteomes from environmental sequencing confirms a low occurrence of shared tryptic peptides among disparate marine microorganisms, implying tractability for targeted metaproteomics. METATRYP was designed to facilitate ocean metaproteomics and has been integrated into the Ocean Protein Portal (https://oceanproteinportal.org); however, it can be readily applied to other domains. We describe the rapid deployment of a coronavirus-specific web portal (https://metatryp-coronavirus.whoi.edu/) to aid in use of proteomics on coronavirus research during the ongoing pandemic. A coronavirus-focused METATRYP database identified potential SARS-CoV-2 peptide biomarkers and indicated very few shared tryptic peptides between SARS-CoV-2 and other disparate taxa analyzed, sharing <1% peptides with taxa outside of the betacoronavirus group, establishing that taxonomic specificity is achievable using tryptic peptide-based proteomic diagnostic approaches.

Progress and Challenges in Ocean Metaproteomics and Proposed Best Practices for Data Sharing.

Ocean metaproteomics is an emerging field enabling discoveries about marine microbial communities and their impact on global biogeochemical processes. Recent ocean metaproteomic studies have provided insight into microbial nutrient transport, colimitation of carbon fixation, the metabolism of microbial biofilms, and dynamics of carbon flux in marine ecosystems. Future methodological developments could provide new capabilities such as characterizing long-term ecosystem changes, biogeochemical reaction rates, and in situ stoichiometries. Yet challenges remain for ocean metaproteomics due to the great biological diversity that produces highly complex mass spectra, as well as the difficulty in obtaining and working with environmental samples. This review summarizes the progress and challenges facing ocean metaproteomic scientists and proposes best practices for data sharing of ocean metaproteomic data sets, including the data types and metadata needed to enable intercomparisons of protein distributions and annotations that could foster global ocean metaproteomic capabilities.

Association between Bispectral Index System and airway obstruction: an observational prospective cohort analysis during third molar extractions.

BACKGROUND: Sedation regimes during oral procedures frequently associated with airway obstruction. The aim of this study was to define the association of Bispectral Index (BIS) to the depth of sedation and airway obstruction events. METHODS: Forty-seven patients between 14-21 years old, who were candidates for 3rd molar teeth extraction, were enrolled in this study. Patients received a total of 4 mg midazolam, 100 microgram fentanyl followed by titrated incremental propofol in 10 mg. The Richmond Agitation Sedation Score (RASS) was used to assess the depth of sedation. Each patient was attached to BIS monitor, while clinicians were not involved in the data collection process. Apnea, airway obstruction, O2 saturation, timing and interventions for controlling the situation were recorded. All data was synchronized with BIS data monitoring. RESULTS: The results show that 97.5% of cases were ASA 1 and 2, with average age of 17.3 years (±1.4) and a median BMI of 26.1. By using linear regression, for every unit decrease of median RASS (less than zero), there was 1.78 decrease in mean BIS Score (P=0.045, 95% CI: 0.08-3.47). The mean BIS Index (over 1 minute) with airway obstruction was 64 (±10.2), which was significantly lower than the BIS during non-airway obstruction (77±11.6), (P<0.001). By using logistic regression analysis, for every on unit increase in BIS Index, there is 24% decrease in odds in having airway obstruction (P=0.0009, 95% CI: 0.65-8.94). CONCLUSIONS: This study demonstrates that the BIS could potentially be a valid continuous monitoring method to avoid airway obstruction during sedation for patients undergoing dental surgery.