The Association Between Obesity and Polycystic Ovary Syndrome: An Epidemiologic Study of Observational Data.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common female cardiometabolic-reproductive disorder. It is unclear whether the global obesity epidemic is impacting the high PCOS prevalence. OBJECTIVE: To determine the association between the prevalence of PCOS and obesity. MATERIALS AND METHODS: A systematic review was conducted to identify population studies on PCOS prevalence globally through July 2023. Linear regression and random-effect models were applied to examine the association of mean body mass index (BMI) or obesity prevalence with the prevalence of PCOS diagnosed by 1990 National Institutes of Health (NIH), 2003 Rotterdam (Rotterdam), and 2006 Androgen Excess-PCOS (AE-PCOS) criteria. Subgroup analyses were also conducted for recruitment methods and study quality. RESULTS: Fifty-eight studies with 85 956 adults from 24 countries were included. Considering all available data, a borderline association was observed between PCOS and obesity prevalence when using the AE-PCOS but not the NIH or Rotterdam criteria. Alternatively, subgroup analysis of studies with better recruitment methods demonstrated a significant positive association of population mean BMI or obesity prevalence with PCOS prevalence when using the Rotterdam or AE-PCOS criteria, while using only high-quality studies revealed an association using NIH as well as Rotterdam and AE-PCOS criteria. Overall, we observed that a 1% increase in obesity prevalence resulted in an approximately 0.4% increase in PCOS prevalence by the Rotterdam criteria. CONCLUSION: The prevalences of PCOS and obesity appear to be modestly associated, although our data cannot establish causality. This study also emphasizes the need to undertake only high-quality studies in assessing PCOS epidemiology.

Characteristics of pelvic organ prolapse content available on social media.

AIMS: To analyze the quality, understandability, and actionability of pelvic organ prolapse (POP) content and to characterize creators of content and treatment options discussed on social media platforms YouTube, Instagram, and Pinterest. METHODS: A cross-sectional, qualitative study was conducted for each platform. A search for "pelvic organ prolapse" was conducted and the first 100 relevant results analyzed. Data collected include source characteristics, treatments discussed, and scores for each criterion of validated Patient Education Materials and Assessment Tool and DISCERN metrics to evaluate quality, actionability, and understandability. The χ 2 analysis, univariate and multivariate logistic regressions were done to assess correlations and the impact of variables on outcomes of interest across platforms. RESULTS: Low to moderate quality was present in 74.1% of posts. Poor understandability was seen in 37.1% of posts, and 56.1% had poor actionability. The most common publisher of content overall was health and wellness or physical therapy groups (44.6%). The most common YouTube publisher was doctors, hospitals, or clinics (49%). Pelvic floor muscle training was the most discussed treatment overall (57.4%). On YouTube surgery was discussed more frequently than Instagram or Pinterest (58% vs. 11% vs. 43%, p < 0.001. Pinterest posts had better understandability ratings than YouTube videos (odds ratio = 0.19; 95% confidence interval: [0.10-0.36]; p < 0.001). CONCLUSION: Information on popular platforms regarding POP demonstrates inconsistent quality and poor understandability and actionability. There is an opportunity for health care providers to direct patients to curated lists of high-quality educational content on these platforms. Awareness of information available on social media is an increasingly important aspect of patient care.

Analysis of Pelvic Organ Prolapse-related Content on Pinterest.

OBJECTIVES: Our study is a cross-sectional, qualitative study analyzing pelvic organ prolapse-related content on Pinterest, a social media platform that also functions as a visual search engine. Primary outcomes assessed include quality, understandability, and actionability of content. Secondary outcomes include levels of misinformation and commercial bias. Our study further characterizes sources of prolapse content and treatment modalities discussed. METHODS: A Pinterest search was conducted using the term "pelvic organ prolapse," analyzing the first 100 relevant results. We examined the publisher of each pin and the writer of linked content. Using validated tools including the Patient Education Materials Assessment Tool and DISCERN criteria, we assessed understandability and actionability of content. We further compared content to professional guidelines for discussing and treating prolapse, evaluating for misinformation. We also evaluated for commercial bias and subjectively rated pin quality. RESULTS: Of pins evaluated, low understandability was found in 16, low actionability in 30, and low-to-moderate quality in 69. The most common publisher of pins was health and wellness groups, and the most common writer of content was physical therapists. Pelvic floor muscle training (PFMT) is the treatment modality discussed most frequently on Pinterest. CONCLUSIONS: Pinterest content discussing pelvic organ prolapse shows good levels of understandability for patients at all levels of health literacy. However, the number of pins showing poor actionability raises concern that content may not encourage readers to take direct steps toward prolapse assessment and management. In all, a majority of prolapse-related content on Pinterest was of low-to-moderate quality.

Methods for fabrication and evaluation of a 3D microengineered model of myelinated peripheral nerve.

OBJECTIVE: The cost and low success rates of the neurological drug development pipeline have diverted the pharmaceutical industry to 'nerve-on-a-chip' systems as preclinical models to streamline drug development. We present a novel micro-engineered 3D hydrogel platform for the culture of myelinated embryonic peripheral neural tissue to serve as an effective in vitro model for electrophysiological and histological analysis that could be adopted for preclinical testing. APPROACH: Dorsal root ganglions (DRG) from 15 d old embryonic rats were cultured in 3D hydrogel platforms. The interaction between Schwann cells (SC) and neurons during axonal development and regeneration affects the direction of growth and the synthesis of myelin sheaths. Induction of myelination was performed with two approaches: the addition of exogenous SC and promoting migration of endogenous SC. MAIN RESULTS: Histological analysis of the preparation utilizing exogenous SC showed aligned, highly fasciculated axonal growth with noticeable myelin sheaths around axons. Separately, electrophysiological testing of the preparation utilizing endogenous SC showed increased amplitude of the compound action potential and nerve conduction velocity in the presence of ascorbic acid (AA). SIGNIFICANCE: This platform has immense potential to be a useful and translatable in vitro testing tool for drug discovery and myelination studies.

Lymphocytes influence intracranial aneurysm formation and rupture: role of extracellular matrix remodeling and phenotypic modulation of vascular smooth muscle cells.

BACKGROUND: Intracranial aneurysms (IA) are increasingly recognized as a disease driven by chronic inflammation. Recent research has identified key mediators and processes underlying IA pathogenesis, but mechanistic understanding remains incomplete. Lymphocytic infiltrates have been demonstrated in patient IA tissue specimens and have also been shown to play an important role in abdominal aortic aneurysms (AAA) and related diseases such as atherosclerosis. However, no study has systematically examined the contribution of lymphocytes in a model of IA. METHODS: Lymphocyte-deficient (Rag1) and wild-type (WT; C57BL/6 strain) mice were subjected to a robust IA induction protocol. Rates of IA formation and rupture were measured, and cerebral artery tissue was collected and utilized for histology and gene expression analysis. RESULTS: At 2 weeks, the Rag1 group had significantly fewer IA formations and ruptures than the WT group. Histological analysis of unruptured IA tissue showed robust B and T lymphocyte infiltration in the WT group, while there were no differences in macrophage infiltration, IA diameter, and wall thickness. Significant differences in interleukin-6 (IL-6), matrix metalloproteinases 2 (MMP2) and 9 (MMP9), and smooth muscle myosin heavy chain (MHC) were observed between the groups. CONCLUSIONS: Lymphocytes are key contributors to IA pathogenesis and provide a novel target for the prevention of IA progression and rupture in patients.

Age-related changes affect rat rotator cuff muscle function.

BACKGROUND: The influence of age on rotator cuff function and muscle structure remains poorly understood. We hypothesize that normal aging influences rotator cuff function, muscle structure, and regulatory protein expression in an established rat model of aging. METHODS: Seventeen rats were obtained from the National Institute on Aging. The supraspinatus muscles in 11 middle-aged (12 months old) and 6 old (28 months old) rats were studied for age-related changes in rotator cuff neuromuscular function by in vivo muscle force testing and electromyography (EMG). Changes in muscle structure and molecular changes were assessed with quantitative immunohistochemistry for myogenic determination factor 1 (MyoD) and myogenic factor 5 (Myf5) expression. RESULTS: Old animals revealed significantly decreased peak tetanic muscle force at 0.5 N and 0.7 N preload tension (P < .05). The age of the animal accounted for 20.9% of variance and significantly influenced muscle force (P = .026). Preload tension significantly influenced muscle force production (P < .001) and accounted for 12.7% of total variance. There was regional heterogeneity in maximal compound motor action potential (CMAP) amplitude in the supraspinatus muscle; the proximal portion had a significantly higher CMAP than the middle and distal portions (P < .05). The expression of muscle regulatory factors MyoD and Myf5 was significantly decreased in old animals compared with middle-aged animals (P < .05). CONCLUSIONS: The normal aging process in this rat model significantly influenced contractile strength of the supraspinatus muscle and led to decreased expression of muscle regulatory factors. High preload tensions led to a significant decrease in force production in both middle-aged and old animals.

A human hair keratin hydrogel scaffold enhances median nerve regeneration in nonhuman primates: an electrophysiological and histological study.

A human hair keratin biomaterial hydrogel scaffold was evaluated as a nerve conduit luminal filler following median nerve transection injury in 10 Macaca fascicularis nonhuman primates (NHP). A 1 cm nerve gap was grafted with a NeuraGen® collagen conduit filled with either saline or keratin hydrogel and nerve regeneration was evaluated by electrophysiology for a period of 12 months. The keratin hydrogel-grafted nerves showed significant improvement in return of compound motor action potential (CMAP) latency and recovery of baseline nerve conduction velocity (NCV) compared with the saline-treated nerves. Histological evaluation was performed on retrieved median nerves and abductor pollicis brevis (APB) muscles at 12 months. Nerve histomorphometry showed a significantly larger nerve area in the keratin group compared with the saline group and the keratin APB muscles had a significantly higher myofiber density than the saline group. This is the first published study to show that an acellular biomaterial hydrogel conduit filler can be used to enhance peripheral nerve regeneration and motor recovery in an NHP model.

The effect of human hair keratin hydrogel on early cellular response to sciatic nerve injury in a rat model.

Peripheral nerve injuries requiring surgery can be repaired by autograft, the clinical "gold standard", allograft, or nerve conduits. Most published clinical studies show the effectiveness of nerve conduits in small size defects in sensory nerves. Many preclinical studies suggest that peripheral nerve regeneration through conduits can be enhanced and repair lengths increased with the use of a biomaterial filler in the conduit lumen. We have previously shown that a luminal hydrogel filler derived from human hair keratin (HHK) can improve electrophysiological and histological outcomes in mouse, rabbit, and non-human primate nerve injury models, but insight into potential mechanisms has been lacking. Based on the premise that a keratin biomaterial (KOS) hydrogel provides an instantaneous structural matrix within the lumen, the current study compares the cellular behavior elicited by KOS hydrogel to Matrigel (MAT) and saline (SAL) conduit fillers in a 1 cm rat sciatic nerve injury model at early stages of regeneration. While there was little difference in initial cellular influx, the KOS group showed earlier migration of dedifferentiated Schwann cells (SC) from the proximal nerve end compared to the other groups. The KOS group also showed faster SC dedifferentiation and myelin debris clearance, and decreased macrophage infiltration during Wallerian degeneration of the distal nerve tissue.