Overstory functional groups indicate the legacy of land use in a secondary tropical forest in southwestern China

Anthropogenic disturbances are widespread in tropical forests and influence the species composition in the overstory.However,the impacts of historical disturbance on tropical forest overstory recovery are unclear due to a lack of disturbance data,and previous studies have focused on understory species.In this study,the purpose was to deter-mine the influence of historical disturbance on the diver-sity,composition and regeneration of overstory species in present forests.In the 20-ha Xishuangbanna tropical sea-sonal rainforest dynamics plot in southwestern China,the historical disturbance boundaries were delineated based on panchromatic photographs from 1965.Factors that drove species clustering in the overstory layer(DBH≥40 cm)were analyzed and the abundance,richness and composition of these species were compared among different tree groups based on multiple regression tree analysis.The coefficient of variation of the brightness value in historical panchro-matic photographs from 1965 was the primary driver of spe-cies clustering in the overstory layer.The abundance and richness of overstory species throughout the regeneration process were similar,but species composition was always different.Although the proportion of large-seeded and vigorous-sprouting species showed no significant differ-ence between disturbed and undisturbed forests in the tree-let layer(DBH<20 cm),the difference became significant when DBH increased.The findings highlight that historical disturbances have strong legacy effects on functional group composition in the overstory and the recovery of overstory species was multidimensional.Functional group composi-tion can better indicate the dynamics of overstory species replacement during secondary succession.

Upregulation of the glycine-rich protein-encoding gene GhGRPL enhances plant tolerance to abiotic and biotic stressors by promoting secondary cell wall development

Abiotic and biotic stressors adversely affect plant survival,biomass generation,and crop yields.As the global availability of arable land declines and the impacts of global warming intensify,such stressors may have increasingly pronounced effects on agricultural productivity.Currently,researchers face the overarching challenge of comprehensively enhancing plant resilience to abiotic and biotic stressors.The secondary cell wall plays a crucial role in bolstering the stress resistance of plants.To increase plant resistance to stress through genetic manipulation of the secondary cell wall,we cloned a cell wall protein designated glycine-rich protein-like(GhGRPL)from cotton fibers,and found that it is specifically expressed during the period of secondary cell wall biosynthesis.Notably,this protein differs from its Arabidopsis homolog,AtGRP,since its glycine-rich domain is deficient in glycine residues.GhGRPL is involved in secondary cell wall deposition.Upregulation of GhGRPL enhances lignin accumulation and,consequently,the thickness of the secondary cell walls,thereby increasing the plant’s resistance to abiotic stressors,such as drought and salinity,and biotic threats,including Verticillium dahliae infection.Conversely,interference with GhGRPL expression in cotton reduces lignin accumulation and compromises that resistance.Taken together,our findings elucidate the role of GhGRPL in regulating secondary cell wall development through its influence on lignin deposition,which,in turn,reinforces cell wall robustness and impermeability.These findings highlight the promising near-future prospect of adopting GhGRPL as a viable,effective approach for enhancing plant resilience to abiotic and biotic stress factors.

Strigolactones modulate cotton fiber elongation and secondary cell wall thickening

Cotton is one of the most important economic crops in the world,and it is a major source of fiber in the textile industry.Strigolactones(SLs)are a class of carotenoid-derived plant hormones involved in many processes of plant growth and development,although the functions of SL in fiber development remain largely unknown.Here,we found that the endogenous SLs were significantly higher in fibers at 20 days post-anthesis(DPA).Exogenous SLs significantly increased fiber length and cell wall thickness.Furthermore,we cloned three key SL biosynthetic genes,namely GhD27,GhMAX3,and GhMAX4,which were highly expressed in fibers,and subcellular localization analyses revealed that GhD27,GhMAX3,and GhMAX4 were localized in the chloroplast.The exogenous expression of GhD27,GhMAX3,and GhMAX4 complemented the physiological phenotypes of d27,max3,and max4 mutations in Arabidopsis,respectively.Knockdown of GhD27,GhMAX3,and GhMAX4 in cotton resulted in increased numbers of axillary buds and leaves,reduced fiber length,and significantly reduced fiber thickness.These findings revealed that SLs participate in plant growth,fiber elongation,and secondary cell wall formation in cotton.These results provide new and effective genetic resources for improving cotton fiber yield and plant architecture.

A spatiotemporal evolution model of a short-circuit arc to a secondary arc based on the improved charge simulation method

The initial shape of the secondary arc considerably influences its subsequent shape.To establish the model for the arcing time of the secondary arc and modify the single-phase reclosing sequence,theoretical and experimental analysis of the evolution process of the short-circuit arc to the secondary arc is critical.In this study,an improved charge simulation method was used to develop the internal-space electric-field model of the short-circuit arc.The intensity of the electric field was used as an independent variable to describe the initial shape of the secondary arc.A secondary arc evolution model was developed based on this model.Moreover,the accuracy of the model was evaluated by comparison with physical experimental results.When the secondary arc current increased,the arcing time and dispersion increased.There is an overall trend of increasing arc length with increasing arcing time.Nevertheless,there is a reduction in arc length during arc ignition due to short circuits between the arc columns.Furthermore,the arcing time decreased in the range of 0°-90°as the angle between the wind direction and the x-axis increased.This work investigated the method by which short-circuit arcs evolve into secondary arcs.The results can be used to develop the secondary arc evolution model and to provide both a technical and theoretical basis for secondary arc suppression.

Experimental study on secondary air mixing along the bed height in a circulating fluidized bed with a multitracer-gas method

A multitracer-gas method was proposed to study the secondary air(SA)mixing along the bed height in a circulating fluidized bed(CFB)using carbon monoxide(CO),oxygen(O_(2)),and carbon dioxide(CO_(2))as tracer gases.Experiments were carried out on a cold CFB test rig with a cross-section of 0.42 m×0.73 m and a height of 5.50 m.The effects of superficial velocity,SA ratio,bed inventory,and particle diameter on the SA mixing were investigated.The results indicate that there are some differences in the measurement results obtained using different tracer gases,wherein the deviation between CO and CO_(2) ranges from 42%to 66%and that between O_(2) and CO_(2) ranges from 45%to 71%in the lower part of the fluidized bed.However,these differences became less pronounced as the bed height increased.Besides,the high solid concentration and fine particle diameter in the CFB may weaken the difference.The measurement results of different tracer gases show the same trends under the variation of operating parameters.Increasing superficial velocity and SA ratio and decreasing particle diameter result in better mixing of the SA.The effect of bed inventory on SA mixing is not monotonic.

Highly divergent sympatric lineages of Leptotila verreauxi(Aves:Columbidae)suggest a secondary contact area in the Isthmus of Tehuantepec,Mexico

Due to a complex geological and biotic history,the Isthmus of Tehuantepec(IT),has been long recognized as a driver for the evolutionary divergence of numerous lowland and highland taxa.Widely distributed in the lowlands of the American continent,the White-Tipped Dove(Leptotila verreauxi)is a polytypic species with 13 recognized subspecies.Four of these have been recorded in Mexico,and the distribution of three abuts at the IT,suggesting a contact zone.To estimate phylogenetic patterns,divergence times and genetic differentiation,we examined two mt DNA(ND2 and COI)and one n DNA(β-fibint 7)markers.We also used correlative ecological niche models(ENM)to assess whether ecological differences across the IT may have acted as a biogeographical boundary.We estimated paleodistributions during the Middle Holocene,Last Glacial Maximum and Last Interglacial,to evaluate the influence of climate changes on the distribution and demographic changes.Our results showed genetically distinct lineages that diverged approximately 2.5 million years ago.Climatic and ecological factors may have played a dual role in promoting differentiation,but also in the formation of a secondary contact zone in the southern IT.Our ecological niche comparisons indicated that the ecological niche of sympatric lineages at the IT are not identical,suggesting niches divergence;in addition,environmental niche models across the region indicated no abrupt biogeographic barriers,but the presence of regions with low suitability.These results suggest that genetic differentiation originated by a vicariant event probably related to environmental factors,favored the evolution of different ecological niches.Also,the absence of a biogeographic barrier but the presence of less suitable areas in the contact regions,suggest that secondary contact zones may be also maintained by climatic factors for the eastern group,but also by biotic interactions for the western group.

Optimal Cooperative Secondary Control for Islanded DC Microgrids via a Fully Actuated Approach

DC-DC converter-based multi-bus DC microgrids(MGs) in series have received much attention, where the conflict between voltage recovery and current balancing has been a hot topic. The lack of models that accurately portray the electrical characteristics of actual MGs while is controller design-friendly has kept the issue active. To this end, this paper establishes a large-signal model containing the comprehensive dynamical behavior of the DC MGs based on the theory of high-order fully actuated systems, and proposes distributed optimal control based on this. The proposed secondary control method can achieve the two goals of voltage recovery and current sharing for multi-bus DC MGs. Additionally, the simple structure of the proposed approach is similar to one based on droop control, which allows this control technique to be easily implemented in a variety of modern microgrids with different configurations. In contrast to existing studies, the process of controller design in this paper is closely tied to the actual dynamics of the MGs. It is a prominent feature that enables engineers to customize the performance metrics of the system. In addition, the analysis of the stability of the closed-loop DC microgrid system, as well as the optimality and consensus of current sharing are given. Finally, a scaled-down solar and battery-based microgrid prototype with maximum power point tracking controller is developed in the laboratory to experimentally test the efficacy of the proposed control method.

Roles of Upper-Level Descending Inflow in Moat Development in Simulated Tropical Cyclones with Secondary Eyewall Formation

This study investigated the effects of upper-level descending inflow(ULDI)associated with inner-eyewall convection on the formation of the moat in tropical cyclones(TCs)with secondary eyewall formation(SEF).In our numerical experiments,a clear moat with SEF occurred in TCs with a significant ULDI,while no SEF occurred in TCs without a significant ULDI.The eyewall convection developed more vigorously in the control run.A ULDI occurred outside the inner-eyewall convection,where it was symmetrically unstable.The ULDI was initially triggered by the diabatic warming released by the inner eyewall and later enhanced by the cooling below the anvil cloud.The ULDI penetrated the outer edge of the inner eyewall with relatively dry air and prevented excessive solid-phase hydrometeors from being advected further outward.It produced extensive sublimation cooling of falling hydrometeors between the eyewall and the outer convection.The sublimation cooling resulted in negative buoyancy and further induced strong subsidence between the eyewall and the outer convection.As a result,a clear moat was generated.Development of the moat in the ongoing SEF prevented the outer rainband from moving farther inward,helping the outer rainband to symmetrize into an outer eyewall.In the sensitivity experiment,no significant ULDI formed since the eyewall convection was weaker,and the eyewall anvil developed relatively lower,meaning the formation of a moat and thus an outer eyewall was less likely.This study suggests that a better-represented simulation of inner-eyewall convective structures and distribution of the solid-phase hydrometeors is important to the prediction of SEF.

Nonlinear change of ion-induced secondary electron emission in theκ-Al_(2)O_(3) surface charging from first-principle modelling

Secondary electron emission(SEE)induced by the positive ion is an essential physical process to influence the dynamics of gas discharge which relies on the specific surface material.Surface charging has a significant impact on the material properties,thereby affecting the SEE in the plasma-surface interactions.However,it does not attract enough attention in the previous studies.In this paper,SEE dependent on the charged surface of specific materials is described with the computational method combining a density functional theory(DFT)model from the first-principle theory and the theory of Auger neutralization.The effect ofκ-Al2O3 surface charge,as an example,on the ion-induced secondary electron emission coefficient(SEEC)is investigated by analyzing the defect energy level and band structure on the charged surface.Simulation results indicate that,with the surface charge from negative to positive,the SEEC of a part of low ionization energy ions(such as Ei=12.6 eV)increases first and then decreases,exhibiting a nonlinear changing trend.This is quite different from the monotonic decreasing tendency observed in the previous model which simplifies the electronic structure.This irregular increase of the SEEC can be attributed to the lower escaped probability of orbital energy.The results further illustrate that the excessive charge could cause the bottom of the conduction band close to the valence band,thus leading to the decrease of the orbital energy occupied by the excited electrons.The nonlinear change of SEEC demonstrates a more realistic situation of how the electronic structure of material surface influences the SEE process.This work provides an accurate method of calculating SEEC from specific materials,which is urgent in widespread physical scenarios sensitive to surface materials,such as increasingly growing practical applications concerning plasma-surface interactions.

Analysis of secondary makeup characteristics of drill collar joint and prediction of downhole equivalent impact torque of Well SDTK1

Based on the three-dimensional elastic-plastic finite element analysis of the 8"(203.2 mm)drill collar joint,this paper studies the mechanical characteristics of the pin and box of NC56 drill collar joints under complex load conditions,as well as the downhole secondary makeup features,and calculates the downhole equivalent impact torque with the relative offset at the shoulder of internal and external threads.On the basis of verifying the correctness of the calculation results by using measured results in Well GT1,the prediction model of the downhole equivalent impact torque is formed and applied in the first extra-deep well with a depth over 10000 m in China(Well SDTK1).The results indicate that under complex loads,the stress distribution in drill collar joints is uneven,with relatively higher von Mises stress at the shoulder and the threads close to the shoulder.For 203.2 mm drill collar joints pre-tightened according to the make-up torque recommended by American Petroleum Institute standards,when the downhole equivalent impact torque exceeds 65 kN·m,the preload balance of the joint is disrupted,leading to secondary make-up of the joint.As the downhole equivalent impact torque increases,the relative offset at the shoulder of internal and external threads increases.The calculation results reveal that there exists significant downhole impact torque in Well SDTK1 with complex loading environment.It is necessary to use double shoulder collar joints to improve the impact torque resistance of the joint or optimize the operating parameters to reduce the downhole impact torque,and effectively prevent drilling tool failure.

A perspective review on the biosynthesis of plant-based secondary metabolites and their application as potent drugs

Many phytochemicals and their derived metabolites produced by plants are extensively employed in commercial goods,pharmaceutical products as well as in the environmental and medicalfields.However,these secondary metabolites obtained from plants are in low amounts,and it is difficult to synthesize them at the industrial level.Despite these challenges,they may be utilized for a variety of medicinal products that are either available in the market or are being researched and tested.Secondary metabolites are complex compounds that exhibit chirality.Further,under controlled conditions with elicitors,desired secondary metabolites may be produced from plant cell cultures.This review emphasizes the various aspects of secondary metabolites including their types,synthesis,and applications as medicinal products.The article aims to promote the use of plant secondary metabolites in the management and treatment of various diseases.

Risk factors for secondary infection after liver failure and effect of comprehensive nursing intervention

BACKGROUND In patients with liver failure(LF),the high rate of secondary infections,which are associated with poor prognosis,highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs.AIM To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions.METHODS This retrospective study included 64 patients with LF,including 32 with and 32 without secondary infections.A questionnaire was used to collect data on age;laboratory parameters,including total and direct bilirubin,prothrombin time,blood ammonia,and other biochemical parameters;invasive procedures;and complications.Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care,whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes.RESULTS The infection rate,which was not associated with age or complications,was significantly associated with biochemical parameters and invasive procedures(P<0.05).The infection rate was 61.6%in patients who had undergone invasive procedures and 32.1%in those who had not undergone invasive procedures during the hospital stay.The infection rate was also significantly associated with the type of LF(P<0.05),with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF.The nursing satisfaction rate was 58.3%in the uninfected group and 91.7%in the infected group,indicating significantly higher satisfaction in the infected group(P<0.05).CONCLUSION In patients with LF,the rate of secondary infections was high and associated with biochemical parameters and type of LF.Comprehensive nursing intervention can improve patient satisfaction.

Turbine Passage Secondary Flow Dynamics and Endwall Heat Transfer Under Different Inflow Turbulence

This study presents endwall hydrodynamics and heat transfer in a linear turbine cascade at Re 5×105 at low and high intensities of turbulence.Results are numerically predicted using the standard SST model and Reθ-γtransition model as well as using the high-resolution LES separately.The major secondary flow components,comprising the horseshoe,corner,and passage vortices are recognized and the impact on heat or mass transfer is investigated.The complicated behavior of turbine passage secondary flow generation and establishment are impacted by the perspective of boundary layer attributes and inflow turbulence.The passage vortex concerning the latest big leading-edge vane is generated by the enlargement of the circulation developed at the first instance adjacent to the pressure side becomes powerful and mixes with other vortex systems during its migration towards the suction side.The study conclusions reveal that substantial enhancements are attained on the endwall surface,for the entire spanwise blade extension on the pressure surface,and in the highly 3-D region close to the endwall on the suction surface.The forecasted suction surface thermal exchange depicts great conformity with the measurement values and precisely reproduces the enhanced thermal exchange owing to the development and lateral distribution of the secondary flows along the midspan of the blade passage downstream.The impacts of the different secondary flow structures on the endwall thermal exchange are described in depth.

Ladder Time Stepwise Inertia Coordinated Control Method of Multiple Wind Farms to Suppress System Frequency Secondary Drop

Currently,both regulated and deregulated power trading exist in China’s power system,which has caused imbalanced funds in the electricity market.In this paper,a simulation analysis of the electricity market with wind energy resources is conducted,and the calculation methods of unbalanced funds are investigated systematically.In detail,the calculation formulas of unbalanced funds are illustrated based on their definition,and a two-track electricity market clearing model is established.Firstly,the concept of the dual-track system is explained,and the specific calculation formulas of various types of unbalanced funds are provided.Next,considering the renewable energy consumption,the market clearing model based on DC power flow is constructed and solved;by combining fitting methods of mid-and long-term curves,the unbalanced funds are calculated based on clearing results and formulas.

Secondary diabetes due to different etiologies:Four case reports

BACKGROUND As research on diabetes continues to advance,more complex classifications of this disease have emerged,revealing the existence of special types of diabetes,and many of these patients are prone to misdiagnosis and underdiagnosis,leading to treatment delays and increased health care costs.The purpose of this study was to identify four causes of secondary diabetes.CASE SUMMARY Secondary diabetes can be caused by various factors,some of which are often overlooked.These factors include genetic defects,autoimmune disorders,and diabetes induced by tumours.This paper describes four types of secondary diabetes caused by Williams–Beuren syndrome,Prader–Willi syndrome,pituitary adenoma,and IgG4-related diseases.These cases deviate significantly from the typical progression of the disease due to their low incidence and rarity,often leading to their neglect in clinical practice.In comparison to regular diabetes patients,the four individuals described here exhibited distinct characteristics.Standard hypoglycaemic treatments failed to effectively control the disease.Subsequently,a series of examinations and follow-up history confirmed the diagnosis and underlying cause of diabetes.Upon addressing the primary condition,such as excising a pituitary adenoma,providing glucocorticoid supplementation,and implementing symptomatic treatments,all patients experienced a considerable decrease in blood glucose levels,which were subsequently maintained within a stable range.Furthermore,other accompanying symptoms improved.CONCLUSION Rare diseases causing secondary diabetes are often not considered in the diag-nosis of diabetes.Therefore,it is crucial to conduct genetic tests,antibody detection and other appropriate diagnostic measures when necessary to facilitate early diagnosis and intervention through proactive and efficient management of the underlying condition,ultimately improving patient outcomes.

Commuting Space of Primary and Secondary Schools in the Context of Child Friendly Cities:A Case Study of Bajiao Street of Shijingshan District

With the continuous promotion of the construction of child friendly cities,the school commuting space is an important component of the construction of child friendly roads.Based on the background of child friendly cities,the commuting space of 11 primary and secondary schools in Bajiao Street is analyzed through literature analysis and field research methods.Firstly,the relevant literature on school commuting space is sorted out,and the characteristics of school commuting space are summarized,including transportation,landscape,culture,leisure,and security.Secondly,the characteristics of commuting space of primary and secondary schools in Bajiao Street are analyzed from three aspects:in front of the school gate,path space,and node space.This paper aims to provide reference and guidance for the future construction of children’s walking school commuting and promote the construction of a child friendly city.

Secondary Metabolites of Entomopathogenic Fungi, Biological Alternative for the Control of Agricultural Pests and Disease: Present and Perspectives

The use of entomopathogenic fungi (EF) in recent years has been highly effective against the different orders of insects considered pests of agricultural importance and their conidia have been commonly applied, but it has been reported that these are sensitive to the environmental conditions. For this reason, biopesticides products have been formulated based on secondary metabolites, recently. These biomolecules participate as biological control agent, such as: cyclic depsipeptides, amino acids, polyketides, polyphenols and terpenoids, affecting their morphology, life cycle and insect behavior. The use of secondary metabolites of entomopathogenic fungi opens the possibility of application in a more efficient way for the control of agricultural pests in a compatible with the environment and human health;therefore, it is important to know, analyzing the type of molecules, their effects, and their different methods of application.

Disruption of sleep patterns among secondary school adolescents

Objectives:This study aims to assess sleep disorders among secondary school adolescents and explore the relationship between sociodemographic factors(age,gender,household income,and sleep duration)and the occurrence of these disorders.Methods:A quantitative,descriptive,cross-sectional study,was conducted from November 20th,2022,to May 25th,2023,involving 200 secondary school students selected through convenience sampling.Data collection utilized a structured questionnaire divided into sociodemographic and sleep disorder sections.Validity was ensured by a panel of ten experts,and reliability was confirmed using Cronbach’s Alpha(0.77).Statistical analysis employed SPSS version 26.Results:Findings revealed that a majority of participants(70.5%)had low-level sleep disorders,followed by moderate disorders represented(29%).Significant associations were found between sleep disorders and gender(P=0.000),economic status for family(P=0.020),and nightly sleep duration(P=0.016).However,no significant relationship was observed between sleep disorders and family structure or age(P>0.05).Conclusions:The study highlights that most secondary school students experience mild sleep disorders,followed by moderate disorders.Notably,gender,income,and sleep duration showed significant correlations with sleep disorders.

Evaluation of Hemoglobin and Serum Erythropoietin Levels in Patients with Polycythemia Vera and Secondary Polycythemia

Objective: This study compares hemoglobin and erythropoietin levels in patients with polycythemia vera and secondary polycythemia. Study Design: A retrospective cross-sectional study evaluating the serum erythropoietin and hemoglobin levels in patients with polycythemia vera and secondary polycythemia. This study was performed simultaneously in Texas state of the U.S. and Fars Province in Iran. Methods: Hemoglobin, hematocrit and erythropoietin test results were collected from patients aged 19 to 75 years who were diagnosed with polycythemia vera and secondary polycythemia. Patients records with history of thrombocythemia, congestive heart failure, dyspnea, anemia and pregnant woman were excluded from study. Patients in each decade of life were examined in separate groups, so that changes in hemoglobin related to aging did not affect the research results. Results: 75% of the patients were men, and 25% were women. A total of 1580 patients were analyzed in this study. 57.3% of patients in UTMB and 38.8 patients in Iran have hemoglobin level above 17 mg/dl. 74% of patients in UTMB and 88% of patients in Iran have erythropoietin below 10 IU/mL. Polycythemia in UTMB was more common in people over 50 and in Iran in patients under 50 years old. The serum hemoglobin and erythropoietin levels in patients with polycythemia vera were not significantly different in compare to secondary polycythemia patients. Data showed that there were 84 polycythemia patients per 100,000 people. The results of this study in UTMB and Iran showed that 4.5% and 7%, respectively, of patients with polycythemia had a positive JAK2 test. Conclusion: Low erythropoietin levels may not be helpful in differentiating polycythemia vera from secondary polycythemia. .

Management of male obesity-related secondary hypogonadism:A clinical update

The global obesity pandemic has resulted in a rise in the prevalence of male obesity-related secondary hypogonadism(MOSH)with emerging evidence on the role of testosterone therapy.We aim to provide an updated and practical approach towards its management.We did a comprehensive literature search across MEDLINE(via PubMed),Scopus,and Google Scholar databases using the keywords“MOSH”OR“Obesity-related hypogonadism”OR“Testosterone replacement therapy”OR“Selective estrogen receptor modulator”OR“SERM”OR“Guidelines on male hypogonadism”as well as a manual search of references within the articles.A narrative review based on available evidence,recommendations and their practical implications was done.Although weight loss is the ideal therapeutic strategy for patients with MOSH,achievement of significant weight reduction is usually difficult with lifestyle changes alone in real-world practice.Therefore,androgen administration is often necessary in the management of hypogonadism in patients with MOSH which also improves many other comorbidities related to obesity.However,there is conflicting evidence for the appropriate use of testosterone replacement therapy(TRT),and it can also be associated with complications.This evidence-based review updates the available evidence including the very recently published results of the TRAVERSE trial and provides comprehensive clinical practice pearls for the management of patients with MOSH.Before starting testosterone replacement in functional hypogonadism of obesity,it would be desirable to initiate lifestyle modification to ensure weight reduction.TRT should be coupled with the management of other comorbidities related to obesity in MOSH patients.Balancing the risks and benefits of TRT should be considered in every patient before and during longterm management.