Gender Differences Research Articles

Cancer Mortality Among Women in the European Union: A Comprehensive Analysis of Economic, Social, and Health Factors

This study provides a comprehensive analysis of factors associated with cancer mortality among women in twenty-seven European Union (EU) countries from 2013 to 2021. Using Pooled Ordinary Least Squares and Quantile Regression models, we examine the impact of socioeconomic, health, and lifestyle factors on gender disparities in cancer mortality. Key findings reveal that higher average years of schooling among women is associated with an increase in cancer mortality, while higher Gross National Income per capita is linked to reduced mortality rates. Lifestyle variables, such as regular physical activity and dietary habits, are associated with lower cancer mortality, whereas unmet healthcare needs and certain socio-political factors correlate with increased mortality. The results underscore the importance of addressing healthcare access and gender equity to inform policy interventions aligned with UN Sustainable Development Goals (SDGs) aimed at reducing cancer mortality among women in the EU.

Gender‐specific genetic influence of rs1111875 on diabetes risk: Insights from the Taiwan biobank study

ABSTRACTBackgroundThis study investigates the gender‐specific genetic influence of the single nucleotide polymorphism (SNP) rs1111875 on diabetes risk within the Taiwanese population using data from the Taiwan Biobank. Diabetes mellitus, particularly type 2 diabetes (T2D), is influenced by genetic factors, and the rs1111875 SNP near the hematopoietically expressed homeobox (HHEX) gene has been linked to T2D susceptibility.MethodsThe study included 69,272 participants after excluding those from arsenic‐polluted areas and those with incomplete data. Logistic regression models were used for analyses.ResultsThe analyses revealed that the CT genotype of rs1111875 was associated with an increased risk of diabetes (OR = 1.092, 95% CI = 1.030–1.157, P = 0.003), as was the TT genotype (OR = 1.280, 95% CI = 1.165–1.407, P < 0.001). The effect was more pronounced in women (CT: OR = 1.118, 95% CI = 1.036–1.207, P = 0.004; TT: OR = 1.404, 95% CI = 1.243–1.585, P < 0.001). Men exhibited a higher overall risk of diabetes (OR = 1.565, 95% CI = 1.445–1.694, P < 0.001) and had a higher prevalence (12.71% vs 7.80%, P < 0.001) compared to women.ConclusionsThe findings underscore the importance of considering gender differences in genetic studies of diabetes and suggest that personalized diabetes management strategies should account for both genetic and gender‐specific risk factors. This research contributes to the broader understanding of genetic determinants of diabetes and their interaction with gender, aiming to enhance personalized healthcare strategies for diabetes prevention and treatment.

Emerging socioeconomic correlates of loneliness. Evidence from the Barcelona Health Survey 2021

Abstract Purpose Recent evidence shows that loneliness is associated with socioeconomic factors. However, studies often focus on traditional socioeconomic indicators (income, occupation, educational level) only, disregarding other important socioeconomic determinants, such as job insecurity, housing conditions or material deprivation. Therefore, we analyse the association of a broad range of socioeconomic indicators with loneliness. Moreover, we investigate potential age and gender differences in this relationship. Methods We used cross-sectional data from the Barcelona Health Survey 2021, representative of the population of Barcelona (Spain). Individuals over the age of 14 were selected (n = 3,337). The outcome was a loneliness score based on 4 items of the UCLA scale. Loneliness was regressed on a series of sociodemographic and emerging socioeconomic correlates. Linear regression models were fitted, and potential age and gender moderation effects were tested by means of two-way interactions. Results Job insecurity and precarity-related factors, such as having a temporary job or working without a contract, material deprivation and financial difficulties, as well as poor housing conditions and facing housing insecurity were associated with increased loneliness levels. While the association between loneliness and precarity-related factors is stronger among younger individuals, material deprivation is associated with increased loneliness among older workers and women. Conclusion Beyond sociodemographic individual characteristics, socioeconomic factors are strongly associated with loneliness levels in the population. Findings support the relevance of broadening the scope of socioeconomic indicators, assessing both material conditions as well as perceived insecurity.

Knowledge, perception, and attitude toward premarital screening among university students in Kurdistan region–Iraq

Premarital screening programs are essential for identifying and providing counseling to couples at risk of transmitting genetic diseases or sexually transmitted infections. Despite their importance, university students’ awareness and knowledge of premarital screening programs remain inadequate. This study aimed to evaluate the knowledge, perceptions, and attitudes of university students in the Kurdistan Region of Iraq regarding premarital screening programs. A cross-sectional survey involving 960 students was conducted from December 2023 to February 2024. The survey assessed participants’ demographics, knowledge, perception, and attitudes toward PMSP using a structured questionnaire. Findings revealed that a significant portion of participants (39.4%) had poor knowledge of premarital screening programs, 35.9% had fair knowledge, and only 24.7% had good knowledge. Despite limited knowledge, there was strong support for premarital screening programs, with 83.1% agreeing on its importance and 78.8% recognizing the need for premarital awareness. Most participants (65.8%) believed premarital screening programs could reduce genetic diseases, and 65.6% thought it could lower sexually transmitted diseases’ prevalence. Cultural acceptance of marrying relatives was notable, with 59.7% disagreeing with the preference for not marrying relatives. Married participants showed significantly higher knowledge and attitude scores compared to single participants. Gender differences were observed, with males having higher knowledge scores. There were no significant differences in perception and attitude scores based on gender or residential area. The study underscores the need for enhanced educational campaigns to improve premarital screening programs awareness and positively influence attitudes, especially targeting cultural aspects like accepting relative marriages. Comprehensive education and fostering positive attitudes toward premarital screening programs are vital for their broader acceptance and implementation.

Trends and disparities in age, gender, ethnoracial background, and urbanization status in adult mortality due to thoracic aortic aneurysm: a retrospective nationwide study in the United States

Introduction: Thoracic aortic aneurysms (TAA) are a significant health concern, with the true prevalence likely underestimated due to undiagnosed cases. Outcomes in TAA are influenced by factors like age, gender, and comorbidities such as hypertension. This study examines mortality trends and disparities associated with TAA in US adults. Methodology: This study analyzed death certificates from 1999 to 2020 using the CDC WONDER Database to identify TAA-related deaths in individuals aged 25 and older using ICD-10 codes I71.1 and I71.2. Age-adjusted mortality rates (AAMRs) per 1,000,000 and annual percent changes (APCs) were calculated and stratified by year, gender, age group, race/ethnicity, region, and urbanization status. Results: Between 1999 and 2020, 47,136 TAA-related deaths were reported among US adults. The AAMR decreased from 16.2 to 8.2 per 1,000,000, with a significant decline from 1999 to 2013 (APC: −5.00; 95% CI: −5.54 to −4.54; P<0.001). Older adults had the highest AAMRs at 44.6 per 1,000,000. Men had higher AAMRs than women (11.2 vs. 9). AAMRs were highest among non-Hispanic (NH) Black (11), followed by NH White (10.3), NH Asian or Pacific Islander (9.5), NH American Indian or Alaska Native (7.8), and Hispanic (5.2) populations. Non-metropolitan areas had higher AAMRs than metropolitan areas (11 vs. 9.8). Conclusions: The analysis showed a significant decline in TAA mortality since 1999, with recent stabilization. However, disparities persist, with higher AAMRs among men, older adults, NH Black adults and non-metropolitan residents, highlighting the need for targeted and equitable interventions.

Global patterns of gender disparities in STEM and explanations for their persistence

Global patterns of gender disparities in STEM and explanations for their persistence

IMPACTO DA PNEUMONIA NA MORTALIDADE INFANTIL: ANÁLISE HOSPITALAR NO ESTADO DA BAHIA

Introduction: Pneumonia is a severe respiratory infection, often caused by bacteria, viruses, or fungi, that primarily affects the lungs and can impair gas exchange, leading to respiratory difficulties. In Brazil, pneumonia presents a significant public health challenge, with a particular impact on children under five years of age. This issue is especially evident in the state of Bahia, where the infant mortality rate due to pneumonia is one of the highest in the country. The causes of this high mortality are linked to a combination of factors such as lack of access to adequate medical care, low vaccination coverage, poor living conditions, overcrowded homes, and insufficient air quality. Objectives: The main objective of this study is to analyze the impact of pneumonia on infant mortality in the state of Bahia, focusing on hospital data analysis between 2020 and 2024. The research aims to identify the epidemiological trends of the disease, understand the associated risk factors, and encourage the implementation of public policies to reduce infant mortality caused by pneumonia. Justification: This research is relevant to public health because it highlights the persistent high rates of infant mortality due to pneumonia, a critical issue in socially vulnerable areas. The study contributes to understanding the social, economic, and healthcare access factors affecting the child population in Bahia, providing essential data for more effective public health policies. Methodology: The study is of an epidemiological nature, using a quantitative approach. Data were collected from records of pediatric pneumonia cases provided by the Health Department of the State of Bahia (SESAB) and DATASUS, covering the period from 2020 to 2024. Data on incidence, mortality, demographic characteristics (age, sex, race/ethnicity), and regional conditions were analyzed. The analysis was performed using descriptive statistics and techniques such as calculating mortality rates and identifying risk factors. Results and Discussion: The data revealed that between January 2020 and September 2024, there were 295 deaths due to pneumonia in children in Bahia. The highest mortality was observed in the age groups under 1 year (33.6%) and 1 to 4 years (37.3%), indicating extreme vulnerability of these age groups to the disease. Additionally, pneumonia mortality was higher among children of mixed-race (parda) background (76.3%), reflecting socioeconomic and healthcare access inequalities, particularly in peripheral and rural areas. A slight predominance of deaths among girls was also observed, though the gender difference was small (2.37%). Conclusion: This study highlights the social and regional inequalities contributing to high infant mortality from pneumonia in Bahia, emphasizing the difficulties in accessing healthcare services in more vulnerable areas. The analysis revealed that children under 5 years of age, especially those under 1 year old, are the most affected. To reduce these rates, it is urgent to implement public policies focused on improving healthcare access, expanding vaccination coverage, and strengthening living conditions in the most underserved areas of Bahia.

Abstract A039: Characterization of the heterogeneous nature of the peritumoral zone of glioblastomas and its relevance for the clinical progression of the disease

Abstract Glioblastoma (GBM) is one of the most aggressive forms of cancer, with a recurrence rate of nearly 100% within 12 months of diagnosis. This is attributable to the persistence of residual tumor cells following surgical resection, which can repopulate the tumor even after the administration of aggressive chemoradiotherapy. These cells are embedded in a specific microenvironment in the peritumoral zone (PTZ), which is formed by their interaction with the brain parenchyma. The PTZ can be classified radiologically into two distinct categories: areas of clear tumor infiltration (non-contrast-enhancing (non-CE) tumor) and areas of vascular edema. Recent data suggest that the extent of surgical resection to non-CE regions may confer substantial benefits to patients with GBM. However, while the tumor core niche has been the subject of extensive study, there is a paucity of knowledge regarding the nature of the PTZ. In this study, we prospectively collected a large cohort of radiologically guided biopsies from GBM patients and performed a comprehensive cellular analysis. To this end, we initially integrated publicly available single-cell RNA sequencing (scRNA-seq) datasets from non-pathogenic human brains and gliomas, resulting in an integrated atlas representing the major cell types: immune (myeloid cells and T cells), astrocytic, oligodendroglial, and vascular. By means of a meticulous multi-stage examination of differentially expressed genes in glioma and cell type-specific markers, we were able to identify several genes that could serve to characterize the cellular content of the biopsies obtained from the tumor core and the periphery, comprising non-CE tumor, edema, and what was deemed "normal" tissue. The application of unsupervised clustering enabled the separation of the most pathogenic samples (including CE and non-CE tumor biopsies) based on the enrichment of proliferative markers and the pronounced absence of normal endothelial and oligodendrocyte expression. The tumorigenic samples were clustered into two main groups: one group that was enriched in astrocytic and proliferative markers and another one that was enriched in myeloid cells. Furthermore, our findings indicate the existence of inter- and intra-tumor heterogeneity in the cellular composition of the PTZ in GBM, with observed differences associated with the degree of tumor infiltration, but also patient age and gender. In particular, a distinct pathological pattern was discerned in select edema and normal biopsies from multiple patients, particularly those of an advanced age. Moreover, several markers of neural and immune cells associated with a favorable prognosis were identified, though only when expressed in the periphery. In conclusion, our study offers a comprehensive scRNA-seq resource for investigating the involvement of diverse cell types in the pathobiology of GBM. Additionally, it highlights the heterogeneous nature of the glioma periphery, which could explain the gender and age-related prognostic differences that have been observed among patients with GBM. Citation Format: Olaya de Dios, María de los Ángeles Ramírez-González, Beatriz Herranz, Juan Romero, Ana Ramos, Juan Manuel Sepúlveda-Sánchez, Ricardo Gargini, Aurelio Hernández-Laín, Pedro González, Luis Jiménez-Roldán, Guillermo García-Posadas, Ángel Pérez-Núñez, Pilar Sánchez-Gómez. Characterization of the heterogeneous nature of the peritumoral zone of glioblastomas and its relevance for the clinical progression of the disease [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr A039.

Age- and sex-specific upper reference limits for cardiac biomarkers in Chinese children and adolescents: a prospective study.

Cardiac biomarkers are being increasingly applied in pediatric populations, including those with cardiogenic and non-cardiogenic myocardial injury disease. The upper reference limits of biomarkers are an important reference for disease diagnosis and health evaluation. However, the upper reference limits of pediatric cardiac biomarkers remains unknown. A total of 1,797 serum samples were collected prospectively from healthy respondents aged 0 to 18 years old. These samples were analyzed using Roche cobas e411 to determine the concentrations of hs-cTnT, CK-MB mass, and NT-proBNP. The upper reference limits and 90% confidence interval were calculated according to Clinical and Laboratory Standards Institute C28- A3 guidelines. The study successfully established the upper reference limits for hs-cTnT, CK-MB mass, and NT-proBNP in healthy children and adolescents aged 0 to 18. The hs-cTnT, CK-MB mass, and NT-proBNP levels were visibly higher in neonatal serum. With the increase in age, hs-cTnT, CK-MB mass, and NT-proBNP decline gradually. They decrease quickly in the first year after birth and decrease slowly after 1 year old. Gender differences were observed in the concentrations of hs-cTnT and CK-MB mass among healthy children and teenagers aged 10 to 18 and 13 to 18. Specifically, boys had relatively higher concentrations of hs-cTnT and CK-MB mass. However, no gender difference was found in NT-proBNP concentration. The concentrations of hs-cTnT, CK-MB mass, and NT-proBNP were simultaneously tested in healthy Chinese children for the first time. The specific upper reference limits of age and gender in pediatrics were established. The results provide comprehensive references for medical institutions specializing in children's healthcare, which are conducive to preliminary screening, diagnosis, and treatment of pediatric cardiovascular diseases.

Declining pain medicine fellowship applications from 2019 to 2024: A concerning trend among anesthesia residents and a growing gender disparity.

The fields of anesthesiology and pain medicine are experiencing significant changes driven by market forces and professional preferences. While demand for anesthesiologists is rising, pain medicine is facing a decline in fellowship applications. This study analyzed data from the Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP) from 2019 to 2023, focusing on trends in fellowship applications to pain medicine programs. Additionally, preliminary data from the 2024 match cycle were examined. There has been a notable decrease in anesthesiology residents applying to pain medicine fellowships, with applications dropping from 351 in 2019 to 193 in 2023. The overall decline in anesthesia-based applicants to pain medicine fellowships was 45%, signaling the highest detriment among anesthesiology applicants compared to other specialties. Gender disparities have been prevalent, with the absolute number of female applicants decreasing every year since 2019. Additionally, the 2023 match saw a significant number of unfilled programs, with 35 out of 115 programs failing to fill all positions. Preliminary data from the 2024 match cycle suggest this downward trend is continuing. The decline in pain medicine fellowship applications, particularly among anesthesiology residents, signals potential future workforce shortages and challenges in patient care. Recruitment strategies should include early exposure to pain medicine during residency, enhanced mentorship programs, and robust recruitment efforts (including virtual options). Addressing these issues is essential to ensure enough trained specialists to meet the growing need for pain specialists nationally.

"It was really helpful for me, and at the same time it was really tough": a qualitative study among Afghan peer refugee helpers in Greece.

Aid workers with a refugee background are increasingly engaged in the humanitarian field. These individuals, known as peer refugee helpers (PRHs), contribute to providing psychosocial support for other refugees. However, few studies have focused on the mental health and wellbeing of PRHs. This study aims to investigate the experiences of PRHs of Afghan origin in the humanitarian field in Greece. Seven focus group interviews took place in a hybrid format, online or in-person. PRHs of Afghan origin (N = 18), working for various Aid/Humanitarian Organizations (AOs), participated. Data was analyzed using template analysis. The analysis identified job resources reflected in the dimensions of sense of coherence (meaningfulness, manageability, comprehensibility) and job demands associated with role overload, role conflict, and role boundaries. Gender differences were noticeable. Specifically, female PRHs experienced empowerment, through accessing new opportunities often not available within Afghan communities. Female PRHs frequently reported going against traditional gender roles and faced negative reactions from their peers. Male PRHs reported feeling empowered through their engagement as a PRH, as it helped them fulfill their personal goals, such as becoming a good example within their families or communities. Recommendations for policymakers and AOs based on the study results include: (1) Offer training, supervision, and psychosocial support for PRHs to enhance work engagement and prevent emotional exhaustion; (2) Address gender differences ensuring the protection and support of female PRHs; (3) Adopt scalable psychosocial interventions to promote agency and a concrete way of engaging with beneficiaries; (4) Formalize job roles outlining responsibilities and expectations for PRHs.

Gender and role differences of lecturer and student perspectives on sex- and gender-based medicine in the medical curriculum - a cross-sectional survey.

Sex- and gender-based medicine (SGBM) addresses differences between males/men and females/women with regard to clinical manifestation, diagnostics, treatment and outcomes of diseases. The implementation of SGBM in the medical curriculum varies, and data on the knowledge of lecturers and students about SGBM is scarce. This study aims to evaluate the perceived importance and knowledge of SGBM among lecturers and students. This cross-sectional observational survey was conducted using a questionnaire,including ranked with a Likert Scale. Statistical analysis was performed with the Chi-squared test. All lecturers and students at the Bern University Medical School in Switzerland were invited to voluntarily participate. 114 (34.1%) lecturers and 903 (41.4%) students participated in the survey. Women perceived education of SGBM to be of greater importance than men in lecturer and student subgroups respectively (lecturers women vs. men median 6.0 vs. 5.0, P = 0.011; students 6.0 vs. 5.0, P < 0.001). No significant differences between genders of self-reported knowledge of SGBM were found (lecturers women vs. men median 4.0 vs. 4.0, P = 0.624; students 3.0 vs. 4.0, P = 0.562). There were significant differences in the perception of the SGBM being actively addressed in lectures between lecturers and students (59.4% vs. 28.8%, P < 0.001) and whether the curriculum should include SGBM (strongly agree 28.9% vs. 51.3%, P < 0.001). Women lecturers and students consider teaching of SGBM during medical studies to be more important than men. Lecturers perceived the amount of SGBM already included in the lectures to be greater compared to students.

Effectiveness of modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy

To investigate the effectiveness of modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy for temporomandibular joint anterior disc displacement (ADD). A clinical data of 30 patients (45 sides) with temporomandibular joint ADD, who met selective criteria and were admitted between September 2022 and February 2024, was retrospectively analyzed. Among them, 15 patients (23 sides) were treated with temporomandibular joint disc reduction and suture via small incision (open operation group), and 15 patients (22 sides) with modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy (arthroscopy group). There was no significant difference in gender, age, disease duration, affected side, Wilkes-Bronstein stage, preoperative visual analogue scale (VAS) score, maximal interincisal opening (MIO), and temporomandibular joint dysfunction index (DI), craniomandibular index (CMI), palpation index (PI), and other baseline data between groups ( P>0.05). VAS score, MIO, and temporomandibular joint function indicators (PI, DI, CMI) of patients were recorded at 3 months after operation, and the difference (change value) of the above indicators between pre- and post-operation was calculated. At 1 week after operation, MRI was performed to evaluate the reduction of the articular disc compared to the preoperative image. The results were classified as excellent, good, and poor, with excellent and good being considered effective reduction. The condition of condyle process repair was observed by cone beam CT (CBCT) at 3 months after operation. All incisions healed by first intention in the two groups. All patients were followed up 3-18 months (mean, 8.2 months). Facial nerve injury occurred in 3 cases in the open operation group and 1 case in the arthroscopy group, all of which returned to normal after physiotherapy and drug treatment. At 3 months after operation, MIO and VAS scores of both groups significantly improved when compared with those before operation ( P<0.05), and temporomandibular joint function indicators (PI, DI, CMI) significantly decreased ( P<0.05). The change values of MIO and temporomandibular joint function indicators in arthroscopy group were significantly higher than those in open operation group ( P<0.05). There was no significant difference in the change value of VAS score between groups ( P>0.05). There was no recurrence during follow-up. Postoperative MRI review showed that the effective reduction rate of joint disc was 95.65% (22/23) in the open operation group and 95.45% (21/22) in the arthroscopy group, with no significant difference between groups ( P>0.05). Postoperative CBCT found that early and timely effective reduction of joint disc was conducive to condyle process repair and reconstruction. Modified temporomandibular joint disc reduction and suture with tragus incision assisted by arthroscopy has a clear effect in the treatment of ADD, with less trauma, fewer postoperative complications, and good early effectiveness.

Clinicians' experiences of obtaining informed consent for research and treatment: a nested qualitative study from Pakistan.

Informed consent is considered to be the standard method for respecting the autonomy of individual participants in research and practices and is thought to be based on several conditions: (1) providing information on the purpose of the research or a specific treatment, what it will entail, (2) the participants being mentally competent to understand the information and weigh it in the balance, and (3) the participants to be free from coercion. While there are studies of informed consent in other countries, especially Low and Middle Income Countries (LMICs), this study explored the experiences of clinicians regarding the process of obtaining informed consent to participate in a Randomised Controlled Trial (RCT) in particular and treatment in general in healthcare settings, both general and mental health, specifically focusing on the tension between individualistic concept of autonomy and collectivist values in cultures such as Pakistan. Qualitative interviews with 20 clinicians from healthcare settings in Pakistan who also served as recruiters in a suicide prevention RCT in Pakistan. The interviews were guided by semi-structured topic guide. All interviews were audio-recorded and transcribed verbatim. The interviews revealed that shared decision making was more morally important than individual autonomy, the role of the family played a dominant part in the consent-taking procedure, the decision of the elder and/or family patriarch took prominence, and that clinician-researchers encountered significant challenges in consent process in Pakistan, while recruiting patients into the trial as well as during routine treatment processes in healthcare settings. Four distinct themes emerged which were (1) Family deciding for patients, (2) Benefits of involving family in consent process, (3) Gender disparity in consent process, (4) Challenges experienced by clinician-researchers during consent process in Pakistan. The concept of consent is generally considered important in many cultures, however, there are two strands of understanding. There seems to be consensus that participant agreement is necessary to protect the participant but with regards to autonomy there are significant cultural differences whether it is the right for autonomy of the individual (individualistic concept) or family, community, or expert authority in other cultures. In Pakistan clinician-researchers sometimes preferred one approach and sometimes the other as they appreciated the interests of the patient to be.

Evaluating parental knowledge and attitudes toward childhood hearing loss: a cross-sectional study in Rawalpindi, Pakistan.

Childhood hearing loss poses a significant public health challenge in Pakistan, with prevalence rates over double the global average. Parental knowledge and attitudes play a crucial role in timely detection and intervention. However, limited research explores this issue within the Pakistani context. This study aimed to examine parental knowledge and attitudes regarding childhood hearing loss in Rawalpindi, Pakistan, and identify key demographic factors influencing parental perspectives. This cross-sectional survey was conducted in Rawalpindi, Pakistan from March 1 to August 31, 2023. A total of 150 parents (79 fathers and 71 mothers) of children aged 0-12 years were recruited through convenience sampling at public locations such as schools, malls, and hospitals. Data were collected through face-to-face interviews using the validated "Parental Knowledge and Attitudes towards Childhood Hearing Loss Questionnaire," administered by a graduate student to assess parental knowledge and attitudes about childhood hearing loss. Descriptive statistics determined the percentage of correct responses and knowledge/attitudes scores. Chi-square tests explored associations between demographic factors and parental perspectives. Overall, 67.3% of parents demonstrated good knowledge of childhood hearing loss. Notably, parents scored high on recognizing congenital causes (79.3%) but displayed low awareness of measles as a risk factor (29.3%). Significant gender disparities emerged in parental knowledge, with mothers exhibiting superior knowledge compared to fathers regarding newborn screening (63.4% vs. 46.8%), treatment availability (81.7% vs. 64.6%), and educational inclusion for children with hearing impairment (57.7% vs. 38.0%). Despite these knowledge gaps, parents generally held positive attitudes towards childhood hearing loss, with an average score of 94.7%. Gender and educational level significantly influence knowledge and attitudes. Although parents in Rawalpindi generally have a good understanding and positive attitudes towards childhood hearing loss, gaps in knowledge about preventable causes and gender disparities need attention. Providing tailored counselling for higher-risk, less educated groups and expanding policies for paediatric audiology services nationwide can help address these issues.

Scarcity of Women in Interventional Radiology in SubSaharan Africa: Survey and Insights

Purpose: Globally, women are underrepresented in Interventional Radiology (IR) and calls have been made to increase gender equity. In sub-Saharan Africa specifically, IR is a rapidly emerging field. However, concerns have been raised about the lack of women in IR in the region. The purpose of this study was to assess the state of women in IR in sub-Saharan Africa, with attention to their training experiences, and perceived barriers, to identify opportunities to increase gender equity. Methods: We distributed a survey to all identifiable female IR physicians and trainees in sub-Saharan Africa (SSA). The survey included questions on demographics, training experiences, barriers faced professionally, and suggestions for encouraging more women in Africa to pursue IR. Results: Eight women in IR in SSA were identified, six of whom responded to the survey (75% response rate). Commonly cited perceived barriers include lack of training opportunities, gender underrepresentation and societal expectations. Suggestions for increasing women's participation in IR can be increased by creating more training opportunities in Africa, including gender-specific opportunities, integrating IR into diagnostic radiology training programs, developing mentoring programs, and concerted efforts by professional societies to establish dedicated committees, scholarships and sponsorship of women. Conclusions: While interventional radiologists are few in SSA, gender disparities already exist. As increasing the number of IR physicians in low resource areas is essential to addressing health disparities, and women in IR frequently treat women's health conditions, including maternal mortality, building physician capacity in a gender-sensitive manner is essential.

Gender differences in perioperative complications following carotid endarterectomy: A retrospective analysis

Aim: This study aims to examine the distribution of major complications in patients undergoing carotid endarterectomy (CEA) based on gender. The primary objective is to assess the potential effects of gender on perioperative events in hospital. Material and Methods: At Başakşehir Çam and Sakura City Hospital, patients aged 18 and over who underwent CEA between September 2020 and November 2023, were retrospectively analyzed. The patients were categorized into two groups based on their gender. Patient characteristics were obtained from electronic medical records. Postoperative stroke, surgical revision, hematoma, and nerve injury were defined as perioperative events. Results: In this study, the average age of the 225 evaluated patients was found to be 65.8 ± 8.89. There were 73 female patients (32.44%) in Group 1 and 152 male patients (67.56%) in Group 2. Two patients (0.9%) experienced a stroke during the perioperative period. Hematomas were present in 24 patients (10.7%), and nerve damage was also observed in 15 patients (6.7%). Surgical revision due to bleeding was required in thirteen patients (5.8%). Perioperative events were observed in 27 patients. Perioperative events were significantly higher in men than in women (p=0.037). In multivariate logistic regression analysis, male gender was found to be the predictor of perioperative events (odds ratio [OR]: 3.701;95% CI: 1.145-11.963, p=0.029). Conclusion: Our results showed that male gender may be a predictor of perioperative events in patients undergoing carotid endarterectomy. Multicenter and larger study groups may be needed for healthier results.

Potential Adverse Drug Events Identified with Decision Support Algorithms from Janusmed Risk Profile—A Retrospective Population-Based Study in a Swedish Region

Adverse drug events (ADEs) occur frequently and are a common cause of suffering, hospitalizations, or death, and can be caused by harmful combinations of medications. One method used to prevent ADEs is by using clinical decision support systems (CDSSs). Janusmed Risk Profile is a CDSS evaluating the risk for nine common or serious ADEs resulting from combined pharmacodynamic effects. The aim of this study was to examine the prevalence of potential ADEs identified using CDSS algorithms from Janusmed Risk Profile. This retrospective, cross-sectional study covered the population of a Swedish region (n = 246,010 inhabitants in year 2020) using data on all medications dispensed and administered. More than 20% of patients had an increased risk of bleeding, constipation, orthostatism, or renal toxicity based on their medications. The proportion of patients with an increased risk varied from 3.5% to almost 30% across the nine categories of ADEs. A higher age was associated with an increased risk of potential ADEs and there were gender differences. A cluster analysis identified groups of patients with an increased risk for several categories of ADEs. This study shows that combinations of medications that could increase the risk of ADEs are common. Future studies should examine how this correlates with observed ADEs.

Mental preparation in runners: gender differences, competition levels, and psychological training effects on performance

IntroductionThe present study aimed to investigate the mental and sports psychological preparation, as well as tactical preparation, of distance runners for competition. We examined whether there are differences based on gender, competition level and various race disciplines, as well as how mental preparation influences sports skills applicable in different competitive situations.MethodsThe sample consisted of 201 distance runners who completed the Sports Mental Training Questionnaire (SMTQ) alongside assessments of their sports psychology and race tactics.ResultsThe results indicated that neither gender, competition level, nor race discipline had a significant impact on mental preparedness. However, women demonstrated notably higher scores in the use of self-talk as a mental technique. Additionally, participants who received training in sports psychology scored significantly higher across several mental skills, as well as on the overall mental preparedness score.DiscussionThis article validates the SMTQ and its association with mental readiness, as confirmatory factor analysis demonstrates adequate validity. Additionally, mental preparation was found to enhance performance and well-being among distance runners. Further research is needed to explore the impact of group interventions to broaden the reach of mental training programs.

Predictive factors of extremity graft occlusion after endovascular repair of abdominal aortic aneurysm: A 13-year single center experience

Aim: Graft leg thrombosis (GLT) after Endovascular Aortic Repair (EVAR) is an important problem affecting morbidity/mortality. In addition to anatomical factors such as aortic neck angle and diameter in graft leg thrombosis; we aimed to convey the roles of graft extension to the external iliac artery and the effect of graft type selection on the results. Material and Methods: Analysis of 512 patients who underwent EVAR between 2010 and 2023 was performed. The effects of anatomical factors, graft material, underlying diseases, age and gender on the development of graft leg thrombosis were evaluated. Anatomical measurements were evaluated in terms of their predictive power for graft leg thrombosis by Receiver Operating Characteristic (ROC) analysis. Results: The prevalence of graft leg occlusion was significantly associated with some anatomical factors, especially increased aortic neck angle (OR=1.07, p&lt;0.001) and descent to the external iliac artery (OR=13.43, p&lt;0.001). Poliytetrafluoroethylene (PTFE) grafts were associated with a reduced risk of graft leg occlusion (OR=0.26, p=0.002). ROC analysis showed that aortic neck angle had the highest predictive accuracy for GLT (AUC=0.817, p&lt;0.001). There were no significant differences in age, gender, smoking status, diabetes, and hypertension as comorbidities. Peripheral artery disease was shown to increase the risk. Conclusion: Our findings highlight the role of aortic anatomy and graft material selection in the risk of graft leg thrombosis. The use of PTFE grafts appears to be protective against graft leg thrombosis. This information highlights the importance of personalized surgical planning and postoperative management to optimize patient outcomes. Future research should focus on developing models that include these factors.