Male Individuals Research Articles

Relationships between abdominal adipose tissue and neuroinflammation with diffusion basis spectrum imaging in midlife obesity

AbstractObjectiveThis study investigated how obesity, BMI ≥ 30 kg/m2, abdominal adiposity, and systemic inflammation relate to neuroinflammation using diffusion basis spectrum imaging.MethodsWe analyzed data from 98 cognitively normal midlife participants (mean age: 49.4 [SD 6.2] years; 34 males [34.7%]; 56 with obesity [57.1%]). Participants underwent brain and abdominal magnetic resonance imaging (MRI), blood tests, and amyloid positron emission tomography (PET) imaging. Abdominal visceral and subcutaneous adipose tissue (VAT and SAT, respectively) was segmented, and Centiloids were calculated. Diffusion basis spectrum imaging parameter maps were created using an in‐house script, and tract‐based spatial statistics assessed white matter differences in high versus low BMI values, VAT, SAT, insulin resistance, systemic inflammation, and Centiloids, with age and sex as covariates.ResultsObesity, high VAT, and high SAT were linked to lower axial diffusivity, reduced fiber fraction, and increased restricted fraction in white matter. Obesity was additionally associated with higher hindered fraction and lower fractional anisotropy. Also, individuals with high C‐reactive protein showed lower axial diffusivity. Higher restricted fraction correlated with continuous BMI and SAT particularly in male individuals, whereas VAT effects were similar in male and female individuals.ConclusionsThe findings suggest that, at midlife, obesity and abdominal fat are associated with reduced brain axonal density and increased inflammation, with visceral fat playing a significant role in both sexes.image

Sex Differences in Moderate-to-Severe Traumatic Brain Injury Randomized Controlled Trials.

Understanding sex differences among persons with moderate-to-severe traumatic brain injury (TBI) is critical to addressing the unique needs of both males and females from acute care through to rehabilitation. Epidemiological studies suggest that 7 of every 10 persons with moderate-to-severe TBI are male, with females representing about 30%-33%. To examine the proportion of female and male individuals included in randomized controlled trials (RCTs) of interventions for moderate-to-severe TBI. A systematic review was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines up to and including December 2022 using MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO databases. Studies were included if they met the following criteria: (1) human participants with a mean age ≥18 years, (2) ≥50% of the sample had moderate-to-severe TBI and (3) the study design was a RCT. Data extracted included author, year, country, sample size, number of female/male participants and time post-injury. 595 RCTs met the criteria for inclusion, published between 1978 and 2022, totaling 86,662 participants. The average proportion of female participants was 23.14%, and the percentage increased a small but significant amount over time. There was a significantly lower percentage of female participants in RCTs initiated in the acute phase (≤ 1 month) when compared with RCTs conducted in the chronic phase (≥ 6 months) post-injury (p < 0.001). Female participants are underrepresented in RCTs of moderate-to-severe TBI. Addressing this underrepresentation is critical to establish effective treatments for all persons with TBI.

Reconciling British Values with Professional Identity: The Pursuit of Ontological Security Among Muslim Teachers in England

This article aims to investigate how the legal requirement to promote fundamental British values (FBVs) impacts Muslim teachers’ professional identity formation, utilising Interpretive Phenomenological Analysis. Semi-structured interviews were conducted with self-identified Muslim teachers, including both male and female individuals from diverse ethnic backgrounds, employed in secondary schools across England. This study seeks to interpret Muslim teachers’ experiences through Anthony Giddens’ ontological security theory. Firstly, Muslim teachers expressed pride in being British and their successful integration into society. Secondly, the meaning of Britishness was elucidated by the participants through references to the values described in the current government guidelines on promoting FBVs. Finally, the impact of the obligation to promote FBVs on the professional identity formation of Muslim teachers points to a degree of ambivalence rooted in seeking ontological security. Certain teachers adopted an uncritical stance towards FBV policy, prioritising ‘values’ within the debate and thereby normalising the discourse surrounding FBVs. In contrast, others engaged in a critical analysis of FBV rhetoric, highlighting its adverse impact on academic discussions and their professional identities. From the perspective of ontological security theory, Muslim teachers are situated in a fragile position; while the majority grapple with ontological insecurity, others exist in a realm between ontological security and insecurity.

Association among therapeutic adherence, health literacy, and engagement in care: How to increase health-conscious management of HIV disease.

In the context of People Living with HIV (PLWH), poor health literacy (HL) seems to be linked to poorer health outcomes and reduced engagement in care. Additionally, the level of HL can affect HIV knowledge and may impact adherence to antiretroviral therapy (ART). This research explored the connection between ART adherence, HL, and engagement in care in a cohort of 250 PLWH receiving ART in Italy. A questionnaire was given to PLWH at Policlinico Gemelli in Rome to assess their health literacy and adherence to therapy. The Brief Health Literacy Screening (BHLS) and the Newest Vital Sign (NVS) were used to evaluate subjective and objective HL. Adherence levels were self-reported as poor, good, or excellent, and the assessment included the Patient Health Engagement Scale (PHE-S). Notably, the majority of the sample comprised male individuals (67.9%), with 69.2% reporting a 10-years or longer duration between their HIV diagnosis and their initiation of ART. It was found that PLWH with poor adherence had low schooling, had been living with HIV for 1-5years, were HCV co-infected, had a viremia >50copies/mL, poor health status, poor engagement in care, and poor HL (p = <0.001). They exhibited lower mean scores on the subjective HL scale and lower CD4 T-cell counts and nadir CD4 T-cell counts (p < .001). Our study demonstrated a positive correlation between higher HL levels and improved disease management, treatment adherence, and overall physical and mental well-being. Enhanced HL capabilities are paramount in bolstering health management and treatment adherence.

Effect of Beta-Alanine Supplementation on Maximal Intensity Exercise in Trained Young Male Individuals: A Systematic Review and Meta-Analysis.

Beta-alanine is a nonessential amino acid that is commonly used to improve exercise performance. It could influence the buffering of hydrogen ions produced during intense exercise and delay fatigue, providing a substrate for increased synthesis of intramuscular carnosine. This systematic review evaluates the effects of beta-alanine supplementation on maximal intensity exercise in trained, young, male individuals. Six databases were searched on August 10, 2023, to identify randomized, double-blinded, placebo-controlled trials investigating the effect of chronic beta-alanine supplementation in trained male individuals with an age range of 18-40years. Studies evaluating exercise performance through maximal or supramaximal intensity efforts falling within the 0.5-10min duration were included. A total of 18 individual studies were analyzed, employing 18 exercise test protocols and 15 outcome measures in 331 participants. A significant (p = .01) result was observed with an overall effect size of 0.39 (95% confidence interval [CI] [0.09, 0.69]), in favor of beta-alanine supplementation versus placebo. Results indicate significant effects at 4weeks of supplementation, effect size 0.34 (95% CI [0.02, 0.67], p = .04); 4-10min of maximal effort, effect size 0.55 (95% CI [0.07, 1.04], p = .03); and a high beta-alanine dosage of 5.6-6.4g per day, effect size 0.35 (95% CI [0.09, 0.62], p = .009). The results provide insights into which exercise modality will benefit the most, and which dosage protocols and durations stand to provide the greatest ergogenic effects. This may be used to inform further research, and professional or recreational training design, and optimization of supplementation strategies.

Effects of Physical Activity Level and Sedentary Behavior on the Musculoskeletal System in Young Adults

Aim: The aim of this study is to investigate the relationship between the level of physical activity and sedentary behavior in young adults aged 18-35 and to evaluate the effects of this relationship on musculoskeletal pain, posture, muscle shortness, and trunk muscle endurance. Methods: In this cross-sectional descriptive study, conducted at the Faculty of Health Sciences of a university between March 2018 and August 2018, 219 students were included. Data were obtained by using the case report form which determines the demographic characteristics and sedentary behavior of the students, The International Physical Activity Index - short form, posture analysis form, muscle shortness evaluation form, and trunk muscle endurance evaluation form. Results: In the study, 66.2% of patients were female and 33.8% were male. In the evaluation of physical activity level, the ratio of highly active individuals in males, and inactive and insufficiently active individuals in females was significantly higher (p &amp;lt;0.05). Musculoskeletal pain was significantly higher in inactive and insufficiently active individuals (p&amp;lt;0.001). A negative correlation existed between physical activity level and pain frequency, duration, and scores (p&amp;lt;0.001). There was a positive correlation between trunk endurance tests and physical activity and exercise participation. Non-exercisers showed shortening of lumbar extensor muscles and gastrosoleus, with increased thoracic kyphosis (p&amp;lt;0.05). Daily sitting time correlated positively with elbow, wrist, and knee pain, and lumbar lordosis (p&amp;lt;0.05). Those spending more time at the computer experienced higher levels of head-neck and elbow pain, pain duration, muscle shortness, thoracic kyphosis, shoulder protraction, and anterior head tilt (p&amp;lt;0.05). Conclusion: In young adults, increasing physical activity and reducing daily sitting time are necessary to prevent musculoskeletal pain and reduce postural deformities. Keywords: Musculoskeletal diseases, musculoskeletal pain, physical exertion, posture, sedentary behavior, trunk muscular endurance, young adult.

Vedic astrological factors for human immunodeficiency virus transmission within male individuals with sexual orientation as homosexual

Background: For almost more than 70 years, the modern science had labeled homosexuality as a mental disorder and was part of DSM (Diagnostic and Statistical Manual of Mental Disorders) until the fifth edition was released in the year 2013 and homosexuality was removed from the mental disorder list. Despite of the removal of homosexuality along with all kind of sexual orientation from mental disorder, it is still being considered taboo in the society. From Sanatana Dharma perspective, homosexuality is very well mentioned in multiple scriptures. In Vedic Astrology as well, this homosexuality along with diseases due to sexual intercourse is being described. In this modern era, one of the most common disease due to sexual intercourse is HIV. Although, HIV is considered relatively new transmission due to its first scientific mention in the late twentieth century, the symptoms and overall nature of this disease is clearly described in Vedic Astrology. Finding: This research paper is an extension of the existing research paper in the field of Vedic Astrology especially in the field of Vedic Astrology focusing on HIV transmission. A total of 314 HIV positive samples was collected from 18 countries selected from Asia, Europe, North America, South America, Africa as well as Australia in order to have a coverage of all the continents. All these HIV positive people belong to LGBT community, to be very specific Gay (homosexuals) and have been identified as HIV transmission due to anal intercourse with another Gay partner. The Astrological Natal Chart were analyzed for all these 314 samples against the KIRAN sutra (5 thumb rules) to find the possibility of HIV based on the sutras i.e. rules. Out of 314 samples, 310 charts fit the criteria (KIRA sutra) mentioned in the KIRAN sutra for HIV transmission. 4 samples were not checked against the criteria (N) due to insufficient Nakshatra-Pada i.e. Constellation-Phase coverage along with the complex nature of the Nakshatra sutra i.e. N sutra of KIRAN sutra. The result indicates that the KIRAN sutra is very effective sutra even to identify the HIV transmission from male-to-male partner with an accuracy of 98.73% (310 cases out of 314 cases) using only 4 sutras i.e. KIRA. Conclusion: The research is an effort to raise awareness and to help males with homosexual orientation to identify whether they are highly prone to HIV or not using their Vedic Astrological Natal Chart so that they can take preventive action. A new yoga i.e. Samalaingika Yauna Sankramaṇa Yoga is being introduced in the field of Medical Astrology focusing on males with sexual orientation as homosexual, commonly known as Gay in LGBT community in order to support Gays living a HIV free life without judging their sexual orientation. Novelty/Originality of this article: This study introduces the application of the KIRAN sutra from Vedic Astrology as a predictive method for assessing HIV transmission risk in homosexual men, achieving an accuracy rate of 98.73%, along with the introduction of a new configuration, Samalaingika Yauna Sankramaṇa Yoga.

Financial Literacy and Mobile Banking Usage: The Moderating Role of Demographic Characteristics

This study aimed to analyze the relationship between financial literacy and mobile banking ‎usage, considering the moderating role of demographic characteristics among commercial ‎bank clients in the Jordanian southern provinces of Jordan. Using a sample of 1,380 commercial bank clients from ‎Jordan's southern region. To achieve the study's objective and test its hypotheses, the authors employed the quantitative method and utilized SPSS software version 28 for data analysis. The results revealed a strong positive relationship between ‎the level of financial literacy and mobile banking usage, with a moderating role of ‎demographic characteristics on the relationship between the level of financial literacy and ‎mobile banking usage. The study found that male clients and individuals with higher income levels were more inclined to utilize mobile banking services compared to female clients and those with lower income levels. On the other hand, age and educational level did not show a ‎moderating effect on this relationship. Based on the findings, the study recommends enhancing financial literacy through the development of programs and diverse digital banking products to meet client's needs, thereby promoting the adoption of mobile banking services. ‎

Autism Diagnosis Among US Children and Adults, 2011-2022

An improved understanding of autism spectrum disorder (ASD) prevalence over time and across the lifespan can inform health care service delivery for the growing population of autistic children and adults. To describe trends in the prevalence of ASD diagnoses using electronic records data from a large network of health systems in the US. This cross-sectional study examined annual diagnosis rates in health records of patients in US health systems from January 1, 2011, to December 31, 2022. Eligible individuals were included in the study sample for a given calendar year if they were enrolled in a participating health system for at least 10 months out of the year. Data were extracted from 12 sites participating in the Mental Health Research Network, a consortium of research centers embedded within large, diverse health care systems. Diagnoses of ASD were ascertained using International Classification of Diseases, Ninth Revision (ICD-9) and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) revision codes. Annual diagnosis rates were calculated as the number of unique members diagnosed, divided by the total members enrolled. A total of 12 264 003 members were enrolled in 2022 (2 359 359 children aged 0 to 17 years [19.2%]; 6 400 222 female [52.2%]; 93 002 American Indian or Alaska Native [0.8%], 1 711 950 Asian [14.0%], 952 287 Black or African American [7.8%], 2 971 355 Hispanic [24.2%], 166 144 Native Hawaiian or Pacific Islander [1.4%], and 6 462 298 White [52.7%]). The ASD diagnosis rate was greatest among 5-to-8-year-olds throughout the study period and increased by 175% among the full sample, from 2.3 per 1000 in 2011 to 6.3 per 1000 in 2022. The greatest relative increase in diagnosis rate from 2011 to 2022 occurred among 26-to-34-year-olds (450%) and increases were greater for female vs male individuals among children (305% [estimated annual percentage change (EAPC), 13.62 percentage points; 95% CI, 12.49-14.75 percentage points] vs 185% [EAPC, 9.63 percentage points; 95% CI, 8.54-10.72 percentage points], respectively) and adults (315% [EAPC, 13.73 percentage points; 95% CI, 12.61-14.86 percentage points] vs 215% [EAPC, 10.33 percentage points; 95% CI, 9.24-11.43 percentage points]). Relative increases were greater in racial and ethnic minority groups compared with White individuals among children, but not adults. In this cross-sectional study of children and adults in the US, ASD diagnosis rates increased substantially between 2011 and 2022, particularly among young adults, female children and adults, and children from some racial or ethnic minority groups. Diagnosis prevalence trends generated using health system data can inform the allocation of resources to meet the service needs of this growing, medically complex population.

Biomolecular analysis of the Epigravettian human remains from Riparo Tagliente in northern Italy

The Epigravettian human remains from Riparo Tagliente in northern Italy represent some of the earliest evidence of human occupation in the southern Alpine slopes after the Last Glacial Maximum. Genomic analyses of the 17,000-year-old Tagliente 2 mandible revealed the oldest presence of a genetic profile with affinities to the Near East in the Italian peninsula, which later became the most widespread hunter-gatherer ancestry across Europe. However, a comparable biomolecular characterization of the Tagliente 1 burial remains unavailable, preventing us from defining its biological relationships with Tagliente 2. Here, we apply paleogenomic, isotopic, and radiocarbon dating analyses on a femur fragment of Tagliente 1 and compare the reconstructed data with previously reported results from Tagliente 2. Despite their different isotopic signatures and non-overlapping radiocarbon dates, we reveal that the two human remains belong to the same male individual. We determine that the distinct isotopic values can be explained by different dietary practices during lifetime, whereas the non-overlapping radiocarbon dates can be caused by minimal radiocarbon contamination, possibly deriving from chemical treatments for conservation purposes. These findings highlight the importance of interdisciplinary biomolecular studies in offering new perspectives on the Palaeolithic fossil record and addressing long-standing bioarchaeological questions.

PARACOCCIDIOIDOMICOSE NA ODONTOLOGIA

Paracoccidioidomycosis is a fungal disease caused by the fungus Paracoccidioides brasiliensis, which prefers humid and warm places. Male individuals between 30 and 60 years of age are generally the most affected by this disease, especially those who work in rural areas or gardening. The objective of this study was to conduct a literature review addressing the topic of paracoccidioidomycosis in dentistry, highlighting its oral clinical aspects, increasing the knowledge of dentists so that they can help in the early recognition and diagnosis of the lesion. Diagnosis can be made through fungal culture, incisional biopsy, serological tests, histopathological analysis of the skin and mucous membranes, and chest X-rays to check for possible lung involvement. The most frequent clinical signs appear in the alveolar mucosa, gums, palate, and tongue, but other areas of the body can also be affected by the condition. In most cases, the disease is identified through oral clinical characteristics, and the dentist is the first professional to treat these patients. Treatment for paracoccidioidomycosis is prolonged and varies according to the severity of the lesions, involving the use of various antifungals such as itraconazole and cotrimoxazole. To increase the patient's life expectancy and prevent the spread of the disease, it is essential that the dentist recognizes the oral clinical manifestations, performs tests, and correctly refers the patient for appropriate medical treatment.

Inflammatory arthropathies: Perspectives from a Portuguese male individual (1574–1834 CE)

AbstractArthropathies are common in past populations and can be categorized into two groups: those with predominant bone production (e.g., osteoarthritis) and those with significant bone loss (e.g., erosive arthropathies). The former is frequent in the archaeological record, whereas the latter are uncommon. We present a Post‐Medieval male individual, recovered in the Convent of the Holy Spirit (Loures, Portugal), with multiple articular and entheseal bone changes, particularly extensive periarticular, marginal, and subchondral erosive processes, often exposing trabecular bone. Proliferative lesions and extensive ankylosis are also observed in the synovial joints. These pathological changes affect both the axial and peripheral skeleton in a polyarticular, bilateral, and asymmetric pattern. Given that the appendicular skeleton, particularly the hands and feet, are the most affected areas, the most probable diagnosis is a peripheral spondyloarthropathy such as psoriatic arthritis or reactive arthritis. This case study is the first archaeological instance of psoriatic arthritis or reactive arthritis described in Portugal, highlighting the importance of a differential diagnosis and the need for reflection when pathological changes characteristics overlap, advocating for a broader diagnostic approach.

DELINEATING TOXIC MASCULINITY IN TANA FRENCH’S THE WITCH ELM

This article explores the concept of toxic masculinity in The Witch Elm (2018), a novel by Tana French, using R.W. Connell's theory of hegemonic masculinity and Amy Wharton's sociology of gender frameworks. The research focuses on the protagonist, Toby, who shows toxic masculine traits such as emotional suppression, independence, aggression, and vulnerability avoidance. The study uses qualitative descriptive analysis, examining key scenes in the novel in which these behaviors manifest, especially in relation to family and romantic partners. Through this analysis, the findings reveal how toxic masculinity not only contributes to Toby's deteriorating mental health but also isolates him emotionally, resulting in damaged relationships and increased psychological distress. Ultimately, the article concludes that toxic masculinity extends emotional isolation, reinforcing harmful gender norms that prevent men from seeking support or expressing vulnerability. The research contributes to a broader discourse on how societal expectations of masculinity negatively impact individual males while continuing gender inequality. The study highlights the importance of challenging these norms to foster healthier emotional expression, stronger relationships, and more fair gender dynamics in society.

Peri-implant clinical profile and subgingival yeasts carriage among cigarette-smokers with peri-implant mucositis

BackgroundThe present observational clinical investigation is based on the hypothesis that subgingival yeast carriage (SYC) is higher in cigarette-smokers with peri-implant mucositis (PM) than non-smokers with and without PM.ObjectiveThe aim was to assess peri-implant clinical profile and SYC among cigarette-smokers with PM.MethodologyParticipants were divided into four groups: Group-1—Cigarette-smokers with PM; Group-2—Cigarette-smokers without PM; Group-3—Non-smokers with PM; and Group-4—Non-smokers without PM. Information on duration and daily frequency of cigarette smoking (pack years), age, gender, familial history of smoking and most recent visit to a dentist and/or dental hygienist was collected. The following information was retrieved from healthcare records: implant dimensions, implant insertion torque, depth of insertion (credidastal or subcrestal), implant abutment connection, jaw location, implant surface characteristic, and mode of implant prosthesis retention. Peri-implant modified plaque and gingival indices (mPI and mGI), probing depth (PD) and crestal bone loss were recorded. Subgingival biofilm samples were collected, and SYC was recorded in colony forming units per milliliter (CFU/ml). P < 0.05 were considered statistically significant.ResultsEighty male individuals (20, 19, 21 and 20 individuals were included in groups 1, 2, 3 and 4, respectively) were included. The mPI was higher in Group-1 than groups 2 (P < 0.05) and 4 (P < 0.05). The mPI was higher in Group-3 than groups 2 (P < 0.05) and 4 (P < 0.05). The mGI was higher in Group-3 than groups 1 (P < 0.05), 2 (P < 0.05) and 4 (P < 0.05). The PD was higher in Group-1 than groups 2 (P < 0.05) and 4 (P < 0.05). The PD was higher in Group-3 than Groups 2 (P < 0.05) and 4 (P < 0.05). The CFU/ml were higher in Group-1 than groups 2 (P < 0.05) and 4 (P < 0.05). The CFU/ml were higher in Group-3 than groups 2 (P < 0.05) and 4 (P < 0.05).ConclusionPeri-implant soft-tissue inflammatory parameters are worse and SYC is higher in moderate smokers than light smokers with PM and non-smokers without PM.

Pharmacokinetics and ADME Profiling of Tanimilast Following an Intravenous 14C-Microtracer co-administered with an Inhaled Dose in Healthy Male Individuals.

Tanimilast is an inhaled phosphodiesterase-4 inhibitor currently in phase 3 clinical development for treating chronic obstructive pulmonary disease (COPD) and asthma. This trial aimed to characterize the pharmacokinetics, mass balance, and metabolite profiling of tanimilast. Eight healthy male volunteers received a single dose of non-radiolabeled tanimilast via powder inhaler (NEXThaler® (3200μg)), followed by a concomitant intravenous (IV) infusion of a microtracer ([14C]-tanimilast: 18.5μg and 500nCi). Plasma, whole blood, urine, and feces samples were collected up to 240 hours post-dose to quantify non-radiolabeled tanimilast, [14C]-tanimilast, and total-[14C]. The inhaled absolute bioavailability of tanimilast was found to be approximately 50%. Following IV administration of [14C]-tanimilast, plasma clearance was 22 L/h, the steady-state volume of distribution was 201 L, and the half-life was shorter compared to inhaled administration (14 vs. 39 hours, respectively), suggesting that plasma elimination is limited by the absorption rate from the lungs. 79% (71% in feces; 8% in urine) of the IV dose was recovered in excreta as total-[14C]. [14C]-tanimilast was the major radioactive compound in plasma, while no recovery was observed in urine and only 0.3% was recovered in feces, indicating predominant elimination through metabolic route. Importantly, as far as no metabolites accounting for more than 10% of the circulating drug-related exposure in plasma or the administered dose in excreta were detected, no further qualification is required according to regulatory guidelines. This study design successfully characterized the absorption, distribution, and elimination of tanimilast, providing key pharmacokinetic parameters to support its clinical development and regulatory application. Significance Statement This trial investigates PK and ADME profile of tanimilast, an inhaled PDE4 inhibitor for COPD and asthma. Eight male volunteers received a dose of non-radiolabeled tanimilast via NEXThaler® and a microtracer IV dose. Results show pivotal PK results for the characterization of tanimilast, excretion route and quantification of significant metabolites, facilitating streamlined clinical development and regulatory approval.

Association between a new healthcare access index and life expectancy in Japan: A nationwide study

Abstract Background Access to medical institutions is crucial to healthcare systems. Japan has universal health coverage and unrestricted access to medical institutions; patients can visit any medical institution without requiring referral letters. We developed the Japan- Spatial Accessibility Scale for Medical Institutions (J-AMI) to provide integrated spatial accessibility to multiple sized healthcare institutions. We also examined the association between the J-AMI and life expectancy. Methods This study included 220,621 administrative census mesh blocks defined by address; 89,248 clinics and 8,181 hospitals across 47 provinces in Japan, with a total population of approximately 126 million. The road distance between the centre of each block and the nearest clinic was calculated and scored every 1 km. Hospitals were classified as secondary and tertiary hospitals based on the availability of emergency and critical care centres. Secondary and tertiary hospitals were scored every 2 and 4 km, respectively. The scores for clinics and secondary and tertiary hospitals (1-8 points each) were aggregated and scored using a mesh. The population-weighted municipal J-AMI (PWM-J-AMI) scores were calculated for each municipality. Correlations between the PWM-J-AMI scores and life expectancy by municipality were examined. Geographic information was analysed using ArcGIS Pro. Results Median life expectancies for male and female individuals were 81.4 years (interquartile range [IQR]: 80.9-81.9 years) and 87.5 years (IQR: 87.2-88.0 years), respectively. The median PWM-J-AMI score was 9.5 (IQR: 5.4-14.5). The PWM-J-AMI scores were negatively correlated with male and female individual’s life expectancy by municipality (r=-0.29, p &amp;lt; 0.01 and r = 0.18, p &amp;lt; 0.01, respectively). Conclusions The results suggest that the better a region’s access to medical care, the longer its life expectancy. Efficient medical institution allocation and telemedicine promotion may be essential to improving access. Key messages • We developed the Japan- Spatial Accessibility Scale for Medical Institutions (J-AMI) to provide integrated spatial accessibility to multiple sized healthcare institutions, using ArcGIS Pro. • The PWM-J-AMI scores were negatively correlated with male and female individual’s life expectancy by municipality, which suggest that the better a region’s access, the longer its life expectancy.

Assessing the Efficacy of Lokomat Training in Pediatric Physiotherapy for Cerebral Palsy: A Progress Evaluation

Background: Gait disturbances in children with cerebral palsy can increase the hindrance caused by loss of independence and social engagement. The Lokomat, developed by Hocoma, shows promise as a supplementary tool for gait rehabilitation. This study investigates the impact of Lokomat training on gait parameters and trends observed during training. Methods: A total of 26 children (13 male individuals) with a diagnosis of cerebral palsy (CP), aged 4 to 23 years, were enrolled in the study. Patients participated in a standard comprehensive rehabilitation program with additional Lokomat training sessions. Gait function was assessed using the Timed Up and Go Test (TUG) and the 10 m walking test (10mWT) at the beginning and end of the rehabilitation period. Changes in Lokomat parameters (step number, session duration, speed, body weight support, and guidance force) were also analysed. Results: The median duration of the 10mWT and TUG significantly decreased across the groups after the treatment program. The highest increases were observed for the number of steps taken. Across the entire cohort, the linear trend curves for distance and number of steps exhibited near-perpendicular alignment with the horizontal axis, suggesting significant improvement in these parameters. A consistent trend was noted for speed, with the trend line aligned parallel with the horizontal axis. Decreasing trends were observed for body weight support and guidance force. Conclusions: Therapy with the Lokomat functioning as the active gait orthosis can be used as a form of support to the standard rehabilitation protocol for patients with CP.

“More stress, more addiction?” The relationship between stress and relapse of male individuals with drug addiction: A chain mediation model

This study aims to investigate the mechanism of relapse tendency in male drug abusers and provide empirical evidence for reducing relapse tendency of drug abusers. A survey was conducted on 310 male individuals with drug addiction using Chinese Perceived Stress Scale (CPSS), Simple Coping Style Questionnaire (SCSQ), the Regulatory Emotional Self-Efficacy Scale, and the Relapse Tendency Scale (RTS). (1) Stress is significantly positively correlated with the relapse tendency of individuals with drug addiction; (2) Stress indirectly affects relapse tendency through regulatory emotional self-efficacy; (3) Regulatory emotional self-efficacy can directly and negatively predict relapse tendency, and can also indirectly and negatively predict relapse tendency through coping style. Stress coping theory, tension elimination theory, and the self-administration hypothesis are applicable to explain the tendency to relapse due to stress among compulsory isolated drug abusers in China; Regulatory emotional self-efficacy and coping style play a chain mediating role between stress and relapse tendency of male individuals with drug addiction.

Proportion and characteristics of Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue lymphoma: A systematic review and meta-analysis.

While Helicobacter pylori (H. pylori) infection is common in patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma, there are still individuals who test negative for it. The proportion and characteristics of these patients remain unclear. We conducted a systematic search of the PubMed, Embase, and Cochrane Library databases for relevant articles. Using a random effects model, we performed a meta-analysis to assess the pooled proportion of gastric MALT lymphoma patients with negative H. pylori tests. Additionally, we compared characteristics between gastric MALT lymphoma patients with and without H. pylori infection to examine clinical features in H. pylori-negative cases. A total of 50 studies involving 6033 patients were included. The overall proportion of gastric MALT lymphoma patients with negative H. pylori tests was 20.5% (95% confidence interval: 17.0%-24.6%). This rate exhibited an increasing trend over the years, particularly in non-Asian countries and in studies published after 2013, as well as in cases with sample sizes exceeding 100 participants, in male individuals, and among those with proximal or multiple lesions, non-superficial type morphology, submucosal invasion, and advanced clinical staging. Compared to H. pylori-positive patients, those who tested negative were more likely to be male, have proximal lesions, exhibit submucosal invasion, and present with an advanced clinical stage. This study provides comprehensive information on the proportion and characteristics of H. pylori-negative gastric MALT lymphoma cases, highlighting the need for future clinical attention to treatment and surveillance in this patient population.

Different dorsolateral prefrontal activation during an emotionalautobiographical memory task between male and female depressed individuals: a fNIRS study.

Depression in male and female are commonly associated with different prevalence, severity, and, in some cases, distinct syndromes or subtypes. However, only a small amount of research has been conducted to completely understand the underlying neuroanatomical mechanisms. The goal of the current study was to provide neural markers for specific depression therapies by demonstrating the differences in aberrant prefrontal activity between male and female depressed subjects during an emotional autobiographical memory test. The study included 127 young adults who were randomly assigned to one of two groups: male depression (62 participants) or female depression (65 participants). The average oxyhemoglobin levels in the dorsolateral prefrontal cortex throughout the emotional autobiographical memory task were assessed utilizing 53-channel functional near-infrared spectroscopy imaging equipment. The oxy-Hb activation in the left dorsolateral prefrontal cortex (lDLPFC) and right dorsolateral prefrontal cortex (rDLPFC) had no significant interaction between groups and emotional valences. A significant main effect was found between male and female, with female depression groups showing lower oxy-Hb activity in lDLPFC and rDLPFC than male depression groups. Male and female depression patients showed distinct brain activation in the DLPFC during an emotional autobiographical memory test, suggesting potential specific neurological indicators for varied somatic symptoms in male and female depression patients. These distinctions should be taken into account while creating preventive measures.