Low Percentage Of Women Research Articles

Depressive and Anxiety Symptoms in Community-Dwelling Women in Rural Areas of Greece in the Post-COVID-19 Pandemic Era

Background/Objectives: Depressive and anxiety syndromes are associated with elevated disability and are more prevalent in women. Data on the prevalence of depressive and anxiety disorders in the rural context are limited and contradictory. It is relevant to study common mental disorders in rural areas in the most vulnerable population of women, particularly in the post-COVID-19 pandemic era. Methods: This is a cross-sectional study that was conducted in two primary healthcare sites in the rural region of Farsala, Central Greece after the obviation of all restrictive measures that had been posed due to the COVID-19 pandemic. All consecutive female patients that attended the study sites for any non-emergent reason were asked to participate in the study. For the recording of symptoms of depression and anxiety, the self-reported Depression, Anxiety, Stress Scale-21 (DASS-21) was used. Results: The study sample consisted of 129 women. The majority of participants were >50 years, with 27.9% being older adults. A small percentage (13.2%) suffered a chronic physical disease. A large proportion of the sample, slightly exceeding 40%, reported clinically relevant symptoms of anxiety, whereas a lower percentage of women with depressive symptoms was detected (17.1%). Symptoms of anxiety and depression were found to be interrelated, while a number of sociodemographic variables were associated with both, such as older age, education (primary), living status (alone, OR 123.5; 95% CI: 7.3–2098.8 for anxiety; OR 3.5; 95% CI: 1.3–9.8 for depression), employment (not working, (OR 0.157; 95% CI: 0.06–0.41 for anxiety; OR 0.08; 95% CI: 0.01–0.62 for depression) and the history of a chronic disease (OR 33.8; 95% CI: 4.3–264.7 for anxiety; OR 37.2; 95% CI: 10–138.1 for depression). Self-rated financial status was not related to symptoms of anxiety or depression. Conclusions: The study highlights the importance of inquiring for symptoms of depression and anxiety in women attending the rural primary care setting. The use of valid and reliable self-reported instruments that are easy to administrate may be helpful in this regard.

Cannabis and Craniotomy for Glioblastoma: Impact on Complications and Health Care Utilization

Despite advances in treatment of glioblastomas (GBMs), the median survival remains 14-16 months. In the United States, 52.5 million people ≥12 years of age used cannabis in 2021. We aim to elucidate differences in complications after craniotomy for resection of GBM between users and nonusers of cannabis. Merative MarketScan Research Data (2008-2019) (includes >265 million patients) were used to extract adults (≥18 years of age) with GBM diagnosis (International Classification of Diseases-9 code 191.x and International Classification of Diseases-10 code C71.x) who had a craniotomy (Current Procedure Terminology code 61510) from inpatient admission data. The inverse probability treatment weighted analysis balanced the groups of cannabis abuse disorder (CAD) and no CAD in terms of age, gender, insurance coverage, comorbidities, and prior 12-month opioid dependence. Individuals with CAD were younger (median, 37 vs. 51 years; P < 0.0001). There was a lower percentage of women (19% vs. 45%; P < 0.0001). In the CAD group, opioid abuse pattern for ≥12 months was higher (16% vs. 5%; P=0.001) and the rate of complications was higher (32% vs. 15%; P= 0.001) during index hospital stay. At 6 months postdischarge, neurologic complications were higher among the CAD group (27% vs. 8%; P < 0.001). At 1 year postdischarge, patients with CAD sought feweroutpatient services (P= 0.012). More neurologic complications were seen in the CAD group (31% vs. 12%; P< 0.001). This retrospective population-based study sounds a higher rate of neurologic complications among patients using cannabis who also had a newly diagnosed GBM. This suggests the lack of a protective effect from use of cannabis in patients with primary malignant brain tumors.

Comparison of Gender Diversity Among Spine Surgeons in the Japanese Society for Spine Surgery and Related Research and the Neurospinal Society of Japan: A Descriptive Study Through Secondary Analysis of Aggregated Data.

This was a descriptive study through secondary analysis of aggregated data. This study aimed to describe changes in women's membership in the Japanese Society for Spine Surgery and Related Research (JSSR) for orthopedic surgery and the Neurospinal Society of Japan (NSJ) for neurosurgery over the past decade and make predictions for the future. Although the ratio of women physicians in the field of spine surgery is known to be low worldwide, there is a lack of detailed surveys in Japan. We sent emails to the JSSR and NSJ secretariats to verify membership information (gender and age) from 2013 to 2022. Using ordinary least squares, we projected the years it would take for the JSSR and NSJ to achieve a gender diversity ratio of 30%. In 2013, the percentage of women in JSSR and NSJ was 2.3% and 2.7%, respectively. However, after 2018, the percentage of women in NSJ will be higher than in JSSR, rising to 2.7% in JSSR and 4.7% in NSJ by 2022. It would require 101 years for the NSJ and more than 1,000 years for the JSSR to realize 30% gender diversity. JSSR and NSJ have low percentages of women. Improving gender diversity is an important issue for both societies, and they may collaborate on finding a good solution. Both the JSSR and NSJ societies need to actively address gender diversity and become more attractively represented in society for the next generation of spine surgeons.

Abstract PO5-16-09: Associations of age, body mass index, diabetes and hypertension with relative dose intensity among women receiving anthracycline- and/or taxane-based chemotherapy for invasive breast cancer

Abstract Research suggests that medical comorbidity is associated with reduced relative dose intensity (RDI) in patients receiving chemotherapy for treatment of breast cancer. We aimed to determine factors associated with RDI of specific chemotherapy drugs in anthracycline- and/or taxane-based regimens. Women with a diagnosis of lymph node positive, invasive breast cancer who received neoadjuvant or adjuvant chemotherapy with either doxorubicin (DOX) + paclitaxel (PAC) or docetaxel (DOCE)-containing regimens at a single centerfrom2012 to2019 were included in this retrospective study. Age, race, comorbidities, height, weight, and chemotherapy regimen and dose were abstracted from the electronic health record. BMI was calculated using height and weight measured in clinic at the time initial chemotherapy orders were written and categorized according to US national guidelines (18.5 to &amp;lt; 25, 25 to &amp;lt; 30, and &amp;gt;30kg/m2). Presence of diabetes (DM) and hypertension (HTN) at time of diagnosis were determined by chart review. The oncologists’ initial chemotherapy orders (dose and duration) were used as the basis for RDI calculations. Cumulative actual dose received and duration of treatment were compared to planned dose and duration for individual chemotherapy drug and by regimen (DOX+PAC vs. DOCE). Associations between patient characteristics and RDI were evaluated in bivariate and multivariable analyses. A total of 230 women met the inclusion criteria, with 125 receiving a DOX+PAC regimen and 105 receiving a DOCE-based regimen. A higher percentage of women on DOX+PAC received &amp;gt;85% RDI compared to women receiving DOCE (80.8% vs 67.6%). Women aged 65+ years had lower median RDI [IQR] for DOCE than younger women (0.83 [0.67 - 0.98] vs 0.94 [0.84 - 1.00], p = 0.04), and a lower percentage in the older group received &amp;gt;85% RDI (35.3% vs 73.9%, p&amp;lt; 0.01). Median RDIs of PAC and DOX+PAC were lower for Black women than for White and Asian women (PAC: 0.91 [0.75 - 1.00] vs 1.00 [0.89 - 1.00], p = 0.02, DOX+PAC: 0.92[0.87-0.99] vs. 0.97 [0.91-1.00], p = 0.03), and the percent of Black women receiving &amp;gt;85% RDI of PAC was also lower (55.3% vs 77.6%, p = 0.01). BMI category was associated with median RDI for PAC (p= 0.03) and DOX+PAC (p = 0.01), with women in the &amp;gt;30kg/m2 category having the lowest median RDIs and PAC RDI &amp;gt;85% (p &amp;lt; 0.01). Median RDI of DOX+PAC was lower for women with DM (0.89 [0.84-0.92] vs. 0.96 [0.88-1:00], p = 0.03), and a lower percentage of women with DM received DOX RDI &amp;gt;85% compared to women without DM (66.7% vs 91.6%, p &amp;lt; 0.01). Median RDI was lower among women with HTN compared to women without for PAC (0.85 [0.73 - 1.00] vs 0.98 [0.83 - 1.00], p = 0.01) and DOX+PAC (0.91 [0.84 - 0.97] vs 0.97 [0.90 - 1.00], p = 0.01), and a lower percentage of women with HTN received &amp;gt;85% RDI for PAC (50.0% vs 73.3%, p = 0.01). Multiple logistic regression models adjusted for age (continuous), race, BMI (continuous), DM, and HTN had modestly improved predictive value compared to null models (McFadden’s R2 = 0.10 to 0.19); each year of increased age was associated with lower odds of RDI &amp;gt; 85% for DOX (OR [95% confidence interval] 0.91 [0.84-0.97], p = &amp;lt; 0.01), DOX+PAC (0.95 [0.90-0.99], p = 0.02), and DOCE (0.93 [0.88-0.97], p &amp;lt; 0.01), and DM with lower odds for DOX (0.26 [0.07-0.95], p = 0.04). Our findings of associations between increasing age, Black race, BMI, DM, and HTN and reduced RDI are consistent with prior research and present new data regarding associations between medical comorbidities and individual components of chemotherapy regimens. Citation Format: Heather Wopat, Annette Aldous, Adam Ciarleglio, Kendall Anderson, Kim Robien. Associations of age, body mass index, diabetes and hypertension with relative dose intensity among women receiving anthracycline- and/or taxane-based chemotherapy for invasive breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-16-09.

Pediatric dentistry, prosthodontics, and oral and maxillofacial surgery residents' stress, career satisfaction, and gender-based discrimination/harassment.

Dental residents experience high stress in their demanding programs and gender-based harassment/discrimination can contribute to their stress. The objectives were to compare stress, satisfaction, experienced sexual harassment and observed discrimination of women in dental graduate programs with high, medium, and low percentages of women and to explore relationships between these constructs of interest. Note that, 112 pediatric dentistry (PD), 44 prosthodontics, and 56 oral and maxillofacial surgery (OMS) residents responded to a survey. PD residents had the lowest personal life-related stress (4-point scale with 4=very stressful: PD=2.99/P=3.67/OMS=3.56; p<0.001), faculty-related stress (2.68/3.66/3.03; p<0.001), lack of confidence-related stress (2.79/3.31/2.96; p<0.01) and academic stress (2.65/3.24/3.02; p<0.001), while prosthodontics residents had the highest stress levels. The average frequency of experiencing sexual harassment was highest for OMS residents and lowest for PD residents (5-point scale with 1=never: 1.15/2.62/2.74; p<0.001). PD residents observed least and OMS residents most frequently that female residents were treated less positively by other residents because of their gender (1.59/2.57/3.00; p <0.001). Prosthodontics residents had the lowest job satisfaction score (5-point scale with 1=lowest satisfaction: 4.12/3.14/4.20; p<0.001). The more frequently male and female residents experienced sexual harassment, the higher their personal life-related stress, faculty-related stress, lack of confidence-related stress, and academic stress, and the lower their career satisfaction, specialty content satisfaction, and stress-related satisfaction. Women's frequencies of observed gender-based discrimination were associated with higher stress and lower satisfaction, while men's frequencies of these observations were not associated with stress, but associated with increased satisfaction. Dental residents' stress, career satisfaction, experienced sexual harassment, and observed discrimination of women residents differ depending on the dental specialty program. Both male and female residents report more stress and less satisfaction the more they experience sexual harassment. The more women observe discrimination of women, the more stressed and the less satisfied they are. For men, the frequencies of these observations are not associated with stress, but positively associated with increased satisfaction.

Use of Opioids and Epidural Anaesthesia in Labor Analgesia as Important Risk Factors for Apparent Postpartum Urinary Retention: A Case-Control Study.

Labor analgesic interventions, particularly the use of opioids and epidural anaesthesia, have raised concerns regarding their potential impact on postpartum urinary retention (PUR), necessitating a comprehensive investigation into their association with this clinical outcome. This retrospective case-control study analysed clinical data from postpartum patients at our hospital from January 2023 to December 2023. Anaesthetic methods, including opioid and non-opioid drug usage, epidural analgesia and non-use of analgesia, were assessed. Logistic regression analysis was also performed to determine important associations with apparent PUR. This study included clinical data from 54 postpartum patients with PUR and 54 without urinary retention. A higher percentage of women with apparent PUR received opioids during labour compared with those without PUR (p = 0.033). Conversely, a lower percentage of women with apparent PUR received non-opioid analgesics compared with those without PUR (p = 0.026). In addition, a higher percentage of women with apparent PUR received epidural analgesia compared with those without PUR (p = 0.041). Logistic regression analysis demonstrated that opioid consumption during labour was significantly associated with apparent PUR (odds ratio (OR) = 2.469, p = 0.022). By contrast, non-opioid consumption during labour was inversely associated with apparent PUR (OR = 0.297, 95% CI = 0.123-0.681, p = 0.005). In addition, the use of epidural analgesia during labour showed a remarkable association with apparent PUR (OR = 2.857, 95% CI = 1.289-6.552, p = 0.011). Opioid use during labour and the use of epidural analgesia were identified as important risk factors for apparent PUR. These findings emphasise the need for a thoughtful and balanced approach to analgesic management during labour to minimise the risk of PUR in obstetric patients.

Validation of US CDC National Death Index mortality data, focusing on differences in race and ethnicity

ObjectivesThe US Center for Disease Control and Prevention’s National Death Index (NDI) is a gold standard for mortality data, yet matching patients to the database depends on accurate and available...

P81 IMPACT OF CORONAROGRAPHY AND CORONARY ANGIOPLASTY ON MORTALITY IN A COHORT OF PATIENTS WITH NEW–ONSET HEART FAILURE IN ITALY

Abstract Background Although myocardial ischemia and coronary artery disease play a crucial role in the pathophysiology of new–onset heart failure (HF), the impact of coronary angiography and percutaneous coronary angioplasty (PCI) revascularization on HF mortality is not well clarified. Objective To evaluate the efficacy of performing coronary angiography and PCI in reducing medium–term outcomes in a cohort of patients hospitalized with new–onset HF in Italy. Methods Retrospective cohort study enrolling all patients aged 18–100 years hospitalized for new–onset heart failure in an Italian accredited public or private hospital in the years 2015–2019 and survived 30 days after index hospitalization. Patients with a prior diagnosis of CAD were excluded from the analysis. The enrolled patients were classified into: patients not undergoing coronary angiography (No CVG); patients undergoing coronary angiography without PCI (CORO) and patients undergoing coronary angiography and PCI (PCI). The primary outcome measure of the study was all–cause mortality 1 year after the index hospitalization. A multivariate Cox model estimated through a stepwise procedure was used to compare the study groups taking into account the different distribution of risk factors. Results 342,090 hospitalizations for new–onset HF were recorded in Italy during the study period. Of these, 32,240 (9.42%) patients underwent coronary angiography without PCI and only 5,890 (1.72%) underwent PCI as well. Patients undergoing an invasive procedure were on average younger (mean age =80.7 in No CVG, 69.0 in CORO and 72.3 in PCI), with a lower percentage of women (58.8% in No CVG, 37.0% in CORO and 27.6% in PCI) and with fewer comorbidities than untreated. After adjusting for gender, age, and comorbidities, coronary angiography was protective versus no treatment whether performed alone (HR=0.57; p&amp;lt;0.0001) or followed by PCI (HR=0.67; p&amp;lt;0.0001). 0.0001). Conclusions In this cohort of consecutive patients with new–onset HF, coronary angiography and/or PCI was associated with a significant reduction in 1–year mortality.

Underrepresented groups make small gains

From 2011 to 2021, women and Hispanic or Latino scientists achieved the largest increases in employment among underrepresented groups in the science, technology, engineering, and mathematics (STEM) workforce. Still, their share of the workforce remains low compared with their proportion of the US population, the newest National Science Foundation report on diversity in STEM shows. “Today’s report serves as a critical benchmark for measuring and evaluating the nation’s progress in this area,” NSF director Sethuraman Panchanathan said at a press conference. The fields of engineering and physical sciences, including chemistry, continue to have especially low percentages of women and underrepresented people of color (see pie chart) compared with social science fields. In 2021, the chemistry workforce, for example, included about 4.4% Black or African American people and 7.0% Hispanic or Latino people, data tables accompanying the report show. Women make up 35.1% of all chemists. Just 3% of people in

1044 CHARACTERISTIC AND OUTCOME IN PATIENTS WITH LOW FLOW, LOW GRADIENT AORTIC STENOSIS

Abstract Aim The aim of this study was to assess the prevalence and outcome in patients with severe low flow, low gradient aortic stenosis (LFLG-AS) undergoing transcatheter aortic valve intervention (TAVI). Methods Patients with LFLG AS undergoing TAVI from 2013 to 2022 were prospectively collected. Clinical, imaging data and procedural parameters were collected. LFLG-AS was defined as indexed aortic valve area (iAVA) ≤0.6 cm2/m2, mean transaortic gradient &amp;lt;40 mmHg and stroke volume index &amp;lt;36 ml/m2. Overall population was classified in due subgroups: classical LFLG AS if left ventricular ejection fraction (LVEF) was &amp;lt;50%, and paradoxical in patients with preserved LVEF. The major comorbidities and primary outcome defined as a composite of all-cause mortality and rehospitalization for worsening heart failure (HF) up to 1 year in the different subtypes of severe LFLG AS undergoing TAVI were evaluated. Results The study included 268 patients [81±6 years; 142 (53%) females]; of these, 155 patients (58%) had paradoxical LFLG AS and 113 patients (42%) had LFLG AS with low LVEF. Regarding echocardiography parameters, in the overall population the mean transaortic gradient was 31±6 mmHg, the mean iAVA 0.38±0.08 cm/m2, and the median LVEF 50% (IQR 38-55). Compared with paradoxical LFLG AS, the patients with classical form were characterized by a lower percentage of women (43% vs. 60% p 0.07), worse renal function (46% vs. 30%, p 0.012), and a significantly higher number of cardiovascular disease as coronary artery disease (52% vs. 29%, p &amp;lt;0.001) and atrial fibrillation (37% vs. 23%, p 0.018), resulting in higher Society of Thoracic Surgeons scores [7,34% (IQR: 4.96 to 13,25) versus 5,36% (IQR: 3,22 to 11); p value 0.037]. Higher percentage of patients of New York Heart Association functional class III or IV (61% vs. 27%; p 0.037) was observed in classical LFLG AS. At one-year follow-up, the composite outcome was reported in 49 patients (18%), 21 patients (13%) had paradoxical LFLG AS and 28 patients (24%) had classical form. Kaplan-Meier survival free from the composite outcome was significantly lower in patients with classical LFLG AS compared to those paradoxical LFLG AS (Log-Rank 0,022, Figure 1). Conclusion LFLG AS is a complex population with significant incidence of adverse event at one years. Patients with classical LFLG AS have higher number of risk factor and cardiovascular disease and lower survival compared paradoxical form. Figure 1

Combating Corruption in the Private Sector

Combating private sector corruption is indispensable for economic growth. This paper sought to interrogate the impact of corruption in private sector and explore enabling strategies to retard private sector corruption and allow the economy to grow. The research applied a qualitative approach using an exploratory research design. The research participants were purposively selected from the Chief Executive Officers of private corporations that were conveniently accessed in Harare Metropolitan Province. Data collection methods included unstructured interviews and documentary review. The results established that major causes of corruption in the private sector include effects of colonial heritage, low percentage of women in the labour force, deteriorating cultural factors and endowment of natural resources. It was also found that the impact of private sector corruption negatively manifest itself in the community, it derails investments, foreign direct investment, foreign trade and foreign aid, affects gross domestic product and the economic growth and productivity. The study recommended that strong adherence to corporate governance principles, building strong positive culture and improving corporate integrity, incorporating financial institutions and promulgating effective laws against bribery and corruption in the private will help in reducing private sector corruption. It can be concluded that the fight against corruption should be given top priority as its success has the potential to grow the economy. Keywords: private sector corruption, strategies, economy DOI: 10.7176/JESD/13-20-02 Publication date: October 31 st 2022

Thriving, Persisting, or Agonizing: Integrated Math Anxiety Experiences of University Students in Introductory Geoscience Classes

Many factors may contribute to women being underrepresented and marginalized in college-level geoscience majors. Limited research has examined students’ math anxiety as a possible factor. To address the dearth of research, we conducted a qualitative study to explore the math anxiety experiences held by students in college-level geoscience classes. Through analysis of students’ written math narratives, we identified three themes capturing students’ integrated math anxiety experiences (IMAEs), which integrated students’ feelings, physiological reactions, and thoughts. Students with Thriving IMAEs liked math and had positive assessments of themselves in math. Students with Agonizing IMAEs had negative feelings and thoughts about math and experienced negative physiological reactions. Students with Persisting IMAEs had positive and negative feelings and thoughts, but thought that, ultimately, they could persist in math. A higher percentage of women than men held Agonizing IMAEs, and a lower percentage of women than men held Thriving IMAEs. Students in introductory geoscience classes had a range of IMAEs, which may have an important role in their success in class and in their decisions to take additional geoscience classes.

Resolution of the III International menopause expert forum

The III International Menopause Expert Forum took place on November 24, 2021. The working group of the expert council included leading experts in endocrine gynaecology from Belarus, Armenia, Georgia, Kazakhstan, Kyrgyzstan, Uzbekistan, and Ukraine.To date, menopause hormone therapy (MHT) initiated during the “therapeutic window of opportunity” has proved to have a protective effect against various age-associated diseases. Despite this, the percentage of women using MHT remains low and, for example, in Ukraine and Kazakhstan, equals nearly 2%. However, only one in four of these women have been using MHT for more than a year. The main reasons for such low percentage of women using MHT are as follows:1. Low patient adherence to MHT (due to misunderstanding of the menopause factors, menopause symptoms, treatments, hormonophobia, poor communication with healthcare professionals etc.).2. Healthcare professional’s vigilance due to the possible risks associated with MHT (breast cancer, venous thromboembolism, cardiovascular diseases etc.).3. Healthcare professionals face difficulties during the MHT prescription or subsequent patient management (unplanned haemorrhages, concomitant pathologies in a woman, i.e. fibroids, varicose veins, arterial hypertension etc.). Aiming to improve medical care for menopausal women, experts attending the Forum focused on the latest data on the risks of breast cancer and venous thromboembolism, MHT effect on the risk of coronary heart disease and arterial hypertension, the potential of prescribing MHT to patients with uterine myoma and on increasing treatment adherence.

Women and cardiac rehabilition in Mallorca

Abstract Funding Acknowledgements Type of funding sources: None. Background Women are less likely to be referred to a cardiac rehabilitation program (CRP) than men. Little is known about the different indications between genders and whether women who attend a CRP have different health characteristics from men. Purpose To study the differences between men and women in the frequency of referral to the only CRP in Mallorca (Spain), their indication and whether there were different health characteristics by gender among referred patients. Methods Retrospective observational study. We studied the indication, cardiovascular risk factors (CVRF), somatometric data, blood test and psychosocial health (by hospital anxiety and depression scale, HADS) of all patients referred to a CRP in Mallorca since the program was launched in 2014. Results 524 patients have been referred to the CRP. 18% (95) were women, with no differences in mean age compared to men (55.9 ± 11 vs 56.2 ± 10 years). Women were referred more frequently due to non-coronary diseases (20% vs 4%, p &amp;lt;0.05), such as congenital heart disease, valve disease, or heart failure due to other cardiomyopathies. Among patients referred with coronary disease (485), only 15.7% (76) were women. The most frequent indication (84% in men and 80% in women) was an acute coronary syndrome (ACS), with similar percentages of NSTEACS and STEACS (women 43 and 57%, men 41 and 59%). Women were referred more frequently due to chronic coronary syndrome than men (17% vs 5%, p &amp;lt;0.05) and only one woman was referred after a coronary artery bypass grafting (vs 19 men, 1% vs 4%). Among patients with coronary disease, women had less frequent history of smoking (64% vs 81%, p &amp;lt;0.05), but similar percentages of other classic CVRF (Hypertension -59 vs 56% -, diabetes -27% vs 26% - and dyslipidemia -59% vs 63% - p&amp;gt;0,05). Women didn’t have significant differences when compared to men in their levels of LDL cholesterol (73 ± 23 vs 76 ± 25), triglycerides (122 ± 64 vs 135 ± 72), HbA1c (6.2 ± 1% vs 6, 1 ± 3%), p&amp;gt;0,05. A lower percentage of women were overweight or obese (71% vs 85%, p &amp;lt;0.05). Women with ischemic heart disease referred to the CRP had a higher degree of anxiety and depression measured in the HADS questionnaire (anxiety 9.2 ± 4 vs 7.0 ± 4, depression 6.7 ± 5 vs 5.1 ± 4, p &amp;lt;0.05). The percentage of women with a high degree of anxiety or depression (score&amp;gt; 11 in HADS) was higher than for men (anxiety 44% vs 22%, depression 24% vs 13%, p &amp;lt;0.05). Conclusions Only 18% of the patients referred to a CRP in Mallorca were women. This percentage was lower (15,8%) in patients with coronary disease referred to CRP. Women were referred in a higher percentage of cases than men for non-coronary pathology and chronic coronary syndrome. A lower percentage of women with coronary disease were smokers, overweighted or obese. Finally, a higher degree of anxiety and depression was observed among women than among men.

A Principal Component Analysis Approach to Estimate the Disability Status for Patients with Multiple Sclerosis Using Japanese Claims Data.

IntroductionClaims databases are preferred for research on multiple sclerosis (MS) as this condition is characterized by low prevalence and long disease course. However, Japanese claims databases contain no information on disease severity or disability status of MS. Here, we aimed to explore the possibility of utilizing a principal component analysis (PCA) to estimate MS severity using a Japanese claims database.MethodsAn MS severity score was developed using a PCA. Factors related to functional systems for Expanded Disability Status Scale (EDSS) and higher disease severity (74 diagnoses, 68 drug prescriptions, and 77 procedures) were extracted from the claims database (April 2008–August 2018). The score (PC1 score) was developed for each patient-year—each year from the first diagnosis (excluding the year of the first diagnosis), based on the first principal component of the included factors. Finally, the patient-years were classified into quartiles based on the PC1 score, and demographic information and medical status were analyzed.ResultsThe database contained 7067 patients with MS. The highest score group had a higher mean age (55.4 ± 0.2 [mean ± standard error] years), lower percentage of women (64.4 ± 0.7%), and longer mean disease duration from first diagnosis (8.1 ± 0.1 years) than the lowest score group (43.3 ± 0.2 years, 68.4 ± 0.8%, and 6.0 ± 0.1 years, respectively). In addition, the PC1 score of each patient positively correlated with disease duration from diagnosis.ConclusionWe developed a PC1 score to indicate MS severity using information from a Japanese claims database. Since changes in demographic features we observed are consistent with findings of previous research, this score might represent MS severity to some extent. Further research is necessary to validate this score with clinical measurement of disability such as the EDSS.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40120-022-00324-0.

Progestin-Primed Ovarian Stimulation with Clomiphene Citrate Supplementation May Be More Feasible for Young Women with Diminished Ovarian Reserve Compared with Standard Progestin-Primed Ovarian Stimulation: A Retrospective Study.

PurposeThe present study was designed to compare the efficiency of the progestin-primed ovarian stimulation (PPOS) protocol with clomiphene citrate (CC) supplementation (PPOS+CC) and the standard PPOS protocol for women of different ages with diminished ovarian reserve (DOR).Patients and MethodsThis retrospective cohort study included 364 DOR women who underwent controlled ovarian stimulation with PPOS+CC (n = 223) or standard PPOS (n = 141). They were divided into subgroups based on age: ≤35 years and >35 years. Differences in baseline characteristics, ovarian stimulation characteristics, endocrinological characteristics, and clinical outcome between the two groups were assessed. Statistical analyses were stratified by age.ResultsIn all women with DOR, PPOS+CC was associated with a lower percentage of women with profound pituitary suppression than standard PPOS (0.0% vs 18.6%, P < 0.001 and 1.3% vs 11.0%, P = 0.002). In young women with DOR, more high-quality cleavage-stage embryos were harvested (1.96 vs 1.38, P = 0.018) and a lower dosage of gonadotropin per oocyte retrieved was required (558.37 vs 909.82, P = 0.036) in PPOS+CC. In older women with DOR, PPOS+CC led to an increase in the incidence of luteinizing hormone (LH) surge levels above 10 IU/L on trigger day (12.7% vs 4.9%, P = 0.028) and a decrease in the rate of oocyte maturation (84.7% vs 89.9%, P = 0.034) compared to standard PPOS.ConclusionClomiphene citrate is an effective adjuvant to alleviate pituitary suppression in PPOS protocols; for young women with DOR, CC supplementation had a positive impact on the number of high-quality embryos. However, older women with DOR would be at risk of developing a premature LH surge and having poor oocyte maturation rate under the PPOS+CC protocol.

Rural and Female Patients with Old Myocardial Infarction Lacked Knowledge and Preventive Measures During the Beginning of the COVID-19 Epidemic in Chongqing, Southwest China.

BackgroundCoronavirus disease 2019 (COVID-19) has emerged as a global threat. This study was performed to gain an understanding of COVID-19-related knowledge, attitudes, and practices among susceptible individuals.Material/MethodsPatients who had been diagnosed with old myocardial infarction were followed up via telephone survey based on an established follow-up system at the beginning of the COVID-19 outbreak (January 2020) in Chongqing, Southwest China.ResultsA total of 631 eligible patients participated in this survey, and 40.6% of the rural respondents did not know the transmission routes of SARS-CoV-2, which was higher than the proportion of urban respondents (40.6% vs 31.0). Rural residents had a lower rate of adopting preventive measures than urban residents, such as wearing masks (76.7% vs 90.1%), avoiding meetings and gatherings (58.6% vs 68.5%), and hand washing (56.0% vs 63.8%). A higher percentage of women than men did not take any preventive measures (11.3% vs 7.6%), while a lower percentage of women than men wore masks (77.7% vs 84.5%). Multiple logistic regression revealed that rural patients were more likely to lack knowledge about transmission (odds ratio (OR): 1.51). Rural patients had an increased risk of failing to implement protective measures.ConclusionsFemale and rural populations lacked knowledge and failed to adopt protective measures during the beginning of the COVID-19 epidemic. Therefore, these populations may benefit from health education campaigns and policies.

Gender distribution in emergency medicine journals: editorial board memberships in top-ranked academic journals.

Despite an established gender gap in academic medicine, evidence on gender diversity in emergency medicine is scarce. In the present study, gender distribution of editorial boards and among editors-in-chief of 31 emergency medicine journals was investigated in 2020/2021 and compared to 2015 and 2010. Additionally, gender distribution in editorial boards of emergency medicine journals was compared to editorial boards in five different medical specialties. In this cross-sectional analysis, gender of editorial board members and editors-in-chief of journals ranked in the Clarivate Analytics 'Journal Citation Report' (JCR) of 2019 in the sections 'Emergency Medicine', 'Medicine General and Internal', 'Surgery', 'Obstetrics and Gynecology', 'Pediatrics' and 'Orthopedics' were analyzed. In the investigated 31 emergency medicine journals, three out of 35 editors-in-chief (9%) and 299 out of 1810 editorial board members (17%) were women in 2020/2021. In 2015 and 2010, two editors-in-chief were women (13% vs. 15%). In 2015, 19% of editorial board members were women and in 2010 it was 18%, respectively. There was no significant difference in gender distribution among editors-in-chief and editorial board members comparing 2020/2021 with 2015 and 2010 (P = 0.76 vs. P = 0.40, respectively). There was a lower percentage of women in editorial boards of emergency medicine journals compared to the top five JCR-ranked journals in the categories 'Medicine General and Internal', 'Surgery', 'Gynecology and Obstetrics' and 'Pediatrics'. The gender gap in editorial boards and among editors-in-chief of emergency medicine journals seems to be consistent for the last 10 years. Gender disparity appears to be substantial in academic emergency medicine: The percentage of women in emergency medicine editorial boards was lower compared to editorial boards of four other medical specialties.

Abstract P680: Stroke, Stroke Risk Factors and Physical Activity Among Overweight and Obese Women of Reproductive Age

Background: Stroke is a concern for women of reproductive age, as pregnant women have an increased risk of stroke. Primary prevention is critical to reducing this burden among this group. High physical activity levels (compared to low physical activity levels) can decrease stroke risks in adults, though this is not well-researched among women of reproductive age. Methods: Using NHANES 2013-2017 data, we examined the impact of physical activity on self-reported stroke and risk factors for stroke among overweight and obese women of reproductive age (20-44) using logistic regression models. Covariates include age, race, and smoking status. Risk factors examined were stroke history, hypertension, elevated total cholesterol, LDL cholesterol, triglycerides, and blood glucose levels. Results: Logistic regression models showed that getting at least 150 minutes of exercise per week reduced the odds of having elevated glucose levels by 58% (aOR=0.425, 95% CI=0.19-0.95). While physical activity did not show any significant differences in the other stroke risk factors, there was a trend toward a lower percentage of women having hypertension and elevated triglycerides if they were physically active. Further, compared to white women, Black women had nearly two times higher odds of having hypertension (aOR=1.97, 95%CI 1.41-2.76). Conclusions: Previous studies show that increasing physical activity can lower stroke risk, including lowering blood pressure and insulin levels. While our results show lower blood glucose among physically active overweight or obese women of reproductive age, a similar effect was not seen for hypertension. In this population, hypertension may result in adverse maternal outcomes such as pre-eclampsia, eclampsia or stroke during pregnancy, should a woman become pregnant. This demonstrates the importance of managing stroke-related risk factors during a woman’s reproductive years.

Comparison of brain atrophy and cognitive performance in individuals with low and high cardiovascular risk: Data from the Diabetes and Dementia (D2) Study

AbstractBackgroundGrowing evidence suggests that increased cardiovascular risk might accelerate brain atrophy and cognitive decline. The aim of this analysis was to investigate associations between the Framingham Risk Score (FRS), brain volume and cognitive function in individuals with type 2 diabetes (T2DM) participating in the Diabetes‐and‐Dementia (D2) study.MethodNinety cognitively‐normal participants with T2DM completed neuropsychological assessments, health‐and‐lifestyle questionnaires, 24‐hour ambulatory blood pressure monitoring and a 3T‐MRI scan. FreeSurfer (version 6.0) was used to estimate total brain volume (TBV), mean cortical thickness and subcortical volumes, including the thalami and caudate nuclei. TBV was expressed as a percentage of intracranial volume. Averages between left and right volumes were calculated for subcortical structures. The sample was divided into low (n=45) and high (n=45) FRS groups based on the median score (X=39.7). Differences in volumes were compared between groups. Four cognitive domains, including visuospatial skills, verbal memory, language, and executive functions &amp; speed of processing information, were derived using a factor analysis. These domains were used to compare cognitive performance between individuals with low and high FRS.ResultParticipants in the high FRS group were significantly older and had a lower percentage of women: age (F (1, 89)=26.6; p&lt;0.000); sex (x2=10.07, p=0.01). The high FRS group, after correcting for age and sex, had significantly smaller TBV (F (1, 86)=60.6; p=0.023) and reduced cortical thickness (F (1, 82)=9.93; p=0.002). No difference was found in other subcortical structures. Multivariate analysis revealed a statistically significant difference in cognition between individuals with low and high FRS (F (1, 85)=4.46, p=0.003). Univariate analyses showed statistically significant differences in executive function &amp; processing speed (F (1, 81) = 5.69; p=0.019), with the low FRS group outperforming the high FRS group.ConclusionHigh cardiovascular risk in T2DM is associated with accelerated structural brain aging, manifesting as cerebral atrophy and poorer cognitive function, particularly in processing speed and executive function.