Cancer incidence (2000-2020) among individuals under 35: an emerging sex disparity in oncology.

BACKGROUND: Aggressive malignancies, such as pancreatic cancer, are increasingly impacting young, female populations. Our investigation centered on whether the observed trends in cancer incidence were unique to pancreatic cancer or indicative of a broader trend across various cancer types. To delve deeper into this phenomenon, we analyzed cancer incidence trends across different age and sex groups. Furthermore, we explored differences in cancer incidence within specific young subgroups aged 18 to 26 and 27 to 34, to better understand the emerging incidence trend among young individuals. METHODS: This study collected cancer incidence data from one of the Surveillance, Epidemiology, and End Results cancer registry databases (SEER22), with 10,183,928 total cases from 2000 to 2020. Data were analyzed through Joinpoint trend analysis approach to evaluate sex- and age-specific trends in cancer incidence. Exposure rates were reported as Average Annual Percentage Changes (AAPCs). RESULTS: The analysis revealed significant age and sex-specific disparities, particularly among individuals aged 18-26 and 27-34. Pancreatic cancer incidence rates increased more in females aged 18-26 (AAPC, 9.37% [95% CI, 7.36-11.41%]; p < .0001) than in males (4.43% [95% CI, 2.36-6.53%]; p < .0001). Notably, among gender, age, and other malignancies, young females had the highest AAPCs for pancreatic cancer. Additionally, the incidence of gastric cancer, myeloma, and colorectal malignancies also showed higher AAPCs in young females compared to males. CONCLUSIONS: Recognizing emerging risk populations for highly lethal malignancies is crucial for early detection and effective disease management.

Investigating how blood cadmium levels influence cardiovascular health scores across sexes and dose responses.

Background: The association between exposure to cadmium (Cd) and cardiovascular health (CVH) has received considerable scientific interest. However, findings thus far have been inconclusive, particularly regarding sex-specific effects and dose-response relationships. The aim of our study was to investigate the relationships of blood Cd levels with the overall and component CVH scores. Methods: We used data from the 2011-2018 NHANES to assess CVH using indicators such as BMI, blood pressure, lipid profiles, glucose levels, diet, physical activity, nicotine use, and sleep quality, each rated on a 0-100 scale. The overall CVH score was calculated as the average of these indicators. We employed both multiple linear and restricted cubic spline analyses to examine the relationship between blood Cd levels and CVH scores, including nonlinear patterns and subgroup-specific effects. Results: Our analysis revealed that higher blood Cd levels were associated with lower overall CVH, nicotine exposure, sleep, and diet scores, with nonlinear decreases observed in overall CVH and nicotine exposure scores at specific thresholds (-1.447 and -1.752 log µg/dL, respectively). Notably, sex differences were evident; females experienced more adverse effects of Cd on CVH and lipid scores, while in males, Cd exposure was positively correlated with BMI, a link not observed in females. Conclusion: Our study highlights the complex interplay between blood Cd levels and various aspects of CVH, revealing significant dose-response relationships and sex disparities. These findings enhance our understanding of the biobehavioral mechanisms linking Cd exposure to cardiovascular risk.

Role of intergenerational connections in cognitive aging: Evidence from a Chinese longitudinal study.

Objective: To explore the impact of intergenerational connections on cognitive function in middle-aged and older adults (45-60 years and over 60 years, respectively) and analyze the urban-rural and sex differences in the effects of intergenerational connections on cognitive function. Method: Based on China Health and Retirement Longitudinal Study data (CHARLS), this study conducted ID matching for four waves of data from 2011, 2013, 2015, and 2018. Cognitive function was measured via Telephone Interview for Cognitive Status-modified (TICS-m), word recall, and imitation drawing. Using a combination of cross-sectional and longitudinal research, we constructed the cross-lagged panel model (CLPM) with a sample of 1,480 participants to explore the relationship between intergenerational connections and cognitive function. Results: This study examines the impact of intergenerational connections on cognitive function in middle-aged (45-60 years) and older adults (over 60 years) using data from the CHARLS. It identifies urban-rural and sex differences, with notable effects among rural female participants. The frequency of meeting with one child negatively predicts cognitive function (ß = -0.040, p = 0.041), and the frequency of communication with one child positively predicts cognitive function (ß = 0.102, 0.068, 0.041, p < 0.001, p = 0.001, 0.045). Meanwhile, intergenerational connections with multiple children positively predicts cognitive function (ß = 0.044, p = 0.031), (ß = 0.128, 0.084, and 0.056, p < 0.001, 0.001, p = 0.008). There are urban-rural and sex differences in the effects of intergenerational connections on cognitive function; additionally, the effects of intergenerational connections on cognitive function are significant in rural female middle-aged and older adults. Discussion: This study proposes the theory of skewed intergenerational support, which suggests that as middle-aged and older adults age, the responsibility for intergenerational support is skewed toward one child. This leads to conflicts between middle-aged and older parents and the child, which further affects cognitive function. In addition, this study put forward the boat-carrying theory of intergenerational relations and "to hold a bowl of water level" is the art of dealing with intergenerational relationships.

Understanding the Effect of Loneliness on Quality of Life in Older Adults from Longitudinal Approaches.

Aim: To study the longitudinal relationship between loneliness and quality of life (QoL) in adults to identify key mechanisms to better design future psychosocial interventions. Method: 13,222 participants from three consecutive waves of the Survey of Health, Ageing, and Retirement in Europe (SHARE), aged 65 or older, 56.3% women. They were analyzed using cross-lagged panel model (CLPM), random intercept cross-lagged panel model (RI-CLPM), and multi-group models disaggregated by gender. Results: The RI-CLPM provided a better fit than the CLPM. Both models showed the stability of QoL and loneliness. All autoregressive paths were significant, and a negative association between concurrent QoL and loneliness was observed across all waves. The CLPM supported a reciprocal relationship, while the RI-CLPM only confirmed the effects of loneliness on QoL. Women reported higher levels of loneliness and poorer QoL, but no gender differences were identified in the longitudinal association. Conclusions: Addressing loneliness in early stages could be a better preventive measure to promote quality of life in both genders.

Female-dominated disciplines have lower evaluated research quality and funding success rates, for men and women.

We use data from 30 countries and find that the more women in a discipline, the lower quality the research in that discipline is evaluated to be and the lower the funding success rate is. This affects men and women, and is robust to age, number of research outputs, and bibliometric measures where such data are available. Our work builds on others' findings that women's work is valued less, regardless of who performs that work.

There have been growing concerns around sexism in science. Studies have found that women in science are often paid less, are less likely to get credit for their work and receive fewer and smaller grants than men at similar stages in their careers. This can make it harder for women to advance in their careers, resulting in less women than men taking up positions of leadership. There are also gender imbalances between scientific disciplines, with a higher proportion of women working in some fields compared to others. Here, James et al. set out to find whether having more women working in a discipline leads to biases in how the research is evaluated. The team examined four datasets which included information on the research evaluations and funding success of thousands of researchers across 30 different countries. The analysis suggested that scientists working in women-dominated disciplines were less likely to succeed in their grant applications. Their research was also often evaluated as being lower quality compared to researchers working in fields dominated by men. These biases applied to both men and women working in these disciplines. There were not sufficient data to analyse patterns faced by non-binary individuals. The study by James et al. cannot pinpoint a specific cause for these outcomes. However, it suggests that funding organisations should analyse the pattern of successful applications across disciplines and consider taking steps to ensure all disciplines have similar success rates. James et al. also propose that when hiring or making promotions, scientific institutions should take care when comparing researchers across disciplines and ensure there is no built-in assumption that fields dominated by men are intrinsically better.

Identification of sexual myths of university students in health-related departments and affecting factors.

AIM: The research aimed to determine the attitudes of students studying in health-related departments toward sexual myths and the factors affecting them. METHODS: The study is descriptive research involving 287 students enrolled in health-related departments. The data were collected using a "Descriptive Information Form" and the "Sexual Myths Scale (SMS)" and analyzed using the SPSS 22.0 software package. The SPSS 22.0 package program was used to evaluate the data. In statistical analysis, Spearman correlation analysis was employed to determine the relationship between continuous variables and the SMS score, and the statistical significance level was accepted as p<0.05. RESULTS: The total score was found to be 53.57±17.54 (min: 28.00 to max: 140.00), reflecting a moderate level. There was a statistically significant difference between the total score of SMS according to gender, family type, maternal employment status, and paternal education level (p<0.05). It was also determined that male students, students whose mothers were unemployed, who lived in extended families, and whose fathers had low education had lower SMS scores. CONCLUSION: Despite students studying in health-related departments and receiving relevant courses, their level of sexual myths remains at a moderate level, indicating the presence of knowledge gaps and misconceptions in the subject matter. Therefore, it is crucial to implement comprehensive education and counseling services on reproductive and sexual health for all university students.

Effect of sex-specific abdominal fat tissue composition on WHO/ISUP nuclear grade of clear cell renal cell carcinoma.

Background/aim: To investigate the relationship between sex-related visceral obesity and WHO/ISUP nuclear grade in clear cell renal cell carcinoma (ccRCC). Materials and methods: Between January 2018 and June 2022, 95 patients (56 men and 39 women) with pathologically proven ccRCC who underwent abdominal computed tomography examination were retrospectively examined. The patients were classified into two groups: low- and high-WHO/ISUP nuclear grade ccRCC (n = 58 and n = 37), respectively. Patient height, weight, body mass index (BMI), sex, age, subcutaneous fat area (SFA), visceral fat area (VFA), total fat area (TFA), and percentage of visceral fat (VF%) were recorded for the two groups. Results: No significant differences were found in age, BMI, SFA, or TFA, but VFA and VF% were significantly higher in the high-grade patient group. In males, maximal tumor diameter (MTD) (67.8% sensitivity and 76.9% specificity) had the highest area under the curve (AUC), while in females, VF% (70.0% sensitivity and 73.7% specificity) had the highest AUC. VF% revealed an odds ratio (OR) of 1.09 in females with high-grade ccRCC, and in males, MTD was an independent predictor of ccRCC with an OR of 1.03. Conclusions: Sex-related body fat tissue, including VFA and VF%, could be used for estimating WHO/ISUP nuclear grade in patients with ccRCC, especially in females.

Disparities in the access to atrial fibrillation ablation in Denmark: who gets ablated, who neglected?

AIMS: Atrial fibrillation (AF) is a common arrhythmia associated with reduced quality of life that can lead to serious complications such as stroke and heart failure. Ablation is a safe and effective treatment for AF but is not offered equally to all patients. The aim of this study is to identify demographic groups more or less likely to undergo AF ablation. METHODS AND RESULTS: All patients with newly diagnosed AF between 2010 and 2018 were identified in the Danish nationwide registries. The association between gender, age, level of education and attachment to the job market, and the likelihood of receiving AF ablation was investigated using multivariable Cox proportional hazard analysis. Cumulative incidence was calculated using the Aalen-Johansen estimator. A total of 176 248 patients were included. Men were more likely to receive ablation than women (7% vs. 3%). Patients aged 25-44 and 45-64 were most likely to receive ablation, while only 0.7% of patients aged 80 or above received ablation. The rate of ablation significantly decreased with decreasing level of education. Full-time employed patients were most likely to receive ablation, followed by self-employed, unemployed, on sick leave, undergoing education, and early retired patients. Retired patients were the least likely to receive ablation (3%). CONCLUSION: This study found that women, older patients, patients with lower levels of education, and patients on social benefits are less likely to receive AF ablation. These findings suggest that there are significant social and economic disparities in AF ablation treatment in Denmark.

Sex disparities in the associations of overall versus abdominal obesity with the 10-year cardiovascular disease risk: Evidence from the Indonesian National Health Survey.

BACKGROUND: Cardiovascular diseases (CVDs) are a leading cause of disability-adjusted life years in Indonesia. Although obesity is a known risk factor for CVDs, the relative contributions of overall versus abdominal obesity are less clear. We aimed to estimate the 10-year CVD risks of the Indonesian population and investigate the separate and joint associations of overall and abdominal obesity with these risks. METHODS: Using nationally representative data from the Indonesian Health Survey (n = 33,786), the 10-year CVD risk was estimated using the Framingham Score. The score was calculated as %-risk, with >20% indicating high risk. Overall obesity was measured by BMI, while abdominal obesity was measured by waist circumference. We performed sex-stratified multivariable linear regressions to examine the associations of standardized units of BMI and waist circumference with the 10-year CVD risk, mutually adjusted for waist circumference and BMI. RESULTS: Mean (SD) 10-year CVD risks were 14.3(8.9)% in men and 8.0(9.3)% in women, with 37.3% of men and 14.1% of women having high (>20%) risks. After mutual adjustment, one SD in BMI and waist circumference were associated with 0.75(0.50-1.01) and 0.95(0.72-1.18) increase in the %-risk of CVD in men, whereas in women, the ß(95% CIs) were 0.43(0.25-0.61) and 1.06(0.87-1.26). CONCLUSION: Abdominal fat accumulation showed stronger associations with 10-year CVD risks than overall adiposity, particularly in women. Although men had higher overall CVD risks, women experienced more detrimental cardiovascular effects of obesity. Raising awareness of abdominal/visceral obesity and its more damaging cardiovascular effects in women is crucial in preventing CVD-related morbidity and mortality.

Mapping resilience: a scoping review on mediators and moderators of childhood adversity with a focus on gender patterns.

BACKGROUND: Childhood adversity is associated with a host of negative health and socioeconomic outcomes far into adulthood. The process of avoiding such outcomes is often referred to as resilience. Mapping resilience comprehensively and across contexts is highly relevant to public health, as it is a step towards understanding environments and interventions that contribute to preventing or reversing negative outcomes after early adverse experiences. OBJECTIVES: This review scoped out the literature on resilience factors in relation to adulthood outcomes as diverse as mental health and educational attainment. Our aim was to understand where there is untapped research potential, by examining the current evidence base on resilience factors in terms of (a) resources that can buffer the impact of childhood adversity and (b) the pathways linking adversity to long-term outcomes. Furthermore, we aimed to identify gender patterns in these resources and pathways, which has not been a primary interest of reviews on resilience to date, and which can add to our understanding of the different ways in which resilience may unfold. ELIGIBILITY CRITERIA: Studies had to include an adversity experienced in childhood, an outcome considered indicative of resilience in adulthood, and at least one putative resilience factor, which had to be approached via mediation or moderation analysis. We considered cohort, case-control and cross-sectional studies. SOURCES OF EVIDENCE: We searched PubMed, Scopus and PsycINFO and included original, peer-reviewed articles published before 20 July 2023 in English, German, French, Spanish, Dutch and Swedish. CHARTING METHODS: All three authors collaborated on the extraction of information relevant to answering the research questions. The results were visually and narratively summarised. RESULTS: We included 102 studies. Traditionally anchored in the field of psychology, the resilience literature focuses heavily on individual-level resilience factors. Gender was considered in approximately 22% of included studies and was always limited to comparisons between men and women. There is no evidence that childhood adversity impacts men and women differently in the long term, but there is some evidence for gender differences in resilience factors. CONCLUSIONS: There is untapped potential in resilience research. By considering structural-level factors simultaneously with individual-level factors, and including gender as one of the elements that shape resilience, we can map resilience as a heterogeneous, multilevel process from a public health perspective. This would complement the extensive existing literature on individual-level factors and help reframe resilience as a concept that can be intervened on at a structural level, and that is subject to societal norms and forces, such as gender. There is a lack of quantitative studies including transgender and gender-non-conforming persons.

Influenza Hemagglutinin Antibody Levels in the Elderly: Impact of Sex, Age, and Influenza/COVID-19 Vaccination Status During the 2021/2022 Epidemic Season in Warsaw, Poland.

BACKGROUND The purpose of the study was to determine the level of antihemagglutinin antibodies in the serum of patients in the geriatric population in Doctor's Surgery NZOZ Nucleus Warsaw, Poland, during the epidemic season 2021/2022 using the hemagglutination inhibition assay (HAI), according to anti-influenza and anti-COVID-19 vaccination, age, and sex. MATERIAL AND METHODS Serum samples taken from 256 patients aged 65 to 99 years were examined for anti-hemagglutinin antibodies and protective levels of antibodies against antigens: A/Victoria/2570/2019 (H1N1)pdm09, A/Cambodia/e0826360/2020(H3N2), B/Washington/02/2019 (B/Victoria lineage), and B/Phuket/3073/2013 (B/Yamagata lineage) of the quadrivalent influenza vaccine for epidemic season 2021/2022. RESULTS The highest protective level, ie, the percentage of people with antibody titers ≥40 was 87.5% and was recorded for subtype A/Cambodia/e0826360/2020(H3N2), the dominant type causing infections in the epidemic season 2021/2022 confirmed by molecular biology methods. Geometric mean titer (GMT) values and protective levels for B/Washington/02/2019 (B/Victoria lineage) antigen were higher for men than women (respectively 38.4 vs 67.6; P<0.001 and 58.0% vs 74.6%; P<0.001). The protective levels of antibodies among patients vaccinated vs unvaccinated against COVID-19 were higher for B/Washington/02/2019 (B/Victoria lineage) and B/Phuket/3073/2013 (B/Yamagata lineage) antigens (64.2% vs 44.4%; P=0.023 and 78.6% vs 55.6%; P=0.004). GMT values for vaccinated against COVID-19 were also higher. There were no significant differences between younger (65-79 years) and older (≥80 years) seniors. CONCLUSIONS The analysis shows differences in the level of individual antibodies, GMT and the protective level depending on subtypes of influenza A or B virus, B/Victoria or B/Yamagata lineage, sex, and previous vaccination history against influenza and COVID-19.

The Role of Institutional Review Boards in Improving the Inclusion of Sex and Gender as Variables in Clinical Research.

ABSTRACT: In orthopaedic clinical research, as in other fields, sex and gender-specific analyses are not consistently performed, despite evidence of sex differences in outcomes. Both institutional review boards (IRBs) and journal editors have a role in impacting the rate at which such analyses are performed and reported. The authority, responsibilities, and potential actions of IRBs are discussed herein, with the aim of setting investigator expectations and propelling changes to the study plan before the research is initiated.

The influence of age, sex and player position on skill demands in junior Australian football.

This study aimed to investigate how ecological constraints influence individual player skill demands in community-level junior Australian Football (AF). Footage from 68 junior AF games, incorporating 1874 unique players, were analysed for individual skill demands such as disposals, kicks, handballs, tackles, marks, and shots at goal per player per game. Multiple linear mixed effect models were created for each skill, using player as a random effect. The impact of age, relative area per player (RAPP), number of players on the team, quarters in midfield, and weather on skill demands was assessed in U9-U14 boys. Finally, the influence of sex on the same skills was explored in U11-U14 boys and girls. Younger players were found to have fewer disposals and handballs, but more tackles, per player than older players (all p < 0.05). Further, more quarters in the midfield increased all skill demands (all p < 0.001). Finally, girls had fewer disposals and marks, but more tackles, per player than boys (all p < 0.05). Overall, age, sex, and position significantly impacted players' exposure to skills in junior AF. Game designers should consider methods to improve skill involvement and reduce tackling exposure early in the junior pathway, with further emphasis on the girls' game.

Impact of Biological Sex on Emotional Perception Among Adults With Schizophrenia Spectrum Disorders: Protocol for a Systematic Review.

BACKGROUND: It is well established that individuals with schizophrenia experience deficits in emotional perception that can impact long-term social and occupational functioning. Understanding the factors that impact these impairments is important for targeting interventions to improve recovery. In the general population, compared with males, females tend to show greater perception of emotions. Whether this sex difference persists in schizophrenia is less clear. In contrast to males, females diagnosed with schizophrenia tend to have a higher age of disease onset and better premorbid functioning but do not necessarily have better outcomes. Effective treatments for social cognitive impairments are highly relevant to long-term functional rehabilitation. A greater understanding of the cognitive deficits in emotional perception within females and males living with schizophrenia may assist interventions to be better tailored to individuals. OBJECTIVE: This systematic review aims to collate, synthesize, and critically appraise evidence considering the influence of biological sex (female and male) on the emotional perception of individuals with schizophrenia. METHODS: This is a systematic review protocol based on the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. The electronic databases MEDLINE, Embase, CENTRAL, CINAHL, and PsycINFO will be systematically searched. To be included in this review, studies must compare the emotional perceptions of male and female participants older than 18 years who have a primary diagnosis of a schizophrenia spectrum disorder. Qualitative studies, case reports, case series, unpublished manuscripts, and studies not reported in English will be excluded. Key search strategies will include combinations of the following terms: "men," "male," "man," "female," "women," "woman," "sex," "gender," "emotional perception," "emotional processing," "schizophrenia," "schizophren," "psychotic disorders," "psychosis," "psychoses," "psychotic," "schizoaffective," "schizotypal personality disorder," and "schizotyp." Identified studies will be uploaded to the web-based Covidence systematic review management software. The risk of bias for individual studies will be assessed using the relevant Joanna Briggs Institute checklist tools. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system will also be used to evaluate the strength of the evidence base. Findings will be synthesized to provide a systematic summary of the existing literature. If sufficiently comparable data to permit meta-analysis emerges, a random-effects meta-analysis will be performed. RESULTS: This systematic review was registered with the PROSPERO (International Prospective Register of Systematic Reviews) in October 2023. The search and screening of study titles and abstracts are currently underway. Data are expected to be extracted and analyzed in July 2024. CONCLUSIONS: Results will contribute to an improved understanding of the social cognitive profiles of males and females with schizophrenia. This knowledge is expected to inform the adaptation of interventions to improve functional outcomes. TRIAL REGISTRATION: PROSPERO CRD42023463561; https://tinyurl.com/34sr3rnf. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56977.

Fundamental movement skills proficiency in preschool-aged boys and girls: Family matters.

To investigate the associations of fundamental movement skill (FMS) proficiency with family factors, including socioeconomic status (SES) and caregiver characteristics, by sex in young children in China. Participants included 1,207 Chinese children aged 3-6 years in this cross-sectional study. Children's FMS, consisting of locomotor skills and object control (OC) skills, were assessed. Information on family SES and caregiver characteristics was reported by the parents. Sex differences in outcomes and the associations of FMS with family factors by sex were examined using SPSS 26.0. Boys scored significantly higher than girls in terms of overall FMS and OC skills (both p < 0.01). There were significant and negative associations between children's FMS and parental education level and parental body mass index (BMI), which varied by sex. Boys who were regularly cared for by parents had higher FMS and OC skill scores than did those who were primarily looked after by grandparents (both p < 0.01). This complex interplay between sex and family factors (i.e. parental education level, parental BMI, and the identity of primary caregiver) on FMS proficiency in young children underscores the urgent need for developing sex-tailored, family-involved, and socio-culturally adapted interventions to enhance FMS proficiency at the preschool stage.

Cycling position optimisation - a systematic review of the impact of positional changes on biomechanical and physiological factors in cycling.

Bike positional configuration changes strongly affect cycling performance. While consensus has emerged on saddle height optimisation, there is none for the relationship between other bike positional variables and cycling performance. Accordingly, this systematic review examines the effect of all major positional variables on performance in cycling, assessing differences between cycling disciplines and sex where possible. The systematic review, conducted per PRISMA guidelines, searched databases including Embase, Web of Science, Medline, and CINAHL, screening 16,578 studies. Of these, 47 were fully analysed. Study quality assessment using the NIH tool revealed none rated "good", 5 "fair" and 33 "poor". The analysis involved 724 participants (90 female, 454 male, 180 sex unstated). Studies focused on trunk angle/upper body position, handlebar height, Q factor, foot position, saddle fore-aft/height, seat tube angle and crank length. Participant cycling disciplines were often unspecified and few papers address women cyclists specifically. Key findings were associated with changing saddle height, trunk angle and saddle fore-aft. For trunk angle, accounting for the biomechanical and physiological effects as well as aerodynamic changes is important. Saddle fore-aft affects the hip angle and trunk angle. There are no clear recommendations for crank length, handlebar height, Q factor or cleat position.

Long-term PTSD prevalence and associated adverse psychological, functional, and economic outcomes: a 12-15 year follow-up of adults with suspected serious injury.

Background: An increasing number of longitudinal studies investigates long-term PTSD, related outcomes and potential gender differences herein. However, a knowledge gap exists when it comes to studies following individual civilian trauma beyond a decade post-trauma.Objective: To investigate the long-term PTSD prevalence, associated adverse psychological, functional and economic outcomes related to (suspected) serious injury of 12-15 years ago in Dutch adults, as well as potential gender differences herein.Method: N = 194 trauma-exposed adults (34% women) admitted to an emergency department following suspected serious injury completed a follow-up assessment 12-15 years (M = 14.30, SD = 1.00) post-trauma. Participants completed assessments of clinician-rated PTSD symptom severity, as well as self-report questionnaires on psychological, functional and economic outcomes.Results: Nine participants (4.8%) fulfilled the DSM-5 diagnostic criteria for PTSD related to the index trauma of 12-15 years ago. Results showed that PTSD symptom severity (CAPS-5) was significantly associated with more severe symptoms of anxiety (HADS) and depression (QIDS), lower well-being (WHO-5) and (health-related) quality of life (WHOQOL; EQ-5D-5L), but not with alcohol use (AUDIT), productivity loss at work (iPCQ) and health care use (iMCQ). No significant gender differences in the long-term PTSD prevalence nor in its related psychological, functional and economic outcomes were found.Conclusions: Our findings underscore the long-term presence of PTSD and associated adverse psychological and functional outcomes in a proportion of adults who experienced (suspected) serious injury over a decade ago. PTSD is already widely recognized for its substantial impact in the aftermath of a trauma. The current study emphasizes the potential long-term consequences of individual civilian trauma, highlighting the importance of accurate screening and prevention for PTSD.

We investigated long-term PTSD and associated adverse outcomes 12­15 years post-trauma.4.8% had PTSD 12­15 years following suspected serious injury.Higher PTSD symptoms were associated with adverse psychological and functional outcomes.

Sex-specific alterations in pulmonary metabolic, xenobiotic and lipid signalling pathways after e-cigarette aerosol exposure during adolescence in mice.

BACKGROUND: E-cigarette use is now prevalent among adolescents and young adults, raising concerns over potential adverse long-term health effects. Although it is hypothesised that e-cigarettes promote inflammation, studies have yielded conflicting evidence. Our previous work showed that JUUL, a popular e-cigarette brand, elicited minimal lung inflammation but induced significant molecular changes in adult C57BL/6 mice. METHODS: Now, we have profiled immunological and proteomic changes in the lungs of adolescent male and female BALB/c and C57BL/6 mice exposed to a flavoured JUUL aerosol containing 18 mg/mL of nicotine for 14 consecutive days. We evaluated changes in the immune composition by flow cytometry, gene expression levels by reverse transcription-quantitative PCR and assessed the proteomic profile of the lungs and bronchoalveolar lavage (BAL) by tandem mass tag-labelled mass spectroscopy. RESULTS: While there were few significant changes in the immune composition of the lungs, proteomic analysis revealed that JUUL exposure caused significant sex-dependent and strain-dependent differences in lung and BAL proteins that are implicated in metabolic pathways, including those related to lipids and atherosclerosis, as well as pathways related to immune function and response to xenobiotics. Notably, these changes were more pronounced in male mice. CONCLUSIONS: These findings raise the possibility that vaping dysregulates numerous biological responses in lungs that may affect disease risk, disproportionally impacting males and raising significant concerns for the future health of male youth who currently vape.

Predictors of Adherence to Antiretroviral Therapy among People Living with HIV in Northern Egypt.

Background: Adherence to medications is a crucial factor in achieving the best therapeutic outcomes for patients who have human immunodeficiency virus (HIV). Little is known about the rate and predictors of adherence to antiretroviral therapy (ART) in Egypt. Objectives: To assess the degree of adherence to ART among people living with HIV/AIDS (PLWHA) in Egypt and to explore the predictors of non-adherence. Methods: A cross-sectional study was conducted from January 2021 to December 2021 on 785 PLWHA attending an ART clinic at the main fever hospital in Alexandria, Egypt. Data collection was done using an interviewing questionnaire and pharmacy database records. Multivariate logistic regression analysis was done to identify the predictors of adherence to ART. Results: The overall adherence rate to ART among the study subjects was 66.7%. Female sex (Adjusted Odds Ratio [95% CI]: 1.73 [1.01-2.96]), intravenous drug use (AOR [95% CI]: 2.87 [1.27-6.49]), fair satisfaction with the health service at ART clinics (OR [95% CI]: 1.86 [1.27-2.73]) appeared as independent predictors of poor adherence. Conclusion: The degree of adherence to ART among PLWHA in Egypt is noticeably high, although it was influenced by several patient-, healthcare-, and community-related factors. This work provides an accurate, standardized tool to measure adherence and identify factors that contribute to non-adherence.

Females with diabetes have a higher risk of ischemic stroke readmission: a retrospective cohort study.

BACKGROUND: There are significant sex differences in the incidence of stroke or diabetes mellitus. However, little is known about sex differences in stroke rehospitalization among diabetic patients. OBJECT: To explore the sex differences in short-term and long-term rehospitalization of ischemic stroke patients with Type 2 diabetes mellitus. METHODS: A retrospective cohort study was conducted from 2017 to 2021. The rehospitalization events of ischemic stroke patients with diabetes mellitus were identified by the national unified Electronic Health Record. Propensity score matching was applied to adjust for multiple covariates, and LASSO regression was used to screen for independent variables. Cox proportional hazards model was utilized to analyze the different sex in short-term (90 days, 1 year) and long-term (5 years) rehospitalization in ischemic stroke patients with type 2 diabetes mellitus. RESULT: A total of 10,724 ischemic stroke patients were included in this study, of whom 5,952 (55.5%) were males. After a 1:1 propensity score matching, there were 3,460 males and 2,772 females. After adjusting for confounding factors, female patients with type 2 diabetes had an increased risk of ischemic stroke rehospitalization at 90 days (HR: 1.94, 95%CI: 1.13-3.33, P < 0.05), 1 year (HR: 1.65, 95%CI:1.22-2.23, P = 0.001), and 5 years (HR: 1.58, 95%CI: 1.26-1.97, P < 0.001). However, there was no significant relationship between male patients with type 2 diabetes and the risk of ischemic stroke rehospitalization, either in the short or long term. CONCLUSION: Females with type 2 diabetes mellitus have a higher risk of ischemic stroke rehospitalization in both the short-term and long-term.