Male Mortality Research Articles

Childhood neighborhoods and cause-specific adult mortality in Sweden 1939–2015

The socioeconomic health gradient has widened in recent decades. We study how childhood socioeconomic neighborhood conditions influence gender- and cause-specific adult mortality. Using uniquely detailed geocoded longitudinal microdata for a Swedish town (1939–1967), with a follow-up in national registers (1968–2015), we apply Cox proportional hazards models and estimate individual neighborhoods at the address-level. We find that childhood neighborhood social class has a lasting influence on male adult mortality (ages 40–69), even when adjusting for class position, class origin, neighborhood physical attributes and school districts. This impact was particularly pronounced for preventable causes of death, pointing to lifestyle and behavioral factors as important mechanisms.

Lung cancer mortality and soil content of arsenic and cadmium: an ecological study in 26 EU countries

Abstract Background Environmental risk factors, such as exposure to air pollution, are linked with lung cancer. However, potential health impacts of exposure to carcinogenic pollutants in soil are less defined. In this ecological study, we evaluated at a regional scale potential associations between lung cancer mortality and the soil content of two carcinogens: arsenic and cadmium. Methods Data on deaths from lung cancer were from EUROSTAT. Soil content of arsenic and cadmium were from the Land use/cover area frame (LUCAS) 2009 survey. Analysis covered 26 EU countries and 21,035 sampling points. Three socioeconomic indicators and seven lung cancer risk factors were included. Data were linked at the NUTS2 level (n = 219) and analysed by negative binomial regression. Results After inclusion of significant predictors, the ratio of lung cancer mortality rates in the population resident in the regions within the highest quantile of arsenic concentration in soil, compared to the rest of the dataset, was 1.062 for females (95% CI 1.024 - 1.101) and 1.037 for males (95% CI 1.020 - 1.074). In the regions within the highest quantile of cadmium in soil, compared to the lower quantiles, the ratio of the mortality rates was 1.062 for females (95% CI 1.019 - 1.101) and 1.075 for males (95% CI 1.033 - 1.117). When data were stratified by land cover, significant (p < 0.05) positive associations in males were only shown for cadmium sampled from agricultural land (cropland and grassland) but not from the non-agricultural land. Conclusions Higher rates of lung cancer mortality were reported in regions with high concentration of arsenic or cadmium in soil, relative to regions with lower concentration. Due to the ecological design, this study cannot prove causality but is in agreement with other reports linking exposure to arsenic or cadmium and lung cancer. This warrants future investigations at a finer geographical scale, focused on regions with high soil levels of arsenic and cadmium. Key messages • Higher lung cancer mortality rates were reported in regions with high concentration of arsenic or cadmium in soil, relative to regions with their lower concentration. • There was an association between cadmium in soil and lung cancer mortality in males for the subset of sampling points from the agricultural land but not for the non-agricultural land.

Males die young, which may cause an Allee effect during a population collapse of the Vendace Coregonus albula

AbstractObjectiveWe estimated the difference in mortality between mature male and female Vendace Coregonus albula based on a large data set of catch samples from 25 locations in Finland. We then used this estimate and age distribution data from Lake Etelä‐Konnevesi to illustrate how the sex ratio (females per one male) might decrease as the average age of spawners increases during a several‐year‐long period of recruitment failure.MethodsWe estimated mortalities first from sex‐specific age–ln(catch) curves and second from the average age‐specific proportions of different sexes.ResultThe estimate of the additional mortality of males was around 0.2–0.4, depending on the method of estimation, and assumed true proportions in the population at age 1 (two growing seasons), when Vendace reaches sexual maturity. When using the additional mortality estimate and age distribution data from Lake Etelä‐Konnevesi, the hypothetical sex ratio in the most extreme year was even as skewed as four females per one male.ConclusionIf the lack of males per female spawner during a population decline reduces the per capita recruitment success of females, this is a depensatory density‐dependent effect, the Allee effect. This phenomenon may partly explain the rapid population collapses and contribute to 2‐year cyclicity typical of the dynamics of Vendace populations.

The impact of sex differences on 3-year outcomes of patients with non-ST-segment elevation myocardial infarction after successful stent implantation according to symptom-to-balloon time

BackgroundBecause no data are available, we compared the 3-year outcomes of patients with non-ST-elevation myocardial infarction (NSTEMI) based on sex and symptom-to-balloon time (SBT). MethodsThis study included 4910 patients who were divided into two groups based on SBT: SBT <48 h (n = 3,293, 67.1%) and SBT ≥48 h (n = 1,617, 32.9%). The primary outcome was all-cause death during the 3-year follow-up period. The secondary outcome was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction, or repeat coronary revascularization. ResultsAfter adjustment, the in-hospital mortality rates for males and females in the SBT <48 h and SBT ≥48 h groups were similar. During a 3-year follow-up period, females in the SBT <48 h group had significantly higher rates of all-cause death (adjusted hazard ratio [aHR], 1.482; P = 0.006), cardiac death (CD, aHR, 1.617; P = 0.009), and MACE (aHR, 1.268; P = 0.024) than those males in the same groups. Females and males in the SBT ≥48 h group did not differ significantly in the primary and secondary outcomes. In males, the rates of all-cause death (P = 0.008) and CD (P = 0.024) were significantly higher in the SBT ≥48 h group than in the SBT <48 h group. ConclusionsThis study has identified a higher 3-year mortality rate in female patients with NSTEMI and SBT <48 h compared to their male counterparts. As such, a more preventive approach may be required to reduce mortality in these female patients.

Extracellular nanovesicles produced by Bacillus licheniformis: A potential anticancer agent for breast and lung cancer

Cancer is a major public burden and leading cause of death worldwide; furthermore, it is a significant barrier to increasing life expectancy in most countries of the world. Among various types of cancers, breast and lung cancers lead to significant mortality in both males and females annually. Bacteria-derived products have been explored for their use in cancer therapy. Although bacteria contain significant amounts of anticancer substances, attenuated bacteria may still pose a potential risk for infection owing to the variety of immunomodulatory molecules present in the parental bacteria; therefore, non-cellular bacterial extracellular vesicles (BEVs), which are naturally non-replicating, safer, and are considered to be potential anticancer agents, are preferred for cancer therapy. Gram-positive bacteria actively secrete cytoplasmic membrane vesicles that are spherical and vary between 10 and 400 nm in size. However, no studies have considered cytoplasmic membrane vesicles derived from Bacillus licheniformisin cancer treatment. In this study, we investigated the potential use of B. licheniformis extracellular nanovesicles (BENVs) as therapeutic agents to treat cancer. Purified BENVs from the culture supernatant of B. licheniformis using ultracentrifugation and ExoQuick were characterized using a series of analytical techniques. Human breast cancer cells (MDA-MB-231) and lung cancer cells (A549) were treated with different concentrations of purified BENVs, which inhibited the cell viability and proliferation, and increased cytotoxicity in a dose-dependent manner. To elucidate the mechanism underlying the anticancer activity of BENVs, the oxidative stress markers such as reactive oxygen species (ROS) and glutathione (GSH) levels were measured. The ROS levels were significantly higher in BENV-treated cells, whereas the GSH levels were markedly reduced. Cells treated with BENVs, doxorubicin (DOX), or a combination of BENVs and DOX showed significantly increased expression of p53, p21, caspase-9/3, and Bax, and concomitantly decreased expression of Bcl-2. The combination of BENVs and doxorubicin enhanced mitochondrial dysfunction, DNA damage, and apoptosis. To our knowledge, this is the first study to determine the anticancer properties of BENVs derived from industrially significant probacteria on breast and lung cancer cells.

Trends in all-cause mortality and leading causes of death from 2009 to 2019 among older adults in China

BackgroundThis study aimed to determine long-term variations in mortality trends and identify the leading causes of death among older adults in China from 2009 to 2019 so as to propose interventions to further stabilise the mortality rate among older adults and facilitate healthy ageing.MethodsWe extracted data from the China Death Surveillance database from 2009 to 2019 for all-cause mortality and cause-specific death among individuals aged ≥ 65 years. A joinpoint regression model was used to estimate mortality trends by calculating the annual percentage change (APC). A trend chi-square test was used to estimate sex differences in mortality, and descriptive analysis was used to estimate the leading causes of death. Semi-structured expert interviews were conducted to examine health interventions for older adults.ResultsWe observed an overall declining trend in age-adjusted mortality rates among older adults aged ≥ 65 years in China from 2009 to 2019 (APC, -2.44; P < 0.05). In this population, the male mortality rate was higher than the female mortality rate during this period (P < 0.05). However, the mortality rate among older adults aged ≥ 85 years increased since 2014, particularly among females. Cardiovascular disease (CVD) was the leading cause of death among older adults aged 65–84 years, whereas ischaemic heart disease was the leading cause of death among individuals aged ≥ 85 years, especially among females. The majority of injuries resulting in death were caused by falls, showing an increasing trend.ConclusionsCVD is a major cause of death among older adults aged ≥ 65 years in China, and relevant health intervention strategies should be implemented from the perspectives of physiology, psychology, and living environment. The change in the mortality trend and the distribution of cause of death among older adults aged ≥ 85 years is noteworthy; a diagnostic and management model centred around females aged ≥ 85 years should be implemented. Additionally, a multidimensional fall prevention strategy involving primary medical institutions and care services needs to be implemented to reduce the risk of falls among older adults.

Early life exposure to cigarette smoking and adult and old-age male mortality: Evidence from linked US full-count census and mortality data.

Smoking is a leading cause of premature death across contemporary developed nations, but few longitudinal individual-level studies have examined the long-term health consequences of exposure to smoking. We examine the effect of fetal and infant exposure to exogenous variation in smoking, brought about by state-level cigarette taxation, on adulthood and old-age mortality (ages 55-73) among cohorts of boys born in the United States during the 1920s and 1930s. We use state-of-the-art methods of record linkage to match 1930 and 1940 US full-count census records to death records, identifying early life exposure to the implementation of state-level cigarette taxes through contemporary sources. We examine a population of 2.4 million boys, estimating age at death by means of OLS regression, with post-stratification weights to account for linking selectivity. Fetal or infant exposure to the implementation of state cigarette taxation delayed mortality by about two months. Analyses further indicate heterogenous effects that are consistent with theoretical expectations; the largest benefits are enjoyed by individuals with parents who would have been affected most by the tax implementation. Despite living in an era of continuously increasing cigarette consumption, cohorts exposed to a reduction in cigarette smoking during early life enjoyed a later age at death. While it is not possible to comprehensively assess the treatment effect on the treated, the magnitude of the effect should not be underestimated, as it is larger than the difference between having parents belonging to the highest and lowest socioeconomic groups. The study provides the first estimates of long-run health effects from early life exposure to cigarette smoking.

Is there a sex difference in mortality rates in paediatric intensive care units?: a systematic review.

Mortality rates in infancy and childhood are lower in females than males. However, for children admitted to Paediatric Intensive Care Units (PICU), mortality has been reported to be lower in males, although males have higher admission rates. This female mortality excess for the subgroup of children admitted in intensive care is not well understood. To address this, we carried out a systematic literature review to summarise the available evidence. Our review studies the differences in mortality between males and females aged 0 to <18 years, while in a PICU, to examine whether there was a clear difference (in either direction) in PICU mortality between the two sexes, and, if present, to describe the magnitude and direction of this difference. Any studies that directly or indirectly reported the rates of mortality in children admitted to intensive care by sex were eligible for inclusion. The search strings were based on terms related to the population (those admitted into a paediatric intensive care unit), the exposure (sex), and the outcome (mortality). We used the search databases MEDLINE, Embase, and Web of Science as these cover relevant clinical publications. We assessed the reliability of included studies using a modified version of the risk of bias in observational studies of exposures (ROBINS-E) tool. We considered estimating a pooled effect if there were at least three studies with similar populations, periods of follow-up while in PICU, and adjustment variables. We identified 124 studies of which 114 reported counts of deaths by males and females which gave a population of 278,274 children for analysis, involving 121,800 (44%) females and 156,474 males (56%). The number of deaths and mortality rate for females were 5,614 (4.61%), and for males 6,828 (4.36%). In the pooled analysis, the odds ratio of female to male mortality was 1.06 [1.01 to 1.11] for the fixed effect model, and 1.10 [1.00 to 1.21] for the random effects model. Overall, males have a higher admission rate to PCU, and potentially lower overall mortality in PICU than females. www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=203009, identifier (CRD42020203009).

FRI043 The Double Pandemic Effect Of Obesity And COVID-19 Among United States Adult Hospitalizations: Outlining Hospitalization Outcomes Of A Synergistic Catastrophe

Abstract Disclosure: H. Shaka: None. A. Ilelaboye: None. E. Krishnaraju: None. M. Dasgupta: None. A. Shaka: None. P. Kanemo: None. Introduction: The COVID-19 pandemic exacerbated significant health disparities among adults in the US. Obesity has been on the rise in the US for decades and has been described as a pandemic. Morbid obesity (MO) is a known risk factor for worse outcomes for viral pneumonia including SARS-CoV-2. This study outlined the national impact of the COVID-19 pandemic on the ongoing obesity pandemic and assessed possible healthcare disparities in this population. Methods: The study obtained data from the US National Inpatient Sample from 2016 - 2020. This provides a nationally representative estimate of all US hospitalizations for each calendar year. We assessed rates of MO hospitalizations per 1000 adult hospitalizations yearly. We compared outcomes between 2019 and 2020 to evaluate the COVID-19 pandemic's effect on this population. Outcomes were also stratified by sex, race, and median household income. Results: From 2016 to 2020, hospitalizations involving adults with MO increased by 61%. While national hospitalizations dropped by about 9% in 2020, those involving adults with MO increased by 7.1% compared with 2019 adjusted for age, race, sex, and comorbidity index. In 2020, hospitalized adults with MO had a lower mean age and a higher proportion of men compared to 2019. There was no significant difference in the race, income and comorbidity index distribution of the patients in 2020 compared to 2019. Among adults with MO who died during hospitalization in 2020, about 1 in 5 had COVID-19 as the reason for admission. The mortality rate in all adults with MO increased from 1.5 to 2.7%. This represented an 84.5% higher odds of mortality compared to 2019. Stratification showed that there was an 80.0 vs 88.9% higher mortality in females vs males. Mortality in Hispanics increased by 169.7%, compared to 111.7% in Blacks and 66.8% in Whites. Patients in the lowest income quartile had an increase of 97.2 vs 61.7% in the highest income quartile. There were also significant regional variations in the increase in mortality among hospitalizations with MO. Year on year, total hospitalization charges in the studied population increased by $10 billion to over $156 billion, adjusted for inflation. The year 2020 also saw an overall increase in the length of hospitalizations for adults with MO. Discussion/conclusion: This study provides evidence that at the national level, patients with MO were significantly impacted by the COVID-19 pandemic. This contributed to significant healthcare costs. We recommend a national approach and response to the obesity pandemic as people with morbid obesity are projected to make up to 30% of the US population by 2030. We also highlighted significant racial and economic disparities in the outcomes of these patients. Although the reasons for such disparities are likely multifactorial, this adds to a growing body of evidence of disparities in healthcare across various health conditions. Presentation: Friday, June 16, 2023

SAT020 Is Testosterone The Male Sex Hormone Responsible For Increased Male Mortality In Melanoma? In-vitro Studies On Two Human Melanoma (BLM, 1205Lu) Cell Models

Abstract Disclosure: P. Ramaraj: None. Epidemiological data pointed to increased male mortality in melanoma and clinical studies pointed to better protection of menstruating females in melanoma than post-menopausal women and men of any age. Our in-vitro studies with progesterone (P) on human melanoma (BLM and 1205Lu) cell lines showed a significant decrease in cell growth along with a decrease in the secretion of proinflammatory cytokine IL-8 by these cells. These in-vitro studies correlated with the hormonal data which showed that progesterone levels in menstruating females ranged between 1000 - 1500 ng/dl, compared to post-menopausal women 20 - 100 ng/dl and men 27-90 ng/dl, suggesting low progesterone levels meant no protection in melanoma. This observation prompted us to hypothesize that lack of progesterone in males could be a cause for increased male mortality. This hypothesis also raised the question of the role of male sex hormones (AD-androstenedione and T-testosterone) in increased male mortality. In order to address these questions in-vitro experiments were planned. First, to indirectly induce endogenous IL-8 by pretreating the cells with endothelin and then adding steroid hormones (AD, T, P). Secondly, to add IL-8 directly to the cells and then add steroid hormones. Finally, to suppress endogenous IL-8 with curcumin and then add T to one set of cells and IL-8 + T to another set of cells. For the first experiment, the result was a marginal increase in cell growth (67%) in cells pretreated with endothelin followed by T-treatment compared to straight T-treated cells (60% cell growth) without endothelin pretreatment. For the second experiment, there was a slight increase in cell growth in IL-8-added cells, but it was not statistically significant. For the final experiment, the cells treated with IL-8 + T after curcumin pretreatment showed a partial restoration of cell growth (49%) compared to cells (40% cell growth) treated with plain T after curcumin treatment, suggesting T was not able to control or regulate IL-8 action like progesterone. These in-vitro experiments suggested that in males 2 reasons 1) a deficiency of progesterone and 2) inefficiency of T to control endogenous IL-8 could possibly result in increased IL-8 levels. This increased IL-8 level in males could lead to increased cell growth and metastasis in melanoma leading to death. So, a situation arising out of male reproductive endocrine physiology could probably be responsible for increased male mortality in melanoma. Presentation: Saturday, June 17, 2023

Long-term outcomes of lung cancer screening in males and females

BackgroundThis study explored female and male overall mortality and lung cancer (LC) survival in two LC screening (LCS) populations, focusing on the predictive value of coronary artery calcification (CAC) at baseline low-dose computed tomography (LDCT). MethodsThis retrospective study analysed data of 6495 heavy smokers enrolled in the MILD and BioMILD LCS trials between 2005 and 2016. The primary objective of the study was to assess sex differences in all-cause mortality and LC survival. CAC scores were automatically calculated on LDCT images by a validated artificial intelligence (AI) software. Sex differences in 12-year cause-specific mortality rates were stratified by age, pack-years and CAC score. ResultsThe study included 2368 females and 4127 males. The 12-year all-cause mortality rates were 4.1 % in females and 7.7 % in males (p < 0.0001), and median CAC score was 8.7 vs. 41 respectively (p < 0.0001). All-cause mortality increased with rising CAC scores (log-rank test, p < 0.0001) for both sexes. Although LC incidence was not different between the two sexes, females had lower rates of 12-year LC mortality (1.0 % vs. 1.9 %, p = 0.0052), and better LC survival from diagnosis (72.3 % vs. 51.7 %; p = 0.0005), with a similar proportion of stage I (58.1 % vs. 51.2 %, p = 0.2782). ConclusionsOur findings demonstrate that female LCS participants had lower rates of all-cause mortality at 12 years and better LC survival than their male counterparts, with similar LC incidence rates and stage at diagnosis. The lower CAC burden observed in women at all ages might contribute to explain their lower rates of all-cause mortality and better LC survival.

Gender Differences in COVID-19 Among Liver Transplant Recipients - Results from a Multicenter Brazilian Cohort

Introduction: Existing literature presents varying perspectives on the impact of COVID-19 on liver transplant recipients. However, no research has specifically investigated the role of gender differences in the manifestation of COVID-19 among liver transplant recipients. This study aims to examine the effects of COVID-19 on liver transplant recipients, with a focus on gender differences in disease presentation and progression. Methods: Conducted as a multicenter historical cohort study, this research collected patient records through an online questionnaire. Assessing COVID-related mortality was the main objective. Additionally, demographic, clinical, and laboratory data pertaining to disease presentation and progression were collected. Results:The study included a total of 283 patients, of whom 76 were female and 206 were male. The median follow-up period for males was 99 days (IQR 38-283), while for females, it was 126 days (IQR 44-291). A higher prevalence of cardiovascular disease was observed in males (p=0.002). Females frequently experienced a loss of smell (p=0.021), whereas males commonly exhibited fever (p=0.031). Levels of ALT and gamma-glutamyl transferase were significantly elevated in males (p=0.008 and 0.004, respectively). Although there was a trend towards increased mortality in males, it did not reach statistical significance.Conclusion: This study is the first attempt to investigate gender differences in COVID-19 among liver transplant recipients. Our findings highlight the need for a comprehensive and personalised approach to treating this patient population and underscore the importance of further elucidating the disease presentation in these individuals

Factors Predicting Outcome of Surgically Treated Acute Subdural Hematoma

Objective: The study aimed to evaluate operative mortality and prognosis factors in posttraumatic acute subdural hematoma patients. Material &amp; Methods: A prospective cross-sectional study was done in the Department of Neurosurgery, Ayub Teaching Hospital Abbottabad. 82 patients operated for Acute Subdural Hematoma were included in the study. Variables that influence the outcome were recorded. The outcome was measured in terms of mortality. Results: Of 82 patients operated on, 61 were male, and 21 were female. 51 were &lt;40 old years, 21 were aged 41-60, and 7 were over 60. The most common cause is fall from height (47.6%). Cerebral contusion is often associated (28%). Overall mortality: 39.2%. Male mortality: 29.2%, female: 9.7%. Surgery &gt;4 hours post-injury had higher mortality (18.2%) vs. &lt;4 hours (8.5%). 14/43 GCS &lt;8 patients survived, with no deaths when GCS &gt;12. Pupillary abnormalities had higher mortality (31.9%) vs. normal pupils (7.3%). No deaths with hematoma thickness &lt;10mm and only 1 survived with a thickness &gt;16mm. 25/29 died with midline shift &gt;11mm. Conclusion: Prognostic factors for surgically treated traumatic acute subdural hematoma include GCS at presentation, pupils, hematoma thickness, midline shift, and time to surgery. Better outcomes associated with GCS&gt;9, normal pupils, hematoma width &lt;1.5cm, midline shift &lt;1cm, and surgery within 4 hours.

Investigation of ATR Inhibitor VX970 as a Radiosensitizer in Colorectal Cancer Cells

Colorectal cancer (CRC) is the second leading cause of combined cancer-related mortality in males and females in the U.S. Traditional treatment of locally advanced rectal cancer consists of neoadjuvant chemoradiation followed by surgery and adjuvant chemotherapy. Emerging data suggests that higher response rates can be achieved with total neoadjuvant therapy (TNT) where delivery of all chemotherapy and radiation therapy (RT) occurs prior to surgery. In addition, for patients with a complete response to TNT, non-operative management (NOM) can be considered. However, despite the use of TNT, pathologic complete response rates remain below 40% and NOM is only achieved in approximately 50% of rectal cancer patients. A strong need remains for more active anti-cancer therapies in rectal cancer to both reduce pelvic recurrence and facilitate NOM. Here, we tested the hypothesis that inhibition of the ataxia telangiectasia and Rad3-related protein kinase (ATR), a critical regulator of cellular DNA damage response, could increase the sensitivity of CRC to RT. VX970, a highly potent and selective ATR inhibitor, was investigated as a radiosensitizer in SW48 and LoVo CRC cell models. In vitro, IC50 of VX970 was assessed by alamarBlue cytotoxicity assay, while radiosensitivity was revealed by radiation clonogenic assays (0, 2, 4, 6, 8 Gy). ATR activity was determined by p-Chk1 using immunoblotting, and cell cycle distribution was analyzed by propidium iodide flow cytometry. CRC xenografts were generated using both LoVo and SW48 cells injected in the left flanks of athymic nude mice to explore the radiosensitizing effects of VX970 in vivo. Tumors were allowed to grow to 100-150 mm3, and the mice were randomized into multiple groups [vehicle alone, RT alone (10 Gy/5 fractions), VX970 alone, and VX970+RT]. Mouse weights and tumor size were measured three times weekly. Comparison of treatment groups was performed using the log-rank test with P<0.05 considered significant. The IC50 concentrations of VX970 on SW48 and LoVo cells were about 500 and 100 nM, respectively. VX970 at doses of 3 nM did not alter the viability of CRC cells, but significantly sensitized CRC cells to radiotherapy (P<0.05), with DER of 1.43 and 1.59, respectively, in SW48 and LoVo cells. VX970 efficiently attenuated p-Chk1 expression and significantly abrogated radiation induced G2/M cell cycle arrest (P<0.05). In addition, VX970 in combination with radiotherapy significantly prolonged tumor growth delay of CRC xenografts compared to radiation alone (P<0.05), with minimal toxicity observed. Inhibition of the ATR-Chk1 pathway by targeting ATR kinase with VX970 sensitizes CRC to radiotherapy in vitro and in vivo. Our findings support that ATR inhibition by VX970 is a promising new approach to improve the therapeutic ratio of radiotherapy for patients with CRC and warrants further clinical testing.

Histopathological Spectrum of Prostatic Lesions in a Tertiary Care Hospital

Background: Prostatic lesions like nodular hyperplasia, inflammation and carcinoma are common causes of morbidity and mortality in males. The incidence of these lesions increases with advancing age. Prostatic diseases show varying incidence in different geographical locations worldwide.&#x0D; Objectives: To evaluate the histopathological spectrum of various prostatic lesions in biopsy specimen.&#x0D; Methods: This was a retrospective study comprising 220 cases, carried out at the Department of Pathology, Enam Medical College and Hospital from January 2014 to December 2020. The histopathological slides were analyzed according to type of specimen, age of the patient, and histopathological pattern. Adenocarcinomas were graded according to Gleason score.&#x0D; Results: Of the total 220 specimens, 202 (91.8%) were of nodular hyperplasia, 14 (6.4%) were carcinoma and 4 (1.8%) cases were high grade prostatic intraepithelial neoplasia (HGPIN). All the cases of prostatic malignancies were adenocarcinoma and majority were belonged to Gleason’s score 7. Maximum numbers of cases of nodular hyperplasia were seen in the 61-70 years age group and carcinomas were peak in the 71-80 years age group.&#x0D; Conclusion: Non-neoplastic lesions of the prostate are more common than neoplastic ones. Histopathological diagnosis and grading plays a definitive role in the management of prostatic carcinoma.&#x0D; Mugda Med Coll J. 2023; 6(1): 5-10

Effects of de-snaring on the demography and population dynamics of African lions

Lions and other African large carnivores are in decline, due in part to effects of illegal hunting with snares, which can reduce prey availability and directly kill or injure carnivores. It is difficult to effectively remove snares from large ecosystems by patrolling, but an additional approach to reduce effects on large carnivores is to monitor the population closely and de-snare individuals who are found in a snare or have broken free but still carry the wire (often with serious injury). The effectiveness of de-snaring programs to reduce impacts on large carnivores has not been directly tested. Here, we used long-term demographic data from 386 individually identified lions in the Luangwa Valley Ecosystem to test the effects on population growth (λ) and population size (N) of a program to remove snares from injured lions and treat their wounds. Stochastic Leslie matrix projections for a period of five years showed that the population grew with the benefits of de-snaring, but was expected to decline without de-snaring. Mean annual growth (λ) with de-snaring was 1.037 (with growth in 70% of years), closely matching observed changes in population size. Mean annual growth was 0.99 (with growth in 47% of years) for a model that assumed snared animals would have died if not treated, and 0.95 (with growth in 37% of years) for models that also accounted for super-additive effects via the death of dependent cubs and increased infanticide with increased male mortality. De-snaring requires intensive effort, but it can appreciably reduce the effect of snaring on lion population dynamics.

Co-exposure to multiple vitamins and the risk of all-cause mortality in patients with diabetes.

Although the effect of vitamins on the risk of mortality in diabetic patients has been reported, most studies focus on individual vitamins. However, humans are often exposed to multiple vitamins simultaneously in daily life. Therefore, it is worth exploring the effects of co-exposure to multiple vitamins on the risk of mortality in diabetic patients. This study included diabetic patients aged ≥20WD years who participated in NHANES from 2003 to 2006. An unsupervised K-means clustering method was used to cluster eight vitamins in serum into several patterns of co-exposure to multiple vitamins, and the Cox proportional hazards model was used to evaluate the impact of different patterns of co-exposure to multiple vitamins on the risk of all-cause mortality in diabetic patients. Three patterns of co-exposure to multiple vitamins were generated based on K-means clustering, namely, low-level, moderate-level, and high-level. Among the 484 diabetic patients, with a median follow-up of 13.7 years, a total of 211 deaths occurred. After adjusting for covariates, the individual vitamins had varying effects on the risk of all-cause mortality in diabetic patients. Compared to the low-level group of co-exposure to multiple vitamins, the high-level group significantly reduced the risk of all-cause mortality in diabetic patients, with a HR of 0.42 (95% CI: 0.20, 0.87). Subgroup analysis demonstrated that high levels of co-exposure to multiple vitamins significantly reduced the risk of all-cause mortality in males, individuals aged ≥ 60 years, and non-Hispanic White people with diabetes compared to the low-level group, with HR of 0.42 (95% CI: 0.18, 0.98), 0.53 (95% CI: 0.26, 0.98), and 0.26 (95% CI: 0.12, 0.58) respectively. While individual vitamins had different effects on the risk of all-cause mortality in patients with diabetes, high-level co-exposure to multiple vitamins significantly reduced the risk of all-cause mortality in patients with diabetes, with differences observed among genders, ages, and race. This suggests that when developing vitamin intervention strategies for patients with diabetes, consideration should be given not only to the dosage of individual vitamins but also to the variations between different population groups.

Is East-West Life Expectancy Gap Narrowing in the Enlarged European Union?

The fall of the Berlin Wall in 1990 and EU enlargement in 2004 are two major political events in the recent history of the Central and Eastern European region. By systematically comparing the changes and differences in life expectancy at birth between the seven new member countries from Central and Eastern Europe and more advanced countries of the EU-15, this article attempts to identify the vanguards and laggards in the health convergence process before and after the 2004 EU enlargement. The results of decomposition analysis highlight the changing patterns of age- and cause-specific contributions to the differences in life expectancy. Finally, we focus on the variations in the progress in reducing the burden of cardiovascular diseases and external causes of death, which were known to be responsible for the long-term mortality crisis during the period of communist rule. Our findings suggest that the collapse of the communist regimes led to immediate positive changes in the Central European countries. At the same time, health disadvantages persisted and even worsened in the Baltic countries. Later on, joining the EU in 2004 was not accompanied by immediate systematic convergence of life expectancy. However, very rapid progress in the initially worst performing Baltic countries after 2007 and especially during the 2010s, may suggest a delayed positive impact of EU enlargement leading to decreasing longevity disadvantage. The convergence process after 2004 was generally slower in the initially better-performing four Central European countries. Despite these country-specific variations, Czechia, Poland, and, especially, Estonia remain clear health vanguards in the region. Further progress requires much more systematic efforts to combat cardiovascular diseases and the persisting burden of excess male mortality at adult working ages.&#x0D; * This article belongs to a special issue on “Demographic Developments in Eastern and Western Europe Before and After the Transformation of Socialist Countries”.

Exploring the males' terminal investment strategy: Impact of the dose of stress and the time lapse between stress and mating

Abstract In the terminal investment strategy, organisms allocate resources to maximize current reproduction when their future reproductive opportunities are uncertain due to a high risk of mortality. However, whether the role of time lapse between stress and reproductive investment (courtship vs. courtship and mating) triggers the terminal investment strategy remains unknown. We examined this hypothesis in Tenebrio molitor using oxidative stress as the stressor. Given that this is the first time that oxidative stress is used to trigger terminal investment, we first conducted mate choice trials where males exposed to 5, 20, 40 or 80 mM of the pro‐oxidant, paraquat (PQ) engaged in courtship behaviour towards the females. Subsequently, we analysed the male mortality against each of these doses. Males exposed to a 5 mM treatment exhibited higher survival rates compared with the control group, whereas males exposed to 80 mM experienced a shorter lifespan. After courtship, no significant differences in mortality were observed between the control group and those treated with 20 or 40 mM of PQ. Notably, only males exposed to 40 mM of PQ were preferred over the control group. In a third experiment, we quantify the survival costs when males courted and mated at varying time intervals after oxidative stress (40 mM). When males were exposed to 40 mM of PQ and mated 3 h later, their mortality rates significantly decreased compared with males exposed to oxidative stress, courted and mated, but 24 h later. We suggest that the interaction of the dose of oxidative stress and the time lapse between courtship and mating may explain opposed results to support either the terminal investment or honest signalling.

Sociosexual Exposure Has Opposing Effects on Male and Female Actuarial Senescence in the Fruit Fly Drosophila melanogaster.

Males and females rarely express the same length of life. Here, we studied how sociosexual exposure shapes male and female age-specific mortality rates in Drosophila melanogaster. We maintained focal females and males within large, replicated cohorts throughout life with individuals of the same or opposite sex. Consistent with previous works, we found that females kept throughout their lives with males had only half the lifespan of those maintained throughout life at the same density in same-sex cohorts. In contrast, only a small lifespan decrease was observed in the corresponding male treatments and the reduction in male lifespan following exposure throughout life to other males or females was similar. Deconvolution of underlying aging parameters revealed that changes in lifespan were underpinned by opposing effects on actuarial aging in males versus females. Exposure to the opposite or same sex increased initial mortality rate in both sexes. However, in females, increasing exposure to males increased the rate of aging, while increasing exposure to females actually decreased it. The effects were in the opposite direction in males and were much smaller in magnitude. Overall, the findings were consistent with reports suggesting that exposure to the same versus opposite sex can affect survival differently in males and females. However, they also reveal a new insight-that overall lifespan can be underpinned by key differences in actuarial senescence in each sex. The findings suggest that responses to same or opposite sex exposure may have fundamentally and qualitatively different physiological consequences for health in males and females.