Introduction: A nonconducive and at-risk work environment provides an opportunity for the occurrence of significant Work-related Musculoskeletal Disorders (WMSDs), affecting the physical, psychological, and social aspects of workers' health. This study aims to analyze differences in individual characteristics, such as gender, age, work experience, work duration, and marital status. Materials and methods: This study was a quantitative observational study with a population of laundry workers in Tomohon and Tondano, Minahasa, North Sulawesi, Indonesia. A sample of 225 people was selected using an incidental sampling technique with inclusion criteria aged 19-60 years. The instrument used the Nordic Musculoskeletal Questionnaire (NMQ) to measure musculoskeletal disorders, with statistical analysis involving Spearman rank and Mann-Whitney tests. Results: There is a significant positive relationship between age and the risk of WMSDs with a correlation coefficient (R = 0.226, p = 0.001) for age, with male and married workers exhibiting higher susceptibility (R = 0.242, p = 0.000; R = 0.257, p = 0.000, respectively). Surprisingly, work experience demonstrated a negative association, indicating increased vulnerability in new workers (<2 years) compared to seasoned counterparts (R = -0.317, p = 0.000). Mann-Whitney analysis confirmed significant disparities between genders, work experience durations, and marital statuses. However, age and work duration showed no significant differences between those experiencing WMSDs and those who did not (p > 0.05). Conclusion: Our findings found that age, gender, and marital status were significantly associated with the risk of WMSDs, with findings that older, male, and married workers were at higher risk. In contrast, work experience showed a negative association with WMSDs, suggesting that new workers are more vulnerable. Although BMI, education level, and work duration were not significant. Limitations: Some variables that may affect musculoskeletal complaints, such as personal medical history, physical activity outside work, and psychosocial factors, were not controlled or measured in this study. This may affect the interpretation of the study results

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. Materials and Methods: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). Results: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09–17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81–15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39–25.89]; p<0.01). Conclusions This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. Materials and Methods: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). Results: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09–17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81–15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39–25.89]; p<0.01). Conclusions This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. Materials and Methods: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). Results: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09–17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81–15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39–25.89]; p<0.01). Conclusions This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. Materials and Methods: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). Results: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09–17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81–15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39–25.89]; p<0.01). Conclusions This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. Materials and Methods: This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). Results: Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09–17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81–15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39–25.89]; p<0.01). Conclusions This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.

Circadian rhythms are endogenous oscillations coordinating the physiological and behavioral activities with the daily light-dark cycle and are controlled by molecular mechanisms. Nicotinamide adenine dinucleotide (NAD+), a critical cofactor in redox processes and a substrate for many enzymes, is an important metabolite in circadian rhythms. NAD+ levels show strong circadian oscillations, which are caused by the rhythmic production of biosynthetic enzymes such as nicotinamide phosphoribosyl transferase. In contrast, the circadian clock system regulates the expression of NAD+ biosynthetic enzymes, resulting in a bidirectional regulatory loop. Sirtuins, a class of NAD+-dependent protein deacetylases, regulate the circadian clock by interacting with the core clock components and transcriptional regulators. Sirtuin (SIRT) 1 deacetylates and modulates the activity of key circadian transcription factors such as brain and muscle arnt-like 1 and period circadian regulator 2, while SIRT6 regulates the expression of circadian-controlled metabolic genes. This review explored the complex relationships among NAD+, sirtuins, and the circadian clock machinery, emphasizing their roles in sustaining metabolic homeostasis and coordinating cellular processes with daily environmental cycles. Moreover, circadian disruptions are strongly associated with aging, which results in the dysregulation of NAD+ homeostasis and sirtuin activity and contributes to the development of various age-related pathologies. Strategies to restore NAD+ levels or modify the sirtuin activity have emerged as promising treatment options for circadian rhythm disturbances and age-related disorders. This review also aimed to cover new horizons in this subject, such as the development of NAD+ boosters and sirtuin modulators, chrono-pharmacological methods, and the study of epigenetic mechanisms underlying sirtuin-mediated circadian regulation.

Background: The proximal sural island sensate (PSIS) fasciocutaneous flap presents an ideal alternative in reconstruction of defects of the knee and proximal leg. It provides a thin sensate flap with good aesthetic outcomes and reduced donor site morbidity. However, only limited reports exist in the literature about this flap. Methods: This is a retrospective study done between December 2018 and December 2021 including 30 patients, among which seven cases had defects located on the knee and 23 cases in the proximal part of the leg. Mean age of the study population was 41 years. The maximum flap size was 8×12 cm, while the maximum pedicle length was 15 cm. Results: All 30 flaps survived well with only minimal complications occurring in a few patients such as epidermal loss and distal tip necrosis. No arterial or venous crisis occurred postoperatively in any case. Donor sites were managed with one-stage primary closure or split-thickness skin grafts. Functional deficits were not detected in any of the cases. Conclusion We found the PSIS fasciocutaneous flap to be a simple and reliable technique to perform. The flap offers extensive coverage, reaching from the knee to the proximal leg, and provides thin, pliable, and sensate skin, resulting in excellent aesthetic and functional outcomes.

Circadian rhythms are endogenous oscillations coordinating the physiological and behavioral activities with the daily light-dark cycle and are controlled by molecular mechanisms. Nicotinamide adenine dinucleotide (NAD+), a critical cofactor in redox processes and a substrate for many enzymes, is an important metabolite in circadian rhythms. NAD+ levels show strong circadian oscillations, which are caused by the rhythmic production of biosynthetic enzymes such as nicotinamide phosphoribosyl transferase. In contrast, the circadian clock system regulates the expression of NAD+ biosynthetic enzymes, resulting in a bidirectional regulatory loop. Sirtuins, a class of NAD+-dependent protein deacetylases, regulate the circadian clock by interacting with the core clock components and transcriptional regulators. Sirtuin (SIRT) 1 deacetylates and modulates the activity of key circadian transcription factors such as brain and muscle arnt-like 1 and period circadian regulator 2, while SIRT6 regulates the expression of circadian-controlled metabolic genes. This review explored the complex relationships among NAD+, sirtuins, and the circadian clock machinery, emphasizing their roles in sustaining metabolic homeostasis and coordinating cellular processes with daily environmental cycles. Moreover, circadian disruptions are strongly associated with aging, which results in the dysregulation of NAD+ homeostasis and sirtuin activity and contributes to the development of various age-related pathologies. Strategies to restore NAD+ levels or modify the sirtuin activity have emerged as promising treatment options for circadian rhythm disturbances and age-related disorders. This review also aimed to cover new horizons in this subject, such as the development of NAD+ boosters and sirtuin modulators, chrono-pharmacological methods, and the study of epigenetic mechanisms underlying sirtuin-mediated circadian regulation.

Circadian rhythms are endogenous oscillations coordinating the physiological and behavioral activities with the daily light-dark cycle and are controlled by molecular mechanisms. Nicotinamide adenine dinucleotide (NAD+), a critical cofactor in redox processes and a substrate for many enzymes, is an important metabolite in circadian rhythms. NAD+ levels show strong circadian oscillations, which are caused by the rhythmic production of biosynthetic enzymes such as nicotinamide phosphoribosyl transferase. In contrast, the circadian clock system regulates the expression of NAD+ biosynthetic enzymes, resulting in a bidirectional regulatory loop. Sirtuins, a class of NAD+-dependent protein deacetylases, regulate the circadian clock by interacting with the core clock components and transcriptional regulators. Sirtuin (SIRT) 1 deacetylates and modulates the activity of key circadian transcription factors such as brain and muscle arnt-like 1 and period circadian regulator 2, while SIRT6 regulates the expression of circadian-controlled metabolic genes. This review explored the complex relationships among NAD+, sirtuins, and the circadian clock machinery, emphasizing their roles in sustaining metabolic homeostasis and coordinating cellular processes with daily environmental cycles. Moreover, circadian disruptions are strongly associated with aging, which results in the dysregulation of NAD+ homeostasis and sirtuin activity and contributes to the development of various age-related pathologies. Strategies to restore NAD+ levels or modify the sirtuin activity have emerged as promising treatment options for circadian rhythm disturbances and age-related disorders. This review also aimed to cover new horizons in this subject, such as the development of NAD+ boosters and sirtuin modulators, chrono-pharmacological methods, and the study of epigenetic mechanisms underlying sirtuin-mediated circadian regulation.