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This study investigated the ERK pathway of the peripheral nervous system and discovered a gender-specific pattern of ERK activation in the dorsal root ganglion of an acid-induced chronic widespread muscular pain model. We employed a twice acid-induced chronic musculoskeletal pain model in rats to evaluate mechanical pain behavior in both male and female groups. We further conducted protein analysis of dissected dorsal root ganglions from both genders. Both male and female rats exhibited a similar pain behavior trend, with females demonstrating a lower pain threshold. Protein analysis of the dorsal root ganglion (DRG) showed a significant increase in phosphorylated ERK after the second acid injection in all groups. However, phosphorylation of ERK was observed in the dorsal root ganglion, with higher levels in the male ipsilateral group compared to the female group. Moreover, there was a no difference between the left and right sides in males, whereas the significant difference was observed in females. In conclusions, the administration of acid injections induced painful behavior in rats, and concurrent with this, a significant upregulation of pERK was observed in the dorsal root ganglia, with a greater magnitude of increase in males than females, and in the contralateral side compared to the ipsilateral side. Our findings shed light on the peripheral mechanisms underlying chronic pain disorders and offer potential avenues for therapeutic intervention.
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MAP Quinases Reguladas por Sinal Extracelular , Fibromialgia , Gânglios Espinais , Ratos Sprague-Dawley , Caracteres Sexuais , Animais , Masculino , Feminino , Fibromialgia/metabolismo , Gânglios Espinais/metabolismo , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Fosforilação/efeitos dos fármacos , Ratos , Limiar da Dor , Modelos Animais de Doenças , Dor/metabolismo , Dor/fisiopatologiaRESUMO
OBJECTIVE: Women have a higher prevalence of osteoarthritis (OA) and worse clinical courses than men. However, the underlying factors and therapeutic outcomes of these sex-specific differences are incompletely researched. This review examines the current state of knowledge regarding sex differences in OA prevalence, risk factors, pain severity, functional outcomes, and use and response to therapeutics. METHODS: PubMed database was used with the title keyword combinations "{gender OR sex} AND osteoarthritis" plus additional manual search of the included papers for pertinent references, yielding 212 references. Additional references were added and 343 were reviewed for appropriateness. RESULTS: Globally, women account for 60% of people with osteoarthritis, with a greater difference after age 40. The higher risk for women may be due to differences in joint anatomy, alignment, muscle strength, hormonal influences, obesity, and/or genetics. At the same radiographic severity, women have greater pain severity than men, which may be explained by biologically distinct pain pathways, differential activation of central pain pathways, differences in pain sensitivity, perception, reporting, and coping strategies. Women have greater limitations of physical function and performance than men independent of BMI, OA severity, injury history, and amount of weekly exercise. Women also have greater use of analgesic medications than men but less use of arthroplasty and poorer prognosis after surgical interventions. CONCLUSIONS: The recognition of sex differences in OA manifestations and management could guide tailoring of sex-specific treatment protocols, and analysis of sex as a biological variable in future research would enhance development of precision medicine.
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Osteoartrite , Percepção da Dor , Humanos , Osteoartrite/terapia , Osteoartrite/epidemiologia , Osteoartrite/fisiopatologia , Prevalência , Fatores Sexuais , Feminino , Percepção da Dor/fisiologia , Masculino , Fatores de RiscoRESUMO
Bis(2-ethylhexyl)-tetrabromophthalate (TBPH), a typical novel brominated flame retardant, has been ubiquitously identified in various environmental and biotic media. Consequently, there is an urgent need for precise risk assessment based on a comprehensive understanding of internal exposure and the corresponding toxic effects on specific tissues. In this study, we first investigated the toxicokinetic characteristics of TBPH in different tissues using the classical pseudo-first-order toxicokinetic model. We found that TBPH was prone to accumulate in the liver rather than in the gonad, brain, and muscle of both female and male zebrafish, highlighting a higher internal exposure risk for the liver. Furthermore, long-term exposure to TBPH at environmentally relevant concentrations led to increased visceral fat accumulation, signaling potential abnormal liver function. Hepatic transcriptome analysis predominantly implicated glycolipid metabolism pathways. However, alterations in the profile of associated genes and biochemical indicators revealed gender-specific responses following TBPH exposure. Besides, histopathological observations as well as the inflammatory response in the liver confirmed the development of nonalcoholic fatty liver disease, particularly in male zebrafish. Altogether, our findings highlight a higher internal exposure risk for the liver, enhancing our understanding of the gender-specific metabolic-disrupting potential associated with TBPH exposure.
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Retardadores de Chama , Peixe-Zebra , Animais , Masculino , Feminino , Fígado/metabolismo , Metabolismo dos Lipídeos , Retardadores de Chama/toxicidade , Retardadores de Chama/análiseRESUMO
PURPOSE: Most studies about medial open-wedge high tibial osteotomy (HTO) reported outcomes without focusing on gender differences. Therefore, the study compared the long-term survival rate and postoperative subjective knee function after HTO in female versus male patients with symptomatic medial compartment knee osteoarthritis. METHODS: The data of three cohorts with long-term outcomes were analysed (n = 245; 32% females; age: 49 ± 7 years; Kellgren Lawrence Grade I 6.1%, II 32.7%, III 42.4%; IV 18.8%). The minimum follow-up was at least 6 years or an earlier conversion to total knee arthroplasty (TKA). The gender-specific survival rate after HTO was calculated after 5 and 10 years and compared using Kaplan-Meier analysis and the logrank test. Baseline characteristics and subjective knee function (International Knee Documentation Committee [IKDC]/Lysholm) were analysed between both genders. RESULTS: Forty of 78 (51.3%) women and 41 of 167 men (24.5%) underwent TKA. HTO survival in females was significantly lower (p = 0.0010). The 5- and 10-year survival rates were 85.9% and 62.6% for females and 93.4% and 77.7% for males. In females and males, from preoperative to the last follow-up, the IKDC (43 ± 15 to 58 ± 17; 47 ± 14 to 67 ± 18) and the Lysholm (42 ± 18 to 72 ± 18; 55 ± 22 to 77 ± 23) improved significantly (all p < 0.0001). Females had significantly lower preoperative and postoperative IKDC (p = 0.0438; p = 0.0035) and Lysholm scores (p = 0.0002; p = 0.0323). But the absolute improvements of the IKDC and Lysholm were not significantly different between genders. CONCLUSIONS: Females had higher conversion rates to TKA and lower knee function at the last follow-up. However, preoperative knee function was lower in females and the absolute improvement following HTO was similar for both genders. In general, females benefit from HTO to treat medial knee arthritis, and TKA could be postponed for half of female patients for more than 10 years. However, surgeons must be aware of the described inferior outcomes in females for realistic patient expectation management. LEVEL OF EVIDENCE: Level II.
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Non-suicidal self-injury (NSSI) is considered a strong risk factor for suicide. Although NSSI is prevalent among adolescents and varies by gender, few studies have examined the gender-specific trajectory of NSSI and its predictors. This study examined the trajectory of NSSI among Chinese adolescent boys and girls separately, and the roles of distal (i.e., childhood maltreatment and its specific subtypes) and proximal risk factors (i.e., emotional dysregulation, peer victimization) on their trajectories. A total of 3290 Chinese adolescents (Mage = 13.08; SD = 0.84; 57.6% boys) participated in assessments at three time points. Latent class growth models identified three trajectories for boys: Low stable (92.5%), moderate increasing (5.0%) and high decreasing (2.5%). Four trajectories were identified for girls: Low stable (87.9%), moderate increasing (7.6%), high decreasing (3.0%) and high stable (1.5%). Multinomial logistic regression analyses revealed that both emotional dysregulation and emotional abuse predicted the trajectories of moderate increasing, high decreasing and high stable for girls, as well as predicted moderate increasing and high decreasing trajectories for boys. Peer victimization served as a significant risk factor predicting the moderate increasing and high decreasing trajectories only for girls, while overall childhood maltreatment was a remarkable predictor for the moderate increasing and high decreasing trajectories of boys. The findings highlighted the importance of gender differences in understanding the progression of NSSI and the key predictors, informing effective strategies for prevention and intervention.
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AIM: To identify practices of assessment of gender effects in research articles in orthodontics and detect whether there were significant differences in the treatment effects on outcomes according to gender. MATERIALS AND METHODS: Four major orthodontic journals were sought over a 3-year period to identify publications which included assessment of gender effects on outcomes in their reporting. Data were extracted on the following characteristics: journal, year of publication, region of authorship, and study design. For the studies including reporting of gender effects, whether a significant effect existed was further documented. Additionally, for these studies, data were extracted on population, sample size per gender, treatment, comparison, outcome type, and nature and whether gender analysis was based on subgroup testing or included as a main effect. Descriptive statistics, cross-tabulations, univariable, and multivariable regression models were utilized as appropriate. RESULTS: A total of 718 research articles were eligible for inclusion out of a pool of 1,132 screened articles. Of those, 95 reported on any type of analysis on gender effects (95/718; 13.2%). In the 95 studies that reported assessment of gender effects, it was clear that the majority did not detect significant gender-related differences across the documented outcomes (range of frequency distribution for significant gender differences across all outcomes: 0-50%). Twenty-two articles overall (22/95; 23.2%) described a significant gender effect classified by outcome, 12 favoring female and 10 favoring male participants. Patterns of efficacy and adverse outcomes were schemed either favoring female (root resorption: 4/10; 40.0%, periodontal outcomes: 3/11; 27.3%) or male (cephalometric/growth changes following orthodontic treatment: 4/17; 23.5%) patients across the 22 studies with significant effects. Appropriately designed and adequately powered statistical analyses, with gender effect assessment as a main effect in a multivariable regression model was associated with 6.53 times higher odds for identifying significant gender effects (ORâ =â 6.53; 95% CI: 2.15, 19.8; Pâ =â .001). CONCLUSIONS: A very small proportion of research studies included gender effect assessment in their analyses. Of those, a quarter described significant effects. Nevertheless, careful analysis planning and strategies should be prioritized to allow for any meaningful interpretation.
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Ortodontia , Projetos de Pesquisa , Humanos , Masculino , Feminino , Estudos Transversais , Tamanho da Amostra , AutoriaRESUMO
Cardiospecific troponins are specifically localized in the troponin-tropomyosin complex and in the cytoplasm of cardiac myocytes. Cardiospecific troponin molecules are released from cardiac myocytes upon their death (irreversible damage in acute coronary syndrome) or reversible damage to cardiac myocytes, for example, during physical exertion or the influence of stress factors. Modern high-sensitive immunochemical methods for detecting cardiospecific troponins T and I are extremely sensitive to minimal reversible damage to cardiac myocytes. This makes it possible to detect damage to cardiac myocytes in the early stages of the pathogenesis of many extra-cardiac and cardiovascular diseases, including acute coronary syndrome. So, in 2021, the European Society of Cardiology approved diagnostic algorithms of acute coronary syndrome, which allow the diagnosis of acute coronary syndrome in the first 1-2 hours from the moment of admission of the patient to the emergency department. However, high-sensitive immunochemical methods for detecting cardiospecific troponins T and I may also be sensitive to physiological and biological factors, which are important to consider in order to establish a diagnostic threshold (99 percentile). One of the important biological factors that affects the 99 percentile levels of cardiospecific troponins T and I are gender characteristics. This article examines the role of gender-specific concentration of cardiospecific troponins in the diagnosis of acute coronary syndrome and the mechanisms of formation of gender-specific serum levels of cardiospecific troponins T and I.
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BACKGROUND: Chemotherapy predisposes people who menstruate to abnormal uterine bleeding that can be life-threatening and may also damage ovaries, resulting in premature menopause. The purpose of this study was to explore the incidence of menstrual history documentation and counseling before, during, and after cancer treatment. PATIENTS AND METHODS: The medical charts of 137 consecutive females (self-reported) aged 18 to 49 years receiving anticancer treatment at a major tertiary metropolitan hospital in Australia between 2017 and 2020 were reviewed. Data collected included primary diagnosis, stage of cancer, treatment(s) received, rates of remission or progression, documentation of involvement of a specialist gynecologist, reproductive history, menstrual disturbances, menstruation counseling or intervention offered, and diagnosis of early ovarian failure. RESULTS: Only 16.1% of patients had their menstrual history documented at the initial consult, and 49.6% had their menstrual history documented at a subsequent consult with their treating oncologist or hematologist. Most (82.4%) patients with a menstrual history documented experienced menstrual disturbance posttreatment, most commonly amenorrhea (48.0%), followed by menopause or menopause symptoms (20.6%), irregular menstrual bleeding (16.7%), menorrhagia (13.7%), dysmenorrhea (3.9%), and iron deficiency from bleeding (2.9%). Menopause/Menopausal symptoms and iron deficiency were more likely to be treated than other disturbances. CONCLUSIONS: Menstruation disturbance is a common side effect of cancer treatment. Menstrual care should be integral to cancer care for people who menstruate, and higher engagement could be achieved through education of medical and allied health staff, information technology systems automating prompts and referral pathways, regular audits to ensure compliance, better alliances between cancer and fertility specialists, and the creation of accessible patient information to promote awareness and facilitate discussion.
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Menstruação , Neoplasias , Feminino , Humanos , Amenorreia , Menopausa , Aconselhamento , Neoplasias/epidemiologia , Neoplasias/terapiaRESUMO
Male and female gametocytes are sexual precursor cells essential for mosquito transmission of malaria parasite. Differentiation of gametocytes into fertile gametes (known as gametogenesis) relies on the gender-specific transcription program. How the parasites establish distinct repertoires of transcription in the male and female gametocytes remains largely unknown. Here, we report that an Apetala2 family transcription factor AP2-O3 operates as a transcription repressor in the female gametocytes. AP2-O3 is specifically expressed in the female gametocytes. AP2-O3-deficient parasites produce apparently normal female gametocytes. Nevertheless, these gametocytes fail to differentiate into fully fertile female gametes, leading to developmental arrest in fertilization and early development post-fertilization. AP2-O3 disruption causes massive upregulation of transcriptionally dormant male genes and simultaneously downregulation of highly transcribed female genes in the female gametocytes. AP2-O3 targets a substantial proportion of the male genes by recognizing an 8-base DNA motif. In addition, the maternal AP2-O3 is removed after fertilization, which is required for the zygote to ookinete development. Therefore, the global transcriptional repression of the male genes in the female gametocytes is required for safeguarding female-specific transcriptome and essential for the mosquito transmission of Plasmodium.
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Plasmodium berghei , Plasmodium falciparum , Animais , Feminino , Gametogênese/genética , Masculino , Plasmodium falciparum/genética , Proteínas de Protozoários/genética , Fatores de Transcrição/genética , TranscriptomaRESUMO
OBJECTIVE: This study aimed to examine the mediating role of social isolation between physical mobility and cognitive function, and whether there are gender differences in the above mediating effects among Chinese older adults. METHODS: This is a prospective and cohort study. We obtained data from the 2011 (Time 1, T1), 2015 (Time 2, T2) and 2018 (Time 3, T3) waves of China Health and Retirement Longitudinal Study, including 3,395 participants aged 60 years or above. Cognition was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing, which was widely used in previous research. We used a cross-lagged model to test the hypothesis that social isolation mediated the association between physical mobility and cognitive function among Chinese older adults. RESULTS: The total effects of T1 physical mobility limitations on T3 cognitive function (ß = -0.055, bootstrap p < 0.001) were significantly negative. Social isolation played a mediating role among both males and females (male: ß = -0.008, bootstrap p = 0.012; female: ß = -0.006, bootstrap p = 0.023), demonstrating that the mediating effect of social isolation between physical mobility and cognitive function was not gender specific. CONCLUSION: This study confirmed that social isolation mediated the association between physical mobility and cognitive function among both Chinese male and female older adults. These findings indicate that reversing social isolation can be a priority intervention target for cognitive decline prevention and promote successful ageing, particularly among older adults with impaired physical mobility.
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Disfunção Cognitiva , Mobilidade Social , Humanos , Masculino , Feminino , Idoso , Estudos Longitudinais , Estudos de Coortes , Fatores Sexuais , Estudos Prospectivos , Isolamento Social/psicologia , Cognição , Disfunção Cognitiva/psicologia , China/epidemiologiaRESUMO
OBJECTIVES: The Munich Breathlessness Service (MBS) significantly improved control of breathlessness measured by the Chronic Respiratory Questionnaire (CRQ) Mastery in a randomized controlled fast track trial with waitlist group design spanning 8 weeks in Germany. This study aimed to assess the within-trial cost-effectiveness of MBS from a societal perspective. METHODS: Data included generic (5-level version of EQ-5D) health-related quality of life and disease-specific CRQ Mastery. Quality-adjusted life years (QALYs) were calculated based on 5-level version of EQ-5D utilities valued with German time trade-off. Direct medical costs and productivity loss were calculated based on standardized unit costs. Incremental cost-effectiveness ratios (ICER) and cost-effectiveness-acceptance curves were calculated using adjusted mean differences (AMD) in costs (gamma-distributed model) and both effect parameters (Gaussian-distributed model) and performing 1000 simultaneous bootstrap replications. Potential gender differences were investigated in stratified analyses. RESULTS: Between March 2014 and April 2019, 183 eligible patients were enrolled. MBS intervention demonstrated significantly better effects regarding generic (AMD of QALY gains of 0.004, 95% confidence interval [CI] 0.0003 to 0.008) and disease-specific health-related quality of life at nonsignificantly higher costs (AMD of 605 [95% CI -1109 to 2550]). At the end of the intervention, the ICER was 152 433/QALY (95% CI -453 545 to 1 625 903) and 1548/CRQ Mastery point (95% CI -3093 to 10 168). Intervention costs were on average 357 (SD = 132). Gender-specific analyses displayed dominance for MBS in males and higher effects coupled with significantly higher costs in females. CONCLUSIONS: Our results show a high ICER for MBS. Considering dominance for MBS in males, implementing MBS on approval within the German health care system should be considered.
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Dispneia , Qualidade de Vida , Masculino , Feminino , Humanos , Análise Custo-Benefício , Dispneia/terapia , Inquéritos e Questionários , Alemanha , Anos de Vida Ajustados por Qualidade de VidaRESUMO
DNA methylation patterns are set up in a relatively fixed programmed manner during normal embryonic development and are then stably maintained. Using genome-wide analysis, we discovered a postnatal pathway involving gender-specific demethylation that occurs exclusively in the male liver. This demodification is programmed to take place at tissue-specific enhancer sequences, and our data show that the methylation state at these loci is associated with and appears to play a role in the transcriptional regulation of nearby genes. This process is mediated by the secretion of testosterone at the time of sexual maturity, but the resulting methylation profile is stable and therefore can serve as an epigenetic memory even in the absence of this inducer. These findings add a new dimension to our understanding of the role of DNA methylation in vivo and provide the foundations for deciphering how environment can impact on the epigenetic regulation of genes in general.
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Metilação de DNA , Epigênese Genética/genética , Fígado/metabolismo , Androgênios/farmacologia , Animais , Castração , Metilação de DNA/efeitos dos fármacos , Elementos Facilitadores Genéticos/genética , Epigênese Genética/efeitos dos fármacos , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Estudo de Associação Genômica Ampla , Histonas/genética , Histonas/metabolismo , Humanos , Fígado/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Caracteres Sexuais , Testosterona/metabolismo , Testosterona/farmacologiaRESUMO
Vitamin D (VitD) and its receptor (VDR) have been intensively investigated in many cancers. As knowledge for head and neck cancer (HNC) is limited, we investigated the (pre)clinical and therapeutic relevance of the VDR/VitD-axis. We found that VDR was differentially expressed in HNC tumors, correlating to the patients' clinical parameters. Poorly differentiated tumors showed high VDR and Ki67 expression, whereas the VDR and Ki67 levels decreased from moderate to well-differentiated tumors. The VitD serum levels were lowest in patients with poorly differentiated cancers (4.1 ± 0.5 ng/mL), increasing from moderate (7.3 ± 4.3 ng/mL) to well-differentiated (13.2 ± 3.4 ng/mL) tumors. Notably, females showed higher VitD insufficiency compared to males, correlating with poor differentiation of the tumor. To mechanistically uncover VDR/VitD's pathophysiological relevance, we demonstrated that VitD induced VDR nuclear-translocation (VitD < 100 nM) in HNC cells. RNA sequencing and heat map analysis showed that various nuclear receptors were differentially expressed in cisplatin-resistant versus sensitive HNC cells including VDR and the VDR interaction partner retinoic acid receptor (RXR). However, RXR expression was not significantly correlated with the clinical parameters, and cotreatment with its ligand, retinoic acid, did not enhance the killing by cisplatin. Moreover, the Chou-Talalay algorithm uncovered that VitD/cisplatin combinations synergistically killed tumor cells (VitD < 100 nM) and also inhibited the PI3K/Akt/mTOR pathway. Importantly, these findings were confirmed in 3D-tumor-spheroid models mimicking the patients' tumor microarchitecture. Here, VitD already affected the 3D-tumor-spheroid formation, which was not seen in the 2D-cultures. We conclude that novel VDR/VitD-targeted drug combinations and nuclear receptors should also be intensely explored for HNC. Gender-specific VDR/VitD-effects may be correlated to socioeconomic differences and need to be considered during VitD (supplementation)-therapies.
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Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Terapia de Alvo Molecular , Receptores de Calcitriol , Vitamina D , Vitaminas , Feminino , Humanos , Masculino , Carcinoma de Células Escamosas/tratamento farmacológico , Cisplatino/uso terapêutico , Antígeno Ki-67/metabolismo , Ligantes , Fosfatidilinositol 3-Quinases/metabolismo , Receptores de Calcitriol/metabolismo , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Neoplasias de Cabeça e Pescoço/tratamento farmacológicoRESUMO
Gender differences in mental health emerge as early as in childhood and adolescence, highlighting the potential need for gender-specific child and adolescent mental health care. However, it is unclear how gender-specific child and adolescent mental health care is implemented and whether its' approaches are useful. Therefore, this study reviews gender-specific interventions and their effectiveness for child and adolescent mental health. Five databases were searched for articles published between 2000 and 2021. In total, 43 studies were included. Most interventions were conducted in school (n = 15) or community settings (n = 8). Substance-related disorders (n = 13) and eating disorders (n = 12) were addressed most frequently. Most interventions targeted girls (n = 31). Various gender-specific aspects were considered, including gender-specific risk and protective factors (n = 35) and needs (n = 35). Although most interventions yielded significant improvements in mental health outcomes (n = 32), only few studies reported medium or large effect sizes (n = 13). Additionally, there was a lack of strong causal evidence derived from randomized controlled trials, calling for more rigorous trials in the research field. Nevertheless, our findings indicate that gender-specific mental health care can be a promising approach to meet gender-specific mental health needs.
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The current study was conducted in the Department of Anatomy, Osmania Medical College, Koti, Hyderabad over a period of 1year. A total of 30 human pineal glands (16-males,11-females,3 excluded for post-mortem autolysis) from those bodies between the age groups of 1-80years were collected during the post-mortem study at the Mortuary of Osmania General Hospital, Koti, Hyderabad and were included in the study. Morphological parameters like weight and transverse diameter at the maximum width of the pineal glands were measured and then the pineal glands were processed for light microscopy. 4-5micron thick sections were cut and stained with H&E and Masson Trichrome for highlighting the connective tissue pattern of the pineal gland. Under light microscope, the capsular delineation, pattern of septation and lobulation, calcification, intracellular brown pigment, intraparenchymal inflammatory cells, fibrosis, gliosis and cystic changes in the pineal glands were observed in relation to age and gender.
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Calcinose , Glândula Pineal , Masculino , Feminino , Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Glândula Pineal/anatomia & histologia , Calcificação Fisiológica , Coloração e Rotulagem , MicroscopiaRESUMO
BACKGROUND AND PURPOSE: In recent decades, the global incidence of aneurysmal subarachnoid hemorrhage (aSAH) has declined. However, significant regional differences exist. We present the first comprehensive analysis of time trends in the incidence of aSAH and case fatality in Germany. METHODS: All patients hospitalized with aSAH in Germany between 2005 and 2018 were identified using International Classification of Disease, 10th Revision codes I60.0-I60.7. RESULTS: A total of 101,105 cases were included. The incidence of aSAH in Germany decreased at a mean annual rate of 0.5% (p = 0.003) from 8.9 per 100,000 population in 2005 to 8.2 in 2018. Over time, incidences of aSAH declined among patients younger than 55 years and patients aged 70-79 years, increased among ages 60-64 years, and remained stable in age groups 65-69 and 85-89 years. This corresponded to an increase in the mean age of aSAH onset from 55.6 (±14.3) to 59.0 (±14.0) years. Throughout the study period, the mean age of aSAH onset was higher in women compared to men (58.3 ± 14.4 years vs. 56.1 ± 14.1 years). There were no changes in in-hospital case fatality (16.2 vs. 16.6%, p = 0.18), but the duration of hospital stay increased significantly from 19.7 to 24.8 days (p < 0.001). The most frequent aSAH-associated aneurysm location was the anterior circulation throughout the entire study period. CONCLUSIONS: In Germany, the incidence of aSAH decreased between 2005 and 2018, especially in younger parts of the population. This may reflect effects of lifestyle adjustments most pronounced in younger age groups.
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Hemorragia Subaracnóidea , Adulto , Idoso , Feminino , Alemanha/epidemiologia , Hospitalização , Humanos , Incidência , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/epidemiologiaRESUMO
The toxicity of organophosphate esters (OPEs) on embryonic development is well noted in animal experiments, but epidemiological studies are still lacking. This study evaluated the prenatal exposure of OPEs and its trimester-specific and gender-specific effects on fetal growth. The correlations between OPE exposure and fetal growth were investigated by linear mixed-effect models and multivariable linear regression analyses. Prenatal exposure to tributyl phosphate (TBP) was negatively associated with a z-score of fetal abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and head circumference (HC). In the second trimester, the serum concentration of TBP was inversely related to the z-score of AC, BPD, and HC. In the third trimester, serum concentration of TBP was inversely related to AC, BPD, and FL z-scores. Prenatal exposure to tri-m-cresyl phosphate (TMCP) was inversely related to the z-score of AC, BPD, and HC. In the second trimester, TMCP was negatively correlated with AC, BPD, FL, and HC z-scores. After stratification by gender, male fetuses were more sensitive to OPE exposure. The above results remained robust after excluding pregnant women who gave preterm birth or those with low or high pre-pregnancy BMI. Our findings suggested that health effects of typical OPEs, particularly TBP and TMCP, should be taken into consideration in future works.
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Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal , Recém-Nascido , Gravidez , Masculino , Feminino , Humanos , Ultrassonografia Pré-Natal , Desenvolvimento Fetal , Organofosfatos/toxicidade , ÉsteresRESUMO
OBJECTIVE: Food-away-from-home (FAFH) is one of the leading dietary patterns in Chinese families. However, the relationship between FAFH and dyslipidemia remains unclear, especially in the rural adult population. This study explored the relationship of FAFH frequency with serum lipid levels and dyslipidemia in rural Chinese adults. METHODS: A total of 12,002 men and 17,477 women aged 18-79 were included from the Henan rural cohort. Serum lipid levels were measured by enzyme colorimetry. Information on FAFH frequency was collected using a validated questionnaire. The associations of FAFH frequency and serum lipid levels were assessed through multiple linear regression modeling. Logistic regression was performed to explore the linkages of the FAFH frequency to dyslipidemia and its four parameter types. Mediation analysis examined whether body mass index (BMI) acted as a mediator between the FAFH frequency and dyslipidemia. RESULTS: After adjusting for potential confounders, the adjusted odds ratio (OR) and 95% confidence interval (CI) of the groups with 8-11 FAFH times/week for dyslipidemia were 1.991 (1.569, 2.526) in men compared with 0-frequency subgroup. Participants who consumed 8-11 FAFH times/week had a higher risk of high total cholesterol (TC), high triglycerides (TG), high LDL-cholesterol (LDL-C), and low HDL-cholesterol (HDL-C) with the OR and 95% CI of 1.928 (1.247, 2.980), 1.723 (1.321, 2.247), 1.875 (1.215, 2.893), and 1.513 (1.168, 1.959), respectively. In addition, the interaction effect between FAFH and gender was significantly associated with dyslipidemia and lipid levels (P < 0.001). BMI played a fully mediating effect between FAFH frequency and dyslipidemia in men, and the Sobel test showed the significance of the mediating effect (z = 4.2158, P < 0.001). CONCLUSION: In rural Chinese adults, FAFH was significantly associated with a higher risk of dyslipidemia, which indicated the importance of FAFH reduction and dietary intervention in patients with dyslipidemia and cardiovascular disease, especially in clinical practice. TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15,006,699).
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Dislipidemias , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , China/epidemiologia , Colesterol , HDL-Colesterol , Estudos de Coortes , Lipídeos , População Rural , TriglicerídeosRESUMO
BACKGROUND: Gender is increasingly recognised as a critical factor in designing community-based health promotion programmes. Men's Sheds ('Sheds') are community-based informal environments that represent a safe space in which to engage cohorts of hard-to-reach (HTR) men in health promotion. Sheds for Life (SFL), the first structured health promotion initiative evaluated globally in Sheds, is a 10-week initiative co-designed with Shed Members (Shedders) and delivered directly in the Shed setting in Ireland. This research describes the health and wellbeing outcomes experienced by SFL participants. METHODS: Purposive sampling was used to recruit a diverse representation of Shedders (n = 421) participating in SFL alongside a wait list control (n = 86). Questionnaires assessing constructs of health and wellbeing were administered one-to-one in Sheds at baseline, 3, 6 and 12 months. Descriptive data for health outcomes were generated for each time point and assessed for significant changes using inferential testing, while considering COVID-19 impact. RESULTS: Outcomes related to subjective wellbeing, mental wellbeing, physical activity, social capital and healthy eating significantly increased post SFL (p < 0.05). Mental wellbeing scores (SWEMWBS) post SFL remained significantly higher than baseline despite COVID-19 impact (p < 0.05). Binary logistic regression indicated that the odds of a meaningful SWEMWBS change was significantly higher for shedders that had lower SWEMWBS (OR 0.804), less loneliness (OR 0.638) and lived alone (OR 0.456) at baseline. Shedders with lower SWEMBWS had higher odds of experiencing positive changes in life satisfaction (OR 0.911) and trust (OR 0.928), while Shedders who lived alone had also higher odds of experience positive changes in healthy eating (OR 0.481). Finally, inactive Shedders at baseline had higher odds of experiencing increased levels of physical activity (OR 0.582). CONCLUSIONS: Findings suggest that the inclusive, community-based SFL model is effective in engaging Shedders and facilitating positive and sustained changes in health and wellbeing outcomes. Using gender-specific approaches in the informal and safe environment of the Shed are effective in engaging men in structured health and wellbeing initiatives, particularly those who may be more vulnerable, isolated or lonely. TRIAL REGISTRATION: This study has been retrospectively registered with the 'International Standard Randomised Controlled Trial Number' registry (ISRCTN79921361) as of 05/03/2021.
Assuntos
COVID-19 , Saúde do Homem , Serviços de Saúde Comunitária , Promoção da Saúde , Humanos , Irlanda , MasculinoRESUMO
An important function of the construction of the Brain-Computer Interface (BCI) device is the development of a model that is able to recognize emotions from electroencephalogram (EEG) signals. Research in this area is very challenging because the EEG signal is non-stationary, non-linear, and contains a lot of noise due to artifacts caused by muscle activity and poor electrode contact. EEG signals are recorded with non-invasive wearable devices using a large number of electrodes, which increase the dimensionality and, thereby, also the computational complexity of EEG data. It also reduces the level of comfort of the subjects. This paper implements our holographic features, investigates electrode selection, and uses the most relevant channels to maximize model accuracy. The ReliefF and Neighborhood Component Analysis (NCA) methods were used to select the optimal electrodes. Verification was performed on four publicly available datasets. Our holographic feature maps were constructed using computer-generated holography (CGH) based on the values of signal characteristics displayed in space. The resulting 2D maps are the input to the Convolutional Neural Network (CNN), which serves as a feature extraction method. This methodology uses a reduced set of electrodes, which are different between men and women, and obtains state-of-the-art results in a three-dimensional emotional space. The experimental results show that the channel selection methods improve emotion recognition rates significantly with an accuracy of 90.76% for valence, 92.92% for arousal, and 92.97% for dominance.