Role Of Sex Research Articles

Adherence to preventive behaviors and perceived risk of Iranian medical students in response to the COVID-19 pandemic: Structural Equation Modeling

BackgroundThe COVID-19 pandemic resulted in a significant threat to people’s lives. Detection of adherence to preventive behaviors and risks perceived by people is essential for infection control. Medical students are future healthcare providers.ObjectiveThis study explored adherence to preventive behaviors and risk perception of the COVID-19 pandemic in Iran’s medical students.Material and methodsIn this cross-sectional study, Iranian medical students participated whose preventive behaviors and risk perceptions of COVID-19 were assessed by an online tool. Generalized Structural Equation Modeling (SEM) with a beta-regression family was used for mediation analysis.ResultsA total of 654 medical students participated. The mean risk perception of COVID-19 on a 1 to 7 range scale was 3.53±1.7 for themselves and 3.66±1.7 for their family members. The risk perception for disease severity was 2.9±1.5. According to SEM, male sex, COVID-19 history, and living with parents were predictors of adherence directly and through the mediator pathway of risk perception (P <0.1). Briefly, the male sex reduced adherence directly and through risk perception reduction. The history of COVID-19 directly reduced adherence, but through the mediation pathway of risk perception, it increased adherence. However, the total effect was in favor of adherence reduction. Living with parents directly increased adherence but reduced adherence through the mediation pathway of risk perception. However, the total effect was in favor of adherence increase.ConclusionsAlthough conventionl statistical analaysis did not support the association of risk perception and adherence, the generalized SEM showed risk perception as a potential mediator with a small effect. The present study showed the roles of sex, COVID-19 history, and living with parents as the factors affecting risk perception and preventive behaviors on the basis of SEM results. Among the results, living with parrants was a modifiable factor to increase the adherence.

Percutaneous coronary intervention versus coronary artery bypass grafting in left main disease according to patients' sex: A meta-analysis.

The role of sex in choosing between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease has gained interest. Randomized controlled trials and adjusted observational studies comparing PCI versus CABG in ULMCA patients with outcomes by sex were included. The primary endpoint was major adverse cardiovascular events (MACE), with secondary endpoints being all-cause mortality and repeated revascularization. Ten studies (3 randomized, 7 observational) involving 22,141 ULMCA disease patients (13,411 PCI, 8730 CABG) with a median 5-year follow-up were included. Among males, PCI was associated with a higher risk of MACE (HR 1.18, 95% CI 1.01-1.38), while no significant difference was seen in females. However, moderator analysis showed no significant interaction between sex and revascularization strategy for MACE (p for interaction .422). No differences in all-cause mortality were observed between PCI and CABG for either sex. Repeated revascularization risk was significantly higher with PCI for both sexes (HR 3.51, 95% CI 2.21-5.59 in males and HR 4.20, 95% CI 2.57-6.87 in females). In males with ULMCA disease, CABG was associated with a lower risk of MACE compared to PCI, while no significant differences were seen in females. The lack of a significant interaction between sex and revascularization strategy suggests that these findings may not reflect true sex-based effect modification. PCI was linked to a higher risk of repeated revascularization in both sexes compared to CABG. The protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42024537726).

Sex differences in pneumonia risk during COVID-19 in Mexico.

This study aimed to evaluate the pneumonia risk based on the patient's sex during the COVID-19 pandemic and the early months of the endemic phase of the disease in Mexico. A retrospective cohort study was conducted using a dataset resulting from the epidemiological surveillance of COVID-19 (February 2020 to August 2023). Data from 1.6million adults with laboratory-positive disease, were analyzed. Risk ratios (RR) and 95% confidence intervals (CI), computed through generalized linear regression models, were used. The overall risk of pneumonia was 9.3% (95% CI 9.2-9.4%), with sex-specific estimates of 7.0% (95% CI 6.9-7.1%) for women and 12.0% (95% CI 11.9-12.1%) for men. This disparity was consistently observed throughout all phases of the pandemic, including the endemic phase of the disease. After adjusting for age, predominant viral genotype at illness onset and preexisting medical conditions, men had a 3.3% higher risk of severe manifestations when compared to women (RR = 1.033, 95% CI 1.032-1.034). Our research highlights the potential role of patients' sex as a factor influencing pneumonia risk during and after the COVID-19 pandemic in Mexico. These findings may provide useful considerations for healthcare planning and policy development focused on addressing the impact of the disease on vulnerable populations.

Abstract 4138397: Gender Difference in Prevalence and Survival of Pulmonary Hypertension: A Prospective Cohort Study of 502,173 UK Biobank Participants

Background: Research into pulmonary hypertension (PH) reveals significant sex-based disparities in long-term survival rates. Notably, women, despite being more susceptible to PH, often experience better survival outcomes than men—a phenomenon possibly linked to the "estrogen paradox." This study leverages the comprehensive UK Biobank to examine the role of sex in influencing these outcomes. By exploring differences in PH incidence and survival rates across genders, our research aims to provide a deeper understanding of the mechanisms at play and inform more effective, gender-specific analysis. Methods: This prospective cohort study utilized data from the UK Biobank, with baseline assessment between 2006 and 2010 and follow-up until November 30, 2023, for England and Scotland, and May 31, 2022, for Wales. Through diagnostic codes, medical records, and imaging studies, 3,296 PH cases and 497,580 cases without PH were identified . We followed them for the mortality rates over a period of 10 years. Survival analysis was conducted using Kaplan-Meier curves and Cox proportional hazards models to assess sex-specific survival differences, adjusting for confounders like age, BMI, ethnic, menopause, smoking status, and comorbidities. Results: During 7,978,349 person-years of follow-up, of 502,173 participants in this prospective cohort, 3,296 were diagnosed with PH, while 497,580 did not receive the PH diagnosis. The prevalence of PH in the male cohort and the female cohort were 0.76% (1743 of 228,991 men) and 0.57% (1553 of 273,182 women), respectively, with significant difference between the two groups (p<0.001). In the PH cohort, the mortality rates of patients were 47.06%. In the male patients with PH, the mortality rate was significantly higher than the female PH patients (51.78% vs. 41.53%, p<0.001). After stratifying women into menopause and no-menopause group, Kaplan-Meier curves showed that even the age of male group was significantly younger than the menopause group (p<0.001), the male still had worse survival situation. Conclusion: To conclude, the prevalence of PH in the male participants was significantly higher than the female participants. While the mortality rate in the male participants was also significantly higher than the female participants.

The relationship between sleep difficulties and externalizing and internalizing problems in children and adolescents with mental illness.

Sleep difficulties are presumably a transdiagnostic factor in the complex aetiology of psychiatric disorders in youth. This study assessed the prevalence of sleep difficulties in children and adolescents seeking specialized psychiatric care, examined the relationships of internalizing and externalizing problems, and considered the moderating role of sex and age on these relationships. Parent-reported data on difficulties initiating sleep, difficulties maintaining sleep, early morning awakenings and daytime fatigue from a large sample of children and adolescents referred for specialized psychiatric care (n = 4638; < 18 years) were used to estimate prevalence rates. To examine associations between these sleep difficulties and internalizing/externalizing problems, multiple linear regression analyses were conducted on available data (n = 3768) stratified in three age groups (1.5-5 years; 6-11 years; 12-18 years). Overall prevalence, i.e. at least one sleep difficulty was reported to be often or always present, was 65%. Difficulties initiating sleep occurred the most, closely followed by daytime fatigue. In all age groups, sleep difficulties were positively related to internalizing and externalizing problems. In young children and school-age children, age moderated the interaction between sleep difficulties and internalizing problems. To conclude, prevalence rates of sleep difficulties in children with mental illness appear higher than it has been reported in the general youth population, especially difficulties initiating sleep and daytime fatigue. We observed that the associations between internalizing problems and sleep difficulties in young children and school-age children seemed to be amplified with age, suggesting a negative, bidirectional, spiral in development.

EXTH-26. EXPLORING THE ROLE OF ANDROGEN RECEPTOR SIGNALING IN GLIOBLASTOMA IN AN ORTHOTOPIC ANIMAL MODEL

Abstract OBJECTIVE Gliomas, particularly glioblastoma which is the most common and deadly type, frequently express androgen receptors (AR). We systematically characterized AR expression in low- and high-grade gliomas to investigate whether disrupting AR signaling with readily available blood-brain-barrier penetrant drugs could improve treatment. METHODS Low- and high-grade glioma samples were stained for AR by immunohistochemistry, with AR-expression correlated to grade and sex. Localization of AR and the influence of dihydrotestosterone (DHT) and anti-androgens in glioblastoma cell line (U251) were determined by immunofluorescence and immunoblot. Building on previous in vitro data, we used an orthotopic AR-positive patient-derived model (RN1) to test the efficacy of seviteronel, a blood-brain-barrier penetrant anti-androgen. RESULTS Two thirds of biopsy samples were positive for AR expression by IHC (n=25/39). AR expression correlated with increasing tumor grade (p&amp;lt;0.05) but was similar between sexes (p=0.94). Anti-androgens enzalutamide and seviteronel prevented DHT-induced nuclear translocation of AR; however, seviteronel did so to a lesser extent, as measured by immunofluorescence and immunoblot. In the mouse model, seviteronel significantly improved survival compared to vehicle (n=12, 36.0 vs 27.5 days, p=0.03), and demonstrated reduced Ki67 expression in tumors at the endpoint (68.9% vs 85.0%, p&amp;lt;0.001). Combining seviteronel with temozolomide limited tumor growth as measured by bioluminescence imaging, but did not significantly extend survival compared to temozolomide alone (n=16, 63.5 vs 56.5 days, p=0.37). Adding seviteronel to radiotherapy did not extend survival compared to radiotherapy alone (n=16, 33.0 vs 39.0 days, p=0.19). CONCLUSIONS Targeting AR signaling with blood-brain-barrier penetrant anti-androgens may represent a promising biomarker-directed therapeutic strategy. The mechanisms underlying the effects of seviteronel are being further investigated through affinity-purification mass spectrometry analysis and CUT&amp;RUN sequencing of untreated and treated glioma cells. Additional animal experiments are underway to examine the role of biological sex and the glioma immune microenvironment on the efficacy of anti-androgens in vivo.

Associations Between Gender Diversity and Eating Disorder Symptoms in Early Adolescence.

To assess associations between multiple dimensions of gender diversity with eating disorder symptoms in a national cohort of U.S. early adolescents. This cross-sectional study utilized data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,092, Mage = 12.9 years, 2019-2021). Gender diversity was measured using multiple dimensions, including categorical gender identity (e.g., transgender, cisgender), categorical and continuousfelt gender (congruence between gender identity and assigned sex), ordinal gender non-contentedness (dissatisfaction with one's gender), and ordinal gender expression (communication of gender through appearance and mannerisms). Multivariable logistic regression models were used to analyze the associations among gender diversity measures and eating disorder symptoms, adjusting for potential confounders. Greater felt gender diversity was associated with self-worth tied to weight (OR 1.30, 95% CI 1.11-1.53), binge eating (OR 1.24, 95% CI 1.06-1.46), and distress with binge eating (OR 1.32, 95% CI 1.09-1.59). Greater gender expression diversity was associated with self-worth tied to weight (OR 1.16, 95% CI 1.02-1.33), distress with binge eating (OR 1.26, 95% CI 1.04-1.51), and characteristics of binge eating episodes (OR 1.33, 95% CI 1.06-1.66). Gender non-contentedness was associated with self-worth tied to weight (OR 1.38, 95% CI 1.20-1.58) and compensatory behaviors related to weight gain (OR 1.12, 95% CI 1.01-1.26). Transgender identity was not significantly associated with any eating disorder symptoms. We found that greater gender diversity across multiple dimensions was associated with various eating disorder symptoms, and that measures beyond binary gender identity may be important to assess gender diversity in early adolescence.

Altered immune response is associated with sex difference in vulnerability to Alzheimer's disease in human prefrontal cortex.

Alzheimer's disease (AD) is a neurodegenerative disorder with a higher risk incidence in females than in males, and there are also differences in AD pathophysiology between sexes. The role of sex in the pathogenesis of AD may be crucial, yet the cellular and molecular basis remains unclear. Here, we performed a comprehensive analysis using four public transcriptome datasets of AD patients and age-matched control individuals in prefrontal cortex, including bulk transcriptome (295 females and 402 males) and single-nucleus RNA sequencing (snRNA-seq) data (224 females and 219 males). We found that the transcriptomic profile in female control was similar to those in AD. To characterize the key features associated with both the pathogenesis of AD and sex difference, we identified a co-expressed gene module that positively correlated with AD, sex, and aging, and was also enriched with immune-associated pathways. Using snRNA-seq datasets, we found that microglia (MG), a resident immune cell in the brain, demonstrated substantial differences in several aspects between sexes, such as an elevated proportion of activated MG, altered transcriptomic profile and cell-cell interaction between MG and other brain cell types in female control. Additionally, genes upregulated in female MG, such as TLR2, MERTK, SPP1, SLA, ACSL1, and FKBP5, had high confidence to be identified as biomarkers to distinguish AD status, and these genes also interacted with some approved drugs for treatment of AD. These findings underscore the altered immune response in female is associated with sex difference in susceptibility to AD, and the necessity of considering sex factors when developing AD biomarkers and therapeutic strategies, providing a scientific basis for further in-depth studies on sex differences in AD.

Conformed to Gender Conformity? Gender Nonconformity Stigma is Buffered by Personal Contact

Research has shown that individuals from sexual and gender minorities are more likely to be stigmatized. Taking the perceiver’s perspective, we conducted two experimental studies to examine gender nonconformity stigma and the conditions under which such stigma is more (or less) likely to emerge. In both studies, participants were asked to read descriptions of targets varying in gender (non)conformity and assigned sex (Study 1; N = 337) or sexual identity (Study 2; N = 406). Results from both studies showed that participants preferred more social distance from gender nonconforming (vs. conforming) targets, tended to dehumanize them (i.e., attributed them more primary and less secondary emotions), and reported less anti-violence behavioral intentions and justifications. In both studies, results further showed that having more frequent and positive personal contact with gender nonconforming individuals helps buffer against gender nonconformity bias. Unexpectedly, results from Study 2 showed that humanizing gender nonconforming targets (rather than dehumanizing them) was associated with more violence predispositions for participants who reported having more negative personal contact with gender nonconforming individuals. No differences were found according to the targets’ assigned sex or sexual identity. Taken together, our findings highlight the need to understand the causes and boundaries of gender nonconformity bias.

‘They don’t have bad intentions.’ The disciplinary power of heteronormative communication in upper secondary Polish physical education – a case study

ABSTRACT Background Previous studies have shown unequal treatment of female and male students during PE. However, few studies have focused on gendered communication between teachers and students. Particularly, students’ perceptions of communication have often remained unexplored. Understanding this process appears to be highly significant for ensuring gender equality in schools. In this study, we applied Foucault’s theory of normalization and Butler’s theory of gender performativity and heteronormativity to present data obtained during PE lessons in Polish upper secondary school. In Poland PE teachers still do not formally acquire knowledge of the significance of gender equality in the education process. No policies are formulated on teaching gender equality in schools. Hence, analyzing gendered communication during PE classes in Poland, where no specific gender equity legislation has been introduced, complements the ongoing discussion regarding prevailing gender structures in PE. Purpose The purpose of the study was to explore gendered communication between PE teachers and students in Polish upper secondary school, and perceptions about this communication specifically among male PE teachers and girls. Methods Data were gathered through three qualitative methods: observation of 60 PE lesson units, 17 focus group interviews with male (n = 27) and female students (n = 33), and 5 semi-structured in-depth interviews with PE teachers whose lessons were observed. Discourse analysis, informed by content analysis, was conducted to uncover fundamental communication patterns between teachers and students in the context of gender performativity and heteronormativity. Findings Communication between PE teachers and students demonstrated gender bias, indicating deeply rooted practices of heteronormativity. The male teachers communicated more frequently with female students than with male students and a significant portion of the communication took the form of jokes, teasing, and comments related to the physical appearance of the girls, romantic relationships and dating, and traditional gender roles assumed by women. Students’ statements obtained in the interviews indicate a significant degree of downplaying the impact of teachers’ way of communicating and ‘defending teachers’. They encountered a strong normalization process that restricted their ability to resist teacher communication. Although the PE teachers emphasized the importance of being ‘sensitive’ when communicating with students, PE the teachers’ understanding of gender issues appeared to be fragmented and unrefined, with insufficient recognition of the importance of proper communication with students. Conclusions The implications of this study emphasize the necessity for Polish PE teachers to acquire a deeper understanding of how gender operates within school environments and PE classes, recognizing its impact on students. This awareness is pivotal in recognizing and addressing heteronormative structures during lessons. In connection with that, a thorough discussion on the impact of political and cultural factors shaping the knowledge acquired by teachers and the curriculum in schools is required. Additionally, the research highlights a need for appropriate student education because they are currently subject to strong normalization processes. The normalization processes they undergo hinder their recognition of dominant gender relations in the school environment, and, consequently, their resistance to them.

Large-scale characterization of cocaine addiction-like behaviors reveals that escalation of intake, aversion-resistant responding, and breaking-points are highly correlated measures of the same construct.

Addiction is commonly characterized by escalation of drug intake, compulsive drug seeking, and continued use despite harmful consequences. However, the factors contributing to the transition from moderate drug use to these problematic patterns remain unclear, particularly regarding the role of sex. Many preclinical studies have been limited by small sample sizes, low genetic diversity, and restricted drug access, making it challenging to model significant levels of intoxication or dependence and translate findings to humans. To address these limitations, we characterized addiction-like behaviors in a large sample of >500 outbred heterogeneous stock (HS) rats using an extended cocaine self-administration paradigm (6 hr/daily). We analyzed individual differences in escalation of intake, progressive ratio (PR) responding, continued use despite adverse consequences (contingent foot shocks), and irritability-like behavior during withdrawal. Principal component analysis showed that escalation of intake, progressive ratio responding, and continued use despite adverse consequences loaded onto a single factor that was distinct from irritability-like behaviors. Categorizing rats into resilient, mild, moderate, and severe addiction-like phenotypes showed that females exhibited higher addiction-like behaviors, with a lower proportion of resilient individuals compared to males. These findings suggest that, in genetically diverse rats with extended drug access, escalation of intake, continued use despite adverse consequences, and PR responding are highly correlated measures of a shared underlying construct. Furthermore, our results highlight sex differences in resilience to addiction-like behaviors.

Socioeconomic inequalities and dyslipidaemia in adult population of the Ravansar Non-Communicable Disease Cohort Study: the role of sex and age

ObjectivesThis study represents a pioneering attempt to quantify the contribution of age, sex and socioeconomic status (SES) to the observed inequalities in lipid profile components.DesignCross-sectional study.SettingThe data from the Ravansar...

Role of Sex and Early Life Stress Experience on Porcine Cardiac and Brain Tissue Expression of the Oxytocin and H2S Systems

Early life stress (ELS) significantly increases the risk of chronic cardiovascular diseases and may cause neuroinflammation. This post hoc study, based on the material available from a previous study showing elevated “serum brain injury markers” in male control animals, examines the effect of sex and/or ELS on the cerebral and cardiac expression of the H2S and oxytocin systems. Following approval by the Regional Council of Tübingen, a randomized controlled study was conducted on 12 sexually mature, uncastrated German Large White swine of both sexes. The control animals were separated from their mothers at 28–35 days, while the ELS group was separated at day 21. At 20–24 weeks, animals underwent anesthesia, ventilation, and surgical instrumentation. An immunohistochemical analysis of oxytocin, its receptor, and the H2S-producing enzymes cystathionine-β-synthase and cystathionine-γ-lyase was performed on hypothalamic, prefrontal cortex, and myocardial tissue samples. Data are expressed as the % of positive tissue staining, and differences between groups were tested using a two-way ANOVA. The results showed no significant differences in the oxytocin and H2S systems between groups; however, sex influenced the oxytocin system, and ELS affected the oxytocin and H2S systems in a sex-specific manner. No immunohistochemical correlate to the elevated “serum brain injury markers” in male controls was identified.

The Role of Agricultural Inputs on Crop Productivity: The Case of Zigam Woreda

In spite of the importance of agriculture in Ethiopia, it is characterized by low productivity and has been unable to produce sufficient quantities of output to feed the country’s population. In light of this various development strategies has been undertaken to improve the performance of agriculture. Intensification of agriculture through the use of new agricultural technologies has been emphasized over the last three decades. This study attempted to examine the contribution of agricultural input for crop productivity. The data for the study was collected from 91 sample farmers. This study was the study used both primary and secondary data. In this study researcher was used simple random sampling techniques. This research was use cross sectional approach and econometric method of data analysis to investigate the role of age, sex, land size, labor force, fertilizer, improved seed, extension service, and access to credit, education level and pesticides for crop production by collecting data from the household. In econometric method of data analysis researcher was used ordinary least square (OLS) Model. The econometric result show that land size, labor force, improved seed, fertilizer, credit service, extension service and education level have positive and significant effect on crop production. However, pesticide has a negative and significant impact on crop production. From the explanatory variables, education level has a higher coefficient. This indicates education level is more significant for crop production. According regression result &amp;lt;i&amp;gt;R&amp;lt;/i&amp;gt;&amp;lt;sup&amp;gt;&amp;lt;i&amp;gt;2&amp;lt;/i&amp;gt;&amp;lt;/sup&amp;gt; is 0.97, which implies 97% of output function is explained by the selected ten (10) explanatory variables. The policy implication is that to reduce farmers resistant to use farm inputs and to create knowledge about the optimal input use educate and training of farmers is necessary.

Relationship between obesity and hypertrophic or dilated cardiomyopathy: the role of sex

Abstract Background Evidence suggests an association between obesity and the risk for cardiomyopathy development, however robust evidence is still lacking. In this study we sought to explore the relationship of obesity with hypertrophic (HCM) and dilated cardiomyopathy (DCM) and possible interactions with sex using large scale epidemiological real-world data. Methods and Results We analyzed data from the Nationwide Inpatient Sample (NIS) of U.S. hospitalizations for the years 2015-2019. There were a total of n=46,934 admissions with a diagnosis of HCM and n=170,924 with DCM. There was a significant interaction between cardiomyopathies’ diagnosis with sex and age subgroups; the rates of both DCM and HCM increased with age (p&amp;lt;0.001 for both); DCM diagnosis was significantly higher in males compared with females (0.85% vs. 0.35%, p&amp;lt;0.001). After adjustment for age, sex, race, and presence of arterial hypertension there was a significant stepwise positive association between obesity and the population rates of both cardiomyopathy subtypes. For hospitalized patients with a body mass index (BMI) ≥30kg/m2 there was an odds ratio (OR) of 1.68 (95%CI: 1.55-1.81, p&amp;lt;0.001) for HCM andOR=1.82 (95%CI: 1.79-1.84, p&amp;lt;0.001) for DCM. More importantly, the positive relationship between a cardiomyopathy diagnosis (HCM or DCM) with increasing BMI was driven by the male sex (p&amp;lt;0.001 for both) and it was non-significant in females. Conclusions The findings from this nationwide observational analysis support a sexual dimorphism in the relationship between obesity and hypertrophic or dilated cardiomyopathy, which should be further investigated.Cardiomyopathy-obesity

Work- &amp; family-related stress &amp; the risk of hazardous alcohol use: role of sex and social support

Abstract Background There is a lack of longitudinal studies investigating the effect of individual stress factors on alcohol use behaviour, and how sex and social support may mitigate the effect of these stressors. We aimed to determine the association of work- and family-related stressors with developing hazardous alcohol use over time among habitual drinkers, and to examine the role of sex and social support in these associations. Methods A sample of 4,046 individuals, working and living in Stockholm, age 25-55 years, habitual drinkers, who answered the PART study (Swedish acronym for Mental Health, Work and Social Relations) questionnaire regarding work- and family-related stress (exposures) in 1998-2000 (wave1) and 2001-2003 (wave2) were followed until 2010 (wave3) regarding hazardous alcohol use (outcome) measured using Alcohol-Use-Disorder-Identification-Test (AUDIT) score ( &amp;gt; =8 in men, &amp;gt; =7 in women). Weights for selective attrition were calculated, and crude and multivariate (adjusting for sociodemographic, health- and previous stress-related factors) logistic regression models, yielding Odds Ratios (OR) with 95% Confidence Intervals (CI), were used to estimate the exposure-outcome associations. Analyses were stratified for sex and social support in general and at work. Results Job strain (a combination of high demand and low control) was not statistically significantly associated with hazardous alcohol use (OR, CI: 1.3, 0.9-1.9). Among those reporting any family-related stress, a significantly higher risk was observed (OR, CI: 1.5, 1.1-2.1), particularly among women (OR, CI: 1.7, 1.02-2.7) and those with low social support (OR, CI: 2.1, 1.2-3.6). These associations became non-significant after adjusting for previous family-related stress. Conclusions Public health measures aiming to prevent transitions from habitual to hazardous alcohol use should give special attention to individuals with family-related stress, especially among women and those with low social support. Key messages • While job stress was not significantly associated, those experiencing family-related stress had a higher risk of hazardous alcohol use, especially among women and those without social support. • Individuals experiencing family-related stress, particularly women and those lacking social support, require special attention in public health prevention strategies for risky alcohol consumption.

T2 mapping as a marker of active myocardial injury in Anderson-Fabry disease patients

Abstract Background In Anderson-Fabry Disease (AFD) with cardiac involvement, left ventricular hypertrophy (LVH) is often associated with myocardial scarring by cardiovascular magnetic resonance (CMR) late gadolinium enhancement (LGE) imaging. Myocardial inflammation, detected as increased T2 weighted/T2 mapping (T2m) signal, has also been reported, although its role in disease progression is still unclear. Purpose To investigate the relationship between T2m and LGE/LVH progression in AFD patients. Methods 67 paired CMR scans (1.5T) from 30 AFD patients were included. Three groups were defined according to LGE: no LGE at either scan (LGE-/-); LGE at baseline, unchanged at follow-up (LGE+/-); LGE at follow-up, appeared or increased compared to baseline (LGE+/+). T2m was measured in the infero-lateral basal segment in all scans; in LGE+ scans only, LGE was also manually contoured (ROI_LGE), and the ROI_LGE copied and pasted on the matching T2m image (T2m_ROI_LGE). See Figure 1. Troponin I (TnI) was also dosed at each scan. A univariate repeated measures analysis of variance was used to compare the groups and Tukey-Kramer correction was applied. Results As expected, the presence of LGE was strongly associated with older age, higher global and regional T2m, left ventricular (LV) mass and TnI values. As a novelty, in the LGE+/+ scans (scar appearance/progression) T2m in the ROI_LGE was higher than in the LGE+/- scans (scar unchanged) (p value 0.02). None of the other parameters, such as LV mass, TnI and global T2m values, differ between the the LGE+/+ compared to the LGE +/- group. See Table 1. Conclusions In our AFD patients’ cohort, scar progression was associated with focal increase in T2m values, i.e. T2m may identify patients with active myocardial injury. The potential implication on management/disease progression monitoring needs to be tested in future research, with longer follow-up. The role of sex, with females known to have higher average T2m values, will also need to be explored in a wider patient’s cohort.

Remodeling of adult rat heart subjected to pressure overload from the neonatal period is dependent on the sex

Abstract Background Congenital heart diseases (CHD) represents the most common birth defect. Despite progress in their treatment improving acute survival, there is a paucity of data concerning the long-term consequences of CHD in adults. Purpose Here, we investigate the remodeling in adult rat hearts subjected to pressure overload from the early postnatal period. Methods We used the neonatal abdominal aortic constriction (AAC) model to analyze morphological, functional (by echocardiography), and electrophysiological long-term outcomes. Given the known differences in cardiac pathologies between males (M) and females (F), we focused on the role of sex in cardiac remodeling. Results Our data showed that both sexes exhibited a similar left ventricular weight/body weight ratio at the age of 12 weeks, indicating comparable left ventricle (LV) enlargement as a response to AAC (increase by 103 ± 9 % in M AAC and 99 ± 10 % in F AAC vs. sham-operated animals). However, the right ventricular weight/body weight and lung/ body weight ratios, indicative of LV failing, differed significantly between sexes with better values in F AAC. The favorable cardiac remodeling in F AAC was corroborated by significantly smaller LV systolic and diastolic diameters, along with a lower amount of myocardial fibrosis. Using optical mapping, we revealed preserved longitudinal and transversal conduction velocities (CVL; CVT) in females (CVL 104 ± 8 vs. 109 ± 8 cm/s and CVT 66 ± 7 vs. 59 ± 6 cm/s in F AAC and F Sham, respectively). However, compared to M Sham, the conduction velocities in M AAC showed a significant decrease (CVL 80 ± 3 vs. 92 ± 3 cm/s and CVT 35 ± 2 vs. 54 ± 3 cm/s). Similarly, the amount of connexion 43 (Cx43) and its phosphorylated state (Cx43Ser368) was preserved in F AAC while exhibiting a decrease in M AAC compared to the sham-operated controls. Thus, electrophysiological findings implicate that while the adult M AAC underwent pro-arrhythmogenic remodeling due to the elevated workload, the adult F AAC preserved physiological conduction properties. Conclusion Our data showed different consequences of the increased pressure load exposed from early after birth to the adult M and F heart. These findings highlighted the involvement of both sexes in cardiac studies.

Sex-biased proteomic regulation in obesity

Abstract Background Obesity is a major risk factor for heart failure with preserved ejection fraction, particularly in women. Obesity-associated inflammation is thought to contribute to this relationship. However, the role of biological sex in the regulation of circulating inflammatory proteins in obesity is not well understood. Purpose We aimed to explore sex differences in the plasma inflammatory protein profile in obese subjects. Methods Clinical data and samples were collected from 450 women and men with a body mass index (BMI) &amp;gt;27 kg/m² without known cardiovascular disease participating in the FAT associated CardiOvasculaR dysfunction study. Obesity was defined as BMI≥30 kg/m². Olink’s Target 96 inflammation panel, which profiles 92 proteins using proximity extension assay technology, was analysed in biobank samples. A comprehensive correlation analysis was performed to describe relationships between protein biomarkers and clinical variables. Gene enrichment analysis was performed to shed light on biological pathways associated with differentially expressed proteins (DEPs). To determine the functional significance of the DEPs, we used the repositories Gene Ontology and Kyoto Encyclopedia of Genes and Genomes. Pearson correlation coefficients were calculated to assess linear associations between the DEPs and relevant clinical variables. Results Women and men did not differ by age (49±9 vs 48±9 years), BMI (32.3±4.6 vs 31.6±3.7 kg/m²) or in prevalences of diabetes (both 11%) or obesity (65% vs 62%) (all p&amp;gt;0.05). However, hypertension was more common in men than women (74% vs 52%, p&amp;lt;0.001). In men (n=188), obesity was associated with downregulation of monocyte chemotactic protein 3, tumor necrosis factor (ligand) superfamily member 12, interleukin 10 and protein S100-A12 and with upregulation of neurotrophin-3 (all p&amp;lt;0.05), thereby suggesting a mechanism for the observed impaired inflammatory response and insulin resistance. In women (n=262), obesity was associated with the downregulation of interleukin 7, interleukin 12 subunit beta, interleukin 6, and C-X-C motif chemokine 11, suggesting a state of persistent low-grade inflammation. In addition, the upregulated sulfotransferase 1A1 and SIR2-like protein 2 proteins indicate a physiologic adaptation to oxidative stress and the metabolic excess endemic to obesity. Conclusion We found that the abundance of several circulating inflammatory proteins was altered in presence of obesity, and that the plasma proteomic profile differed by sex. Interestingly, there was no overlap in the DEPs between women and men in the presence of obesity. These findings support the hypothesis that the pathophysiological mechanisms driving obesity-associated inflammation and immune dysregulation differ by sex. In turn, this may aid in the pursuit of discovering sex-specific biomarkers to identify obese individuals at particular risk of heart failure.

The determinants of oral health in Turkish elderly: an analysis of Turkey Health Survey (THS) 2022

Abstract Background Oral health is an integral part of health and wellbeing; however, the use of dental care by the elderly is lower compared to other services. Considering the relationship between oral health and chronic diseases, along with healthcare use patterns, evaluating oral health in the elderly is crucial. This study aims to assess the oral health status and individual, socioeconomic and healthcare related factors in people aged 65 and over in Turkey. Methods This cross-sectional study was based on THS 2022 micro dataset. Participants aged 65 and over constituted the population of this study, with 3144 participants included. Data analysis was performed using SPSS 28.0 and included descriptive statistics, Pearson’s chi-square and logistic regression. Results The mean age of participants was 72.57 with 54% being women.Self-reported poor oral health was noted in 25.8%, and 75.2% did not receive dental care in the past year. Individual factors such as older age, obesity, and multimorbidity, as well as social factors like female gender, being single, and language barrier, were associated with worse oral health. Education and social support were also associated with oral health. Among economic factors, employment showed a significant association. Concerning healthcare-related factors, not using oral care in the past year, unmet dental care needs due to financial constraints, appointments, and transportation were associated with worse oral health. Logistic regression revealed significant associations between oral health and age, multimorbidity, gender, language, education, social support, employment, dental care use, unmet dental care needs due to financial constraints and transportation. Conclusions Addressing barriers and risk factors is needed to improve oral health among Turkey’s elderly. Efforts should focus on enhancing access to dental care and addressing socioeconomic determinants of oral health. Key messages • Identifying and addressing barriers and individual, socioeconomic and health-care related risk factors associated with poor oral health among the elderly in Turkey is important. • It is needed to prioritize efforts aimed at enhancing access to oral care for the elderly in Turkey by both improving physical access and addressing social determinants to ensure better oral health.