Sex differences in body temperature and thermal perception under stable and transient thermal environments: A comparative study.

Sex difference stands as a crucial factor necessitating consideration in personalized thermal environment control, with the mechanisms of its emergence potentially differing across different thermal environments. However, a comparative analysis of sex differences regarding body temperature (skin and core body temperature) and thermal perception across different environments is lacking. A stable environmental experiment (comprising three conditions: 16 °C, 20 °C, and 24 °C) and a transient environmental experiment (involving a whole-body step-change from 19 °C to 35 °C and back to 19 °C) were conducted, with participation from 20 young males and 20 young females. Skin temperature and core body temperature were continuously recorded during the experiments, and three types of thermal perceptions were regularly collected. The results showed that: (1) The impact of thermal environment on females' skin temperature surpassed that on males, in stable environment, with every 1 °C rise in ambient temperature, the mean skin temperature increased by 0.28 °C for males and 0.35 °C for females respectively; in transient environment, females' mean skin temperature raise and fell at a faster rate. (2) Males exhibited stronger thermal regulation abilities than females, particularly evident during sudden increase in ambient temperature (from 19 °C to 35 °C), where the reduction magnitude of males' core body temperature was notably larger. (3) Whether in stable or transient environments, significant sex differences often occurred in skin temperature and thermal sensation at distal parts, particularly at the hand. (4) Males typically fed back higher levels of thermal comfort and thermal acceptability than females, suggesting that in addition to physiological sex differences, psychological sex distinctions also play a role. In summary, personalized design for stable thermal environment can focus on sex differences in skin temperature, while transient thermal environment requires consideration of both skin temperature and core body temperature. A comprehensive consideration of physiological and psychological sex differences aids in creating personalized thermal environments with greater precision.

Main effects and interactions of multiple key factors related to thermal perception.

The real indoor environment involves the comprehensive interaction of multiple factors, and human subjective responses to different factors are influenced by various aspects such as physics, physiology, and psychology. The relative significance of various factors influencing different types of human subjective thermal perception, as well as the extent of their interactions, remains somewhat unclear. This investigation, leveraging the "Chinese Thermal Comfort Dataset," analyzed the integrated impact of basic thermal perception factors-temperature, humidity, air speed, as well as clothing insulation and metabolic rate-on subjective thermal perception. The findings underscored the definitive role of air temperature as the primary determinant of thermal sensation, with the impact of other factors generally remaining below 15 % of temperature. Nonetheless, the sensitivity of thermal sensation to temperature is significantly affected by other factors, demonstrating a significant interaction between temperature and different factors in influencing temperature sensation. Additionally, it was observed that significant differences (p < 0.001) in thermal comfort levels existed even at the same thermal sensation. For instance, in the state of thermal neutrality, occupants with relatively higher clothing insulation reported higher thermal comfort level (d = 0.40, p < 0.001) during the cooling season but lower thermal comfort level (d = 0.54, P < 0.001) during the heating season. Consequently, it can be deduced that when comprehensively considering the impact of multiple factors, evaluating the environment solely based on thermal sensation or thermal neutrality may prove insufficient.

Refusal of treatment among HER2-positive breast cancer patients in China: a retrospective analysis.

Background: There is a need to update the understanding of treatment refusal among cancer patients in China, taking into account recent developments. This study investigated how public insurance coverage of the first breast cancer targeted therapy contributed to the changes in treatment refusal among HER2-positive breast cancer patients in China. And it intensively examined and discussed additional barriers affecting patient utilization of innovative anticancer medicines based on the types and reasons for treatment refusal. Methods: This retrospective study included female breast cancer patients diagnosed as HER2-positive who received treatment at a provincial oncology center in southern China between 2014 and 2020. Multivariable analysis was conducted using a binary logistic regression model. Subgroup analysis was performed with the same regression model. Results: Among the 1,322 HER2-positive breast cancer patients who received treatment at the study hospital between 2014 and 2020, 327 (24.55%) had ever refused treatment. Economic reasons were reported as the primary cause by 142 patients (43.43%). Patients diagnosed after September 2017, when the first breast cancer targeted therapy was included in the public health insurance, were less likely to refuse treatment (OR = 0.64, 95% CI:0.45 ~ 0.91, p = 0.01) compared to those diagnosed before September 2017. Patients enrolled in the resident health insurance were more likely to refuse treatment (OR = 2.43, 95% CI:1.77 ~ 3.35, p < 0.001) than those enrolled in the employee health insurance. Conclusion: This study reveals a high rate of treatment refusal among HER2-positive breast cancer patients, primarily attributed to financial factors. The disparity in public health insurance benefits resulted in a heavier economic burden for patients with less comprehensive benefits. Furthermore, the study identified challenges faced by patients seeking quality-assured cancer care in underdeveloped regions in China. By addressing economic barriers, promoting accurate health information, and improving cancer care capacity across the country can reduce the rate of treatment refusal.