Female Age Research Articles

Vascular calcification in Takayasu arteritis: relationship with metabolic syndrome, left ventricular mass index, and intima-media thickness

ObjectiveThe present study aims to determine the frequency of vascular calcification in Takayasu arteritis (TA) and the risk factors for it and to evaluate its relation with atherosclerotic predictors such as metabolic syndrome (MS), left ventricular mass index (LVMI) and carotid intima-media thickness (CIMT). MethodsA cross-sectional study was conducted in patients with TA; MS was defined according to the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria. The study included 49 TA patients (22 with MS, 27 without MS) and 31 healthy controls (HCs). Non-contrast computed tomography measured calcification in coronary arteries, aorta, and branches. ResultsForty-seven patients (95.9%) were female and mean age was 33.45 ± 8.53 years. Total calcification score (mean ± SD; 5223.9 ± 18041.1 AU vs. 35.87 ± 72.70 AU (p = 0.05)), CIMT, and LVMI were found to be significantly higher in TA patients than HCs (p < 0.05). While there was no significant difference between the total calcification score of MS (+) TA patients and MS (−) TA patients, in both patient groups, the total calcification score was found to be significantly higher than HCs. MS (+) and MS (−) groups were found to have significantly higher CIMT and LVMI values than the control group, in addition, MS (+) patients were found to have significantly higher LVMI and CIMT values than MS (−) group (p < 0.05). ConclusionVascular calcification, CIMT, and LVMI are elevated in all TA patients, with greater impact in the presence of MS.

Research progress on mechanism of follicle injury after frozen ovarian tissue transplantation and protective strategies.

The iatrogenic ovarian dysfunction caused by cancer treatment have been increasing, along with the age at onset of malignant tumors getting younger, the survival of cancer patients being longer, as well as the delayed childbearing age for females; therefore it becomes a major clinical challenge to preserve the fertility of these patients. Ovarian tissue cryopreservation is the only solution for female cancer patients in prepubertal ages and those who cannot delay gonadotoxic therapy. However, the successful rate of cryopreservation and transplantation of ovarian tissue is still low at present due to the risk of ischemia and hypoxia of grafted tissues. Abnormal activation of primordial follicle and ischemia-reperfusion injury after blood supply recovery also cause massive loss of follicles in grafted ovarian tissues. It has been tried in various studies to reduce the damage of follicles during freezing and transplantation by adding certain drugs, and extend the duration of endocrine and reproductive function in patients with ovarian transplantation. For example, melatonin, N-acetylcysteine, erythropoietin or other antioxidants are used to reduce oxidative stress; mesenchymal stem cells derived from different tissues, basic fibroblast growth factor, vascular endothelial growth factor, angiopoietin 2 and gonadotropin are used to promote revascularization; anti-Müllerian hormone and rapamycin are used to reduce abnormal activation of primordial follicles. This article reviews the research progress on the main mechanisms of follicle loss after ovarian tissue transplantation, including hypoxia, ischemia-reperfusion injury and associated cell death, and abnormal activation of follicles; and explores the methods of reducing graft follicle loss to provide reference for improving the efficiency of ovarian tissue cryopreservation and transplantation.

IJCM_42A: Nutritional Assessment and Association of Malnutrition with Food Insecurity among Adolescent Females of Age 15-19 Years in an Urban Slum of Raipur City

Background: Adolescent girls constitute about one-tenth of our country’s population. They suffer the brunt of malnutrition due to increased nutritional needs; compounded by urbanization, peer and social pressure. They are food insecure either due to unavailability, lack of resources or lower priority in food allocation. The NFHS-5 revealed that in the age group of 15€“19 years, about 39.7% of girls were thin, while 5.4% were overweight or obese. Objective: To assess the nutritional status of adolescent females of age 15-19 years in the urban field practice area of the CFM department of AIIMS Raipur and to determine if malnutrition is associated with food insecurity. Methodology: A sample size of 401 was determined, using the prevalence of 46.1% malnourishment among girls aged 15-19 years from NFHS-4 data. A community-based cross-sectional study was conducted. Participants were selected using consecutive sampling method, and anthropometric measurements were taken. Food insecurity was measured using Food Insecurity Experiential Scale. Results: According to WHO BMI-for-age Z scores for adolescents, 2% had severe thinness (&lt;-3SD), 9.7% had thinness (-3 to &lt;-2SD), 5% were overweight (&gt;1 to 2SD) and 1.5% were obese (&gt;2SD). The odds of being thin (low BMI for age) were high among girls who faced moderate to severe food insecurity [OR 3.2, CI 1.5-6.8, P &lt;0.002]. Conclusion: The high prevalence of thinness and its significant association with food insecurity as revealed in our study, calls for immediate nutritional policy interventions to make this vulnerable group, food secure.

Ethnic fertility and exposure to armed conflict: the case of Sri Lanka

AbstractThis paper investigates the impact of exposure to armed conflict on fertility in Sri Lanka. Using a difference-in-difference methodology, I find that exposure to civil war led to a reduction in female fertility in Sri Lanka, with evidence of an increased female age at marriage in high-conflict districts as a mechanism. The paper further focuses on ethnic disparities in demographic adjustments triggered by exposure to conflict. It determines if conflict altered the fertility patterns of the Sinhalese majority and the Sri Lankan Tamil minority differently. Estimates suggest that there is a differential in fertility adjustments of the two ethnic groups in response to conflict: the reduction in crude birth rate was significantly smaller for the Sri Lankan Tamils compared to the Sinhalese across various model specifications. The presence of an ethnic group-level replacement effect led to a lesser reduction in fertility for Sri Lankan Tamils. These results contribute to the literature on the impact of armed conflict and underscore the importance of studying demographic adjustments by sub-groups, specifically ethnicity in this context, as the intensity of adjustment often varies with the socio-political vulnerability of the group. Understanding these disparities is crucial as a sustained demographic differential has the potential to impact the ethnic composition of Sri Lanka and may further crystallize the ethnic divide in an already volatile political setting.

Assessment of Fall Risk and its Association with Frailty among Elderly

Falls are a major public health concern about 10% of falls result in serious injuries like traumatic brain injury. Falls can cause poor quality of life and financial costs for both individuals and society. Early detection of who are at high risk of falling makes it easier to provide rehabilitation therapy in the future. Objectives: To assess functional mobility, fall risk and its association with frailty among elderly. Methods: This cross-sectional study design comprised 90 male / female elderly patients ages 65 to 75. Subjects with limb amputation history, cognitive impairment and ICU status were excluded. Data were gathered from DHQ Kasur andAriz Memorial Hospital. Non-probability convenience sampling was applied. Ethical approval was obtained from institute before conducting research study ran July 2022 to December 2022.Evaluation tools included Berg Balance Scale, Elderly Mobility Scale, Functional Reach Test, and FRAIL Scale. SPSS version 25.0 used to analyze data. Frequencies, percentages, cross tabulations, bar charts, and pie charts were used to display the categorical variables. Results: Frailty and fall risk are significantly correlated, with a p-value of less than &lt; 0.001. Mobility and Frailty had significant relationship (p&lt; 0.001). There was significant association between Frailty and balance dysfunction with (p&lt;0.001). There was significant association between Frailty and fall risk with (p&lt;0.001). Conclusions: Results suggested that frail elderly were at higher risk of fall and their functional mobility is more compromised as compared to non-frail.

Post molar choriocarcinoma with solitary renal metastasis in the absence of primary uterine tumor: a case report and review of the literature

BackgroundChoriocarcinoma is a rare and highly malignant form of gestational trophoblastic disease that may develop following pregnancy, abortion, or a hydatiform mole. Renal metastatic involvement by post molar choriocarcinoma is even rarer. In this case report, we describe a unique case of post molar choriocarcinoma with a solitary renal metastasis in the absence of a primary uterine tumor and metastases in other sites, which presented with urological symptoms and spontaneous renal hemorrhage.Case presentationA 41-year-old Persian woman with history of complete hydatiform mole presented with severe flank pain, nausea, vomiting, gross hematuria, and vaginal bleeding. Laboratory tests demonstrated a serum beta human chorionic gonadotropin hormone level of 60,000 mIU/mL. Imaging studies showed a lesion at the lower pole of the left kidney with active bleeding surrounded by hematoma, as well as an empty uterine cavity. Additionally, bilateral pleural effusion was detected without any lesion within the lungs. Subsequently, the patient underwent laparotomy, partial nephrectomy, and left para-ovarian cystectomy. Endometrial curettage was also carried out. The histopathology report revealed choriocarcinoma renal metastasis with high expression of beta human chorionic gonadotropin, cytokeratin 7, and Ki 67. Moreover, there were no malignant cells in the endometrial curettage specimens, and a corpus luteum cyst was found within the para-ovarian cyst. Further investigations revealed that the pleural effusion was free of malignant cells, and there was no evidence of metastatic lesions in the brain. As a result, the patient was referred to the oncology department to receive chemotherapy, and the beta human chorionic gonadotropin levels dropped to 5 mIU/mL after receiving courses of a standard regimen of etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine/oncovin over 3 weeks. Finally, monthly measurements of beta human chorionic gonadotropin levels for 6 months indicated that levels have constantly remained within normal ranges, showing no evidence of recurrence or new metastasis.ConclusionsUrological symptoms such as hematuria or spontaneous renal hemorrhage might be the only presentation of post molar choriocarcinoma with renal involvement. Thus, it can be beneficial to measure serum beta human chorionic gonadotropin levels among females of childbearing age who present with unexplained urological symptoms, especially if there is a history of prior hydatiform mole.

Correlation between psychological status, revised Müller AO classification and patient-reported outcomes: a prospective cohort analysis.

The impact of psychological status on clinical outcomes is valued in several medical conditions, but rare attention is given to it in orthopedic trauma. We aimed to assess the correlation between psychological status, fracture severity and patient-reported outcomes in fractured patients needing urgency surgical treatment. We prospectively followed 139 consecutive patients undergoing urgency surgical treatment of a lower/upper limb fracture. Before surgery, all patients were divided into grades of fracture severity according to the Revised AO Müller Classification (AO grades). On the 15th and the 120th days after surgery, all patients underwent a psychological status assessment through the Hospital Anxiety and Depression Score (HADS), in addition to a pain evaluation through VAS. One year after surgery, patient-reported outcomes were obtained by using specific scales depending on the site of fracture. AO grades and VAS scores were significantly correlated to scores at HADS-A (anxiety component) and HADS-D (depression component), both on the 15th and the 120th. Patients presenting persistent HADS-A and HADS-D scores equal or greater than 8 points had a risk of more than 2.5 or 2.0 times of experiencing unsatisfactory surgical outcomes, respectively [HADS-A: RR = 2.8 (95% CI: 2.2-3.5)] [HADS-D: RR = 2.2 (95% CI: 1.7-3.1)]. AO grade C and the persistency of significant symptoms of anxiety or depression were independent predictors of unsatisfactory patient-reported outcomes (OR: 1.7, p = 0.03 // OR: 2.9, p < 0.01). Female gender, age, and BMI did not present any statistically significant utility in predicting unsatisfactory patient-reported outcomes. In fractured patients needing urgency surgical treatment, the risk of presenting unsatisfactory outcomes is more than twice as high in patients that present significant persistent changes in psychological status. Changes in psychological status are more frequent in patients presenting more severe pain and more severe fractures. AO grades and HADS scores are independent predictors of unsatisfactory outcomes in these patients.

Age and Sex in the Development of Hepatic Encephalopathy: Role of Alcohol.

Hepatic encephalopathy (HE) is a neurological condition linked to liver failure. Acute HE (Type A) occurs with acute liver failure, while chronic HE (Type C) is tied to cirrhosis and portal hypertension. HE treatments lag due to gaps in understanding its development by gender and age. We studied how sex and age impact HE and its severity with combined liver toxins. Our findings indicate that drug-induced (thioacetamide, TAA) brain edema was more severe in aged males than in young males or young/aged female rats. However, adding alcohol (ethanol, EtOH) worsens TAA's brain edema in both young and aged females, with females experiencing a more severe effect than males. These patterns also apply to Type A HE induced by azoxymethane (AZO) in mice. Similarly, TAA-induced behavioral deficits in Type C HE were milder in young and aged females than in males. Conversely, EtOH and TAA in young/aged males led to severe brain edema and fatality without noticeable behavioral changes. TAA metabolism was slower in aged males than in young or middle-aged rats. When TAA-treated aged male rats received EtOH, there was a slow and sustained plasma level of thioacetamide sulfoxide (TASO). This suggests that with EtOH, TAA-induced HE is more severe in aged males. TAA metabolism was similar in young, middle-aged, and aged female rats. However, with EtOH, young and aged females experience more severe drug-induced HE as compared to middle-aged adult rats. These findings strongly suggest that gender and age play a role in the severity of HE development and that the presence of one or more liver toxins may aggravate the severity of the disease progression.

Correlation between obesity and early vascular aging in middle-aged and young adult health check-up populations.

The obesity rate among middle-aged and young adults in China is increasing annually, and the incidence of cardiovascular diseases is becoming more prevalent in younger populations. However, it has not yet been reported whether obesity is associated with early vascular aging (EVA). This study aims to explore the correlation between obesity and EVA in middle-aged and young adult health check-up populations, providing a reference for the prevention of cardiovascular diseases. A total of 15 464 middle-aged and young adults aged 18-59 who completed brachial-ankle pulse wave velocity (baPWV) test in the Third Xiangya Hospital of Central South University from January to December 2020 were included. Among them, 1 965 individuals with normal blood pressure and no cardiovascular risk factors were selected as the healthy population. The baPWV thresholds for determining EVA in each age group for males and females were calculated based on the baPWV values of the healthy population. The number and percentage of individuals meeting the EVA criteria in the middle-aged and young adult health check-up populations were statistically analyzed by age and gender. The differences in obesity indicators [visceral adiposity index (VAI), body mass index (BMI), waist circumference (WC)] between the EVA and non-EVA groups for males and females were compared. Using EVA as the dependent variable, VAI, BMI, and WC were included as independent variables in a Logistic model to analyze the correlation between each obesity indicator and EVA before and after adjusting for other influencing factors. Furthermore, the correlation between each obesity indicator and EVA in each age group was analyzed. In the health check-up populations, the detection rate of EVA in different age groups was 1.65%-10.92% for males, and 1.16%-10.50% for females, the detection rate of EVA increased with age in both males and females. Except for the 40-<50 age group, the EVA detection rate was higher in males than in females in all other age groups. Regardless of gender, obesity indicators VAI, BMI, and WC were significantly higher in the EVA group than in the non-EVA group (all P<0.01). Before and after adjusting for other influencing factors, VAI and WC were both correlated with EVA (both P<0.05). BMI was a risk factor for EVA before adjusting for other influencing factors (P<0.01), but after adjustment, the correlation between BMI and EVA was not statistically significant (P=0.05). After adjusting for other influencing factors, the correlation between VAI and EVA was statistically significant in the 18-<40 and 50-<60 age groups (both P<0.05), while the correlation between BMI and WC with EVA was not statistically significant (both P>0.05). In the 40-<50 age group, the correlation between VAI and BMI with EVA was not statistically significant (both P>0.05), but the correlation between WC and EVA was statistically significant (P<0.01). VAI is closely related to the occurrence of EVA in middle-aged and young adults aged 18-<40 and 50-<60 years, while WC is closely related to the occurrence of EVA in those aged 40-<50 years.

Assessment of caries diagnostic threshold of DMFT, and ICDAS II in the estimation of caries prevalence rate in first permanent molars among students of College of Dentistry-Hawler Medical University.

Background: Dental caries is a common chronic infectious disease resulting from tooth-adherent cariogenic bacteria primarily S. Mutans, which metabolize sugars to produce acid, demineralizing the tooth structure over time. First permanent molars (FPMs) have a key role in establishing dental occlusion. They are very prone to caries because of their anatomical structure and early eruption. Hence, the estimation of dental caries in FPMs at individual and community levels could help understand the pattern and severity of dental caries. Aim: The current study aimed to evaluate the caries prevalence of FPMs amongst the students of collage of dentistry/HMU. The rate of decay between male and female, maxillary and mandibular FPM teeth. Method: This study was carried out among the students of Hawler medical university/college of dentistry. The total number of samples was (100) samples. The age of the students ranged from (18-24 years) of age. Clinical examinations were carried out under artificial light using dental mirrors and dental probe/explorers. Dental caries was diagnosed on teeth number (3, 14, 19, and 30), according to the criteria of DMFT index looking for missing, filling, decayed teeth. then ICDAS to further classify the amount of dental caries later the collected data was analyzed by using SPSS. Results: in this study the difference in decay between maxillary and mandibular teeth was significant with the P value being (0.27). Between genders the P value was (0.38) and between age groups was (0.30) their result being insignificant, according to chi-square test. Conclusion: this study indicates that; the rate of decay is more in mandibular FPMs in comparison to maxillary FPMs. While the difference between the male, female and different age group in caries prevalence are non-significant, hence, more education about the aforementioned problems is necessary. Keywords: Caries Diagnostic Threshold, Prevalence Rate.

Social Determinants Associated with Substance Use and Treatment Seeking in Females of Reproductive Age in the United States.

Introduction: Females of reproductive age (FoRA; 15-49 years) are the demographic most likely to be diagnosed with a substance use disorder. Preventative treatment prior to or during pregnancy is critical. Stigma and social inequities can delay access to care. There is limited research examining social determinants of health (SDoH) and how they are related to substance use and treatment seeking in this demographic. Methods: We analyzed the 2016-2019 data from the United States National Survey on Drug Use and Health using multivariable logistic regression models. Statistically significant variables were conceptually linked to the Office of Disease Prevention and Health Promotion's (ODPHP's) SDoH framework's five domains. Results: From a total sample of 1,477,336 (weighted) pregnant people and 39,600,523 (weighted) FoRA, substance use was reported by 879,209 (2.14% [95% confidence interval = 2.13-2.15]). Pregnancy status was not associated with substance use or treatment seeking. Past-month substance use was associated with high educational attainment, an annual income <$20,000, a history of criminality, low religiosity, and having health insurance. Past-month treatment-seeking behavior was associated with older age, an annual income >$20,000, a history of criminality, and greater religiosity. Behavioral health support seeking in the past month was associated with some college education. Higher depression severity was associated with all the three models. Conclusions: Using the ODPHP's SDoH framework, we begin to elicit critical connections that can describe substance use and treatment-seeking practices in FoRA. We encourage additional research to inform public health, health care, behavioral health, and other support service programming.

Intramuscular endometriosis of the forearm: a case report.

Endometriosis is a disorder that commonly affects females of reproductive age and is defined as the presence of endometrial glands or stroma outside the uterine cavity. Patients typically present with cyclical pain during menses. Endometriosis can be characterized as endopelvic or extrapelvic depending on the sites involved. We report a case of a 40-year-old, right-hand-dominant, female who presented with a painful mass in her right proximal forearm. She was ultimately diagnosed with intramuscular endometriosis and underwent surgical excision.

The Effect of Infection with some Intestinal Parasites on some Immune Parameters

275 fecal samples were collected from visitors to Tikrit Teaching Hospital and some private laboratories in Tikrit city/Salah al-Din Governorate. The collection period lasted from December 2022 until April 2023. The study included examining samples of both males and females of different ages. The study showed a significant decrease in level of IgG among people infected with Entamoeba histolytica by 92.00 ± 19.1, as well as for people infected with Giardia lamblia, as a significant decrease was recorded by 76.43 ± 15.1 compared to healthy people by a percentage of 130.60 ± 29.5. No significant difference was recorded between people infected with E.histolytica in level of IgM, as the percentage reached 83.4 ± 13.6. Likewise, for people infected with G.lamblia, no significant difference was recorded, as the percentage was (106.0 ± 21.7) compared to healthy people, as the percentage reached ( 84.6 ± 18.0. ). There was a significant decrease in the level of the CD4 differentiation complex among people infected with E. histolytica by a rate of 160.8 ± 23.9. Likewise, for people infected with G. lamblia, a significant decrease was recorded, reaching a rate of 187.5 ± 31.8 compared to healthy people by a rate of 475.2 ± 28.1. A significant decrease was recorded among people infected with E. histolytica in the level of CD8 differentiation complex, as the percentage reached 9.00 ± 2.51. Likewise, for people infected with G. lamblia , a significant decrease was recorded by 10.18 ± 2.60 compared to healthy people, with a percentage of 14.50 ± 3.40. There was a significant decrease in the level of IL6 in people infected with E. histolytica, as the percentage reached 85.02 ± 13.20, while in people infected with G. lamblia, no significant difference was recorded, as the percentage reached 196.30 ± 17.10, compared to healthy people, with a percentage of 220.20 ± 23.20.

Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular disease.

Fixed-dose combination (FDC) therapy, also known as polypill therapy, targets risk factors for atherosclerotic cardiovascular disease (ASCVD) and has been proposed as a strategy to reduce global ASCVD burden. Here we conducted a systematic search for relevant studies from 2016-2022 to assess the effects of FDC therapy for prevention of ASCVD. The studies selected include randomized trials evaluating FDC therapy with at least one blood pressure-lowering drug and one lipid-lowering drug. The study data were independently extracted, the quality of evidence was appraised by multiple reviewers and effect estimates were pooled using a fixed-effect meta-analysis when statistical heterogeneity was low to moderate. The main outcomes of the analysis were all-cause mortality, fatal and nonfatal ASCVD events, adverse events, systolic blood pressure, low-density lipoprotein cholesterol and adherence. Among 26 trials (n = 27,317 participants, 43.2% female and mean age range 52.9-76.0), FDC therapy was associated with lower low-density lipoprotein cholesterol and systolic blood pressure, with higher rates of adherence and adverse events in both primary and mixed secondary prevention populations. For studies with a mostly primary prevention population, FDC therapy was associated with lower risk of all-cause mortality by 11% (5.6% versus 6.3%; relative risk (risk ratio) of 0.89; 95% confidence interval 0.78 to 1.00; I2 = 0%; four trials and 16,278 participants) and risk of fatal and nonfatal ASCVD events by 29% (6.1% versus 8.4%; relative risk (risk ratio) of 0.71; 95% confidence interval 0.63 to 0.79; I2 = 0%; five trials and 15,503 participants). One adequately powered trial in an exclusively secondary prevention population showed that FDC therapy reduced the risk of major adverse cardiovascular events by 24%. These findings support adoption and implementation of polypills to lower risk for all-cause mortality and ASCVD.

Long-term outcome of stem cell transplantation with and without anti-tumor necrotic factor therapy in perianal fistula with Crohn's disease.

Stem cell transplantation is a promising therapeutic option for curing perianal fistula in Crohn's disease (CD). Anti-tumor necrotic factor (TNF) therapy combined with drainage procedure is effective as well. However, previous studies are limited to proving whether the combination treatment of biologics and stem cell transplantation improves the effect of fistula closure. This study aimed to evaluate the long-term outcomes of stem cell transplantation and compare Crohn's perianal fistula (CPF) closure rates after stem cell transplantation with and without anti-TNF therapy, and to identify the factors affecting CPF closure and recurrence. The patients with CD who underwent stem cell transplantation for treating perianal fistula in our institution between Jun 2014 and December 2022 were enrolled. Clinical data were compared according to anti-TNF therapy and CPF closure. A total of 65 patients were included. The median age of females was 26 years (range: 21-31) and that of males was 29 (44.6%). The mean follow-up duration was 65.88 ± 32.65 months, and complete closure was observed in 50 (76.9%) patients. The closure rates were similar after stem cell transplantation with and without anti-TNF therapy (66.7% vs 81.6% at 3 year, P = 0.098). The patients with fistula closure had short fistulous tract and infrequent proctitis and anorectal stricture (P = 0.027, 0.002, and 0.008, respectively). Clinical factors such as complexity, number of fistulas, presence of concurrent abscess, and medication were not significant for closure. The cumulative 1-, 2-, and 3-year closure rates were 66.2%, 73.8%, and 75.4%, respectively. Anti-TNF therapy does not increase CPF closure rates in patients with stem cell transplantation. However, both refractory and non-refractory CPF have similar closure rates after additional anti-TNF therapy. Fistulous tract length, proctitis, and anal stricture are risk factors for non-closure in patients with CPF after stem cell transplantation.

Uneven effects of twenty years of Chile's cannabis policy implementation in cannabis onset

BackgroundIn Chile, Laws 19366 and 20000, implemented in 1995 and 2005 respectively, regulated and sanctioned cannabis’ personal use, cultivation and trafficking. MethodsWe use thirteen biannual cross-sectional national surveys data from 1994 to 2018 to examine the effect of Laws 19366 and 20000—using the rate of individuals incarcerated per 100000 population due to drug-related crimes as proxy—on the age of onset of cannabis use over time. We estimate the effect of these policies using a mixed proportional hazards framework that models the transition to first cannabis use in 47,832 individuals aged 12-21. ResultsOverall, changes in these laws did not affect the transition to first cannabis use. However, increases in the rate of individuals incarcerated were associated with decreases on the age of onset of cannabis use in females and individuals living in affluent neighborhoods or in specific regions. ConclusionWe find no evidence of cannabis policy changes affecting the age of onset of cannabis use across all individuals aged 12-21. Policy effects associated with decreases in cannabis onset age in females and individuals from affluent neighborhoods or specific regions can be explained by using theoretical frames that recognize specific dynamics of cannabis supply and demand.

Disruption of Thyroid Hormone Receptor Thrab Leads to Female Infertility in Zebrafish.

Thyroid hormones (THs) T4 and T3 are vital for development, growth, and metabolism. Thyroid dysfunction can also cause problems in fertility, suggesting involvement of THs in reproduction. In zebrafish, there exist 2 forms of TH receptor alpha gene (thraa and thrab). Disruption of these genes by CRISPR/Cas9 showed no reproductive irregularities in the thraa mutant; however, inactivation of the thrab gene resulted in female infertility. Although young female mutants (thrabm/m) showed normal ovarian development and folliculogenesis before sexual maturation, they failed to release eggs during oviposition after sexual maturation. This spawning failure was due to oviductal blockage at the genital papilla. The obstruction of the oviduct subsequently caused an accumulation of the eggs in the ovary, resulting in severe ovarian hypertrophy, abdominal distention, and disruption of folliculogenesis. Gene expression analysis showed expression of both TH receptors and estrogen receptors in the genital papilla, suggesting a direct TH action and potential interactions between thyroid and estrogen signaling pathways in controlling genital papilla development and function. In addition to their actions in the reproductive tracts, THs may also have direct effects in the ovary, as suggested by follicle atresia and cessation of folliculogenesis in the heterozygous mutant (thrab+/m), which was normal in all aspects of female reproduction in young and sexually mature fish but exhibited premature ovarian failure in aged females. In summary, this study provides substantial evidence for roles of THs in controlling the development and functions of both reproductive tract and ovary.

Adolescents’ Knowledge of Sexuality in a School Context: A Descriptive Study

INTRODUCTION: School is a privileged place for sex education that equips adolescents with the knowledge and skills to make choices about their health, well-being and safe experience of sexuality. The study was carried out as part of a health promotion project with secondary school students from a school in the Lisbon Metropolitan Region, with the aim of drawing up a profile of knowledge, beliefs and attitudes about sexuality, which would inform the development of specific and adapted interventions. MATERIALS AND METHODS: This was a descriptive, correlational, cross-sectional study using a questionnaire comprising questions on socio-demographic and academic characterization and two scales of knowledge, beliefs and attitudes towards sexuality (QCS and QACSES), validated for the population under study. The sample consisted of students from a secondary school attending the 10th, 11th and 12th grades. RESULTS: The sample had an average age of 16,4 years, 51,1% boys and 48,5% girls. Female gender, age and previous attendance at courses on sexuality showed statistically significant correlations with knowledge and/or attitudes and these also showed a positive correlation with each other. The different areas of study also showed significant differences in terms of both attitudes and knowledge. CONCLUSIONS: The instruments used are suitable for the initial diagnosis and/or assessment of sexuality.

Association between serum ferritin and bone turnover marker levels in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease

ABSTRACT Objective To investigate the correlation between serum ferritin (SF) and bone turnover markers in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD). Methods Seven hundred and forty-two people with T2DM were selected. Serum bone turnover markers: osteocalcin (OC), type I procollagen N-terminal peptide (PINP), β-I type collagen carboxy-terminal peptide (β-CTx), and 25-hydroxyvitamin D3 (25-[OH]-D) levels were detected. High SF (HF) was defined as the indicated SF levels above 400 ng/mL in males and more than 150 ng/mL in females. Patients were divided into four groups: T2DM+normal SF (non-HF); T2DM+high SF (HF); T2DM+NAFLD+non-HF; andT2DM+NAFLD+HF. Relationships between SF and bone turnover markers were analyzed. Results Compared with the T2DM+non-HF group, β-CTx levels were higher in the T2DM+HFgroup. Compared with the T2DM+NAFLD+non-HF group, β-CTx levels were increased and 25-(OH)-D levels decreased in the T2DM+NAFLD+HF group (all p < 0.05). SF was positively correlated with β-CTx [β = 0.074; 95% CI (0.003, 0.205)] and negatively correlated with 25-(OH)-D [β=-0.108; 95%CI (−0.006, −0.001)]. Compared with the T2DM+non-HF group, an independent positive correlation was found between β-CTx and SF in the T2DM+NAFLD+HF group [OR = 1.002; 95% CI (1.001, 1.004)]. Among males, SF was positively correlatedwith β-CTx [β = 0.114; 95% CI (0.031, 0.266)]. SF was negatively correlated with 25-(OH)-D levels in both male and female patients [β=-0.124; 95% CI (0.007,0.001) and β=-0.168; 95% CI (−0.012, −0.002)]. Among those >50 years of age and postmenopausal females, SF was negatively correlated with 25-(OH)-D levels [β=-0.117; 95% CI (−0.007, −0.001) and β=-0.003; 95% CI (−0.013, −0.003)]. Conclusion SF level was positively correlated with β-CTx in T2DM patients with NAFLD, which may promote bone resorption and increase the risk of bone loss.

BODY COMPOSITION AND REGIONAL PHASE ANGLE AS INDICATORS OF VO2max IN ELITE MALE AND FEMALE COMBAT ATHLETES

Various potentially related factors, such as maximal oxygen consumption (VO2max) and anthropometric, physiological, genetic, and chronotype data, can contribute to athletes' training programs. Therefore, this study examined the relationship between bioelectric impedance analysis (BIA), phase angle (PhA) values, and aerobic power in female and male combat athletes. PhA, lean mass (kg), fat mass (kg), and body fat percentage (%) values of the athletes were measured using the BIA method. Oxygen consumption (VO2) was measured using a mobile cardiopulmonary exercise test system. Statistical tests included analyses of bivariate correlation, t-tests, and multiple regressions. All parameters differed except for male and female athletes' age and training experience. Male athletes have higher maximal oxygen consumption (VO2max) and PhA values than female athletes. BIA and PhA were differentially (small-medium) associated with absolute and relative VO2max in all athletes (p&lt;0.05), whereas no correlation was found between both PhA and relative VO2max, respectively. The relationship between PhA and VO2max is more revealing, especially in male and female athletes. PhA and BIA have the potential to be used in the field by conditioning and trainers to assess aerobic endurance swiftly; this can aid in determining competition readiness, training progress, and monitoring the recovery of muscle performance following injury.