5%, and 58% and 88%, respectively. After VSR repair, right and left heart chamber sizes were significantly decreased and these improvements were stable throughout the subsequent follow-up period (median 4.0 years). Tricuspid annular plane systolic excursion and right ventricular fractional area change remained constant throughout the observation period without changing after VSR repair. The extended sandwich patch technique through a right ventriculotomy offered safe and simple, leak-free repair even in technically demanding acute phase or posterior VSR. No significant decline was found in the right heart function after surgery. The extended sandwich patch technique through a right ventriculotomy offered safe and simple, leak-free repair even in technically demanding acute phase or posterior VSR. No significant decline was found in the right heart function after surgery. Only few studies have assessed sexual dysfunction in men with Klinefelter syndrome (KS). To define pooled prevalence estimates and correlates of erectile dysfunction (ED) and decreased libido (DL) in KS. A thorough search of Medline, Embase and Web of Science was performed to identify suitable studies. Quality of the articles was scored using the Assessment Tool for Prevalence Studies. Data were combined using random effect models and the between-studies heterogeneity was assessed by the Cochrane's Q and I . The sources of heterogeneity were investigated by meta-regression and sub-group analyses. Funnel plot, Begg's rank correlation and trim-and-fill test were used to assess publication bias. The pooled prevalence of ED and DL in KS as well as 95% confidence intervals (CIs) were estimated from the proportion of cases of sexual dysfunction and the sample size. Variables that could affect the estimates were identified by linear meta-regression models. Sixteen studies included collectively gave informhe androgenic status. https://www.selleckchem.com/products/rxdx-106-cep-40783.html A Barbonetti, S D'Andrea, W Vena, et al. Erectile Dysfunction and Decreased Libido in Klinefelter Syndrome A Prevalence Meta-Analysis and Meta-Regression Study. J Sex Med 2021;181054-1064. Bedtime media use has been associated with poor sleep and attention difficulties among adolescents, but much of this research has been cross-sectional, limiting current understanding of directionality of effects. This 2-wave prospective study tested bidirectional effects between bedtime media use and sleep measures, including time in bed, sleep onset latency, and daytime sleepiness, and further examined whether bedtime media use and sleep variables were related to attention control difficulties. Data were collected from 345 middle-schoolers (ages 12-14, 47% female) at baseline (T1) and at 6-month follow-up (T2). Students self-reported their access to media devices and internet in their bedroom, bedtime media use, sleep, and attention control. Data were analyzed using cross-lagged panel modeling. Greater bedtime media use (at T1) was associated with less time in bed and longer sleep onset latency at T2, controlling for T1 levels of these variables. In the case of sleep effects on bedtime media use, greater daytime sleepiness and less time in bed (at T1) were associated with greater bedtime media use at T2, controlling for T1 levels. Further, greater daytime sleepiness (at T2, controlling for T1 levels) was associated with greater attention control difficulties at T2. Findings provide evidence for some reciprocal relations between bedtime media use and poor sleep in adolescents. Furthermore, higher daytime sleepiness was linked to greater attention control difficulties. Findings provide evidence for some reciprocal relations between bedtime media use and poor sleep in adolescents. Furthermore, higher daytime sleepiness was linked to greater attention control difficulties.Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2, a newly discovered coronavirus that exhibits many similarities with the severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses (SARS-CoV and MERS-CoV, respectively). The definite pathogenesis and immunological influences of SARS-CoV-2 have not been fully elucidated. Therefore, we constructed a brief summary comparison of SARS-CoV-2, SARS-CoV, and MERS-CoV infections regarding their immunological changes. In addition, we further investigated the immunological differences between severe and nonsevere COVID-19 cases, and we searched for possible immunological predictors of the patient outcome by reviewing case series studies to date. Possible immunological predictors of a poor outcome are leukocytosis, neutrophilia, lymphopenia (both CD4 and CD8 T cells), an increased neutrophil-to-lymphocyte ratio (NLR), and increased levels of pro-inflammatory cytokines (IL-6 and TNF-α), Th1 cytokines (IL-2 and IFN-γ), regulatory T cell cytokines (IL-10) and Th17 cytokines (IL-17). A more precise immunological map needs to be established, which may assist in diagnosing this disease and facilitate immunological precision medicine treatment. Behçet's disease (BD) is a systemic vasculitis of unknown cause. The spectrum of the disease ranges from mucocutaneous manifestations to other organ diseases with relevant morbidity. Associations between disease severity and male sex, earlier age at onset, and the presence of erythema nodosum have been described. To evaluate clinical factors associated with manifestations of severe disease in a single-center cohort. A longitudinal, prospective, unicentric cohort study with patients followed in a specialized outpatient clinic between 1981 and 2020. Severe BD was defined as a Krause total clinical severity score >4 points. We included 243 patients, of whom 31% were male, with an average follow-up time of 14.6 years. Regarding organ manifestations, all patients had mucous manifestations (N=243, 100%), 133 (55%) skin, 104 (43%) joint, 71 (29%) ocular, 48 (20%) vascular, 47 (19%) neurological, 22 (9%) gastrointestinal and 1 (0.4%) cardiac involvement by BD. One hundred fifty-six (64%) patients were classified as having severe BD. Severe BD was more frequent in men (OR=2.004, p=0.024), increasing with age (OR=1.021 per year, p=0.037), in the presence of skin manifestations (OR=4.711, p<0.001), specifically erythema nodosum (OR=8.381, p<0.001), and pseudofolliculitis (OR=2.910, p<0.001). In the multivariate model, variables independently associated with severe BD were male gender (Adjusted OR=1.961, p=0.047), erythema nodosum (Adjusted OR=8.561, p<0.001) and pseudofolliculitis (Adjusted OR=2.372, p=0.007). Male gender, erythema nodosum, and pseudofolliculitis were independently associated with severe BD forms and therefore should serve as warning signs to the clinician. Male gender, erythema nodosum, and pseudofolliculitis were independently associated with severe BD forms and therefore should serve as warning signs to the clinician.