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Pathologic hypogonadism occurs when serum testosterone is significantly and persistently reduced by irreversible organic (structural, genetic) disorders of the hypothalamic pituitary testicular (HPT) axis. Men with pathologic hypogonadism require life-long testosterone replacement. In contrast, mild or moderate reductions in serum testosterone frequently accompany obesity and its numerous co-morbidities in men and are best considered as non-gonadal illness syndromes, wherein reduction in serum testosterone is usually reversible upon amelioration of the underlying non-gonadal illness. Obesity can result in non-specific symptoms in conjunction with reduced serum testosterone and serum SHBG. Obesity-related reductions in SHBG, testosterone's principal circulating carrier protein, are primarily responsible for measured reductions in testosterone. However, obesity is not a cause of pathological hypogonadism and proportionately reduced testosterone and SHBG concentrations accompanied by normal serum LH and FSH concentrations confirm a eugonadal state, best described as the pseudo-hypogonadism of obesity. Herein we demonstrate how clinically significant weight loss substantially reverses obesity-related reductions in serum testosterone and ameliorates non-specific symptoms resembling, but not due to, androgen deficiency. The important reversible steps include weight reduction, optimizing management of type 2 diabetes mellitus, obstructive sleep apnea, depression and other obesity related co-morbidities as well as rationalizing concomitant drug regimens. In the absence of pathological hypogonadism, testosterone treatment is less effective than a diet and lifestyle intervention to rectify the reversible conditions responsible for the non-specific symptoms and associated reduced serum testosterone concentrations observed in men with obesity. As such, testosterone treatment is not indicated and unwarranted off-label testosterone treatment can lead to adverse effects such as infertility, elevated hematocrit requiring venesection, a prothrombotic state and testosterone dependence.

Parkinson's disease (PD) presents with a variety of non-motor symptoms such as sleep disorders, hyposmia, pain, cognitive dysfunction, neuropsychiatric and autonomic symptoms. One of the most neglected motor symptoms is the impairment of eye movements, which occurs in 75% of PD patients. The aim of our study was to investigate the relationship between the severity of non-motor symptoms and the impairment of different types of eye movements.

This study assessed the impact of the COVID-19 pandemic on the health status of self-employed workers by comparing their status before and during the pandemic, using nationwide data from the Korean Working Conditions Survey (KWCS).

Brief behavioral treatment for insomnia is an effective short-term therapy focusing on stimulus control and sleep restriction to enhance sleep quality. As a crucial part of this therapy, diaphragmatic breathing is often recommended when patients fail to fall asleep within 30 minutes. With the rise of health apps and gamification, these tools are increasingly seen as effective ways to boost self-efficacy and user engagement; however, traditional games tend to increase attention, which can negatively impact sleep and contradicts the aim of sleep therapy. This study thus explored the potential for gamification techniques to promote relaxation without disrupting sleep processes.

Childhood obstructive sleep apnea syndrome (OSAS) disrupts normal ventilation and sleep structure and affects cognitive functions. However, the neurophysiological mechanisms underlying cognitive impairment are unclear. This study investigates the topological connectivity of white matter networks in children with moderate to severe OSAS and explores the underlying mechanisms of cognitive impairment. We collected clinical data of patients with moderate to severe OSAS (n = 43) and non-OSAS (n = 30). Intelligence testing was conducted using the China Wechsler Intelligence Scale for Children-Fourth Edition (C-WISC IV), including Processing speed, Working memory, Verbal comprehension, Perceptual reasoning, and Full-scale intelligence quotient (FSIQ). DTI data were collected using 3.0T MRI scanner (Ingenia, Philips, Netherlands). White matter network topology connections were analyzed using FSL and DSI Studio and inter group differences were statistically assessed. The difference of clinical and intelligence test was calculated by two sample t-test. Pearson correlation analysis was employed to examine the correlation between the abnormal white matter network metrics and cognitive function in OSAS patients. Clustering coefficient (Cp) and global efficiency (Eg), nodal degree (Dc), and nodal efficiency (Ne) were lower in the OSAS group (p < 0.05). Correlations between white matter network metrics and cognitive function: The Cp and Eg were positively correlated with Perceptual reasoning, and the shortest path length (Lp) was negatively correlated with Perceptual reasoning. The results indicate that there was impairment of cognitive function and abnormality of topological structural connectivity in white matter networks for children with OSAS. The Cp, Eg, and Lp correlate with Perceptual reasoning, indicating that abnormal topological structural connectivity of the white matter network might be neurofunctional basis for impaired perceptual reasoning.

Depression, characterized by persistent sadness and loss of interest in daily activities, greatly reduces quality of life. Early detection is vital for effective treatment and intervention. While many studies use wearable devices to classify depression based on physical activity, these often rely on intrusive methods. Additionally, most depression classification studies involve large participant groups and use single-stage classifiers without explainability.

The COVID-19 pandemic has had a profound global impact, leading to a range of persistent sequelae referred to as post-COVID-19 condition or "long COVID" that continue to affect patients worldwide. Among these sequelae, post-COVID-19 insomnia (PCI) has emerged as a significant issue. Conventional treatments, including cognitive behavioral therapy and pharmacological interventions, face limitations such as variable efficacy, potential side effects, and substantial costs. Recently, acupuncture has gained traction due to its efficacy, cost-effectiveness, and safety profile.

Women are particularly vulnerable to depression during pregnancy, which is one of the strongest risk factors for developing postpartum depression (PPD). Addressing antenatal depressive symptoms in these women is crucial for preventing PPD. However, little is known about the effectiveness of internet-based cognitive behavioral therapy (ICBT) in preventing PPD in this high-risk group.

The purpose of this study was to extend previous work using a pilot delayed cohort design with a more geographically and linguistically diverse group of people with aphasia (PWA) to explore the impact of a virtual, adapted, and aphasia-friendly yoga program; expand our original outcome measures to include a self-report of aphasia impact in addition to measures of resilience, stress, sleep disturbance, and pain management; and continue programmatic development through participant feedback about the program structure.

Major depressive disorder (MDD) and Insomnia disorder (ID) are characterized by sleep alterations. To define their polysomnographic profiles, we conducted a Network Meta-Analysis comparing MDD and ID patients versus healthy controls (HCs). The literature search, conducted from 2008 up to January 2023 and following PRISMA guidelines, covered PubMed, Web of Science, Scopus, and Embase databases. We addressed publication bias using funnel plot asymmetry inspection and Egger's test, evaluated statistical heterogeneity with I, and local and global inconsistencies with the separate indirect from direct evidence method and Q between designs, respectively. Pairwise meta-analyses employed a fixed-effects model, while network analysis utilized a random-effect approach. We evaluated 86 ID and 17 MDD studies, comparing sleep parameters for 636 MDDs versus 491 HCs, and 3661 IDs versus 2792 HCs. The network meta-analysis reported that patients with MDD have greater rapid eye movement (REM) sleep duration and REMs density, and lower REM sleep latency compared to IDs. ID patients instead exhibited lower total sleep time and time in bed, and greater wake after sleep onset and non-REM sleep stage 3 than MDD patients. This work emphasized sleep depth and continuity alterations in both MDD and ID, with major involvement of REM sleep in MDD.